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3.
J Coll Physicians Surg Pak ; 30(7): 759-764, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271772

RESUMO

BACKGROUND:  To evaluate the role of the traditional risk scoring system (TRSS) in detecting subclinical atherosclerosis in HIV (+) patients. STUDY DESIGN: Cohort study. PLACE AND DURATION OF STUDY: Infectious Diseases Clinic, Izmir Katip Çelebi University, Atatürk Training and Research Hospital, from March 2017 to January 2018. METHODOLOGY: The patient group was formed with 52 HIV (+) patients, aged 18-60 years, and a control group was formed with 52 HIV (-) healthy volunteers. For all groups, there was no comorbid diseases or family history. Diabetes mellitus, hypertension, chronic kidney disease and cardiovascular disease were excluded from the two groups. Carotid intima-media thickness (CIMT) measurements were performed with high resolution B mode Doppler USG and patients with subclinical atherosclerosis were identified by the presence of atheroma plaque. RESULTS: The median right CIMT measurement was 0.91 (0.73-0.97) mm and the median left CIMT was 0.90 (0.73-0.98) mm in HIV (+) patients. The median values of CIMT on right and left sides in the control group were 0.77 (0.67-0.81) mm and 0.76 (0.70-0.81) mm. Atheroma plaque was detected in 13.5% of the HIV (+) patients and in none of the control group. Subclinical atherosclerosis was found in 51.9% of HIV (+) patients and this rate was 7.7% in the HIV (-) group (p<0.001). There was a weak correlation between CIMT and TRSS. CONCLUSION: In this study, the scoring systems (Framingham, ACC/AHA CVHRS) that determine the risk of cardiovascular disease recommended in current practice and the results of CIMT measurements were not found to be compatible. The development of new scoring systems including CIMT testing for the determination of this risk will open important new horizons. Key Words: AIDS, Cardiovascular disease, Subclinical atherosclerosis, CIMT.


Assuntos
Aterosclerose , Infecções por HIV , Aterosclerose/diagnóstico por imagem , Aterosclerose/epidemiologia , Espessura Intima-Media Carotídea , Estudos de Coortes , Infecções por HIV/complicações , Humanos , Fatores de Risco
4.
J Spec Oper Med ; 21(2): 19-24, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34105116

RESUMO

BACKGROUND: Autopsy studies of trauma fatalities have provided evidence for the pervasiveness of atherosclerosis in young and middle-aged adults. The objective of this study was to determine the prevalence of atherosclerosis in elite US military forces. METHODS: We conducted a retrospective study of all US Special Operations Command (USSOCOM) fatalities from 2001 to 2020 who died from battle injuries. Autopsies were evaluated from Afghanistan- and Iraq-centric combat operations for evidence of coronary and/or aortic atherosclerosis and categorized as minimal (fatty streaking only), moderate (10-49% narrowing of ≥1 vessel), and severe (≥50% narrowing of ≥1 vessel). Prevalence of atherosclerosis was determined for the total population and by subgroup characteristics of age, sex, race/ethnicity, combat operation, service command, occupation, rank, cause of death, manner of death, and body mass index (BMI). RESULTS: From the total of 388 USSOCOM battle injury fatalities, 356 were included in the analysis. The mean age was 31 years (range, 19-57 years), and 98.6% were male. The overall prevalence of coronary and/or aortic atherosclerosis was 17.4%. The prevalence of coronary atherosclerosis alone was 13.8%. Coronary atherosclerosis was categorized as minimal in 1.1%, moderate in 7.6%, and severe in 5.1%. Of those with atherosclerosis, 24.2% were <30 years old, 88.7% were from enlisted ranks, and 95.2% had combatant occupations. When BMI could be calculated, 73.5% of fatalities with atherosclerosis had a BMI =25. CONCLUSIONS: Autopsy-determined atherosclerosis is prevalent in elite US military Special Operations Forces despite young age and positive lifestyle benefits of service in an elite military unit.


