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1.
Work ; 67(2): 281-283, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33044209

RESUMO

The COVID-19 pandemic has affected the entire world. It is difficult to follow protocols and regulations set forth by governments, designed by the World Health Organization. The most common protocol set forth by governments is quarantining at home. Many occupations must stay home to comply with this protocol. Among these occupations, office workers are the most common group to comply and work from home. This has led to a lack of daily movement and increased sedentary lifestyle, which has made employees prone to developing coronary heart disease (CHD). Additionally, obesity is a known risk factor for this group. This commentary presents feasible protocols aimed at helping home-based office workers stay healthy and decrease the risk of developing CHD.


Assuntos
Doença das Coronárias/etiologia , Infecções por Coronavirus/psicologia , Coronavirus , Ocupações/estatística & dados numéricos , Quarentena/psicologia , Comportamento Sedentário , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/prevenção & controle , Surtos de Doenças , Humanos , Irã (Geográfico) , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/prevenção & controle
2.
Am J Physiol Heart Circ Physiol ; 319(1): H76-H88, 2020 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-32442027

RESUMO

Blood lipoproteins are formed by various amounts of cholesterol (C), triglycerides (TGs), phospholipids, and apolipoproteins (Apos). ApoA1 is the major structural protein of high-density lipoprotein (HDL), accounting for ~70% of HDL protein, and mediates many of the antiatherogenic functions of HDL. Conversely, ApoB is the predominant low-density lipoprotein (LDL) Apo and is an indicator of circulating LDL, associated with higher coronary heart disease (CHD) risk. Thus, the ratio of ApoB to ApoA1 (ApoB/ApoA1) is used as a surrogate marker of the risk of CHD related to lipoproteins. Elevated or abnormal levels of lipids and/or lipoproteins in the blood are a significant CHD risk factor, and several studies support the idea that aerobic exercise decreases CHD risk by partially lowering serum TG and LDL-cholesterol (LDL-C) levels and increasing HDL-C levels. Exercise also exerts an effect on HDL-C maturation and composition and on reverse C transport from peripheral cells to the liver to favor its catabolism and excretion. This process prevents atherosclerosis, and several studies showed that exercise training increases heart lipid metabolism and protects against cardiovascular disease. In these and other ways, it more and more appears that regular exercise, nutrition, and strategies to modulate lipid profile should be viewed as an integrated whole. The purpose of this review is to assess the effects of endurance training on the nontraditional lipid biomarkers, including ApoB, ApoA1, and ApoB/ApoA1, in CHD risk.


Assuntos
Doença das Coronárias/prevenção & controle , Exercício Físico , Metabolismo dos Lipídeos , Apolipoproteínas/sangue , Doença das Coronárias/sangue , Doença das Coronárias/etiologia , Humanos
3.
BMC Public Health ; 20(1): 726, 2020 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-32429951

RESUMO

BACKGROUND: A growing body of studies that investigated the longitudinal association between physical activity (PA) and the outcome of incident obesity, coronary heart disease (CHD), diabetes and hypertension has become available in recent years. Thus, the purpose of this systematic review was to provide an update on the association between PA and onset of obesity, CHD, diabetes and hypertension in individuals aged ≥18 years who were free of the respective conditions at baseline. METHODS: We systematically searched OVID, Pubmed, and Web of Science databases for pertinent literature published between January of 2012 and February of 2019. To ensure that conclusions are based on high quality evidence, we only included longitudinal studies conducted in samples of ≥500 participants and with ≥5 years of follow-up. RESULT: The search yielded 8929 records of which 26 were included in this review. Three studies were conducted on the outcome of incident obesity, eight on incident CHD, nine on incident diabetes, four on incident hypertension, one on the outcome of both diabetes and hypertension, and one on the outcome of CHD, diabetes and hypertension. Overall, there was an association between PA and lower risk of incident obesity, CHD and diabetes, but not hypertension. Higher levels or amount of PA were associated with a reduced risk of new onset of the respective diseases in 20 studies (77%). Whereas four studies reported an elevated risk of incidence of diseases with lower PA levels (15%). PA was not associated with incidence of diseases in two studies (8%). CONCLUSION: Higher levels of PA are likely associated with a lower risk of becoming obese, develop CHD or diabetes. These findings replicate and strengthen conclusions from earlier reviews underlining the importance of promoting PA in adults. The associations between PA and incident hypertension were less consistent. More research, particularly using prospective cohort designs in large population-based samples, is needed to further untangle the association between PA and incident hypertension. TRAIL REGISTRATION: CRD42019124474 (PROSPERO Protocol registration). Date of registration in PROSPERO 27 February 2019.


