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Diabetic retinopathy（DR） and coronary heart disease（CHD） are both major chronic vascular complications that seriously jeopardize the health of the population and often occur together in clinical practice， it is of great clinical value to actively explore the association between the two in the process of disease development and methods of prevention and treatment of modern medicine and traditional Chinese medicine（TCM）. According to TCM， the heart and eyes physiologically communicate with each other by taking Qi， blood and veins as bridges， blood stasis obstructing collaterals is the common TCM etiology of DR and CHD， whose mechanism involves inflammation， oxidative stress and endothelial dysfunction. Promoting blood circulation and removing blood stasis plays an important role in the same treatment for different diseases and prevention and treatment of comorbidities， possibly by inhibiting the expression of interleukin-1β（IL-1β）， endothelin-1（ET-1） and hypoxia inducible factor-1α/vascular endothelial growth factor（HIF-1α/VEGF）， regulating phosphatidylinositol 3-kinases/protein kinase B/mammalian target of rapamycin（PI3K/Akt/mTOR） pathway， initiating adenosine monophosphate（AMP）-activated protein kinase/silent information regulator 1（AMPK/SIRT1） and nuclear transcription factor erythroid 2-related factor 2/heme oxygenase-1（Nrf2/HO-1） signaling pathways， inhibiting Hippo/Yes-associated protein（Hippo/YAP） signaling pathway， inhibiting mitochondrial permeability transition pore and anti-platelet agglutination for treating DR and CHD， which provides a multi-component， multi-pathway and multi-target selection strategies and ideas for the prevention and treatment of DR and CHD by TCM from a biological perspective. Based on this， subsequent studies should focus on constructing clinically relevant comorbidity models， conducting multicenter prospective studies， and fully utilizing artificial intelligence technology to gain a deeper understanding of the relationship between the two diseases， so as to elucidate the mechanism of promoting blood circulation and removing blood stasis in preventing and treating panvascular diseases.
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Objective To establish an individual Nomgram model for predicting the risk of coronary heart disease complicated with pulmonary hypertension. Methods From January 2017 to December 2021 , 352 patients with coronary heart disease (CHD) complicated with pulmonary hypertension in our hospital were selected, and 352 patients with coronary heart disease but without pulmonary hypertension were selected as the control group. The clinical baseline data of the two groups were analyzed first, and then logistics multivariate analysis was performed. To explore the risk factors of coronary heart disease complicated with pulmonary hypertension, the Nomgram model was established to predict the risk, and the predictive value of the model was tested by receiver characteristic curve (ROC). Results Logistics multivariate analysis showed that alcoholism, smoking, stroke history, hypertension course, CHD course, PASP, HCT, PaCO2, D-dimer, NIHSS score and low PaO2 were all independent risk factors for CHD complicated with pulmonary hypertension. Nomgram model prediction results for patients with coronary heart disease showed that Alcohol abuse, smoking, stroke history, duration of hypertension (5.66 years), duration of coronary heart disease (2.12 years), NIHSS (12.33 points), PASP (75.22mmHg), HCT (33.22%), PaCO2 (56.11mmHg), D-dimer (255.12μg/L), PaO2 (56.22mmHg) is a risk factor for coronary heart disease complicated with pulmonary hypertension. ROC curve showed that the area under the prediction curve of Nomgram model for coronary heart disease complicated with pulmonary hypertension was 0.675. Conclusion Nomgram model can predict pulmonary hypertension in patients with coronary heart disease to a certain extent.
