Artykuły w czasopismach: „Coronary heart disease – Mortality – Western Australia”

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Masarei, J. R. L., i R. W. Parsons. "Factors related to coronary heart disease prevalence and mortality in busselton, Western Australia". Pathology 22 (1990): 12. http://dx.doi.org/10.1016/s0031-3025(16)36349-8.

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Sarink, Danja, Lee Nedkoff, Tom Briffa, Jonathan E. Shaw, Dianna J. Magliano, Christopher Stevenson, Haider Mannan i in. "Trends in age- and sex-specific prevalence and incidence of cardiovascular disease in Western Australia". European Journal of Preventive Cardiology 25, nr 12 (17.07.2018): 1280–90. http://dx.doi.org/10.1177/2047487318786585.

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Background Temporal trends in incidence and mortality of cardiovascular disease (CVD) have been well described, with recent data suggesting declining improvements in those aged under 55 years. However, little is known about the combined impact of incidence and mortality trends on disease prevalence, an important indicator of disease burden and cost. We analysed changes in age-specific and age-standardised temporal trends in prevalence and incidence of CVD subtypes. Methods Annual prevalence and incidence rates of coronary heart disease, cerebrovascular disease and peripheral arterial disease for the Western Australian population for 1995–2010 were calculated using data from the Western Australian Data Linkage System. Joinpoint regression analyses were used to identify joinpoints in trends in age-specific and age-standardised annual prevalence and incidence rates for each CVD subtype. Results Between 1995 and 2010, age- and sex-specific incidence and prevalence of the CVD subtypes generally decreased among middle-aged and older adults, but were stable or increased among younger adults. In < 55 year olds, increases in incidence tended to occur from 2003, while increases in prevalence were from 2007/2008. Declines in age-standardised incidence were greater than those in crude incidence, with changes in population structure having a greater impact among men than women. Conclusions The majority of CVDs occurs in older adults. Our findings of generally worsening trends in prevalence in younger adults across most CVD subtypes were in contrast to generally declining trends in older age groups. These data highlight the importance of monitoring prevalence and incidence, particularly in younger adults.

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Gupta, Sabrina, Rosalie Aroni, Siobhan Lockwood, Indra Jayasuriya i Helena Teede. "South Asians and Anglo Australians with heart disease in Australia". Australian Health Review 39, nr 5 (2015): 568. http://dx.doi.org/10.1071/ah14254.

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Objectives The aim of the present study was to determine cardiovascular disease (CVD) risk factors and compare presentation and severity of ischaemic heart disease (IHD) among South Asians (SAs) and Anglo Australians (AAs). Methods A retrospective clinical case audit was conducted at a public tertiary hospital. The study population included SA and AA patients hospitalised for IHD. Baseline characteristics, evidence of diabetes and other CVD risk factors were recorded. Angiography data were also included to determine severity, and these were assessed using a modified Gensini score. Results SAs had lower mean (± s.d.) age of IHD presentation that AAs (52 ± 9 vs 55 ± 9 years, respectively; P = 0.02), as well as a lower average body mass index (BMI; 26 ± 4 vs 29 ± 6 kg/m2, respectively; P = 0.005), but a higher prevalence of type 2 diabetes (57% vs 31%, respectively; P = 0.001). No significant differences were found in coronary angiography parameters. There were no significant differences in the median (interquartile range) Gensini score between SAs and AAs (43.5 (27–75) vs 44 (26.5–68.5), respectively), median vessel score (1 (1–2) vs 2 (1–3), respectively) or multivessel score (37% (33/89) vs 54% (22/41), respectively). Conclusions The findings show that in those with established IHD, cardiovascular risk factors, such as age at onset and BMI, differ between SAs and AAs and these differences should be considered in the prevention and management of IHD. What is known about the topic? There is much evidence on CVD and SAs, it being a leading cause of mortality and morbidity for this population both in their home countries and in countries they have migrated to. Studies conducted in Western nations other than Australia have suggested a difference in the risk profiles and presentations of CVD among SA migrants compared with the host populations in developed countries. Although this pattern of cardiovascular risk factors among SAs has been well documented, there is insufficient knowledge about this population, currently the largest population of incoming migrants, and CVD in the Australian setting. What does this paper add? This paper confirms that a similar pattern of CVD exists in Australia among SAs as does in other Western nations they have migrated to. The CVD pattern found in this population is that of an earlier age of onset at lower BMI compared with the host AA population, as well as a differing cardiovascular risk profile, with higher rates of type 2 diabetes and lower smoking rates. In addition, this study finds similar angiographic results for both the SAs and AAs; however, the SAs exhibit these similar angiographic patterns at younger ages. What are the implications for practitioners? SAs in Australia represent a high cardiovascular risk group and should be targeted for more aggressive screening at younger ages. Appropriate preventative strategies should also be considered bearing in mind the differing risk factors for this population, namely low BMI and high rates of type 2 diabetes. More intensive treatment strategies should also be regarded by practitioners. Importantly, both policy makers and health professionals must consider that all these strategies should be culturally targeted and tailored to this population and not assume a ‘one-size fits all’ approach.

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Knuiman, M. W., i H. T. Vu. "Prediction of coronary heart disease mortality in Busselton, Western Australia: an evaluation of the Framingham, national health epidemiologic follow up study, and WHO ERICA risk scores." Journal of Epidemiology & Community Health 51, nr 5 (1.10.1997): 515–19. http://dx.doi.org/10.1136/jech.51.5.515.

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Seaman, Karla L., Frank M. Sanfilippo, Max K. Bulsara, Tom Brett, Anna Kemp-Casey, Elizabeth E. Roughead, Caroline Bulsara i David B. Preen. "Frequent general practitioner visits are protective against statin discontinuation after a Pharmaceutical Benefits Scheme copayment increase". Australian Health Review 44, nr 3 (2020): 377. http://dx.doi.org/10.1071/ah19069.

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ObjectiveThis study assessed the effect of the frequency of general practitioner (GP) visitation in the 12 months before a 21% consumer copayment increase in the Pharmaceutical Benefits Scheme (PBS; January 2005) on the reduction or discontinuation of statin dispensing for tertiary prevention. MethodsThe study used routinely collected, whole-population linked PBS, Medicare, mortality and hospital data from Western Australia. From 2004 to 2005, individuals were classified as having discontinued, reduced or continued their use of statins in the first six months of 2005 following the 21% consumer copayment increase on 1 January 2005. The frequency of GP visits was calculated in 2004 from Medicare data. Multivariate logistic regression models were used to determine the association between GP visits and statin use following the copayment increase. ResultsIn December 2004, there were 22495 stable statin users for tertiary prevention of prior coronary heart disease, prior stroke or prior coronary artery revascularisation procedure. Following the copayment increase, patients either discontinued (3%), reduced (12%) or continued (85%) their statins. Individuals who visited a GP three or more times in 2004 were 47% less likely to discontinue their statins in 2005 than people attending only once. Subgroup analysis showed the effect was apparent in men, and long-term or new statin users. The frequency of GP visits did not affect the proportion of patients reducing their statin therapy. ConclusionsPatients who visited their GP at least three times per year had a lower risk of ceasing their statins in the year following the copayment increase. GPs can help patients maintain treatment following rises in medicines costs. What is known about the topic?Following the 21% increase in medication copayment in 2005, individuals discontinued or reduced their statin usage, including for tertiary prevention. What does this paper add?Patients who visited their GP at least three times per year were less likely to discontinue their statin therapy for tertiary prevention following a large copayment increase. What are the implications for practitioners?This paper identifies the important role that GPs have in maintaining the continued use of important medications following rises in medicines costs.

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Smil, Vaclav. "Coronary Heart Disease, Diet, and Western Mortality". Population and Development Review 15, nr 3 (wrzesień 1989): 399. http://dx.doi.org/10.2307/1972440.

