203 results found
Halliday BP, Gulati A, Ali A, et al., 2018, Sex- and age-based differences in the natural history and outcome of dilated cardiomyopathy., Eur J Heart Fail
AIM: To evaluate the relationship between sex, age and outcome in dilated cardiomyopathy (DCM). METHODS AND RESULTS: We used proportional hazard modelling to examine the association between sex, age and all-cause mortality in consecutive patients with DCM. Overall, 881 patients (290 women, median age 52 years) were followed for a median of 4.9 years. Women were more likely to present with heart failure (64.0% vs. 54.5%; P = 0.007) and had more severe symptoms (P < 0.0001) compared to men. Women had smaller left ventricular end-diastolic volume (125 mL/m2 vs. 135 mL/m2 ; P < 0.001), higher left ventricular ejection fraction (40.2% vs. 37.9%; P = 0.019) and were less likely to have mid-wall late gadolinium enhancement (23.0% vs. 38.9%; P < 0.0001). During follow-up, 149 (16.9%) patients died, including 41 (4.7%) who died suddenly. After adjustment, all-cause mortality [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41-0.92; P = 0.018] was lower in women, with similar trends for cardiovascular (HR 0.60, 95% CI 0.35-1.05; P = 0.07), non-sudden (HR 0.63, 95% CI 0.39-1.02; P = 0.06) and sudden death (HR 0.70, 95% CI 0.30-1.63; P = 0.41). All-cause mortality (per 10 years: HR 1.36, 95% CI 1.20-1.55; P < 0.0001) and non-sudden death (per 10 years: HR 1.51, 95% CI 1.26-1.82; P < 0.00001) increased with age. Cumulative incidence curves confirmed favourable outcomes, particularly in women and those <60 years. Increased all-cause mortality in patients >60 years of age was driven by non-sudden death. CONCLUSION: Women with DCM have better survival compared to men, which may partly be due to less severe left ventricular dysfunction and a smaller scar burden. There is increased mortality driven by non-sudden death in patients >60 years of age that is less ma
Krauskopf J, Caiment F, van Veldhoven K, et al., 2018, The human circulating miRNome reflects multiple organ disease risks in association with short-term exposure to traffic-related air pollution, ENVIRONMENT INTERNATIONAL, Vol: 113, Pages: 26-34, ISSN: 0160-4120
Liu S, Grigoryan H, Edmands WMB, et al., 2018, Cys34 Adductomes Differ between Patients with Chronic Lung or Heart Disease and Healthy Controls in Central London, ENVIRONMENTAL SCIENCE & TECHNOLOGY, Vol: 52, Pages: 2307-2313, ISSN: 0013-936X
Sinharay R, Gong J, Barratt B, et al., 2018, Respiratory and cardiovascular responses to walking down a traffic-polluted road compared with walking in a traffic-free area in participants aged 60 years and older with chronic lung or heart disease and age-matched healthy controls: a randomised, crossover study, LANCET, Vol: 391, Pages: 339-349, ISSN: 0140-6736
Khan TZ, Hsu L-Y, Arai AE, et al., 2017, Apheresis as novel treatment for refractory angina with raised lipoprotein(a): a randomized controlled cross-over trial, EUROPEAN HEART JOURNAL, Vol: 38, Pages: 1561-1569, ISSN: 0195-668X
Plummer C, Collins P, Rosario DJ, et al., 2017, Managing cardiovascular risk in high-risk prostate cancer, TRENDS IN UROLOGY & MENS HEALTH, Vol: 8, Pages: 13-18, ISSN: 2044-3730
Webb CM, Collins P, 2017, Role of testosterone in the treatment of cardiovascular disease, European Cardiology Review, Vol: 12, Pages: 83-87, ISSN: 1758-3756
© Radcliffe Cardiology 2017. Cardiovascular disease (CVD) is the most prevalent non-communicable cause of death worldwide. Testosterone is a sex hormone that is predominant in males but also occurs in lower concentrations in females. It has effects directly on the blood vessels of the cardiovascular system and on the heart, as well as effects on risk factors for CVD. Serum testosterone concentrations are known to decrease with age and reduced testosterone levels are linked to premature coronary artery disease, unfavourable effects on CVD risk factors and increased risk of cardiovascular mortality independent of age. A significant number of men with heart failure demonstrate reduced serum testosterone concentrations and there is early evidence suggesting that low testosterone levels affect cardiac repolarisation. Any association between endogenous testosterone concentrations and CVD in women has yet to be established. Testosterone replacement is used to treat men with hypogonadism but also has cardiovascular effects. This review will present the current evidence, expert opinion and controversies around the role of testosterone in the pathophysiology of CVD and surrounding the use of testosterone treatment and its effects on the cardiovascular system and CVD.
