Abstract Background: Nonalcoholic fatty liver disease (NAFLD) and metabolic syndrome are strongly related from both an epidemiological and a pathological point of view. The main aim of our study was ...to evaluate if two validated indexes of NAFLD are able to predict the 4-year metabolic syndrome incidence in a large population sample of pharmacologically untreated subjects without metabolic syndrome, type 2 diabetes, history of alcohol abuse, or known liver diseases at the baseline.
From the database of the Brisighella Heart Study, we selected a subsample of 824 pharmacologically untreated subjects (male, 401; female, 423) without metabolic syndrome, type 2 diabetes, alcohol abuse, or known liver diseases at the 2004 survey and revisited in 2008. The Hepatic Steatosis Index (HSI) and Lipid Accumulation Product (LAP) values were calculated for everyone to evaluate their predictive role for metabolic syndrome through a Cox-regression analysis adjusted by metabolic syndrome components.
We observed 46 new cases of metabolic syndrome (male, 25; female, 21) with a cumulative incidence of 5.6% (1.4% per year): 6.2% in men (1.5% per year), 4.9% in women (1.2% per year). In women, the 4-year metabolic syndrome predictors (R(2)=0.680) were age odds ratio (OR) 1.13, 95% confidence interval (CI) 1.12-1.15, HSI (OR 1.20, 95% CI 1.15-1.26), and lnLAP (OR 1.16, 95% CI 1.14-1.17), whereas in men they were (R(2)=0.554) age (OR 1.13, 95% CI 1.11-1.14) and lnLAP (OR 1.17, 95% CI 1.15-1.18).
HSI and LAP differently predict the 4-year incidence of metabolic syndrome. In women, both indexes can be considered significant predictors, whereas in men only LAP can be considered predictive.
The purpose of this study was to verify the impact on the number and characteristics of coronary invasive procedures for acute coronary syndrome (ACS) of two hub centers with cardiac catheterization ...facilities, during the first month of lockdown following the COVID-19 pandemic.
Procedural data of ACS patients admitted between 10 March and 10 April 2020 were compared with those of the same period of 2019.
We observed a 23.4% reduction in ACS admissions during 2020, with a decrease for both ST-elevation myocardial infarction (STEMI) (-5.6%) and non-ST-elevation myocardial infarction (-34.5%), albeit not statistically significant (P = 0.2). During the first 15 days of the examined periods, the reduction in ACS admissions reached 52.5% (-25% for STEMI and -70.3% for non-ST-elevation myocardial infarction, P = 0.04). Among STEMI patients, the rate of those with a time delay from symptoms onset longer than 180 min was significantly higher during the lockdown period (P = 0.01). Radiograph exposure (P = 0.01) was higher in STEMI patients treated in 2020 with a slightly higher amount of contrast medium (P = 0.1) and number of stents implanted (P = 0.1), whereas the number of treated vessels was reduced (P = 0.03). Percutaneous coronary intervention procedural success and in-hospital mortality were not different between the two groups and in STEMI patients (P NS for all).
During the early phase, the COVID-19 outbreak was associated with a lower rate of admissions for ACS, with a substantial impact on the time delay presentation of STEMI patients, but apparently without affecting the in-hospital outcomes.
During the early phase of the lockdown following the COVID-19 pandemic, an alarm on the impact on cardiology admissions for cardiac causes, particularly in the field of acute coronary syndromes ...(ACS), has emerged. In order to evaluate this trend, we analyzed the literature data published since the beginning of the COVID-19 pandemic to date, in addition to our intensive cardiac care unit (ICCU) experience. This analysis showed (i) a reduction of the overall ICCU admissions up to 50%; (ii) a 40-50% reduction of ACS admissions, greater for non-ST-elevation myocardial infarction (NSTEMI) than for ST-elevation myocardial infarction (STEMI); (iii) a reduction greater than 50% of coronary angiography and percutaneous coronary angioplasty; (iv) a higher time delay of STEMI; and (v) a higher number of ICCU admissions for non-primarily cardiac problems. In conclusion, the lockdown imposed due to the spread of COVID-19 infection has led to a change in the number and type of cardiology admissions. It seems therefore necessary that patients, especially for time-dependent diseases such as ACS, continue to refer to hospital care; that contemporary standard of care for acute cardiac disease should be guaranteed, and that intensivist cardiologists acquire specific skills for the treatment of patients with clinical conditions normally treated by other specialists.
Abstract Despite a recent health claim by the European Agency on Food Safety, the effect of high doses of dietary monacolin supplements from red yeast rice on cholesterolemia has not been tested in ...Italian subjects. Our aim via a crossover, double-blind, placebo-controlled randomized clinical trial was to test if a short-term treatment with 10 mg monacolins could improve lipid pattern, high-sensitivity C-reactive protein (hs-CRP), and vascular remodeling biomarkers in a small cohort of Mediterranean subjects. Thus, 25 healthy, mildly hypercholesterolemic subjects were enrolled, and after 4 weeks of a stabilization diet, subjects were randomized to the sequence placebo-washout-monacolins or monacolins-washout-placebo, with each period being 4 weeks long. At each study step, a complete lipid pattern, safety parameters, hs-CRP, and matrix metalloproteinases 2 and 9 levels were measured. When compared to the placebo group, monacolins-treated patients experienced a more favorable percent change in total cholesterol (-12.45%, 95% CI −16.19 to −8.71), low-density lipoprotein cholesterol (−21.99%, 95% CI −26.63 to −17.36), non–high-density lipoprotein cholesterol (−14.67%, 95% CI −19.22 to −10.11), matrix metalloproteinase 2 (−28.05%, 95% CI −35.18 to −20.93), matrix metalloproteinase 9 (−27.19%, 95% CI −36.21 to −18.15), and hs-CRP (−23.77%, 95% CI −30.54 to −17.01). No significant differences were observed in regards to triglycerides, high-density lipoprotein cholesterol, and safety parameters. On the basis of our data, we demonstrate that a 10-mg monacolin nutraceutical appears to safely reduce cholesterolemia, hs-CRP, and markers of vascular remodeling in Italian subjects. These results have to be confirmed in larger patient samples and longer studies.
