|
Authors' Interview : Drs. William F. McIntyre MD & Adrian Baranchuk MD FACC |
Publication:
Authors' Interview : Drs. William F. McIntyre MD & Adrian Baranchuk MD FACC
Snow-shoveling and the risk of acute coronary syndromes.
Nichols RB, McIntyre WF, Chan S, Scogstad-Stubbs D, Hopman WM, Baranchuk A.
Cardiac Electrophysiology and Pacing, Division of Cardiology, Kingston General Hospital, Queen's University, Kingston, ON, K7L 2V7, Canada.
Clin Res Cardiol. 2011 Sep 9.
|
What are the main findings of the study?
|
Our research group recently released a study entitled "Snow-shoveling and the risk of acute coronary syndromes", published online in the September 2011 edition of Clinical Research in Cardiology.
This study examines the relationship between snow-shoveling and acute coronary syndromes (heart attacks) over two consecutive winters in our hospital catchment area of 500,000 persons.
|
Were any of the findings unexpected?
|
Our study found that over two winter seasons, 35 acute coronary syndromes occurred that could be linked to snow-shoveling by clinical history; this represented 7 % of all acute coronary syndromes over those two winter seasons.
Those that had snow-shoveling related events were 3.6 times more likely to have a family history of premature coronary artery disease and 4.8 times more likely to be male. There was also a trend towards an increasing frequency of chronic, stable angina in those patients with snow-shoveling related events.
|
What should clinicians and patients take away from this study?
|
This study is the first to lend evidence to the long-standing assumption that snow-shoveling is a risk factor for acute coronary syndromes.
Where the American Heart Association (2007) currently considers snow-shoveling a high-risk activity based on expert consensus, there is now data to support these recommendations.
|
What recommendations do you have for nephrology health care providers as a result of your study?
|
Patients and physicians need to be made aware of the high risk nature of snow-shoveling, particularly in at-risk persons such as those with a family history of premature cardiovascular disease and a personal history of angina.
Snow-shoveling is a demanding exercise and patients should consult their physicians before undertaking this or any other strenuous physical activity.
|
Abstract: |
BACKGROUND:
Snow-shoveling is a necessary activity for those living in temperate climates, but there are no large studies identifying a connection between this activity and the development of acute coronary syndromes (ACS).
OBJECTIVES:
The aim of this study was to identify potential factors that place individuals at higher risk for developing a snow-shoveling-related ACS.
METHODS:
We performed a chart review over two consecutive winter seasons to identify a sample of ACS events associated with shoveling snow. Demographics, cardiovascular risk factors and medication use of the shoveling-related and non-shoveling-related event groups were compared, and multivariate regression was used to identify a subset of relevant factors.
RESULTS:
Our study population included 500 patients with ACS, mean age of 65.7 ± 13.4 years (range 31-94) and 66.7% of the events occurred in males. A total of 35 (7%) events were documented to have occurred following snow-shoveling. Between patients with snow-shoveling-related and non-related events there were no significant differences in the prevalence of diabetes, hypertension, hypercholesterolemia or sleep apnea.
Logistic regression did not show any significant group differences in age and known coronary artery disease; however, those suffering a snow-shoveling-related event were 3.6 times more likely to have a family history of premature cardiovascular disease (p = 0.001) and were 4.8 times more likely to be male (p = 0.01).
CONCLUSION:
A family history of premature cardiovascular disease and male gender were found to have strong, independent associations with having a snow-shoveling-related ACS. A history of chronic stable angina trended toward an association.
|
|
|
|
Featured Angina| Acute Coronary Syndrome and Heart Disease Interviews
|
Author Interview: Claes Held MD
Associate professor at Uppsala Clinical Research Center and the
Cardiology department at Uppsala University Hospital in Sweden
|
Publication:
Physical activity levels, ownership of goods promoting sedentary behaviour and risk of myocardial infarction: results of the INTERHEART study
Eur Heart J first published online January 11, 2012 doi:10.1093/eurheartj/ehr432
2012 doi:10.1093/eurheartj/ehr432
Claes Held, Romaina Iqbal, Scott A. Lear, Annika Rosengren, Shofiqul Islam,James Mathew, and Salim Yusuf
|
What are the main findings of the study?
|
The main findings are he following:
-
It is well known that physical inactivity is a risk factor for developing cardiovascular disease.
-
Our study shows that being physically active reduces the risk of having a heart attack.
-
Older studies have mostly studied people in the developed countries. This study which has a global perspective and includes 52 countries from all continents, shows that physical inactivity reduces the risk also in both low- middle-and high-income countries.
-
We also found that ownership of a car and TV was associated with a more than doubled risk of being sedentary and that in low- and middle income the risk for a heart attack was increased with 27 %.
