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2009 Canadian Cardiovascular Society/Canadian guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult - 2009 recommendations.

https://arctichealth.org/en/permalink/ahliterature148105
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Publication Type
Article
Date
Oct-2009
Author
Jacques Genest
Ruth McPherson
Jiri Frohlich
Todd Anderson
Norm Campbell
André Carpentier
Patrick Couture
Robert Dufour
George Fodor
Gordon A Francis
Steven Grover
Milan Gupta
Robert A Hegele
David C Lau
Lawrence Leiter
Gary F Lewis
Eva Lonn
G B John Mancini
Dominic Ng
Glen J Pearson
Allan Sniderman
James A Stone
Ehud Ur
Author Affiliation
McGill University Health Centre, Montreal, Canada. jacques.genest@muhc.mcgill.ca
Source
Can J Cardiol. 2009 Oct;25(10):567-79
Date
Oct-2009
Language
English
Publication Type
Article
Keywords
Adult
Canada
Cardiovascular Diseases - etiology - prevention & control
Congresses as topic
Diagnostic Techniques, Cardiovascular
Dyslipidemias - complications - diagnosis - drug therapy
Humans
Hypolipidemic Agents - therapeutic use
Practice Guidelines as Topic - standards
Risk Assessment - methods
Societies, Medical
Abstract
The present article represents the 2009 update of the Canadian Cardiovascular Society guidelines for the diagnosis and treatment of dyslipidemia and prevention of cardiovascular disease in the adult.
Notes
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PubMed ID
19812802 View in PubMed
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Access to cardiac rehabilitation among South-Asian patients by referral method: a qualitative study.

https://arctichealth.org/en/permalink/ahliterature143716
Source
Rehabil Nurs. 2010 May-Jun;35(3):106-12
Publication Type
Article
Author
Keerat Grewal
Yvonne W Leung
Parissa Safai
Donna E Stewart
Sonia Anand
Milan Gupta
Cynthia Parsons
Sherry L Grace
Author Affiliation
University of Toronto, ON. keerat.grewal@utoronto.ca
Source
Rehabil Nurs. 2010 May-Jun;35(3):106-12
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - ethnology - rehabilitation
Asia, Western - ethnology
Asian Continental Ancestry Group
Automation
Continuity of Patient Care
Emigrants and Immigrants
Female
Health Knowledge, Attitudes, Practice
Health Services Accessibility
Humans
India - ethnology
Male
Middle Aged
Ontario
Referral and Consultation
Abstract
People of South-Asian origin have an increased prevalence of coronary artery disease. Although cardiac rehabilitation (CR) is effective, South Asians are among the least likely people to participate in these programs. Automatic referral increases CR use and may reduce access inequalities. This study qualitatively explored whether CR referral knowledge and access varied among South-Asian patients. Participants were South-Asian cardiac patients receiving treatment at hospitals in Ontario, Canada. Each hospital refers to CR via one offour methods: automatically through paper or electronically, through discussion with allied health professionals (liaison referral), or through referral at the physician's discretion. Data were collected via interviews and analyzed using interpretive-descriptive analysis. Four themes emerged: the importance of predischarge CR discussions with healthcare providers, limited knowledge of CR, ease of the referral process for facilitators of CR attendance, and participants'needs for personal autonomy regarding their decision to attend CR. Liaison referral was perceived to be the most suitable referral method for participants. It facilitated communication between patients and providers, ensuring improved understanding of CR. Automatic referral may not be as well suited to this population because of reduced patient-provider communication.
PubMed ID
20450019 View in PubMed
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Altered health status and quality of life in South Asians with coronary artery disease.