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Coronary heart disease （CHD） with atherosclerosis is a common chronic disease worldwide， and anxiety and depression are potential and crucial risk factors for adverse prognosis in CHD. Chaihu Longgu Mulitang （CLMT）， first mentioned in the Shang Han Lun （《伤寒论》）， is a classic prescription for treating Shaoyang diseases combined with disturbance of the mind and spirit， with the effects of harmonizing Shaoyang and calming the mind. Current research on mechanisms has shown that CLMT can play a role in CHD complicated with anxiety and depression through multiple pathways， including regulating related signaling pathways， inhibiting the expression of inflammatory factors， improving oxidative stress damage， modulating neurotransmitter levels， suppressing the hypothalamic-pituitary-adrenal axis， promoting mobilization of mesenchymal stem cells from the bone marrow， and inhibiting platelet activation. Clinical studies have demonstrated that CLMT significantly improves symptoms such as angina and insomnia caused by CHD complicated with anxiety and depression， effectively reduces negative emotions， improves traditional Chinese medicine （TCM） syndrome scores， and decreases levels of inflammatory factors. Furthermore， it has fewer adverse reactions and higher safety than conventional western medicine treatments. This article provides a review of the mechanisms and clinical studies of CLMT in the treatment of CHD complicated with anxiety and depression based on a comprehensive analysis of literature from the China National Knowledge Infrastructure （CNKI）， Wanfang Data， VIP， PubMed， and other databases in the past 15 years， in order to provide references for further research on the use of CLMT in the management of CHD complicated with anxiety and depression.
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Objective To analyze the risk factors of coronary heart disease (CHD) in patients with type 2 diabetes mellitus (T2M) in Suining area, and build a risk prediction model to provide theoretical basis for the prevention and treatment of CHD in PATIENTS with T2M. Methods A total of 476 T2M patients treated in our hospital from January 2021 to December 2021 were selected and divided into experimental group (n=79) and control group (n=397) according to whether they had coronary heart disease. The angiographic characteristics of coronary artery lesions in patients with T2M combined with coronary heart disease were observed. Age, sex, body mass index (BMI), smoking, alcohol consumption , T2M course, FBG, FINS, HOMA, TC, LDL-C, SBP, DBP and UA levels of all patients were analyzed. Univariate analysis and Logistic regression were used to analyze the influencing factors of coronary heart disease and establish a risk prediction model. ROC curve was used to predict the efficiency of the model. Results A total of 79 cases (16.60%) of patients with T2M complicated with coronary heart disease, including 64 cases (81.01%) of patients with T2M complicated with coronary artery disease. Mild stenosis in 5 cases (6.33%), moderate stenosis in 20 cases (25.32%) and severe stenosis in 54 cases (68.35%); The mean age, smoking proportion, BMI, T2M course and the levels of FBG, FINS, HOMA-IR, TC, LDL-C, SBP, DBP and UA in experimental group were significantly higher than those in control group (P-(-0.513+0.919×(old age)+1.129×(increased SBP)+ 1.724×(increased FBG)+ 1.529×(increased LDL-C)]. ROC curve was used to analyze the predictive performance of the regression model. The results showed that the AUC of the risk prediction model for coronary heart disease in T2M patients was 0.728, 95% CI (0.651-0.829). Conclusions T2M patients in Suining have a high risk of coronary heart disease. For elderly patients with elevated SBP, LDL-C and FBG, the risk of coronary heart disease can be assessed by predictive model and targeted intervention measures can reduce the risk of coronary heart disease in T2M patients.
