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Background Recent studies have reported that the associations between dietary carbohydrates and cardiovascular disease (CVD) may depend on the quality, rather than the quantity, of carbohydrates consumed. This study aimed to assess the associations between types and sources of dietary carbohydrates and CVD incidence. A secondary aim was to examine the associations of carbohydrate intakes with triglycerides within lipoprotein subclasses. Methods A total of 110,497 UK Biobank participants with ≥ two (maximum five) 24-h dietary assessments who were free from CVD and diabetes at baseline were included. Multivariable-adjusted Cox regressions were used to estimate risks of incident total CVD (4188 cases), ischaemic heart disease (IHD; 3138) and stroke (1124) by carbohydrate intakes over a median follow-up time of 9.4 years, and the effect of modelled dietary substitutions. The associations of carbohydrate intakes with plasma triglycerides within lipoprotein subclasses as measured by nuclear magnetic resonance (NMR) spectroscopy were examined in 26,095 participants with baseline NMR spectroscopy measurements. Results Total carbohydrate intake was not associated with CVD outcomes. Free sugar intake was positively associated with total CVD (HR; 95% CI per 5% of energy, 1.07;1.03–1.10), IHD (1.06;1.02–1.10), and stroke (1.10;1.04–1.17). Fibre intake was inversely associated with total CVD (HR; 95% CI per 5 g/d, 0.96;0.93–0.99). Modelled isoenergetic substitution of 5% of energy from refined grain starch with wholegrain starch was inversely associated with total CVD (0.94;0.91–0.98) and IHD (0.94;0.90–0.98), and substitution of free sugars with non-free sugars was inversely associated with total CVD (0.95;0.92–0.98) and stroke (0.91;0.86–0.97). Free sugar intake was positively associated with triglycerides within all lipoproteins. Conclusions Higher free sugar intake was associated with higher CVD incidence and higher triglyceride concentrations within all lipoproteins. Higher fibre intake and replacement of refined grain starch and free sugars with wholegrain starch and non-free sugars, respectively, may be protective for incident CVD.

Systems designed with persuasive software features can influence users to adopt attitudes and/or behaviours that contribute to better health outcomes. Studies on Coronary Heart Disease (CHD) interventions have shown how they can be used to support lifestyle changes. Meta-analytic reviews of randomised controlled trials (RCTs) are needed to appraise, summarise, and show their effects on health. To this end, we investigated the effectiveness of digital health interventions (DHI) designed for CHD and examined the impact of persuasive features in the DHIs. We performed a systematic search using three academic databases for scientific papers on CHD and digital interventions from 2010 to 2020, yielding 1556 papers. The systematic review and meta-analysis included 12 RCTs after screening. Our findings show that digital health interventions had an impact on diastolic blood pressure, systolic blood pressure, low-density lipoprotein, high-density lipoprotein, total cholesterol, glycated haemoglobin, glucose, triglyceride, heart rate, and depression but not body mass index. We present effective interventions and insights into persuasive software features that were associated with effective DHIs. More research is needed to investigate the effectiveness of persuasive features in other contexts and other factors that can impact the effectiveness of DHIs.

Background: Following guidelines for cardiovascular disease prevention of the European Society for Cardiology (ESC), the current study validated the German Comprehensive Psychosocial Screening Instrument in participants who underwent coronary angiography.Methods: 314 participants (Mage = 69.7 ± 12.0; 69 % male) completed the German Comprehensive Psychosocial Screening Instrument and validated comparison scales to measure depression (PHQ-9), anxiety (GAD-7), Type D personality (DS14), work stress (ERI), family stress (SMSS), trauma (PC-PTSD), and anger and hostility (Z-scale of MMPI-2).Results: Confirmatory factor analysis (CFA) confirmed that the psychosocial risk factors were separate entities rather than a signs or symptoms of a single broad indication of distress (CFI = .872, RMSEA = .056, SRMR = .058). Intraclass coefficients (ICC), kappa and diagnostic accuracy indicators (receiver operator characteristic [ROC] curves, sensitivity, specificity, and the positive and negative predictive values [PPV; NPV]) indicated that most screener scales were sufficient to good. We also compared patients with established coronary heart disease (CHD; n = 213) to those with no current CHD (n = 100) and found overall similar results.Discussion: The German version of the Comprehensive Psychosocial Screening Instrument has an acceptable performance. Aside from minor improvements, the screening instrument could be implemented in the cardiological practice to screen patients on multidimensional psychosocial risk.

Aims Coronary heart disease is the most common reason for referral to exercise-based cardiac rehabilitation (CR) globally. However, the generalizability of previous meta-analyses of randomized controlled trials (RCTs) is questioned. Therefore, a contemporary updated meta-analysis was undertaken. Methods and results Database and trial registry searches were conducted to September 2020, seeking RCTs of exercise-based interventions with ≥6-month follow-up, compared with no-exercise control for adults with myocardial infarction, angina pectoris, or following coronary artery bypass graft, or percutaneous coronary intervention. The outcomes of mortality, recurrent clinical events, and health-related quality of life (HRQoL) were pooled using random-effects meta-analysis, and cost-effectiveness data were narratively synthesized. Meta-regression was used to examine effect modification. Study quality was assessed using the Cochrane risk of bias tool. A total of 85 RCTs involving 23 430 participants with a median 12-month follow-up were included. Overall, exercise-based CR was associated with significant risk reductions in cardiovascular mortality [risk ratio (RR): 0.74, 95% confidence interval (CI): 0.64–0.86, number needed to treat (NNT): 37], hospitalizations (RR: 0.77, 95% CI: 0.67–0.89, NNT: 37), and myocardial infarction (RR: 0.82, 95% CI: 0.70–0.96, NNT: 100). There was some evidence of significantly improved HRQoL with CR participation, and CR is cost-effective. There was no significant impact on overall mortality (RR: 0.96, 95% CI: 0.89–1.04), coronary artery bypass graft (RR: 0.96, 95% CI: 0.80–1.15), or percutaneous coronary intervention (RR: 0.84, 95% CI: 0.69–1.02). No significant difference in effects was found across different patient groups, CR delivery models, doses, follow-up, or risk of bias. Conclusion This review confirms that participation in exercise-based CR by patients with coronary heart disease receiving contemporary medical management reduces cardiovascular mortality, recurrent cardiac events, and hospitalizations and provides additional evidence supporting the improvement in HRQoL and the cost-effectiveness of CR.

Objective: Diverse risk factors influence the development and prognosis of coronary heart disease (CHD) independently and mutually. Low socioeconomic status (SES) seems to exacerbate these risk factors' influences. In addition, sex differences have been identified for individual risk factors. Network analysis could provide in-depth insight into the interrelatedness of the risk factors, their predictability, and the moderating role of sex, to ultimately contribute to more refinement in prevention and cardiac rehabilitation. Methods: A total of 1682 participants (78% male; mean [standard deviation] age = 69.2 [10.6] years) with CHD completed questionnaires on psychosocial factors and health behaviors. Cardiometabolic data were retrieved through medical records. An SES index was created based on self-reported occupation, education, and area (i.e., postal code)-based median family income. Using R, we conducted a mixed graphical model network analysis on all risk factors combined with and without the moderating role of sex. Results: SES belonged to the more influential risk factors with moderate to high levels of expected influence and degree centrality, indicating that it plays a considerable role in the risk factor network. When considering the moderating role of sex, relationships between SES and most risk factors were found to be stronger for women ( b = 0.06-0.48). Conclusions: The current study provided an insight into an interrelated network of psychosocial and medical risk factors among CHD patients. With SES belonging to the more influential risk factors and female sex influencing the strength of all the SES-risk factor relationships, cardiac rehabilitation and prevention techniques could be more refined by accounting for both influences.

