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Background Patients with coronary heart disease (CHD) with and without diabetes mellitus have an increased risk of recurrent events requiring multifactorial secondary prevention of cardiovascular risk factors. We compared prevalences of cardiovascular risk factors and its determinants including lifestyle, pharmacotherapy and diabetes mellitus among patients with chronic CHD examined within the fourth and fifth EUROASPIRE surveys (EA-IV, 2012–13; and EA-V, 2016–17) in Germany. Methods The EA initiative iteratively conducts European-wide multicenter surveys investigating the quality of secondary prevention in chronic CHD patients aged 18 to 79 years. The data collection in Germany was performed during a comprehensive baseline visit at study centers in Würzburg (EA-IV, EA-V), Halle (EA-V), and Tübingen (EA-V). Results 384 EA-V participants (median age 69.0 years, 81.3% male) and 536 EA-IV participants (median age 68.7 years, 82.3% male) were examined. Comparing EA-IV and EA-V, no relevant differences in risk factor prevalence and lifestyle changes were observed with the exception of lower LDL cholesterol levels in EA-V. Prevalence of unrecognized diabetes was significantly lower in EA-V as compared to EA-IV (11.8% vs. 19.6%) while the proportion of prediabetes was similarly high in the remaining population (62.1% vs. 61.0%). Conclusion Between 2012 and 2017, a modest decrease in LDL cholesterol levels was observed, while no differences in blood pressure control and body weight were apparent in chronic CHD patients in Germany. Although the prevalence of unrecognized diabetes decreased in the later study period, the proportion of normoglycemic patients was low. As pharmacotherapy appeared fairly well implemented, stronger efforts towards lifestyle interventions, mental health programs and cardiac rehabilitation might help to improve risk factor profiles in chronic CHD patients.

Patients with coronary heart disease (CHD) with and without diabetes mellitus have an increased risk of recurrent events requiring multifactorial secondary prevention of cardiovascular risk factors. We compared prevalences of cardiovascular risk factors and its determinants including lifestyle, pharmacotherapy and diabetes mellitus among patients with chronic CHD examined within the fourth and fifth EUROASPIRE surveys (EA-IV, 2012-13; and EA-V, 2016-17) in Germany.The EA initiative iteratively conducts European-wide multicenter surveys investigating the quality of secondary prevention in chronic CHD patients aged 18 to 79 years. The data collection in Germany was performed during a comprehensive baseline visit at study centers in Würzburg (EA-IV, EA-V), Halle (EA-V), and Tübingen (EA-V).384 EA-V participants (median age 69.0 years, 81.3% male) and 536 EA-IV participants (median age 68.7 years, 82.3% male) were examined. Comparing EA-IV and EA-V, no relevant differences in risk factor prevalence and lifestyle changes were observed with the exception of lower LDL cholesterol levels in EA-V. Prevalence of unrecognized diabetes was significantly lower in EA-V as compared to EA-IV (11.8% vs. 19.6%) while the proportion of prediabetes was similarly high in the remaining population (62.1% vs. 61.0%).Between 2012 and 2017, a modest decrease in LDL cholesterol levels was observed, while no differences in blood pressure control and body weight were apparent in chronic CHD patients in Germany. Although the prevalence of unrecognized diabetes decreased in the later study period, the proportion of normoglycemic patients was low. As pharmacotherapy appeared fairly well implemented, stronger efforts towards lifestyle interventions, mental health programs and cardiac rehabilitation might help to improve risk factor profiles in chronic CHD patients.

Additional file 2. EuroAspire IV Germany I Follow-up interview I Questionnaire.

Additional file 1: Supplemental Table 1. Current smokers at index event* (n = 124) stratified by their participation at telephone-based follow-up interview. Supplemental Table 2. Clinical data of current smokers at index event* (n = 104) stratified by their smoking status reported 3.5 years later. Supplemental Table 3. Factors associated with smoking cessation (block-wise multivariable logistic regression).

