CVD, cardiovascular disease

CVD,心血管疾病
  • 文章类型: Journal Article
    衰老,影响所有生物的复杂生理过程,是一个主要的研究领域,特别关注减缓其进展的干预措施。这项研究评估了达格列净(DAPA)对人工诱导衰老的小鼠模型中各种衰老相关参数的抗衰老功效。将40只雄性瑞士白化病小鼠随机分为四组,每组十只动物。对照组(I组)接受生理盐水。衰老模型组(Ⅱ组)口服D-半乳糖500mg/kg诱导衰老。在老化诱导之后,阳性对照组接受维生素C补充剂(第三组),而DAPA组(IV组)接受达格列净治疗。炎症介质(TNF-α和IL-1β)显示出相似的变化模式。在III组和IV组之间没有观察到统计学上的显著差异。与GII相比,两组的数值均明显较低,虽然与GI相比明显更高。谷胱甘肽过氧化物酶(GSH-Px)在GIII组和GIV组之间无统计学差异,但是与GII相比,GIII中的GIII更高,而与GI相比,GIII中的GIII明显更低。研究表明,达格列净对小鼠衰老的许多指标都有有益的影响。干预导致心肌细胞肥大减少,增强皮肤活力,炎症介质的存在减少,和改善抗氧化剂的功效。
    Aging, a complex physiological process affecting all living things, is a major area of research, particularly focused on interventions to slow its progression. This study assessed the antiaging efficacy of dapagliflozin (DAPA) on various aging-related parameters in a mouse model artificially induced to age. Forty male Swiss albino mice were randomly divided into four groups of ten animals each. The control group (Group I) received normal saline. The aging model group (Group II) was administered D-galactose orally at 500mg/kg to induce aging. Following the aging induction, the positive control group received Vitamin C supplementation (Group III), while the DAPA group (Group IV) was treated with dapagliflozin. The inflammatory mediators (TNF-α and IL-1β) showed similar patterns of change. No statistically significant difference was observed between groups III and IV. Both groups had significantly lower values compared to GII, while it was significantly higher compared to GI. Glutathione peroxidase (GSH-Px) showed no statistically significant difference between groups GIII and GIV, but it was higher in GIII compared to GII and significantly lower in GIII compared to GI. The study demonstrated that dapagliflozin exerts a beneficial impact on many indicators of aging in mice. The intervention resulted in a reduction in hypertrophy in cardiomyocytes, an enhancement in skin vitality, a decrease in the presence of inflammatory mediators, and an improvement in the efficacy of antioxidants.
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  • 文章类型: Journal Article
    本文旨在研究不同膳食脂肪类型与肥胖和冠状动脉指数的相关性。以横断面方式纳入了491名健康成年人的样本。膳食脂肪的摄入量,肥胖指数(锥度指数(CI),身体肥胖指数(BAI),腹部容积指数(AVI),身体圆度指数(BRI),和体重调整腰围指数(WWI)),和心血管指数(心脏代谢指数(CMI),脂质积累产物(LAP),计算并研究了血浆动脉粥样硬化指数(AIP)。Omega-3摄入量可接受的参与者的BRI得分较高(1·90±0·06v.1·70±0·06)。胆固醇摄入量不可接受的参与者的CI较高(1·31±0·11v.1·28±0·12;P=0·011),AVI(20·24±5·8·18·33±6·0;P<0·001),BRI(2·00±1·01v.1·70±1·00;P=0·003),一战(11·00±0·91诉10·80±0·97;P=0·032),和较低的AIP(0·46±0·33与0·53±0·33;P=0·024)。总脂肪,饱和脂肪(SFA)多不饱和脂肪(PUFA)摄入量与AVI和BRI呈中度显著相关。单不饱和脂肪(MUFA)摄入量与CI、AVI、BRI,WWI,和AIP。胆固醇和omega-6与所有指标的相关性较弱。在男性和女性参与者中也看到了类似的相关性。不同类型的脂肪摄入显著影响肥胖和冠状动脉指数,特别是SFA和PUFA,以及欧米茄-3和胆固醇。性别和饮食类型的脂肪摄入量对肥胖和冠状动脉指数的指标都有影响。
    This article aims to study the different dietary fat types associated with obesity and coronary indices. A sample of 491 healthy adults was included in a cross-sectional manner. Dietary fats intake, obesity indices (conicity index (CI), body adiposity index (BAI), abdominal volume index (AVI), body roundness index (BRI), and weight-adjusted-waist index (WWI)), and cardiovascular indices (cardiometabolic index (CMI), lipid accumulation product (LAP), and atherogenic index of plasma (AIP)) were calculated and studied. Participants with an acceptable intake of omega-3 had a higher BRI score (1⋅90 ± 0⋅06 v. 1⋅70 ± 0⋅06). Participants with an unacceptable intake of cholesterol had a higher CI (1⋅31 ± 0⋅11 v. 1⋅28 ± 0⋅12; P = 0⋅011), AVI (20⋅24 ± 5⋅8 v. 18⋅33 ± 6⋅0; P < 0⋅001), BRI (2⋅00 ± 1⋅01 v. 1⋅70 ± 1⋅00; P = 0⋅003), WWI (11⋅00 ± 0⋅91 v. 10⋅80 ± 0⋅97; P = 0⋅032), and lower AIP (0⋅46 ± 0⋅33 v. 0⋅53 ± 0⋅33; P = 0⋅024). Total fat, saturated fat (SFA), and polyunsaturated fat (PUFA) intake had a significant moderate correlation with AVI and BRI. The monounsaturated fat (MUFA) intake had a significantly weak correlation with CI, AVI, BRI, WWI, and AIP. Cholesterol and omega-6 had weak correlations with all indices. Similar correlations were seen among male and female participants. The different types of fat intake significantly affected obesity and coronary indices, especially SFA and PUFA, as well as omega-3 and cholesterol. Gender and the dietary type of fat intake have a relationship to influence the indicators of both obesity and coronary indices.
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  • 文章类型: Randomized Controlled Trial
    我们试图研究每日食用澳洲坚果对体重和成分的影响,超重和肥胖成年人在自由生活环境中的血浆脂质和血糖参数在心脏代谢风险升高。利用随机交叉设计,35名患有腹部肥胖的成年人在8周(干预)内消耗了通常的饮食加澳洲坚果(约占每日卡路里的15%),在8周(对照)内没有坚果的日常饮食,进行了2周的冲洗。通过生物电阻抗确定身体成分;通过24小时饮食回顾评估饮食摄入量。食用澳洲坚果导致总脂肪和MUFA摄入量增加,而SFA摄入量不变。通过混合模型回归分析,平均体重没有显著变化,BMI,腰围,身体脂肪百分比或血糖参数,血浆总胆固醇无明显下降2·1%(-4·3mg/dl;95%CI-14·8,6·1)和低密度脂蛋白(LDL-C)4%(-4·7mg/dl;95%CI-14·3,4·8)。降低胆固醇的作用因肥胖而改变:在超重和肥胖的人群中发生了更大的降脂作用。以及那些身体脂肪百分比低于中位数的人。在超重或肥胖的成年人的自由生活条件下,每天食用澳洲坚果不会导致体重或体脂肪增加;在没有改变饱和脂肪摄入量与其他坚果降低胆固醇的幅度相似的情况下,发生了不显著的胆固醇降低。临床试验登记号和网站:NCT03801837https://clinicaltrials.gov/ct2/show/NCT03801837?term=澳洲坚果+坚果&draw=2&rank=1。
    We sought to examine the effects of daily consumption of macadamia nuts on body weight and composition, plasma lipids and glycaemic parameters in a free-living environment in overweight and obese adults at elevated cardiometabolic risk. Utilising a randomised cross-over design, thirty-five adults with abdominal obesity consumed their usual diet plus macadamia nuts (~15 % of daily calories) for 8 weeks (intervention) and their usual diet without nuts for 8 weeks (control), with a 2-week washout. Body composition was determined by bioelectrical impedance; dietary intake was assessed with 24-h dietary recalls. Consumption of macadamia nuts led to increased total fat and MUFA intake while SFA intake was unaltered. With mixed model regression analysis, no significant changes in mean weight, BMI, waist circumference, percent body fat or glycaemic parameters, and non-significant reductions in plasma total cholesterol of 2⋅1 % (-4⋅3 mg/dl; 95 % CI -14⋅8, 6⋅1) and low-density lipoprotein (LDL-C) of 4 % (-4⋅7 mg/dl; 95 % CI -14⋅3, 4⋅8) were observed. Cholesterol-lowering effects were modified by adiposity: greater lipid lowering occurred in those with overweight v. obesity, and in those with less than the median percent body fat. Daily consumption of macadamia nuts does not lead to gains in weight or body fat under free-living conditions in overweight or obese adults; non-significant cholesterol lowering occurred without altering saturated fat intake of similar magnitude to cholesterol lowering seen with other nuts. Clinical Trial Registry Number and Website: NCT03801837 https://clinicaltrials.gov/ct2/show/NCT03801837?term = macadamia + nut&draw = 2&rank = 1.
