{"title":"Additional role of low-density lipoprotein cholesterol on the risk of osteoporosis in men with or without coronary heart disease: a real-world longitudinal study.","authors":"Jing Zeng, Zi-Mo Pan, Ting Li, Ze-Yu Chen, Xiao-Yan Cai, Mei-Liang Gong, Xin-Li Deng, Sheng-Shu Wang, Nan Li, Miao Liu, Chun-Lin Li","doi":"10.26599/1671-5411.2025.02.008","DOIUrl":"10.26599/1671-5411.2025.02.008","url":null,"abstract":"<p><strong>Background: </strong>Early control of low-density lipoprotein cholesterol (LDL-C) is crucial for reducing the progress of cardiovascular disease. However, its additional role to the risk of primary osteoporosis in men with coronary heart disease was inconclusive. Our study aims to determine the association of LDL-C and its trajectories for osteoporosis risk in the middle-aged and aged men of China.</p><p><strong>Methods: </strong>The retrospective cohort study of 1546 men aged 69.74 ± 11.30 years conducted in Beijing, China from 2015 to 2022. And the incidence of primary osteoporosis was annually recorded. LDL-C trajectories were further identified by latent class growth model using repeated measurements of LDL-C. The association of baseline LDL-C for osteoporosis was estimated using hazard ratio (HR) with 95% CI in Cox proportional hazard model, while mean level and trajectories of LDL-C for osteoporosis were evaluated using odds ratio (OR) with 95% CI in logistic regression model.</p><p><strong>Results: </strong>During the median 6.2-year follow-up period, 70 men developed primary osteoporosis. The higher level of baseline LDL-C (HR = 1.539, 95% CI: 1.012-2.342) and mean LDL-C (OR = 2.190, 95% CI: 1.443-3.324) were associated with higher risk of osteoporosis in men with coronary heart disease after adjusted for covariates. Compared with those in the LDL-C trajectory of low-stable decrease, participants with medium-fluctuant trajectory, whose longitudinal LDL-C started with a medium LDL-C level and appeared an increase and then decrease, were negatively associated with osteoporosis risk (OR = 2.451, 95% CI: 1.152-5.216). And participants with initially high LDL-C level and then a rapid decrease demonstrated a tendency towards reduced risk (OR = 0.718, 95% CI: 0.212-2.437).</p><p><strong>Conclusions: </strong>Elevated LDL-C level and its long-term fluctuation may increase the risk of primary osteoporosis in men. Early controlling a stable level of LDL-C is also essential for bone health.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 2","pages":"219-228"},"PeriodicalIF":1.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Siti Zaleha Suki, Ahmad Syadi Mahmood Zuhdi, Abqariyah Yahya, Nur Lisa Zaharan
{"title":"Dual antiplatelets therapy prescription trends and mortality outcomes among senior citizens with acute coronary syndrome: insights from the Malaysian National Cardiovascular Disease Database.","authors":"Siti Zaleha Suki, Ahmad Syadi Mahmood Zuhdi, Abqariyah Yahya, Nur Lisa Zaharan","doi":"10.26599/1671-5411.2025.02.004","DOIUrl":"10.26599/1671-5411.2025.02.004","url":null,"abstract":"<p><strong>Objectives: </strong>To examine 5-year trends and variations in dual antiplatelet therapy (DAPT) prescription among multiethnic Malaysian patients aged 60 years and older.</p><p><strong>Methods: </strong>Using the Malaysian National Cardiovascular Disease-Acute Coronary Syndrome (NCVD-ACS) registry, DAPT 5-year temporal trends prescribing patterns at discharge were examined. Multivariate logistic regression was used to calculate the adjusted odds ratio (aOR) of DAPT prescription. The 1-year all-cause mortality by Cox proportional hazard regression model (adjusted hazard ratio, aHR) using inverse proportional weighting covariates adjustment was performed to assess DAPT prognostic impacts.</p><p><strong>Results: </strong>Data of patients aged 60 years and older were extracted from 2013 to 2017 (<i>n</i> = 3718, mean age: 68 ± 6.74 years, men: 72%, and Malay ethnicity: 43%). The majority of patients were diagnosed with non-ST-segment elevation acute coronary syndrome (63%), predisposed hypertension (76%) and were overweight (74%), while only 35% of patients underwent percutaneous coronary intervention. Over the five years, there was a significant increasing trend in DAPT prescriptions (<i>P</i> < 0.001), with the aspirin-clopidogrel combination being the most common. Aspirin-ticagrelor prescriptions have also increased over the years. Variations in DAPT prescriptions were observed based on patient characteristics. Patients who underwent percutaneous coronary intervention were more