Rates Of Heart Attack Research Articles

Exploring an immune cells-related molecule in STEMI by bioinformatics analysis

BackgroundST-elevated myocardial infarction (STEMI) is the leading cause of mortality worldwide. The mortality rate of heart attacks has decreased due to various preventive factors and the development of early diagnostic resuscitation measures, but the long-term prognosis remains poor. The present study aimed to identify novel serum biomarkers in STEMI patients and explored a possible new mechanism of STEMI from an immune molecular angle with bioinformatics analysis.MethodsGene expression profiles were obtained from Gene Expression Omnibus (GEO) database. Differential gene analysis, machine learning algorithms, gene set enrichment analysis, and immune cell infiltration analysis were conducted using R software.ResultsWe identified 146 DEGs (differentially expressed genes) in the integrated dataset between the STEMI and CAD (coronary artery disease) groups. Immune infiltration analysis indicated that eleven cell types were differentially infiltrated. Through correlation analysis, we further screened 25 DEGs that showed a high correlation with monocytes and neutrophils. Afterwards, five genes consistently selected by all three machine learning algorithms were considered candidate genes. Finally, we identified a hub gene (ADM) as a biomarker of STEMI. AUC curves showed that ADM had more than 80% high accuracy in all datasets.ConclusionsIn this study, we explored a potentially new mechanism of STEMI from an immune molecular perspective, which might provide insights into the pathogenesis of STEMI. ADM positively correlated with monocytes and neutrophils, suggesting its potential role in the immune response during STEMI. Additionally, we validated the diagnostic performance of ADM in two external datasets, which could help to develop new diagnostic tools or therapeutic strategies.

Preventive health care in India: Are we doing enough

Preventive health care in India: Are we doing enough

Heart attack frequency and geomagnetic field instability (Primates: Hominidae)

It is believed that the high activity of sun with eruptions causing instability of the magnetic field of the Earth cause various health problems in sensitive people, including such events as heart attack. We analysed the daily frequency of patients admitted with heart attack to the Cardiocentre of the Institute of Clinical and Experimental Medicine in relation to daily mean value of the geomagnetic Ap index representing fluctuations in the magnetic field. There were slightly more days with both low Ap and low number of patients than expected by random, and slightly more days with both high Ap and number of patients. However, very high magnetic activity (Ap>30) did not cause high rate of heart attacks.

Abstract 14054: Monocyte Vascular Endothelial Growth Factor Receptor-1 Signaling in Peripheral Artery Disease

Introduction: Peripheral artery disease (PAD) is caused by atherosclerosis of large arteries of the leg(s). Beyond complications from poor perfusion to the legs, patients with PAD suffer higher than expected rates of heart attack and strokes. Monocytes are subdivided into three subtypes: CD14++CD16- (classical), CD14+CD16+ (intermediate), and CD14-CD16+ (non-classical). The intermediate monocyte subtype is linked to PAD. Vascular Endothelial Growth Factor receptor (VEGFR)-1 is a member of tyrosine kinase family that is expressed in monocytes and has high affinity for the VEGF-A ligand. Recent studies showed that inhibition of VEGFR1/STAT-3 signaling decreases angiogenesis in PAD. We hypothesized that in patients with PAD, intermediate monocytes would have less VEGFR1/STAT3 activation than controls. Methods: Blood samples were collected from PAD patients (n=11) and risk factor closely matched controls (n=17). PBMCs were isolated by gradient centrifugation. By flow cytometry, gating strategy on monocytes was done by excluding granulocytes (CD66b), B and T lymphocytes (CD3,CD19), and natural killer cells (CD56). Next, monocytes were subdivided into three populations (intermediate, classical, and non-classical) by gating according to their CD14/CD16 expression. Within each population, levels of p(Y1333)VEGFR1, VEGFR1, pSTAT3, and STAT3 were determined. Results: Data from flow cytometry analysis showed a significant increase in the intermediate monocyte population in PAD vs control (~1.5-fold change; p=0.01). However, there was no significant difference in the non-classical or classical monocytes between PAD and control. Within the intermediate monocytes, P(Y1333) VEGFR1/VEGFR1 was decreased (~2-fold change) and pSTAT3/STAT3 was significantly decreased (~2-fold change) in PAD vs control. In both the non-classical and classical monocytes, there was no significant difference in either phosphorylated receptor between PAD and control. Conclusions: The data confirm the intermediate monocyte is associated with PAD and suggest that VEGFR1/STAT3 signaling is decreased in intermediate monocytes in PAD vs control. Understanding the mechanism of VEGFR1 activation may prove to be a promising therapeutic target for patients with PAD.

