Risk Factors For Coronary Disease Research Articles

Patients With Coronary Microvascular Dysfunction Have Less Circulating α-Klotho.

Coronary microvascular dysfunction (CMD) represents an early functional characteristic of coronary vascular aging. Klotho (α-klotho) is a circulating protein inversely linked to physiological aging. We examined low klotho as a potential marker for vascular aging in patients with CMD and no coronary artery disease. Patients undergoing nonurgent angiogram for chest pain who had no coronary artery disease underwent invasive coronary microvascular and endothelial function testing. CMD was defined by ≤50% increase in coronary blood flow (percentage change in coronary blood flow) in response to intracoronary acetylcholine or coronary flow reserve ≤2. Fresh arterial whole blood was used to analyze circulating endothelial progenitor cells with flow cytometry. Stored arterial plasma was used for klotho analysis by ELISA. Participants with CMD (n=62) were compared with those without CMD (n=36). Those with CMD were age 55±10 years (versus 51±11 years; P=0.07) and 73% women (versus 81%; P=0.38). Traditional risk factors for coronary artery disease were similar between groups. Patients with CMD had less klotho (0.88±1.50 versus 1.75±2.38 ng/mL; P=0.03), and the odds of low klotho in CMD were significant in a logistic regression model after adjusting for traditional cardiovascular risk factors (odds ratio [OR], 0.80 [95% CI, 0.636-0.996]; P=0.05). Higher klotho was associated with higher numbers of endothelial progenitor cells with vascular regenerative potential (CD34+ and CD34+CD133+KDR+). Among a subgroup of patients with atherosclerotic cardiovascular disease risk <5% (n=58), CMD remained associated with lower klotho (OR, 0.80 [95% CI, 0.636-0.996]; P=0.047). Klotho may be a biomarker for CMD and may be a therapeutic target for groups of patients without significant traditional cardiovascular risk.

Plasma Homocysteine Levels as Cardiovascular Disease Risk vis-a-vis Estrogen Levels in Pre and Postmenopausal Women

Objectives: The objective of the study is to evaluate plasma homocysteine level and its relation with serum estrogen in pre and postmenopausal women as a risk factor in coronary artery disease (CAD). Materials and Methods: A cross-sectional study was conducted among premenopausal (n = 50) and postmenopausal women (n = 50) with an estimation of plasma homocysteine (Hcy) and serum estradiol (E2). Postmenopausal women based on their angiographic status were sub-grouped into A (with normal coronaries) and B (with CAD). Results: The levels of Hcy, 21.98 (20.89–24.05) μmol/L, increased significantly (P &lt; 0.0001) and that of E2, 3.05 (2.32–3.6) pg/mL, decreased significantly (P = 0.0001) in the postmenopausal group when compared to Hcy, 6.11 (4.94–8.27) μmol/L and E2, 26.37 (25.3–29) pg/mL in premenopausal group. The levels of Hcy were elevated (24.7 ± 3.92 μmol/L) in postmenopausal Group B in comparison with postmenopausal Group A (21.37 ± 3.31 μmol/L), P = 0.002. Logistic regression analysis showed Hcy and body mass index to be independent predictors of CAD. Plasma Hcy showed an area under curve (AUC) of 1.00 with sensitivity and specificity of 100% at cutoff &gt;12.6 μmol/L between pre and postmenopausal groups and AUC of 0.722 with 60% sensitivity and 84% specificity at cutoff &gt;23.7 μmol/L between postmenopausal Groups A and B. Conclusion: We observed low E2 and high Hcy levels in postmenopausal women in comparison with premenopausal women. Among postmenopausal women, those with CAD had higher Hcy levels. Assessing Hcy levels routinely in postmenopausal women will help in better risk prediction of CAD and may also help in conjunction with other risk factors to decide the initiation of hormone replacement therapy.

Ballerina foot in heart.

A 67-year-old woman with no known risk factors for coronary artery disease presented to the outpatient department with complaints of exertional fatigue and angina New York Heart Association class III.

Managing hypertriglyceridemia for cardiovascular disease prevention: Lessons from the PROMINENT trial.

