bluuebunny/crossref_metadata_2025_split huggingface dataset:
The prevalence of cardiovascular risk factors and cardiovascular disease among primary care patients in Poland: results from the LIPIDOGRAM2015 study
Authors: Jozwiak J , Studzinski K , Tomasik T , Windak A , Banach M 
Published: November 2020

Abstract

Background
Cardiovascular disease (CVD) is currently one of the leading cause of mortality in the European Union. Well-established, modifiable cardiovascular (CV) risk factors include hypertension (HTN), hypercholesterolaemia, diabetes mellitus (DM), obesity, low activity levels, poor diet and smoking. There are no current estimates on the prevalence of CV risk factors among Polish patients solely in the primary care setting.

Methods
A nationwide cross-sectional study, LIPIDOGRAM2015, was carried out in Poland in the 4th quarter of 2015 and 1st and 2nd quarters of 2016. 438 primary care physicians enrolled 13,724 adult patients that sought medical care for any medical reason in primary health care practices.

Results
Nearly 19% of men and approximately 12% of women had CVD. Over 60% of the recruited patients had HTN, &gt;80% had dyslipidaemia and &lt;15% of patients were previously diagnosed with DM. All of these disorders were more frequent in men. Overweight and obesity were present in more than 75% of patients with 80% of them exceeding the waist circumference norm for the European population. Slightly less than half of the patients were current smokers or had smoked in the past. Patients with CVD had significantly higher blood pressure and glucose levels but lower low density lipoprotein-cholesterol level (LDL-C). In patients with CVD, HTN and dyslipidaemia were twice as frequent and DM three times more so than in patients without it (Figure 1).

Conclusions
The incidence of CVD and CV risk factors among patients attending primary healthcare in Poland is high. CVD is more common in men than in women. The most common CV risk factors are excess waist circumference, dyslipidaemia and HTN. Family physicians working in primary health care, as well as health authorities should conduct activities to prevent, diagnose early and treat CVD in the primary health care population.

Funding Acknowledgement
Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): The present study was an initiative of the Polish Lipid Association (PoLA) and the College of Family Physician in Poland (CFPiP). The present study was funded by an unrestricted educational grant from Valeant.
Nutritional risk index is an independent predictor of one-year mortality after primary angioplasty for ST-segment elevation myocardial infarction, regardless of age, frailty and clinical severity
Authors: Arroyo-Espliguero R , Silva-Obregon A , Viana-Llamas M.C , Estrella-Alonso A , Saboya-Sanchez S , Marian-Crespo C , Arriero-Fernandez N.G , Eguileor-Marin Z , Tirado-Fernandez M.A , Ruiz De Santaquiteria-Torres V , Castillo-Sandoval A , Toran-Martinez C , Uribe-Heredia G , Garcia-Magallon B , Perez-Sanchez A 
Published: November 2020

Abstract

Background
Undernutrition is a common feature of elderly and hospitalized patients with cardiovascular diseases and is associated with adverse events.

Purpose
Assess the impact of nutritional risk index (NRI) in one-year mortality in ST-segment elevation myocardial infarction (STEMI) patients following primary angioplasty (PA).

Methods
Cohort of 319 consecutive patients (64.4 years [54.3–75.2]; 21.9% women) admitted to a general ICU after a PA for STEMI. NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (actual body weight [kg]/ideal weight [kg]). Patients were dichotomized in no to mild (NRI ≥97.5) and moderate to severe (NRI &lt;97.5) nutritional risk. We used Kaplan-Meier and Cox survival models.

Results
Patients with NRI &lt;97.5 were older, mainly women, had a higher GRACE 2.0 and required more inotropic agents (P=0.001) and mechanical ventilation (P=0.002) during admission. They had lower CK and higher BNP levels, despite the lack of differences in LVEF and MI location (P=0.164) (Table 1). One-year mortality rate was higher in patients with NRI &lt;97.5 (P&lt;0.001), mainly from cardiogenic shock (P&lt;0.001) (Table). After Cox regression analysis, moderate to severe nutritional risk showed a 3.10-fold higher risk of one-year mortality (95% confidence interval [CI], 1.21 to 7.90, P=0.018), independently of age, female gender, frailty (Clinical Frailty Scale ≥4), GRACE 2.0 and LVEF (Figure 1).

