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Objectives: The study investigated the relationship between shiftwork and mortality, both total mortality and cause-specific mortality from coronary heart disease (CHD), stroke, and diabetes. Methods The cohort consisted of 2354 shiftworkers and 3088 dayworkers in two pulp and paper manufacturing plants. The mortality of the cohort was monitored from 1 January 1952 to 31 December 2001 by linkage to the national Cause of Death Register. Groups of workers defined by different durations of shiftwork exposure were compared with dayworkers by calculating standardized relative rates (SRR)., Results: Death due to any cause (total mortality) was not higher among the shiftworkers than among the dayworkers [SRR 1.02, 95% confidence interval (95% CI) 0.93-1.11]. A longer duration of shiftwork was associated with an increased risk of CHD, and shiftworkers with >30 years of shiftwork had the highest risk of CHD (SRR 1.24, 95% CI 1.04-1.49) Diabetes was more common as the number of shift years of exposure increased [b(linear coefficient) = 4.14 x 10(-5), 95% CI 2.46 x 10(-5) -5.81 x 10(-5)]. Compared with dayworkers, shiftworkers had a greater risk of death due to stroke (SRR 1.56, 95% CI 0.98-2.51)., Conclusions: In the present study, no general increase in mortality was observed among shiftworkers when they were compared with dayworkers. However, the results demonstrate an increased mortality from CHD among shiftworkers with a long duration of shiftwork exposure. Mortality due to diabetes also increased as the number of shift years and mortality due to ischemic stroke in shiftworkers increased.

Cardiovascular mortality has decreased over the past 25 years, largely because of acute coronary syndrome care and preventive actions. Nevertheless, the rate of coronary heart disease remains high, with an annual risk of 4.7% (cardiac mortality, myocardial infarction, stroke). Cardiovascular risk factor management must be a priority in primary and secondary prevention, to improve the prognosis of this severe disease, in which absence of symptoms does not mean benignity. The current goals of therapeutic patient education are smoking cessation, regular physical activity, a cardioprotective (Mediterranean) diet, management of stress, good treatment adherence (which improves compliance), judicious use of the care system and help with occupational reintegration. Current and future programmes must be in accordance with the Haute Autorité de Santé recommendations published in 2007., (Copyright © 2013 Elsevier Masson SAS. All rights reserved.)

Coronary heart disease (CHD) is the leading cause of death and disability worldwide. Despite current therapy, the morbidity and mortality for patients with CHD remains significant. The most important manifestations of CHD arise from acute myocardial ischaemia-reperfusion injury (IRI) in terms of cardiomyocyte death and its long-term consequences. As such, new therapeutic interventions are required to protect the heart against the detrimental effects of acute IRI and improve clinical outcomes. Although a large number of cardioprotective therapies discovered in pre-clinical studies have been investigated in CHD patients, few have been translated into the clinical setting, and a significant number of these have failed to show any benefit in terms of reduced myocardial infarction and improved clinical outcomes. Because of this, there is currently no effective therapy for protecting the heart against the detrimental effects of acute IRI in patients with CHD. One major factor for this lack of success in translating cardioprotective therapies into the clinical setting can be attributed to problems with the clinical study design. Many of these clinical studies have not taken into consideration the important data provided from previously published pre-clinical and clinical studies. The overall aim of this ESC Working Group Cellular Biology of the Heart Position Paper is to provide recommendations for optimizing the design of clinical cardioprotection studies, which should hopefully result in new and effective therapeutic interventions for the future benefit of CHD patients.

Oral antiplatelet drugs are a cornerstone of modern pharmacotherapy in cardiovascular atherothrombotic diseases. The efficacy of acetylsalicylic acid (ASA, aspirin) and clopidogrel in decreasing the risk of adverse events in coronary heart disease patients has been well established in the past 20 years. Despite chronic oral antiplatelet therapy, a number of atherothombotic events continue to occur. In recent years, a number of reports in the literature have shown possible relationships between residual platelet activity, as measured with a variety of laboratory tests, and clinical outcome, raising the possibility that 'resistance' to oral antiplatelet drugs may underlie many such clinical adverse events. The present position paper, conveyed within a group of clinical cardiologists with expertise in thrombosis appointed by the Section of Cardiovascular Interventions of the Polish Cardiac Society, has been further elaborated and endorsed by the Working Group on Thrombosis of the European Society of Cardiology. It aims at summarizing the main findings in this complex area, issuing opinions in cases of high controversy, and fostering future research in this area to obtain reliable laboratory and clinical data for the resolution of the many problems still open.