The role of cytochromes P450 in the metabolism of selected antidepressants and anxiolytics under psychological stress.

In today's modern society, it seems to be more and more challenging to cope with life stresses. The effect of psychological stress on emotional and physical health can be devastating, and increased stress is associated with increased rates of heart attack, hypertension, obesity, addiction, anxiety and depression. This review focuses on the possibility of an influence of psychological stress on the metabolism of selected antidepressants (TCAs, SSRIs, SNRIs, SARIs, NDRIs a MMAs) and anxiolytics (benzodiazepines and azapirone), as patients treated with antidepressants and/or anxiolytics can still suffer from psychological stress. Emphasis is placed on the drug metabolism mediated by the enzymes of Phase I, typically cytochromes P450 (CYPs), which are the major enzymes involved in drug metabolism, as the majority of psychoactive substances are metabolized by numerous CYPs (such as CYP1A2, CYP2B6, CYP2C19, CYP2C9, CYP2A6, CYP2D6, CYP3A4). As the data on the effect of stress on human enzymes are extremely rare, modulation of the efficacy and even regulation of the biotransformation pathways of drugs by psychological stress can be expected to play a significant role, as there is increasing evidence that stress can alter drug metabolism, hence there is a risk of less effective drug metabolism and increased side effects.

TOBACCO PRODUCTS: CHEMICAL ANALYSIS AND COMPARATIVE HARMFULNESS

Tobacco consumption is a major social health problem in India as well as throughout the world, because it harms both health and wealth of an addict. Tobacco is a Sthavara Patra Visha received from the plant Nicotiana tobacum/ Nicotiana rusticum leaves by curing them. Tobacco contains an alkaloid nicotine in abundant amount, which is sufficient to make addict like alcohol, cocaine and morphine. There are so many different forms of smoking and smokeless tobacco in India, like cigarette, bidi, gutka, jarda, pan masala etc. Long timed use of Tobacco like adductive products by oral route, acts as a slow poison (Dushi Visha) induces chronic toxicity to the gastrointestinal tract like oral diseases, gingivitis and periodontitis, Leukoplakia (precancerous stage), and may lead to cancer also in advance stage. This chronic toxicity affects cardiovascular system and results as increasing coronary blood flow, heart rate and blood pressure which may trigger the chances of heart attack rate in addict person. Before we can do any effort for reducing toxicity produced by tobacco products its mandatory to knowing the basic knowledge of tobacco products, their chemical composition, their mechanism of action with comparative toxicity and specific tobacco product related to a specific mouth part cancer. Because we can’t stop a person to start tobacco use but we can circulate the knowledge of tobacco products in adolescent groups so that when the beginner chose a tobacco product, he will be aware about the toxicity and affecting organ because of its use. So that, the toxicity can be minimised. Keywords: Tobacco consumption, nicotine, slow poison, cancer, comparative toxicity