WOS: 000468732700018, PubMed ID: 31054483, Background and aims: One of the objectives of the ESC-EORP EUROASPIRE V survey is to determine how well European guidelines on the management of dyslipidaemias are implemented in coronary patients. Methods: Standardized methods were used by trained technicians to collect information on 7824 patients from 130 centers in 27 countries, from the medical records and at a visit at least 6 months after hospitalization for a coronary event. All lipid measurements were performed in one central laboratory. Patients were divided into three groups: on high-intensity LDL-C-lowering-drug therapy (LLT), on low or moderate-intensity LLT and on no LLT. Results: At the time of the visit, almost half of the patients were on a high-intensity LLT. Between hospital discharge and the visit, LLT had been reduced in intensity or interrupted in 20.8% of the patients and had been started or increased in intensity in 11.7%. In those who had interrupted LLT or had reduced the intensity, intolerance to LLT and the advice of their physician were reported as the reason why in 15.8 and 36.8% of the cases, respectively. LDL-C control was better in those on a high-intensity LLT compared to those on low or moderate intensity LLT. LDL-C control was better in men than women and in patients with self-reported diabetes. Conclusions: The results of the EUROASPIRE V survey show that most coronary patients have a less than optimal management of LDL-C. More professional strategies are needed, aiming at lifestyle changes and LLT adapted to the need of the individual patient., ESC - EORP; AmgenAmgen; Eli LillyEli Lilly; PfizerPfizer; SanofiSanofi-Aventis; Ferrer; Novo NordiskNovo Nordisk, The EUROASPIRE V survey was carried out under the auspices of the ESC - EORP. Since the start of EORP, the following companies have supported the programme: Amgen, Eli Lilly, Pfizer, Sanofi, Ferrer and Novo Nordisk. The sponsors of the EUROASPIRE surveys had no role in the design, data collection, data analysis, data interpretation, decision to publish, or writing the manuscript.

BACKGROUND AND OBJECTIVE Implantation of a VDD pacemaker (ventricular pacing; dual sensing [atrial and ventricular]; dual response [triggered + inhibited]) together with a single VDD electrode catheter restores synchronous AV ventricular stimulation in patients with higher-grade AV block and intact sinus function. If higher-frequency stimulation occurs it may be a sign of pacemaker malfunction or of inadequate pacemaker programming. This study was undertaken to determine, at first follow-up examination, in how many patients with a VDD pacemaker VVI stimulation occurred more than 5% of the time; how such patients differed from those with 5% or fewer VVI stimulations; and whether a changed program reduced the proportion of VVI stimulations. PATIENTS AND METHODS 67 consecutive patients were tested 1 to 3 months after implantation of the Unity VDD pacemaker (Sulzer Intermedics). The frequency of VVI stimulations was determined via a diagnostic pacemaker memory store. After intermediate analysis, programming was optimized and the patients then re-tested 12 months after the initial implantation. RESULTS At the first follow-up examination 54 patients had VVI stimulations of 5% of the time (19.8 +/- 10.7%). The two groups differed significantly from one another in their lower intervention frequency ( 5% VVI stimulations: 58 +/- 5/min). In particular, the pacemakers in patients with > 5% VVI stimulations had been significantly more often programmed to values of > 50/min. As a result, the pacemakers of these patients were reprogrammed to a lower frequency. A year after implantation there was no longer any difference in the lower intervention frequency, 44 +/- 4/min, between patients with initially > 5% VVI stimulations and those with initially 95%. INTERPRETATION At first follow-up, patients with > 5% VVI stimulations differed from those with 95% by reducing the lower intervention frequency to < or = 50/min.

