Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age

Davis, Patricia H.; Dawson, Jeffrey D.; Riley, Ward A.; Lauer, Ronald M.

doi:10.1161/hc4601.099486

Cited by 792 publications

(581 citation statements)

References 41 publications

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“…The NATPOL-Plus study [20] showed that the most prevalent risk factors in younger age group were smoking and hypercholesterolaemia, while the number of patients with hypertension is highest in the older population. Mukherjee et al [21] showed that in patients undergoing percutaneous coronary intervention (PCI), smoking was much more common in those below 40 years of age compared to patients above 60 years of age (58.7% vs. 43%). In most studies, smoking was considered the major risk factor for CAD in young men and women [1, 10,12].…”

Section: Discussionmentioning

confidence: 99%

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Maroszyńska-Dmoch

Wożakowska−Kapłon

2016

Kardiol Pol

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A b s t r a c tBackground: Coronary artery disease (CAD) in young adults under 40 years of age is a growing medical, social, psychological and economical problem, related to the prevalence of civilization-related diseases and unhealthy lifestyle. The problem of CAD in young people has not been characterised as well as in older individuals, as the available data mostly come from case reports and small series, often related to genetic aspects and familial occurrence of the disease. Aim:To assess clinical and angiographic characteristics of young adults with CAD and to evaluate in-hospital and long-term mortality in this patient group. The study combined a retrospective and a prospective approach.Methods: A total of 239 patients aged 40 years or younger who underwent coronary angiography (CAG) in the Swietokrzyskie Centre of Cardiology in Kielce in [2001][2002][2003][2004][2005][2006][2007][2008] were included in this study. Demographic characteristics, risk factor profile, laboratory test results, electrocardiographic and echocardiographic findings, CAG findings, and in-hospital mortality were assessed retrospectively in the selected groups. During the second stage of the study, clinical and mortality data were obtained prospectively in 130 patients (54.4% of the study group) during up to 5 years of follow-up. Results:The mean patient age was 35.1 ± 4.4 years. Men made up 86.2% of the study sample, and the proportion of rural area residents was 54.8%. Among young patients with acute coronary syndromes (ACS), the most common presentation (52.8%) was ST segment elevation myocardial infarction (STEMI). Angiographically normal coronary arteries were found in 37.2% of CAD patients and in 16.9% of patients with the diagnosis of ACS. The mean degree of coronary artery lumen stenosis was 75.4% in the group with significant atherosclerotic coronary lesions (50-90%) and 95.9% in the group demonstrating a critical coronary obstruction (≥ 90%). Single-vessel disease was identified in 61.9% of patients with a positive result of CAG (stenosis > 50%, CORO(+) group). The most common location of significant atherosclerotic coronary lesions was the left anterior descending artery (61.6%) followed by the right coronary artery (27.4%). The most prevalent conventional cardiovascular risk factors were lipid abnormalities, cigarette smoking and an increased body mass index ≥ 25 kg/m 2 , followed by a family history of CAD and hypertension. The proportion of patients with abnormal lipid profile, cigarette smoking and overweight or obesity was particularly high in the CORO(+) group (85.6%, 83.9%, and 64.4%, respectively). In-hospital mortality rate was low, at 0.7% among ACS patients. Long-term mortality during up to 5 years of follow-up was not so favourable, at 7.75% in ACS patients and 8.5% in the CORO(+) group. Conclusions:The population of young patients with CAD is predominantly male, rural, and characterised by a low socioeconomic status. The aetiology of CAD in this patient group differs significantly from that in older patients a...

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Section: Discussionmentioning

confidence: 99%

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Maroszyńska-Dmoch

Wożakowska−Kapłon

2016

Kardiol Pol

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“…No Muscatine Study, o ultrassom de carótida foi utilizado para avaliação da espessura íntima-média das paredes vasculares e os dados foram associados aos níveis de CT e Índice de Massa Corporal (IMC) 10 . Semelhantes resultados com carótidas foram obtidos no Bogalusa Heart Study 11 e no Young Finns Study, reafirmando a ligação entre exposição a fatores de risco (LDL, IMC, pressão sistólica elevados e presença de tabagismo) em jovens e o aparecimento de aterosclerose subclínica no adulto jovem 12 .…”

Section: Artigo Original Introduçãounclassified

Desconhecimento da diretriz de prevenção da aterosclerose na infância e adolescência por pediatras em São Paulo

Grosso

Santos

Luz

2010

Rev. Assoc. Med. Bras.