An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort

Sedentary life styles coupled with high-calorie diets and unhealthy social habits such as smoking, have put an ever-increasing number of people at risk of cardiovascular disorders (CVD), worldwide. A concomitant increase in the prevalence of type 2-diabetes (hyperglycemia), a risk factor for CVD, has further contributed towards escalating CVD-related mortalities. The increase in number of cases of type 2-diabetes underscores the importance of early diagnosis of cardiovascular disease in those with diabetes. In this work, we have evaluated the sensitivity and specificity of dyslipidemia and proinflammatory cytokines to be used as biomarkers for predicting the risk of CVD in those with diabetes. We hypothesize that interplay between dyslipidemia and diabetes-induced low-grade inflammation in those with type 2-diabetes increases the risk of CVD. A total of 215 participants were randomly recruited from the Cameron County Hispanic Cohort (CCHC). Of these, 99% were Mexican Americans living on Texas-Mexico border. Levels of cytokines, adipokines and lipid profile were measured. Cardiovascular disease (CVD) for this study was defined as prior diagnosis of heart attack, angina and stroke, while diabetes was defined by fasting blood glucose (FBG) of > 100 mg/dL and HbA1c of > 6.5, in accordance with American Diabetes Association (ADA) guidelines. Depending on type and distribution of data, various statistical tests were performed. Our results demonstrated higher rates of heart attack (14% vs 11.8%) and stroke (19.8% vs 10%) in those with diabetes as compared to non-diabetes. The odds of having a heart attack were eight times higher in the presence of elevated triglycerides and pro-inflammatory markers (TNFα and IL6) as compared to presence of pro-inflammatory markers only. The odds for heart attack among those with diabetes, increased by 20 fold in presence of high levels of triglycerides, TNFα, and IL6 when coupled with low levels of high-density lipid cholesterol (HDL-C). Lastly, our analysis showed that poorly controlled diabetes, characterized by HbA1c values of > 6.5 increases the odds of stroke by more than three fold. The study quantifies the role of lipid profile and pro-inflammatory markers in combination with standard risk factors towards predicting the risk of CVD in those with type 2-diabetes. The findings from the study can be directly translated for use in early diagnosis of heart disease and guiding interventions leading to a reduction in CVD-associated mortality in those with type 2-diabetes.

Critical Illness in India

This paper gives the first cut rate of Indian incidence of critical illness of cardiovascula r, Strokes and Cancer diseases. This paper also compares the critical illness rates currently used in India, CIBT 93 with the rates calculated in this paper. The paper concludes that CIBT 93 should be modified before using in the Indian conditions. Summary 1. In India Coronary Heart Disease (“CHD”) is more prevalent than cancer whereas in UK the trend is reverse. 2. In the next ten years, CHD is expected to increase many folds in rural as well as in Urban India. The range may vary from 13% to 80% at different ages. The major increase is expected in the younger ages than older ages. 3. In India both males and females have higher incidence rates of CHD than corresponding rates in UK. 4. In India females have higher heart attack rates than males, whereas in UK, the trend is opposite. 5. The incidence rates of strokes in India are very low as compared to UK. 6. Both in India and UK the incidence rates of cancer of females are heavier than males between the ages 20 to 60 years. 7. The cancer incidence rates in males and females in India are heavier up to age 60, after that, UK rates become heavier. 8. According to this paper, one of the options available with the profession is either to make some serious adjustments to CIBT 93 rates to make it useable in India or to construct Indian specific critical illness rates

Socioeconomic and behavioral determinants of cardiovascular diseases among older adults in Belgium and France: A longitudinal analysis from the SHARE study.

Despite advances in the healthcare system, cardiovascular diseases (CVDs) are still an important public health problem with disparities in the burden within and between countries. Studies among the adult population documented that socioeconomic and environmental factors play a role in the incidence and progression of CVDs. However, evidence is scarce on the socioeconomic determinants and the interplay with behavioral risks among older adults. Therefore, we identified socioeconomic and behavioral determinants of CVDs among older adults. Our sample consisted of 14,322 people aged 50 years and above from Belgium and France who responded to the waves 4, 5, 6 and/or 7 of the Survey of Health Ageing and Retirement in Europe. The effect of determinants on the occurrence of CVD was examined using a Generalized Estimating Equation (GEE) approach for binary longitudinal data. The overall rate of heart attack was 8.3%, which is 7.6% in Belgium and 9.1% in France. Whereas, 2.6% and 2.3% in Belgium and France, respectively, had experienced stroke. In the multivariable GEE model, older age [AOR: 1.057, 95%CI: 1.055-1.060], living in large cities [AOR: 1.14, 95%CI: 1.07-1.18], and retirement [AOR: 1.21, 95%CI: 1.16-1.31] were associated with higher risk of CVD. Furthermore, higher level of education [AOR: 0.82, 95%CI: 0.79-0.90], upper wealth quantile [AOR: 0.82, 95%CI: 0.76-0.86] and having social support [AOR: 0.81, 95%CI: 0.77-0.84] significantly lowers the odds of having CVD. A higher hand grip strength was also significantly associated with lower risk of CVD [AOR: 0.987, 95%CI: 0.984-0.990]. This study demonstrated that older adults who do not have social support, live in big cities, belong to the lowest wealth quantile, and have a low level of education have a higher likelihood of CVD. Therefore, community-based interventions aimed at reducing cardiovascular risks need to give more emphasis to high-risk retired older adults with lower education, no social support and those who live in large cities.

