• 제목/요약/키워드: Ischemic heart disease

검색결과 277건 처리시간 0.026초

유방암 환자의 수술 후 보조적 항암 치료가 심혈관질환 위험에 미치는 영향 (Effects on the Risk of Cardiovascular Disease in Breast Cancer Patients Received Postoperative Adjuvant Anticancer Therapy)

  • 유미선;이태용
    • 한국산학기술학회논문지
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    • 제15권5호
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    • pp.2971-2980
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    • 2014
  • 유방암 환자에서 항암 치료가 심혈관질환의 위험에 미치는 영향을 파악하고자 2003년 1월부터 2006년 12월까지 1개 대학병원 유방암센터에서 유방암으로 진단 후 수술을 받은 환자 432명을 대상으로 혈청지질과 10년 내 허혈성 심질환 발생예측위험도의 변화를 보조적 항암 치료와 연관하여 조사하였다. 연구결과 총콜레스테롤과 중성지방은 수술 후 2년 및 5년 측정 시점에서 증가했으며 총콜레스테롤은 내분비요법 비시행군이 시행군보다 2년 및 5년경과 후 증가폭이 컸고 중성지방은 내분비요법 치료 유무에 따라 차이가 없었다. 항암 치료 방법에 따른 총콜레스테롤과 중성지방의 변화는 차이가 없었다. 10년 내 허혈성 심질환 발생예측위험도는 기저치보다 치료 5년 후에 0.44%p 위험도가 증가하였다. 유방암 수술 후 항암화학요법, 방사선 및 내분비요법 치료 시 심혈관질환 위험은 심각한 부작용을 발현하고 있지 않은 것으로 나타났으나 내분비요법 약물사용 유무에 의한 혈청 지질 성분 변화에 대해 정기적인 관련 검사 시행되어야 하며, 운동과 영양 관리 등의 다각적인 고려가 이루어져야 할 것이다.

허혈성 흉통 환자의 응급의료센터 방문 전 상황 (Prehospital Status of the Patients with Ischemic Chest Pain before Admitting in the Emergency Department)

  • 진혜화;이삼범;도병수;천병렬
    • Journal of Yeungnam Medical Science
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    • 제24권1호
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    • pp.41-54
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    • 2007
  • 2004년 10월부터 2005년 4월 중순까지 6개월 동안 영남대학교병원 응급의료센터에서 흉통으로 내원하여 허혈성 심장질환으로 진단받은 환자 170명을 대상으로 면담 조사를 통하여 다음과 같은 결과를 얻었다. 170명의 대상자중 남자가 118명, 여자가 52명이었고, 평균연령은 $63{\pm}12$세였다. 전체 대상자의 48.2%가 고혈압을 가지고 있었다. 타병원 경유여부는 2차병원 50.9%, 직접 내원 30.6%, 의원 12.4%, 본원외래 순이었으며 전원되어 온 환자가 직접 내원한 환자보다 2배 이상 많았다. 특히 거리가 25 km이상 먼 지역에서 방문한 경우는 전원군에서는 55.5%, 직접 내원군은 28.3%으로 전원군에서 먼 거리 지역의 환자가 많았다(p<0.05). 교통이용에 소요된 시간은 전원군이 $53.3{\pm}19.6$분, 직접내원군이 $33.0{\pm}25.3$분으로 전원군에서 더 많은 시간이 소요되었다(p<0.05). 이용교통수단은 119나 129가 31.8%, 자가용은 31.2%, 앰블런스 22.9%, 택시 10.0%, 대중교통 4.1% 순이었다. 흉통 발생시각으로부터 응급의료센터에 도착까지 총 소요된 시간은 최소 30분에서 최대 86,400분(30일)이며, 환자의 44.1%가 증상발현 이후 6시간 이내에 도착했으며, 24시간 이내에 도착한 경우는 67.1%였다. 특히 심근경색증 환자군중 6시간 이상 지체된 경우는 58명으로 54.8%를 차지하였다. 응급의료센터에 내원 전에 응급처치 여부에 있어서 환자 대부분이 의식이 명료하였기 때문에 심폐소생술은 거의 시행되지 않았다. 대체 의료 행위로는 아무것도 안함이 74.7%로 가장 많았고, 그 다음은 사혈, 소화제, 청심원, 부황과 뜸 순이었다. 니트로글리세린이용은 환자의 52.4%가 이용하였고, 타병원에서 혈전용해제를 쓰고 온 경우는 전체 대상자의 1.2%였다. 환자의 최초 흉통 발생 시간대는 오전 6~12시가 34.1%로 가장 많이 발생하였고, 흉통 발생 당시 상황은 휴식중(37.1%), 수면중(22.9%) 순으로 나타났다. 증상발현 장소로는 집이 79.4%로 가장 많았고, 흉통양상은 둔한 양상, 쥐어짜는 듯한 양상 순 등으로 나타났다. 흉통발생시각에서 응급의료센터 도착까지 각 지연 요소별 소요된 시간의 중앙값은 환자 지연시간은 521분, 교통이용 소요시간은 40분, 타병원에 들렀다 온 경우 타병원에서 소요된 시간은 40분으로 총소요시간의 중앙값은 600분이었다. 향후 추적결과에서 자진퇴원은 7.6%, 사망은 6.5%, 입원은 85.9%로 대부분 입원하였다. 심근경색증 환자의 경우 총 106명중 12.2%에서 혈전용해제가 투여되었고, 45.3%에서는 PTCA와 stent 삽입술이 시행되었다. 결론적으로 흉통을 호소한지 6시간 이상 지체된 체 병원에 방문한 경우가 많았고 직접 본원으로 내원한 환자보다 전원 되어 온 환자가 많으므로 의원이나 특히 병원급 이상의 의료기관에서는 적극적으로 혈전용해제 투여가 이루어질 수 있도록 의료 인력에 대해 지속적인 교육 및 시설과 장비를 갖출 수 있는 방안이 모색되어야 하고 심근경색증의 전구증상 및 증상에 관한 일반인들의 교육이 시급하며 특히 흡연자나 고혈압, 당뇨 및 협심증, 고지혈증, 뇌졸중 등 심근경색증의 위험인자와 병력을 가진 환자들에 대한 체계적이고 지속적인 교육이 이루어져야 할 것으로 사료된다.

