cardiovascular risk

Introduction: Cardiovascular diseases are the leading cause of death in the world, headed by coronary artery disease, which is secondary to atherosclerosis. The latter recognizes classic risk factors such as diabetes, high blood pressure, tobacco, and dyslipidemia and other less classic factors such as chronic inflammation of rheumatoid arthritis. Many studies have highlighted the correlation between this chronic inflammation and clinical coronary disease but very few have focused on the anatomical correlation. Objective: To describe the correlation between the chronic biological inflammation of rheumatoid arthritis and anatomical coronary lesions on angiography. Method: This observational, retrospective, single-center study, including over 10 years, of patients with rheumatoid arthritis, confirmed the EULAR 2010 criteria and presented with coronary artery disease requiring coronary angiography. Patients with missing data or in whom coronary angiography was not done were excluded (n = 14). We divided then the patients according to the existence or not of chronic inflammation to study the impact of the latter on the existence (Stenosis < 50% vs. stenosis ≥ 50%), the extent (single vs. multivessel disease), and the severity of the coronary lesions (syntax score < 32 vs. ≥ 32). Results: 202 patients (49♂/153♀) aged between 30-75 years with a history of rheumatoid arthritis have had a coronary event requiring coronary angiography, were included; The mean ejection fraction at baseline was 57.3% +/- 5.8 (37 vs.-65%). 75% of them were ≥ 65 years old. 55% were diabetics, 61% with hypertension, 38% with dyslipidemia, and 19% were smokers. Chronic inflammation was diagnosed in 70% of them on non-specific parameters (ESR, CRP, fibrinogen, anemia, and rheumatoid factor). All patients had coronary angiography, which made it possible to identify the coronary lesions according to their existence (Stenosis < 50%: 51 patients vs. stenosis ≥ 50%: 151 patients), the extent (single: 86 patients vs. multivessel disease: 116 patients) and the severity of the coronary lesions (syntax score < 32: 142 patients vs. ≥ 32: 60 patients). Chronic inflammation of rheumatoid arthritis was correlated in bivariate and multivariate analysis (after excluding the impact of other risk factors) with the existence and extent of coronary lesions (p < 0.05) but not with their severity (p > 0.05). Discussion: The two limitations of this work are the monocentric nature of the study and the absence of specific inflammatory parameters such as anti-CCP antibodies. Strengths are anatomical correlations and multivariate analysis. Chronic inflammation apart from any influence of the various risk factors predisposes to the existence and extent of coronary lesions (p < 0.05). The severity of coronary lesions assessed by Syntax Score was not correlated with chronic inflammation, although other studies suggest that this inflammation is the cause of complex lesions.Interpretation: Rheumatoid arthritis is associated with an increase in cardiac morbidity and mortality. Atheromatous lesions are more frequent in those patients than the existence of classic cardiovascular risk factors would suggest. Several explanations could account for this risk: the inflammatory syndrome and its impact on the cardiovascular risk factors and the vessel and the deleterious effect of the treatments. This requires stricter screening and management of risk factors in rheumatoid arthritis.

Background: This retrospective study examines the importance of preoperative cardiology consultations in optimizing patient care and anesthesia surgical perioperative management.Methods: The study includes 7,756 patients from the Department of Anesthesiology at Mohammed V Military Teaching Hospital. Out of these, 122 patients were referred to cardiology consultations. Demographics, surgical specialties, reasons for referral, diagnostic tests, and interventions were analyzed.Results: Referred patients (average age 61.45 years) were mainly over 65 years old, with 59.01% being male. Common surgical specialties seeking consultations were abdominal surgery (30.327%), orthopedic surgery (26.230%), and urological surgery (19.672%). Hypertension, dyslipidemia, and diabetes were prevalent risk factors. Most patients were classified as ASA II (50%) or ASA III (27.04%), with NYHA I (61.5%) or NYHA II (31.2%) classifications. Referrals were due to ECG abnormalities (41.0%), routine evaluation (19.7%), and history of myocardial infarction or previous coronary angiography (39.3%).Discussion: Preoperative cardiology consultations accounted for 1.57% of all pre-anesthesia clinic patients. They were vital in assessing and managing cardiovascular risks, consistent with previous studies. The impact of these consultations was evident in optimizing patient management through treatment plan adjustments and interventions.Conclusion: Preoperative cardiology consultations play a crucial role in identifying and managing cardiovascular risks, contributing significantly to patient care and improving perioperative management. Further research should evaluate long-term outcomes and cost-effectiveness across different patient populations.

