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Table of Contents
HISTORY OF MEDICINE
Year : 2017  |  Volume : 18  |  Issue : 3  |  Page : 109-114  

Risk factors for coronary artery disease: Historical perspectives

Rachel Hajar
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha, Qatar

Date of Web Publication8-Nov-2017

Correspondence Address:
M.D. Rachel Hajar
Department of Cardiology, Heart Hospital, Hamad Medical Corporation, Doha
Qatar
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/HEARTVIEWS.HEARTVIEWS_106_17

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How to cite this article:
Hajar R. Risk factors for coronary artery disease: Historical perspectives. Heart Views 2017;18:109-14

How to cite this URL:
Hajar R. Risk factors for coronary artery disease: Historical perspectives. Heart Views [serial online] 2017 [cited 2023 Dec 4];18:109-14. Available from: https://www.heartviews.org/text.asp?2017/18/3/109/217850


   Introduction Top


We consider our current understanding and therapy of cardiovascular diseases (CVD) state-of-the-art, but heart disease is still a problem because there is still a lot that we do not know. There is still no cure for any form of heart disease. However, research is ongoing, and new clues are emerging which could lead to better treatments in the future. Results from epidemiological studies, foremost among them the Framingham study, have been crucial to our current knowledge about CVD. Emphasis is on the identification of risk factors, assessment of their predictive ability, and their implications for disease prevention.

The concept of “risk factors” in coronary heart disease (CHD) was first coined by the Framingham heart study (FHS), which published its findings in 1957. FHS demonstrated the epidemiologic relations of cigarette smoking, blood pressure, and cholesterol levels to the incidence of coronary artery disease (CAD). The findings were truly revolutionary for it helped bring about a change in the way medicine is practiced.

Beginnings of our understanding

For thousands of years, our knowledge of the causes of CVD and its therapy was static. It was only in the last half of the 20th century that research into the causes of CVDs accelerated, and with it, new therapies were found.

What stimulated this research? The premature death in 1945 of the US President Franklin D. Roosevelt from hypertensive heart disease and stroke stimulated this research in USA.[1] Deaths from CVD and stroke reached epidemic proportions in the USA at that time which induced the Americans to take the lead in cardiovascular research.

The death of President Roosevelt illustrated how little we knew about the general causes of heart disease and stroke. Therefore, a health project was set up in the USA– the FHS – to identify the common factors or characteristics that contribute to CVD. FHS was under the direction of the National Heart Institute, now known as the National Heart, Lung, and Blood Institute.[2] Researchers followed the development of CHD over a long period in a large group of participants who had not yet developed overt symptoms of CVD or suffered a heart attack or stroke. The small town of Framingham in Massachusetts, USA was chosen due to its geographical proximity to the many cardiologists at Harvard Medical School. Furthermore, the residents had already participated in the Framingham tuberculosis demonstration study two decades earlier.[3]

The town of Framingham is located outside Boston. It was a small, middle-class community, and its small population made it an ideal site to launch the heart study. Everybody knew everyone. It was a typical small-town in the USA. The researchers hoped they would find clues in the medical histories of the people of Framingham which might shed light on causes of CVD. They recruited 5,209 men and women between the ages of 30 and 62 from the town of Framingham, Massachusetts. These study subjects underwent extensive physical examinations and lifestyle interviews that were analyzed for common patterns related to CVD development. Since 1948, the subjects have continued to return to the study every 2 years for a detailed medical history, physical examination, and laboratory tests, and in 1971, the study enrolled a second generation-5,124 of the original participants' adult children, and their spouses to participate in similar examinations.[2] The FHS is now on its third generation of participants. The study has provided substantial insight into the epidemiology of CVD and its risk factors.

Framingham study leads the way

The Framingham study was responsible for pointing out fallacies in our understanding of CVDs and identification of its major risk factors: high blood pressure, high blood cholesterol, smoking, obesity, diabetes, and physical inactivity as well as other valuable information on the effects of related factors such as blood triglyceride and high density lipoprotein (HDL) cholesterol levels, age, gender, and psychosocial issues. To date, no single risk factor has been identified to be responsible for causing CVD; rather, multiple interrelated factors seem responsible for its development. Although the Framingham cohort is Caucasian, other studies have shown that the major risk factors identified in this group apply universally to other racial and ethnic groups.

The notion of CVD risk factors is an integral part of modern medicine which has led to the development of effective treatment and preventive strategies in clinical practice.

Fallacies corrected

Physicians are sometimes taught some theories that are believed to be true without having been proven. These ideas or notions have been doctrines from centuries' old practices. Many of these concepts are taught us in medical school such as the notion that an elevated systolic blood pressure (BP) in the elderly is “normal,” which of course is false as I will discuss later. Then, a study comes along to dispel these erroneous ideas. Such a study was the Framingham heart study. Its epidemiological model of research has unraveled many of the fallacies in our understanding and helped to bring about a change in the way medicine is practiced.

The development of CHD through the prism of its major conventional cardiovascular risk factors – hypertension, hypercholesterolemia, smoking, and diabetes mellitus– is interesting, and hence, I will briefly look at how they evolved as risks through the “eyes” of the FHS and other epidemiological studies.

The major risk factors

There are many risk factors for CAD and some can be controlled but not others. The risk factors that can be controlled (modifiable) are: High BP; high blood cholesterol levels; smoking; diabetes; overweight or obesity; lack of physical activity; unhealthy diet and stress. Those that cannot be controlled (conventional) are: Age (simply getting older increases risk); sex (men are generally at greater risk of coronary artery disease); family history; and race.

Hypertension

Hypertension is one of the risks in the development of CHD. The American President Roosevelt died from cerebral hemorrhage, sequelae of hypertension.

Old myths corrected

Many old physicians thought that high BP was necessary to force blood through the stiffened arteries of older persons and that it was a normal element of aging. The medical community believed that a permissible systolic BP was 100 plus the participant's age in millimeters of mercury.[4],[5] For those aged >70 years, some considered the acceptable upper limits of normal BP to be 210 mmHg systolic and 120 mmHg diastolic.[6]

It was considered appropriate to ignore benign essential hypertension and isolated systolic hypertension. I remember that I was taught in medical school that diastolic pressure was a superior measure of blood pressure. The cardiovascular hazard of hypertension was believed to derive chiefly from the diastolic pressure component. Consequently, elevated systolic pressure was considered harmless, especially in the elderly.[7],[8]

FHS dispelled the concept of “benign essential hypertension.” Belief in the prime importance of the diastolic pressure was convincingly refuted by Framingham study data and later confirmed by other prospectively obtained data demonstrating that the impact of systolic pressure is actually greater than the diastolic component and that even isolated systolic hypertension is dangerous.[9],[10] FHS investigators found an increased risk of CAD morbidity with rising baseline blood pressure. They challenged the existing belief “that systolic pressure is unimportant, and that labile or benign essential hypertension is of little consequence.” They stated that there was “little evidence to support these contentions but considerable reason to doubt them.”[11]

The importance of controlling BP was finally embraced in practice guidelines in the first “Report of the Joint National Committee (JNC) on Detection, Evaluation, and Treatment of High Blood Pressure” in 1977.[12] It is now recognized universally that hypertension increases atherosclerotic CVD incidence; the risk burden is 2–3-fold. CAD is the most common sequelae for hypertensive patients of all ages.[13] Hypertension predisposes to all clinical manifestations of CHD including myocardial infarction, angina pectoris, and sudden death. Even high normal BP values are associated with an increased risk of CVD.[14]

It was thought that the risk ratio for intracerebral hemorrhage was greater than for atherothrombotic brain infarction. This was not true. It was found that hypertension was as strong a risk for atherothrombotic brain infarction as intracerebral hemorrhage.[11]

Framingham showed that the preponderance of hypertension-related strokes were atherothrombotic brain infarctions whether the hypertension was severe or mild. The proportion of strokes due to hemorrhage in mild hypertension was identical to that for severe hypertension.[4]

The Seventh JNC on hypertension established that those with BP of 120–139/80–89 mmHg are prehypertensives, that is, these individuals may become hypertensives in the future. Starting as low as 115/75 mmHg, the risk of heart attack and stroke doubles for every 20-point jump in systolic BP or every 10-point rise in diastolic BP for adults aged 40–70.

