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CKD Tied To Higher Prevalence Of Incomplete Revascularization In Chronic Coronary Syndrome Patients, Reveals Indian Study
Chronic kidney disease tied to higher prevalence of incomplete revascularization in Chronic coronary syndrome patients suggests a new study published in the Indian Heart Journal.
A study was done to determine the impact of CKD on the completeness of revascularization and major adverse cardiovascular events (MACE) in patients with chronic coronary syndrome (CCS). The study enrolled 400 CCS patients who underwent revascularization by PCI. They were separated into two categories according to their eGFR levels: the control group: 200 patients with eGFR ≥60mL/min/1.73m2, and the CKD Group: 200 patients with eGFR< 60ml/min/1.73m.2 Patients were reclassified according to revascularization into complete and incomplete revascularization groups with one-year follow-up to assess the MACE. Results: CKD patients were significantly older (65.78 ± 6.41 vs. 56.70 ± 9.20 years, P=<0.001). They had higher syntax scores (P = 0.005), CIN (P = 0.001), all-cause mortality (P = 0.02), MACE (P = 0.037), and heart failure (P = 0.014). After reclassification according to revascularization. GFR was significantly reduced among patients with incomplete revascularization (51.08 ± 28.15 vs. 65.67 ± 26.62, respectively, P =<0.001). Repeated revascularization (P < 0.001), STEMI (P = 0.003), stent thrombosis (P = 0.015), MACE (P < 0.001), stroke (P < 0.001), and all-cause mortality (P < 0.001) were more prevalent among patients with incomplete revascularization. Multivariate regression analysis revealed eGFR (P = 0.001) and Syntax score (SS) (P=<0.001) as independent predictors of incomplete revascularization. The optimal eGFR cutoff value for predicting partial revascularization is 49.50mL/min/1.73m2, with 58.8% sensitivity and 69.3 % specificity. Chronic kidney disease is associated with a higher syntax score and incomplete revascularization prevalence in CCS patients. Additionally, incomplete revascularization is associated with an increased incidence of major adverse cardiac events. In patients with CCS, CKD predicts partial revascularization and subsequent MACE.
Reference:
Shereen Ibrahim Farag, Shaimaa Ahmed Mostafa, Hamza Kabil, Mohamed Reda Elfaramawy. Chronic kidney disease's impact on revascularization and subsequent major adverse cardiovascular events in patients with chronic coronary syndrome,
Indian Heart Journal. Volume 76, Issue 1, 2024, Pages 22-26, ISSN 0019-4832,
https://doi.Org/10.1016/j.Ihj.2023.11.006.
(https://www.Sciencedirect.Com/science/article/pii/S001948322300192X)
Keywords:
Chronic kidney disease, prevalence, revascularization, Chronic, coronary syndrome patients,Indian Heart Journal, Chronic coronary syndrome; Chronic kidney disease; Incomplete revascularization, Shereen Ibrahim Farag, Shaimaa Ahmed Mostafa, Hamza Kabil, Mohamed Reda Elfaramawy
Senior Living: Understanding The Signs And Symptoms Of Heart Failure
By Dr. Andrew Yoon, Guest columnist
Heart failure is the leading cause of hospitalizations in people older than 65.
Most seniors who experience heart failure already have a prior history of chronic cardiovascular disease. This is why it's important for seniors to understand what heart failure is and to know its signs and symptoms to catch the disease in the early stages.
The earlier heart failure is found, after all, the easier it is to treat.
As we age, our arteries become stiffer and less flexible, causing our blood pressure to increase. To compensate for this increase in blood pressure, the heart pumps harder and the walls of the heart thicken to help increase its blood output. Unfortunately, the heart can't keep up this hard work forever — and it eventually dilates and weakens.
As the heart's structure gradually changes, the symptoms of heart failure build up slowly and are not immediately obvious, leaving many patients unaware they are experiencing heart failure for months or years, until their heart is severely weak. For this reason, it is important for seniors to maintain regular checkups with their doctor to monitor their heart.
In other cases, symptoms of heart failure can occur suddenly, like after a large heart attack, which permanently damages the structure and function of the heart.
If you are experiencing symptoms of heart failure, talk with your doctor immediately. Symptoms of heart failure may include:
The American Heart Association, in collaboration with the American College of Cardiology, has identified four stages of heart failure to help seniors know where they stand in the disease process:
It is important to know where you are in these four stages in order to take a proactive approach with your doctor in preventing the progression of heart failure from occurring as you age.
Maintaining a healthy lifestyle is one of the most effective ways to prevent heart failure, according to the American College of Cardiology and the American Heart Association. The earlier you can implement lifestyle changes, the greater the chance you have of maintaining a healthy heart.
The first action everyone can take to maintain a healthy lifestyle is to stay active. Adults aged 65 and older need at least 150 minutes a week of moderate-intensity activity (like walking). Ask your doctor to discuss what activities best fit your abilities.
In addition to exercise, it's important to also follow a healthy diet to avoid heart failure. As you age, be sure your meals are giving you maximum health benefits by following these guidelines:
Every person's body reacts differently to diet and exercise, so it is important to talk with your doctor to create a fitness regimen and nutrition plan that works best for you.
Dr. Andrew Yoon serves as the medical director of heart failure at the MemorialCare Heart & Vascular Institute at Long Beach Medical Center. He is board-certified in advanced heart failure and transplant cardiology; cardiology; and internal medicine. He joined Long Beach Medical Center in 2018.