Collins P, Webb CM, de Villiers TJ, et al., 2016, Cardiovascular risk assessment in women - an update, CLIMACTERIC, Vol: 19, Pages: 329-336, ISSN: 1369-7137
Kotecha D, Altman DG, Collins PD, et al., 2016, Authors' reply to Cunningham and Messerli and colleagues., BMJ, Vol: 353
Kotecha D, Manzano L, Krum H, et al., 2016, Effect of age and sex on efficacy and tolerability of beta blockers in patients with heart failure with reduced ejection fraction: individual patient data meta-analysis, BMJ-BRITISH MEDICAL JOURNAL, Vol: 353, ISSN: 1756-1833
Webb CM, Collins P, 2016, Coronary heart disease in women
Dr Carolyn Webb and Professor Peter Collins highlight common presenting symptoms in women with coronary heart disease (CHD) and reflects on the need to take a careful gynaecological history. Key learning points for healthcare professionals include the influence of female-specific factors on the development of CHD, and conditions that raise cardiovascular risk including polycystic ovary syndrome.
Webb CM, Collins P, 2016, Syndrome X: How should it be investigated and treated?, Dialogues in Cardiovascular Medicine, Vol: 21, Pages: 191-195, ISSN: 1272-9949
© 2016, AICH - Servier Research Group. All rights reserved. Syndrome X describes patients with angina, a positive exercise test for myocardial ischemia, and smooth epicardial coronary arteries on arteriography. Patients with syndrome X are predominantly female, with a peak incidence of presentation around 50 years of age, and they have very troublesome, disabling, and persistent symptoms that are frequently not amenable to treatment with standard antianginal medications alone. As coronary arteriography is indicated by an abnormal noninvasive test, many groups have sought to identify evidence of myocardial ischemia resulting from coronary microvascular abnormalities. However, this condition remains an enigma with regard to pathophysiology, diagnosis, and management of syndrome X. Using current evidence, we will provide guidance on the investigation and management of patients with cardiac syndrome X.
Webb CM, Rosano GMC, Kaski JC, et al., 2016, Twenty-five year follow-up of patients with chest pain and smooth, unobstructed epicardial coronary arteries, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 802-802, ISSN: 0195-668X
de Silva R, Tsujioka H, Gaze D, et al., 2015, Serial Changes in High-Sensitivity Cardiac Troponin, N-terminal Pro-B-Type Natriuretic Peptide, and Heart Fatty Acid Binding Protein during Exercise Echocardiography in Patients with Suspected Angina Pectoris and Normal Resting Left Ventricular Function, CLINICAL CHEMISTRY, Vol: 61, Pages: 554-556, ISSN: 0009-9147
Kotecha D, Jenkins E, Flather MD, et al., 2014, Long-term predictors of death and incident myocardial infarction in cardiology patients assessed for coronary artery disease, Annual Meeting of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 819-819, ISSN: 0195-668X
Niespialowska-Steuden M, Christopoulos C, Okafor O, et al., 2014, COMPARISON OF GLOBAL THROMBOTIC STATUS IN AF AND CORONARY DISEASE, HEART, Vol: 100, Pages: A15-A15, ISSN: 1355-6037
Niespialowska-Steuden M, Christopoulos C, Okafor O, et al., 2014, CHARACTERISATION OF DIFFERING IN VITRO THROMBOTIC PROFILES IN AF AND CORONARY DISEASE: ROLE OF ENDOGENOUS THROMBOLYSIS, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 63, Pages: A467-A467, ISSN: 0735-1097
Niespialowska-Steuden M, Collins P, Costopoulos C, et al., 2014, NOAC in acute coronary syndrome and AF?, Cardiovasc Hematol Disord Drug Targets, Vol: 14, Pages: 154-164
Cardiovascular disease remains a major cause of morbidity and mortality in developed countries. New treatments, in the form of novel oral anticoagulants (NOAC) that reduce thrombotic risk are now available for patients with atrial fibrillation (AF) or acute coronary syndrome (ACS). Warfarin has been the cornerstone of thromboprophylaxis in patients with AF, but treatment is cumbersome, inconvenient and often unreliable, with fluctuating time in therapeutic range. Thrombotic events also continue to occur in a significant number of ACS patients despite antiplatelet therapy. Thus there is an unfilled need to reduce thrombotic events in ACS and AF patients. NOAC comprise direct factor Xa inhibitors (apixaban, rivaroxaban, darexaban, edoxaban), direct thrombin inhibitors (dabigatran) and PAR-1 antagonists (vorapaxar, atopaxar). In this review, we compare and contrast NOACs and review their individual and specific clinical trial database in ACS and AF. In the setting of ACS, the role of NOAC is unclear, as any reduction in ischemic events appears to be offset by hemorrhagic risk. However, NOAC have a definite place in the treatment of patients with non-valvular AF, where they are at least as effective, if not superior to warfarin.
