bluuebunny/crossref_metadata_2025_split huggingface dataset:
Monocyte count to high-density lipoprotein cholesterol ratio and mean platelet volume may be related to the severity of carotid artery stenosis
Authors: Kuyumcu M S , Ayyildiz V A , Ulusan S 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Objective
The pathophysiology of carotid artery stenosis (CAD) is not fully understood. Research has shown that mean platelet volume (MPV) is a potential marker for platelet activation and a key factor in the pathophysiology of atherosclerosis. Recently, the ratio of monocyte count to HDL (MHR) has been identified as a predictor of cardiovascular events in patients. In the light of these findings, the goal of this study was to evaluate the potential association of MPV and MHR with the severity of CAD.

Material-Method
The patients were divided into three groups: CAD≥ 60% (40 patients), CAD &lt;60% (40 patients) and no carotid atherosclerotic disease (40 individuals). Patients' demographic characteristics, clinical features and laboratory findings were compared between the groups.

Results
MPV and MHR levels were lower in the control group than CAD &lt;60 group and lower in CAD &lt;60 group than CAD ≥60 group (p &lt;0.001, p &lt;0.001). Higher MPV (OR= 6.050; 95% CI: 2.946-12.427; p &lt;0.001) and MHR (OR= 1.107; 95% CI: 1.045-1.159; p &lt;0.001) levels were detected as an independent predictor for ≥60% carotid artery stenosis after multiple linear regression analysis. In the correlation analysis, a positive correlation was found between MPV and the rate of carotid artery stenosis (p&lt;0.001, r=0.680).

Conclusion
In our study, a potential relationship between MPV and MHR with carotid artery disease was determined. Our study may make contributions to understanding the pathophysiology of carotid artery atherosclerosis and developing treatments for it.
Prognostic value of exercise stress echocardiography in patients with known coronary artery disease
Authors: Cardoso A , Lourenco MR , Von Hafe P , Dias G , Pereira T , Tinoco M , Fernandes M , Azevedo O , Lourenco A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
Exercise stress echocardiography (EE) is useful for diagnosis and risk stratification in patients (pts) with suspected coronary artery disease (CAD). Pts with known CAD carry a high risk of events. Our aim was to assess the utility of EE in predicting outcomes in this population.

Methods
Single center retrospective study of consecutive pts with known CAD who performed an EE between 2018 and 2019. The primary endpoint was a composite of admission for acute coronary syndrome (ACS), coronary revascularization and cardiovascular death during the follow-up.

Results
A total of 76 pts were included (mean age 59±9 years; 87% male). Fifty-nine (78%) pts had history of ACS, 51 (67%) of percutaneous coronary intervention (PCI) and 14 (18%) of coronary artery bypass graft. The majority of pts had 2 or more vessel disease (42 pts; 55%).
The main reason for performing EE was new onset of chest pain (38 pts; 50%) followed by functional assessment of coronary stenoses after incomplete revascularization (29 pts; 38%). The majority of pts had a preserved left ventricular ejection fraction (67; 88%). The exam was performed under beta-blocker effect in 35 (46%) pts.
The results of EE were positive for myocardial ischemia in 7 (9%) pts, negative in 37 (49%) pts and inconclusive in 32 (42%) pts. Mean exercise time was 8±3 minutes and mean METs achieved was 9.4±2.6. ST-segment depression fulfilling electrocardiographic criteria for ischemia occurred in 17 (22%) pts. Eleven (14%) pts complained of chest pain during the exam.
During a median follow up of 22 months (IQR 15-26), the primary endpoint occurred in 9 pts (admission for ACS in 5 pts; revascularization for chronic coronary syndrome in 4 pts). No cardiovascular death occurred. The positive predictive value of EE for the primary endpoint was 57.1% and the negative predictive value (NPV) 97.3%.
In a survival analysis, the predictors of the primary endpoint were lower exercise time, lower METs achieved, untreated significant coronary lesions and a positive EE (figure).
After adjustment in a multivariate analysis, a positive EE was an independent predictor of the primary endpoint (HR 4.6, 95%CI: 1.1-16.7, p=.044).

