bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-term opiate use and risk of cardiovascular mortality: results from the Golestan Cohort Study
Authors: Nalini Mahdi , Shakeri Ramin , Poustchi Hossein , Pourshams Akram , Etemadi Arash , Islami Farhad , Khoshnia Masoud , Gharavi Abdolsamad , Roshandel Gholamreza , Khademi Hooman , Zahedi Mahdi , Abedi-Ardekani Behnoush , Vedanthan Rajesh , Boffetta Paolo , Dawsey Sanford M , Pharaoh Paul D , Sotoudeh Masoud , Abnet Christian C , Day Nicholas E , Brennan Paul , Kamangar Farin , Malekzadeh Reza 
Published: January 2021

AbstractAimsTens of millions of people worldwide use opiates but little is known about their potential role in causing cardiovascular diseases. We aimed to study the association of long-term opiate use with cardiovascular mortality and whether this association is independent of the known risk factors.Methods and resultsIn the population-based Golestan Cohort Study—50 045 Iranian participants, 40–75 years, 58% women—we used Cox regression to estimate hazard ratios and 95% confidence intervals (HRs, 95% CIs) for the association of opiate use (at least once a week for a period of 6 months) with cardiovascular mortality, adjusting for potential confounders—i.e. age, sex, education, wealth, residential place, marital status, ethnicity, and tobacco and alcohol use. To show independent association, the models were further adjusted for hypertension, diabetes, waist and hip circumferences, physical activity, fruit/vegetable intake, aspirin and statin use, and history of cardiovascular diseases and cancers. In total, 8487 participants (72.2% men) were opiate users for a median (IQR) of 10 (4–20) years. During 548 940 person-years—median of 11.3 years, &gt;99% success follow-up—3079 cardiovascular deaths occurred, with substantially higher rates in opiate users than non-users (1005 vs. 478 deaths/100 000 person-years). Opiate use was associated with increased cardiovascular mortality, with adjusted HR (95% CI) of 1.63 (1.49–1.79). Overall 10.9% of cardiovascular deaths were attributable to opiate use. The association was independent of the traditional cardiovascular risk factors.ConclusionLong-term opiate use was associated with an increased cardiovascular mortality independent of the traditional risk factors. Further research, particularly on mechanisms of action, is recommended.
Epidemiology of cardiomyopathies: essential context knowledge for a tailored clinical work-up
Authors: Pasqualucci Daniele , Iacovoni Attilio , Palmieri Vittorio , De Maria Renata , Iacoviello Massimo , Battistoni Ilaria , Macera Francesca , Olivotto Iacopo , Arbustini Eloisa , Mortara Andrea 
Published: January 2021

Abstract
Cardiomyopathies (CMPs) are primary disorders of myocardial structure and function in the absence of coronary artery disease, hypertension, valvular disease, and congenital heart disease. Knowledge of the incidence and prevalence of CMPs may help clinicians to compare their observations in clinical practice with expected cases per person-year and to avoid under-reporting in clinical context. Currently, available estimates of prevalence and incidence of CMPs are based on clinical data, collected with a wide variability in population-source, and before the genetic testing evolved as a standard diagnostic tool. This review focuses on the epidemiology of CMPs in subjects aged between 18 and 55 years. A structured up-to-date diagnostic flow-chart for CMPs diagnosis and assessment is proposed to avoid misdiagnosis of CMPs in the young population and in subjects with unexplained cardiac disorders.
The impact of coronary heart disease prevention on work productivity: a 10-year analysis
Authors: Savira Feby , Wang Bing H , Kompa Andrew R , Ademi Zanfina , Owen Alice J , Liew Danny , Zomer Ella 
Published: January 2021

Abstract

Aims
To determine the impact of preventing new (incident) cases of coronary heart disease (CHD) on years of life and productivity, using the novel measure ‘productivity-adjusted life year’ (PALY), over the next 10 years.

