Preventive cardiology最新文献

{"title":"Effect of obesity on platelet reactivity and response to low-dose aspirin.","authors":"Bryan C Bordeaux, Rehan Qayyum, Lisa R Yanek, Dhananjay Vaidya, Lewis C Becker, Nauder Faraday, Diane M Becker","doi":"10.1111/j.1751-7141.2009.00058.x","DOIUrl":"10.1111/j.1751-7141.2009.00058.x","url":null,"abstract":"<p><p>Insufficient platelet function suppression by aspirin is a predictor of cardiovascular events in high-risk patients. The authors assessed the impact of obesity on platelet responsiveness before and after 2 weeks of aspirin 81 mg/d in 2014 people. Obese individuals had greater baseline platelet reactivity. Comparing obese and nonobese individuals after aspirin therapy, results for aggregometry to collagen were 6.7 vs 6.1 ohms, P=.008; aggregometry to adenosine diphosphate were 13.1 vs 11.8 ohms,P<.0001; aggregometry to arachidonic acid (AA) were 4.9% vs 8.3% nonzero aggregation, P=.002; urinary excretion of 11-dehydro-thromboxane B2 (Tx-M) were 4.9% vs 8.3% nonzero aggregation, P=.002; and aspirin resistance were 26.% vs 20.5%, P=.002; respectively. These remained significantly different for AA aggregation and Tx-M excretion after adjustment for covariates. Obese individuals have greater native platelet reactivity and retain greater reactivity after suppression by aspirin.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 2","pages":"56-62"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12269955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28910471","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":"Cardiovascular disease in special populations III: stroke.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2009.00041.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00041.x","url":null,"abstract":"Stroke is a sudden devastating event that, if it does not kill immediately, leaves the patient with various degrees of disability that affect physical and psychological well-being. It is the third most common cause of death in the United States. Unlike a myocardial infarction, in which the general functioning of ambulation, speech, and thought processes is left intact, stroke produces a physical and psychological dependence on caregivers, leads to a sense of isolation unlike most other cardiovascular (CV) events, and, especially in the case of special populations such as many blacks, puts a powerful strain on economic resources. In addition, there is evidence that the risk for stroke and interventions to the stroke patient in special populations may vary. Blacks, Hispanics, American Indians ⁄ Alaska Natives, and Asians have a higher mortality at younger ages than whites. In 2005, the prevalence of stroke among Native Americans (6.0%), multiracial persons (4.6%), and blacks (4.0%) was higher than whites (2.3%), with Asians and Hispanics having similar prevalence as whites. Higher educational status is also associated with a history of stroke, from 1.8% in college graduates to 4.4% in persons with less than 12 years of education. The particularly excessive burden of stroke in blacks is seen especially in the southeastern United States and in those who are relatively young (aged 35–64 years). Of stroke deaths in 2002, 12% occurred in persons younger than 65 years and the proportion of stroke deaths in this younger age group was higher among blacks, Native Americans, and Asians compared with whites. This amounted to 3400 excess strokes in blacks in this younger population compared with whites. Although mortality rates have decreased in both blacks and whites, there remains an unchanging magnitude of the excess rates in blacks compared with whites. Although the mortality from stroke in the United States per population has decreased ever since records were first kept early in the 20th century, the vast increase in population and increase in average lifespan has led to many more cases. Trends in the age-, race-, and sex-adjusted prevalence of stroke between 1971 and 1994 from the National Health and Nutrition Examination Surveys (NHANES I to NHANES III) demonstrated an increase from 1.4% to 1.9%, an average increase of 7.5%. The noninstitutionalized stroke survivor rate increased by 60% during this period, from 1.5 million to 2.4 million. As for racial differences, 5-year mean change in stroke prevalence in noninstitutionalized survivors of stroke increased by 28% in black women and 12% in white men, but decreased by 3% in black men and white women (Table I). However, in terms of number-estimated noninstitutional stroke survivors, 5-year changes in numbers of survivors increased in all groups, from an increase of 18,000 in black men to 159,000 in white men. These differences of course were accounted for by the 10-fold larger population of whites than bl","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00041.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603796","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":"Impact of chronic aspirin and statin therapy on presentation of patients with acute myocardial infarction and impaired renal function.","authors":"Alessandro Sciahbasi,&nbsp;Romano Arcieri,&nbsp;Maria Quarto,&nbsp;Gianluca Pendenza,&nbsp;Chiara Lanzillo,&nbsp;Francesco Summaria,&nbsp;Enrico Romagnoli,&nbsp;Cosimo Commisso,&nbsp;Maria Penco,&nbsp;Ernesto Lioy","doi":"10.1111/j.1751-7141.2009.00050.