Conclusion
Moderate to severe NRI was associated with one-year all-cause mortality in patients undergoing PA for STEMI, regardless of age, female gender, frailty and clinical severity. The prognostic impact of NRI in mortality suggests the need to include its assessment in clinical examination of STEMI patients.
Figure 1. Kaplan-Meier and Cox survival curves

Funding Acknowledgement
Type of funding source: None
Association of habitual alcohol consumption with carotid atherosclerotic lesions: results from the Corinthia study
Authors: Theofilis P , Oikonomou E , Vogiatzi G , Lazaros G , Tsalamandris S , Mystakidi V.C , Goliopoulou A , Chasikidis C , Miliou A , Fountoulakis P , Papaioannou N , Papakonstantinou M , Tousoulis D 
Published: November 2020

Abstract

Introduction
Alcohol is implicated in the pathophysiology of cardiovascular diseases. However, it is also believed to play a cardioprotective role if consumed in appropriate amounts.

Purpose
To assess the association between alcohol consumption and carotid atherosclerosis.

Methods
In the setting of the cross-sectional Corinthia study, volunteers filled in questionnaires regarding drinking habits and were characterized as social drinkers (SD) or habitual alcohol consumers (HAC). Furthermore, they underwent carotid ultrasonography examination to evaluate the carotid intima-media thickness (cIMT). Thickness of cIMT&gt;1.5 mm or protrusion &gt;50% compared to adjacent segments was considered as atherosclerotic plaque.

Results
HAC consumers were usually male (HAC: 61.1%, SD: 24.9%, p&lt;0.001), smokers (HAC: 33.3%, SD: 23.5%, p&lt;0.001) and frequently had a history of hypertension (HAC: 72.8%, SD: 67.5%, p=0.02) when compared to SD (Table 1). However, no significant differences were noted regarding other risk factors of atherosclerosis (Table). Notably, HAC had a greater extent of carotid atherosclerosis as demonstrated by an increased cIMT (HAC: 1.03±0.45mm, SD: 0.96±0.39mm, p&lt;0.001) and carotid plaque burden (HAC: 27.7%, SD: 21.3%, p=0.004). Importantly, when taking into account the number of alcoholic drinks (in wine glasses), alcohol consumption of more than 1 wine glass resulted in significantly higher values of cIMT (1 wine glass: 1.00±0.42mm, &gt;1 wine glass: 1.06±0.45mm, p=0.04) (Figure 1A) and extensive amount of carotid plaques (1 wine glass: 22.7%, &gt;1 wine glass: 30.4%, p=0.02) when compared to consumption of 1 wine glass (Figure 1B).

Conclusion
Habitual alcohol consumption of more than one wine glass is associated with a higher carotid atherosclerotic burden.
Figure 1

Funding Acknowledgement
Type of funding source: None
Salt Intake in Nigeria: a nationwide population survey
Authors: Odili A.N , Chori B.S , Danladi B , Nwakile P.C , Ogedengbe J.O , Nwegbu M.M , Isiguzo G.C 
Published: November 2020

Abstract

Background
Population wide salt reduction programmes are cost effective strategies for control of cardiovascular diseases (CVDs). Obtaining a nationwide salt consumption data in a multi-cultural setting as Nigeria's is key for proper implementation and monitoring of such strategy.

Methods
We measured sodium in 24-hour urine of free-living adult Nigerians selected from an urban and a rural site each from the 6 geopolitical zones of Nigeria to evaluate patterns of salt intake and its associations with blood pressures (BP).

Results
Across the 12 sites, sodium intake ranged from 97.9 in the rural South-South to 210 mmol/day in the urban site of the same zone. Overall, the median (IQR) daily sodium intake was 143.5 (97.8) mmol; with higher (p=0.0028) levels among the urban 149.7 (113.8) compared to the rural 133.1 (105.2) dwellers. Overall, 20% of the subjects consumed less than the recommended 2g (86mmol) of sodium daily. After adjustment for age, sex and BMI; sodium intake and BP (systolic and diastolic) were positively associated in 8 out of the 12 sites; significantly so in 2 (p&lt;0.05) for systolic. Within population analysis; which included 973 individuals, increasing sodium intake tended (not significantly) to increase SBP but decrease DBP. However, among subjects whose sodium intake was in excess of 257mmol/day, a 100 mmol/day increase in sodium intake was significantly (p=0.04) associated with a 3.3 mmHg increase in SBP.