Assuntos
Doença das Coronárias/epidemiologia , Diabetes Mellitus/epidemiologia , Exercício Físico , Hipertensão/epidemiologia , Obesidade/epidemiologia , Adulto , Doença das Coronárias/etiologia , Diabetes Mellitus/etiologia , Feminino , Humanos , Hipertensão/etiologia , Incidência , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Obesidade/etiologia , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
4.
J Card Surg ; 35(5): 1152-1155, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32302027
5.
JAAPA ; 33(5): 1-4, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32345952

RESUMO

A patient who presented after falling out of bed had signs of right-sided stroke, which, after imaging, was suspicious for embolism with cardiac origin. Further investigation revealed a large aortic valve vegetation with mild aortic insufficiency, and the patient eventually developed heart failure requiring surgical intervention. Infective endocarditis is slowly becoming more prevalent, and clinicians should have a high index of suspicion when patients present with common complications of this disease, such as valvular dysfunction, heart failure, or stroke. Early diagnosis has been shown to reduce time to appropriate antibiotic treatment and definitive care, which can lead to better outcomes.


Assuntos
Endocardite Bacteriana/diagnóstico , Endocardite Bacteriana/microbiologia , Infecções Estreptocócicas , Streptococcus agalactiae , Insuficiência da Valva Aórtica/diagnóstico por imagem , Insuficiência da Valva Aórtica/etiologia , Doença das Coronárias/etiologia , Ecocardiografia , Embolia/etiologia , Endocardite Bacteriana/complicações , Endocardite Bacteriana/terapia , Evolução Fatal , Feminino , Insuficiência Cardíaca/etiologia , Insuficiência Cardíaca/cirurgia , Humanos , Pessoa de Meia-Idade , Choque Cardiogênico/etiologia , Acidente Vascular Cerebral/etiologia , Tomografia Computadorizada por Raios X
6.
PLoS One ; 15(3): e0229598, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32130248

RESUMO

BACKGROUND AND AIM: Coronary heart disease (CHD) is a chronic complex disease caused by a combination of factors such as lifestyle behaviors and environmental and genetic factors. We conducted this study to evaluate the risk factors affecting the development of CHD in Xinjiang, and to obtain valuable information for formulating appropriate local public health policies. METHOD: We conducted a nested case-control study with 277 confirmed CHD cases and 554 matched controls. The association of the risk factors with the risk of CHD was assessed using the multivariate Cox proportional hazard model. Multiplicative interactions were evaluated by entering interaction terms in the Cox proportional hazard model. The additive interactions among the risk factors were assessed by the index of additive interaction. RESULTS: The risk of CHD increased with frequent high-fat food consumption, dyslipidemia, obesity, and family history of CHD after adjustment for drinking, smoking status, hypertension, diabetes, family history of hypertension, and family history of diabetes. We noted consistent interactions between family history of CHD and frequent high-fat food consumption, family history of CHD and obesity, frequent high-fat food consumption and obesity, frequent high-fat food consumption and dyslipidemia, and obesity and dyslipidemia. The risk of CHD events increased with the presence of the aforementioned interactions. CONCLUSIONS: Frequent high-fat food consumption, family history of CHD, dyslipidemia and obesity were independent risk factors for CHD, and their interactions are important for public health interventions in patients with CHD in Xinjiang.


Assuntos
Doença das Coronárias/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , China/epidemiologia , Doença das Coronárias/etiologia , Dieta Hiperlipídica/efeitos adversos , Dislipidemias/complicações , Feminino , Humanos , Masculino , Anamnese , Pessoa de Meia-Idade , Análise Multivariada , Obesidade/complicações , Modelos de Riscos Proporcionais , Fatores de Risco , População Rural
7.
Artigo em Inglês | MEDLINE | ID: mdl-32079287

