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BACKGROUND: The burden of cardiovascular diseases (CVDs) is increasing worldwide with CVD being one of the leading causes of death, including atherosclerosis, myocardial infarction, cardiomyopathy, and heart failure (HF). Fibroblast growth factor 21 (FGF21) is an endocrine hormone that regulates carbohydrate and lipid metabolism. It exerts direct effects on the cardiovascular system and can serve as an early indicator of CVDs. FGF21's therapeutic properties include reducing obesity, dyslipidaemia, and hyperglycemia, which can help treat metabolic disorders, autophagy, and apoptosis. Atherosclerosis is developed due to chronic inflammatory conditions, and the immune system's reaction to oxidized lipoproteins is mainly responsible for the development of atherosclerosis. FGF21's precise role in the pathogenesis of coronary artery disease (CAD) remains elusive. Aim: This study aimed to assess the role of FGF21 in predicting the severity and magnitude of CAD in individuals diagnosed with stable angina pectoris (SAP). MATERIALS AND METHODS: A prospective cross-sectional study was conducted on 110 consecutive patients with SAP reported to the cardiology department of the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, India. They were divided into two groups based on coronary angiography findings. Control groups included patients not showing any atherosclerotic lesions and case groups with atherosclerotic lesions. The SYNTAX score is a grading system that measures the location and complexity of coronary arteries using anatomical principles. The Gensini score assessment technique was employed to determine the severity of CAD. We compared serum FGF21 levels,left ventricular ejection fraction (LVEF), and inflammatory biomarker C-reactive protein (CRP) levels between the two groups. Moreover, we examined the correlation between the serum FGF21 level and the SYNTAX and Gensini scores. The statistical analysis was done using Version 23.0 of SPSS Statistics. P-values below 0.05 were considered statistically significant. RESULTS: The study found that the case group had a higher average age and a higher proportion of male patients. The case group had considerably higher levels of FGF21 (166.59 ± 94.49791 pg/mL) compared to the control group (54.13 ± 48.467 pg/mL) (p=0.034). The LVEF exhibited a significant difference between the case and control groups, with mean values of 50.3056 ± 7.8242% and 56.078 ± 5.3987%, respectively (p=0.031). CRP levels were comparable in both groups. The case group had mean values of SYNTAX and Gensini scores of 23.19±7.43 and 50.03±27.30, respectively. We found that there was no statistically significant association between the risk assessments for CAD severity and the levels of serum FGF21 (correlation coefficient r=0.14070, p>0.05, and r=0.206415, p>0.05, respectively) Conclusions: FGF21 is gaining recognition as a prospective addition to the FGF family, potentially playing a significant role in cardiovascular disease, particularly atherosclerosis. A statistically significant difference was seen in the serum FGF21 levels between the case and control groups, indicating that it can help in the diagnosis of CAD. However, there was no apparent correlation found between the serum FGF21 levels and the SYNTAX and Gensini scores. The role of FGF21 in the development of atherosclerosis and whether FGF21 could serve as a reliable marker need to be studied further.
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BACKGROUND: Coronary artery disease, one of the leading causes of mortality and morbidity globally, is a major burden on healthcare resources. Cardiovascular rehabilitation is highly recommended for the early recovery of patients with Ischemic heart disease by improving the functional capacity and decreasing disease progression. A randomized controlled trial was conducted to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters. MATERIALS AND METHODS: Sixty-two adult patients who underwent percutaneous coronary intervention (PCI) were randomised to two groups to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters, including adherence to drugs, cardiac diet, lifestyle changes, and selected physiological parameters. The intervention group had nurse-led individualized discharge counseling and clinical follow-up by telephone, whereas the control group received usual care. The comparisons between the control and intervention groups were made using independent Student's t-test or Mann-Whitney U test as appropriate. Pre-test and post-test scores were compared using paired t-test; all tests performed at 5% significance level. RESULTS: Participants in the intervention group presented with moderate to good smoking cessation, improved adherence to drugs (P < 0.0001), physically active lifestyle in 90.3 versus 45.2% (P < 0.0001), adherence to dietary changes, and improved healthcare satisfaction (P < 0.0001). There was also a significant reduction in triglycerides level in the intervention group at 62.51 versus 20.12 mg/dl in the control arm with (P < 0.05), and better controlled physiological indices, including a reduction in systolic blood pressure of 1.54 vs-7.12 mmHg (P = 0.003), bodyweight reduction of 2.48 kg versus-0.09 kg (P < 0.0001) and body mass index of 0.9 versus-0.05 (P < 0.0001). CONCLUSION: Personalised, nurse-led CR significantly improved the participants adherence to healthy lifestyle behaviors and decreased the cardiac risk factors in patients with coronary artery disease.
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BACKGROUND: Many studies have shown that evidence supporting the relationship between low bone mineral density (BMD) and coronary artery disease (CAD) has been increasing. There is a significant increase of myocardial infarction in men with low BMD. PURPOSE: We aimed to detect the relationship between BMD and CAD in patients whose CAD was detected with coronary angiography, and its severity and prevalence was detected with Gensini score. METHODS: A total of 55 patients were selected who were found to have single or multiple infarctions through using coronary angiography in the cardiology clinic. The CAD severity was evaluated by calculating the Gensini score. These patients were divided into two groups: mild CAD and severe CAD groups. Femur bone mineral density (FBMD) was measured with dual energy X-ray absorptiometry. T score values were determined to be normal if the values were >-1.0 (n=22, 40%), and osteopenia-osteoporosis (osteopenic syndrome) if the T score values were ≤-1 (n=33, 60%). RESULTS: The FBMD of severe CAD according to the Gensini risk score was found to be significantly lower. FBMD values in patients decreased as their Gensini scores increased. CONCLUSION: There was a significant relationship between CAD and osteopenic syndrome. FBMD level in men with severe CAD is significantly low when compared with patients who have mild CAD.