Clinical characteristics and management of hyperlipoproteinemia in patients with chronic coronary heart disease in Slovakia

Author(s):  
Martin Studencan ◽  
Daniel Pella ◽  
Peter Bramlage ◽  
Eva Kaszasova

IntroductionA reduction of LDL-cholesterol is beneficial for high-risk patients, including patients with previously documented coronary heart disease (CHD). Data on the overall composition, risk profile, and management of these patients is very limited in Slovakia.Material and methodsThis cross-sectional multicentre observational study was conducted by cardiologists and internists providing outpatient care at 35 sites across Slovakia between 11/2015 and 01/2016. All patients had documented CHD and fulfilled the very high CV risk criteria (ESC recommendations).ResultsA total of 349 patients were recruited, had a mean age of 67.8 years, 67.9% were male, 41% had diabetes and a mean BMI of 29.5 kg/m2. As many as 65.3% had prior myocardial infarction, 59.2% underwent PCI, and 24.1% CABG. At baseline 90.5% of patients reported taking a statin, 10.3% ezetimibe and 5.4% a fibrate. The mean LDL-C level was 2.69±1.02 mmol/L with only 18.6% meeting their treatment target of <1.8 mmol/L. Mean values for TC (4.44mmol/L), HDL-C (1.20 mmol/L, and triglycerides (1.68 mmol/L) were within normal limits. A higher age (aOR 3.40; 95%CI 1.77-6.53) and the use of more than 20 mg per day atorvastatin equivalent dose of a statin (aOR 2.20; 95%CI 1.13-4.28) were associated with treatment target achievement in a multivariable adjusted model while female gender conferring a reduced likelihood (aOR 0.48; 95%CI 0.24-0.99).ConclusionsPatients at high cardiovascular risk in Slovakia are far off the <1.8 mmol/L LDL-C level recommended for the protection from adverse events and achieve their treatment targets less often (18.6%) than in the mean of other countries globally (29.4%).

1998 ◽  
Vol 44 (6) ◽  
pp. 1224-1232 ◽  
Author(s):  
Judith R McNamara ◽  
Paulesh K Shah ◽  
Katsuyuki Nakajima ◽  
L Adrienne Cupples ◽  
Peter W F Wilson ◽  
...  

Abstract Remnants of triglyceride-rich lipoproteins of both intestinal and liver origin are considered atherogenic, but they have been difficult to isolate and measure. An assay has been developed that allows the measurement of remnant-like particle cholesterol (RLP-C) and triglyceride (RLP-TG). RLP-C and RLP-TG concentrations were measured in &gt;3000 fasting plasma samples obtained from participants in exam cycle 4 of the Framingham Offspring Study and stored at −80 °C. After exclusions, comparisons were made for 2821 samples (1385 women, 1436 men; mean age, 52 years). For women, the mean RLP-C and RLP-TG values were 0.176 ± 0.058 mmol/L (6.8 ± 2.3 mg/dL) and 0.204 ± 0.159 mmol/L (18.1 ± 14.1 mg/dL), respectively; for men, the mean values were 0.208 ± 0.096 mmol/L (8.0 ± 3.7 mg/dL) and 0.301 ± 0.261 mmol/L (26.7 ± 23.1 mg/dL), respectively. Women had significantly lower RLP-C and RLP-TG values (P &lt;0.0001) than men; premenopausal women had significantly lower values than postmenopausal women (P &lt;0.0001); and younger subjects (&lt;50 years) had significantly lower values than older individuals (P &lt;0.0001). The 75th percentile values for RLP-C and RLP-TG were 0.186 mmol/L (7.2 mg/dL) and 0.225 mmol/L (19.9 mg/dL), respectively, for women, and 0.225 mmol/L (8.7 mg/dL) and 0.346 mmol/L (30.6 mg/dL) for men. These data provide reference ranges for use in the evaluation of RLP-C and RLP-TG as potential indicators of risk for coronary heart disease.


2020 ◽  
Vol 47 (2) ◽  
pp. 255-263
Author(s):  
Dayana Dias-Mendonça ◽  
Mariana Vargas-Furtado ◽  
Roberta Aguiar-Sarmento ◽  
Bruna Bellincanta-Nicoletto ◽  
Alex Nogueira-Haas ◽  
...  