Conclusion
Salt intake among Nigerians is higher than the recommended. The impact of sodium intake on BP appears to be evident only among individuals with high salt intake.

Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): Wellcome Trust
Impact of cardiovascular health status on the dose-response relationship between physical activity and incident morbidity and mortality
Authors: Bakker E.A , Oymans E.J , Hopman M.T.E , Thijssen D.H.J , Eijsvogels T.M.H 
Published: November 2020

Abstract

Background
Although the health benefits of a physically active lifestyle are well-known, there is ongoing discussion about the dose-response relationship between physical activity (PA) and incident morbidity/mortality, and whether this association may be affected by cardiovascular health status.

Purpose
We compared the dose-response relationship of PA, incident major cardiovascular events (MACE) and all-cause mortality between healthy individuals and individuals with cardiovascular disease risk factors (CVRF) or cardiovascular diseases (CVD).

Methods
This study used data from Lifelines, which is a multi-disciplinary population-based cohort including 167,729 participants from the northern population of the Netherlands. Adults (&gt;18 yrs old) without severe illnesses or limited life expectancy (&lt;5 yrs) were included (N=143,059). PA volumes were presented as Metabolic Equivalent of Task (MET) minutes/week, and divided into quartiles (Q1-Q4). The primary outcome was a composite endpoint of incident MACE (i.e. myocardial infarction, stroke, heart failure, CABG or PCI) and all-cause mortality.

Results
Age (42±12 yrs) and proportion of male (40%) was lower in healthy individuals compared to individuals with CVRF (54±11 yrs, 45% male) or with CVD (57±13 yrs, 62% male). During a median follow-up of 7 years (IQR 6–9), 2,485 events occurred in healthy individuals (2% of n=112,018), 2,214 in individuals with CVRF (8% of n=27,982) and 1,100 (36% of n=3,059) in those with CVD. Higher PA volumes were associated with a lower risk of adverse outcomes in healthy individuals and in individuals with CVRF (Table 1). In contrast, only the highest PA quartile was associated with a risk reduction for adverse outcomes in individuals with CVD (Table 1). Also, effect-modification was present in the dose-response relationship between PA volumes and health outcomes for CVD (P-interaction&lt;0.05), but not for healthy or CVRF.

Conclusions
Cardiovascular health status impacts the dose-response relationship between PA volumes and adverse outcomes. These findings indicate that PA recommendations should be adjusted to an individual's health status for achieving maximal health benefits from a physically active lifestyle.

Funding Acknowledgement
Type of funding source: Foundation. Main funding source(s): The work of T.M.H.E is supported by the Netherlands Heart Foundation. The Lifelines Biobank initiative received a subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen [UMCG], University Groningen and the Northern Provinces of the Netherlands.
Impact of physical activity on all-cause mortality in European patients with atrial fibrillation: a report from the ESC-EHRA EORP AF General Long-Term Registry
Authors: Vitolo M , Proietti M , Harrison S , Kalarus Z , Tavazzi L , Potpara T , Lane D.A , Boriani G , Lip G.Y.H 
Published: November 2020

Abstract

Background
Physical activity (PA) may have a beneficial contribution for outcomes in patients with atrial fibrillation (AF).

Purpose
We aimed to evaluate the impact of self-reported PA in a large contemporary cohort of European AF patients on the risk of all-cause mortality.

Methods
We analyzed patients enrolled in the ESC-EHRA EORP-AF General Long-Term Registry. Self-reported PA was categorized, on the basis of reported time spent exercising, as follows: i) No PA; ii) Occasional PA; iii) Regular PA; iv) Intense PA. The primary outcome was all-cause death.

