-
1.
Long-term alcohol and caffeine intake and risk of sudden cardiac death in women.
Bertoia, ML, Triche, EW, Michaud, DS, Baylin, A, Hogan, JW, Neuhouser, ML, Freiberg, MS, Allison, MA, Safford, MM, Li, W, et al
The American journal of clinical nutrition. 2013;(6):1356-63
-
-
Free full text
-
Abstract
BACKGROUND Alcohol and caffeine intakes may play a role in the development of sudden cardiac death (SCD) because of their effects on cholesterol, blood pressure, heart rate variability, and inflammation. OBJECTIVE Our objective was to examine the association between long-term alcohol and caffeine intakes and risk of SCD in women. DESIGN We examined 93,676 postmenopausal women who participated in the Women's Health Initiative Observational Study. Women were enrolled between 1993 and 1998 and were followed until August 2009. Women completed a food-frequency questionnaire at baseline and again at year 3. We modeled exposure to alcohol 3 ways: by using baseline intake only, a cumulative average of baseline and year 3 intake, and the most recent reported intake (a simple time-varying analysis). RESULTS Intake of 5-15 g alcohol/d (about one drink) was associated with a nonsignificantly reduced risk of SCD compared with 0.1-5 g/d of baseline intake (HR: 0.64; 95% CI: 0.40, 1.02), of cumulative average intake (HR: 0.69; 95% CI: 0.43, 1.11), and of most recent intake (HR: 0.58; 95% CI: 0.35, 0.96), with adjustment for age, race, income, smoking, body mass index, physical activity, hormone use, and total energy. No association was found between SCD and total caffeine intake (mg/d) or cups of caffeinated coffee, decaffeinated coffee, and caffeinated tea. CONCLUSIONS Our results suggest that about one drink per day (or 5.1-15 g/d) may be associated with a reduced risk of SCD in this population; however, this association was only statistically significant for a model using the most recent alcohol intake. Total caffeine, regular coffee, decaffeinated coffee, and regular tea intake were not associated with the risk of SCD. This trial was registered at clinicaltrials.gov as NCT00000611.
-
2.
Oral nicorandil to reduce cardiac death after coronary revascularization in hemodialysis patients: a randomized trial.
Nishimura, M, Tokoro, T, Nishida, M, Hashimoto, T, Kobayashi, H, Imai, R, Yamazaki, S, Okino, K, Iwamoto, N, Takahashi, H, et al
American journal of kidney diseases : the official journal of the National Kidney Foundation. 2009;(2):307-17
Abstract
BACKGROUND Survival after invasive coronary revascularization is worse in patients with chronic kidney disease than in patients without chronic kidney disease. We examined whether oral administration of nicorandil, a hybrid nitrate and adenosine triphosphate-sensitive potassium channel opener, could improve outcome after coronary revascularization in hemodialysis patients. STUDY DESIGN Open-labeled prospective randomized trial. SETTING & PARTICIPANTS Maintenance hemodialysis patients who underwent percutaneous coronary artery intervention and had complete coronary revascularization (absence of both restenosis and de novo coronary lesion) at coronary arteriography 6 months later. Enrollment occurred between January 1, 2002, and December 31, 2004. INTERVENTIONS Treatment with or without oral administration of nicorandil, 15 mg/d. OUTCOMES & MEASUREMENTS The primary end point was cardiac death (sudden cardiac death or death from acute myocardial infarction or congestive heart failure). The secondary end point was all-cause death. End-point adjudication was performed masked to the intervention. RESULTS 129 patients (91 men, 38 women) with a mean age of 66 +/- 9 (SD) years. During a 2.7 +/- 1.5-year follow-up, 26 died of cardiac events (acute myocardial infarction, 6; congestive heart failure, 5; sudden cardiac death, 15), and 12 died of noncardiac causes. Cardiac death-free survival rates were greater in the nicorandil group than in the control group (P = 0.009; at 3 years, 86.6% in the nicorandil group and 70.7% in the control group). All-cause death-free survival rates were also greater in the nicorandil group than in the control group (P = 0.01; at 3 years, 79.2% in the nicorandil group versus 60.5% in the control group). Additional percutaneous coronary artery intervention was performed in 6 participants in the nicorandil group and 2 participants in the control group. No serious side effects of nicorandil were reported during the course of the study. LIMITATIONS Small sample size and open-label design. CONCLUSIONS Oral administration of nicorandil may reduce cardiac death and improve the survival of hemodialysis patients after coronary revascularization.
