Research

13 pages, 1217 KiB

Open AccessArticle

Early Atherosclerosis in Familial Hypercholesterolemia Patients: Significance of Vascular Markers for Risk Stratification

by Urte Aliosaitiene, Zaneta Petrulioniene, Egidija Rinkuniene, Antanas Mainelis, Jurate Barysiene, Urte Smailyte, Vaida Sileikiene and Aleksandras Laucevicius

J. Cardiovasc. Dev. Dis. 2024, 11(3), 91; https://doi.org/10.3390/jcdd11030091 - 13 Mar 2024

Viewed by 927

Abstract

BACKGROUND: Familial hypercholesterolemia (FH) is a genetic disorder that manifests as impaired low-density lipoprotein cholesterol (LDL-C) metabolism, resulting in lifelong exposure to high cholesterol levels and increased risk of cardiovascular disease (CVD). There is heterogeneity in cardiovascular risk for FH patients, so risk [...] Read more.

BACKGROUND: Familial hypercholesterolemia (FH) is a genetic disorder that manifests as impaired low-density lipoprotein cholesterol (LDL-C) metabolism, resulting in lifelong exposure to high cholesterol levels and increased risk of cardiovascular disease (CVD). There is heterogeneity in cardiovascular risk for FH patients, so risk stratification is of utmost importance. The aim of this study was to evaluate the impact of increases in LDL-C and the impact of other CVD risk factors on vascular markers in the FH patient population. METHODS: A total of 428 patients were included in this study and divided into two groups according to age: ≤40 years in the first group and ≥41 years in the second group. Vascular markers of atherosclerosis included the common carotid artery (CCA) intima–media thickness (IMT), pulse wave velocity (PWV), flow-mediated dilation (FMD), ankle–brachial index (ABI), and cardio-vascular index (CAVI). The influence of traditional CVD risk factors on atherosclerotic changes in vascular markers was analyzed. RESULTS: A statistically significant difference in IMT was detected between the same sex and different age groups (p < 0.001), whereas no significant difference was detected between the sexes within each age group. In the ≤40-year-old group, the mean IMT among males was 612.5 μm (±88.2) and that among females was 580.6 μm (±77.7) (p > 0.05); in the ≥41-year-old group, the mean IMT was 697.4 μm (±138.4) for males and 700.3 μm (±114.4) for females (p > 0.05). Higher LDL-C was associated with greater IMT (r = 0.405; p = 0.009) in the younger age group (≤40 years); however, in the older age group (≥41 years), this correlation was not evident (r = −0.07; p = 0.596). Carotid plaque formation was more common among males (OR = 2.2; 95% CI: 1.2–4.0) and hypertensive patients (OR = 2.7; 95% CI: 1.6–4.7). Age was a mildly significant risk factor for increased ABI (β = 0.13, p < 0.05). FMD was found to be impaired for all patients, and no risk factors were shown to have further influence. Age was a significant risk factor for increased arterial stiffness, as measured by both the CAVI and PWV. Conclusions: Although vascular markers of atherosclerosis may provide a unique and valuable way to evaluate cardiovascular risk, the results of this study show that only increased IM thickness could be beneficial for risk stratification in young FH patients, whereas other vascular markers of atherosclerosis would be excessive, as they do not provide merit in risk evaluation in this population. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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11 pages, 246 KiB

Open AccessArticle

Change over Five Years in Important Measures of Methodological Quality and Reporting in Randomized Cardiovascular Clinical Trials

by Odgerel Baasan, Omar Freihat, Dávid U. Nagy and Szimonetta Lohner

J. Cardiovasc. Dev. Dis. 2024, 11(1), 2; https://doi.org/10.3390/jcdd11010002 - 21 Dec 2023

Viewed by 1137

Abstract

Objectives: The aim of our current study was to analyze whether the use of important measures of methodological quality and reporting of randomized clinical trials published in the field of cardiovascular disease research haschanged over time. A furtheraim was to investigate whether there [...] Read more.

