bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient education interventions for health behaviour change in adults diagnosed with coronary heart disease: a systematic review and meta-analysis
Authors: Shi W , Ghisi GLM , Zhang L , Hyun K , Pakosh M , Gallagher R 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Patient education is recommended to increase disease-related knowledge and modify coronary heart disease (CHD) risk factors. Although the importance has been established, there is a lack of knowledge of its efficacy and relative impact of duration on disease-related knowledge and health behaviour outcomes.

Purpose
It aimed to assess the efficacy of structured patient education on those outcomes in adults with CHD for short-term (less than six months) and long-term (six to 12 months) effect.

Methods
Eligible randomised controlled trials published in English, Simplified Chinese, Spanish, and Portuguese were searched in seven electronic databases from database inception through 2020. Reference lists, relevant conference lists, and keywords from the Internet were also searched. Outcomes included disease-related knowledge, smoking cessation, medication adherence, physical activity, and healthy dietary behaviour.

Results
Overall, 73 studies reporting 71 unique trials were included. Participants (n = 24,985) were aged mean 60.5 ± 5.7 years, mostly male (72.5%). About 74% of studies used more than one mode for education delivery, with phone calls and booklets being used the most frequent. Patient education was associated with significant improvement in all outcomes measured in meta-analyses (P &lt; 0.05). In addition, regression analyses showed that a prolonged intervention duration does not significantly improve the outcomes, except for the disease knowledge (p = 0.009) and physical activity (p = 0.026).

Conclusions
Structured patient education, in a variety of modes and intensities, improves disease-related knowledge and health behaviours in adults with CHD. The findings can be used to guide design of cardiac programs, particularly related to intervention duration in clinical practice.
Abstract Figure 1. PRISMA flow diagram
Does lipoprotein(a) predict cardiovascular events in a long-term follow-up?
Authors: Borges-Rosa J , Campos GM , Martinho S , Almeida JPL , Goncalves V , Ferreira C , Freitas AA , Ferreira JA , Milner J , Oliveira-Santos M , Baptista R , Goncalves L 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Elevated plasma lipoprotein(a) [Lp(a)] concentrations are associated with an increased risk of atherosclerotic cardiovascular disease and its role in risk categorizing was recognized in the new ESC guidelines for the management of dyslipidaemias. We investigated 1) the association between baseline Lp(a) levels and incident long-term cardiovascular (CV) events and 2) its relationship with type 2 diabetes mellitus (T2DM) in a Southern European population.

Methods
We retrospectively assessed baseline Lp(a) concentrations in a total of 499 patients of a primary prevention cohort followed at the Lipidology Clinic of our hospital, with a median follow-up time of 15 (IQR 12-17) years. Lp(a) was analysed as a continuous variable, as a categorical variable with a 180mg/dL cut-off and by quartiles. We collected data on major CV events (CV death, myocardial infarction, stroke) as a composite outcome. Cox proportional hazard regression analyses were used to estimate hazard ratios (HR) and 95% confidence interval (CI).

Results
Mean age was 48.30 ± 14.41 years and 61.70% were male (n = 499). Median Lp(a) was 36.60 (IQR 0-396) mg/dL and 12.4% of patients had very high Lp(a) (≥180mg/dL); T2DM prevalence was 13.60%. The composite outcome incidence was 10%. At the baseline, individuals with T2DM had lower Lp(a) levels (11.85 IQR 3-330 mg/dL vs. 46.40 IQR 0-396, p &lt; 0.01 mg/dL). There was a moderate inverse correlation between Lp(a) and HbA1c (r = -0.67, p &lt; 0.01) but no significant correlations with lipid profile (total, LDL or HDL), risk scores (SCORE or the ACC pooled cohort equation), age nor gender. We found no relationship between baseline Lp(a) quartiles and composite outcome’s incidence (age-, sex-, and diabetes-adjusted HR: 1.15, 95%CI: 0.71-1.87, p = 0.57) (Figure 1), neither with the individual CV endpoints. Exploratory analysis showed that patients on aspirin had lower Lp(a) levels (29.55 IQR 0-264 mg/dL vs. 63.60 IQR 1-396 mg/dL, p &lt; 0.01).

Conclusion
In a single centre cohort of a primary prevention southern European population, we did not find an association between Lp(a) levels and incident CV events in a 15-year median follow-up time.
The values of low-density lipoprotein cholesterol and acute coronary syndrome
Authors: Ferraz LM , Faustino A , Neves A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
All individuals with a history of acute coronary syndrome (ACS) should receive intensive statin therapy in order to achieve the desirable low-density lipoprotein cholesterol (LDL-C) values recently modified in the guidelines of the European Society of Cardiology.