Assuntos
Aterosclerose , Militares , Ferimentos e Lesões , Adulto , Campanha Afegã de 2001- , Afeganistão , Aterosclerose/epidemiologia , Autopsia , Feminino , Humanos , Iraque , Guerra do Iraque 2003-2011 , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
5.
BMJ Open ; 11(6): e047356, 2021 06 14.
Artigo em Inglês | MEDLINE | ID: mdl-34127492

RESUMO

OBJECTIVES: Using free-text clinical notes and reports from hospitalised patients, determine the performance of natural language processing (NLP) ascertainment of Framingham heart failure (HF) criteria and phenotype. STUDY DESIGN: A retrospective observational study design of patients hospitalised in 2015 from four hospitals participating in the Atherosclerosis Risk in Communities (ARIC) study was used to determine NLP performance in the ascertainment of Framingham HF criteria and phenotype. SETTING: Four ARIC study hospitals, each representing an ARIC study region in the USA. PARTICIPANTS: A stratified random sample of hospitalisations identified using a broad range of International Classification of Disease, ninth revision, diagnostic codes indicative of an HF event and occurring during 2015 was drawn for this study. A randomly selected set of 394 hospitalisations was used as the derivation dataset and 406 hospitalisations was used as the validation dataset. INTERVENTION: Use of NLP on free-text clinical notes and reports to ascertain Framingham HF criteria and phenotype. PRIMARY AND SECONDARY OUTCOME MEASURES: NLP performance as measured by sensitivity, specificity, positive-predictive value (PPV) and agreement in ascertainment of Framingham HF criteria and phenotype. Manual medical record review by trained ARIC abstractors was used as the reference standard. RESULTS: Overall, performance of NLP ascertainment of Framingham HF phenotype in the validation dataset was good, with 78.8%, 81.7%, 84.4% and 80.0% for sensitivity, specificity, PPV and agreement, respectively. CONCLUSIONS: By decreasing the need for manual chart review, our results on the use of NLP to ascertain Framingham HF phenotype from free-text electronic health record data suggest that validated NLP technology holds the potential for significantly improving the feasibility and efficiency of conducting large-scale epidemiologic surveillance of HF prevalence and incidence.


Assuntos
Aterosclerose , Insuficiência Cardíaca , Algoritmos , Aterosclerose/epidemiologia , Registros Eletrônicos de Saúde , Insuficiência Cardíaca/epidemiologia , Humanos , Pacientes Internados , Processamento de Linguagem Natural , Fenótipo
6.
Curr Opin Lipidol ; 32(4): 231-243, 2021 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-34116544

RESUMO

PURPOSE OF REVIEW: Coronavirus Disease 2019 (COVID19) has caused significant global morbidity and mortality, especially in persons with underlying cardiovascular disease. There have been concerns that lipid-lowering therapy (LLT) increases angiotensin-converting enzyme 2 levels. Conversely, pleiotropic effects of statins can theoretically protect against severe COVID19 infection, supporting evidence from other respiratory illnesses in which statin use probably confers benefit. RECENT FINDINGS: There is an abundance of studies that show that statins are safe and potentially protect against severe COVID19 infection (critical illness and death), even when adjustment for potential confounders is undertaken. However, the evidence is limited to retrospective cohorts. The benefit for patients with diabetes is less clear. There is a paucity of evidence for other LLT agents. Available clinical guidelines recommend the ongoing use of LLT in patients with COVID19 (unless specifically contra-indicated) and the data from available studies support these. SUMMARY: In patients with COVID19 infection, LLT should be continued. However, the current findings need substantiating in larger prospective clinical studies with specific examination of the possible mechanisms by which LLT confers benefit from COVID19.


Assuntos
Aterosclerose/tratamento farmacológico , COVID-19/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Dislipidemias/tratamento farmacológico , Aterosclerose/complicações , Aterosclerose/epidemiologia , Aterosclerose/virologia , COVID-19/complicações , COVID-19/epidemiologia , COVID-19/virologia , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/virologia , LDL-Colesterol/efeitos dos fármacos , Dislipidemias/complicações , Dislipidemias/epidemiologia , Dislipidemias/virologia , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipolipemiantes/uso terapêutico , SARS-CoV-2/patogenicidade
7.
Clin Interv Aging ; 16: 1139-1149, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34168437