The presence of other risk factors for CVD such as high cholesterol, obesity, and diabetes is seen more in people with prehypertension than in those with normal blood pressure. The CVD risk in prehypertensives increases with the number of associated risk factors present. Therefore, prehypertension confers a greater risk for CVD.

In persons with mild to moderate hypertension, the substantial risk was shown to be concentrated in those with coexistent dyslipidemia, diabetes, and left ventricular hypertrophy. Hypertensive elderlies were commonly found to already have target organ damage such as impaired renal function, silent myocardial infarction, strokes, transient ischemic attacks, retinopathy, or peripheral artery disease. At least 60% of older men and 50% of elderly women with hypertension in the Framingham study had one or more of these conditions.[11]

In the past, initiation of antihypertensive treatment was often delayed until there was evidence of target organ involvement. Framingham study data indicated that this practice was unwise because 40%–50% of hypertensive persons developed overt cardiovascular events before evidence of target organ damage such as proteinuria, cardiomegaly, or electrocardiogram abnormalities.[11]

Various guidelines and numerous updates of guidelines on hypertension have been promulgated to improve its treatment and to prevent its adverse cardiovascular consequences. There is no cure for hypertension, but there are helpful pharmacological therapy and some strategies that a person can do to lower risk such as diet and exercise and checking BP regularly.

Hypercholesterolemia

The other major risk for CVD was cholesterol. In 1953, an association between cholesterol levels and CHD mortality was reported in various populations.[15] Animal and clinical observation have suggested such relationship. This association was confirmed by epidemiological studies showing a strong relation between serum total cholesterol and cardiovascular risk.[16],[17],[18]

It was shown that changes in cholesterol levels were associated with changes in CVD incidence rate.[19] Clinicians and epidemiologists accepted these findings, agreeing that total plasma cholesterol was a useful marker for predicting CVD. It was found that its component– the low-density lipoprotein cholesterol (LDL-C) which is the principal lipoprotein transporting cholesterol in the blood, was also directly associated with CVD.[20],[21],[22] It was also found out that LDL cholesterol levels in young adulthood predict development of CVD later in life.[22]

Current guidelines identify LDL-C as the primary target for high blood cholesterol therapy.[23] The benefits of LDL-C lowering drug therapies has been shown in various clinical, observational and experimental studies.[24] It has been shown that the benefits of reducing serum cholesterol for CHD risk are age-related: a 10% reduction in serum cholesterol produces a drop in CHD risk of 50% at the age of 40, 40% at age 50, 30% at age 60, and 20% at age 70.[25]

Now, high density lipoprotein cholesterol (HDL-C) is accepted by the medical community as an important factor in atherosclerosis and consequently, raising HDL-C has become an accepted therapeutic strategy for decreasing CHD incidence rate. There are some drugs that increase HDL-C such as fibrates, niacin, and torcetrapib, a cholesterol ester transfer protein but only fibrates have been shown to reduce risk of major coronary events. It is estimated that a 1 mg/dL increase in HDL level is associated with a decrease in coronary risk of 2% in men and 3% in women.[26]

Smoking

The Framingham study showed that smokers were at increased risk of myocardial infarction (MI) or sudden death and that risk was associated to the number of cigarettes smoked each day.[27] These results were confirmed by other epidemiological studies.[28],[29],[30] The deleterious effect of smoking on health has been proven in many studies, in particular on atherosclerosis.

The harmful effects of smoking on the heart can be appreciated in the following statistics:

  • Cigarette smoking approximately doubles the risk of morbidity and mortality from ischemic heart disease compared with a lifetime of not smoking, and the risk is related to the duration and amount of smoking.[31],[32]
  • There is evidence that in patients with CHD, smoking cessation reduces the risk of all-cause mortality and nonfatal MI.[33] Therefore, all patients with ischemic heart disease should be advised to stop smoking because it is a strong risk factor for a first MI and for fatal and nonfatal recurrences.
  • The risk of morbidity and mortality associated with cigarette smoking falls immediately after stopping smoking, although it may be >20 years, if at all, before the risk associated with smoking is completely reversed.[31],[34]
  • About 20% of patients will give up smoking after an acute MI with resultant 40% reduction in mortality rates and infarct recurrences.[35],[36]
  • For smokers under the age of 50 years the risk of developing CHD is 10 times greater than for nonsmokers of the same age.[37]
  • Passive smoking also increases the risk of CHD.[38]


Diabetes

The role of diabetes in the pathogenesis of CVD was unclear until 1979 when Kannel et al. used data from the Framingham heart study to identify diabetes as a major cardiovascular risk factor. Based on 20 years of surveillance of the Framingham cohort, a two-fold to threefold increased risk of clinical atherosclerotic disease was reported. It was also one of the first studies to demonstrate the higher risk of CVD in women with diabetes compared to men with diabetes.[39] These results have been duplicated by multiple studies. The Kannel article changed the way the medical community thought about diabetes. It is now accepted as a major cardiovascular risk factor. There is a clear-cut relationship between diabetes and CVD. The American Heart association cites the following statistics:[40]

  • At least 68% of people age 65 or older with diabetes die from some form of heart disease; and 16% die of stroke.
  • Adults with diabetes are two to four times more likely to die from heart disease than adults without diabetes.
  • The American Heart association considers diabetes to be one of the seven major controllable risk factors for CVD.


Diabetes is treatable but even if glucose levels are under control it greatly increases the risk of heart disease and stroke because people with diabetes also have other conditions that are risks for developing CHD such as hypertension, smoking, abnormal cholesterol, obesity, lack of physical activity, and metabolic syndrome. The good news is that by managing these risk factors, people with diabetes may avoid or delay the development of CVD.

Physical inactivity

“Conductors on London's double-decker buses (up and down stairs 11 days a fortnight, 50 weeks a year, often for decades) experienced half or less the incidence of acute MI and “sudden death” ascribed to CHD in the sedentary bus drivers.”[41] Thus, began Morris et al. in his landmark article in 1953 which appeared in The Lancet on the association of physical activity and coronary artery disease. Since then a number of epidemiological studies have confirmed the relationship. The relative risk of death from CHD for sedentary compared with active individuals is 1.9 (95% confidence interval).[42] The recommendation of physical exercise has become an important element of preventative policies for the general population (in adults, elderly, and children).