Ischemic heart disease (CHD) is one of the most common diseases of the circulatory system, which is the main cause of death in Ukraine. The purpose of this study was to analyze the incidence, disability, mortality from ischemic heart disease, its individual nosological forms in the adult population evacuated from the 30km zone of the Chernobyl nuclear power plant in the post-accident period, taking into account the age at the date of the accident, sex and time after the accident for further improving the system of dispensary observation evacuees and reducing the risk of cardiovascular complications. The study used epidemiological surveillance data (1988-2016) for the category of the adult evacuated population (18-60years old as of the date of the accident) with a population of 42982 people, of which 58.7% are women according to the data of the State Register of Ukraine of persons injured in as a result of the Chernobyl disaster (GRU). The research results were assessed both in general for ischemic heart disease and the main nosological forms according to ICD-9 and ICD-10. In the study, epidemiological, analytical, mathematical and statistical methods were used, as well as the method of internal comparison (with indicators of 1988-1992). As the results of the study have shown, in the structure of the causes of morbidity, disability and mortality of the adult evacuated population from diseases of the circulatory system, IHD takes a leading place. The statistically significant influence of age, calendar observation period, gender was established. Among nosological forms, chronic CHD is in the lead. Evacuees at the age of18–39years show an increase in the incidence of coronary artery disease with a maximum rate after 17 years, and at the age of 40-60years – at the beginning of the observation with a subsequent noticeable decrease since2003. In recent years (2013-2016), there has been a significant decrease in the incidence of coronary artery disease at the age of 40-60years by 9.3times, and at the age of18-39years, on the contrary, an increase by 3.8times. During the post-accident period, the level of disability and mortality of the studied contingents from ischemic heart disease has significantly increased. High rates of growth of disability in recent years in persons aged18-39at the date of the accident. The mortality rate of the evacuees in recent years has increased in comparison with the early observation period by 5.8times, higher mortality rates in men compared to women. Further more in-depth studies are required to assess the contribution of non-cancer diseases to the total radiation damage to human health.

Self-care performed by patients and the caregiver contribution to this self-care are essential for improving cardiovascular outcomes; however, so far, no studies have sufficiently investigated this field in Italy. This paper describes a research protocol of a multi-center longitudinal study designed to investigate the self-care of patients affected by coronary heart disease (CHD), the caregiver's contribution to this self-care, the predictors of patient and caregiver self-care, the mediating role of self-efficacy, and the self-care outcomes. Data collection will be performed across seven Italian inpatient settings at baseline and 3 and 6 months from enrollment. Multilevel modeling and actor partner interdependence models will be implemented on a sample of 330 patient-caregiver dyads to adjust for the interdependence of measurements. The study received approval from an ethics committee in Italy and was financed in January 2021 by a grant from the Solidal Foundation in Alessandria. This research will advance the knowledge about the self-care process in CHD. The results will guide research and clinical practice by identifying variables sensitive to educational interventions.

Background: In developed countries, cardiovascular disease is the most common cause of both death and functional disability. The last decades, scientific community shows an increasing interest exploring the relationship between religious and health factors. Aim: The aim of the present study was to explore associations between factors related to religiosity and self-reported Coronary Heart Disease (CHD). Material and Method: This was a descriptive observational study, conducted during a 2-year period. The final studied sample consisted of 1062 citizens of Greece. Data collection was performed by using a special designed questionnaire based on relevant literature review. Results: Half of the studied sample was men, (n=529, 49.9%). The majority of participants (77.1%) was living in urban areas of the country and was mean educated (67.1%). When asked about their employment status, most of them (65%) answered that they were professionally active. As far as their medical history is concerned, the majority of participants (88%) had no CHD history, no history of diabetes mellitus (90.3%), no history of dyslipidemias (71.8%) and no history of hypertension (71.8%). Moreover, 29.9% of the participants were overweight. Religious fasting follows 51.4% of the sample and the reason for fasting is because the church imposes fasting rules. The factor “fasting” was also related to CHD occurrence, as those who were following religious fasting had no history of CHD. A significant difference was found between responders with conscious belief in God and CHD occurrence. Conclusion: The findings of this study suggest that factors related to religiosity, such as doubt in God belief and religious fasting may influence CHD incidence. Prospective cohort studies and clinical trial studies that specifically designed to assess the effect of religiosity on CHD outcome are necessary to be conducted.

Fish represents one of the most important dietary sources of omega-3 polyunsaturated fatty acids, which are known to be associated with various health benefits. This study aimed to systematically review existing meta-analyses of observational studies exploring the association between fish intake and various health outcomes. A systematic search of electronic databases was conducted to retrieve a total of 63 studies. Evidence was deemed as possible for the association between higher fish intake and decreased risk of the acute coronary syndrome, liver cancer, and depression, and limited for other outcomes (including age-related macular degeneration, Alzheimer's disease, heart failure, all-cause and coronary heart disease mortality, total and ischaemic stroke) due to heterogeneity between results and potential otherwise inexplicable confounding factors. In conclusion, results from epidemiological studies support the mechanistic effects associated with omega-3 fatty acids from high fish consumption, but evidence needs to be further corroborated with more reliable results.

Coffee and tea are amongst the most consumed beverages worldwide, and are the main source of caffeine in adults. In this review we present findings on the effects of habitual coffee and tea consumption on cardiovascular disease (CVD) prevention. Mild-moderate coffee/ caffeine consumption, at 2-3 cups/day, is associated with beneficial effects on metabolic syndrome, including hypertension and diabetes mellitus, although may elevate lipid levels. Furthermore, coffee consumption reduces the risk of coronary heart disease, heart failure, arrhythmia, stroke, CVD and all cause mortality. Higher tea consumption, in particular green tea, confers similar cardiovascular benefits to coffee with 3 cups/day associated with improved survival in population based studies.

Coronary heart disease (CHD) is defined by atherosclerosis, which may result in stenosis or blockage of the arterial cavity, leading to ischemic cardiac diseases such as angina and myocardial infarction (MI). Accumulating evidence indicates that the gut microbiota play a critical role in the initiation and progression of CHD. The gut microbial metabolite trimethylamine N-oxide (TMAO) is intimately linked to the pathophysiology of CHD. The hepatic flavin-containing monooxygenases (FMOs) convert trimethylamine (TMA) to TMAO. As a result, it is critical to prevent TMA generation. Stilbenes could reduce cardiovascular disease mortality. Twelve stilbenes with inhibitory activity against TMA-lyase were compiled and evaluated in this study. Docking results showed Resveratroloside had the highest Vina score, indicating that it was the most active and might be employed as a lead molecule for further structural modification.

Aim: of this paper is to review the recent literature on the relationship between ectopic fat accumulation and cardiovascular disease. Data synthesis: Ectopic fat is an important predictor of metabolic (in particular insulin resistance) and cardiovascular disease, carrying more risk than general fat accumulation. Recent studies have shown a link between ectopic fat accumulation, as cardiac (epicardial or intra-myocardial fat) and/or visceral and/or hepatic fat, and development of atherosclerosis, coronary heart disease and hypertension. Conclusions: Ectopic fat accumulation is not only a marker of cardiometabolic disease, since through the release of adipocitokines, lipotoxic and glucotoxic agents, participates in the crosstalk with insulin-sensitive organs leading to metabolic, cardiac and vascular dysfunctions., This article version may be used for non-commercial purposes in accordance with CC BY-NC-ND license terms and conditions.

Роль наследственной отягощенности в развитии ишемической болезни сердца (ИБС) не вызывает сомнений. При этом механизмы реализации данного фактора риска до сих пор полностью неизвестны. Множество исследований генов-кандидатов, кодирующих образование пептидов, вовлеченных в процесс воспаления, участвующих в регуляции системы коагуляции и в развитии атеросклероза не принесли существенного результата. Главной проблемой подобных исследований, существенно их лимитирующей, был крайне низкий уровень репликации полученных результатов. Исследование полного генома человека дало новые возможности в изучении этого вопроса. В результате на коротком плече 9 хромосомы был обнаружен локус, ассоциированный с повышением риска развития ИБС. Одним из значимых однонуклеотидных полиморфизмов (ОНП) данной области является rs1333049. В нашем обзоре представлены имеющиеся на сегодняшний день результаты научного поиска., The role of hereditary burden in coronary heart disease (CHD) is beyond doubt. However, the mechanisms of this risk factor are still completely unknown. Multiple studies of candidate genes encoding the formation of peptides involved in inflammation, coagulation, and atherosclerosis have not produced significant results. The main problem of such studies, essentially limiting them, was the extremely low level of replication of the obtained results. The full human genome research gave new possibilities in studying this question. As a result, a locus associated with an increased risk of CHD was found on the short arm of chromosome 9. One of the significant single nucleotide polymorphisms (SNPs) in this region is rs1333049. Our review presents the results of the scientific search available to date., Международный научно-исследовательский журнал, Выпуск 7 (133) 2023