RESUMO

To assist interpretation of a study in rural Pakistan on the use of biomass for cooking and the risk of coronary heart disease, we continuously monitored airborne concentrations of fine particulate matter (PM2.5) and carbon monoxide (CO) for up to 48 h in the kitchens of households randomly selected from the parent study. Satisfactory data on PM2.5 and CO respectively were obtained for 16 and 17 households using biomass, and 19 and 17 using natural gas. Linear regression analysis indicated that in comparison with kitchens using natural gas, daily average PM2.5 concentrations were substantially higher in kitchens that used biomass in either a chimney stove (mean difference 611, 95% CI: 359, 863 µg/m3) or traditional three-stone stove (mean difference 389, 95% CI: 231, 548 µg/m3). Daily average concentrations of CO were significantly increased when biomass was used in a traditional stove (mean difference from natural gas 3.7, 95% CI: 0.8, 6.7 ppm), but not when it was used in a chimney stove (mean difference -0.8, 95% CI: -4.8, 3.2 ppm). Any impact of smoking by household members was smaller than that of using biomass, and not clearly discernible. In the population studied, cooking with biomass as compared with natural gas should serve as a good proxy for higher personal exposure to PM2.5.


Assuntos
Poluição do Ar em Ambientes Fechados/análise , Biomassa , Monóxido de Carbono/efeitos adversos , Culinária , Gás Natural , Material Particulado/análise , Doença das Coronárias/etiologia , Monitoramento Ambiental , Humanos , Paquistão , População Rural
8.
Med Care ; 58 Suppl 6 Suppl 1: S53-S59, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32011424

RESUMO

BACKGROUND: Electronic health records (EHRs) and claims records are widely used in defining type 2 diabetes mellitus (T2DM) complications across different types of health care encounters. OBJECTIVE: This study investigates whether using different EHR encounter types to define diabetes complications may lead to different results when examining associations between diabetes complications and their risk factors in patients with T2DM. RESEARCH DESIGN: The study cohort of 64,855 adult patients with T2DM was created from EHR data from the Research Action for Health Network (REACHnet), using the Surveillance Prevention, and Management of Diabetes Mellitus (SUPREME-DM) definitions. Incidence of coronary heart disease (CHD) and stroke events were identified using International Classification of Diseases (ICD)-9/10 codes and grouped by encounter types: (1) inpatient (IP) or emergency department (ED) type, or (2) any health care encounter type. Cox proportional hazards regression was used to estimate associations between diabetes complications (ie, CHD and stroke) and risk factors (ie, low-density lipoprotein cholesterol and hemoglobin A1c). RESULTS: The incidence rates of CHD and stroke in all health care settings were more than twice the incidence rates of CHD and stroke in IP/ED settings. The age-adjusted and multivariable-adjusted hazard ratios for incident CHD and stroke across different levels of low-density lipoprotein cholesterol and hemoglobin A1c were similar between IP/ED and all settings. CONCLUSION: While there are large variations in incidence rates of CHD and stroke as absolute risks, the associations between both CHD and stroke and their respective risk factors measured by hazard ratios as relative risks are similar, regardless of alternative definitions.


Assuntos
Complicações do Diabetes/epidemiologia , Registros Eletrônicos de Saúde/estatística & dados numéricos , Idoso , Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Pacientes Internados/estatística & dados numéricos , Masculino , Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos , Modelos de Riscos Proporcionais , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia
9.
Nutr Cancer ; 72(1): 1-4, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31842617

RESUMO

Was the Annals of Internal Medicine recently acting as a mouthpiece for meat-industry propaganda? Five papers underpinned recommendations on meat consumption; their central deceit was to review only randomized controlled trials and cohort studies, which, in research on the associations between common foods and disease outcomes, are nearer to the bottom than the top of the evidence hierarchy. Despite concluding that their own recommendations were "weak and based on low certainty evidence", the authors were happy to recommend that there is "No need to reduce red or processed meat consumption for good health." What we actually know is that: red meat consumption is an order of magnitude higher now than through most of human history; red meat is a probable, and processed meat is a definite, human carcinogen; saturated fat increases risk of heart disease; and vegans and vegetarians have better lipid profiles, lower risk of chronic disease, and greater longevity than meat eaters. There are other consequences of meat consumption too, including: altered sexual development; widespread antimicrobial resistance; and disrupted planetary health, including depletion of aquifers, groundwater pollution, and increased greenhouse gases. The pseudoscience presented in the Annals of Internal Medicine appears to have been written solely to create doubt and confusion in the wider population. Scientists and journals should hold themselves to a higher standard.