Results
Over 11096, a total of 8699 (78.4%) patients (mean age (SD) 69.1 (11.5); 40.7% female) had available data about PA and follow-up observation and were included in the analysis. Of these, 3703 (42.6%) reported no PA, 2829 (32.5%) occasional PA, 1824 (21.0%) regular PA, with only 343 (3.9%) reporting intense PA. With the 4 increasing PA categories, mean age, proportion of female patients, CHA2DS2-VASc and HAS-BLED scores were progressively lower (all p&lt;0.001). Use of vitamin K antagonist (VKA) declined across the classes of PA (53.1% vs. 52.2% vs. 44.5% vs. 33.9%, p&lt;0.001), while use of non-VKA OACs (NOACs) conversely increased. During a mean (SD) 680.6 (171.5) days of follow-up, there were a total of 848 (9.7%) all-cause death events. Based on Kaplan-Meier analysis, there was a progressively lower cumulative risk for all-cause death according to PA categories [Figure]. A multivariable Cox regression analysis, adjusting for CHA2DS2-VASc score, use of OAC at baseline and type of AF, found a lower risk of all-cause death associated with increasing levels of PA (Hazard ratio [HR]: 0.69, 95% confidence interval [CI]: 0.59–0.81 for occasional PA, HR: 0.45, 95% CI: 0.35–0.58 for regular PA, HR: 0.41, 95% CI: 0.23–0.76 for intense PA, when compared to no PA). In a sensitivity analysis, a regular-intense PA was inversely associated with occurrence of cardiovascular (CV) death, after multivariable adjustments for comorbidities (HR: 0.54, 95% CI: 0.37–0.77).

Conclusions
In a large contemporary cohort of European AF patients, self-reported PA was found to be inversely associated with all-cause death and CV death.
Kaplan-Meier Curves

Funding Acknowledgement
Type of funding source: Private company. Main funding source(s): Since the start of EORP, several companies have supported the programme with unrestricted grants
Ticagrelor could cause central sleep apnea after acute coronary syndrome in patients without left ventricular dysfunction or heart failure
Authors: Meurin P , Ben Driss A , Defrance C , Renaud N , Dumaine R , Weber H , Grosdemouge A , Mouram S , Pericart L , Bonnevie L , Tabet J.Y 
Published: November 2020

Abstract

Background
Although the prevalence of obstructive sleep apnea (OSA) syndrome is high in patients with acute coronary syndrome (ACS), little is known about central sleep apnea (CSA) in these patients, especially if they have no left ventricular dysfunction (indeed, it is well known that heart failure could be a confounding factor as it is an important cause of CSA). Furthermore, central apnea could be promoted by ticagrelor, a relatively new drug, already known to cause dyspnea (which could modify the apneic threshold) in some patients.

Purpose
To investigate the prevalence of central sleep apnea in patients without left ventricular dysfunction after ACS.

Methods
Monocentric prospective survey. All consecutive patients within 365 days after ACS were included if they had (1) left ventricular ejection fraction LVEF &gt;45%, (2) no history of heart failure, (3) systolic arterial pulmonary artery pressure &lt;45 mm Hg, and (4) no history of sleep apnea. After inclusion, patients underwent an overnight sleep study with a portable sleep monitor validated to differentiate central and obstructive apneas. Patients were then classified as “normal” patients if they had an AHI (apnea hypopnea index) &lt;15, “CSA patients” if they had an AHI &gt;15 with a majority of central sleep apneas and “OSA patients” if they had an AHI &gt;15 with a majority of obstructive sleep apneas.

Results
Between January 2018 and January, 2020, we included 115 consecutive patients (age 56.1±10.5, male 84%, mean body mass index 28.4±4.5, LVEF: 56±4%). Sleep study was performed 68±62 days (7–350 days) after ACS on average. All of the patients were receiving a single or (mostly) dual antiplatelet therapy: aspirin (n=114: 99%, ticagrelor (n=80: 69.5%), clopidogrel (n=28: 24%), prasugrel (n=4: 3.5%).
Finally 80 patients were taking ticagrelor, while 35 were not.
A total of 49/115 patients (42.6%) had a clinically significant (moderate to severe) sleep disordered breathing, with an AHI&gt;15: (CSA: n=27/115: 23.5%, OSA:n=22/115: 19%). Among them, 25/115 patients (22%) had a severe (AHI &gt;30) sleep disordered breathing: CSA 12% OSA: 10%.
Among patients receiving ticagrelor, 24/80 (30%) had a CSA with an AHI &gt;15, while, in patients not taking ticagrelor only 3/35 (8.5%) had CSA with an AHI &gt;15 (p=0.04)

Conclusion
As expected, OSA is frequent after ACS, as in all types of coronary artery disease patients. High prevalence of CSA was less expected and seemed to be correlated with ticagrelor administration. This monocentric survey is a preliminary safety signal. Further studies are needed to investigate the exact incidence, the sustainability and the potential consequences of ticagrelor induced central sleep apnea.