Numerous epidemiological studies have shown that hypertriglyceridemia is a significant risk factor for cardiovascular diseases (CVD). However, large clinical studies on triglyceride-lowering therapy have yielded inconsistent results. In the current review, we reassess the importance of triglyceride-lowering therapy in preventing CVD based on previous literature and the recently published findings of the PROMINENT trial. This narrative review is based on literature and public documents published up to November 2023. Meta-analyses of trials on peroxisome proliferator-activated receptor α agonists and triglyceride-lowering therapy, including the PROMINENT trial, have indicated that triglyceride-lowering therapy can reduce CVD events. Mendelian randomization studies have also indicated that triglyceride is indeed a true risk factor for coronary artery disease, leaving no doubt about its relationship to CVD. Meanwhile, the negative results from the PROMINENT trial were likely due to the insufficient triglyceride-lowering effect, slight increases in low-density lipoprotein cholesterol and apolipoprotein B, and the inclusion of mostly high-intensity statin users as target patients. It is unlikely that adverse events counteracted the effectiveness of pemafibrate on outcomes. Additionally, pemafibrate has shown positive effects on non-alcoholic fatty liver disease and peripheral artery disease. Although the PROMINENT trial did not demonstrate the significance of pemafibrate as a triglyceride-lowering therapy in a specific population, it does not necessarily negate the potential benefits of treating hypertriglyceridemia in reducing CVD events. It is necessary to explore appropriate populations that could benefit from this therapy, utilize data from the PROMINENT trial and other databases, and validate findings in real-world settings.

Fibrinogen and Atherosclerosis

Cardiovascular disease has a multifactorial origin. Among these risk markers, fibrinogen is the most prominent. Interest in the role of fibrinogen in the atherogenic process is long-standing. In the 1960s, one of the first studies correlating fibrinogen and coronary artery disease was published. Since then, much evidence has been accumulating establishing elevated plasma levels of fibrinogen as an independent risk factor for coronary artery disease. As in acute myocardial infarction, fibrinogen is also elevated in cases of cerebrovascular accident and peripheral artery disease. It is noteworthy that fibrinogen levels are elevated in patients with transient ischemic attacks, suggesting that fibrinogen levels should be elevated before necrosis occurs. It is known that plasma fibrinogen is a dimer made up of alpha, beta and gamma chains, whose union is made through disulfide bonds. Measures to reduce plasma fibrinogen include diet, alcohol, physical activity, and drugs. Since fibrinogen is a risk factor for coronary artery disease, measures to reduce its levels should be adopted. In the future, with the evolution of genetic studies, the detection of individuals predisposed to hyperfibrinogenemia may be performed. It is up to pharmaceutical research to continue the investigation of effective and easy-to-use drugs to reduce fibrinogen levels.

The Relationship Between Serum Testosterone Level as an Independent Variable in Men with the Risk Factors for Coronary Artery Disease &amp; Rehospitalization for Acute Coronary Syndrome

The Relationship Between Serum Testosterone Level as an Independent Variable in Men with the Risk Factors for Coronary Artery Disease &amp; Rehospitalization for Acute Coronary Syndrome

Increased epicardial adipose tissue thickness as a sign of subclinical atherosclerosis in patients with rheumatoid arthritis and ıts relationship with disease activity ındices.

Epicardial adipose tissue is a novel cardiometabolic risk factor and indicator of subclinical atherosclerosis. We aimed to evaluate the epicardial adipose tissue thickness in rheumatoid arthritis (RA) patients and its association with disease activity scores. A total of 81 rheumatoid arthritis patients and 70 age- and sex-matched healthy individuals were recruited for this cross-sectional study. Epicardial adipose tissue thickness (EATT) was measured by transthoracic two-dimensional echocardiography. Tender and swollen joint counts were recorded at the time of inclusion. The laboratory tests included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor, anti-citrullinated protein antibodies, and serum lipid levels. Disease activity was calculated based on Disease Activity Scores for 28 joints (DAS-28) ESR and CRP, the Simple Disease Activity Index (SDAI), and the Clinical Disease Activity Index (CDAI). Epicardial adipose tissue thickness was significantly higher in the RA patients compared to the healthy controls (p < 0.001). We found statistically significant correlations of EATT with all disease activity indices (p < 0.001) and CRP (p = 0.002). According to a cut-off value of 6.4mm determined for epicardial adipose tissue thickness, the RA patients with thickness ≥ 6.4mm had higher disease activity scores and CRP levels. In the multivariable regression analysis, only SDAI score was found as an independent risk factor for increased EATT (OR, (95%CI), 13.70 (3.88-48.43), p < 0.001). Epicardial adipose tissue thickness measurement by echocardiography is a reliable method for assessing subclinical atherosclerosis in rheumatoid arthritis patients, and a higher disease activity score is an independent risk factor for coronary artery disease.