Assuntos
Manteiga/efeitos adversos , Doença das Coronárias/etiologia , Dieta/efeitos adversos , Comportamento Alimentar/psicologia , Neoplasias/etiologia , Carne Vermelha/efeitos adversos , Vegetarianos/estatística & dados numéricos , Estudos de Coortes , Doença das Coronárias/prevenção & controle , Humanos , Carne/efeitos adversos , Neoplasias/prevenção & controle , Ensaios Clínicos Controlados Aleatórios como Assunto , Fatores de Risco
10.
PLoS One ; 14(12): e0225991, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31805166

RESUMO

Coronary heart disease (CHD) is one of the leading causes of death worldwide; if suffering from CHD and being in its end-stage, the most advanced treatments are required, such as heart surgery and heart transplant. Moreover, it is not easy to diagnose CHD at the earlier stage; hospitals diagnose it based on various types of medical tests. Thus, by predicting high-risk people who are to suffer from CHD, it is significant to reduce the risks of developing CHD. In recent years, some research works have been done using data mining to predict the risk of developing diseases based on medical tests. In this study, we have proposed a reconstruction error (RE) based deep neural networks (DNNs); this approach uses a deep autoencoder (AE) model for estimating RE. Initially, a training dataset is divided into two groups by their RE divergence on the deep AE model that learned from the whole training dataset. Next, two DNN classifiers are trained on each group of datasets separately by combining a RE based new feature with other risk factors to predict the risk of developing CHD. For creating the new feature, we use deep AE model that trained on the only high-risk dataset. We have performed an experiment to prove how the components of our proposed method work together more efficiently. As a result of our experiment, the performance measurements include accuracy, precision, recall, F-measure, and AUC score reached 86.3371%, 91.3716%, 82.9024%, 86.9148%, and 86.6568%, respectively. These results show that the proposed AE-DNNs outperformed regular machine learning-based classifiers for CHD risk prediction.


Assuntos
Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Aprendizado Profundo , Redes Neurais de Computação , Algoritmos , Humanos , Reprodutibilidade dos Testes , Medição de Risco , Fatores de Risco
11.
PLoS Biol ; 17(12): e3000572, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31860674

RESUMO

Cholesteryl ester transfer protein (CETP) inhibition reduces vascular event risk, but confusion surrounds its effects on low-density lipoprotein (LDL) cholesterol. Here, we clarify associations of genetic inhibition of CETP on detailed lipoprotein measures and compare those to genetic inhibition of 3-hydroxy-3-methylglutaryl-coenzyme A reductase (HMGCR). We used an allele associated with lower CETP expression (rs247617) to mimic CETP inhibition and an allele associated with lower HMGCR expression (rs12916) to mimic the well-known effects of statins for comparison. The study consists of 65,427 participants of European ancestries with detailed lipoprotein subclass profiling from nuclear magnetic resonance spectroscopy. Genetic associations were scaled to 10% reduction in relative risk of coronary heart disease (CHD). We also examined observational associations of the lipoprotein subclass measures with risk of incident CHD in 3 population-based cohorts totalling 616 incident cases and 13,564 controls during 8-year follow-up. Genetic inhibition of CETP and HMGCR resulted in near-identical associations with LDL cholesterol concentration estimated by the Friedewald equation. Inhibition of HMGCR had relatively consistent associations on lower cholesterol concentrations across all apolipoprotein B-containing lipoproteins. In contrast, the associations of the inhibition of CETP were stronger on lower remnant and very-low-density lipoprotein (VLDL) cholesterol, but there were no associations on cholesterol concentrations in LDL defined by particle size (diameter 18-26 nm) (-0.02 SD LDL defined by particle size; 95% CI: -0.10 to 0.05 for CETP versus -0.24 SD, 95% CI -0.30 to -0.18 for HMGCR). Inhibition of CETP was strongly associated with lower proportion of triglycerides in all high-density lipoprotein (HDL) particles. In observational analyses, a higher triglyceride composition within HDL subclasses was associated with higher risk of CHD, independently of total cholesterol and triglycerides (strongest hazard ratio per 1 SD higher triglyceride composition in very large HDL 1.35; 95% CI: 1.18-1.54). In conclusion, CETP inhibition does not appear to affect size-specific LDL cholesterol but is likely to lower CHD risk by lowering concentrations of other atherogenic, apolipoprotein B-containing lipoproteins (such as remnant and VLDLs). Inhibition of CETP also lowers triglyceride composition in HDL particles, a phenomenon reflecting combined effects of circulating HDL, triglycerides, and apolipoprotein B-containing particles and is associated with a lower CHD risk in observational analyses. Our results reveal that conventional composite lipid assays may mask heterogeneous effects of emerging lipid-altering therapies.