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Hardes, G. R., A. J. Dobson, D. M. Lloyd i S. R. Leeder. "Coronary Heart Disease Mortality Trends and Related Factors in Australia". Cardiology 72, nr 1-2 (1985): 23–28. http://dx.doi.org/10.1159/000173837.

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Ragland, D. R., i R. J. Brand. "Coronary Heart Disease Mortality in the Western Collaborative Group Study". Journal of Cardiopulmonary Rehabilitation 8, nr 6 (czerwiec 1988): 240. http://dx.doi.org/10.1097/00008483-198806000-00010.

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RAGLAND, DAVID R., i RICHARD J. BRAND. "CORONARY HEART DISEASE MORTALITY IN THE WESTERN COLLABORATIVE GROUP STUDY". American Journal of Epidemiology 127, nr 3 (marzec 1988): 462–75. http://dx.doi.org/10.1093/oxfordjournals.aje.a114823.

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WILSON, ANDREW, i VICTOR SISKIND. "Coronary Heart Disease Mortality in Australia: Is Mortality Starting to Increase among Young Men?" International Journal of Epidemiology 24, nr 4 (1995): 678–84. http://dx.doi.org/10.1093/ije/24.4.678.

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Gardner, Christian, Elizabeth Geelhoed, Jamie Rankin, Matthew Knuiman, Michael Nguyen, Mark Newman, Donald Cutlip, Michael Hobbs, Thomas Briffa i Frank Sanfilippo. "O131 Index and coronary heart disease related readmission costs for percutaneous coronary intervention in Western Australia". Global Heart 9, nr 1 (marzec 2014): e36. http://dx.doi.org/10.1016/j.gheart.2014.03.1341.

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Lawrence, David M., Cashel D'Arcy, J. Holman, Assen V. Jablensky i Michael S. T. Hobbs. "Death rate from ischaemic heart disease in Western Australian psychiatric patients 1980–1998". British Journal of Psychiatry 182, nr 1 (2.01.2003): 31–36. http://dx.doi.org/10.1192/bjp.182.1.31.

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BackgroundPeople with mental illness suffer excess mortality due to physical illnesses.AimsTo investigate the association between mental illness and ischaemic heart disease (IHD) hospital admissions, revascularisation procedures and deaths.MethodA population-based record-linkage study of 210 129 users of mental health services in Western Australia during 1980–1998. IHD mortality rates, hospital admission rates and rates of revascularisation procedures were compared with those of the general population.ResultsIHD (not suicide) was the major cause of excess mortality in psychiatric patients. In contrast to the rate in the general population, the IHS mortality rate in psychiatric patients did not diminish over time. There was little difference in hospital admission rates for IHD between psychiatric patients and the general community, but much lower rates of revascularisation procedures with psychiatric patients, particularly in people with psychoses.ConclusionsPeople with mental illness do not receive an equitable level of intervention for IHD. More attention to their general medical care is needed.

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Spataro, J. Anthony, Alan R. Dyer, Jeremiah Stamler, Richard B. Shekelle, Kurt Greenlund i Dan Garside. "Measures of adiposity and coronary heart disease mortality in the Chicago Western Electric Company study". Journal of Clinical Epidemiology 49, nr 8 (sierpień 1996): 849–57. http://dx.doi.org/10.1016/0895-4356(96)00067-4.

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Nedkoff, Lee, Raphael Goldacre, Melanie Greenland, Michael J. Goldacre, Derrick Lopez, Nick Hall, Matthew Knuiman, Michael Hobbs, Frank M. Sanfilippo i F. Lucy Wright. "Comparative trends in coronary heart disease subgroup hospitalisation rates in England and Australia". Heart 105, nr 17 (4.04.2019): 1343–50. http://dx.doi.org/10.1136/heartjnl-2018-314512.

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BackgroundPopulation-based coronary heart disease (CHD) studies have focused on myocardial infarction (MI) with limited data on trends across the spectrum of CHD. We investigated trends in hospitalisation rates for acute and chronic CHD subgroups in England and Australia from 1996 to 2013.MethodsCHD hospitalisations for individuals aged 35–84 years were identified from electronic hospital data from 1996 to 2013 for England and Australia and from the Oxford Region and Western Australia. CHD subgroups identified were acute coronary syndromes (ACS) (MI and unstable angina) and chronic CHD (stable angina and ‘other CHD’). We calculated age-standardised and age-specific rates and estimated annual changes (95% CI) from age-adjusted Poisson regression.ResultsFrom 1996 to 2013, there were 4.9 million CHD hospitalisations in England and 2.6 million in Australia (67% men). From 1996 to 2003, there was between-country variation in the direction of trends in ACS and chronic CHD hospitalisation rates (p<0.001). During 2004–2013, reductions in ACS hospitalisation rates were greater than for chronic CHD hospitalisation rates in both countries, with the largest subgroup declines in unstable angina (England: men: −7.1 %/year, 95% CI −7.2 to –7.0; women: −7.5 %/year, 95% CI −7.7 to –7.3; Australia: men: −8.5 %/year, 95% CI −8.6 to –8.4; women: −8.6 %/year, 95% CI −8.8 to –8.4). Other CHD rates increased in individuals aged 75–84 years in both countries. Chronic CHD comprised half of all CHD admissions, with the majority involving angiography or percutaneous coronary intervention.ConclusionsSince 2004, rates of all CHD subgroups have fallen, with greater declines in acute than chronic presentations. The slower declines and high proportion of chronic CHD admissions undergoing coronary procedures requires greater focus.

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Chew, Derek P., Robert Carter, Bree Rankin, Andrew Boyden i Helen Egan. "Cost effectiveness of a general practice chronic disease management plan for coronary heart disease in Australia". Australian Health Review 34, nr 2 (2010): 162. http://dx.doi.org/10.1071/ah09742.

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Background.The cost effectiveness of a general practice-based program for managing coronary heart disease (CHD) patients in Australia remains uncertain. We have explored this through an economic model. Methods.A secondary prevention program based on initial clinical assessment and 3 monthly review, optimising of pharmacotherapies and lifestyle modification, supported by a disease registry and financial incentives for quality of care and outcomes achieved was assessed in terms of incremental cost effectiveness ratio (ICER), in Australian dollars per disability adjusted life year (DALY) prevented. Results.Based on 2006 estimates, 263 487 DALYs were attributable to CHD in Australia. The proposed program would add $115 650 000 to the annual national heath expenditure. Using an estimated 15% reduction in death and disability and a 40% estimated program uptake, the program’s ICER is $8081 per DALY prevented. With more conservative estimates of effectiveness and uptake, estimates of up to $38 316 per DALY are observed in sensitivity analysis. Conclusions.Although innovation in CHD management promises improved future patient outcomes, many therapies and strategies proven to reduce morbidity and mortality are available today. A general practice-based program for the optimal application of current therapies is likely to be cost-effective and provide substantial and sustainable benefits to the Australian community. What is known about this topic?Chronic disease management programs are known to provide gains with respect to reductions in death and disability among patients with coronary heart disease. The cost effectiveness of such programs in the Australian context is not known. What does this paper add?This paper suggests that implementing a coronary heart disease program in Australia is highly cost-effective across a broad range of assumptions of uptake and effectiveness. What are the implications for practitioners? These data provide the economic rationale for the implementation of a chronic disease management program with a disease registry and regular review in Australia.

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Liyanage, K., J. Burnett i F. van Bockxmeer. "Abstract: P846 DETECTION OF FAMILIAL HYPERCHOLESTEROLAEMIA IN A COHORT OF CORONARY HEART DISEASE PATIENTS IN WESTERN AUSTRALIA". Atherosclerosis Supplements 10, nr 2 (czerwiec 2009): e989. http://dx.doi.org/10.1016/s1567-5688(09)70967-5.

