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cardiovascular risk assessment

Nghia H Nguyen, Lucila Ohno-Machado, William J Sandborn, Siddharth Singh
Background and Aims: Prevalence of inflammatory bowel diseases (IBD) in older patients is increasing. Risk-benefit trade-offs of therapy are poorly understood in older patients, who may be at higher risk of nonIBD and/or treatment-related complications, rather than disease-related complications. We conducted a nationally representative cohort study to estimate and compare annual burden, costs, and causes for hospitalization in older versus younger patients with IBD. Methods: Using the Nationwide Readmissions Database 2013, we created a cohort of 47,402 patients with IBD who had been hospitalized at least once between January-June 2013 and followed for rehospitalization until December 2013...
March 19, 2018: Inflammatory Bowel Diseases
Rupert W Major, Mark R I Cheng, Robert A Grant, Saran Shantikumar, Gang Xu, Issaam Oozeerally, Nigel J Brunskill, Laura J Gray
BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is a global health burden and is independently associated with increased cardiovascular disease risk. Assessment of cardiovascular risk in the general population using prognostic models based on routinely collected risk factors is embedded in clinical practice. In CKD, prognostic models may misrepresent risk due to the interplay of traditional atherosclerotic and non-traditional risk factors. This systematic review's aim was to identify routinely collected risk factors for inclusion in a CKD-specific cardiovascular prognostic model...
2018: PloS One
Peter Ueda, Thomas Wai-Chun Lung, Yuan Lu, Joshua A Salomon, Kazem Rahimi, Philip Clarke, Goodarz Danaei
BACKGROUND: The updated national guidelines for cardiovascular risk assessment and lipid modification in the UK and US expand the indications for statin therapy in primary prevention to adults with moderate risk of cardiovascular disease (CVD) but many adults at high CVD risk remain untreated in both countries. We set out to identify treatment gaps in English and American adults at moderate and high risk of cardiovascular disease (CVD), and to estimate the number of CVD events that would be prevented from expanding statin therapy to those who are currently untreated...
2018: PloS One
Anthony S Wierzbicki, Timothy M Reynolds, Adie Viljoen
PURPOSE OF REVIEW: A number of novel trials have assessed the efficacy of new lipid-lowering therapies in cardiovascular disease (CVD). RECENT FINDINGS: Proprotein convertase subtilisin kexin-9 inhibitors reduce low-density lipoprotein cholesterol (LDL-C) by 50-55%. A CVD outcome trial in patients with acute coronary syndromes with evolocumab achieved a LDL-C of 0.8 mmol/l (31 mg/dl) and a 20% relative risk reduction in CVD events in 2.2 years. Cholesterol ester transfer protein inhibitors raise high-density lipoprotein cholesterol and can lower LDL-C...
March 19, 2018: Current Opinion in Cardiology
Panagiota Anyfanti, Areti Triantafyllou, Eugenia Gkaliagkousi, Nikolaos Koletsos, Spyros Aslanidis, Stella Douma
OBJECTIVES: Arterial stiffness has emerged as a surrogate marker of cardiovascular disease. We investigated the role of myocardial performance and hemodynamic parameters in arterial stiffness in patients with rheumatoid arthritis (RA), which is accompanied by excess cardiovascular risk. DESIGN: Arterial stiffness was evaluated with pulse wave velocity (PWV) in RA patients and controls. Cardiac and hemodynamic characterization was based on impedance cardiography...
March 21, 2018: Scandinavian Cardiovascular Journal: SCJ
Lidia Capotosto, Francesco Massoni, Simone De Sio, Serafino Ricci, Antonio Vitarelli
Cardiovascular disease (CVD) still remains the main cause of morbidity and mortality and consequently early diagnosis is of paramount importance. Working conditions can be regarded as an additional risk factor for CVD. Since different aspects of the job may affect vascular health differently, it is important to consider occupation from multiple perspectives to better assess occupational impacts on health. Standard echocardiography has several targets in the cardiac population, as the assessment of myocardial performance, valvular and/or congenital heart disease, and hemodynamics...
2018: BioMed Research International
Ha-Yoon Choi, Hee-Jun Han, Ji-Won Choi, Han-Young Jung, Kyung-Lim Joa
Objective: To evaluate the effect of high-intensity interval training (HIIT) on psychological symptoms, activity states, and cardiovascular functions in patients with myocardial infarction (MI) of low and moderate risk stratification. Methods: This prospective study randomly allocated 44 patients with MI to 18 sessions of HIIT or conventional moderate-intensity continuous training (MICT). Outcome measures were assessed at baseline and after 18 sessions. Results: Post-exercise cardiovascular and functional states, maximal oxygen uptake (VO2max ), metabolic equivalents (METs), 6-Minute Walking Test (6MWT), and Korean Activity Scale/Index (KASI) scores were significantly improved in the HIIT group compared to those in the MICT group after 18 exercise sessions...