Conclusion
In pts with known CAD, EE had a high NPV and a positive result was an independent predictor of future cardiovascular events.
Modest association between peak exercise blood pressure and ambulatory hypertension in endurance athletes
Authors: Janssens K , Mitchell A , Foulkes S , Head G , Saner N , Howden E , Claessen G , La Gerche A 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
An exaggerated blood pressure (BP) response to exercise may be an early indicator of hypertension. However, it is common in endurance athletes and the association between systolic blood pressure (SBP) during exercise and hypertension is not well established in this group.

Purpose
To establish whether there is an association between exercise-induced hypertension (EIH) and clinical hypertension in endurance athletes.

Methods
250 current and former endurance athletes (16-80 years, 75% male) performed a maximal exercise test on a cycle ergometer with BP measured every 2 min. Athletes were diagnosed with EIH based on international guidelines (SBP ≥210mmHg males, ≥190mmHg females). The relationship between SBP and workload was determined by linear regression analysis. Office hypertension was identified from either supine SBP ≥140mmHg or diastolic BP ≥90mmHg, or if treated for hypertension. Gold-standard 24-hour ambulatory blood pressure monitoring (ABPM) was performed in a subset of 42 athletes with EIH and 9 athletes with a normotensive response to exercise (NRE).

Results
On average, peak exercise SBP values were universally high (221±26mmHg in males and 199±21mmHg in females). 71% of athletes (70% of males and 74% of females) met criteria for EIH of which 12% had a peak SBP≥250mmHg. EIH and NRE groups were of similar age, sex, body mass index (BMI) and fitness (Figure 1). The strongest determinant of peak exercise SBP was exercise workload (R=0.78, P&lt;0.001), which remained significant after adjusting for age, sex, BMI and antihypertensive medication (p&lt;0.001) In the full cohort, resting SBP was higher in the EIH group (EIH: 128±13mmHg vs NRE: 122±15mmHg, P=0.006 – Figure 1), however there was a similar prevalence of office hypertension between the EIH (19%) and NRE (15%) groups (P=0.59). This prevalence remained similar (EIH: 13% vs NRE: 10%, P=0.49) after excluding those being treated for hypertension (n=15). In the subset of athletes who underwent 24h ABPM (n=51), there were no diagnoses of clinical hypertension in NRE (n=9, Figure 1). Of the 42 athletes with EIH, a majority (n=32, 76%) were normotensive on ABPM. In the 10 athletes with EIH and hypertension on ABPM, the majority were classified with Grade 1 hypertension (n=5) or daytime hypertension (n=3). Interestingly only two of these athletes would have been identified with office BP measures (see Figure 2).

Conclusion
EIH is common in endurance athletes and is strongly associated with peak exercise workloads suggesting this may be a reflection of superior cardiovascular fitness. In a small proportion of athletes, EIH may be associated with mild hypertension.
Alternations in markers of insulin resistance: HOMA-IR, HOMA-B, QUICKI, after dual therapy combination with telmisartan/amlodipine in prediabetic hypertensive patients
Authors: Liontos A , Papathanasiou A , Biros D , Papagiannopoulos C , Tsourlos S , Athanasiou L , Veliani C , Kolios NG , Pappa C , Zarachi A , Christaki E , Liberopoulos E , Elisaf M , Milionis H , Liamis G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction-Purpose
The combination of telmisartan and amlodipine in tablet form indicated for patients whose arterial blood pressure cannot be fully managed with monotreatment. The purpose of this study was to investigate the effect of the fixed combination telmisartan/amlodipine 80/5mg per day on arterial pressure levels and the variation of HOMA-IR, HOMA-B and QUICKI values in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and with prediabetes (IFG/IGT) before and after the 3-month treatment with the administration of the fixed combination.