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Briffa, T., L. Nedkoff, S. Ridout, A. Peeters, A. Tonkin, J. Hung i M. Knuiman. "Incident Trends for Fatal Coronary Heart Disease (CHD) Vary by Age Group in Western Australia, 1996–2007". Heart, Lung and Circulation 19 (styczeń 2010): S29. http://dx.doi.org/10.1016/j.hlc.2010.06.732.

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Gallacher, J. E. J. "RE. “CORONARY HEART DISEASE MORTALITY IN THE WESTERN COLLABORATIVE GROUP STUDY: FOLLOW-UP EXPERIENCE OF 22 YEARS”". American Journal of Epidemiology 130, nr 2 (sierpień 1989): 429. http://dx.doi.org/10.1093/oxfordjournals.aje.a115355.

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George, Grace Mariam, Sanjeev Badiger, K. G. Kiran i Nanjesh Kumar. "Awareness of coronary heart disease in rural areas of Mangalore". International Journal Of Community Medicine And Public Health 4, nr 6 (22.05.2017): 1888. http://dx.doi.org/10.18203/2394-6040.ijcmph20172005.

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Background: Coronary heart disease is the impairment of heart function due to inadequate blood flow to the heart, compared to its needs caused by obstruction. It is the cause of 25-30 percent of deaths in most industrialised countries. The WHO has drawn its fact that coronary heart disease is a modern epidemic .A steady decline in mortality is seen in western countries due to changes in lifestyles and related risk factors. Objectives of the study to assess the knowledge of the people regarding coronary heart disease, to identify who are at risk and to test their attitudes and practices.Methods: This is a descriptive study. The sample size was 256. The study was done among the OPD patients attending the rural health centres of a tertiary hospital in Mangalore. Time period was two months.Results: Our community based cross-sectional study demonstrated good knowledge (57.42%), good attitude but poor practice regarding the cardiovascular health in the rural population of Mangalore. Conclusions: There is a need for concerted efforts for health education (e.g. audio visual aids) focusing more on Coronary heart disease causations, signs and symptoms, and treatment facilities. Conducting screening camps aiming more towards cardiovascular check-up- including lipid profile, blood sugar, ECG in addition to routine check-up; preferably once in a year covering a mass population for the purpose of prevention and management is necessary.

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Kromhout, Daan. "Epidemiology of cardiovascular diseases in Europe". Public Health Nutrition 4, nr 2b (kwiecień 2001): 441–57. http://dx.doi.org/10.1079/phn2001133.

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AbstractWithin Europe large differences exist in mortality from coronary heart disease and stroke. These diseases show a clear West-East gradient with high rates in Eastern Europe. In spite the decreasing trend in age-adjusted cardiovascular disease mortality in Western European countries an increase in the number of cardiovascular patients is expected because of the ageing of the population. Consequently the health care cost for these diseases will increase.Total and HDL cholesterol are major determinants of coronary heart disease. Saturated and trans fatty acids have a total and LDL cholesterol elevating effect and unsaturated fatty acids a lowering effect. N-3 polyunsaturated fatty acids seem to have a protective effect on coronary heart disease occurrence independent of their effect on cholesterol.Dietary antioxidants could be of importance because they may prevent oxidation of the atherogenic cholesterol rich LDL lipoproteins. There is however no convincing evidence that either vitamin E, carotenoids or vitamin C protect against coronary heart disease. Observational research has shown that flavonols, polyphenols with strong antioxidant properties present in plant foods, may protect against coronary heart disease.Blood pressure is a major determinant of coronary heart disease and stroke. Historically salt is viewed as the most important dietary determinant of blood pressure. Recent research shows that also a low-fat diet rich in potassium, calcium and magnesium lowers blood pressure substantially. This suggests a multifactorial influence of different nutrients on blood pressure.It can be concluded that a diet low in saturated and trans fatty acids and rich in plant foods in combination with regular fish consumption is associated with a low risk of cardiovascular mortality.

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O'Flaherty, Martin, Steven Allender, Richard Taylor, Chris Stevenson, Anna Peeters i Simon Capewell. "The decline in coronary heart disease mortality is slowing in young adults (Australia 1976–2006): A time trend analysis". International Journal of Cardiology 158, nr 2 (lipiec 2012): 193–98. http://dx.doi.org/10.1016/j.ijcard.2011.01.016.

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Taylor, Richard, Annette Dobson i Masoud Mirzaei. "Contribution of changes in risk factors to the decline of coronary heart disease mortality in Australia over three decades". European Journal of Cardiovascular Prevention & Rehabilitation 13, nr 5 (październik 2006): 760–68. http://dx.doi.org/10.1097/01.hjr.0000220581.42387.d4.

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Meirhaeghe, Aline, Michèle Montaye, Katia Biasch, Samantha Huo Yung Kai, Marie Moitry, Philippe Amouyel, Jean Ferrières i Jean Dallongeville. "Coronary heart disease incidence still decreased between 2006 and 2014 in France, except in young age groups: Results from the French MONICA registries". European Journal of Preventive Cardiology 27, nr 11 (26.02.2020): 1178–86. http://dx.doi.org/10.1177/2047487319899193.

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Background Over the past few decades decreases in coronary heart disease morbidity and mortality rates have been observed throughout the western world. We sought to determine whether the acute coronary event rates had decreased between 2006 and 2014 among French adults, and whether there were sex and age-specific differences. Methods We examined the French MONICA population-based registries monitoring the Lille urban area in northern France, the Bas-Rhin county in north-eastern France and the Haute Garonne county in south-western France. All acute coronary events among men and women aged 35–74 were collected. Results Over the study period, the age-standardised attack rates decreased in both men (annual percentage change −1.5%, P = 0.0006) and women (annual percentage change −2.1%, P = 0.002). Also, the age-standardised incidence rates decreased in both men (annual percentage change −0.9%, P = 0.03) and women (annual percentage change −1.8%, P = 0.002) due to decreases in the 65–74 year age group. In men, age-standardised mortality rates decreased by 3.5% per year ( P = 0.0004), especially in the 55–64 and 65–74 year age groups. In women, these rates decreased by 4.3% per year ( P = 0.0009), particularly in the 35–44 and 65–74 year age groups. We also observed significant decreases in case fatality among both men (annual percentage change −1.7%, P < 0.0001) and women (annual percentage change −1.9%, P = 0.009). Conclusions Downward trends in acute coronary event attack, incidence and mortality rates were observed between 2006 and 2014 in men and women. This effect was age dependent and was primarily due to decreases in the 65–74 year age group. There were no substantial declines in the younger age groups except for mortality in young women. Prevention measures still need to be strengthened, particularly in young adults.

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Hung, Joseph, Matthew W. Knuiman, Mark L. Divitini, Paul E. Langton, Caroline L. Chapman i John P. Beilby. "C-Reactive Protein and Interleukin-18 Levels in Relation to Coronary Heart Disease: Prospective Cohort Study from Busselton Western Australia". Heart, Lung and Circulation 17, nr 2 (kwiecień 2008): 90–95. http://dx.doi.org/10.1016/j.hlc.2007.07.002.

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Rao, A. V. "Lycopene, Tomatoes, and the Prevention of Coronary Heart Disease". Experimental Biology and Medicine 227, nr 10 (listopad 2002): 908–13. http://dx.doi.org/10.1177/153537020222701011.

