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Primary Prevention CAD

Tatsiana Suvorava, Miriam M Cortese-Krott
Moderate exercise training is a key aspect of primary and secondary prevention strategies. Shear-induced upregulation of eNOS activity and function in the vascular endothelium is considered as one of the main molecular mechanisms of exercise-induced protection against myocardial ischemia/reperfusion (I/R) injury. It has been reported that levels of plasma nitrite, which are largely dependent on eNOS activity, were increased in healthy subjects after acute exercise, while this increase was abolished in coronary artery disease (CAD) patients...
March 6, 2018: Current Medicinal Chemistry
V A Levin, X Jiang, R Kagan
Menopause predisposes women to osteoporosis due to declining estrogen levels. This results in a decrease in bone mineral density (BMD) and an increase in fractures. Osteoporotic fractures lead to substantial morbidity and mortality, and are considered one of the largest public health priorities by the World Health Organization (WHO). It is therefore essential for menopausal women to receive appropriate guidance for the prevention and management of osteoporosis. The Women's Health Initiative (WHI) randomized controlled trial first proved hormonal therapy (HT) reduces the incidence of all osteoporosis-related fractures in postmenopausal women...
March 8, 2018: Osteoporosis International
Katsumi Miyauchi, Takeshi Kimura, Hiroaki Shimokawa, Hiroyuki Daida, Satoshi Iimuro, Hiroshi Iwata, Yukio Ozaki, Ichiro Sakuma, Yoshihisa Nakagawa, Kiyoshi Hibi, Takafumi Hiro, Yoshihiro Fukumoto, Seiji Hokimoto, Yasuo Ohashi, Hiroshi Ohtsu, Yasushi Saito, Masunori Matsuzaki, Ryozo Nagai
Large-scale clinical trials in patients in Western countries with coronary artery disease (CAD) have found that aggressive lipid-lowering therapy using high-dose statins reduces cardiovascular (CV) events further than low-dose statins. However, such evidence has not yet been fully established in Asian populations, including in Japan. The Randomized Evaluation of Aggressive or Moderate Lipid-Lowering Therapy with Pitavastatin in Coronary Artery Disease (REAL-CAD) study addresses whether intensification of statin therapy improves clinical outcomes in Japanese patients with CAD...
March 5, 2018: International Heart Journal
Nitika Setia, Renu Saxena, J P S Sawhney, Ishwar C Verma
OBJECTIVE: Familial Hypercholesterolemia (FH) is an inherited disorder of lipid metabolism characterized by very high low density lipoprotein (LDL) cholesterol since birth, resulting in premature atherosclerosis and coronary artery disease (CAD). Cascade screening of children and family members of proven FH individuals can identify more subjects who have high LDL cholesterol or the family mutation and appropriate intervention can reduce their risk of atherosclerosis and prevent its complications...
February 15, 2018: Indian Journal of Pediatrics
Udit Bhaskar Bhatnagar, Josh Rezkalla, Tomasz Stys, Adam Stys
Drug eluting stents (DES) have been increasingly being used for treatment of coronary artery disease (CAD) and have been shown to be very effective in prevention of primary in-stent restenosis (ISR). However DES have been increasingly associated with acute to subacute risk of stent fractures (SF). There is also a paucity of data about different management strategies for SF, especially in the long term. We present a case of recurrent ISR in an area of previous acute SF at the touchdown of saphenous venous graft (SVG) to first diagonal artery (D1)...
January 2018: South Dakota Medicine: the Journal of the South Dakota State Medical Association
Simukayi Mutasa, Peter D Chang, Carrie Ruzal-Shapiro, Rama Ayyala
Bone age assessment (BAA) is a commonly performed diagnostic study in pediatric radiology to assess skeletal maturity. The most commonly utilized method for assessment of BAA is the Greulich and Pyle method (Pediatr Radiol 46.9:1269-1274, 2016; Arch Dis Child 81.2:172-173, 1999) atlas. The evaluation of BAA can be a tedious and time-consuming process for the radiologist. As such, several computer-assisted detection/diagnosis (CAD) methods have been proposed for automation of BAA. Classical CAD tools have traditionally relied on hard-coded algorithmic features for BAA which suffer from a variety of drawbacks...
February 5, 2018: Journal of Digital Imaging: the Official Journal of the Society for Computer Applications in Radiology
Hélder Dores, Pedro de Araújo Gonçalves, Nuno Cardim, Nuno Neuparth
Regular physical exercise is responsible for various health benefits, and is recommended for primary and secondary cardiovascular (CV) prevention. Despite these recognized benefits, various clinical events can occur in athletes, including acute myocardial infarction and sudden cardiac death (SCD); the main cause of SCD in veteran athletes is coronary artery disease (CAD). The relationship between intense exercise training and CAD is controversial, and a U-shaped association has been hypothesized. If this is the case, screening for subclinical CAD in older athletes may be justified, and various different methodologies have been proposed...