February 2018: Annals of Rehabilitation Medicine
Gaëlle Cheisson, Sophie Jacqueminet, Emmanuel Cosson, Carole Ichai, Anne-Marie Leguerrier, Bogdan Nicolescu-Catargi, Alexandre Ouattara, Igor Tauveron, Paul Valensi, Dan Benhamou
In diabetic patients undergoing surgery, we recommend assessing glycaemic control preoperatively by assessing glycated haemoglobin (HbA1c) levels and recent capillary blood sugar (glucose) levels, and to adjust any treatments accordingly before surgery, paying particular attention to specific complications of diabetes. Gastroparesis creates a risk of stasis and aspiration of gastric content at induction of anaesthesia requiring the use of a rapid sequence induction technique. Cardiac involvement can be divided into several types...
March 17, 2018: Anaesthesia, Critical Care & Pain Medicine
William S Harris, Nathan L Tintle, Mark R Etherton, Ramachandran S Vasan
BACKGROUND: The extent to which omega-3 fatty acid status is related to risk for death from any cause and for incident cardiovascular disease (CVD) remains controversial. OBJECTIVE: To examine these associations in the Framingham Heart Study. DESIGN: Prospective and observational. SETTING: Framingham Heart Study Offspring cohort. MEASUREMENTS: The exposure marker was red blood cell levels of eicosapentaenoic and docosahexaenoic acids (the Omega-3 Index) measured at baseline...
March 2, 2018: Journal of Clinical Lipidology
T N Anand, Linju M Joseph, A V Geetha, Joyita Chowdhury, Dorairaj Prabhakaran, Panniyammakal Jeemon
BACKGROUND: One of the potential strategies to improve health care delivery in understaffed low- and middle-income countries (LMICs) is task sharing, where specific tasks are transferred from more qualified health care cadre to a lesser trained cadre. Dyslipidemia is a major risk factor for cardiovascular disease but often it is not managed appropriately. OBJECTIVE: We conducted a systematic review with the objective to identify and evaluate the effect of task sharing interventions on dyslipidemia in LMICs...
February 16, 2018: Journal of Clinical Lipidology
Carolina A Escudero, James E Potts, Pei-Yoong Lam, Astrid M De Souza, Gerald J Mugford, George G S Sandor
BACKGROUND: Anorexia nervosa (AN) is associated with abnormalities in biomarkers of cardiovascular risk. Arterial stiffness, as measured by pulse-wave velocity (PWV), is also a risk factor for cardiovascular disease. The aims of this study were to determine the stiffness of the aorta in female adolescents with AN and to determine if either the severity or the type of AN was associated with PWV. METHODS: This was a retrospective case-control study. Adolescent patients with a clinical diagnosis of AN were included...
March 17, 2018: Journal of the American Society of Echocardiography
Muhyeddine Al-Taki, Hamdi G Sukkarieh, Jamal J Hoballah, Sarah F Jamali, Mohamad Habbal, Karim Z Masrouha, Racha Abi-Melhem, Hani Tamim
Full extent of gender differences on postoperative outcomes has never been studied on large scale, specifically postoperative complications. This study aims to assess the effect of gender on 30-day morbidity and mortality after major surgery. A retrospective cohort study was carried out using data of patients undergoing major surgeries from the American College of Surgeons' National Surgical Quality Improvement Program database between 2008 and 2011. Demographics, pre- and perioperative risk factors, as well as 30-day morbidities, both overall and specific, were reviewed...
March 1, 2018: American Surgeon
Han-Yun Tseng, Shu-Han Yu, Chun-Yi Lee, Wen-Hao Huang, Seng-Loong Huang, Chi-Shin Wu, Yen-Feng Chiu, Chao A Hsiung
BACKGROUND: Sedative-hypnotic medication use has been related to severe adverse events and risks. This study investigated the prevalence of and characteristics associated with the use of sedatives and hypnotics among community-dwelling elderly persons aged 65 years and over in Taiwan. METHODS: A representative sample of community-dwelling adults was recruited. Clinical and sociodemographic data were collected for assessing physical, mental, and cognitive functioning and disorders...