Daniels LB, Grady D, Mosca L, et al., 2013, Is Diabetes Mellitus a Heart Disease Equivalent in Women? Results From an International Study of Postmenopausal Women in the Raloxifene Use for the Heart (RUTH) Trial, CIRCULATION-CARDIOVASCULAR QUALITY AND OUTCOMES, Vol: 6, Pages: 164-+, ISSN: 1941-7705
Kotecha D, New G, Collins P, et al., 2013, Radial artery pulse wave analysis for non-invasive assessment of coronary artery disease, INTERNATIONAL JOURNAL OF CARDIOLOGY, Vol: 167, Pages: 917-924, ISSN: 0167-5273
Asbury EA, Webb CM, Probert H, et al., 2012, Cardiac Rehabilitation to Improve Physical Functioning in Refractory Angina: A Pilot Study, CARDIOLOGY, Vol: 122, Pages: 170-177, ISSN: 0008-6312
Asbury EA, Webb CM, Probert H, et al., 2012, Exercise Training for Refractory Angina: Improving the Coronary Collateral Circulation Reply, CARDIOLOGY, Vol: 123, Pages: 80-80, ISSN: 0008-6312
Hodis HN, Collins P, Mack WJ, et al., 2012, The timing hypothesis for coronary heart disease prevention with hormone therapy: past, present and future in perspective, CLIMACTERIC, Vol: 15, Pages: 217-228, ISSN: 1369-7137
Kotecha D, Flather M, New G, et al., 2012, B-type natriuretic peptide and central haemodynamics: association with angiographic coronary disease and adverse cardiovascular outcomes, Congress of the European-Society-of-Cardiology (ESC), Publisher: OXFORD UNIV PRESS, Pages: 1010-1011, ISSN: 0195-668X
Webb CM, Collins P, 2012, Hormonal changes in cardiac syndrome X - Role of testosterone, Chest Pain with Normal Coronary Arteries: A Multidisciplinary Approach, Pages: 303-307, ISBN: 9781447148388
© Springer-Verlag London 2013. All rights are reserved. Cardiac Syndrome X occurs predominately in peri- or post-menopausal women. The onset of the chest pain associated with Cardiac Syndrome X coincides with the menopause or hysterectomy and the related decrease in circulating ovarian hormones. As well as estrogens and progestogens, testosterone is synthesized in the ovaries and adrenal glands of women, and has important physiological actions in women, either directly via androgen receptors or as precursors of estrogen production. Testosterone replacement can be given to menopausal women, with or without estrogen, to increase libido, relieve menopausal symptoms, increase bone density and improve quality of life. As well as chest pain, common symptoms of Cardiac Syndrome X include tiredness and lethargy, and it is feasible that reduced androgen concentrations may be involved in the pathophysiology of the syndrome. Relatively few studies have investigated the effects of testosterone replacement in women, and even fewer in women with Cardiac Syndrome X. Further studies are needed to better understand the role of testosterone in the pathophysiology and treatment of Cardiac Syndrome X.
Asbury E, Webb C, Probert H, et al., 2011, Cardiac Rehabilitation Improves Physical Functioning in Refractory Angina, CIRCULATION, Vol: 124, ISSN: 0009-7322
Asbury EA, Webb CM, Collins P, 2011, Group support to improve psychosocial well-being and primary-care demands among women with cardiac syndrome X, CLIMACTERIC, Vol: 14, Pages: 100-104, ISSN: 1369-7137
Collins P, Vitale C, Spoletini I, et al., 2011, Gender Differences in the Clinical Presentation of Heart Disease, CURRENT PHARMACEUTICAL DESIGN, Vol: 17, Pages: 1056-1058, ISSN: 1381-6128
Webb CM, Collins P, Moat NE, et al., 2011, Response to Letters Regarding Article, "Vascular Reactivity and Flow Characteristics of Radial Artery and Long Saphenous Vein Coronary Bypass Grafts: A 5-Year Follow-Up", CIRCULATION, Vol: 123, Pages: E414-E414, ISSN: 0009-7322
Iellamo F, Volterrani M, Caminiti G, et al., 2010, Testosterone Therapy in Women With Chronic Heart Failure A Pilot Double-Blind, Randomized, Placebo-Controlled Study, JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, Vol: 56, Pages: 1310-1316, ISSN: 0735-1097
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