Current Issue : April - June Volume : 2020 Issue Number : 2 Articles : 5 Articles
This review paper focuses on the genetic contribution, in particular, the association\nof Apolipoprotein E gene polymorphism to lipid abnormality and\nsubsequent acute coronary syndrome in Han Chinese of China. Many researches\nhave been published pertaining the influence of ApoE gene polymorphism\non coronary artery disease, dyslipidemia and the response of statin\nin Han Chinese. Most of the studies in Han Chinese like other populations\ndemonstrated that ApoE 4 allele genetically predisposes coronary artery disease,\nacute coronary syndrome, severity of occlusion of coronary artery and\nhigher incidence of major adverse cardiovascular events (In Han Chinese,\nApoE allele carriers demonstrated 85% increase in major adverse cardiovascular\nevents (MACE) in six months follow up). In addition, ApoE4 allele carrier\nalso showed both increased in LDL level and decrease response to statin\ntherapy in dyslipidemic Han Chinese. On the other hand, ApoE2 carrier is\nscavenger of cholesterol and triglyceride from the blood; thus it is cardiovascular-\nprotective. Despite positive relationship between ApoE gene polymorphism\nand cardiovascular pathologies, prognostic outcome and resistance to\nintervention, this area of research still requires extensive investigation in Han\nChinese. Because, several other studies revealed either negative effect or\nshowed no effect by ApoE gene polymorphism on cardiovascular disease.\nSome of the causes of such debatable results could be explained by factors\nsuch as diminutive frequency allele and expression of ApoE gene in coronary\nheart disease. This part of the research yet requires extensive study with bulkier\nsample size and retrospective in nature, in order to ascertain the influ- ence of ApoE genotype on lipid, anti-hyperlipidemic agent and coronary\nheart disease. Such studies could assist us to confirm whether to test healthier\nsubjects to predict genetic risk of coronary heart disease in Han Chinese population.\nThe aim of this review paper is to critically analyze the effect of ApoE\ngene on the occurrence of coronary heart disease in Han Chinese....
Background: Secondhand smoke (SHS) exposure is a well-established cardiovascular risk factor, yet association\nbetween SHS and prognosis of heart failure remains uncertain.\nMethod: Data were obtained from the US National Health and Nutrition Examination Surveys III from 1988 to 1994.\nCurrently nonsmoking adults with a self-reported history of heart failure were included. Household SHS exposure\nwas assessed by questionnaire. Participants were followed up through December 31, 2011. Cox proportionalhazards\nmodels were used to assess the association of household SHS exposure and mortality risk. Potential\nconfounding factors were adjusted.\nResults: Of 572 currently nonsmoking patients with heart failure, 88 were exposed to household SHS while 484\nwere not. There were totally 475 deaths during follow-up. In univariate analysis, household SHS was not associated\nwith mortality risk (hazard ratio [HR]: 0.98, 95% confidence interval [CI]: 0.76â??1.26, p = 0.864). However, after\nadjustment for demographic variables, socioeconomic variables and medication, heart failure patients in exposed\ngroup had a 43% increase of mortality risk compared with those in unexposed group (HR: 1.43, 95% CI: 1.10â??1.86,\np = 0.007). Analysis with further adjustment for general health status and comorbidities yielded similar result (HR:\n1.47, 95% CI: 1.13â??1.92, p = 0.005).\nConclusion: Household SHS exposure was associated with increased mortality risk in heart failure patients....
Background: Cardiovascular disease (CVD) imposes much mortality and morbidity worldwide. The use of â??deep\nlearningâ?, advancements in genomics, metabolomics, proteomics and devices like wearables have the potential to\nunearth new insights in the field of cardiology. Currently, in Asia, there are no studies that combine the use of\nconventional clinical information with these advanced technologies. We aim to harness these new technologies to\nunderstand the development of cardiovascular disease in Asia.\nMethods: Singapore is a multi-ethnic country in Asia with well-represented diverse ethnicities including Chinese,\nMalays and Indians. The SingHEART study is the first technology driven multi-ethnic prospective population-based\nstudy of healthy Asians. Healthy male and female subjects aged 21â??69 years old without any prior cardiovascular\ndisease or diabetes mellitus will be recruited from the general population. All subjects are consented to undergo a\ndetailed on-line questionnaire, basic blood investigations, resting and continuous electrocardiogram and blood\npressure monitoring, activity and sleep tracking, calcium score, cardiac magnetic resonance imaging, whole\ngenome sequencing and lipidomic analysis. Outcomes studied will include mortality and cause of mortality,\nmyocardial infarction, stroke, malignancy, heart failure, and the development of co-morbidities.\nDiscussion: An initial target of 2500 patients has been set. From October 2015 to May 2017, an initial 683 subjects\nhave been recruited and have completed the initial work-up the SingHEART project is the first contemporary\npopulation-based study in Asia that will include whole genome sequencing and deep phenotyping: including\nadvanced imaging and wearable data, to better understand the development of cardiovascular disease across\ndifferent ethnic groups in Asia....