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Tong （dredging） method in traditional Chinese medicine （TCM） emphasizes soothing the stagnated Qi， blood， and body fluid in zang-fu organs， meridians， and collaterals to remove pathogens， reinforce vital Qi， and balance Yin and Yang of the human body. Tong method can be adopted to disperse sweat pore， attack pathogenic Qi， harmonize Yin and Yang， as well as tonify deficiency， and resolve stagnation. It has been proved effective in treating coronary heart disease （CHD）， which falls into the category of "chest impediment and heart pain" in TCM， with the key pathogenesis lying in blood vessel obstruction. Therefore， dredging blood vessels is the primary therapeutic principle for CHD. Specifically， there are four aspects. The first is dispersing and dredging the sweat pore of the heart. If the sweat pore is occluded by pathogenic cold， which makes Yang-qi undissipated， Cinnamomi Ramulus， Piperis Longi Fructus， Alpiniae Officinarum Rhizoma， and Asari Radix et Rhizoma can be prescribed for warming and dredging heart Yang. If the Yang-qi of the heart and chest stagnated in the body， which hinders Qi and blood to nourish the myocardium， resulting in chest pain， Poria and Alismatis Rhizoma can be prescribed. For CHD due to atherosclerosis and inflammation， heat-clearing， toxin-removing， and inflammation-resisting Chinese medicinal herbs such as Coptidis Rhizoma and Rhei Radix et Rhizoma are recommended. The second is attacking and dredging the collaterals of the heart. Salviae Miltiorrhizae Radix et Rhizoma， Chuanxiong Rhizoma， Notoginseng Radix et Rhizoma， etc. can be prescribed for blood stasis， Trichosanthis Fructus， Allii Macrostemonis Bulbus， Pinelliae Rhizoma， etc. for phlegm， and Aquilariae Lignum Resinatum， Euodiae Fructus， etc. for pathogenic cold. Since the chronic disease can affect collaterals， Moschus and Santali Albi Lignum can be added to promote blood circulation and remove the obstruction of collaterals of the heart. The third is harmonizing and dredging the mind. Cinnamomi Ramulus， Coptidis Rhizoma， Cinnamomi Cortex， etc. are selected for restoring the coordination between the heart and the kidney. According to the specific syndrome， the methods of nourishing the mind and calming the nerves through tranquilizing the mind， calming down the mind， and inducing resuscitation can be selected using such Chinese medicines as Ziziphi Spinosae Semen， Polygalae Radix， and Draconis Ossa. The fourth is tonifying and dredging the Qi and blood of the heart. The deficiency syndrome of CHD is divided into Qi deficiency and kidney deficiency. Invigorating Qi and strengthening the heart are the first essentials for the treatment of CHD. In Qi invigoration， Qi and blood must be strengthened simultaneously to strengthen the heart and clear the pulse. Hence， Bazhentang modified by Salviae Miltiorrhizae Radix et Rhizoma and Carthami Flos can be chosen. In kidney Qi tonifying， kidney and heart must be strengthened simultaneously， and the methods of tonifying kidney and activating blood can be used. Ginseng Radix et Rhizoma and Astragali Radix are considered as the first choice for tonifying heart Qi， and Epimedii Folium and Morindae Officinalis Radix for tonifying kidney Qi， which are added with Salviae Miltiorrhizae Radix et Rhizoma and Rehmanniae Radix Praeparata to obtain the kidney-tonifying and blood-activating prescription. It is suitable for treating CHD due to kidney deficiency and blood stasis. Simultaneous treatment of heart and kidney is more suitable for middle-aged and elderly patients and chronically ill patients. Tong method can be used in various clinical diseases as well as CHD.
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The present study explored the correlation of coronary heart disease(CHD) with blood stasis syndrome in postmenopausal women with artery elasticity and endothelial function indexes and evaluated the diagnostic efficacy of the prediction model via logistic regression and receiver operating characteristic(ROC) curve model. A retrospective comparison was made between 366 postmenopausal CHD patients from August 1, 2020, to September 30, 2021, in the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of China-Japan Friendship Hospital, who were divided into the blood stasis syndrome group(n=196) and the non-blood stasis syndrome group(n=170). General clinical characteristics of the two groups were compared. Multivariate logistic regression analysis was used to probe the correlation of CHD with blood stasis syndrome in postmenopausal women with brachial-ankle pulse wave velocity(baPWV), ankle-brachial index(ABI), and flow-mediated dilatation(FMD), and the ROC curve was drawn to evaluate the diagnostic efficiency of the prediction model. Multivariate logistic regression analysis showed that the correlation coefficients of CHD with blood stasis syndrome in postmenopausal women with baPWV, ABI, and FMD were 1.123, 0.109, and 0.719, respectively(P=0.004, P=0.005, P<0.001),and the regression equation for predicting probability P was P=1/[1+e~(-(3.131+0.116×baPWV-2.217×ABI-0.330×FMD))]. ROC curve analysis suggested that in the context of baPWV≥19.19 m·s~(-1) or ABI≤1.22 or FMD≤9.7%, it was of great significance to predict the diagnosis of CHD with blood stasis syndrome in postmenopausal women. The AUC of baPWV, ABI, FMD, and prediction probability P was 0.763, 0.607, 0.705, and 0.836, respectively. The AUC of prediction probability P was higher than that of each index alone(P<0.001), and the sensitivity and specificity were 0.888 and 0.647, respectively. The results demonstrate that baPWV, ABI, and FMD are independently correlated with CHD with blood stasis syndrome in postmenopausal women, and show certain independent predictive abilities(P<0.05). The combined evaluation of the three possesses the best diagnostic efficiency.