likely to be prescribed DAPT in general (aOR = 2.53, 95% CI: 1.95-3.28, <i>P</i> < 0.001) and aspirin-ticagrelor specifically (aOR = 7.76, 95% CI: 5.65-10.68, <i>P</i> < 0.001). Patients with chronic lung disease (aOR = 0.62, 95% CI: 0.42-0.92, <i>P</i> = 0.02) and a history of angina within two weeks (aOR = 0.69, 95% CI: 0.56-0.85, <i>P</i> < 0.001) were approximately 30% less likely to be prescribed DAPT. Approximately 15% of 1-year all-cause mortality were reported. Older patients prescribed DAPT showed significantly higher survival rates than those who were not (aHR < 1.0, <i>P</i> < 0.001). Aspirin-ticagrelor was associated with higher survival rates than aspirin-clopidogrel (aHR = 0.21, 95% CI: 0.11-0.40, <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>Despite the optimal prescription rate and variation of DAPT in the older Malaysian population, there is room for investigation and improvement in the prescription of newer DAPT combinations that have been suggested to improve patient survival.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 2","pages":"237-245"},"PeriodicalIF":1.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911155/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wei Zhang, Yi Chen, Lei-Xiao Hu, Jia-Hui Xia, Xiao-Fei Ye, Wen-Yuan-Yue Wang, Xin-Yu Wang, Quan-Yong Xiang, Qin Tan, Xiao-Long Wang, Xiao-Min Yang, De-Chao Zhao, Xin Chen, Yan Li, Ji-Guang Wang, For The Impression Investigators And Coordinators
{"title":"Exploring urban versus rural disparities in atrial fibrillation: prevalence and management trends among elderly Chinese in a screening study.","authors":"Wei Zhang, Yi Chen, Lei-Xiao Hu, Jia-Hui Xia, Xiao-Fei Ye, Wen-Yuan-Yue Wang, Xin-Yu Wang, Quan-Yong Xiang, Qin Tan, Xiao-Long Wang, Xiao-Min Yang, De-Chao Zhao, Xin Chen, Yan Li, Ji-Guang Wang, For The Impression Investigators And Coordinators","doi":"10.26599/1671-5411.2025.02.001","DOIUrl":"10.26599/1671-5411.2025.02.001","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a common cardiac arrhythmia in the elderly. This study aimed to evaluate urban-rural disparities in its prevalence and management in elderly Chinese.</p><p><strong>Methods: </strong>Consecutive participants aged ≥ 65 years attending outpatient clinics were enrolled for AF screening using handheld single-lead electrocardiogram (ECG) from April 2017 to December 2022. Each ECG rhythm strip was reviewed from the research team. AF or uninterpretable single-lead ECGs were referred for 12-lead ECG. Primary study outcome comparison was between rural and urban areas for the prevalence of AF. The Student's <i>t</i>-test was used to compare mean values of clinical characteristics between rural and urban participants, while the Pearson's chi-square test was used to compare between-group proportions. Multivariate stepwise logistic regression analysis was performed to estimate the association between AF and various patient characteristics.</p><p><strong>Results: </strong>The 29,166 study participants included 13,253 men (45.4%) and had a mean age of 72.2 years. The 7073 rural participants differed significantly (<i>P</i> ≤ 0.02) from the 22,093 urban participants in several major characteristics, such as older age, greater body mass index, and so on. The overall prevalence of AF was 4.6% (<i>n</i> = 1347). AF was more prevalent in 7073 rural participants than 22,093 urban participants (5.6% <i>vs.</i> 4.3%, <i>P</i> < 0.01), before and after adjustment for age, body mass index, blood pressure, pulse rate, cigarette smoking, alcohol consumption and prior medical history. Multivariate logistic regression analysis identified overweight/obesity (OR = 1.35, 95% CI: 1.17-1.54) in urban areas and cigarette smoking (OR = 1.62, 95% CI: 1.20-2.17) and alcohol consumption (OR = 1.42, 95% CI: 1.04-1.93) in rural areas as specific risk factors for prevalent AF. In patients with known AF in urban areas (<i>n</i> = 781) and rural areas (<i>n</i> = 338), 60.6% and 45.9%, respectively, received AF treatment (<i>P</i> < 0.01), and only 22.4% and 17.2%, respectively, received anticoagulation therapy (<i>P</i> = 0.05).</p><p><strong>Conclusions: </strong>In China, there are urban-rural disparities in AF in the elderly, with a higher prevalence and worse management in rural areas than urban areas. Our study findings provide insight for health policymakers to consider urban-rural disparity in the prevention and treatment of AF.