Vascular Health and Risk Management最新文献

{"title":"A Link Between the Triglyceride-Glucose Index and the Risk of Hypertension Among Employees in the Titanium Dioxide Industry.","authors":"Fengni Qin, Guangzi Qi, Suren Sooranna, Jingyi Lu, Hongyan Tian, Feiyu Lu, Yinxia Lin, Yaqin Pang","doi":"10.2147/VHRM.S567638","DOIUrl":"10.2147/VHRM.S567638","url":null,"abstract":"<p><strong>Purpose: </strong>The TyG index is a reliable marker of insulin resistance, and studies suggest its association with hypertension risk. However, no relevant research has been conducted among employees of titanium dioxide (TiO₂) manufacturing enterprises. This study aims to investigate the association between the TyG index and hypertension risk in this population.</p><p><strong>Methods: </strong>This study employed a cross-sectional design, conducting questionnaire surveys and health examinations among 596 employees at a titanium dioxide manufacturing enterprise in Guangxi. The TyG index was calculated, and the relationship between TyG and hypertension risk, along with its predictive value, was analyzed using multivariate logistic regression, restricted cubic splines, and ROC curve analysis.</p><p><strong>Results: </strong>The prevalence of hypertension among titanium dioxide workers was 17.22%. Univariate analysis showed that age, gender, work experience, alcohol consumption, hyperglycemia, abnormal liver function, dyslipidemia, and the TyG index were associated with hypertension (P<0.05). Multivariate analysis revealed that the hypertension risk in the highest TyG quartile (Q4) was 11.12 times higher than that in the lowest quartile (Q1) (95% CI: 3.52-35.16). Results from the restricted cubic spline model indicated a nonlinear association between the TyG index and hypertension risk (P for overall < 0.0001, P for nonlinearity < 0.0001). Stratified analysis confirmed the TyG index as a major risk factor with a positive effect (P < 0.05). The ROC curve AUC was 0.775, indicating that the TyG index has good predictive ability for hypertension.</p><p><strong>Conclusion: </strong>A high TyG index increases the risk of hypertension among workers in titanium dioxide production enterprises. As a low-cost, easily implemented early screening tool, the TyG index facilitates early identification and intervention for high-risk populations, providing scientific basis for developing targeted intervention measures for hypertension and cardiovascular health among occupational populations.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"567638"},"PeriodicalIF":3.2,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12994393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147481971","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":"Clinical Advances in Heart Failure with Preserved Ejection Fraction: A Systematic Review of Therapeutic and Mechanistic Evidence.","authors":"Razieh Parizad, Juniali Hatwal, Mohammadreza Taban Sadeghi, Ajit Brar, Rupak Desai, Akash Batta, Bishav Mohan","doi":"10.2147/VHRM.S578698","DOIUrl":"10.2147/VHRM.S578698","url":null,"abstract":"<p><strong>Background: </strong>Heart failure with preserved ejection fraction (HFpEF) has emerged as the predominant of heart failure (HF), particularly among aging populations and individuals with a high burden of comorbidities. Its underlying pathophysiological mechanisms are complex, multifactorial and, heterogeneous.</p><p><strong>Objective: </strong>This systematic review aims to synthesize contemporary evidence on the epidemiology, pathophysiology, diagnostic challenges, and therapeutic strategies for HFpEF, with especially emphasis on emerging clinical approaches and future research directions.</p><p><strong>Methods: </strong>A comprehensive systematic literature search was conducted using PubMed, Scopus, Web of Science, and the Cochrane Library, covering publications from January 2015 through June 2025. Eligible studies included randomized controlled trials (RCTs), observational cohort studies, systematic reviews, meta-analyses, and current clinical guidelines talking key aspects of HFpEF.