RESUMO

Background: Silent myocardial infarction (SMI) accounts for more than half of all MIs, and common risk factors and pathophysiological pathways coexist between SMI and frailty. The risk of frailty among patients with SMI is not well established. This study aimed to examine the association between SMI and frailty. Methods and Results: This analysis included data from the Atherosclerosis Risk in Communities study. Patients without MI at baseline were eligible for inclusion. SMI was defined as electrocardiographic evidence of MI without clinical MI (CMI) after the baseline and until the fourth visit. Frailty was assessed during the fifth visit. A total of 4953 participants were included with an average age of 52.2±5.1 years. Among these participants, 2.7% (n=135) developed SMI, and 2.9% (n=146) developed CMI. After a median follow-up time of 14.7 (14.0-15.3) years, 6.7% (n=336) of the participants developed frailty. Patients with SMI and CMI were significantly more likely to become frail than those without MI (15.6% vs 6.2%, P<0.001 and 16.4% vs 6.2%, P<0.001, respectively). After adjusting for confounders, SMI and CMI were found to be independent predictors of frailty (odds ratio [OR]=2.243, 95% confidence interval [CI]=1.307-3.850, P=0.003 and OR=2.164, 95% CI=1.259-3.721, P=0.005, respectively). The association was consistent among the subgroups of age, sex, race, diabetes, and hypertension. Conclusion: In conclusion, both SMI and CMI were found to be associated with a higher risk of frailty. Future studies are needed to confirm the beneficial effects of screening for SMI as well as to implement standardized preventive treatment to reduce the risk of frailty. Clinical Trial Registration: URL: https://www.clinicaltrials.gov; Unique identifier: NCT00005131.


Assuntos
Aterosclerose/epidemiologia , Fragilidade/epidemiologia , Infarto do Miocárdio/epidemiologia , Idoso , Aterosclerose/fisiopatologia , Eletrocardiografia/métodos , Fragilidade/fisiopatologia , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/fisiopatologia , Prognóstico , Medição de Risco , Fatores de Risco
8.
Curr Cardiol Rep ; 23(7): 84, 2021 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-34081222

RESUMO

PURPOSE OF REVIEW: Cardiovascular disease is a leading cause of morbidity and mortality in both men and women, although there are notable differences in presentation between men and women. Atherosclerosis remains the predominant driver of coronary heart disease in both sexes; however, sex differences in atherosclerosis should be investigated further to understand clinical manifestations between men and women. RECENT FINDINGS: There are sex differences in the prevalence, progression, and prognostic impact of atherosclerosis. Furthermore, developing evidence demonstrates unique differences in atherosclerotic plaque characteristics between men and women on both noninvasive and invasive imaging modalities. Coronary microvascular dysfunction may be present even if no obstructive lesions are found. Most importantly, non-obstructive coronary artery disease is associated with a heightened risk of future adverse cardiovascular events and should not be ignored. The distinct plaque signature in women should be recognized, and optimal preventive strategies should be performed for both sexes.


Assuntos
Aterosclerose , Doença da Artéria Coronariana , Placa Aterosclerótica , Aterosclerose/diagnóstico por imagem , Aterosclerose/epidemiologia , Doença da Artéria Coronariana/diagnóstico por imagem , Doença da Artéria Coronariana/epidemiologia , Feminino , Humanos , Masculino , Placa Aterosclerótica/diagnóstico por imagem , Fatores de Risco , Fatores Sexuais
9.
Nutrients ; 13(6)2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34067469

RESUMO

While targeting elevated serum levels of low-density lipoprotein cholesterol has been the mainstay of atherosclerosis prevention and treatment for decades, the evidence regarding the atherogenic role of hypertriglyceridemia is still controversial. Various epidemiological population-based studies on statin-treated subjects nominated triglycerides, triglyceride-rich lipoproteins (namely, chylomicrons and very-low-density lipoprotein particles), and their remnants as major determinants of the substantial residual cardiovascular risk. With the triglyceride-glucose index and triglyceride to high-density lipoprotein ratio emerging as surrogate indicators of peripheral artery disease and atherosclerotic cerebrovascular disease, one can conclude that further research addressing the intricate relationship between triglycerides and atherosclerosis is warranted. Therefore, this review aims to provide insight into the current clinical and epidemiological state of knowledge on the relationship between triglycerides and atherosclerotic cardiovascular disease. It also intends to highlight the connection between triglycerides and other metabolic disorders, including diabetes mellitus, and the potential benefits of triglyceride-lowering agents on cardiovascular outcomes and all-cause mortality.


