Heart & LungPub Date : 2025-03-11DOI: 10.1016/j.hrtlng.2025.03.003
Alperen Aksakal , Buğra Kerget , Burcu Nur Gülbahar , Esra Laloğlu , Leyla Sağlam
{"title":"Can apelins guide the diagnosis of coronary artery disease in COPD patients?","authors":"Alperen Aksakal , Buğra Kerget , Burcu Nur Gülbahar , Esra Laloğlu , Leyla Sağlam","doi":"10.1016/j.hrtlng.2025.03.003","DOIUrl":"10.1016/j.hrtlng.2025.03.003","url":null,"abstract":"<div><h3>Background</h3><div>Apelins are adipokines known for their anti-inflammatory, vasodilator, and antiatherosclerotic effects. They are involved in the pathogenesis of chronic diseases like chronic obstructive pulmonary disease (COPD) and coronary artery disease (CAD).</div></div><div><h3>Objectives</h3><div>This study aims to investigate apelin as a potential biomarker for early diagnosis and management of CAD in COPD patients.</div></div><div><h3>Methods</h3><div>The study included 73 stable COPD patients admitted between June 2023 and June 2024 and 35 healthy volunteers matched by age and gender. COPD patients were categorized into two groups: those without CAD (Group 1) and those with CAD (Group 2). Serum levels of apelin 12, 13, 17, and 36 were measured using ELISA.</div></div><div><h3>Results</h3><div>Serum apelin levels were significantly lower in COPD patients than in controls (<em>p</em> < 0.001). Among COPD patients, those with CAD showed lower serum apelin levels compared to those without CAD (<em>p</em> = 0.005 for apelin 12, <em>p</em> < 0.001 for apelin 13, 17, and 36). ROC analysis indicated high sensitivity and specificity for apelin 13 and 36 in predicting CAD in COPD patients. Apelin 13 and 36 were positively correlated with ejection fraction (EF) (<em>R</em> = 0.43, <em>p</em> = 0.01; <em>R</em> = 0.4, <em>p</em> = 0.01), and apelin 12 was positively correlated with FEV1 and FVC (<em>R</em> = 0.24, <em>p</em> = 0.04; <em>R</em> = 0.27, <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>While CAD worsens the prognosis in COPD patients, it remains underdiagnosed. Serum apelin, especially apelin 13 and 36, may assist in the early diagnosis and management of CAD in COPD patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 90-97"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143594001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart & LungPub Date : 2025-03-11DOI: 10.1016/j.hrtlng.2025.03.002
Sibo Liu , Nicholas Graves , Chenxinan Ma , Jingxiang Pan , Yewei Xie , Shan Yin Audry Lee , Sameera Senanayake , Sanjeewa Kularatna
{"title":"Preventability of readmissions for patients with heart failure - A scoping review","authors":"Sibo Liu , Nicholas Graves , Chenxinan Ma , Jingxiang Pan , Yewei Xie , Shan Yin Audry Lee , Sameera Senanayake , Sanjeewa Kularatna","doi":"10.1016/j.hrtlng.2025.03.002","DOIUrl":"10.1016/j.hrtlng.2025.03.002","url":null,"abstract":"<div><h3>Background</h3><div>Heart failure (HF) remains a significant global health issue and poses challenges to patient families and healthcare systems through index hospitalizations and subsequent readmissions. The readmission rate has been utilized as a quality indicator, and a proportion of readmissions are perceived preventable. However, the definitions and measures of preventability remain unclear and inconsistent, lacking an explicit integration, analysis, and critique of current evidence.</div></div><div><h3>Objectives</h3><div>This scoping review aims to improve the understanding of the definitions and measures of preventable readmissions for patients with HF, by identifying the judgements in published literature and examining the reasonings behind them.</div></div><div><h3>Methods</h3><div>Systematic literature searches with a search strategy combining three compartments describing preventability, readmission, and HF were conducted. The inclusion and exclusion were performed against prespecified eligibility criteria.</div></div><div><h3>Results</h3><div>A total of 15 papers were identified. Substantial heterogeneity was observed in study characteristics and judgement of preventability. The proportion of readmissions deemed preventable ranged vastly from 6.66 % to 86 % and required careful interpretation due to inconsistency of denominators. The reasonings behind preventability can be categorized into four groups based on nature, focus, and purpose.</div></div><div><h3>Conclusions</h3><div>There is currently no consensus on definitions and measures of preventable readmissions for patients with HF. Scattered research efforts were observed with inconsistent and unstandardized methods, criteria, and data used for judgement of preventability. Adopting an identical readmission calculation framework is critical for fair comparison. The timeframe of readmission is worth further reconsideration and investigation. Comprehensive, explicit, and disease-specific judgement criteria for preventable readmissions are urgently needed.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 81-89"},"PeriodicalIF":2.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143593977","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}