Obesity

The association of obesity and CHD was fist noted by Kannel et al.[43] in Framingham 50 years ago. Obesity is also an independent risk factor for all-cause mortality. It is a metabolic disorder associated with comorbidities such as CHD, type 2 diabetes, hypertension, and sleep apnea. Alterations in metabolic profile and various adaptations in cardiac structure and function occur as excess adipose tissue accumulates.[44] A recent study reported that higher body mass index (BMI) during childhood is associated with an increased risk of CHD in adulthood.[44]

The prevention and control of overweight and obesity in adults and children has become a key element for the prevention of cardiovascular diseases.[45],[46]

Cardiovascular diseases risk assessment

Absolute prediction of CVD risk of a person can be made using prediction charts issued or published by the WHO and ACC/AHA. The recommendations are made for management of major cardiovascular risk factors through changes in lifestyle and prophylactic drug therapies.

The ACC/AHA have produced guidelines for the procedures of detection, management, or prevention of CVD. In November 2013, The ACC and AHA released updated risk-assessment guidelines for atherosclerotic CVD. Changes and recommendations include the following.[47],[48],[49],[50],[51]

  • Stroke is added to the list of coronary events traditionally covered by risk prediction equations.
  • The guidelines focus primarily on the 10-year risk of atherosclerosis-related events; they focus secondarily on the assessment of lifetime risk for adults aged 59 or younger without high shorter-term risk.
  • The strongest predictors of 10-year risk are identified as age, sex, race, total cholesterol, HDL-C, blood pressure, blood-pressure treatment status, diabetes, and current smoking status.
  • Adjunct formulas for refining risk estimates by gender and race are provided.
  • If risk prediction needs to be further sharpened after risk prediction equations have been performed, the guidelines indicate that coronary-artery calcium scores, family history, high-sensitivity C-reactive protein, and the ankle-brachial index can be used.
  • The guidelines recommend that statin therapy be considered in individuals whose 10-year atherosclerotic cardiovascular disease (ASCVD) event risk is 7.5% or greater.


Guidelines from AHA/ACC recommend use of a revised calculator for estimating the 10-year risk of developing a first ASCVD event, which is defined as a nonfatal MI, death from CHD, or stroke (fatal or nonfatal) in a person who was initially free from ASCVD.[51] The calculator incorporates the following risk factors: sex, age, race, total cholesterol, HDL, systolic blood pressure, treatment for elevated blood pressure, diabetes, and smoking.

For patients 20–79 years of age who do not have existing clinical ASCVD, the guidelines recommend assessing clinical risk factors every 4–6 years. For patients with low 10-year risk (<7.5%), the guidelines recommend assessing 30-year or lifetime risk in patients 20–59-year-old.

The guidelines note that regardless of the patient's age, physicians should communicate risk data to the patient and refer to the AHA/ACC lifestyle guidelines, which cover diet and physical activity. For patients with elevated 10-year risk, physicians should communicate risk data and refer to the AHA/ACC guidelines on blood cholesterol and obesity.


   Summary Top


CVD is a major cause of disability and premature death throughout the world. The underlying pathology of atherosclerosis develops over many years and is usually advanced by the time symptoms occur, generally in middle age. The risk of developing CAD increases with age, and includes age >45 years in men and >55 years in women. A family history of early heart disease is also a risk factor, such as heart disease in the father or a brother diagnosed before age 55 years and in the mother or a sister diagnosed before age 65 years. Acute coronary and cerebrovascular events frequently occur suddenly, and are often fatal before medical care can be given. I have discussed above the major traditional risk factors.

Many traditional risk factors for CAD are related to lifestyle, therefore preventative treatment can be tailored to modifying specific factors. It is very important to know these risks to reduce disability and premature deaths from CHD, cerebrovascular disease and peripheral vascular disease in people at high risk, who have not yet experienced a cardiovascular event. People with established CVD are at very high risk of recurrent events.

Current guidelines provide advice on screening and identifying asymptomatic individuals at risk of developing CVD. The objectives of these guidelines are to reduce the incidence of first or recurrent clinical events due to CHD, ischemic stroke, and peripheral artery disease. The focus is on prevention of disability and early death. The guidelines emphasize the importance of lifestyle changes and use of different prophylactic drug therapies in the management of risks.