</p><p><strong>Results: </strong>HFpEF now accounts for more than 50% of all HF diagnoses worldwide. Although it shares overlapping clinical features with other cardiovascular (CV) and systemic disorders, recent advances in echocardiographic techniques and the use of circulating biomarkers have substantially improved diagnostic accuracy. Current management strategies primarily focus on comorbidity control, optimization of volume status, structured exercise and rehabilitation programs, and the adoption of novel pharmacological therapies, most notably sodium glucose cotransporter 2 (SGLT2) inhibitors. Notable recent advances include the nonsteroidal mineralocorticoid receptor antagonist finerenone, which demonstrated reductions in worsening HF events and CV mortality in patients with heart failure with mildly reduced ejection fraction (HFmrEF) and HFpEF in the FINEARTS-HF trial. In addition, incretin-based therapies such as semaglutide (STEP-HFpEF program) and tirzepatide (SUMMIT trial) have shown clinically meaningful improvements in symptoms, exercise capacity, weight reduction, and composite CV or HF outcomes, notably in obesity-associated HFpEF phenotypes.</p><p><strong>Conclusion: </strong>HFpEF continues to pose substantial diagnostic and therapeutic challenges owing to its marked heterogeneity and historically limited treatment options. Advances in phenotypic classification, personalized therapeutic strategies, and integrated multidisciplinary care models are critical for improving long-term outcomes in this expanding patient population. The emergence of finerenone and glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide (GLP-1/GIP) receptor agonists, including semaglutide and tirzepatide, represents a promising extension beyond SGLT2 inhibitors, particularly in cardiometabolic and obesity-driven HFpEF. However, further incorporation into clinical guidelines and validation through real-world evidence remain necessary.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"578698"},"PeriodicalIF":3.2,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13054715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147639772","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":"Evaluation of Prothrombin Time and Activated Partial Thromboplastin Time in Antithrombotic-Treated Cardiac Patients: A Cross-Sectional Study from Sana'a City, Yemen.","authors":"Abdulrahman H Amer, Abdulelah H Al-Adhroey, Abdulqawi Ali Al-Shammakh","doi":"10.2147/VHRM.S587006","DOIUrl":"10.2147/VHRM.S587006","url":null,"abstract":"<p><strong>Background: </strong>Antithrombotic therapy is a cornerstone of managing cardiac diseases, necessitating routine monitoring of coagulation parameters like Prothrombin Time (PT) and Activated Partial Thromboplastin Time (APTT). Data on the coagulation profiles of treated patients in resource limited settings like Yemen are scarce.</p><p><strong>Objective: </strong>This study aimed to evaluate PT and APTT in antithrombotic-treated cardiovascular patients and assess their variation across different cardiac diagnoses and therapy regimens in Sana'a, Yemen.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 200 cardiovascular patients on antithrombotic therapy at selected hospitals in Sana'a City between January and March 2024. Demographic, clinical, and therapeutic data were collected. Coagulation parameters (PT, INR, APTT) were measured and compared across diagnostic groups and treatment types using Kruskal-Wallis and Mann-Whitney <i>U</i>-tests, with Bonferroni correction for multiple comparisons.</p><p><strong>Results: </strong>The study group was predominantly male (69.0%), aged 51-80 years (57.0%). Coagulation parameters varied significantly across cardiac diagnoses (p <0.01 for PT, INR, APTT). Patients with Mitral Valve Replacement (MVR) had the highest median PT (36.45s) and INR (2.75). Post-hoc analysis confirmed MVR patients had significantly elevated parameters compared to other groups (e.g. PT 19.01s higher than Segment Elevation Myocardial Infarction (STEMI), p=0.003). Rheumatic Heart Disease (RHD) patients showed intermediate PT elevation. No significant differences were found between STEMI and Non-ST-segment Elevation - Acute Coronary Syndrome (NSTE-ACS) subtypes. Antithrombotic type significantly influenced results: warfarin patients had the highest median PT (20.00s), INR (1.53), and APTT (40.00s) (p<0.05). Dosage analysis confirmed warfarin's significant impact compared to aspirin doses.</p><p><strong>Conclusion: </strong>Coagulation profiles in cardiovascular patients vary significantly according to both the underlying cardiac diagnosis and the type of antithrombotic therapy. MVR and RHD patients display notably elevated parameters, while ACS subtypes show similar profiles. These findings underscore the need for diagnosis-specific monitoring strategies and confirm the expected pharmacological effects of different antithrombotic agents in a Yemeni population.