Background: Obesity remains a global epidemic with over 2.8 million people dying due to complications of being overweight or obese every year. The low-carbohydrate and high-fat ketogenic diet has a rising popularity for its rapid weight loss potential. However, most studies have a maximal 2-year follow-up, and therefore long-term adverse events remain unclear including the risk of Atherosclerotic Cardiovascular Disease (ASCVD).Results: Based on current evidence on PubMed and Google Scholar, there is no strong indication ketogenic diet is advantageous for weight loss, lipid profile, and mortality. When comparing a hypocaloric ketogenic diet with a low-fat diet, there may be faster weight loss until 6 months, however, this then appears equivalent. Ketogenic diets have shown inconsistent Low-Density Lipoprotein (LDL) changes; perhaps from different saturated fat intake, dietary adherence, and genetics. Case reports have shown a 2-4-fold elevation in LDL in Familial hypercholesterolaemic patients which has mostly reversed upon dietary discontinuation. There is also concern about possible increased ASCVD and mortality: low (< 40%) carbohydrate intake has been associated with increased mortality, high LDL from saturated fats, high animal product consumption can increase trimethylamine N-oxide, and cardioprotective foods are likely minimally ingested.Conclusion: Ketogenic diets have been associated with short-term positive effects including larger weight reductions. However, by 2 years there appears no significant differences for most cardiometabolic risk markers. Therefore, this raises the question, excluding those who have a critical need to lose weight fast, is this diet worth the potentially higher risks of ASCVD and mortality while further long-term studies are awaited?

Background: Obesity is a significant health risk linked to hypertension and heart-related disorders in adolescents, impacting their future well-being . Since, the present work is to determine the body constitute including percentage of body fat correlates with cholesterol level which associate with Body Mass Index. Methods: This cross-sectional work was held in 120 college girls aged 19-23 years of Bhavan’s Tripura College of Science and Technology, Anandanagar at West Tripura. Anthropometric measurements such as standing height, body weight, sub scapular and triceps skinfolds, waist &hip circumference were collected. These records were used to calculate Body Fat Percentage (%BF) and Fat Mass (FM). Waist and Hip ratio (WHR) and Body Mass Index (BMI). FM, %BF and biochemical studies such as serum cholesterol level were also used to measures the body fat composition. Results: According to the present study, 53.33% of girls have a normal BMI, 8.83% are underweight, 31.67% are overweight, and 6.67% are obese. WHR results indicate that 54.17% of participants are classified as obese and 45.83% as non-obese. Out of 114 (95%) girls with normal cholesterol levels of 16 (13.33%) students are pre-hypertensive and 10 (8.33%) students are hypertensive. Out of 38 overweight and 8 obese students 13.34% are in pre or hypertensive. Based on WHR, 65 (54.17%) female students are obese; out of 65 obese students, 12 (10%) and 7 (5.83%) female students are pre-hypertensive and hypertensive, respectively and this value is statistically significant (p value < 0.05). Out of 55 (45.83%) no-obese students 8 (6.67%) girls are pre-hypertensive and 5 (6.67%) girls are hypertensive. According to BMI female students who are overweight or obese (5%) also have excessive blood cholesterol.Conclusion: This study expressed clear evidence of correlation in BMI, serum cholesterol level and Hypertension. These results are important for epidemiological studies to identify the cardiovascular risk in obese adults and help to solve a health problem of present Youngers in their future life. This study serves as an early health warning for female college students.