Da sich die Stimulationsimpedanz invers zum Stimulationsstrom verhalt, senken hohe Impedanzwerte bei gleichbleibenden Stimulationsimpulsen zusatzlich den Stimulationsstrom. Inwieweit der intraoperativ gemessene Impedanzwert der Ventrikelstimulation reprasentativ fur den Langzeitverlauf ist, wurde bei 87 Patienten untersucht, die die VDD-Einzelelektrode UniPass 425 und den Schrittmacher Unity (Sulzer Intermedics) erhalten hatten. Es wurden die Impedanzanderungen zwischen Implantations- und 6-Monats-Zeitpunkt ermittelt. Als gleiche Impedanzwerte wurde definiert, wenn beide Meswerte ≤± 100 Ω voneinander abwichen. Kleinere bzw. grosere Impedanzwerte lagen 6 Monate nach Implantation vor, wenn sie sich > ± 100 Ω vom Implantationswert unterschieden. Intraoperativ betrug die Impedanz 535 ± 98 Ω (Spannweite: 333–811 Ω) und war nach 6 Monaten signifikant auf 604 ± 160 Ω (Spannweite: 361–1150 Ω) angestiegen. Der Unterschied zwischen den beiden Impedanzwerten betrug 69 ± 162 Ω (Spannweite: -336 bis +560 Ω). Gleiche Impedanzwerte lagen bei 43 (Implantation: 527 ± 75 Ω, 6 Monate: 531 ± 87 Ω), kleinere bei 11 (Implantation: 660 ± 83 Ω, 6 Monate: 494 ± 73 Ω) und grosere bei 33 Patienten (Implantation: 503 ± 99 Ω, 6 Monate: 735 ± 168 Ω) vor. Im Vergleich zu den Patienten mit gleichbleibenden Impedanzwerten hatten Patienten mit niedrigeren Impedanzen bei Implantation signifikant hohere Ausgangswerte. Schlusfolgerungen: Die Stimulanzimpedanz nimmt im Laufe von 6 Monaten nach Implantation signifikant zu. Bei 51% der Patienten kommt es zu deutlichen Veranderungen der Stimulationsimpedanz. Diese lassen sich in der Tendenz, aber nicht im Einzelfall voraussagen.

As pacing impedance is inversely related to pacing current, the increase of pacing impedance additionally decreases pacing current. Whether the impedance measurement at implantation predicts the outcome during follow-up, was studied in 87 patients who received the VDD-single lead UniPass 425 connected to the pacemaker Unity (Sulzer Intermedics). The impedance changes between implantation and 6 months follow-up were assessed for each patient. Similar impedance values were defined, if the two measurements were within a rangeor = -100 to +100 omega. Six-months impedance was lower or higher compared to implantation, if the difference exceeded-100 or+100 omega. At implantation, impedance was 535 +/- 98 omega (range: 333-811 omega) and significantly increased to 604 +/- 160 omega (range: 361-1150 omega) after 6 months. Mean difference between the two measurements was 69 +/- 162 omega (range: -336 bis + 560 omega). Similar impedance had 43 (implantation: 527 +/- 75 omega, 6 months: 531 +/- 87 omega), lower values 11 (implantation: 660 +/- 83 omega, 6 months: 494 +/- 73 omega) and higher values 33 patients (implantation: 503 +/- 99 omega, 6 months: 735 +/- 168 omega). Compared to the patients with similar impedance patients with lower impedance had a significantly higher impedance values at implantation.Pacing impedance increased significantly within 6 months after implantation. Pacing impedance changed100 omega in 51% of the patients. The long-term follow-up of pacing impedance can be predicted generally, but not for the individual patient.

Implantation of a VDD pacemaker (ventricular pacing; dual sensing [atrial and ventricular]; dual response [triggered + inhibited]) together with a single VDD electrode catheter restores synchronous AV ventricular stimulation in patients with higher-grade AV block and intact sinus function. If higher-frequency stimulation occurs it may be a sign of pacemaker malfunction or of inadequate pacemaker programming. This study was undertaken to determine, at first follow-up examination, in how many patients with a VDD pacemaker VVI stimulation occurred more than 5% of the time; how such patients differed from those with 5% or fewer VVI stimulations; and whether a changed program reduced the proportion of VVI stimulations.67 consecutive patients were tested 1 to 3 months after implantation of the Unity VDD pacemaker (Sulzer Intermedics). The frequency of VVI stimulations was determined via a diagnostic pacemaker memory store. After intermediate analysis, programming was optimized and the patients then re-tested 12 months after the initial implantation.At the first follow-up examination 54 patients had VVI stimulations ofor = 5% (0.5 +/- 0.9%) and 13 had5% of the time (19.8 +/- 10.7%). The two groups differed significantly from one another in their lower intervention frequency (or = 5% VVI stimulations: 47 +/- 6/min;5% VVI stimulations: 58 +/- 5/min). In particular, the pacemakers in patients with5% VVI stimulations had been significantly more often programmed to values of50/min. As a result, the pacemakers of these patients were reprogrammed to a lower frequency. A year after implantation there was no longer any difference in the lower intervention frequency, 44 +/- 4/min, between patients with initially5% VVI stimulations and those with initiallyor = 5% stimulations. At the same time, the proportion of VVI stimulations fell to 4 +/- 6%, with 67% of patients having AV synchronicity of95%.At first follow-up, patients with5% VVI stimulations differed from those withor = 5% stimulations with regard to an increased lower intervention frequency. In most of these patients the proportion of AV stimulations was increased to95% by reducing the lower intervention frequency toor = 50/min.