Koronarna bolest srca znači veliki problem današnjice budući da predstavlja veliki socijalnoekonomski problem. U razvijenim zemljama ona predstavlja vodeći uzrok smrtnosti, usprkos činjenici da je u posljednja tri desetljeća smanjena smrtnost uslijed ove bolesti. Javlja se među pripadnicima oba spola, iako se češće javlja kod muškaraca i to u omjeru 4:1. Uzrokuje više smrti, invalidnosti i ekonomskih gubitaka od bilo koje druge bolesti. Koronarna bolest srca predstavlja skup kliničkih sindroma koji su posljedica promijenjene koronarne cirkulacije i neravnoteže između potrebe miokarda za kisikom i opskrbe miokarda kisikom, što uzrokuje ishemiju miokarda. Najčešći uzrok ishemijske bolesti srca je aterosklerotka bolest koronarnih arterija. Ovdje važnu ulogu ima prevencija koronarne bolesti, a možemo ju podijeliti na primarnu i sekundarnu prevenciju. Primarne preventivne mjere odnose se na sprečavanje nastanka kliničkog manifestiranja bolesti, a uključuju sprečavanje nastanka rizičnih faktora ili njihovo uklanjanje, što se odnosi na prestanak pušenja, zdravu prehranu i redovitu tjelesnu aktivnost. Sekundarne mjere prevencije se primjenjuju kod bolesnika kojima je već dijagnosticirana bolest. Uloga fizioterapeuta je pridonositi provedbi preventivnih mjera pravilnom edukacijom i motivacijom pacijenata. Koronarna bolest ujedno predstavlja jedan od najčešćih uzroka srčanog zastoja. Tijekom srčanog zastoja dolazi do nemogućnosti pumpanja krvi u ostale dijelove tijela, što predstavlja hitno stanje i potrebna je brza reakcija osobe koja se nađe u blizini takvog pacijenta. Hitan postupak pružanja kardiopulmonalne reanimacije može pomoći spasiti život unesrećene osobe. Ovdje je bitno poznavanje algoritama osnovnog životnog održavanja što uvelike pridonosi mogućnosti pozitivnog ishoda i povećava vjerojatnost preživljavanja osobe koja je doživjela srčani zastoj. Edukacija zdravstvenih djelatnika i poznavanje postupaka pružanja kardiopulmonalne reanimacije i korištenja automatskog vanjskog defibrilatora uvelike pridonosi sigurnosti osobe koja pruža KPR što ujedno pridonosi bržoj reakciji koja je potrebna u takvim hitnim slučajevima. Coronary heart disease represents a big problem today since it represents a big socio-economic problem. In developed countries, it is the leading cause of mortality, despite the fact that mortality from this disease has decreased in the last three decades. It occurs among members of both sexes, although it occurs more often in men in a ratio of 4:1. It causes more death, disability and economic loss than any other disease. Coronary heart disease represents a set of clinical syndromes as a result of which the coronary circulation is changed and the imbalance between myocardial oxygen demand and myocardial oxygen supply, which causes myocardial ischemia. The most common cause of ischemic heart disease is atherosclerotic disease of the coronary arteries. Coronary disease prevention plays an important role here, and it can be divided into primary and secondary prevention. Primary preventive measures refer to the prevention of the clinical manifestation of the disease, and include the prevention of risk factors or their removal, which refers to smoking cessation, healthy nutrition and regular physical activity. Secondary prevention measures are applied to patients who have already been diagnosed with the disease. The role of physiotherapists is to contribute to the implementation of preventive measures through proper education and motivation of patients. Coronary artery disease is also one of the most common causes of cardiac arrest. During a cardiac arrest, there is an inability to pump blood to other parts of the body, which represents an emergency and requires a quick reaction of a person who is near such a patient. The emergency procedure of providing cardiopulmonary resuscitation can help save the life of an accident victim. Knowledge of basic life support algorithms is essential here, which greatly contributes to the possibility of a positive outcome and increases the probability of survival of a person who has experienced a cardiac arrest. Education of healthcare workers and knowledge of the procedures for providing cardiopulmonary resuscitation and using an automatic external defibrillator greatly contributes to the safety of the person providing CPR, which also contributes to the faster reaction needed in such emergencies.

Background: The angiopoietic endothelial dysfunction in ischemic cardiomyopathy (ICMP) remains unexplored. Aim: The identification of the imbalance of endothelial dysfunction mediators and the number of endothelial progenitor (EPC) and desquamated (EDC) cells in patients with coronary heart disease (CHD) with and without ICMP. Methods: A total of 87 patients (47 with ICMP and 40 without ICMP) were observed. The content of EPCs (CD14+CD34+VEGFR2+) in vein blood and EDCs (CD45−CD146+) in the blood from the coronary sinus and cubital vein was determined by flow cytometry. The contents of HIF-1α and HIF-2α in vein blood as well as that of ADMA and endothelin-1 in sinus plasma and angiopoietin-2, MMP-9 and galectin-3 in both samples were assessed using ELISA, and VEGF, PDGF, SDF-1 and MCP-1 contents using immunofluorescence. Results: ADMA and endothelin-1 levels in the sinus blood were comparable between the patient groups; a deficiency of HIF-1α and excess of HIF-2α were detected in the vein blood of ICMP patients. The EDC content in the vein blood increased in CHD patients regardless of ICMP, and the concentrations of VEGF-A, VEGF-B, PDGF, MCP-1, angiopoietin-2, and MMP-9 were normal. In ICMP patients, vein blood was characterized by an excess of galectin-3 and sinus blood by an excess of EDCs, angiopoietin-2, MMP-9 and galectin-3. Conclusion: ICMP is accompanied by angiopoietic endothelial dysfunction.

BACKGROUND: Car use has been associated with higher risk of coronary heart disease (CHD). However, whether the associations of transport modes with CHD vary by genetic susceptibility to CHD are unknown. This study aims to investigate the associations of genetic susceptibility and modes of transport with incidence of CHD. METHODS: We included 339,588 white British participants from UK Biobank with no history of CHD or stroke at baseline or within two years of follow-up (52.3% in work). Genetic susceptibility to CHD was quantified through weighted polygenic risk scores derived from 300 single-nucleotide polymorphisms related to CHD risk. Categories of transport mode included exclusive car use and alternatives to the car (e.g., walking, cycling and public transport), separately for non-commuting (e.g., getting about [n=339,588] excluding commuting for work), commuting (in the sub-set in work [n=177,370] who responded to the commuting question), and overall transport (transport mode for both commuting and non-commuting [n=177,370]). We used Cox regression with age as the underlying timescale to estimate hazard ratios (HR) of CHD (n=13,730; median 13.8-year follow-up) and tested the interaction between genetic susceptibility and travel modes with adjustment for confounders. RESULTS: Compared to those using alternatives to the car, hazards of CHD were higher for exclusive use of cars for overall transport (HR: 1.16, 95% confidence interval (CI): 1.08-1.25), non-commuting (HR: 1.08, 95% CI: 1.04-1.12) and commuting (HR: 1.16, 95% CI: 1.09-1.23), after adjusting for confounders plus genetic susceptibility. HRs of CHD were 1.45 (95% CI: 1.38-1.52) and 2.04 (95% CI: 1.95-2.12) for the second and third tertile of genetic susceptibility to CHD, respectively, compared to the first. There was, in general, no strong evidence of interactions between genetic susceptibility and categories of overall, non-commuting and commuting transport. Estimated 10-year absolute risk of CHD was lower for the alternatives to the car across strata of genetic susceptibility, compared with exclusive use of cars for overall, non-commuting and commuting transport. CONCLUSION: Exclusive use of cars was associated with a relatively higher risk of CHD across all strata of genetic susceptibility. Using alternatives to the car should be encouraged for prevention of CHD for the general population including individuals at high genetic risk.

