Cvd Prevention and Control最新文献

{"title":"Highlights of the first Malaysian National Cardiovascular Disease Database (NCVD): Percutaneous Coronary Intervention (PCI) Registry","authors":"Wan Azman Wan Ahmad ,&nbsp;Rosli Mohd Ali ,&nbsp;Robaayah Zambahari ,&nbsp;Omar Ismail ,&nbsp;Lee Chuey Yan ,&nbsp;Liew Houng Bang ,&nbsp;Chee Kok Han ,&nbsp;Sim Kui Hian","doi":"10.1016/j.cvdpc.2011.02.006","DOIUrl":"10.1016/j.cvdpc.2011.02.006","url":null,"abstract":"<div><h3>Objective</h3><p>The Malaysian NCVD-PCI registry attempts to determine the number and to monitor the outcomes of Percutaneous Coronary Intervention (PCI), based on selected performance indicators. It provides a comprehensive view to determine the level of adherence to existing guidelines, to evaluate the cost-effectiveness of treatment and prevention programs and to facilitate quality improvement activities of the participants. It also aims to stimulate research and to act as a reference for future studies.</p></div><div><h3>Methods</h3><p>It was a voluntary, multi-centered, observational, cohort study and included patients of 18<!--> <!-->years or above, with coronary artery disease who underwent PCI at eight participating centers in the year 2007.</p></div><div><h3>Results</h3><p>A total of 3677 patients underwent 3920 PCI procedures with 6299 stents for 5512 lesions. The mean age of patients was 56.7<!--> <!-->±<!--> <!-->10.11<!--> <!-->years. The mean BMI was 26.38<!--> <!-->±<!--> <!-->4.21<!--> <!-->kg/m², while 80% of all subjects had a BMI above 23<!--> <!-->kg/m². Males constituted 81.2% of the total population and 98.4% of the total population had at least one cardiovascular risk factor. Regarding PCI status, 90.1% were elective cases and 94% of cases had a low TIMI risk index at the beginning of PCI. Femoral approach accounted for 59%, radial approach for 34% and brachial approach for 1% of all cases. The median fluoroscopy time was 15.7<!--> <!-->min and the median door-to-balloon time for primary infarct PCI was 93.5<!--> <!-->min. The commonest site of lesion was the left anterior descending artery, accounting for 48% of all lesions and 92.8% of all lesions were de novo. The mean lesion length was 24.4<!--> <!-->±<!--> <!-->15.18<!--> <!-->mm and about 28% of all lesions had high risk characteristics. Drug-eluting stents and bare metal stents were used in 53.6% and 42.5% of cases, respectively. After PCI, 91% of all lesions achieved TIMI grade 3 flow. Regarding pharmacotherapy, 99.5% of all patients received unfractionated heparin, 5% received LMWH prior to intervention, 96% received aspirin and 98% received clopidogrel. Over-all in-hospital mortality and 30<!--> <!-->day mortality for the entire cohort was 1.1% and 1.8%, respectively.</p></div><div><h3>Conclusion</h3><p>A summary of the first nationwide PCI registry has been presented. The subjects were much younger with a high prevalence of cardiovascular risk factors. The majority of cases (90%) were elective procedures with a low TIMI risk index. Mean door-to-balloon time for primary PCI was higher than the recommended guidelines. There was good prescribing of antiplatelets and heparin. Over-all in-hospital and 30<!--> <!-->day mortality were comparable to other registries.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"6 2","pages":"Pages 57-61"},"PeriodicalIF":0.0,"publicationDate":"2011-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2011.02.006","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82482137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remote preconditioning by aortic constriction: Does it afford cardioprotection similar to classical or other remote ischaemic preconditioning? Role of inducible nitric oxide synthase","authors":"Ashish Kumar Sharma ,&nbsp;Arshee Munajjam ,&nbsp;Bhawna Vaishnav ,&nbsp;Richa Sharma ,&nbsp;Kunal Kishore ,&nbsp;Ashok Sharma ,&nbsp;Akash Sharma ,&nbsp;Divya Sharma ,&nbsp;Rita Kumari ,&nbsp;Ashish Tiwari ,&nbsp;B.P. Srinivasan ,&nbsp;Shyam Sunder Agarwal","doi":"10.1016/j.cvdpc.2010.12.001","DOIUrl":"10.1016/j.cvdpc.2010.12.001","url":null,"abstract":"<div><h3>Purpose of the research</h3><p>Does remote preconditioning by aortic constriction (RPAC) afford cardioprotection similar to classical or other remote ischaemic preconditioning stimulus? Moreover, the study was also designed to investigate the role of inducible nitric oxide synthase (iNOS) in remote preconditioning by aortic constriction. There are sufficient evidence that ‘ischaemic preconditioning’ has surgical applications and affords clinically relevant cardioprotection. Transient occlusion of the circumflex artery, renal artery, limb artery or mesenteric artery preconditions the myocardium against ischaemia/reperfusion injury in case of ischaemic heart disease leading to myocardial infarction. Here, the abdominal aorta was selected to produce RPAC.