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Coronary heart disease (CHD) is one of the primary causes of death in the Western world. The emphasis so far has been on the relationship between serum cholesterol levels and the risk of CHD. More recently, oxidative stress induced by reactive oxygen species (ROS) is also considered to play an important part in the etiology of this disease. Oxidation of the circulating low-density lipoprotein (LDLox) is thought to play a key role in the pathogenesis of atherosclerosis and CHD. According to this hypothesis, macrophages inside the arterial wall take up the LDLox and initiate the process of plaque formation. Dietary antioxidants such as vitamin E and ß-carotene have been shown in In vitro studies to prevent the formation of LDLox and their uptake by microphages. In a recent study, healthy human subjects ingesting lycopene, a carotenoid antioxidant, in the form of tomato juice, tomato sauce, and oleoresin soft gel capsules for 1 week had significantly lower levels of LDLox compared with controls. The antioxidant effects of lycopene have also been shown in four other human trials, including one where lycopene consumption reduced the levels of breath pentane. However, in one recent study, dietary supplementation with ß-carotene but not with lycopene was shown to inhibit LDL oxidation. The sources of lycopene used in most of these studies were either tomato products or lycopene extracted from tomatoes containing other carotenoids in various proportions. Therefore, it is not possible to attribute the effects solely to lycopene. Mechanisms other than the antioxidant properties of lycopene have also been shown to reduce the risk of CHD. Lycopene was shown to inhibit the activity of an essential enzyme involved in cholesterol synthesis in an in vitro and a small clinical study suggesting a hypocholesterolemic effect. Other possible mechanisms include enhanced LDL degradation, LDL particle size and composition, plaque rupture, and altered endothelial functions. Recent epidemiological studies have also shown an inverse relationship between tissue and serum levels of lycopene and mortality from CHD, cerebrovascular disease, and myocardial infraction. However, the most impressive population-based evidence comes from a multicenter case-control study where subjects from 10 European countries were evaluated for relationship between antioxidant status and acute myocardial infarctions. After adjusting for a range of dietary variables, only lycopene levels but not ß-carotene were found to be protective. At present, the role of lycopene in the prevention of CHD is strongly suggestive. Although the antioxidant property of lycopene may be one of the principal mechanism for its effect, other mechanisms may also be responsible. Controlled clinical and dietary intervention studies using well-defined subject populations and disease end points must be undertaken in the future to provide definitive evidence for the role of lycopene in the prevention of CHD. Mechanistic studies must also be initiated to understand the mode of lycopene action.

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Gabaldon-Perez, Ana, Victor Marcos-Garces, Jose Gavara, Cesar Rios-Navarro, Gema Miñana, Antoni Bayes-Genis, Oliver Husser i in. "Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome". Journal of Clinical Medicine 10, nr 4 (5.02.2021): 610. http://dx.doi.org/10.3390/jcm10040610.

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Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CCS), the increase in life expectancy provided by coronary revascularization is controversial. Over more than 40 years, several clinical trials have been carried out comparing optimal medical treatment (OMT) alone with a strategy of routine coronary revascularization on top of OMT. Beyond a certain degree of symptomatic improvement and lower incidence of minor events, routine invasive management has not demonstrated a convincing effect in terms of reducing mortality in CCS. Based on the accumulated evidence more than half a century after the first revascularization procedures were used, invasive management should be considered in those patients with uncontrolled symptoms despite OMT or high-risk features related to left ventricular function, coronary anatomy, or functional assessment, taking into account the patient expectations and preferences.

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Grant, William B. "Prevalence of apolipoprotein E epsilon4 allele may explain the geographical variation of coronary heart disease mortality rates in Western Europe". European Journal of Epidemiology 25, nr 9 (29.07.2010): 667. http://dx.doi.org/10.1007/s10654-010-9494-9.

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Hetzel, B. "Fall in coronary heart disease mortality in U.S.A. and Australia due to sudden death: Evidence for the role of polyunsaturated fat". Journal of Clinical Epidemiology 42, nr 9 (1989): 885–93. http://dx.doi.org/10.1016/0895-4356(89)90102-9.

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Zhang, Hong-Liang, Yi Yang i Jiang Wu. "Can prevalence of apolipoprotein E epsilon 4 allele explain the geographical variation of coronary heart disease mortality rates in Western Europe?" European Journal of Epidemiology 25, nr 12 (18.09.2010): 897–98. http://dx.doi.org/10.1007/s10654-010-9509-6.

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Nakamura, Tomoki, Akihiro Azuma, Toshiro Kuribayashi, Hiroki Sugihara, Seisuke Okuda i Masao Nakagawa. "Serum fatty acid levels, dietary style and coronary heart disease in three neighbouring areas in Japan: the Kumihama study". British Journal of Nutrition 89, nr 2 (luty 2003): 267–72. http://dx.doi.org/10.1079/bjn2002747.

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CHD mortality is extremely low in Japan, particularly in rural districts, when compared with that in Western countries. This has been partly attributed to the difference in dietary lifestyle. We investigated the factors influencing CHD mortality in a rural coastal district of Japan, comprising mercantile, farming, and fishing areas with distinct dietary habits. We prospectively examined the incidence of CHD from 1994 to 1998, as well as coronary risk factors and serum fatty acid concentrations. The incidence of angina pectoris was significantly (P=0·01) lower in the fishing area than in the mercantile and farming areas. Blood pressure, physical activity, prevalence of diabetes, serum levels of uric acid and HDL-cholesterol were similar between the three areas. Total- and LDL-cholesterol levels were significantly lower but the smoking rate was markedly higher in the fishing area than in the other two areas. Serum levels of saturated fatty acids andn−6 polyunsaturated fatty acids (PUFA) were lowest in the fishing area, butn−3 PUFA did not differ significantly. Then−6:n−3 PUFA ratio was lowest and eicosapentaenoic:arachidonic acid was highest in the fishing area. Although many previous studies have emphasized the beneficial effect ofn−3 PUFA in preventing CHD, the present study indicated that a lower intake ofn−6 PUFA and saturated fatty acids has an additional preventive effect on CHD even when the serum level ofn−3 PUFA is high because of high dietary fish consumption.

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Briffa, T., L. Nedkoff, A. Peeters, A. Tonkin, J. Hung, S. C. Ridout i M. Knuiman. "Discordant age and sex-specific trends in the incidence of a first coronary heart disease event in Western Australia from 1996 to 2007". Heart 97, nr 5 (6.01.2011): 400–404. http://dx.doi.org/10.1136/hrt.2010.210138.

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Rasmussen, Laust Dupont, Morten Bøttcher, Per Ivarsen, Hanne Skou Jørgensen, Mette Nyegaard, Henriette Buttenschøn, Camilla Gustafsen i in. "Association between circulating proprotein convertase subtilisin/kexin type 9 levels and prognosis in patients with severe chronic kidney disease". Nephrology Dialysis Transplantation 35, nr 4 (22.08.2018): 632–39. http://dx.doi.org/10.1093/ndt/gfy257.

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Abstract Background Chronic kidney disease is a risk factor for premature development of coronary atherosclerosis and mortality. A high level of proprotein convertase subtilisin/kexin type 9 (PCSK9) is a recently recognized cardiovascular risk factor and has become the target of effective inhibitory treatment. In 167 kidney transplantation candidates, we aimed to: (i) compare levels of PCSK9 with those of healthy controls, (ii) examine the association between levels of PCSK9 and low-density lipoprotein cholesterol (LDL-c) and the degree of coronary artery disease (CAD) and (iii) evaluate if levels of PCSK9 predict major adverse cardiac events (MACE) and mortality. Methods Kidney transplant candidates (n = 167) underwent coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) before transplantation. MACE and mortality data were extracted from the Western Denmark Heart Registry, a review of patient records and patient interviews. A group of 79 healthy subjects were used as controls. Results Mean PCSK9 levels did not differ between healthy controls and kidney transplant candidates. In patients not receiving lipid-lowering therapy, PCSK9 correlated positively with LDL-c (rho = 0.24, P < 0.05). Mean PCSK9 was similar in patients with and without obstructive CAD at both CCTA and ICA. In a multiple regression analysis, PCSK9 was associated with neither LDL-c (β=−6.45, P = 0.44) nor coronary artery calcium score (β=2.17, P = 0.84). During a follow-up of 3.7 years, PCSK9 levels were not associated with either MACE or mortality. Conclusions The ability of PCSK9 levels to predict cardiovascular disease and prognosis does not seem to apply to a cohort of kidney transplant candidates.

