Risk Of IHD Research Articles

Analysis of elective coronary angiography findings in patients with suspected angina pectoris in the cardiocenter Hradec Králové – Real-life clinical practice in light of the guidelines

IntroductionCoronary angiography (CA) is a gold standard of diagnosis of occlusive coronary atherosclerosis in patients with high pre-test probability of IHD (PTP) and in patients with medium pre-test probability, in whom a prognostically significant ischemia was detected during a stress test. The imaging stress tests are preferred to the stress electrocardiogram due to higher sensitivity and specificity. The aim of this work was to analyze the profile of patients undergoing the elective CA due to suspected IHD. Study population and methodsPopulation of 184 patients who underwent elective CA due to suspected ischemic heart disease between April and August 2016 was retrospectively analyzed in the cardiocenter at the University Hospital Hradec Králové. The patient risk profile and use of cardiac stress tests and their relation to the CA findings were evaluated. The CA result was evaluated as positive if stenosis of coronary artery of ≥50% in at least one of the main coronary arteries was found. ResultsPatients with medium PTP prevailed in our study population – 154 (84%), there were 6 (3%) patients with low and 24 (13%) with high PTP. 112 (61%) patients had negative and 72 (39%) positive CA finding. Stress test was performed in 43 cases (23%) and the stress electrocardiograms predominated significantly over the imaging stress tests: 37 (86%) versus 6 (14%). In the medium-risk group, a stress test was performed in 36 (23%) patients, in 92% it consisted of stress electrocardiogram. None of the patients with low PTP had positive CA, in the medium-risk group the CA was positive in 38% and in the high-risk group in 54%. In the patients with positive exercise electrocardiogram, the CA was positive only in 10% of cases. 44% of patients with positive and 39% of patients with negative CA had typical angina pectoris. ConclusionMost of the patients referred for elective CA had medium risk of IHD. The patient medical history alone was not a reliable predictor of IHD. The stress tests for detection of ischemia were performed scarcely with the dominance of stress electrocardiogram, which was not reliable in the ischemia detection in the clinical practice. The imaging stress tests were not used to a sufficient extent and the rate of negative elective CAs was high in the analyzed study population.

Abstract P407: Five-year Longitudinal Bp In Treated Hypertensive Patients Shows Evidence For Diastolic J-curve And Cardiovascular Outcomes

Current guidelines recommend a BP target <140/90 mmHg irrespective of cardiovascular (CV) risk level. The SPRINT showed significant benefit of treating SBP to <120 mmHg. Concerns exist regarding the potential increased CV risk from intensive DBP lowering - the diastolic J-curve. We analysed the relationship of longitudinal on-treatment SBP and DBP on CV events. Methods: Longitudinal BPs were obtained from clinic records for hypertensive patients attending the Glasgow BP Clinic. AUC BP for the first year (Y1) and 2-5years (Y2-5) were calculated for patients who had >2 BP measurements during these periods. Survival analyses were performed using Cox proportional hazard model adjusted for age, sex, cholesterol, smoking status, BP (time-dependent) and Charlson comorbidity index (time-dependent). Results: There were 4813 eligible patients (mean age 54±14 years; female 52%). The average baseline, Y1 and Y2-5 BPs were 167/97±26/12, 153/91±19/9 and 146/87±16/8 mmHg respectively. There were 398, 452 and 455 first admissions with IHD in 15, 25, 35 years (31,563, 39,255 and 40,714 person-years respectively). DBP demonstrated a J-shaped relationship with IHD and MI events but not for CVA (Figure). Compared to DBP80-90 mmHg, DBP<80mmHg was associated with a nearly two-fold increased risk of IHD admissions 1.95[95%C.I. 1.46;2.61, P=7.6E-06]. Similar results were observed for 25- and 35-year follow-up periods. Conclusions: Low DBP (<90mmHg) is associated with increased risk of IHD but not CVA. Increasing SBP is linearly associated with increased risk of IHD and CVA. Therefore, intensive SBP reduction measures should recognise potential risks of concomitant DBP reduction.