The Impact of Periodontal Inflammation on the Severity of Coronary Atherosclerosis.

Introduction Through plausible biological mechanisms, periodontitis causes systemic inflammatory burden and response, thus resulting in damage far beyond the oral cavity. Studies have demonstrated periodontitis to be a significant risk factor for coronary heart disease (CHD) and stroke. The larger the quantum of periodontal inflamed tissue, the greater the chances of periodontitis eliciting bacteremiaand systemic inflammatory responses. Studies have reported that periodontitis and other common oral infections play an important role in the development of atherosclerosis. Therefore, the quantity of inflamed periodontal tissue assumes significance in determining the severity of atherosclerosis. Hence, this study investigates the impact of periodontal inflamed surface area (PISA) on the severity of coronary atherosclerosis. Materials and methods In this cross-sectional study, a total of 160 patients who presented at the department of periodontics of The British University in Egypt (BUE) from 1 January 2023 to 30 September 2023 were enrolled. Patients were only enrolled if they had undergone coronary angiography within the last six months, were less than 60 years of age, shared their previous medical history and coronary angiographic report, and gave informed written consent. Data on classic coronary risk factors and periodontal inflammatory status and angiographic findings were recorded and subjected to appropriate statistical analysis. Results The results revealed that the periodontal inflamed surface area (p = 0.002) apart from age (p < 0.047) and low-density lipoprotein cholesterol(LDL-C) (p < 0.001) is a significant independent predictor of the severity of coronary atherosclerosis. Conclusions The periodontal inflamed surface area is an independent predictor of the severity of coronary atherosclerosis.

A Comparative Analysis of the Serum Paraoxonase (PON1) Activity and the Concentration of Parameters of Lipid Profile after 3 Months of Statin Therapy

Background: Human serum paraoxonase (PON1) residing on HDL can prevent the oxidation of low densitylipoprotein (LDL), the initiating factor in atherosclerosis. Statins are commonly used to treat dyslipidemia,aknown risk factor for coronary artery disease (CAD).The aim of the studyis to evaluate the alterations in theconcentrationof PON1 along with that of other parameters of lipid profile in patients of CAD before and after 3 months of statin therapy.Materials and Methods: The study included 30 new patients who were put on statin therapy following thediagnosis of acute coronary syndrome. The activity of PON1 (units-IU/L) and the concentration of lipid profileparameters (units-mg/dl) were estimated before starting statin therapy and again after three months. Patients with co-morbidities like diabetes, kidney disease, liver disease and other cardiac diseases of infectious aetiology were excluded.Results and Analysis: As expected, both PON1 and HDL have increased after 3 months. There was a statistically significant increase in both PON1 (p&lt;0.05)and HDL (p&lt;0.001) and a decrease (p &lt;0.05, also statistically significant)in LDL after 3 months of statin therapy.Conclusion: This knowledge may be exploited in the follow up CAD patients. The increase in PONI and thesimilar increase in HDL after 3 months of statin therapy may be exploited in the follow-up of cardiac patients.

Work stress and changes in heart rate variability among employees after first acute coronary syndrome: a hospital-based longitudinal cohort study.