Assuntos
Aterosclerose/epidemiologia , Lipoproteínas/sangue , Doenças Metabólicas/epidemiologia , Triglicerídeos/sangue , Adulto , Aterosclerose/sangue , Aterosclerose/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Transtornos Cerebrovasculares/epidemiologia , LDL-Colesterol/sangue , Diabetes Mellitus/tratamento farmacológico , Diabetes Mellitus/epidemiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Hipertrigliceridemia/tratamento farmacológico , Hipertrigliceridemia/epidemiologia , Hipolipemiantes/uso terapêutico , Masculino , Doenças Metabólicas/sangue , Pessoa de Meia-Idade , Adulto Jovem
10.
Nutrients ; 13(6)2021 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-34067500

RESUMO

BACKGROUND: Sugar-sweetened beverage (SSB) intake is associated with higher risk of weight gain, diabetes, hypertension, cardiovascular disease, and cardiovascular mortality. However, the association of SSB with subclinical atherosclerosis in the general population is unknown. OBJECTIVE: Our primary objective was to investigate the association between SSB intake and prevalence of atherosclerotic plaque in the coronary arteries in The National Heart, Lung, and Blood Institute (NHLBI) Family Heart Study. METHODS: We studied 1991 participants of the NHLBI Family Heart Study without known coronary heart disease. Intake of SSB was assessed through a semi-quantitative food frequency questionnaire. Coronary artery calcium (CAC) was measured by cardiac Computed Tomography (CT) and prevalent CAC was defined as an Agatston score ≥100. We used generalized estimating equations to calculate adjusted prevalence ratios of CAC. A sensitivity analysis was also performed at different ranges of cut points for CAC. RESULTS: Mean age and body mass index (BMI) were 55.0 years and 29.5 kg/m2, respectively, and 60% were female. In analysis adjusted for age, sex, BMI, smoking, alcohol use, physical activity, energy intake, and field center, higher SSB consumption was not associated with higher prevalence of CAC [prevalence ratio (95% confidence interval) of: 1.0 (reference), 1.36 (0.70-2.63), 1.69 (0.93-3.09), 1.21 (0.69-2.12), 1.05 (0.60-1.84), and 1.58 (0.85-2.94) for SSB consumption of almost never, 1-3/month, 1/week, 2-6/week, 1/day, and ≥2/day, respectively (p for linear trend 0.32)]. In a sensitivity analysis, there was no evidence of association between SSB and prevalent CAC when different CAC cut points of 0, 50, 150, 200, and 300 were used. CONCLUSIONS: These data do not provide evidence for an association between SSB consumption and prevalent CAC in adult men and women.


Assuntos
Doença da Artéria Coronariana/epidemiologia , Placa Aterosclerótica/epidemiologia , Bebidas Adoçadas com Açúcar/efeitos adversos , Calcificação Vascular/epidemiologia , Adulto , Idoso , Aterosclerose/epidemiologia , Cálcio/metabolismo , Vasos Coronários/patologia , Estudos Transversais , Ingestão de Energia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , National Heart, Lung, and Blood Institute (U.S.) , Inquéritos Nutricionais , Prevalência , Fatores de Risco , Fumar , Estados Unidos
11.
Curr Environ Health Rep ; 8(2): 113-126, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34086258

RESUMO

PURPOSE OF REVIEW: Epidemiological studies of short- and long-term health impacts of ambient air pollutants require accurate exposure estimates. We describe the evolution in exposure assessment and assignment in air pollution epidemiology, with a focus on spatiotemporal techniques first developed to meet the needs of the Multi-ethnic Study of Atherosclerosis and Air Pollution (MESA Air). Initially designed to capture the substantial variation in pollutant levels and potential health impacts that can occur over small spatial and temporal scales in metropolitan areas, these methods have now matured to permit fine-scale exposure characterization across the contiguous USA and can be used for understanding long- and short-term health effects of exposure across the lifespan. For context, we highlight how the MESA Air models compare to other available exposure models. RECENT FINDINGS: Newer model-based exposure assessment techniques provide predictions of pollutant concentrations with fine spatial and temporal resolution. These validated models can predict concentrations of several pollutants, including particulate matter less than 2.5 µm in diameter (PM2.5), oxides of nitrogen, and ozone, at specific locations (such as at residential addresses) over short time intervals (such as 2 weeks) across the contiguous USA between 1980 and the present. Advances in statistical methods, incorporation of supplemental pollutant monitoring campaigns, improved geographic information systems, and integration of more complete satellite and chemical transport model outputs have contributed to the increasing validity and refined spatiotemporal spans of available models. Modern models for predicting levels of outdoor concentrations of air pollutants can explain a substantial amount of the spatiotemporal variation in observations and are being used to provide critical insights into effects of air pollutants on the prevalence, incidence, progression, and prognosis of diseases across the lifespan. Additional enhancements in model inputs and model design, such as incorporation of better traffic data, novel monitoring platforms, and deployment of machine learning techniques, will allow even further improvements in the performance of pollutant prediction models.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Aterosclerose , Poluentes Atmosféricos/análise , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Aterosclerose/epidemiologia , Exposição Ambiental/efeitos adversos , Monitoramento Ambiental , Estudos Epidemiológicos , Humanos , Material Particulado/análise
12.
Vasc Health Risk Manag ; 17: 175-185, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33953561