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"587006"},"PeriodicalIF":3.2,"publicationDate":"2026-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12984049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147463929","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":"Hidden Triplets: Coexisting Spinal Epidural and Dural Arteriovenous Fistulae - A Rare Case Report and Literature Review.","authors":"Ghaya Alrumaihi, Kazim Mohammed, Ghanem Alsulaiti","doi":"10.2147/VHRM.S526645","DOIUrl":"10.2147/VHRM.S526645","url":null,"abstract":"<p><p>A Spinal epidural and dural Arteriovenous Fistula is a rare vascular malformation that rarely presents as multiple synchronous lesions. We report a rare case of three synchronous lumbar spinal arteriovenous shunts in a 22-year-old male presenting with subarachnoid hemorrhage (SAH) symptoms. Angiographic evaluation revealed a complex vascular pathology consisting of one anterior epidural arteriovenous fistula (AVF) fed by the L3 radiculomedullary branch and two smaller dural AVFs at L4-L5 levels. Initial cranial imaging was unremarkable, but spinal MRI demonstrated intrathecal hemorrhage with perimedullary flow voids. The dominant epidural fistula, characterized by a large venous pouch draining into medullary veins, was successfully treated with endovascular embolization, fistula and staged management was planned for the remaining lesions. This case highlights three important clinical aspects: (1) the coexistence of epidural and dural spinal shunts represents a distinct pathological entity from classic spinal dural AVFs; (2) hemorrhagic presentation may occur in spinal AVFs with epidural venous drainage; and (3) comprehensive spinal angiography is crucial when evaluating SAH of unknown origin. The anatomical and hemodynamic differences between these fistula types underscore the need for precise angiographic characterization to guide appropriate management.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"526645"},"PeriodicalIF":3.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12967041/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147378751","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":"Postoperative Blood Glucose Trajectories are Associated with Inflammatory Markers and Functional Outcomes in Acute Ischemic Stroke Treated by Thrombectomy.","authors":"Yunpeng Liu, Hanlin Zhong, Jumei Huang, Yang Wang","doi":"10.2147/VHRM.S587043","DOIUrl":"10.2147/VHRM.S587043","url":null,"abstract":"<p><strong>Purpose: </strong>To describe postoperative blood glucose trajectories in patients with acute ischemic stroke treated by mechanical thrombectomy (MT) and to examine their associations with 90-day functional outcomes and early postoperative inflammatory markers.</p><p><strong>Patients and methods: </strong>This retrospective cohort study included 150 patients who underwent MT for large vessel occlusion (LVO) stroke between March 2023 and September 2024. Daily capillary blood glucose levels (fasting and postprandial) were recorded for seven days post-procedure, and linear regression was used to calculate individual postoperative glucose slopes. Patients were classified into a Glucose-Increasing Group or Glucose-Decreasing Group based on the median slope. The primary outcome was the 90-day modified Rankin Scale (mRS). Secondary outcomes included postoperative day-1 levels of C-reactive protein (CRP), interleukin-6 (IL-6), and interleukin-10 (IL-10). Statistical analyses included group comparisons and multivariate logistic regression adjusting for potential confounders.</p><p><strong>Results: </strong>Patients in the Glucose-Increasing Group had significantly higher median 90-day mRS scores compared with the Glucose-Decreasing Group (4.0 vs 3.0; P = 0.030). They also exhibited higher postoperative inflammatory markers: CRP (5.2 vs 4.1 mg/L; P = 0.022), IL-6 (6.9 vs 5.7 pg/mL; P = 0.015), and IL-10 (134 vs 104 pg/mL; P = 0.0017). However, in multivariate logistic regression, glucose trajectory was not an independent predictor of poor outcome (mRS ≥ 3; OR 0.67, 95% CI 0.34-1.37; P = 0.272).</p><p><strong>Conclusion: </strong>An increasing postoperative blood glucose trend is associated with higher early inflammatory marker levels and poorer 90-day functional outcomes in LVO stroke patients undergoing thrombectomy. Although not an independent predictor after adjustment, postoperative glycemic trajectory may reflect underlying metabolic and inflammatory stress. Prospective studies are needed to further clarify these relationships.