https://arctichealth.org/en/permalink/ahliterature131706
Source
Am Heart J. 2011 Sep;162(3):501-6
Publication Type
Article
Date
Sep-2011
Author
Kevin R Bainey
Colleen M Norris
Milan Gupta
Danielle Southern
Diane Galbraith
Merril L Knudtson
Michelle M Graham
Author Affiliation
University of Alberta, Edmonton, Alberta, Canada.
Source
Am Heart J. 2011 Sep;162(3):501-6
Date
Sep-2011
Language
English
Publication Type
Article
Keywords
Alberta - epidemiology
Asian Continental Ancestry Group
Cardiac Catheterization
Coronary Angiography
Coronary Artery Disease - diagnosis - ethnology
Female
Health status
Humans
Male
Middle Aged
Outcome Assessment (Health Care) - methods
Quality of Life
Questionnaires
Registries
Retrospective Studies
Severity of Illness Index
Abstract
People of South Asian (SA) ancestry are susceptible to coronary artery disease (CAD). Although studies suggest that SA with CAD has a worse prognosis compared with Europeans, it is unknown whether corresponding differences in functional status and quality-of-life (QOL) measures exist. Accordingly, we compared symptoms, function, and QOL in SA and European Canadians with CAD using the Seattle Angina Questionnaire (SAQ).
Using the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease, an outcomes registry that captures patients undergoing cardiac catheterization in Alberta, Canada, we identified 635 SA and 18,934 European patients with angiographic CAD from January 1995 to December 2006 who reported health status outcomes using the SAQ at 1 year after the index catheterization. To obtain comparable clinical variables among SA and Europeans, we used a propensity score-matching technique.
One-year adjusted mean (SD) scores were significantly lower in SA compared with European Canadians for most SAQ domains: exertional capacity (75 [23] vs 80 [23], P = .011), anginal stability (77 [28] vs 77 [27], P = .627), anginal frequency (86 [23] vs 88 [20], P
PubMed ID
21884867 View in PubMed
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Assessment and management of acute coronary syndromes (ACS): a Canadian perspective on current guideline-recommended treatment--part 1: non-ST-segment elevation ACS.

https://arctichealth.org/en/permalink/ahliterature129038
Source
Can J Cardiol. 2011 Nov-Dec;27 Suppl A:S387-401
Publication Type
Article
Author
David H Fitchett
Pierre Theroux
James M Brophy
Warren J Cantor
Jafna L Cox
Milan Gupta
Heather Kertland
Shamir R Mehta
Robert C Welsh
Shaun G Goodman
Author Affiliation
St Michael's Hospital, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada. fitchettd@smh.ca
Source
Can J Cardiol. 2011 Nov-Dec;27 Suppl A:S387-401
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - therapy
Canada
Cardiac Catheterization
Catheter Ablation
Delivery of Health Care
Electrocardiography
Humans
Practice Guidelines as Topic
Risk assessment
Abstract
Despite the reduction of coronary heart disease mortality over the past 40 years, hospital admissions for acute coronary syndromes (ACS) continue to increase. The goal of this 2-part article is to review the issues at each stage of assessment and management of the ACS patient, and to propose an optimal treatment strategy for the individual patient in the context of the realities, culture, and delivery of healthcare in Canada. ACS patients are categorized as either ST segment elevation myocardial infarction (STEMI) or non-ST-elevation ACS (NSTE-ACS). For the patients with NSTE-ACS, prevention of recurrent ischemic events is the primary goal. Assessment of risk for recurrent ischemic and bleeding events helps to determine the net benefit of early cardiac catheterization and percutaneous coronary intervention (PCI) and intensive antiplatelet and anticoagulant treatment. Those with higher ischemic risk features should be considered for an early invasive strategy and receive both dual antiplatelet therapy and an anticoagulant at the time of first medical assessment. Patients without high-risk features could be considered for medical treatment and a selectively invasive strategy; with coronary angiography and revascularization only if high-risk features become apparent. Long-term vascular protection with lifestyle modification (especially smoking cessation), lipid lowering, blood pressure and glycemic control, and the use of renin angiotensin aldosterone system (RAAS) blockade to prevent recurrent ischemic events, is important in all patients with ACS.
PubMed ID
22118042 View in PubMed
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Assessment and management of acute coronary syndromes (ACS): a Canadian perspective on current guideline-recommended treatment--part 2: ST-segment elevation myocardial infarction.

