European Journal of Cardiovascular Prevention & Rehabilitation最新文献

{"title":"Anemia does not preclude increments in cardiac performance during a short period of intensive, exercise-based cardiac rehabilitation.","authors":"Fabio Bellotto,&nbsp;Pietro Palmisano,&nbsp;Leonida Compostella,&nbsp;Nicola Russo,&nbsp;Maria Zaccaria,&nbsp;Piero Guida,&nbsp;Tiziana Setzu,&nbsp;Arianna Cati,&nbsp;Anna Maddalozzo,&nbsp;Stefano Favale,&nbsp;Sabino Iliceto","doi":"10.1177/1741826710389372","DOIUrl":"https://doi.org/10.1177/1741826710389372","url":null,"abstract":"<p><strong>Background and aims: </strong>Anemia seems to be rather common in cardiac rehabilitation patients but it is not known whether it could influence cardiovascular performance indexes and prognosis immediately after an acute cardiac event. The purposes of this study were to define its prevalence and to investigate the safety and efficacy of an intensive exercise-based cardiac rehabilitation in patients with and without anemia.</p><p><strong>Methods: </strong>436 participants (77% males; mean age 64 ± 13 years) were submitted to a two-week cardiac rehabilitation program consisting of low to medium intensity, individualized training with respiratory, aerobic and calisthenic exercises (three sessions daily, six times per week). A six-minute walking test was performed at enrolment and repeated at discharge together with a cardiopulmonary test.</p><p><strong>Results: </strong>Anemia, as defined according to World Health Organization criteria, was detected in 328 patients (75.2% of the entire population). The distance walked increased from 381 ± 117 m at baseline to 457 ± 110 m (p < 0.001) after a mean period of 12.4 ± 4 days. A direct correlation was found between hemoglobin concentrations and both the absolute distance walked (r = 0.48; p < 0.001) and peak VO(2) (r = 0.39; p < 0.001). Anemic patients walked a significantly shorter distance at baseline and at discharge (p < 0.001); however, both groups showed the same increment in the distance walked: 76.0 ± 61 m vs 76.0 ± 60 m (p = 0.99).</p><p><strong>Conclusions: </strong>Our data indicate: 1) a high prevalence of anemia in the study population and 2) that, in spite of a clear reduction in exercise capacity, a moderate anemia does not preclude increments in cardiac performance during a short period of intensive, exercise-based cardiac rehabilitation.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389372","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29781520","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":"Strategies for the prevention of sudden cardiac death during sports.","authors":"Domenico Corrado,&nbsp;Jonathan Drezner,&nbsp;Cristina Basso,&nbsp;Antonio Pelliccia,&nbsp;Gaetano Thiene","doi":"10.1177/1741826710389924","DOIUrl":"https://doi.org/10.1177/1741826710389924","url":null,"abstract":"<p><p>Sudden cardiac death of a young athlete is the most tragic event in sports and devastates the family, the sports medicine team, and the local community. Such a fatality represents the first manifestation of cardiac disease in up to 80% of young athletes who remain asymptomatic before sudden cardiac arrest occurs; this explains the limited power of screening modalities based solely on history and physical examination. The long-running Italian experience showed that electrocardiogram (ECG) screening definitively improves the sensitivity of pre-participation evaluation for heart diseases and substantially reduces the risk of death in the athletic field (primary prevention). However, some cardiac conditions, such as coronary artery diseases, present no abnormalities on 12-lead ECG. Moreover, cardiac arrest due to non-penetrating chest injury (commotio cordis) cannot be prevented by screening. This justifies the efforts for implementing programmes of early external defibrillation of unpredictable arrhythmic cardiac arrest. This article reviews the epidemiology of sudden cardiac arrest in the athlete in terms of incidence, sport-related risk, underlying causes, and the currently available prevention programmes such as pre-participation screening and early external defibrillation by using automated external defibrillators. The best strategy is to combine synergistically primary prevention of sudden cardiac death by pre-participation identification of athletes affected by at-risk cardiomyopathies and secondary prevention with back-up defibrillation of unpredictable sudden cardiac arrest on the athletic field.