ABSTRACT
INTRODUCTION: The management of patients with dyslipidemia (DLP) requires intensive medical follow-up as an essential part of treatment and to reduce the risk of cardiovascular (CV) outcomes. The aim of this study was to evaluate whether adherence to medical treatment changed the prevalence of CV disease events in a retrospective 7-year follow-up analysis. METHODS: This retrospective study involved 92 patients divided into two groups according to their adherence: the REG group with 64 patients who had medical appointments from 2012 to 2018, and the DROP group, with 28 patients who had medical appointments in 2012 but did not complete regular appointments until 2018. Cox proportional hazard models were fitted to estimate hazard ratios associated with CV outcomes as primary endpoints. RESULTS: We observed a total of 32 cases of acute myocardial infarction (AMI) in the study population, 17 (338.41 pY) in the REG group and 15 (62.97 pY) in the DROP group. An increased hazard of AMIs was observed in the DROP group compared with the REG group by follow-up time (p < 0.001). We found that previous events of AMI and congestive heart failure (CHF) were associated with progression to treatment dropout (p < 0.05) and that two drugs were considered a risk factor for treatment dropout, diuretics and fibrates (p < 0.05). CONCLUSIONS: A reduced hazard of AMI was observed in patients who complete a greater number of medical appointments and receive multidisciplinary treatment on a regular basis.
ABSTRACT
BACKGROUND: Nut consumption has been related to improvements on cardiometabolic parameters and reduction in the severity of atherosclerosis mainly in primary cardiovascular prevention. The objective of this trial is to evaluate the effects of the Brazilian Cardioprotective Diet (DIeta CArdioprotetora Brasileira, DICA Br) based on consumption of inexpensive locally accessible foods supplemented or not with mixed nuts on cardiometabolic features in patients with previous myocardial infarction (MI). METHODS: DICA-NUTS study is a national, multicenter, randomized 16-week follow-up clinical trial. Patients over 40 years old with diagnosis of previous MI in the last 2 to 6 months will be recruited (n = 388). A standardized questionnaire will be applied to data collection and blood samples will be obtained. Patients will be allocated in two groups: Group 1: DICA Br supplemented with 30 g/day of mixed nuts (10 g of peanuts, 10 g of cashew, 10 g of Brazil nuts); and Group 2: only DICA Br. The primary outcome will consist of LDL cholesterol means (in mg/dL) after 16 weeks of intervention. Secondary outcomes will consist of other markers of lipid profile, glycemic profile, and anthropometric data. DISCUSSION: It is expected that DICA Br supplemented with mixed nuts have superior beneficial effects on cardiometabolic parameters in patients after a MI, when compared to DICA Br. TRIAL REGISTRATION: ClinicalTrials.gov Identifier NCT03728127 . First register: November 1, 2018; Last update: June 16, 2021. World Health Organization Universal Trial Number (WHO-UTN): U1111-1259-8105.
Subject(s)
Diet , Myocardial Infarction , Adult , Biomarkers , Blood Glucose , Cholesterol, LDL , Humans , Multicenter Studies as Topic , Myocardial Infarction/diagnosis , Myocardial Infarction/prevention & control , Randomized Controlled Trials as TopicABSTRACT
Comparar a prevalência dos fatores de risco para doenças cardiovasculares em pacientes com fenótipo de HF com e sem mutação. Métodos: Estudo transversal com pacientes que apresentam níveis de LDL-c ≥ 190 mg/dl e história pessoal ou familiar de hipercolesterolemia com diagnóstico genético positivo ou negativo. Foi aplicado um questionário padronizado para obtenção de informações sobre os fatores de risco cardiovascular (idade, sexo, perfil bioquímico, histórico de DCV, tabagismo, HAS, DM tipo II e estado nutricional). Também foram realizadas avaliações antropométricas e laboratoriais. Os dados foram analisados no software IBM® SPSS® Statistics versão 21 e o nível de significância estatística foi estabelecido em p < 0,05. Resultados: Foram avaliados 103 pacientes de ambos os sexos (67% mulheres) com média de idade de 55,27 ± 15,07 anos. Trinta e três pacientes tinham diagnóstico de HF. A comorbidade mais prevalente foi a hipertensão arterial sistêmica (65,05%), seguida de sobrepeso/obesidade (57,28%) e diabetes mellitus tipo II (26,21%). Conclusão: Portadores de HF apresentaram menor prevalência de FR cardiovasculares, quando comparados com pacientes sem a mutação. No entanto, eles ainda merecem atenção diferenciada e focada no manejo de FR modificáveis, uma vez que a presença de pelo menos um FR já aumenta significantemente o risco CV nessa população
To compare the prevalence of risk factors for cardiovascular disease in patients with FH phenotype with and without mutation. Methods: A cross-sectional study with patients who present LDL-c levels ≥190mg/dL and a personal or family history of hypercholesterolemia with positive or negative genetic diagnosis. We applied a standardized questionnaire to obtain information on cardiovascular risk factors (age, sex, biochemical profile, history of CVD, smoking, hypertension, type 2 diabetes mellitus and nutritional status). Anthropometric measurements and laboratory tests were also performed. The data were analyzed using version 21 of the IBM® SPSS® Statistics software and statistical significance was established as p <0.05. Results: We studied 103 patients of both sexes (67% female) with a mean age of 55.27 ± 15.07 years. Thirty-three patients had a diagnosis of FH. The most prevalent comorbidity was systemic hypertension (65.05%), followed by overweight/obesity (57.28%) and type 2 diabetes mellitus (26.21%). Conclusion: The population with FH had lower cardiovascular RF prevalence when compared with patients without the mutation. However, they still merit differentiated care focused on the management of modifiable RFs, since the presence of at least one RF already significantly increases the CV risk in this population