Katalase reagiert in wasriger Losung mit dem hydratisierten Elektron und mit dem OH-Radikal mit Geschwindigkeitskonstanten von 3,7.109 bzw. 8,3.1010 Mol−11. sec−1. Die Reaktion OH + Katalase it diffusionskontrolliert, obgleich ein Teil der Aminosaren der Katalase im isolierten Zustand nicht bei jeder Begegnung mit einem OH-Radikal reagiert. Aus den Messungen ergibt sich ein Diffusionskoeffizient des OH-Radikals von 2,3.10−5 cm2. sec−1. Die Ergebnisse werden im Hinblick auf die Strahlenzersetzung der Katalase in wasriger Losung und auf den Einflus der Katalase auf die Strahlenempfindlichkeit biologischer Systeme diskutiert. Es wird ferner eine Hypothese vorgetragen, nach der Reaktionen kleiner Radikale mit Monomeren, die zwar schnell, aber nicht ausschlieslich diffusionskontrolliert enfolgen, zu diffusionskontrollierten Prozessen werden konnen, wenn der Reaktionspartner eine aus derselben Grundeinheit aufgebaute Makromolekel ist. Catalase reacts with the hydrated electron and the OH radical in aqueous solutions with rate constants of 3.7. 109 and 8.3.1010 mole−1 1. sec−1, respectively. The reaction OH + catalase is diffusion-controlled, although part of the amino acids of catalase does not react at every collision with an OH radical under isolated conditions. A diffusion coefficient of 2.3.10−5 cm2.sec−1 of the OH radical is derived from the measurements. The results are discussed with respect to the radiolysis of catalase in aqueous solution and to the influences of catalase on the radiation sensitivity of biological systems. It is also postulated that fast but not exclusively diffusion-controlled reactions of small radicals with monomers may become diffusion-controlled if the reaction partner is a macromolecule consisting of the same kind of base units.

Zusammenfassung Die Geschwindigkeitskonstanten der Reaktionen freier Radikale aus der Radiolyse des Wassers mit H 2 Se und HSe - wurden bestimmt. H 2 Se wird auch durch organische Radikale oxidiert, wobei intermediar ein Komplex auftritt: . Die Gleichgewichtskonstante K und Zerfallskonstante k wurden fur verschiedene Komplexe H 2 SeR bestimmt. Das Endprodukt der Pulsradiolyse ist Wasserstoffdiselenid, H 2 Se 2 . Das Spektrum dieses Teilchens ist identisch mit dem Spektrum des Produkts, das man durch Autoxidation von H 2 Se in wassriger Losung bei kleinem Umsatz erhalt. Die pK-Werte der Gleichgewichte und wurden pulsradiolytisch zu 1,7 bzw. 9,3 bestimmt. Das HSe-Radikal entsteht als Zwischenprodukt der Radiolyse. HSe absorbiert maximal bei 3500 A ( e = 3,0.10 2 l mol −1 cm −1 = 30 m 2 mol −1 ), Se - bei 4500 A ( e = 3,8.10 2 l mol −1 cm −1 = 38 m 2 mol −1 ). Die Geschwindigkeitskonstanten 2 k der Reaktionen 2HSe→H 2 Se 2 und 2Se - →Se 2 2- wurden zu 8,1.10 9 bzw. 4,6.10 9 l mol −1 s −1 bestimmt. HSe lagert sich an HSe - an ( k etwa gleich 5.10 9 l mol −1 s −1 ). H 2 Se 2 - absorbiert bei 4100 A mit e = 8,6.10 3 l mol −1 s −1 = 860 m 2 mol −1 . Die Konstante des Gleichgewichts betragt 6.10 −5 mol l −1 . H 2 Se 2 - verschwindet bei pH-Werten unter etwa 3,8 (pK des H 2 Se) nach zweiter Ordnung, indem HSe-Radikale im Gleichgewicht kombinieren. Bei hoheren ph-Werten verschwindet H 2 Se 2 - nach erster Ordnung mit einer Halbwertszeit von 5 μs (pH = 8 bis 12), die von der HSe - -Konzentration unabhangig ist. Das Gleichgewicht wird zur Erklarung der Effekte diskutiert.

