Coronavirus disease (COVID-19) pandemic is affecting the world unevenly. One of the highest numbers of cases were recorded in the most polluted regions worldwide. The risk factors for severe COVID-19 include diabetes, cardiovascular, and respiratory diseases. It has been known that the same disease might be worsened by chronic exposure to air pollution. The study aimed to determine whether long-term average exposure to air pollution is associated with an increased risk of COVID-19 cases and deaths in Poland. The cumulative number of COVID-19 cases and deaths for each voivodeship (the main administrative level of jurisdictions) in Poland were collected from March 4, 2020, to May 15, 2020. Based on the official data published by Chief Inspectorate of Environmental Protection voivodeship-level long-term exposure to main air pollution: PM2.5, PM10, NO2, SO2, O3 (averaged from 2013 to 2018) was established. There were statistically significant correlation between COVID-19 cases (per 100,000 population) and annual average concentration of PM2.5 (R2 = 0.367, p = 0.016), PM10 (R2 = 0.415, p = 0.009), SO2 (R2 = 0.489, p = 0.003), and O3 (R2 = 0.537, p = 0.0018). Moreover, COVID-19 deaths (per 100,000 population) were associated with annual average concentration of PM2.5 (R2 = 0.290, p = 0.038), NO2 (R2 = 0.319, p = 0.028), O3 (R2 = 0.452, p = 0.006). The long-term exposure to air pollution, especially PM2.5, PM10, SO2, NO2, O3 seems to play an essential role in COVID-19 prevalence and mortality. Long-term exposure to air pollution might increase the susceptibility to the infection, exacerbates the severity of SARS-CoV-2 infections, and worsens the patients’ prognosis. The study provides generalized and possible universal trends. Detailed analyzes of the phenomenon dedicated to a given region require taking into account data on comorbidities and socioeconomic variables as well as information about the long-term exposure to air pollution and COVID-19 cases and deaths at smaller administrative level of jurisdictions (community or at least district level).
In conclusion, dyslipidaemia is highly prevalent in professional drivers. Obesity is one of the major contributors to the cardiovascular risk, and dyslipidaemia along with other risk factors highly prevalent in this subgroup accounts for poorer prognosis.
2MACE score for long -term mortality prediction in atrial fibrillation 635In 2016, Pastori et al 4 developed a risk score for predicting major adverse cardiovascular events in patients with AF. The 2MACE score includes metabolic syndrome, age of 75 years or older, myocardial infarction or revascularization, congestive heart failure (HF), and thromboembolism. 4 Several subsequent studies confirmed the usefulness of the score for the prediction of major cardiovascular events and mortality. 5-7 The current study aimed to investigate the utility of the 2MACE score for predicting long -term all -cause mortality in patients with nonvalvular AF.METhOds This post hoc analysis of a prospective observational cohort study included consecutive patients with nonvalvular AF. We identified INTROduCTION Cardiovascular risk reduction is one of the pivotal issues in the management of patients with atrial fibrillation (AF). Arrhythmia--related thromboembolic risk, including the risk of stroke and peripheral thromboembolism, remains a significant concern in this population. 1 Most current guidelines and risk prediction scores focus on thromboembolic risk stratification. Nevertheless, studies show that the occurrence, progression, and outcomes of AF are strongly associated with cardiovascular risk factors and that AF itself may contribute to the development of other cardiovascular diseases possibly affecting mortality. 2,3 Therefore, early detection of increased cardiovascular risk might be highly beneficial in this group of patients.
Background The presence of obstructive sleep apnea (OSA), a novel cardiovascular risk factor, contributes to the development of peripheral arterial diseases (PAD). There is a lack of data showing how often these diseases coexist. Aims The aim of the study was to determine the prevalence of OSA in the population of patients with PAD. Methods Patients previously qualified for the first revascularization due to PAD were included in the study. All patients underwent an overnight sleep study to detect OSA. Diagnosis of OSA was made when the apnea-hypopnea index (AHI) was ≥5 per hour. Results From 141 patients (60% men, age 69.6 ± 9.5 years), OSA was diagnosed in 68 patients (48%). OSA occurred in mild form (5 ≤ AHI < 15/h) in 39 cases (28%), in moderate form (15 ≤ AHI < 30/h) in 21 cases (15%), and in severe form (AHI ≥ 30/h) in 8 cases (6%). Patients without OSA had significantly lower body mass index (BMI; 26.9 ± 5.5 vs. 27.7 ± 5.3 kg/m 2 , p = 0.01) and lower hip circumference (97.4 ± 11.7 vs. 98.7 ± 7.4, p = 0.04). There were no differences in the distribution of other investigated cardiovascular risk factors and diseases between these groups. There were no significant differences in OSA distribution or its severity between patients with lower extremity artery disease and carotid artery disease. Conclusions The prevalence of OSA in patients with PAD is very high, affecting nearly half of the studied population.
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