Assuntos
Proteínas de Transferência de Ésteres de Colesterol/antagonistas & inibidores , Doença das Coronárias/sangue , Hidroximetilglutaril-CoA Redutases/sangue , Lipoproteínas/sangue , Adolescente , Adulto , Alelos , Apolipoproteínas B/sangue , Proteínas de Transferência de Ésteres de Colesterol/sangue , Proteínas de Transferência de Ésteres de Colesterol/genética , LDL-Colesterol/sangue , Estudos de Coortes , Doença das Coronárias/tratamento farmacológico , Doença das Coronárias/etiologia , Doença das Coronárias/genética , Feminino , Seguimentos , Variação Genética , Humanos , Hidroximetilglutaril-CoA Redutases/genética , Hidroximetilglutaril-CoA Redutases/metabolismo , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Lipoproteínas/classificação , Masculino , Pessoa de Meia-Idade , Triglicerídeos/sangue , Adulto Jovem
12.
Rev Chilena Infectol ; 36(5): 636-641, 2019 Oct.
Artigo em Espanhol | MEDLINE | ID: mdl-31859805

RESUMO

BACKGROUND: Kawasaki disease (EK) is an acute systemic vasculitis with a risk of developing coronary aneurysms. AIM: To describe the clinical and epidemiological characteristics of children with EK in Argentina and to analyse the risk factors for the development of coronary's complications (CC). METHODS: Multicenter, retrospective, cross-sectional, observational and analytical study. It included patients younger than 18 years of age diagnosed with EK in hospitals in Argentina, between January the 1st, 2010 and December the 31th, 2013. RESULTS: N = 193 subjects. Age: medium: 29 months. Total incidence 5 cases / 10,000 hospital discharges. CC was observed in 15.5% of patients. Increased risk factors for CC: Elevated number of days with fever at the time of treatment placement (p = 0.0033); Increased of: heart frequency (p = 0.0021), erythrosedimentation (ESR) (p = 0.005), C-reactive protein (CRP) (p < 0.0001), leukocytes (p = 0.0006), neutrophils (p = 0.0021); Decreased of hematocrit (p = 0.0007) and hemoglobin (p < 0.0001).Association with CC: non-coronary cardiological alterations (OR = 10,818); PCR greater than 68 mg /L (OR = 11,596); leukocytes greater than 20,000 / mm3 (OR = 4.316); and ESR greater than 64 mm / 1 hour (OR = 4.267). CONCLUSION: The most frequent form of presentation was complete EK, the risk of CC was higher in males, younger than 5 years old, the risk factors (clinical and laboratory) were similar to those described in the literature.


Assuntos
Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Síndrome de Linfonodos Mucocutâneos/complicações , Síndrome de Linfonodos Mucocutâneos/epidemiologia , Argentina/epidemiologia , Sedimentação Sanguínea , Proteína C-Reativa/análise , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Imunoglobulinas Intravenosas/uso terapêutico , Incidência , Lactente , Masculino , Síndrome de Linfonodos Mucocutâneos/terapia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Estações do Ano , Estatísticas não Paramétricas
13.
Minerva Med ; 110(6): 530-545, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31726814

