ABSTRACT
AIM OF THE STUDY: The aim of our review is to indicate and discuss the impact of cardiovascular risk factors, such as obesity, diabetes, lipid profile, hypertension and smoking on the course and mortality of COVID-19 infection. BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic is spreading around the world and becoming a major public health crisis. All coronaviruses are known to affect the cardiovascular system. There is a strong correlation between cardiovascular risk factors and severe clinical complications, including death in COVID-19 patients. All the above-mentioned risk factors are widespread and constitute a significant worldwide health problem. Some of them are modifiable and the awareness of their connection with the COVID-19 progress may have a crucial impact on the current and possible upcoming infection. DATA COLLECTION: We searched for research papers describing the impact of selected cardiovascular risk factors on the course, severity, complications and mortality of COVID-19 infection form PubMed and Google Scholar databases. Using terms, for example: "COVID-19 cardiovascular disease mortality", "COVID-19 hypertension/diabetes mellitus/obesity/dyslipidemia", "cardiovascular risk factors COVID-19 mortality" and other related terms listed in each subtitle. The publications were selected according to the time of their publications between January 2020 and December 2021. From the PubMed database we obtain 1552 results. Further studies were sought by manually searching reference lists of the relevant articles. Relevant articles were selected based on their title, abstract or full text. Articles were excluded if they were clearly related to another subject matter or were not published in English. The types of articles are mainly randomized controlled trial and systematic review. An additional criterion used by researchers was co-morbidities and age of patients in study groups. From a review of the publications, 105 of them were selected for this work with all subheadings included. Findings and Results: The intention of this review was to summarize current knowledge about comorbidities and development of COVID-19 infection. We tried to focus on the course and mortality of the abovementioned virus disease in patients with concomitant CV risk factors. Unfortunately, we were unable to assess the quality of data in screened papers and studies we choose because of the heterogenicity of the groups. The conducted studies had different endpoints and included different groups of patients in terms of nationality, age, race and clinical status. We decide to divide the main subjects of the research into separately described subtitles such as obesity, lipid profile, hypertension, diabetes, smoking. We believe that the studies we included and gathered are very interesting and show modern and present-day clinical data and approaches to COVID-19 infection in specific divisions of patients.
ABSTRACT
The increasing prevalence of cardiovascular disease and concomitant chronic kidney disease among the aging populations is responsible for considerable growth of mortality. Additionally, frequent, prolonged hospitalizations and long-term treatment generates progressive decline in bodily functions as well as substantial public health and economic burden. Accessibility to easy, non-invasive prognostic markers able to detect patients at risk of cardiovascular events may improve effective therapy and mitigate disease progression. Moreover, an early diagnosis allows time for implementation of prophylactic and educational programs that may result in decreased morbidity, improved quality of life and reduced public health expenditure. One of the promising candidates for a novel cardiovascular biomarker is mid-regional proadrenomedullin, a derivative of adrenomedullin. Adrenomedullin is a peptide hormone known for its vasodilatory, antioxidant, antiapoptotic and antifibrotic effects. A remarkable advantage of mid-regional proadrenomedullin is its longer half-life which is a prerequisite for plasma measurements. These review aims to discuss the importance of mid-regional proadrenomedullin with reference to its usefulness as a biomarker of increased cardiovascular risk and kidney disease progression.
ABSTRACT
INTRODUCTION: Atrial fibrillation (AF) and chronic coronary syndrome (CCS) share common risk factors and frequently coexist. Additionally, AF symptoms may mimic CCS. OBJECTIVES: The aim of the study was to investigate the hypothesis indicating absence of significant coronary lesions in patients with AF as compared with those with sinus rhythm. PATIENTS AND METHODS: We conducted a singlecenter retrospective study including consecutive patients referred for elective coronary angiography between 2007 and 2016. RESULTS: The study population included 8288 patients out of whom 1674 had AF. There were substantial differences between groups with and without AF. Patients with AF were significantly older, more often were men and had diabetes, and more frequently were diagnosed with both chronic kidney disease and heart failure. On the other hand, they had history of hyperlipidemia less often. CCS was less frequently detected in patients with AF as compared with those with sinus rhythm (37.5% vs 41.1%; P <0.001). Additionally, the latter group more often underwent subsequent coronary angioplasty (19.2% vs 22.3%; P = 0.004). Multivariable analysis identified AF as an independent factor associated with absence of significant coronary lesions (odds ratio, 1.57; 95% CI, 1.32-1.87; P <0.001). Moreover, a comparison between patients with and without angiographically significant CCS revealed a higher prevalence of AF in the latter group (18.7% vs 21.2%; P = 0.006). CONCLUSIONS: In our study, AF was associated with the absence of significant coronary lesions on angiography, reflecting difficulties with qualifying patients with AF for invasive CCS diagnostic workup. Our findings suggest the need for more efficacious noninvasive diagnostic approach for patients with AF and suspected CCS.