The understanding of such risk factors is critical to the prevention of cardiovascular morbidities and mortality.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
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Bioactive Materials. 2024; 31: 590
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2 Ethnic Disparities in the Burden of Cardiovascular Disease Among Immigrants in Canada
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Current Problems in Cardiology. 2024; 49(1): 102059
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3 Temporal trends in Percutaneous Coronary Intervention in Australia: A retrospective analysis from 2000-2021
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4 The Brazilian Cardioprotective Nutritional (BALANCE) Program improves diet quality in patients with established cardiovascular disease: results from a multicenter randomized controlled trial
Aline Rosignoli da Conceição, Alessandra da Silva, Leidjaira Lopes Juvanhol, Aline Marcadenti, Ângela Cristine Bersch-Ferreira, Bernardete Weber, Nitin Shivappa, Josefina Bressan
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5 Cardiovascular Risk Prediction with Cardio-Ankle Vascular Index in The Malaysian Cohort Study
Noraidatulakma Abdullah, Joan Anak Blin, Azwa Shawani Kamalul Arifin, Nazihah Abd Jalal, Norliza Ismail, Nurul Ain Mohd Yusof, Mohd Shaharom Abdullah, Nurul Faeizah Husin, Andri Dauni, Mohd Arman Kamaruddin, Azmawati Mohammed Nawi, Norfazilah Ahmad, Mohd Rohaizat Hassan, Rahman Jamal
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6 Risk for acquired coronary artery disease in genetic vs. congenital thoracic aortopathy
Onur B. Dolmaci, Tugay Ayyildiz, Robert E. Poelmann, Antoine H. G. Driessen, Dave R. Koolbergen, Robert J. M. Klautz, Jan H. N. Lindeman, Nimrat Grewal
Frontiers in Cardiovascular Medicine. 2023; 9
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7 The association of the paraoxonase 1 Q192R polymorphism with coronary artery disease (CAD) and cardiometabolic risk factors in Iranian patients suspected of CAD
Mina Darand, Amin Salehi-Abargouei, Mohammad Yahya Vahidi Mehrjardi, Awat Feizi, Seyed Mustafa Seyedhossaini, Gholamreza Askari
Frontiers in Cardiovascular Medicine. 2023; 9
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8 Evaluation of pericoronary adipose tissue attenuation on CT
Runlei Ma, Roberto Fari, Pim van der Harst, Carlo N. De Cecco, Arthur E.Stillman, Rozemarijn Vliegenthart, Marly van Assen
The British Journal of Radiology. 2023;
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9 Improved bias and reproducibility of coronary artery calcification features using deconvolution
Yingnan Song, Ammar Hoori, Hao Wu, Mani Vembar, Sadeer Al-Kindi, Leslie Ciancibello, James G. Terry, David R. Jacobs, John J. Carr, David L. Wilson
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10 Association between sociodemographic factors and cholesterol-lowering medication use in U.S. adults post-myocardial infarction
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11 Insulin-like growth factor 1 reduces coronary atherosclerosis in pigs with familial hypercholesterolemia
Sergiy Sukhanov, Yusuke Higashi, Tadashi Yoshida, Svitlana Danchuk, Mitzi Alfortish, Traci Goodchild, Amy Scarborough, Thomas Sharp, James S. Jenkins, Daniel Garcia, Jan Ivey, Darla L. Tharp, Jeffrey Schumacher, Zach Rozenbaum, Jay K. Kolls, Douglas Bowles, David Lefer, Patrice Delafontaine
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12 Preventive effect of Helicobacter pylori eradication on the coronary heart diseases depending on age and sex with a median follow-up of 51 months
Sang Bin Kim, Nayoung Kim, Jaehyung Park, In-Chang Hwang, Seon Hee Lim, Du Hyun Song, Yonghoon Choi, Hyuk Yoon, Cheol Min Shin, Young Soo Park, Dong Ho Lee, Soyeon Ahn
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13 Ethnic differences in the lifestyle behaviors and premature coronary artery disease: a multi-center study
Media Babahajiani, Ehsan Zarepur, Alireza Khosravi, Noushin Mohammadifard, Feridoun Noohi, Hasan Alikhasi, Shima Nasirian, Seyed Ali Moezi Bady, Parisa Janjani, Kamal Solati, Masoud Lotfizadeh, Samad Ghaffari, Elmira Javanmardi, Arsalan Salari, Mahboobeh Gholipour, Mostafa Dehghani, Mostafa Cheraghi, Ahmadreza Assareh, Habib Haybar, Seyedeh Mahdieh Namayandeh, Reza Madadi, Javad Kojuri, Marjan Mansourian, Nizal Sarrafzadegan
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14 Significance of Serum Ferritin and Vitamin-D Level in Coronary Artery Disease Patients
E. Vasudevan, Mary Chandrika Anton, B. Shanthi, Chaganti Sridevi, K. Sumathi, Nivethini Nivethini
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15 A Review of the Impact of Education on the Adoption of Smart Technologies for Atrial Fibrillation Detection
Adna Sijercic
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16 CHD-related/specific mortality of 3.17 million people in a transitioning region: trends, risk factors, and prevention
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17 The association between frailty and incident cardiovascular disease events in community-dwelling healthy older adults
A.R.M. Saifuddin Ekram, Andrew M. Tonkin, Joanne Ryan, Lawrence Beilin, Michael E. Ernst, Sara E. Espinoza, John J. McNeil, Mark R. Nelson, Christopher M. Reid, Anne B. Newman, Robyn L. Woods
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18 The relationship between social isolation, social support, and loneliness with cardiovascular disease and shared risk factors: a narrative review
Achamyeleh Birhanu Teshale, Htet Lin Htun, Jessie Hu, Lachlan L Dalli, Michelle H Lim, Barbara Barbosa Neves, J R Baker, Aung Zaw Zaw Phyo, Christopher M Reid, Joanne Ryan, Alice J Owen, Sharyn M Fitzgerald, Rosanne Freak-Poli
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19 Effects of Omega-3 Fatty Acids on Flow-mediated Dilatation and Carotid Intima Media Thickness: A Meta-analysis
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20 Gold Nanoparticles: Synthesis, Functionalization and Biomedical Applications Especially in Cardiovascular Therapy
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21 Multiplex analysis of inflammatory proteins associated with risk of coronary artery disease in type-1 diabetes patients
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22 Role of serum cytokines in the prediction of heart failure in patients with coronary artery disease
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23 Fatty acid metabolism disorders and potential therapeutic traditional Chinese medicines in cardiovascular diseases
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24 An insight to treat cardiovascular diseases through phytochemicals targeting PPAR-a
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25 Fat fighting liraglutide based nano-formulation to reverse obesity: Design, development and animal trials
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26 Cardiovascular risk factors in diabetic patients with and without metabolic syndrome: a study based on the Rafsanjan cohort study
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27 Consumption of unprocessed or minimally processed foods and their association with cardiovascular events and cardiometabolic risk factors in Brazilians with established cardiovascular events
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28 A multicomponent index method to evaluate the relationship between urban environment and CHD prevalence
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29 Genetic data visualization using literature text-based neural networks: Examples associated with myocardial infarction
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30 Treating adult patients of severe psoriasis with methotrexate leads to reduction in biomarkers of atherosclerosis: A prospective study
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31 COVID-19 and coronary artery disease; A systematic review and meta-analysis
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32 A longitudinal study of the association between attending cultural events and coronary heart disease
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33 The common pathobiology between coronary artery disease and calcific aortic stenosis: Evidence and clinical implications
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34 In regard to Milo et al.,
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35 Frank's sign associated with the severity of ischemic heart disease in patients under 65 years old
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36 Organ-specific model of simulated ischemia/reperfusion and hyperglycemia based on engineered heart tissue
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37 The relationship of circulating neuregulin 4 and irisin, and traditional and novel cardiometabolic risk factors with the risk and severity of coronary artery disease
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38 Competitor induced dissipation of carbon quantum dot based hierarchical vesicular self-assembly: A theranostic nanoplatform towards hypercholesterolemia
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39 Hypertensive heart disease: risk factors, complications and mechanisms
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40 Relationship between the Castelli risk indeces and the presence and severity of ischemia in non-geriatric patients with suspected coronary artery disease
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41 Predictors of Cardiovascular Morbidity Among Adult Hypertensive Patients: A Cross-Sectional Study from the Kingdom of Saudi Arabia
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42 A multivariate genome-wide association study of psycho-cardiometabolic multimorbidity
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43 The relationship between ultra processed food consumption and premature coronary artery disease: Iran premature coronary artery disease study (IPAD)