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"587043"},"PeriodicalIF":3.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356428","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":"Intervening Early in the Cardiovascular-Kidney-Metabolic Syndrome: Expert Recommendations from the United Arab Emirates on the Management of Prediabetes.","authors":"Salah Abusnana, Hani Sabbour, Bachar Afandi, Mohamed N M H Farghaly, Muhammad H Farooqi, Khadija Hafidh, Mohamed Hassanein, Abdul Jabbar, Abdulla Shehab, Raya Kalimat, Kerstin M G Brand","doi":"10.2147/VHRM.S579970","DOIUrl":"10.2147/VHRM.S579970","url":null,"abstract":"<p><p>The emerging concept of the cardiovascular-kidney-metabolic (CKM) syndrome encapsulates the interrelated nature of metabolic processes and metabolic dysfunction. Prediabetes, which describes the presence of elevations of blood glucose measurements insufficient to provoke a diagnosis of type 2 diabetes (T2D), is an important, - and crucially, reversible - early manifestation of the CKM syndrome. Numerous clinical studies and meta-analyses have shown that a substantial minority of people with prediabetes have microvascular and/or macrovascular complications reminiscent of those seen in clinical T2D. Prediabetes therefore represents an early stage of a continuum of increased insulin resistance, hyperglycaemia and associated vascular risk that begins at blood glucose concentrations that are well below those required for a diagnosis of diabetes. This condition also provides an opportunity for early intervention. All people with prediabetes should receive a multifactorial lifestyle intervention that focuses of weight management, nutrition, physical activity and smoking cessation. Where this is insufficient, ineffective or not followed, metformin remains the best studied pharmacotherapy for the management of prediabetes, with formal therapeutic indications for this purpose in many countries and support within international guidelines. Weight management is crucial for diabetes prevention, and weight loss during receipt of incretin agonist drugs is effective in diabetes prevention in populations with prediabetes, although consideration should be given to how long the treatment should be maintained and how the patient should be managed when it is ultimately withdrawn.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"579970"},"PeriodicalIF":3.2,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12955368/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147356382","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":"Role of Cardiopulmonary Exercise Testing in the Monitoring of Cardiovascular Risk Factors in Athletes - State-of-the-Art Review.","authors":"Przemysław Kasiak","doi":"10.2147/VHRM.S575333","DOIUrl":"10.2147/VHRM.S575333","url":null,"abstract":"<p><p>Although physical activity has beneficial effects for health, athletes also suffer from cardiovascular diseases (CVD). The type and prevalence of CVD in athletes depend on their age, but typically include hypertrophic cardiomyopathy, arrhythmias, and valve diseases. In pediatric athletes <18 years old, congenital heart diseases (CHD) are prevalent, while in master athletes >35 years old, coronary artery disease (CAD) is the most common. Cardiopulmonary exercise testing (CPET) is a gold standard to evaluate cardiorespiratory fitness (CRF). Although CRF is most often identified as peak oxygen uptake ([Formula: see text]O_2peak), CPET provides a multidimensional assessment through several other cardiorespiratory variables. CVD aggravates CRF and reduces [Formula: see text]O_2peak. While there is no universal pattern of alteration in the remaining CPET parameters, the specific deviations depend on the type of CVD. Therefore, precise monitoring of changes in CPET scores is crucial for risk stratification, adjusting exercise intensity, enabling safe sports participation, and authorizing return to sport after treatment. Among athletes, CPET plays a pivotal role across all fields. Therefore, this review aimed to evaluate the value of CPET in 1) identification of risk factors of CVD among athletes, considered as changes in CRF, 2) monitoring of treatment, and 3) making shared decisions on returning to sport. A special focus was placed on the needs of emerging age groups - pediatric and master athletes. Additionally, evidence gaps and directions for future research were discussed.