Objective: To elucidate the bidirectional correlation of sarcopenia with coronary heart disease (CHD), as well as to investigate the mediating role of cardiometabolic factors and inflammatory biomarkers, a bidirectional two-sample, two-step Mendelian randomization (MR) study was conducted. Methods: Summary statistics were obtained from genome-wide association studies (GWAS). In our bidirectional two-sample MR, genetic variants associated with sarcopenia-related traits and CHD were instrumented for the estimation of bidirectional correlations. Besides, genetic variants associated with thirteen cardiometabolic factors and six inflammatory biomarkers were selected for further mediation analyses. To confirm the consistency of the results, several sensitivity analyses were carried out. Results: Genetically predicted higher appendicular lean mass (OR = 0.835, 95% CI: 0.790–0.882), left hand grip strength (OR = 0.703, 95% CI: 0.569–0.869), right hand grip strength (OR = 0.685, 95% CI: 0.555–0.844), and walking pace (OR = 0.321, 95% CI: 0.191–0.539) reduced CHD risk, while genetic predisposition to CHD did not affect any of the sarcopenia-related traits. Seven mediators were identified for the effects of appendicular lean mass on CHD, including waist-to-hip ratio, hip circumference, systolic blood pressure, low-density lipoprotein cholesterol, total cholesterol, triglycerides, and fasting insulin. The mediation proportion ranged from 10.23% for triglycerides to 35.08% for hip circumference. Hip circumference was found to mediate the relationships between both left (mediation proportion: 24.61%) and right-hand grip strength (24.14%) and CHD, and the link between walking pace and CHD was partially mediated by waist-to-hip ratio (31.15%) and body mass index (26.66%). Conclusion: Our results showed that higher appendicular lean mass, hand grip strength, and walking pace reduced CHD risk, but the causal relationship was not bidirectional. Several mediators were found to mediate the causal pathways between sarcopenia-related traits and CHD, and intervention of these factors may be helpful in terms of CHD prevention in sarcopenia patients.

Objective: This study analyzed the relationship between the coronary FAI on CCTA and coronary adverse events in patients with moderate coronary artery disease based on machine learning. Methods: A total of 172 patients with coronary artery disease with moderate or lower coronary artery stenosis were included. According to whether the patients had coronary adverse events, the patients were divided into an adverse group and a non-adverse group. The coronary FAI of patients was quantified via machine learning, and significant differences between the two groups were analyzed via t-test. Results: The age difference between the two groups was statistically significant (p < 0.001). The group that had adverse reactions was older, and there was no statistically significant difference between the two groups in terms of sex and smoking status. There was no statistical significance in the blood biochemical indexes between the two groups (p > 0.05). There was a significant difference in the FAIs between the two groups (p < 0.05), with the FAI of the defective group being greater than that of the nonperforming group. Taking the age of patients as a covariate, an analysis of covariance showed that after excluding the influence of age, the FAIs between the two groups were still significantly different (p < 0.001).

BackgroundThe majority of patients with suspected acute coronary syndrome presenting to the emergency department will be discharged once myocardial infarction has been ruled out, although a proportion will have unrecognised coronary artery disease. In this setting, high-sensitivity cardiac troponin identifies those at increased risk of future cardiac events. In patients with intermediate cardiac troponin concentrations in whom myocardial infarction has been ruled out, this trial aims to investigate whether outpatient computed tomography coronary angiography (CTCA) reduces subsequent myocardial infarction or cardiac death.MethodsTARGET-CTCA is a multicentre prospective randomised open label with blinded endpoint parallel group event driven trial. After myocardial infarction and clear alternative diagnoses have been ruled out, participants with intermediate cardiac troponin concentrations (5 ng/L to 99th centile upper reference limit) will be randomised 1:1 to outpatient CTCA plus standard of care or standard of care alone. The primary endpoint is myocardial infarction or cardiac death. Secondary endpoints include clinical, patient-centred, process and cost-effectiveness. Recruitment of 2270 patients will give 90% power with a two-sided P value of 0.05 to detect a 40% relative risk reduction in the primary endpoint. Follow-up will continue until 97 primary outcome events have been accrued in the standard care arm with an estimated median follow-up of 36 months.DiscussionThis randomised controlled trial will determine whether high-sensitivity cardiac troponin-guided CTCA can improve outcomes and reduce subsequent major adverse cardiac events in patients presenting to the emergency department who do not have myocardial infarction.Trial registrationClinicalTrials.gov Identifier: NCT03952351. Registered on May 16, 2019.

Coronary heart disease (CHD) is the leading cause of death worldwide. However, current diagnostic tools for CHD, such as coronary computed tomography angiography (CCTA), are poorly suited for monitoring treatment response. Recently, we have introduced an artificial-intelligence-guided integrated genetic–epigenetic test for CHD whose core consists of six assays that determine methylation in pathways known to moderate the pathogenesis of CHD. However, whether methylation at these six loci is sufficiently dynamic to guide CHD treatment response is unknown. To test that hypothesis, we examined the relationship of changes in these six loci to changes in cg05575921, a generally accepted marker of smoking intensity, using DNA from a cohort of 39 subjects undergoing a 90-day smoking cessation intervention and methylation-sensitive digital PCR (MSdPCR). We found that changes in epigenetic smoking intensity were significantly associated with reversion of the CHD-associated methylation signature at five of the six MSdPCR predictor sites: cg03725309, cg12586707, cg04988978, cg17901584, and cg21161138. We conclude that methylation-based approaches could be a scalable method for assessing the clinical effectiveness of CHD interventions, and that further studies to understand the responsiveness of these epigenetic measures to other forms of CHD treatment are in order.

Coronary heart disease (CHD) contributes to decreased health-related quality of life (HRQOL). This review article investigates the factors that can affect the HRQOL in CHD patients. A literature search from PubMed and EBSCO databases was performed until March 2021 with predetermined keywords. The review of 15 included articles showed that many factors that can affect the HRQOL by using EQ-5D instrument in CHD patients, such as education, gender, comorbidity, percutaneous coronary intervention (PCI)/coronary artery bypass graft (CABG) intervention, patient-physician interaction, obesity, physical activity, numbers of medication, smoking, self-efficacy, social/family life, alcohol drinking, income, employment, and behavioral risk factor profile. The top three factors associated with HRQOL in CHD patients were education, gender, and comorbidity. Therefore, we should pay more attention to CHD patients with lower education levels, females, and comorbidity.

Abstrct A composite Air Health Index (AHI) is helpful for separately emphasizing the health risks of multiple stimuli and communicating the overall risks of an adverse atmospheric environment to the public. We aimed to establish a new AHI by integrating daily mortality risks due to air pollution with those due to non-optimum temperature in China. Based on the exposure-response (E-R) coefficients obtained from time-series models, the new AHI was constructed as the sum of excess mortality risk associated with air pollutants and non-optimum temperature in 272 Chinese cities from 2013 to 2015. We examined the association between the “total AHI” (based on total mortality) and total mortality, and further compared the ability of the “total AHI” to predict specific cardiopulmonary mortality with that of “specific AHIs” (based on specific mortalities). On average, air pollution and non-optimum temperature were associated with 28.23% of daily excess mortality, of which 23.47% was associated with non-optimum temperature while the remainder was associated with fine particulate matter (PM2.5) (1.12%), NO2 (2.29%,), and O3 (2.29%). The new AHI uses a 10-point scale and shows an average across all 272 cities of 6 points. The E-R curve for AHI and mortality is approximately linear, without any thresholds. Each one unit increase in “total AHI” is associated with a 0.84% increase in all-cause mortality and 1.01%, 0.98%, 1.02%, 1.66%, and 1.71% increases in cardiovascular disease, coronary heart disease, stroke, respiratory diseases, and chronic obstructive pulmonary disease mortality, respectively. Cause-specific mortality risk estimates using the “total AHI” are similar to those predicted by “specific AHIs”. In conclusion, the “total AHI” proposed herein could be a promising tool for communicating health risks related to exposure to the ambient environment to the public.