RESUMO

INTRODUCTION: Thyroid hormones have multiple effects on lipid metabolism as well as on the cardiovascular system function. These negative cardiovascular effects have long been recognized in overt hypothyroidism but can be reversed by treatment with levothyroxine. EVIDENCES ACQUISITION: We performed on PubMed a literature search for the articles published until March 2019 by using the search terms "subclinical hypothyroidism," "cardiovascular disease," "cholesterol," "LDL," "HDL," "triglycerides," "coronary heart disease," "heart failure," "atherosclerosis," "all-cause mortality," "levothyroxine." EVIDENCES SYNTHESIS: Subclinical hypothyroidism, defined as an elevated thyrotropin (TSH) with a normal free thyroxine (FT4), is frequent in the general population and increase with age. Subclinical hypothyroidism has been linked to cardiovascular risk factors, dyslipidemia and increased atherosclerosis. Although some studies have demonstrated that lipids are elevated in subclinical hypothyroidism, other studies did not confirm these data. Clinical trials have also demonstrated there is no clear evidence that levothyroxine therapy in subjects with milder form (TSH<10 mU/L) of subclinical hypothyroidism could improve lipid status and the other cardiovascular risk factors. Nevertheless, TSH level seems the best predictor of cardiovascular disease, in particular when its levels are above 10 mU/L. CONCLUSIONS: Prospective studies are necessary to clarify the cardiovascular risk in patients with mild subclinical hypothyroidism and to assess the importance of treating elderly people in order to improve or counteract the correlated risks. However, until clinical recommendations will be updated, the decision to treat or not treat patients with subclinical hypothyroidism will still base on clinical judgment, clinical practice guidelines, and expert opinion.


Assuntos
Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Hipotireoidismo/complicações , Doenças Assintomáticas , Fenômenos Fisiológicos Cardiovasculares , Doença das Coronárias/etiologia , Humanos , Fatores de Risco , Hormônios Tireóideos/fisiologia
14.
Basic Res Cardiol ; 114(6): 45, 2019 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-31617010

RESUMO

Cardioprotection aims at infarct size reduction and improvement of clinical outcome from myocardial infarction. The translation of cardioprotection from preclinical and promising proof-of-concept studies to clinical benefit for patients has been largely disappointing. Almost all of these studies which did not translate into clinical benefit had infarct size reduction as the primary endpoint and used protocols selected to achieve infarct size reduction. The present review puts forward the hypothesis that the coronary circulation is a so far neglected target of cardioprotection. Mechanisms of ischemia-reperfusion injury to the coronary circulation are detailed. Clinical methods and measures to assess coronary microvascular impairment in reperfused acute myocardial infarction are presented. A comparison of magnetic resonance imaging data on infarct size vs. coronary microvascular obstruction is made. Finally, the design of studies which are optimized not only for infarct size reduction but also for salvage of the coronary microcirculation is advocated.


Assuntos
Doença das Coronárias/prevenção & controle , Vasos Coronários , Microcirculação , Infarto do Miocárdio/prevenção & controle , Animais , Doença das Coronárias/diagnóstico , Doença das Coronárias/etiologia , Humanos , Infarto do Miocárdio/complicações
15.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 41(4): 457-463, 2019 Aug 30.
Artigo em Chinês | MEDLINE | ID: mdl-31484606

RESUMO

To systematically evaluate the risks of cardiocerebral vascular events in patients with primary biliary cholangitis(PBC). Methods We carried out a Meta analysis by RevMan 5.3 software to investigate literatureon the risk of cardiocerebral vascular events in patients with PBC and controls. Results Compared with non-PBC controls,PBC patients had significantly higher risk of coronary events(RR=1.56,P=0.0002);however,the risk of cerebrovascular events showed no significant difference between these two groups(RR=1.01,P=0.94).Subgroup analysis demonstrated a significantly lower risk of transient ischemic attack or carotid stenosis in PBC patients(RR=0.63,P=0.03);however,there was no significant difference in the risk of stroke(RR=1.11,P=0.40). Conclusion Patients with PBC have an increased risk of coronary events but may have a lower risk of transient ischemic attack or carotid stenosis.


Assuntos
Colangite/complicações , Doença das Coronárias/etiologia , Cirrose Hepática Biliar/complicações , Estenose das Carótidas/etiologia , Humanos , Ataque Isquêmico Transitório/etiologia , Fatores de Risco , Acidente Vascular Cerebral/etiologia
16.
Am J Clin Nutr ; 110(3): 733-741, 2019 09 01.
Artigo em Inglês | MEDLINE | ID: mdl-31374564

