scholarly journals Skin autofluorescence assessment of cardiovascular risk in people with severe mental illness

BJPsych Open ◽  
2018 ◽  
Vol 4 (4) ◽  
pp. 313-316 ◽  
Author(s):  
Daniëlle Emmerink ◽  
Sybiel Bakker ◽  
Thomas Van Bemmel ◽  
Eric O. Noorthoorn ◽  
Paul Naarding
Keyword(s):  
Risk Assessment ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Severe Mental Illness ◽  
Ease Of Use ◽  
Glycation End Products ◽  
Prospective Longitudinal ◽  
Score Table ◽  
Observation Period

BackgroundPeople with severe mental illness (SMI) show significantly shorter life expectancy, mostly due to more prevalent cardiovascular disease. Although age is a prominent contributor to contemporary risk assessment and SMI usually affects younger people, these assessments still do not reveal the actual risk. By assessing advanced glycation end products (AGEs), cardiovascular risk can be assessed independent of age.AimsTo establish whether detection of AGEs with the AGE-reader will give a more accurate cardiovascular risk assessment in people with SMI.MethodWe compared assessment with the AGE-reader with that of the Systematic Coronary Risk Evaluation (SCORE) table in a group of 120 patients with SMI.ResultsThe AGE-reader showed an increased cardiovascular risk more often than the SCORE table, especially in the youngest group.ConclusionsBecause of its ease of use and substantiation by studies done on other chronic diseases, we advocate use of the AGE-reader in daily care for patients with SMI to detect cardiovascular risk as early as possible. However, the findings of the current study should be evaluated with caution and should be seen as preliminary findings that require confirmation by a prospective longitudinal cohort study with a substantial follow-up observation period.Declaration of interestNone.

scholarly journals Cardiovascular risk assessment in patients with a severe mental illness: a systematic review and meta-analysis

2016 ◽  
Vol 16 (1) ◽  
Author(s):  
Quintí Foguet-Boreu ◽  
Maria Isabel Fernandez San Martin ◽  
Gemma Flores Mateo ◽  
Edurne Zabaleta del Olmo ◽  
Luís Ayerbe García-Morzon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Mental Illness ◽  
Cardiovascular Risk ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Cardiovascular Risk Assessment

scholarly journals Circulating Troponin As Measured by a Sensitive Assay for Cardiovascular Risk Assessment in Primary Prevention

2012 ◽  
Vol 58 (1) ◽  
pp. 200-208 ◽  
Author(s):  
David M Leistner ◽  
Jens Klotsche ◽  
Lars Pieper ◽  
Günter K Stalla ◽  
Hendrik Lehnert ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Primary Prevention ◽  
Cardiac Troponin ◽  
Troponin I ◽  
Major Adverse Cardiovascular Events ◽  
Sensitive Assay ◽  
Prospective Longitudinal

Abstract BACKGROUND Measuring circulating cardiac troponin using novel sensitive assays has revealed that even minute elevations are associated with increased mortality in patients with coronary artery disease or even in the general population. Less well defined, however, is the incremental value of measuring circulating cardiac troponin I (cTnI) by a sensitive assay for risk assessment in primary prevention. METHODS We measured circulating concentrations of cTnI, N-terminal pro–B-type natriuretic peptide (NT-proBNP), and high-sensitivity C-reactive protein (hsCRP) in 5388 individuals free of known cardiovascular disease recruited into the DETECT study, a prospective longitudinal population-based cohort study. We determined the prognostic implications for incident major adverse cardiovascular events (MACE) during 5 years of follow-up. RESULTS Circulating cTnI was detectable in 19% of the subjects. Increased cTnI concentrations were associated with established risk factors for atherosclerosis and demonstrated a graded relationship with all-cause mortality and incident MACE during 5-year follow-up. A single measurement of cTnI significantly improved risk prediction over established risk factors, and also added prognostic information, when adjusted for serum concentrations of NT-proBNP and hsCRP. CONCLUSIONS Minute increases in cTnI are associated with increased mortality and incident MACE in a large primary prevention cohort and, thus, identify contributors to cardiovascular risk not fully captured by traditional risk factor assessment.

scholarly journals Natriuretic peptides and risk of type 2 diabetes: Results from the Biomarkers for Cardiovascular Risk Assessment in Europe (BiomarCaRE) Consortium

2021 ◽  
Author(s):  
Chaterina Sujana ◽  
Veikko Salomaa ◽  
Frank Kee ◽  
Simona Costanzo ◽  
Stefan Söderberg ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Inverse Association ◽  
Cardiovascular Risk Assessment ◽  
Multiplicative Interaction ◽  
Incident Type ◽  
Incident Type 2 Diabetes