Fish represents one of the most important dietary sources of omega-3 polyunsaturated fatty acids, which are known to be associated with various health benefits. This study aimed to systematically review existing meta-analyses of observational studies exploring the association between fish intake and various health outcomes. A systematic search of electronic databases was conducted to retrieve a total of 63 studies. Evidence was deemed as possible for the association between higher fish intake and decreased risk of the acute coronary syndrome, liver cancer, and depression, and limited for other outcomes (including age-related macular degeneration, Alzheimer’s disease, heart failure, all-cause and coronary heart disease mortality, total and ischaemic stroke) due to heterogeneity between results and potential otherwise inexplicable confounding factors. In conclusion, results from epidemiological studies support the mechanistic effects associated with omega-3 fatty acids from high fish consumption, but evidence needs to be further corroborated with more reliable results.

La vitamine K est reconnue pour son rôle dans la coagulation sanguine. Les apports alimentaires de cette vitamine influencent la stabilité de l’anticoagulothérapie à la warfarine sodique. Une intervention visant à augmenter de ≥ 150 μg/j les apports alimentaires de vitamine K a été développée au sein du laboratoire de Guylaine Ferland. Les données préliminaires d’un essai clinique randomisé contrôlé de 24 semaines ont montré que les participants ayant suivi la stratégie alimentaire portant sur la vitamine K ont présenté une anticoagulothérapie plus stable, comparativement aux participants du groupe témoin. Cette stratégie a été décrite afin de fournir les informations nécessaires à son application en pratique clinique. Les anticoagulants demeurent des piliers dans la prévention des évènements thrombotiques notamment chez certaines personnes atteintes de maladies cardiovasculaires (MCV). Parmi les MCV, les maladies du coeur [particulièrement la maladie coronarienne (MC)] sont les plus répandues. La MC peut accélérer le développement de troubles cognitifs avec l’âge, et ce déclin cognitif relève en grande partie de l’atteinte vasculaire sous-jacente. La vitamine K constitue un nutriment d’intérêt pour le système vasculaire et la cognition au cours du vieillissement et aurait le potentiel d'atténuer les effets néfastes de la MC sur le cerveau. Une étude pilote d’intervention de 12 semaines examinant l’impact d’un supplément de 500 μg/j de vitamine K sur les fonctions cognitives et vasculaires d’individus atteints de MC stable a été développée. Ce projet a été implanté à l’Institut de Cardiologie de Montréal en mai 2022, et à ce jour, quatre participants ont complété l’intervention. À terme, cette étude permettra d’obtenir une évaluation préliminaire des bénéfices associés à la supplémentation de vitamine K sur la cognition et à recueillir des preuves suffisantes justifiant la planification d’une étude de plus grande envergure au sein de cette population., Vitamin K is known for its role in blood coagulation. Dietary intakes of this vitamin influence the stability of warfarin anticoagulation therapy. An intervention aiming to increase dietary vitamin K intakes by ≥ 150 μg/d was developed in Guylaine Ferland's laboratory. Preliminary data from a 24-week randomized controlled trial showed that participants who followed the vitamin K dietary strategy had more stable anticoagulation therapy compared to participants in the control group. This strategy was described to provide the necessary information for its application in clinical practice. Anticoagulants remain mainstays in the prevention of thrombotic events notably in certain people with cardiovascular disease (CVD). Among CVD, heart disease [particularly coronary heart disease (CHD)] is the most prevalent. Coronary heart disease can accelerate the development of cognitive impairment with age, and this cognitive decline is largely a consequence of the underlying vascular impairment. Vitamin K is a nutrient of interest for the vascular and nervous systems during aging, and has the potential to mitigate the adverse effects of CHD on the brain. A 12-week pilot study examining the impact of a 500 μg/d vitamin K supplement on cognitive and vascular functions in individuals with stable CHD was developed. This project was implemented at the Montreal Heart Institute in May 2022, and to date, four participants have completed the intervention. This study will provide a preliminary assessment of the benefits associated with vitamin K supplementation on cognition and provide sufficient evidence to justify the planning of a larger study in this population.

BackgroundCoronary heart disease (CHD) and its major risk factor hypertension have both been associated with altered activity of the hypothalamus-pituitary-adrenal (HPA)-axis but the biological mechanisms underlying prospective associations with adverse disease outcomes are unclear. We investigated diurnal HPA-axis activity in CHD-patients, hypertensive (HT) and healthy normotensive men (NT) and tested for prospective associations with biological CHD risk factors.MethodsEighty-three male CHD-patients, 54 HT and 54 NT men repeatedly measured salivary cortisol over two consecutive days. Prospective CHD risk was assessed by changes between baseline and follow-up in the prothrombotic factors D-dimer and fibrinogen, the pro-inflammatory measures interleukin (IL)-6, tumor necrosis factor-alpha (TNF-α), and acute phase protein C-reactive protein (CRP), as well as blood lipids in terms of total cholesterol (tChol)/high-density-lipoprotein cholesterol (HDL)-ratio. We aggregated coagulation and inflammatory measures to respective indices.ResultsThe groups differed in repeated daytime cortisol (dayCort) secretion (p=.005,η2p=.03,f=0.18) and cortisol awakening response (CAR) (p=.006,η2p=.03,f=0.18), with similarly lower overall dayCort and CAR in CHD-patients and HT, as compared to NT. The groups differed further in cortisol at awakening (p=.015,η2p=.04,f=0.20) with highest levels in HT (p´s≤.050), and in diurnal slope between waking and evening cortisol (p=.033,η2p=.04,f=0.20) with steepest slopes in HT (p´s≤.039), although in part not independent of confounders. Lower aggregated dayCort and CAR in terms of area-under-the-curve (AUC) independently predicted increases in future overall CHD risk (AUCdayCort: p=.021,η2p=.10,f=0.33;AUCCAR: p=.028,η2p=.09,f=0.31) 3.00 ± 0.06(SEM) years later, with risk prediction most pronounced in fibrinogen (AUCdayCort: p=.017,ΔR2= 0.12;AUCCAR: p=.082).ConclusionWe found evidence for an HPA-axis hypoactivity in CHD and HT with lower diurnal HPA-axis activity predicting increases in cardiovascular risk as evidenced by increases in circulating levels of biomarkers of atherothrombotic risk. Down-regulation of basal HPA-axis activity may contribute to the pathogenesis of atherosclerosis and thrombosis in CHD via effects on coagulation.

Introduction: Behavioral and physiological risk factors worsen the prognosis of coronary heart disease (CHD). Anxiety is known to be a psychological predictor of CHD. In this study, we investigated whether this factor is associated with all-cause mortality in CHD patients in the long term. Methods: We studied 180 patients (mean age 60.6 SD 9.2 years, 26% women) with CHD from the Berlin Anxiety Trial (BAT) and the Stepwise Psychotherapy Intervention for Reducing Risk in Coronary Artery Disease (SPIRR-CAD) study. Their cardiac and psychological risk profile was represented by standardized procedures, including the Hospital Anxiety and Depression Scale (HADS) questionnaire. Mortality outcomes were assessed using a community-based registry. Results: Of 180 patients, we obtained information on all-cause mortality in 175 (96.7%) after a mean follow-up of 12.2 years (range 10.4–16.6 years). Of all participants, 54.4% had prior myocardial infarction, 95.3% had percutaneous transluminal coronary angioplasty and 22.2% had prior coronary artery bypass graft. Most of the patients (98.4%) had New York Heart Association class I and II, 25.6% had diabetes and 38.2% were smokers. Patients had a mean HADS anxiety score of 9.7 SD 4.1 at study entrance. We found the highest HADS anxiety quartile all-cause mortality in 14%, 30.2% in the middle quartiles and 58.7% in the lowest quartile (chi2 20.8, p = 0.001). Related to psychological mechanisms, a low level of anxiety, seemed to be a significant predictor of all-cause mortality. We found no advantage for patients who had received psychosocial therapy in terms of survival. Conclusion: These first data confirmed our hypothesis about the association of psychological risk factors with the long-term outcome of CAD patients. Future studies will clarify whether the severity of disease, age or a particular type of coping or denial mechanism are associated with the presented outcome in low-anxious patients.