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389924","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29878847","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":"Seasonal variation in incidence of acute myocardial infarction in a sub-Arctic population: the Tromsø Study 1974-2004.","authors":"Laila Arnesdatter Hopstock,&nbsp;Tom Wilsgaard,&nbsp;Inger Njølstad,&nbsp;Jan Mannsverk,&nbsp;Ellisiv B Mathiesen,&nbsp;Maja-Lisa Løchen,&nbsp;Kaare Harald Bønaa","doi":"10.1097/HJR.0b013e32833c7c28","DOIUrl":"https://doi.org/10.1097/HJR.0b013e32833c7c28","url":null,"abstract":"<p><strong>Background: </strong>A seasonal pattern with higher winter morbidity and mortality has been reported for acute myocardial infarction (MI). The magnitude of the difference between peak and nadir season has been associated with latitude, but results are inconsistent. Studies of seasonal variation of MI in population-based cohorts, based on adjudicated MI cases,are few.We investigated the monthly and seasonal variation in first-ever nonfatal and fatal MI in the population of Tromsø in northern Norway, a region with a harsh climate and extreme seasonal variation in daylight exposure.</p><p><strong>Design: </strong>Prospective population-based cohort study.</p><p><strong>Methods: </strong>A total of 37 392 participants from the Tromsø Study enrolled between 1974 and 2001 were followed throughout 2004. Each incident case of MI was validated by the review of medical records and death certificates. MI incidence rates for months and seasons were analyzed for seasonal patterns with Poisson regression and the Cosinor procedure. All analyses were stratified by sex, age and smoking status.</p><p><strong>Results: </strong>A total of 1893 first-ever MIs were registered, of which 592 were fatal. There was an 11 % (95% confidence interval: 1.00-1.23, P=0.04) increased risk of incident MI during winter (November-January) compared with non-winter seasons, with no statistically significant interaction with sex, age, smoking or calendar year. Other seasonal modelling gave similar but not statistically significant results.</p><p><strong>Conclusion: </strong>We found a small increase in risk of incident MI during the darkest winter months. Populations living in sub-Arctic areas may be adapted to face climate exposure during winter through behavioural protection.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e32833c7c28","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29104555","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":"Prediction of coronary heart disease risk by Framingham and SCORE risk assessments varies by socioeconomic position: results from a study in British men.","authors":"Sheena E Ramsay,&nbsp;Richard W Morris,&nbsp;Peter H Whincup,&nbsp;A Olia Papacosta,&nbsp;Mary C Thomas,&nbsp;S Goya Wannamethee","doi":"10.1177/1741826710389394","DOIUrl":"https://doi.org/10.1177/1741826710389394","url":null,"abstract":"<p><strong>Aim: </strong>Evidence is limited on performance of the Framingham risk score (FRS) in different socioeconomic groups; similar limitations apply to the Systematic Coronary Risk Evaluation (SCORE). We examined the performance of coronary risk prediction systems in different socioeconomic groups in British men.</p><p><strong>Methods and results: </strong>In a socially and geographically representative cohort of British men aged 40-59 between 1978 and 1980, predicted 10-year coronary heart disease (CHD) (fatal and non-fatal) risk was calculated using FRS, and CHD mortality using SCORE. Prevalent cardiovascular disease cases were excluded. Occupational social class ranged from I (professionals) to V (unskilled workers), and was summarized as non-manual (I, II, III non-manual) and manual (III manual, IV, V). Both FRS and SCORE over-estimated 10-year CHD risk; over-prediction by both was particularly marked in high social classes. With FRS, predicted/observed risk fell progressively from 2.30 in social class I to 1.19 in social class V. Sensitivity of FRS at a ≥20% threshold (27% of men) fell from 53% to 37% from social class I to V; specificity varied similarly. With SCORE, predicted/observed CHD mortality fell from 1.53 to 1.26 from social class I to V; sensitivity at a ≥5% threshold (29% of men) fell between non-manual (61%) and manual (57%) groups, as did specificity. However, including social class in FRS barely improved risk prediction (net reclassification improvement = 0.18%).</p><p><strong>Conclusions: </strong>Framingham and SCORE predictions varied between socioeconomic groups and are more likely to identify those at greater CHD risk in higher socioeconomic groups. To ensure equitable primary prevention, strategies to adequately estimate risk in lower socioeconomic groups (at increased CHD risk) should be developed.