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CARDIOLOGY

CARDIOLOGY

Carotid intima-media thickness progression as a surrogate indicator of cardiovascular disease risk

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Recently, a research article was published in Circulation, an authoritative journal in the cardiovascular field..The researchers systematically compiled data from randomized controlled trials.The cIMT is evaluated by the average value of the common carotid artery; if not available, the maximum value of the common carotid artery or other cIMT measurements are used.The main outcome of the study was the combined CVD endpoint, defined as myocardial infarction, stroke, revascularization, or fatal CVD.Before using the Bayesian meta-regression method to assess the association between the two, the researchers estimated the effect of intervention on cIMT progression and CVD occurrence in each trial.The researchers analyzed data from 119 randomized controlled trials involving 100,667 patients (mean age 62 years, 42% female).During an average follow-up of 3.7 years, 12,038 patients had a combined CVD endpoint.In all interventions, every 10 μm reduction in cIMT progress each year reduces the relative risk of CVD by 0.91 (95% confidence interval 0.87-0.94), while the relative risk of CVD that is not related to cIMT progress is 0.92 (0.87-0.97).In summary, the researchers estimate that the relative risk of interventions that reduce cIMT progress by 10, 20, 30, or 40 μm each year is reduced to 0.84 (0.75-0.93), 0.76 (0.67-0.85), 0.69 (0.59-0.79) or0.63 (0.52-0.74).The results were similar when the trials were grouped by type of intervention, time of implementation, time of ultrasound follow-up, availability of individual participant data, primary and secondary prevention trials, cIMT measurement type, and proportion of female patients.This shows that the degree of influence of intervention on the progress of cIMT can predict the degree of reduction of CVD risk.These data support cIMT reduction progress as a surrogate marker of CVD risk.The above content is only authorized for exclusive use by 39Health.com.

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CARDIOLOGY

Heart: Vertical connection between loneliness and cardiovascular events

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Recently, an authoritative journal in the field of heart disease published a research article, this study aims to assess the relationship between autism, social isolation and cardiovascular disease (CVD), while exploring self-reported CVD diagnosis and CVD-relatedOf hospitalizations.The data for this study was derived from a longitudinal study of the elderly in the United Kingdom and was related to administrative hospital records and death registration data.The number of samples analyzed for self-reported CVD was 5,850, and the number of CVD samples extracted from hospital records was 4,587, with a follow-up period of 9.6 years.Researchers use survival analysis to analyze data to resolve competition risk events.The average age of the subjects was 64 years (SD 8.3).About 44%–45% are men.During the follow-up process, 17% of the participants reported newly diagnosed CVD, and 16% of the participants were CVD-related hospitalizations.The researchers found that loneliness is associated with an increased risk of CVD events, but not potential confounders and risk factors.The population with the highest loneliness had a 30% higher risk of CVD diagnosis (HR: 1.05, 95% CI: 1.01-1.09), while the risk of CVD-related hospitalization was 48% higher (HR: 1.08, 95% CI:1.03-1.14), compared to the group with the least loneliness.There is little evidence that social isolation is independently associated with CVD diagnosis or admission risk.This shows that the study provides strong evidence for the relationship between loneliness and cardiovascular events.In the research and intervention of cardiovascular diseases, loneliness is considered as a psychosocial risk factor for CVD.The above content is only authorized for exclusive use by 39Health.com.

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CARDIOLOGY

When does myocardial infarction often occur?