The reactions of the OH radical with H2S and SH⊖ are very fast (k = 1.1·1010 and 5.4·109 mole-1 liter sec-1, respectively). The hydrated electron reacts with H2S (1.1·1010) but does not react with SH⊖. The rate constant of the reaction CNS+SH⊖ CNS⊖ +SH was found to be equal to 9.8·108. Species absorbing at 3800 Å (e ∼ 104 mole-1 liter cm-1) are formed in these reactions of H2S and SH⊖ The intensity of this absorption is very low in strongly acid solutions, increases with pH, goes through a broad maximum at about pH=7, reaches a lower plateau between pH = 8.5 -10.5 and decreases in strongly alkaline solutions. At pH values below 7, the intensity is dependent on the concentrations of both SH⊖ and free H2S, i. e. at constant SH⊖ concentration a stronger absorption occurs if more free H2S is present. In the plateau below pH = 8.5 -10.5, the intensity is practically independent of the SH⊖ concentration above 4·10-5 mole/l. The decay of the 3800 A absorption after the pulse is first order with τ1/2 = 5 μsec independent of the OH⊖ and SH⊖ concentrations in alkaline solutions.Below pH = 7, the absorption disappears by second order, the rate constant being larger at lower pH values. SH or S⊖ absorb weakly in the near UV and do not contribute to the 3800 Å absorption. This absorption is attributed to the ions H2S2 ⊖ or H2S2⊖ in alkali and to H2S2⊖or higher complexes such as H3S4 ⊖ in acid. The first order decay of 5 μsec is attributed to the spontaneous decomposition of S2H2⊖ into S⊖ +SH⊖. Two S⊖ ions form S2 2⊖ (2 k=2·109 mole-1 liter sec-1). The complex H2S2 ⊖ is formed in the fast reaction SH + SH⊖ ↔ S2H2 ⊖ (dissociation constant about 4·10-5 mole/l). The formation of an intermediate complex SHOH⊖ in the reaction of OH with SH⊖ is discussed. This intermediate reacts with either SH⊖ to form S2H2⊖ or with OH⊖ (or other proton acceptors such as ΗΡΟ4 2Θ) to form SΘ+ H2O+OHΘ.

Zusammenfassung Die Geschwindigkeitskonstanten der Reaktionen von OH-Radikalen, hydratisierten Elektronen und freien organischen Radikalen mit einigen Merkaptanen RSH wurden bestimmt. Als Zwischenprodukt der Merkaptan-Oxidation tritt das Radikal-Anion RSSR - auf, das stark bei 4200 A (Merkaptoathanol) bzw. bei 4100 A (Methylmerkaptan) absorbiert. Es befindet sich mit dem RS-Radikal im Gleichgewicht: RSSR - ⇆RS +RS - . Die Gleichgewichtskonstante betragt 5,5 × 10 −4 mol/l fur 2-Merkaptoathanol. Die RS-Radikale kombinieren mit 2 k = 5,2 × 10 9 l mol −1 s −1 . In stark alkalischer Losung wird teilweise anstelle von RSSR - ein bei 3000 A absorbierendes Teilchen gebildet, dem versuchsweise die Struktur eines Kohlenstoff-Radikal-Anions (z.B. · CH 2 S − in Methylmerkaptan) zugeschrieben wird.