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  • 文章类型: Journal Article
    在没有心血管疾病的女性中,性别特异性激素与基于冠状动脉CT血管造影(CCTA)的斑块特征之间的关系尚不清楚。我们在没有临床冠状动脉疾病(CAD)的当代多种族队列中调查了性别特异性激素与冠状动脉斑块特征的关系。
    在此横截面分析中,我们利用了来自迈阿密心脏(MiHeart)研究的2,325例无临床CAD患者的数据.采用多变量logistic回归模型研究性激素的相关性:性激素结合球蛋白(SHBG),脱氢表雄酮(DHEA),免费和总睾酮,雌二醇,具有女性和男性的斑块特征。
    在1,155名女性中,34.2%有任何斑块,3.4%有任何高危斑块特征(HRP),而男性(n=1170),63.1%有任何斑块,10.4%有HRP。在女性中,在校正年龄和种族因素后,雌二醇和SHBG与较低的斑块形成几率相关(雌二醇OR每SD增加:0.87,95CI:0.76~0.98;SHBGOR每SD增加:0.82,95CI:0.72~0.93),但在校正心血管危险因素后,显著性没有持续.高游离睾酮与较高的HRP几率相关(aOR:3.48,95CI:1.07-11.26),但其他性激素与HRP的关联无效,在样本量有限的情况下。在男性中,性别特异性激素与斑块或HRP之间无显著关联.
    在没有临床CAD的年轻至中年女性中,雌二醇和SHBG升高与出现斑块的几率较低相关,游离睾酮升高与HRP相关.可能需要更大的队列来验证这一点。
    UNASSIGNED: The association of sex-specific hormones with coronary computed tomography angiography(CCTA)-based plaque characteristics in women without cardiovascular disease is not well understood. We investigated the association of sex-specific hormones with coronary artery plaque characteristics in a contemporary multiracial cohort with no clinical coronary artery disease (CAD).
    UNASSIGNED: In this cross-sectional analysis, we utilized data from 2,325 individuals with no clinical CAD from the Miami Heart (MiHeart) study. Multivariable logistic regression models were used to investigate the association of sex hormones: sex hormone binding globulin (SHBG), dehydroepiandrosterone (DHEA), free and total testosterone, estradiol, with plaque characteristics among women and men.
    UNASSIGNED: Of the 1,155 women, 34.2% had any plaque and 3.4% had any high-risk plaque features (HRP) while among men (n = 1170), 63.1% had any plaque and 10.4% had HRP. Among women, estradiol and SHBG were associated with lower odds of any plaque after adjusting for age and race-ethnicity (estradiol OR per SD increase: 0.87, 95%CI: 0.76-0.98; SHBG OR per SD increase: 0.82, 95%CI: 0.72-0.93) but the significance did not persist after adjustment of cardiovascular risk factors. High free testosterone was associated with higher odds of HRP (aOR:3.48, 95%CI:1.07-11.26) but null associations for the other sex hormones with HRP, in the context of limited sample size. Among men, there were no significant associations between sex-specific hormones and plaque or HRP.
    UNASSIGNED: Among young to middle-aged women with no clinical CAD, increasing estradiol and SHBG were associated with lower odds of any plaque and higher free testosterone was associated with HRP. Larger cohorts may be needed to validate this.