RESUMO

BACKGROUND: Epidemiological evidence has demonstrated a positive association between artificially sweetened beverage (ASB) and sugar-sweetened beverage (SSB) consumption and type 2 diabetes (T2D) risk. However, research informing this topic in young adults is limited. OBJECTIVE: This study examined the association between ASB, SSB, and total sweetened beverage (TSB; combined ASB and SSB) consumption and T2D risk in young adults. METHODS: A prospective analysis of 4719 Black and White men and women aged 18-30 y at baseline was conducted from the Coronary Artery Risk Development in Young Adults (CARDIA) study. Each participant's beverage intake was assessed using the CARDIA Diet History at baseline and at study Years 7 and 20. Multivariable Cox proportional hazards regression models were used to examine cumulative average ASB, SSB, and TSB intakes and risk of T2D. RESULTS: During the 30-y follow-up period, 680 participants developed T2D. ASB consumption was associated with a 12% greater risk of T2D per serving/day (HR 1.12, 95% CI 1.04-1.20) in a model adjusted for lifestyle factors, diet quality, and dieting behavior. Further adjustments for baseline BMI (HR 1.07, 95% CI 0.99-1.14) and weight change during follow-up (HR 1.04, 95% CI 0.97-1.12) attenuated the association. SSB and TSB consumption as continuous variables per 1 serving/day of intake were associated with 6% and 5% increased risks of T2D, respectively (HRSSB 1.06, 95% CI 1.01-1.10; HRTSB 1.05, 95% CI 1.01-1.09), in the model accounting for lifestyle factors, dieting behavior, baseline BMI, and weight change. Results were consistent when the exposures were modeled in categories of consumption and quintiles. CONCLUSIONS: In young adults, long-term ASB, SSB, and TSB consumption were associated with increased risks of T2D. However, the estimates for ASB were attenuated when accounting for weight changes.


Assuntos
Bebidas Adoçadas Artificialmente/efeitos adversos , Doença das Coronárias/etiologia , Diabetes Mellitus Tipo 2/etiologia , Bebidas Adoçadas com Açúcar/efeitos adversos , Edulcorantes/efeitos adversos , Adulto , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Adulto Jovem
17.
Nutrients ; 11(8)2019 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-31398911

RESUMO

Sugar-sweetened beverages (SSBs) have little nutritional value and a robust body of evidence has linked the intake of SSBs to weight gain and risk of type 2 diabetes (T2D), cardiovascular disease (CVD), and some cancers. Metabolic Syndrome (MetSyn) is a clustering of risk factors that precedes the development of T2D and CVD; however, evidence linking SSBs to MetSyn is not clear. To make informed recommendations about SSBs, new evidence needs to be considered against existing literature. This review provides an update on the evidence linking SSBs and cardiometabolic outcomes including MetSyn. Findings from prospective cohort studies support a strong positive association between SSBs and weight gain and risk of T2D and coronary heart disease (CHD), independent of adiposity. Associations with MetSyn are less consistent, and there appears to be a sex difference with stroke with greater risk in women. Findings from short-term trials on metabolic risk factors provide mechanistic support for associations with T2D and CHD. Conclusive evidence from cohort studies and trials on risk factors support an etiologic role of SSB in relation to weight gain and risk of T2D and CHD. Continued efforts to reduce intake of SSB should be encouraged to improve the cardiometabolic health of individuals and populations.


Assuntos
Doenças Cardiovasculares/etiologia , Diabetes Mellitus Tipo 2/etiologia , Síndrome Metabólica/etiologia , Bebidas Adoçadas com Açúcar/efeitos adversos , Doença das Coronárias/etiologia , Feminino , Humanos , Masculino , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Ganho de Peso
18.
Artigo em Inglês | MEDLINE | ID: mdl-31343130

RESUMO

Type 1 diabetes mellitus (T1DM) is a chronic autoimmune disease characterised by a destruction of pancreatic  cells, which leads to absolute insulin deficiency. Persistently high glycaemia causes vascular damage throughout the body. Microvascular complications com-prise the following: nephropathy, retinopathy, and neuropathy. Macrovascular complications include coronary heart disease (CHD), which may result in myocardial infarction, cerebrovascular disease (leading to strokes), and peripheral vascular disease. The pathogene-sis of vascular complications is multifactorial and is probably the combination of direct glucose-mediated endothelial damage, oxidative stress, production of sorbitol, and advanced glycation end-products. Precise understanding of these mechanisms could help clinicians to identify diabetic complications earlier and subsequently implement indispensable therapy on time. It is vital to determine biomarkers of microvascular and macrovascular complications in children affected with T1DM. Advanced glycation end-products and their receptors, adhesive molecules, pro- and anti-inflammatory cytokines, enzymes such as N-acetyl-ß-D-glucosaminidase, and growth factors are the subject of ongoing studies. Numerous biomarkers of diabetic microangiopathy are already known and may constitute therapeutic targets in the future. Unfortunately, despite substantial progress in the understanding of the processes by which microvascular and macrovascu-lar complications develop, much effort still needs to be devoted to the matter, and further investigations are required.