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중풍 발생 위험인자에 대한 환자-대조군 연구 (The Case-Control Study on the Risk Factors of Stroke in Korean Adults)

  • 강경원;강병갑;차민호;고미미;박세욱;방옥선;조기호;김윤식;최선미
    • 한국한의학연구원논문집
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    • 제13권2호통권20호
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    • pp.65-69
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    • 2007
  • Background and Purpose : The purpose of this case-control study was to show the relationship between risk factors(past medical history, BMI, WHR, smoking, drinking), warning signs(dyscinesia, sightless, dysarthria, sensory disorder, numbness, blephalospasm, facial spasm, tension) and the incidence of stroke in korean adults. Methods : 455 stroke patients were enrolled as the case group and 180 non-stroke patients as control group from Oct. 2005 to Feb. 2006. Patients were hospitalized within 2 weeks after the onset of stroke. Obesity were defined as $BMI{\geq}25kg/m2$, $WHR{\geq}0.9$ in male and $WHR{\geq}0.8$ in female. Risk factors and warning signs were obtained from personal interview. The analysis of the data was done by chi-square test. Fisher's exact test and test-sample t-test. Results : The percentage of current smokers(or current drinkers) of case group is higher significantly than that of control group. The past medical history of risk factors were found to be transient ischemic attack(p=0.0698), facial palsy(p=0.4061), hypertension(p<0.0001), hyperlipidemia(p=0.1484), DM(p<0.0001), ischemic heart disease(p=0.0093), migraine(p=0.0014) and hypochondria(p=0.2370). $WHR{\geq}0.9$ in male had a 6.696 (3.711-12.082) odds ratio, $WHR{\geq}0.8$ in female had a 1.567 (0.659-3.726) odds ratio. $BMI{\geq}25kg/m2$ had a 2.017(1.263-3.222). The dyscinesia and sensory disorder of warning signs were found to be statistical difference between case and control group. Conclusions : According to the above results, it was found that smoking, drinking, BMI, WHR, hypertension, DM, ischemic heart disease, migraine affected to the incidence of stroke.