Objectives: The aim of our current study was to analyze whether the use of important measures of methodological quality and reporting of randomized clinical trials published in the field of cardiovascular disease research haschanged over time. A furtheraim was to investigate whether there was an improvement over time in the ability of these trials to provide a good estimate of the true intervention effect. Methods: We conducted two searches in the Cochrane Central Register of Controlled Trials (CENTAL) database to identify randomized cardiovascular clinical trials published in either 2012 or 2017. Randomized clinical trials (RCTs) trials in cardiovascular disease research with adult participants were eligible to be included. We randomly selected 250 RCTs for publication years 2012 and 2017. Trial characteristics, data on measures of methodological quality, and reporting were extracted and the risk of bias for each trial was assessed. Results: As compared to 2012, in 2017 there were significant improvements in the reporting of the presence of a data monitoring committee (42.0% in 2017 compared to 34.4% in 2012; p < 0.001), and a positive change in registering randomized cardiovascular disease research in clinical trial registries (78.4% in 2017 compared to 68.9% in 2012; p = 0.03). We also observed that significantly more RCTs reported sample size calculation (60.4% in 2017 compared to 49.6% in 2012; p < 0.01) in 2017 as compared to 2012. RCTs in 2017 were more likely to have a low overall risk of bias (RoB) than in 2012 (29.2% in 2017 compared to 21.2% in 2012; p < 0.01). However, fewer 2017 RCTs were rated low (50.8% compared to 65.6%; p < 0.001) risk for blinding of participants and personnel, for blinding of outcome assessors (82.4% compared to 90.8%; p < 0.001), and selective outcome reporting (62.8% compared to 80.0%; <0.001). Conclusions: As compared to 2012, in 2017 there were significant improvements in some, but not all, the important measures of methodological quality. Although more trials in the field of cardiovascular disease research had a lower overall RoB in 2017, the improvement over time was not consistently perceived in all RoB domains. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

13 pages, 1026 KiB

Open AccessArticle

Prevalence, Risk Factors, Prognosis, and Management of Pericardial Effusion in COVID-19

by İbrahim Saraç, Sidar Şiyar Aydın, Murat Özmen, Halil İbrahim Doru, Gökhan Tonkaz, Melike Nur Çırçır, Furkan Akpınar, Onur Zengin, Orhan Delice and Faruk Aydınyılmaz

J. Cardiovasc. Dev. Dis. 2023, 10(9), 368; https://doi.org/10.3390/jcdd10090368 - 27 Aug 2023

Viewed by 1584

Abstract

Background: There is limited data in the literature about the clinical importance and prognosis of pericardial effusion (PE) in patients discharged after recovering from COVID-19, but large-scale studies have yet to be available. This study investigated the prevalence, risk factors, prognosis, late clinical [...] Read more.

Background: There is limited data in the literature about the clinical importance and prognosis of pericardial effusion (PE) in patients discharged after recovering from COVID-19, but large-scale studies have yet to be available. This study investigated the prevalence, risk factors, prognosis, late clinical outcomes, and management of PE in COVID-19. Materials and Methods: Between August 2020 and March 2021, 15,689 patients were followed up in our pandemic hospital due to COVID-19. Patients with positive polymerase chain reaction (PCR) test results and PE associated with COVID-19 in computed tomography (CT) were included in the study. The patients were divided into three groups according to PE size (mild, moderate, and large). Transthoracic echocardiography (TTE) records, laboratory data, clinical outcomes, and medical treatments of patients discharged from the hospital were retrospectively reviewed. Results: According to the PE size (mild, moderate, large) of 256 patients with PE at admission or discharge, the mean age was 62.17 ± 16.34, 69.12 ± 12.52, and 72.44 ± 15.26, respectively. The mean follow-up period of the patients was 25.2 ± 5.12 months. Of the patients in the study population, 53.5% were in the mild group, 30.4% in the moderate group, and 16.1% in the large group. PE became chronic in a total of 178 (69.6%) patients at the end of the mean three months, and chronicity increased as PE size increased. Despite the different anti-inflammatory treatments for PE in the acute phase, similar chronicity was observed. In addition, as the PE size increased, the patients’ frequency of hospitalization, complications, and mortality rates showed statistical significance between the groups. Conclusions: The clinical prognosis of patients presenting with PE was quite poor; as PE in size increased, cardiac and noncardiac events and mortality rates were significantly higher. Patients with large PE associated with COVID-19 at discharge should be monitored at close intervals due to the chronicity of PE and the increased risk of tamponade. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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14 pages, 870 KiB

Open AccessArticle

In-Hospital Mortality Outcomes of ST-Segment Elevation Myocardial Infarction: A Cross-Sectional Study from a Tertiary Academic Hospital in Johannesburg, South Africa

by Lindokuhle Ndaba, Arthur Mutyaba, Dineo Mpanya and Nqoba Tsabedze

J. Cardiovasc. Dev. Dis. 2023, 10(8), 348; https://doi.org/10.3390/jcdd10080348 - 15 Aug 2023

Viewed by 1433

Abstract

In sub-Saharan Africa, the burden of atherosclerotic cardiovascular disease (ASCVD) is increasing. This study aimed to describe the clinical characteristics of patients with ST-segment elevation myocardial infarction (STEMI) and estimate the in-hospital all-cause mortality rate. We conducted a cross-sectional retrospective single-centre study of [...] Read more.