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44 Thoracic aortic atherosclerosis in patients with a bicuspid aortic valve; a case–control study
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45 The prognostic role of the low and very low baseline LDL-C level in outcomes of patients with cardiac revascularization; comparative registry-based cohort design
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46 Innovative Attention-Based Explainable Feature-Fusion VGG19 Network for Characterising Myocardial Perfusion Imaging SPECT Polar Maps in Patients with Suspected Coronary Artery Disease
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47 Association of blood pressure trajectories with coronary heart disease among the disabled population in Shanghai, China: a cohort study of 7 years following up
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48 Association of 25-hydroxyvitamin D levels with lipid profiles in osteoporosis patients: a retrospective cross-sectional study
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49 CREB-binding protein and HIF-1a/ß-catenin to upregulate miR-322 and alleviate myocardial ischemia-reperfusion injury
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50 Feasibility of a smartphone app for prescribed exercise tutoring in patients with stable coronary heart disease
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51 Risk factors and longitudinal changes of dyslipidemia among Chinese people living with HIV receiving antiretroviral therapy
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52 Análisis transversal de especies vegetales del sureste de México, en su uso para enfermedades cardiovasculares
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53 Healthy lifestyle behaviors and risk of cardiovascular diseases among nursing faculty during COVID-19 Pandemic
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54 Biological Activities of Morita-Baylis-Hillman Adducts (MBHA)
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55 Positioning of PCSK9 Inhibitors in hypercholesterolemia
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56 The impact of risk factors on the development and severity of coronary artery stenosis
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57 Cardiovascular diseases in Ukraine: results of a retrospective analysis of the morbidity and current problems of its monitoring
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58 Does social media drive remittances in Africa?
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59 Low birth weight and reduced postnatal nutrition lead to cardiac dysfunction in piglets
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60 Risk of myocardial infarction, heart failure, and cerebrovascular disease with the use of valsartan, losartan, irbesartan, and telmisartan in patients
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61 Atypical Presentations of Myocardial Infarction: A Systematic Review of Case Reports
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62 Role of the Gut Microbiome in the Development of Atherosclerotic Cardiovascular Disease
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63 Role of Terpenophenolics in Modulating Inflammation and Apoptosis in Cardiovascular Diseases: A Review
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64 The Role of Epicardial Adipose Tissue-Derived MicroRNAs in the Regulation of Cardiovascular Disease: A Narrative Review
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65 Recent advances in diagnosis and management of ischemic heart diseases in perspective of contemporary and Ayurveda medicine—a comprehensive review
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66 Prediction of obstructive coronary artery disease in patients undergoing heart valve surgery: A cross-sectional study in a tertiary care hospital
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67 The Correlation between High Sensitive C-reactive Protein Levels and Gensini Score in Diabetes Patients
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68 Association between the Phytochemical Index and Risk Factors for Cardiovascular Disease in Adults
Vanessa Zanoni Carvalhaes, George César Ximenes Meireles, Regina Maria Catarino, Rosemeire Bueno
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69 Comparison of Genetic Susceptibility to Coronary Heart Disease in the Hungarian Populations: Risk Prediction Models for Coronary Heart Disease
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70 C-Reactive Protein Levels and Risk of Cardiovascular Diseases: A Two-Sample Bidirectional Mendelian Randomization Study
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71 Automated Cardiovascular Disease Prediction Models: A Comparative Analysis
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72 Patterns of Coronary Artery Dominance and Association with Severity of Coronary Artery Disease at a Large Tertiary Care Hospital in Pakistan
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73 Ejercicio: la medicina menos valorada y utilizada
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74 How Do Minerals, Vitamins, and Intestinal Microbiota Affect the Development and Progression of Heart Disease in Adult and Pediatric Patients?
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75 Bioactive Functions of Lipids in the Milk Fat Globule Membrane: A Comprehensive Review
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76 Assessment of the Dimensions of Coronary Arteries for the Manifestation of Coronary Artery Disease
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77 Phytochemicals from Piper betle (L.) as Putative Modulators of a Novel Network-Derived Drug Target for Coronary Artery Disease: An In Silico Study
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78 Evaluating the Potential of Plukenetia volubilis Linneo (Sacha Inchi) in Alleviating Cardiovascular Disease Risk Factors: A Mini Review
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79 Presence of trans-Fatty Acids Containing Ingredients in Pre-Packaged Foods and the Availability of Reported trans-Fat Levels in Kenya and Nigeria
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80 Is It Feasible to Predict Cardiovascular Risk among Healthy Vegans, Lacto-/Ovo-Vegetarians, Pescatarians, and Omnivores under Forty?
Izabela Kwiatkowska, Jakub Olszak, Alicja Brozek, Anna Blacha, Marcin Nowicki, Kalina Mackowiak, Piotr Formanowicz, Dorota Formanowicz
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81 IgG N-Glycosylation Is Altered in Coronary Artery Disease
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82 Predictors of Coronary Heart Disease (CHD) among Malaysian Adults: Findings from MyDiet-CHD Study
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83 Lycopene: A Natural Arsenal in the War against Oxidative Stress and Cardiovascular Diseases
May Nasser Bin-Jumah, Muhammad Shahid Nadeem, Sadaf Jamal Gilani, Bismillah Mubeen, Inam Ullah, Sami I. Alzarea, Mohammed M. Ghoneim, Sultan Alshehri, Fahad A. Al-Abbasi, Imran Kazmi
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84 Vital Signs Monitoring Based on Interferometric Fiber Optic Sensors
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85 Acute coronary syndrome: role of the nurse in patient assessment and management
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86 The use of screening tools for cardiovascular risk assessment in psoriasis – A case- control study
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87 PCSK9 Promotes Cardiovascular Diseases: Recent Evidence about Its Association with Platelet Activation-Induced Myocardial Infarction
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88 Why Do High-Risk Patients Develop or Not Develop Coronary Artery Disease? Metabolic Insights from the CAPIRE Study
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89 Bone Health in Patients with Dyslipidemias: An Underestimated Aspect
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90 Assessment of Right Ventricular Function in Patients With Acute Myocardial Infarction
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91 Sex Differences in Baseline Characteristics Do Not Predict Early Outcomes after Percutaneous Coronary Intervention: Results from the Australian GenesisCare Cardiovascular Outcomes Registry (GCOR)
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92 Atherogenic Index of Plasma and Its Association with Risk Factors of Coronary Artery Disease and Nutrient Intake in Korean Adult Men: The 2013–2014 KNHANES
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93 Handgrip Strength-Related Factors in a Colombian Hypertensive Population: A Cross-Sectional Study
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94 Untargeted Metabolomics Profiling Reveals Perturbations in Arginine-NO Metabolism in Middle Eastern Patients with Coronary Heart Disease
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95 Aging of Vascular System Is a Complex Process: The Cornerstone Mechanisms
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96 Clinical Patterns of Traditional Chinese Medicine for Ischemic Heart Disease Treatment: A Population-Based Cohort Study
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97 Knowledge, Attitude, and Practice Toward Cardiovascular Diseases in the Lebanese Population
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98 Clinical Significance of Monocyte Chemoattractant Protein-1 and CC Chemokine Receptor Type 2 Gene Polymorphisms in Young Patients with Acute Coronary Syndrome
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99 From Diabetes to Atherosclerosis: Potential of Metformin for Management of Cardiovascular Disease
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100 Apolipoprotein E in Cardiometabolic and Neurological Health and Diseases
