subject:(primary myocardial disease)

University of Melbourne

1. NGIAN, GENE-SIEW. Cardiovascular disease in systemic sclerosis: an emerging association?.

Degree: 2013, University of Melbourne

► Systemic sclerosis (SSc) is a multiorgan connective tissue disease in which vasculopathy features prominently. Whilst microvascular disease occurs universally, it is not yet established whether… (more)

▼ Systemic sclerosis (SSc) is a multiorgan connective tissue disease in which vasculopathy features prominently. Whilst microvascular disease occurs universally, it is not yet established whether the prevalence of macrovascular disease is increased. This thesis addresses several aspects of cardiovascular disease in SSc. In the first study, survival and predictors of mortality were examined in a nation-wide Australian cohort of patients with connective tissue disease-associated pulmonary arterial hypertension (PAH). Three-year survival was found to be 73% and an independent survival benefit was observed with both anti-coagulation with warfarin and combination pulmonary vasodilator therapy. In the second study, a cross-sectional analysis of the prevalence of coronary heart disease (CHD) in a nation-wide Australian cohort of patients with SSc was performed. CHD was found to be more prevalent than in controls drawn from two contemporaneous population-based studies, with a fully adjusted odds ratio of 3.2 (95% CI 2.3 to 4.5) for CHD in SSc patients compared with controls. The metabolic conditions hypercholesterolaemia, diabetes mellitus and obesity, however, were all less prevalent in SSc patients than in controls. Furthermore, within the SSc cohort CHD was independently associated with PAH. In the third study, a cross-sectional analysis of arterial stiffness in SSc patients with comparison to age- and sex-matched controls was performed. Augmentation index (AIx) was higher in SSc patients than in controls (31.0% [IQR 25.7 – 38.7] vs 23.8% [IQR 13.5 – 30.1], p < 0.001), but pulse wave velocity was not. Within the SSc cohort higher AIx was associated with calcium channel blocker (CCB) use, a paradoxical finding that could reflect the impact of microvascular disease in these patients given that CCBs are first-line therapy for Raynaud’s phenomenon. Finally, a study of primary myocardial disease using tissue Doppler imaging and the serum biomarkers high-sensitivity troponin T (hsTnT) and N-terminal pro-brain natriuretic peptide (NT-proBNP) was undertaken in SSc patients free from CHD or reduced left ventricular (LV) ejection fraction. NT-proBNP, but not hsTnT, was found to be higher in SSc patients with systolic dysfunction defined as LV long-axis or right ventricular long- or short-axis systolic dysfunction. hsTnT was independently associated with LV mass index, LV long-axis systolic dysfunction and lack of anti-centromere antibody; whilst NT-proBNP was independently associated with E/e`, a marker of left atrial pressure. The studies described in this thesis contribute to the growing body of data suggesting that the prevalence of macrovascular disease is increased in SSc. Uncertainty remains, however, as to the exact nature of CHD in SSc, and as to the relationship between microvascular disease and macrovascular disease. These issues, as well as the relationship of CHD with primary myocardial disease and PAH in SSc warrant further…

Subjects/Keywords: systemic sclerosis; cardiovascular disease; atherosclerosis; coronary artery disease; arterial stiffness; pulmonary hypertension; primary myocardial disease

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APA (6^th Edition):

NGIAN, G. (2013). Cardiovascular disease in systemic sclerosis: an emerging association?. (Doctoral Dissertation). University of Melbourne. Retrieved from http://hdl.handle.net/11343/38624

Chicago Manual of Style (16^th Edition):

NGIAN, GENE-SIEW. “Cardiovascular disease in systemic sclerosis: an emerging association?.” 2013. Doctoral Dissertation, University of Melbourne. Accessed April 18, 2021. http://hdl.handle.net/11343/38624.

MLA Handbook (7^th Edition):

NGIAN, GENE-SIEW. “Cardiovascular disease in systemic sclerosis: an emerging association?.” 2013. Web. 18 Apr 2021.

Vancouver:

NGIAN G. Cardiovascular disease in systemic sclerosis: an emerging association?. [Internet] [Doctoral dissertation]. University of Melbourne; 2013. [cited 2021 Apr 18]. Available from: http://hdl.handle.net/11343/38624.

Council of Science Editors:

NGIAN G. Cardiovascular disease in systemic sclerosis: an emerging association?. [Doctoral Dissertation]. University of Melbourne; 2013. Available from: http://hdl.handle.net/11343/38624

UCLA

2. Richards, Adam Kimball. Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment.

Degree: Health Services, 2013, UCLA

URL: http://www.escholarship.org/uc/item/5js6x36k

► Cardiovascular disease (CVD) risk is negatively associated with socioeconomic status (SES) independent of traditional CVD risk factors but clinicians lack the tools to incorporate this… (more)