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Shibata, Marcelo, Belinda Lees, Peter Collins, John Stevenson, Rebecca Mister i Marcus Flather. "Prevention of cardiovascular disease in women: evidence for the use of hormone replacement therapy". British Menopause Society Journal 7, nr 1 (1.03.2001): 33–37. http://dx.doi.org/10.1258/136218001100321100.

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Coronary artery disease (CAD) is the number one cause of death and disability in the Western world. Its incidence increases with age and women present with symptomatic CAD on average about ten years later than men. Rationale for using hormone replacement therapy (HRT) is based on its effects on vasoreactivity, progression of atherosclerosis, lipids and lipoproteins, effects on the haemostatic system and impaired glucose tolerance. However, unopposed oestrogen might be related to an increased risk of endometrial cancer. The overall beneficial effect of HRT on cardiovascular diseases is derived from prospective cohort studies. The Heart and Estrogen/progestin Replacement Study showed no beneficial effect of HRT on cardiovascular morbidity and mortality. However, there are uncertainties about the duration and optimal type of HRT regimen. Ongoing trials addressing similar questions are not expected to be published within the next five years. The Women's Hormone Intervention Secondary Prevention (WHISP) pilot study addresses the effect of a novel HRT regimen on lipid and haemostatic risk markers of heart disease and may pave the way for a large trial evaluating the effect of HRT on morbidity and mortality.

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Zifan, Ali, i Panos Liatsis. "Patient-Specific Computational Models of Coronary Arteries Using Monoplane X-Ray Angiograms". Computational and Mathematical Methods in Medicine 2016 (2016): 1–12. http://dx.doi.org/10.1155/2016/2695962.

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Coronary artery disease (CAD) is the most common type of heart disease in western countries. Early detection and diagnosis of CAD is quintessential to preventing mortality and subsequent complications. We believe hemodynamic data derived from patient-specific computational models could facilitate more accurate prediction of the risk of atherosclerosis. We introduce a semiautomated method to build 3D patient-specific coronary vessel models from 2D monoplane angiogram images. The main contribution of the method is a robust segmentation approach using dynamic programming combined with iterative 3D reconstruction to build 3D mesh models of the coronary vessels. Results indicate the accuracy and robustness of the proposed pipeline. In conclusion, patient-specific modelling of coronary vessels is of vital importance for developing accurate computational flow models and studying the hemodynamic effects of the presence of plaques on the arterial walls, resulting in lumen stenoses, as well as variations in the angulations of the coronary arteries.

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Atkins, Emily R., Elizabeth A. Geelhoed, Lee Nedkoff i Tom G. Briffa. "Disparities in equity and access for hospitalised atherothrombotic disease". Australian Health Review 37, nr 4 (2013): 488. http://dx.doi.org/10.1071/ah13083.

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Objective. This study of equity and access characterises admissions for coronary, cerebrovascular and peripheral arterial disease by hospital type (rural, tertiary and non-tertiary metropolitan) in a representative Australian population. Methods. We conducted a descriptive analysis using data linkage of all residents aged 35–84 years hospitalised in Western Australia with a primary diagnosis for an atherothrombotic event in 2007. We compared sociodemographic and clinical features by atherothrombotic territory and hospital type. Results. There were 11670 index admissions for atherothrombotic disease in 2007 of which 46% were in tertiary hospitals, 41% were in non-tertiary metropolitan hospitals and 13% were in rural hospitals. Coronary heart disease comprised 72% of admissions, followed by cerebrovascular disease (19%) and peripheral arterial disease (9%). Comparisons of socioeconomic disadvantage reveal that for those admitted to rural hospitals, more than one-third were in the most disadvantaged quintile, compared with one-fifth to any metropolitan hospital. Conclusions. Significant differences in demographic characteristics were evident between Western Australian tertiary and non-tertiary hospitals for patients hospitalised for atherothrombotic disease. Notably, the differences among tertiary, non-tertiary metropolitan and rural hospitals were related to socioeconomic disadvantage. This has implications for atherothrombotic healthcare provision and the generalisation of research findings from studies conducted exclusively in the tertiary metropolitan hospitals. What is known about the topic? Equity and access to hospital care for atherothrombotic disease in a geographically diverse population is poorly characterised. National data show that both fatal and non-fatal coronary heart disease and non-fatal stroke hospitalisations increase with remoteness. Fatal in-hospital stroke is greatest in major cities, whereas peripheral arterial disease hospitalisations are greatest in the inner and outer regional areas. What does this paper add? This study demonstrates that around 13% of atherothrombotic events were treated in rural hospitals with in-hospital case fatality higher than in tertiary and non-tertiary metropolitan hospitals. A greater proportion of atherothrombotic disease cases treated in rural hospitals were in the most disadvantaged Socioeconomic Indices For Area group. What are the implications for practitioners? It is important to consider differences in disadvantage when generalising results of studies generated from tertiary hospital data to non-tertiary metropolitan and rural patients.

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Parks, Dale, i Francois Booyse. "Moderate Wine and Alcohol Consumption: Beneficial Effects on Cardiovascular Disease". Thrombosis and Haemostasis 86, nr 08 (2001): 517–28. http://dx.doi.org/10.1055/s-0037-1616080.

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SummaryCardiovascular disease, in particular coronary heart disease (CHD) and associated myocardial infarction (MI), is the leading cause of death among adults in the Western world (1). Although CHD is a complex multi-factorial disease, major insights have been gained in our understanding of the etiology underlying the initiation and progression of CHD. The pathogenesis of CHD and the ensuing atherothrombotic complications resulting in MI, involves the complex and often synergistic interplay between multiple dysfunctional cellular and molecular mechanisms that have been altered through interactions with various environmental and/or systemic factors (i. e. CHD risk factors). Typically, these deleterious effects are exerted at the level of the heart muscle, blood vessels and blood components and result in dysfunction in endothelial cells (ECs), smooth muscle cells, cardiac myocytes, blood cells (platelets and monocytes) and plasma components (lipoproteins, fibrinogen, clotting factors, etc.). These combined effects will then contribute further to the initiation and progression of CHD and eventual MI. Consequently, any systemic factors (such as alcohol or wine components) that will reduce, minimize or inhibit these induced dysfunctions will be expected to reduce the overall risk for cardiovascular disease and CHD-related mortality.

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Gardner, C., J. M. Rankin, E. Geelhoed, M. Nguyen, M. Newman, D. Cutlip, M. W. Knuiman, T. G. Briffa, M. S. T. Hobbs i F. M. Sanfilippo. "Evaluation of long-term clinical and health service outcomes following coronary artery revascularisation in Western Australia (WACARP): a population-based cohort study protocol". BMJ Open 4, nr 10 (październik 2014): e006337. http://dx.doi.org/10.1136/bmjopen-2014-006337.

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IntroductionCoronary artery bypass grafting (CABG) and percutaneous coronary interventions (PCI) are procedures commonly performed on patients with significant obstructive coronary artery disease to relieve symptoms of ischaemia, improve survival or both. Although the efficacy of both procedures at the individual level has been established, the impact of advances in coronary artery revascularisation procedures (CARP) on long-term outcomes and cost-effectiveness at the population level are yet to be assessed. Our aim is to evaluate a minimum of 6-year outcomes and costs for the total population of patients who had CARP in Western Australia (WA) in 2000–2005.Methods and analysisThis retrospective population cohort study will link clinical and administrative health data for a previously defined cohort including all patients in WA who had a CARP in the period 2000–2005. The cohort consists of 19 014 patients who had 21 175 procedures (15 429 PCI and 5746 CABG). We are now collecting a minimum of 6 years follow-up of morbidity and mortality data for the cohort using the WA Data Linkage System, clinical registries and hospital records, with 12 years follow-up for cases in the year 2000. Comparison of long-term outcomes for different CARP will be reported (PCI vs CABG; bare metal stents vs drug-eluting stents vs CABG). Cost-effectiveness analysis of CARP from the perspective of the healthcare sector will be performed using individual level cost data and average costs from Australian Refined Diagnosis Related Groups.Ethics and disseminationThis study has received ethics approval from the University of Western Australia, the Western Australian Department of Health and all participating hospitals. Being a large population cohort study, approval included a waiver of informed consent. All findings will be presented at local, national and international healthcare/academic conferences and published in peer-reviewed journals.

