Butyrylcholinesterase Predicts Cardiac Mortality in Young Patients with Acute Coronary Syndrome

Background

The incidence of acute coronary syndrome (ACS) in young people (≤65 years) is continuously rising. While prognostic factors in ACS are well-investigated less attention has been paid to their age-dependent prognostic value and their particular relevance in younger patients. The aim of our study was to assess the age-dependent prognostic impact of butyrylcholinesterase (BChE).

Methods

Retrospective cohort study including 624 patients with ACS. Patients were stratified by age into equal groups (n = 208) corresponding to “young patients” (45–64 years), "middle-aged patients” (65–84 years) and “old patients” (85–100 years). Cox regression hazard analysis was used to assess the influence of BChE on survival.

Results

After a mean follow-up time of 4.0 (interquartile range [IQR] 2.0–6.4) years, 154 patients (24.7%) died due to a cardiac cause. In the overall cohort, BChE was indirectly associated with cardiac mortality-free survival (adjusted hazard ratio (HR): 0.70 (95% confidence interval [CI] 0.53–0.93, p = 0.01). The primary-analysis of BChE by age strata showed the strongest effect in the age group 45–64 years with an adjusted HR per 1-SD of 0.28 (95% CI 0.12–0.64, p = 0.003), a weaker association with mortality in middle aged (65–84 years: adjusted HR per 1-SD 0.66 [95% CI: 0.41–1.06], p = 0.087), and no association in older patients (85–100 years: adjusted HR per 1-SD 0.89 [95% CI: 0.58–1.38], p = 0.613).

Conclusion

BChE is a strong predictor for cardiac mortality specifically in younger patients with ACS aged between 45 and 64 years. No significant association of BChE with cardiac-mortality was detected in other age classes.     

Horizontal Hostility among Non-Meat Eaters

The present study examined intergroup judgments made between four groups of non-meat eaters: health vegetarians; ethical vegetarians; health vegans, and ethical vegans. Consistent with hypotheses based on horizontal hostility and the need to maintain ingroup distinctiveness, ethical vegetarians gave unfavorable evaluations to health vegetarians relative to vegans, especially when the mainstream omnivore group was made salient. Contrary to expectations, vegans gave relatively more favorable evaluations to ethical vegetarians than health vegetarians when mainstream salience was low. This was especially true for vegans who were motivated primarily by ethical concerns. When mainstream salience was high, vegans did not distinguish between the vegetarian subgroups. Results suggest that one’s motives for abstaining from meat often play a larger role in this type of intergroup perceptions than one’s dietary practices.     

Carnivorous Cats,Vegetarian Dogs,and the Resolution of the Vegetarian's Dilemma

The present research sought to further clarify the vegetarian's dilemma, the conflict that pits feeding one's pet an animal-based diet that may be perceived as best promoting their well-being with concerns over animal welfare and environmental degradation threatened by such diets. It specifically examined whether non-meat eaters would distinguish between pet dogs and cats in the percentage of their diet derived from animal products, guilt experienced from such diets, and perceived appropriateness of non-vegetarian diets. Survey responses from 290 vegans and vegetarians indicated that participants fed their pet dogs a diet significantly more vegetarian than they fed their pet cats, and reported experiencing less guilt feeding their cats a diet derived highly from animals than in feeding their dogs such a diet. This lack of guilt largely arose from greater endorsement that vegetarian diets were more inappropriate for cats than dogs. For dogs, then, the vegetarian's dilemma was resolved primarily through feeding them diets reduced in meat/fish. For cats, the primary attempt at resolving the dilemma was not behavioral but perceptual in that vegetarian diets were deemed inappropriate. As discussed, this latter strategy was met with mixed success. Overall, the reaction of participants reflected prevailing medical wisdom that vegetarian diets are somewhat acceptable for dogs but problematic for cats.