Preventive cardiology最新文献

{"title":"Diagnosis, treatment, and referral of hypertension in an emergency department.","authors":"Tushar Shah,&nbsp;Wilbert S Aronow,&nbsp;Stephen J Peterson","doi":"10.1111/j.1751-7141.2009.00034.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00034.x","url":null,"abstract":"<p><p>The authors prospectively audited 500 randomly selected charts of patients seen during a 6-month period ending in October 2008, in the emergency department of a university medical center for the prevalence of hypertension and how it was managed. Of the 187 patients with hypertension, 14 (8%) were treated for hypertension in the emergency department and 99 (53%) were hospitalized or referred to a physician or clinic for follow-up of their hypertension. Much improvement is needed, especially since many of the patients seen in the emergency department do not have a primary care physician.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 4","pages":"173-5"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00034.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28472783","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":"Left ventricular geometric patterns in normotensive type 2 diabetic patients in Nigeria: an echocardiographic study.","authors":"Dike B Ojji,&nbsp;Adewole A Adebiyi,&nbsp;Olulola O Oladapo,&nbsp;Jokotade A Adeleye,&nbsp;Akinyemi Aje,&nbsp;Okechukwu S Ogah,&nbsp;Adedeji K Adebayo,&nbsp;Ayodele O Falase","doi":"10.1111/j.1751-7141.2009.00033.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00033.x","url":null,"abstract":"<p><p>Left ventricular hypertrophy has been linked with diabetes mellitus and abnormal glucose tolerance in several studies. Most previous studies have been carried out in the western world with dearth of data in native Africans. A total of 122 type 2 diabetic patients with a mean age of 55.0+/-8.5 years and another 90 normal patients with a mean age of 55.4+/-8.7 years were recruited for the study. Two-dimensional guided M-mode echocardiography was performed on each patient. In the diabetic patients, 49.2% had normal geometry, 23.0% had concentric hypertrophy, 13.0% had concentric remodeling, and 14.8% had eccentric hypertrophy. In the control group, 72.2% had normal geometry, 4.4% had concentric hypertrophy, 11.2% had concentric remodeling, and 12.2% had eccentric hypertrophy. In a multiple regression analysis, there was significant difference in the geometric pattern of the diabetics and controls (chi(2)=11.09, P<.001). Diabetes mellitus is independently associated with left ventricular structural changes in Nigerian diabetics.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 4","pages":"184-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00033.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28472785","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":"Jupiter and accomplish.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2009.00032.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00032.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"114-9"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00032.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202971","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":"Is there a need to continue anticoagulation following \"successful\" atrial fibrillation ablation?","authors":"Howard L Levitt,&nbsp;Saddad Z Toor,&nbsp;Neil L Coplan","doi":"10.1111/j.1751-7141.2008.00013.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00013.x","url":null,"abstract":"<p><p>Atrial fibrillation (AF) is the most common clinically significant arrhythmia worldwide, and its incidence is increasing. There has been increasing interest in ablation therapy to treat atrial fibrillation. One reason some patients undergo AF ablation might be to obviate the need for warfarin therapy, although current guidelines do not support this rationale. The current review shows that it is difficult to define a true \"cure\" postablation, as many of these patients will go on to experience future paroxysms of AF (either symptomatic or silent). The mechanism underlying embolism in patients with AF is not completely understood, and no long-term evidence exists that \"successfully ablated\" patients return to a baseline risk of stroke comparable to an AF-naive population. The authors recommend continued long-term anticoagulation post-AF ablation in patients satisfying CHADS criteria for elevated stroke risk.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 1","pages":"39-42"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00013.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28135727","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":"Low-density lipoprotein reduction and magnitude of cardiovascular risk reduction.","authors":"Catherine R Rahilly-Tierney,&nbsp;Elizabeth V Lawler,&nbsp;Richard E Scranton,&nbsp;J Michael Gaziano","doi":"10.1111/j.1751-7141.2008.00018.