RESUMO

Purpose: Arterial stiffness describes the rigidity of the arterial walls and is associated with risk factors for cardiovascular disease (CVD). Arterial stiffness predicts future events and mortality, and the predictive value is stronger in younger versus older subjects. The aims of the present study were, firstly, to present data on physical activity (PA) and time spent sedentary, in the population of Swedish, young adults. Secondly, to explore the association between PA and arterial stiffness. Material and Methods: Self-reported healthy, non-smoking, Swedish, young adults, 18-25 years old, participated in the cross-sectional Lifestyle, Biomarkers and Atherosclerosis (LBA) study. The daily PA was objectively measured with an accelerometer for 1 week. Of the 834 participants, 658 individuals had valid registrations. The arterial stiffness measures, pulse wave velocity (PWV) and augmentation index (AIx) were measured with applanation tonometry. Results: Women were on overall more physically active than men, they spent 214 min/day in light PA (LPA) compared to men who spent 202 min/day. Women took significantly more steps per day than men, 7796 vs 7336 steps/day, and spent less time sedentary, 523 min/day, compared to men who spent 547 min/day sedentary. In total, 76% of the individuals spent on average at least 30 minutes per day in the recommended moderate and vigorous PA (MVPA). Lower arterial stiffness was associated with more MVPA and total PA in the total population. Conclusion: We conclude that in this age group of young, self-reported healthy adults 18-25 years, it is important to highlight the health-enhancing possibilities of time spent in physical activity on the vascular function, measured as PWV and AIx. It is of high relevance in a public health perspective to expand preventive efforts beyond the high-risk groups and encourage young adults to be physically active.


Assuntos
Aterosclerose/prevenção & controle , Exercício Físico , Estilo de Vida Saudável , Comportamento de Redução do Risco , Rigidez Vascular , Adolescente , Adulto , Fatores Etários , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Aterosclerose/fisiopatologia , Estudos Transversais , Feminino , Humanos , Masculino , Fatores de Proteção , Análise de Onda de Pulso , Medição de Risco , Fatores de Risco , Fatores Sexuais , Suécia/epidemiologia , Fatores de Tempo , Adulto Jovem
13.
Maturitas ; 148: 1-6, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-34024345

RESUMO

OBJECTIVE: To assess the association between the atherogenic index of plasma (AIP) and the trabecular bone score (TBS) in postmenopausal women. Furthermore, to analyze its relationship with bone mineral density (BMD), and serum concentrations of 25OHD, PTH, and bone turnover markers. STUDY DESIGN: Cross-sectional study nested in a population-based cohort of 1,367 postmenopausal women aged 44-94 years. Participants were classified according to TBS values (<1.230, between 1.230-1.310 and >1.310) and regarding a widely accepted cut-off point of ≥0.11 for AIP. We analyzed TBS, BMD, serum levels of 25OHD, PTH, P1NP, CTX, and clinical covariates. A multivariate analysis was performed to assess the adjusted association between AIP and TBS. RESULTS: The mean age of participants was 63±10 years. Women with TBS values <1.230 were older, had greater BMI, greater prevalence of fractures after the age of 40 years, more years since menopause, higher values of AIP, and significantly lower levels of HDL-C, serum phosphate, and 25OHD. AIP values ≥0.11 were not associated with the presence of densitometric osteoporosis (OR=0.83, 95%CI 0.58-1.18; p = 0.30) but, in multivariate analysis, AIP values ≥0.11 were related to a degraded microarchitecture after controlling for age, BMI, smoking, diabetes status, ischemic heart disease, statin use, GFR, a fragility fracture at over 40 years of age and lumbar osteoporosis by DXA, with an adjusted OR=1.61 (95%CI 1.06-2.46; p = 0.009). CONCLUSIONS: AIP is significantly and independently associated with a degraded bone microarchitecture as measured by TBS. In this sense, AIP might be a useful tool in the overall assessment of bone metabolism in postmenopausal women.


