{"title":"Deep Learning in Medical Research: Strengths and Pitfalls","authors":"J. Kwon, Kyung-Hee Kim","doi":"10.51789/cmsj.2021.1.e21","DOIUrl":"https://doi.org/10.51789/cmsj.2021.1.e21","url":null,"abstract":"","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"147 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86112632","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":"Metabolic Syndrome, Cardiorespiratory Fitness and the Risk of All-cause and Cardiovascular Mortality in Men: A Long-Term Prospective Cohort Study","authors":"S. Jae, S. Kurl, S. Kunutsor, J. Laukkanen","doi":"10.51789/cmsj.2021.1.e17","DOIUrl":"https://doi.org/10.51789/cmsj.2021.1.e17","url":null,"abstract":"Background and Objectives: Cardiorespiratory fitness (CRF) ameliorates the increased risk of cardiovascular disease and mortality attributed to various risk factors. It is unclear whether the cardioprotective effects of CRF extend to attenuating the mortality risk associated with metabolic syndrome (MetS), which comprises a cluster of cardiometabolic risk factors. The purpose of this study was to examine the individual and joint associations of CRF and MetS with the risk of all-cause mortality and cardiovascular mortality. Methods: This prospective study was based on a general population sample of 1,711 men in the Kuopio Ischemic Heart Disease cohort study. MetS was defined using the National Cholesterol Education Program criteria. CRF was directly measured as peak oxygen uptake during maximal exercise testing. Results: During a median of 26 years follow-up, 799 all-cause mortality and 376 cardiovascular mortality events occurred. Men with MetS had a 41% increased risk of all-cause mortality and 76% increased risk of cardiovascular mortality in multivariable analysis, while men with upper levels of CRF demonstrated a 41% and 50% decreased risk of all-cause mortality and cardiovascular mortality, respectively, following adjustment for potential confounders. For the joint associations of MetS and CRF with the risk of outcomes, fit with MetS were at increased risks of death (all-cause mortality, hazard ratio [HR], 1.73; 95% confidence interval [CI], 1.42–2.11; cardiovascular mortality, HR, 2.29; 95% CI, 1.71–3.07) compared with fit without MetS. Conclusions: Although these results suggest that MetS and CRF were each independently associated with the risk of death, the latter did not eliminate the heightened risk of death associated with the former.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78179496","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":"Mobile Healthcare System Provided by Primary Care Physicians Improves Quality of Diabetes Care","authors":"T. Oh, J. Lee, Seok Kim, Sooyoung Yoo, H. Jang","doi":"10.51789/CMSJ.2021.1.E6","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E6","url":null,"abstract":"Background and Objectives: To evaluate the clinical feasibility of a mobile healthcare (mHealthcare) system comprising a smartphone application with electronic feedback from the primary care physicians. Methods: We enrolled 169 patients with type 2 diabetes from 10 primary care clinics; data for 138 patients were analyzed. Patients' data were recorded including self-monitoring of blood glucose (SMBG) and physical activity. Primary care physicians performed electronic monitoring, sent feedback messages, and referred patients to the tertiary hospital as needed. We evaluated glycated hemoglobin A1C (HbA1c) and quality of diabetes care at baseline and at 3-month follow-up. Results: The mean age of participants was 57.5±9.0 years, and 58.7% were men. HbA1c levels decreased significantly from 7.9±1.1% to 7.5±0.9% (p<0.001). The quality of self-management assessed by a summary of diabetes self-care activities and the degree of diabetes knowledge improved without increasing diabetes-specific distress or hypoglycemia. We also found that patients with higher baseline HbA1c and with a better knowledge of diabetes care were good responders to this system. Professional feedback, SMBG, and daily activates seemed to be important factors to success of mHealthcare. Conclusions: We showed that a proposed mHealthcare system has clinical feasibility to improve the quality of diabetes care in subjects with type 2 diabetes who can use a smartphone in real clinical practice.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74486555","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":"Effective of Mobile Healthcare for Diabetes Care","authors":"S. Jung","doi":"10.51789/CMSJ.2021.1.E10","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E10","url":null,"abstract":"https://e-cmsj.org Diabetes is a multifactorial metabolic disease, in which increased blood glucose levels lead to stroke, heart disease, kidney failure, damage to the eyes.1 Lifestyle management is an essential aspect of diabetes care, which includes physical activity, nutrition therapy, smoking cessation counseling, and diabetes self-management education.2 In addition, the importance of self-monitoring of blood glucose (SMBG) is broadly appreciated and recommended as a fundamental component of management in patients with diabetes.3 From the perspective of multifactorial characteristics of diabetes management, diabetes is the most common disease for patient generated health data (PGHD) collection.4","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81966629","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":"Emerging New Lipid-Lowering Therapies in the Statin Era","authors":"A. Jang, S. Jo, K. Koh","doi":"10.51789/CMSJ.2021.1.E5","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E5","url":null,"abstract":"Statins