Work stress is considered as a risk factor for coronary heart disease, but its link with heart rate variability (HRV) among heart attack survivors is unknown yet. The aim of this study was to investigate associations between baseline work stress and the changes of HRV over one-year after onset of acute coronary syndrome (ACS). Hundred and twenty-two patients with regular paid work before their first ACS episode were recruited into this hospital-based longitudinal cohort study. During hospitalization (baseline), all patients underwent assessments of work stress by job strain (JS) and effort-reward imbalance (ERI) models, and were assigned into low or high groups; simultaneously, sociodemographic and clinical data, as well depression, anxiety, and job burnout, were collected. Patients were followed up 1, 6, and 12 months after discharge, with HRV measurements at baseline and each follow-up point. Generalized estimating equations were used to analyze the effects of baseline work stress on HRV over the following 1 year. After adjusting for baseline characteristics and clinical data, anxiety, depression, and burnout scores, high JS was not associated with any HRV measures during follow-up (all p > 0.10), whereas high ERI was significantly related to slower recovery of 5 frequency domain HRV measures (TP, HF, LF, VLF, and ULF) (all p < 0.001), and marginally associated with one time domain measure (SDNN) (p = 0.069). When mutually adjusting for both work stress models, results of ERI remained nearly unchanged. Work stress in terms of ERI predicted lower HRV during the one-year period after ACS, especially frequency domain measures.

Identification of a mechanism promoting mitochondrial sterol accumulation during myocardial ischemia-reperfusion: role of TSPO and STAR.

Hypercholesterolemia is a major risk factor for coronary artery diseases and cardiac ischemic events. Cholesterol per se could also have negative effects on the myocardium, independently from hypercholesterolemia. Previously, we reported that myocardial ischemia-reperfusion induces a deleterious build-up of mitochondrial cholesterol and oxysterols, which is potentiated by hypercholesterolemia and prevented by translocator protein (TSPO) ligands. Here, we studied the mechanism by which sterols accumulate in cardiac mitochondria and promote mitochondrial dysfunction. We performed myocardial ischemia-reperfusion in rats to evaluate mitochondrial function, TSPO, and steroidogenic acute regulatory protein (STAR) levels and the related mitochondrial concentrations of sterols. Rats were treated with the cholesterol synthesis inhibitor pravastatin or the TSPO ligand 4'-chlorodiazepam. We used Tspo deleted rats, which were phenotypically characterized. Inhibition of cholesterol synthesis reduced mitochondrial sterol accumulation and protected mitochondria during myocardial ischemia-reperfusion. We found that cardiac mitochondrial sterol accumulation is the consequence of enhanced influx of cholesterol and not of the inhibition of its mitochondrial metabolism during ischemia-reperfusion. Mitochondrial cholesterol accumulation at reperfusion was related to an increase in mitochondrial STAR but not to changes in TSPO levels. 4'-Chlorodiazepam inhibited this mechanism and prevented mitochondrial sterol accumulation and mitochondrial ischemia-reperfusion injury, underlying the close cooperation between STAR and TSPO. Conversely, Tspo deletion, which did not alter cardiac phenotype, abolished the effects of 4'-chlorodiazepam. This study reveals a novel mitochondrial interaction between TSPO and STAR to promote cholesterol and deleterious sterol mitochondrial accumulation during myocardial ischemia-reperfusion. This interaction regulates mitochondrial homeostasis and plays a key role during mitochondrial injury.

The effectiveness of green heart application to manage modifiable risk factors of coronary artery disease in Tehran Heart Center: Study protocol for a randomized controlled trial

The burden of cardiovascular disease (CVD) is diminishing in developed countries. However, in middle- and low-income countries the CVD death rates are growing. CVD is the most common cause of death and disability in Iran and accounts for nearly half of all mortalities in Iranians. Therefore, preventive strategies by risk factor modification are a top priority in the country.Recently, Mobile-Health (mHealth) technology has been the focus of increasing interest in improving the delivery of cardiovascular prevention, targeting a combination of modifiable risk factors.This parallel-group single-blinded randomized controlled trial study has been designed to evaluate the impact of using a mHealth application on risk factors control. Individuals aged between 25 and 75 years who have documented CVD by coronary angiography in Tehran Heart Center and have at least one uncontrolled risk factor from the three including hypertension, dyslipidemia, and current cigarette smoking will be included. We are going to randomize 1544 patients into two study arms as follows: 1- Intervention: usual care + mHealth 2- Control: usual care + paper-based recommendations and educational materials. After 3 and 6 months of follow-up, the status of risk factors will be determined through outpatient visits and face-to-face interviews for both arms. Outcome: Successful risk factor control will be measured after 3 and 6 months.Nowadays, mHealth is becoming increasingly popular, providing a good opportunity for constant monitoring of risk factors and changing health behavior in a target population. Meanwhile, providing evidence for the effectiveness of health intervention delivery using mobile technologies could help health providers encourage their at-risk population to stop smoking, control blood pressure and blood cholesterol, and participate in regular physical activity. While the burden of CVD is growing in developing countries, this type of intervention can be a cost-effective way to reduce it in these countries.

