Diseases Commons^™

Is Apixaban Effective For The Prevention Of Stroke In Patients With Non-Valvular Atrial Fibrillation?, Amira Moore

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this EBM review is to determine whether or not Apixaban is effective for the prevention of stroke in patients with non-valvular atrial fibrillation.

STUDY DESIGN: Review of three English language primary studies published all published in 2011.

DATA SOUCRES: Three double-blind randomized control trials found using the Cochrane Database and PubMed.

OUTCOME(S) MEASURED: Outcomes measured were occurrence of stroke (TIA or CVA), systemic embolism, major bleeding or clinically relevant non-major bleeding, and incidence of death.

RESULTS: Apixaban 2.5mg and 5mg were both superior to Warfarin in the prevention of stroke or …

Is L-Carnitine Effective In Reducing Mortality After An Acute Myocardial Infarction?, Jeremiah Spearman

PCOM Physician Assistant Studies Student Scholarship

OBJECTIVE: The objective of this selective EBM review is to determine whether or not L-carnitine decreases mortality rates post MI.

STUDY DESIGN: Review of three randomized controlled trials published in 1996, 2000, and 2012, all English language.

DATA SOURCES: Three double blind, randomized controlled clinical trials comparing mortality rates in patients post MI who were treated with L-carnitine or a placebo. All articles were found using PubMed and EBSCO.

OUTCOMES MEASURED: In the Singh et al. study the outcomes were total cardiac events that included death and nonfatal infarctions, cardiac enzymes activity, infarct size, and any …

Alternative Treatment With Red Yeast Rice To Reduce Hyperlipidemia, Lisa Froemke

Physician Assistant Scholarly Project Posters

• First line treatment of cardiovascular disease is lifestyle modification followed by the pharmacologic intervention of HMG-CoA reductase inhibitors or statins

• Statins are commonly associated with intolerable side effects such as myalgia leading to medication non-compliance

• RYR preparations claim to inhibit cholesterol synthesis without causing myalgia

• RYR preparations have naturally occurring monacolins such as monacolin K which is chemically identical to lovastatin

• RYR is not regulated by the FDA leading to questionable manufacturing practices producing varying ingredient composition

• The purpose of this study is to investigate the role RYR in hyperlipidemia treatment compared to statins …

New Age Anticoagulants: A Safer And More Effective Alternative To Warfarin?, Benjamin Johnson

Physician Assistant Scholarly Project Posters

Atrial fibrillation is the most common sustained heart rhythm in the United States with estimated prevalence rates of 8.8/100 (Wolf, Abbott, & Kannel, 1991). The largest risk for patients with atrial fibrillation is that of ischemic stroke from embolization of an atrial clot, thus the long standing treatment for this arrhythmia is aggressive anticoagulation. For decades this has been accomplished with the use of warfarin, however, the increased risk of hemorrhage combined with the inconvenience of weekly blood testing has prompted the development of potentially safer and more effective alternatives. A systematic review of the literature identified studies that examined …

Acute Myocardial Infarction: Are We Overlooking Nstemi?, Kevin D. Swenson

Physician Assistant Scholarly Project Posters

• Acute myocardial infarction (AMI) is one of the leading causes of death in the United States.

• The purpose of this study was to examine methods of clinical differentiation between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and then to compare the various treatment methods and subsequent outcomes in STEMI versus NSTEMI.

• A compilation of systematic reviews, medical journals, practice guidelines, medical texts and meta-analyses were researched for the purpose of this study.

• NSTEMI patients are older, have more comorbidities and present with more atypical symptoms than STEMI patients.

• NSTEMI patients are treated less aggressively …

Assessing Prevalence Of Known Risk Factors In A Regional Central Kentucky Medical Center Heart Failure Population As An Approach To Assessment Of Needs For Development Of A Program To Provide Targeted Services To Reduce 30 Day Readmissions, Christeen Ivy Broaddus

DNP Projects

Abstract

Objectives:

1. Determine demographic, physiologic, and laboratory characteristics at time of admission of the heart failure (HF) population in a regional acute care facility in Central Kentucky through review of patient electronic medical records.
2. Determine which HF population characteristics are significantly associated with readmissions to the hospital.
3. Provide identification of the statistically significant common characteristics of the HF population to this facility so that they may work towards development of an electronic risk for readmission predictive instrument.

Design: Retrospective chart review.

Setting: Regional acute care facility in Central Kentucky.