Risk of Ischemic Heart Disease in Patients With Sjögren’s Syndrome

BackgroundIschemic heart disease (IHD) has emerged as a major cause of morbidity and mortality in patients with autoimmune conditions such as systemic lupus erythematosus and rheumatoid arthritis, but the risk of IHD in Sjögren’s syndrome (SjS) is unknown. To fill this knowledge gap, we estimated the prevalence and risk of IHD with SjS compared to controls from the general population using the Healthcare Cost and Utilization Project National Inpatient Sample 2011 database. Materials and MethodsThe Healthcare Cost and Utilization Project administrative longitudinal database contains encounter-level information on inpatient stays, emergency department visits and ambulatory surgery in all U.S. hospitals. We conducted a cross-sectional study among the inpatient population diagnosed with SjS and matched 1:4 with controls for age, sex and hospital region. Odds ratio for IHD was calculated as cases compared to controls. The contribution of various risk factors to IHD was also evaluated by logistic regression. ResultsAnalysis demonstrated that 7,154 of 13,086 cases (54.7%) of SjS had IHD compared to 27,367 of 52,448 controls (52.2%). The adjusted odds ratio for IHD in those with SjS was 0.898 (95% CI: 0.844-0.955). Patients with SjS were significantly more likely to have hypertension, diabetes, apnea and lipid disorders. ConclusionsTo our knowledge, this is the largest population-based study investigating the risk of IHD in patients with SjS. We found a modest, though statistically significant, decrease in the risk of IHD in SjS compared to controls.

Risk of Cerebrovascular Accidents and Ischemic Heart Disease in Cutaneous Lupus Erythematosus: A Population-Based Cohort Study.

It is unclear whether isolated cutaneous lupus erythematosus (CLE) affects cardiovascular risk. We estimated the cumulative incidence and mortality of cardiovascular diseases in a population-based CLE cohort and compared the risk with a matched non-CLE cohort. All incident cases of CLE in Olmsted County, Minnesota, between 1965 and 2005 were followed until December 2013. The cumulative incidence of cerebrovascular accidents (CVAs [including stroke and transient ischemic attack]), ischemic heart disease (IHD [including coronary artery disease, myocardial infarction, and angina pectoris]), heart failure, and peripheral arterial disease (PAD) was derived and compared to an age-, sex-, and calendar year-matched non-CLE cohort using Cox models. There were 155 patients with CLE (mean ± SD age at diagnosis 48 ± 16 years, 65% female, mean ± SD BMI 26.3 ± 7.1 kg/m2 , 40% smokers, 9% with diabetes mellitus). During a median followup of 14.6 years, 41 CLE patients had cardiovascular events (15 patients with CVAs, 32 patients with IHD), with a 20-year cumulative incidence of 31.6%. As compared to non-CLE subjects, the risk of CVAs (smoking-adjusted hazard ratio [HR] 2.97 [95% confidence interval (95% CI) 1.13-7.78]) and PAD (HR 2.06 [95% CI 0.99-4.32]) was increased in patients with CLE, but the risk of IHD was not increased (HR 0.94 [95% CI 0.57-1.54]). There was no increase in cardiovascular mortality (HR 1.68 [95% CI 0.76-3.75]). The magnitude of risk for any cardiovascular outcome was not significantly influenced by the extent of cutaneous involvement. CLE may be associated with an increased risk of CVAs and PAD, but not IHD. Factors contributing to increased CVA risk in patients with CLE merit evaluation.