</p></div><div><h3>The principal results</h3><p>Four episodes of ischaemia/reperfusion of 5<!--> <!-->min each to the abdominal aorta produced RPAC by assessment of infarct size, lactate dehydrogenase (LDH) and creatine phosphokinase (CK). These studies suggest RPAC produced acute (FWOP) and delayed (SWOP) cardioprotective effects. RPAC demonstrated a significant decrease in ischaemia/reperfusion-induced release of LDH, CK and extent of myocardial infarct size. <span>l</span>-NAME (nitro-<span>l</span>-arginine-methylester) (10<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.), aminoguanidine (150<!--> <!-->mg<!--> <!-->kg⁻¹ s.c.), aminoguanidine (300<!--> <!-->mg<!--> <!-->kg⁻¹ s.c.), S-methyl isothiourea (3<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.) and 1400W (1<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.) administered 10<!--> <!-->min. before global ischaemia/reperfusion produced no marked effect. Aminoguanidine (150<!--> <!-->mg<!--> <!-->kg⁻¹ s.c.), aminoguanidine (300<!--> <!-->mg<!--> <!-->kg⁻¹ s.c.), S-methyl isothiourea (3<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.) and 1400W (1<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.) pre-treatment after RPAC produced no significant effect on acute RPAC-induced decrease in LDH, CK and infarct size, whereas <span>l</span>-NAME (10<!--> <!-->mg<!--> <!-->kg⁻¹ I.V.) increased RPAC-induced decrease in LDH, CK and infarct size. The most interesting observation is with respect to delayed RPAC, where all NOS inhibitors’ pre-treatment attenuate RPAC-induced decrease in LDH, CK and infarct size.</p></div><div><h3>Major conclusions</h3><p>RPAC affords cardioprotection similar to classical or other remote ischaemic preconditioning stimulus. Moreover, late or delayed phase of RPAC has been mediated iNOS, whereas it is not involved in acute RPAC.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"6 1","pages":"Pages 15-33"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.12.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73547723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication adherence and associated barriers in hypertension management in India","authors":"Dennis Thomas ,&nbsp;N.K. Meera ,&nbsp;K. Binny ,&nbsp;M. Sonal Sekhar ,&nbsp;Githa Kishore ,&nbsp;Salini Sasidharan","doi":"10.1016/j.cvdpc.2010.11.001","DOIUrl":"https://doi.org/10.1016/j.cvdpc.2010.11.001","url":null,"abstract":"<div><p>Hypertension is inadequately controlled in most patients due to poor adherence to treatment. Not much is known about the underlying reasons for poor adherence. The main objective of this study was to assess medication adherence in hypertensive patients and to identify the main barriers associated with medication adherence. A questionnaire-based survey was conducted in the medicine outpatient department of Kempe Gowda Institute of Medical Sciences and Research Centre, Bangalore, India. Self reported adherence was measured by using a short validated questionnaire and detailed patient interviews. Of the 608 patients participated, non-adherence was found in 49.67% of patients. Belief barrier was reported in 39.14% patients. Access barrier and recall barrier were reported by 82.57% and 62.17%, respectively. 78.62% of patients reported that it is difficult to pay for the medication and 54.93% indicated that it is difficult to get a refill on time. It was concluded that about half of the Indian patients studied were not adherent to their antihypertensive regimen and this might result in poor blood pressure control. Non-adherence to hypertension management remains a major limiting factor among Indians in the effective control of hypertension and in the prevention of cardiovascular diseases.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"6 1","pages":"Pages 9-13"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.11.