Coronary artery disease incidence, risk factors, awareness, and medication utilization in a 10-year cohort study DOI Creative Commons
Mohammadtaghi Sarebanhassanabadi, Seyed Reza Mirjalili, Pedro Marques‐Vidal

et al.

BMC Cardiovascular Disorders, Journal Year: 2024, Volume and Issue: 24(1)

Published: Feb. 12, 2024

Abstract Background There is a substantial disparity in coronary artery disease (CAD) burden between Iran and other nations that place strong emphasis on the assessment of CAD risk factors individuals’ awareness ability to control them. Methods Two thousand participants community-based Iranian population aged 20–74 years were investigated with mean follow-up 9.9 (range: 7.6 12.2). An analysis Cox regression was conducted determine association development classic such as age, sex, smoking, physical activity, education, obesity, dyslipidemia, hypertension, diabetes mellitus. Furthermore, we computed attributable fraction for these factors. Results After period nearly 10 years, 225 events reported, constituting 14.5% overall incidence. Nighty three percent had more than one factor. Age most predictive factor, hazard ratio (HR) confidence interval (CI) 5.56 (3.87–7.97, p < 0.001) men older 45 females 55 compared lower ages. In comparison females, males an HR 1.45 (CI: 1.11–1.90, value = 0.006) developing CAD. Nearly 80% patients 2.19 1.40–3.44, 0.01). Among participants, 28.9% 52% prehypertension, which HRs 4.1 (2.4–7.2, 2.4 (1.4–4.2, 0.001), respectively. Diabetes, prevalence 17%, 2.63 2 -3.47, but prediabetes not significantly associated Awareness diabetes, hypertension 81%, 27.9%, 48.1%, Regarding medication usage, corresponding percentages 51% 13.2% 41% hypertension. Conclusions Compared previous studies neighboring countries, current study found higher incidence CAD, prevalent factors, Thus, effective preventive strategy needed reduce Iran.

Language: Английский

Quantitative effects on cardiovascular risk factors and coronary heart disease risk of replacing partially hydrogenated vegetable oils with other fats and oils DOI Open Access
Dariush Mozaffarian, Robert Clarke

European Journal of Clinical Nutrition, Journal Year: 2009, Volume and Issue: 63(S2), P. S22 - S33

Published: May 1, 2009

Language: Английский

Citations

410
Ezetimibe Lipid-Lowering Trial on Prevention of Atherosclerotic Cardiovascular Disease in 75 or Older (EWTOPIA 75) DOI Open Access
Yasuyoshi Ouchi, Junichi Sasaki, Hidenori Arai

et al.

Circulation, Journal Year: 2019, Volume and Issue: 140(12), P. 992 - 1003

Published: Aug. 22, 2019

Background: Evidence regarding the primary prevention of coronary artery disease events by low-density lipoprotein cholesterol (LDL-C) lowering therapy in older individuals, aged ≥75 years, is insufficient. This trial tested whether LDL-C–lowering with ezetimibe useful for cardiovascular patients. Methods: multicenter, prospective, randomized, open-label, blinded end-point evaluation conducted at 363 medical institutions Japan examined preventive efficacy patients elevated LDL-C without history disease. Patients, who all received dietary counseling, were randomly assigned (1:1) to receive (10 mg once daily) versus usual care randomization stratified site, age, sex, and baseline LDL-C. The outcome was a composite sudden cardiac death, myocardial infarction, revascularization, or stroke. Results: Overall, 3796 enrolled between May 2009 December 2014, 1898 each control. Median follow-up 4.1 years. After exclusion 182 203 control because lack appropriate informed consent other protocol violations, 1716 (90.4%) 1695 (89.3%) included analysis, respectively. Ezetimibe reduced incidence (hazard ratio [HR], 0.66; 95% CI, 0.50–0.86; P =0.002). Regarding secondary outcomes, incidences (HR, 0.60; 0.37–0.98; =0.039) revascularization 0.38; 0.18–0.79; =0.007) lower group than group; however, there no difference stroke, all-cause mortality, adverse groups. Conclusions: prevented events, suggesting importance individuals years Given open-label nature trial, its premature termination issues follow-up, magnitude benefit observed should be interpreted caution. Clinical Registration: URL: https://www.umin.ac.jp . Unique identifier: UMIN000001988.