-
3.
Kidney dysfunction and sudden cardiac death among women with coronary heart disease.
Deo, R, Lin, F, Vittinghoff, E, Tseng, ZH, Hulley, SB, Shlipak, MG
Hypertension (Dallas, Tex. : 1979). 2008;(6):1578-82
Abstract
We evaluated the association between kidney dysfunction and sudden cardiac death risk among ambulatory women with coronary heart disease. The Heart and Estrogen Replacement Study evaluated the effects of hormone treatment on cardiovascular events among 2763 postmenopausal women with coronary heart disease. Kidney dysfunction was categorized by estimated glomerular filtration rate (eGFR) using the Modification of Diet in Renal Disease equation. Multivariate proportional hazards models were used to adjust for cardiovascular risk factors, congestive heart failure, and myocardial infarction. At baseline, 37% (n=1027) had an eGFR of >60 mL/min, 54% (n=1503) had an eGFR of 40 to 60 mL/min, and 8% (n=230) had an eGFR of <40 mL/min. During the 6.8-year follow-up period, there were 136 adjudicated sudden cardiac deaths. The rate of sudden cardiac death was higher in those with lower kidney function (0.5% per year among those with an eGFR >60; 0.6% per year with an eGFR between 40 and 60; and 1.7% per year with an eGFR <40 mL/min; P for trend <0.001). After multivariate analysis with baseline risk factors, eGFR at 40 to 60 mL/min was not a significant predictor, but eGFR at <40 mL/min remained strongly associated with sudden cardiac death (hazard ratio: 3.2; 95% CI: 1.9 to 5.3); adjustment for incident congestive heart failure and myocardial infarction during follow-up diminished this association (hazard ratio: 2.3; 95% CI: 1.3 to 3.9), suggesting that congestive heart failure and myocardial infarction mediated only part of the association between kidney dysfunction and sudden cardiac death. Advanced kidney dysfunction is an independent predictor of sudden cardiac death among women with coronary heart disease.
-
4.
Atorvastatin therapy may reduce the incidence of sudden cardiac death in patients with advanced chronic heart failure.
Vrtovec, B, Okrajsek, R, Golicnik, A, Ferjan, M, Starc, V, Schlegel, TT, Radovancevic, B
Journal of cardiac failure. 2008;(2):140-4
Abstract
BACKGROUND In retrospective studies, statin therapy has been related to decreased incidence of sudden cardiac death (SCD) in heart failure. We sought to prospectively investigate a relation between atorvastatin therapy and SCD in patients with advanced chronic heart failure. METHODS AND RESULTS We enrolled 110 patients with heart failure with a left ventricular ejection fraction less than 30% and cholesterol level greater than 150 mg/dL. Fifty-five patients were randomized to atorvastatin (10 mg/day) (statin group); the remaining 55 patients received no statins (controls). Patients were followed for 1 year. At baseline, the two groups did not differ in age, sex, left ventricular ejection fraction, cholesterol, B-type natriuretic peptide, heart rate variability, or QT variability. During follow-up, 29 patients died (26%) and 2 patients (2%) underwent heart transplantation. Of the 29 deaths, 13 were attributed to pump failure, 15 were attributed to SCD, and 1 was attributed to noncardiac causes. All-cause mortality was lower in the statin group (9/55, 16%) than in controls (20/55, 36%) (P = .017). The same was true of the SCD rate (3/55 [5%] vs. 12/55 [22%], P = .012), but not of the pump failure (5/55 [9%] vs. 8/55 [15%], P = .38). SCD-free survival was 2.3-times higher in the statin group than in controls (P = .01). CONCLUSIONS Atorvastatin therapy seems to be associated with decreased incidence of SCD in patients with advanced chronic heart failure. Larger studies are ongoing to confirm this hypothesis.
-
5.
Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial.