https://arctichealth.org/en/permalink/ahliterature129037
Source
Can J Cardiol. 2011 Nov-Dec;27 Suppl A:S402-12
Publication Type
Article
Author
David H Fitchett
Pierre Theroux
James M Brophy
Warren J Cantor
Jafna L Cox
Milan Gupta
Heather Kertland
Shamir R Mehta
Robert C Welsh
Shaun G Goodman
Source
Can J Cardiol. 2011 Nov-Dec;27 Suppl A:S402-12
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - therapy
Canada
Electrocardiography
Humans
Myocardial Infarction - therapy
Practice Guidelines as Topic
Risk assessment
Abstract
Acute ST-segment elevation myocardial infarction (STEMI) accounts for approximately 30% of all acute coronary syndromes (ACS). The high early mortality for patients with STEMI is largely due to the extent of the ischemic injury. However, immediate reperfusion either pharmacologically with fibrinolysis or mechanically by primary percutaneous coronary intervention (PCI) limits the size of the infarction and reduces mortality. Reperfusion therapy by primary PCI reduces mortality and the risk of reinfarction, beyond the benefits achieved by fibrinolysis, especially when the primary PCI is initiated within 90 minutes of first medical contact. The use of adjuvant therapy with antiplatelet and anticoagulant agents is essential to enhance the results of reperfusion, and/or maintain vessel patency following either mode of reperfusion. This review discusses the assessment and management of the patient with an acute STEMI, using recommendations from the most recent American College of Cardiology/American Heart Association, European Society of Cardiology, and existing Canadian guidelines. It provides an updated perspective and critical appraisal with practical application of the recommendations within the Canadian Healthcare system.
PubMed ID
22118043 View in PubMed
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Cardiometabolic risk in Canada: a detailed analysis and position paper by the cardiometabolic risk working group.

https://arctichealth.org/en/permalink/ahliterature135666
Source
Can J Cardiol. 2011 Mar-Apr;27(2):e1-e33
Publication Type
Article
Author
Lawrence A Leiter
David H Fitchett
Richard E Gilbert
Milan Gupta
G B John Mancini
Philip A McFarlane
Robert Ross
Hwee Teoh
Subodh Verma
Sonia Anand
Kathryn Camelon
Chi-Ming Chow
Jafna L Cox
Jean-Pierre Després
Jacques Genest
Stewart B Harris
David C W Lau
Richard Lewanczuk
Peter P Liu
Eva M Lonn
Ruth McPherson
Paul Poirier
Shafiq Qaadri
Rémi Rabasa-Lhoret
Simon W Rabkin
Arya M Sharma
Andrew W Steele
James A Stone
Jean-Claude Tardif
Sheldon Tobe
Ehud Ur
Author Affiliation
Li Ka Shing Knowledge Institute of St. Michael's Hospital, Toronto, Ontario, Canada.
Source
Can J Cardiol. 2011 Mar-Apr;27(2):e1-e33
Language
English
Publication Type
Article
Keywords
Canada - epidemiology
Cardiovascular Diseases - epidemiology - etiology - therapy
Diabetes Mellitus, Type 2 - epidemiology - etiology - prevention & control
Humans
Metabolic Syndrome X - complications - epidemiology - therapy
Practice Guidelines as Topic
Risk factors
Abstract
The concepts of "cardiometabolic risk," "metabolic syndrome," and "risk stratification" overlap and relate to the atherogenic process and development of type 2 diabetes. There is confusion about what these terms mean and how they can best be used to improve our understanding of cardiovascular disease treatment and prevention. With the objectives of clarifying these concepts and presenting practical strategies to identify and reduce cardiovascular risk in multiethnic patient populations, the Cardiometabolic Working Group reviewed the evidence related to emerging cardiovascular risk factors and Canadian guideline recommendations in order to present a detailed analysis and consolidated approach to the identification and management of cardiometabolic risk. The concepts related to cardiometabolic risk, pathophysiology, and strategies for identification and management (including health behaviours, pharmacotherapy, and surgery) in the multiethnic Canadian population are presented. "Global cardiometabolic risk" is proposed as an umbrella term for a comprehensive list of existing and emerging factors that predict cardiovascular disease and/or type 2 diabetes. Health behaviour interventions (weight loss, physical activity, diet, smoking cessation) in people identified at high cardiometabolic risk are of critical importance given the emerging crisis of obesity and the consequent epidemic of type 2 diabetes. Vascular protective measures (health behaviours for all patients and pharmacotherapy in appropriate patients) are essential to reduce cardiometabolic risk, and there is growing consensus that a multidisciplinary approach is needed to adequately address cardiometabolic risk factors. Health care professionals must also consider risk factors related to ethnicity in order to appropriately evaluate everyone in their diverse patient populations.
PubMed ID
21459257 View in PubMed
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Clinical characteristics of South Asian patients hospitalized with heart failure.