have become the backbone of lipid-lowering therapy today by dramatically improving cardiovascular (CV) outcomes. Despite well-controlled low-density lipoprotein cholesterol (LDL-C) through statins, up to 40% patients still experience CV diseases. New therapeutic agents to target such residual cholesterol risk by lowering not only LDL-C but triglyceride (TG), TG-rich lipoproteins (TRL), or lipoprotein(a) (Lp[a]) are being newly introduced. Proprotein convertase subtilisin/kexin type 9 (PCSK9) small interference RNA (siRNA) and bempedoic acid therapies adding to statin therapies have shown additional improvement in CV outcomes. Recent trials investigating eicosapentaenoic acid to patients with high TG despite statin therapy have also demonstrated significant CV benefit. Antisense oligonucleotide (ASO) therapies with hepatocyte-specific targeting modifications are now being newly introduced with promising lipid-lowering effects. ASOs targeting TG/TRL, such as angiopoietin-like 3 or 4 (ANGPTL3 or ANGPTL4), apolipoprotein C-III (APOC3), or Lp(a) have effectively lowered the corresponding lipids without requiring high or frequent doses. Clinical outcomes from such novel therapeutics are yet to be proven. In this article, we review emerging therapeutics targeting LDL-C, TG, TRL, and Lp(a) to reduce the residual risk.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75572665","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":"Pathophysiology and Optimal Management of Hypertension in Patients with Cardiometabolic Syndrome","authors":"S. Ihm","doi":"10.51789/CMSJ.2021.1.E3","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E3","url":null,"abstract":"Metabolic syndrome (MS) is a common cardiometabolic disorder that increases in prevalence as the population becomes more obese and increases the risk for cardiovascular disease (CVD). MS is highly prevalent among hypertensive patients and hypertension (HTN) is a major risk factor for CVD. Therefore, strict blood pressure (BP) control is an important factor for prevention and proper management of CVD in patients with MS. The underlying mechanisms for development of HTN in the MS and obesity are very complicated and has not yet been fully elucidated. However, several pathophysiology including central obesity, insulin resistance and increased sympathetic nervous system (SNS) activity, renin-angiotensinaldosterone system (RAAS) activity and sodium reabsorption (salt sensitivity) have been proposed. In addition, the leptin-related brain system, endothelial dysfunction, natriuretic peptides and other various factors may be involved in the development of HTN in MS/ obese patients. Lifestyle modifications including weight loss with diet and exercise are very important strategy in management of HTN. For the treatment of HTN in this population, agents that block the RAAS, the SNS and renal sodium excretion are frequently required. In patients with MS, data from prospective studies are very limited, but many guidelines recommended angiotensin receptor blockers (ARBs) and angiotensin converting enzyme (ACE) inhibitors as initial antihypertensive drugs. Calcium channel blockers or low dose thiazide diuretic are recommended in addition to ARBs or ACE inhibitors, and then the use of a 3-drug combination comprising these 3 antihypertensive drugs. Further longer-term, prospective studies including new drugs and devices are needed.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73404461","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}
Jiesuck Park, Hack‐Lyoung Kim, Myung-A Kim, Mi-Na Kim, S. Park, H. Yoon, M. Shin, K. Hong, W. Shim
{"title":"Traditional Cardiovascular Risk Factors and Obstructive Coronary Disease in Patients with Stable Chest Pain: Gender-specific Analysis","authors":"Jiesuck Park, Hack‐Lyoung Kim, Myung-A Kim, Mi-Na Kim, S. Park, H. Yoon, M. Shin, K. Hong, W. Shim","doi":"10.51789/CMSJ.2021.1.E7","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E7","url":null,"abstract":"Background and Objectives: The effect of gender difference on the association between major cardiovascular risk factors and obstructive coronary artery disease (CAD) has not yet been fully determined. We investigated whether the strength of association between traditional cardiovascular risk factors and obstructive CAD differs according to gender in patients with stable chest pain. Methods: A total of 1,254 patients (61.0±11.2 years, 45.7% women) with stable chest pain who had elective invasive coronary angiography under suspicion of obstructive CAD were reviewed from the KoRean wOmen'S chest pain rEgistry multi-center registry database. Obstructive CAD was defined as ≥50% diameter stenosis in ≥1 epicardial coronary arteries. Age, body mass index, hypertension, diabetes mellitus, dyslipidemia, and smoking were focused as traditional risk factors. Results: Of the total patients, 453 (36.1%) had obstructive CAD (men vs. women: 38.0 vs. 33.9%, p=0.140). In multivariable analyses, old age (≥65 years) (odds ratio [OR], 1.92; 95% confidence interval [CI], 1.37–2.69; p<0.001) was only associated to obstructive CAD in men. In women, however, old age (OR, 2.02; 95% CI, 1.39–2.94; p=0.002), hypertension (OR, 1.76; 95% CI, 1.19–2.61; p=0.005) and diabetes mellitus (OR, 2.06; 95% CI, 1.30–3.26; p=0.002) were associated to obstructive CAD. The association between multiple risk factors and obstructive CAD was stronger in women compared to men. Conclusions: Among women presenting stable angina, those with old age, hypertension, diabetes mellitus or multiple cardiovascular risk factors need a higher suspicion for obstructive CAD.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88603062","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}