Purpose
To evaluate the lipid profile control of ACS patients with 6 year follow-up.

Methods
Retrospective study of 138 consecutive patients (P) admitted in our hospital for ACS during one year: 63 ± 13 years, 76.8% male, 26.9% with history of coronary artery disease and 56.5% of dyslipidemia. A 6 year follow-up was performed and a therapeutic goal was defined as LDL-C values below 55mg/dL and an LDL-C reduction of ≥50% from baseline, according to the guidelines of the European Society of Cardiology. High/moderate/low intensity statins were defined according to the therapeutic recommendations of the American College of Cardiology. Univariate analysis was performed.

Results
The mean LDL-C value at ACS admission was 112.5 ± 36.9mg/dL. 96.4% of patients were discharged on statins: 41.3% with rosuvastatin 10mg, 15.2% with simvastatin 20mg, 15.2% with atorvastatin 10mg, 10.9% with pitavastatin 2mg and 6.5% with atorvastatin 20mg.
Antidislipidemic therapy was changed in 7.9% of patients in the scheduled evaluation 1 month after discharge.
The mean LDL-C value after a 6 year follow-up was 83.6 ± 27.2mg/dL, with 85.8% P not meeting the defined therapeutic goal. Most of them (97.5%) continued medicated with statin, however, only 28.3% of P were on high-intensity statins and 3.8% were on low-intensity statins, despite the verified statistically significant association between LDL-C values and statin type used (high/medium/low intensity, p &lt; 0.05).

Conclusion
Despite the proven benefit of statins, especially in high-risk patients, there are still aspects to improve, notably in the establishment of more effective therapies in order to achieve the desired new goals.
Nichtrauchen ist clever: a smoking prevention program for schoolchildren and what we learn from the kids
Authors: Meienberg A , Mayr M , Vischer A , Zellweger M , Burkard T 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Private company. Main funding source(s): PFIZER: unrestricted medical grant

Background
Tobacco consumption is an important preventable cause of premature death worldwide. Nevertheless, smoking is still common, globally. Smoking in adulthood is closely associated with smoking during adolescence. Therefore, as a global epidemic, tobacco consumption must not only be tackled in adults, but it is particularly important to focus on smoking prevention among young people.

Purpose
In 2014, a hospital-based smoking prevention program "Nichtrauchen ist clever!" (NIC!) for adolescents was initiated, consisting of three parts: namely a workshop, a film, and a patient interview. The aim of the study was to evaluate the acceptance of the program, and to explore participants’ awareness on smoking related diseases and factors that promote smoking initiation.

Methods
We performed an observational study to evaluate students’ acceptance of the program and their smoking habits, and a qualitative approach, to assess their view on reasons for smoking initiation and their knowledge about smoking-related diseases.

Results
Between January 2016 and December 2019, 1658 students participated our observational study with a mean age of 13.3 years (SD ±0.9). Twenty-six percent (429/1658) have already tried tobacco products (so called triers), specifically cigarettes, electronic (e)-cigarettes, and shisha. Use of e-cigarettes was most popular among triers 58% (252/429). All parts of the program were widely rated as good and excellent, and 88% (1408/1604) of participants reported they had acquired good or excellent knowledge about smoking.
Particularly lung cancer, cancer in general and heart diseases were frequently mentioned to be smoking related; peer pressure, stress and coolness were identified as reasons for smoking initiation. The influence of marketing and multimedia on smoking behaviour in the young was barely noticed.