Participants: All patients (n = 175) with a diagnosis or history …

Effect Of Chronic Angiotensin Ii Infusion On Plasma Tnfalpha And Il 6 Levels In Adiponectin Deficient Mice, Alexis O'Brien, Minnette Smith, Jaya Pamidimukkala

College of Osteopathic Medicine (TUN) Publications and Research

Chronic low grade inflammation plays an integral part in the development of many types of cardiovascular diseases. Adipose tissue is a well known source of many proinflammatory mediators. Adiponectin (APN) is one of the few proteins secreted by the adipose tissue that is known to have anti-inflammatory properties. Our research goal is to understand if APN deficiency contributes to a proinflammatory milieu especially when provided with an appropriate stimulus. Angiotensin II (ANGII) is a well known prohypertensive agent. Recently, ANGII has emerged as a growth factor and stimulator of proinflammatory cytokine expression in cardiovascular & renal tissue. The present study …

Lifetime Racism And Blood Pressure Changes During Pregnancy: Implications For Fetal Growth, Clayton J. Hilmert, Tyan Parker Dominguez, Christine Dunkel Schetter, Sindhu K. Srinivas, Laura M. Glynn, Calvin J. Hobel, Curt A. Sandman

Psychology Faculty Articles and Research

Objective: Research suggests that exposure to racism partially explains why African American women are 2 to 3 times more likely to deliver low birth weight and preterm infants. However, the physiological pathways by which racism exerts these effects are unclear. This study examined how lifetime exposure to racism, in combination with maternal blood pressure changes during pregnancy, was associated with fetal growth. Methods: African American pregnant women (n = 39) reported exposure to childhood and adulthood racism in several life domains (e.g., at school, at work), which were experienced directly or indirectly, meaning vicariously experienced when someone …

Older Couples With And Without Cardiovascular Disease: Testing Associations Between And Among Affective Communication, Marital Satisfaction, Physical And Mental Health, Josh Novak, James M. Harper, Jonathan G. Sandberg

Faculty Publications

The American Heart Association (Go et al., 2013) estimated that about 2,150 Americans die each day from cardiovascular disease (CVD). For those 65 years of age or older, the total cost of heart related services in 2009 was $121.2 billion (Go et al., 2013). Many people live with the chronic conditions of cardiovascular disease (Petersen et al., 2005). Researchers have identified the genetic, medical, and lifestyle habits of those with CVD, yet there is a dearth of literature focusing on the relational/social aspects of cardiovascular disease and how such factors are associated with the risk, presentation, and maintenance of cardiovascular …

Examining The Effect Of Race On The Relationship Between Posttraumatic Stress Disorder And Metabolic Syndrome In Women, Leia Harper

Theses and Dissertations

Posttraumatic stress disorder (PTSD) is a psychiatric condition affecting approximately 8% of the adult U.S. population with rates twice as high in women than men. Increasingly, evidence has suggested a close relationship between PTSD and increased risk of metabolic diseases. However, the literature on PTSD and metabolic disease risk factors has been limited by the lack of investigation of the potential influence of race on this relation. The current study examined the possible effect of race on the relation between PTSD and metabolic risk. Data for this study were provided from sample of that included 50 African American women and …

Comparison Of Two Different Sprint Interval Training Work-To-Rest Ratios On Acute Metabolic And Inflammatory Responses, Christopher R. Harnish

Theses and Dissertations

High intensity exercise is believed to yield greater results on health and human performance than moderate intensity exercise. Extensive research indicates that not only do high-intensity interval training (HIT) and sprint interval training (SIT) produce significant improvements in cardiovascular fitness and disease, they may be more effective at improving long-term metabolic function, including insulin sensitivity (Si), by producing more mitochondria. Moreover, compliance rates for HIT and SIT participation are reported to be the same or better than traditional moderate intensity exercise. Because lack of time is often cited as major hindrance to exercise participation, SIT is also seen as a …

Risk Factors Of Cvd Mortality Among The Elderly In Beijing, 1992 - 2009: An 18-Year Cohort Study, Tao Zhou, Xia Li, Zhe Tang, Changchun Xie, Lixin Tao, Lei Pan, Da Huo, Fei Sun, Yanxia Luo, Wei Wang, Aoshuang Yan, Xiuhua Guo

Research outputs 2014 to 2021

Few researchers have examined the effects of multiple risk factors of cardiovascular disease (CVD) mortality simultaneously. This study was to determine the associations of combined lifestyle and other factors with CVD mortality among the elderly (n = 3,257), in Beijing, China, through data mining of the Beijing Longitudinal Study of Aging (BLSA). BLSA is a representative cohort study from 1992 to 2009, hosted by Xuan Wu Hospital. Competing risk survival analysis was conducted to explore the association between risk factors and CVD mortality. The factors focused mainly on lifestyle, physical condition, and the model was adjusted for age and gender. …

The Identity Of The Heart Patient In The Context Of The Gift Economy: Heartnet And Media Framing, Lynsey Uridge

Theses: Doctorates and Masters

This health communication research examines the identity levels of the heart patient on a therapeutic website HeartNET through an empirical investigation of site interactions as manifestations of a gift economy. The thesis also explores the media’s representation of heart health in both television and print.