Aortic valve stenosis is the most common valvular heart disease in the Western world. Lipoprotein(a) (Lp(a)) is an independent risk factor of coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS). The aim of this study was to assess the role of Lp(a) and its autoantibodies [autoAbs] in CAVS in patients with and without CHD. We included 250 patients (mean age 69 ± 3 years, males 42%) and divided them into three groups. There were two groups of patients with CAVS depending on the presence (group 1) or absence of CHD (group 2). The control group included the patients without CHD or CAVS. According to logistic regression analysis, levels of Lp(a), IgM autoAbs to oxidized Lp(a) (oxLp(a)), and age were independent predictors of CAVS. A concomitant increase in Lp(a) level (≥30 mg/dL) and a decrease in IgM autoAbs concentration (

Coronary artery bypass graft surgery (CABG) is an impactful treatment for coronary heart disease. Intimal hyperplasia is the central reason for the restenosis of vein grafts after CABG. The introduction of external vascular sheaths around VGs (VGs) can effectively inhibit intimal hyperplasia and ensure the patency of VGs. In this study, the well-known biodegradable copolymer poly (e-caprolactone-co-L, L-lactide) (PLCL) was electrospun into high porosity external sheaths. The prednisone loaded in the PLCL sheath was slowly released during the degradation process of PLCL. Under the combined effects of sheath and prednisone, intimal hyperplasia was inhibited. For the cell experiments, all sheaths show low cytotoxicity to L929 cells at different concentrations at different time intervals. The ultrasonography and histological results showed prominent dilation and intimal hyperplasia of VG without sheath after two months of surgery. But there was no dilation in PLCL and PLCLPrednisone groups. Notably, the prednisone-loaded sheath group exhibited efficacy in inhibiting intimal hyperplasia and ensured graft patency.

Aims This study aimed to evaluate the association between physical activity and the incidence of coronary heart disease (CHD) in individuals with and without CHD risk factors. Methods and results EPIC-CVD is a case-cohort study of 29 333 participants that included 13 582 incident CHD cases and a randomly selected sub-cohort nested within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort. Self-reported physical activity was summarized using the Cambridge physical activity index (inactive, moderately inactive, moderately active, and active). Participants were categorized into sub-groups based on the presence or the absence of the following risk factors: obesity (body mass index ≥30 kg/m2), hypercholesterolaemia (total cholesterol ≥6.2 mmol/L), history of diabetes, hypertension (self-reported or ≥140/90 mmHg), and current smoking. Prentice-weighted Cox regression was used to assess the association between physical activity and incident CHD events (non-fatal and fatal). Compared to inactive participants without the respective CHD risk factor (referent), excess CHD risk was highest in physically inactive and lowest in moderately active participants with CHD risk factors. Corresponding excess CHD risk estimates amongst those with obesity were 47% [95% confidence interval (CI) 32–64%] and 21% (95%CI 2–44%), with hypercholesterolaemia were 80% (95%CI 55–108%) and 48% (95%CI 22–81%), with hypertension were 80% (95%CI 65–96%) and 49% (95%CI 28–74%), with diabetes were 142% (95%CI 63–260%), and 100% (95%CI 32–204%), and amongst smokers were 152% (95%CI 122–186%) and 109% (95%CI 74–150%). Conclusions In people with CHD risk factors, moderate physical activity, equivalent to 40 mins of walking per day, attenuates but does not completely offset CHD risk.

Effective treatment strategies and medical devices continue to be needed in Japan and the United States of America (US) to mitigate the growing burden of cardiovascular disease and coronary heart disease. Unfortunately, there can be a delay in gaining cardiovascular device approval in Japan after a device has already been approved and is in use in the US. The Harmonization by Doing (HBD) program; however, can eliminate this delay and reduce the cost of completing a clinical trial in Japan. The HBD proof-of-concept study, COAST, resulted in approval of the Diamondback 360® Coronary Orbital Atherectomy System Micro Crown simultaneously in Japan and the US on the same day. Subsequently, the Diamondback 360® Coronary OAS Classic Crown also received approval in Japan. The COAST study provides further evidence that global clinical trials via HBD for medical devices are practical and advantageous.

Background: Observational findings for high-density lipoprotein (HDL)-mediated cholesterol efflux capacity (HDL-CEC) and coronary heart disease (CHD) appear inconsistent, and knowledge of the genetic architecture of HDL-CEC is limited. Objectives: A large-scale observational study on the associations of HDL-CEC and other HDL-related measures with CHD and the largest genome-wide association study (GWAS) of HDL-CEC. Participants/methods: Six independent cohorts were included with follow-up data for 14,438 participants to investigate the associations of HDL-related measures with incident CHD (1,570 events). The GWAS of HDL-CEC was carried out in 20,372 participants. Results: HDL-CEC did not associate with CHD when adjusted for traditional risk factors and HDL cholesterol (HDL-C). In contradiction, almost all HDL-related concentration measures associated consistently with CHD after corresponding adjustments. There were no genetic loci associated with HDL-CEC independent of HDL-C and triglycerides. Conclusion: HDL-CEC is not unequivocally associated with CHD in contrast to HDL-C, apolipoprotein A-I, and most of the HDL subclass particle concentrations. publishedVersion

Meat consumption has represented an important evolutionary step for humans. However, modern patterns of consumption, including excess intake, type of meat and cooking method have been the focus of attention as a potential cause of rise in non-communicable diseases. The aim of this study was to investigate the association between total, red and processed meat with health outcomes and to assess the level of evidence by performing a systematic search of meta-analyses of prospective cohort studies. Convincing evidence of the association between increased risk of (i) colorectal adenoma, lung cancer, CHD and stroke, (ii) colorectal adenoma, ovarian, prostate, renal and stomach cancers, CHD and stroke and (iii) colon and bladder cancer was found for excess intake of total, red and processed meat, respectively. Possible negative associations with other health outcomes have been reported. Excess meat consumption may be detrimental to health, with a major impact on cardiometabolic and cancer risk.

BACKGROUND: Oxidative stress and chronic inflammation are among the leading causes of coronary heart disease (CHD). Studies investigated the relationship between dietary antioxidants and the risk/odds of CHD, and contradictory results have been reported. Dietary antioxidant index (DAI) is a novel and reliable nutritional tool that examines the diet’s overall antioxidant capacity. Its validity was examined using serum total antioxidant capacity and malondialdehyde. OBJECTIVE: This study aimed to investigate the relationship between DAI score and odds of CHD. METHODS: In this incidence case-control study, 320 individuals with a definitive diagnosis of CHD and 320 participants without CHD or related risk factors attending the same hospitals/polyclinics were selected as the case and control groups. We estimated the DAI by summing up six standardized intakes of major dietary antioxidants, including manganese, vitamin E, A, C, selenium, and zinc. RESULTS: Modeling DAI categorized according to the median (–0.38), in multi-adjusted model showed a significant protective association with the odd of CHD (OR = 0.72; 95%CI:0.51–0.99, p-value = 0.05). Also, modeling DAI as a continuous variable in multi-adjusted models (OR = 0.94;95%CI:0.90–0.95; p-value = 0.01) showed significant results. CONCLUSION: Using the DAI to investigate the relationship between dietary antioxidants and CHD can show more realistic results than a single study of antioxidants.

[Purpose] Type D personality has recently attracted attention as a psychological factor closely related to the onset and progression of coronary heart disease (CHD). The purpose of this study was to examine the rate of discrimination of the Japanese version of the Type D Scale (DS14) in patients with CHD.[Method] Participants (N=255; 135 patients with CHD, 121 normal adults) completed questionnaires including the Japanese version of the DS14. [Results and discussion] Logistic regression analysis indicated that the discriminative predictive value of the DS14 was 77.0% in patients with CHD, 73.1% in normal adults, and 75.2% overall. A relatively high rate of discrimination was observed, so the current results indicate that Type D personality is closely associated with the development of CHD.【目的】タイプＤパーソナリティは、冠動脈性心疾患（CHD）の発症と進行に密接に関連する心理的要因として最近注目を集めている。本研究の目的は、CHD患者における日本語版DS14の判別率について検討することである。【方法】CHD患者135名および健常者121名に日本語版Type D Scale-14（DS14）の回答を求めた。【結果と考察】ロジスティック回帰分析を行った結果、患者群において77.0%、健常者群において73.1%、全体として75.2%の判別率が示された。これらの結果は、比較的高い判別率が認められたことから、タイプＤパーソナリティ性格がCHDの発症に高い関連性を有することを示している。

The purpose of this study is to explore the relationship between Chinese visceral adipose index (CVAI) and the risk of coronary heart disease (CHD) in Chinese through a large cohort study.This study included 42,165 adults who were without CHD at baseline and who completed at least one annual follow-up between 2009 and 2016. We used the Cox proportional hazards model to estimate Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) for the association between CVAI and risk of CHD. During the median follow-up of 3.36 years (154,808 person years), 520 participants developed CHD, including 374 males and 146 females. Compared with the first quartile of CVAI, the risk of CHD was significantly increased in the fourth quartile of CVAI in multivariate model (HR [95% CI]: 9.92 [5.45, 18.04], P 0.001). Sensitivity analysis by excluding incident CHD developed in the first two years of follow-up reinforced our results. Gender stratification analyses showed that the relationship between CVAI and CHD risk was higher in males than that in females. The restricted cubic spline showed a non-linear dose-response relationship between CVAI and CHD risk. In addition, CVAI was associated with CHD risk in the subgroups of participants without T2DM, without hypertension, and without fatty liver.CVAI was significantly associated with the risk of CHD. Individuals should keep CVAI at normal level to prevent CHD.