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101 Incidence of Coronary Artery Disease in King Abdulaziz University Hospital, Jeddah, Saudi Arabia, 2019–2020: A Retrospective Cohort Study
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102 Correlation of Angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers with serum GDF-15 in a group of hypertensive Iraqi patients
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103 The Role of Fatty Acid Binding Protein 3 in Cardiovascular Diseases
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104 Influence of Risk Factors on Exercise Tolerance in Patients after Myocardial Infarction—Early Cardiac Rehabilitation in Poland
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105 Religiosity Is Associated with Reduced Risk of All-Cause and Coronary Heart Disease Mortality among Jewish Men
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106 Awareness of Coronary Artery Disease Risk Factors Among the Population of Taif City, Saudi Arabia
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107 The New Markers of Early Obesity-Related Organ and Metabolic Abnormalities
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108 Are Thoracic Aortic Aneurysm Patients at Increased Risk for Cardiovascular Diseases?
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109 First Successful Human Coronary Artery Bypass Surgery Postoperative Heart Transplant: A Case Report
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110 Increased risk of coronary heart disease with hysterectomy in young women: A longitudinal follow-up study using a national health screening cohort
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111 The correlation of long non-coding RNAs IFNG-AS1 and ZEB2-AS1 with IFN-? and ZEB-2 expression in PBMCs and clinical features of patients with coronary artery disease
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112 Estimation of the segmental left ventricular physical and mechanical parameters using echocardiographic imaging for stent candidate patients
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113 Commercial pure titanium – A potential candidate for cardiovascular stent
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114 Effects of intervention on lifestyle changes among coronary artery disease patients: A 6-month follow-up study
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115 Forensic autopsy-confirmed thrombosis-related deaths: the danger in the bones
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116 Contraception for Adolescents and Young Women with Type 2 Diabetes–Specific Considerations
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117 Coronary Artery Disease and Aspirin Intolerance: Background and Insights on Current Management
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118 The efficacy of Zingiber officinale on dyslipidaemia, blood pressure, and inflammation as cardiovascular risk factors: A systematic review
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119 Complications of Vascular Disease
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120 Role of Sex in Atherosclerosis: Does Sex Matter?
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121 Daytime napping and coronary heart disease risk in adults: a systematic review and dose–response meta-analysis
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122 Inequity in exercise-based interventions for adults with rheumatoid arthritis: a systematic review
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123 The Impact of Accelerated Diagnostic Protocol Implementation on Chest Pain Observation Unit Utilization
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124 Genetic variations of renin-angiotensin and fibrinolytic systems and susceptibility to coronary artery disease: a population genetics perspective
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125 Pooled prevalence of three major cardiovascular risk factors in patients undergoing left main bifurcation stenting: a systematic review and meta-analysis
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126 Effectiveness of a Nurse-Led Support Programme Using a Mobile Application versus Phone Advice on Patients at Risk of Coronary Heart Disease – A Pilot Randomized Controlled Trial
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127 Hemp Seeds, Flaxseed, and Açaí Berries: Health Benefits and Nutritional Importance with Emphasis on the Lipid Content
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128 Triglyceride glucose index for the detection of the severity of coronary artery disease in different glucose metabolic states in patients with coronary heart disease: a RCSCD-TCM study in China
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129 Differences in the number of stented coronary arteries based on the seven traditional obesity parameters among patients with coronary artery diseases undergoing cardiac catheterization
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130 Knowledge of modifiable cardiovascular diseases risk factors and its primary prevention practices among diabetic patients at Jimma University Medical Centre: A cross-sectional study
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131 Occupational Exposure to Poorly Soluble Low Toxicity Particles and Cardiac Disease: A Look at Carbon Black and Titanium Dioxide
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132 Chrysin reduces hypercholesterolemia-mediated atherosclerosis through modulating oxidative stress, microflora, and apoptosis in experimental rats
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133 Risk assessment indicators and brachial-ankle pulse wave velocity to predict atherosclerotic cardiovascular disease
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134 Familial hypercholesterolaemia and coronary risk factors among patients with angiogram-proven premature coronary artery disease in an Asian cohort
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135 Variations in coronary artery diameter: a retrospective observational study in Indian population
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136 Inequalities in the prevalence of cardiovascular disease risk factors in Brazilian slum populations: A cross-sectional study
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137 Relationship between active Helicobacter pylori infection and risk factors of cardiovascular diseases, a cross-sectional hospital-based study in a Sub-Saharan setting
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138 Elucidating the relationship between dyslipidemia and osteoporosis: A multicenter, prospective cohort study protocol
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139 Coronary Artery Disease in Patients Undergoing Transvalvular Aortic Valve Implantation
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140 Rs420137, rs386360 and rs7763726 polymorphisms in fibronectin type III domain containing 1 are associated with susceptibility to coronary heart disease: Analysis in the Han population
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141 The Association of Preoperative Depression, and C-Reactive Protein Levels with a Postoperative Length of Stay in Patients Undergoing Coronary Artery Bypass Grafting
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142 Pathophysiological and clinical aspects of the circadian rhythm of arterial stiffness in diabetes mellitus: A minireview
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143 Vegetarian ethnic foods of South India: review on the influence of traditional knowledge
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144 The effects of olive leaf extract on cardiovascular risk factors in the general adult population: a systematic review and meta-analysis of randomized controlled trials
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145 Improving physical and psychological outcomes of cardiac patients using the Naluri app: A study protocol for a randomized controlled trial
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146 Unsupervised machine learning based on clinical factors for the detection of coronary artery atherosclerosis in type 2 diabetes mellitus
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147 Correlation between chronic inflammation of rheumatoid arthritis and coronary lesions: “About a monocentric series of 202 cases”
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148 Neuropsychological tests and prediction of dementia in association with the degree of carotid stenosis
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149 Living donor liver transplantation in a cohort of recipients with left ventricular systolic dysfunction
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150 Longitudinal effects of lipid indices on incident cardiovascular diseases adjusting for time-varying confounding using marginal structural models: 25 years follow-up of two US cohort studies
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151 Effect of losartan potassium, metformin hydrochloride, and simvastatin on in vitro bioaccessibility of Cu, Fe, Mn, and Zn in oat flour from Brazil
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152 Why binge television viewing can be bad for you
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153 Role of miRNA-27a and miRNA-224 in posttranscriptional regulation of PCSK9 gene in Iraqi patient with coronary artery disease
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154 A urinary peptidomics approach for early stages of cardiovascular disease risk: The African-PREDICT study
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155 Contribution of lncRNA CASC8, CASC11, and PVT1 Genetic Variants to the Susceptibility of Coronary Heart Disease
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156 Usability of Wireless ECG Body Sensor for Cardiac Function Monitoring During Field Testing