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Stephen, Alison M., i Glynis M. Sieber. "Trends in individual fat consumption in the UK 1900–1985". British Journal of Nutrition 71, nr 5 (maj 1994): 775–88. http://dx.doi.org/10.1079/bjn19940183.

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Mortality from coronary heart disease is decreasing in a number of Western countries, although the pattern of the decrease differs from country to country. In the UK the mortality rate from coronary heart disease has declined since 1979, whereas in the USA mortality from this disease began to fall in 1968 and has continued since that time. Of many factors suggested as reasons for the decline, diet has been implicated, particularly dietary fat intake. However, food balance information suggests little change in fat intake. A recent examination of all published studies from the USA where individual fat intake has been reported indicated that fat intake in that country has fallen steadily since the mid 1960s. The present study describes a similar compilation of all published studies from the UK giving individual fat intakes. Ninety-seven studies, representing information for 24045 individuals, were used. Studies ranged in size from two to 3581 individuals and were drawn from all regions of the UK. Most studies used 7 d weighed intakes as the method of dietary assessment. Quadratic regression equations were applied to the fat intakes from all studies over time, with each study weighted by the number of individuals surveyed. Data were also divided into 10-year periods and weighted fat intakes for each decade were calculated. Data were expressed for all studies, then subdivided into males, females, children and the elderly. Comparisons between Scotland and the South-East of England were made. Results indicate that fat represented 30% or less of dietary energy in the UK until the 1930s, when it began to rise. This rise was curtailed by rationing during and after the Second World War, after which the rise continued, reaching a plateau of about 40% energy in the late 1950s, with little change until the late 1970s. Trends were similar in all age-groups, but less change has occurred recently in Scotland compared with South-East England. These results differ from the pattern in the USA and suggest that if greater changes in mortality from coronary heart disease are to be seen in the UK a greater reduction in dietary fat intake will have to occur.

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Mathur, Rohit, Palsingh Yadav, Sanjeev Sanghvi, Pawan Sarda, Anil Baroopal i Swati Mahajan. "Evaluation of clinical outcome of thrombolytic therapy in elderly patients in Western Rajasthan: a single centre experience". International Journal of Research in Medical Sciences 7, nr 10 (25.09.2019): 3773. http://dx.doi.org/10.18203/2320-6012.ijrms20194308.

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Background: Heart disease is the leading cause of mortality in population above the age of 65 years. Severity and prevalence of coronary artery disease (CAD) increase with increasing age. Thrombolysis remains the standard of care in the management of acute ST-elevation myocardial infarction (STEMI) in developing countries like India where primary percutaneous coronary intervention (PCI) is still not possible in the majority of patients. The risks and benefits of thrombolytic reperfusion therapy among the elderly patients with STEMI is much less known. Authors aimed to evaluate the outcome and complications of thrombolytic therapy in elderly patients admitted with acute STEMI.Methods: The present observational study was done between January 2017 and January 2019 in the department of cardiology, Dr. S.N. Medical College, Jodhpur, India. It included a study group comprising 102 consecutive elderly patients who had acute STEMI and underwent thrombolytic therapy and a control group comprising 102 consecutive elderly patients who had STEMI who were not given thrombolytic therapy. Both groups were evaluated for an outcome (in-hospital mortality) and complications.Results: The overall in-hospital mortality was less in thrombolytic therapy group as compared to control group although not statistically significant (8.82% versus 14.70%, p=0.277). Similarly, in-hospital mortality was less in thrombolytic therapy subgroup A (age 66-74 years) as compared to control subgroup A (6.45% versus 10.75%, p=0.583) and also less in thrombolytic therapy subgroup B (age 75-85years) as compared to control subgroup B (12.50% versus 21.62%, p=0.445). Among the traditional risk factors, co-morbid conditions and complications, there was less prevalence of diabetes mellitus (4.90% versus 15.68%, p=0.021), hypertension (5.88% versus 6.86%, p=1.000), cardiogenic shock (8.82% versus 9.80%, p=1.000), left ventricular failure (LVF) (0.98% versus 3.92%, p=0.365) and atrioventricular (AV) block (0% versus 4.90%, p=0.245) but more acute kidney injury (AKI) (2.94% versus 0%, p=0.070) in thrombolytic therapy group patients as compared to control group patients. Cerebrovascular accident (CVA) did not occur in both group patients.Conclusion: Despite the higher prevalence of co-morbidities and high risk features in elderly patients of acute STEMI, timely thrombolysis is beneficial. A mortality benefit was seen in all groups suggesting net benefit regardless of increasing age up to the age of 85 years.

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Farouk Musa, Ahmad, Chou Zhao Quan, Low Zheng Xin, Trived Soni, Jeswant Dillon, Yuen Kah Hay i Rusli Bin Nordin. "A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur". F1000Research 7 (8.02.2018): 164. http://dx.doi.org/10.12688/f1000research.13244.1.

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Background: Atrial fibrillation (AF) is common after cardiac surgery and has been associated with poor outcome and increased resource utilization. The main objective of this study is to determine the incidence of POAF in Malaysia and identify the predictors of developing POAF. The secondary outcome of this study would be to investigate the difference in mortality and morbidity rates and the duration of intensive care unit (ICU), high dependency unit (HDU) and hospital stay between the two. Methods: This is a retrospective single-center, cross sectional study conducted at the National Heart Institute, Malaysia. Medical records of 637 who underwent coronary artery bypass grafting (CABG) surgery in 2015 were accrued. Pre-operative, operative and post-operative information were subsequently collected on a pre-formulated data collection sheet. Data were then analyzed using IBM SPSS v23. Results: The incidence of POAF in our study stands at 28.7% with a mean onset of 45±33 hours post operatively. Variables with independent association with POAF include advancing age, Indian population, history of chronic kidney disease, left ventricular ejection fraction and beta-blocker treatment. The mortality rate is significantly higher statistically (p < 0.05), and similarly the incidence of stroke. The incidence of other post-operative complications was also significantly higher statistically. The duration of ICU, HDU and hospital stays were statistically longer (p < 0.001) with higher rates of ICU readmissions and reintubations seen. Conclusion: We conclude that the incidence of POAF in Malaysia is comparable to the figures in Western countries, making POAF one of the most commonly encountered condition after CABG with similar higher rates of mortality, poor outcomes and longer duration of stay, and therefore increased cost of care. Strategies to reduce the incidence of AF after cardiac surgery should favorably affect surgical outcomes and reduce utilization of resources and thus lower cost of care.

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Farouk Musa, Ahmad, Chou Zhao Quan, Low Zheng Xin, Trived Soni, Jeswant Dillon, Yuen Kah Hay i Rusli Bin Nordin. "A retrospective study on atrial fibrillation after coronary artery bypass grafting surgery at The National Heart Institute, Kuala Lumpur". F1000Research 7 (1.08.2018): 164. http://dx.doi.org/10.12688/f1000research.13244.2.

