1. The role of environmental PM2.5 in admission acute heart failure in ST-elevation myocardial infarction patients : an observational retrospective studyAndreja Sinkovič, Andrej Markota, Manja Kraševec, David Šuran, Martin Marinšek, 2021, original scientific article Abstract: Background: Air pollution with increased concentrations of fine (< 2.5 μm) particulate matter (PM2.5) increases the risk of cardiovascular morbidity and mortality. Even short-term increase of PM2.5 may help trigger ST-elevation myocardial infarction (STEMI) and heart failure (HF) in susceptible individuals, even in areas with good air quality.
Purpose: To evaluate the role of PM2.5 levels ≥ 20 μg/m3 in admission acute HF in STEMI patients.
Materials and Methods: In 290 STEMI patients with the leading reperfusion strategy primary percutaneous coronary intervention (PPCI), we retrospectively studied independent predictors of admission acute HF and included admission demographic and clinical data as well as ambient PM2.5 levels ≥ 20 μg/m3. We defined admission acute HF in STEMI patients as classes II–IV by Killip Kimball classification.
Results: Acute admission HF was observed in 34.5% of STEMI patients. PPCI was performed in 87.1% of acute admission HF patients and in 94.7% non-HF patients (p= 0.037). Significant independent predictors of acute admission HF were prior diabetes (OR 2.440, 95% CI 1.100 to 5.400, p=0.028), admission LBBB (OR 10.190, 95% CI 1.160 to 89.360, p=0.036), prior resuscitation (OR 2.530, 95% CI 1.010 to 6.340, p=0.048), admission troponin I≥ 5μg/l (OR 3.390, 95% CI 1.740 to 6.620, p< 0.001), admission eGFR levels (0.61, 95% CI 0.52 to 0.72, p < 0.001), and levels of PM2.5 ≥ 20 μg/m3 (OR 2.140, 95% CI 1.005 to 4.560, p=0.049) one day before admission.
Conclusion: Temporary short-term increase in PM2.5 levels (≥ 20 μg/m3) one day prior to admission in an area with mainly good air quality was among significant independent predictors of acute admission HF in STEMI patients.
Keywords: admission acute heart failure, ST-elevation myocardial infarction, air pollution, PM2.5
Published in DKUM: 14.10.2024; Views: 0; Downloads: 3
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2. Objectively measured physical activity in patients with coronary artery disease : a cross-validation studyTim Kambič, Nejc Šarabon, Vedran Hadžić, Mitja Lainščak, 2021, original scientific article Abstract: Physical activity (PA) and sedentary behavior (SB) levels in healthy adults are predominately based on self-reporting measures, which generally overestimate PA but underestimate SB. Patients with coronary artery disease (CAD) eligible for cardiac rehabilitation (CR) follow an individualized program; thus, objective assessment of physical performance and regular daily activity is required. This study aimed to compare self-reported and objectively measured PA and SB in patients with CAD prior to out-patient CR. We included 91 patients with CAD and assessed their PA with an accelerometer for 8 days prior to CR, along with the short form of the international physical activity questionnaire. We found that most patients were sedentary (61%, ~8 h/day), and on average performed 63 min/day of moderate-to-vigorous-intensity physical activity (MVPA). Males performed less daily light-intensity physical activity (−5%, p = 0.011) and performed more MVPA (+2%, p = 0.002) compared to females. Maximal aerobic capacity was significantly associated with MVPA (Spearman rho = 0.483, p < 0.001) and MVPA > 10 min bouts (Spearman rho = 0.391, p < 0.001). Self-reported measures overestimated MVPA (total MVPA, +108 min/day, p < 0.001; MVPA > 10 min bouts, +152 min, p < 0.001) and underestimated SB (−174 min/day, p < 0.001) compared to objective measures. There was no significant correlation between methods in MVPA (Spearman rho = 0.147, p = 0.165)), MVPA > 10 min bouts (Spearman rho = −0.059, p = 576), and SB (Spearman rho = 0.139, p = 0.187). Quantitative analysis demonstrated the huge proportional bias for MVPA, MVPA > 10 min bouts, and SB. Our findings demonstrate that self-reported physical activity provides inaccurate estimates of MVPA and SB in patients with CAD entering the ambulatory CR. This strongly supports the more objective assessments of daily PA, preferably using an accelerometer.
Keywords: myocardial infarction, cardiovascular disease, acute coronary syndrome, sedentary behavior, motor activity, accelerometry, moderate intensity, vigorous intensity
Published in DKUM: 20.08.2024; Views: 117; Downloads: 10
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3. Lipoprotein(a) as a risk factor in a cohort of hospitalised cardiovascular patients : A retrospective clinical routine data analysisDavid Šuran, Tadej Završnik, Peter Kokol, Marko Kokol, Andreja Sinkovič, Franjo Naji, Jernej Završnik, Helena Blažun Vošner, Vojko Kanič, 2023, original scientific article Abstract: Lipoprotein(a) (Lp(a)) is a well-recognised risk factor for ischemic heart disease (IHD) and calcific aortic valve stenosis (AVS). Methods: A retrospective observational study of Lp(a) levels (mg/dL) in patients hospitalised for cardiovascular diseases (CVD) in our clinical routine was performed. The Lp(a)-associated risk of hospitalisation for IHD, AVS, and concomitant IHD/AVS versus other non-ischemic CVDs (oCVD group) was assessed by means of logistic regression. Results: In total of 11,767 adult patients, the association with Lp(a) was strongest in the IHD/AVS group (eβ = 1.010, p < 0.001), followed by the IHD (eβ = 1.008, p < 0.001) and AVS group (eβ = 1.004, p < 0.001). With increasing Lp(a) levels, the risk of IHD hospitalisation was higher compared with oCVD in women across all ages and in men aged ≤75 years. The risk of AVS hospitalisation was higher only in women aged ≤75 years (eβ = 1.010 in age < 60 years, eβ = 1.005 in age 60–75 years, p < 0.05). Conclusions: The Lp(a)-associated risk was highest for concomitant IHD/AVS hospitalisations. The differential impact of sex and age was most pronounced in the AVS group with an increased risk only in women aged ≤75 years.
Keywords: acute myocardial infarction, aortic valve stenosis, atherosclerosis, cardiovascular diseases, cardiovascular risk, ischemic heart disease, lipoprotein(a), postmenopausal women
Published in DKUM: 12.06.2024; Views: 137; Downloads: 11
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