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https://www.readbyqxmd.com/read/28806190/the-challenges-of-proprotein-convertase-subtilisin-kexin-9-inhibitors-for-lipid-guidelines-and-models-of-care
#1
Anthony S Wierzbicki
PURPOSE OF REVIEW: The article reviews the challenges facing cardiovascular disease (CVD) guidelines committees. RECENT FINDINGS: Clinical trials in high-risk populations have shown additional CVD event reduction with ezetimibe and proprotein convertase subtilisin-kexin-9 inhibitors. These trials recruit middle-aged secondary prevention populations, whereas increasingly the population at risk of CVD comprises the elderly in primary prevention. Some major guidelines have moved from a lipid-target to a risk-based approach...
August 12, 2017: Current Opinion in Lipidology
https://www.readbyqxmd.com/read/28801393/protocol-for-the-mwellcare-trial-a-multicentre-cluster-randomised-12-month-controlled-trial-to-compare-the-effectiveness-of-mwellcare-an-mhealth-system-for-an-integrated-management-of-patients-with-hypertension-and-diabetes-versus-enhanced-usual-care-in-india
#2
Dilip Jha, Priti Gupta, Vamadevan S Ajay, Devraj Jindal, Pablo Perel, David Prieto-Merino, Pramod Jacob, Jonathan Nyong, Vidya Venugopal, Kavita Singh, Shifalika Goenka, Ambuj Roy, Nikhil Tandon, Vikram Patel, Dorairaj Prabhakaran
INTRODUCTION: Rising burden of cardiovascular disease (CVD) and diabetes is a major challenge to the health system in India. Innovative approaches such as mobile phone technology (mHealth) for electronic decision support in delivering evidence-based and integrated care for hypertension, diabetes and comorbid depression have potential to transform the primary healthcare system. METHODS AND ANALYSIS: mWellcare trial is a multicentre, cluster randomised controlled trial evaluating the clinical and cost-effectiveness of a mHealth system and nurse managed care for people with hypertension and diabetes in rural India...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801210/the-longitudinal-relationship-between-hand-hip-and-knee-osteoarthritis-and-cardiovascular-events-a-population-based-cohort-study
#3
Tetyana Kendzerska, Peter Jüni, Lauren K King, Ruth Croxford, Ian Stanaitis, Gillian A Hawker
OBJECTIVE: In this population-based cohort study, we examined the association between the presence of symptomatic osteoarthritis (OA) and risk for cardiovascular (CV) events. METHOD: A cohort aged ≥55 years recruited from 1996-98 was followed through provincial health administrative data to 2014. Demographics, joint complaints and functional limitations were collected. Hip, knee and hand OA were defined using a validated definition. Using Cox-regressions, the relationship between OA and a composite CV outcome (myocardial infarction, stroke, angina, heart failure, revascularization) was assessed controlling for age, BMI, sex, pre-existing metabolic factors, comorbidities, income status, primary care exposure and functional limitations...
August 8, 2017: Osteoarthritis and Cartilage
https://www.readbyqxmd.com/read/28799164/preconception-care-for-diabetic-women-for-improving-maternal-and-infant-health
#4
REVIEW
Joanna Tieu, Philippa Middleton, Caroline A Crowther, Emily Shepherd
BACKGROUND: Infants born to mothers with pre-existing type 1 or type 2 diabetes mellitus are at greater risk of congenital anomalies, perinatal mortality and significant morbidity in the short and long term. Pregnant women with pre-existing diabetes are at greater risk of perinatal morbidity and diabetic complications. The relationship between glycaemic control and health outcomes for both mothers and infants indicates the potential for preconception care for these women to be of benefit...
August 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28796275/immature-platelets-as-a-novel-biomarker-for-adverse-cardiovascular-events-in-patients-after-non-cardiac-surgery
#5
Aida Anetsberger, Manfred Blobner, Bernhard Haller, Sebastian Schmid, Katrin Umgelter, Theresa Hager, Clemens Langgartner, Eberhard F Kochs, Karl-Ludwig Laugwitz, Bettina Jungwirth, Isabell Bernlochner
This study evaluates whether immature platelets (IPF) determined in the post anesthesia care unit (PACU) can predict major adverse cardiovascular events (MACE) or other thromboembolic events after intermediate and high-risk surgery. IPF are increased in patients with acute coronary syndrome and recently gained interest as novel biomarker for risk stratification. In this prospective observational trial 732 patients undergoing intermediate or high-risk non-cardiac surgery were enrolled (NCT02097602). IPF was measured preoperatively and postoperatively in the PACU...
