male sex, and positive family history .  Age, sex, Body Mass Index (BMI), systolic and Effects of some coronary risk factors (age, diastolic blood pressures, levels of serum total Hypertension, Diabetes mellitus and smoking) on QTd cholesterol, triglyceride, HDL-cholesterol and LDL- have been investigated [6-9] . However, effect of cholesterol were taken into account. Of the patients using hyperlipidemia, positive family history and independent Oral Antidiabetic Drugs (OAD) and insulin or ones with effects of all coronary risk factors on QTd have not been a 2 hour blood sugar over 200 mg dLG on an oral glucose
papaverine (10 mg) were selectively infused into the left anterior descending coronary artery of 28 patients, in whom the study artery was angiographically normal (n = 16) or with mild stenosis < or = 40% (n = 12). Coronary blood flow (CBF) was estimated from the product of mean CBF velocity measured by an intracoronary Doppler catheter and the arterial cross- sectional area of the study artery determined by quantitative arteriography. ACH increased CBF in a dose-dependent manner. However, the maximum CBF response to ACH varied widely among patients (from 50% to 660%). By multivariate analysis, the presence of atherosclerotic lesions in the study artery was an independent predictor for impaired CBF response to ACH (P < 0.01). Hypertension (P < 0.001), hypercholesterolemia (r = -0.52, P < 0.005), age > or = 50 yr (P < 0.01) and total number of coronary risk factors (r = -0.62, P < 0.001) were associated with the impaired increase in CBF with ACH by univariate analysis. The percent increase in CBF evoked with papaverine did not correlate with these risk factors. The results suggest that mild atherosclerotic lesions […]
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perception of symptoms is responsible for the different presentation of symptoms. Also, men might be less likely to show CAD symptoms than women. The reason of gender difference might be because of lagging in male patients in meeting doctors. Therefore coronary artery disease in men probably has been diagnosed in the more obstructive plaque status. Our findings of higher prevalence of CAD risk factors in the Iranian females similar to other study , may be because of this reason that female patients report their CAD risk factors to their doctors more than male patients.
AAD naturally has an extremely poor prognosis, and it has been noted that many cases prove fatal shortly after the onset with emergency operation normally required to rescue patients suffering from type A aortic dissection [1–3]. Exclusion of the entry by replacing the dissected ascending aorta and/or aortic arch to the artificial graft is the standard technique for Stanford A dissection; however, surgeons generally do not recognize asymp- tomatic coronary artery disease without ST-T changes in the electrocardiogram because CAG or coronary CT are not routinely performed before emergent operation. Therefore, treating AAD still carries a potential risk for Table 2 Coronary risk factors
angiographically normal coronary arteries. The effects of intracoronary L-NG monomethyl arginine (L-NMMA) were investigated at rest and after ACH, sodium nitroprusside, and adenosine. L-NMMA (64 mumol/min) increased resting coronary vascular resistance by 22% (P < 0.001), reduced distal epicardial coronary artery diameter by 12.6% (P < 0.001), and inhibited ACH-induced coronary epicardial and microvascular vasodilation. These effects were reversed with intracoronary L-arginine. L-NMMA did not inhibit dilation in response to sodium nitroprusside and adenosine. 23 patients were exposed to one or more coronary risk factors. The vasoconstrictor effect of L-NMMA on the epicardial and
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There have been several reports of SCAD not being caused by chest trauma or during PCI [1-6]. SCAD is observed in acute coronary syndromes or in the sudden death of women post-partum [1, 2]. Other causes of SCAD are connective-tissue diseases , systemic congenital diseases such as Ehlers-Danlos syndrome, fibromuscular dysplasia  as well as in cocaine abuse. Common coronary artery disease can be expressed as coronary dissection. Some authors [7, 8] have suggested a correlation between coronary vasospasm and SCAD but a systematic study on the relationship between them has not been done. Mark et al.  reported a 50-year-old female, who had ST elevation in the inferior leads on chest pain that was relieved with nitrate. Coronary angiography showed a definite dissection in the posterior descending artery. During the angiographic study, spontaneous chest pain with ST elevation in the inferior leads arose. At this time, the posterior descending artery was occluded transiently. Nishikawa et al.  described 4 patients with considerable dissection upon angiography after they suffered myocardial infarction. Two of these patients had chest pain at rest before infarction. They suggested the possibility of vasospasm in these cases but the authors did not try to demonstrate vasospasm with Holter recordings or with provocation of vasospasm in the angiographic study. Roth et al.  reviewed 103 cases who sustained myocardial infarction post-partum and 41 of these showed coronary artery dissection. Among these, only 2 subjects were shown to have vasospasm. SCAD, like aortic dissection, can be caused by cystic medial necrosis or inflammation. However, none of the cases reported here had aortic dissection, systemic congenital diseases, connective-tissue disorders, chronic inflammatory diseases or abused cocaine. Other possible causes of dissection include strong force to the coronary arteries (e.g., chest trauma) or extreme physical activity. As reported by Roth et al., pregnancy and delivery can give rise to various mechanical or hormonal stresses to the vascular system. Eight of our cases were females but the intervals between their last delivery and