<p><b>Objective: </b>Natriuretic peptide (NP) concentrations are increased in cardiovascular diseases (CVD) but are associated with a lower diabetes risk. We investigated associations of N-terminal pro-B-type NP (NT-proBNP) and mid-regional pro-atrial NP (MR-proANP) with incident type 2 diabetes stratified by the presence of CVD. </p> <p><b> </b></p> <p><b>Research Design and Methods:</b> Based on the Biomarkers for Cardiovascular Risk Assessment in Europe-(BiomarCaRE) Consortium, we included 45,477 participants with NT-proBNP measurements (1,707 developed type 2 diabetes over 6.5 years of median follow-up; among these, 209 had CVD at baseline) and 11,537 participants with MR-proANP measurements (857 developed type 2 diabetes over 13.8 years of median follow-up; among these, 106 had CVD at baseline). The associations were estimated using multivariable Cox regression models. </p> <p> </p> <p><b>Results: </b>Both NPs were inversely associated with incident type 2 diabetes (hazard ratios [95%CI] per 1-standard deviation increase of log NP: 0.84 [0.79; 0.89] for NT-proBNP and 0.77 [0.71; 0.83] for MR-proANP). The inverse association between NT-proBNP and type 2 diabetes was significant in individuals without, but not in individuals with CVD (0.81 [0.76; 0.86] vs 1.04 [0.90; 1.19]; <i>P</i>-multiplicative interaction= 0.001). There was no significant difference in the association of MR-proANP with type 2 diabetes between individuals without and with CVD (0.75 [0.69; 0.82] vs 0.81 [0.66; 0.99]; <i>P</i>-multiplicative interaction= 0.236). </p> <p> </p> <p><b>Conclusions:</b> NT-proBNP and MR-proANP are inversely associated with incident type 2 diabetes. However, the inverse association of NT-proBNP seems to be modified by the presence of CVD. Further investigations are warranted to confirm our findings and to investigate the underlying mechanisms.</p>

Prediction of fatal and non-fatal cardiovascular events in young and middle-aged healthy workers: The IberScore model

2019 ◽  
pp. 204748731989488 ◽  
Author(s):  
Carlos Fernández-Labandera ◽  
Eva Calvo-Bonacho ◽  
Pedro Valdivielso ◽  
Luis Quevedo-Aguado ◽  
Paloma Martínez-Munoz ◽  
...  
Keyword(s):  
Risk Assessment ◽  
Cardiovascular Risk ◽  
High Risk ◽  
Cardiovascular Events ◽  
Clinical Utility ◽  
Superior Performance ◽  
Valuable Insight ◽  
New Model ◽  
Temporal Validation

Aims Our primary objective was to improve risk assessment for fatal and non-fatal cardiovascular events in a working population, mostly young and healthy. Methods We conducted a prospective cohort study to derive a survival model to predict fatal and non-fatal 10-year cardiovascular risk. We recruited 992,523 workers, free of diagnosed cardiovascular disease at entry, over six years, from 2004–2009. We divided the sample into two independent cohorts: a derivation one (626,515 workers; from 2004–2006) and a temporal validation one (366,008 workers; over 2007–2009). Then, we followed both cohorts over 10 years and registered all fatal and non-fatal cardiovascular events. We built a new risk calculator using an estimation of cardiovascular biological age as a predictor and named it IberScore. There were remarkable differences between this new model and Systematic Coronary Risk Evaluation (SCORE) (in both the specification and the equation). Results Over the 10-year follow-up, we found 3762 first cardiovascular events (6‰) in the derivation cohort. Most of them (80.3%) were non-fatal ischaemic events. If we had been able to use our model at the beginning of the study, we had classified in the ‘high-risk’ or ‘very high-risk’ groups 82% of those who suffered a cardiovascular event during the follow-up. All the post-estimation tests showed superior performance (true positive rate: 81.8% vs 11.8%), higher discrimination power and better clinical utility (standardised net benefit: 58% vs 13%) for IberScore when compared to SCORE. Conclusion Risk assessment of fatal and non-fatal cardiovascular events in young and healthy workers was improved when compared to the previously used model (SCORE). The latter was not reliable to predict cardiovascular risk in our sample. The new model showed superior clinical utility and provided four useful measures for risk assessment. We gained valuable insight into cardiovascular ageing and its predictors.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

scholarly journals Future risk of cardiovascular disease risk factors and events in women after a hypertensive disorder of pregnancy

Heart ◽  
2019 ◽  
Vol 105 (16) ◽  
pp. 1273-1278 ◽  
Author(s):  
Laura Benschop ◽  
Johannes J Duvekot ◽  
Jeanine E Roeters van Lennep
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Hypertensive Disorder ◽  
Cardiovascular Risk Assessment ◽  
Increased Risk

Hypertensive disorders of pregnancy (HDP), such as gestational hypertension and pre-eclampsia, affect up to 10% of all pregnancies. These women have on average a twofold higher risk to develop cardiovascular disease (CVD) later in life as compared with women with normotensive pregnancies. This increased risk might result from an underlying predisposition to CVD, HDP itself or a combination of both. After pregnancy women with HDP show an increased risk of classical cardiovascular risk factors including chronic hypertension, renal dysfunction, dyslipidemia, diabetes and subclinical atherosclerosis. The prevalence and onset of cardiovascular risk factors depends on the severity of the HDP and the coexistence of other pregnancy complications. At present, guidelines addressing postpartum cardiovascular risk assessment for women with HDP show a wide variation in their recommendations. This makes cardiovascular follow-up of women with a previous HDP confusing and non-coherent. Some guidelines advise to initiate cardiovascular follow-up (blood pressure, weight and lifestyle assessment) 6–8 weeks after pregnancy, whereas others recommend to start 6–12 months after pregnancy. Concurrent blood pressure monitoring, lipid and glucose assessment is recommended to be repeated annually to every 5 years until the age of 50 years when women will qualify for cardiovascular risk assessment according to all international cardiovascular prevention guidelines.

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