In sub-Saharan Africa, the burden of atherosclerotic cardiovascular disease (ASCVD) is increasing. This study aimed to describe the clinical characteristics of patients with ST-segment elevation myocardial infarction (STEMI) and estimate the in-hospital all-cause mortality rate. We conducted a cross-sectional retrospective single-centre study of STEMI patients who underwent diagnostic coronary angiography with or without percutaneous coronary intervention (PCI) between January 2015 and December 2019. We compared demographic and clinical parameters between survivors and non-survivors with descriptive statistics. Univariable and multivariable logistic regression analyses were performed to determine the predictors of all-cause mortality. The study population consisted of 677 patients with a mean age of 55.5 ± 11.3 years. The in-hospital all-cause mortality rate was 6.2% [95% confidence interval (CI): 4.5–8.3%]. Risk factors for ASCVD included smoking (56.1%), hypertension (52.8%), dyslipidemia (40.0%), and a family history of coronary artery disease (32.7%). A pharmaco-invasive management strategy (treatment with thrombolytic therapy and PCI) was implemented in 36.5% of patients and reduced all-cause mortality risk (OR: 0.16; CI: 0.04–0.71, p = 0.015). The in-hospital all-cause mortality rate in STEMI patients was 6.2%, and a pharmaco-invasive management strategy proved to be an effective approach. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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11 pages, 452 KiB

Open AccessArticle

Disparity Analysis for Cardiac Surgical Outcomes: The Citizenship Factor

by Mohammad F. Babgi, Haitham M. Albar, Mohammed H. Miny, Haitham Alzahrani, Mohammad Shakil Ahmad, Riyaz Ahmed Shaik and Elnazeer O. Ahmed

J. Cardiovasc. Dev. Dis. 2023, 10(7), 292; https://doi.org/10.3390/jcdd10070292 - 09 Jul 2023

Viewed by 896

Abstract

(1) Background: Disparity in clinical care on the basis of gender, socioeconomic status, ethnic and racial variation is an established phenomenon. The focus on health disparities was led on by the report of the Secretary’s Task Force on Black & Minority Health, which [...] Read more.

(1) Background: Disparity in clinical care on the basis of gender, socioeconomic status, ethnic and racial variation is an established phenomenon. The focus on health disparities was led on by the report of the Secretary’s Task Force on Black & Minority Health, which emphasized that the burden of death and illness was in excess among black people and other minorities. In Saudi Arabia, cardiac health care is being provided to a heterogeneous group of patients during pilgrimage time. This mixed population comprises different socio-economic backgrounds, demographics, ethnicities and languages. This study was carried out to assess for any disparities in cardiac surgical outcomes after isolated CABG surgery between Saudi citizens and non-Saudi patients. (2) Methods: The data of 2178 patients who underwent isolated coronary artery bypass surgery at King Abdullah Medical City from December 2014 to July 2020 were extracted. Patient demographics, clinical features, comorbidities, diagnoses, surgical procedures, complications, length of hospital stay and mortality were included in the data. The primary outcome was mortality after coronary artery bypass grafting surgery. (3) Results: A total of 2178 isolated CABG procedures were conducted during the study period with almost 57.5% of patients being Saudi citizens in comparison with 42.5% of non-Saudi citizens. The male gender represented the majority of the population, with a total of 1584 patients, representing 72.7% of the total study population. The rate of mortality had no statistical significance with the mortality rate of 5% vs. 5.3% (p < 0.786). The postoperative morbidities were comparable for all the parameters except for postoperative extracorporeal membrane oxygenation (ECMO). (4) Conclusions: In the present study, the chances of survival and postoperative outcomes are not associated with nationality per se, but with underlying comorbidities. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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9 pages, 1176 KiB

Open AccessCommunication

Association of Circulating Plasma Secreted Frizzled-Related Protein 5 (Sfrp5) Levels with Cardiac Function

by Conagh J. Kelly, Matthew Chu, Rossana Untaru, Bahador Assadi-Khansari, Dongqing Chen, Amanda J. Croft, John D. Horowitz, Andrew J. Boyle, Aaron L. Sverdlov and Doan T. M. Ngo

J. Cardiovasc. Dev. Dis. 2023, 10(7), 274; https://doi.org/10.3390/jcdd10070274 - 28 Jun 2023

Cited by 1 | Viewed by 1327

Abstract

Secreted frizzled-related protein 5 (SFRP5) is a novel anti-inflammatory adipokine that may play a role in cardiovascular development and disease. However, there is yet to be a comprehensive investigation into whether circulating SFRP5 can be a biomarker for cardiac function. Plasma SFRP5 levels [...] Read more.

