Current Issue : July - September Volume : 2017 Issue Number : 3 Articles : 7 Articles
The main mechanism of the CHADS2 and CHA2DS2-VASc scores to predict stroke in non valvular atrial fibrillation (NVAF) is\nstill controversial. We evaluated the association of the CHADS2 and CHA2DS2-VASc scores with left atrial thrombus (LAT) as\ndetected by trans esophageal echocardiographic (TEE) and compared the predictive ability of these risk stratification schemes\nwith non valvular atrial fibrillation (NVAF). Data from 2,695 consecutive NVAF patients in whom TEE was performed for\nscreening LAT from July 2007 to February 2014 were analyzed. Only 3% of the subjects had LAT. Presence of LAT was not\nsignificantly associated with either CHADS2 (...
Background: Erythropoietin (EPO) has been suggested to promote cardiac repair after MI. However, the\nrandomized, double-blind, placebo controlled REVIVAL-3 trial showed that short term high dose EPO in timely\nreperfused myocardium does not improve left ventricular ejection fraction after 6 months. Moreover, the study\nraised safety concerns due to a trend towards a higher incidence of adverse clinical events as well as a increase in\nneointima formation after treatment with EPO. The present study therefore aimed to assess the 5-year clinical\noutcomes.\nMethods: After successful reperfusion 138 patients with STEMI were randomly assigned to receive epoetin\nbeta (3.33Ã?â??104 U, n = 68) or placebo (n = 70) immediately, 24 and 48 h after percutaneous coronary intervention. The\nprimary outcome of the present study- the combined incidence of MACE 5 years after randomization - occurred in\n25% of the patients assigned to epoetin beta and 17% of the patients assigned to placebo (RR 1.5; 95% CI 0.8-3.5; p = 0.\n26). Target lesion revascularization was required in 15 patients (22.1%) treated with epoetin-Ã?Ÿ and 9 patients (12.9%)\ntreated with placebo (p = 0.15). Analysis of patients in the upper and lower quartile of baseline hemoglobin as an\nindirect estimate of endogenous erythropoietin levels revealed no significant impact of endogenous erythropoietin on\nefficiency of exogen administered epoetin-Ã?Ÿ in terms of death and MACE.\nConclusion: These long-term follow-up data show that epoetin beta does not improve clinical outcomes of patients\nwith acute myocardial infarction....
Background: Malaria and human immunodeficiency virus are the two most devastating global health problems\ncausing more than two million deaths each year. Hematological abnormalities such as anemia, thrombocytopenia\nand leucopenia are the common complications in malaria and HIV co-infected individuals. The aim of this study\nwas to determine the effect of malaria infection on hematological profiles of people living with HIV attending\nGambella Hospital ART clinic, Southwestern Ethiopia.\nObjective: To determine the effect of malaria infection on hematological profiles of people living with HIV\nattending Gambella Hospital ART clinic, Southwestern Ethiopia.\nMethods: A facility based comparative cross-sectional study was conducted from May 25 to November 11, 2014 in\nGambella Hospital. A total of 172 adult people living with HIV (86 malaria infected and 86 malaria non-infected)\nparticipants were included in the study. Demographic, anthropometric and clinical data were collected. Venous\nblood samples and stool specimen were collected for laboratory analysis. Microscopic examination of peripheral\nblood films was done for detection of malaria parasites. Descriptive statistics, student T- test, bivariable and\nmultivariable analyses were performed using SPSS V-20. Statistical significance was set at p < 0.05.\nResults: A total of 172 adult people living with HIV were included in the study. The prevalence of anemia,\nthrombocytopenia and leucopenia in malaria and HIV co-infected participants were 60.5%, 59.3%, and 43.0%,\nrespectively. Resident (AOR: 4.67; 95% CI: 1.44, 15.14), malaria infection (AOR: 2.42; 95% CI: 1.16, 5.04) and CD4\n+\ncount were predictors for anemia. A predictor for thrombocytopenia was malaria infection (AOR: 9.79; 95% CI: 4.33,\n22.17). Malaria parasitic density (AOR: 0.13; 95% CI: 0.03, 0.57) and CD4\n+ count (AOR: 4.77; 95% CI: 1.23, 18.45) were\npredictors of leucopenia.\nConclusions: Findings suggest that the prevalence of anemia and thrombocytopenia were significantly higher in the\nmalaria and HIV coinfected participants than the HIV mono-infected participants. Mean values of hematological profiles\nwere significantly different in the two groups. Future prospective studies with larger sample size from other settings\nare needed to substantiate the findings....