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Female , Humans , Ankle Brachial Index , Brachial Artery , Coronary Disease/diagnosis , Elasticity , Logistic Models , Postmenopause , Pulse Wave Analysis , ROC Curve , Retrospective StudiesABSTRACT
This research was to evaluate the economics of Shexiang Tongxin Dropping Pills combined with conventional therapy for patients with coronary heart disease(CHD) in Chinese medical environment. From the perspective of medical insurance, a Markov model was established in this study based on the results of Meta-analysis comparing the effectiveness and safety of Shexiang Tongxin Dripping Pills combined with conventional treatment and conventional treatment alone. The experimental group was treated with She-xiang Tongxin Dropping Pills combined with conventional Western medicine treatment, while the control group was treated with conventional Western medicine treatment alone. The cost-utility analysis and sensitivity analysis were performed for the two regimens using Treeage pro. After 30 cycles of model simulation, according to the results of Markov model, the total cost and health output were CNY 237 795.73 and 16.36 QALYs(the quality adjusted life years, QALYs), respectively for Shexiang Tongxin Dropping Pills combined with conventional Western medicine treatment, CNY 247 396.55 and 16.36 QALYs respectively for the conventional Western medicine treatment alone. Compared with the conventional treatment alone, the Shexiang Tongxin Dropping Pills combined with conventional treatment had lower long-term cost and higher health output, with advantages of cost-utility and pharmacoeconomic advantages. The sensitivity analysis results showed that the conclusion was relatively stable. Based on the above results, it is considered that compared with the conventional Western medicine alone, Shexiang Tongxin Dropping Pill combined with conventional Western medicine is a treatment regimen with pharmacoeconomic advantages for the treatment of CHD.
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Female , Humans , Coronary Disease/drug therapy , Drugs, Chinese Herbal , Economics, PharmaceuticalABSTRACT
Objective: In this study our main goal is to find out theassociation of cardiac troponin I level on admission with theangiographic severity of coronary artery disease in acuteSTEMI patients.Method: This cross-sectional observational study was done inthe NICVD, Dhaka from October 2010 to September 2011. Atotal of 100 consecutive patients were included. Studypopulations were sub-divided into two groups on the basis ofcTn I level. In group I cTn I level ≥20ng/ml and in group II cTnI level <20ng/ml. 50 patients were included in group I and 50patients were included in group II.Results: Most of the patients presented with more than 4hours chest pain which was 68% vs. 60% patients in group Iand group II respectively. Where mean heart rate was higher ingroup I than group II (83.08.4 vs. 78.210.6). It wasstatistically significant (p=0.01) in student-test. Vessel score 2and 3 together formed the main bulk of the patients (68%) ingroup I, while vessel score 0 and 1 were frequently common ingroup II (80%). In group I there was no patient with vesselscore 0, in group II 12(24%) patients had vessel score 0 (5patients had normal coronaries and 7 patients had insignificantlesions, p-value from Chi square test).Conclusion: From our study we can say that, estimation ofserum cardiac troponin I might facilitate the triage of patientswith acute myocardial infarction by clinicians and moreaggressive approach to promote myocardial reperfusion mightbe warranted in the patients with high cardiac troponin I level.