March 21, 2018: International Psychogeriatrics
Kunal N Karmali, Donald M Lloyd-Jones, Joep van der Leeuw, David C Goff, Salim Yusuf, Alberto Zanchetti, Paul Glasziou, Rodney Jackson, Mark Woodward, Anthony Rodgers, Bruce C Neal, Eivind Berge, Koon Teo, Barry R Davis, John Chalmers, Carl Pepine, Kazem Rahimi, Johan Sundström
BACKGROUND: Clinical practice guidelines have traditionally recommended blood pressure treatment based primarily on blood pressure thresholds. In contrast, using predicted cardiovascular risk has been advocated as a more effective strategy to guide treatment decisions for cardiovascular disease (CVD) prevention. We aimed to compare outcomes from a blood pressure-lowering treatment strategy based on predicted cardiovascular risk with one based on systolic blood pressure (SBP) level. METHODS AND FINDINGS: We used individual participant data from the Blood Pressure Lowering Treatment Trialists' Collaboration (BPLTTC) from 1995 to 2013...
March 2018: PLoS Medicine
Y H Lee, G G Song
OBJECTIVE: This study aimed to assess the all-cause and cause-specific standardized mortality ratios (SMRs) in patients with giant cell arteritis (GCA). METHODS: We surveyed studies examining all-cause and/or cause-specific SMRs in patients with GCA compared to the general population, using MEDLINE, EMBASE, Cochrane databases, and manual searches. We then performed a meta-analysis of all-cause, sex-specific, region-specific, and cause-specific SMRs in patients with GCA...
March 20, 2018: Zeitschrift Für Rheumatologie
Scott J Lee, Jianmin Liu, Jianhua Yao, Andrew Kanarek, Ronald M Summers, Perry J Pickhardt
OBJECTIVE: To investigate a fully-automated CT-based adiposity tool, applying it to a longitudinal adult screening cohort. METHODS: A validated automated adipose tissue segmentation algorithm was applied to non-contrast abdominal CT scans in 8852 consecutive asymptomatic adults (mean age, 57.1 years; 3926M/4926F) undergoing colonography screening. The tool was also applied to follow-up CT scans in a subset of 1584 individuals undergoing longitudinal surveillance (mean interval, 5...
March 20, 2018: British Journal of Radiology
Brandon K Martinez, C Michael White
OBJECTIVE: To review the role of inflammatory suppression in patients with atherosclerotic cardiovascular disease (ASCVD) with a focus on the interleukin-1β blocker canakinumab. DATA SOURCES: An Ovid MEDLINE literature search (1946 to February 2018) was performed using search terms inflammation, ASCVD, atherosclerosis, C-reactive protein, canakinumab. Additional references were identified from a review of literature citations. STUDY SELECTION AND DATA EXTRACTION: English-language studies assessing the impact of pharmacological agents, including canakinumab, on inflammation as measured by high-sensitivity C-reactive protein (hsCRP) and the association with reducing ASCVD events were evaluated...
March 1, 2018: Annals of Pharmacotherapy
Arthur E Stillman, Matthijs Oudkerk, David A Bluemke, Menko Jan de Boer, Jens Bremerich, Ernest V Garcia, Matthias Gutbertlet, Pim van der Harst, W Gregory Hundley, Michael Jerosch-Herold, Dirkjan Kuijpers, Raymond Y Kwong, Eike Nagel, Stamatios Lerakis, John Oshinski, Jean-François Paul, Riemer H J A Slart, Vinod Thourani, Rozemarijn Vliegenthart, Bernd J Wintersperger
Non-invasive imaging plays a growing role in the diagnosis and management of ischemic heart disease from its earliest manifestations of endothelial dysfunction to myocardial infarction along the myocardial ischemic cascade. Experts representing the North American Society for Cardiovascular Imaging and the European Society of Cardiac Radiology have worked together to organize the role of non-invasive imaging along the framework of the ischemic cascade. The current status of non-invasive imaging for ischemic heart disease is reviewed along with the role of imaging for guiding surgical planning...
March 19, 2018: International Journal of Cardiovascular Imaging
Kevin C Maki, Mary R Dicklin
PURPOSE OF REVIEW: The aims of this review are to provide perspective on evaluation of relative and absolute cardiovascular disease (CVD) risk reductions for assessing the efficacy of preventive therapies and to summarize methods for evaluation of CVD risk in clinical practice. RECENT FINDINGS: Major CVD risk factors can be used to stratify patients into risk categories. Results from recent trials reinforce the view that benefits of preventive therapies will be greatest in those with the highest absolute risk and in those with the most severe disturbance in the risk factor targeted...
March 20, 2018: Current Atherosclerosis Reports
Stephen Boone, Dick Kuo
PURPOSE OF REVIEW: Early lowering of blood pressure is advised for patients with severe hypertension associated with signs of impending or progressive organ damage, whereas aggressive treatment is not recommended in patients with asymptomatic severe hypertension. As treatment goals for asymptomatic hypertension and true hypertensive emergency drastically differ, it is essential to identify patients with evidence of impending or progressive organ damage. Biomarkers may assist providers in identifying high-risk patients who would benefit from early blood pressure reduction...
March 19, 2018: Current Hypertension Reports
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