Methods
Data collected from 51 patients who have visited our outpatient clinic for lipid metabolism disorders during the period 2014-2018. 51 persons with BMI: 29.32 [27.37-31.65] (25 male, 16 female) had been randomized in the group for telmisartan/amlodipine 80/5mg per day.
The median values for the study’s sample in SBP and DBP were: 163[158-168] and 100[95-106] mmHg, respectively. Their somatometric and demographic characteristics were recorded in the beginning of the study and are presented on Table 1Α.

Results
The results of the variations in SBP and DBP, as well as the variations in glucose, insulin, HOMA-IR, HOMA-B and QUICKI before and after the 3-month treatment are presented on Table 1B.

Conclusions
From the sampled patients it can be observed that the 3-month treatment with telmisartan/amlodipine statistically significantly improved (p=0.005) the HOMA-IR values while improving fasting glucose and insulin levels. Finally, there was a statistically significant reduction in QUICKI values and a statistically insignificant reduction in HOMA-B.
Changes in TRG/ApoA-1 ratio, TRG/HDL-C ratio and lipid serum profile after combination therapy with valsartan/amlodipine in prediabetic patients
Authors: Liontos A , Papathanasiou A , Biros D , Papagiannopoulos C , Tsourlos S , Athanasiou L , Zarachi A , Pargana E , Nasiou M , Veliani C , Christaki E , Liberopoulos E , Elisaf M , Milionis H , Liamis G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction-Purpose
The combination of valsartan with amlodipine is a commonly administered combination of an agonist ATII (angiotensin receptor II) and CCB (calcium channel blocker) for the management of hypertension. There is already data from different studies that describe the effect of each of those medications in the lipidemic profile. Ratios TRG/ApoA-1, TRG/HDLC are useful markers of insulin resistance. The purpose of this study is to investigate the effect of the fixed combination of valsartan/amlodipine 160/5mg per day on the levels of serum lipids, as well as the levels of serum apolipoproteins and the TRG/ApoA-1, TRG/HDLC ratios, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-179 mmHg and/or diastolic blood pressure (DBP) 100-109 mmHg) and prediabetes (IFG/IGT), before and after the 3-month treatment.

Methods
Data from 54 patients who were referred to our outpatient clinic for lipid metabolism disorders during the period 2014-2018 and had been randomized in the valsartan/amlodipine group 160/5mg per day. Those patients (33 male/21 female from whom 14 were smokers and 8 alcohol users) all completed the study successfully with mean BMI: 28.09[26.81-29.89]. The median values of SBP and DBP for the sample group were: 162 [159.25-165] και 100 [92-103.75] mmHg, respectively. The levels of apolipoproteins B, A-1, Lp(a) and E were measured prior to the beginning of treatment and 3-months after its administration.

Results
The resulting alternations of SBP and DBP levels before and after the 3-month treatment, as well as the changes of serum lipid, apolipoprotein levels and TRG/ApoA-1, TRG/HDL-C ratios are presented in Table 1.

Conclusions
From the sample group it seems like that the 3-month therapy with valsartan/amlodipine improved statistically significant both SBP and DBP levels (decreased by -13.58% and -13% respectively, p&lt;0.001 for both values). Concerning lipid levels, no significant variation was observed across the board. Finally, no significant change was observed in apolipoprotein levels and TRG/ApoA-1, TRG/HDL-C ratios.
Changes in TRG/ApoA-1 ratio, TRG/HDL-C ratio and lipid serum profile after combination therapy with telmisartan/amlodipine in prediabetic patients
Authors: Liontos A , Papathanasiou A , Biros D , Papagiannopoulos C , Tsourlos S , Athanasiou L , Zarachi A , Kolios NG , Pargana E , Nasiou M , Christaki E , Liberopoulos E , Elisaf M , Milionis H , Liamis G 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction-Purpose
The combination of telmisartan with amlodipine is a commonly administered combination of an agonist ATII (angiotensin receptor II) and CCB (calcium channel blocker) for the management of hypertension. The purpose of this study is to evaluate the effect of the fixed of combination telmisartan/amlodipine 80/5mg per day on the levels of serum lipids, as well as the levels of serum apolipoproteins and the TRG/ApoA-1, TRG/HDL-C ratios, in patients with stage 2 hypertension (systolic blood pressure (SBP) 160-180 mmHg and/or diastolic blood pressure (DBP) 100-110 mmHg) and with prediabetes (IFG/IGT), before and after the 3-month treatment.