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91687953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication adherence and associated barriers in hypertension management in India","authors":"T. Dennis, N. Meera, K. Binny, M. Sekhar, G. Kishore, S. Sasidharan","doi":"10.1016/J.CVDPC.2010.11.001","DOIUrl":"https://doi.org/10.1016/J.CVDPC.2010.11.001","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"16 1","pages":"9-13"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81697774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mosaic of CVD risk factors – A study on 10,000 Pakistani cardiac patients","authors":"A. Kayani, Nausheen Bakht, R. Munir, Irum Abid","doi":"10.1016/J.CVDPC.2010.10.002","DOIUrl":"https://doi.org/10.1016/J.CVDPC.2010.10.002","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"30 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76892266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The mosaic of CVD risk factors – A study on 10,000 Pakistani cardiac patients","authors":"Azhar Mahmood Kayani ,&nbsp;Nausheen Bakht ,&nbsp;Rubab Munir ,&nbsp;Irum Abid","doi":"10.1016/j.cvdpc.2010.10.002","DOIUrl":"https://doi.org/10.1016/j.cvdpc.2010.10.002","url":null,"abstract":"<div><h3>Objective</h3><p>To determine the cardiovascular disease risk factor profile of Pakistani patients.</p></div><div><h3>Material and methods</h3><p>In this cross sectional study, 10,000 patients with CVD were recruited. This 1<!--> <!-->year study was conducted in the outpatient department of Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC-NIHD), which provides primary, secondary and tertiary cardiac care to patients from all over the country. The CVD risk factors studied included hypertension, diabetes, dyslipidemia, obesity, smoking, alcohol intake, inactivity, eating &lt;5 portions of fruits and/or vegetables per day.</p></div><div><h3>Results and discussion</h3><p>Of the study participants 73.5% were males while 26.5% were females. Their average age was 53.83<!--> <!-->±<!--> <!-->14.18<!--> <!-->years and 51.68<!--> <!-->±<!--> <!-->15.83<!--> <!-->years, respectively. The frequency of premature CVD was 27.2% in males and 49.1% in females. 46.9% males and 77.4% females had abdominal obesity, 15.6% men and 1.9% women being current smokers. Blood cholesterol levels were &gt;200<!--> <!-->mg/dl in 10% of all study subjects. In a decreasing order, poor lipid values were seen for HDL, VLDL, TG, cholesterol, LDL and LDL/HDL. Diabetes and hypertension affected 18.5% and 8% study subjects, respectively. Mean BMI was 21.02<!--> <!-->kg/m² in men and 22.41<!--> <!-->kg/m² in women. 64.5% participants did not take five or more servings of fruits and/or vegetables per day. 66% males and 68% females were physically inactive.</p></div><div><h3>Conclusion</h3><p>Risk factors in Pakistani patients can be rank ordered as abdominal obesity, eating &lt;5 portions of fruits and/or vegetables per day, HDL, physical inactivity, diabetes, VLDL, TG, smoking, cholesterol, hypertension, obesity, LDL, LDL/HDL and alcohol.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"6 1","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2011-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.10.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91642288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A strategy to improve hypertension control: The Canadian experience","authors":"Simon W. Rabkin ,&nbsp;Ross D. Feldman ,&nbsp;Sheldon W. Tobe ,&nbsp;Denis Drouin ,&nbsp;Finlay A. McAlister ,&nbsp;Norm R. Campbell","doi":"10.1016/j.cvdpc.2010.10.001","DOIUrl":"10.1016/j.cvdpc.2010.10.001","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 4","pages":"Pages 107-113"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89473647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary risk factors in South Asians: A prevalence study in an urban populace of Eastern India","authors":"D.S. Prasad ,&nbsp;Zubair Kabir ,&nbsp;A.K. Dash ,&nbsp;B.C. Das","doi":"10.1016/j.cvdpc.2010.08.003","DOIUrl":"10.1016/j.cvdpc.2010.08.003","url":null,"abstract":"<div><h3>Aim</h3><p>This study examined the prevalence of coronary risk factors and significant predictors of coronary artery disease (CAD) in one of the poorest states of Eastern India among a unique ethnic urban population that is experiencing changing lifestyle patterns.</p></div><div><h3>Methods</h3><p>A multi-stage probability sampling from a sampling frame of 37 electoral wards geographically representative of the urban population of Berhampur, with a population of 307,724 in 2001, was based on an estimated sample of 1200 with adequate power. One thousand one hundred and seventy eight subjects (590 males; 588 females) ⩾20<!