Coronary heart disease

Theaimof this studywasto assesswhethernitrateadministra tion improvesthe imagingcapabilitiesof @°‘Tc-MlBl tomogra phy in detectingviablemyocardiumin coronaryarterydisease (CAD). Methods: Thirty-one patients withangiographically proven CADand chronicLV dysfunction(ejectionfraction39% ±9%) underwenttwo @°‘Tc-MlBl studieson separatedays:oneunder rest conditionsand the other after nitroglycerine(0.005mg/kg per Os)administration.Within1 wk, all patientsalso underwent rest-redistribution 2o1@fl imaging. Eightpatients werealsostud ied by echocardiography before and 5 ±3 mo after coronary revascularization. Results: On resting 99mTc.MlBl im ages, 302 segmentshad normal uptake, 183 segmentshad moderatelyreduceduptakeand 197 had severelyreducedup take. Of the segmentswith severelyreduceduptake,54 (27%) had increased uptake after nitroglycerineand were viable on 201fl images. Of the 143 (73%) segmentswith severely reduced @°Tc-MlBl uptakeand no changeafternitroglycerine, 81% werenonvi...

Patients with severe coronary artery disease with a clinical indication for revascularization but who are at high procedural risk because of patient comorbidities, complexity of coronary anatomy, and/or poor hemodynamics represent an understudied and potentially underserved patient population. Through advances in percutaneous interventional techniques and technologies and improvements in patient selection, current percutaneous coronary intervention may allow appropriate patients to benefit safely from revascularization procedures that might not have been offered in the past. The burgeoning interest in these procedures in some respects reflects an evolutionary step within the field of percutaneous coronary intervention. However, because of the clinical complexity of many of these patients and procedures, it is critical to develop dedicated specialists within interventional cardiology who are trained with the cognitive and technical skills to select these patients appropriately and to...

Interest in the development of functions that estimate the likelihood of an individual suffering a future cardiovascular disease (CVD) event has increased in recent times (e.g. Framingham sheets, SCORE-Systematic COronary Risk Estimation, PROCAM, etc.). However, the estimates of absolute risk may show substantial variations between different populations, because of geographical, cultural, social, behavioural and genetic differences, as well as various methodological issues related to the predictive models employed. We sought to calibrate the SCORE equations to the Greek population. We used the SCORE system that offers an estimation of total fatal CVD risk in "high" and "low" CVD risk European countries. The project pulls together a pool of datasets from 12 European countries and 2.7 million person-years of observation. A mathematical procedure to adjust the risk estimates for individual countries was applied, based on local mortality and risk factor prevalence da...

The aim of this study was to determine the extent of accumulation of lipoprotein(a) [Lp(a)] in human arterial wall and to define its potential role in atherogenesis. Biopsies routinely taken from the ascending aorta of 107 patients undergoing aortocoronary bypass surgery were analyzed for lipid and lipoprotein parameters, which were then correlated to serum values. A significant positive correlation was established between serum Lp(a) and arterial wall apolipoprotein (apo)(a) by enzyme-linked immunosorbent assay. High serum Lp(a) also led to a significant increase of apo B in the arterial wall. No significant correlation was found between apo B in serum and aortic tissue. Apo B was found to be partially linked to apo(a) in the aortic extract. Furthermore, apo(a) was found to be intact, as determined by its molecular weight in sodium dodecyl sulfate electrophoresis. This technique also revealed that the apo(a) isoform pattern of aortic homogenate was comparable to the individual seru...

This prospective cohort study examined the association between educational level and major causes of death in Japan.A baseline survey was conducted between 1988 and 1990 among 110,792 inhabitants of 45 areas aged 40–79 years. Follow-up surveys were conducted annually and causes of death were identified from death certificates. The analysis was restricted to 16,715 men and 23,284 women.During the follow-up period (377,139 person-years), 6628 deaths were recorded. Individuals with low levels of education had an increased overall risk of death [relative risk (RR) = 1.16, 95% confidence interval (CI): 1.08, 1.25, in men; RR = 1.26, 95% CI: 1.14, 1.39, in women], cancers (RR = 1.17, 95% CI: 1.04, 1.32, in men; RR = 1.10, 95% CI: 0.93, 1.30, in women), and death from external causes (RR = 1.81, 95% CI: 1.29. 2.54, in men; RR = 1.78, 95% CI: 1.18, 2.70, in women). Ischemic heart disease risk was marginally reduced in men with low levels of education (RR = 0.77, 95% CI: 0.58, 1.01).These results show that health inequalities exist in Japan, even though wealth inequalities are relatively low. Social and political initiatives will be needed to correct these inequities between different socioeconomic statuses.