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Objective To study the effects of combination therapy (psychological intervention+clopidogrel+aspirin) for coronary heart disease. Methods 88 cases were selected from January 2016 to April 2017 in patients with coronary heart disease in our hospital. In a randomized approach, patients were divided into treatment groups and control groups, with 44 cases per patient. Patients in the control group were treated with aspirin, and the treatment group was treated with a combination therapy (psychological intervention+clopidogrel+aspirin). The treatment effect, angina and adverse reaction were observed and compared. Results Comparing the therapeutic effect of two groups of patients, the treatment group total effective rate was 97.73%, control group total effective rate was 79.55%, significant difference was statistically significant (P<0.05); Compared two groups of patients with angina, the treatment group patients with onset time (4.32±1.18) shorter, longer time interval (5.03 ±1.34), less number of attacks (1.67±0.49), with statistical significance (P<0.05); Compared to the adverse reactions in the two groups, the incidence of adverse reactions in the treatment group was 4.55%, compared with 18.18% in the control group. Statistical significance (P<0.05). Conclusion Psychological intervention in combination with clopidogrel and aspirin enteric-coated metformin hydrochloride in the treatment, in the clinical treatment of patients with coronary heart disease angina pectoris, shows good therapeutic effect, has higher application value.
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Objective To investigate the effect of atorvastatin on endothelial diastolic function in patients with coronary artery disease.Methods he selected in January 2014 to December 2016 in our hospital make a diagnosis and give treatment of 80 patients with coronary heart disease(CHD)as the research object, the patients with its treatment is divided into two groups(control group and observation group)experiment, for the control group, 40 patients were treated with trimetazidine for observation group 40 cases of patients with trimetazidine+atorvastatin treatment;Compare the data of the two groups of patients.Results Observation group after treatment in patients with endothelial diastolic function level change is better than that of control group, the observation group vascular endothelin-1(60.48±12.72), nitric oxide(391.45±68.52), peripheral blood circulating endothelial microparticles(849.13±115.49), and other indicators are superior to control group vascular endothelin-1(70.47±15.52), nitric oxide(328.15±56.74), peripheral blood circulating endothelial microparticles(1019.67±127.52), compare the difference between groups was statistically significant(P< 0.05);The clinical therapeutic effect(95.0%)was superior to the control group(77.5%), and the difference in the group was statistically significant(P< 0.05).The incidence of adverse reactions(5.0%)was lower in the observed group(5.0%)than the control group(20.0%), and the difference in the group was statistically significant(P< 0.05).Conclusion Trimetazidine+atorvastatin therapy in patients with coronary heart disease in clinical effect is remarkable, can improve the endothelial diastolic function in patients with fully, is widely used in clinical treatment of coronary heart disease(CHD).
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Cardiovascular diseases have the characteristics of high morbidity and high mortality, and are recognized as the first cause of death by World Health Organization in World Health Statistics 2016. In recent years, traditional Chinese medicines have been widely applied in the treatment of cardiovascular diseases, while studies for integrated traditional Chinese and western medicines for treating cardiovascular diseases have made a great progress. Xiongshao capsule was developed by Academician Chen Keji according to classic formula Xuefu Zhuyu decoction and composed of effective parts of Rhizoma Ligusticum Wallichii and Radix Paeonia Rubra, with remarkable therapeutic effects on angina pectoris, restenosis after percutaneous coronary intervention(PCI), atherosclerosis, dyslipidemia and so on. In this review, basic and clinical studies for the effect of Xiongshao capsule in treating cardiovascular diseases were reviewed to provide reference for reasonable clinical use and example for new traditional Chinese medicine development and application under the guidance of theory of integrated traditional Chinese and western medicines.