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"575333"},"PeriodicalIF":3.2,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950176/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147345286","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":"Accuracy of the Withings BPM Pro 2 (WPM07) Device for Self-Blood Pressure Measurements in the General Populations According to the International Organization for Standardization Universal Standard (ISO 81060-2:2018/AMD 2:2024) Protocol.","authors":"Parounak Zelveian, Zoya Hakobyan, Jirar Topouchian, Avag Avagyan, Heghine Gharibyan, Roland Asmar","doi":"10.2147/VHRM.S585947","DOIUrl":"10.2147/VHRM.S585947","url":null,"abstract":"<p><strong>Background: </strong>The accuracy of blood pressure (BP) measurements performed by electronic devices is crucial in clinical practice. International professional societies emphasize the need for rigorous, standardized validation of electronic BP measuring devices to ensure their accuracy and reliability.</p><p><strong>Objective: </strong>This study evaluated the accuracy of the Withings BPM Pro2 (WPM07) upper‑arm oscillometric BP monitor in the adult general population using the ISO 81060‑2:2018/AMD 2:2024 Universal Standard.</p><p><strong>Methods: </strong>Following the ISO same‑arm sequential measurement protocol, 89 eligible pre-selected participants underwent paired test‑device and mercury reference auscultatory measurements. Nine BP measurements were performed on each participant, four with the tested device and five with the auscultatory method. The accuracy of BP measurements was assessed based on the difference between simultaneous measurements taken by two observers and those displayed by the tested device using ISO Criterion 1 (mean and standard deviation of test-reference differences) and Criterion 2 (within‑subject variability of averaged difference values).</p><p><strong>Results: </strong>Eighty-nine participants underwent the BP measurements protocol, data from 87 were analyzed after excluding 2 participants due to excessive BP variability. Inter‑observer agreement for reference measurements was 0.64 ± 2.14 mmHg for systolic BP (SBP) and 0.39 ± 1.98 mmHg for diastolic BP (DBP). ISO criterion 1 was met with mean test-reference differences of 1.0 ± 4.9 mmHg (SBP) and 0.6 ± 4.1 mmHg (DBP) below ISO requirements (≤ 5±8 mmHg). ISO criterion 2 was also satisfied, with within‑subject standard deviations of 3.50 mmHg (SBP) and 3.01 mmHg (DBP), well below the ISO thresholds (≤6.87/6.91 mmHg).</p><p><strong>Conclusion: </strong>The BPM Pro2 (WPM07) fulfills the ISO 81060‑2:2018/AMD 2:2024 accuracy requirements and is suitable for reliable home BP self‑measurement in adults.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"585947"},"PeriodicalIF":3.2,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12950639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147348017","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":"Sex-Specific Trends and Predictors of Outcomes in Acute Myocardial Infarction in Almaty, Kazakhstan.","authors":"Kamilya Kedelbayeva, Salim Berkinbaev, Gulnara Junusbekova, Meiramgul Tundybayeva, Ainur Umarova","doi":"10.2147/VHRM.S585203","DOIUrl":"10.2147/VHRM.S585203","url":null,"abstract":"<p><strong>Background: </strong>Acute myocardial infarction (AMI) disproportionately affects older adults, highlighting the need for equitable, high-quality cardiovascular care. In Kazakhstan, recent primary health care reforms may have improved outcomes, but it remains unclear whether these gains are comparable for women and men. This study aimed to assess sex-specific trends in AMI outcomes and identify independent predictors of adverse clinical events.</p><p><strong>Methods: </strong>We performed a two-stage retrospective study. Stage 1 analyzed 2018-2024 hospitalization data by sex. Stage 2 examined electronic records of 1,866 AMI patients from a tertiary cardiology center. Demographics, clinical parameters, and outcomes were collected. Statistical analysis included group comparisons and uni-/multivariable logistic regression using SPSS.