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  • 文章类型: Journal Article
    非酒精性脂肪性肝病(NAFLD)是全球和印度慢性肝病的主要原因。在印度,NAFLD的负担已经很高,预计未来将与肥胖和2型糖尿病的持续流行同时进一步增加。鉴于NAFLD在社区中的高患病率,确定有进展性肝病风险的患者对于简化转诊和指导适当的管理至关重要.各种国际社会关于NAFLD的现有指南未能捕捉到印度NAFLD的整个景观,并且由于印度可用的社会文化方面和卫生基础设施的根本差异,通常难以纳入临床实践。自2015年印度全国NAFLD肝脏研究协会发表初始立场文件以来,NAFLD领域取得了很大进展。Further,关于NAFLD命名法的争论正在引起临床医师的过度混淆.随后的全面审查提供了基于共识的,关于命名法的指导声明,诊断,以及在印度环境中实际上可以实施的NAFLD治疗。
    Nonalcoholic fatty liver disease (NAFLD) is a major cause of chronic liver disease globally and in India. The already high burden of NAFLD in India is expected to further increase in the future in parallel with the ongoing epidemics of obesity and type 2 diabetes mellitus. Given the high prevalence of NAFLD in the community, it is crucial to identify those at risk of progressive liver disease to streamline referral and guide proper management. Existing guidelines on NAFLD by various international societies fail to capture the entire landscape of NAFLD in India and are often difficult to incorporate in clinical practice due to fundamental differences in sociocultural aspects and health infrastructure available in India. A lot of progress has been made in the field of NAFLD in the 7 years since the initial position paper by the Indian National Association for the Study of Liver on NAFLD in 2015. Further, the ongoing debate on the nomenclature of NAFLD is creating undue confusion among clinical practitioners. The ensuing comprehensive review provides consensus-based, guidance statements on the nomenclature, diagnosis, and treatment of NAFLD that are practically implementable in the Indian setting.
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  • 文章类型: Journal Article
    吸烟会增加血脂水平,包括甘油三酯,导致心血管疾病风险增加。我们进行了荟萃分析,以量化吸烟和戒烟对甘油三酸酯水平的影响。搜索PubMed和Scopus数据库以确定报告吸烟者和非吸烟者的甘油三酯水平或戒烟对甘油三酯水平的影响的研究。当三个或更多的研究/比较可用时,使用固定和随机效应模型进行分析。我们确定了169和21项评估吸烟和戒烟效果的研究,分别,甘油三酯水平。吸烟者的甘油三酯水平比不吸烟者高0.50mmol/L(95%置信区间:0.49-0.50mmol/L),但不同研究的效果差异很大。在基线和6周之间,对甘油三酯水平没有观察到统计学上显著的影响(平均差[MD]=0.02[-0.09,0.12]mmol/L),2个月(MD=0.03[-0.21,0.27]mmol/L),3个月(MD=0.08[-0.03,0.21]mmol/L),或戒烟后1年(MD=0.04[-0.06,0.14]mmol/L)。然而,停药后1个月观察到甘油三酯水平略有显著下降(MD=-0.15[-0.15,-0.01]mmol/L).这项荟萃分析的结果为了解吸烟和戒烟对甘油三酯水平的影响提供了基础。这可能对公共卫生产生重要影响。
    Smoking increases lipid levels, including triglycerides, leading to increased cardiovascular disease risk. We performed a meta-analysis to quantify the effects of smoking and smoking cessation on triglyceride levels. The PubMed and Scopus databases were searched to identify studies reporting either triglyceride levels in smokers and non-smokers or the effects of smoking cessation on triglyceride levels. Fixed- and random-effects models were used to perform the analyses when three or more studies/comparisons were available. We identified 169 and 21 studies evaluating the effects of smoking and smoking cessation, respectively, on triglyceride levels. Triglyceride levels were 0.50 mmol/L (95% confidence interval: 0.49-0.50 mmol/L) higher in smokers than non-smokers, but the effect differed widely across studies. No statistically significant effect was observed on triglyceride levels between baseline and 6 weeks (mean difference [MD] = 0.02 [-0.09, 0.12] mmol/L), 2 months (MD = 0.03 [-0.21, 0.27] mmol/L), 3 months (MD = 0.08 [-0.03, 0.21] mmol/L), or 1 year (MD = 0.04 [-0.06, 0.14] mmol/L) after quitting. However, a slightly significant decrease in triglyceride levels was observed at 1 month after cessation (MD = -0.15 [-0.15, -0.01] mmol/L). The results of this meta-analysis provide a basis for understanding the effects of smoking and smoking cessation on triglyceride levels, which could have important implications for public health.