Landfall After the Perfect Storm: Cohort Differences in the Relationship Between Debt and Risk of Heart Attack.

Analyses of the Health and Retirement Study (HRS) between 1992 and 2014 compare the relationship between different levels and forms of debt and heart attack risk trajectories across four cohorts. Although all cohorts experienced growing household debt, including the increase of both secured and unsecured debt, they nevertheless encountered different economic opportunity structures and crises at sensitive times in their life courses, with implications for heart attack risk trajectories. Results from frailty hazards models reveal that unsecured debt is associated with increased risk of heart attack across all cohorts. Higher levels of housing debt, however, predict higher rates of heart attack among only the earlier cohorts. Heart attack risk trajectories for Baby Boomers with high levels of housing debt are lower than those of same-aged peers with no housing debt. Thus, the relationship between debt and heart attack varies by level and form of debt across cohorts but distinguishes Baby Boomer cohorts based on their diverse exposures to volatile housing market conditions over the sensitive household formation period of the life course.

Positive Aspects of COVID 19 Pandemic: A Blessing in Disguis

COVID 19 is undeniably one of the deadliest diseases that humanity has ever seen. It continues to affect the lives and livelihood of people appallingly across the world. Maximum discussions focus towards the apprehension of catching the infection, dwelling in homes, overpopulated nursing homes and shut down of all kinds. But, here let’s discuss the positive side of COVID 19 pandemic.As COVID 19 has spread its influence all over the world, affected countries have either announced lockdown or have implemented severe restrictions in their respective countries. Because of this, everyone dwells in their homes. Thus, exercising social distancing and functioning from home. All of the above is directed at restricting the transmission of coronavirus and expectantly ostracising the fatality from COVID 19. These transformations have also brought about some unanticipated emanations; some good things have come out of the pandemic as well. Positive effects of COVID 19 are seen on reduced road traffic, and road traffic accidents lowered levels of air pollution which has to lead to lowered heart attack rates and rejuvenating environment. Crime rates have fallen, and expenses are reduced in most places. Community action, communication amongst families, behaviour, sanitation, hygiene, online and distance education has positively impacted by COVID 19 pandemic. COVID 19 despite a bane for humans, can be thought of a boon for living beings. The habitats and elements have been purified with the stringent use of petrochemical products. To breathe fresh air and to consume purified water is a boon by itself. Now, it is time for humans to lead a caring life to every bounty bestowed on them by Nature. This thoughtful and considerate life will give hope for a healthy, stress-free life.

EZETYMIB JAKO LECZENIE DYSLIPIDEMII W PRZEWLEKŁEJ CHOROBIE NEREK

Cardiovascular disease is the leading cause of death among patients with chronic kidney disease (CKD). Primary and secondary prevention of cardiovascular events is one of the major CKD patients' treatment targets. Dyslipidaemia is the important modifiable risk factor in general population. Each 1.0 mmol reduction in LDL cholesterol with statins reduces annual rate of heart attack, coronary revascularization or ischemic stroke by 20% leading to 10% reduction of all-cause mortality. Adding ezetimibe, an inhibitor of intestinal lipids absorption, further reduces LDL cholesterol by 20%. Optimal lipid lowering treatment for CKD patients remains unclear. Cardiovascular risk reduction observed with statins therapy decreases together with a progression of the disease, moreover patients with advanced CKD treated with high doses of statins have an increased risk of adverse events. These patients might benefit from adding ezetimibe to moderate dose statin therapy for prevention of cardiovascular events.