LIPOPROTEIN(A) MEANING AS AN ADDITIONAL MARKER OF CARDIOVASCULAR RISK IN PATIENTS WITH FAMILIAL HYPERCHOLESTEROLEMIA

Aim. To analyze the relation of Lp(a) and atherosclerosis development in familial hypercholesterolemia (FHCE). Material and methods. Totally, 81 patient with definite FHCE studied, mean age 39,1±0,4 y. o. The participants were selected to two groups: first — with increased level of Lp(a) >0,3 g/L (n=34); mean age — 44,5±0,3; second — with normal Lp(a) <0,3 g/L (n=47, 58,1%); mean age — 37,5±0,3 y. o. Results. Mean level of Lp(a) in various age persons did not differ significantly. In both subgroups in about a half of all participants there was arterial hypertension (AH) revealed (50,8% and 42,6%, respectively), obesity was diagnosed in one third of both groups, number of smokers was higher in higher Lp(а) group (11,8% and 8,5%). IHD had 25,9% of participants. Revalence of IHD in IHD group was 44, 4%, in non-smoker group — 25,8% (RR 1,72 (0,75; 3,99)), acute myocardial infarction prevalence (MI) in smoking subgroup was — 44,6% versus 13,5% (RR 3,26 (1,26; 8,43)). Among lipid profile parameters LDL level was definitive for IHD development (p=0,012). Presence of obesity increased MI risk 2,54 times in FHCE (OR 2,4 (1,05; 5,63)). With increase of Lp(a) IHD was diagnosed more commonly: 32,4% versus 19%, non-significant (p=0,47). Prevalence of MI in the first group was higher than in the second: 8 (23,5%) and 4 (8,5%), respectively, (OR 3,3 (1,1; 9,8), р=0,03). Conclusion. In FHCE, the risk of IHD was influenced by traditional RF (smoking, obesity, LDL level).

The long-term health of vegetarians and vegans.

Vegetarians, who do not eat any meat, poultry or fish, constitute a significant minority of the world's population. Lacto-ovo-vegetarians consume dairy products and/or eggs, whereas vegans do not eat any foods derived wholly or partly from animals. Concerns over the health, environmental and economic consequences of a diet rich in meat and other animal products have focussed attention on those who exclude some or all of these foods from their diet. There has been extensive research into the nutritional adequacy of vegetarian diets, but less is known about the long-term health of vegetarians and vegans. We summarise the main findings from large cross-sectional and prospective cohort studies in western countries with a high proportion of vegetarian participants. Vegetarians have a lower prevalence of overweight and obesity and a lower risk of IHD compared with non-vegetarians from a similar background, whereas the data are equivocal for stroke. For cancer, there is some evidence that the risk for all cancer sites combined is slightly lower in vegetarians than in non-vegetarians, but findings for individual cancer sites are inconclusive. Vegetarians have also been found to have lower risks for diabetes, diverticular disease and eye cataract. Overall mortality is similar for vegetarians and comparable non-vegetarians, but vegetarian groups compare favourably with the general population. The long-term health of vegetarians appears to be generally good, and for some diseases and medical conditions it may be better than that of comparable omnivores. Much more research is needed, particularly on the long-term health of vegans.

COMORBIDITIES OF ISCHEMIC HEART DISEASE WITH OTHER NON-COMMUNICABLE DISEASES IN ADULT POPULATION: AGE AND RISK FACTORS ASSOCIATION

Aim. To study the prevalence of ischemic heart disease as one of the most common cardiovascular disorders, together with arterial hypertension (AH), diabetes mellitus (DM) and liver diseases (LD) in adult (25-64 y.o.) population of selected RF regions, the variance of those with gender and age, and association of cardiovascular risk factors (FR). Material and methods. Into analysis we included the results of representative selections studies from 13 RF regions, studied according to the program of multicenter study ESSE-RF during the years 2012­2014; totally 21923 patients studied. Investigation included standard questioning, including anamnesis. For statistics we used applied software SAS. Results. In men the prevalence of IHD is associated with the growth of comorbidity from 0 in the age group 25-34 y. to 77% in the age 55-64 y., almost duplicating every decade. For women there is analogic tendency, less prominent. In men there are significant associations only with AH, which increases the risk of IHD 2,5 times, though in women together with AH the associations are significant for LD. Comorbidities with DM do not influence the prevalence of IHD in men and women. At the same time, any association with two diseases increases the risk of IHD >304 times. The most negative is the association of all three diseases, with which IHD is 8,7 times more prevalent, than in their absence. Using multidimensional logistic regression after correction for the age and comorbidity in the patients with IHD of both genders, there are associations revealed of high density cholesterol lipoproteids (HDL) in blood and abdominal obesity. In men there are also positive associations with smoking and negative — with increased cholesterol. Conclusion. Comorbidities of IHD with AH, DM and LD in adult population are common, are associated with the general FR, are increasing with the age. Taking modern tendencies of population ageing, it is plausible to expect an increase of the prevalence of comorbidities, that requires a necessity of the healthcare services to these changes.