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  • 文章类型: Journal Article
    作者确定了GLP-1受体激动剂利拉鲁肽对小鼠载脂蛋白E敲除动脉粥样硬化中血管细胞粘附分子(VCAM)-1内皮表面表达的影响。使用靶向VCAM-1的微泡和对照微泡的对比增强超声分子成像显示,在媒介物处理的动物中,内皮表面VCAM-1信号增加了3倍,而在利拉鲁肽治疗的动物中,信号比在整个研究过程中保持在1左右.利拉鲁肽对低密度脂蛋白胆固醇或糖化血红蛋白无影响,但降低了TNF-α,IL-1β,MCP-1和OPN。在利拉鲁肽治疗下,免疫组织学上的主动脉斑块病变面积和管腔VCAM-1表达减少。
    The authors determined the effect of the GLP-1 receptor agonist liraglutide on endothelial surface expression of vascular cell adhesion molecule (VCAM)-1 in murine apolipoprotein E knockout atherosclerosis. Contrast-enhanced ultrasound molecular imaging using microbubbles targeted to VCAM-1 and control microbubbles showed a 3-fold increase in endothelial surface VCAM-1 signal in vehicle-treated animals, whereas in the liraglutide-treated animals the signal ratio remained around 1 throughout the study. Liraglutide had no influence on low-density lipoprotein cholesterol or glycated hemoglobin, but reduced TNF-α, IL-1β, MCP-1, and OPN. Aortic plaque lesion area and luminal VCAM-1 expression on immunohistology were reduced under liraglutide treatment.
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  • 文章类型: Journal Article
    本研究旨在回顾自2009年中国卫生体制改革以来中国在初级卫生保健(PHC)层面的非传染性疾病(NCD)预防和控制方面的国家政策。筛选了来自中国国务院和20个部委官方网站的政策文件,其中包括1,799人中的151人。进行了主题内容分析,确定了十四个“主要政策举措”,包括基本健康保险计划和基本公共卫生服务。几个领域显示出强有力的政策支持,包括服务交付,卫生筹资,领导/治理。与世卫组织的建议相比,仍然存在一些差距,包括缺乏对多部门合作的重视,未充分利用非卫生专业人员,缺乏以质量为导向的PHC服务评估。在过去的十年里,中国继续表现出加强非传染性疾病预防和控制PHC系统的政策承诺。我们建议未来的政策,以促进多部门合作,加强社区参与,完善绩效评价机制。
    This study aims to review China\'s national policies related to non-communicable disease (NCD) prevention and control at the primary health care (PHC) level since China\'s 2009 health system reform. Policy documents from official websites of China\'s State Council and 20 affiliated ministries were screened, where 151 out of 1,799 were included. Thematic content analysis was performed, and fourteen \'major policy initiatives\' were identified, including the basic health insurance schemes and essential public health services. Several areas showed to have strong policy support, including service delivery, health financing, and leadership/governance. Compared with WHO recommendations, several gaps remain, including lack of emphasis on multi-sectoral collaboration, underuse of non-health-professionals, and lack of quality-oriented PHC services evaluations. Over the past decade, China continues to demonstrate its policy commitment to strengthen the PHC system for NCD prevention and control. We recommend future policies to facilitate multi-sectoral collaboration, enhance community engagement, and improve performance evaluation mechanisms.
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  • 文章类型: Journal Article
    UNASSIGNED:我们的目标是估计到2040年日本所有47个县的冠心病(CHD)和中风死亡率的未来负担,同时考虑年龄的影响,period,并将其纳入国家一级,以解决各州之间的区域差异。
    未经评估:我们估计了未来的冠心病和中风死亡率预测,在人群中建立贝叶斯年龄周期队列(BAPC)模型以及按年龄划分的CHD和卒中数量,性别,以及从1995年到2019年观察到的所有47个县;然后将这些应用于官方的未来人口估计,直到2040年。目前的参与者都是30岁以上的男性和女性,都是日本居民。
    未经评估:在BAPC模型中,从2020年到2040年,全国心血管死亡人数将减少(39,600[95%可信区间:32,200-47,900]至36,200[21,500-58,900]男性冠心病死亡人数,和27,400[22,000-34,000]至23,600[12,700-43,800]妇女;和50,400[41,900-60,200]至40,800[25,200-67,800]男子中风死亡,和52,200[43,100-62,800]至47,400[26,800-87,200]妇女)。
    UNASSIGNED:调整这些因素后,未来冠心病和卒中死亡人数将下降至2040年,在全国范围内和大多数州.