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Myocardial infarction, also known as myocardial infarction in clinic, is a relatively harmful disease.In my country, the incidence of myocardial infarction is on the rise, and the work of protecting the heart cannot be ignored.In addition to maintaining good living habits, you can usually learn more about the causes of this disease, so that you can prevent it beforehand. What are the causes of myocardial infarction?Here are some common factors for myocardial infarction.1. Excessive fatigue.Excessive fatigue is one of the main causes of myocardial infarction. According to related research, excessive physical labor, such as loading on the floor with heavy weight and excessive physical activity, will often increase the burden on the heart, resulting in a sudden increase in myocardial oxygen demand.Especially for patients with coronary heart disease, due to the sclerosis and stenosis of the coronary arteries, rupture of plaque may also be induced due to severe physical load, resulting in acute myocardial infarction.2. Emotional excitement.Emotional excitement is also one of the main causes of myocardial infarction. Generally speaking, this factor is induced by intense emotional changes such as excitement, tension, and anger.3. Overeating.Myocardial infarction also has a large number of patients with overeating. According to clinical practice, many cases of myocardial infarction occur after overeating.Why is this?In fact, the reason is very simple. Generally speaking, if you eat a lot of high-fat and high-calorie foods, it will cause a sudden increase in blood lipid concentration, which will increase the blood viscosity and increase the aggregation of platelets.Especially for patients with coronary artery stenosis, acute myocardial infarction is often induced.4. Cold stimulation.According to clinical practice, cold stimulation is also one of the main causes of myocardial infarction, and sudden cold stimulation may induce acute myocardial infarction.Therefore, for patients with coronary heart disease, we must pay great attention to cold and warmth in the cold winter.5. Smoking and drinking heavily.Smoking and heavy drinking can induce acute myocardial infarction by inducing coronary artery spasm and increased myocardial oxygen consumption.Everyone should pay attention to proper physical activity and exercise. At least 150 minutes of moderate-intensity aerobic exercise should be maintained every week. Walking, gymnastics, tai chi, qigong and other exercise methods can be taken to enhance immunity and strengthen physical fitness.In addition, we must pay attention to arrange reasonable meals and quit smoking and alcohol.

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CARDIOLOGY

Which color thrombus recanalization rate is higher?

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Before officially talking about the indications of thrombolysis that may become mainstream in the future, let me ask you a small question: Which kind of thrombosis has a higher recanalization rate after intravenous thrombolysis?Is it a red thrombus or a white thrombus?
The answer is: red blood clots.01. The composition of the thrombus is clear, but the composition is very complicated. Although the answer is very clear, it is really difficult to see a single red thrombus in actual work. Generally, the thrombus is composed of a mixture of red and white.The academic community generally believes that thrombus is composed of fibrin, red blood cells and platelets.But further subdivision will find that although the components of different types of thrombus are the same, the proportion, spatial conformation and mechanical strength of each part are also different.As mentioned above, there are spatial conformational differences (ie structural differences) in thrombi.The main part of the thrombus is composed of fibrin, red blood cells and platelets, but there are still white blood cells and atherosclerotic plaque fragments at the edge of the thrombus.What is more complicated is that the occurrence and formation of thrombosis is a dynamic process, and the distal stagnation part and the proximal blood flow contact part are actually different components.On this basis, due to the difference in the volume of the thrombus, the complexity of its composition is increased.Since the first paper on thrombus composition was published in 1964, research on thrombus composition has been conducted for 56 years.So far, the academic community has reached consensus on the following points: Red blood cells rich in red blood cells (red blood cell ratio exceeds 64%) are associated with high recanalization rate; high ratio of platelet/lymphoid series in thrombus is a sign of low recanalization rate; such as fatAnd atherosclerotic plaque fragments are present in thrombi, but they are not very common.This is true even in patients with ischemic stroke due to the loss of atherosclerotic plaque.02. It is necessary to clarify the nature of thrombosis to guide thrombolytic therapy. So much knowledge about the composition of thrombosis, what is the significance of thrombolytic therapy?After all, the current diagnosis and treatment technology does not theoretically tell us what constitutes a particular thrombosis that occurs in a patient, nor is it clear whether it is sensitive to thrombolytic therapy.Considering that CT and MRI are routine imaging tests received by almost all stroke patients after admission, clinicians must rely on these results to determine the extent of stroke infarction caused by patients with thrombosis, proceed and decide the next treatment strategy and predict the patient’s prognosis.Imaging results have become one of the most practical and promising clinical data to predict thrombus composition.Recently, a cross-medicine team said that they can analyze and process the MRI images to detect the proportion of red blood cells in the thrombus, to determine whether the thrombus is a red thrombus that accounts for more than 64% of the red blood cells, and then do the recanalization rate of patients.Make scientific predictions.Their inspiration comes from an imaging technique that has been put into clinical use: using imaging data to predict iron load in the liver of patients with hemochromatosis.At present, this research result is still in the process of submission, and it is expected that the publication of this result will help further development of individualized decision-making for thrombolytic therapy.03. Is it all right to start thrombolysis?Beware of thrombus migration!The formation of thrombus is a dynamic process, as is thrombolysis.When part of the thrombus is dissolved and the connection between the embolus and the blood vessel wall becomes loose, if it happens to fluctuate blood pressure or vasospasm, the thrombus will inevitably migrate along the direction of blood flow.A review that is still in the process of submission has made a statistical analysis of the effect of tPA thrombolysis on thrombotic migration.difference.But what does migration mean, is it related to the preservation of the patient’s neurological function?Is it related to the patient’s long-term prognosis?The review did not give a clear answer, all of which requires further research to reach a conclusion.The composition of the thrombus at the time of nodulation is different, and the recanalization rate after embolization is also different: the high proportion of red blood cells is related to the high recanalization rate; the proportion of white thrombus components is high, and the recanalization rate of thromboembolism is low;
In the future, the clinical decision whether to use tPA for thrombolysis will be based on the thrombus composition.Reference source: 2020 ISC Pre-Con Ia-Stroke in the Real World: A Star is Born: Thrombolysis & Thrombectomy; Blockbuster: Thrombus Composition and Implications for LysisDo not reprint.