Drinking 2 Servings Of Sugary Drinks Like Soda Per Week May Harm Heart Health
A diet high in added sugar is associated with numerous health problems. And new research shows that even if you exercise it won't help in reducing the risk of developing cardiovascular issues.
According to a new study, physical activity does not cancel out the health implications of drinking sugar-sweetened beverages and cardiovascular disease risk.
The findings were published in The American Journal of Clinical Nutrition.
Researchers examined data from 100,000 adults over a 30-year period.
Results showed people who drank sugar-sweetened beverages more than twice a week had an increased risk of cardiovascular disease despite their level of physical activity. For those who consumed these beverages on a daily basis, the risk was even higher.
Even if they engaged in 150 minutes of weekly physical activity (the recommended workout quota) it didn't outweigh the harmful impact of sugar-sweetened beverage consumption.
High-sugar-based drinks can thwart the beneficial effects of exercise.
"The ultra-processed nature of these sugary beverages can cause alterations in the natural bacterial communities in your gut (microbiota), which can lead to increased build of plaque (atherosclerosis) in the major arteries of the body (i.E. Coronary arteries, cerebral arteries, etc)," said Dr. Hosam Hmoud, a cardiologist fellow at Northwell Lenox Hill Hospital, who wasn't involved in the study.
"The bacterial communities in our gut play a crucial role in either promoting or mitigating risk of major diseases such as diabetes, heart disease, and cancer," Dr. Hmoud told Medical News Today.
While exercise can decrease basal levels of inflammation in the body, sugar-sweetened beverages raise them.
"Think of exercise as a control valve on the human immune system. However, processed foods and high sugar beverages increase basal levels of inflammation which accelerates arterial plaque buildup and also increases your risk of developing cancer," Dr. Hmoud explained.
Despite the beneficial health effects of exercise, it doesn't cancel out a diet high in sugar and the damage it can cause to your body.
"Physical activity, while it is cardioprotective on its own, cannot mitigate the harmful effects of soda and other sugar-sweetened beverages on cardiovascular health," said Dr. Brooke Aggarwal, assistant professor of medical sciences in the division of cardiology at Columbia's Vagelos College of Physicians and Surgeons, who also wasn't involved in the study.
"It's possible that consuming a diet high in added sugars from soda could lead to having less energy to perform physical activity compared to a more healthful diet, although this study didn't look at that specifically," she told MNT.
Soda is high in added sugar, which can have harmful health implications.
"Soda consumption is associated with increased weight due to consumption of excess calories and sugar, tooth decay due to high sugar contents fueling bacterial growth, type 2 diabetes and cardiovascular disease," said Jacquelyn Davis, registered dietitian and clinical nutrition manager at Yale New Haven Health – Bridgeport Hospital, who wasn't involved in the study.
Excess sugar can cause hardening of the arteries, which can contribute to cardiovascular disease.
"High dietary sugar intake can lead to increased triglycerides, a type of lipid, circulating in the blood, which increases risk of cardiovascular disease by promoting hardening of the arteries over time. Excess sugar intake can overload the liver, leading to poor metabolic health," Dr. Aggarwal said.
"Excess sugar intake also promotes chronic inflammation, which puts stress on the heart and blood vessels and is a precursor to cardiovascular disease. In addition, added sugar is a source of 'empty calories' in the diet, which means that it comes with no nutritional benefit and may lead to excess body weight. In turn, overweight and obesity are major risk factors for chronic disease," she added.
Diet vs. Regular soda
"Diet soda has been shown to have similar negative effects to regular soda and should also be consumed in moderation or avoided for healthy dietary patterns."— Jacquelyn Davis, registered dietitian
It is important to note there is a difference between diet soda and regular soda.
"The evidence for the harmful health effects of regular soda is overwhelming, but the evidence for the effects of artificial sweeteners on health is less clear," said Dr. Aggarwal. "Recent studies do show associations between diet soda and increased risk for obesity, type 2 diabetes, and hypertension, but the magnitude of these associations is weaker than those for regular soda."
"Also, it's not known if people are switching to diet soda from regular because they have already noticed increased weight or other adverse health effects," Dr. Aggarwal said.
Experts recommend cutting out soda altogether.
"Whether it's diet or regular soda, you should ideally cut them out of your diet and replace them with water and unprocessed fruit juices," Dr. Hmoud stated.
As a general dietary guideline, it's best to limit added sugar consumption.
"The American Heart Association provides specific recommendations for upper limits on added sugar intake, including up to 6 teaspoons of added sugar per day for women and 9 teaspoons of added sugar for men," Dr. Aggarwal explained.
"One can of soda contains about 10 teaspoons of added sugar. Most public health organizations recommend sticking to under 12 ounces of sugar-sweetened beverages per week, which is equivalent to 1 can of soda per week."— Dr. Brooke Aggarwal
Too much added sugar can lead to chronic inflammation and obesity, which can raise the risk of developing cardiovascular disease.
Experts advise people to avoid soda completely and drink water, and coffee or tea without added sugar.
When it comes to healthy beverage choices, there are a variety of options.
"The best thing to drink is water, plain or sparkling, and flavored with fruit slices if needed," said Dr. Aggarwal. "Coffee or tea without added sugar is also fine. Smoothies made with real fruit and milk are also a great choice."
Davis recommended water infused with natural flavors (such as cucumber, lemon, etc.), herbal teas, or sparkling waters.
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