Cardiovascular Disease Disparities in Sexual Minority Adults: An Examination of the Behavioral Risk Factor Surveillance System (2014-2016).

Investigate sexual orientation differences in cardiovascular disease risk and cardiovascular disease. Cross-sectional. The 2014 to 2016 Behavioral Risk Factor Surveillance System. A total of 395 154 participants. The exposure measure was sexual orientation. Self-report of cardiovascular disease risk factors and cardiovascular disease was assessed. Sex-stratified logistic regression analyses to examine sexual orientation differences in cardiovascular disease risk and cardiovascular disease (heterosexuals = reference group). Sexual minority men reported higher rates of mental distress (gay adjusted odds ratio [AOR]: 1.59; bisexual AOR: 1.88) and lifetime depression (gay AOR: 2.48; bisexual: AOR 2.67). Gay men reported higher rates of current smoking (AOR: 1.28), but lower rates of obesity (AOR: 0.82) compared to heterosexual men. Sexual minority women reported higher rates of several cardiovascular risk factors including mental distress (lesbian AOR: 1.37; bisexual AOR: 2.33), lifetime depression (lesbian AOR: 1.96; bisexual AOR: 3.26), current smoking (lesbian AOR: 1.65; bisexual AOR: 1.29), heavy drinking (lesbian AOR: 2.01; bisexual AOR: 2.04), and obesity (lesbian AOR: 1.50; bisexual AOR: 1.29), but were more likely to exercise than heterosexual women (lesbian AOR: 1.34; bisexual AOR: 1.24). Lesbian women reported lower rates of heart attack (AOR: 0.62), but bisexual women had higher rates of stroke than heterosexual women (AOR: 1.46). Findings can inform the development of prevention efforts to reduce cardiovascular disease risk in sexual minorities.

Making Strides in Type 2 Diabetes Prevention.

The prevalence of diagnosed diabetes in adults in the United States, currently at 23.1 million people, has tripled in the past two decades (1). In addition, an estimated 84 million adults have prediabetes, putting them at increased risk of type 2 diabetes, heart attack, and stroke; only 1 in 10 know they have it (2). If interventions to slow the increase in and ultimately reduce the number of new cases of diabetes are not widely implemented, projections estimate that one in three adults in the United States could have diabetes by 2050 (3). Diabetes remains a leading cause of blindness, kidney failure, and lower-limb amputation, increasing these risks to 6–10 times that of people without diabetes (2). It also increases risks of macrovascular conditions such as heart attack and stroke by 60–80% (2). Fortunately, rates of heart attack, stroke, and cardiovascular disease (CVD) death have recently declined for many people with diabetes, but this has led to an exposure to and diversification of other outcomes, including increasingly diverse causes of death (4). Although CVD remains the leading cause of death for people with diabetes, its proportion has declined from half of all such deaths ∼20 years ago to one-third of all deaths today. As a result, other causes, including influenza, pneumonia, septicemia, and chronic liver disease, now make up a greater proportion of the deaths of people with diabetes (4). Furthermore, diabetes doubles the risk of physical disability; adults with diabetes who are ≥50 years of age lose independence 6–7 years before their peers without diabetes (5). Diabetes is the costliest of the 155 most common diseases in the country, at $327 billion in 2017, including $237 billion in direct medical costs and $90 billion in indirect costs (e.g., reduced productivity and absenteeism)—an increase of 60% from 2007 …

Method of Obtaining Inter-Arrival Distribution between Two Consecutive Heart Attacks Using Palm Probability

An attempt has been made to obtain the inter-arrival times of two consecutive heart attacks by using the technique of Palm probability. The arrival rate of heart attacks is taken to be Poisson, which is assumed to vary individual to individual following gamma distribution leading to a dependent process. In this communication, a methodology has been used to estimate the consecutive failure time of heart attack with compound Poisson inputs weighted by gamma distribution based on hospital discharge data relating to heart failures.