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29781523","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":"Preventing sudden cardiac death in athletes: finding the needle in the haystack or closing the barn door?","authors":"Arend Mosterd,&nbsp;Jeff P Senden,&nbsp;Peter Engelfriet","doi":"10.1177/1741826710389374","DOIUrl":"https://doi.org/10.1177/1741826710389374","url":null,"abstract":"The sudden, unexpected demise of an athlete is a devastating event that invariably leads to calls for prevention. In this edition of the journal, Corrado and colleagues provide an overview of strategies to prevent sudden cardiac death during sports. Timely identification of asymptomatic athletes at increased risk of sudden cardiac death (finding the needle in the haystack) or prompt resuscitation efforts with the use of an automated external defibrillator if an athlete suffers a cardiac arrest (closing the barn door) are two complementary strategies. The former strategy is largely based on the Italian practice of mandatory preparticipation screening of young athletes (aged 35 years or younger) launched in 1982. The latter strategy is addressed in the pioneering work of Drezner, co-author of Corrado et al. The Italian experience, which has provided the sports medicine community with a wealth of information on different cardiologic aspects of (intense) training, forms the basis for the 2005 European Society of Cardiology (ESC) consensus statement that essentially recommends routine preparticipation screening of young athletes. As such these recommendations are based on information from a population-based, observational study and expert opinion, which would qualify the level of scientific evidence for this intervention (mandatory preparticipation screening) as Class II B (usefulness/efficacy is less well established by evidence/ opinion) and level of evidence C. This view is reflected in the 2007 American Heart Association scientific statement ‘Exercise and Acute Cardiovascular Events, placing the risks into perspective’: ‘. . . other strategies, such as screening patients before participation in exercise. . . appear prudent, but have not been systematically evaluated’. Professor Corrado is one of the authors of this statement. The ESC recommendations have provoked fierce debates and opponents of mandatory screening have made their case, often noting that the Italian setting is likely to differ from that in many other countries, both in terms of incidence and causes of sudden death in young athletes and, more importantly, in the availability of highly trained physicians that perform the preparticipation evaluation of many thousands of athletes on a 2-yearly basis. Notwithstanding the intrinsic appeal of screening to prevent future events, the harsh reality is that only few screening programmes live up to the expectations. Even the case for diabetes mellitus screening, a highly prevalent condition that is well studied in terms of diagnostic tests, prognosis, and treatment, is not very strong. It seems evident that, at this moment in time, accepted prerequisites for screening are not met for routine preparticipation screening of young athletes, as discussed below.","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389374","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29781524","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":"Prevalence of impaired coronary flow reserve and its association with left ventricular diastolic function in asymptomatic individuals with major cardiovascular risk factors.","authors":"George Karayannis,&nbsp;Gregory Giamouzis,&nbsp;Elias Alexandridis,&nbsp;Panagiotis Kamvrogiannis,&nbsp;Javed Butler,&nbsp;John Skoularigis,&nbsp;Filippos Triposkiadis","doi":"10.1177/1741826710389356","DOIUrl":"https://doi.org/10.1177/1741826710389356","url":null,"abstract":"<p><strong>Aim: </strong>The aims of this study were to evaluate: i) the prevalence of impaired coronary flow reserve (CFR), ii) the association of impaired CFR with indices of left ventricular function, and iii) the independent predictors of impaired CFR in a cohort of high-risk asymptomatic individuals.</p><p><strong>Methods: </strong>Ninety-nine consecutive individuals (age, 52.5 ± 13.2 years; 68% male; left ventricular ejection fraction, 62 ± 6%) with at least one major cardiovascular risk factor (49% hypertension, 23% diabetes mellitus, 42% hypercholesterolemia, 32% smoking) were evaluated. Based on CFR values, patients were divided into normal (CFR ≥2.5), borderline (2.5>CFR ≥2.0), and abnormal (CFR < 2.0). Left ventricular function was assessed with comprehensive transthoracic echocardiography.</p><p><strong>Results: </strong>Impaired CFR was identified in 39 individuals (borderline, n = 25; abnormal, n = 14). Isovolumic relaxation time was significantly increased for abnormal compared with normal CFR (94 ± 12 vs. 85 ± 11 msec, p < 0.05), as was the left atrial volume index (LAVI) (24 ± 7 cm(3)/m(2) vs. 19.1 ± 5.2, p < 0.01). A stepwise linear regression analysis identified the LAVI and the deceleration time of E wave of transmitral flow as the only independent predictors of CFR value. An ordinal regression analysis model revealed two predictors of CFR categorization: diabetes mellitus (proportional odds ratio (POR) for CFR group deterioration, 4.55; 95% confidence interval (CI), 1.13-18.28; p = 0.033) and LAVI (POR, 1.11 per 1 cm(3)/m(2) increment; 95% CI, 1.01-1.23; p = 0.034).</p><p><strong>Conclusions: </strong>CFR is often impaired among asymptomatic individuals with major cardiovascular risk factors and is associated with changes in left ventricular diastolic function and left atrial size. The prognostic importance of these early derangements should be assessed in prospective studies.