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Objective To study associations between manganese superoxide dismutase 9 Ala/Val (Mn-SOD 9 Ala/Val)genet-ic polymorphism and total superoxide dismutase (T-SOD)and Mn-SOD activity and the impact on coronary heart disease (CHD)were studied.Methods There were 82 CHD patients and 57 controls in this research.Sequencer was used to identify the genotype of Mn-SOD 9 Ala/Val genetic polymorphism and colorimeter was used to detect the serum T-SOD and Mn-SOD activity.Results Compared with the control group,the serum T-SOD and Mn-SOD activity of the CHD group was significantly reduced(t=4.83,6.57,P all<0.05),while the VV genotype and V allele of Mn-SOD 9 Ala/Val genetic poly-morphism of the CHD group were higher (χ2 =4.75,P <0.05).The serum T-SOD and Mn-SOD activity of the Mn-SOD 9 VV genotype was significantly lower than the Mn-SOD 9 AA genotype(t=2.96,3.11,P all<0.05).Conclusion The ser-um T-SOD and Mn-SOD activity in the CHD patients was reduced.Mn-SOD 9 Ala/Val genetic polymorphism was involved in the pathogenesis of CHD by influencing the Mn-SOD activity.
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Background & objectives: Low serum levels of high density lipoprotein cholesterol (HDL-C) is an established risk factor for coronary heart disease (CHD). Among a variety of lipid modifying drugs, the best single drug therapy to increase HDL-C levels, especially among high risk, isolated low HDL-C (ILHDL-C) cases is yet to be identified. The objectives of the present study were to evaluate the best pharmacological measure among atorvastatin, fenofibrate and niacin aimed to raise HDL-C and its effect in decreasing the estimated Framingham-10-year CHD risk percentage (CHD-RP) among high risk ILHDL-C cases in north India. Methods: Two hundred CHD equivalent (CHD-RP≥20), ILHDL-C cases were randomly assigned for treatment either with atorvastatin 10 mg/day (n=70), micronized fenofibrate 160 mg/day (n=65) or niacin-extended release (ER) 750 mg/day (n=65). After 6 wk of treatment, the dosages of drugs were doubled and the patients were finally assessed after 12 wk for their lipid values. Results: Baseline characteristics were similar in the three groups. Niacin therapy 750 mg and 1.5 g/day resulted in a significant rise in HDL-C by 8.10 ± 3.19 and 12.41 ± 4.39 per cent (P<0.001), respectively. Fenofibrate 160 and 320 mg/day also resulted in a significant rise in HDL-C by 3.85 ± 3.48 and 6.24 ± 4.43 per cent (P<0.001), respectively, while atorvastatin 10 and 20 mg/day resulted in a non-significant increase in HDL-C by 0.13 ± 2.92 per cent and 0.51 ± 2.63 per cent, respectively. By increasing HDL-C values, niacin was found to be most effective in reduction of 10-year CHD-RP (P<0.001), followed by fenofibrate (P=0.010), while atorvastatin had no effect. Interpretation & conclusions: Our findings indicate that niacin rather than fibrates or statins seems to provide a safe and effective therapy for increasing HDL-C, thus reducing the cumulative CHD risk among ILHDL-C cases.
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@#ObjectiveTo investigate the correlation between the interpersonal trust and coping modes in aged patients with coronary heart disease (CHD).MethodsA total of 246 aged patients with CHD at home and in hospital were tested on their interpersonal trust and reply modes by adopting the Interpersonal Trust Scale (ITS) and Medical Coping Modes Questionnaire (MCMQ).ResultsThe interpersonal trust level of patients with higher educational background was significantly higher than those with poor educational background ( P<0.05). The patient's interpersonal trust was significantly positive correlation to the confrontation coping mode ( r=0.388, P=0.000) and significantly negative correlation to the compromising coping mode ( r=-0.434, P=0.000), but was not significantly correlation to avoidance coping mode ( P>0.05).ConclusionThe interpersonal trust of aged patients with CHD can influence their choice of coping modes.