Coronary heart disease has been defined as “impairment of heart function due to inadequate blood flow to the heart compared to its needs, caused by obstructive changes in the coronary circulation to the heart”. Coronary artery disease is the leading cause of death among women, regardless of race or ethnicity and causing the deaths of 1 in 3 women; this amounts to more deaths from heart disease than from stroke, lung cancer, chronic obstructive lung disease, and breast cancer combined. Women with coronary artery disease present differently than men, have different pathophysiologies and risks profiles and are often significantly older and thus often have poorer outcomes. Experts in industrialized
H. pylori infected patients are at higher risk of developing dyslipidemia. The presence dyslipidemia among H. pylori positive patients shows the possible modi ﬁ cation of serum lipid pro ﬁ le. So, it is possible to conclude that H. pylori positive patients are more likely to have modi ﬁ ed lipid pro ﬁ le than H. pylori negative patients. Monitoring and evaluation of TC, TG, LDL-C, and HDL-C in H. pylori infected patient is impor- tant. Further studies should be conducted with larger sample size using prospective study design and advanced test for H. pylori determination to investigate the effect of H. pylori infection on serum lipid pro ﬁ les. There for assessment of lipid pro ﬁ le in H. pylori infected patient is recommended.
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Nonnormal values of arterial stiffness and thickness were log transformed. General linear models were con- structed to elucidate independent de- terminates of carotid thickness and stiffness. The full model contained group, age, race, and gender. Height was included in the full model of AIx because height inﬂuences the distance of reﬂection sites to the heart, which in turn affects AIx. BMI, lipids, BP, glu- cose, and insulin were excluded from the model because they are incorpo- rated into the high- and low-risk clus- tering score. Similarly, we classiﬁed the PDAY score as equal to or less than the median score (PDAY low) and greater than the median score (PDAY high), a method previously used for ad- olescents and young adults. 9 Similar to
Tobacco contributes to 17 percent of all female deaths in the United States and results in more deaths from CHD and stroke than any other cause. The combination of accelerated atherosclerosis and propensity to vascular thrombosis induced by cigarette smoking is responsible for a six-to nine-fold increased risk of myocardial infarction among female smokers compared with nonsmokers. There is a similar increase in stroke risk. The combination of cigarette smoking and oral contraceptive use appears to be particularly potent at increasing the risk of arterial thrombosis.
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Dyslipidemia is a well-established risk factor for CAD in different populations, with and without diabetes mel- litus . In our high risk group, approximately 80% of patients had dyslipidemia. Low levels of HDL choles- terol, often associated with elevated triglyceride levels, are the most prevalent pattern of dyslipidemia in per- sons with T2DM . Both alterations were more preva- lent in T2DM with CAD in our group. This lipid modification is commonly associated with insulin resist- ance [27,28]. However, we found no differences between HOMA-IR between the groups. It is noteworthy that the HOMA-IR in patients with T2DM was much higher when compared to normoglycemic individuals, in agree- ment with the role of insulin resistance in T2DM (Table 1). If elevated LDL-cholesterol is a well defined causal risk factor for CAD, uncertainty exists about whether elevated triglyceride levels represents an add- itional independent CVD risk factor . Of course, data from these epidemiological studies do not necessarily
Based on the results of table 6, almost all respondents experienced recurrence of CHD. Respondents who both comply with the treatment and did not comply with the treatment had a big difference between the incidence of the risk of relapse and the relapse of CHD. Based on Chi square test results, it is known that the Sig.Pearson Chi- Square value is 0.033 which is smaller than the error tolerance value (α) = 5%. So it was concluded that the variable adherence to taking medication had a significant effect on the risk of CHD recurrence.
