Journal of cardiovascular risk最新文献

{"title":"Imaging of atherosclerosis. Remodelling of coronary arteries.","authors":"Gerard Pasterkamp,&nbsp;Pieter C Smits","doi":"10.1177/174182670200900502","DOIUrl":"https://doi.org/10.1177/174182670200900502","url":null,"abstract":"<p><p>Next to plaque formation, arterial geometric remodelling is an important determinant of luminal narrowing in atherosclerotic disease. Expansive remodelling retards, whereas constrictive remodelling accelerates lumen loss by plaque formation. Expansive arterial remodelling is a double edged sword, however. While luminal area is preserved, the plaque beneath the surface of the lumen often reveals large atheroma with heavy inflammation in expansive remodelling. These characteristics have been associated with plaque rupture and subsequent myocardial infarction. Thus, in the long term expansive remodelling may lead to thrombosis of angiographically silent lesions while constrictive remodelling is often associated with stable coronary syndromes. The mechanisms of arterial remodelling are poorly understood. This is mainly due to lack of good in vitro and animal models which makes mechanistic studies difficult.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 5","pages":"229-35"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900502","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A simple biomarker to exclude the presence of low grade inflammation in apparently healthy individuals.","authors":"Shlomo Berliner,&nbsp;David Zeltser,&nbsp;Itzhak Shapira,&nbsp;Einor Ben Assayag,&nbsp;Tamar Mardi,&nbsp;Jacob Serov,&nbsp;Stanislav Aharonov,&nbsp;Nadir Arber,&nbsp;Rivka Rotstein","doi":"10.1177/174182670200900509","DOIUrl":"https://doi.org/10.1177/174182670200900509","url":null,"abstract":"<p><strong>Background: </strong>Atherosclerosis is accompanied by a low grade inflammatory response.</p><p><strong>Hypothesis: </strong>To use erythrocyte aggregability as a biomarker to exclude the presence of low grade inflammatory response in apparently healthy individuals.</p><p><strong>Methods: </strong>The adhesiveness/aggregation of red blood cells was quantitated by using a simple slide test and image analysis.</p><p><strong>Results: </strong>We included 121 apparently healthy individuals and found a significant correlation between the degree of erythrocyte adhesiveness/aggregation and either the concentration of high sensitive CRP (r = 0.6, P < 0.001), erythrocyte sedimentation rate (r = 0.5, P < 0.0001) or fibrinogen (r = 0.5, P < 0.0001). By using certain cutoff points for the erythrocyte adhesiveness/aggregation test we could define individuals with a very low grade inflammatory response.</p><p><strong>Conclusions: </strong>By using this inexpensive and rapid assessment, we could clearly discriminate between individuals with a very low inflammatory response and those with a more intense one. This biomarker should be further evaluated as a possible screening test for use in large populations of apparently healthy individuals in whom the detection of low grade inflammation might contribute to guiding appropriate lifestyle modifications and therapeutic interventions.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 5","pages":"281-6"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900509","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077651","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":"Imaging of atherosclerosis. Raman spectroscopy of atherosclerosis.","authors":"Sweder W E van de Poll,&nbsp;Tjeerd J Römer,&nbsp;Gerwin J Puppels,&nbsp;Arnoud van der Laarse","doi":"10.1177/174182670200900505","DOIUrl":"https://doi.org/10.1177/174182670200900505","url":null,"abstract":"<p><p>Raman spectroscopy can provide detailed, quantitative information about the chemical composition of an atherosclerotic plaque. Recent development of compact clinical Raman systems and specially developed Raman catheters allow the remote, intravascular application of the technique. This shows prospects for the detection of coronary plaques that are prone to rupture and for the quantitative study of atherosclerosis in terms of chemical composition. This review discusses the basic principles and advances of Raman spectroscopy in the field of atherosclerosis, and its future directions in cardiovascular medicine.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 5","pages":"255-61"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077647","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":"Rates of smoking in the households of cardiac patients.","authors":"David Hevey,&nbsp;Katriona Slack,&nbsp;Alison Cahill,&nbsp;Helen Newton,&nbsp;John H Horgan","doi":"10.1177/174182670200900507","DOIUrl":"https://doi.org/10.1177/174182670200900507","url":null,"abstract":"<p><strong>Background: </strong>Non-smokers who live with smokers are at increased risk for coronary heart disease (CHD). However, such a risk may be increased if the non-smoker is a patient with established CHD. The present study assessed the percentage of cardiac rehabilitation patients who share a household with regular smokers.