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 2","pages":"246-254"},"PeriodicalIF":1.8,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11911157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143659658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Chinese Guidelines for the Prevention and Treatment of Hypertension (2024 revision).","authors":"Ji-Guang Wang","doi":"10.26599/1671-5411.2025.01.008","DOIUrl":"10.26599/1671-5411.2025.01.008","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 1","pages":"1-149"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pablo Díez-Villanueva, Pedro Cepas-Guillén, María Thiscal López Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Martín Negreira-Caamaño, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, David Escribano, Pablo Salinas, María Martínez-Avial, Antonio Martínez-Guisado, Clea González-Maniega, Felipe Díez-Delhoyo
{"title":"One-year clinical events according to frailty in older patients with non-ST elevation acute coronary syndrome undergoing coronary angiography: an analysis of the IMPACT-TIMING-GO study.","authors":"Pablo Díez-Villanueva, Pedro Cepas-Guillén, María Thiscal López Lluva, Alfonso Jurado-Román, Pablo Bazal-Chacón, Martín Negreira-Caamaño, Iván Olavarri-Miguel, Ane Elorriaga, Ricardo Rivera-López, David Escribano, Pablo Salinas, María Martínez-Avial, Antonio Martínez-Guisado, Clea González-Maniega, Felipe Díez-Delhoyo","doi":"10.26599/1671-5411.2025.01.003","DOIUrl":"10.26599/1671-5411.2025.01.003","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the prevalence and one-year prognosis associated with frailty in a contemporary cohort of older patients with non-ST-elevation acute coronary syndrome (NSTEACS).</p><p><strong>Methods: </strong>The IMPACT-TIMING-GO registry (IMPACT of Time of Intervention in patients with Myocardial Infarction with Non-ST seGment elevation. ManaGement and Outcomes) prospectively included 1020 patients with NSTEACS undergoing invasive coronary angiography between April and May 2021. For this sub-study, patients ≥ 65 years were selected. Frailty was assessed according to FRAIL scale. We studied all-cause mortality and the composite of all-cause mortality or all-cause hospitalizations at one-year follow-up after discharge.</p><p><strong>Results: </strong>Five hundred and sixty seven patients (mean age: 75.8 ± 6.7 years, 28.2% women) were included: 316 (55.7%) were robust, 183 (32.3%) prefrail, and 68 (12.0%) frail. Frail patients were significantly older, more often women, and presented a worse baseline clinical profile. There were no differences among groups regarding pretreatment with a P2Y12 inhibitor. An urgent angiography (< 24 h) was less frequently performed in frail patients, with no differences regarding revascularization approach or in main in-hospital adverse events, although acute kidney disease occurred more frequently in frail patients. At 1-year follow-up, 20 patients died (3.6%). Chronic kidney disease was independently associated with 1-year all-cause death, although a trend towards higher mortality was observed in frail patients (HR = 3.01; 95% CI: 0.93-9.78; <i>P</i> = 0.065). Frailty was independently associated with higher 1-year all-cause mortality or all-cause rehospitalizations (HR = 2.23; 95% CI: 1.43-3.46; <i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>In older patients with NSTEACS, frailty independently associates higher all-cause mortality or all-cause hospital admissions at one-year follow-up.</p>","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 1","pages":"159-168"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937830/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hadeer Elsharnoby, Louie Kamel-Abusalha, Ahmed Maraey, George V Moukarbel
{"title":"Temporal trends and contemporary outcomes of percutaneous left atrial appendage occlusion in nonagenarians.","authors":"Hadeer Elsharnoby, Louie Kamel-Abusalha, Ahmed Maraey, George V Moukarbel","doi":"10.26599/1671-5411.2025.01.005","DOIUrl":"10.26599/1671-5411.2025.01.005","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 1","pages":"210-213"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abdominal wall hematoma related to subcutaneous low-molecular-weight heparin injection following coronary intervention therapy: case presentation.","authors":"Xiao-Hua Liu, Yi-Zhou Xu","doi":"10.26599/1671-5411.2025.01.002","DOIUrl":"10.26599/1671-5411.2025.01.002","url":null,"abstract":"","PeriodicalId":51294,"journal":{"name":"Journal of Geriatric Cardiology","volume":"22 1","pages":"214-218"},"PeriodicalIF":1.8,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11937832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}