Conclusion
NIC!" had a high acceptance among the participants and a large number of students reported relevant knowledge gain. We identified important knowledge-gaps relating smoking initiation and smoking related diseases, helping to improve further smoking prevention approaches.
Features of emotional status of smoking patients with ischemic heart disease
Authors: Ibatov A 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Purpose. To study emotional status of smoking patients with ischemic heart disease (IHD).
Methods. 277 patients with IHD (angina pectoris II - IV function class) were examined. Patients were divided in two group according to their smoking status. The first group included 139 smoking patients (average age 53.9 ± 0.7 years). The second group included 138 nonsmoking patients with IHD (average age 59.9 ± 0.7 years). A level of anxiety and the depression were examined by the Hospital Anxiety and Depression Scale (HADS), personality characteristics - by the Mini-Mult questionnaire - short form MMPI questionnaire.
Results. The groups did not differ in class of angina pectoris and treatment. The patients of 1st group had level of anxiety and depression 6.9 ± 0.3 score and 5.4 ± 0.4 score accordingly. The patients of 2nd group had level of anxiety and depression 8.7 ± 0.4 score (p &lt; 0.01) and 6.8 ± 0.3 score accordingly (p &lt; 0.05). The patients of 1st group had such personality characteristics accordingly: on scale of Hypochondriasis – 54.9 ± 0.7 T-score; on scale of Depression – 50.3 ± 1.1 T-score; on scale of Hysteria – 52.1 ± 0.6 T-score; on scale of Psychopathic Deviate – 45.1 ± 0.8 T-score; on scale of Paranoia – 51.3 ± 0.9 T-score; on scale of Psychasthenia – 47.6 ± 0.9 T-score; on scale of Schizophrenia – 47.6 ± 0.9 T-score; on scale of Hypomania – 49.9 ± 1.0 T-score. The patients of 2nd group had the such personality characteristics accordingly: on scale of Hypochondriasis - 58,1 ± 0,7 T-score (p &lt; 0.01); on scale of Depression – 53.4 ± 1.1 T-score (p &lt; 0.05); on scale of Hysterias – 55.4 ± 0.6 T-score (p &lt; 0.01); on scale of Psychopathia Deviate – 46.9 ± 0.9 T-score (p &gt;0.05); on scale of Paranoia – 55.0 ± 1.1 T-score (p &lt; 0.05); on scale of Psychasthenia – 51.5 ± 1,0 T-score (p &lt; 0.05); on scale of Schizophrenia – 51.3 ± 1.0 T-score (p &lt; 0.05); on scale of Hypomania – 49.6 ± 0.9 T-score (p &gt; 0.05). Conclusion. The smoking patients with ischemic heart disease had less expressed accentuated personality characteristics and lower level of anxiety and depression, in comparison with nonsmoking patients, that should be considered in treatment and rehabilitation.
Smoking and associated unhealthy lifestyle behaviours in patients with chronic cardiac diseases during COVID-19 related lockdown
Authors: Chague F , Boulin M , Eicher JC , Bichat F , Saint-Jalmes M , Cransac-Miet A , Trojak B , Soudry A , Danchin N , Laurent G , Cottin Y , Zeller M 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public hospital(s). Main funding source(s): Dijon University Hospital France

OnBehalf
CLEO-CD

Background
Lockdown can affect tobacco smoking (TS) behaviours.

Purpose
To evaluate the impact of lockdown on (TS) and associated lifestyle behaviours in patients with Chronic coronary syndrome (CCS) and congestive heart failure (CHF)

Methods
CCS and CHF patients were invited to answer to a phone-call questionnaire during the 1st COVID-19 lockdown start

Results
(Table) 343 questionnaires were fit for analysis, 43 (12.5%) were current smokers (CS). CS were younger (p &lt; 0.001), none stopped and 13 increased their consumption (main reasons were stress and boredom). CS felt more often cramped (p = 0.023). CS who increased their TS consumption showed a trend toward a higher rate of unhealthy lifestyle behaviours

Conclusions
During the lockdown, more than ¼ of CS with CCS or CHF increased their TS consumption and none quitted. Moreover, TS was often associated with other deleterious behaviours increasing their risk for short and long term
Main results Total Non-Smokers Smokers p* N(%) 344 301 43 Age, years 67.7 ± 12.8 69.2 ± 12.2 57.2 ± 12.1 &lt;0.001 Men/Women 229/115 197/104 32/11 0.300 CCS/CHF 220/124 185/116 36/7 0.004 Urban/Rural 163/181 137/164 26/17 0.073 Living alone at home 83(24.3) 68(22.7) 15(34.9) 0.089 COVID screening (PCR) 11(3.2) 7(2.3) 4(9.3) 0.037 Feeling cramped 19(5.5) 13(4.4) 6(14.0) 0.023 Feeling less well 75(21.9) 65(21.7) 10(23.8) 0.842 K6 ≥ 5 81(23.7) 70(23.5) 11(25.6) 0.845 Physical activity decrease 146(42.6) 125(42.1) 21(48.8) 0.323 Screen time increase 154(45.0) 130(43.5) 24(55.8) 0.100 Alcohol consumption increase 14(5.5) 11(4.9) 3(7.5) 0.419 Sleep change 83(24.6) 68(22.5) 15(39.5) 0.083 Weight increase 77(22.4) 64(21.3) 13(30.2) 0.242 Smokers (n = 43) Smoking increase No smoking increase p** Feeling less well 5(38.5) 5(17.2) 0.238 Screen time increase 10(76.9) 14(46.7) 0.104 Weight increase 6(46.2) 7(23.3) 0.173 n(%) or mean ± SD. *p value: Smokers vs non smokers. **p value: Smoking increase vs no smoking increase
Metabolic determinants of proximal aortic stiffness among healthy people with abdominal obesity
Authors: Tsaban G , Yaskolka-Meir A , Rinott E , Zelicha H , Kaplan A , Shalev A , Katz A , Shai I 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): (1) the Deutsche Forschungsgemeinschaft; (2) Israel Ministry of Health

Background
Increased proximal aortic stiffness (PAS) is directly associated with cardiovascular risk. Likewise, metabolic syndrome (MS) and abdominal obesity are associated with cardiovascular risk. The direct association between MS determinants and PAS among a healthy population with abdominal obesity remains to be examined.