Objective: To develop a pen-and-paper coronary heart disease (CHD) 10-year risk estimator for patients with type 2 diabetes based on the United Kingdom Prospective Diabetes Study (UKPDS) risk equation (based on 4000 patients with diabetes but only available electronically)., Patients and Methods: We used data collected from adults with type 2 diabetes from 6 primary care practices that participated in a randomized trial in Rochester, Minn; patients were enrolled in the study from July 2001 to December 2003, with follow-up through June 2004. We used multivariable linear regression of the CHD risk estimate to formulate prediction equations to estimate average (<15%), elevated, or high (>30%) 10-year CHD risk according to sex, age, diabetes duration, smoking, hemoglobin A1c level, systolic blood pressure, ratio of total cholesterol to high-density lipoprotein cholesterol, and microalbuminuria categories. We selected cut points for the predicted score, seeking to (1) maximize the number of patients with total agreement between our estimator and the UKPDS risk equation, (2) avoid any patient's risk being either overestimated or underestimated by 2 risk categories, and (3) overestimate rather than underestimate coronary risk., Results: A total of 535 patients with type 2 diabetes participated in this study, 400 in the generation cohort and 135 in the validation cohort. Of the 400 patients in the generation cohort, our estimator had an 82% total agreement with the UKPDS calculation, 11% overestimated risk, and 7% underestimated UKPDS coronary risk (weighted kappa=0.77). Results were similar in the 135 patients in the validation cohort (kappa=0.79) and in an independent validation cohort of 52 patients attending a referral diabetes clinic (kappa=0.68)., Conclusion: The pen-and-paper estimator facilitates the point-of-care estimation of coronary risk in situations in which use of a desktop or handheld version of the electronic UKPDS risk engine is not practical or feasible. In our experience, estimation of risk using this tool, when done with patients, can further patients' insight into their risk of coronary events, often leading to enlightened discussions about modification of Individual risk factors.

The possible confounding caused by smoking was studied in connection with a mortality and cancer incidence study of 3,520 workers in the pulp and paper industry. A group 1,290 sawmill workers was used for comparison in addition to the expected numbers based on national statistics. A total of 801 questionnaires was sent to a representative sample of the workers, 537 to people still alive and 264 to the next-of-kin of decedents. The reply percentage was 86.6 for the former and 80.9 for the latter. The prevalence of smoking was determined for 1956 and 1981. The proportions of moderate and heavy smokers were assessed for 1981, and smoking indices were calculated for each occupational group. The estimated rate ratios for lung cancer in relation to smoking categories and the corresponding smoking-adjusted standardized incidence ratios were calculated for 1981, and they were compared with the observed standardized incidence ratios for lung cancer. The smoking habits could not explain the observed excess of lung cancer, nor the increased mortality from coronary heart disease found among the pulp and paper workers. Postal questionnaires may be a feasible tool for assessing smoking habits in retrospective cohort studies.