Bolland, MJ, Barber, PA, Doughty, RN, Mason, B, Horne, A, Ames, R, Gamble, GD, Grey, A, Reid, IR
BMJ (Clinical research ed.). 2008;(7638):262-6
-
-
Free full text
-
Abstract
OBJECTIVE To determine the effect of calcium supplementation on myocardial infarction, stroke, and sudden death in healthy postmenopausal women. DESIGN Randomised, placebo controlled trial. SETTING Academic medical centre in an urban setting in New Zealand. PARTICIPANTS 1471 postmenopausal women (mean age 74): 732 were randomised to calcium supplementation and 739 to placebo. MAIN OUTCOME MEASURES Adverse cardiovascular events over five years: death, sudden death, myocardial infarction, angina, other chest pain, stroke, transient ischaemic attack, and a composite end point of myocardial infarction, stroke, or sudden death. RESULTS Myocardial infarction was more commonly reported in the calcium group than in the placebo group (45 events in 31 women v 19 events in 14 women, P=0.01). The composite end point of myocardial infarction, stroke, or sudden death was also more common in the calcium group (101 events in 69 women v 54 events in 42 women, P=0.008). After adjudication myocardial infarction remained more common in the calcium group (24 events in 21 women v 10 events in 10 women, relative risk 2.12, 95% confidence interval 1.01 to 4.47). For the composite end point 61 events were verified in 51 women in the calcium group and 36 events in 35 women in the placebo group (relative risk 1.47, 0.97 to 2.23). When unreported events were added from the national database of hospital admissions in New Zealand the relative risk of myocardial infarction was 1.49 (0.86 to 2.57) and that of the composite end point was 1.21 (0.84 to 1.74). The respective rate ratios were 1.67 (95% confidence intervals 0.98 to 2.87) and 1.43 (1.01 to 2.04); event rates: placebo 16.3/1000 person years, calcium 23.3/1000 person years. For stroke (including unreported events) the relative risk was 1.37 (0.83 to 2.28) and the rate ratio was 1.45 (0.88 to 2.49). CONCLUSION Calcium supplementation in healthy postmenopausal women is associated with upward trends in cardiovascular event rates. This potentially detrimental effect should be balanced against the likely benefits of calcium on bone. TRIAL REGISTRATION Australian Clinical Trials Registry ACTRN 012605000242628.
-
6.
[Use of allicor to lower the risk of myocardial infarction].
Sobenin, IA, Prianishnikov, VV, Kunnova, LM, Rabinovich, EA, Orekhov, AN
Klinicheskaia meditsina. 2007;(3):25-8
Abstract
The aim of the study was to investigate the effects of allicor (a long-action garlic-based preparation) on the risk of acute myocardial infarction (MI) and sudden death (SD) in patients with coronary artery disease (CAD). Fifty one CAD patients were included in this double-blind placebo-controlled study. The prognostic risk of MI and SD during ten following years was counted using Cox proportional hazards model based on the results of Munster study. Allicor administered for 12 months was demonstrated to reduce absolute ten-year risk of acute MI and SD 1.5 times in men and 1.3 times in women. The reduction in calculated risk parameters was associated with changes in blood plasma lipid profile, the most significant of which was reduction in the level of low density lipoprotein cholesterol (p < 0.05) by 32.9 mg/dl in men and 27.3 mg/dl in women. The results of this study demonstrate that allicor is effective for the reduction of multifactor MI and SD risk as a means of secondary CAD prophylaxis.
-
7.
[Reduction of cardiovascular risk in primary prophylaxy of coronary heart disease].
Sobenin, IA, Prianishnikov, VV, Kunnova, LM, Radinovich, EA, Orekhov, AN
Klinicheskaia meditsina. 2005;(4):52-5
Abstract
The purpose of the study was to evaluate the effects of Allicor, an Allium sativum (garlic) preparation with prolonged activity, on 10-year prognostic risk of coronary heart disease (CHD), acute myocardial infarction (MI) and sudden death in patients with elevated and high risk of CHD. 79 patients with elevated and high risk of CHD were included in a double blind randomized placebo-controlled study. They underwent multifactor evaluation of cardiovascular risk by algorithms based on the results of Framingham and Munster studies. Prolonged (12 months) administration of Allicor significantly reduced the multifactor risk, which was demonstrated by a 13.2% (p = 0.005) reduction of prognostic 10-year risk of CHD in men, and a 7.1% (p = 0.040) reduction of the same parameter in women. Prognostic 10-year risk of MI and sudden death in men was reduced by 26.1% (p = 0.025) and did not change significantly in women. In men the main factor of cardiovascular risk reduction was the decrease of cholesterol and low-density lipoprotein concentration by 23.5 +/- 6.6 mg/dl (p = 0.004), and in women - the increase of high-density lipoprotein level by 2.8 +/- 1.5 mg/dl (p = 0.040). The results of the study demonstrate that prolonged Allicor therapy can be applied to the large category of patients who are in need of atherosclerosis prevention.
