Vladislava Stojic, Bojana Andjelkovic Cirkovic, Nebojsa Zdravkovic, Jelena Dimitrijevic, Vladan Kocic and Nenad Filipovic
Currently, an integrated site-specific and patient-specific comprehensive predictive model of plaque progression in various CVD is not available. In this study, we considered medical records of 256 patients obtained within the EU H2020 SMARTool project which is carefully designed to collect the features from various domains relevant for disease which are used in everyday clinical practice. The database contains detailed information of patients with suspected CAD disease regarding the clinical status, risk factors, routine blood analyses, CAD morphology and progression and current therapy. Results showed that there was statistically significant difference of values of this parameter for the SMARTool patients with and without disease progression, measured at the follow-up, F(1,250)=33.39, p < 0.001, while the CAD Score in the follow-up is significantly different from the score measured at the initial time point, F(1,254)=76.244, p < 0.001. The significant interaction of statins is achieved with aspirin F(1,252)= 3.921, p=0.049, while interactions with other medicaments are insignificant for CAD Score. The results showed that there was no significant interaction of statins and dyslipidemia, F(1,251)=0.877, p = 0.350. Also, there was no significant interaction of statins and hypertension, F(1,245)=0.283, p=0.596. The CAD score in the baseline was significantly different among patients who were further prescribed with therapy than those who were not, and this trend remained unchanged after a given time period, i.e. those patients who were at risk had progression in addition to statins, but the combination of statins and aspirin was shown as effective in decreasing the CAD Score. The Random Forest classifier applied on 24 selected features is the most reliable among all tested ML algorithms for the prediction of CAD progress.
Stefani Bolevich, Nevena Draginic, Marijana Andjic, Nevena Jeremic, Sergey Bolevich, Petr F Litvitskiy and Vladimir Jakovljevic
evidence is needed to determine if improvements in lipid profile and BP might translate into reductions and amelioration of cardiovascular outcomes.
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Cardiovascular Diseases (cvds)
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Tsvetan S. Stefanov and Theodora S. Temelkova-Kurktschiev
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10. Merjanov C. Bulgaria - a world leader in CVD mortality. A compromising championship. Sofia: University Press “St. Kliment Ochridski”; 1995:224-6.
Mariya Marushchak, Khrystyna Maksiv and Inna Krynytska
, given the heterogeneity of the definitions used, the study populations, patient COPD severity and age ( 3 ). Despite these differences, most studies conclude to a high prevalence of COPD patients with associated comorbidities, from 70% to virtually all patients ( 4 ). Cardiovascular diseases (CVDs) are arguably the most important comorbidities in COPD. CVDs are common in people with COPD, and their presence is associated with an increased risk for hospitalization, longer length of stay and all-cause and CVD-related mortality ( 5 ). The mechanisms that underlie the
Angel M. Dzhambov, Mariya P. Tokmakova, Penka D. Gatseva, Nikolai G. Zdravkov, Dolina G. Gencheva, Nevena G. Ivanova, Krasimir I. Karastanev, Stefka V. Vladeva, Aleksandar T. Donchev and Svetlan M. Dermendzhiev
Background: Road traffic noise (RTN) is a risk factor for cardiovascular disease (CVD) and hypertension; however, few studies have looked into its association with blood pressure (BP) and renal function in patients with prior CVD.
Aim: This study aimed to explore the effect of residential RTN exposure on BP and renal function in patients with CVD from Plovdiv Province.
Materials and methods: We included 217 patients with ischemic heart disease and/or hypertension from three tertiary hospitals in the city of Plovdiv (March – May 2016). Patients’ medical history, medical documentation, and medication regimen were reviewed, and blood pressure and anthropometric measurements were taken. Blood samples were analyzed for creatinine, total cholesterol, and blood glucose. Participants also filled a questionnaire. Glomerular filtration rate was estimated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. All participants were asked about their annoyance by different noise sources at home, and those living in the city of Plovdiv (n = 132) were assigned noise map Lden and Lnight exposure. The effects of noise exposure on systolic blood pressure (SBP), diastolic blood pressure (DBP), and estimated glomerular filtration rate (eGFR) were explored using mixed linear models.
Results: Traffic noise annoyance was associated with higher SBP in the total sample. The other noise indicators were associated with non-significant elevation in SBP and reduction in eGFR. The effect of Lden was more pronounced in patients with prior ischemic heart disease/stroke, diabetes, obesity, not taking Ca-channel blockers, and using solid fuel/gas at home. Lnight had stronger effect among those not taking statins, sleeping in a bedroom with noisy façade, having a living room with quiet façade, and spending more time at home. The increase in Lden was associated with a significant decrease in eGFR among men, patients with ischemic heart disease/stroke, and those exposed to lower air pollution. Regarding Lnight, there was significant effect modification by gender, diabetes, obesity, and time spent at home. In some subgroups, the effect of RTN was statistically significant.
Conclusions: Given that generic risk factors for poor progression of cardiovascular diseases cannot be controlled sufficiently at individual level, environmental interventions to reduce residential noise exposure might result in some improvement in the management of blood pressure and kidney function in patients with CVD.
Velin Stratev, Diana Petkova, Valentina Dimitrova and Jordan Petev
Background:wis a disease with constantly rising economic and social burden; it is associated with multiple comorbidities which contribute to the disease severity.
Aim: To investigate the prevalence of co-morbidities in COPD patients and their association with the disease severity and CRP levels.
Patients and methods: We conducted a retrospective study among 338 COPD patients (mean age 65.2±7.6 years) with assessment of comorbidities, spirometry measurements and serum levels of CRP. In 183 patients we found metabolic syndrome (MS) according to IDF criteria.