A notable diagnostic for the detection of hemolytic diseases is bilirubin, a by-product of haemoglobin breakdown. The concentration of bilirubin ranges from 0.3 to 1.9 mg in 100 mL of blood. Low blood bilirubin levels are associated with a greater risk of coronary heart disease and anaemia. Hyperbilirubinemia results from a serum bilirubin level of more than 2.5 mg/100 mL. Therefore, it is very crucial to check the serum bilirubin level. Analytical equipment for point-of-care testing must be portable, small, and affordable. A unique method is used to detect bilirubin selectively using paper-based screen-printed carbon electrodes that were covalently linked with nanoparticles, that serves as a key biomarker for jaundice. In order to create an electrochemical biosensor, bilirubin oxidase was immobilised on electrodes modified with AgNPs. The morphology of Ag nanoparticles in terms of size and shape was determined using both UV- Vis Spectroscopy and transmission electron microscopy (TEM). The biosensor's analytical response was assessed using potentiostat (Cyclic voltammetry (CV) and linear sweep voltammetry (LSV)). The developed paper-based sensor provided optimum feedback and a broad linear range of 1 to 9 µg/mL for bilirubin, with a lower LOD of 1 µg/mL. Through tests of bilirubin in artificial blood serum, the viability is confirmed. The method that is being used makes it possible to create and use an inexpensive, miniature electrochemical sensor. [ABSTRACT FROM AUTHOR]

Contemporary cardiovascular medicine is complex, dynamic, and interactive. Therefore, multidisciplinary dialogue between different specialists is required to deliver optimal and patient-centred care. This has led to the concept of explicit collaborations of different specialists caring for patients with complex cardiovascular diseases—that is 'heart teams'. These teams are particularly valuable to minimize referral bias and improve guideline adherence as so to be responsive to patient preferences, needs, and values but may be challenging to coordinate, especially in the acute setting. This position paper—jointly developed by four cardiovascular associations—is intended to provide conceptual and practical considerations for the composition, structure, and function of multidisciplinary teams. It focuses on patients with complex coronary artery diseases in both elective and urgent setting and provide guidance on how to implement the heart team both in chronic and in acute coronary syndromes patients, including cases with mechanical complications and haemodynamic instability; it also discusses strategies for clear and transparent patient communication and provision of a patient-centric approach. Finally, gaps in evidence and research perspectives in this context are discussed. [ABSTRACT FROM AUTHOR]

Background: The efficacy of traditional Chinese exercise (TCE)-based intervention in the improvement of physiological indicators and quality of life in patients with coronary heart disease (CHD) is controversial., Method: Five databases were systematically searched for relevant articles published from inception to February 2023. Controlled trials examining TCE intervention in patients with CHD. The treatment effects were estimated using a random-effect meta-analysis model with standardized mean differences (Hedges g). The categorical and continuous variables were used to conduct moderator analyses. Two investigators independently screened abstracts and full-text articles and graded the certainty of evidence based on the Grading of Recommendations Assessment, Development and Evaluation approach. This review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (identifier CRD42023401934)., Result: Ten studies involving a total of 718 participants were included in the final analysis. In the physiological indicators outcomes, the meta-analytic findings revealed large and significant improvements in systolic blood pressure (g = 0.78, 95% confidence interval [CI] = 0.51-1.05, P = .00, I2 = 98%), diastolic blood pressure (g = 0.90, 95% CI = 0.61-1.20, P = .00, I2 = 98%) and body mass index (g = 1.05, 95% CI = 0.75-1.34, P = .00, I2 = 99%), small and significant improvements in heart rate (g = 0.28, 95% CI = 0.01-0.54, P = .04, I2 = 98%) and ventilatory equivalents/carbon dioxide (g = -1.10, 95% CI = -1.47 to -0.74, P = .00, I2 = 96%).In the quality of life outcomes, the findings revealed small and significant improvements in physical functioning (g = -3.01, 95% CI = -3.45 to -2.57, P = .00, I2 = 96%), bodily pain (g = -2.16, 95% CI = -2.57 to -1.74, P = .00, I2 = 98%), vitality (g = -3.67, 95% CI = -4.16 to -3.16, P = .00, I2 = 97%) and mental health (g = -1.23, 95% CI = -1.771 to -0.692, P = .00, I2 = 99%). The moderator shows that the effects of TCE on physiological indicators and quality of life were moderated by PEDro score, type of exercise, exercise frequency, exercise duration, and number of sessions., Conclusion: TCE intervention is a beneficial nonpharmacological approach to improving physiological indicators in patients with CHD, especially in systolic blood pressure, diastolic blood pressure, and body mass index. However, there was no significant effect on quality of life. Our findings require broader clinical trials and higher-quality study designs to strengthen the evidence., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.)