▼ Cardiovascular disease (CVD) risk is negatively associated with socioeconomic status (SES) independent of traditional CVD risk factors but clinicians lack the tools to incorporate this SES gradient into their calculation of CVD risk; and policymakers infrequently evaluate the impact of CVD interventions on summary measures of health inequity. Current CVD risk calculators in the United States under-estimate CVD risk among low SES populations and may exacerbate SES inequity in CVD outcomes. The goals of this dissertation were to develop and evaluate a clinically practical equation that improves CVD risk prediction among middle age low SES groups, and to estimate the potential impact of using the equation on the income-related inequity in CVD in a community-based middle-age cohort.Primary analyses were conducted 12,218 participants in the Atherosclerosis Risk in Communities (ARIC) who were free vascular disease and diabetes at baseline and followed for up to 22 years. Geocoded observations were linked to a neighborhood deprivation index calculated from six census tract-level variables of the U.S. Census. Cox proportional hazards and competing risk regression models were used to predict 10 and 20 year risk of coronary heart disease or ischemic stroke (CVD), respectively. Applying methods recommended by the American Heart Association for the evaluation of novel CVD risk factors, the dissertation demonstrates that the addition of an SES-5 variable comprised of education and neighborhood SES is associated with CVD, predicts development of future outcomes, adds incremental value to established risk factors and has demonstrated clinical utility by changing predicted risk sufficiently to modify treatment decisions, in a middle-age cohort free of CVD at baseline in the late 1980s.The analyses also demonstrate how the Framingham risk function systematically under-estimates the socioeconomic gradient in CVD at 10 and 20 years, for multiple CVD outcomes; and that inclusion of an SES-5 variable attenuates this bias. We report results specific to low SES participants with low income or educational attainment, and demonstrate that the SES-5 variable improves reclassification to a greater extent in this low SES group than in the cohort as a whole. We further demonstrated that additional improvement in net reclassification is possible when single risk equations are replaced by a hybrid approach that uses the higher of two predicted risks to classify individuals into treatment categories. The individuals reclassified into higher risk categories experience elevated risk of CVD, and the expected numbers needed to treat with a statin for ten years (NNT) compares favorably with the NNT of traditional approaches. The SES-5 and hybrid approaches would begin to ameliorate CVD inequity by minimizing under-treatment among low SES groups and increasing the proportion of CVD events potentially averted by approximately 7.6% percentage points, representing a relative increase in events averted of 15% to 50%.We further explore the population-wide…

Subjects/Keywords: Public health; Epidemiology; Medicine; cardiovascular disease; health equity; myocardial infarction; primary prevention; risk prediction; stroke

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Richards, A. K. (2013). Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment. (Thesis). UCLA. Retrieved from http://www.escholarship.org/uc/item/5js6x36k

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Richards, Adam Kimball. “Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment.” 2013. Thesis, UCLA. Accessed April 18, 2021. http://www.escholarship.org/uc/item/5js6x36k.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Richards, Adam Kimball. “Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment.” 2013. Web. 18 Apr 2021.

Vancouver:

Richards AK. Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment. [Internet] [Thesis]. UCLA; 2013. [cited 2021 Apr 18]. Available from: http://www.escholarship.org/uc/item/5js6x36k.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Richards AK. Quantifying and ameliorating socioeconomic inequity in first cardiovascular events through improved risk prediction and treatment. [Thesis]. UCLA; 2013. Available from: http://www.escholarship.org/uc/item/5js6x36k

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

3. Nerpin, Elisabet. Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter.

Degree: Medical Science, 2007, Dalarna University

URL: http://urn.kb.se/resolve?urn=urn:nbn:se:du-3123

Subjects/Keywords: Heredity; adult children; siblings; family; first degree relatives; premature CHD; myocardial infarction; infarction; myocardial revascularization; coronary disease; ischemic heart disease; primary prevention.

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Nerpin, E. (2007). Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter. (Thesis). Dalarna University. Retrieved from http://urn.kb.se/resolve?urn=urn:nbn:se:du-3123

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Chicago Manual of Style (16^th Edition):

Nerpin, Elisabet. “Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter.” 2007. Thesis, Dalarna University. Accessed April 18, 2021. http://urn.kb.se/resolve?urn=urn:nbn:se:du-3123.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

MLA Handbook (7^th Edition):

Nerpin, Elisabet. “Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter.” 2007. Web. 18 Apr 2021.

Vancouver:

Nerpin E. Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter. [Internet] [Thesis]. Dalarna University; 2007. [cited 2021 Apr 18]. Available from: http://urn.kb.se/resolve?urn=urn:nbn:se:du-3123.

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Council of Science Editors:

Nerpin E. Screening av förstagradsanhöriga till yngre kranskärlssjuka patienter. [Thesis]. Dalarna University; 2007. Available from: http://urn.kb.se/resolve?urn=urn:nbn:se:du-3123

Note: this citation may be lacking information needed for this citation format:
Not specified: Masters Thesis or Doctoral Dissertation

Leiden University

4. Velders, M.A. Optimization of care for ST-elevation myocardial infarction.

Degree: 2014, Leiden University

URL: http://hdl.handle.net/1887/23056

► 978-94-6182-393-9 The first part of this thesis identified several high-risk sub-populations to improve the care and risk stratification of patients with ST-elevation myocardial infarction (STEMI).… (more)

Subjects/Keywords: Drug-eluting stents; Risk factors; Coronary heart disease; Primary percutaneous coronary intervention; ST-elevation myocardial infarction

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APA · Chicago · MLA · Vancouver · CSE | Export to Zotero / EndNote / Reference Manager

APA (6^th Edition):

Velders, M. A. (2014). Optimization of care for ST-elevation myocardial infarction. (Doctoral Dissertation). Leiden University. Retrieved from http://hdl.handle.net/1887/23056

Chicago Manual of Style (16^th Edition):

Velders, M A. “Optimization of care for ST-elevation myocardial infarction.” 2014. Doctoral Dissertation, Leiden University. Accessed April 18, 2021. http://hdl.handle.net/1887/23056.

MLA Handbook (7^th Edition):

Velders, M A. “Optimization of care for ST-elevation myocardial infarction.” 2014. Web. 18 Apr 2021.

Vancouver:

Velders MA. Optimization of care for ST-elevation myocardial infarction. [Internet] [Doctoral dissertation]. Leiden University; 2014. [cited 2021 Apr 18]. Available from: http://hdl.handle.net/1887/23056.

Council of Science Editors:

Velders MA. Optimization of care for ST-elevation myocardial infarction. [Doctoral Dissertation]. Leiden University; 2014. Available from: http://hdl.handle.net/1887/23056

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Open Access Theses and Dissertations