Language: Английский

Citations

181
Pemafibrate, a New Selective PPARα Modulator: Drug Concept and Its Clinical Applications for Dyslipidemia and Metabolic Diseases DOI Creative Commons
Shizuya Yamashita, Daisaku Masuda,

Yūji Matsuzawa

et al.

Current Atherosclerosis Reports, Journal Year: 2020, Volume and Issue: 22(1)

Published: Jan. 1, 2020

Abstract Purpose of Review Reduction serum low-density lipoprotein cholesterol (LDL-C) levels by statins, ezetimibe and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors has been shown to significantly reduce cardiovascular events risk. However, fasting postprandial hypertriglyceridemia as well reduced high-density (HDL-C) remain residual risk factors atherosclerotic diseases (ASCVD). To treat patients with and/or low HDL-C, drugs such fibrates, nicotinic acids, n-3 polyunsaturated fatty acids have used. fibrates were demonstrated cause side effects liver dysfunction increase in creatinine levels, thus large-scale clinical trials negative results for prevention ASCVD. The failure could be attributed their selectivity potency binding peroxisome proliferator-activated receptor (PPAR) α. resolve these issues, the concept selective PPARα modulator (SPPARMα) a superior balance efficacy safety proposed pemafibrate (K-877) developed. Recent Findings Pemafibrate, one SPPARMsα, was synthesized Kowa Company, Ltd. better efficiency safety. Clinical Japan established superiority on triglycerides (TG) reduction HDL-C elevation Although available showed worsening kidney function test values, indicated improved values less likely or decrease estimated glomerular filtration rate (eGFR). Very few drug-drug interactions observed even when used concomitantly statins. Furthermore, is metabolized excreted into bile, while many are mainly from kidney. Therefore, can safely impaired renal since there no significant its blood concentration. A trial pemafibrate, PROMINENT, dyslipidemic 2 diabetes ongoing. Summary Pemafibrate novel SPPARMsα benefit-risk compared conventional applicable whom usage existing difficult those who taking statins dysfunction. In current review, all recent data will summarized.

Language: Английский

Citations

148
JCS/JACR 2021 Guideline on Rehabilitation in Patients With Cardiovascular Disease DOI Open Access
Shigeru Makita, Takanori Yasu, Yoshihiro J. Akashi

et al.

Circulation Journal, Journal Year: 2022, Volume and Issue: 87(1), P. 155 - 235

Published: Dec. 8, 2022

PAD peripheral arterial disease PCI percutaneous coronary intervention peak V ˙O2 oxygen uptake PH pulmonary hypertension PVCs premature ventricular contraction QOL quality of life RCT randomized controlled trial RPE rating perceived exertion SGA Subjective Global Assessment STEMI ST elevation myocardial infarction TG triglyceride TAVI transcatheter aortic valve implantation VAD assist device ˙CO2 carbon dioxide output ˙E minute ventilation ˙E/V ventilatory equivalent for vs. slope ˙O2/HR pulse capacity is assessed by cardiopulmonary exercise testing (CPX), an prescription prepared based on the risk in terms severity illness, and then a treatment CR plan established.If CPX cannot be performed due to complications, low physical fitness, or left function, should confirmed 6-minute walk test.For frail patients, after hospital discharge, their living environment, nursing care certification, use services confirmed.In addition, counseling program lifestyle modification adherence medication, assessment management comorbidity, psychological provided.It not rare patients with cardiac depressed discharge anxiety about health, financial problems, concerns returning work sexual potency. 11Regarding recovery phase CR, comprehensive that includes training, smoking cessation, diet therapy, appropriate factors, as well evaluations, return-to-work counseling, support, are important.In importance self-management prevent recurrence explained families, information goals content shared within multidisciplinary team discussed at regular conferences.Counseling will given activity capacity, excessive adjusted level.If there signs findings suggest exacerbation medical condition/heart failure load, must reviewed consideration intensify treatment.Admission Acute (Phase I) Return daily Early mobilization Comprehensive (disease program) Discharge from hospital, home Maintain comfortable life, Prevention Returning society-workforce, Establish new healthy Inpatient rehabilitation (CCU/ICU/ward) Exercise stress tests (other than CPX) may considered IIb B C1 III balance function In suspected frailty falling, "Single leg standing time", "Functional reach test", "Timed up go test" COR, class recommendation; CPX, testing; rehabilitation; GOR, grade LOE, level evidence.* If ≥3 items apply, patient frail.If only 1 2 diagnosed pre-frailty

Language: Английский

Citations

145
Japan Atherosclerosis Society (JAS) Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases 2022 DOI Open Access
Tomonori Okamura, Kazuhisa Tsukamoto, Hidenori Arai

et al.