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Background: Atrial fibrillation (AF) is common after cardiac surgery and has been associated with poor outcome and increased resource utilization. The main objective of this study is to determine the incidence of POAF in Malaysia and identify the predictors of developing POAF. The secondary outcome of this study would be to investigate the difference in mortality and morbidity rates and the duration of intensive care unit (ICU), high dependency unit (HDU) and hospital stay between the two. Methods: This is a retrospective single-center, cross sectional study conducted at the National Heart Institute, Malaysia. Medical records of 637 who underwent coronary artery bypass grafting (CABG) surgery in 2015 were accrued. Pre-operative, operative and post-operative information were subsequently collected on a pre-formulated data collection sheet. Data were then analyzed using IBM SPSS v23. Results: The incidence of POAF in our study stands at 28.7% with a mean onset of 45±33 hours post operatively. Variables with independent association with POAF include advancing age, Indian population, history of chronic kidney disease, left ventricular ejection fraction and beta-blocker treatment. The mortality rate is significantly higher statistically (p < 0.05), and similarly the incidence of stroke. The incidence of other post-operative complications was also significantly higher statistically. The duration of ICU, HDU and hospital stays were statistically longer (p < 0.001) with higher rates of ICU readmissions and reintubations seen. Conclusion: We conclude that the incidence of POAF in Malaysia is comparable to the figures in Western countries, making POAF one of the most commonly encountered condition after CABG with similar higher rates of mortality, poor outcomes and longer duration of stay, and therefore increased cost of care. Strategies to reduce the incidence of AF after cardiac surgery should favorably affect surgical outcomes and reduce utilization of resources and thus lower cost of care.

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Gokhale, Vijayashree S., Atiulla I. Malik, Atiulla I. Malik, Ponvijaya M. Yadav, Ponvijaya M. Yadav, Kunal Garg i Kunal Garg. "Early diagnosis HFpEF, heart failure with preserved ejection fraction in cardiomyopathy, a chance to treat and reduce morbidity and mortality". International Journal of Research in Medical Sciences 9, nr 2 (29.01.2021): 454. http://dx.doi.org/10.18203/2320-6012.ijrms20210423.

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Background: Cardiomyopathy as a diagnosis almost signifies a kind of end stage disease of the myocardium. With conditions like hypertension, diabetes and ischemic heart disease on the rise, we are seeing a large number of cases diagnosed as cardiomyopathy, most common presenting feature being Heart failure. Echocardiography (ECG), is non-invasive and easily available and can pick up early signs of failure in the form of diastolic and systolic dysfunction. To study patients with cardiac symptoms, by clinical, ECG, and Echocardiography parameters.Methods: A cross-sectional, observational study of 50 patients aged 18-80 years with cardiac symptoms (dyspnoea, palpitations, pedal odema) was carried out over a period of 3 years in a semi-urban Medical College Hospital in Western Maharashtra. Patients of Acute coronary disease, valvular and congenital heart disease and chronic obstructive pulmonary disease (COPD) were excluded from the study. Data collected, tabulated and subjected to statistical analysis.Results: Our study of 50 patients had 50% Diabetic and 42% Hypertensive patients. 2D echo findings were clinically significant in the form of diastolic dysfunction (36%), systolic dysfunction (12%). Ejection fraction (EF) was significantly reduced, in most patients, but 4% patients had HFpEF, i.e. EF=55% and 24% had EF between 30-55%Conclusions: Our study of 50 patients of Cardiomyopathy had more hypertensives and diabetics, and most of them less than 60 years of age and mostly male. HFpEF was detected in 4% and 76% had EF30-60% and 24% had EF<30%. Diastolic dysfunction was diagnosed in more than half and systolic dysfunction in few on ECG.

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Diehm, Kareem i Lawall. "Epidemiology of peripheral arterial disease". Vasa 33, nr 4 (1.11.2004): 183–89. http://dx.doi.org/10.1024/0301-1526.33.4.183.

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Peripheral arterial disease (PAD) is not an uncommon but a commonly neglected condition by many medical practitioners. It is a disease that threatens not only the limb but also life itself! Atherosclerosis is the commonest cause of PAD in the western nations. The cardinal symptom is intermittent claudication (IC) but majority of the patients are asymptomatic. Ankle-brachial pressure index (ABI) is an effective screening tool for PAD. A diminished ABI (< 0.9) is a definite sign of PAD. Its prevalence steadily increases with age. In Germany almost a fifth of the patients aged over 65 years suffer from it. With increasing life expectancy the prevalence of PAD is on the increase. PAD is a manifestation of diffuse and severe atherosclerosis. It is a strong marker of cardiovascular disease; a very strong association exists between PAD and other atherosclerotic disorders such as coronary artery disease (CAD) and cerebrovascular disease (CVD). PAD is an independent predictor of high mortality in patients with CAD. Smoking, diabetes mellitus and advancing age are the cardinal risk factors. A relatively small number of PAD patients lose limbs by amputation. Most patients with PAD die of either heart attacks or strokes and they die of the former conditions far earlier than controls. PAD still remains an esoteric disease and there is a significant lack of awareness of this condition by many physicians, and therefore under-diagnosed and underestimated. Measures to promote awareness of PAD among physicians and the society in general are needed. Since most patients are asymptomatic and carry potentially significant morbidity and mortality risks, screening for PAD should be made a routine practice at primary care level.

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Nedkoff, Lee, Matthew Knuiman, Joseph Hung i Tom G. Briffa. "Comparative Trends in the Incidence of Hospitalized Myocardial Infarction and Coronary Heart Disease in Adults With and Without Diabetes Mellitus in Western Australia From 1998 to 2010". Circulation: Cardiovascular Quality and Outcomes 7, nr 5 (wrzesień 2014): 708–17. http://dx.doi.org/10.1161/circoutcomes.114.000952.

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Sotnikov, A. V., M. V. Melnikov, V. A. Marinin, Yu V. Kisil i K. V. Samko. "Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study)". HERALD of North-Western State Medical University named after I.I. Mechnikov 10, nr 2 (15.12.2018): 52–57. http://dx.doi.org/10.17816/mechnikov201810252-57.

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Aim. To assess the potential of prevention cardiogenic embolism by resection of left atrium appendage (LAA) during open heart surgery in patients with atrial fibrillation (AFib). Materials and methods. Study design - cohort prospective. Study group consisted of 19 patients with AFib whom during open heart surgery for coronary and/or valvular disease additional radical resection of LAA was made. After removal of the appendage two-layer linear suture to left atrium was performed without leaving a stump. Control group consisted of 20 patients with AFib, in whom during open heart surgery LAA remained intact. Long-term results were studied using CROQ telephone questionnaire. Results. There was no hospital mortality in both groups. Long-term results in control group were followed up to 6 years, in study group up to 2 years. Radical resection of LAA in patients with AFib reduced the risk of thromboembolic events in long-term period. In control group there were 4 strokes (2 of them were fatal), but no strokes in study group (p < 0,05). Conclusion. Radical resection of LAA in patients with AFib during open heart surgery for coronary and/or valvular disease prevents cardiogenic arterial embolism. (For citation: Sotnikov AV, Melnikov MV, Marinin VA, et al. Prevention of embolism in patients with atrial fibrillation after resection of left atrium appendage during open heart surgery (pilot study). Herald of North-Western State Medical University named after I.I. Mechnikov. 2018;10(2):52-57. doi: 10.17816/mechnikov201810252-57).

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Lopez, Derrick, Lee Nedkoff, Matthew Knuiman, Michael S. T. Hobbs, Thomas G. Briffa, David B. Preen, Joseph Hung i in. "Exploring the effects of transfers and readmissions on trends in population counts of hospital admissions for coronary heart disease: a Western Australian data linkage study". BMJ Open 7, nr 11 (listopad 2017): e019226. http://dx.doi.org/10.1136/bmjopen-2017-019226.