</p><p><strong>Results: </strong>From 2018 to 2024, clinical improvement exceeded 90% annually except in 2021-2022, while mortality declined to 4.7%. Female were consistently presented at older ages than males and had less favorable baseline profiles, including lower hemoglobin levels and reduced renal function, whereas males had slightly higher creatinine levels and longer hospital stays. Hospital length of stay showed moderate variability with a post-pandemic increase, and hospitalization costs rose steadily for both sexes. Among 1,866 patients, hypertension was highly prevalent and 6.4% died. Deceased patients were older and showed worse hemodynamic, renal, metabolic, and inflammatory profiles with lower ejection fraction. In multivariable analysis, sex was not an independent predictor, while age, glucose, non-ST-elevation myocardial infarction (NSTEMI) status, systolic blood pressure, hemoglobin, glomerular filtration rate, and ejection fraction remained significant.</p><p><strong>Conclusion: </strong>Advanced age, metabolic and renal dysfunction, hemodynamic instability, and impaired cardiac function were the strongest predictors of adverse outcomes, while NSTEMI presentation and better physiological status were associated with lower mortality. Females presented at older ages with less favorable risk profiles; although sex was not an independent predictor after adjustment, these differences underscore the need for tailored, risk-stratified care for high-risk patients.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"585203"},"PeriodicalIF":3.2,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949561/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327186","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":"Effectiveness of Conservative Treatment on Chronic Venous Disease Symptoms and Quality of Life in Patients with Type 2 Diabetes: Results from a Subanalysis of the VEIN STEP Observational Study.","authors":"Jorge Hernando Ulloa, Zoubida Tazi Mezalek, Alejandro José González Ochoa, Faezeh Hosseini Sadrabadi, Vanessa Blanc-Guillemaud, Jean-Christophe Philips, Toni Feodor","doi":"10.2147/VHRM.S556035","DOIUrl":"10.2147/VHRM.S556035","url":null,"abstract":"<p><strong>Background: </strong>This post-hoc subanalysis of the VEIN STEP study assessed the effectiveness of conservative treatment, particularly venoactive drugs (VAD), in reducing chronic venous disease (CVD) signs and symptoms and improving quality of life (QoL) for patients with type 2 diabetes (T2D) in a real-life setting.</p><p><strong>Methods: </strong>VEIN STEP was an observational, prospective study conducted in adult outpatients who consulted for symptomatic CVD (NCT04574375). CVD symptoms (10-cm Visual Analog Scale and Patient Global Impression of Change), disease severity (Venous Clinical Severity Score), and QoL (Chronic Venous Insufficiency Questionnaire [CIVIQ-14]) were assessed.</p><p><strong>Results: </strong>Overall, 6084 patients were analyzed, of whom 702 (11.5%) had T2D. These patients were more likely to be older, present with a more advanced CEAP class, have a higher body mass index, greater symptom severity and reduced QoL scores than those without T2D (p<0.001 for all). Almost all patients with T2D (97.3%) received VAD-based treatment, mainly micronized purified flavonoid fraction (MPFF, 72.2%) or diosmin (24.6%). After 4 weeks, conservative therapy was associated with significant improvements in CVD symptoms and QoL (p<0.001). Physicians also noted a significant improvement in disease severity (p<0.001). The decrease in global symptom intensity was significantly greater among patients treated with MPFF than in those treated with diosmin (mean -2.7±1.8 vs -2.0±1.8, p=0.004). Greater reductions in symptom intensity were also observed in patients treated with MPFF for pain (p=0.011), leg heaviness (p=0.006), and swelling (p=0.014), with a tendency for greater improvement of cramps. QoL improved for patients receiving MPFF and those receiving diosmin, with changes in CIVIQ-14 global index score of -21.3±15.8 and -15.5±14.6, respectively.</p><p><strong>Conclusion: </strong>These findings indicate that patients with concomitant CVD and T2D are more likely to have greater symptom severity and disease burden. In such patients, VAD-based conservative therapy, particularly MPFF, was associated with significant improvements in CVD-related symptoms and QoL.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"22 ","pages":"556035"},"PeriodicalIF":3.2,"publicationDate":"2026-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12949572/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147327202","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}