August 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28794121/changes-in-primary-noncardiac-diagnoses-over-time-among-elderly-cardiac-intensive-care-unit-patients-in-the-united-states
#6
Shashank S Sinha, Michael W Sjoding, Devraj Sukul, Hallie C Prescott, Theodore J Iwashyna, Hitinder S Gurm, Colin R Cooke, Brahmajee K Nallamothu
BACKGROUND: Early reports suggest the number of cardiac intensive care unit (CICU) patients with primary noncardiac diagnoses is rising in the United States, but no national data currently exist. We examined changes in primary noncardiac diagnoses among elderly patients admitted to a CICU during the past decade. METHODS AND RESULTS: Using 2003 to 2013 Medicare data, we grouped elderly patients admitted to CICUs into 2 categories based on principal diagnosis at discharge: (1) primary noncardiac diagnoses and (2) primary cardiac diagnoses...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28783810/adaptation-and-validation-of-a-pediatric-sequential-organ-failure-assessment-score-and-evaluation-of-the-sepsis-3-definitions-in-critically-ill-children
#7
Travis J Matics, L Nelson Sanchez-Pinto
Importance: The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) uses the Sequential Organ Failure Assessment (SOFA) score to grade organ dysfunction in adult patients with suspected infection. However, the SOFA score is not adjusted for age and therefore not suitable for children. Objectives: To adapt and validate a pediatric version of the SOFA score (pSOFA) in critically ill children and to evaluate the Sepsis-3 definitions in patients with confirmed or suspected infection...
August 7, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28783533/predictive-factors-of-developing-type-2-diabetes-mellitus-acute-myocardial-infarction-and-stroke-in-a-cohort-with-impaired-fasting-glucose-in-singapore
#8
Dennis Bingzhu Chia, Lai Yin Wong, Daveon Yu Kai Liu, Matthias Paul Han Sim Toh
AIMS: This study describes the incidence and predictive factors for development of Type II Diabetes Mellitus (T2DM), Acute Myocardial Infarction (AMI) and stroke, among subjects with IFG over a five-year period. METHODS: This is a retrospective cohort study of subjects with newly diagnosed IFG from the Singapore National Healthcare Group hospitals and primary care clinics from 1 January 2008 to 31 December 2010. Clinical data were collected over a five-year period from the date of diagnosis...
July 20, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28780542/improving-risk-factor-management-for-patients-with-poorly-controlled-type-2-diabetes-a-systematic-review-of-healthcare-interventions-in-primary-care-and-community-settings
#9
Mark E Murphy, Molly Byrne, Rose Galvin, Fiona Boland, Tom Fahey, Susan M Smith
OBJECTIVES: Poorly controlled type 2 diabetes mellitus (T2DM) is a major international health problem. Our aim was to assess the effectiveness of healthcare interventions, specifically targeting patients with poorly controlled T2DM, which seek to improve glycaemic control and cardiovascular risk in primary care settings. DESIGN: Systematic review. SETTING: Primary care and community settings. INCLUDED STUDIES: Randomised controlled trials (RCTs) targeting patients with poor glycaemic control were identified from Pubmed, Embase, Web of Science, Cochrane Library and SCOPUS...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28774317/measuring-the-effect-of-nurse-practitioner-np-led-care-on-health-related-quality-of-life-in-adult-patients-with-atrial-fibrillation-study-protocol-for-a-randomized-controlled-trial
#10
Marcie J Smigorowsky, Colleen M Norris, Micheal Sean McMurtry, Ross T Tsuyuki
BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia associated with significant morbidity, mortality, and healthcare resource use. The prevalence of AF is increasing with a growing and aging population, and timely access to care for these patients is a concern. Nontraditional models of care delivery, such as nurse practitioner (NP)-led clinics, may improve access to care and quality of care, but they require formal assessment. The objective of this study is to assess the effect of NP-led care on the health-related quality of life (HRQoL) of adult patients with AF...