Methods
Data from 51 patients who had visited our outpatient clinic for lipid metabolism disorders during the period 2014-2018 and had been randomized in the telmisartan/amlodipine group 80/5mg per day. The patients (35 male/16 female) had BMI: 29.32 [27.37-31.65]. The levels serum lipids and of apolipoproteins B, A1, Lp(a) and E were measured before the beginning of the treatment and 3-months after its administration.

Results
The resulting variations of SBP and DBP levels before and after the 3-month treatment, as well as the variations of serum lipid, apolipoprotein levels and TRG/ApoA-1, TRG/HDL-C ratios are presented on Table 1.

Conclusion
The 3-month telmisartan/amlodipine therapy seems to improved, statistically significant both SBP and DBP levels (decreased by -13.58 % and -13 % respectively, p&lt;0.001, for both values). Serum lipid levels didn’t show any significant variation before and after treatment. Statistically significant changes were not present in apolipoprotein levels, also. Finally, there were no statistically significant variations in either TRG/ApoA-1 or TRG/HDL-C ratios.
Relationship between phytosterol intake and cardiovascular disease in the adult Polish population
Authors: Waskiewicz A , Witkowska AM , Cicha-Mikolajczyk A , Mironczuk-Chodakowska I , Zujko ME , Drygas W 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Plant sterols are compounds with multiple biological functions, mainly cholesterol-reducing. Although phytosterols lower LDL-cholesterol, their relationship to cardiovascular risk is unclear.

Purpose
To assess dietary total phytosterol, β-sitosterol, campesterol and stigmasterol and to determine the relationship between total plant sterols and the chance of cardiovascular disease (CVD) in the adult Polish population.

Methods
Within the frame of the National Multicenter Health Survey (WOBASZ II), a random sample of the whole Polish population aged 20 years and above was screened during the years 2013-2014. Dietary habits and an interview of a history of CVD were assessed in 2554 men and 3136 women. The international food databases were used to develop a database on plant sterols in the products consumed in Poland. Plant sterols were calculated from the amount of food consumed by the participants combined with the phytosterol content of the food. The subjects were divided according to the tertiles of total phytosterol intake – 1st tertile (mean [mg/day]); 153 (men 174; women 141); 2nd tertile – 257 (293; 233 respectively), and 3rd tertile 439 (496; 383). The logistic regression method was used to calculate the odds ratio (OR) of the occurrence of CVD in phytosterol tertiles after adjustment for age, BMI and consumption of lipid-lowering drugs, fiber, and alcohol.

Results
The average total plant sterol intake [mg/day] was significantly lower in subjects with CVD than in subjects without CVD (men 299 vs 326, p= 0.0016 and women 238 vs 256, p= 0.0016); β-sitosterol (186 vs 201, p= 0.0062 and 149 vs 160 p= 0.0016 respectively), campesterol (63.2 vs 70.6; p=0.0044 and 46.8 vs 51.9 p= 0.0015) and stigmasterol (24.2 vs 26.9; p=0.0017; 20.7 vs 23.1 p=0.0023).
In the whole group there was a significantly lower OR=0.695 (0.528-0.916) of developing CVD in the third tertile compared to the first. In men, the odds ratios of CVD were significantly lower in the second tertile OR=0.637 (95%CI 0.445-0.911) and in the third tertile OR=0.581 (95%CI 0.372-0.907) compared to the first tertile. In women, the trends were similar, although no significant differences were shown – in the second tertile OR = 0.927 (95% CI 0.695-1.237) and in the third tertile OR=0.843 (95%CI 0.600-1.184). In addition, there was a better overall quality of nutrition in people in the third tertile of phytosterol intake compared to the first tertile.