Hyperthermia, hypoxia, and other conditions induce the appearance of heat shock or stress proteins in cells. We have previously shown that in the ischemic dog myocardium the level of a messenger RNA (mRNA) coding for a protein with migration characteristics similar to heat shock/stress protein 71 increases. Using a human heat-shock protein (hHSP) 70 genomic clone and anti-HSP70 antibodies as probes, we demonstrate in this report that heart stress protein (SP) 71 mRNA and its translational products (71 kDa polypeptides) are members of the stress protein family. In rabbit hearts, the ischemia-induced mRNAs translate into three isoforms with different isoelectric points (6.0, 6.1, and 6.15), in contrast to dog heart mRNA that translates into a protein with a pI of 5.8. The levels of SP71 mRNA in the dog and rabbit ischemic myocardium increased by sixfold and 18-fold, respectively. In the same samples, the levels of creatine kinase M mRNA decreased by about 40%, whereas those of myosin heavy chain mRNA remain unaltered. Our comparative analysis of three different mRNAs indicates that ischemia manifests its effects by differentially changing the levels of specific mRNAs coding for proteins with separate and distinct roles in the cell.

An 8-year follow-up of workers exposed for at least 5 years to carbon disulfide showed an excess of deaths due to coronary heart disease in reference to a comparison cohort. However, after effective preventive measures, e.g., leaving only 19% of the original group exposed and reducing the level of exposure to less than 10 ppm, had been undertaken after the 5th year of follow-up, coronary mortality decreased and no excess mortality during the last 3 years of follow-up occurred. These results, although only suggestive -- due to the small number of deaths and the short time of follow-up after the intervention -- seem promising from the point of view of improving the prognosis of workers who have already accumulated an excess risk for coronary death.

Despite advances in myocardial reperfusion therapies, acute myocardial ischaemia/reperfusion injury and consequent ischaemic heart failure represent the number one cause of morbidity and mortality in industrialized societies. Although different therapeutic interventions have been shown beneficial in preclinical settings, an effective cardio-protective or regenerative therapy has yet to be successfully introduced in the clinical arena. Given the complex pathophysiology of the ischaemic heart, large scale, unbiased, global approaches capable of identifying multiple branches of the signalling networks activated in the ischaemic/reperfused heart might be more successful in the search for novel diagnostic or therapeutic targets. High-throughput techniques allow high-resolution, genome-wide investigation of genetic variants, epigenetic modifications, and associated gene expression profiles. Platforms such as proteomics and metabolomics (not described here in detail) also offer simultaneous readouts of hundreds of proteins and metabolites. Isolated omics analyses usually provide Big Data requiring large data storage, advanced computational resources and complex bioinformatics tools. The possibility of integrating different omics approaches gives new hope to better understand the molecular circuitry activated by myocardial ischaemia, putting it in the context of the human 'diseasome'. Since modifications of cardiac gene expression have been consistently linked to pathophysiology of the ischaemic heart, the integration of epigenomic and transcriptomic data seems a promising approach to identify crucial disease networks. Thus, the scope of this Position Paper will be to highlight potentials and limitations of these approaches, and to provide recommendations to optimize the search for novel diagnostic or therapeutic targets for acute ischaemia/reperfusion injury and ischaemic heart failure in the post-genomic era. [ABSTRACT FROM AUTHOR]

Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury (IRI). During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic--however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing. Therefore, in this Position Paper of the European Society of Cardiology Working Group on Cellular Biology of the Heart, we critically analyse the current state of ischaemic conditioning in both the experimental and clinical settings, provide recommendations for improving its translation into the clinical setting, and highlight novel therapeutic targets and new treatment strategies for reducing acute myocardial IRI. [ABSTRACT FROM AUTHOR]