Therapeutic role of yoga in hypertension.

Systemic hypertension is an established risk factor for coronary artery disease and cerebrovascular accident and control of blood pressure reduces the risk of a major cardiovascular event. Both non-pharmacological and pharmacological treatment options are available to treat hypertension. Yoga, recently received more attention as a treatment modality for various lifestyle disorders, even though practiced in India since ancient times. In this review, we are analyzing the role of yoga in the treatment of systemic hypertension.

Abstract P277: Adherence to Time-Restricted Eating, Plasma Metabolomic Signatures, and Risk of Coronary Heart Disease

Introduction: Early time-restricted eating (TRE) has been recently suggested as an effective dietary intervention strategy to improve risk factors of coronary heart disease (CHD), whereas late TRE may be related to poor cardiometabolic health. Metabolomic pathways linking the adherence to habitual TREs depending on the time of the day and CHD risk are unknown. Hypothesis: We tested whether adherence to early or late TRE was related to distinct metabolomic signatures (including those in pathways of energy/purine pyrimidine metabolism, lipids, carbohydrates, and acylcarnitines). We then tested whether TRE-related plasma metabolites were associated with the risk of incident CHD among women without prior CHD. Methods: This study included 674 women without cardiovascular disease who completed 7-day food records and measurements of untargeted plasma metabolomics in a sub-study of the Nurses’ Health Studies (NHS/NHSII). TRE was indicated by 4-12 hours of daily eating window. The adherence to TRE was assessed by summing up the TRE days in a week (0-7 days). We analyzed two TRE habits: early TRE (starting before 9 a.m./ending no later than 9 p.m.) and late TRE (beginning after 9 a.m.). Separately, plasma metabolites were measured in a prospective nested case-control of 762 incident cases of CHD and 762 matched controls identified over 10-14 years of follow-up in the NHS. A metabolomic risk score for predicting adherence to late TRE (MRS-TRE late ) was created based on metabolites selected through the elastic net procedure with a 10-fold cross-validation. Results: Adherence to late TRE was positively associated with greater adiposity, insulin/proinsulin, uric acid, and medium-chain fatty acids/acylcarnitines; the late TRE habit was inversely related to metabolites in the TCA cycle/pyruvate metabolism and specific PC species ( P FDR &lt;0.05). On the other hand, metabolites in lipid pathways (including diglyceride DG 38:5) and glucose were inversely related to the adherence to early TRE. Individual levels of late-TRE-related metabolites in energy/phosphatidylcholine /acylcarnitine pathways were significantly associated with an increased risk of CHD. Every 1 SD increment of MRS-TRE late , based on 21 metabolites in various metabolic pathways, was associated with a relative risk (RR) of 1.24 (95% CI: 1.11, 1.38) for CHD in a model adjusted for matching factors, and a RR of 1.15 (1.02, 1.29) after adjusting for covariates, such as demographic factors, diet quality, alcohol, lifestyle factors, and BMI. Women in the top tertile of MRS-TRE late had a 1.44-fold (1.10, 1.89) increased risk of CHD as compared to those in the lowest tertile after adjusting for the covariates. Conclusions: TRE habit, depending on the timing, was related to distinct metabolomic pathways, and adherence to late TRE may be associated with metabolic reliance linked to the risk of incident CHD among women.