</p><p><strong>Methods: </strong>One hundred and three consecutive cardiac patients attending a hospital-based outpatient 10-week multidisciplinary cardiac rehabilitation programme completed a questionnaire to assess the smoking behaviour of cardiac patients and the smoking behaviour of others in the patient's household.</p><p><strong>Results: </strong>Forty percent of the present sample reported sharing a household with someone else who smoked. The single most common smoker in the household was the patient's spouse (36%), followed by son (12%), daughter (12%) and son and daughter (12%). Of those living with a smoker, only 15% reported that the smoker did not smoke in their presence. Thus, 85% of cardiac patients living in a house where somebody smoked were regularly exposed to environmental smoke.</p><p><strong>Conclusion: </strong>A substantial number of cardiac patients may be exposed to environmental smoke in the household. Interventions to modify the lifestyle behaviour of other members of the cardiac patient's household may be warranted in order to achieve optimum secondary prevention.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 5","pages":"271-4"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077649","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coronary risk versus cardiovascular risk for treatment decisions in mild hypertension.","authors":"Wilfred W Yeo,&nbsp;Karen Rowland Yeo","doi":"10.1177/174182670200900508","DOIUrl":"https://doi.org/10.1177/174182670200900508","url":null,"abstract":"<p><strong>Background: </strong>British guidelines recommend treatment for mild hypertension at a cardiovascular (CVD) risk threshold of 20% over 10 years. However, treatment is targeted at the equivalent coronary (CHD) risk of 15% over 10 years. We examined the relationship between CHD and CVD risk in men and women with mild hypertension and assessed the accuracy of using a 10-year CHD risk threshold of 15% to identify patients at a 10-year CVD risk > or = 20%.</p><p><strong>Design: </strong>Cross-sectional survey of England in 1998.</p><p><strong>Methods: </strong>We identified 5588 subjects aged 35-74 years free of cardiovascular disease with complete data for risk assessment. Of these, 1364 (24.4%) had mild hypertension (systolic pressure 140-159 mmHg or diastolic pressure 90-99 mmHg). The Framingham functions were used to estimate CHD and CVD event risk for each individual.</p><p><strong>Results: </strong>At a 10-year CHD risk of 15%, the corresponding 10-year CVD risk for men and women, respectively was 20% and 21% in those aged < 55 years, and 24% and 25% in those aged > or = 55 years. Using a 10-year CHD risk threshold of 15% to identify patients at a 10-year CVD risk > or = 20% had high specificity (>96%) in all four groups. For men and women respectively, the sensitivity was 73% (62-84%) and 62% (35-88%) in younger subjects, and 89% (85-93%) and 47% (38-56%) in older subjects.</p><p><strong>Conclusion: </strong>Using a 10-year CHD risk of 15% to target patients at a 10-year CVD risk > or = 20% was reasonably accurate for men but missed about 50% of women eligible for antihypertensive treatment.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 5","pages":"275-80"},"PeriodicalIF":0.0,"publicationDate":"2002-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900508","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077650","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":"Accuracy of cardiovascular risk estimation for primary prevention in patients without diabetes.","authors":"Timothy M Reynolds,&nbsp;Patrick Twomey,&nbsp;Anthony S Wierzbicki","doi":"10.1177/174182670200900402","DOIUrl":"https://doi.org/10.1177/174182670200900402","url":null,"abstract":"<p><strong>Background: </strong>The burden of atherosclerosis has led to treatment prioritization on high-risk individuals without established cardiovascular disease based on risk estimates. We investigated the effects of biological variation in risk factors on risk estimate accuracy and whether current primary prevention screening (risk assessment) models correctly categorize patients.</p><p><strong>Methods: </strong>A population of 10 000 'perfect' individuals with 100 stimulants affected by biological and analytical variation for systolic blood pressure, total cholesterol, high-density lipoprotein-cholesterol was mathematically modelled. Coronary heart disease (CHD) risks were calculated using the Framingham study algorithm and the mathematical properties of the screening system were evaluated.