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00050.x","url":null,"abstract":"<p><p>Chronic use of aspirin and statins has been associated with reduced risk of subsequent myocardial infarction (MI). However, in patients with chronic kidney disease (CKD), the cardioprotective role of aspirin and statins seems to be reduced. To evaluate the impact of chronic aspirin and statin use on clinical presentation of acute MI according to renal function, the authors retrospectively analyzed 595 consecutive patients admitted to our hospital for acute MI. Renal function was normal in 404 patients and impaired in 191. Patients on therapy (113 patients) were less likely to have ST-segment elevation MI (STEMI) compared with patients not treated (36% vs 53%, respectively, P=.0002). These results have been confirmed in the population of patients with CKD (48% of STEMI in patients receiving chronic therapy and 67% in patients without therapy,P=.01). Multivariate analysis in the group of patients with CKD showed that use of aspirin or statins was an independent predictor of a decreased probability of STEMI (odds ratio, 0.5; 95% confidence interval, 0.2-1.0,P=.05). The authors' results suggest that in a community-based sample of patients with acute MI, chronic aspirin and statin therapy has a cardioprotective role that is evident also in patients with CKD.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"18-22"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00050.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603799","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":"Incidence of myocardial infarction or stroke or death at 47-month follow-up in patients with diabetes and a predicted exercise capacity <or=85% vs >85% during an exercise treadmill sestamibi stress test.","authors":"Bredy Pierre-Louis,&nbsp;Wilbert S Aronow,&nbsp;Joo H Yoon,&nbsp;Chul Ahn,&nbsp;Albert J DeLuca,&nbsp;Melvin B Weiss,&nbsp;Kumar Kalapatapu,&nbsp;Anthony L Pucillo,&nbsp;Craig E Monsen","doi":"10.1111/j.1751-7141.2009.00051.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00051.x","url":null,"abstract":"<p><p>A treadmill exercise sestamibi stress test (TESST) was performed in 609 consecutive diabetic persons with a mean age of 70 years and no history of coronary artery disease (CAD) who were referred for a TESST because of chest pain or dyspnea. Of 609 patients, 301 (49%) had a predicted exercise capacity <or=85% (group A) and 308 (51%) had a predicted exercise capacity >85% (group B). Group A patients had a higher prevalence of myocardial ischemia (43% vs 30%, P=.0005), 2- or 3-vessel obstructive CAD (38% vs 18%, P=.001), myocardial infarction (17% vs 9%, P=.004), death (10% vs 4%, P=.008), and myocardial infarction or stroke or death at 47-month follow-up (21% vs 12%, P=.001). Stepwise Cox regression analysis showed that the only significant independent predictor for the time to development of myocardial infarction or stroke or death was a predicted exercise capacity >85% (hazard ratio, 0.52; 95% confidence interval, 0.34-0.78; P=.002). Diabetic persons with a predicted exercise capacity >85% had a 48% lower chance of myocardial infarction, stroke, or death than those with a predicted exercise capacity <or=85%.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"14-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00051.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603798","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":"Cardiovascular health promotion for children: a model for a Parish (County)-wide program (implementation and preliminary results).","authors":"Gerald S Berenson","doi":"10.1111/j.1751-7141.2009.00049.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00049.x","url":null,"abstract":"<p><p>Cardiovascular (CV) risk factors in childhood result in a lifetime burden on the CV system. The Bogalusa Heart Study, a prevention program for children, addresses behaviors and lifestyles associated with CV risk. This prevention program utilizes the substructure of a Parish (County) that can be a model for other areas. All aspects in educating school children-the classroom, physical activity, cafeteria, teachers, and parents with community involvement-are included. The program requires cooperation of parents, schools, physicians, and political and business personnel. Their collaboration helps implement and sustain the program. Understanding the origin of coronary artery disease, hypertension, diabetes, and now the obesity epidemic shows the need to develop a framework for improving lifestyles and behaviors beginning in childhood. In addition to nutrition and exercise, the program addresses tobacco, alcohol, and drug use, and societal problems such as dropping out of school, violent behavior, and teenage pregnancy. An initial accomplishment is the entry into all elementary schools, representing approximately 7000 children. Early results show reduction in obesity, increased physical activity, improved decision making, and healthy attitudes. This public health model is inexpensive by utilizing prior research findings and integrating into community resources. Health education of children is an important aspect of preventive cardiology with a need for pediatric and adult cardiologists' involvement.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"23-8"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00049.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603800","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":"Biomarkers for coronary heart disease clinical risk prediction: a critical appraisal. Counterpoint.","authors":"John T Wilkins,&nbsp;Donald M Lloyd-Jones","doi":"10.1111/j.1751-7141.2010.00081.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2010.00081.x","url":null,"abstract":"<p><p>The following Point/Counterpoint articles were derived from a debate presentation sponsored by the American Society for Preventive Cardiology at the March 2010 meeting of the American Heart Association Council on Epidemiology and Prevention, titled \"Should We Focus on Novel Risk Marker and Screening Tests to Better Predict and Prevent Cardiovascular Disease?