Heart & LungPub Date : 2025-03-09DOI: 10.1016/j.hrtlng.2025.03.001
Christina L. Craigo DNP MSN ACNP AACC , Claire M. Dow MSN AGACNP FNP , Yervant M. Malkhasian PharmD , Margo B. Minissian PhD, ACNP, AACC , Ronit Zadikany MD FACC , Raymond Zimmer MD FACC
{"title":"A multidisciplinary transition of care approach to reduce 30-day readmissions in heart failure patients","authors":"Christina L. Craigo DNP MSN ACNP AACC , Claire M. Dow MSN AGACNP FNP , Yervant M. Malkhasian PharmD , Margo B. Minissian PhD, ACNP, AACC , Ronit Zadikany MD FACC , Raymond Zimmer MD FACC","doi":"10.1016/j.hrtlng.2025.03.001","DOIUrl":"10.1016/j.hrtlng.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>While advancements in pharmacologic and device therapies have improved survival, one in five adults with heart failure (HF) patients is readmitted within 30 days of discharge. Thus, the epidemic of HF is largely one of increasing hospitalizations.</div></div><div><h3>Objective</h3><div>To determine if a comprehensive HF program reduces 30-day readmission rate.</div></div><div><h3>Methods</h3><div>A convenience sample of adults with Medicare and HF (N = 1617) admitted to a large academic medical center were identified. Patients received HF education by a specialized registered nurse while inpatient and were seen by a pharmacist prior to discharge. Post-discharge, patients were called by a pharmacist within 72 h, followed by an ambulatory care manager for 90 days, and scheduled for a multidisciplinary clinic visit with a nurse practitioner within 7 days of hospitalization. High risk patients were referred to a community health worker (CHW). Clinic services included phlebotomy, education, point-of-care ultrasound, intravenous diuretic administration, and referrals to appropriate services. Data were analyzed descriptively.</div></div><div><h3>Results</h3><div>The 30-day readmission rate was 18.39 % (N = 930) during the intervention period compared to 22.71 % (N = 617) at baseline, resulting in a 4.32 % reduction, <em>p</em> value 0.0325. Approximately 40 percent of the patient cohort was over age 85. Pharmacy was able to contact greater than 86 % of patients post discharge. Only half of patients were agreeable to ambulatory care management. Less than half (42 %) of eligible patients were seen in the post-discharge clinic. The CHW supported approximately 146 patients in a 9-month period.</div></div><div><h3>Conclusions</h3><div>A real-world comprehensive multidisciplinary team approach to the management of HF patients can reduce 30-day hospital readmissions.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 76-80"},"PeriodicalIF":2.4,"publicationDate":"2025-03-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143577718","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparing perceptions of leading causes of death in a diverse sample of community-dwelling women in the United States","authors":"Yoshimi Fukuoka PhD, RN, FAAN (Professor) , Diane Dagyong Kim MA, PhD (student) , Haruno Suzuki MS, RN, PhD (student) , Kenji Sagae PhD (Professor) , Holli A. DeVon PhD, RN, FAAN, FAHA (Professor) , Thomas J. Hoffmann PhD (Professor) , Jingwen Zhang PhD (Associate Professor)","doi":"10.1016/j.hrtlng.2025.02.007","DOIUrl":"10.1016/j.hrtlng.2025.02.007","url":null,"abstract":"<div><h3>Background</h3><div>Heart disease is the leading cause of death (LCOD) for women in the United States. However, despite decades of public health campaigns, awareness of heart disease among women, especially those with racial/ethnic minority backgrounds and young women, significantly declined from 2009 to 2019.</div></div><div><h3>Objectives</h3><div>The aim of this study was to compare the differences in heart disease awareness as the LCOD among Black, Hispanic, White, and Asian/Other women groups.</div></div><div><h3>Methods</h3><div>In this cross-sectional, online survey study, 422 community-dwelling women were analyzed. Heart disease as the LCOD was categorized as the correct answer. We implemented log-linear models via a Poisson regression to estimate unadjusted and adjusted relative risks [RRs] of race in predicting correct knowledge of LCOD.