</p><p><strong>Results: </strong>At internationally recommended 10-year CHD risk treatment threshold levels of 15, 20 and 30%, the 95% confidence intervals were +/- 5.1, +/- 6.0 and +/- 6.9% for single-point (singlicate), +/- 3.6, +/- 4.2 and +/- 4.9% for duplicate and +/- 2.8, +/- 3.3 and +/- 3.9% for triplicate estimates respectively (i.e. for singlicate 15% risk, 95% confidence interval is 9.9-20.1%). Consequently, using the 30% risk threshold from the National Service Framework (NSF) for CHD with singlicate estimation, 30% of patients who should receive treatment would be denied it and 20% would receive treatment unnecessarily. Multiple measurements improve precision but cannot absolutely define risk. Blood pressure should be measured to the greatest accuracy possible and not rounded prior to averaging.</p><p><strong>Conclusions: </strong>This study suggests biological variation in cardiovascular risk factors has profound consequences on calculated risk for therapeutic decision-making. Current guidelines recommending multiple measurements are usually ignored. Triplicate measurement is required to allow risk to be identified and clinical judgement has to be exercised in interpretation of the results.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 4","pages":"183-90"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900402","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077597","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":"Distribution of risk factors and prophylactic drug usage in Turkish patients with angiographically established coronary artery disease.","authors":"Kenan Sonmez,&nbsp;Ahmet Akcay,&nbsp;Mustafa Akcakoyun,&nbsp;Durmus Demir,&nbsp;Orhan Hakan Elonu,&nbsp;Selcuk Pala,&nbsp;Nilüfer Eksi Duran,&nbsp;Murat Gencbay,&nbsp;Muzaffer Degertekin,&nbsp;Fikret Turan","doi":"10.1177/174182670200900404","DOIUrl":"https://doi.org/10.1177/174182670200900404","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery disease (CAD) is the leading cause of adult deaths in our country. In clinical practice, an adequate level of secondary prevention towards CAD primarily requires full recognition of the distribution of risk factors. The aim of our study was to determine the prevalence of coronary risk factors and the use of prophylactic drugs among patients who have an angiographically proven CAD in our centre, and to compare it with those of the EUROASPIRE I and II studies.</p><p><strong>Design: </strong>Cross-sectional, observational study.</p><p><strong>Methods: </strong>Our patients comprise 617 subjects (516 male, mean age 57.2 +/- 10.8 years) who underwent an angiography between January 2000 and May 2000 for the first time and in whom significant coronary lesions were detected. Age, gender, family history of premature CAD (FH), diabetes mellitus (DM), hypertension (HT), lipid profile, smoking, body mass index, waist circumference, hip circumference and physical activity data were recorded prior to angiography. The medical treatments received by these cases at discharge from hospital were investigated. Data thus obtained were compared with the results of the EUROASPIRE I and II trials, which studied the frequency of existing risk factors and prophylactic drug use among CAD patients in European countries.</p><p><strong>Results: </strong>Hyperlipidaemia, FH, DM, HT, smoking, obesity, central obesity were found in 52, 26, 20, 41, 65, 18 and 29% of patients, respectively. The use of antiplatelets, beta-blockers, ACE inhibitors, statins and calcium antagonists were 99, 86, 40, 63 and 16%, respectively.</p><p><strong>Conclusion: </strong>Upon comparison of the risk factors, prevalence of obesity and DM was found to be similar to the average of nine European countries among our subjects. Smoking was found to be considerably higher, whereas HT, hyperlipidaemia and family history of premature CAD were lower than the European average within our subjects. In our cases the frequency of prophylactic drug usage at discharge was higher than the European means.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 4","pages":"199-205"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900404","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077599","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":"Airborne occupational exposure, ABO phenotype and risk of ischaemic heart disease in the Copenhagen Male Study.","authors":"P Suadicani,&nbsp;H O Hein,&nbsp;F Gyntelberg","doi":"10.1177/174182670200900403","DOIUrl":"https://doi.org/10.1177/174182670200900403","url":null,"abstract":"<p><strong>Objectives: </strong>To test the hypothesis that long-term occupational exposure to airborne pollutants is a stronger risk factor for ischaemic heart disease (IHD) in men with blood type O than in men with other ABO phenotypes.</p><p><strong>Design: </strong>Cross-sectional and prospective study taking into account potential confounders.</p><p><strong>Setting: </strong>The Copenhagen Male Study.</p><p><strong>Subjects: </strong>3321 men aged 53-74 years.</p><p><strong>Main outcome measure: </strong>Lifetime prevalence of myocardial infarction and incidence of IHD in an 8-year follow-up among men without overt cardiovascular disease.