Methods and results
A dynamic life table model was constructed for the total Australian working-age population (15–69 years) over 10 years (2020–2029), separated by CHD status. Productivity estimates were sourced from the literature. The PALY was ascribed a financial value in terms of gross domestic product (GDP) per equivalent full-time worker. The total number of years lived, PALYs, and economic burden (in terms of GDP per PALY) were estimated. The model simulation was repeated assuming incidence was reduced, and the differences represented the impact of CHD prevention. All outcomes were discounted by 5% per annum. Over 10 years, the total projected years lived and PALYs in the Australian working-age population (with and without CHD) were 133 million and 83 million, respectively, amounting to A$17.2 trillion in GDP. We predicted more than 290 000 new (incident) CHD cases over the next 10 years. If all new cases of CHD could be prevented during this period, a total of 4 000 deaths could be averted, resulting in more than 8 000 years of life saved and 104 000 PALYs gained, equivalent to a gain of nearly A$21.8 billion (US$14.8 billion) in GDP.

Conclusion
Prevention of CHD will prolong years of life lived and productive life years, resulting in substantial economic benefit. Policy makers and employers are encouraged to engage in preventive measures addressing CHD.
EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care: the DA VINCI study
Authors: Ray Kausik K , Molemans Bart , Schoonen W Marieke , Giovas Periklis , Bray Sarah , Kiru Gaia , Murphy Jennifer , Banach Maciej , De Servi Stefano , Gaita Dan , Gouni-Berthold Ioanna , Hovingh G Kees , Jozwiak Jacek J , Jukema J Wouter , Kiss Robert Gabor , Kownator Serge , Iversen Helle K , Maher Vincent , Masana Luis , Parkhomenko Alexander , Peeters André , Clifford Piers , Raslova Katarina , Siostrzonek Peter , Romeo Stefano , Tousoulis Dimitrios , Vlachopoulos Charalambos , Vrablik Michal , Catapano Alberico L , Poulter Neil R ,   the DA VINCI study
Published: January 2021

Abstract

Aims
To provide contemporary data on the implementation of European guideline recommendations for lipid-lowering therapies (LLTs) across different settings and populations and how this impacts low-density lipoprotein cholesterol (LDL-C) goal achievement.

Methods and results
An 18 country, cross-sectional, observational study of patients prescribed LLT for primary or secondary prevention in primary or secondary care across Europe. Between June 2017 and November 2018, data were collected at a single visit, including LLT in the preceding 12 months and most recent LDL-C. Primary outcome was the achievement of risk-based 2016 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) LDL-C goal while receiving stabilized LLT; 2019 goal achievement was also assessed. Overall, 5888 patients (3000 primary and 2888 secondary prevention patients) were enrolled; 54% [95% confidence interval (CI) 52–56] achieved their risk-based 2016 goal and 33% (95% CI 32–35) achieved their risk-based 2019 goal. High-intensity statin monotherapy was used in 20% and 38% of very high-risk primary and secondary prevention patients, respectively. Corresponding 2016 goal attainment was 22% and 45% (17% and 22% for 2019 goals) for very high-risk primary and secondary prevention patients, respectively. Use of moderate–high-intensity statins in combination with ezetimibe (9%), or any LLT with PCSK9 inhibitors (1%), was low; corresponding 2016 and 2019 goal attainment was 53% and 20% (ezetimibe combination), and 67% and 58% (PCSK9i combination).

Conclusion
Gaps between clinical guidelines and clinical practice for lipid management across Europe persist, which will be exacerbated by the 2019 guidelines. Even with optimized statins, greater utilization of non-statin LLT is likely needed to reduce these gaps for patients at highest risk.
Effects of individual and integrated cumulative burden of blood pressure, glucose, low-density lipoprotein cholesterol, and C-reactive protein on cardiovascular risk
Authors: Chen Zimo , Mo Jinglin , Xu Jie , Wang Anxin , Dai Liye , Cheng Aichun , Yalkun Gulbahram , Meng Xia , Zhao Xingquan , Li Hao , Wu Shouling , Wang Yongjun 
Published: January 2021

Abstract

Aim
This study aimed to demonstrate the impact of cumulative burden of cardiovascular risk factors (CVRFs) on risk of cardiovascular events (CVEs).