August 3, 2017: Trials
https://www.readbyqxmd.com/read/28772017/an-initiative-to-improve-primary-prevention-of-cardiovascular-disease-in-adults-with-type-ii-diabetes-based-on-the-acc-aha-2013-and-ada-2016-guidelines
#11
Litzie Garza, Jean Dols, Maria Gillespie
PURPOSE: This project was designed to increase family practice clinicians' adherence to the American College of Cardiology/American Heart Association (2013) and American Diabetes Association (ADA, 2016) clinical practice guidelines for the prevention of cardiovascular disease (CVD) in 40- to 75-year-old adults with type II diabetes (DMII) through interactive education, an electronic alert, and quality improvement sessions on the treatment and management of cholesterol in a family practice primary care setting...
August 3, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28771089/cardiovascular-risk-screening-for-individuals-with-serious-mental-illness
#12
Denise R Black, Mary L Held
Cardiovascular disease (CVD) is a significant health risk for individuals with serious mental illness (SMI). Screening for CVD risk factors is a key strategy to reduce this health disparity. This study examined medical, lifestyle, and access predictors for comprehensive screening. Data on 1036 adults were analyzed from the 2015 National Health Interview Survey. Multivariate multinomial logistic regression was used to examine factors associated with individuals with SMI receiving CVD risk screening in the past 12 months...
August 3, 2017: Social Work in Health Care
https://www.readbyqxmd.com/read/28765760/study-design-of-general-general-practitioners-and-embolism-prevention-in-nvaf-patients-treated-with-rivaroxaban-real-life-evidence-a-multicenter-prospective-cohort-study-in-primary-care-physicians-to-investigate-the-effectiveness-and-safety-of-rivaroxaban-in
#13
Kengo Kusano, Masaharu Akao, Hikari Tsuji, Kunihiko Matsui, Shinya Hiramitsu, Yutaka Hatori, Hironori Odakura
BACKGROUND: Rivaroxaban, a direct oral anticoagulant (DOAC), has become available for stroke prevention in patients with non-valular atrial fibrillation (NVAF). However, little is known about its effectiveness and safety when prescribed by general practitioners in real-life settings. METHODS: GENERAL is a multicenter, prospective, non-interventional observational study of patients receiving rivaroxaban for NVAF in daily clinical practice prescribed specifically by general practitioners...
August 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28765261/burden-of-child-and-adolescent-obesity-on-health-services-in-england
#14
Russell M Viner, Sanjay Kinra, Dasha Nicholls, Tim Cole, Anthony Kessel, Deborah Christie, Billy White, Helen Croker, Ian C K Wong, Sonia Saxena
OBJECTIVE: To assess the numbers of obese children and young people (CYP) eligible for assessment and management at each stage of the childhood obesity pathway in England. DESIGN: Pathway modelling study, operationalising the UK National Institute for Health and Care Excellence guidance on childhood obesity management against national survey data. SETTING: Data on CYP aged 2-18 years from the Health Survey for England 2006 to 2013. MAIN OUTCOME MEASURES: Clinical obesity (body mass index (BMI) >98th centile), extreme obesity (BMI ≥99...
August 1, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28765036/world-heart-federation-cholesterol-roadmap
#15
Adrianna Murphy, Jose R Faria-Neto, Khalid Al-Rasadi, Dirk Blom, Alberico Catapano, Ada Cuevas, Francisco Lopez-Jimenez, Pablo Perel, Raul Santos, Allan Sniderman, Rody Sy, Gerald F Watts, Dong Zhao, Salim Yusuf, David Wood
BACKGROUND: The World Heart Federation has undertaken an initiative to develop a series of Roadmaps. OBJECTIVES: The aim of these is to promote development of national policies and health systems approaches and identify potential roadblocks on the road to effective prevention, detection and management of cardiovascular disease (CVD) in low-and middle-income countries (LMIC), and strategies for overcoming these. This Roadmap focuses on elevated blood cholesterol, a leading risk factor for myocardial infarction, stroke, and peripheral arterial disease...