Assuntos
Aterosclerose/epidemiologia , Densidade Óssea , Osso Esponjoso/patologia , Vértebras Lombares/patologia , Fraturas por Osteoporose/epidemiologia , Pós-Menopausa , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/sangue , Aterosclerose/patologia , Estudos de Casos e Controles , Estudos de Coortes , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Fraturas por Osteoporose/patologia , Espanha/epidemiologia
14.
BMJ ; 373: n776, 2021 05 04.
Artigo em Inglês | MEDLINE | ID: mdl-33947652

RESUMO

First developed in 1990, the Agatston coronary artery calcium (CAC) score is an international guideline-endorsed decision aid for further risk assessment and personalized management in the primary prevention of atherosclerotic cardiovascular disease. This review discusses key international studies that have informed this 30 year journey, from an initial coronary plaque screening paradigm to its current role informing personalized shared decision making. Special attention is paid to the prognostic value of a CAC score of zero (the so called "power of zero"), which, in a context of low estimated risk thresholds for the consideration of preventive therapy with statins in current guidelines, may be used to de-risk individuals and thereby inform the safe delay or avoidance of certain preventive therapies. We also evaluate current recommendations for CAC scoring in clinical practice guidelines around the world, and past and prevailing barriers for its use in routine patient care. Finally, we discuss emerging approaches in this field, with a focus on the potential role of CAC informing not only the personalized allocation of statins and aspirin in the general population, but also of other risk-reduction therapies in special populations, such as individuals with diabetes and people with severe hypercholesterolemia.


Assuntos
Aterosclerose/prevenção & controle , Cálcio/análise , Vasos Coronários/química , Guias de Prática Clínica como Assunto , Prevenção Primária/normas , Aterosclerose/diagnóstico , Aterosclerose/epidemiologia , Angiografia por Tomografia Computadorizada , Angiografia Coronária , Vasos Coronários/diagnóstico por imagem , Diabetes Mellitus/epidemiologia , Humanos , Hipercolesterolemia/epidemiologia , Programas de Rastreamento/métodos , Programas de Rastreamento/normas , Literatura de Revisão como Assunto , Medição de Risco/métodos , Fatores de Risco
15.
Comput Biol Med ; 134: 104459, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34020127

RESUMO

BACKGROUND: Corona virus disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus -2 (SARS-CoV-2) has created ruckus throughout the world. Growing epidemiological studies have depicted atherosclerosis as a comorbid factor of COVID-19. Though both these diseases are triggered via inflammatory rage that leads to injury of healthy tissues, the molecular linkage between them and their co-influence in causing fatality is not yet understood. METHODS: We have retrieved the data of differentially expressed genes (DEGs) for both atherosclerosis and COVID-19 from publicly available microarray and RNA-Seq datasets. We then reconstructed the protein-protein interaction networks (PPIN) for these diseases from protein-protein interaction data of corresponding DEGs. Using RegNetwork and TRRUST, we mapped the transcription factors (TFs) in atherosclerosis and their targets (TGs) in COVID-19 PPIN. RESULTS: From the atherosclerotic PPIN, we have identified 6 hubs (TLR2, TLR4, EGFR, SPI1, MYD88 and IRF8) as differentially expressed TFs that might control the expression of their 17 targets in COVID-19 PPIN. The important target proteins include IL1B, CCL5, ITGAM, IFIT3, CXCL1, CXCL2, CXCL3 and CXCL8. Consequent functional enrichment analysis of these TGs have depicted inflammatory responses to be overrepresented among the gene sets. CONCLUSION: Finally, analyzing the DEGs in cardiomyocytes infected with SARS-CoV-2, we have concluded that MYD88 is a crucial linker of atherosclerosis and COVID-19, the co-existence of which lead to fatal outcomes. Anti-inflammatory therapy targeting MYD88 could be a potent strategy for combating this comorbidity.


Assuntos
Aterosclerose , COVID-19 , Aterosclerose/epidemiologia , Aterosclerose/genética , Comorbidade , Humanos , Mapas de Interação de Proteínas , SARS-CoV-2
16.
BMC Neurol ; 21(1): 186, 2021 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-33964889