Conclusion
The content of phytosterols in the diet may determine the chance of developing CVD, especially in men.
Gender differences in acute cardiovascular mortality in France
Authors: Alami O , Alami M 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Introduction
Cardiovascular diseases are usually known as men’s diseases, and many beliefs tend to assert that women are protected by their hormones before menopause. However, in France, women are suspected to die more than men due to acute cardiovascular disease.

Purpose
Our aim is to confirm this excess women mortality and to propose a new indicator in order to assess the probable delay in diagnosis and hospital care in acute cardiovascular settings among women.

Methods
We focused on major acute cardiovascular pathologies : Pulmonary Embolism (PE), Myocardial Infarction (MI) and Stroke. We compared males and females death numbers for these diseases. Deaths were age-standardized in order to assess mortality differences by sex. Then we suggested a new ratio which relates number of hospitalizations to number of deaths for each one of the three cardiovascular pathologies.

Results
Women died more than men from acute cardiovascular pathologies in France between 2000 and 2016. Stroke is the first cause of death from acute cardiovascular disease in women in 2016. Men’s Standardized Mortality Ratio (SMR) over women’s SMR was in favor of an excess man mortality when age bias is taken into account (SMR men/SMR women = 1,18 for PE, 1,25 for Stroke and 2,16 for MI). The new indicator (HD) was lower in women for Stroke and Myocardial Infarction (3,23 and 3,08 in females versus 5,05 and 4,72 in males, respectively).

Conclusion
Women in France die more than men from cardiovascular causes. This new indicator should contribute to a better understanding of delays in diagnoses and care in acute cardiovascular settings among women. Imperative measures should be taken in order to reverse the excess women mortality trend.
Combined environmental and educational intervention in hospital food service to increase patients attitude and intention about a healthy diet
Authors: De Frel DL , Janssen VR , Van Keulen N , Atsma DE 
Published: May 2022

Abstract

Funding Acknowledgements
Type of funding sources: None.

Background
The elimination of unhealthy risk behaviors such as unhealthy diet, smoking or physical inactivity can prevent at least 80% of cardiovascular disease.(1) Diet has been the number two in modifiable factors attributing to cardiovascular disease burden in the last thirty years.(2) In spite of this, adherence to dietary guidelines in The Netherlands is as low as 20-30%.(3) Clearly, more effective strategies towards healthier dietary behavior are needed.(1) According to the dual process theory, behavior can be influenced via the deliberate system and the intuitive system.(4) The food services on the cardiology ward were revised aiming to influence both systems in admitted patients to gear them towards healthier choices.

Purpose
To assess the impact of a combined environmental and rational intervention on patients’ attitude and intention towards a healthier diet.

Methods
A pre-post interventional study was conducted from June 2020 till November 2021 in patients admitted to the Cardiology ward. Patients’ attitude, self-efficacy and intention towards a healthy diet were evaluated through the validated Dietary Intention Evaluation Tool for In-hospitalized patients (DIETI). The intervention was aimed at intuitive and rational behavioral processes. The intuitive part consisted of posters, healthy standard options and a traffic light system on the menu. The rational part consisted of information about a healthy diet on the menu, emphasis on the importance of a healthy diet, a renewed website on lifestyle and an educational course on diet and nudging for nurses and food service employees. Also, at discharge, patients received two salt free spice mixes with healthy, easy and cheap recipes to prepare at home.

Results
A total of 512/853 (60%) complete responses were received. The intervention group reported to have learned significantly more during their admission than patients in the control group (4.58 vs. 4.80, p=0.009). However, our intervention does not influence patients’ attitude or intention regarding a healthy diet (p=0,41 and p=0,49 respectively).

Conclusions
A hospital admission of approximately 3 days is enough to make a significant impact on patients’ perceived learning. However, a combined environmental and educational intervention did not have an effect on patients’ attitude or intention regarding a healthy diet.