Old myocardial infarction

THURSDAY, Nov. 7, 2024 -- Elevated baseline resting heart rate (RHR) is associated with an increased risk for incident atrial fibrillation (AF) in Black adults, according to a study published online Oct. 30 in JAMA Network Open . Vidhushei Yogeswaran, M.D., from the University of Washington in Seattle, and colleagues evaluated the association between RHR and incident AF in a large community-based sample of Black adults. The analysis included 4,965 participants in the Jackson Heart Study (2000 through 2016). The researchers found that during a median 14 years of follow-up, there were 458 incident AF events, yielding an incident rate of 7.5 per 1,000 person-years. For each 10 beats per minute higher RHR, there was a higher risk for incident AF when adjusting for AF risk factors (hazard ratio, 1.09; 95 percent confidence interval, 1.00 to 1.19). When excluding individuals with prior heart failure, prior myocardial infarction, and antiarrhythmic medication use at baseline, the risk was even higher (hazard ratio, 1.14; 95 percent confidence interval, 1.02 to 1.28). Age, sex, body mass index, hypertension, and physical activity level did little to modify the effect. "Additional research is needed to determine whether RHR can improve the selection of individuals for AF screening, which may help to mitigate long-standing health disparities," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

THURSDAY, Aug. 22, 2024 -- A study published online Aug. 21 in the Journal of the American Heart Association reveals the major contributors to heart failure risk in American Indians, highlighting the roles of age, smoking, and diabetes. Irene Martinez-Morata, M.D., M.P.H., from the Columbia University Mailman School of Public Health in New York City, and colleagues developed a parsimonious heart failure risk prediction equation that accounts for relevant risk factors affecting American Indian communities using data from 3,059 participants from the Strong Heart Study (507 of whom developed heart failure). Risk factors for heart failure and heart failure subtypes were identified using progressively adjusted Cox proportional hazards models. The researchers found that at five and 10 years, predictors of risk included older age (hazard ratios, 1.79 and 1.68, respectively), smoking (hazard ratios, 2.26 and 2.08, respectively), macroalbuminuria (hazard ratios, 8.38 and 5.20, respectively), microalbuminuria (hazard ratios, 2.72 and 1.92, respectively), and previous myocardial infarction (hazard ratios, 6.58 and 3.87, respectively). At 10 and 28 years, these predictors were significant, together with diabetes diagnosis and glycated hemoglobin. At five, 10, and up to 28 years of follow-up, high discrimination performance was achieved (C-index, 0.81, 0.78, and 0.77, respectively). There was variation observed in some associations across heart failure subtypes, but associations for diabetes, albuminuria, and previous myocardial infarction were consistent across subtypes. "Our proposed model may serve as a relevant tool for early risk detection and prevention of heart failure in American Indian communities and other populations with a high burden of diabetes," the authors write. Abstract/Full Text Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

Researchers found that patients with persistently high levels of urinary albumin excretion in the long term are at high risk of new-onset heart failure. Preventive treatment associated with the lowering of urinary albumin excretion levels in these patients could reduce the risk of later heart failure or mortality. They say that an ounce of prevention is worth a pound of cure; knowing which preventive treatment to administer to which patient could undoubtedly up that yield. Now, an international research team led by Osaka University has identified an important treatment target that could help prevent patients from developing a serious heart condition in the future. In a study published last month in the European Journal of Heart Failure, the research team reported the identification of long-term patterns in levels of kidney health indicators in healthy European adults, and the impact of these patterns on the risk of new-onset heart failure. One in five people will develop HF in their lifetime, and impaired kidneys are one of the most critical risk factors for developing this condition. Because of this connection, it is common practice to monitor markers of kidney health in patients who are at risk of developing heart failure. "Day-to-day or short-term fluctuations in renal biomarkers are well-known," says lead author of the study Dr.Ryoto Sakaniwa. "However, the connection between long-term patterns in biomarker levels and the risk of heart failure is unknown." To address this, the researchers looked at levels of two common markers of kidney health -- urinary albumin excretion (UAE) and serum creatinine -- in almost 7000 patients from the Dutch study Prevention of Renal and Vascular End-stage Diseases (PREVEND). Patterns in UAE and serum creatinine levels were tracked over 11 years and investigated for their association with new-onset heart failure and death. "The results were very clear," explains Dr. Jasper Tromp, senior author. "While most participants had stable low UAE or serum creatinine, those with persistently high UAE had a statistically higher risk of new-onset heart failure or all-cause mortality. Interestingly, annual levels of renal biomarkers were remarkably stable year to year across the 11 years of follow up" Stable serum creatinine levels over time were associated with heart failure, but not with a higher risk of death. More detailed analysis showed that patients with persistently higher UAE or serum creatinine levels were more likely to be older and male, and to have conditions such as diabetes, previous heart attack, or dyslipidemia. "Our results highlight the importance of the heart-kidney link in heart failure by showing that patients with persistently worse renal function, as indicated by higher UAE or serum creatinine levels, are at a higher risk of heart failure or mortality," says Sakaniwa. "Reducing these renal biomarkers could help prevent heart failure." The findings from this study suggest that reducing UAE could help lower the risk of future heart failure and death in these patients. Given that one in five men and women will develop heart failure during their lifetime, these findings could have an important impact on preventive medicine and should be confirmed in non-European populations.