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ObjectivesTo develop a method for categorising coronary heart disease (CHD) subtype in linked data accounting for different CHD diagnoses across records, and to compare hospital admission numbers and ratios of unlinked versus linked data for each CHD subtype over time, and across age groups and sex.DesignCohort study.Data sourcePerson-linked hospital administrative data covering all admissions for CHD in Western Australia from 1988 to 2013.Main outcomeRatios of (1) unlinked admission counts to contiguous admission (CA) counts (accounting for transfers), and (2) 28-day episode counts (accounting for transfers and readmissions) to CA counts stratified by CHD subtype, sex and age group.ResultsIn all CHD subtypes, the ratios changed in a linear or quadratic fashion over time and the coefficients of the trend term differed across CHD subtypes. Furthermore, for many CHD subtypes the ratios also differed by age group and sex. For example, in women aged 35–54 years, the ratio of unlinked to CA counts for non-ST elevation myocardial infarction admissions in 2000 was 1.10, and this increased in a linear fashion to 1.30 in 2013, representing an annual increase of 0.0148.ConclusionThe use of unlinked counts in epidemiological estimates of CHD hospitalisations overestimates CHD counts. The CA and 28-day episode counts are more aligned with epidemiological studies of CHD. The degree of overestimation of counts using only unlinked counts varies in a complex manner with CHD subtype, time, sex and age group, and it is not possible to apply a simple correction factor to counts obtained from unlinked data.

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Feng, Jia-Li, Siobhan Hickling, Lee Nedkoff, Matthew Knuiman, Christopher Semsarian, Jodie Ingles i Tom G. Briffa. "Sudden cardiac death rates in an Australian population: a data linkage study". Australian Health Review 39, nr 5 (2015): 561. http://dx.doi.org/10.1071/ah14226.

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Objective The aim of the present study was to develop criteria to identify sudden cardiac death (SCD) and estimate population rates of SCD using administrative mortality and hospital morbidity records in Western Australia. Methods Four criteria were developed using place, death within 24 h, principal and secondary diagnoses, underlying and associated cause of death, and/or occurrence of a post mortem to identify SCD. Average crude, age-standardised and age-specific rates of SCD were estimated using population person-linked administrative data. Results In all, 9567 probable SCDs were identified between 1997 and 2010, with one-third aged ≥35 years having no prior admission for cardiovascular disease. SCD was more frequent in men (62.1%). The estimated average annual crude SCD rate for the period was 34.6 per 100 000 person-years with an average annual age-standardised rate of 37.8 per 100 000 person-years. Age-specific standardised rates were 1.1 per 100 000 person-years and 70.7 per 100 000 person-years in people aged 1–34 and ≥35 years, respectively. Ischaemic heart disease (IHD) was recorded as the underlying cause of death in approximately 80% of patients aged ≥35 years, followed by valvular heart disease and heart failure. IHD was the most common cause of death in those aged 1–34 years, followed by unspecified cardiomyopathy and dysrhythmias. Conclusions Administrative morbidity and mortality data can be used to estimate rates of SCD and therefore provide a suitable methodology for monitoring SCD over time. The findings highlight the magnitude of SCD and its potential for public health prevention. What is known about the topic? There is considerable variability in rates of SCD worldwide. Different data sources and varied methods of case ascertainment likely contribute to this variation. What does this paper add? The rate of SCD in Australia is low compared with international estimates from USA, Ireland, Netherlands and China. Two in every three cases of SCD aged ≥35 years had a hospitalisation history of cardiovascular disease, highlighting the opportunity for prevention. What are the implications for practitioners? High-quality person-linked administrative hospital morbidity and registered mortality data can be used to estimate rates of SCD in the population. Understanding the magnitude and distribution of SCD is imperative for developing effective public health policy and prevention measures.

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Løgstrup, Brian Bridal, Kevin Kris Warnakula Olesen, Dzenan Masic, Christine Gyldenkerne, Pernille Gro Thrane, Torkell Ellingsen, Hans Erik Bøtker i Michael Maeng. "Impact of rheumatoid arthritis on major cardiovascular events in patients with and without coronary artery disease". Annals of the Rheumatic Diseases 79, nr 9 (29.05.2020): 1182–88. http://dx.doi.org/10.1136/annrheumdis-2020-217154.

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IntroductionRheumatoid arthritis (RA) is a risk factor for cardiovascular disease. The clinical consequences of coincident RA and coronary artery disease (CAD) are unknown.ObjectiveWe aimed to estimate the impact of RA on the risk of adverse cardiovascular events in patients with and without CAD.MethodsA population-based cohort of patients registered in the Western Denmark Heart Registry, who underwent coronary angiography (CAG) between 2003 and 2016, was stratified according to the presence of RA and CAD. Endpoints were myocardial infarction (MI), major adverse cardiovascular events (MACE; MI, ischaemic stroke and cardiac death) and all-cause mortality.ResultsA total of 125 331 patients were included (RA: n=1732). Median follow-up was 5.2 years. Using patients with neither RA nor CAD as reference (cumulative MI incidence 2.7%), the 10-year risk of MI was increased for patients with RA alone (3.8%; adjusted incidence rate ratio (IRRadj) 1.63, 95% CI 1.04 to 2.54), for patients with CAD alone (9.9%; IRRadj 3.35, 95% CI 3.10 to 3.62), and highest for patients with both RA and CAD (12.2%; IRRadj 4.53, 95% CI 3.66 to 5.59). Similar associations were observed for MACE an all-cause mortality.ConclusionsIn patients undergoing CAG, RA is significantly associated with the 10-year risk of MI, MACE and all-cause mortality regardless of the presence of CAD. However, patients with RA and CAD carry the largest risk, while the additive risk of RA in patients without CAD is minor. Among patients with RA, risk stratification by presence or absence of documented CAD may allow for screening and personalised treatment strategies

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Drew, Leslie R. H. "Mortality and Mental Illness". Australian & New Zealand Journal of Psychiatry 39, nr 3 (marzec 2005): 194–97. http://dx.doi.org/10.1080/j.1440-1614.2005.01543.x.

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Background: The finding by Lawrence, Holman and Jablensky (Duty to Care) that mortality among the mentally ill in Western Australia was 2.5 times that of the general population, seemingly, has great significance for public policy concerning the mentally ill. ‘Mortality’ could be a useful outcome measure for mental health services. Objectives: To replicate that study in the Australian Capital territory (ACT), comparing mortality rates in the mentally ill with those of the total population. Method: A list of all people who contacted the ACT mental health services between 1985 and 2000 was compiled. Using the national register of deaths (Australian Institute of Health and Welfare), persons known to the mental health services who died between 1990 and 2000 were identified and sex, date of birth, date of death, cause of death and place of death were noted. Using Australian Bureau of Statistics data for all deaths in the ACT, deaths in the total population and in the mentally ill population were tabulated for the period 1996–2000. With 1996 data as the base, using total population data from the ABS and mental health population data derived by amending ‘the list’ to remove duplications, pre1996 deaths and post1996 additions, mortality rates for the period 1996–2000 were compared. Results: The gender and age distribution of the mentally ill population and the total population, and of deaths in those populations, were very different. One third of all deaths in the mentally ill occurred outside of the ACT. Compared with the general population, mortality in the mentally ill (including deaths outside of the ACT) was only slightly excessive for ‘all causes’ and ischaemic heart disease but grossly excessive for ‘suicide’. Conclusions: This study did not confirm the excessive mortality rate in the mentally ill reported by Lawrence et al. except for suicide. Many methodological issues in using population studies to attempt to measure the size of the increase were identified. Differences in method between the ACT and WA studies probably explain the differences in results. Caution is urged in using the results of mortality studies as determinants of public policy or to evaluate services.

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Marques-Vidal, P., J. Ferrires, M. H. Metzger, J. P. Cambou, B. Filipiak, H. Lowel i U. Keil. "Trends in coronary heart disease morbidity and mortality and acute coronary care and case fatality from 1985-1989 in southern Germany and south-western France: Results from the MONICA Projects in Augsburg and Toulouse". European Heart Journal 18, nr 5 (1.05.1997): 816–21. http://dx.doi.org/10.1093/oxfordjournals.eurheartj.a015347.

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