\" Dr. James de Lemos presented the pro side, titled \"Novel Risk Markers and Screening Tests Will Improve the Prediction and PRevention of Cardiovascular Disease,\" and Dr. Donald Lloyd-Jones advocated the con side, titled \"Better Implementation of Existing Knowledge Will Save More Lives Than All of the Novel Biomarkers in the World.\" The following articles include points from the debate, rebuttal, and questions raised by the audience. We thank all authors for sharing this debate with the readership.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 4","pages":"160-5"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2010.00081.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"29298173","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":"Effect of right ventricular function and pulmonary pressures on heart failure prognosis.","authors":"Srilakshmi M Adhyapak","doi":"10.1111/j.1751-7141.2009.00053.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00053.x","url":null,"abstract":"<p><p>The relationship of right ventricular function and pulmonary systolic pressure in patients with congestive heart failure was evaluated to risk-stratify them. The study included 147 consecutive patients with symptomatic heart failure who underwent clinical and laboratory examination and echocardiography including Doppler tissue echocardiography. They were followed for a mean of 11.2+/-6.4 months. During follow-up, 16 patients died and 45 patients had nonfatal cardiac events. There were 60 readmissions for heart failure. Pulmonary artery systolic pressure and right ventricular systolic function were inversely related (r(2)=0.66, P<.001). On Cox multivariate survival analysis, early worsening of pulmonary arterial pressures was an independent prognostic predictor (hazard ratio, 0.44; confidence interval, 0.28-0.91, P=.024). The patients with pulmonary hypertension and right ventricular systolic dysfunction had the worst prognosis. The assessments of right ventricular function help to risk-stratify patients with heart failure. The early worsening of pulmonary hypertension is a powerful predictor of worse prognosis.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 2","pages":"72-7"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00053.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28910966","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":"Managing mixed dyslipidemia in special populations.","authors":"Michael Miller","doi":"10.1111/j.1751-7141.2009.00057.x","DOIUrl":"10.1111/j.1751-7141.2009.00057.x","url":null,"abstract":"<p><p>Controlling low-density lipoprotein cholesterol is one of the major focuses of cardiovascular care. However, the twin global pandemics of obesity and diabetes are promoting an increased prevalence of associated cardiometabolic risk factors. These factors include mixed dyslipidemia, which is prevalent among several important subgroups of the overall population. Cardiovascular risk increases as women reach and extend beyond menopause, partly reflective of dyslipidemia. In addition, women with polycystic ovary syndrome display a cluster of risk factors reminiscent of the metabolic syndrome. Certain ethnic groups are also at increased risk for type 2 diabetes or the metabolic syndrome. Dyslipidemia contributes significantly to overall cardiovascular risk in the elderly, and the frequency of children and adolescents presenting with type 2 diabetes or metabolic syndrome is increasing worldwide. Physicians should be aware of the possibility of mixed dyslipidemia in patients at elevated cardiometabolic risk. However, while combination therapy may successfully correct the associated dyslipidemia, it remains to be established whether the addition of a second agent improves coronary risk beyond statin monotherapy.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 2","pages":"78-83"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923824/pdf/nihms-224667.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28910967","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":"Diet, lifestyle, and hypertension and mediterranean diet and risk of dementia.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2009.00064.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00064.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 2","pages":"94-6"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00064.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28910970","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 stents and noncardiac surgery: current clinical challenges and conundrums.","authors":"Jagtar S Heir,&nbsp;Vijaya Gottumukkala,&nbsp;Manmeet Singh,&nbsp;Syed Wamique Yusuf,&nbsp;Bernhard Riedel","doi":"10.1111/j.1751-7141.2009.00044.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00044.x","url":null,"abstract":"<p><p>This article discusses how perioperative physicians are currently faced with unique challenges when providing care for surgical patients who have undergone recent percutaneous transluminal coronary angioplasty with drug-eluting stent (DES) placement. Despite adhering to the currently recommended antiplatelet regimens, these patients may still be at risk for sustaining a myocardial infarction secondary to stent thrombosis during the perioperative period. Given the high morbidity and mortality rates associated with perioperative myocardial infarction, it is important that the perioperative care of surgical patients with previous DES placement should be discussed, evaluated, and clarified by all practitioners who may be involved in their care.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"13 1","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00044.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28603797","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}