Abstract P105: Blood Lipids, Lipoproteins, and Apolipoproteins With Risk of Coronary Heart Disease: A Prospective Study Among Multi-Racial Populations

Background: Blood lipids, such as total cholesterol (TC), LDL-cholesterol (LDL-C), and triglycerides (TG), are well-known risk factors for coronary heart disease (CHD). However, studies that examined the associations of circulating lipids and apolipoproteins carried by different lipoproteins with incident CHD remain limited, particularly among racially diverse populations. Hypothesis: Potential novel lipoprotein biomarkers, other than TC, TG, LDL-C, and HDL-C, are associated with incident CHD in diverse populations. Methods: We conducted nested case-control studies of CHD among White Americans (542 pairs; n =1084), Black Americans (622 pairs; n =1244), and Chinese adults (557 pairs; n =1114) drawn from the Southern Community Cohort Study and Shanghai Women’s and Men’s Health Studies. We examined the associations of 36 plasma lipids, lipoproteins, and apolipoproteins (measured by Bruker IVDr NMR platform) with incident CHD using conditional logistic regression, adjusted for sociodemographics, lifestyle, family history of CHD, and menopausal status (women only). Race-specific odds ratios (ORs) were pooled using fixed-effect meta-analysis. Results: TC, TG, LDL-C, and HDL-C were associated with incident CHD, with pooled ORs being 1.35, 1.31, 1.26, and 0.79 per 1-SD increase. Sixteen lipoprotein biomarkers showed larger effect sizes than those conventional lipids, with pooled ORs per 1-SD ranged from 1.37 to 1.59 and a negative OR of 0.77 ( Figure 1 ); all associations were significant within each race. Significant associations were observed across subpopulations defined by sociodemographics, lifestyle, and status of obesity, diabetes, hypertension, and dyslipidemia, including among individuals with normal levels of TC, TG, LDL-C, and HDL-C. Conclusion: Our study identified several lipoprotein biomarkers (e.g., ApoB/ApoA1 ratio and LDL-TG) associated with incident CHD among multi-racial populations, suggesting potential clinical utility complementing the current lipid panel.

Paclitaxel-induced acute myocardial infarction: a case report and literature review

BackgroundPaclitaxel is a chemotherapeutic agent commonly used for ovarian, lung, breast carcinoma, and Kaposi’s sarcoma. Its common side effects include hypersensitivity reaction, bone marrow suppression, and peripheral neuropathy. However, a rare and life-threatening side effect is paclitaxel-induced myocardial infarction.Case presentationA 71-year-old man with type 2 diabetes mellitus, hypertension, heavy smoking history, previous coronary artery disease with percutaneous coronary intervention (PCI) in left anterior descending artery (LAD), and non-small lung cancer presented with non-ST elevation myocardial infarction during infusion of paclitaxel infusion. Coronary angiogram showed de novo three vessel disease with 70% stenosis in ostial to distal left main artery (LM) and 80% in-stent re-stenosis in proximal to mid left anterior descending artery.ConclusionsPhysicians should be keeping this in mind when dealing with patients on paclitaxel, especially if they have previous risk factors for coronary artery disease.

Predictive value of the serum uric acid to high-density lipoprotein cholesterol ratio for culprit plaques in patients with acute coronary syndrome

BackgroundHyperuricemia and low level of high-density lipoprotein cholesterol (HDL-C) are both risk factors for coronary artery disease (CAD). The uric acid to HDL-C ratio (UHR) has recently been identified as a new inflammatory and metabolic biomarker. However, the relationship between the UHR and coronary culprit plaques has not been fully investigated in patients with acute coronary syndrome (ACS).MethodsA total of 346 patients with ACS were enrolled in this study. Culprit lesion characteristics were assessed by optical coherence tomography (OCT). Logistic regression and linear correlation analyses were performed to assess the association between the UHR and culprit plaques. The predictive value of the UHR was investigated by receiver operating characteristic (ROC) curve analysis.ResultsThe percentages of typical culprit plaques, including ruptures, erosions and thrombi, were greater in the high-UHR subgroup than those in the low-UHR subgroup. A positive relationship was also found between the UHR and diameter stenosis (r = 0.160, P = 0.003) and between the UHR and area stenosis (r = 0.145, P = 0.007). The UHR was found to be independently associated with plaque rupture, erosion and thrombus. Furthermore, ROC analysis suggested that the UHR had a better predictive value than low-density lipoprotein cholesterol.ConclusionsAn elevated UHR level was independently related to the occurrence rate of culprit plaques. The UHR is a simple and easily acquired parameter for detecting culprit plaques in patients with ACS.