Both preoperative alpha and calcium channel blockade impact intraoperative hemodynamic stability similarly in the management of pheochromocytoma

Alpha-blockade is the standard management preoperatively to prevent intraoperative hemodynamic instability (IHD) during resection of a pheochromocytoma. Calcium channel blockers also have been shown to lessen the risk of IHD. We aim to determine differences between these classes of antihypertensive agents in minimizing IHD. This was a retrospective analysis from a tri-institutional database. Inclusion criteria were unilateral transabdominal adrenalectomy for pheochromocytomas between 2002 and 2012. IHD was defined as at least one systolic blood pressure (SBP) measurement >160 mm Hg and at least one episode of mean arterial pressure 60 mm Hg. A total of 155 patients were included: 110 receiving calcium channel blockers, 41 alpha-blockade, and 4 no medication. Intraoperatively, mean maximal SBP was less after alpha-blockade (P < .0001) as well as the incidence and duration of episodes of SBP >200 mm Hg (P < .01); however, severe hypotensive episodes (MAP <60 mm Hg) were more frequent (P < .001) and longer (P < .0001) with alpha-blockade. Consequently, intraoperative vasoactive drugs were used more frequently (P = .03), and mean fluid volume infused was larger (P < .001). Fifty-four patients had IHD, but these were independent of type of preoperative medication used. Familial disease was the only independent predictor of IHD. IHD was independent of type of preoperative medical management but was dependent on familial disease. These findings broaden options for clinicians in the preoperative management of pheochromocytoma.

Questioning the Benefit of Adjuvant Endocrine Therapy (ET) in Elderly Women With Early-Stage Hormone Receptor Positive (HR+) Breast Cancer Treated With Breast-Conserving Surgery (BCS) and Radiation Therapy (RT)

and high risk in 31 (38%), 43 (53%), and 7 (9%) pts, respectively. Median prescription dose was 50.4 Gy in 1.8 Gy fractions. The observed 10-year rate of IHD was 1.4% (95% CI Z 0.2-9.4). MRE for IHD with ABC and FB were 3.56% (95% CI Z 2.78-4.33) and 4.31% (95% CI Z 3.35-5.28), respectively [Table]. Cardiac testing was performed in 15 (19%) pts due to signs and symptoms of IHD: 1 of 3 pts had occlusive CAD on angiography, 1 of 7 pts had ischemic signs on stress testing, and 8 pts had normal stress myocardial perfusion single photon emission tomography (SPECT) imaging. Conclusions: The rate of IHD at 10 years was 1.4% in this first report of cardiac outcomes following RT with ABC. While limited by small study size, the low prevalence of abnormal cardiac testing corroborates findings. Using MRE, RT with ABC reduces the risk of IHD when compared to FB with the largest benefit observed for AHA high-risk pts. In appropriately selected pts, RT with ABC can provide a clinically significant reduction in the risk of IHD in survivors of LBC. Author Disclosure: H.B. Eldredge-Hindy: None. D. Duffy: None. K. Yamoah: None. A.P. Dicker: None. J. Skowronski: None. N.L. Simone: None. P.R. Anne: None.

Influenza vaccination and reduction in risk of ischemic heart disease among chronic obstructive pulmonary elderly

COPD estimates the third leading cause of death by 2020. To reduce its complications becomes an important issue. The purpose of this study is to investigate the influenza vaccine effect for IHD occurrence with secondary to COPD. We used 11 years Taiwan National Health Insurance cohort research database and analyzed the relationships between vaccination and incident of IHD for COPD patients stratified by age. Total 29,178 COPD patients, 703 patients got vaccination out of 1464 who have developed IHD and 6010 patients vaccinated out of 27,714 that did not developed IHD. Major findings we observed: vaccination was associated with a reduced risk of IHD (OR, 0.746; 95% CI, 0.595–0.937) in elderly COPD patients. Influenza vaccination was associated with a reduced risk for IHD only in elderly COPD patients. Moreover, COPD patients with IHD had higher vaccination rate than without IHD.

