scholarly journals How much of the increased incidence of heart failure in rheumatoid arthritis is attributable to traditional cardiovascular risk factors and ischemic heart disease?

2005 ◽  
Vol 52 (10) ◽  
pp. 3039-3044 ◽  
Author(s):  
Cynthia S. Crowson ◽  
Paulo J. Nicola ◽  
Hilal Maradit Kremers ◽  
W. Michael O'Fallon ◽  
Terry M. Therneau ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Heart Failure ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Ischemic Heart

scholarly journals Role of Duke treadmill score in the diagnosis of ischemic heart disease in women

2015 ◽  
Vol 53 (2) ◽  
pp. 146-152
Author(s):  
Alexandra Dǎdârlat ◽  
D. Zdrenghea ◽  
Dana Pop
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
High Blood Pressure ◽  
Ischemic Heart ◽  
Risk Category ◽  
Duke Treadmill Score

Abstract Ischemic heart disease is underdiagnosed in women due to atypical symptomatology as well as to the lower specificity of several paraclinical tests, such as exercise stress testing. The aim of the study was to ascertain whether the Duke treadmill score (DTS) could be an efficient parameter in the diagnosis of ischemic heart disease in women. Material and method. 105 patients were enrolled in the study, 45.71% women with average age ranged between 20 and 70 years, investigated in the Rehabilitation Hospital, Cardiology-Departament, Cluj-Napoca, Romania. All the patients were clinically assessed as concerns the presence of cardiovascular risk factors, and they underwent electrocardiographic, echocardiographic and treadmill stress tests. DST was calculated according to the formula: exercise time – 5 x (ST deviation expressed in mm–4 x Angina Index). Results. DTS was lower in women as compared to men: 2.54±5.36 vs. 6±4.69, p=0.0006. 54.28% of the patients were ranged with a low DTS risk category, whereas 45.71% belonged to a moderate and high risk category. DTS was significantly lower in women than in men with high blood pressure (2.03±4.8 vs. 5.8±4.28), hypercholesterolemia (1.14±4.51 vs. 6.24±4.13), diabetes mellitus (1.83 ± 3.73 vs. 6.13±4.8), and obesity (2.42±5.35 vs. 5.81±4.64). By analyzing the presence of cardiovascular risk factors only in women, we noticed that only those with high blood pressure (2.03±4.89 vs. 8.13 ±7.85) and hypercholesterolemia (2.31±4.76 vs. 3.89±5.95) had a statistically significant low DTS (p<0.05). In conclusion, our research, which showed differences in DTS between women and men, raises concerns about the early diagnosis of ischemic heart disease in women.

scholarly journals Influence of Conventional Cardiovascular Risk Factors and Lifestyle Characteristics on Cardiovascular Disease After Hematopoietic Cell Transplantation

2014 ◽  
Vol 32 (3) ◽  
pp. 191-198 ◽  
Author(s):  
Eric J. Chow ◽  
K. Scott Baker ◽  
Stephanie J. Lee ◽  
Mary E.D. Flowers ◽  
Kara L. Cushing-Haugen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Cell Transplantation ◽  
Hematopoietic Cell Transplantation ◽  
Ischemic Heart

Purpose To determine the influence of modifiable lifestyle factors on the risk of cardiovascular disease after hematopoietic cell transplantation (HCT). Patients and Methods HCT survivors of ≥ 1 year treated from 1970 to 2010 (n = 3,833) were surveyed from 2010 to 2011 on current cardiovascular health and related lifestyle factors (smoking, diet, recreational physical activity). Responses (n = 2,362) were compared with those from a matched general population sample (National Health and Nutrition Examination Survey [NHANES]; n = 1,192). Results Compared with NHANES participants, HCT survivors (median age, 55.9 years; median 10.8 years since HCT; 71.3% allogeneic) had higher rates of cardiomyopathy (4.0% v 2.6%), stroke (4.8% v 3.3%), dyslipidemia (33.9% v 22.3%), and diabetes (14.3% v 11.7%; P < .05 for all comparisons). Prevalence of hypertension was similar (27.9% v 30.0%), and survivors were less likely to have ischemic heart disease (6.1% v 8.9%; P < .01). Among HCT survivors, hypertension, dyslipidemia, and diabetes were independent risk factors for ischemic heart disease and cardiomyopathy, and smoking was associated with ischemic heart disease and diabetes (odds ratios [ORs], 1.8 to 2.1; P = .02). Obesity was a risk factor for post-transplantation hypertension, dyslipidemia, and diabetes (ORs ≥ 2.0; P < .001). In contrast, lower fruit/vegetable intake was associated with greater risk of dyslipidemia and diabetes (ORs, 1.4 to 1.8; P ≤ .01), and lower physical activity level was associated with greater risk of hypertension and diabetes (ORs, 1.4 to 1.5; P < .05). Healthier lifestyle characteristics among HCT survivors attenuated risk of all cardiovascular conditions assessed. Conclusion Attention of clinicians to conventional cardiovascular risk factors and modifiable lifestyle characteristics offers hope of reducing serious cardiovascular morbidity after HCT.