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치매환자에서의 심혈관계 약물사용 분석 (Analysis of Cardiovascular Medication Use in Dementia Patients)

  • 유기연
    • 한국임상약학회지
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    • 제27권3호
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    • pp.136-142
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    • 2017
  • Background: Dementia is one of important social and economic healthcare issues in the aging age. Therefore, it signifies to analyze the relationship between chronic disease or cardiovascular drug use and the incidence of dementia to establish a basis for increasing or preventing the risk of dementia. The purpose of this study was to investigate the correlation between the prevalence of chronic diseases and the use of cardiovascular drugs in patients diagnosed with dementia. Methods: In this study, we used data from sample of elderly patients from the Health Insurance Review and Assessment Service. We analyzed by logistic regression analysis with age, gender, and medication as covariates. KCD-7 was used to diagnosis of the disease, and drugs were analyzed using ATC codes and Korean standardized drug classification codes. Results: A total of 1,276,331 patients were analyzed in the sample of the elderly population, of which 532,075 (41.7%) were male and 744,256 (58.3%) were female. The patients have the higher risk of dementia in the older, women, and lower socioeconomically status. Cerebral infarction and ischemic heart disease increases risk of dementia. Patients taking statins, angiotensin converting enzyme inhibitor (ACEI) or angiotensin II receptor antagonists (ARB) showed low incidence of dementia. Conclusion: This study has been shown that ACEI, ARB, and statin drugs may associate with lower incidence of Alzheimer's and other dementia except vascular dementia.

항산화성 비타민 보충 급여가 흡연자의 혈중 지질 양상에 미치는 영향 (Effect of Antioxidant Vitamin Supplementation on Plasma Lipid Pattern in Smoking College Men)

  • 이성숙
    • Journal of Nutrition and Health
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    • 제31권3호
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    • pp.297-304
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    • 1998
  • Cigarette smoking is a well known risk factor for cardiovascular disease and has negative effects on blood lipid and lipoprotein . Some of the associations between smoking and chronic disease can be attributed to the less healthful lifestyles of smokers. A large body of epidemiologic evidence suggests inverse relationships between ischemic heart disease and plasma vitamin C and E concentrations . Smokers have lower plasma concentrations of these vitamins than do nonsmokers. Smokers therefore need antioxidant vitamin supplementation. The purpose of this study was to investigate the effect vitamin supplementation on plasma lipid patterns in smoking college men. 24subjects were divided into 3 groups of which were the vitamin C supplementation group (n=8), the vitamin E supplementation group(n=8) and the vitamin C+E supplementation group(n=8). The vitamin C supplementation group consumed 500mg of ascorbic acid, the vitamin E supplementation group consumed 200IU of D-$\alpha$-tocopherol, and the vitamin C+E supplementation group consumed 500mg of ascorbic acid+ 200IU of D-$\alpha$-tocopherol for 4 weeks. We examined the plasma lipid patterns before and after the vitamins were supplemented. The results obtained were as follows ; In the vitamin C supplementation group, the concentration of total cholesterol decreased significantly and HDL-cholesterol increased significantly with the supplementation of vitamin. In the vitamin E and vitamin C+E supplementation groups, however, there were no significant differences observed with the supplementation of vitamin. Concentration of plasma LDL, triglyceride, free fatty acid were not significantly affected by the supplementation of vitamin in all groups. In terms of plasma fatty acid composition, the concentrations of saturated fatty acid were not significantly affected by the supplementation of vitamin in all groups. The concentrations of palmitoleic acid, arachidonic acid, and docosahexaenoic acid, however, significantly increased in the vitamin E supplementation group(p<0.05). The concentration of plasma linoleic acid significantly increased in the vitamin C+ E supplementation group)(p<0.05). The results of this study show that antioxidant vitamin supplementation in smokers has a tendency to decrease coronary heart disease risk in view of the plasma total cholestrol and HDL-cholesterol concentrations of the vitamin C supplementation group and fatty acid concentration of the vitamin E supplementation group.

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Study of Novel Markers for Early Diagnosis of Cardiovascular Diseases

  • Kang Jae Heon;Han Jung Soon;Kim Kyung A;Song Hong Ji
    • Journal of Community Nutrition
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    • 제6권3호
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    • pp.155-163
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    • 2004
  • In our country, cardiovascular disease (CVD) and Coronary heart diseases (CHD) are the leading causes of death. It is well known that CHD is multifactorial, involving environmental factors such as diet, level of exercise and cigarette smoking, and inherited factors. According to the statistical data in 2003, the cause of death with the highest mortality was including hypertension, ischemic heart disease and atherosclerosis, which accounted for $24.7\%$ of total mortality. In spite of, there have been few study reports on the change of biochemical markers and mechanisms concerned. The development of biochemical markers is required for an early diagnosis and treatment of cardiovascular diseases that are related with dietary habits of Korean people enjoying mixtures of traditional dietary style and westernized food-styles. Therefore, the most efficient cost-saving biochemical marker was established in this study, through analysis of biochemical markers related with dietary habits which are susceptibly being changed in association to cardiovascular diseases from the pre-disease phase, and through reanalysis and assessment of early diagnosis of and preventive effects of diagnosis of cardiovascular diseases by demographical character including sex, age, and socioeconomic level with use of biochemical markers that are identified and selected among the parameters in consideration of the effectiveness and appropriateness of early diagnosis of diseases. The appropriateness of biochemical markers was reviewed by professionals (medical, pharmaceutical area and food/ nutrition area) and CRP(C-Reactive Protein) and was identified to be possible in Korea. It is thought that these biochemical markers may be used as the basic data for early diagnosis and prevention of cardiovascular diseases (CVD) which may be used for Korean people.