Funding Acknowledgement
Type of funding source: None
Effects of CPAP treatment on cardiac structure and function in individuals with obstructive sleep apnea and cardiovascular disease: a prospective 6-month randomised control trial
Authors: Franke K , Loffler K.A , Nicholls S.J , Anderson C.S , Cowan B.R , McEvoy R.D , Young A.A , Verjans J.W 
Published: November 2020

Abstract

Background
Obstructive sleep apnea (OSA) is associated with an increased risk of cardiovascular events. The influence of continuous positive airway pressure (CPAP) on cardiac function remains uncertain.

Purpose
To prospectively determine the effects of CPAP on cardiovascular function, as measured by cardiac magnetic resonance imaging (CMR) as a sub-study of the international SAVE trial (NCT00738179).

Methods
Participants with OSA and established cardiovascular disease were randomized to CPAP treatment plus usual cardiovascular care or Usual Care alone. Primary outcomes were defined as change in ventricular ejection fraction (EF) and stroke volume (SV) between baseline and 6-month follow-up both groups. Secondary outcomes included other ventricular parameters including volumes, mass, and strain, and atrial parameters.

Results
140 participants were included; mean CPAP adherence in those allocated to receive the treatment was 4.31±2.45 hours per night. Most were male (91%) and had moderate-severe OSA with minimal daytime sleepiness. There were no significant differences in left or right ventricular EF between groups after 6 months of treatment. There was an 8.5 mL increase in LV SV (95% CI; [4.3–12.6], p&lt;0.001) and a 7.7 mL increase in RV SV (95% CI; [3.4–12.0], p&lt;0.001) in the CPAP group compared to Usual Care. CPAP also affected left and right ventricular EDV, RV strain, and atrial parameters.

Conclusions
In the first prospective CMR imaging study of patients with OSA and cardiovascular disease, CPAP treatment did not change EF after 6 months, but did have significant effects on other parameters of cardiac function.

Funding Acknowledgement
Type of funding source: Other. Main funding source(s): Respironics Foundation; Australian National Health and Medical Research; New Zealand Health Research Council
Relationship between AF-risk, ischemic stroke AF related, and cognitive dysfunction in population older than 65 years-old. MIND-COR study
Authors: Ballesta-Ors J , Muria-Subirats E , Lorman-Carbo B , Panisello-Tafalla A , Clua-Espuny J.L 
Published: November 2020

Abstract

Background
The number of individuals with atrial fibrillation (AF) and cognitive impairment (CI) will increase 150% by 2050.

Purpose
The main objective of this study is to elucidate the relationship between AF-risk, the ischemic stroke, and the cognitive dysfunction.

Methods
Multicenter, longitudinal and retrospective community-based study of cohort ≥65 year-old without AF between 1/1/2013–31/12/2017 conducted by 11 Primary Care teams. Variables: sociodemographic; Charlson, CHA2DS2VASc score, Pfeiffer and NIHSS scores from records database (primary care, specialty clinics and hospitalizations). Kaplan-Meier to evaluate mortality.

Descriptive analysis
Cox regression to create an AF risk score was developed: Q1 (lowest AF-risk)-Q4 (highest AF-risk). Incidence density (ID) rate per 1000/people/years of AF and stroke; and CI prevalence were calculated by risk stratum.
Approved by Ethics Committee of IDIAP Jordi Gol PP15/047.

Results
46706 (women 49%) cases, aged 78.01±11.9 and average follow-up time 4.9±0.7 years. Q4 risk group (Q4) was characterized by women's (85.2%), highest age, AF, stroke, CI and mortality.
1244 AF were diagnosed (ID 10.5/1000/year's IC95% 9.9–11.2). Q3–4 levels included 53.8% of AF in men vs 84.2% in women. 214 strokes were diagnosed and 78.5% happened in Q3–4, especially among women (88.1%). The stroke and AF were diagnosed simultaneously in 9.8% (ID 5.8/1000/year CI95% 3.4–8.1) and showed higher severity (NIHSS 7.25±8.62 vs 4.55±5.74, p=0.002). The cognitive impairment increased from 2.6% (Q1) up to 16.4% (Q4) significantly higher in women (17.6% vs 12.1%)

Conclusions
Differences were found according to gender and risk groups. The risk-based screening could improve the effectiveness of AF screening in primary care.

Funding Acknowledgement
Type of funding source: None