n-3 Polyunsaturated fatty acids (PUFAs) are organic acids, essential for mammals, whose deficiency is associated with different diseases. The American Heart Association recommends that all adults ...increase food-derived n-3 PUFA intake and also suggests that patients with documented coronary heart disease consume approximately 1 g of eicosapentaenoic acid and docosahexaenoic acid per day. However, recent evidence broadens their potential application to many other health disorders directly or indirectly associated with cardiovascular disease risk such as rheumatological diseases, mood depression, chronic kidney disease, chronic inflammatory lung diseases and others. These effects seem to be largely dependent on the dosages employed and on the characteristics of the selected patients. The cardiometabolic effects of PUFAs have been largely reviewed elsewhere, so the aim of our review is to point out the potential usefulness of such drugs with pleiotropic effects in the management of the actual typical aging patient, with co-morbidities and multidrug therapies.
Introduction
Serum uric acid (SUA) may contribute to the increased cardiovascular damage through direct injury to the endothelium and alteration of cardiovascular function.
Aim
To evaluate the ...association of SUA with the presence of the most recurrent electrographic alterations and with the length of the main ECG intervals in a large sample of general population.
Methods
For this study, on the database of the Brisighella Heart Study, we evaluated the available data of 790 men and 849 women, excluding subjects affected by gout or taking antihyperuricemic agents, those taking drug increasing the QT interval and those using beta-blockers or non-dihydropyridine calcium channel blockers at the moment of the ECG registration. Multiple ascending stepwise regression analyses were carried out to determine the independent predictors of the predefined ECG alterations.
Results
The prevalence of predefined ECG alterations was comparable between genders, with the exception of sinus bradicardia, left-anterior fascicular block, atrio-ventricular blocks and left ventricular hypertrophy (LVH), which appeared to be more frequent in men. The multivariate analysis revealed that SUA was associated to ischaemic alterations, LVH, sinus tachycardia and tachyarrhytmias. Age was associated to all evaluated ECG alterations beyond sinus tachycardia and LVH. Male sex was associated to sinus bradicardia, atrio-ventricular blocks, anterior-left fascicular block and LVH. Blood pressure was associated to different ECG alterations, but with clinically relevant OR with ischaemic alterations and LVH.
Conclusion
SUA level is related the prevalence of both organic and rhythm ECG alterations in a wide sample of general population.
Introduction
One of the most frequent side effect of oral contraceptives use is a stable alteration of the lipid profile. This could be even more relevant in women affected by polycystic ovary ...syndrome (PCOS).
Aim
Considering the importance of a balanced lipid profile in cardiovascular prevention and that the exposure to the drugs could be many years long, our aim was to investigate the possible beneficial effect of a largely tested low-dosed combined lipid-lowering nutraceutical on dyslipidemias induced by oestroprogestins prescribed to young women for different indications.
Methods
We prospectively enrolled 84 patients in primary cardiovascular disease prevention, with low estimated cardiovascular disease risk (<5 % according to the ESC/EAS guidelines), and LDL-C increased above normal value (LDL-C >130 mg/dL) after the use of at least two different oral oestroprogestins treatments. Forty-four women were prescribed oral oestroprogestins for PCOS, while 40 for pure contraception. The tested nutraceutical contained berberine 500 mg/tab and monacolins 3 mg/tab was prescribed to all enrolled patients, associated the previously prescribed standard lipid-lowering diet.
Results
After 3 months of nutraceutical treatment, we observed a significant improvement in BMI (−1.5 ± 0.8 %,
p
< 0.001), FPG (−6.9 ± 5.8 %,
p
< 0.001), HOMA index (−3.5 ± 5.6 %,
p
< 0.001), TC (−20.1 ± 6.6 %,
p
< 0.001), LDL-C (−25.3 ± 8.9 %,
p
< 0.001), HDL-C (+14.1 ± 2.2 %,
p
< 0.001), TG (−29.9 ± 25.2 %,
p
< 0.001) and hsCRP (−2.5 ± 2.4 %,
p
= 0.019). Similar results have been obtained even repeating the analysis by subgroups, beyond hsCRP that significantly improved in PCOS patients compared to both the baseline and the non-PCOS group.
Conclusion
It appears that the tested combined lipid-lowering nutraceutical is able to equally improve lipid metabolism in oral contraceptive induced hypercholesterolemia in women affected or not by PCOS.
Uric acid, the final product of purine catabolism, tends to accumulate in humans due to the lack of the enzyme uricase. Serum uric acid (SUA) higher than 7 mg/dL is defined as hyperuricemia, the main ...established risk factor for the development of gout. Nonetheless, since the nineteenth century evidence has increased about the involvement of SUA in the development of cardiovascular diseases. This review will analyze the evidence supporting the existence of a causal relationship between hyperuricemia and the most common cardiovascular disorders such as hypertension, coronary artery disease, heart failure and stroke. We will also review the strength of the relationship as well as the role of hyperuricemia as a new risk factor for cardiovascular diseases. Finally we will discuss if treating hyperuricemia could have a role in terms of cardiovascular prevention.
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