https://arctichealth.org/en/permalink/ahliterature172226
Source
Ethn Dis. 2005;15(4):615-9
Publication Type
Article
Date
2005
Author
Narendra Singh
Milan Gupta
Author Affiliation
Emory University School of Medicine, Division of Cardiology, Atlanta, Georgia, USA. mnsingh@yahoo.com
Source
Ethn Dis. 2005;15(4):615-9
Date
2005
Language
English
Publication Type
Article
Keywords
Aged
Aged, 80 and over
Arrhythmias, Cardiac - ethnology - therapy
Asia - ethnology
Asian Continental Ancestry Group
Biological Markers - blood
Blood Pressure - physiology
European Continental Ancestry Group
Female
Heart Failure - ethnology - etiology - therapy
Hospitalization - statistics & numerical data
Humans
Male
Middle Aged
Myocardial Ischemia - complications - ethnology - therapy
Ontario
Retrospective Studies
Stroke Volume - physiology
Abstract
Ethnic variations in prevalence, presentation characteristics, and mortality have been identified in Canadian patients with coronary artery disease. Similar data with respect to heart failure do not exist. A retrospective sequential chart review of South Asians and non-South Asian Whites in Canada hospitalized with a primary diagnosis of congestive heart failure between 1997 and 1999 showed South Asians were significantly younger, of lower body mass index, were more often diabetic, and were less often smokers. In-hospital mortality was not different between groups, although South Asians were more likely to experience ventricular arrhythmias. Despite presenting at a younger age, South Asians had more high-risk features at hospital discharge. Since South Asians are at high risk of developing premature coronary artery disease, a more aggressive approach to prevention strategies in this ethnic group may reduce the subsequent burden of heart failure.
PubMed ID
16259484 View in PubMed
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A comparison of physical activity environments between South Asians and white Caucasians with coronary heart disease.