Cardiovascular risk factors in ischemic heart disease and in general population

1999 ◽  
Vol 144 ◽  
pp. 135
Author(s):  
C. Morillas ◽  
C. Riera ◽  
C. Meliá ◽  
E. Solá ◽  
J. Sanchez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
General Population ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Ischemic Heart

Cardiovascular Risk Factors in Men With Ischemic Heart Disease and Erectile Dysfunction

Urology ◽  
2013 ◽  
Vol 82 (2) ◽  
pp. 377-381 ◽  
Author(s):  
Yael Pauker-Sharon ◽  
Yaron Arbel ◽  
Ariel Finkelstein ◽  
Amir Halkin ◽  
Itzhak Herz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Erectile Dysfunction ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Ischemic Heart

scholarly journals Arterial Thrombotic Complications Are Uncommon in Patients without Cardiovascular Risk Factors and Occur at Equivalent Rates in Chronic Myeloid Leukemia (CML) Patients Treated with Imatinib and Nilotinib

Blood ◽  
2014 ◽  
Vol 124 (21) ◽  
pp. 1811-1811 ◽  
Author(s):  
Hesam Hekmatjou ◽  
Gail J. Roboz ◽  
Ellen K. Ritchie ◽  
Sangmin Lee ◽  
Pinkal Desai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Ischemic Heart ◽  
Increased Risk ◽  
Prior Risk

Abstract Arterial thrombosis (AT), including ischemic heart disease, stroke, and peripheral artery occlusive disease (PAOD), have been observed in several studies of CML patients treated with tyrosine kinase inhibitors (TKI’s), most often in patients treated with ponatinib. Reports of AT in patients treated with other TKI’s are based on anecdotal observations and/or studies with relatively short follow-up times and limited data on underlying risk factors. From 1999 to 2014, 408 patients with CML were seen at Weill-Cornell/New York Presbyterian Hospital. Of these, a cohort of 224 patients in chronic phase received ongoing therapy with TKI’s with continuous clinical observation with a median follow-up of 7 years (range 1-15 years). There were 124 (55.4%) men and 100 (44.6%) women with a median age of 52 years (range 21-75 years). Initial therapy with a TKI occurred in 86% whereas 14% had received prior therapy with interferon-alpha and 2% had a prior allogeneic transplant. The initial TKI therapy was imatinib in 82%, nilotinib in 14% and dasatinib in 4%. 49% of patients were treated with only 1 TKI, 21% with 2 TKI’s and 30% with > 2 TKI’s. Over the course of therapy, overall 82% of patients were exposed to imatinib, 33.9% to nilotinib, 25% to dasatinib and 2.2% to ponatinib. Information on pre-treatment cardiovascular risk factors which included; a history of a prior AT, diabetes, hyperlipidemia, hypertension and smoking, were available on all patients. Prior AT occurred in 7.5%; 25% had 1 risk factor and 20.6% had 2 or more risk factors. Overall AT was observed in 7.1% (95% CI = 3.8%, 10.5%) of all patients and there were no deaths associated with AT. Ischemic heart disease occurred in 4.9%, a stroke in 0.4% and PAOD in 1.8%. The median time from start of TKI therapy to development of AT was 7 years (range 4-14). The median age of patients who developed AT was 68 years (range 47-80). AT occurred predominantly in patients with pre-existing risk factors; the incidence was 14.6% in patients with prior risk factors whereas only 1.6% of patients without risk factors developed this complication (p<0.0001). In 16 /224 patients, 17 AT’s occurred; 10 while on treatment with imatinib, 5 on nilotinib, 1 on dasatinib and 2 on ponatinib. By overall TKI exposure, AT occurred in 5.4 % of patients exposed to imatinib 6.6% exposed to nilotinib and 1.8% exposed to dasatinib (p=not significant). Apart from ponatinib, neither the initial TKI used, the overall exposure or length of exposure to TKI’s, or the number of TKI’s administered were associated with an increased risk of AT. These data would suggest that the development of AT is uncommon in patients without prior risk factors and occurs with equal frequency in patients exposed to either imatinib or nilotinib. Additional data are needed to conclusively determine whether treatment with a TKI (excluding ponatinib) is an independent risk factor for the development of AT in CML patients. Importantly, identification of the mechanism(s) associated with TKI-related AT in CML patients are needed to plan preventive measures, particularly in patients with preexisting risk factors. Disclosures Roboz: Novartis: Consultancy; Agios: Consultancy; Celgene: Consultancy; Glaxo SmithKline: Consultancy; Astra Zeneca: Consultancy; Sunesis: Consultancy; Novartis: Consultancy; Teva Oncology: Consultancy; Astex: Consultancy. Allen-Bard:Novartis: Speakers Bureau. Feldman:Novartis: Honoraria, Research Funding, Speakers Bureau; Ariad: Honoraria, Speakers Bureau.