</div></div><div><h3>Results</h3><div>The mean age was 41.2 (±12.9) years. The sample represents 39.8 % Hispanic, 28.4 % White, 19.9 % Black, 11.9 % Asian/others. After adjusting for age and cardiovascular disease risks, Black and Hispanic women, as compared to White women, had significantly lower awareness of heart disease as the LCOD [(Adjusted RR=0.69, 95 % CI: 0.52, 0.92); (Adjusted RR= 0.78, 95 % CI: 0.78 -0.94), respectively]. Additionally, physical inactivity and hypertension medication intake were significantly associated with this level of awareness (<em>P</em> < 0.5).</div></div><div><h3>Conclusion</h3><div>Lower heart disease awareness in Black and Hispanic women persists. It is crucial to develop more effective approaches to close this disparity. Testing new methods, such as applying artificial intelligence to send more culturally appropriate and personalized messages, is urgently needed to raise women's awareness of their heart disease risk.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 69-75"},"PeriodicalIF":2.4,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143520999","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":"Effects of the oral probiotic Familact on dyspnea management in COPD patients: A randomized controlled trial","authors":"Mehdi Aghamohammadi , Samad Ghodrati , Nooshin Jalili , Roghayeh Jafari , Effat Rafiee , Koorosh Kamali , Mahsa Ghasemi , Javad Alizargar","doi":"10.1016/j.hrtlng.2025.02.002","DOIUrl":"10.1016/j.hrtlng.2025.02.002","url":null,"abstract":"<div><h3>Background</h3><div>Emerging evidence suggests that oral probiotics may enhance the immune response in respiratory diseases, offering potential benefits in managing Chronic Obstructive Pulmonary Disease (COPD).</div></div><div><h3>Objectives</h3><div>This trial aims to evaluate whether the addition of the oral probiotic Familact to standard therapies significantly enhances dyspnea management in COPD patients compared to standard treatment alone.</div></div><div><h3>Methods</h3><div>In this single-blind randomized clinical trial 60 COPD patients randomly allocated into the control and intervention groups (<em>n</em> = 30). Over three months, the control group received standard treatment, while the intervention group received standard treatment plus oral Familact. Spirometry was conducted twice, and dyspnea was assessed four times using the Borg Scale Ratings (BORG) and Modified Medical Research Council Dyspnea Scale Scores in COPD patients (MMRC) scales and were evaluated using repeated measurement analysis.</div></div><div><h3>Results</h3><div>No significant change was observed in FEV1 post-intervention, but MMRC and BORG scores showed a statistically significant improvement in the intervention group compared to the control group (<em>P</em> < 0.01). Repeated measures tests based on estimated marginal means revealed significant MMRC differences within groups over time, with inter-group differences notable only between the first and second measurements. BORG showed significant within- and between-group differences at all time points, confirmed by post hoc tests.</div></div><div><h3>Conclusion</h3><div>This study demonstrates that Familact, as an oral probiotic can significantly alleviate dyspnea in COPD patients, as reflected in notable improvements in BORG and MMRC scores. These findings underscore the potential of probiotics as an adjunctive therapy for COPD, particularly in improving patient-reported outcomes related to respiratory difficulty.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 63-68"},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart & LungPub Date : 2025-02-27DOI: 10.1016/j.hrtlng.2025.02.010
Seda Gülbahar Ateş , Hüseyin Emre Tosun , Gamze Tatar
{"title":"Electrocardiogram parameters in predicting reversible ischemia in myocardial perfusion SPECT: A case-control study","authors":"Seda Gülbahar Ateş , Hüseyin Emre Tosun , Gamze Tatar","doi":"10.1016/j.hrtlng.2025.02.010","DOIUrl":"10.1016/j.hrtlng.2025.02.010","url":null,"abstract":"<div><h3>Background</h3><div>Myocardial perfusion single photon emission computed tomography (SPECT) and electrocardiogram(ECG) are crucial modalities in the evaluation of coronary artery disease(CAD) in clinical practice.</div></div><div><h3>Objective</h3><div>To evaluate the relationship between ventricular repolarization parameters, index of cardiac electrophysiological balance (iCEB) from basal electrocardiograms (ECG), and reversible ischemia findings on SPECT.