This research utilised a longitudinal qualitative ethnographic and netnographic approach involving twenty-six participants who completed two in-depth interviews. The first one-on-one interview occurred during the early stages of the participants’ heart journey, explored their heart story and use of interactive technology for heart health support. The second interview occurred six to twelve months later, and …

Humans' Bonding With Their Companion Dogs: Cardiovascular Benefits During And After Stress, Rebecca A. Campo, Bert N. Uchino

The Journal of Sociology & Social Welfare

This study examined whether having one's companion dog present during and after stress posed similar cardiovascular benefits as having a close friend present, even when the relationship quality for both the companion dog and friend was highly positive. Positive aspects of relationship quality for participants' dog and friend were not associated with one another, suggesting that these relationships exist independently. Additionally, compared to participants with a close friend present, those with their dog present had lower heart rate and diastolic blood pressure (p's < .05) while undergoing the stressors, and tended to have lower heart rate and systolic blood pressure (p's < .09) when recovering from stressors. This study indicates that even when relationship quality is similarly high for companion dogs and friends, dogs may be associated with greater reductions in owners' cardiovascular reactivity to stress, particularly if there is a potential for evaluation apprehension in the human friendships. These findings support the value of the human- companion animal relationship in promoting human welfare.

Predictors Of Disease Progression In Pediatric Dilated Cardiomyopathy., Kimberly M. Molina, Peter Shrader, Steven D. Colan, Seema Mital, Renee Margossian, Lynn A. Sleeper, Girish S. Shirali, Piers Barker, Charles E. Canter, Karen Altmann, Elizabeth Radojewski, Elif Seda Selamet Tierney, Jack Rychik, Lloyd Y. Tani, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

Background: Despite medical advances, children with dilated cardiomyopathy (DCM) remain at high risk of death or need for cardiac transplantation. We sought to identify predictors of disease progression in pediatric DCM.

Methods and results: The Pediatric Heart Network evaluated chronic DCM patients with prospective echocardiographic and clinical data collection during an 18-month follow-up. Inclusion criteria were age <22 years and DCM disease duration >2 months. Patients requiring intravenous inotropic/mechanical support or listed status 1A/1B for transplant were excluded. Disease progression was defined as an increase in transplant listing status, hospitalization for heart failure, intravenous inotropes, mechanical support, or death. Predictors of disease progression were identified using …

New Oral Anticoagulants Are Not Superior To Warfarin In Secondary Prevention Of Stroke Or Transient Ischemic Attacks, But Lower The Risk Of Intracranial Bleeding: Insights From A Meta-Analysis And Indirect Treatment Comparisons, Partha Sardar, Saurav Chatterjee, Wen-Chih Wu, Edgar Lichstein, Joydeep Ghosh, Shamik Aikat, Debabrata Mukherjee

Internal Medicine Faculty Publications

PURPOSE: Patients with Atrial Fibrillation (AF) and prior stroke are classified as high risk in all risk stratification schemes. A systematic review and meta-analysis was performed to compare the efficacy and safety of New Oral Anticoagulants (NOACs) to warfarin in patients with AF and previous stroke or transient ischemic attack (TIA).

METHODS: Three randomized controlled trials (RCTs), including total 14527 patients, comparing NOACs (apixaban, dabigatran and rivaroxaban) with warfarin were included in the analysis. Primary efficacy endpoint was ischemic stroke, and primary safety endpoint was intracranial bleeding. Random-effects models were used to pool efficacy and safety data across RCTs. RevMan …

Seventeenth Annual Scientific Meeting Institute Of Cardiovascular Science And Medicine

Journal of the Hong Kong College of Cardiology

No abstract provided.