Results: We found prevalence of cardiovascular diseases (CVD) of 73.5% (hyper-tension 70.4%, CHF 47.4%, ishemic heart disease 37.5%, and cardiac arrhythmias 12.6%), with higher prevalence in patients with more severe disease. We found prevalence of type 2 diabetes of 21.1%, and 12.4% prevalence of bronchiectasis. In a subpopulation of the patients we found 48.1% prevalence of MS and the serum levels of CRP were significantly higher in patients with COPD and MS compared to those without the syndrome: 7.4 (3.14 – 11. 54) mg/ml vs 4.06 (2.64 – 6.93) mg/ml, p=0.006.
Conclusion: The present study suggests high prevalence of CVD comorbidities in COPD patients and association with the disease severity. Metabolic syndrome is a common comorbidity and is associated with increased inflammatory response.
Despite the association of a worse HF-related clinical status with lower CoQ10 levels, the prognostic use of CoQ10 is controversial. The aim of this study is to optimize pharmacotherapy for patients with ischaemic CHF, based on the clinical and functional parameters of the heart and brain natriuretic peptide (BNP) plasma levels, which are correlated with the CoQ10 plasma levels, and to assess patient prognosis after receiving CoQ10 therapy. This prospective clinical study included 75 patients aged 56 to 63 years old with coronary heart disease (CHD) classified as class I–III according to the NYHA classification. After assessment of the clinical-instrumental characteristics of the CVD course (complaints, medical history, physical examination, a 6-minute walk test, echocardiography, and test for reactive hyperaemia), we determined the BNP level and CoQ10 plasma levels. At the same time, we assessed the efficacy of CoQ10 treatment (at a dose of 60 mg/per day) and tolerability in CVD-combined therapy during a follow-up of 12 weeks. CoQ10 supplementation in HF patients induced improvements in their functional cardiac parameters, such as the ejection fraction. Our results suggest that supplemental CoQ10 may be a useful option for effective management of heart failure and warrant future adequately powered randomized controlled trials of CoQ10 supplementation in patients with HF.
Tamara Nikolic, Ivan Srejovic, Isidora Stojic, Jovana Jeremic, Marko Folic, Stevan Matic, Milena Rakocevic, Snezana Jancic, Biljana Jakovljevic, Radmila Obrenovic, Dusan Djuric and Vladimir Zivkovic
The strong association among the risk of coronary artery diseases (CAD), high levels of LDL-C and low levels of HDLC is well established. Hyperhomocysteinaemia (HHcy) is an independent risk factor for cardiovascular disease (CVD) and causes endothelial dysfunction, a hallmark of atherosclerosis. In this study, we ascertained the influence of statins on the atherogenic index, as an indicator and a significant adjunct for predicting atherosclerosis in hyperhomocysteinaemic male Wistar albino rats. For 4 weeks, the animals were fed with one of the following diets (Mucedola SRL., Milan, Italy): standard rodent chow; a diet enriched in methionine with no deficiency in B vitamins or a diet enriched in methio-nine and deficient in B vitamins. The animals were simultaneously exposed to a pharmacology treatment with atorvastatin at dose of 3 mg/kg/day i.p. or simvastatin, at dose of 5 mg/kg/day i.p. We measured weight gain, food intake, and FER and determined the concentrations of biochemical parameters of dyslipidaemia (TC, TGs, LDL-C, VLDL-C, and HDL-C), AI, and CRR. A histopathological examination was conducted on portions of the right and left liver lobes from each animal. A connection between Hhcy and dyslipidaemia was indicated by the findings of biochemical and histological analyses, suggesting that Hhcy was a pro-atherogenic state. An improvement in the lipid profile along with a decrease in the atherogenic index by statins suggests that atorvastatin and simvastatin could be useful antiatherogenic agents, with protective activities during hyperhomocysteinaemia.
Ivo S. Petrov, Arman Sh. Postadzhiyan, Mariya P. Tokmakova, Lyudmila G. Kitova, Svetlin N. Tsonev, Janet Addison, Reneta T. Petkova and Vasil I. Lachev
Background: Familial hypercholesterolaemia (FH) is a genetic disorder causing accelerated atherosclerosis and premature cardiovascular disease (CVD). This retrospective observational study examined the clinical characteristics and management of FH subjects in Bulgaria over a 12-month period.
Materials and methods: Twelve cardiology sites participated in this study from May 2015 to May 2016. Eligible subjects had at least two routine low-density lipo-protein cholesterol (LDL C) measurements and a prescription for lipid-lowering therapy (LLT) at the start of the observation period. Mean values for gender, age and cardiovascular (CV) event history at baseline and LDL-C over time were estimated.
Results: Of the 220 eligible subjects, 196 fulfilled the criteria for FH diagnosis: 27 definite, 94 probable and 75 possible. Mean age at enrolment was 54.4 years and 64.1% of subjects were male. Mean CV risk classification at baseline was 26.8% high-risk (HR) and 73.2% very high-risk (VHR). Mean LDL-C was 5.6 mmol/L at enrolment and 4.1 mmol/L at last observation visit (12 months). The ESC/EAS Guideline LDL-C targets (applicable at the time of the study) were achieved by 14.5% of HR and 5.0% of VHR subjects. Most subjects (n=219) received statins. One subject was statin intolerant (ezetimibe therapy). Intensive statin treatment (atorvastatin 40–80 mg/daily and rosuvastatin 20–40 mg/daily) was used in 38.6% of individuals during the observation period and 10% of subjects received combination therapy (statin plus ezetimibe or other LLT).
Conclusions: Most subjects with FH do not reach the ESC/EAS defined LDL-C targets. Early identification and physician education may improve FH management.