Evaluation of Ischemic Heart Disease Factors in Hemophilia Patients in Khorramabad

2020 ◽  
Vol 20 ◽  
Author(s):  
Alireza Nezami ◽  
Fariba Tarhani ◽  
Sina Elahi
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Death ◽  
Ischemic Heart ◽  
Cross Sectional ◽  
Risk Predictor

Background: Evaluation of risk factors associated with coronary artery disease and cardiac health in hemophilia patients is necessary to prevent the onset of ischemic heart disease. In this study, we evaluated the cardiovascular status of hemophilic patients in Lorestan province for the early onset of ischemic heart disease. Methods: In this cross-sectional descriptive study, a total of 80 patients presenting severe hemophilia, the detailed questionnaire-based investigation was conducted to analyze the prevalence of cardiovascular risk factors in severe hemophilic patients. In patients with hemophilia, body mass index (BMI), blood pressure, diabetes, LDL, cholesterol and HDL, the risk of cardiovascular death was estimated using a predictive risk predictor algorithm of Europe SCORE. Results: The mean age of the patients was 25 years where all the patients were non-diabetic. Echocardiography did not show any wall motion abnormality and changes in the T wave and dysrhythmia was also not seen by ECG. 7 patients had high blood pressure, 11 had abnormal HDL, and 1 had abnormal LDL. In this study, serum LDL and HDL levels were not significantly correlated with age and BMI. Conversely, age and BMI were significantly associated with hypertension. Hypertension was observed in people over the age of 25 years and in overweighed individuals.78.8% had normal BMI and 21.3% were overweighed. There was no significant correlation between serum LDL, serum HDL, and blood pressure and sex. The levels of abnormal LDL and HDL were higher in men than in women. Conclusion: ECG findings from our study did not report any significant cardiac abnormalities among hemophilic patients. Cardiovascular risk factors were not significantly correlated in these paitents.

Psoriasis as an Independent Risk Factor for Cardiovascular Disease

2015 ◽  
Vol 20 (4) ◽  
pp. 327-333 ◽  
Author(s):  
Yi Chun Lai ◽  
Yik Weng Yew
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Independent Risk Factor ◽  
Ischemic Heart

Background: Psoriasis is known to be associated with metabolic syndrome, a well-established risk factor for ischemic heart disease and stroke. Emerging evidence indicates that psoriasis is an independent risk factor for cardiovascular disease and stroke. Objective: To evaluate whether psoriasis is independently associated with myocardial infarction (MI), ischemic heart disease (MI, angina pectoris, or coronary heart disease), and stroke, we conducted a cross-sectional study using the US National Health and Nutrition Examination Survey (NHANES) database. Methods: Data on clinical history of psoriasis, MI, angina pectoris, coronary heart disease, and stroke from the questionnaire as well as laboratory parameters on serum lipid and uric acid levels in the cycle years 2003-2006 and 2009-2012 were analyzed. Multivariate analysis with logistic regression modelling was performed with the aforementioned cardiovascular events or stroke as the dependent variables and with risk factors such as age, gender, ethnic group, current smoking status, alcohol consumption, metabolic syndrome, hyperuricemia, and psoriasis as independent variables. Results: There were 520 cases of psoriasis, and 108 of them had metabolic syndrome (20.8%). Well-established cardiovascular risk factors such as age, gender, ethnic group, smoking, alcohol consumption, metabolic syndrome, and hyperuricemia were also found to have significant associations with MI and ischemic heart disease (all P values <.001). Psoriatic patients were at significantly higher risks of developing MI (odds ratio [OR] 2.24; 95% CI: 1.27-3.95; P = .005) and ischemic heart disease (OR 1.90; 95% CI: 1.18-3.05; P = .008), but not stroke (OR 1.01; 95% CI: 0.48-2.16; P = .744), after adjustment was made for major cardiovascular risk factors. Conclusion: This study provides epidemiological evidence that psoriasis may be independently associated with the development of MI and ischemic heart disease. Physicians should be cognizant of any underlying cardiovascular risk factors, especially among psoriatic patients with metabolic syndrome, and manage them according to national guidelines.