Journal of Atherosclerosis and Thrombosis, Journal Year: 2023, Volume and Issue: 31(6), P. 641 - 853

Published: Dec. 18, 2023

Language: Английский

Citations

136
Major Global Coronary Artery Calcium Guidelines DOI Creative Commons
Ilana Golub,

Orly G. Termeie,

Stephanie Kristo

et al.

JACC. Cardiovascular imaging, Journal Year: 2022, Volume and Issue: 16(1), P. 98 - 117

Published: Sept. 14, 2022

Language: Английский

Citations

102
Elevated Remnant Cholesterol Reclassifies Risk of Ischemic Heart Disease and Myocardial Infarction DOI Creative Commons
Takahito Doi, Anne Langsted, Børge G. Nordestgaard

et al.

Journal of the American College of Cardiology, Journal Year: 2022, Volume and Issue: 79(24), P. 2383 - 2397

Published: June 1, 2022

Elevated remnant cholesterol causes ischemic heart disease. We tested the hypothesis that inclusion of elevated will lead to appropriate reclassification individuals who later experience myocardial infarction and For >10 years we followed up 41,928 white Danish from Copenhagen General Population Study without a history cardiovascular disease, diabetes, statin use. Using predefined cut points for cholesterol, calculated net index (NRI) below above 5%, 7.5%, and/or 10% 10-year occurrence disease defined as composite death infarction, coronary revascularization. with levels ≥95th percentile (≥1.6 mmol/L, 61 mg/dL), 23% (P < 0.001) 21% were reclassified correctly 5% when added models based on conventional risk factors, whereas no events incorrectly. Consequently, addition yielded NRI (95% CI: 1%-20%) −3% 13%) Correspondingly, reclassifications combined events, 42% 41% appropriately, leading respectively 20% 9%-31%) 11% 2%-21%). considerably improve prediction.

Language: Английский

Citations

81
JCS 2022 Guideline Focused Update on Diagnosis and Treatment in Patients With Stable Coronary Artery Disease DOI Open Access
Shintaro Nakano, Shun Kohsaka,

Taishiro Chikamori

et al.

Circulation Journal, Journal Year: 2022, Volume and Issue: 86(5), P. 882 - 915

Published: March 10, 2022

encompassing the estimated benefit in proportion to risk (Tables 1,2).

Language: Английский

Citations

77
JCS/JSCVS/JATS/JSVS 2020 Guideline on Diagnosis and Treatment of Aortic Aneurysm and Aortic Dissection DOI Open Access
Hitoshi Ogino, Osamu Iida, Koichi Akutsu

et al.

Circulation Journal, Journal Year: 2023, Volume and Issue: 87(10), P. 1410 - 1621

Published: Aug. 31, 2023

Language: Английский

Citations

63
Advances in the Diagnosis and Treatment of Non-Alcoholic Fatty Liver Disease DOI Open Access

Xunzhe Yin,

Xiangyu Guo, Zuojia Liu

et al.

International Journal of Molecular Sciences, Journal Year: 2023, Volume and Issue: 24(3), P. 2844 - 2844

Published: Feb. 2, 2023

Non-alcoholic fatty liver disease (NAFLD) is the most prevalent chronic that affects approximately one-quarter of global adult population, posing a significant threat to human health with wide-ranging social and economic implications. The main characteristic NAFLD considered excessive fat accumulated deposited in hepatocytes without excess alcohol intake or some other pathological causes. progressive disease, ranging from steatosis non-alcoholic steatohepatitis (NASH), cirrhosis, hepatocellular carcinoma, transplantation, death. Therefore, will probably emerge as leading cause end-stage coming decades. Unlike highly diseases, has received little attention public community. Liver biopsy currently gold standard for diagnosis staging because absence noninvasive specific biomarkers. Due complex pathophysiological mechanisms heterogeneity phenotype, no pharmacological therapies have been approved at present, although several drugs are advanced stages development. This review summarizes current evidence on pathogenesis, treatment NAFLD.

Language: Английский

Citations

47