2018 ◽  
Vol 1 (2) ◽  
pp. 99
Author(s):  
Laila Kamila ◽  
Maulidiyah Salim

Abstract: Coronary heart is a disease that offense to blood vessels and heart attack due to constriction of blood vessels. A high level of cholesterol in blood or exceeds the normal limit can form sediment in wall of blodd vessels which cause blood vessels constriction or blockage. This research object to determine whether there is a correlation between cholesterol level total and hypertension with coronary heart disease in patients who hospitalized in Regional Public Hospital of dr. Soedarso Pontianak. This study was used cross sectional design, purposive sampling technique, it gained 50 people as samples. The measurement of blood pressure was done in heart poly and cholesterol total level in clinic laboratory of Regional Public Hospital of dr. Soedarso by using enzymatic CHOD-PAP method. It can be obtained that 10 people had hypertension and 40 people did not.the average of total cholesterol was 224 mg/dl. Maximum value of total cholesterol was 224 mg/dl and 152 mg/dl as minimum value. Data has been analyzed by using statistical test, Chi-Square, to determine the correlation of total cholesterol wit coronary heart disease, obtained p value=0,024 (less than α=0,05). Correlation of hypertension and coronary heart disease gained p value=0,923 (more than α=0,05), it can be concluded that total cholesterol correlated with coronary heart disease, and there was not a correlation between hypertension and coronary heart disease.Abstrak: Jantung koroner adalah penyakit yang  menyerang pembuluh darah dan serangan jantung, karena penyempitan pada pembuluh darah. Kadar kolesterol yang tinggi dalam darah melebihi normal dapat membentuk endapan pada dinding pembuluh darah sehingga menyebabkan penyempitan dan tersumbatnya pembuluh darah. Penelitian ini bertujuan untuk mengetahui hubungan kadar kolesterol total dan hipertensi dengan penyakit jantung koroner pada pasien di RSUD dr. Soedarso Pontianak. Disain penelitian  ini menggunakan cross sectional, teknik pengambilan sampel yaitu purposive sampling, didapat jumlah sampel 50 orang. Pengukuran Tensi Darah dilakukan di poli Jantung dan pemeriksaan kadar kolesterol total di laboratorium klinik RSUD dr. Soedarso Pontianak dengan metode enzimatik CHOD-PAP. Hasil penelitian didapatkan 10 orang mengalami hipertensi dan 40 orang non hipertensi. Rata-rata kadar kolesterol total 224 mg/ dl. Nilai maksimum kadar kolesterol total yaitu 224 mg/dl dan nilai minimum yaitu 152 mg/dl. Analisa data dengan uji statistik Chi-square untuk mengetahui hubungan kolesterol total dengan penyakit jantung koroner didapatkan nilai p = 0,024 (lebih kecil dari  α 0,05). Uji hubungan hipertensi dengan penyakit jantung koroner didapat nilai p = 0,923 (lebih besar dari α 0,05), dapat disimpulkan terdapat hubungan kadar kolesterol total dengan penyakit jantung koroner dan tidak ada hubungan hipertensi dengan penyakit jantung koroner.


2020 ◽  
Vol 98 (3) ◽  
pp. 231-235
Author(s):  
N. Yu. Borovkova ◽  
M. V. Buyanova ◽  
T. E. Bakka ◽  
M. P. Nistratova ◽  
T. V. Vlasova ◽  
...  