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00018.x","url":null,"abstract":"<p><p>The authors examined the relationship between the magnitude of low-density lipoprotein cholesterol (LDL-C) reduction and the magnitude of cardiovascular risk reduction. From the Veterans Integrated Service Network 1 databases, the authors selected 54,611 patients with prevalent ischemic heart disease, peripheral vascular disease or diabetes mellitus, and >or=2 documented LDL-C levels who were followed between 1997 and 2006. The outcome was defined as acute myocardial infarction or revascularization. Preoutcome LDL-C reduction was categorized as follows: <10 mg/dL, reference; >or=10 but <40 mg/dL, small reduction; >or=40 but <70 mg/dL, moderate reduction; >or=70 mg/dL, large reduction. Proportional hazards were used to determine the hazard ratio for the outcome for each LDL-C reduction category compared with the reference. Results revealed a graded relationship between the magnitude of reduction in LDL-C and cardiovascular risk reduction. Stratified analyses demonstrated these findings to be robust regardless of initial LDL-C levels or whether patients achieved \"target\" final LDL-C values of <100 mg/dL.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"80-7"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00018.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202966","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":"An investigation of pre-activity cardiovascular screening procedures in health/fitness facilities--part I: is adherence with national standards decreasing?","authors":"Judy B Springer,&nbsp;Joann M Eickhoff-Shemek,&nbsp;Ernest J Zuberbuehler","doi":"10.1111/j.1751-7141.2009.00026.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00026.x","url":null,"abstract":"<p><p>This investigation determined the number of health/fitness facilities within a Midwestern region conducting pre-activity cardiovascular screening procedures (PACSPs) consistent with American Heart Association/American College of Sports Medicine (AHA/ACSM) standards. Interviews were conducted with 123 commercial, community, corporate, and academic settings (84% response rate), with 40 (33%) facilities requiring members to complete a pre-activity screening device. Of those, 20 (50%) required physician clearance for \"at-risk\" members prior to physical activity participation. Personal training clients completed a pre-activity screening device at 50 (61%) facilities, with 32 (64%) requiring physician clearance for at-risk clients. The data were analyzed by setting, with corporate facilities having a significantly higher (P=.0049) adherence rate with AHA/ACSM standards than other facilities. Data were compared with previous studies and indicated a decrease in the number of facilities conducting PACSPs. Findings indicate that health/fitness personnel need to become aware of the relevance of conducting PACSPs.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 3","pages":"155-62"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00026.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28316585","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 heart disease and dyslipidemia: a cross-sectional evaluation of prevalence, current treatment, and clinical control in a large cohort of Spanish high-risk patients: the PRINCEPS study.","authors":"Francisco Díaz de Rojas,&nbsp;Trinidad De Frutos,&nbsp;Ana Ponte,&nbsp;Joaquin Mateos Chacón,&nbsp;Gustavo C Vitale","doi":"10.1111/j.1751-7141.2008.00022.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2008.00022.x","url":null,"abstract":"<p><p>The authors assessed a large cohort of patients with coronary heart disease (CHD) or at high risk for developing CHD in terms of lipid profile, lipid-lowering treatment, and attainment of National Cholesterol Education Program (NCEP) target low-density lipoprotein cholesterol (LDL-C) levels. The investigation was a cross-sectional study involving Spanish outpatients treated in primary or secondary care facilities. From a total of 26,598 attending patients, 12,128 with CHD or CHD risk equivalents were recruited by 1875 physicians; 49% had CHD and 69% had multiple risk factors. Only 25% of patients attained LDL-C values <100 mg/dL, 76.6% patients received lipid-lowering therapy (statins in 95.4% of cases), and 54% of physicians considered that a treatment change was required (the most frequent choice was the addition of ezetimibe to current statin therapy). In this large cohort of high-risk coronary patients, only 25% attained a target LDL-C of <100 mg/dL. These results highlight a need for improved patient care and physician awareness/training.</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"65-71"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2008.00022.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202964","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":"Fifth Pivotal Research in Cardiology in the Elderly (PRICE-V) symposium: preventive cardiology in the elderly-executive summary. Part I: morning session.","authors":"Michael W Rich, George A Mensah","doi":"10.1111/j.1751-7141.2009.00048.x","DOIUrl":"10.1111/j.1751-7141.2009.00048.x","url":null,"abstract":"","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 4","pages":"198-204"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2920485/pdf/nihms224739.