</div></div><div><h3>Methods</h3><div>A total of 45 patients with reversible ischemia on 99m technetium-sestamibi (<sup>99m</sup>Tc-MIBI) stress-rest myocardial perfusion SPECT and confirmed CAD by coronary angiography were included in the ischemia group. Forty-five patients with normal scans, matched by age and gender with the ischemia patient group, were included in the control group. The two-day 99mTc-MIBI SPECT protocol was performed with adenosine-pharmacologic stress. The presence of ischemia and reversible ischemia size (RIS) were recorded in the ischemia group. The summed stress scores (SSS) were recorded for the ischemia and control groups. The QRS, QTd, cQTd, Tp-Te, Tp-Te/QT, Tp-Te/cQT, iCEB (QT/QRS), and iCEBc (cQT/QRS) were calculated. Correlations between myocardial perfusion SPECT and ECG parameters were evaluated using the Spearman test. Predictors of reversible ischemia were assessed using logistic regression analysis.</div></div><div><h3>Results</h3><div>The ischemia group showed significantly higher values for QRS duration (<em>p</em> = 0.018), cQTmax (<em>p</em> = 0.006), QTd (<em>p</em> = 0.002), and cQTd (<em>p</em> = 0.003). Tp-Te (<em>p</em> = 0.004), Tp-Te/QT ratio (<em>p</em> = 0.003), and Tp-Te/cQT ratio (<em>p</em> = 0.002) were significantly lower in the ischemia group. The multivariate analysis showed that hyperlipidemia, QRS duration, cQTd, and Tp-Te/QTc ratio were found as independent predictors of ischemia.</div></div><div><h3>Conclusion</h3><div>The Tp-Te/cQT ratio, QRS duration, and cQTd might be valuable predictors of reversible ischemia in SPECT, warranting further study.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 56-62"},"PeriodicalIF":2.4,"publicationDate":"2025-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143510694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart & LungPub Date : 2025-02-24DOI: 10.1016/j.hrtlng.2025.02.004
Wei Wang , Jiaxin Bao , Yi Lu , Hao Jiang
{"title":"Association between brominated flame retardants and heart failure in U.S. adults: A cross-sectional analysis of national health and nutrition examination survey 2005-2016","authors":"Wei Wang , Jiaxin Bao , Yi Lu , Hao Jiang","doi":"10.1016/j.hrtlng.2025.02.004","DOIUrl":"10.1016/j.hrtlng.2025.02.004","url":null,"abstract":"<div><h3>Background</h3><div>Brominated flame retardants (BFRs) are environmental pollutants widely used in consumer products, which accumulate in human tissues. Despite their prevalence, the potential impact of BFRs on cardiovascular health, particularly heart failure (HF), remains insufficiently explored.</div></div><div><h3>Objectives</h3><div>This study aims to investigate the association between BFR exposure and the prevalence of HF in U.S. adults.</div></div><div><h3>Methods</h3><div>Data were obtained from the National Health and Nutrition Examination Survey (NHANES) 2005–2016. To assess the relationship between BFR exposure and HF prevalence, weighted generalized linear regressions (GLMs) were applied. Restricted cubic splines (RCS) were used to examine potential nonlinear associations. Additionally, quantile-weighted quantile sum (WQS) regression and quantile g-computation (QGC) analysis were performed to evaluate the overall effect of BFR mixtures on HF.</div></div><div><h3>Results</h3><div>A total of 6,931 individuals participated, with 219 diagnosed with HF. In the adjusted Model 3, BFRs including PBDE28, PBDE47, PBDE85, PBDE99, PBDE100, PBDE154, and PBB153 were significantly associated with increased odds of HF (all <em>p</em> < 0.05). RCS analysis revealed a significant nonlinear relationship between serum BFRs and HF. The WQS analysis showed a positive association between combined BFR exposure and HF (OR: 1.694; 95 % CI: 1.264, 2.270; <em>p</em> < 0.001), and QGC analysis similarly showed a significant positive association (OR: 1.365; 95 % CI: 1.094, 1.705; <em>p</em> = 0.006).</div></div><div><h3>Conclusion</h3><div>This study suggests a link between BFR exposure and an increased risk of HF. Further research is needed to explore the causal relationship and underlying mechanisms.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 47-55"},"PeriodicalIF":2.4,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143474514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart & LungPub Date : 2025-02-22DOI: 10.1016/j.hrtlng.2025.02.006
Yunmei Ding , Shouwei Yue , Jing Li , Lu Wang , Jiayun Gu , Yan Cui
