Smoking Hurts Bypass Odds

 

Smoking habits can alter chances of a successful bypass graft even a year after quitting

There are a lot of reasons to quit smoking. Improved outcomes in bypass surgery is one of them. Quit now and be healthier sooner and later.

A recent study looked at a group of patients in need of coronary artery bypass grafting to improve blood flow through the heart. The group was split into groups defined by smoking habits. Nonsmokers and long-term quitters had much better rates of success than heavy smokers and recent quitters.

"Talk to your doctor about a plan to stop smoking."

Sun Yongxin, MD, from the Department of Cardiac Surgery at Zhongshan Hospital at Fudan University in Shanghai, China, led a team to investigate the effects of smoking on heart surgery, even after quitting smoking.

For the study, 208 coronary artery bypass grafting (CABG) surgery patients were split into six groups:

• Nonsmokers (36)
• Heavy smokers (45)
• 3-month quitters (33)
• 6-month quitters (27)
• 12-month quitters (38)
• Long-term quitters (29)

In CABG, part of the saphenous vein from the leg is used to repair the coronary artery to recreate open and healthy vascular flow.

In order for a CABG to be successful, the vein needs to be healthy and fully functional for the graft to properly take. The goal is for CABG to be successful for the lifetime of the patient.

In the saphenous vein there are specific enzymes, a matrix of metalloproteinase enzymes to be exact. Heavy smoking can increase these levels and throw off the enzyme balance in the vein, making it less viable for successful grafting.

Researchers found smoking was related to higher levels of metalloproteinase, which was linked to vein graft disease in post-surgical follow-up.

Follow-ups were done with multi-detector spiral computed tomography (MSCT) coronary angiographic assessment at 1 month, 1 year and 2 years after surgery.

Enzymes were more than five to nine times greater in heavy smokers compared to nonsmokers. Levels were still nearly double for 12-month quitters compared to nonsmokers. Long-term quitters had slight elevations of enzymes, but less than 1.5 times that of nonsmokers.

Authors said, “[A] noticeable recovery needs at least 6 months (of the enzymes from quitting smoking), and the recovery cannot return to normal levels…[and] can be found in the data from long-term follow-up.”

Post-operative complications were greater in patients who continued to smoke, including heart attack and the need for a re-operation of the CABG.

Authors stressed the need to encourage smoking cessation for quality of health.

This study was published in January in The Annals of Thoracic Surgery.

Research was supported by a grant from the Shanghai Medical Development Research Fund.

No conflicts of interest were reported.

Conditions: 

Smoking Cessation Tobacco Addiction Addictions Mental Health Heart Attack Cardiovascular

Author Info  Joseph V. Madia, MD

Pain And Your Genes

Chronic pain genes have been identified by researchers and may be linked to blood pressure
 A person’s genetics determines a lot about them, including the way they look, their personality traits and health risks. Research suggests more and more that rare DNA combinations can play an important role in diseases and traits. Scientists are trying to find out more.

A recent study studied and compared DNA to find genetic variations associated with pain sensitivity. The study suggests that chronic pain is associated with specific genes and that treating these genes could be an effective treatment.

The study also suggests there is a possible link between blood pressure and chronic pain.

"Talk to a doctor about treatments for your chronic pain"

Dr. Frances Williams of King’s College London and colleagues from King’s College London, Pfizer Ltd and the Beijing Genomics Institute (BGI) tested 2,500 volunteers using a heated probe on the arm.
The study participants pressed a button when the heat became too uncomfortable. This signaled their pain tolerance to the researchers.

The researchers then carried out exome sequencing, a strategy used to sequence genetic coding, on DNA samples from 200 of the least pain sensitive and 200 of the most pain sensitive people.

How sensitive a person is to pain varies and is genetically inherited. Those who are more sensitive to pain are at a greater risk for developing chronic pain.

Chronic pain is pain that lasts for longer six months and typically comes from long-standing medical conditions or injury to the body. This long term pain can interrupt work, recreation, and relationships with friends and families.

Research for chronic pain is important because the condition is common and current treatments can be expensive, have limited efficacy or significant side effects. Understanding underlying genetic factors can help researchers understand the biology of pain and new areas to target for therapy.

The results of the study showed that pain sensitive people had less variation in their DNA than those who were pain insensitive.

The researchers found different patterns of rare variants on 138 genes between those who were pain sensitive and those who were pain insensitive. The strongest difference in a single gene was seen in the gene GZMM.

The researchers also observed an enrichment of these genes on the angiotesin pathway, an area of the DNA associated with the control of blood pressure. This suggests a possible link between pain regulation and blood pressure.

Future research could look further into this link and could include investigating blood pressure drugs as a way to treat pain.

The study was published in the journal PLoS Genetics and was a joint project between King’s College London, Pfizer Ltd and Beijing Genomics Institute. No other conflicts of interest were reported.

Conditions: 

Chronic Pain Conditions Neuromuscular Disease Hypertension Cardiovascular

Author Info; Joseph V. Madia, MD

Reviewed by:Laura Dobberstein

 

The Brain Can Show Hunger

Author Info

Reviewed by: 

Robert Carlson, M.D 

By:Jessica K. Smith

Bottom of Form

Fructose and glucose affect blood flow to hunger areas of the brain differently

  

There's a reason why eating bread and potatoes can be so much more satisfying compared to fruit. Blood flow to the brain can show it.

Ingesting glucose but not fructose reduces blood flow to the brain, specifically the regions in charge of appetite and mood, according to a recently published study.

The findings help show what kinds of foods leave the body feeling full or still hungry, researchers said.

"Eat in moderation."

 The aim of the study, led by Kathleen Page, MD, of Yale University School of Medicine, and colleagues, was to see which factors are behind the link between consuming fructose, which is a simple sugar found in fruits and plants, and gaining weight.

The study included 20 healthy adults who had images of their brain taken during two magnetic resonance imaging (MRI) sessions.

At one MRI session, patients drank a concoction with fructose. To compare the effects, patients consumed glucose, another kind of sugar, during the other session. The patients did not know which of the two they were receiving at each session.

Researchers found that blood flow to the hypothalamus, which is responsible for hunger and mood, was significantly reduced after ingesting the glucose versus the fructose. This means that the body felt satiated and satisfied.

By drinking the glucose, brain connectivity increased between the hypothalamus and other regions of the brain, according to the researchers.

The fructose on the other hand lowered blood flow to fewer areas of the brain, which means that fewer satiety hormones circulated around compared to those caused by the glucose.

"Increases in fructose consumption have paralleled the increasing prevalence of obesity, and high-fructose diets are thought to promote weight gain and insulin resistance," researchers wrote in their report.

"Thus, fructose possibly increases food-seeking behavior and increases food intake," researchers said.

The authors noted that MRIs do not directly measure neuron activity in the brain; rather, they show changes in blood flow and the influx of oxygen in the blood.

The study was published in the January 2 issue of JAMA. The National Institutes of Health and the Yale Center for Clinical Investigation, which was supported by the Clinical Translational Science Award, funded the study. The authors do not report any conflicts of interest.

Conditions: 

Obesity Healthy Eating and Diet