Secreted frizzled-related protein 5 (SFRP5) is a novel anti-inflammatory adipokine that may play a role in cardiovascular development and disease. However, there is yet to be a comprehensive investigation into whether circulating SFRP5 can be a biomarker for cardiac function. Plasma SFRP5 levels were measured via ELISA in 262 patients admitted to a cardiology unit. Plasma SFRP5 levels were significantly lower in patients with a history of heart failure (HF), coronary artery disease (CAD), and atrial fibrillation (AF; p = 0.001). In univariate analyses, SFRP5 levels were also significantly positively correlated with left ventricular ejection fraction (LVEF) (r = 0.52, p < 0.001) and negatively correlated with E/E’ (r = −0.30, p < 0.001). Patients with HF, CAD, low LVEF, low triglycerides, high CRP, and high eGFR were associated with lower SFRP5 levels independent of age, BMI, or diabetes after multivariate analysis (overall model r = 0.729, SE = 0.638). Our results show that low plasma SFRP5 levels are independently associated with the presence of HF, CAD, and, importantly, impaired LV function. These results suggest a potential role of SFRP5 as a biomarker, as well as a mediator of cardiac dysfunction independent of obesity and metabolic regulation. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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Review

Jump to: Research, Other

13 pages, 872 KiB

Open AccessReview

Correlation between Coronary Artery Disease with Other Arterial Systems: Similar, Albeit Separate, Underlying Pathophysiologic Mechanisms

by Alexandru Achim, Orsolya Ágnes Péter, Mihai Cocoi, Adela Serban, Stefan Mot, Alexandra Dadarlat-Pop, Attila Nemes and Zoltan Ruzsa

J. Cardiovasc. Dev. Dis. 2023, 10(5), 210; https://doi.org/10.3390/jcdd10050210 - 11 May 2023

Cited by 2 | Viewed by 3654

Abstract

Atherosclerosis is a multifactorial systemic disease that affects the entire arterial tree, although some areas are more prone to lipid deposits than others. Moreover, the histopathological composition of the plaques differs, and the clinical manifestations are also different, depending on the location and [...] Read more.

Atherosclerosis is a multifactorial systemic disease that affects the entire arterial tree, although some areas are more prone to lipid deposits than others. Moreover, the histopathological composition of the plaques differs, and the clinical manifestations are also different, depending on the location and structure of the atherosclerotic plaque. Some arterial systems are correlated with each other more than in that they simply share a common atherosclerotic risk. The aim of this perspective review is to discuss this heterogeneity of atherosclerotic impairment in different arterial districts and to investigate the current evidence that resulted from studies of the topographical interrelations of atherosclerosis. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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Other

Jump to: Research, Review

7 pages, 231 KiB

Open AccessBrief Report

The COVID-19 Pandemic Decreases Cardiorespiratory Fitness: A 3-Year Follow-Up Study in Industry

by Øivind Skare, Asgeir Mamen and Marit Skogstad

J. Cardiovasc. Dev. Dis. 2024, 11(1), 9; https://doi.org/10.3390/jcdd11010009 - 28 Dec 2023

Viewed by 1235

Abstract

Background: We aimed to determine if maximal oxygen uptake (

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O₂max), resting heart rate (RHR), and self-reported leisure- time moderate to vigorous physical activity (MVPA) changed over a 3-year follow-up (FU) among industrial workers. Methods: We assessed cardiorespiratory fitness [...] Read more.

Background: We aimed to determine if maximal oxygen uptake (

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O₂max), resting heart rate (RHR), and self-reported leisure- time moderate to vigorous physical activity (MVPA) changed over a 3-year follow-up (FU) among industrial workers. Methods: We assessed cardiorespiratory fitness (CRF) August 2018 and August 2021. The last 17–18 months coincided with the COVID-19 pandemic. Data from 86 participants were collected; demographics by questionnaire and cardiovascular outcomes from medical examination:

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O_2max, RHR, and fat mass (%). Workers reported on their leisure-time MVPA twice. To assess changes in health outcomes we applied a linear mixed model, adjusting for baseline (BL) age, sex, pack-years, shift work, and a 5-month plant shutdown. Further, we adjusted for actual age instead of BL age. Results:

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O_2max decreased from 39.6 mL/kg/min at BL to 34.0 at FU, a reduction of 5.6 mL/kg/min (95%CI, −7.6, −3.7). Adjusted for actual age, the corresponding figure for

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O_2max was 5.4 mL/kg/min, (95%CI, −7.4, −3.4), an annual loss of 4.6%. RHR increased from 61.3 to 64.4 beats per minute (95%CI, 0.8, 5.4). Self-reported MVPA decreased by 43.9 min/week, (95%CI, −73.5, −14.4). Conclusions: We observed a decrease in

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O_2max, an increase in RHR and a decrease in self-reported MVPA, suggesting physical inactivity during the COVID-19 pandemic. Full article

(This article belongs to the Special Issue Epidemiology and Risk of Cardiovascular Disease)

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