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CARDIOLOGY

Effects of healthy diet patterns on cardiovascular disease risk

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The 2015-2020 American Dietary Guidelines recommend a variety of healthy eating patterns. Recently, researchers have explored the relationship between the diet scores of four healthy eating patterns and the risk of cardiovascular disease.The study collected data from the NHS, NHS II, and HPF research cohorts, and examined the 2015 Healthy Diet Index (HEI-2015), Mediterranean Alternative Diet Index (AMED), Healthy Plant Diet Index (HPDI), and Healthy Alternative Diet Index (AHEI).Effects of 4 dietary patterns on cardiovascular disease events, including fatal and non-fatal coronary heart disease (CHD) and stroke, NHS cohort includes 74930 female participants (mean baseline age, 50.2 years), and NHS II cohort includes 90864The female participants (mean baseline age, 36.1 years) and the HPFS cohort included 43,339 male participants (mean baseline age, 53.2 years).A total of 5,257,190 participant-years of follow-up were recorded, and 23,366 CVD cases were recorded (18,092 coronary heart disease and 5,687 strokes, and some patients had both coronary heart disease and stroke).Compared with participants with the highest and lowest quintiles of healthy eating patterns, the CVD multivariate comprehensive adjusted hazard ratios (HRs) for HEI-2015 were 0.83, AMED was 0.83, HPDI was 0.86, and AHEI was 0.79.In addition, for every 25% increase in diet score, CVD risk is reduced by 10%-20% (HEI-2015 combined HR is 0.80; AMED is 0.90; HPDI is 0.86; AHEI is 0.81).The study found that the 32-year follow-up of the three large cohorts confirmed that the higher the compliance of healthy eating patterns, the lower the participants’ cardiovascular disease risk.The above content is only authorized for exclusive use by 39Health.com.

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CARDIOLOGY

Is fish oil useful?

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Do you have the habit of eating fish oil?Many people had the experience of being tempted to eat this greasy food when they were young. The main reasons why adults are attached to fish oil can be attributed to: good vision, improved immunity, and may also help grow the body.In short it is good!In fact, the benefits of fish oil are not as miraculous as they say, but they are unexpected. Many studies have shown that fish oil is beneficial to cardiovascular health.Fish oil and cardiovascular “disputes” reversed several times, and the FDA finally approved the drug!The role of fish oil in cardiovascular health has been controversial. At present, it is generally believed that the component Omega-3 in fish oil has a certain role in preventing atherosclerosis.Contradictory to this, however, there are studies that suggest that high doses of Omega-3 may raise “bad” cholesterol.At the end of 2019, the FDA approved a high-concentration fish oil formulation Vascepa for the treatment of cardiovascular disease or diabetes associated with elevated triglyceride levels and at least two other cardiovascular risk factors.Vascepa is mainly composed of Omega-3 fatty acids in the form of ethyl ester, which can be used as an adjuvant therapy after the maximum tolerated dose of statin.Omega-3 has been approved by the FDA for preventing cardiovascular events. How can it avoid the side effects of raising “bad” cholesterol?JAHA: How exactly does fish oil affect cardiovascular health?With many “contradictory” questions, Harvard Medical School scholars conducted a large-scale study to analyze the effect of Omega-3 on lipoprotein biomarkers and study how it regulates lipoprotein, different Omega-3 ingredientsWhat is the difference between cardiovascular health effects.Studies have shown that eating fish or compensating for Omega-3 will increase large particles of low-density lipoprotein, which can cause atherosclerosis.A large amount of compensation for Omega-3 can make extremely low density lipoproteins smaller in size and lower in concentration.In addition, Omega-3 helps reduce triglyceride levels and reduce the risk of cardiovascular disease.To reduce the risk of cardiovascular disease, you need to increase “good” cholesterol and reduce “bad” cholesterol.The total Omega-3 Schaeffler increased, and the HDL particles were larger and larger.The reduction of “bad” cholesterol is only related to Omega-3 subtype ALA.The original content of 39Health.com (www.39.net) may not be reproduced without authorization, and offenders will be investigated.For content cooperation, please contact: 0000 or 0000