Atherosclerosis and Predictors of Cardiovascular Mortality in Hemophilia.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1216-1216 ◽  
Author(s):  
Carolyn Foley ◽  
Lawrence A. Nichols ◽  
Margaret V. Ragni
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Ischemic Heart Disease ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Mortality ◽  
Coronary Stenosis ◽  
Ischemic Heart ◽  
Similar Frequency ◽  
History Of

Abstract The degree of coronary stenosis in men with hemophilia is similar to the general population, yet coronary symptoms and cardiovascular mortality are significantly lower, as we and others have previously showed. Although actor VIII deficiency may be protective against ischemic heart disease (IHD), the role of standard cardiovascular risk factors, most of which are associated with elevated factor VIII, in predicting ischemic heart disease or mortality in hemophilia is not known. We, therefore, conducted a case-control study to compare risk factors for IHD between hemophilic men (n=14) and non-hemophilic controls (n=42), matched 3:1 by age, race, and gender. Cardiovascular risk factors included hypertension, hypercholesterolemia, obesity, creatinine elevation, old age, and history of smoking, diabetes, and coronary symptoms (chest pain, angina, infarction). Clinical data were obtained from de-identified medical records on the cases and controls from the University of Pittsburgh Medical Center (UPMC) Medical Archival Records System (MARS), using an honest broker system. Intraluminal coronary stenosis was evaluated by a semi-quantitative scoring system, with 0=minimal (&lt;25%), 1=mild (³ 25%), 2=moderate (³ 50%), and 3=severe (³ 75%). Continuous data were analyzed by student’s t test, and discrete data were analyzed by chi square test with Yate’s continuity correction, or Fisher’s exact test. Cases and controls did not differ in mean age at death, 40 vs. 41 years, p&gt;0.025; frequency of coronary symptoms, 0 of 14 (0%) vs. 4 of 42 (9.5%), p=0.305; degree of intraluminal coronary stenosis &gt;25% at autopsy, 11 of 14 (78.6%) vs. 25 of 42 (59.5%), p=0.118; or in coronary stenosis &gt;75% at autopsy, 2 of 14 (14.3%) vs. 8 of 42 (19.0%), p=0.302. There was also no difference in the frequency of cardiovascular risk factors between cases and controls, including hypertension (systolic &gt;140 or diastolic &gt;90 mm Hg), 4 of 14 (28.6%) vs. 12 of 42 (28.6%), p = 0.266; smoking, 5 of 14 (37.7%) vs. 14 of 37 (p=0.775); or hypercholesterolemia, 5 of 14 (35.7%) vs. 8 of 42 (19.0%), p = 0.419. Although a significantly fewer cases than controls had BMI &gt; 25, 3 of 14 (21.4%) vs. 28 of 42 (66.7%), p=0.003; diabetes, 0 of 14 (0%) vs. 9 of 38 (23.7%), p=0.044; and creatinine &gt;1.2 mg/dl, 1 of 14 (7.1%) vs. 13 of 39 (33.3%), p=0.047, these findings did not persist after controlling for age and HIV infection. The proportion of hemophilic cases who succumbed to cardiopulmonary death, however, was significantly lower than in non-hemophilic controls, 0 of 14 (0%) vs. 14 of 42 (33.3%), p=0.009, which persisted after correction for age. Other than HIV infection, which was more common among those with severe hemophilia (&lt;0.01 U/ml) than mild or moderate hemophilia (F.VIII ³ 0.01 U/ml), 8 of 9 (88.9%) vs. 1 of 5 (20.0%), p=0.022, hemophilia severity did not affect the proportion with &gt;25% intraluminal coronary stenosis, 7 of 9 (77.8%) vs. 4 of 5 (80.0%), p=0.494; or with &gt;75% intraluminal stenosis, 0 of 9 (0%) vs. 2 of 5 (40.0%), p=0.110; coronary symptoms, p=1.00; hypertension, p=0.419; hypercholesterolemia, p=0.315; creatinine &gt;1.2, p=0.357; or history of smoking, p=0.315; diabetes, p=1.00; BMI ³ 25, p=0.247; or coronary symptoms, p=1.00. In conclusion, hemophilic men not only have a similar frequency of coronary symptoms and a similar degree of intraluminal coronary stenosis as age-, gender-, and race-matched non-hemophilic controls, they also appear to have a similar frequency of cardiovascular risk factors. These findings suggest, but do not prove, that factor VIII deficiency, even in the presence of cardiovascular risk factors and atherosclerotic vessels, may be protective against thrombotic coronary occlusion and ischemic heart disease.

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