Global Heart

Health Services Availability and Readiness for Management of Hypertension and Diabetes in Primary Care Health Facilities in Ghana: a Cardiovascular Risk Management project
Hinneh T, Mensah B, Boakye H, Ogungbe O and Commodore-Mensah Y
Hypertension and diabetes are leading causes of adult hospital admissions and mortality across health facilities in Ghana. Timely screening and diagnosis at primary health facilities are crucial to initiate treatment and avert complications. This study explored service availability and readiness of health systems for managing hypertension and diabetes in selected district hospitals in Ghana.
Decomposing the Poor-Non-Poor Gap in the Prevalence of Undiagnosed and Untreated Hypertension Among Bangladeshi Population
Rahman M, Khatun M, Pinkey AN, Haque SE, Liza FA, Haque MN, Sarkar P, Roy TK, Islam GMR, Alam MR, Hasan M, Adam IF, Duc NHC, Al-Sobaihi S and Hasan A
Our objectives were to ascertain: the prevalence and socio-economic distribution of hypertension, as well as the rates of undiagnosed and untreated hypertension; the association between socioeconomic status (SES) and the occurrence of hypertension, as well as the rates of undiagnosed and untreated hypertension; and the factors influencing the poor-non-poor gap in terms of the prevalence, diagnosis, and treatment of hypertension.
Association Between the Albumin-Bilirubin (ALBI) Score and All-cause Mortality Risk in Intensive Care Unit Patients with Heart Failure
Wang J, Wang K, Feng G and Tian X
The albumin-bilirubin (ALBI) score has demonstrated prognostic value in a range for liver and heart diseases. However, its association with all-cause mortality in intensive care unit (ICU) patients with heart failure remains uncertain.
Integrated Antihypertensive and Statin Treatment Protocols for Cardiovascular Disease Prevention in Low- and Middle-Income Countries
Moran AE, Aimiosior O, Gupta R, Pathni A, Sahoo SK, Dessie G, Osi K, Zhang X, Banigbe B, Garg R and Frieden TR
In low- and middle-income countries where the majority of preventable cardiovascular disease deaths occur, less than 10% of eligible patients receive statins for primary cardiovascular disease prevention. Since 2017, the Global Hearts initiative has implemented simple World Health Organization (WHO) HEARTS hypertension and diabetes treatment protocols. In this editorial, we propose an approach of integrating statin treatment into existing HEARTS hypertension and diabetes protocols as a way of expanding statin coverage in low-and middle-income countries.
Lessons Learnt from HIV and Noncommunicable Disease Healthcare Integration in Sub-Saharan Africa
van der Mannen JS, Heine M, Lalla-Edward ST, Ojji DB, Mocumbi AO and Klipstein-Grobusch K
In sub-Saharan Africa (SSA), a rising burden of noncommunicable diseases (NCDs) coexists with a persistent high burden of human immunodeficiency virus (HIV). Integrating care for chronic conditions is potentially beneficial, but the optimal approach remains unclear. By use of a narrative review of 14 recent case studies from different SSA countries, examples of NCD and HIV healthcare integration were described. Case studies were categorized into three models: integrating NCD care into existing HIV care ( = 8), integrating HIV care into existing NCD care ( = 2), and simultaneous implementation of HIV and NCD services ( = 4). Facilitators include staff and patient education, while barriers encompass the lack of guidelines and inadequate infrastructure. Providers, patients, and policymakers support integrated care but note several challenges. Available health economics data suggest cost-effectiveness in the long run. Concluding, NCD and HIV healthcare integration in SSA was deemed feasible with models of service integration related to the implementation context.
Immediate and Intermediate-Term Outcomes of Infants With Transposition of Great Arteries Who Underwent Balloon Atrial Septostomy in Sudan
Ali SKM, Elsheikh A and Alhassan MA
Transposition of great arteries (TGA) is a critical congenital heart disease leading to a fatal outcome if timely management is not provided. Management in low-income countries is challenging. A retrospective analysis was carried out at Sudan Heart Center for infants with TGA who underwent balloon atrial septostomy (BAS) from January 2010 to December 2020. Immediate clinical- and procedure-related outcomes were evaluated. Intermediate-term outcomes were studied using follow-up hospital records as well as direct telephone calls. The study included 75 infants (70% males) with a median age at presentation of 25 and at the time of BAS of 28 days. Pre-BAS median oxygen saturation was 48 (Interquartile Range (IQR) 40-60%). BAS was performed under fluoroscopy and echocardiography guidance with immediate success achieved in 98% of patients. Post-BAS oxygen saturation increased to 87 (IQR 85-90%) with a median improvement of 40% (p = 0.048), which was more significant in those less than 2 weeks of age. Minor complications occurred in 14 patients, and two patients (2.6%) died. Surgery (atrial in 44% and arterial switch operations in 41%) was performed in 39 patients (52%) at a mean age of three months with perioperative mortality of 30%. Infants who underwent surgery had a significantly higher survival rate (69%) compared to those who did not (5.6%) (p < 0.001). Patients with TGA present at a late age with good immediate outcomes of BAS. Access to surgery is limited with a high surgical mortality. Those who survived surgery had good intermediate-term outcomes while most unoperated patients died.