    UNASSIGNED:这项研究得到了国家脑和心血管中心心血管疾病校内研究基金的支持(21-1-6,21-6-8),JSPSKAKENHI授权号JP22K17821,卫生部,劳动和福利与生活方式相关的综合研究(疾病心血管疾病和糖尿病计划),赠款编号22FA1015。
    UNASSIGNED: We aimed to estimate the future burden of coronary heart disease (CHD) and stroke mortalities by sex and all 47 prefectures of Japan until 2040 while accounting for effects of age, period, and cohort and integrating them to be at the national level to account for regional differences among prefectures.
    UNASSIGNED: We estimated future CHD and stroke mortality projections, developing Bayesian age-period-cohort (BAPC) models in population and the number of CHD and stroke by age, sex, and all 47 prefectures observed from 1995 to 2019; then applying these to official future population estimates until 2040. The present participants were all men and women aged over 30 years and were residents of Japan.
    UNASSIGNED: In the BAPC models, the predicted number of national-level cardiovascular deaths from 2020 to 2040 would decrease (39,600 [95% credible interval: 32,200-47,900] to 36,200 [21,500-58,900] CHD deaths in men, and 27,400 [22,000-34,000] to 23,600 [12,700-43,800] in women; and 50,400 [41,900-60,200] to 40,800 [25,200-67,800] stroke deaths in men, and 52,200 [43,100-62,800] to 47,400 [26,800-87,200] in women).
    UNASSIGNED: After adjusting these factors, future CHD and stroke deaths will decline until 2040 at the national level and in most prefectures.
    UNASSIGNED: This research was supported by the Intramural Research Fund of Cardiovascular Diseases of the National Cerebral and Cardiovascular Center (21-1-6, 21-6-8), JSPS KAKENHI Grant Number JP22K17821, and the Ministry of Health, Labour and Welfare Comprehensive Research on Life-Style Related (Diseases Cardiovascular Diseases and Diabetes Mellitus Program), Grant Number 22FA1015.
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  • 文章类型: Journal Article
    冠状动脉疾病(CAD)是癌症幸存者心血管负担的重要原因。这篇综述确定了可以帮助指导有关筛查的益处的决策的特征,以评估亚临床CAD的风险或存在。根据危险因素和炎症负担,筛选可能适用于选定的幸存者。在接受基因检测的癌症幸存者中,多基因风险评分和克隆造血标志物可能成为未来有用的CAD风险预测工具。癌症的类型(尤其是乳腺癌,血液学,胃肠,和泌尿生殖系统)和治疗的性质(放射治疗,铂剂,氟尿嘧啶,激素治疗,酪氨酸激酶抑制剂,内皮生长因子抑制剂,和免疫检查点抑制剂)在确定风险方面也很重要。积极筛查的治疗意义包括生活方式和动脉粥样硬化干预,在特定情况下,可能需要进行血运重建。
    Coronary artery disease (CAD) is an important contributor to the cardiovascular burden in cancer survivors. This review identifies features that could help guide decisions about the benefit of screening to assess the risk or presence of subclinical CAD. Screening may be appropriate in selected survivors based on risk factors and inflammatory burden. In cancer survivors who have undergone genetic testing, polygenic risk scores and clonal hematopoiesis markers may become useful CAD risk prediction tools in the future. The type of cancer (especially breast, hematological, gastrointestinal, and genitourinary) and the nature of treatment (radiotherapy, platinum agents, fluorouracil, hormonal therapy, tyrosine kinase inhibitors, endothelial growth factor inhibitors, and immune checkpoint inhibitors) are also important in determining risk. Therapeutic implications of positive screening include lifestyle and atherosclerosis interventions, and in specific instances, revascularization may be indicated.
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