Abstract: To improve the correct diagnosis rate of coronary heart disease and to explore the guiding value of electrocardiogram (ECG) ST-T ischemic changes in the clinical diagnosis of coronary heart disease.A retrospective analysis was conducted on a total of 310 cases who underwent a conventional 12-lead ECG, 12-lead dynamic ECG (DECG, Holter) with ST-T ischemic changes, and then coronary angiography (CA) within 1 week in Qingdao Sttarr Heart Hospital from June 2015 to April 2020 in the study. Ischemic ST-T changes were evaluated using conventional diagnostic criteria, and Judkins diagnostic criteria were used in CA. The sensitivity and specificity of ECG were analyzed.The specificity of ST-T changes in conventional ECG for the diagnosis of coronary heart disease is 33.7% and the sensitivity is 66.0%. The specificity of ST-T changes in Holter in the diagnosis of coronary heart disease is 55.6% and the sensitivity is 32.2%. The sensitivity of conventional ECG for the diagnosis of coronary heart disease is better than Holter, but its specificity is inferior to Holter. The negative likelihood ratios of the 2 ECGs for the diagnosis of coronary heart disease were 1.0 and 1.22, both >0.1, and the positive likelihood ratios were 0.99 and 0.73, both <10. The positive results of ST-T in conventional ECG were 128 males (65.7%), 77 females (66.9%), (P < .05), 148 cases (74.7%) in the group ≥60 years old, and 75 cases in the group less than 60 years (67%), (P > .05). The positive results of ST-T change of DECG were 135 males (69.2%), 69 females (60.0%), (P < .05), 152 cases (78.7%) in the group ≥60 years, and 83 cases (70.9%) in the group less than 60 years, (P > .05). Coronary heart disease-related factors: symptoms, hypertension, diabetes, cancer, family history, smoking history as independent variables, and a binary multivariate logistic regression analysis was performed.The sensitivity of DECG in the diagnosis of myocardial ischemia in women and the elderly was slightly higher than that in men and young cases. ST-T ischemic changes in ECG are more significant for the diagnosis of coronary heart disease in male patients. Smoking, hypertension, diabetes, and family history are all high-risk factors for coronary heart disease., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

The article examines mortality among pulp and paper mill workers according to the mail mill pulping process, department, and gender. It states that death from acute myocardial infarction was increased, which was probably related to a combination of different occupational exposures such as dust, sulfur compounds, shift work and noise. It is concluded that the study supports earlier indications of fatal cardiovascular effects among pulp and paper mill workers.

Aim of the Study: This study analyzes research on TCM formulae in CHD over the past 30 years, using VOSviewer and CiteSpace. It aims to highlight key trends and hotspots in the field. Materials and Methods: The core database of Web of Science was collected, and the search time range was from the establishment of the database to the present (August 2023) for the literature related to the study of TCM prescriptions in CHD, and the information on the number of literature, countries, journals, authors, institutions, keywords were summarized by applying the software VOSviewer and CiteSpace. Results: A total of 135 kinds of literature were included. The number of published journal papers on research on TCM therapeutic formulae for CHD showed an upward trend; China was the most prolific country in this field; the largest number of papers were published in Evid Based Complement Alternat Med, MEDICINE; the average number of citations for authors and institutional analysis revealed that Xu Hao of China Academy of Traditional Chinese Medicine, Mao Jingyuan of Tianjin University of Traditional Chinese Medicine, and Shang Hongcai of Beijing University of Traditional Chinese Medicine constituted the core team of researchers studying the study of TCM formulae for CHD; the keyword analysis suggests that there are mainly 42 specifically named TCM formulae for the treatment of CHD, which are classified into a total of 7 major categories, and the research direction is mainly in the clinical efficacy study of different TCM therapeutic formulae and other aspects. Conclusion: This study shows that there are more types of TCM therapeutic formulae for CHD, and the related research has a good prospect. It is foreseeable that more relevant research results will rely on the study of network pharmacology, signalling pathways, and action targets of TCM therapeutic formulae. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells following binding with the cell surface ACE2 receptors, thereby leading to coronavirus disease 2019 (COVID-19). SARS-CoV-2 causes viral pneumonia with additional extrapulmonary manifestations and major complications, including acute myocardial injury, arrhythmia, and shock mainly in elderly patients. Furthermore, patients with existing cardiovascular comorbidities, such as hypertension and coronary heart disease, have a worse clinical outcome following contraction of the viral illness. A striking feature of COVID-19 pandemics is the high incidence of fatalities in advanced aged patients: this might be due to the prevalence of frailty and cardiovascular disease increase with age due to endothelial dysfunction and loss of endogenous cardioprotective mechanisms. Although experimental evidence on this topic is still at its infancy, the aim of this position paper is to hypothesize and discuss more suggestive cellular and molecular mechanisms whereby SARS-CoV-2 may lead to detrimental consequences to the cardiovascular system. We will focus on aging, cytokine storm, NLRP3/inflammasome, hypoxemia, and air pollution, which is an emerging cardiovascular risk factor associated with rapid urbanization and globalization. We will finally discuss the impact of clinically available CV drugs on the clinical course of COVID-19 patients. Understanding the role played by SARS-CoV2 on the CV system is indeed mandatory to get further insights into COVID-19 pathogenesis and to design a therapeutic strategy of cardio-protection for frail patients. [ABSTRACT FROM AUTHOR]