Psychosocial factors as predictors of early onset ischemic heart disease in a sample of Pakistani women

Empirical research documents that in some cases psychosocial factors conquer greater if not equal risk of IHD. This study was conducted to infer the psychosocial factors associated with the risk of IHD in women. Case control study design was utilized to explore the association of psychosocial factors with the risk of IHD in women aged 35 to 55 years. A sample of 71 women cases diagnosed with IHD and 142 age and gender matched community controls were recruited for this purpose. Binary logistic regression analyses was conducted to ascertain the association of proposed psychosocial factors with the risk of IHD. The values of the coefficients revealed that a unit increase in score of trait anger is associated with increase in the odds of IHD by a factor of 1.21 (95 % CI 1.04 and 1.42). A unit increase in optimism score is associated with decrease in the odds of IHD by a factor of 0.67 (95% CI 0.53 and 0.83). The values of the coefficients reveal that each unit increase in score of social support is associated with decrease in odds of IHD by a factor of 0.91 (95% CI 0.89 and 0.95). The study highlights that women aged 35 to 55 years are protected against the risk of IHD, and trait anger is the only risk factor of IHD. Furthermore trait anger is modifiable and can lay directions for designing preventive cardiac interventions.

Abstract P246: A Naturalistic Assessment of Lipid Treatment Strategies: Further LDL-C Reduction Versus Comprehensive Lipid Management

Objective: To compare cardiovascular (CV) outcomes between patients initiating adjunct therapy with either niacin extended-release (NER) for broader lipid panel management or ezetimibe (EZE) for continued LDL-C reduction. Methods: Statin-treated patients aged ≥30 augmenting with NER or EZE between 1/1/05-11/30/09 (Index Date) were identified. Patients with ≥12 months of health plan eligibility before the Index Date (baseline) were included, and patients with secondary risk and ≥1 full lipid panel were retained. A propensity score (PPS) model was developed controlling for the following baseline factors: age, gender, geographic region, type of health coverage, baseline lipids, mode of therapy augmentation, potency of adjunct statin therapy, baseline statin adherence, comorbidities, and alternative CV medications. NER and EZE patients were matched based on PPS. Clinical outcomes included incidence of a major adverse cardiovascular event (MACE). MACE was defined as a composite of acute ischemic heart (IHD), peripheral vascular (PVD), and cerebrovascular disease (CVD) events. The economic outcome was annual CV disease-related costs. These outcomes were compared using univariate Cox proportional hazards and generalized linear models respectively. Results: A total of 15,195 patients initiated adjunct therapy with NER (n=3,098) and EZE (n=12,097) meeting all study criteria. Post-PPS match, 2,261 patients were identified in each cohort with no statistically significant differences in baseline or concurrent treatment characteristics. Frequency of MACE was lower among NER patients (3.5%) vs. EZE (5.4%), with a hazard ratio (HR) of 0.89 (95% CI: 0.67-1.20). Specifically, NER patients demonstrated a lower risk of IHD (HR: 0.90; 95% CI: 0.65-1.25) and CVD (HR: 0.69; 95% CI: 0.34-1.41) events vs. EZE patients. These findings correspond to significantly lower adjusted annual cost among NER patients ($8,168; 95% CI: $7,720 - $8,641) vs. EZE ($9,030; 95% CI: $8,535 - $9,553) ( P= 0.0136). Conclusions: Positive clinical benefits observed in this broader naturalistic population are consistent with results from recent clinical trials and suggest that treating beyond LDL-C with statin + NER in secondary risk patients may reduce CV risk and associated costs.

Statistical Approach to Predict the Ischemic Heart Disease

Objectives: The objectives of this study were to see the degree of dependency of Ischemic Heart Disease (I.H.D) on different risk factors and to develop a model to predict the probabilities of I.H.D in various situations. Study Design: This was a retrospective study. Setting: The data was taken from the Department of Cardiology Mayo Hospital Lahore. Total Number of Patients: The record of 364 patients was taken who presented first time for coronary angiography at the Department of Cardiology Mayo Hospital Lahore. Methods: Data was analyzed using SPSS 16. The age of patient’s was presented in form of Mean ± S.E. Binary Logistic Regression Model was used to estimate the probabilities of Ischemic Heart Disease (I.H.D). Odds Ratio was used to see the role of risk factors. Results: Among 60.7% male and 39.3% female, the average age was 50.33± 0.61 years. In this study; Age, Gender, Body Mass Index, Smoking History, Diabetes Mellitus and Hypertension contributed to develop I.H.D. Conclusion: Our study has shown that the risk of IHD increases with advancing age and low socioeconomic status significantly. The other factors like (smoking, Obesity, diabetes and hypertension) enhance the disease but are not significant.