-
8.
Neuroprotection becomes reality: changing times for cerebral resuscitation.
Damian, MS
Advances in experimental medicine and biology. 2004;:143-50
-
9.
Impact of sodium-hydrogen exchange inhibition by cariporide on death or myocardial infarction in high-risk CABG surgery patients: results of the CABG surgery cohort of the GUARDIAN study.
Boyce, SW, Bartels, C, Bolli, R, Chaitman, B, Chen, JC, Chi, E, Jessel, A, Kereiakes, D, Knight, J, Thulin, L, et al
The Journal of thoracic and cardiovascular surgery. 2003;(2):420-7
-
-
Free full text
-
Abstract
OBJECTIVES To evaluate the effects of cariporide on all-cause mortality or myocardial infarction at 36 days in patients at risk of myocardial necrosis after coronary artery bypass graft surgery. METHODS In the coronary artery bypass graft cohort of the GUARD During Ischemia Against Necrosis trial, patients > or =18 years who required urgent coronary artery bypass graft, repeat coronary artery bypass graft, or had a history of unstable angina and > or =2 risk factors (age >65 years, female gender, diabetes mellitus, ejection fraction <35%, or left main or 3-vessel disease) were randomized to placebo (n = 743) or cariporide 20 mg (n = 736), 80 mg (n = 705), or 120 mg (n = 734). A 1-hour intravenous infusion was initiated shortly before surgery and administered every 8 hours for 2 to 7 days. Patients were followed up for 6 months. A nonparametric covariance analysis was used to calculate the primary efficacy endpoint. RESULTS Baseline characteristics were similar between treatment groups. The cariporide 20- and 80-mg groups had event rates similar to placebo. The endpoint of all-cause mortality or myocardial infarction at day 36 was significant with cariporide 120 mg versus placebo (event rate 12.2% vs 16.2%; P =.027). The risk reduction was evident on postoperative day 1 (3.3% vs 6.5%; P =.005) and was maintained at 6 months (event rate 15.0% vs 18.6%; P =.033). Cariporide was well tolerated, and most adverse events were mild and transient in this high-risk population. CONCLUSIONS Clinical benefit with cariporide 120 mg was observed early after treatment initiation and continued for 6 months postsurgery, suggesting that sodium-hydrogen exchange inhibition with cariporide is cardioprotective in patients undergoing high-risk coronary artery bypass graft surgery.
-
10.
Prospective study of C-reactive protein, homocysteine, and plasma lipid levels as predictors of sudden cardiac death.
Albert, CM, Ma, J, Rifai, N, Stampfer, MJ, Ridker, PM
Circulation. 2002;(22):2595-9
Abstract
BACKGROUND Sudden cardiac death (SCD) is an important cause of mortality even among apparently healthy populations. However, our ability to identify those at risk for SCD in the general population is poor, and more specific markers are needed. METHODS AND RESULTS To compare and contrast the relative importance of C-reactive protein (CRP), homocysteine, and lipids as long-term predictors of SCD, we performed a prospective, nested, case-control analysis involving 97 cases of SCD among apparently healthy men enrolled in the Physician's Health Study. Of these plasma markers measured, only baseline CRP levels were significantly associated with the risk of SCD over the ensuing 17 years of follow-up (P for trend=0.001). The increase in risk associated with CRP levels was primarily seen among men in the highest quartile, who were at a 2.78-fold increased risk of SCD (95% CI 1.35 to 5.72) compared with men in the lowest quartile. These results were not significantly altered in analyses that (in addition to the matching variables of age and smoking status) controlled for lipid parameters, homocysteine, and multiple cardiac risk factors (relative risk for highest versus lowest quartile 2.65, 95% CI 0.79 to 8.83; P for trend=0.03). In contrast to the positive relationship observed for CRP, neither homocysteine nor lipid levels were significantly associated with risk of SCD. CONCLUSIONS These prospective data suggest that CRP levels may be useful in identifying apparently healthy men who are at an increased long-term risk of SCD.