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Primary Prevention CAD

Joseph Brent Muhlestein, Fidela Ll Moreno
PURPOSE OF REVIEW: It is well known that there is a very high risk of cardiovascular complications among diabetic patients. In spite of all efforts at aggressive control of diabetes and its complications, the incidence of cardiovascular morbidity and mortality remains high, including in patients with no prior symptoms, underscoring a possible advantage for appropriate screening of asymptomatic patients for the presence of obstructive coronary artery disease (CAD). In this article, we sought primarily to review the results of studies designed to evaluate a possible role of coronary computed tomography angiography (CCTA) in the screening of asymptomatic diabetic patients for possible obstructive CAD...
November 2016: Current Atherosclerosis Reports
G B John Mancini, Michael E Farkouh, Maria M Brooks, Bernard R Chaitman, William E Boden, Helen Vlachos, Pamela M Hartigan, Flora S Siami, Mandeep S Sidhu, Vera Bittner, Robert Frye, Valentin Fuster
BACKGROUND: There are scant outcomes data in patients with type 2 diabetes and stable coronary artery disease (CAD) stratified by detailed angiographic burden of CAD or left ventricular ejection fraction (LVEF). OBJECTIVES: This study determined the effect of optimal medical therapy (OMT), with or without percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG), on long-term outcomes with respect to LVEF and number of diseased vessels, including proximal left anterior descending artery involvement...
September 6, 2016: Journal of the American College of Cardiology
Laura D Bilek, Nancy L Waltman, Joan M Lappe, Kevin A Kupzyk, Lynn R Mack, Diane M Cullen, Kris Berg, Meghan Langel, Melissa Meisinger, Ashlee Portelli-Trinidad, Molly Lang
BACKGROUND: In the United States, over 34 million American post-menopausal women have low bone mass (osteopenia) which increases their risk of osteoporosis and fractures. Calcium, vitamin D and exercise are recommended for prevention of osteoporosis, and bisphosphonates (BPs) are prescribed in women with osteoporosis. BPs may also be prescribed for women with low bone mass, but are more controversial due to the potential for adverse effects with long-term use. A bone loading exercise program (high-impact weight bearing and resistance training) promotes bone strength by preserving bone mineral density (BMD), improving bone structure, and by promoting bone formation at sites of mechanical stress...
2016: BMC Women's Health
Trevor J Orchard, Jye-Yu C Backlund, Tina Costacou, Patricia Cleary, Maria Lopes-Virella, Andrew P Levy, John M Lachin
AIMS/HYPOTHESIS: Haptoglobin(Hp) 2-2 genotype has been shown to increase coronary artery disease (CAD) risk in numerous type 2 diabetes studies but in only one type 1 diabetes cohort. We assessed the association of Hp2-2 with incident CAD over 26years of follow-up in 1303 Caucasian participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) study. METHODS: DCCT randomized volunteers with type 1 diabetes to intensive versus conventional therapy within two cohorts: 'primary prevention' with 1-5years diabetes duration and 'secondary intervention' with 1-15years diabetes duration and early retinopathy, with or without albuminuria, but no advanced complications...
November 2016: Journal of Diabetes and its Complications
Tetsuro Tsujimoto, Takehiro Sugiyama, Ritsuko Yamamoto-Honda, Miyako Kishimoto, Hiroshi Noto, Miyako Morooka, Kazuo Kubota, Munehiro Kamimura, Hisao Hara, Hiroshi Kajio, Masafumi Kakei, Mitsuhiko Noda
Glycemic control alone does not reduce cardiovascular events in patients with type 2 diabetes (T2D), and routine screening of all T2D patients for asymptomatic coronary artery disease (CAD) is not effective for preventing acute cardiac events. We examined the effectiveness of an aggressive screening protocol for asymptomatic CAD in T2D patients with advanced vascular complications.We designed a 3-year cohort study investigating the effectiveness of the aggressive coronary screening for T2D patients with advanced vascular complications and no known coronary events using propensity score adjusted analysis at a national center in Japan...
August 2016: Medicine (Baltimore)
Kishore Kumar Gundapaneni, Nivas Shyamala, Rajesh Kumar Galimudi, Sanjib Kumar Sahu, Surekha Rani Hanumanth
INTRODUCTION: Coronary Artery Disease (CAD) a multifactorial chronic heart disease and the most frequent cause of death and disabling symptoms worldwide, occurs due to the formation of atheromatous lipid rich plaques in the arteries. Statins, which inhibit cholesterol biosynthesis, have both pleiotropic and Low-Density Lipoprotein (LDL)-lowering properties. Atorvastatin is one of the choices for the primary and secondary prevention of cardiovascular disease and management of hypercholesterolaemia...