{"title":"Investigating the effect of illness perception on motor function in cardioembolic stroke patients using the fear-avoidance model: The mediating role of kinesiophobia","authors":"Yunmei Ding , Shouwei Yue , Jing Li , Lu Wang , Jiayun Gu , Yan Cui","doi":"10.1016/j.hrtlng.2025.02.006","DOIUrl":"10.1016/j.hrtlng.2025.02.006","url":null,"abstract":"<div><h3>Background</h3><div>Cardioembolic stroke is the most common cause of ischemic stroke, and patients frequently have motor dysfunction as well as psychological disorders. Both physical and psychological causes can have an impact on a patient's motor function.</div></div><div><h3>Objectives</h3><div>In this study, we used the fear-avoidance model to examine the impact of patients' illness perception and kinesiophobia (excessive fear of exercise) on their motor function.</div></div><div><h3>Methods</h3><div>Between June 2021 and February 2022, we conducted a cross-sectional study of 319 participants diagnosed with cardioembolic stroke in the selected hospitals. Correlation analyses and mediation effects tests were used to analyze the relationship between patients' illness perception, kinesiophobia, and motor function.</div></div><div><h3>Results</h3><div>The total motor function score of the patients was (21.39 ± 29.30), the total kinesiophobia score was (48.51 ± 8.33), and the total illness perception score was (53.37 ± 16.82). There was a negative correlation between illness perception and motor function (<em>r</em> = -0.734, <em>P</em> < 0.001), a negative correlation between kinesiophobia and motor function (<em>r</em> = -0.522, <em>P</em> < 0.001), and a positive correlation between illness perception and kinesiophobia (<em>r</em> = 0.508, <em>P</em> < 0.001); kinesiophobia played a mediating role between illness perception and motor function (β = -0.63, <em>P</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>The findings revealed that individuals with cardioembolic strokes had poor motor function, as well as negative illness perception and kinesiophobia. Negative illness perception had a direct impact on patients' motor function as well as an indirect effect via kinesiophobia. The fear-avoidance model contributes to understanding the process of reduced motor function in cardioembolic stroke patients.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 39-46"},"PeriodicalIF":2.4,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143463381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart & LungPub Date : 2025-02-21DOI: 10.1016/j.hrtlng.2025.02.003
Jiaqing Fei MPH , Xiaoyan Gong MPH
{"title":"Association between dental floss use and atherosclerotic cardiovascular disease in American adults","authors":"Jiaqing Fei MPH , Xiaoyan Gong MPH","doi":"10.1016/j.hrtlng.2025.02.003","DOIUrl":"10.1016/j.hrtlng.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>Atherosclerotic cardiovascular disease (ASCVD) remains a major cause of global morbidity and mortality. Emerging research suggests that oral hygiene practices, particularly dental floss use, may reduce the risk of ASCVD.</div></div><div><h3>Objectives</h3><div>The purpose of this study was to examine the association between dental floss use and ASCVD prevalence.</div></div><div><h3>Methods</h3><div>Data from NHANES participants who completed home interviews and dental evaluations were analyzed. ASCVD was defined as angina, stroke, myocardial infarction, or coronary artery disease. Dental floss use was self-reported over the past seven days. Covariates included demographic, socioeconomic, lifestyle, and clinical factors. Weighted logistic regression was used to assess the relationship between dental floss use and ASCVD prevalence.</div></div><div><h3>Results</h3><div>This study included a total sample of 7253 participants with a mean age of 53.8±14.6 years. The sample consisted of 47.6 % male participants. The ethnic composition included 64.3 % Non-Hispanic White. Regular dental floss use was correlated with a lower likelihood of developing ASCVD and Stringent Criteria (infarction or stroke), with ORs of 0.76 (95 % CI: 0.60, 0.97) <em>p</em>=0.028 and 0.68 (95 % CI: 0.49, 0.94) <em>p</em>=0.022, respectively. Flossing 3–4 days/week was associated with reduced ASCVD risk, OR = 0.57 (95 % CI: 0.38, 0.84) <em>p</em>=0.006. Similar reductions were seen for stringent criteria: flossing 3–4 days/week: OR = 0.57 (95 % CI: 0.32, 0.99) <em>p</em>=0.047, flossing ≥5 days/week: OR = 0.69 (95 % CI: 0.47, 1.00) <em>p</em>=0.049.</div></div><div><h3>Conclusions</h3><div>Regular dental floss use may reduce the risk of ASCVD. These results support the inclusion of oral hygiene practices in cardiovascular disease prevention strategies.</div></div>","PeriodicalId":55064,"journal":{"name":"Heart & Lung","volume":"71 ","pages":"Pages 32-38"},"PeriodicalIF":2.4,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143453122","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}