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28476798","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":"ACTIVE A and AURORA.","authors":"Philip R Liebson","doi":"10.1111/j.1751-7141.2009.00039.x","DOIUrl":"https://doi.org/10.1111/j.1751-7141.2009.00039.x","url":null,"abstract":"EFFECT OF CLOPIDOGREL ADDED TO ASPIRIN IN PATIENTS WITH ATRIAL FIBRILLATION: (ACTIVE) TRIAL The Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events Introduction. In the prevention of thromboembolism in patients with atrial fibrillation, the benefits of long-term anticoagulation have to be balanced against the very possible adverse effects. Does this hold true for antiplatelet combinations vs aspirin alone when anticoagulants cannot be used? Summary. In order to determine the effects of additional platelet antagonist activity, 7554 patients with atrial fibrillation at increased risk for stroke in whom vitamin K antagonist therapy was unsuitable for various reasons (see below) were randomized to aspirin alone with placebo or a combination of aspirin and clopidogrel and followed for a median of 3.6 years. Primary outcome events, consisting of the composite of stroke, myocardial infarction (MI), non–central nervous system (CNS) embolism, or vascular death, were lower in the drug combination group (relative risk [RR], 0.89; 95% confidence interval [CI], 0.81–0.98; P=.01). However, major bleeding was higher in the aspirin plus clopidogrel group (RR, 1.57; 95% CI, 1.29–1.92; P<.001). Thus, drug combination reduced composite events, mainly stroke, at the cost of increased major hemorrhage. Background. Although vitamin K antagonists decrease the risk of stroke by 64% in patients with atrial fibrillation and by 38% compared with aspirin, they double the risk of intracranial hemorrhage compared with aspirin and have no effect on mortality. Nonetheless, warfarin and other anticoagulants are considered first-line agents in atrial fibrillation unless contraindicated. The current trial was initiated in order to determine whether a combination of antiplatelet agents was superior to aspirin alone. A previous trial (Atrial Fibrillation Clopidogrel Trial With Irbesartan for Prevention of Vascular Events [ACTIVE W]) that compared clopidogrel plus aspirin with an oral anticoagulant was previously reported. The study was stopped early because of the clear evidence of superiority of oral anticoagulant therapy. Study Design. Patients were enrolled who had at least two episodes of atrial fibrillation within 6 months and evidence for at least one of the risk factors for stroke, including age 75 years and older, systemic hypertension, previous stroke or transient ischemic attack, left ventricular (LV) ejection fraction <45%, peripheral vascular disease, or age 55 to 74 years with diabetes or coronary artery disease. Patients had to be unsuited for vitamin K antagonist therapy primarily because of increased risk factors for hemorrhage. All patients received aspirin 75 mg ⁄d to 100 mg ⁄d and were randomized to either clopidogrel 75 mg ⁄d or matching placebo. If cardioversion for atrial fibrillation was undertaken, these patients received open-label vitamin K antagonist for 4 weeks before and after cardioversion and then the study assignmen","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 4","pages":"205-8"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1751-7141.2009.00039.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28476799","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":"Use of an electronic medical record to characterize cases of intermediate statin-induced muscle toxicity.","authors":"Ravi K Mareedu, Falgun M Modhia, Elenita I Kanin, James G Linneman, Terrie Kitchner, Catherine A McCarty, Ronald M Krauss, Russell A Wilke","doi":"10.1111/j.1751-7141.2009.00028.x","DOIUrl":"10.1111/j.1751-7141.2009.00028.x","url":null,"abstract":"<p><p>Statin use can be accompanied by a variety of musculoskeletal complaints. The authors describe the clinical characteristics of case patients who experienced adverse statin-induced musculoskeletal symptoms within a large population-based cohort in Central Wisconsin. Case status was determined based on elevated serum creatine kinase (CK) levels and the presence of at least 1 physician note reflecting an increased index of suspicion for statin intolerance. From the medical records of nearly 2 million unique patients, the authors identified more than 20,000 potential study patients ( approximately 1%) having CK data and at least 1 exposure to a statin drug. Manual screening was completed on 2227 patients with CK levels in the upper 10th percentile. Of those screened, 267 met inclusion criteria (12.0% eligibility) and 218 agreed to participate in a retrospective study characterizing the risk determinants of statin-induced muscle toxicity. Three categoric pain variables were graded retrospectively (distribution, location, and severity of pain). The presenting complaints of the case patients were extremely heterogeneous. The number of patients with a compelling pain syndrome (diffuse, proximal muscle pain of high intensity) increased at higher serum CK levels; the number of patients with indeterminate pain variables decreased at higher serum CK levels. The lines reflecting these relationships cross at a CK level of approximately 1175 U/L, approximately half the threshold level needed to make a clinical diagnosis of \"myopathy\" (ie, CK >10-fold the upper limit of normal).</p>","PeriodicalId":83876,"journal":{"name":"Preventive cardiology","volume":"12 2","pages":"88-94"},"PeriodicalIF":0.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3773543/pdf/nihms247966.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28202967","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}