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@#ObjectiveTo investigate the correlation of lipids and lipoproteins with cardiac function in patients with coronary heart disease (CHD).MethodsParameters of blood pressure, serum lipids and lipoproteins, clinical features, radionuclide ventriculographic and coronary angiographic findings were analyzed retrospectively in 584 CHD patients treated with standard treatment.ResultsThe left cardiac dysfunction of CHD patients was correlative positively with age, systolic blood pressure (SBP), diastolic blood pressure (DBP), blood glucose, body mass index (BMI), smoking, total cholesterol(TC) and low density lipoprotein cholesterol(LDL-ch) significantly(P<0.001), not correlative with high density lipoprotein-cholesterol (HDL-ch). The left ventricular ejection fraction (LVEF) and left ventricular peak filling rate (LVPFR) were decreased along with the levels of TC and LDL-ch increased (P<0.05～0.01).ConclusionTC and LDL-ch are positively correlative with left cardiac dysfunction in CHD patients. In order to reduce cardiac damage of CHD associated with hyperlipoidemia, more attention should be paid to the amelioration of coronary arteriosclerosis and the reduction of serum lipids and lipoproteins.
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OBJECTIVE: The purpose of this study was to investigate the association between dietary quality and the risk of coronary heart disease (CBD) among Korean men by a case-control study. METHODS: The cases were 108 male patients with a first acute myocardial infarction or a new diagnosis of angina pectoris who were admitted to a university teaching hospital in Seoul. Controls were 142 age-matched patients admitted to the departments of ophthalmology and orthopedic surgery at the same hospital. Dietary information was assessed by a nutritionist using a semiquantitative food frequency questionnaire (FFQ), and dietary quality index (DQI) scores were calculated. RESULTS: The intakes of total fat and cholesterol and body mass index (BMI) in cases were significantly higher than those in controls. The mean DQI scores were 8.6 for the cases and 9.4 for the controls. A higher DQI, which was indicative of a better quality diet, was inversely associated with the risk of CHD when comparing the highest to lowest quatiles, but borderline significant (odd ratios 0.60, 95% confidence interval 0.25-1.39, P for trend=0.05). CONCLUSIONS: Our findings suggest that better dietary quality may reduce the risk of CHD among Korean men.
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Humans , Male , Angina Pectoris , Body Mass Index , Case-Control Studies , Cholesterol , Coronary Disease , Diagnosis , Diet , Hospitals, Teaching , Myocardial Infarction , Nutritionists , Ophthalmology , Orthopedics , Surveys and Questionnaires , SeoulABSTRACT
This study focuses on the predictability of two alternative questionnaires for nicotine dependence, i.e., the Fagerstrom Tolerance Questionnaire (FTQ) and the Tobacco Dependence Screener (TDS), each of which represents a different aspect of dependence, among patients with coronary heart disease (CHD). Twenty-nine male inpatients that had been newly diagnosed as CHD were followed up for 30 weeks after hospital discharge. The baseline information included age, number of cigarettes per day, years of smoking, disease type (angina pectoris [AP] or acute myocardial infarction [AMI), whether they had received a briefing on smoking cessation, the FTQ, and the TDS. At 30 weeks after hospital discharge, 19 (66%) were abstainers. The group with a high TDS score (of 6 or greater) was significantly less likely to quit smoking than the group with a low TDS score (p=0.046). The FTQ score was not significantly different between the abstainers and non-abstainers. The subjects with AP were significantly less likely to quit smoking than those with AMI (p=0.021). Multiple logistic regression analysis showed that belonging to the high-TDS group and being diagnosed as AP were significantly associated with failure in smoking cessation (p<0.05). The present study suggests that the TDS may have higher predictability than the FTQ concerning smoking cessation among CHD inpatients.