Inflammation also affects endothelial cell function. Endothelial dysfunction may impair endothelium- dependent relaxation, induce vasoconstriction and vasos- pasm and promote platelet adhesion [33,34]. Release of von Willebrand factor (vWF) may mediate this platelet adhesion . Endothelial cell activation with adherence of infected erythrocytes is considered a key factor in the pathogenesis of a P. falciparum infection. Indeed, the occurrence of endothelial cell activation with release of active vWF has previously been demonstrated in early experimental malaria infections . Increasing evidence suggests a potential mechanistic role for vWF in the patho- genesis of acute coronary syndromes. However, sig- nificant rises in vWF levels have also been demonstrated in patients with naturally acquired malaria without the development of any coronary syndromes .
This is the first nationwide study of the incidence of POAF following coronary artery and/or AVR surgery. Other strengths of the study were that the patients were found using two separate registries and the phenotype of POAF was well defined, with comprehensive arrhythmia surveillance of longer duration than in most other stud- ies. All patients were operated on and treated for POAF at a single centre, and they were therefore less likely to be affected by bias due to tertiary referral. Furthermore, none of the patients were lost to follow-up. The weak- ness of the study was its non-randomized nature and the inability to infer causality.
Using this technique, important insights into the role of endothelium in the pathogenesis of atherosclerotic disease have been obtained. Normal endothelium mediates vasodilatation, but at the site of atherosclerotic plaques, dysfunctional endothelium may mediate paradoxical vasoconstriction in response to acetylcholine (Ludmer et al 1986). This observation underscores the importance of dynamic plaque constriction as an active mechanism in ischaemia, in addition to ischaemia which may result from fixed stenoses limiting tissue perfusion at times of increased metabolic demand. Similar experiments have linked endothelial dysfunction to failure of vasodilatation or constriction of arteries in response to exercise (Gordon et al 1989), increased flow (Nabel et al 1990), sympathetic stimulation (Nabel et al 1988) and mental stress (Yeung et al 1991). A similar shift towards constrictor responses has been observed in angiographically smooth arteries in patients who have overt disease in other coronary vessels (Zeiher et al 1991), and in subjects with known risk factors for atheroma (Vita et al 1990). Increasing age is also associated with impaired endothelium-dependent responses (Yasue et al 1990). These latter observations in angiographically smooth vessels emphasise the importance of endothelial dysfunction in the early stages of atherosclerosis (Zeiher et al 1991).
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3. Luepker RV, Apple FS, Christenson RH, Crow RS, Fortmann SP, Goff D, Goldberg RJ, Hand MM, Jaffe AS, Julian DG, Levy D. Case definitions for acute coronary heart disease in epidemiology and clinical research studies: A statement from the AHA Council on Epidemiology and Prevention; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation. 2003; 108(20):2543-9.
The findings in our study indicate that an increased common carotid intima-media thickness is associated with diabetes. Also the LA is more prevalent in diabetic patients. It is important to realize that there were no matching in atherosclerosis risk factors except age and sex.
Objective: to present a reflection about the risk factors that lead to the onset of coronary artery disease. Method: Descriptive and exploratory study, conducted through integrative review of literature. The survey was conducted in the month of March 2019, where he researched the following descriptors: risk factors; Coronary artery disease. The initial sample was of 69 articles, however, after the application of the exclusion criteria, obtained a sample of 15 articles where only 05 were considered for this review, by address in more depth the subject of this study. On identification of sources for location articles were consulted databases: Virtual Health Library; Latin American Caribbean system on health sciences information; Coordenação de Aperfeiçoamento de Pessoal de Nível Superior; Regional online information system for scholarly journals from Latin America, Caribbean, Spain and Portugal and Ibero-American Network of Scientific Publishing in nursing. Results and Discussion: Among the various diseases that contribute to the involvement of coronary artery disease diabetes and hypertension are diseases that has been excelling in recent years, being regarded as a worldwide epidemic, becoming a problem public health. Conclusion: the presentation of the data brings a warning about the need for the development of strategies for the prevention of diseases and for the early detection of risk factors for coronary artery disease.
The coronary risk factors in both sexes are the same but after menopause their influence on women is different. This is due to the female specific hormonal changes during menopausal period. The data collected from POLISH ACS registry revealed that women with ACS were older than men by 7.7 years. In our study, 88% of the female patients had attained menopause and this was clearly indicative of the age related and hormonal influence on the incidence of ACS .
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patients with SLE had lower high-density lipoprotein (HDL) cholesterol as well as higher very low-density lipoprotein (VLDL) cholesterol, triglycerides, and lipo- protein (a) concentrations. Increased carotid intima thickness, increased plasma concentrations of circulating oxidized LDL and homocysteine, as well as endothelial defects, have all been incriminated in the premature coronary heart disease seen in patients with SLE. 9–11