A Coronary Rupture In The Left Anterior Descending Artery At Second Diagonal Artery Bifurcation Level In An Intervention With A Tryton Side Branch Stent, Muhammed Hakan Tas, Ziya Simsek, Yavuzer Koza, Zakir Lazoglu

Journal of the Hong Kong College of Cardiology

Percutaneous coronary intervention (PCI) for bifurcation lesions (BLs) is considered high risk due to increased procedural adverse events when compared to non-bifurcation lesion. Dedicated bifurcation stents, specifically designed to allow minimally traumatic implantation in the main vessel and/or side branch while providing adequate scaffolding of the side branch ostium may offer an advantage over utilization of conventional stents. Coronary perforation as a complication of PCI is a rare but potentially lethal complication that is associated with a high rate of morbidity. Coronary artery perforation during PCI has been reported repeatedly. To our best knowledge perforation in a BL, PCI with …

Cardiac Fibroblast-Dependent Extracellular Matrix Accumulation Is Associated With Diastolic Stiffness In Type 2 Diabetes., Kirk R. Hutchinson, C. Kevin Lord, T. Aaron West, James A. Stewart

CAS Publications

Cardiovascular complications are a leading cause of death in patients with type 2 diabetes mellitus (T2DM). Diastolic dysfunction is one of the earliest manifestations of diabetes-induced changes in left ventricular (LV) function, and results from a reduced rate of relaxation and increased stiffness. The mechanisms responsible for increased stiffness are not completely understood. Chronic hyperglycemia, advanced glycation endproducts (AGEs), and increased levels of proinflammatory and profibrotic cytokines are molecular pathways known to be involved in regulating extracellular matrix (ECM) synthesis and accumulation resulting in increased LV diastolic stiffness. Experiments were conducted using a genetically-induced mouse model of T2DM generated by …

The Effect Of Heart Failure Education On Reducing Readmissions, Mayola Lara Villarruel

Evidence-Based Practice Project Reports

Management of heart failure is a significant financial challenge for the health care industry, costing approximately $33.2 billion annually. Common reasons for preventable heart failure readmissions include inadequate discharge education and lack of self-care and health management activities. Education at discharge is a vital component of improving heart failure outcomes. Following a review of the literature, high quality evidence supports that heart failure education should focus on medication adherence, sodium and fluid restriction, daily weights, activity tolerance, identification of deteriorating signs and symptoms of heart failure, and smoking cessation. The purpose of this EBP project was to reduce heart failure …

Prognostic Value Of Heart Rate Turbulence For Risk Assessment In Patients With Unstable Angina And Non-St Elevation Myocardial Infarction, Patricia R.E. Harris, Phyllis K. Stein, Gordon L. Fung, Barbara J. Drew

Collected Faculty Scholarship

Background: We sought to examine the prognostic value of heart rate turbulence derived from electrocardiographic recordings initiated in the emergency department for patients with non-ST elevation myocardial infarction (NSTEMI) or unstable angina.

Methods: Twenty-four-hour Holter recordings were started in patients with cardiac symptoms approximately 45 minutes after arrival in the emergency department. Patients subsequently diagnosed with NSTEMI or unstable angina who had recordings with ≥18 hours of sinus rhythm and sufficient data to compute Thrombolysis In Myocardial Infarction (TIMI) risk scores were chosen for analysis (n = 166). Endpoints were emergent re-entry to the cardiac emergency department and/or death at …

Exercise Participation During Weight Loss On A High Protein – Low Carbohydrate Diet Plan In Females Aged 15-25 Years, Margaret Mobley-Meulman

Electronic Theses and Dissertations

Weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year (U.S. Department of Health and Human Services, 2010). Obese adults have an increased risk for serious health conditions including high blood pressure and cholesterol, type 2 diabetes, coronary heart disease, stroke, gallbladder disease, osteoarthritis, sleep apnea, respiratory problems, and certain cancers (National Cancer Institute, 2012). Participation in exercise can help control weight, strengthen muscles and bones, and reduce the incidence of cardiac events, stroke, hypertension, type 2 diabetes, colon and breast cancers, osteoporotic fractures, gallbladder disease, obesity, depression, anxiety, and delay mortality …

Hybrid Nanostructured Textile Bioelectrode For Unobtrusive Health Monitoring, Pratyush Rai

Graduate Theses and Dissertations

Coronary heart disease, cardiovascular diseases and strokes are the leading causes of mortality in United States of America. Timely point-of-care health diagnostics and therapeutics for person suffering from these diseases can save thousands of lives. However, lack of accessible minimally intrusive health monitoring systems makes timely diagnosis difficult and sometimes impossible. To remedy this problem, a textile based nano-bio-sensor was developed and evaluated in this research. The sensor was made of novel array of vertically standing nanostructures that are conductive nano-fibers projecting from a conductive fabric. These sensor electrodes were tested for the quality of electrical contact that they made …

Relationship Of Global Dna Methylation With Cardiovascular Fitness And Body Composition, Michael Steele Jarrett