January 8, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Zhu Zhu, Yuyuan Xu, Yilong Wang, Zhenhua Zhou, Xiang Han, Aihua Liu, Jing Peng, Yi Xu, Luyao Wang
BACKGROUND: Cervicocephalic artery dissection (CAD) is an important etiology of stroke in the youth. Findings from recent studies suggest it a "group of disease entities" with different underlying etiologies, presentations and prognosis, necessitating an integral study including various types of CAD to get a better understanding of this disease. In addition, Chinese patients with CAD are likely to carry different features from their western counterparts, which remains uncertain yet. Chinese Cervicocephalic Artery Dissection Study (CCADS) therefore aims at exploring the epidemiology, risk factors, clinical/radiological features, diagnosis and prognosis of CAD in Chinese patients...
January 11, 2018: BMC Neurology
Robert Roberts
PURPOSE OF REVIEW: The current review is to describe the genetic risk variants that have been discovered predisposing to coronary artery disease (CAD) and how they are utilized to stratify for risk of CAD. RECENT FINDINGS: Over 90 genetic risk variants have been discovered that predispose to risk for CAD. SUMMARY: The total genetic risk burden for CAD is proportional to the number of risk variants inherited and can be combined into a single number referred to as the genetic risk score (GRS)...
January 9, 2018: Current Opinion in Cardiology
Samir Kapadia
Outcomes for patients with coronary artery disease (CAD) have improved in the past 20 years likely due to advances in clinical care such as angiotensin-converting enzyme inhibitors, antiplatelet agents, and reduced time to cardiac cauterization procedures. But how have the risk factors for CAD changed in the past 2 decades? Analysis of nearly 4,000 patients with ST-elevation myocardial infarction (STEMI) at a tertiary care center found that patients presenting with acute STEMI are younger and more obese than in the past...
December 2017: Cleveland Clinic Journal of Medicine
William Koon, Ali Rowhani-Rahbar, Linda Quan
Drowning is a global health problem that can be addressed with multiple strategies including utilisation of lifeguards in recreational swim areas. However, few studies have described lifeguard prevention activities. We conducted a retrospective analysis using lifeguard activity data collected in real time with a Computer-Aided-Dispatch (CAD) system to characterise the nature of lifeguard primary and secondary drowning prevention at a popular ocean beach in California. Preventative actions constituted the majority (232 065/423 071; 54...
October 10, 2017: Injury Prevention: Journal of the International Society for Child and Adolescent Injury Prevention
Marija Polovina, Dijana Đikić, Ana Vlajković, Matej Vilotijević, Ivan Milinković, Milika Ašanin, Miodrag Ostojić, Andrew J S Coats, Petar M Seferović
BACKGROUND: In addition to thromboembolism, atrial fibrillation (AF) may also predispose to major adverse cardiovascular events (MACE) attributable to coronary artery disease (CAD), including myocardial infarction (MI). The 2MACE score (2 points - Metabolic syndrome and Age≥75years, 1 point - MI/revascularization, Congestive heart failure/ejection-fraction <40%, and thrombo-Embolism) was recently proposed to help identify AF patients at risk of MACE. We assessed the predictive validity of the 2MACE score for MACE occurrence in AF patients free of CAD at baseline...
December 15, 2017: International Journal of Cardiology
Amanda Rosewell Shaw, Caroline E Porter, Norihiro Watanabe, Kiyonori Tanoue, Andrew Sikora, Stephen Gottschalk, Malcolm K Brenner, Masataka Suzuki
In solid tumors, chimeric antigen receptor (CAR)-modified T cells must overcome the challenges of the immunosuppressive tumor microenvironment. We hypothesized that pre-treating tumors with our binary oncolytic adenovirus (CAd), which produces local oncolysis and expresses immunostimulatory molecules, would enhance the antitumor activity of HER2-specific CAR T cells, which alone are insufficient to cure solid tumors. We tested multiple cytokines in conjunction with PD-L1-blocking antibody and found that Ad-derived IL-12p70 prevents the loss of HER2...
November 1, 2017: Molecular Therapy: the Journal of the American Society of Gene Therapy
Joseph A Ladapo, Adrian Coles, Rowena J Dolor, Daniel B Mark, Lawton Cooper, Kerry L Lee, Jonathan Goldberg, Michael D Shapiro, Udo Hoffmann, Pamela S Douglas
OBJECTIVES: To evaluate potential gaps in preventive medical therapy and healthy lifestyle practices among symptomatic patients with suspected coronary artery disease (CAD) seeing primary care physicians and cardiologists and how gaps vary by sociodemographic characteristics and baseline cardiovascular risk. DESIGN: Cross-sectional study assessing potential preventive gaps. PARTICIPANTS: 10 003 symptomatic outpatients evaluated by primary care physicians, cardiologists or other specialists for suspected CAD...
