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Underlying Cardiovascular Disease (underlying + cardiovascular_disease)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Reporting of diabetes on death certificates using data from the UK Prospective Diabetes Study

DIABETIC MEDICINE, Issue 8 2005
M. J. Thomason
Abstract Aims To study the effect of age at death, sex, ethnic group, date of death, underlying cause of death and social class on the frequency of reporting diabetes on death certificates in known cases of diabetes. Methods Data were extracted from certificates recording 981 deaths which occurred between 1985 and 1999 in people aged 45 years or more who participated in the UK Prospective Diabetes Study, to which 23 English, Scottish and Northern Ireland centres contributed. Diabetes (9th revision of the International Classification of Diseases; ICD-9 250) entered on parts 1A,1C or 2A,2C of the death certificate was considered as reporting diabetes. Logistic regression analyses were used to determine independent factors associated with the reporting of diabetes. Results Diabetes was reported on 42% (419/981) of all death certificates and on 46% (249/546) of those with underlying cardiovascular disease causes. Reporting of diabetes was independently associated on all death certificates with per year of age increase (OR 1.02; 95% CI 1.001,1.04, P = 0.037), underlying cause of death (non-cardiovascular causes OR 0.76; 95% CI 0.59,0.98, P = 0.035) and social class (classes I,II OR 1.00; class III OR 1.35; 95% CI 0.96,1.89, P = 0.084, classes IV,V OR 1.48; 95% CI 1.05,2.10, P = 0.027). Stratification by age, sex, and underlying cause of death also revealed significant differences in the frequency of reporting diabetes over time. Conclusions The rate of reporting of diabetes on cardiovascular disease death certificates remains poor. This may indicate a lack of awareness of the importance of diabetes as a risk factor for cardiovascular disease. [source]

Early onset pneumonia in patients with cholinesterase inhibitor poisoning

RESPIROLOGY, Issue 6 2010
Chen-Yu WANG
ABSTRACT Background and objective: Organophosphates and carbamates are potent cholinesterase inhibitors that are widely used as insecticides in agriculture. Pneumonia is a frequent complication of cholinesterase inhibitor poisoning (CIP) and a risk factor for death. The aim of this retrospective study was to assess the risk factors for pneumonia in patients with CIP. Methods: The medical records of 155 patients, who were treated for CIP in a 1300-bed medical centre in central Taiwan, from January 2002 to December 2004, were retrospectively analysed. Pneumonia was diagnosed by a new or persistent infiltrate on CXR, as well as clinical symptoms. Demographic data, comorbidities, acute respiratory failure and in-hospital mortality were also recorded. Results: Of the 155 patients, 31 (20%) died and 92 (59.4%) developed acute respiratory failure. Thirty-four patients (21.9%) were diagnosed with early onset pneumonia during hospitalization. Acute respiratory failure (OR 12.10, 95% CI: 2.55,57.45), underlying cardiovascular disease (OR 3.02, 95% CI: 1.02,8.91), undergoing gastric lavage at peripheral hospitals (OR 6.23, 95% CI: 1.52,25.98) and development of respiratory failure at the study centre after gastric lavage (OR 3.43, 95% CI: 1.17,10.0) were predictive factors for early onset pneumonia. Cardiopulmonary resuscitation (OR 23.58, 95% CI: 6.03,92.29), early onset pneumonia (OR 7.45, 95% CI: 2.02,27.5) and lower Glasgow coma score (OR 1.26, 95% CI: 1.08,1.48) were predictive factors for mortality. Conclusions: Pneumonia was a significant risk factor for death in patients with CIP. In addition to aggressive management of patients with CIP who develop respiratory failure, careful respiratory evaluation before and after gastric lavage would help to decrease the incidence of early onset pneumonia in patients with CIP. [source]

Epidemiology of transient ischemic attack and ischemic stroke in patients with underlying cardiovascular disease

CLINICAL CARDIOLOGY, Issue S2 2004
M.P.H., Philip B. Gorelick M.D.
Abstract It is estimated that 15 to 30% of ischemic strokes are cardioembolic in origin, and that atrial fibrillation, valvular heart disease, coronary artery disease, congestive heart failure, and myocardial infarction are significant risk factors for stroke, which underscores the importance for cardiologists to understand this condition. The high incidence and substantial cost of stroke justify aggressive treatment of stroke risk factors, especially in the elderly, diabetic, and black populations, and in patients who have had an initial stroke. Antiplatelet therapy and administration of oral anticoagulants have both been shown to have a substantial impact on stroke in specified populations at risk. [source]

Role of the cardiologist: Clinical aspects of managing erectile dysfunction

CLINICAL CARDIOLOGY, Issue S1 2004
Adolph M. Hutter Jr. M.D.
Abstract Erectile dysfunction (ED) is often a marker for serious underlying cardiovascular disease (CVD), and cardiologists are increasingly involved in the care of men with ED. It is important to ask specifically about ED when evaluating men with CVD, since they may be embarrassed to volunteer this information. During the clinical workup, it is also important to check for contributing factors to ED such as diabetes, depression, stress, alcohol abuse, and cardiovascular risk factors. Patients should be advised that many treatment options are available for ED, including the phosphodiesterase type 5 (PDE5) inhibitors. The PDE5 inhibitors are safe and effective in most patients with CVD, including those taking multiple antihypertensive drugs. Furthermore, they have no deleterious effect on exercise capacity, heart rate, or extent of exercise-induced ischemia. In the future, the PDE5 inhibitors may have a role in reducing pulmonary hypertension in persons with primary pulmonary arterial hypertension (PAH) or congestive heart failure. The one major precaution for men taking PDE5 inhibitors is to avoid concomitant administration of therapeutic and recreational nitrate preparations. Patients with chest pain suggestive of a heart attack need to inform emergency room (ER) personnel if they are taking a PDE5 inhibitor. Similarly, before giving nitrates, ER personnel need to ask patients if they have used PDE5 inhibitors. Nitrates should not be given for at least 24 h after a patient uses sildenafil or vardenafil and at least 48 h after a patient uses tadalafil. [source]