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ResumoObjetivO. Relatar a extensão do conhecimento de pediatras de São Paulo sobre a diretriz. MétOdOs. Durante eventos de pediatria ou nos locais de trabalho, pediatras responderam um questionário contendo informações sobre o tempo de formação, local de trabalho, dedicação dentro da área de pediatria, atuação em área acadêmica e questões de múltipla escolha com informações retiradas da diretriz. As diferenças de expressão e associações foram consideradas significantes estatisticamente quando p<0,05. Todas as análises foram realizadas usando teste de Quiquadrado e teste de Quiquadrado de tendência linear por meio dos Softwares Primer of Biostatistics ou SPSS for Windows. ResultadOs. Dos 370 pediatras entrevistados, 65,7% afirmaram não ter tido conhecimento prévio da diretriz. O valor de corte para os acertos foi maior ou igual a 70% (maior ou igual a cinco questões corretas). Apenas 136 pediatras (36,7%) alcançaram tal valor e dentre esses não havia relação no conhecimento da diretriz quanto aos sexos (p=0,25). Dos 187 profissionais envolvidos em atividades acadêmicas, 45 (24%) acertaram o valor de corte e dos 183 não participantes de atividades acadêmicas, 23 (12,7%) acertaram maior ou igual a cinco questões (p<0,001). Pediatras do setor público apresentaram melhor conhecimento da prática preventiva da aterosclerose (46,1%; p=0,01). O desconhecimento da diretriz foi independente do tempo de formação. COnClusãO. A meta da diretriz de servir como referência para o estabelecimento de estratégias individuais e populacionais no controle dos fatores de risco para a aterosclerose desde a infância não foi alcançada na cidade de São Paulo. A divulgação mais adequada e cursos de educação médica continuada em que o conhecimento da diretriz se torne mais efetivo são sugeridos para corrigir tais achados.unitermos: Prevenção primária. Aterosclerose. Criança. Adolescente. Diretrizes para o planejamento em saúde. desCOnheCiMentO da diRetRiz de pRevençãO da ateROsCleROse na infânCia e adOlesCênCia pOR pediatRas eM sãO paulO

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“…The high prevalence of obesity, 1 the recognition that hyperlipidemia in childhood has an immediate impact and might have a long-term impact on cardiovascular physiology, [2][3][4] and the increasing number of treatment options for hyperlipidemia in children 5,6 have all led the American Academy of Pediatrics (AAP) and the American Heart Association to recommend fasting lipid panel screening for children as young as 2 years who are at risk for dyslipidemia. 6,7 Screening of children for lipid disorders presents unique challenges.…”

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confidence: 99%

Fasting Might Not Be Necessary Before Lipid Screening: A Nationally Representative Cross-sectional Study

2011

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WHAT'S KNOWN ON THIS SUBJECT:Fasting lipid panels are recommended to screen for lipid abnormalities; however, fasting can be difficult for children and make screening difficult. Results of studies in adult patients are raising questions of whether fasting is needed before lipid screening. WHAT THIS STUDY ADDS:In a nationally representative sample of children, small but likely unimportant differences in lipid panel results were found between children who had fasted and those who had not fasted before testing, which indicates that fasting before lipid screening in children might not be necessary. abstract BACKGROUND: There are barriers to fasting lipid screening for at-risk children. Results of studies in adults have suggested that lipid testing might be reliably performed without fasting. OBJECTIVE:To examine population-level differences in pediatric lipid values based on length of fast before testing. METHODS:We used the National Health and Nutrition Examination Survey (1999Survey ( -2008 to examine total cholesterol (TC), HDL (high-density lipoprotein), LDL (low-density lipoprotein), and triglyceride cholesterol components on the basis of the period of fasting. Young children fasted for varying times before being tested, and children older than 12 years were asked to fast; however, adherence was variable. We used ordinary least-squares regression to test for differences in lipid values that were based on fasting times, controlling for weight status, age, race, ethnicity, and gender.RESULTS: TC, HDL, LDL, or triglyceride values were available for 12 744 children. Forty-eight percent of the TC and HDL samples and 80% of the LDL and triglyceride samples were collected from children who had fasted Ն8 hours. Fasting had a small positive effect for TC, HDL, and LDL, resulting in a mean value for the sample that was 2 to 5 mg/dL higher with a 12-hour fast compared with a no-fast sample. Fasting time had a negative effect on triglycerides (␤ ϭ Ϫ0.859; P ϭ .02), which resulted in values in the fasting group that were 7 mg/dL lower. DISCUSSION:Comparison of cholesterol screening results for a nonfasting group of children compared with results for a similar fasting group resulted in small differences that are likely not clinically important. Physicians might be able to decrease the burden of childhood cholesterol screening by not requiring prescreening fasting for these components.

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Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age

Cited by 792 publications

References 41 publications

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Clinical and angiographic characteristics of coronary artery disease in young adults: a single centre study

Desconhecimento da diretriz de prevenção da aterosclerose na infância e adolescência por pediatras em São Paulo

Fasting Might Not Be Necessary Before Lipid Screening: A Nationally Representative Cross-sectional Study

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