RESUMO

BACKGROUND: When dizziness/vertigo patients presented with balance disorder, it will bring severe morbidity. There is currently lack of research to explore risk factor related balance disorder in dizziness patients, especially in those who walk independently. AIM: To investigate risk factors related balance disorder in dizziness/vertigo patients who walk independently. METHODS: Medical data of 1002 dizziness/vertigo patients registered in vertigo/balance disorder registration database were reviewed. The demographic data, medical history, and risk factors for atherosclerosis (AS) were collected. Enrolled dizziness/vertigo patients could walk independently, completed Romberg test, videonystagmography (VNG), and limits of stability (LOS). The subjective imbalance was patient complained of postural symptom when performing Romberg test. Multivariable logistic regression analyzed risk factors related balance disorder. The receiver operating characteristic (ROC) curve evaluated the utility of regression model. RESULTS: Five hundred fifty-three dizziness/vertigo patients who walk independently were included in the final analysis. According to LOS, patients were divided into 334 (60%) normal balance and 219 (40%) balance disorder. Compared with normal balance, patients with balance disorder were older (P = 0.045) and had more risk factors for AS (P<0.0001). The regression showed that risk factors for AS (OR 1.494, 95% CI 1.198-1.863), subjective imbalance (OR 4.835, 95% CI 3.047-7.673), and abnormality of optokinetic nystagmus (OR 8.308, 95% CI 1.576-43.789) were related to balance disorder. The sensitivity and specificity of model were 71 and 63% (P<0.0001). The area under the curve (AUC) was 0.721. CONCLUSIONS: Risk factors for AS, subjective imbalance, and abnormality of optokinetic nystagmus were predictors for balance disorder in patients with dizziness/vertigo who walk independently.


Assuntos
Tontura/complicações , Transtornos das Sensações/etiologia , Vertigem/complicações , Adulto , Idoso , Aterosclerose/complicações , Aterosclerose/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Equilíbrio Postural/fisiologia , Fatores de Risco , Transtornos das Sensações/epidemiologia
17.
Kardiologiia ; 61(3): 12-17, 2021 Mar 30.
Artigo em Russo | MEDLINE | ID: mdl-33849413

RESUMO

Aim        To analyze first results of using the Aterostop calculator for a comprehensive evaluation of the risk for cardiovascular diseases (CVD).Material and methods        A cross-sectional study analyzed major and additional risk factors in 460 subjects without apparent disease and in patients with documented CVD of atherosclerotic origin using the application (calculator) Aterostop developed in the National Medical Research Center of Cardiology in Moscow, Russia.Results   45.4% of evaluated persons belonged to the categories of very high and extreme risk. Age and frequencies of smoking, arterial hypertension, and diabetes mellitus (DM) increased with the increase in risk; the growth of DM was exponential. 129 (28%) individuals used lipid-lowering medications at the time of study. Their plasma levels of low-density lipoprotein cholesterol (LDL-C) were significantly lower than in those who did not received this treatment. However, achieving the target level was inversely proportional to the risk: the greatest proportion of individuals who reached the LDL-C target was in the category of low risk and the smallest proportion was in the category of extreme risk (75 % vs. 3.7 %, respectively).Conclusion            The results obtained with the calculator Aterostop were consistent with earlier reports of insufficient effectiveness of primary and secondary prevention of atherosclerotic CVDs, which requires more tight and fruitful cooperation of the physician and the patient.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Inibidores de Hidroximetilglutaril-CoA Redutases , Aterosclerose/epidemiologia , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Fatores de Risco de Doenças Cardíacas , Humanos , Moscou/epidemiologia , Medição de Risco , Fatores de Risco , Federação Russa/epidemiologia
18.
Clin Interv Aging ; 16: 665-674, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33907388

RESUMO

Objective: It remains unclear whether irregular morphological features of intracranial aneurysms (IAs) are associated with atherosclerosis. We investigated the effect of cerebrovascular atherosclerosis stenosis (CAS) on irregular morphology of IAs. Patients and Methods: This single-center case-control study included consecutive patients with IAs at our institution from September 2011 to September 2018. Cases were patients with irregular IAs, and age- and location-matched controls were patients with regular IAs. Conditional logistic regression models were used to assess the relationship between angiographic variables of CAS and aneurysmal irregularity. Results: A total of 140 cases of irregular IAs and 140 controls were included in the analysis. Sixteen patients with irregular IAs (11.4%) and eleven patients with regular IAs (7.9%) had >50% parent artery stenosis; however, the differences were not statistically significant between these two groups. In addition, no significant between-group differences were observed in distributions of the cerebrovascular stenosis, number of arterial stenoses, and location of the stenosis. In the final adjusted conditional logistic regression model, only aneurysm size (≥7 mm) was significantly associated with irregular IA morphology (P = 0.022). Moreover, 89 cases of irregular IAs and 89 controls were included in the analysis of unruptured IAs (UIAs). In the final adjusted conditional logistic regression model, only aneurysm size (≥7 mm) was significantly associated with irregular UIA morphology (P = 0.020). Conclusion: Our findings indicate that the morphological irregularity of unruptured intracranial aneurysms is more related with aneurysm size rather than cerebrovascular atherosclerosis. Further studies are needed to use prospective data to identify causative factors responsible for aneurysmal irregularity.