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157 Plasma Oxylipins: A Potential Risk Assessment Tool in Atherosclerotic Coronary Artery Disease
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158 Harnessing the Benefits of Endogenous Hydrogen Sulfide to Reduce Cardiovascular Disease
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159 Genetic information improves the prediction of major adverse cardiovascular events in the GENEMACOR population
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160 Machine learning algorithms for predicting coronary artery disease: efforts toward an open source solution
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161 Relative Impact of Clinical Risk Versus Procedural Risk on Clinical Outcomes After Percutaneous Coronary Intervention
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162 Extent of Coronary Artery Disease in Patients With Stenotic Bicuspid Versus Tricuspid Aortic Valves
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163 A hybrid recurrent neural network - logistic chaos-based whale optimization framework for heart disease prediction with electronic health records
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164 An Integrated Machine Learning Framework for Effective Prediction of Cardiovascular Diseases
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165 Effects of Danhong injection on cardiac function and blood lipid in patients with angina pectoris of coronary heart disease
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166 Cardiovascular Risk Factors in Colombian Penitentiary Staff: An Interdisciplinary View of a High-Risk Occupation
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167 Combined lipid-lowering therapy from standpoint of modern guidelines for management of dyslipidaemias
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168 Adherence to guideline-recommended HbA1c testing frequency and better outcomes in patients with type 2 diabetes: a 5-year retrospective cohort study in Australian general practice
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169 Supporting Real World Decision Making in Coronary Diseases Using Machine Learning
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170 Effect of guidewire insertion in fractional flow reserve procedure for real geometry using computational fluid dynamics
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BioMedical Engineering OnLine. 2021; 20(1)
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171 Sex differences in total cholesterol of Vietnamese adults
Nga Thi Thu Tran, Christopher Leigh Blizzard, Khue Ngoc Luong, Ngoc Le Van Ngoc Truong, Bao Quoc Tran, Petr Otahal, Mark R. Nelson, Costan G. Magnussen, Tan Van Bui, Velandai Srikanth, Thuy Bich Au, Son Thai Ha, Hai Ngoc Phung, Mai Hoang Tran, Michele Callisaya, Seana Gall, Lee-Ling Lim
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172 The serum levels of testosterone in coronary artery disease patients; relation to NO, eNOS, endothelin-1, and disease severity
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173 The effect of paraoxonase 1 (PON1) gene polymorphisms T(-107)C and L55M and diet composition on serum PON1 activity in women
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174 The optimal WC cut-off points for the prediction of subclinical CVD as measured by carotid intima-media thickness among African adults: a cross-sectional study
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175 Clusters of the Risk Markers and the Pattern of Premature Coronary Heart Disease: An Application of the Latent Class Analysis
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Frontiers in Cardiovascular Medicine. 2021; 8
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176 The relationship between the exercise capacity and somatotype components, body composition, and quadriceps strength in individuals with coronary artery disease
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177 Cardiovascular risk in primary care: comparison between Framingham Score and waist circumference
Nina Vitória de Souza Silva Andrade, Isis Marinho de Noronha, Larisse Xavier Almeida, Fernanda Siqueira, Tatiana Onofre
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178 New susceptibility alleles associated with severe coronary artery stenosis in the Lebanese population
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179 Coronary calcification is associated with elevated serum lipoprotein (a) levels in asymptomatic men over the age of 45 years
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180 A hybrid approach for mortality prediction for heart patients using ACO-HKNN
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181 Association between satellite-based estimates of long-term PM2.5 exposure and cardiovascular disease: evidence from the Indonesian Family Life Survey
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182 A Meta-Analysis on the Global Prevalence, Risk factors and Screening of Coronary Heart Disease in Nonalcoholic Fatty Liver Disease
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183 Investigation of climate change impacts on long-term care facility occupants
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184 Phytotherapy with active tea constituents: a review
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185 Chrysin attenuates high-fat-diet-induced myocardial oxidative stress via upregulating eNOS and Nrf2 target genes in rats
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187 The effectiveness of planned discharge education on health knowledge and beliefs in patients with acute myocardial infarction: a randomized controlled trial
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188 Convolutional and recurrent neural networks for the detection of valvular heart diseases in phonocardiogram recordings
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189 Cannabis Use and Electrocardiographic Myocardial Injury
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190 The Effect of Laparoscopic Sleeve Gastrectomy on Subclinical Atherosclerosis in Patients with Severe Obesity
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191 Strengthening the Case for Cluster Set Resistance Training in Aged and Clinical Settings: Emerging Evidence, Proposed Benefits and Suggestions
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192 Uncurtaining the pivotal role of ABC transporters in diabetes mellitus
Tapan Behl,Aayush Sehgal,Madhuri Grover,Sukhbir Singh,Neelam Sharma,Saurabh Bhatia,Ahmed Al-Harrasi,Lotfi Aleya,Simona Bungau
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193 Unmet Medical Need as a Driver for Pharmaceutical Sciences – A Survey Among Scientists
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194 Histamine 2 receptors in cardiovascular biology: A friend for the heart
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195 Effects of guar gum supplementation on the lipid profile: A systematic review and meta-analysis of randomized controlled trials
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196 In silico investigation on alkaloids of Rauwolfia serpentina as potential inhibitors of 3-hydroxy-3-methyl-glutaryl-CoA reductase
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197 The global prevalence of Chlamydia pneumoniae, Helicobacter pylori, Cytomegalovirus and Herpes simplex virus in patients with coronary artery disease: A systematic review and meta-analysis
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198 A Numerical Analysis of Blood Flow in Clogged Artery
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199 Examining Acute Coronary Syndrome Across Ethnicity, Sex, and Age
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200 Validation and comparison of 28 risk prediction models for coronary artery disease
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201 The relationship of lipid peroxidation and antioxidant status to selected modifiable risk factors in coronary artery disease patients
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202 An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort
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203 Modelling the spread of atherosclerosis considering relapse and linear treatment
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204 Effects of data preprocessing on results of the epidemiological analysis of coronary heart disease and behaviour-related risk factors
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205 Evaluation of ERRFI1 +808 T/G variant and its mRNA expression in coronary artery in-stent restenosis
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206 The Degradation of G3BP2 by Trim-away Method Inhibits Oscillatory Shear Stress induced Endothelial Cell Inflammation
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207 Ultra-processed foods consumption is associated with cardiovascular disease and cardiometabolic risk factors in Brazilians with established cardiovascular events
Alessandra da Silva,Matheus Brum Felício,Ana Paula Silva Caldas,Helen Hermana Hermsdorff,Camila Ragne Torreglosa,Ângela Cristine Bersch-Ferreira,Bernardete Weber,Aline Marcadenti,Josefina Bressan
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208 Outbreak of SARS-CoV2: Pathogenesis of infection and cardiovascular involvement
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209 The Risk Factors of Coronary Heart Disease and its Relationship with Endothelial Nitric Oxide Synthase
Eka Fithra Elfi,Eva Decroli,Ellyza Nasrul,Yanwirasti Yanwirasti,Eryati Darwin
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210 KNOWLEDGE REGARDING RISK FACTORS AND PREVENTION OF CORONARY ARTERY DISEASE (CAD) AMONG BANK WORKERS OF BANKS: A PREEXPERIMENTAL STUDY
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211 Factors Affecting the Intention to Modify Lifestyle in the Cardiovascular Disease Risk Group in Korea