Hyunjung Kim, Myung-A Kim, Hack‐Lyoung Kim, S. Park, Mi-Na Kim, H. Yoon, M. Shin, Sang-Min Park, K. Hong, W. Shim
{"title":"Differences in Clinical Characteristics between Men and Post-menopausal Women with Chest Pain who Have Normal Coronary Arteries","authors":"Hyunjung Kim, Myung-A Kim, Hack‐Lyoung Kim, S. Park, Mi-Na Kim, H. Yoon, M. Shin, Sang-Min Park, K. Hong, W. Shim","doi":"10.51789/CMSJ.2021.1.E4","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E4","url":null,"abstract":"Background and Objectives: Atherosclerosis is the main mechanism for coronary artery disease (CAD). However, normal coronary arteries may be present on coronary angiography (CAG) in patients with suspected CAD. This study investigated the difference in clinical characteristics and prognoses between men and post-menopausal women who have normal coronary arteries. Methods: Study data were obtained from a registry of patients with chest pain who underwent CAG. We dichotomized patients with normal coronary arteries according to sex as follows: men and post-menopausal women. The primary outcomes were the composite clinical events of rehospitalization due to one of the following: acute coronary syndrome, stroke, or worsening of heart failure. Results: Among 999 patients, there were 623 post-menopausal women patients. According to the final diagnosis, microvascular angina was more frequent in post-menopausal women, and vasospastic angina was more frequent in men. The rate of composite clinical events was significantly lower in post-menopausal women than in men. Post-menopausal women had a significant higher cumulative clinical event-free survival rate at the long-term follow-up. Current smoking was independently associated with increased risk of adverse clinical events by 13.34-fold, after adjusting for confounding factors. Conclusions: Post-menopausal women have a better prognosis than men with suspected cardiovascular disease but no obstructive lesions. Among those patients, men had more vasospastic angina, while women had more microvascular angina. Because current smoking is an important factor in rehospitalization for cardiovascular events, clinicians need to be aware of the importance of lifestyle modification for patients with normal coronary arteries. this the gender-specific difference","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89974212","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":"Visceral Obesity with Excess Ectopic Fat: A Prevalent and High-Risk Condition Requiring Concerted Clinical and Public Health Actions","authors":"J. Despres","doi":"10.51789/CMSJ.2021.1.E11","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E11","url":null,"abstract":"The current epidemic of chronic societal diseases results from the exposition of a growing segment of the population to a “toxic” environment not compatible with healthy behaviours. About 60% of all deaths result from noncommunicable chronic diseases that are largely attributed to 4 behaviours: smoking, excessive alcohol consumption, poor nutritional habits, and lack of physical activity. Despite the fact that such behaviours are critical for health, few physicians assess nutritional quality and physical activity level in clinical practice. Cardiometabolic imaging studies have consistently found that the health risk of overweight and obesity is largely determined by the accumulation of fat in the abdomen (excess visceral adiposity) which is a good marker of an accumulation of toxic lipids in normally lean tissues such as the heart, the liver, the skeletal muscle, the kidney, and the pancreas, a condition that has been described as ectopic fat deposition. At any given body mass index, an elevated waistline is predictive of an increased accumulation of abdominal fat which is more likely to be resulting from an excess of visceral fat when accompanied by elevated triglyceride concentrations, a condition that we have defined as “hypertriglyceridemic waist.” It is proposed that 4 key “lifestyle vital signs” should be assessed and targeted in clinical practice as powerful predictors of various health outcomes: waist circumference, cardiorespiratory fitness, nutritional quality and physical activity level. Substantial benefits should be expected from assessing the above 4 “lifestyle vital signs.” It is proposed that the time for “preventive lifestyle medicine” has come.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86203315","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":"Sex Differences Focused on the Pathogenesis and Clinical Expression in Obstructive Coronary Artery Disease","authors":"S. Park","doi":"10.51789/CMSJ.2021.1.E12","DOIUrl":"https://doi.org/10.51789/CMSJ.2021.1.E12","url":null,"abstract":"First, we should confine the concept of “sex.” it is largely distinguished by the meaning of “gender.” Sex is a biological distinction of genital and genetic differences while gender is primarily mentioned as the focus on a social role.2 The authors described the sex differences in traditional risk factors for cardiovascular disease and some characteristics in stable obstructive coronary disease in women with chest pain.","PeriodicalId":87477,"journal":{"name":"Journal of the cardiometabolic syndrome","volume":"544 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77197780","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}