Predictors of Long-term Clinical Endpoints in Patients With Refractory Angina Coronary Heart Disease
Background Clinical outcomes in patients with refractory angina (RA) are poorly characterized and variably described. Using the Duke Database for Cardiovascular Disease (DDCD), we explored characteristics that drive clinical endpoints in patients with class II to IV angina stabilized on medical therapy. Methods and Results We explored clinical endpoints and associated costs of patients who underwent catheterization at Duke University Medical Center from 1997 to 2010 for evaluation of coronary artery disease (CAD) and were found to have advanced CAD ineligible for additional revascularization, and were clinically stable for a minimum of 60 days. Of 77 257 cardiac catheterizations performed, 1908 patients met entry criteria. The 3-year incidence of death; cardiac rehospitalization; and a composite of death, myocardial infarction, stroke, cardiac rehospitalization, and revascularization were 13.0%, 43.5%, and 52.2%, respectively. Predictors of mortality included age, ejection fraction (EF), low body mass index, multivessel CAD, low heart rate, diabetes, diastolic blood pressure, history of coronary artery bypass graft surgery, cigarette smoking, history of congestive heart failure (CHF), and race. Multivessel CAD, EF
Publication date: 15 November 2020Source: Life Sciences, Volume 261Author(s): Yuan Zhang, Hui Jiang, Shengqian Dou, Bin Zhang, Xia Qi, Jing Li, Qingjun Zhou, Weina Li, Chen Chen, Qun Wang, Lixin Xie
Discussion Syphilis is caused by the spirochete Treponema pallidum. It is a very old disease that despite understanding the organism and readily available treatment, still causes disease. Syphilis is transmitted sexually. According to the Centers for Disease Control, “[i]n 2018, a total of 35,063 cases of [Primary and Secondary] syphilis were reported in the United States, yielding a rate of 10.8 cases per 100,000 population …. This rate represents a 14.9% increase compared with 2017 (9.4 cases per 100,000 population), and a 71.4% increase compared with 2014 (6.3 cases per 100,000 population).” The incre...
HEART attack symptoms include difficulty breathing, chest pain, and an overwhelming feeling of anxiety. But you could also be at risk of a deadly myocardial infarction and heart disease symptoms if you develop this sign on your skin. Has your skin changed colour?
Duchenne/Becker muscular dystrophy (DMD/BMD) is a progressive skeletal myopathy as well as a cardiomyopathy. Historically, it is reported that patients with DMD/BMD experience significant morbidity/mortality as a result of rhythm abnormalities. However, natural history data is limited regarding the specific mode of death, e.g. heart failure vs. sudden cardiac death vs. non-cardiac death. We identified 82 patients at our institution to analyze retrospectively (67 DMD/15 BMD). Average age was 21 (range 10-38) years.
Malignant hyperthermia (MH) and Exertional Heat Stroke (EHS) present hypermetabolic states leading to rhabdomyolysis and muscle rigidity with progressive hyperthermia; MH is triggered by volatile inhaled anesthetics, while EHS is triggered by exercise in hot/humid environment. Given the similarity of clinical features and the fact that a portion of EHS cases were diagnosed as MH susceptible by the in vitro contracture test, MH and EHS are believed to share common etiology. Mutations in RYR1 and CACNA1S have been found to be associated with MH; however the genetic cause remains to be identified in approximately 30% of MH cases.
Abstract BACKGROUND: Alpha-glucosidase inhibitors (AGI) reduce blood glucose levels and may thus prevent or delay type 2 diabetes mellitus (T2DM) and its associated complications in people at risk of developing of T2DM. OBJECTIVES: To assess the effects of AGI in people with impaired glucose tolerance (IGT), impaired fasting blood glucose (IFG), moderately elevated glycosylated haemoglobin A1c (HbA1c) or any combination of these. SEARCH METHODS: We searched CENTRAL, MEDLINE, Embase, ClinicalTrials.gov, the World Health Organization International Clinical Trials Registry Platform, and the reference lists ...
ConclusionsThis study confirms the high prevalence of CKD in patients with multiple comorbidities: T2D and CVD. It also provides estimates of the prevalence of CKD categories based on KDIGO 2012 classification for US adults with T2D.
Objective: Studies have shown that famine exposure during early life may increase the risk of cardiovascular disease (CVD), hypertension, and diabetes during adulthood. We aimed to assess whether exposure to the Chinese famine (1959–1961) modifies the association between hypertension and CVD. Methods: We investigated data of 5772 adults born between 1954 and 1964 from the China Health and Retirement Longitudinal Study. CVD was based on self-reported doctor's diagnosis of heart problems (heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems) and stroke. Results: Overal...
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