External validation and extension of a diagnostic model for obstructive coronary artery disease: a cross-sectional predictive evaluation in 4888 patients of the Austrian Coronary Artery disease Risk Determination In Innsbruck by diaGnostic ANgiography (CARDIIGAN) cohort

Objective To externally validate and extend a recently proposed prediction model to diagnose obstructive coronary artery disease (CAD), with the ultimate aim to better select patients for coronary angiography. Design Analysis of individual baseline data of a prospective cardiology cohort. Setting Single-centre secondary and tertiary cardiology clinic. Participants 4888 patients with suspected CAD, without known previous CAD or other heart diseases, who underwent an elective coronary angiography between 2004 and 2008 as part of the prospective Coronary Artery disease Risk Determination In Innsbruck by diaGnostic ANgiography (CARDIIGAN) cohort. Relevant data were recorded as in routine clinical practice. Main outcome measures The probability of obstructive CAD, defined as a stenosis of minimally 50% diameter in at least one of the main coronary arteries, estimated with the predictors age, sex, type of chest pain, diabetes status, hypertension, dyslipidaemia, smoking status and laboratory data. Missing predictor data were multiply imputed. Performance of the suggested models was evaluated according to discrimination (area under the receiver operating characteristic curve, depicted by the c statistic) and calibration. Logistic regression modelling was applied for model updating. Results Among the 4888 participants (38% women and 62% men), 2127 (44%) had an obstructive CAD. The previously proposed model had a c statistic of 0.69 (95% CI 0.67 to 0.70), which was lower than the...
Source: BMJ Open - Category: Journals (General) Authors: Tags: Open access, Cardiovascular medicine, Diagnostics, Epidemiology, Research methods Source Type: research

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Walking is often touted as a perfect exercise to improve multiple aspects of health. But what if walking causes leg pain? Many people shrug off leg pain when they walk as a normal part of aging. In some cases, though, it’s the sign of peripheral artery disease (PAD), which can put heart and brain health at risk. While PAD doesn’t usually run in families, it’s more likely to occur as people age, or among people who smoke or have high blood pressure, high cholesterol, or diabetes. What causes leg pain if you have PAD? People with PAD have fatty deposits in arteries outside the heart — most often in th...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Exercise and Fitness Healthy Aging Heart Health Hypertension and Stroke Pain Management Source Type: blogs
In conclusion, with study of the frailty syndrome still in its infancy, frailty analysis remains a major challenge. It is a challenge that needs to be overcome in order to shed light on the multiple mechanisms involved in the pathogenesis of this syndrome. Although several mechanisms contribute to frailty, immune system alteration seems to play a central role: this syndrome is characterized by increased levels of pro-inflammatory markers and the resulting pro-inflammatory status can have negative effects on various organs. Future studies should aim to better clarify the immune system alteration in frailty, and seek to esta...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
ConclusionHigh blood pressure is a public health problem most often associated with other cardiovascular risk factors. An evaluation of cardiovascular risk is necessary in postmenopausal hypertensive diabetic women and effective management of risk factors is recommended.
Source: Archives of Cardiovascular Diseases Supplements - Category: Cardiology Source Type: research
This study elucidates the potential to use mitochondria from different donors (PAMM) to treat UVR stress and possibly other types of damage or metabolic malfunctions in cells, resulting in not only in-vitro but also ex-vivo applications. Gene Therapy in Mice Alters the Balance of Macrophage Phenotypes to Slow Atherosclerosis Progression https://www.fightaging.org/archives/2019/07/gene-therapy-in-mice-alters-the-balance-of-macrophage-phenotypes-to-slow-atherosclerosis-progression/ Atherosclerosis causes a sizable fraction of all deaths in our species. It is the generation of fatty deposits in blood vessel...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Conclusions: People with moderate-severe TBI experience other medical and mental health comorbidities during the long-term course of recovery and life after injury. The findings can inform further investigation into comorbidities associated with TBI and the role of medical care, surveillance, prevention, lifestyle, and healthy behaviors in potentially modifying their presence and/or prevalence over the life span.
Source: The Journal of Head Trauma Rehabilitation - Category: Neurology Tags: Original Articles Source Type: research
This study sought to investigate what could be learned from how these men have fared. The men were born in 1925-1928 and similar health-related data from questionnaires, physical examination, and blood samples are available for all surveys. Survival curves over various variable strata were applied to evaluate the impact of individual risk factors and combinations of risk factors on all-cause deaths. At the end of 2018, 118 (16.0%) of the men had reached 90 years of age. Smoking in 1974 was the strongest single risk factor associated with survival, with observed percentages of men reaching 90 years being 26.3, 25.7, ...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
When a woman is denied access to an abortion, research has shown that she may face threats to her mental or financial well-being. A new study, published in the Annals of Internal Medicine, suggests her physical health may suffer, too. “There’s a good deal of research that shows, in the short term, having an abortion is much safer than childbirth, but there isn’t much research over the long-term,” says study co-author Lauren Ralph, an assistant professor of obstetrics, gynecology and reproductive sciences at the University of California, San Francisco. “Our study demonstrates that having an abo...
Source: TIME: Health - Category: Consumer Health News Authors: Tags: Uncategorized abortion embargoed study onetime Research Source Type: news
​BY HABIR MANDAIR; KEYUR KURANI; &KHALID MALIK, MDA 62-year-old obese woman with end-stage renal disease (ESRD) who was on hemodialysis, hypertension, diabetes mellitus, and chronically elevated serum calcium levels presented to the ED with altered mental status. Nursing home staff stated that she was unable to answer questions coherently and seemed confused.Her vitals were within normal limits except for a body temperature of 99.9°F. Several necrotic lesions of various sizes were found on her left and right buttocks and the medial aspects of both thighs. The patient also had severe necrosis of the third finger o...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
Conclusion: Our findings describe the most reported risk factors for preventability of oral anticoagulant-induced bleedings. These factors may be useful for targeting interventions to improve pharmacovigilance activities in our regional territory and to reduce the burden of medication errors and inappropriate prescription. Introduction Oral anticoagulant therapy is widely used for the prevention of stroke and systemic embolism in patients with atrial fibrillation, or for the prevention and treatment of deep vein thrombosis and pulmonary embolism (Raj et al., 1994; Monaco et al., 2017). Oral anticoagulants can be di...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Joseph D. Romano1,2,3,4 and Nicholas P. Tatonetti1,2,3,4* 1Department of Biomedical Informatics, Columbia University, New York, NY, United States 2Department of Systems Biology, Columbia University, New York, NY, United States 3Department of Medicine, Columbia University, New York, NY, United States 4Data Science Institute, Columbia University, New York, NY, United States The discovery of new pharmaceutical drugs is one of the preeminent tasks—scientifically, economically, and socially—in biomedical research. Advances in informatics and computational biology have increased productivity at many stag...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
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