</p><p><strong>Results: </strong>Among men with phenotypes other than O no association was found between airborne pollutant exposure and IHD risk. Among men with blood type O (P = 1417, 42%), 4.7% had a history of myocardial infarction, as compared with 5.7% among men with other phenotypes (P = 1904, 58%). Long-term occupational exposure (> 5 years of exposure) to various airborne pollutants: soldering fumes, welding fumes and plastic fumes was associated with a significantly increased lifetime prevalence of myocardial infarction. Odds ratios (95% confidence limits) for these factors were 3.0 (1.6-5.8), P = 0.002, 2.1 (1.05-4.2), P = 0.05, and 8.3 (2.6-27.0), P = 0.003. In an 8-year follow-up a similar though weaker association was found with a significantly increased risk for those exposed long term to soldering fumes: 1.8 (1.0-3.2), P = 0.05.</p><p><strong>Conclusion: </strong>The finding of a quite strong interplay between airborne pollutants, ABO phenotypes, and risk of IHD, may open up new possibilities for clarifying the roles of the ABO blood group and air pollution as cardiovascular risk factors.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 4","pages":"191-8"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900403","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077598","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":"Airborne occupational exposure and ABO phenotype: an example of gene-environment interaction in ischaemic heart disease?","authors":"Kaeng W Lee,&nbsp;Gregory Y H Lip","doi":"10.1177/174182670200900401","DOIUrl":"https://doi.org/10.1177/174182670200900401","url":null,"abstract":"Correspondence and requests for reprints to Professor G.Y.H. Lip, Haemostasis, Thrombosis and Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham B18 7QH, UK. Tel: þ44 121 507 5080; fax: þ44 121 554 4083; e-mail: g.y.h.lip@bham.ac.uk Association studies between gene variants (polymorphisms) and measured intermediate phenotypes (such as lipid/lipoprotein levels), or disease phenotypes (such as ischaemic heart disease (IHD)) are increasingly common in the literature. Indeed, there is mounting evidence that classical risk factors for IHD, such as hypertension, diabetes mellitus and hyperlipidaemia, are polygenic traits, and their interaction with environment factors (such as diet, lifestyle, occupational, socioeconomic factors, etc.) are important in determining their phenotypic expression.","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 4","pages":"179-82"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/174182670200900401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077596","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 modifiable cardiovascular risk factors remain high after coronary bypass graft surgery: a multicentre study among Turkish patients.","authors":"Mehmet Baltali,&nbsp;Hidayet Tarik Kiziltan,&nbsp;Mehmet Emin Korkmaz,&nbsp;Semra Topçu,&nbsp;Mustafa Demirtaş,&nbsp;Mehmet Metin,&nbsp;M Sah Topçuoğlu,&nbsp;Ahmet Birand,&nbsp;Haldun Müderrisoğlu","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>The measures of secondary prevention in patients undergoing coronary bypass graft surgery (CABG) remains largely undetermined in Turkey.</p><p><strong>Design: </strong>We designed a multicentre cross-sectional study to estimate the prevalence of cardiovascular risk factors in patients after CABG and to evaluate the association of demographic-socio-economic factors with secondary prevention in these patients.</p><p><strong>Methods: </strong>A total of 622 patients who underwent CABG between 1 January 1999 and 15 January 2000 at four centres in Adana, Turkey; 273 (ages 35-77, 208 men) were interviewed and examined 1.0-2.2 years after the procedure.</p><p><strong>Results: </strong>Of 273 patients interviewed, 81.5% were overweight, 65.5% had unhealthy food choices for a lipid-lowering diet, 56.0% were physically inactive, 28.8% were obese and 17.6% were current smokers. Hypercholesterolaemia, elevated blood pressure and fasting blood glucose were found in 65.6, 34.1 and 19.8%, respectively. Of diabetic patients, 63.8% had elevated fasting blood glucose. The use of angiotensin-converting enzyme inhibitors, beta-blockers and statins was low. Women had a higher rate of obesity and physical inactivity; smoking was less prevalent in females. More women were taking antihypertensive and lipid-lowering drugs than men. Logistic regression analysis revealed an association between hypercholesterolaemia and low educational level.</p><p><strong>Conclusion: </strong>Turkish patients have a high prevalence of modifiable risk factors related to unhealthy lifestyle and ineffective prophylactic drug use 1 year or more after CABG. Low educational level has a significant influence in this situation.</p>","PeriodicalId":79345,"journal":{"name":"Journal of cardiovascular risk","volume":"9 4","pages":"207-14"},"PeriodicalIF":0.0,"publicationDate":"2002-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"22077600","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}