Triflusal과 Ibudilast 동시처리에 의한 혈소판응집 및 혈액응고 억제효과 (Inhibitory Effects on Platelet Aggregation and Blood Coagulation by Concurrent Administration of Trifusal and Ibudilast)

  • 황인영;손윤아;황선아;구연경;김선영;윤혜숙;권순경;정춘식
    • 약학회지
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    • 제56권4호
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    • pp.248-253
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    • 2012
  • This study aims to develop a novel regimen for enhanced efficacy and reduced side effect in inhibiting platelet aggregation and blood coagulation by concurrent administration of triflusal and ibudilast as anticoaggulants. The result shows this combination of triflusal and ibudilast (300~500 ${\mu}M$, respectively) has additive effect in inhibiting platelet aggregation and blood coagulation over the administration of truflusal or ibdilast as a single treatment. This pharmaceutical composition is expected to be useful for the prevention or treatment of various diseases and symptoms, for example, ischemic heart disease, ischemic cerebral infarction, arteriosclerosis, and thrombosis caused by the insertion of a stent.

한국인에서 치주질환과 관상동맥질환의 관련성에 대한 염증표지자와 IL-1 유전자 다변성의 영향 (Association between Periodontitis and Coronary heart disease in Korea : Inflammatory markers and IL-1 gene polymorphism)

  • 정하나;정현주;김옥수;김영준;김주한;고정태
    • Journal of Periodontal and Implant Science
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    • 제34권3호
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    • pp.607-622
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    • 2004
  • Recently epidemiologic studies have indicated that the patients with periodontitis may have increased risk of ischemic cardiovascular events, and have suggested the important roles of blood cytokines and acute reactant proteins in the systemic infection and inflammatory response. Periodontitis and coronary heart disease (CHD) may share the common risk factors and the genetic mechanism associated with interleukin(IL)-1A, B and RA genotype may be involved in the production of IL-1. This study was aimed to investigate the relationship between angiographically defined CHD and periodontitis as chronic Gram-negative bacterial infection and to determine whether the IL-1 gene polymorphism is associated in both diseases. Patients under the age of 60 who had undergone diagnostic coronary angiography were enrolled in this study. Subjects were classified as positive CHD (+CHD, n=37) with coronary artery stenosis more than 50% in at least one of major epicardial arteries, and negative CHD (-CHD, n=30) without significant stenosis. After recording the number of missing teeth, periodontal disease severity was measured by means of plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing depth (PD), clinical attachment level (CAL), and radiographic bone loss around all remaining teeth. Gingival crevicular fluid (GCF) was collected from the 4 deepest periodontal pockets and assessed for cytokine ($IL-1{\beta}$, IL-6, IL-1ra, tumor necrosis $factor-{\alpha}$, and prostaglandin $E_2$). Additionally, blood CHD markers, lipid profile, and blood cytokines were analyzed. IL-1 gene cluster genotyping was performed by polymerase chain reaction and enzyme restriction using genomic DNA from buccal swab, and allele 2 frequencies of IL-1A(+4845), IL-1B(+3954), IL-B(-511), and IL-1RA(intron 2) were compared between groups. Even though there was no significant difference in the periodontal parameters between 2 groups, GCF level of $PGE_2$ was significantly higher in the +CHD group(p<0.05). Correlation analysis showed the positive relationship among PD, CAL and coronary artery stenosis(%) and blood $PGE_2$. There was also significant positive relationship between the periodontal parameters (PI, PD, CAL) and the blood CHD markers (leukocyte count, C-reactive protein, and lactic dehyrogenase). IL-1 gene genotyping showed that IL-1A(+3954) allele 2 frequency was significantly higher in the +CHD group compared with the -CHD group (15% vs. 3.3%, OR 5.118,p=0.043). These results suggested that periodontal inflammation is related to systemic blood cytokine and CHD markers, and contributes to cardiovascular disease via systemic inflammatory reaction. IL-1 gene polymorphism might have an influence on periodontal and coronary heart diseases in Korean patients.