June 2016: Journal of Clinical and Diagnostic Research: JCDR
Na Zhao, Jin Xu, Balwinder Singh, Xuerong Yu, Taixiang Wu, Yuguang Huang
BACKGROUND: Cardiac complications are not uncommon in patients undergoing non-cardiac surgery, especially in patients with coronary artery disease (CAD) or at high risk of CAD. Perioperative cardiac complications can lead to mortality and morbidity, as well as higher costs for patient care. Nitrates, which are among the most commonly used cardiovascular drugs, perform the function of decreasing cardiac preload while improving cardiac blood perfusion. Sometimes, nitrates are administered to patients undergoing non-cardiac surgery to reduce the incidence of cardiac complications, especially for patients with CAD...
2016: Cochrane Database of Systematic Reviews
Nandhini Rangarajan, Shanthi Balasubramanian, Jing Pang, Gerald F Watts
INTRODUCTION: Familial Hypercholesterolaemia (FH) is the most common monogenic disorder causing premature Coronary Artery Disease (CAD). However, the majority of people with FH are undiagnosed and under treated. AIM: To determine awareness, knowledge and practices of registered medical practitioners regarding FH in India. MATERIALS AND METHODS: Physicians from a southern state of India (Tamil Nadu) who see the general cases were requested to complete a structured online survey questionnaire based on the outcomes on screening, diagnostic and service aspects of FH...
May 2016: Journal of Clinical and Diagnostic Research: JCDR
Syed M Atique, Bruce Shadbolt, Paul Marley, Ahmad Farshid
BACKGROUND: Obesity is increasingly recognized as an important risk factor for coronary artery disease (CAD). HYPOTHESIS: Patients with increased body mass index (BMI) present at a younger age with symptomatic CAD. METHODS: We analyzed data on 2137 consecutive patients admitted for treatment of CAD proven on angiography from 2010 to 2013, excluding those with prior coronary intervention or bypass surgery. RESULTS: Mean age was 64...
July 19, 2016: Clinical Cardiology
Pedro A Villablanca, David F Briceno, Daniele Massera, Ota Hlinomaz, Marissa Lombardo, Anna E Bortnick, Mark A Menegus, Robert T Pyo, Mario J Garcia, Farouk Mookadam, Harish Ramakrishna, Jose Wiley, Michela Faggioni, George D Dangas
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) in patients with concomitant multivessel (MV) coronary artery disease (CAD) is associated with poor outcomes. Percutaneous coronary intervention (PCI) of the culprit-lesion only (CLO) as compared with a MV PCI approach to revascularization remains uncertain. Our objective is to gain a better understanding of the efficacy and safety of CLO as compared with MV PCI in patients with STEMI by conducting an updated meta-analysis...
October 1, 2016: International Journal of Cardiology
Xiyan Zhang, Jun Zhang, Liling Chen, Luzhao Feng, Hongjie Yu, Genming Zhao, Tao Zhang
BACKGROUND: The disease burden of influenza among children in China has not been well described. OBJECTIVE: To estimate the influenza-associated excess hospitalization rate and compare the hospitalization length and costs between pneumonia and influenza (P&I) and other community-acquired diseases (CAD) in Suzhou, China. METHODS: We retrospectively collected hospital discharge data on pediatric patients' discharge diagnosis, hospital costs and length of hospital stay in Suzhou...
July 6, 2016: Influenza and Other Respiratory Viruses
Reema George, Harikrishnan Sivadasanpillai, Narayani Jayakumari, Anugya Bhatt, Jissa V Thulaseedharan, Jaganmohan A Tharakan
Thrombotic risk factors may contribute to premature coronary artery disease (CAD), in addition to the conventional risk factors. There is paucity of data on studies evaluating the role of thrombotic factors in premature CAD in Indian patients. Thus a case-control study was performed to evaluate the role of thrombotic and atherogenic factors in young patients with angiographically proven CAD who are on treatment with statins and anti-platelet drugs. 152 patients (≤55 years) with angiographically proven CAD and 102 asymptomatic controls were recruited...
July 2016: Indian Journal of Clinical Biochemistry: IJCB
Daniel P Rothschild, Eric Novak, Michael W Rich
OBJECTIVES: To examine the effect of statins on long-term mortality in older adults hospitalized with coronary artery disease (CAD). DESIGN: Retrospective analysis. SETTING: University teaching hospital. PARTICIPANTS: Individuals aged 80 and older (mean aged 85.2, 56% female) hospitalized from January 2006 to December 2010 with acute myocardial infarction (AMI), unstable angina pectoris, or chronic CAD and discharged alive (N = 1,262)...