Purpose
To examine the association between MS determinants and PAS among healthy participants with abdominal obesity.

Methods
We utilized the cross-sectional baseline data of the DIRECT-PLUS study (clinicaltrials.gov NCT03020186), where we recruited healthy participants with abdominal obesity/dyslipidemia. Along with anthropometric measurements and blood tests, all participants underwent magnetic-resonance-imaging from which PAS we assessed by calculating the aortic arch pulse-wave-velocity (from the ascending to the descending aorta). We defined MS according to the NCEP-ATP-III criteria.

Results
Of 282 participants who had a valid PAS estimation [mean-age: 51.0, 88.3% male, mean-body-mass-index: 31.2kg/m2, mean-waist circumference (WC): 109.5cm] 171 (60.9%) had MS. PAS was mainly associated with age (r = 0.735, p &lt; 0.001). PAS was associated with an increased 10-year Framingham Risk Score (β=0.165,p = 0.008 after adjustment for age and gender). Participants with MS had higher PAS than non-MS participants (6.6m/sec vs. 5.4m/sec, p = 0.002 after adjusting for age and gender). PAS increased along with cumulative number of MS criteria (p-of-trend &lt; 0.001). In multivariate models, adjusted for gender, age, and dichotomous-components of the MS, worse PAS remained significantly associated with high-density lipoprotein cholesterol (HDL-c; β=0.-116,p = 0.007) and increased blood-pressure (β=0.165,p &lt; 0.001), but not with fasting-glucose, waist-circumference or plasma-triglycerides (p &gt; 0.05 for all). In models adjusted for age, gender, and continuous determinants of MS, worse PAS remained associated with mean-arterial pressure (β=0.218,p &lt; 0.001) and HDL-c (β=0.-126,p = 0.004).

Conclusions
Among a healthy population with abdominal obesity, reduced HDL-c levels and increased blood pressure might be the more dominant predictors of poor PAS state, out of the MS components.
High prevalence of unkown dysglycemia and chronotropic response to exercise in patients admitted in cardiac rehabilitation program
Authors: Abdennbi K , Mouine N , Vallee A , Duval M , Amah G , Gagey S , Guiti C , Blacher J , Valensi P 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.
Introduction : Some studies suggest a high rate of unknown glycemic abnormalities in coronary patients. The aim of the study was to determine the prevalence of dysglycemia detected by oral glucose load (OGL) in patients ongoing Cardiac Rehab , and to analyse chronotropic response to exercise before and after Cardiac rehab in dysglycemic patients.
Patients and methods : We included 838 patients, mostly coronary patients after acute coronary syndrome, including 79% men and 375 were diabetics. OGL has been performed in non-diabetics and ergospirometry test performed in all patients before and after rehabilitation.
Results : At OGL, 189 of 463 non-diabetics (41%) had dysglycemia: Diabetes (n = 42 including 17 according to fasting glycemia), Glucose intolerance (GI) (n = 102 including 32 with fasting hyperglycemia (FH), FH isolated (n = 45). We compared 417 patients with known or discovered diabetes, GI and 319 normoglycemic or FH. Diabetics were older and had a higher BMI than GI and normoglycemic-FH (p &lt;0.001). Resting heart rate (HR) was higher and maximal HR on exercise is lower in diabetics than other 2 groups (p &lt;0.001) without significantly differing between GI and normoglycaemia-FH. VO2max was lower in diabetics and GI than normoglycemic-FH s (p &lt;0.001 and 0.01). After cardiac rehabilitation, resting HR is changed little, HR max and VO2max increased in 3 groups but kept the same inter-group differences
Conclusion :This data confirms the high prevalence of unknown dysglycemia and the importance of OGL for their screening, especially in coronary patients. In diabetics, the higher resting HR and the lack of chronotropic reserve probably indicate autonomic dysregulation which partially improves after cardiac rehabilitation.
Predictive factors of erectile dysfunction in a cardiac rehabilitation programme. What can we improve?
Authors: Adeba Garcia A , Alvarez Velasco R , Vigil-Escalera Diaz M , Martin Fernandez M , Barriales Alvarez V , Persia Paulino YR , Flores Fuentes AY , Alvarez Asensio R , Cuevas Perez J , Aparicio Gavilanes A , Ledesma Odoriz D , Martinez Diaz J , Soroa Ortuno M , Hevia Nava JS 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Erectile dysfunction (ED) is a frequent comorbidity in patients with chronic coronary syndrome; it is related to both cardiovascular risk factors (CVRF), the treatments administered and the vascular disease itself. We analyse the predictors of ED in the cardiac rehabilitation unit of a third level hospital.