Cardioprotection via mitochondrial transplantation supports fatty acid metabolism in ischemia-reperfusion injured rat heart

  • Jehee Jang;Ki-Woon Kang;Young-Won Kim;Seohyun Jeong;Jaeyoon Park;Jihoon Park;Jisung Moon;Junghyun Jang;Seohyeon Kim;Sunghun Kim;Sungjoo Cho;Yurim Lee;Hyoung Kyu Kim;Jin Han;Eun-A Ko;Sung-Cherl Jung;Jung-Ha Kim;Jae-Hong Ko
    • The Korean Journal of Physiology and Pharmacology
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    • 제28권3호
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    • pp.209-217
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    • 2024
  • In addition to cellular damage, ischemia-reperfusion (IR) injury induces substantial damage to the mitochondria and endoplasmic reticulum. In this study, we sought to determine whether impaired mitochondrial function owing to IR could be restored by transplanting mitochondria into the heart under ex vivo IR states. Additionally, we aimed to provide preliminary results to inform therapeutic options for ischemic heart disease (IHD). Healthy mitochondria isolated from autologous gluteus maximus muscle were transplanted into the hearts of Sprague-Dawley rats damaged by IR using the Langendorff system, and the heart rate and oxygen consumption capacity of the mitochondria were measured to confirm whether heart function was restored. In addition, relative expression levels were measured to identify the genes related to IR injury. Mitochondrial oxygen consumption capacity was found to be lower in the IR group than in the group that underwent mitochondrial transplantation after IR injury (p < 0.05), and the control group showed a tendency toward increased oxygen consumption capacity compared with the IR group. Among the genes related to fatty acid metabolism, Cpt1b (p < 0.05) and Fads1 (p < 0.01) showed significant expression in the following order: IR group, IR + transplantation group, and control group. These results suggest that mitochondrial transplantation protects the heart from IR damage and may be feasible as a therapeutic option for IHD.

우황청심원이 당뇨병 Rat의 혈액순환장애에 미치는 영향 (The Effect of Woohwangcheongsim-won on Circulatory Disturbance in Diabetes)

  • 황성록;정승현;신길조;이원철
    • 대한한의학회지
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    • 제23권2호
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    • pp.164-179
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    • 2002
  • Object: Death rate due to hypertension, atherosclerosis, ischemic heart disease and cerebral infarction induced by Westernized diet and increased average life span is on the rise. Decrease in blood circulation, activation of thrombus generation and intravascular lipid accumulation, cited as the principal causes of the above mentioned diseases in recent studies, result in circulatory disturbance and blood vessel obstruction leading to ischemic cell death of heart, brain and peripheral vessels. Method: We investigated the biochemical changes in microvascular permeability, aggregation of platelet and the intravascular lipid accumulation in induced-diabetic rat using Streptozotocin. We also studied the effects of Woohwangcheongsirn-won after oral administration on blood circulation, platelet function and lipid metabolism. The results are as follows: I. Woohwangcheongsim-won increased blood circulation in microvessels. 2. Woohwangcheongsim-won increased the reduced erythrocyte deformability in diabetes. 3. Woohwangcheongsim-won induced the reduction of contents of 2, 3-DPG, but failed to affect the reduced contents of ATP in erythrocyte in diabetes. 4. Woohwangcheongsim-won reduced the activity of Ca/sup 2+/-ATPase in the membrane of erythrocyte. 5. Woohwangcheongsim-won reduced the platelet aggregation evoked by platelet agglutinin factor. 6. Woohwangcheongsim-won reduced the production of platelet-derived granules. 7. Woohwangcheongsim-won reduced the production of metabolites of arachidonic acid in diabetes, and also reduced the production of increased thromboxane B2. 8. Woohwangcheongsim-won reduced the synthesis of oxidized LDL-cholesterol. In conclusion, Woohwangcheongsim-won enhanced blood circulation in microvesseles, erythrocyte deformability and inhibited the increased platelet aggregation and the synthesis of oxidized LDL-cholesterol in diabetes. Therefore Woohwangcheongsim-won is believed to positively affect blood circulation (J Korean Oriental Med 2002;23(2):164-179)

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