July 2016: Journal of the American Geriatrics Society
Hervé Hubert, Joséphine Escutnaire, Pierre Michelet, Evgéniya Babykina, Carlos El Khoury, Karim Tazarourte, Christian Vilhelm, Lahcen El Hiki, Benjamin Guinhouya, Pierre-Yves Gueugniaud
RATIONALE, AIMS AND OBJECTIVES: The aim of this study was to describe the cohort of persons having experiences fatal and non-fatal drowning events, registered in the French cardiac arrest registry and to identify termination of resuscitation criteria. METHODS: We performed a prospective multicenter study based on data from French cardiac arrest registry database. All patients with cardiac arrest after drowning (CAD) recorded between July 2011 and November 2014 were included...
June 13, 2016: Journal of Evaluation in Clinical Practice
Daisy Bang, Jinfeng Xu, Robert Keenan, Virginia Pike, Robert Lehmann, Craig Tenner, Daria Crittenden, Michael Pillinger, Svetlana Krasnokutsky
OBJECTIVE: Osteoarthritis (OA) and gout have each been associated with increased cardiovascular disease (CVD), but their relative impact is unknown. We compared CVD rates among patients with gout versus patients with OA and no gout (OA-only). METHODS: We identified male patients at the VA New York Harbor Healthcare System with gout (with or without concur - rent OA) and with OA-only between August 2007 and August 2008. For each group, we collected baseline demographic data and CVD risk factors...
June 2016: Bulletin of the Hospital for Joint Diseases
Thomas Weber, Irene Lang, Robert Zweiker, Sabine Horn, Rene R Wenzel, Bruno Watschinger, Jörg Slany, Bernd Eber, Franz Xaver Roithinger, Bernhard Metzler
High blood pressure is a major modifiable risk factor for all clinical manifestations of coronary artery disease (CAD). In people without known cardiovascular disease, the lowest systolic (down to 90-114 mmHg) and the lowest diastolic (down to 60-74 mmHg) pressures are associated with the lowest risk for developing CAD. Although diastolic blood pressure is the strongest predictor of CAD in younger and middle-aged people, this relationship becomes inverted and pulse pressure shows the strongest direct relationship with CAD in people above 60 years of age...
July 2016: Wiener Klinische Wochenschrift
Tsuyoshi Nozue, Kazuki Fukui, Takeshi Takamura, Takashi Sozu, Kiyoshi Hibi, Satoru Kishi, Ichiro Michishita
BACKGROUND: Patients with type 2 diabetes are at high risk for developing coronary artery disease (CAD). Noninvasive anatomic assessment by coronary computed tomography angiography (CCTA) is being increasingly used for detecting or excluding CAD. Recently, fractional flow reserve (FFR) using routinely acquired CCTA datasets (FFRCT) has been developed. Although intensive glycemic control can reduce the risk of microvascular complications, intensive glucose control does not seem to be beneficial in preventing major cardiovascular events when compared with standard therapy...
May 25, 2016: Journal of Cardiology
L Di Lullo, R Rivera, V Barbera, A Bellasi, M Cozzolino, D Russo, A De Pascalis, D Banerjee, F Floccari, C Ronco
Chronic kidney disease (CKD) patients demonstrate higher rates of cardiovascular mortality and morbidity; and increased incidence of sudden cardiac death (SCD) with declining kidney failure. Coronary artery disease (CAD) associated risk factors are the major determinants of SCD in the general population. However, current evidence suggests that in CKD patients, traditional cardiovascular risk factors may play a lesser role. Complex relationships between CKD-specific risk factors, structural heart disease, and ventricular arrhythmias (VA) contribute to the high risk of SCD...
August 15, 2016: International Journal of Cardiology
Paolo Emilio Puddu, Michele Schiariti, Concetta Torromeo
BACKGROUND: There are no ready explanations for differences in ischemic heart disease incidence between women and men under an epidemiological perspective. However, when myocardial infarction occurs, there are more likely individuals who happen to die. METHODS: This review from a more recent literature was performed for a two-fold purpose, to describe gender wise: a) the role of classical and novel factors defined to evaluate coronary artery disease (CAD) risk and mortality, aimed at assessing applicability and relevance for primary and secondary prevention; b) the differences in northern versus southern European Countries in risk factors and CAD mortality...
2016: Current Pharmaceutical Design
Jacek Lelakowski, Joanna Pudło, Maria Lelakowska-Pieła, Anna Rydlewska, Justyna Piekarz, Donat Domaracki
UNLABELLED: Ambulatory follow-up of patients with implanted cardioverter-defibrillator (ICD) with/without resynchronisation therapy (CRTD) requires regular visits to assess arrhythmias, device interventions and mortality. AIM: The aim of the study was to examine arrhythmia prevalence, device interventions and mortality in patients with dilative cardiomyopathy with ICD/CRTD implanted in primary sudden cardiac death (SCD) prevention. MATERIALS AND METHODS: The study consisted of patients with ICD and/or CRTD implanted between 2010-2011...
April 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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