Raul Dias dos Santos Filho

Diagonal earlobe crease as a marker of the presence and extent of coronary atherosclerosis

This study evaluates the association between the presence of diagonal earlobe creases (ELC) and coronary artery disease (CAD). One thousand four hundred twenty-four patients (760 men and 664 women, aged 30 to 80 years) were examined for the presence of ELC and classified into 2 groups: group I control--1,086 consecutive patients who denied symptoms of myocardial ischemia and were admitted to a general hospital for other reasons; group II CAD--338 patients with documented CAD (presence of > or = 70% coronary diameter stenosis at angiography). ELC was present in 304 patients (28%) in group I and 220 (65%) in group II (p < 0.0001). The patients were stratified in age groups to isolate the influence of age because the prevalence of ELC and CAD increased with advancing age (p < 0.0001 for both). This association remained statistically significant in all decades, except for patients aged > 70 years. To further remove the confounding effect of different age and sex distributions between the groups, a direct adjustment of the ELC prevalence was performed. When adjusted for age and sex, the prevalence of creases was still 58% higher in patients with CAD than in control subjects (p < 0.001). The presence of ELC was also related to the extent of CAD as measured by the number of major arteries narrowed (p = 0.015). The observed sensitivity of the sign for the diagnosis of CAD was 65%, the specificity 72%, the positive predictive value 42% and the negative predictive value 87%.

Cowpea protein reduces LDL-cholesterol and apolipoprotein B concentrations, but does not improve biomarkers of inflammation or endothelial dysfunction in adults with moderate hypercholesterolemia

INTRODUCTION The risks of cardiovascular diseases, the leading cause of death in the world, can be reduced by diet. Cowpea protein has been shown to significantly reduce total cholesterol, LDL-cholesterol, and liver steatosis in hamsters. OBJECTIVE The objective of this proof-of-concept study was to verify whether the consumption of cowpea protein improves lipid profile and biomarkers of inflammation and endothelial dysfunction in adults with moderate hypercholesterolemia. METHODS In a randomized, double-blind, crossover design, 38 hypercholesterolemic subjects (LDL-cholesterol = 182.5 ± 2.7 mg/dL) consumed 25 g/day of cowpea protein isolate or 25 g/day of casein (control group) for 6 weeks each, separated by a 4-week washout interval. Fasting blood samples were collected at baseline and at the end of each diet period. Lipids (total cholesterol, LDL-cholesterol, triglycerides, HDL-cholesterol) were determined by enzymatic methods, apolipoproteins (apoA-I and apoB) by standardized immunoassays, inflammatory biomarkers (C-reactive protein) by turbidimetry, and biomarkers of endothelial dysfunction (intercellular adhesion molecule 1 and vascular cell adhesion molecule 1) by enzyme-linked immunosorbent assays. RESULTS AND DISCUSSION Consumption of cowpea protein significantly reduced total cholesterol ( 12 %), LDL cholesterol ( 18.9 %), non HDL-cholesterol ( 16 %) and apoB ( 14 %), and increased HDL cholesterol (+2.7 %). No significant differences between treatment groups were observed for any of the serum inflammatory or endothelial dysfunction biomarkers. CONCLUSION The present findings demonstrated the favorable effect of cowpea protein consumption on proatherogenic serum lipids and apoB in subjects with moderate hypercholesterolemia, similar to what was observed in a previous studies on animals.

I Diretriz de Ressonância e Tomografia Cardiovascular da Sociedade Brasileira de Cardiologia Sumário Executivo

Cesar Augusto Mastrofrancisco Cattani, Dany Jasinowodolinsk, Fabiano Lucchesi, Fabio Berezowsky Rocha, Fatima Cristina Pedroti, Gilberto Szarf, Guilherme Urpia Monte, Iugiro Roberto Kuroki , Joalbo Andrade, Jose Rodrigues Parga Filho, Luis Claudio Correia, Luiz Francisco Avila, Marcelo Hadlich, Marcelo Zapparoli, Marcia Barbosa, Marcia Lima Mugnaini, Maria Helena Albernaz Siqueira, Marly Maria Uellendhal, Miguel Abraao Rosario Neto, Paulo R. Schwarzman, Raul Dias dos Santos Filho, Ricardo Loureiro, Roberto Kalil Filho, Robson de Macedo Vieira

Check-up and cardiovascular risk progression: is there a room for innovation?

ABSTRACT Objective: To evaluate the impact of traditional check-up appointment on the progression of the cardiovascular risk throughout time. Methods: This retrospective cohort study included 11,126 medical records of asymptomatic executives who were evaluated between January, 2005 and October, 2008. Variables included participants’ demographics characteristics, smoking habit, history of cardiovascular diseases, diabetes, dyslipidemia, total cholesterol, HDL, triglycerides, glucose, c-reactive protein, waist circumference, hepatic steatosis, Framingham score, metabolic syndrome, level of physical activity, stress, alcohol consumption, and body mass index. Results: A total of 3,150 patients was included in the final analysis. A worsening was observed in all risk factors, excepting in smoking habit, incidence of myocardial infarction or stroke and in the number of individuals classified as medium or high risk for cardiovascular events. In addition, a decrease in stress level and alcohol consumption was also seen. Conclusion: The adoption of consistent health policies by companies is imperative in order to reduce the risk factors and the future costs associated with illness and absenteeism.

Prevalence of Metabolic Syndrome and Framingham Risk Score in Apparently Healthy Vegetarian and Omnivorous Men.

Background Recent studies have shown a lower prevalence of metabolic syndrome (MSyn) in vegetarians (VEG) despite the inconclusive evidence from others. Objective To verify the association between diet and other lifestyle characteristics and the prevalence of MSyn, cardiovascular risk factors (CRF), and Framingham Risk Score (FRS) in apparently healthy VEG and omnivorous (OMN) men. Methods In this cross-sectional study, 88 apparently healthy men ≥ 35 years, 44 VEG and 44 OMN, were assessed for anthropometric data, blood pressure, blood lipids, glucose, C-reactive protein (CRP) and FRS. To test the association between lifestyle and MSyn, Student t test, chi-square test, and multiple logistic regression model were used. A significance level of 5% was considered in all statistical analyses. Results Several CRF were significantly lower in VEG than in OMN: body mass index, systolic blood pressure, diastolic blood pressure, fasting serum total cholesterol, LDL-cholesterol, apolipoprotein b, glucose, and glycated hemoglobin (all p < 0.05). The FRS mean was lower in VEG than in OMN (2.98 ± 3.7 vs 4.82 ± 4.8, p = 0.029). The percentage of individuals with MSyn was higher among OMN than among VEG (52.3 vs.15.9%) (p < 0.001). The OMN diet was associated with MSyn (OR: 6.28 95%CI 2.11-18.71) and alterations in most MSyn components in the multiple regression model independently of caloric intake, age and physical activity. Conclusion The VEG diet was associated with lower CRF, FRS and percentage of individuals with MSyn.