Material and methods
Observational and prospective cohort of male patients participating in the cardiac rehabilitation programme (CRP) between 2015 and 2019. This CRP lasts 1 month, with 3 weekly sessions of monitored and supervised exercise, in addition to talks related on the cardiovascular area, diet, etc. One of these sessions is on ED, in which the patient is asked about the entity, possible interactions with drugs, etc. In addition, the degree of ED is evaluated anonymously using the IIEF5 scale, in which 5 questions are used to evaluate different conditions of the disease by scoring from 1 to 5, with values of less than 21 being considered as ED. For the statistical analysis we carried out a multiple regression model adjusted by the clinical variables collected at the beginning of the programme.

Results
Out of a total of 343 patients 90% were male and 265 completed the questionnaire. 63% presented ED. The mean age is 56 ± 9 years. The distribution of CVRF: 43% hypertense, 23% diabetics, 72% dyslipemia, 22% ex and 48% smokers. As for the diagnoses prior to the start of CRP, 59% suffered from STEMI, 22% from NSTEMI, 9% from unstable angina and 9% were post-operative from cardiac surgery. In the global multiple regression model the factors predisposing to ED and presenting statistically significant coefficients were age (-0.2 CI: -0.27- -0.12, p &lt; 0.001), hypertension (-1.6; CI -2.9- -0.3, p = 0.014) and diabetes (-2.0 CI: -3.1- -0.6, p = 0.007). We performed a predictive model for the different age ranges according to the presence/absence of hypertension and diabetes (Figure 1).

Conclusions
ED is a prevalent entity in our series, with age-adjusted multivariate analysis predicting its development and hypertension and diabetes as potentially modifiable factors related to it.
Abstract Figure. Graph 1: Predictive regression model
The talk test"s responsiveness to an 8-week exercise-training program in cardiovascular disease patients
Authors: Martins EM , Silveira LS , Ribeiro GS , Vieira AM , Roque ABAO , Mortimer FM , Benetti M , Karsten M 
Published: May 2021

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Talk test (TT) is an alternative and accessible tool for prescribing and monitoring aerobic training intensity. Although the TT is reliable and valid for cardiorespiratory assessment, its responsiveness to exercise training remains unexplored.

Purpose
To evaluate the responsiveness of TT in cardiovascular disease (CVD) patients who underwent an exercise training program.

Methods
Twenty-one CVD patients (61.7 ± 8.4 years) performed an exercise-training program on phase II of cardiac rehabilitation (45-min 3-times a week). The six-minute walk test (6MWT) and TT were done to assess functional capacity at baseline and after 8 weeks. In the individualized TT the treadmill’s speed and/or grade were increased every 2-min, with speed changes based on a reference equation for the 6MWT distance (6MWD). The subjects were asked to read a 38 words standard paragraph at the last 30s of each stage and to answer if they could talk comfortably. Answer options were i) YES (TT+), ii) UNCERTAIN (TT±), or iii) NO (TT-). The first ventilatory threshold (VT1) was identified by two reviewers using the heart rate variability analysis. A paired t-test was applied to analyze the TT duration and 6MWD. The VT1 and TT workload were analyzed by the Wilcoxon test. Spearman correlation was adopted to compare the TT± and VT1 stages.

Results
Improvement in the VT1 (2.9 ± 1.2 vs 4.4 ± 1.4 min; p &lt; 0.001), duration (12.1 ± 4.4 vs 14.9 ± 5.2 min; p &lt; 0.001), workload at TT- (67.8 ± 48.4 vs 104.5 ± 65.9 w; p &lt; 0.001), and in the 6MWD (471.5 ± 100.3 vs 533.7 ± 92.9 m; p &lt; 0.001) were observed. There was strong correlation between TT± and VT1 in pre (r = 0.613; p &lt; 0.05) and post-rehabilitation (r = 0.678; p &lt; 0.05).

Conclusion
Talk test performed on a treadmill showed responsiveness after eight weeks of exercise training, being sensitive to the physiological changes provided by the rehabilitation program in CVD patients.