Cholesterol profile in people with newly diagnosed coeliac disease: a comparison with the general population and changes following treatment

Recent studies have suggested that untreated coeliac disease is associated with lower total cholesterol than in the general population while the effect of treatment with a gluten-free diet on the cholesterol profile of clinically apparent coeliac disease is not known. We measured the cholesterol profile at diagnosis, and compared this with Health Survey for England figures, and again following 12 months treatment with a gluten-free diet in 100 consecutive adults with coeliac disease attending the Royal Hallamshire Hospital, Sheffield, UK. The mean total cholesterol was 4.84 (SD 1.2) mmol/l in adults (mean age 51 (SD 16) years) newly diagnosed with coeliac disease. At diagnosis of coeliac disease, men had 21% lower and women had 9% lower mean total cholesterol in comparison to the general population (difference in age-adjusted mean total cholesterol -1.09 mmol/l (95% CI -0.97, - 1.21); -0.46 mmol/l (95% CI -0.24, -0.68), respectively). There was no change in mean total cholesterol following treatment. However, there was a small but statistically significant increase of 0.12 mmol/l (95% CI 0.05, 0.18) in the mean HDL-cholesterol. Total cholesterol was lower at diagnosis in coeliac patients than in the general population and did not increase with 1 year of a gluten-free diet while HDL-cholesterol increased following treatment. Any increase in risk of IHD or stroke in people with coeliac disease is unlikely due to an adverse cholesterol profile either before diagnosis or after treatment with a gluten-free diet.

Is serum ferritin within the reference range a risk predictor of cardiovascular disease? A population-based, long-term study comprising 2874 subjects

The 'iron hypothesis' claims that Fe depletion protects against IHD. The objective of the present study was to investigate the associations between serum ferritin levels and the risk of CVD and IHD in a population-based sample. A total of 2874 subjects with serum ferritin levels between 15 and 300 microg/l from the Danish part of the 'Monitoring of Trends and Determinants in Cardiovascular Disease' (DAN-MONICA) I study and the 1914 Cohort survey were followed for 10 years. Information on behavioural and socio-demographic characteristics were collected and serum ferritin levels measured. Non-fatal and fatal CVD and IHD were identified by the International Classification of Diseases diagnoses numbers. Multivariable Cox proportional hazard regression models with restricted cubic splines were performed. During the follow-up period, 310 subjects (201 men; 109 women) and 161 subjects (117 men; forty-four women) experienced CVD and IHD, respectively. Our analyses revealed no statistically significant associations between serum ferritin levels and the risk of CVD or IHD in both sexes. However, in women, the results argue for a U-shaped relationship between serum ferritin levels and CVD as well as IHD. In concordance with former prospective studies, the present results do not support the hypothesis that normal body Fe stores should play a significant role in the development of CVD.

The -675 4G/5G polymorphism at the Plasminogen Activator Inhibitor 1 (PAI-1) gene modulates plasma Plasminogen Activator Inhibitor 1 concentrations in response to dietary fat consumption

