Editor's presentation.
TL;DR: Interestingly these biomarkers only decreased in patients who benefited the most from cardiac rehabilitation, suggesting the overall improvement of the neuro-hormonal profile as being part of their better outcome, laying the foundation for effective biomarker-guided cardiac rehabilitation.
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Abstract: Cardiac rehabilitation reduces the blood concentration of biomarkers of cardiac damage and inflammatory responses in heart failure, such as: galectin-3 (Gal-3), which is involved in cardiac inflammation and fibrosis and is strongly associated with heart failure development, severity and prognosis; soluble suppressor of tumorigenicity 2 (sST2), which is involved in cardiac fibrosis and hypertrophy, ventricular remodelling and dysfunction and negative cardiovascular prognosis and sudden cardiac death (SCD); mid-regional pro-ANP (MR-proANP), which reflects atrial overload and has been associated with poor prognosis; and mid-regional pro-adrenomedullin (MR-proADM), a hypotensive and natriuretic hormone that has a prognostic value and one-year mortality in heart failure. Interestingly these biomarkers only decreased in patients who benefited the most from cardiac rehabilitation, suggesting the overall improvement of the neuro-hormonal profile as being part of their better outcome, laying the foundation for effective biomarker-guided cardiac rehabilitation. A more complex and comprehensive cardiac rehabilitation programme was able to favourably affect platelet functionality with respect to a traditional cardiac rehabilitation. The former programme included three weeks in a dedicated unit and three months in an outpatient setting and it comprised several interventions: diet, physical activity, stress-management, lifestyle coaching and education during patient group meetings (personal meetings continued monthly, coaching via phone calls every week).
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Citations
The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy
Bernhard H. Rauch,Constantinos H. Davos,Patrick Doherty,Daniel Saure,Maria-Inti Metzendorf,Annett Salzwedel,Heinz Völler,Katrin Jensen,Jean Paul Schmid +8 more
- 01 Jan 2016
TL;DR: CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment, however, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation.
Validation and recalibration of the Framingham cardiovascular disease risk models in an Australian Indigenous cohort: Does the current Framingham risk calculator accurately estimate true CVD risk for Indigenous Australians?
Xinyang Hua,Robyn McDermott,Tom Lung,Mark Wenitong,An Tran-Duy,Ming Li,Philip Clarke,Remote High Risk Populations +7 more
- 01 Jan 2017
TL;DR: The recalibrated 2008 Framingham model shows good performance on predicting five-year cardiovascular disease risk in this population and was used to calculate the first risk chart based on empirical validation using long-term follow-up data from a remote Australian Indigenous population.
References
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Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
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Diagnosis and Classification of Diabetes Mellitus
TL;DR: The chronic hyperglycemia of diabetes is associated with long-term damage, dys-function, and failure of differentorgans, especially the eyes, kidneys, nerves, heart, and blood vessels.
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European Guidelines on Cardiovascular Disease Prevention in Clinical Practice (Version 2012)
Massimo Piepoli,Arno W. Hoes,Stefan Agewall,Christian Albus,Carlos Brotons,Alberico L. Catapano,Marie Therese Cooney,Ugo Corrà,Bernard Cosyns,Christi Deaton,Ian D. Graham,Michael Stephen Hall,FD Richard Hobbs,Maja Lisa Løchen,Herbert Löllgen,Pedro Marques-Vidal,Joep Perk,Eva Prescott,Josep Redon,Dimitrios J. Richter,Naveed Sattar,Y.M. Smulders,Monica Tiberi,H. Bart van der Worp,Ineke van Dis,W M Monique Verschuren +25 more
TL;DR: In this paper, a randomized clinical trial was conducted to evaluate the effect of preterax and Diamicron Modified Release Controlled Evaluation (MDE) on the risk of stroke.
2016 European Guidelines on cardiovascular disease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of 10 societies and by invited experts): Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR).