A study on the prevalence and risk factors of coronary artery disease in patients with metabolic syndrome infected and not infected with COVID 19 from El- Oued (Algeria) region

Introduction and Aim: Coronary artery disease (CAD) is a pathological process described by atherosclerosis plaque in the epicardial arteries. CAD is a chronic process that begins during adolescence and slowly progresses through life. Several traditional risk factors genetics and environmental, involve in the development of atherosclerosis process. This study was aimed to investigate the prevalence of CAD and its associated risk factors among the El Oued (Algeria) population. Materials and Methods: An epidemiological study was carried out on 23422 patients who suffered from cardiovascular diseases. The study of risk factors analysis was focused on 300 voluntary individuals, their origins from different El-Oued areas, and the CAD and metabolic syndrome patients selected from public and private health interests. All the information was obtained by a questionnaire. The risk of socio-clinical factors has been estimated by Binary Logistic regression was carried out between CVD and its associated risk factors. P &lt; 0.05 from two-sided statistical tests was regarded as statistically significant. Results: Through the results presented in our study, we found that the clinical factors such as hypertension (OR=154.846, and; P =0.000), the group aged&gt; 60 (OR=154.84, and; P =0.000 and chest pain (OR=42.667, and; P =0.000), present significant risk factors with CAD patients compared to healthy people (control), respectively, in contrast we show that the most dangerous Socioeconomic factors alcohol consumption and stress respectively for (OR=13.500= and; P =0.001), and obesity (OR=4.495= and; P =0.000), but we estimate that sport is important protective factors for the disease with OR=52.6, P 0.500) in the CAD patients compared to metabolic syndrome patients. Conclusion: The increasing prevalence of risk factors for coronary artery disease among the population has raised concerns for public health, which creates a health threat, especially with inadequate promotion and awareness programs.

Serum immunoglobulin M is associated with the severity of coronary artery disease in adults.

The purpose of this study was to investigate the relationship between serum immunoglobulin M (IgM) and the severity of coronary artery disease in Chinese patients who underwent coronary angiography. A total of 2,045 patients who underwent coronary angiography (CAG) from March 2017 to March 2020 at Beijing Hospital were included in this study. Serum IgM concentration and biochemical indicators were measured before coronary angiography (CAG). The triquartile IgM levels at baseline in the population were analysed. Spearman rank correlation was used to analyse the association between IgM and traditional risk factors for coronary artery disease (CAD). CAD patients were divided into subgroups by affected area, number of affected vessels, and Gensini score to analyse the relationship between IgM and CAD severity. Multivariable logistic regression analysis was used to evaluate the association between IgM and CAD severity. Serum IgM levels were significantly lower in the CAD group (63.5 mg/dL) than in the non-coronary artery disease (NCAD) group (72.3 mg/dL) (P < 0.001). Serum IgM levels were significantly associated with sex. Serum IgM levels were positively correlated with traditional CAD risk factors such as TG, TC and LDL-C (P < 0.05), and negatively associated with the number of obstructed vessels, the number of affected areas, and Gensini scores. After adjusting for age, sex, smoking status, hypertension, dyslipidaemia, diabetes, stroke, and statin use history, a high IgM level was independently negatively associated with the severity of CAD expressed by the Gensini score. We determined that serum IgM was independently negatively associated with the severity of CAD diagnosed by angiography in Chinese adults.

Ghost Passenger in the Heart: The Story of an Intracardiac Cyst Dancing with Coronary and Peripheral Embolisms

Cardiac localization of hydatid cyst, which is a parasitic disease, is rare. In this article, a case of mediastinal hydatid cyst invading the left atrium is presented. A 62-year-old male patient with risk factors for coronary artery disease presented with epigatric pain, nausea and vomiting. Coronary imaging was performed because ongoing epigatric pain was accompanied by ischemic changes and elevated troponin on electrocardiography. No occlusive lesion was observed in the epicardial coronary arteries. Mesenteric embolism was detected in the patient whose epigatric pain continued. The patient, who did not accept surgery after the initial diagnosis, developed peripheral and cerebral emboli in the following period, and the patient was referred for surgery.