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CARDIOLOGY

SGLT2 inhibitor Farxiga reduces the risk of diabetes in patients with heart failure

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Among heart failure patients without reduced type 2 diabetes ejection fraction (HFrEF), Farxiga reduced the risk of new-onset diabetes by 32%.At the 2020 annual meeting of the American Diabetes Association (ADA 2020), AstraZeneca (AstraZeneca) announced its SGLT2 inhibitor Farxiga clinical research analysis of diabetes prevention data.Farxiga received FDA approval last month to reduce the risk of cardiovascular death or hospitalization in heart failure patients with or without diabetes.The results of a sub-analysis of Dapa-HF in a phase III clinical trial showed that in patients with heart failure without reduced ejection fraction (HFrEF) of type 2 diabetes, the drug reduced the risk of new-onset diabetes by 32%.Kiersten Combs, vice president of cardiovascular and metabolic diseases in AstraZeneca, said that although there are still few doctors prescribing the drug just a few weeks after approval, we are very encouraged by the large number of patients using Farxiga.Despite the COVID-19 pandemic, the early release of Farxiga has been successful.The above content is only authorized for exclusive use by 39Health.com, please do not reprint without the authorization of the copyright party.

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CARDIOLOGY

Five questions about “sudden death”, you need to know!

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Sudden death news happened frequently, and even the 90s who came from the young and strong, began to pay attention to health training and heart protection.However, many people have many questions about sudden deaths: why are there more sudden deaths in winter?Why do athletes also die suddenly… All kinds of doubts, today I will answer you one by one!Does sudden death really happen in winter?From various news reports, it seems that the frequency of sudden deaths in winter is higher?The occurrence of sudden death is indeed related to the season to a certain extent.Generally speaking, when the weather changes significantly, especially when the winter and winter seasons alternate, or when the temperature suddenly drops, the cardiovascular “pressure” increases, which is easy for people with cardiovascular disease.The incidence of cardiovascular accidents, often sudden death, has increased significantly.It should be noted that some hereditary sudden deaths are not related to the season.Is sudden death really unexpected?Are there any preventive measures?There are many reasons for sudden death. Cardiovascular disease is the main cause of sudden death.Among them, sudden death due to coronary heart disease is the most common.Other cardiovascular diseases, such as hereditary electrical abnormalities and cardiomyopathy, can also cause sudden death.To prevent sudden death, the first step is to prevent coronary heart disease.Keeping blood pressure, blood sugar, and blood lipids within the normal range while maintaining a healthy lifestyle is the basic measure to prevent coronary heart disease.For patients who have had coronary heart disease and myocardial infarction, they must strictly abide by the doctor’s orders, take medication on time, and regularly review the heart color Doppler ultrasound.When sudden cardiac death occurs, will it accelerate death if you sit up?When it is determined that the patient is at the onset of sudden death, the correct approach is to keep the patient in a quiet state, remembering not to move the patient casually, so as not to worsen the condition.How to give first aid for myocardial infarction?For the sudden death caused by coronary heart disease and myocardial infarction, it is most important to rescue every minute.If it is determined that the patient has a myocardial infarction, the patient can be immediately given nitroglycerin and 300 mg of aspirin, taking care not to move the patient.At the same time of rescue, you must dial 120 emergency number, waiting for the arrival of the doctor.Does work fatigue really cause sudden death?Sudden death of myocardial infarction is mostly malignant ventricular arrhythmia, which is related to acute myocardial ischemia, especially young people, who have no history of angina pectoris. Once myocardial infarction occurs, the symptoms are very serious. When the infarct size is too large,Sudden death occurs easily.