Persistent effect at 30-month post intervention of a community-based randomized trial of KM2H2 in reducing stroke and heart attack among senior hypertensive patients

BackgroundThe effect of the Keep Moving toward Healthy Heart and Healthy Brain (KM2H2) program at 6-month post intervention has been assessed. The purpose of this study is to evaluate the KM2H2 program at 30-month post intervention.MethodsA total of 450 senior hypertensive patients from 12 community health centers were randomized by center to either receive KM2H2 plus standard care (6 centers, n = 232) or standard care only (6 centers, n = 218). Data for outcome measures at 30-month post intervention were analyzed. New cases of stroke and heart attack were verified with medical records; levels of physical activity were assessed using self-reported questionnaire. In addition to comparative analysis, adjusted incidence rate and program effects were determined using mixed effects modeling method.ResultsAt the 30-month follow-up, the adjusted incidence rate [95% CI] of stroke was 11.81% [5.90, 17.72] for patients in the intervention group and 19.78% [14.07, 25.50] (p = 0.03) for the control group. The adjusted incidence rate of heart attack was 3.34% [1.91, 8.58] and 6.68% [1.64, 11.73] for the intervention and control groups (p = 0.16), respectively; the proportion and the duration of engaging in regular physical activity were significantly greater for the intervention group than the control group. The reductions in blood pressure between the intervention and the control was not statistically significant.ConclusionsThe KM2H2 program showed a persistent effect up to 30 months post intervention in enhancing physical activity and reducing the risk of cardio-cerebrovascular events, particularly stroke. These findings demonstrate the persistent effect of the KM2H2 and suggest the need for a full-scale evaluation of the intervention program for practical use.Trial registrationISRCTN Register ISRCTN12608966. Registered 03 March 2015. Retrospectively registered.

Comparative study of mobile phone emitted EM waves on human brain at different charging levels

Vast advances in communication technology have made mobile phone an important gadget of the 21st century. Nowadays, mobile phone is a necessary evil. Now teenagers start using mobile phones at the school level and it shows mobile phone playing a vital role in everyday life. This increased popularity and demand of mobile phone has raised concern about possible interaction between the Electromagnetic (EM) field radiation and human being. This has been found that EM radiations emitted by mobile phones can cause genetic damage, tumours, memory loss, increased blood pressure and weakening of the immune system, headache, increased heart attack rate, skin cancer, sleep disorder, etc. This paper discusses the experimental findings conducted to study the effect of EM radiations emitted from the mobile phone (GSM GT S7392) at different battery level towards human brain. This experiment was conducted to examine whether there is any difference in radiation pattern emitted from a mobile handset at different battery levels, namely at high and low battery levels. Electroencephalogram machine is used to monitor and capture the brain signals at different stimuli. The experimental findings show that the effect of mobile phone emitted EM radiations is more intense at low battery level; especially during ringing mode, P3-O1 and T5-O1 channels are more affected and when call is ongoing, P4-O2 and T6-O2 channels are severely affected.

Duration of daily TV/screen watching with cardiovascular, respiratory, mental and psychiatric health: Scottish Health Survey, 2012–2013

BackgroundThe link of duration of TV and/or screen watching and chronic health conditions by subtypes is unclear. Therefore, the relationship between TV and/or screen watching hours and cardiovascular, respiratory, mental and psychiatric health and well-being (happiness) was assessed in an independent population-based survey to identify correlations of various hours with health conditions. MethodsData was retrieved from the Scottish Health Survey, 2012–2013. Information on demographics, lifestyle factors, self-reported health conditions and TV and/or screen watching duration in both Scottish adults and children was collected by annual household interviews. Chi-square test and survey weighted logistic and multi-nominal modelling were performed. Results5527 (57.0%) Scottish adults aged 16–99 watched TV and/or screen daily for 3+h on average. There was a trend toward more hypertension, angina, stroke, diabetes, chronic obstructive pulmonary disease and poor self-rated health and mental health. Reporting watching TV and/or screen for 4+h, for 5+h and for 8+h was associated with higher rates of heart attack, heart murmur or other heart troubles and abnormal heart rhythms, respectively. 414 (20.7%) Scottish children aged 4–12 watched TV and/or screen for 3h or more. They tended to have poor self-rated health and life difficulties perceived as emotional and behavioural problems. ConclusionThere were associations between various hours of TV and/or screen watching (3+h) and poor health observed both in Scottish adults and children. Future educational and public health programmes minimising TV and/or screen watching in order to protect cardiovascular, respiratory, mental and psychiatric health might be considered.