Background Measurement of biomarkers of vascular inflammation is advocated for the risk stratification for coronary heart disease (CHD). Objectives To systematically explore the added valu...

Background The Coronary Revascularisation Outcome Questionnaire (CROQ) measures health-related quality of life and outcome of invasive revascularization procedures such as percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The CROQ has not been properly validated in Norwegian patient populations. The aim of this study was to examine the psychometric properties of the Norwegian CROQ in patients admitted to elective coronary angiographic assessment and receiving PCI. Moreover, to examine its discriminative ability to detect disease severity and effects of invasive coronary treatment. Methods The patients (N = 280, Mage = 66.9, SDage = 8.91) completed the CROQ, prior to an elective coronary angiography and at one year follow-up. Analyses included internal consistency, floor and ceiling effects, and confirmatory and exploratory factor analyses of the CROQ. Convergent validity was evaluated by comparing CROQ scores with the RAND-12 measure. Sensitivity to treatment was examined by comparing pre-post effect size differences between the PCI treatment and non-treatment group. Results Significant stenosis qualifying for a PCI was detected in 121 (35.1%) patients. The model fit of the original CROQ factor model was inadequate in the PCI group. All but one of the CROQ items demonstrated ceiling effects. The CROQ failed to discriminate between patients’ disease severity prior to the coronary angiography, or improvement in those receiving versus not receiving PCI. Conclusion The present study of the Norwegian version of the CROQ identified serious problems with the factor structure, ceiling effects, and lack of sensitivity for disease severity and effects of invasive treatment. Currently, one cannot recommend the use of CROQ in clinical practice.

Yi Zhou,1 Qiwen Huo,1 Shaoying Du,1 Xiaoyang Shi,1 Qisong Shi,2 Shanshan Cui,3 Cuina Feng,4 Xiaojing Du,1 Yan Wang1 1School of Nursing, Hebei University, Baoding, Hebei, People’s Republic of China; 2Department of Cardiovascular Medicine, The Second Hospital of Baoding, Baoding, Hebei, People’s Republic of China; 3Department of General Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of China; 4Department of Cardiovascular Medicine, Affiliated Hospital of Hebei University, Baoding, Hebei, People’s Republic of ChinaCorrespondence: Yan WangSchool of Nursing, Hebei University, 342 Yuhuadong Road, Baoding, Hebei, 071000, People’s Republic of China, Tel/Fax +86 3125075605, Email chjanwy@163.comPurpose: Medication non-adherence is a major public health issue. Recent evidence suggests that depression, inadequate social support, and lower levels of self-efficacy are associated with poor medication adherence. However, the mechanism underlying the association among depression, social support, self-efficacy and medication adherence is unclear. This study aims to examine the mediating role of social support and self-efficacy between depression and medication adherence in older patients with coronary heart disease.Patients and Methods: Data were collected from 238 hospitalized older patients with coronary heart disease. Depression, social support, self-efficacy, and medication adherence were assessed using structured questionnaires. A serial multiple mediation model was tested using the PROCESS macro for SPSS.Results: A total of 238 older patients with CHD with a mean age of 70.5 years were involved in this cross-sectional study. Depression was negatively correlated with medication adherence in older patients with coronary heart disease. Social support and self-efficacy were positively associated with medication adherence, and fully mediated the relationship between depression and medication adherence. Three mediation paths were included in the model: (a) social support, (b) chain combination of social support and self-efficacy, and (c) self-efficacy.Conclusion: Social support and self-efficacy explain the association of depression and medication adherence in older CHD patients and may be the keys target for enhanced intervention to improve medication adherence in older CHD patients with depression.Keywords: coronary heart disease, depression, medication adherence, self-efficacy, social support

This study aimed to explore whether liquiritin affects the development of coronary heart disease by regulating the proliferation and migration of human vascular smooth muscle cells (hVSMCs). A 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyl-2 H-tetrazolium bromide (MTT) assay and lactate dehydrogenase (LDH) release detection were performed to measure the toxic effects of liquiritin on hVSMCs. An in vitro atherosclerosis model in hVSMCs was established using oxidized low-density lipoprotein (ox-LDL), and cell proliferation and apoptosis were detected using an MTT assay and flow cytometry analysis. Western blotting and reverse transcriptase quantitative polymerase chain reaction (RT-qPCR) were used to detect protein and mRNA expressions, respectively. Caspase3 activity and cell migration were measured using an activity detection kit and Transwell assay, respectively. The results indicated that liquiritin at doses

У статті представлені матеріали наукової конференцій «Карпатські читання 2016». Доповідь С.М. Кузнєцової була присвячена можливостям корекції енергетичного обміну та ендотеліальної дисфункції у хворих на церебральний атеросклероз. Представлені функції і значення ендотелію в організмі. А також обгрунтовано показання та переваги застосування препарату Капікор у хворих із дисциркуляторною енцефалопатією. У доповіді Воронкова Л.Г. відображена важливість своєчасної корекції функції ендотелію як ключової ланки превентивної судинної медицини. Соломенчук Т.М. розповіла про можливості метаболічної терапії при різних формах ішемічної хвороби серця.

Проведений аналіз результатів обстеження 120 пацієнтів із хронічним панкреатитом та ішемічною хворобою серця. Одночасно зі стандартним обстеженням цим пацієнтам проводилась доплерографія черевного відділу аорти та її вісцеральних гілок, а також правої плечової артерії.

Li Wang,1 Sha Li,1 Yihao Mo,1 Mingliang Hu,1 Junwei Zhang,1 Min Zeng,1 Huafeng Li,1 Honglei Zhao2 1Department of Nephrology, People’s Hospital of Longhua District, Shenzhen, Guangdong, People’s Republic of China; 2Department of Cardiology, Fuwai Hospital Chinese Academy of Medical Science, Shenzhen, Guangdong, People’s Republic of ChinaCorrespondence: Honglei Zhao, Tel + 86-755-23650123, Email zhldoctor@tom.comPurpose: The current study was to evaluate the gender-disparities in the in-hospital thrombotic and bleeding events among patients with chronic kidney disease (CKD) undergoing percutaneous coronary intervention (PCI).Patients and Methods: Patients with CKD undergoing PCI were retrospectively enrolled. Baseline characteristics, and thrombotic and bleeding events occurred during hospitalization were collected and compared by gender.Results: Compared to males (n = 558), females (n = 402) were older and more likely to have diabetes mellitus (37.1% vs 29.7%). Females had a lower estimated glomerular filtration rate (eGFR; 51.2 ± 7.9 vs 54.6 ± 5.1 mL/min/1.73m2) and were more likely to undergo urgent PCI (66.7% vs 60.2%) and use glycoprotein IIb/IIIa inhibitor (15.4% vs 7.5%) at peri-PCI period. Compared to males, females had a higher rate of in-hospital mortality which was due to thrombotic events (9.0% vs 3.4%). Females also had a higher rate of moderate-to-severe hemorrhage (8.0% vs 3.2%). After multivariable adjustment, diabetes mellitus (odds ratio [OR] 1.15 and 95% confidence interval [CI] 1.07– 1.29) and acute coronary syndrome (ACS) presentation (OR 1.53 and 95% CI 1.34– 1.93) were associated with gender-disparities in composite thrombotic events. Ageing (OR 1.10 and 95% CI 1.02– 1.33), diabetes mellitus (OR 1.21 and 95% CI 1.07– 1.40) and glycoprotein IIb/IIIa inhibitor use (OR 1.13 and 95% CI 1.02– 1.28) were associated with composite bleeding events.Conclusion: Females with CKD undergoing PCI had a higher risk of experiencing in-hospital thrombotic and bleeding events than males.Keywords: coronary heart disease, chronic kidney disease, prognosis, gender