The objective of the study was to determine whether Plasminogen Activator Inhibitor Type 1 (PAI-1) -675 4G/5G polymorphism is associated with the response of functional plasma PAI-1 concentrations to changes in the amount and quality of dietary fat in healthy subjects. PAI-1 is the major inhibitor of fibrinolysis, and a lower level of fibrinolytic activity could be implicated in an increased risk of IHD. Fifty-nine healthy Spanish volunteers (ten 4G/4G homozygotes, twenty-eight heterozygotes 4G/5G and twenty-one 5G/5G homozygotes) consumed three diets for periods of 4 weeks each: a SFA-rich diet (38 % fat, 20 % SFA), followed by a carbohydrate-rich diet (30 % fat, 55 % carbohydrate) and a MUFA-rich diet (38 % fat, 22 % MUFA) according to a randomized crossover design. At the end of each dietary period plasma lipid and functional plasma PAI-1 concentrations were determined. Subjects carrying the 4G allele (4G/4G and 4G/5G) showed a significant decrease in PAI-1 concentrations after the MUFA diet, compared with the SFA-rich and carbohydrate-rich diets (genotype x diet interaction: P = 0.028). 5G/5G homozygotes had the lowest plasma PAI-1 concentrations compared with 4G/4G and 4G/5G subjects (genotype: P = 0.002), without any changes as a result of the amount and the quality of the dietary fat. In summary, no differences in plasma PAI-1 concentration response were found after changes in dietary fat intake in 5G/5G homozygotes, although these subjects displayed the lowest concentrations of PAI-1. On the other hand, carriers of the 4G allele are more likely to hyper-respond to the presence of MUFA in the diet because of a greater decrease in PAI-1 concentrations.

Early lens aging is accelerated in subjects with a high risk of ischemic heart disease: an epidemiologic study.

BackgroundIschemic heart disease (IHD) is one of the most important causes of mortality and morbidity in the Western world. There is a relationship between aging of the lens of the human eye and cardiovascular disease. The present study was conducted to examine if the risk of ischemic heart disease could be estimated by fluorophotometric assessment of lens aging.MethodsA total of 421 subjects were included. Risk of IHD was estimated from non-ocular data using the Precard ® software. Lens aging was quantified by lens fluorometry.ResultsThe risk of IHD was strongly related to lens fluorophore accumulation (p = 0.001). The relationship between IHD and lens aging was attributable to tobacco smoking and dysglycemia.ConclusionThe risk of ischemic heart disease related to smoking and diabetes mellitus can be estimated using the aging of the lens of the eye as a biomarker for generalized tissue-damage.

Dosulepin associated with increased risk of IHD

Dosulepin associated with increased risk of IHD

Dosulepin associated with increased risk of IHD

Dosulepin associated with increased risk of IHD

Birthweights, maternal cardiovascular events, and Barker hypothesis

It is well established that the intrauterine environment has an important impact on the subsequent health of various animals. 1 Langley SC Jackson AA Increased systolic blood pressure in adult rats induced by fetal exposure to maternal low protein diets. Clin Sci (Colch). 1994; 86: 217-222 Google Scholar However, whether intrauterine programming determines certain aspects of adult health in human beings remains controversial. 2 Paneth N Susser M Early origin of coronary heart disease (the “Barker hypothesis”). BMJ. 1995; 310: 411-412 Crossref PubMed Scopus (250) Google Scholar , 3 Susser M Levin B Ordeals for the fetal programming hypothesis. BMJ. 1999; 318: 885-886 Crossref PubMed Scopus (41) Google Scholar Several anthropometric variables present at birth or in early infancy have been associated with the development in adulthood of risk factors for cardiovascular disease—ie, hypertension or diabetes—or of coronary heart disease itself. 4 Barker DJP Mothers, babies and disease in later life. BMJ Publishing, London1994 Google Scholar The many reports on this topic have polarised clinicians and scientists into camps of believers and non-believers. This segregation has even extended into the publication of the reports in The Lancet or the BMJ. 5 Ben-Schlomo Y Davey Smith G “Place of publication” bias?. BMJ. 1994; 309: 274 Crossref PubMed Scopus (8) Google Scholar Birthweight, early environment, and genetics: a study of twins discordant for acute myocardial infarctionThe lack of an association between birth characteristics and AMI within twin pairs suggests that previously reported associations may be influenced by genetic and early environmental factors, or possibly, by unmeasured maternal factors that operate independently of birthweight. Full-Text PDF Pregnancy complications and maternal risk of ischaemic heart disease: a retrospective cohort study of 129 290 birthsComplications of pregnancy linked to low birthweight are associated with an increased risk of subsequent IHD in the mother. Common genetic risk factors might explain the link between birthweight and risk of IHD in both the individual and the mother. Full-Text PDF