Methods and results
A total of 34 959 participants were enrolled who participated in the four surveys during 2006–2013. Cumulative CVRF burden was calculated as number of years (2006–2013) multiplied by the values of CVRFs including systolic blood pressure, fasting blood glucose (FBG), low-density lipoprotein cholesterol (LDL-C), and high-sensitive C-reactive protein (hs-CRP). The primary outcome was defined as the CVE during 2012–2017, including ischaemic stroke, myocardial infarction, and all-cause mortality. During 4.62 (±0.71) years follow-up on average, there were 2118 (6.06%) CVE, including 847 (2.42%) ischaemic stroke, 221 (0.63%) myocardial infarction, and 1185 (3.39%) all-cause mortality. Higher cumulative burden of individual CVRF was significantly associated with increased risk of outcomes, except for LDL-C for all-cause mortality, FBG for myocardial infarction, and hs-CRP for ischaemic stroke. In Cox proportional hazards model, compared with the group, of the lower quartile of integrated cumulative burden, the hazard ratio (95% confidence intervals) of the upper quartile was 2.45 (2.03–2.94) for CVE, 3.65 (2.68–4.96) for ischaemic stroke, 4.51 (2.19–9.27) for myocardial infarction, and 1.73 (1.36–2.21) for all-cause mortality.

Conclusion
We demonstrated the correlation between cumulative burden of CVRFs and cardiovascular risk, except for cumulative burden of hs-CRP and ischaemic stroke. Thus, our study suggests the necessity to extend the observation duration of CVRFs in order to elucidate the life-course cumulative effect.
Anticoagulation in patients with atrial fibrillation and active cancer: an international survey on patient management
Authors: Boriani Giuseppe , Lee Geraldine , Parrini Iris , Lopez-Fernandez Teresa , Lyon Alexander R , Suter Thomas , Van der Meer Peter , Cardinale Daniela , Lancellotti Patrizio , Zamorano Jose Luis , Bax Jeroen J , Asteggiano Riccardo ,   for the Council of Cardio-Oncology of the European Society of Cardiology
Published: January 2021

Abstract

Background
In patients with active cancer and atrial fibrillation (AF) anticoagulation, thrombotic and bleeding risk still entail uncertainty.

Aim
We explored the results of an international survey examining the knowledge and behaviours of a large group of physicians.

Methods and results
A web-based survey was completed by 960 physicians (82.4% cardiologists, 75.5% from Europe). Among the currently available anticoagulants for stroke prevention in patients with active cancer, direct oral anticoagulants (DOACs) were preferred by 62.6%, with lower values for low molecular weight heparin (LMWH) (24.1%) and for warfarin (only 7.3%). About 46% of respondents considered that DOACs should be used in all types of cancers except in non-operable gastrointestinal cancers. The lack of controlled studies on bleeding risk (33.5% of respondents) and the risk of drug interactions (31.5%) were perceived as problematic issues associated with use of anticoagulants in cancer. The decision on anticoagulation involved a cardiologist in 27.8% of cases, a cardiologist and an oncologist in 41.1%, and a team approach in 21.6%. The patient also was involved in decision-making, according to ∼60% of the respondents. For risk stratification, use of CHA2DS2-VASc and HAS-BLED scores was considered appropriate, although not specifically validated in cancer patients, by 66.7% and 56.4%, respectively.

Conclusion
This survey highlights that management of anticoagulation in patients with AF and active cancer is challenging, with substantial heterogeneity in therapeutic choices. Direct oral anticoagulants seems having an emerging role but still the use of LMWH remains substantial, despite the absence of long-term data on thromboprophylaxis in AF.
Offering, participation and adherence to cardiac rehabilitation programmes in the elderly: a European comparison based on the EU-CaRE multicentre observational study
Authors: González-Salvado Violeta , Peña-Gil Carlos , Lado-Baleato Óscar , Cadarso-Suárez Carmen , Prada-Ramallal Guillermo , Prescott Eva , Wilhelm Matthias , Eser Prisca , Iliou Marie-Christine , Zeymer Uwe , Ardissino Diego , Bruins Wendy , van der Velde Astrid E , Van’t Hof Arnoud W J , de Kluiver Ed P , Kolkman Evelien K , Prins Leonie , González Juanatey José Ramón 
Published: January 2021

Abstract

Aims
Cardiac rehabilitation (CR) is strongly recommended but participation of elderly patients has not been well characterized. This study aims to analyse current rates and determinants of CR referral, participation, adherence, and compliance in a contemporary European cohort of elderly patients.