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389356","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779843","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":"Comparison of waist-to-hip ratio and other obesity indices as predictors of cardiovascular disease risk in people with type-2 diabetes: a prospective cohort study from ADVANCE.","authors":"Sébastien Czernichow,&nbsp;Andre-Pascal Kengne,&nbsp;Rachel R Huxley,&nbsp;George David Batty,&nbsp;Bastiaan de Galan,&nbsp;Diederick Grobbee,&nbsp;Avinesh Pillai,&nbsp;Sophia Zoungas,&nbsp;Michel Marre,&nbsp;Mark Woodward,&nbsp;Bruce Neal,&nbsp;John Chalmers","doi":"10.1097/HJR.0b013e32833c1aa3","DOIUrl":"https://doi.org/10.1097/HJR.0b013e32833c1aa3","url":null,"abstract":"<p><strong>Aims: </strong>The aim of this study was to compare the strength of associations and discrimination capability of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) with cardiovascular disease risk in individuals with type-2 diabetes.</p><p><strong>Methods and results: </strong>Eleven thousand, one hundred and forty men and women were followed for a mean of 4.8 years. The Cox proportional hazard models were used to compute the hazard ratios and 95% confidence intervals (95% CI) for one standard deviation (SD) increase in baseline BMI (SD: 5 kg/m2), WC (SD: 13 cm) and WHR (SD: 0.08) with cardiovascular disease risk. After adjustment, hazard ratio (95% CI) for WC were 1.10 (1.03–1.18) for cardiovascular events, 1.13 (1.03–1.24) for coronary events, and 1.08 (0.98–1.19) for cardiovascular deaths. Estimates for WHR were 1.12 (1.05–1.19), 1.17 (1.08–1.28) and 1.19 (1.09–1.31). BMI was not related to any of these outcomes. Although the receiver operating characteristic curve could not differentiate between anthropometric variables (P values 0.24), the relative integrated discrimination improvement statistic showed an enhancement in the discrimination capabilities of models using WHR for cardiovascular outcomes, except for cerebrovascular events.</p><p><strong>Conclusion: </strong>Strengths of associations and discrimination statistics suggested that WHR was the best predictor of cardiovascular events and mortality in patients with type-2 diabetes and BMI the worst.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e32833c1aa3","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29120829","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":"Knowledge gaps about smoking cessation in hospitalized patients and their doctors.","authors":"Tobias Raupach,&nbsp;Jacqueline Merker,&nbsp;Gerd Hasenfuss,&nbsp;Stefan Andreas,&nbsp;Andrew Pipe","doi":"10.1177/1741826710389370","DOIUrl":"https://doi.org/10.1177/1741826710389370","url":null,"abstract":"<p><strong>Background: </strong>Hospitalization is an opportune time for smoking cessation support; cessation interventions delivered by hospital physicians are effective. While general practitioners' and outpatients' knowledge and attitudes towards smoking cessation have been studied in great detail, in-patient cessation programmes have received less attention.</p><p><strong>Design: </strong>Questionnaire-based survey of a convenience sample of hospital physicians and in-patients at Göttingen University Hospital, Germany.</p><p><strong>Methods: </strong>All 159 physicians directly involved in bedside care on medical and surgical wards received a three-page questionnaire examining smoking status, knowledge of smoking-attributable morbidity and mortality, and their understanding of the effectiveness of methods to achieve long-term smoking cessation. Perceived barriers to the delivery of counselling and cessation services to smoking patients were identified. One thousand randomly selected patients on medical (N = 400) and surgical (N = 600) wards were invited to complete a similar questionnaire.</p><p><strong>Results: </strong>Seventy-seven physicians (response rate 48.4%) and 675 patients (67.5%) completed the questionnaire. Patients and physicians alike underestimated the smoking-attributable risk of developing smoking-related cancers and chronic obstructive lung disease. In addition, severe misperceptions regarding the effectiveness of cessation methods were noted in both populations with 'willpower' being thought to be most effective in achieving abstinence. Only one-third of smoking patients recalled having been counselled to quit. Physicians identified lack of time as a central barrier to counselling smoking patients.</p><p><strong>Conclusions: </strong>These findings suggest that hospitalized smokers in a large German university hospital might not be treated according to international guidelines.