Awareness and Perceptions towards the Role of Systemic Inflammation and High-Sensitivity C-reactive Protein as a Biomarker in Atherosclerotic Cardiovascular Disease and Chronic Kidney Disease: The Multinational FLAME-ASCVD Survey amongst Cardiologists
Marx N, Komuro I, Prasad P, Qian J, Saraiva JFK, Zonoozi AAM, Shete A and Catapano AL
Analysis of the Predictors of Mortality from Ischemic Heart Diseases in the Southern Region of Brazil: A Geographic Machine-Learning-Based Study
de Carvalho Dutra A, Silva LL, Borba IM, Dos Santos AGA, Marquezoni DP, Beltrame MHA, do Lago Franco R, Hatoum US, Miyoshi JH, Leandro GCW, Bitencourt MR, Nihei OK, Vissoci JRN and de Andrade L
Mortality due to ischemic heart disease (IHD) is heterogeneously distributed globally, and identifying the sites most affected by it is essential in developing strategies to mitigate the impact of the disease, despite the complexity resulting from the great diversity of variables involved.
Pregnancy Loss Was Associated With the Increased Risk of Cardiovascular Diseases in Middle-Aged Women: Evidence From the China Health and Retirement Longitudinal Study
Yang X, Fan Q, Shen C, Hou R, Chen R, Yin J, Xiang H, Cao Y and Peng X
Significant associations between pregnancy loss and risk of future maternal cardiovascular disease (CVD) have been found in Western countries, but the association in China is still unclear. Therefore, this study aimed to investigate the associations of pregnancy loss, number of pregnancy losses, subtype of pregnancy loss (i.e. induced abortion, miscarriage and stillbirth) and age at the first pregnancy loss with CVD risk in Chinese population.
Clinical Characteristics and Outcomes of Elderly Patients Undergoing Primary Percutaneous Coronary Intervention: An Observational Cohort Study
Hassan A, Emam AY, Thabet M, Osman A, Shams KA, Labib MS and Elguindy A
The global trend of population aging has resulted in more frequent cardiovascular disease among seniors. Primary percutaneous coronary intervention (pPCI) is the standard of care for ST-elevation myocardial infarction (STEMI) without an upper age limit. Nevertheless, the outcomes are variable among studies, and data on pPCI outcomes in the elderly in Africa is scarce. Thus, we attempted to gain better insight into the outcomes of primary PCI in this age group from a single center in upper Egypt.
Common and Distinct Genetic Architecture of Blood Pressure in Relation to Coronary Artery and Abdominal Aortic Calcium
Huang H, Ruan H, Lu X, Zhang W and Liu J
Association of Time in Target Range of Resting Heart Rate With Adverse Clinical Outcomes in Patients With Acute Coronary Syndromes After Percutaneous Coronary Intervention
Zheng J, Chen C, Fan Z, Ye Q, Zhong Y, Li J, Huang H, Deng J, Zhao J, Xiong T, Tian W and Zhang X
Heart rate (HR) has been proved to be associated with major adverse cardiovascular events (MACE) in Acute coronary syndrome patients. However, the threshold value and clinical significance of time in target of resting heart rate (TTR-HR) remain insufficiently elucidated. Our study aimed to evaluate the independent association between TTR-HR and cardiovascular outcomes in the follow-up study of ACS. A total of 1455 ACS patients who underwent percutaneous coronary intervention (PCI) and were admitted to 22 hospitals between 2019 and 2022 were enrolled and followed up for 12 months. MACE was defined as a composite of cardiac death, nonfatal recurrent myocardial infarction, ischemic-driven revascularization, and ischemic stroke. The association between TTR-HR and cardiovascular outcomes was assessed using Cox regression model. Compared to patients with TTR-HR 0-50% and >50%-75%, patients with TTR-HR > 75%-100% were older and less alcohol user, less likely to use diuretics and anti-diabetic drugs, these patients had less comorbidities of hyperlipidemia, diabetes, heart failure, and cardiac shock. After 12 months follow up, the incidence of MACE and composite endpoint but not mortality was higher in patients with TTR-HR 0-50% and >50%-75% than those with TTR-HR > 75%-100%. After multivariate adjustment, TTR-HR [hazard ratio = 2.11, 95% CI: 1.19-3.74, p = 0.01] was independently associated with composite endpoint. In summary, our study demonstrates that TTR-HR holds significant prognostic value, with TTR-HR > 75%-100% being independently associated with reduced composite endpoint risk in ACS patients following PCI. These findings emphasize the importance of effective heart rate control in ACS patients following PCI.