Methods and results
The EU-CaRE observational study included data from consecutive patients aged ≥ 65 with acute coronary syndrome, revascularization, stable coronary artery disease, or heart valve replacement, recruited in eight European centres. Rates and factors determining offering, participation, and adherence to CR programmes and compliance with training sessions were studied across centres, under consideration of extensive-outpatient vs. intensive-inpatient programmes. Three thousand, four hundred, and seventy-one patients were included in the offering and participation analysis. Cardiac rehabilitation was offered to 80.8% of eligible patients, formal contraindications being the main reason for not offering CR. Mean participation was 68.0%, with perceived lack of usefulness and transport issues being principal barriers. Mean adherence to CR programmes of participants in the EU-CaRE study (n = 1663) was 90.3%, with hospitalization/physical impairment as principal causes of dropout. Mean compliance with training sessions was 86.1%. Older age was related to lower offering and participation, and comorbidity was associated with lower offering, participation, adherence, and compliance. Intensive-inpatient programmes displayed higher adherence (97.1% vs. 85.9%, P &lt; 0.001) and compliance (full compliance: 66.0% vs. 38.8%, P &lt; 0.001) than extensive-outpatient programmes.

Conclusion
In this European cohort of elderly patients, older age and comorbidity tackled patients’ referral and uptake of CR programmes. Intensive-inpatient CR programmes showed higher completion than extensive-outpatient CR programmes, suggesting this formula could suit some elderly patients.
Both incidence and prevalence of ischaemic heart disease are declining in parallel: a national data-linkage study in New Zealand (ANZACS-QI 52)
Authors: Grey Corina , Jackson Rod , Wells Sue , Wu Billy , Pujades-Rodriguez Mar , Schmidt Morten , Selak Vanessa , Kerr Andrew J 
Published: January 2021

Abstract

Aims
To examine trends in ischaemic heart disease (IHD) incidence and prevalence in New Zealand from 2005 to 2016, using comprehensive linked national hospitalization and mortality data as proxy measures of all significant events.

Methods and results
Incident and prevalent cases of IHD in people aged ≥25 years were identified using individual patient-linkage of routinely collected ICD-10-coded hospitalization and mortality data. Incidence rates and prevalence proportions were calculated by sex and age group and then age-standardized to the 2016 New Zealand population. Ischaemic heart disease incidence and prevalence declined in men and women in all age groups. The average annual rate of decline in age-standardized IHD incidence was 3.3% for women and 2.7% for men, and the rate of decline in age-standardized IHD prevalence was 3.2% for women and 2.2% for men. Despite a 17% increase in the New Zealand population aged 25 years and over during the study period, the total number of people living with IHD also decreased, particularly in those aged 65 years and older.

Conclusion
In contrast to observations from other countries, where IHD incidence but not IHD prevalence has been falling, declining IHD incidence in New Zealand in recent decades is now mirrored by declining IHD prevalence.
Non-exercise estimated cardiorespiratory fitness and mortality from all-causes, cardiovascular disease, and cancer in the NIH-AARP diet and health study
Authors: Vainshelboim Baruch , Myers Jonathan , Matthews Charles E 
Published: January 2021

Abstract

Aims
Impractical methods and relatively small cohort have limited the applications of non-exercise estimated cardiorespiratory fitness (NEE-CRF). This study aimed to assess the association between a pragmatic NEE-CRF method and mortality outcomes in a large prospective cohort.

Methods and results
A total of 330 769 participants [men (n = 186 469) and women (n = 144 300)] aged 50–71 years from the NIH-AARP Diet and Health Study were assessed at baseline (1995–96) and prospectively followed until 31 December 2015 (14.9 ± 2.1 years). Non-exercise estimated cardiorespiratory fitness was estimated using pragmatic and previously validated equation, and Cox hazard analysis for mortality was conducted. Non-exercise estimated cardiorespiratory fitness was 9.9 ± 1.5 metabolic equivalents (METs) in men and 7.2 ± 1.6 METs in women. In total, 34 317 men and 20 295 women died during the follow-up. Higher NEE-CRF was associated with lower mortality risk from all-causes, cardiovascular disease, and cancer. Compared to the lowest quartile of NEE-CRF, the hazard ratios and 95% confidence interval for all-cause mortality in the second, third, and fourth quartiles were: 0.82 (0.79–0.84), 0.74 (0.72–0.77), and 0.70 (0.67–0.73) for men, and 0.84 (0.81–0.88), 0.78 (0.75–0.82), and 0.72 (0.68–0.77) for women (P trend &lt;0.001 for all). For each 1-MET increase in NEE-CRF, risks for mortality due to cardiovascular disease and cancer were 0.85 (0.82–0.88) and 0.89 (0.87–0.91) in men, and 0.84 (0.81–0.88) and 0.89 (0.87–0.91) in women, respectively (P &lt; 0.001 for all).