UNLV Theses, Dissertations, Professional Papers, and Capstones

Background: Global DNA Methylation (GDM), an epigenomic modification has been linked to the development of Cardiovascular Disease and its risk factors. Purpose: The purpose of this study was to determine if there is a significant correlation between GDM and cardiovascular fitness, as well as, measures of body composition. Methodology: 26 apparently healthy, adults (11 males) completed a physical activity and diet questionnaire, as well as, had a small blood sample (600μL) collected via finger prick for the determination of GDM. Body composition was assessed by means of a Dual-Energy X-ray Absorptiometry (DEXA) scan, while cardiovascular fitness was evaluated by the …

System Design And Motion Artifact Removal Algorithm Implementation For Ambulatory Women Ecg Measurement System:E-Bra System, Hyeokjun Kwon

Graduate Theses and Dissertations

Cardio Vascular Disease (CVD) leads to sudden cardiac death due to irregular phenomenon of the cardiac signal by the abnormal case of blood vessel and cardiac structure. For last three decades, there is an enhanced interest in research for cardiac diseases.. As a result, the death rate by cardiac disease in men has been falling gradually compared with relatively increasing the death rate for women due to CVD. The main reason for this phenomenon is due to the lack of seriousness to female CVD and different symptoms of female CVD compared with the symptoms of male CVD. Usually, because the …

Redefining Myocardial Infarction: What Is New In The Esc/Accf/Aha/Whf Third Universal Definition Of Myocardial Infarction?, Hani Jneid, Mahboob Alam, Salim S. Virani, Biykem Bozkurt

Office of the Provost

Myocardial infarction (MI) is a major cause of mortality and morbidity worldwide. Each year, an estimated 785,000 persons will have a new MI in the United States alone, and approximately every minute an American will succumb to one.1 In addition, MI has major psychological and legal implications for patients and the society and is an important outcome measure in research studies. The prevalence of MI provides useful data regarding the burden of coronary artery disease and offers insight into health care planning, policy, and resource allocation. The importance of accurately and reproducibly defining MI is therefore self-evident. The Third Universal …

Moderate Alcohol Use And Cardiovascular Disease From Mendelian Randomization, Shiu Lun Au Yeung, Chaoqiang Jiang, Kar Keung Cheng, Benjamin J. Cowling, Bin Liu, Weisen Zhang, Tai Hing Lam, Gabriel M. Leung, Mary Schooling

Publications and Research

Background
Observational studies show moderate alcohol use negatively associated with ischemic heart disease (IHD) and cardiovascular disease (CVD). However, healthier attributes among moderate users compared to never users may confound the apparent association. A potentially less biased way to examine the association is Mendelian randomization, using alcohol metabolizing genes which influence alcohol use.

Methods
We used instrumental variable analysis with aldehyde dehydrogenase 2 (ALDH2) genotypes (AA/GA/GG) as instrumental variables for alcohol use to examine the association of alcohol use (10 g ethanol/day) with CVD risk factors (blood pressure, lipids and glucose) and morbidity (self-reported IHD and CVD) among men in …

The Obesity Epidemic, Lenka Kollar, Evienne Epifano, Molly Mckneight, Jeff Miskovich, Heather Moore

Student Papers in Public Policy

The incidence of chronic, noncommunicable diseases, such as heart disease, is increasing at an alarming rate on the global scale. The growing prevalence of overweight and obesity have led to an upsurge in cases of diabetes and other obesity-related diseases. About 18 million people die every year from heart disease, of which diabetes and obesity are major predisposing factors. Worldwide, more than 1.1 billion adults are overweight, 312 million of which are obese. The number of children that are overweight or obese is also growing (Hossain, Parvez et al.). Obesity, and the associated diseases, has become a worldwide epidemic and …

Corrigendum For “Acute Aortic Valve Rupture From Infective Endocarditis”, Julia Ansari, Gurkaran Singh Garcha, Henry Huang, Faisal G. Bakaeen, Salim S. Virani, Hani Jneid

Office of the Provost

No abstract provided.

A Literature Review Of The Health Effects Of A Plant Based Diet Versus An Animal Based Diet, James Cote

Senior Honors Theses

Health and nutrition can mean a myriad of things to many people in today’s culture. The majority of the time people are unaware of the proper nutrients their body needs and how to get them from food. This thesis will seek to expose the health benefits that are associated with consuming a raw plant-based die, offering a more profound and encompassing view on nutrition. Investigating further into today’s most common diseases such as diabetes, heart disease, obesity, cancer and autoimmune disorders, it will seek to discover and answer why we have so many health issues. This thesis will discuss the …