Assuntos
Diabetes Mellitus Tipo 1/complicações , Angiopatias Diabéticas/etiologia , Inflamação , Biomarcadores , Doença das Coronárias/etiologia , Angiopatias Diabéticas/complicações , Nefropatias Diabéticas/etiologia , Neuropatias Diabéticas/etiologia , Retinopatia Diabética/etiologia , Humanos , Acidente Vascular Cerebral/etiologia
19.
Nutrients ; 11(7)2019 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-31330892

RESUMO

BACKGROUND AND AIMS: The association of fatty acids with coronary heart disease (CHD) has been examined, mainly through dietary measurements, and has generated inconsistent results due to measurement error. Large observational studies and randomized controlled trials have shown that plasma phospholipid fatty acids (PL-FA), especially those less likely to be endogenously synthesized, are good biomarkers of dietary fatty acids. Thus, PL-FA profiles may better predict CHD risk with less measurement error. METHODS: We performed a matched case-control study of 2428 postmenopausal women nested in the Women's Health Initiative Observational Study. Plasma PL-FA were measured using gas chromatography and expressed as molar percentage (moL %). Multivariable conditional logistic regression was used to calculate odds ratios (95% CIs) for CHD associated with 1 moL % change in PL-FA. RESULTS: Higher plasma PL long-chain saturated fatty acids (SFA) were associated with increased CHD risk, while higher n-3 polyunsaturated fatty acids (PUFA) were associated with decreased risk. No significant associations were observed for very-long-chain SFA, monounsaturated fatty acids (MUFA), PUFA n-6 or trans fatty acids (TFA). Substituting 1 moL % PUFA n-6 or TFA with an equivalent proportion of PUFA n-3 were associated with lower CHD risk. CONCLUSIONS: Higher plasma PL long-chain SFA and lower PUFA n-3 were associated with increased CHD risk. A change in diet by limiting foods that are associated with plasma PL long-chain SFA and TFA while enhancing foods high in PUFA n-3 may be beneficial in CHD among postmenopausal women.


Assuntos
Doença das Coronárias/etiologia , Hiperlipidemias/complicações , Fosfolipídeos/sangue , Idoso , Índice de Massa Corporal , Estudos de Casos e Controles , Feminino , Humanos , Pessoa de Meia-Idade , Fatores de Risco
20.
Nutrients ; 11(6)2019 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-31212846

RESUMO

Associations between alcohol consumption and the prevalence of cardiovascular diseases have been the subject of several studies for a long time; however, the presence and nature of any associations still remain unclear. The aim of the study was to analyze the associations between the consumption of alcoholic beverages and the prevalence of cardiovascular diseases in men and women. The data of 12,285 individuals aged 37-66 were used in the analysis. Multiple logistic regression models were utilized to estimate odds ratios and confidence intervals. The multivariable models included several potential confounders including age, education, marital status, body mass index (BMI), physical activity, smoking, coffee consumption, and statin use. The analyses were performed separately for men and women. In the model adjusted for confounders, the consumption from 0.1 to 10.0 g of alcohol/day was related to a lower risk of coronary disease and stroke (p < 0.05), and the consumption from 0.1 to 15.0 g/day was related to a lower risk of hypertension in women (p < 0.05). In men, in the adjusted model, there were no associations between alcohol consumption and the occurrence of hypertension or stroke. The risk of circulatory failure was significantly lower in the group in which participants drank more than 20.0 g of alcohol/day (p < 0.05) compared to nondrinkers. The risk of coronary disease was lower in drinkers at every level of alcohol consumption (p < 0.05) compared to nondrinkers. Alcohol consumption was related to a lower prevalence of cardiovascular diseases (CVD), both in men and women.


Assuntos
Consumo de Bebidas Alcoólicas/efeitos adversos , Doenças Cardiovasculares/epidemiologia , Fatores Sexuais , Adulto , Idoso , Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Doença das Coronárias/epidemiologia , Doença das Coronárias/etiologia , Estudos Transversais , Feminino , Humanos , Hipertensão/epidemiologia , Hipertensão/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Polônia/epidemiologia , Prevalência , Fatores de Risco , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/etiologia
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