Massimo Piepoli,Arno W. Hoes,Stefan Agewall,Christian Albus,Carlos Brotons,Alberico L. Catapano,Marie-Therese Cooney,Ugo Corrà,Bernard Cosyns,Christi Deaton,Ian D. Graham,Michael Stephen Hall,F. D. Richard Hobbs,Maja-Lisa Løchen,Herbert Löllgen,Pedro Marques-Vidal,Joep Perk,Eva Prescott,Josep Redon,Dimitrios J. Richter,Naveed Sattar,Y.M. Smulders,Monica Tiberi,H. Bart van der Worp,Ineke van Dis,W M Monique Verschuren,Additional Contributor: Simone Binno,Guy De Backer,Marco Roffi,Victor Aboyans,Norbert Bachl,Héctor Bueno,Scipione Carerj,Leslie Cho,John Cox,Johan De Sutter,Günther Egidi,Miles Fisher,Donna Fitzsimons,Oscar H. Franco,Maxime Guenoun,Catriona Jennings,Borut Jug,Paulus Kirchhof,Kornelia Kotseva,Gregory Y.H. Lip,François Mach,Giuseppe Mancia,Franz Martin Bermudo,Alessandro Mezzani,Alexander Niessner,Piotr Ponikowski,Bernhard Rauch,Lars Rydén,Adrienne Stauder,Guillaume Turc,Olov Wiklund,Stephan Windecker,José Luis Zamorano +58 more
Abstract: The VI European Guidelines for Cardiovascular Prevention recommend combining population and high-risk strategies with lifestyle changes as a cornerstone of prevention, and propose the SCORE function to quantify cardiovascular risk. The guidelines highlight disease specific interventions, and conditions as women, young people and ethnic minorities. Screening for subclinical atherosclerosis with noninvasive imaging techniques is not recommended. The guidelines distinguish four risk levels (very high, high, moderate and low) with therapeutic objectives for lipid control according to risk. Diabetes mellitus confers a high risk, except for subjects with type 2 diabetes with less than 10 years of evolution, without other risk factors or complications, or type 1 diabetes of short evolution without complications. The decision to start pharmacological treatment of arterial hypertension will depend on the blood pressure level and the cardiovascular risk, taking into account the lesion of target organs. The guidelines don't recommend antiplatelet drugs in primary prevention because of the increased bleeding risk. The low adherence to the medication requires simplified therapeutic regimes and to identify and combat its causes. The guidelines highlight the responsibility of health professionals to take an active role in advocating evidence-based interventions at the population level, and propose effective interventions, at individual and population level, to promote a healthy diet, the practice of physical activity, the cessation of smoking and the protection against alcohol abuse.
EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries:
Kornelia Kotseva,Kornelia Kotseva,David R. Wood,David R. Wood,Dirk De Bacquer,Dirk De Bacquer,Guy De Backer,Guy De Backer,Lars Rydén,Lars Rydén,Catriona Jennings,Catriona Jennings,Viveca Gyberg,Philippe Amouyel,Jan Bruthans,Jan Bruthans,Almudena Castro Conde,Renata Cifkova,Renata Cifkova,J.W. Deckers,Johan De Sutter,Johan De Sutter,Mirza Dilic,Mirza Dilic,Maryna Dolzhenko,Andrejs Erglis,Andrejs Erglis,Zlatko Fras,Zlatko Fras,Dan Gaita,Nina Gotcheva,John A. Goudevenos,John A. Goudevenos,Peter U. Heuschmann,Aleksandras Laucevičius,Aleksandras Laucevičius,Seppo Lehto,Dragan Lovic,Davor Milicic,Davor Milicic,David Moore,Evagoras Nicolaides,Evagoras Nicolaides,Raphael Oganov,Andrzej Pajak,Nana Pogosova,Zeljko Reiner,Zeljko Reiner,Martin Stagmo,Stefan Störk,Lale Tokgozoglu,Lale Tokgozoglu,Dusko Vulic,Dusko Vulic +53 more
TL;DR: A large majority of coronary patients do not achieve the guideline standards for secondary prevention with high prevalences of persistent smoking, unhealthy diets, physical inactivity and consequently most patients are overweight or obese with a high prevalence of diabetes.