--> <!-->years of age were finally selected. In addition to socio-demographic characteristics, physiological, behavioral, anthropometric and biochemical parameters were ascertained using interviewer-completed questionnaires and appropriate clinical examinations. Both descriptive and multivariable logistic regression analyses were performed.</p></div><div><h3>Results</h3><p>The overall prevalence of CAD was 10%. The main coronary risk factor prevalence rates were: hypertension (37%); smoking (27%); hypercholesterolemia (23%); diabetes (16%); central obesity (49%); physical inactivity levels (34%); and 47% had low HDL levels. Overall, age, central obesity, hypertension (adjusted odds ratio: 2.2; 95% confidence interval: 1.4; 3.4), physical inactivity levels and diabetes in females alone were significant predictors of CAD.</p></div><div><h3>Conclusions</h3><p>A high CAD prevalence of 10%, with higher rates of some classical cardiovascular risk factors such as diabetes, hypertension and physical inactivity levels, reinforce the need for a comprehensive CAD prevention and control program. This is the first study conducted in one of the poorest states within the fold of an emerging economy, clearly suggesting the ubiquitous nature of the CAD epidemic.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 4","pages":"Pages 125-132"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.08.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77902335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Volume Contents for CVDPC Volume 5","authors":"","doi":"10.1016/S1875-4570(10)00122-1","DOIUrl":"https://doi.org/10.1016/S1875-4570(10)00122-1","url":null,"abstract":"","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 4","pages":"Pages III-V"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/S1875-4570(10)00122-1","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"137369822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiovascular risk factors in developing countries: A review of clinico-epidemiological evidence","authors":"D.S. Prasad ,&nbsp;Zubair Kabir ,&nbsp;A.K. Dash ,&nbsp;B.C. Das","doi":"10.1016/j.cvdpc.2010.09.001","DOIUrl":"10.1016/j.cvdpc.2010.09.001","url":null,"abstract":"<div><h3>Background</h3><p>Cardiovascular disorders (CVD) are due to a constellation of modifiable and non-modifiable risk factors – some known and others unknown. Such risk factors are reported to vary across ethnicities. CVD will likely become a major public health and clinical problem in Asia such that by the year 2020 Asia will have more individuals with CVD than any other region. However, the current evidence on variations in cardiovascular risk factors both from a clinical and an epidemiological perspective with special reference to developing country settings is limited. In this context, we set out to review the existing evidence and to summarize the findings.</p></div><div><h3>Methods</h3><p>We did not carry out a systematic review but pursued a similar structure. We abstracted the most appropriate published literature from electronic databases, namely, PubMed, Embase and the Cochrane Library applying specific search terms. We searched grey literature and followed up bibliographic references.</p></div><div><h3>Results</h3><p>Ethnicity is emerging as an independent risk factor contributing to the rising epidemic of CVD in developing countries. Furthermore, increasing rates of urbanization have led to striking changes in lifestyle patterns resulting in decreasing physical activity, increasing weight and, consequently, increasing rates of diabetes, hypertension and dyslipidemia in urban Asians.</p></div><div><h3>Conclusions</h3><p>Variations in selected cardiovascular risk factors in developing countries were identified. Prediction tools and risk assessments need to be population-specific and sensitive to ethnic minorities. This summary of evidence could help to shift priorities to populations for targeted cardiovascular prevention and control measures where resources are limited.</p></div>","PeriodicalId":11021,"journal":{"name":"Cvd Prevention and Control","volume":"5 4","pages":"Pages 115-123"},"PeriodicalIF":0.0,"publicationDate":"2010-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.cvdpc.2010.09.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85478682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}