To evaluate possibilities of aspirin-induced gastroduodenopathy treatment in the patients with chronic ischemic heart disease by means of applying the internal endogenous prostaglandins stimulant.  Material and methods. 340 patients suffering from chronic coronary heart disease and receiving a long-term acetylsalicylic acid (ASA) therapy were examined on the base of the cardiovascular care unit of The Nizhny Novgorod Regional Clinical Hospital named after N.A. Semaschko. There were evaluated frequency, nature and severity of the aspirin-induced gastroduodenopathy. The patients with coronary heart disease and aspirin-induced gastroduodenopathy were divided in two groups. In the first group of patients there was applied rebamipide therapy (in a single daily dose 300 mg) in combination with the proton pump inhibitor (PPI) — pantoprazole. In the second group there was applied only pantoprazole therapy. For the purpose of specification of AIG pathogenetic mechanisms development, all the examined chronic coronary heart disease cases were tested on the prostaglandin E2 (PGE2) level in blood serum before the therapy beginning and after the treatment. The control group was formed of chronic coronary heart disease patients showing no AIG evidence. Statistical processing of the received data was fulfilled with the program «Statistika 10.0». Results. AIG was registered in 15% out of 340 chronic coronary heart disease patients. According to the endoscopic examination erosive disease of the body and antrum prevailed among the patients. The PGE2 level in the blood serum was significantly lower (р = 0,00087) in these patients in comparison with the control group. In association with PPI and rebamipide mixed therapy, esophagogastroduodenoscopy results showed no pathological findings in gastrointestinal mucosa and statistically significant (р = 0,00067) blood serum PGE2 level growing in all the treated patients. As a result of exclusive PPI therapy there was marked positive dynamics in endoscopic view in 19 out of 25 patients and a tendency to normalization of PGE2 level in the blood serum. However, PGE2 level growing was insignificant. Conclusion. The presented research demonstrates the possibility of AIG treatment with the use of internal endogenous prostaglandins stimulant — rebamipide in complex with proton pump inhibitor PPI therapy.


2018 ◽  
Vol 8 (6) ◽  
pp. 138-144
Author(s):  
Thien Nguyen Duc ◽  
Tai Tran Tan

Background: Periodontal disease is a prominent and important issue of public health, especially in pregnant women. The objective of this study is to describe the clinical characteristics; learn knowledge, attitudes, practice oral hygiene and assess the need for treatment of periodontal disease in pregnant women. Subjects and Methods: A cross-sectional study of 210 pregnant women who visited the Department of Obstetrics and Gynecology at the Hue University of Medicine and Pharmacy Hospital. Clinical examination and interview questions on knowledge, attitudes and practice of oral care for all subjects. Results: The incidence of gingivitis was 100%, with mild gingivitis of 4,3% and moderate gingivitis of 95.7%. There was a difference in incidence rates of gingivitis in the gestational period (p<0.001). The incidence of periodontitis is 17.6% and there is no difference in gestational age (p>0.05). The mean values of GI and BOP indices differed by gestation period (p<0.05) and PD, OHI-S, PlI have statistically significant relationship with gestation period (p>0.05). The incidence of periodontal disease is 80.5%; The percentage of pregnant women who abstain from brushing their teeth after birth is 61.4%. Prevalence of brushing once a day: 7.1%; Twice a day: 70.5% and 3 times daily: 22.4%; The mean values of GI, PD, BOP, OHI-S and PlI were inversely proportional to the number of brushing (p<0.001). The rate of dental hygiene is just 3.3%; The rate of oral hygiene, dental plaque and plaque removal was 94,3%; The proportion of subjects required for intensive treatment is 2.4%. Conclusion: Periodontal disease, especially for pregnant women, is high. It is necessary to educate the knowledge, attitudes and practice of proper oral hygiene and to better meet the demand for periodontal disease treatment for pregnant women. Key words: Periodontal disease, pregnant women, knowledge, attitude, practice for oral hygiene, treatment needs


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e048590
Author(s):  
Kewei Wang ◽  
Yuanqi Wang ◽  
Ruxing Zhao ◽  
Lei Gong ◽  
Lingshu Wang ◽  
...  

ObjectiveThe objective of this study was to evaluate the influence of secondhand smoke (SHS) exposure during childhood on type 2 diabetes mellitus, hypertension, hyperlipidaemia and coronary heart disease among Chinese non-smoking women.MethodsIn this cross-sectional study, the SHS exposure data in childhood were obtained using a questionnaire survey. Self-reported childhood SHS exposure was defined as the presence of at least one parent who smoked during childhood.ResultsOf the 6522 eligible participants, 2120 Chinese women who had never smoked were assessed. The prevalence of SHS exposure in the entire population was 28.1% (596). SHS exposure during childhood was not significant for the standard risk factors of type 2 diabetes mellitus (p=0.628) and hypertension (p=0.691). However, SHS was positively associated with hyperlipidaemia (p=0.037) after adjusting for age, obesity, education status, physical activity, alcohol consumption, current SHS exposure status, diabetes mellitus and hypertension. In addition, childhood SHS increased the occurrence of coronary heart disease (p=0.045) among non-smokers after further adjusting for hyperlipidaemia.ConclusionSHS exposure during childhood is associated with prevalent hyperlipidaemia and coronary heart disease in adulthood among non-smoking Chinese women.