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CARDIOLOGY

Evaluation of the absolute effect of threatened migraine on women’s cardiovascular disease risk

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Migraine with aura is known to increase the risk of cardiovascular disease (CVD), but the absolute contribution of migraine to the incidence of CVD compared to other CVD risk factors is unclear.Researchers recently evaluated the incidence of CVD in women with threatened migraine.Participants participated in the study from 1992 to 1995. Baseline was free of CVD. Grouping was based on the presence or absence of aura migraine at baseline. The primary endpoint of the study was severe CVD events, including the first myocardial infarction, stroke, or CVD death.27858 women participated in the study. The average age at baseline was 54.7 years, of which 1435 (5.2%) had aura migraine, 26423 (94.8%) had no aura migraine, and 2177 (7.8%) had no history of migraine.24246 (87.0%) had no migraine attacks in the year before baseline.During an average of 22.6 years (629353 person-years) of follow-up, 1666 major CVD events occurred.Women with aura migraine adjusted for 3.36 cases of major CVD per 1000 person-years, compared with 2.11 for women without aura migraine.The incidence of CVD in women with threatened migraine is significantly higher than that in obese women (2.29), patients with high triglycerides (2.67) or low HDL cholesterol (2.63), but it is associated with increased systolic blood pressure (3.78) and increased total cholesterol(2.85) or family history of myocardial infarction (2.71) patients are at equal risk.The incidence of CVD in women with diabetes (5.76) or smoking (4.29) was significantly higher than women with threatened migraine.The risk of CVD events for women with threatened migraine and obesity increased by 1.01 cases per 1,000 person-years, and increased by 2.57 cases with diabetes.Studies suggest that threatened migraine is an important factor in women’s cardiovascular disease risk.The above content is only authorized for exclusive use by 39Health.com, please do not reprint without the authorization of the copyright party.

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CARDIOLOGY

Blood vessels also have “age”?

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Do you know that blood vessels also have “age”?Many people may look young, but the blood vessels in the body are already “old”. If you do not pay attention to the aging of blood vessels, the function of blood vessels will continue to decline over time, causing many harms to human health.So do you know why blood vessels age?How to prevent aging of blood vessels?Blood vessels “age” in advance, often these things you have not done a good diet: often eat high-calorie, high-fat foods.For example, frequent meals outside, or heavy oil and salt in the diet, can easily block cholesterol and other substances in the blood vessel wall.2 Sleep: If we do not pay attention to rest, work irregularly, and often stay up late to work overtime, it is easy to cause endocrine disorders, toxins in the body are difficult to remove, and accumulate in the blood vessels, causing blood vessels to block and contract.3 Exercise: Without exercise, foreign substances in the blood vessels will gradually accumulate, affecting the blood supply of the capillaries.In addition, prolonged sitting can easily lead to vein compression, the formation of thrombosis, affecting blood circulation.4 Lifestyle habits: Smoking is easy to cause blood vessel damage and easy to form thrombosis; regular drinking easily reduces blood vessel elasticity and hardens.5 Mental emotions: Mental stress can cause vascular intimal contraction and accelerate vascular aging.Stress, irritability and irritability can easily make blood vessels hard.These signals may appear when the blood vessels start to age!If there is a problem with the health of blood vessels, the body will actually respond to it!Self-examination, have you performed recently?? Recently there is emotional depression.? Often too stubborn and true.?I like to eat instant food, biscuits and snacks.? Partial meat consumption.? Lack of physical exercise.• The number of cigarettes per day multiplied by age over 400.? Chest pain when climbing stairs.? Cold hands and feet, paralysis.? Often thrown around.• High blood pressure.• High cholesterol or blood sugar levels.• Some of the relatives died of stroke and heart disease.The more the above options are satisfied, the higher the “age” of blood vessels!Aging of blood vessels will bring many hazards and increase the risk of cardiovascular disease and sudden death. We should protect the blood vessels as much as possible.Well, if you want to keep the blood vessels “young”, you need to adjust from all aspects of life, including diet, spiritual and lifestyle habits, so as to protect blood vessels and delay blood vessel aging!

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