A large percentage of people are being exposed to mortality due to cardiovascular diseases. Convention approaches have not provided satisfactory outcomes in the management of these diseases. To overcome the limitations of conventional approaches, nanomaterials like nanoparticles, nanotubes, micelles, lipid-based nanocarriers, dendrimers, and carbon-based nanoformulations represent the new aspect of diagnosis and treatment of cardiovascular diseases. The unique inherent properties of the nanomaterials are the major reasons for their rapidly growing demand in the field of medicine. Profound knowledge in the field of nanotechnology and biomedicine is needed for the notable translation of nanomaterials into theranostic cardiovascular applications. In this review, the authors have summarized different nanomaterials which are being extensively used to diagnose and treat the diseases, such as coronary heart disease, myocardial infarction, atherosclerosis, stroke and thrombosis.

Sidik Maulana,1 Aan Nuraeni,2 Bambang Aditya Nugraha3 1Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia; 2Department of Critical Care and Emergency Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, Indonesia; 3Department of Medical-Surgical Nursing, Faculty of Nursing, Universitas Padjadjaran, Bandung, IndonesiaCorrespondence: Aan NuraeniDepartment of Critical Care and Emergency, Faculty of Nursing, Universitas Padjadjaran, Sumedang, Indonesia, Tel + 6285624217606, Fax +022-7795596, Email aan.nuraeni@unpad.ac.idBackground: This study sought to determine whether uric acid levels have a relationship with and can potentially be used as a prognosis for coronary heart disease (CHD) biomarkers using a scoping review.Methods: This study was conducted following Arksey and O’Malley’s scoping review framework. It was reported as obeying the Preferred Reporting Item for Systematic Review and Meta-analysis for Scoping Review (PRISMA-ScR). The subject was extensively searched for in PubMed, CINAHL, and ScienceDirect. The inclusion criteria in the study were that the sources were journal articles written in English and were available in full text. The age of the subject in the item is the elderly population to capture the relationship between uric acid levels and the prognosis of CHD. The publication time limit was 2010 to 2020. The study was analyzed using thematic analysis.Results: We identified 592 studies in our initial search, and 21 studies with a cohort design were included in this study’s analysis. The majority of the evidence suggests an independent correlation with a poor prognosis of CHD in the elderly population. The prognosis of gout includes the prognosis of clinical outcome, severity, and mortality, all of which influence the prognosis value, which becomes a marker.Conclusion: Uric acid levels have been identified as a potential biomarker for poor CHD prognosis. Nurses and other healthcare workers should learn how to control poor CHD prognosis.Keywords: biomarker, coronary heart disease, prognosis, uric acid

BACKGROUND: Coronary artery disease, one of the leading causes of mortality and morbidity globally, is a major burden on healthcare resources. Cardiovascular rehabilitation is highly recommended for the early recovery of patients with Ischemic heart disease by improving the functional capacity and decreasing disease progression. A randomized controlled trial was conducted to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters. MATERIALS AND METHODS: Sixty-two adult patients who underwent percutaneous coronary intervention (PCI) were randomised to two groups to assess the effect of nurse-led cardiac rehabilitation (CR) on behavioural parameters, including adherence to drugs, cardiac diet, lifestyle changes, and selected physiological parameters. The intervention group had nurse-led individualized discharge counseling and clinical follow-up by telephone, whereas the control group received usual care. The comparisons between the control and intervention groups were made using independent Student's t-test or Mann–Whitney U test as appropriate. Pre-test and post-test scores were compared using paired t-test; all tests performed at 5% significance level. RESULTS: Participants in the intervention group presented with moderate to good smoking cessation, improved adherence to drugs (P < 0.0001), physically active lifestyle in 90.3 versus 45.2% (P < 0.0001), adherence to dietary changes, and improved healthcare satisfaction (P < 0.0001). There was also a significant reduction in triglycerides level in the intervention group at 62.51 versus 20.12 mg/dl in the control arm with (P < 0.05), and better controlled physiological indices, including a reduction in systolic blood pressure of 1.54 vs-7.12 mmHg (P = 0.003), bodyweight reduction of 2.48 kg versus-0.09 kg (P < 0.0001) and body mass index of 0.9 versus-0.05 (P < 0.0001). CONCLUSION: Personalised, nurse-led CR significantly improved the participants adherence to healthy lifestyle behaviors and decreased the cardiac risk factors in patients with coronary artery disease.

Cardiovascular rehabilitation (CR) significantly improves outcomes in patients with cardiovascular diseases (CVD), especially coronary heart disease and heart failure (HF). Although CR is often considered as an exercise training (ET) program for patients following CVD events, CR is more than just ET as it involves education, dietary and psychological counseling, as well as a multi-factorial risk factor modification. However, a major component of ET involves efforts to measure and improve levels of cardiorespiratory fitness (CRF). In this state-of-the-art review, we analyze the data, including from our John Ochsner Heart and Vascular Institute, evaluating CRF and its impact on psychological improvements and major outcomes with CR, especially long-term survival.

Leptin and proprotein convertase subtilisin kexin 9 (PCSK9) play an important role in regulating blood lipid concentration. Recently, they have been found to show the ability to independently regulate the immune response. Vascular immune response has an important pathological function in the development of coronary heart disease (CHD) and thrombosis. The aim of this study was to explore the relationship between leptin, PCSK9, and vascular endothelial cell related inflammatory factors. First, detailed clinical information were collected and analyzed for 27 patients with stable CHD and corresponding 27 healthy controls. Second, using liquid-phase protein chip technology, leptin, PCSK9, and vascular-related inflammatory factors, such as E-selectin, vascular cell adhesion protein 1 (VCAM-1), intercellular cell adhesion molecule-1 (ICAM-1), interferon-gamma (IFN-γ), and interleukin-17 (IL-17), were detected on the same platform. Finally, the correlation between leptin, PCSK9, and the inflammatory factors was analyzed. Through collecting clinical information of patients, it was suggested that there was a significant positive correlation between leptin and blood lipid level in CHD. Compared with healthy people, the levels of leptin, PCSK9, E-selectin, and ICAM-1 were significantly high in patients with CHD. There was a high positive correlation between leptin and E-selectin, ICAM-1, IFN-γ, and IL-17. Also, a high positive correlation between PCSK9 and E-selectin, IFN-γ, and IL-17 concentrations was observed. In general, leptin and PCSK9 may not only be able to regulate lipid metabolism, but may also be able to regulate inflammation in CHD.

Objectives To analyze the correlations between family care, coping strategies and the subject well-being (SWB) of patients with coronary heart disease (CHD) after percutaneous coronary intervention (PCI). Methods From November 2019 to October 2020, 264 CHD patients who had undergone PCI were enrolled in this questionnaire survey. The research tools applied included General Information Questionnaire, the Adaptation, Partnership, Growth, Affection and Resolve, Medical Coping Modes Questionnaire, and the General Well-being Schedule. SPSS 24.0 and Amos 23.0 software packages were used for statistical analysis. Results The mean scores for family care, confrontation, avoidance, acceptance-resignation and SWB, were 7.59 ± 2.24, 20.03 ± 3.78, 16.49 ± 2.70, 10.42 ± 2.01, and 73.31 ± 11.63, respectively. Subgroup analysis showed that the path coefficient between family care and subjective well-being was higher in males than females. Family care was directly related to coping strategies. The coping strategies were directly related to SWB, while family care showed an indirect association with SWB via coping strategies. Conclusions Family care can improve CHD patients' SWB post-PCI, and coping strategies are important for the link between family care and SWB. Also, men received more family care than women. Based on a patient's characteristics, healthcare providers can promote patients' positive coping strategies, increase their perceived family care, and improve the patient's SWB.