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This study focuses on the predictability of two alternative questionnaires for nicotine dependence, i.e., the Fagerstrom Tolerance Questionnaire (FTQ) and the Tobacco Dependence Screener (TDS), each of which represents a different aspect of dependence, among patients with coronary heart disease (CHD). Twenty-nine male inpatients that had been newly diagnosed as CHD were followed up for 30 weeks after hospital discharge. The baseline information included age, number of cigarettes per day, years of smoking, disease type (angina pectoris [AP] or acute myocardial infarction [AMI]), whether they had received a briefing on smoking cessation, the FTQ, and the TDS. At 30 weeks after hospital discharge, 19 (66%) were abstainers. The group with a high TDS score (of 6 or greater) was significantly less likely to quit smoking than the group with a low TDS score (p=0.046). The FTQ score was not significantly different between the abstainers and non-abstainers. The subjects with AP were significantly less likely to quit smoking than those with AMI (p=0.021). Multiple logistic regression analysis showed that belonging to the high-TDS group and being diagnosed as AP were significantly associated with failure in smoking cessation (p<0.05). The present study suggests that the TDS may have higher predictability than the FTQ concerning smoking cessation among CHD inpatients.
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Myocardial InfarctionABSTRACT
Clinical trials have demonstrated significant benefit from low density lipoprotein cholesterol (LDL-C) lowering for primary and secondary prevention of cardiovascular disease. In the US, it is well recognized that a substantial number of hypercholesterolemic patients were not treated to the LDL-C goals recommended by the National Cholesterol Education Program (NCEP) guidelines. In 1996, the Indonesian Heart Association (PERKI) has issued guidelines recommending goals for screening and lipid treatment in Indonesia adopted from NCEP guidelines; however, the frequency of undertreatment in Indonesia is not known. The objective of this study was to determine the percentage of patients treated with lipid-lowering therapy who reached LDL-C goals as defined by NCEP guidelines in routine clinical practice. This was a cross-sectional survey targeted physicians who regularly treated dyslipidemic patients in 13 cities in Indonesia. Participating doctors were asked on their awareness of NCEP guidelines and to complete the case record form (CRF) of the enrolled patients. One-hundred and eighty-eight (188) out of four hundreds (400) physicians who were invited, have participated in this study. Among the evaluable 1420 CRF, 1082 patients received statins, 301 used fibrates, 14 patients used combination drugs, and 23 others received non-drug treatments only. Success rates on achieving target LDL-C in low-risk, high-risk, and CHD groups were 73.0 %, 43.6 %, and 14.8 %, respectively. Overall success rate in patients using statins was 55.1 %, while in low-risk group, high-risk group, and CHD patients, the success rates with statin were 77.8%, 50.1%, and 18.6 %, respectively. Atorvastatin showed the highest success rate (77.4 %) if compared to other statins. Only 14 % of physicians were knowledgeable about the NCEP goals. Conclusion : A large number of dyslipidemic patients who were on lipid-lowering therapy were not achieving the recommended LDL-C target levels. Success rates were lower in CHD patients and high risk group. Atorvastatin seemed more effective in lowering the LDL-C to target levels. There are still many physicians in Indonesia who do not aware about the NCEP guidelines and LDL-C treatment goals.
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Coronary Disease , Dyslipidemias , LipoproteinsABSTRACT
Purpose:It has been shown that the heart is a chaotic oscillator. So it is appropriiate to use the Lyapunov exponent, an important parameter to identify the nature of non-linear dynamical systems, for identifying the state of human heart. Methods:Preliminary results are obtained in this paper using Wolf's algorithm for 8 normal and 107 abnormal ECG recordings. Results:Significant differences are found between the Lyapunov exponents of normal ECG and ECG with obvious coronary stenosis (OCS), but there is no significant difference between the Lyapunov exponents of normal ECG and ECG with mild coronary stenosis (MCS);Significant differences are also found between the Lyapunov exponents of R-R interval series of normal ECG、ECG with MCS and ECG with OCS. Conclusions:It is apparent that the R-R interval series can give us more messages about human heart, and the Lyapunov exponents of ECG and R-R interval series are the appropriate parameters for the identification of the physiological states of human heart. It is possible to use Lyapunov exponent for early diagnosis of Coronary Heart Disease.