Current Issue : October - December Volume : 2019 Issue Number : 4 Articles : 5 Articles
Cardiovascular Health (CVH) metrics scores are associated with cardiovascular disease\nbut whether CVH scores are associated with nonalcoholic fatty liver disease (NAFLD) is uncertain.\nOur aim was to investigate associations between CVH scores and development or regression of\nNAFLD. A cohort study was performed in Korean adults who underwent a comprehensive health\nexamination. The CVH metrics were defined according to the American Heart Association Lifeâ??s\nSimple 7 metrics, ranging from 0 (all metrics considered unhealthy) to 7 (all metrics considered\nhealthy). Fatty liver was diagnosed by ultrasound, and liver fibrosis assessed using NAFLD fibrosis\nscore (NFS). Among 93,500 participants without NAFLD or fibrosis at baseline, 15,899 developed\nNAFLD, and 998 developed NAFLD plus intermediate/high NFS. HealthyCVHmetrics were inversely\nassociated with NAFLD and also NAFLD with fibrosis. In time-dependent models after updating the\nCVH score and confounders as time-varying covariate, the multivariable-adjusted hazard ratio (95%\nconfidence intervals) for incident NAFLD plus intermediate/high NFS participants with CVH metrics\nscore 2, 3, 4, 5, or 6-7 to those with score 0-1 were 0.86 (0.59-1.25), 0.51 (0.36-0.73), 0.44 (0.31-0.62),\n0.20 (0.14-0.29) and 0.09 (0.05-0.14), respectively. Regression of NAFLD occurred in 9742/37,517\nparticipants who had NAFLD at baseline with positive association with CVH metrics. Higher CVH\nscores were significantly associated with both (a) decreased incidence of NAFLD, and (b) regression\nJ. Clin. of existing NAFLD. Promoting adherence to ideal CVH metrics can be expected to reduce the burden\nof NAFLD as well as cardiovascular disease....
Background: Warfarin is the standard of care and NOAC (Novel oral anticoagulants) are a group of newer drugs for\nsuch purposes. NOAC has a generally better profile (Clear interaction, less side effect, require less monitoring). However,\nits efficacy on valvular atrial fibrillation remains unclear.\nMethod: We researched literature articles from Embase, Cochrane and PubMed. Then we meta-analysed these six articles\nto assess pooled estimate of relative risk (RR) and 95% confidence intervals (Cl) using random-effects model for stroke,\nsystemic embolic event, major bleeding and all-cause mortality. Heterogeneity across study was tested with Cochranâ??s Q\nTest and I2 Test. The bias of studies was first tested by examining the symmetry of Funnel Plot. Cochraneâ??s Collaboration\nTool was also used to report any presented bias.\nResults: We collected 496 articles in total and finally we included six articles in our meta-analysis. For SSEE (Stroke, Systemic\nEmbolic Event), the pooled relative risk showed a significantly better clinical outcome of NOAC (RR: 0.66; 95% CI: 0.46 to 0.\n95). However, there is no significant difference in major bleeding (RR: 0.714, 95% CI:0.46 to 1.11) and all-cause mortality (RR:\n0.84, 95% CI: 0.58 to 1.21).\nConclusion: Compared to Warfarin, NOAC is significantly more protective against the embolic event, but no significant\ndifference in lowering risk of major bleeding, all-cause mortality or all aspects of post-TAVI (Trans-catheter aortic valve\nimplantation)....
Background: Cerebral hypoperfusion may aggravate neurological damage after cardiac arrest. Near-infrared\nspectroscopy (NIRS) provides information on cerebral oxygenation but its relevance during post-resuscitation\ncare is undefined. We investigated whether cerebral oxygen saturation (rSO2) measured with NIRS correlates\nwith the serum concentration of neuron-specific enolase (NSE), a marker of neurological injury, and with clinical\noutcome in out-of-hospital cardiac arrest (OHCA) patients.\nMethods: We performed a post hoc analysis of a randomised clinical trial (COMACARE, NCT02698917) comparing two\ndifferent levels of carbon dioxide, oxygen and arterial pressure after resuscitation from OHCA with ventricular fibrillation\nas the initial rhythm. We measured rSO2 in 118 OHCA patients with NIRS during the first 36 h of intensive care. We\ndetermined the NSE concentrations from serum samples at 48 h after cardiac arrest and assessed neurological outcome\nwith the Cerebral Performance Category (CPC) scale at 6 months. We evaluated the association between rSO2 and serum\nNSE concentrations and the association between rSO2 and good (CPC 1-2) and poor (CPC 3-5) neurological outcome.\nResults: The median (inter-quartile range (IQR)) NSE concentration at 48 h was 17.5 (13.4-25.0) microg/l in patients with good\nneurological outcome and 35.2 (22.6-95.8) microg/l in those with poor outcome, p < 0.001. We found no significant\ncorrelation between median rSO2 and NSE at 48 h, rs = - 0.08, p = 0.392. The median (IQR) rSO2 during the first 36 h of\nintensive care was 70.0% (63.5-77.0%) in patients with good outcome and 71.8% (63.3-74.0%) in patients with poor\noutcome, p = 0.943. There was no significant association between rSO2 over time and neurological outcome. In a binary\nlogistic regression model, rSO2 was not a statistically significant predictor of good neurological outcome (odds ratio 0.99,\n95% confidence interval 0.94-1.04, p = 0.635).\nConclusions: We found no association between cerebral oxygenation measured with NIRS and NSE concentrations or\noutcome in patients resuscitated from OHCA....
Arrhythmic sudden cardiac death (SCD) represents a major worldwide public health problem accounting for\n15-20% of deaths. Risk stratification to identify patients at risk of SCD is crucial in order to implement preventive\nmeasures in the general population. Several biomarkers have been tested exploring different pathophysiological\nmechanisms of cardiac conditions. Conflicting results have been described limiting so far their use in clinical\npractice. The use of new biomarkers such as microRNAs and sex hormones and the emerging role of genetic on\nrisk prediction of SCD is a current research topic showing promising results.\nThis review outlines the role of plasma biomarkers to predict ventricular arrhythmias and SCD in non coronary\nartery disease with a special focus on their relationship with the genetic biomarkers....
Background: Recent studies have indicated that monocyte chemoattractant protein-1 (MCP-1) plays an important\nrole in the initiation and progression of ischaemic heart disease. However, no previous research has investigated\nthe correlation between serum MCP-1 levels and early changes in myocardial function in patients with ST-segmental\nelevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI).\nMethods: A total of 87 STEMI patients who had undergone a successful primary PCI were consecutively recruited. All\nthe patients included in this study were grouped into two subgroups according to the median value of MCP-1 upon\nadmission. An early change in left ventricular ejection fraction (LVEF) was defined as (LVEF at 3 months post-STEMI)-\n(LVEF at 2 days post-STEMI).\nResults: Serum MCP-1 levels increased gradually over time during the first 72 h after the onset of STEMI. The\nconcentration of hypersensitive cardiac troponin I (hs-cTnI) upon admission as well as at 24 h and 72 h after\nprimary PCI, especially the peak hs-cTnI concentration, declined significantly in the low admission MCP-1\ngroup. As continuous variable, admission MCP-1 also correlated positively with admission hs-cTnI, hs-cTnI at\n24 h after primary PCI, and peak hs-cTnI...........................
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