-
We can however, not conclude from this study that there is a causal relationship but it is an interesting finding.
|
Were any of the findings unexpected?
|
We looked at the relationship between physical activity both at work and during leisure time.
A bit surprising was that people with heavy physical labor did not have a reduction in the risk of heart attacks, whereas people with both mild and moderate intensity did.
|
What should clinicians and patients take away from this study?
|
The main findings above and also that physical activity with duration below the recommended 30 minutes/day does seem to prevent from heart attacks as well although not as much as when you do it according to guidelines.
This may be a comfort to those who are completely sedentary and feel that it would be a too big step to move to the 30 minutes/day right away.
All PA does a good job for the heart as compared to not doing anything at all!
|
What recommendations do you have for cardiology health care providers as a result of your study?
|
It would be interesting to follow up on the ownership of car and TV and do a prospective study to see if the theory holds true.
|
|
|
|
|
|
Publication:
Short Telomere Length, Myocardial Infarction, Ischemic Heart Disease, and Early Death
- Maren Weischer, Stig E. Bojesen, Richard M. Cawthon, Jacob J. Freiberg,
Anne Tybjærg-Hansen, and Børge G. Nordestgaard
Arterioscler Thromb Vasc Biol. 2011;ATVBAHA.111.237271published online before print December 22 2011, doi:10.1161/ATVBAHA.111.237271 |
What are the main findings of the study?
|
One in four Danes have reduced telomere length, that is, increased cellular ageing, and a 25% increased risk of early death and a 50% increased risk of heart attack.
|
Were any of the findings unexpected?
|
Yes, previous smaller studies have suggested much larger risk increases for early death and heart attack, while we found more modest risk estimates.
|
What should clinicians and patients take away from this study?
|
A possible prospect of the study is a simple blood test done by the general practitioner, which will reveal a person’s telomeric length and thereby the cellular wear and age.
If the celluar wear is more than expected by age alone, this could be a "wake-up call" suggesting for the patient that now is maybe the time to stop smoking and lose weight.
|
What recommendations do you have for cardiology health care providers as a result of your study?
|
We need to know if smoking and obesity is the direct cause of reduced telomeric length and thereby increased cellular wear, and whether decreased telomeric length is a direct cause of heart attack and early death.
|
|
Keywords and tags:
Angina, atypical angina, heart disease,chest pain, angina pectoris, chest pains, cardiology ,ivabradine for chronic angina, emergency room evaluation of chest pain, heart attacks, cardiac syndrome X,cpr, heart disease in women, cholesterol, lipids, heart medications, aspirin, cardiologists, ekg, ecg, echocardiology, heart surgery, bypass surgery, stents, spiral CTs, 64 slice CTs, chest pain, heart risk factors, cardiology news, angina.com, CRP, C Reactive Protein, troponins, troponin I, troponin T, Prinzmetal's angina, nitrates, angina treatment, JUPITER study, Crestor, CHF, congestive heart failure, Avandia, myeloperoxidase, MPO, biomarkers, AEDs, cardiac defibrillators, cardiac CTs, coronary 64 slice scanners,128 slice CT, 256 Cat Scan, Vitamin D and heart disease, Get with the Program -Coronary Artery Disease updates, Acute Coronary Syndrome, stress tests, thallium stress test, PCI, angioplasty, CABG, coronary artery bypass surgery, calcium
Angina | Heart Disease Resourses
| Chest Pain
Amazon.com 's Editorial Reviews
Angina: New Ways to Treat
Chronic Chest Pain
Part of the award winning public television series Healthy head
/Healthy Mind. It's one of the scariest medical symptoms for people who are generally healthy: a tightening, painful feeling in the chest known as Angina. In some cases this chest pain can be a serious warning that requires immediate treatment. But for the millions of people with chronic, stable angina the discomfort is something that can be readily managed with a variety of treatments. In this program we take a look at what generally causes angina, what can be done to prevent it and how it can be effectively treated with lifestyle changes, innovative drug therapies and medical procedures.
|
Amazon.com Editorial Review:
Philips HeartStart Home Defibrillator (AED)
Be prepared for the unexpected.
When sudden cardiac arrest (SCA) strikes, the electrical system of the heart short circuits, causing the heart to quiver rather than pump in a normal rhythm. It typically results in the abnormal heart rhythm know as ventricular fibrillation (VF). It usually happens without warning and the majority of people have no previously recognized symptoms of heart disease. And it most often happens at home. For the best chance of survival from SCA caused by VF, a defibrillator should be used within 5 minutes. Yet, less than 1 in 20 people survive largely because a defibrillator does not arrive in time.
Just as seat belts or airbags do not save every life in a traffic accident, a defibrillator will not save every person who suffers a sudden cardiac arrest. Yet many lives could be saved if more people could be reached more quickly.
|
|
Angina.com Tag Cloud | Angina Keywords
|
**************************************
|
