European journal of preventive cardiology
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Comparative Study
Comparison of different cardiac risk scores for coronary artery disease in symptomatic women: do female-specific risk factors matter?
Cardiovascular diseases remain the leading cause of death in women and there is a need for more accurate risk assessment scores. The aims of our study were to compare the accuracy of several widely used cardiac risk assessment scores in predicting the likelihood of obstructive coronary artery disease (CAD) on CT coronary angiography (CTCA) in symptomatic women and to explore which female-specific risk factors were independent predictors of obstructive CAD on CTCA and whether adding these risk factors to pre-test probability scores would improve their predictive value. ⋯ There is a large variability in prediction of obstructive CAD using different pre-test probability risk scores in symptomatic women. Logistic regression analysis revealed that oestrogen status and GDM were independently associated with the occurrence of obstructive stenosis on CTCA. The predictive ability of cardiac pre-test probability scores improved significantly with the addition of oestrogen status and GDM.
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The contribution of sufficient sleep duration to lower CVD risk in addition to sufficient physical activity, a healthy diet, (moderate) alcohol consumption, and non-smoking has not been investigated yet. ⋯ Sufficient sleep and adherence to all four traditional healthy lifestyle factors was associated with lower CVD risk. When sufficient sleep duration was added to the traditional lifestyle factors, the risk of CVD was further reduced.
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Comparative Study
Tobacco use, smoking quit rates, and socioeconomic patterning among men and women: a cross-sectional survey in rural Andhra Pradesh, India.
Tobacco use is common in India and a majority of users are in rural areas. We examine tobacco use and smoking quit rates along gender and socioeconomic dimensions in rural Andhra Pradesh. ⋯ The social gradients in cigarette smoking and level of consumption contrasted those for indigenous forms of tobacco (bidi smoking and chewing). International prevention and cessation initiatives designed at modifying Western-style cigarette usage will need to be tailored to the social context of rural Andhra Pradesh to effectively influence the use of cigarettes and equally harmful indigenous forms of tobacco.
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Randomized Controlled Trial
Risk stratification in stable coronary artery disease is possible at cardiac troponin levels below conventional detection and is improved by use of N-terminal pro-B-type natriuretic peptide.
Low prevalence of detectable cardiac troponin in healthy people and low-risk patients previously curtailed its use. With a new high-sensitive cardiac troponin assay (hs-cTnT), concentrations below conventional detection may have prognostic value, notably in combination with N-terminal pro-B-type natriuretic peptide (NT-pro-BNP). ⋯ In patients with stable CAD, any detectable hs-cTnT level is significantly associated with all-cause mortality, cardiovascular death, and myocardial infarction after adjustment for traditional risk factors and NT-pro-BNP. Excess mortality is particularly pronounced in patients with NT-pro-BNP >400 ng/l.
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Low birthweight has been linked to increased cardiovascular risk in adulthood. We evaluated the effect on cardiovascular outcome of intrauterine growth restriction (IUGR) with abnormal fetal blood flow in children born very preterm. ⋯ IUGR and preterm birth appear to be associated with structural changes in the arterial wall, whereas preterm birth seems to be associated with higher blood pressure. Using conventional echocardiography, we observed no effect of IUGR on cardiac size and function.