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389370","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779844","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":"Differences in management and outcomes between male and female patients with atherothrombotic disease: results from the REACH Registry in Europe.","authors":"Jonathan Morrell,&nbsp;Uwe Zeymer,&nbsp;Iris Baumgartner,&nbsp;Tobias Limbourg,&nbsp;Joachim Röther,&nbsp;Deepak L Bhatt,&nbsp;Ph Gabriel Steg","doi":"10.1097/HJR.0b013e32833cca34","DOIUrl":"https://doi.org/10.1097/HJR.0b013e32833cca34","url":null,"abstract":"<p><strong>Background: </strong>Although guidelines recommend similar evaluation and treatment for both sexes, differences in approach and outcomes have been reported.</p><p><strong>Design: </strong>Prospective, observational registry.</p><p><strong>Methods: </strong>Consecutive patients at high cardiovascular risk were assessed for risk factors and management at baseline,and followed-up for 2 years.</p><p><strong>Results: </strong>Twenty-two thousand and twenty-eight patients with documented arterial disease (symptomatic) or three or more atherothrombotic risk factors (asymptomatic) completed the 2-year follow-up of the REduction of Atherothrombosis for Continued Health Registry in Europe (women, 31.5%; men, 68.4%). Women patients were 3.3 years (mean) older than men. Few differences were observed between asymptomatic men and women in risk factor profile or management at baseline. Higher proportions of symptomatic women than men had diabetes (P<0.001), hypertension (P<0.0001), elevated total cholesterol levels (P<0.0001) or elevated triglycerides (P<0.01). A much lower proportion of women than men were current smokers (asymptomatic, 14.6 vs. 29.3%; symptomatic, 11.9 vs.19.5%, both P<0.0001). Within the symptomatic population, women received antithrombotic agents (91.8 vs. 94.9%,P<0.0001) and lipid-lowering agents (68.2 vs. 73.1%, P<0.0001) less frequently than men. After multivariate adjustment,fewer symptomatic women than men had undergone coronary revascularizations at 2 years (odds ratio, 0.72; 95% confidence interval, 0.61-0.85). There were no differences in primary outcomes, including cardiovascular death/myocardial infarction/stroke (odds ratio, 1.01, 95% confidence interval, 0.93-1.11, P=0.78), between the sexes.</p><p><strong>Discussion: </strong>Although no differences were found in cardiovascular event rates at 2-year follow-up, secondary prevention could be improved in women, which might further reduce event rates.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1097/HJR.0b013e32833cca34","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29104554","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":"Body mass index is closely correlated to incident diabetes in patients with heart failure or myocardial infarction.","authors":"Michelle Schmiegelow,&nbsp;Charlotte Andersson,&nbsp;Jonas B Olesen,&nbsp;Steen Z Abildstrom,&nbsp;Lars Kober,&nbsp;Christian Torp-Pedersen","doi":"10.1177/1741826710389420","DOIUrl":"https://doi.org/10.1177/1741826710389420","url":null,"abstract":"<p><strong>Background: </strong>Diabetes in patients with heart failure or myocardial infarction (MI) increases morbidity and mortality, but little is known about the impact of obesity on the risk of developing diabetes in these populations.</p><p><strong>Design: </strong>A cohort of patients consecutively hospitalized with heart failure (n = 3472) or MI (n = 5723) was followed in the period 1995-2006.</p><p><strong>Methods: </strong>Multivariable Cox proportional-hazard models were used to estimate the risk of developing diabetes according to the World Health Organization body mass index (BMI) classification. Normal weight patients (BMI 18.5-24.9 kg/m(2)) were used as the reference.</p><p><strong>Results: </strong>In both populations, more than half of the patients with a BMI above 34.9 kg/m(2) developed diabetes. In heart failure patients, a BMI above 24.9 kg/m(2) was associated with an increased risk of diabetes for the three BMI groups, i.e. 25.0-29.9 kg/m(2), 30.9-34.9 kg/m(2), and >34.9 kg/m(2), with adjusted hazard ratios (HRs) of 2.16 (95% confidence interval 1.50-3.12), 3.89 (2.61-5.78), and 6.06 (3.79-9.69), respectively. In MI patients, the adjusted HRs in the three corresponding BMI groups were 1.84 (1.44-2.37), 4.31 (3.26-5.69), and 9.50 (6.70-13.46), respectively. Incident diabetes was associated with increased cardiovascular and all-cause mortality risks with adjusted HRs of greater magnitude than in prevalent diabetes.</p><p><strong>Conclusion: </strong>BMI was an independent predictor of incident diabetes in patients with either heart failure or MI. More than half of the patients with a BMI above 34.9 kg/m(2) developed diabetes during follow-up. Incident diabetes carries an increased mortality risk.</p>","PeriodicalId":50492,"journal":{"name":"European Journal of Cardiovascular Prevention & Rehabilitation","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2011-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/1741826710389420","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29779842","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}