July 29, 2017: Global Heart
https://www.readbyqxmd.com/read/28764273/prevalence-of-metabolic-syndrome-among-psychiatric-inpatients-a-hospital-based-study-from-kashmir
#16
Tajamul Hussain, Mushtaq Ahmad Margoob, Sheikh Shoib, Mahak Shafat, Rajesh Kumar Chandel
INTRODUCTION: Over the last fifty years there has been dramatic change in the human environment, behaviours and way-of-life. These changes have resulted in escalating rates of metabolic syndrome not only in general population but also among people with mental illness. Various factors, like the lack of exercise, use of psychotropic medications and inadequate medical care leads to the increased risk of metabolic changes among people with mental illness. Hence, there is a greater need to evaluate metabolic syndrome in this population...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28761650/pioglitazone-and-risk-of-mortality-in-patients-with-type-2-diabetes-results-from-a-european-multidatabase-cohort-study
#17
Helen Strongman, Pasi Korhonen, Rachael Williams, Shahram Bahmanyar, Fabian Hoti, Solomon Christopher, Maila Majak, Leanne Kool-Houweling, Marie Linder, Paul Dolin, Edith M Heintjes
OBJECTIVES: Estimate and compare the risk of mortality in patients whose antidiabetic therapy is modified to include pioglitazone compared with an alternative antidiabetic medication at the same stage of disease progression. DESIGN: Retrospective cohort study. SETTING: Pooled analysis of clinical data collected from primary and/or secondary care settings in four European countries: Finland, The Netherlands, Sweden and the UK . PARTICIPANTS: 56 337 patients with type 2 diabetes mellitus first prescribed pioglitazone between 2000 and 2011, and 56 337 patients never prescribed pioglitazone matched by treatment stage, history of diabetes, diabetes complications and cardiovascular disease, and year of cohort entry using exact and propensity score matching...
2017: BMJ Open Diabetes Research & Care
https://www.readbyqxmd.com/read/28760800/protocol-for-a-prospective-longitudinal-study-of-risk-factors-for-hypertension-incidence-in-a-mexico-city-population-the-tlalpan-2020-cohort
#18
Eloisa Colín-Ramírez, Susana Rivera-Mancía, Oscar Infante-Vázquez, Raúl Cartas-Rosado, Jesús Vargas-Barrón, Magdalena Madero, Maite Vallejo
INTRODUCTION: Systemic hypertension (HTN) is a common risk factor for cardiovascular disease. In Mexico, HTN prevalence has increased over time and is currently 31%. Nonetheless, information about the country's HTN incidence and its associated risk factors is scarce. Understanding this condition is a priority for identifying the scope of primary prevention. The main objective of this study is to evaluate the effect of traditional and non-traditional risk factors on the incidence of HTN in a cohort of healthy Mexico City residents under biannual follow-up for 10 years...
July 31, 2017: BMJ Open
https://www.readbyqxmd.com/read/28760741/application-of-the-2014-nice-cholesterol-guidelines-in-the-english-population-a-cross-sectional-analysis
#19
Peter Ueda, Thomas Wai-Chun Lung, Philip Clarke, Goodarz Danaei
BACKGROUND: The 2014 guidelines on cardiovascular risk assessment and lipid modification from the National Institute for Health and Care Excellence (NICE) recommend statin therapy for adults with prevalent cardiovascular disease (CVD), and for adults with a 10-year CVD risk of ≥10%, estimated using the QRISK2 algorithm. AIM: To determine risk factor levels required to exceed the risk threshold for statin therapy, and to estimate the number of adults in England who would require statin therapy under the guidelines...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760215/interventions-supporting-long-term-adherence-and-decreasing-cardiovascular-events-island-pragmatic-randomized-trial-protocol
#20
Noah Ivers, J-D Schwalm, Holly O Witteman, Justin Presseau, Monica Taljaard, Tara McCready, Beth Bosiak, Jennifer Cunningham, Shelley Smarz, Laura Desveaux, Jack V Tu, Clare Atzema, Garth Oakes, Wanrudee Isaranuwatchai, Sherry L Grace, R Sacha Bhatia, Madhu Natarajan, Jeremy M Grimshaw
BACKGROUND: Guidelines recommend cardiac rehabilitation and long-term use of cardiac medications for most patients who have had a myocardial infarction (MI), but adherence to these secondary prevention treatments is suboptimal. METHODS: This is a multicenter, pragmatic, 3-arm randomized trial. Eligible patients (n = 2,742) with obstructive coronary artery disease are randomized post-MI to usual care or 1 of 2 intervention arms. Patients in the first intervention arm receive mail-outs sent on behalf of their cardiologist at 4, 8, 20, 32, and 44 weeks post-MI; content is designed to address determinants of adherence and facilitate discussion between the patient and their health care team...
August 2017: American Heart Journal
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