Androgen deprivation therapy (ADT) and cardiovascular (CV) risk: Analysis of German Statutory Health Insurance (SHI) data.

219 Background: ADT is an established part of the guideline-oriented therapy of prostate cancer (PCa). Concerns regarding increased CV risks associated with ADT were raised by the FDA in 2010. Results from a pooled data-analysis of six prospective randomised trials suggest a lower number of CVevents in patients treated with the GnRH antagonist Degarelix compared with GnRH agonist treated patients with preexisting cardiovascular disease [Albertsen P. et al: Eur Urol 2014; 65: 565-73]. Objective: Can SHI data confirm the observation that the risk for CVevents varies depending on the substance used for ADT. Methods: Retrospective data sets of 4 Mio assured people from SHI funds from the years 2009-2012 were analysed to identify PCa patients treated with ADT, GnRH agonists and GnRH antagonists, respectively. An age-adjusted reference group with 1.1 Mio non-PCa persons was identified in the data sets. Results: 44.166 patients suffering from PCa were identified. Of those 10.611 patients were treated with ADT. 10.554 with GnRH agonists and 132 with GnRH antagonists, respectively. An increased prevalence for relevant baseline CV diseases was observed in ADT treated patients compared to the Non-PCa reference group (diabetes mellitus: 28.66% vs 17.43%.; CAD: 35.77% vs 15.70%; Heart failure: 27.54% vs 9.64%). The rate of heart attack and stroke (CVevents) after treatment begin with ADT was determined: 2.37% in the reference group, 5.9% in the PCa group, 7.8% in the ADT group, 2.3% in the GnRH antagonist group. All CVevents in GnRH antagonist group occurred in high risk patients, only. The urologist examined and reported the state of CV risk for 25% of the PCa patients, only. Urologists examine and treat statistically significantly more patients with a combination of PCa and CVevents than general practitioners (30 vs. 5 per year/per physician). Conclusions: This retrospective analysis confirms the hypothesis that the risk of CVevents varies by using different ADT. The risk might be lower by using GnRH antagonists. A close collaboration of urologists, general practitioners and cardiologists is therefore recommended in the management of PCa patients.

Mediterranean diet and cardiovascular disease: a step closer to mechanisms using a precision animal model?

Coronary heart disease (CHD), the leading cause of mortality in the U.S. and other western countries, is a multifactorial disease. As a result of extensive investigations spanning several decades, many contributing factors, such as age, sex, smoking, hypertension, obesity and a high cholesterol level have been identified, and these factors are now known as well-established or traditional risk factors for CHD. Novel factors, including biomarkers of vascular endothelial dysfunction, inflammation, genetics, and dyslipidemia [e.g. small dense low-density lipoprotein and lipoprotein(a)], have emerged recently and their association with CHD, as well as their potential for predicting future risk have been tested in many studies with some showing considerable promise. The diet-heart theory described more than six decades ago by Dr. Ancel Keys, the founder of “The Seven Countries Study” (SCS), has remained central in shaping the efforts to reduce global risk of CHD based on lifestyle modification. The SCS was the first epidemiological longitudinal study systematically investigating the relationship between lifestyle, diet, CHD and stroke risks in multiple populations representing different regions of the world with contrasting dietary patterns [1]. Dr. Keys and his colleagues demonstrated a direct and independent association between the serum total cholesterol level and the risk and rates of heart attack and stroke both at the population and at the individual level across diverse cultures. Through studies like these, the importance of the Mediterranean diet in modulating CHD risk, the impact of changes in lifestyle and diets of populations in the Mediterranean region on the rates of heart disease, and associations between food composition (e.g., saturated fatty acids, mono- and polyunsaturated fatty acids, etc.) and coronary death rate have been explored [2-4].