Conclusion
Higher NEE-CRF is independently associated with lower mortality risk in a large prospective cohort of men and women. These results support the utility of the applied NEE-CRF method for risk stratification, prevention, and rehabilitation programs and application in large epidemiological studies.
Frailty in cardiology: definition, assessment and clinical implications for general cardiology. A consensus document of the Council for Cardiology Practice (CCP), Association for Acute Cardio Vascular Care (ACVC), Association of Cardiovascular Nursing and Allied Professions (ACNAP), European Association of Preventive Cardiology (EAPC), European Heart Rhythm Association (EHRA), Council on Valvular Heart Diseases (VHD), Council on Hypertension (CHT), Council of Cardio-Oncology (CCO), Working Group (WG) Aorta and Peripheral Vascular Diseases, WG e-Cardiology, WG Thrombosis, of the European Society of Cardiology, European Primary Care Cardiology Society (EPCCS)
Authors: Richter Dimitri , Guasti Luigina , Walker David , Lambrinou Ekaterini , Lionis Christos , Abreu Ana , Savelieva Irina , Fumagalli Stefano , Bo Mario , Rocca Bianca , Jensen Magnus T , Pierard Luc , Sudano Isabella , Aboyans Victor , Asteggiano Riccardo 
Published: January 2021

Abstract
Frailty is a health condition leading to many adverse clinical outcomes. The relationship between frailty and advanced age, multimorbidity and disability has a significant impact on healthcare systems. Frailty increases cardiovascular (CV) morbidity and mortality both in patients with or without known CV disease. Though the recognition of this additional risk factor has become increasingly clinically relevant in CV diseases, uncertainty remains about operative definitions, screening, assessment, and management of frailty. Since the burdens of frailty components and domains may vary in the various CV diseases and clinical settings, the relevance of specific frailty-related aspects may be different. Understanding these issues may allow general cardiologists a clearer focus on frailty in CV diseases and thereby make more tailored clinical decisions and therapeutic choices in outpatients. Guidance on identification and management of frailty are sparse and an international consensus document on frailty in general cardiology is lacking. Moreover, new options linked with eHealth are going to better define and manage frailty. This consensus document on definition, assessment, clinical implications, and management of frailty provides an input to integrate strategies pre- and post-acute CV events with a comprehensive view including out of hospital, office-based diagnostic and therapeutic choices, and based on a multidisciplinary team approach (general cardiologists, nurses, and general practitioners).
The search for novel treatment strategies forStreptococcus pneumoniaeinfections
Authors: Cools F , Delputte P , Cos P 
Published: January 2021

ABSTRACTThis review provides an overview of the most important novel treatment strategies against Streptococcus pneumoniae infections published over the past 10 years. The pneumococcus causes the majority of community-acquired bacterial pneumonia cases, and it is one of the prime pathogens in bacterial meningitis. Over the last 10 years, extensive research has been conducted to prevent severe pneumococcal infections, with a major focus on (i) boosting the host immune system and (ii) discovering novel antibacterials. Boosting the immune system can be done in two ways, either by actively modulating host immunity, mostly through administration of selective antibodies, or by interfering with pneumococcal virulence factors, thereby supporting the host immune system to effectively overcome an infection. While several of such experimental therapies are promising, few have evolved to clinical trials. The discovery of novel antibacterials is hampered by the high research and development costs versus the relatively low revenues for the pharmaceutical industry. Nevertheless, novel enzymatic assays and target-based drug design, allow the identification of targets and the development of novel molecules to effectively treat this life-threatening pathogen.