Aim: To evaluate whether a multidisciplinary educational program (EP) in cardiovascular prevention (CVP) for children could improve the Framingham cardiovascular risk (FCR) of their parents after one ...year.
Methods and results: This was a prospective community-based study in Brazil during 2010 that randomized students aged 6 to 10 years old to two different approaches to receiving healthy lifestyle information. The control group received written educational material (EM) for their parents about healthy lifestyle. The intervention group received the same EM for parents, and children were exposed to a weekly EP in CVP with a multidisciplinary health team. At onset and end of the study, we collected data from parents and children (weight, height, arterial blood pressure, and laboratory tests). We studied 197 children and 323 parents. Analyzing the parents’ FCR we found that 9.3% of the control group and 6.8% of the intervention group had more than a 10% year risk of cardiovascular heart disease (CHD) over the next 10 years. After the children’s EP for the year, the intervention group had a reduction of 91% in the intermediate/high FCR group compared with a 13% reduction in the control group, p = 0.002). In the same way, analyzing the FCR of all parents, there was a reduction of the average risk in the intervention group (3.6% to 2.8% respectively, p < 0.001) compared with the control group (4.4% to 4.4%, p = 0.98).
Conclusion: An educational program in cardiovascular prevention directed at school-age children can reduce the FCR risk of their parents, especially in the intermediate/high risk categories.
Abstract only
Introduction:
Cardiac troponin (cTn) measurements play a pivotal role in diagnosing and managing myocardial infarction (MI). Nonetheless, to prevent unnecessary expenditure, it is ...essential to optimize the usage of cTn testing. The AHA guidelines underscore the importance of minimizing low-value care, considering the widespread prevalence and substantial expenses related to cardiovascular disease. Hence, our study hypothesis is that expert-recommended cTn testing could effectively decrease unnecessary testing requests.
Aims:
This study aims to contrast the frequency of normal and of serial cTn I test results within a General University Hospital (GUH) setting and a specialized Cardiology University Hospital (CUH).
Methods:
Our cross-sectional study encompassed all cTn I tests performed at both GUH and CUH between November 2022 and March 2023. We excluded patients receiving postoperative care following invasive cardiac procedures and those engaged in research protocols. We categorized the study population by sex and age (<60 or ≥60 years), as well as by whether the cTn I test was serially conducted (≥2 times within 24 hours). A serial cTn I test, as recommended by the 4th Universal definition of MI to detect any rise and/or fall, was considered a correct request. We utilized the chi-square test for categorical variables and the Mann-Whitney test for continuous data, setting a 5% significance level. Normal reference levels were <16 and <34 ng/L for women and men, respectively.
Results:
The study incorporated a total of 5,360 tests performed in GUH, with 46.2% on women and 60.9% on individuals aged ≥60 years. In CUH, 8,487 tests were conducted, with 42.0% on women and 53.8% on individuals aged ≥60 years. GUH displayed a higher proportion of normal cTn I test results compared to CUH (70% versus 45%, p < 0.0001) and a lower percentage of serial cTn I tests (40.3% versus 53.4%, p < 0.0001). Moreover, GUH demonstrated a lower median troponin value of 8 (2.5-33.8) versus 37 (7-455) in CUH, p < 0.0001.
Conclusions:
The increased prevalence of normal cTn I results and the lower frequency of serial cTn I tests in GUH indicate potential economic inefficiencies related to excessive cTn I testing requests. Expert intervention could help in avoiding unnecessary cTnI test requests.
To assess the use of antithrombotic therapy among atrial fibrillation (AF) patients in a Brazilian University Heart Hospital (InCor).