Assuntos
Aterosclerose/epidemiologia , Aneurisma Intracraniano/epidemiologia , Aneurisma Intracraniano/patologia , Fatores Etários , Idoso , Aterosclerose/patologia , Estudos de Casos e Controles , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais
19.
Curr Cardiol Rep ; 23(5): 52, 2021 04 06.
Artigo em Inglês | MEDLINE | ID: mdl-33822282

RESUMO

PURPOSE OF REVIEW: Hepatitis C virus (HCV) and atherosclerotic cardiovascular disease (ASCVD) are two diseases that affect millions around the globe. Hepatitis C affects more than 70 million individuals globally. ASCVD is commonly encountered and remains the top cause of death worldwide. A link has been identified between HCV and atherosclerosis. RECENT FINDINGS: A review of recent studies which define the association between HCV infection and an increased risk of subclinical ASCVD and experiencing cardiovascular (CV) events. It is now recognized that there is an increased burden of atherosclerosis in individuals infected with HCV that translates into increased cardiovascular events. An increase in the number of diagnosed cases of HCV is expected as screening recommendations for the virus have expanded. Strategies to educate healthcare professionals about this increased CV risk will need to be considered as well as the optimal strategy to lower CV risk in this growing population.


Assuntos
Aterosclerose , Doenças Cardiovasculares , Hepatite C , Antivirais/uso terapêutico , Aterosclerose/tratamento farmacológico , Aterosclerose/epidemiologia , Aterosclerose/etiologia , Doenças Cardiovasculares/tratamento farmacológico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Hepacivirus , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C/epidemiologia , Humanos
20.
Environ Res ; 198: 111211, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33895111

RESUMO

BACKGROUND: Short-duration exposure to ambient particulate matter (PM) air pollution is associated with cardiac autonomic dysfunction and prolonged ventricular repolarization. However, associations with sub-chronic exposures to coarser particulates are relatively poorly characterized as are molecular mechanisms underlying their potential relationships with cardiovascular disease. MATERIALS AND METHODS: We estimated associations between monthly mean concentrations of PM < 10 µm and 2.5-10 µm in diameter (PM10; PM2.5-10) with time-domain measures of heart rate variability (HRV) and QT interval duration (QT) among U.S. women and men in the Women's Health Initiative and Atherosclerosis Risk in Communities Study (nHRV = 82,107; nQT = 76,711). Then we examined mediation of the PM-HRV and PM-QT associations by DNA methylation (DNAm) at three Cytosine-phosphate-Guanine (CpG) sites (cg19004594, cg24102420, cg12124767) with known sensitivity to monthly mean PM concentrations in a subset of the participants (nHRV = 7,169; nQT = 6,895). After multiply imputing missing PM, electrocardiographic and covariable data, we estimated associations using attrition-weighted, linear, mixed, longitudinal models adjusting for sociodemographic, behavioral, meteorological, and clinical characteristics. We assessed mediation by estimating the proportions of PM-HRV and PM-QT associations mediated by DNAm. RESULTS: We found little evidence of PM-HRV association, PM-QT association, or mediation by DNAm. CONCLUSIONS: The findings suggest that among racially/ethnically and environmentally diverse U.S. populations, sub-chronic exposures to coarser particulates may not exert appreciable, epigenetically mediated effects on cardiac autonomic function or ventricular repolarization. Further investigation in better-powered studies is warranted, with additional focus on shorter duration exposures to finer particulates and non-electrocardiographic outcomes among relatively susceptible populations.


Assuntos
Poluentes Atmosféricos , Poluição do Ar , Aterosclerose , Poluentes Atmosféricos/análise , Poluentes Atmosféricos/toxicidade , Poluição do Ar/efeitos adversos , Poluição do Ar/análise , Aterosclerose/induzido quimicamente , Aterosclerose/epidemiologia , Aterosclerose/genética , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Feminino , Humanos , Masculino , Material Particulado/análise , Material Particulado/toxicidade , Saúde da Mulher
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