Perceptions of Cardiovascular Healthcare Professionals Regarding Clinical Trials: A Survey-Based Study from the Middle East
Dakhil ZA, Farhan HA, Marsool MD, Qasim MS, Peters M and Leal J
Low-middle income countries harbor the highest burden of cardiovascular diseases globally, but there is an under-representation of these countries in cardiovascular clinical trials. This limits the generalizability of the trial results to these countries. There is a lack of data on insights of cardiologists in these countries regarding conducting and participating in clinical trials. We sought the views of cardiovascular healthcare professionals in Iraq on participation in clinical trials.
DENND5B Gene Expression as a Trigger for the Development of Diabetes Mellitus-Peripheral Artery Disease: Insights from a Univariate and Multivariate Mendelian Randomization Study
Li Q, Cao F, Gao X, Xu Y, Li B and Hu T
Peripheral artery disease (PAD) is a manifestation of systemic atherosclerosis that can result in limb pain, disability, or mortality. Notably, diabetes mellitus (DM) stands out as one of the most significant risk factors for the development of PAD. Compared to individuals with PAD but no DM, those with concurrent DM and PAD (DM-PAD, diabetes mellitus-peripheral artery disease) face a seven-fold higher risk of critical limb ischemia and a five-fold higher risk of amputation. However, the pathogenic factors and effective therapeutic targets for DM-PAD still remain elusive.
Validation of ACC/AHA and ESC Sudden Cardiac Death Risk Guidelines in Diverse Hypertrophic Cardiomyopathy Cohort: Stratification HCM Study
Oliveira Antunes M, Fernandes F, Arteaga-Fernandez E, Alvarez Ramires FJ, Machado Correia V, Novaes Cardoso J, Romero CE, Sousa HM, Soliani MT, Dal Piaz MRR, Rodrigues Gandarella AD, Rocha Teixeira RG, Mady C, Assis Moura Tavares C, Guimarães PO and Madrini Junior V
Sudden cardiac death (SCD) is a major concern in patients with hypertrophic cardiomyopathy (HCM). The American College of Cardiology/American Heart Association (ACC/AHA) and the European Society of Cardiology (ESC) have different guidelines for SCD risk stratification. Their comparative performance in diverse populations remains uncertain.
Shared Genetic Links Between Nonalcoholic Fatty Liver Disease and Coronary Artery Disease
Di H, Wang S, Xu C, Yin Q, Xu K and Zheng W
Epidemiological and clinical studies have shown that there is a co-morbidity between nonalcoholic fatty liver disease (NAFLD) and coronary artery disease (CAD).
The Experience of the Salim Yusuf Emerging Leaders Programme: A Journey Beyond Borders
Madrini Junior V, Peterson VR, Piotie PN, Sahoo SK, Munot S, Cruz RR, Rodolico D, Ogunmodede JA and Rodriguez G
Knowledge, Attitude, and Practice of the Lebanese University Medical Students and Junior Doctors on Basic Life Support Practices
El Assaad H, Osman B, Honeine MO, Abi-Hanna P and Chahine MN
Basic life support (BLS) is the recognition of sudden cardiac arrest and activation of emergency response system, followed by cardiopulmonary resuscitation (CPR), and rapid defibrillation.
Clinical Laboratory Validation Study of a High Sensitivity Troponin I Assay on a POCT (Point of Care Testing) Device
Pitta FG, Leme AC, Gomes SR, Mota TP, Paladino FV, de Souza Júnior JL, de Paula Braz R, Lamounier TCRL, Ferreira JBG and Dos Santos Ferreira CE
In Acute Coronary Syndrome without ST-segment elevation, the use of high-sensitivity troponins in rapid protocols is considered the gold standard for diagnostic exclusion/confirmation, in conjunction with clinical stratification. The biggest concern regarding the techniques for troponin evaluation is the time required between collection and delivery of the result.
Imaging and Circulating Biomarker-Defined Cardiac Pathology in Pulmonary Tuberculosis: A Systematic Review
Scopazzini MS, Hill KJ, Majonga ED, Zenner D, Ayles H and Shah ASV
Pulmonary tuberculosis (PTB) is associated with increased cardiovascular disease (CVD) mortality. However, underlying pathophysiological mechanisms are poorly understood. This systematic review aims to synthesise the evidence on the prevalence of cardiac pathology based on cardiac imaging and circulating biomarkers in patients with PTB.
Spirituality-Based Intervention in Hypertension: EFfects on Blood PrEssure and EndotheliaL Function-FEEL Trial Results
Teixeira MEF, Barroso WKS, Brandão AA, Sousa ALL, Esporcatte R, de Borba MHE, Baleeiro ACNÁ, Gonçalves BC, Inumaru E, de Sousa EM, Leal GB, de Araújo Pereira Farias HS, de Souza JA, da Silva LEB, de Paiva Queiroz MC, Moreira FR, de Oliveira Vitorino PV, Eikelboom J and Avezum Á
Emerging evidence suggests that spirituality improves patient outcomes, however, this has undergone only limited evaluation in randomized trials. Hypertension is a major cause of cardiovascular morbidity and mortality worldwide.