In a cross-sectional study we analyzed the charts of all patients ...treated at InCor in five separate days of 2002 (Phase 1). To assess the impact of admission to a cardiology hospital, a follow-up of the AF patients selected in Phase 1 was carried out after 1 year (Phase 2). The prevalence of AF in the 3,764 assessed charts was 8.0% (301 patients). In Phase 1, antiplatelets were prescribed to 21.2% and anticoagulant therapy (ACT) to 46.5% of AF patients; in Phase 2, to 19.9 and 57.8%, respectively. Thus, 32.2% (Phase 1) and 22.2% (Phase 2) of AF patients were not receiving any antithrombotic drug. Among AF patients with previous ischemic stroke (17.6%), only 49% (Phase 1) and 60.4% (Phase 2) were receiving ACT. As many as 34 and 22.6%, respectively, were not receiving any antithrombotic drug. After follow-up, a new acute embolic event was documented in 5.6% of patients, 17% died.
Anticoagulation is underused in AF patients and neither the fact of being treated by cardiologists in a University Hospital, nor the learning time-window of 1 year seemed to improve the antithrombotic care significantly.
ObjectiveTo evaluate whether a multidisciplinary educational program in cardiovascular prevention for children could improve the Framingham cardiovascular risk (FCR) of their parents after one year, ...in public schools in Brazil.MethodsWe performed a prospective community-based study in Brazil during 2013 that randomized students aged 6 to 10 years old to two different approaches to receiving healthy lifestyle information. The control group received written educational material (EM) for their parents about healthy lifestyle. The intervention group received the same EM for parents and children were exposed to a weekly educational program in cardiovascular prevention with a multidisciplinary health team. At onset and end of the study we collected data from parents and children (clinical information, weigh, height, arterial blood pressure and laboratorial tests).ResultsWe studied 265 children and 419 parents. Analyzing the parents’ FCR we found that 9% of the control group and 13% of the intervention group had more than a 10% year risk of cardiovascular heart disease over the next 10 years (intermediate/high FCR). After the children educational program during one year in public schools, the intervention group had a reduction of 30% in the intermediate/high FCR group compared with a 0% reduction in the control group (p<0.008). The risk factor that mainly contributed for FCR reduction in the intervention group was blood pressure, with a reduction in SBP of 122.45 to 118.46 mmHg (p<0.001), and DBP of 84.59 to 80.03 mmHg (p<0.001), with no reduction in the control group (117.47 to 118.01 mmHg for SBP, p=0.7241, and 76.60 to 77.45 mmHg for DBP, p=0.1387).ConclusionAn educational program for cardiovascular prevention directed to school age children in public schools can reduce the FCR risk of their parents, especially in the intermediate/high risk categories, like we observed in private schools.
Abstract only Objective: Evaluate the improvement in recreational inactivity (tv/internet/vieogames) in school age children after a multidisciplinary educational program in cardiovascular prevention ...(CVP) at school. Methods: Students aging 6 to 10 years old were exposed to two different approaches at two public schools in Sao Paulo, Brazil. For the control school we delivered written educational material (EM) for their parents during the year of 2012 about healthy lifestyle. The intervention school students received the same EM for their parents and the children were exposed to a weekly educational program in CVP with a multidisciplinary heath team during the year 2012. This intervention tried to teach to these children concepts of healthy nutrition, avoidance of tobacco and physical activity. Both at the inclusion in the study and one year later we collect data of parents and their children, including a questionnarie about the time children spent in tv, computes and videogames during the day (recreational inactivity). Results: We studied 262 children. The control group had 136 children (mean age of 8 years) and the intervention group had 126 children (mean age of 8 years). In the intervention group 79.4% of children (100 children) had a reacreational inactivity time (RIT) > 2 hours/day, and in the control group 80.1% of children (109 children) had a RIT > 2 hours/day. After one year of educational intervention 87 children (69.0%) of the intervention group and 107 children (78.6%) of the control group still had a RIT >2 hours/day, p= 0.03923 (Fisher's Exact test Mid p). This represents a 13% reduction in the intervention group and a 1,8% reduction in the control group. Conclusion: An educational program in cardiovascular prevention directed to children at school age can improve recreational inactivity in children contributing for the reduction of obesity and cardiovascular risk.
I Guideline of the perioperative evaluation Feitosa, Alina Coutinho Rodrigues; Ayub, Beatriz; Caramelli, Bruno ...
Arquivos brasileiros de cardiologia
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Journal Article
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