2021 ◽  
pp. 036354652098781
Author(s):  
Mathias Paiva ◽  
Lars Blønd ◽  
Per Hölmich ◽  
Kristoffer Weisskirchner Barfod

Background: Tibial tubercle–trochlear groove (TT-TG) distance is often used as a measure of lateralization of the TT and is important for surgical planning. Purpose: To investigate if increased TT-TG distance measured on axial magnetic resonance images is due to lateralization of the TT or medialization of the TG. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A total of 84 knees (28 normal [NK], 28 with trochlear dysplasia [TD], and 28 with patellar dislocation without TD [PD]) were examined. The medial border of the posterior cruciate ligament (PCL) was chosen as the central anatomic landmark. The distance from the TT to PCL (TT-PCL) was measured to examine the lateralization of the TT. The distance from the TG to the PCL (TG-PCL) was measured to examine the medialization of the TG. Between-group differences were investigated by use of 1-way analysis of variance. Results: The mean values for TT-TG distance were 8.7 ± 3.6 mm for NK, 12.1 ± 6.0 mm for PD, and 16.7 ± 4.3 mm in the TD group ( P < .01). The mean values for TT-PCL distance were 18.5 ± 3.6 mm for NK, 18.5 ± 4.5 mm for PD, and 21.2 ± 4.2 mm in the TD group ( P = .03). The mean values for TG-PCL distance were 9.6 ± 3.0 mm for NK, 7.1 ± 3.4 mm for PD, and 5.1 ± 3.3 mm in the dysplastic group ( P < .01). Conclusion: The present results indicate that increased TT-TG distance is due to medialization of the TG and not lateralization of the TT. Knees with TD had increased TT-TG distance compared with the knees of the control group and the knees with PD. The TT-PCL distance did not differ significantly between groups, whereas the TG-PCL distance declined with increased TT-TG.


2002 ◽  
Vol 18 (3) ◽  
pp. 121-128 ◽  
Author(s):  
Adelheid Schwarz ◽  
Werner Haberbosch ◽  
Harald Tillmanns ◽  
Andreas Gardemann

Background.Matrix metalloproteinases, such as stromelysin-1, are implicated in the pathogenesis of coronary artery disease (CAD) and acute myocardial infarction (MI). A 5A/6A promoter polymorphism can regulate the transcription of the stromelysin-1 gene in an allele-specific manner. Evidence has been presented that the 6A allele is associated with the progression of coronary heart disease (CHD). In contrast, the 5A allele may be linked to the risk of MI.Results.To analyse the relation of the 5A/6A polymorphism with the risk and severity of CHD and the risk of MI, a case-control study of 515 healthy controls and 1848 participants who underwent coronary angiography for diagnostic purposes was conducted. In the total sample, the mean CHD scores—according to Gensini—were different between 5A/6A genotypes: 5A5A homozygotes had the lowest, 6A6A genotypes the highest and 5A6A heterozygotes intermediate scores. These differences were even more pronounced when the participants were restricted to individuals with a high coronary risk profile (high apoB levels, high Lp(a) levels, high glucose levels, combinations of either high apoB and Lp(a) levels or high apoB, Lp(a) and glucose plasma levels). Mean values were used as cut points for high-risk populations, respectively. In contrast, the 5A allele was not associated with the risk of CHD or MI. Even when angiographically controlled individuals without MI were compared with MI patients in subpopulations of participants with no, single, double and triple vessel disease, the frequencies of the 5A/6A and/or the 5A5A genotypes were not higher in each subgroup, respectively.Conclusions.The present results do not confirm an association of the 5A allele with the risk of MI, observed in another investigation, but strengthen the hypothesis of earlier studies that the 6A allele is a disease marker for progression of coronary heart disease. Further investigations should evaluate whether 6A allele carriers and especially 6A homozygotes might benefit from a more aggressive therapy against CHD progression.


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