September 29, 2017: BMJ Open
Irene M Lang, Roza Badr-Eslam, Nicola Greenlaw, Robin Young, Philippe Gabriel Steg
BACKGROUND: The population of patients with established coronary artery disease (CAD) is growing because of an improvement in outcomes and survival from acute disease episodes. Nevertheless, these patients remain at high risk of cardiovascular events. Thus, CAD management is important in prevention of disease progression. The objective of this analysis was to describe disease management and clinical outcome of Austrian outpatients with stable CAD over 5 years by using data from the international CLARIFY registry...
December 2017: Wiener Klinische Wochenschrift
Domenico Di Raimondo, Giuseppe Miceli, Gaia Musiari, Antonino Tuttolomondo, Antonio Pinto
Exercise training prevents the onset and the development of many chronic diseases, acting as an effective tool both for primary and for secondary prevention. Various mechanisms that may be the effectors of these beneficial effects have been proposed during the past decades: some of these are well recognized, others less. Muscular myokines, released during and after muscular contraction, have been proposed as key mediators of the systemic effects of the exercise. Nevertheless the availability of an impressive amount of evidence regarding the systemic effects of muscle-derived factors, few studies have examined key issues: (I) if skeletal muscle cells themselves are the main source of cytokine during exercise; (II) if the release of myokines into the systemic circulation reach an adequate concentration to provide significant effects in tissues far from skeletal muscle; (III) what may be the role carried out by muscular cytokine regarding the well-known benefits induced by regular exercise, first of all the anti-inflammatory effect of exercise...
August 2017: Annals of Translational Medicine
Fadia Mayyas, Wa'ed Bataineh, Anan Jarab
OBJECTIVE: The angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) are guideline-recommended agents to prevent development and progression of nephropathy and cardiovascular diseases in diabetes mellitus (DM). The aim of this study was to evaluate the prescription of ACEIs/ARBs in DM patients with guideline indications. METHODS: Electronic data files for diabetes patients were retrospectively reviewed at a primary care setting northern Jordan...
November 2017: Endocrine Practice
Yundai Chen, Dandan Li, Jing Jing, Hongbing Yan, Jinghua Liu, Zhujun Shen, Stefan James, Christoph Varenhorst
PURPOSE: Limited data exist on the use of statins in Chinese patients with coronary artery disease (CAD) treated with percutaneous coronary intervention (PCI). We therefore conducted this study to observe the usage trend and the effectiveness of statins on LDL-C goal attainment and other lipid parameters among PCI-treated patients. METHODS: This multicenter, retrospective, observational, longitudinal cohort study was conducted in PCI-treated patients with CAD between July 1, 2011, and February 28, 2015...
September 2017: Clinical Therapeutics
Madelon Minneboo, Sangeeta Lachman, Marjolein Snaterse, Harald T Jørstad, Gerben Ter Riet, S Matthijs Boekholdt, Wilma J M Scholte Op Reimer, Ron J G Peters
BACKGROUND: Among patients with coronary artery disease (CAD), improvement of lifestyle-related risk factors (LRFs) reduces cardiovascular morbidity and mortality. However, modification of LRFs is highly challenging. OBJECTIVES: This study sought to evaluate the impact of combining community-based lifestyle programs with regular hospital-based secondary prevention. METHODS: The authors performed a randomized controlled trial of nurse-coordinated referral of patients and their partners to 3 widely available community-based lifestyle programs, in 15 hospitals in the Netherlands...
July 18, 2017: Journal of the American College of Cardiology
Gilles Lemesle, Gregory Ducrocq, Yedid Elbez, Eric Van Belle, Shinya Goto, Christopher P Cannon, Christophe Bauters, Deepak L Bhatt, Philippe Gabriel Steg
BACKGROUND: It remains uncertain whether patients with atrial fibrillation (AF) requiring long-term oral anticoagulation (OAC) and with stable coronary artery disease (CAD) should receive antiplatelet therapy (APT) in addition to OAC. HYPOTHESIS: APT in addition to OAC would be more effective than OAC alone in preventing ischaemic events in such patients. METHODS: In the international REduction of Atherothrombosis for Continued Health (REACH) Registry including 68 236 outpatients with or at risk for atherothrombosis, we identified 2347 patients with stable CAD and AF receiving vitamin K antagonists (VKA)...
July 10, 2017: Clinical Cardiology
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