Background: Individuals with established cardiovascular disease (CVD) and risk factors such as age, smoking,\nhypertension, and diabetes mellitus are at an increased risk of recurrent cardiovascular events and death. The\nincidence rate of recurrent CVD events varies between countries and populations. The United Arab Emirates (UAE)\nhas one of the highest age-standardized death rates for CVD worldwide. The aim of our study was to estimate the\nincidence rates and determine the predictors of recurrent CVD events among UAE nationals.\nMethods: We investigated an outpatient-based cohort of patients with a history of CVD visiting Tawam Hospital\nbetween April 1, 2008 and December 31, 2008. They were followed-up until July 31, 2018. Univariable and\nmultivariable Cox proportional hazards regression models were used to determine the association between major\nCVD risk factors and the risk of CVD recurrence.\nResults: A total of 216 patients (167 males, 49 females) with a history of CVD were included. They were followed\nfor a median (interquartile range) of 8.1 (5.5â??9.3) years, with a total of 1184 patient-years of follow-up. The overall\nincidence rate of recurrent CVD events was 92.1 per 1000 patient-years. The 8-year cumulative incidence was 73.7%.\nAge, female sex, and diabetes mellitus were significant predictors of recurrent CVD events, where females had a\n1.96 times higher risk of recurrent CVD events than males.\nConclusion: Significant predictors of recurrent CVD events are older age, female sex, and diabetes mellitus. The\nincidence rate of recurrent CVD events was 92.1 per 1000 patient-years. Preventive measures, based on international\nguidelines for CVD management, may improve CVD morbidity and mortality in the UAE population....
Background: Increasing evidence has been presented which suggests that left ventricular (LV) diastolic dysfunction\nmay play an important role in the development of atrial fibrillation (AF). However, the potential for LV diastolic\ndysfunction to serve as a predictor of AF recurrence after radiofrequency catheter ablation remains unresolved.\nMethods: Dual Doppler and M-PW mode echocardiography were performed in 67 patients with AF before ablation\nand 47 patients with sinus rhythm. The parameters measured within identical cardiac cycles included, the time interval\nbetween the onset of early transmitral flow peak velocity (E) and that of early diastolic mitral annular velocity (eâ??) (TE-eâ??),\nthe ratio of E to color M-mode Doppler flow propagation velocity (Vp)(E/Vp), the Tei index, the ratio of E and mitral\nannular septal (S) peak velocity in early diastolic E/eâ??(S) and the ratio of E and mitral annular lateral (L) peak velocity E/\neâ??(L). A follow-up examination was performed 1 year after ablation and patients were divided into two groups based\non the presence or absence of AF recurrence. Risk estimations for AF recurrence were performed using univariate and\nmultivariate logistic regression.\nResults: TE-eâ??, E/Vp, the Tei index, E/eâ??(S) and E/eâ??(L) were all increased in AF patients as compared with the control\ngroup (p < 0.05). At the one-year follow-up examination, a recurrence of AF was observed in 21/67 (31.34%) patients.\nTE-eâ?? and the Tei index within the recurrence group were significantly increased as compared to the group without\nrecurrence (p < 0.001). Results from multivariate analysis revealed that TE-eâ?? can provide an independent predictor for\nAF recurrence (p = 0.001).\nConclusions: Dual Doppler echocardiography can provide an effective and accurate technique for evaluating LV\ndiastolic function within AF patients. The TE-eâ?? obtained within identical cardiac cycles can serve as an independent\npredictor for the recurrence of AF as determined at 1 year after ablation....
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