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212 The Impact of Advance Directive Perspectives on the Completion of Life-Sustaining Treatment Decisions in Patients with Heart Failure: A Prospective Study
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213 Evaluation of the Relationship between Hematological Indices and Cardiovascular Events in Isfahan Cohort Study
Atieh Jafari, Azam Soleimani, Masoumeh Sadeghi, Hamidreza Roohafza, Mohammad Talaei, Minoo Dianatkhah, Nizal Sarrafzadegan
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214 The effect of IgG fraction from blood plasma of patients with acute coronary syndromes on the parameters of primary haemostasis
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Bulletin of Taras Shevchenko National University of Kyiv. Series: Biology. 2021; (87): 27
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215 Prognostic Implication of Stress Induced Hyperglycemia in Non Diabetic Patients with Acute Coronary Syndrome
Sanjay Tukaram Thorat, , Radhika Ratanlal Bajaj, Vaibhav Vijay Rane, Avanti Jayant Damle, Nikhil Dilip Patil, Pankaj Nivrutti Pawar
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216 Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases
Jaideep Mahendra,Abirami Nayaki Rao,Little Mahendra,Hytham N. Fageeh,Hammam Ibrahim Fageeh,Thodur Madapusi Balaji,Saranya Varadarajan,Raghunathan Jagannathan,Deepak Mehta,Venkata V. Suresh,A. Thirumal Raj,Shankargouda Patil
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217 Quantitative determination of EPA and DHA in fish oil capsules for cardiovascular disease therapy in Indonesia by GC-MS
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218 Cross-Sectional Study of Plant Sterols Intake as a Basis for Designing Appropriate Plant Sterol-Enriched Food in Indonesia
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219 Hair Lead, Aluminum, and Other Toxic Metals in Normal-Weight and Obese Patients with Coronary Heart Disease
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220 Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis
Ahmed M. Hedar, Martin H. Stradner, Andreas Roessler, Nandu Goswami
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221 The Effects of Anthocyanin-Rich Bilberry Extract on Transintestinal Cholesterol Excretion
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222 Endometriosis Is Associated with an Increased Risk of Coronary Artery Disease in Asian Women
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223 A Six-Day, Lifestyle-Based Immersion Program Mitigates Cardiovascular Risk Factors and Induces Shifts in Gut Microbiota, Specifically Lachnospiraceae, Ruminococcaceae, Faecalibacterium prausnitzii: A Pilot Study
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224 The Expression of Allele Changes in NLRP3 (rs35829419) and IL-1ß (+3954) Gene Polymorphisms in Periodontitis and Coronary Artery Disease
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225 Determinants of Coronary Heart Disease Incidence among Indonesian Hajj Pilgrims Hospitalized in Saudi Arabia in 2019
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226 Diabesity lipid index: A potential novel marker of 10-year cardiovascular risk
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227 A Machine Learning Approach for Heart Attack Prediction
Suraj Kumar Gupta, Aditya Shrivastava, Satya Prakash Upadhyay, Pawan Kumar Chaurasia*
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228 Coronary Artery Calcium Score - A Reliable Indicator of Coronary Artery Disease?
Devarashetty Shreya, Diana I Zamora, Gautami S Patel, Idan Grossmann, Kevin Rodriguez, Mridul Soni, Pranay K Joshi, Saawan C Patel, Ibrahim Sange
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229 Modifiable and Non-modifiable Risk Factors in Myocardial Infarction in the Iranian Population
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230 Predictors of cardiac self-efficacy among patients diagnosed with coronary artery disease in tertiary hospitals in Nepal
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231 Atherosklerosis and dementia
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232 Modifying Stressors Using Betty Neuman System Modeling in Coronary Artery Bypass Graft: a Randomized Clinical Trial
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233 Spatial Co-Clustering of Cardiovascular Diseases and Select Risk Factors among Adults in South Africa
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234 Evaluation of Psychological Stress Parameters in Coronary Patients by Three Different Questionnaires as Pre-Requisite for Comprehensive Rehabilitation
Ana Maria Pah,Nicoleta Florina Buleu,Anca Tudor,Ruxandra Christodorescu,Dana Velimirovici,Stela Iurciuc,Maria Rada,Gheorghe Stoichescu-Hogea,Marius Badalica-Petrescu,Doina Georgescu,Dorina Nutiu,Mircea Iurciuc,Simona Dragan
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235 Metabolic changes after bariatric surgical procedures
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Iraqi National Journal of Medicine. 2020; 2(1): 14
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236 Analysis of the effect of guidewire position on stenosis diagnosis using computational fluid dynamics
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237 Progressive Muscle Relaxation (PMR) Enhances Oxygen Saturation in Patients of Coronary Heart Disease
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238 miRNA polymorphisms and risk of premature coronary artery disease
Konstantinos Agiannitopoulos,Pinelopi Samara,Miranta Papadopoulou,Astradeni Efthymiadou,Eirini Papadopoulou,Georgios N. Tsaousis,George Mertzanos,Dimitrios Babalis,Klea Lamnissou
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239 Model selection for metabolomics: predicting diagnosis of coronary artery disease using automated machine learning
Alena Orlenko,Daniel Kofink,Leo-Pekka Lyytikäinen,Kjell Nikus,Pashupati Mishra,Pekka Kuukasjärvi,Pekka J Karhunen,Mika Kähönen,Jari O Laurikka,Terho Lehtimäki,Folkert W Asselbergs,Jason H Moore,Janet Kelso.
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240 Study of the relationship between endothelial lipase gene polymorphism and serum levels of HDL-C, Apo A-I and severity of stenosis in non-diabetic coronary artery disease patients
Zohre Afshoon,Alireza Bahiraee,Fataneh Esmaeili,Elaheh Mansouri,Mohammad Amin Emami,Maryam Montaseri,Nahid Davoodian,Reyhane Ebrahimi,Ebrahim Eftekhar
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241 Influenza vaccine and cardiac protection: a study from a tertiary care center
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Human Vaccines & Immunotherapeutics. 2020; 16(4): 846
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242 Association between genetic variants at chromosome 9p21 and risk of coronary artery disease in Emirati Type 2 Diabetes patients
Zahrah Baalfaqih,Fatima Sulaiman,Nadia Abu-Samra,Manar Alshaikh,Aurelie Mawart,Wael Osman,Wael Al Mahmeed,Guan Tay,Habiba Alsafar
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243 Menopause symptom management in women with dyslipidemias: An EMAS clinical guide
Panagiotis Anagnostis,Johannes Bitzer,Antonio Cano,Iuliana Ceausu,Peter Chedraui,Fatih Durmusoglu,Risto Erkkola,Dimitrios G. Goulis,Angelica Lindén Hirschberg,Ludwig Kiesel,Patrice Lopes,Amos Pines,Mick van Trotsenburg,Irene Lambrinoudaki,Margaret Rees
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244 Feature selection and risk prediction for patients with coronary artery disease using data mining
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245 Role of Aspirin for Primary Prevention in Persons with Diabetes Mellitus and in the Elderly
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246 Novel Point Mutations in Mitochondrial MT-CO2 Gene May Be Risk Factors for Coronary Artery Disease
Mohammad Mehdi Heidari,Fatemeh Sadat Mirfakhradini,Fahime Tayefi,Saghar Ghorbani,Mehri Khatami,Mehdi Hadadzadeh
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247 The Role of Gender in the Importance of Risk Factors for Coronary Artery Disease
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248 Contribution of CYP24A1 variants in coronary heart disease among the Chinese population
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249 Eating behavior affects cardio-metabolic risk in high school teenagers in a developing country
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250 Patient’s Information Toward Some Modifiable Risk Factors of Ischemic Heart Disease
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251 Scientist-led Exercise Testing Is Safe With Diagnostic Interpretation Equivalent to a Cardiologist
Mark Whitman,Cliantha Padayachee,Prue Tilley,Casey Sear,Shelley Rosanoff,Hadeir El Shinawi,Christiana Manolis,Carly Jenkins,Prasad Challa
Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine. 2020; 19(1): 14
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252 Is the History of Erectile Dysfunction a Reliable Risk Factor for New Onset Acute Myocardial Infarction? A Systematic Review and Meta-Analysis
Ahmed Adam,Jared McDowall,Sunday Joseph Aigbodion,Callistus Enyuma,Sean Buchanan,Ahmed Vachiat,Judy Sheahan,Abdullah Ebrahim Laher
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253 Relationship of periodontitis and edentulism to angiographically diagnosed coronary artery disease: A cross-sectional study
Mehtap Bilgin Çetin,Canan Önder,Kaan Orhan,Deniz Kumbasar,Muhittin Abdulkadir Serdar,Elif Ünsal
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254 Antiplatelet Ilaç Kullaniminin Mesane Kanseri Tanisi Üzerindeki Etkileri: Kolaylastirici mi, Zorlastirici mi?
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255 Association between Coronary Artery Disease and rs10757278 and rs1333049 Polymorphisms in 9p21 Locus in Iran
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