To determine, among patients who present to the emergency department with symptoms suggestive of acute coronary syndrome (ACS), predictors of short-term revascularization. A prospective descriptive trial was performed. Potential predictors for revascularization were measured by means of a questionnaire of providers, serum for cardiac biomarkers, and an initial ECG. The primary outcome of revascularization (coronary bypass graft or percutaneous intervention) was determined through a medical record review. Potential predictors of revascularization were entered into a family of logistic regressions. 341 eligible subjects were enrolled, of whom 14% underwent revascularization. The predictors of revascularization included ST elevation on initial ECG (odds ratio 12.0), and an elevation in troponin I (odds ratio 8.9), CKMB (odds ratio 6.8), or myoglobin (odds ratio 4.7) on admission. When all three biomarkers competed in the same model, troponin I appeared to be the strongest predictor of short-term revascularization. In a single site study, among emergency department patients with symptoms suggestive of ACS, ST elevation on initial ECG and an elevation in troponin I, CK-MB, and myoglobin upon presentation all predicted short -term revascularization. Among the three biomarkers, elevation in troponin I was the strongest predictor. ABBREVIATED ABSTRACT: We conducted a prospective descriptive trial to identify predictors of short-term revascularization among 341 emergency department patients who presented with symptoms suggestive of ACS. Fourteen percent of the study population received revascularization. Predictors of revascularization included ST elevation on initial ECG (odds ratio 12.0.), and an elevation in troponin I (odds ratio 8.9), CKMB (odds ratio 6.8), or myoglobin (odds ratio 4.7) on admission. When all three biomarkers competed in the same model, troponin I appeared to be the strongest predictor of short-term revascularization.

ABSTRAK Penyakit jantung koroner merupakan penyakit arteri koroner yang ditandai adanya endapan lipid yang terkumpul di dalam sel yang melapisi dinding suatu arteri koroner dan menyumbat aliran darah. Tujuan penelitian mengkaji pengaruh Lipid Profile Terhadap Penyakit Jantung Koroner. Disain penelitian adalah survey analitik. Sampel penelitian adalah sebagian pasien di Instalasi Rawat Jalan Penyakit Dalam RSUD Nganjuk dengan jumlah 32 orang. Variabel penelitian adalah lipid profile yang terdiri dari HDL, LDL, Trigliserida. Instrumen penelitian adalah observasi dan hasil pemeriksaan laboratorium lipid profile. Analisis data menggunakan uji Fisher Exact . Hasil penelitian menunjukkan sebagian memiliki kadar HDL yang normal, lebih dari sebagian memiliki kadar LDL dan trigliserida yang tinggi. Pasien Penyakit Jantung Koroner Di  Instalasi Rawat Jalan Penyakit Dalam RSUD Nganjuk didapatkan terbanyak adalah NSTEMI dan terkecil adalah Asymtomatik. Hasil uji fisher exact menunjukkan terdapa...

Young male subjects, labeled Type A or Type B by means of the Bortner Scale and the Jenkins Activity Survey, first estimated the passage of five different intervals of time under one of three levels of distraction and then solved math and spelling problems. Autonomic nervous ...

Based on community surveys of the elderly of their nutritional habits in big cities throughout Indonesia and in urban and rural areas, the following observations are reported: (i) the elderly tend to reduce their food intake by themselves, in calories, carbohydrate, fat, protein content (15−30% less); (ii) they even reduce their traditional fatty food by themselves in spite of their already low fat intake daily (30−40% less); (iii) they very seldom eat snacks between meals (6.7−25.5%) of the respondents only; (iv) they tend to eat (very seldom − never) new ‘trendy foods’ (78−95%) such as hamburger, pizza, fried chicken etc., which are available in big cities; (v) the elderly usually eat just enough before satiety (84.3%); (vi) the majority of the elderly usually eat rice or other local staple foods, with mostly vegetables every day (50−80%), especially the traditional témpé (soybean cake) and tahu (soybean curd) and green vegetables (80%); fruits are consumed less than vegetables (40%); (vii) milk consumption still needs to be improved; (viii) fish consumption, the best healthy animal protein source, still needs to be promoted to the whole country, especially to the elderly on Java island; and (ix) an urban−rural difference was noted, the urban elderly having a higher intake of calories, fat and protein. Gender differences were practically not observed, except the higher calorie intake in men. The following findings support the aforementioned observations. The elderly have a lower mean body mass index (BMI); only 15.9% are overweight and only 4.5% are obese, although it is admitted that there are many elderly people who are underweight and malnourished. They also have lower mean cholesterol, triglyceride and haemoglobin values, but a higher prevalence of glucose intolerance, hypertension, coronary heart disease etc. is reported in many studies. In conclusion, the elderly in general have good eating habits, and they adjust their food intake to the reduced daily physical activities they perform. However, the consumption of eggs and fish (as low-cost protein sources) needs to be improved. Hence overeating and obesity are not a problem for the Indonesian elderly people, although it is admitted that undernutrition will be a problem unless properly anticipated. They usually prefer to eat the already healthy traditional food, especially the still popular vegetable source of protein and anti-oxidants. They eat the traditional food, témpé and tahu, making them a stronghold against diet ‘westernization’, and they should be used as a good example for the younger generation. Reduced calorie intake among the elderly is also observed in Japan, but not yet in most European elderly populations.