https://arctichealth.org/en/permalink/ahliterature137210
Source
Ethn Dis. 2010;20(4):390-5
Publication Type
Article
Date
2010
Author
Shazareen N Khan
Sherry L Grace
Paul Oh
Sonia Anand
Donna E Stewart
Gilbert Wu
Milan Gupta
Author Affiliation
University of Toronto, Ontario, Canada.
Source
Ethn Dis. 2010;20(4):390-5
Date
2010
Language
English
Publication Type
Article
Keywords
Aged
Asia, Southeastern - ethnology
Coronary disease - ethnology
Female
Humans
Male
Middle Aged
Motor Activity
Multivariate Analysis
Ontario - epidemiology
Abstract
South Asians (SA) are predisposed to developing premature coronary heart disease (CHD), partly due to the early onset of classic risk factors, including physical inactivity. The nature of physical activity (PA) environments in South Asians in Canada remains unknown. Our objective was to examine differences in PA environments for South Asian vs White Caucasian (WC) CHD patients. In a cross-sectional study, 2657 hospitalized CHD patients in Ontario completed The Perceived Environments Related to Physical Activity Questionnaire to assess their home and neighborhood environment, perceived neighborhood safety and availability of recreational facilities. Patients self-reporting their ethnocultural background as WC (N = 1301, 48.6%) or SA (N = 171, 6.4%) were included in this study. South Asians were significantly younger, had lower body mass index, higher levels of education, lower income, were less likely to smoke and reside rurally, and were more likely to be married, have diabetes mellitus and have experienced prior myocardial infarction (MI) than WC patients. South Asians also had lower availability of home exercise equipment and perceived convenience of local PA facilities, but better and safer neighborhood environments than WC patients. Multivariate analyses revealed that SA ethnocultural background remained significantly related to reduced availability of home exercise equipment and fewer convenient local PA facilities. Since physical inactivity is an important CHD risk factor, and SA ethnocultural background is associated with high CHD risk, this may represent a novel target for risk reduction. Thus, further research is required to optimize SA awareness of the need for PA, and access to equipment and facilities.
Notes
SummaryForPatientsIn: Ethn Dis. 2010 Autumn;20(4):48821305843
PubMed ID
21305827 View in PubMed
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Comparison of rosuvastatin versus atorvastatin in South-Asian patients at risk of coronary heart disease (from the IRIS Trial).

https://arctichealth.org/en/permalink/ahliterature163314
Source
Am J Cardiol. 2007 Jun 1;99(11):1538-43
Publication Type
Article
Date
Jun-1-2007
Author
Prakash C Deedwania
Milan Gupta
Michael Stein
Joseph Ycas
Alex Gold
Author Affiliation
Veterans Affairs Central California Health Care System, University of California-San Francisco, Fresno, California, USA. deed@fresno.ucsf.edu
Source
Am J Cardiol. 2007 Jun 1;99(11):1538-43
Date
Jun-1-2007
Language
English
Publication Type
Article
Keywords
Adult
Aged
Analysis of Variance
Anticholesteremic Agents - therapeutic use
Apolipoprotein A-I - blood - drug effects
Asian Continental Ancestry Group
Biological Markers - blood
Canada - epidemiology
Cholesterol, HDL - blood - drug effects
Cholesterol, LDL - blood - drug effects
Coronary Disease - blood - drug therapy - epidemiology
Female
Fluorobenzenes - adverse effects - therapeutic use
Heptanoic Acids - adverse effects - therapeutic use
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects - therapeutic use
Hypercholesterolemia - blood - drug therapy
Male
Middle Aged
Pyrimidines - adverse effects - therapeutic use
Pyrroles - adverse effects - therapeutic use
Risk factors
Sulfonamides - adverse effects - therapeutic use
Treatment Outcome
United States - epidemiology
Abstract
In a large randomized trial of statin therapy in patients of South-Asian origin with hypercholesterolemia, 740 patients in the United States and Canada received 6 weeks of treatment with rosuvastatin 10 or 20 mg or atorvastatin 10 or 20 mg. A total of 485 patients (66%) were categorized as being at high risk of coronary heart disease and had a National Cholesterol Education Program Adult Treatment Panel III treatment goal of low-density lipoprotein (LDL) cholesterol 10 times the upper limit of normal, alanine aminotransferase >3 times the upper limit of normal on 2 consecutive occasions, or proteinuria or hematuria over the relatively short duration of treatment. In conclusion, statin therapy was well tolerated and effective in decreasing LDL cholesterol in patients of South-Asian origin, with the 10- and 20-mg doses of rosuvastatin and atorvastatin allowing most patients to reach recommended LDL cholesterol goals.
PubMed ID
17531577 View in PubMed
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18 records – page 1 of 2.