Background: Exercise intolerance is very common in patients with coronary heart disease (CHD). Although some researches confirming the validation of traditional Chinese medicine (TCM) on CHD treatment, the effect of TCM on improving the exercise tolerance of patients with CHD remains unclear so far. Our trial is to investigate whether the Yangxinshi (YXS) tablet can improve exercise tolerance as well as the quality of life among CHD patients., Methods: It is a randomized, double-blind, placebo-controlled, multi-center trial. A total of 90 patients with CHD from 3 hospitals in China will be enrolled and randomly assigned to one of 2 groups: YXS group, N = 45; placebo group, N = 45. The 2 groups will simultaneously receive standardized western medicine and exercise-based cardiac rehabilitation program for 12 weeks. The primary outcome measure is the exercise capacity, which will be evaluated by the cardiopulmonary exercise test and 6-minute walking test. The 2nd outcomes include symptom improvement, psychologic issues, laboratory tests, side effects, and adverse events., Discussion: To our knowledge, it is the 1st randomized controlled trial to evaluate the effect of TCM YXS tablet on exercise tolerance in patients with CHD. The results will provide more evidence for future studies in this area., Trial Registration: This study protocol was registered in Research Registry (researchregistry5752).

Background: Given the growing population of cardiac surgery patients with impaired preoperative cardiac function and rapidly expanding surgical techniques, continued efforts to improve myocardial protection strategies are warranted. Prior research is mostly limited to either large animal models or ex vivo preparations. We developed a new in vivo survival model that combines administration of antegrade cardioplegia with endoaortic crossclamping during cardiopulmonary bypass (CPB) in the rat. Methods: Sprague-Dawley rats were cannulated for CPB (n = 10). With ultrasound guidance, a 3.5 mm balloon angioplasty catheter was positioned via the right common carotid artery with its tip proximal to the aortic valve. To initiate cardioplegic arrest, the balloon was inflated and cardioplegia solution injected. After 30 min of cardioplegic arrest, the balloon was deflated, ventilation resumed, and rats were weaned from CPB and recovered. To rule out any evidence of cerebral ischemia due to right carotid artery ligation, animals were neurologically tested on postoperative day 14, and their brains histologically assessed. Results: Thirty minutes of cardioplegic arrest was successfully established in all animals. Functional assessment revealed no neurologic deficits, and histology demonstrated no gross neuronal damage. Conclusion: This novel small animal CPB model with cardioplegic arrest allows for both the study of myocardial ischemia-reperfusion injury as well as new cardioprotective strategies. Major advantages of this model include its overall feasibility and cost effectiveness. In future experiments long-term echocardiographic outcomes as well as enzymatic, genetic, and histologic characterization of myocardial injury can be assessed. In the field of myocardial protection, rodent models will be an important avenue of research. [ABSTRACT FROM AUTHOR]

Presents an analysis of articles tackling issues surrounding hypertension. Standard of care in patients who have coronary artery disease; Factor that reduced the risk of myocardial infarction stroke in high-risk patients.