Background: Hypertension is a risk factor for peripheral arterial disease (PAD). Subjects with PAD are at increased\nrisk of future cardiovascular (CV) events. Resistin is involved in the pathological processes of CV diseases. The aim of\nthis study is to investigate whether resistin level is correlated with PAD in hypertensive patients.\nMethods: One hundred and twenty-four hypertensive patients were enrolled in this study. Ankle-brachial index\n(ABI) values were measured using the automated oscillometric method. An ABI value < 0.9 defined the low ABI\ngroup. Anthropometric analysis with waist circumference and body mass index, and fasting serum levels of blood\nurea nitrogen, creatinine, glucose, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density\nlipoprotein cholesterol, total calcium, phosphorus, and high-sensitivity C-reactive protein (hs-CRP) were measured\nusing standard enzymatic automated methods. Serum levels of human resistin were determined using a commercially\navailable enzyme immunoassay.\nResults: Eighteen hypertensive patients (14.5%) were included in the low ABI group. Hypertensive patients in\nthe low ABI group were older (p = 0.043) and had higher serum creatinine (p < 0.001), high-sensitivity C-reactive\nprotein (hs-CRP; p = 0.013), and resistin (p < 0.001) levels but a lower estimated glomerular filtration rate (p = 0.002)\nthan patients in the normal ABI group. After the adjustment for factors that were significantly associated with PAD on\nmultivariate logistic regression analysis, serum resistin (odds ratio [OR], 1.176; 95% confidence interval [CI], 1.028ââ?¬â??1.345;\np = 0.018) was also an independent predictor of PAD in hypertensive patients.\nConclusions: A high serum resistin level is an independent predictor of PAD in hypertensive patients....
The surgical indications for dilated cardiomyopathy (DCM) remain controversial,\nnot including cardiac transplantation and mechanical circulatory support.\nWe describe a case of idiopathic DCM that underwent successful surgical treatment\nusing a modified left ventriculectomy, modification of the Batista procedure.\nThe patient was a 63-year-old man who suffered from heart failure,\nNew York Heart Association (NYHA) Class IV. Heart failure was derived from\nidiopathic DCM with a severely compromised left ventricular function complicated\nby left ventricular thrombosis. He underwent successful surgical\ntreatment, specifically partial left ventriculectomy combined with the papillary\nmuscle approximation, and the postoperative course was uneventful. He has\nbeen well with NYHA Class I for 3 years after the operation without heart failure....
Objectives. To investigate the potential association of a set of serum cytokines with the severity of coronary artery disease (CAD).\nMethods. A total of 201 patients who underwent coronary angiography for chest discomfort were enrolled. The concentrations of\nserum IFN-...
Background: The influence of race/ethnicity on the relationship between sedentary\nscreen time and left ventricular mass has been recently suggested, but\nremains a subject of debate, and has never been explored in Africa. Purpose:\nTo determine whether there is a racial/ethnic influence on the relationship\nbetween sedentary screen time and left ventricular mass in MAGhreb and Sub\nSaharan Africa Left-Ventricul ArGEometry Study (MAG-SALVAGES) participants.\nMethods: 100 blacks sub-Saharan African and 187 white Maghreb\naged 18 - 55 years underwent an interview on their behavioral measures, physical\nactivity and eating habits. Their left ventricular mass has also been measured\nby a resting transthoracic echography according to the American Society\nof Echography. Generalized linear models evaluated a test-for-trend across\nhigher levels of sedentary screen time in progressive models with left ventricular\nmeasurements as dependent variables. The study population was stratified\ninto quartiles of sedentary screen time (separately for whites and blacks) and\nexamined the joint association of sedentary screen time and LVM within quartiles\nof physical activity. Results: Among White Maghreb, higher screen time\nwas associated with smaller left ventricular mass (P < 0.001). This association\npersisted when adjusting for age, gender, heart rate, waist circumference, waistto-\nhip ratio, systolic blood pressure QRS duration, TAPS and PAPS. Whereas,\nin blacks sub-Saharan African, the left ventricular mass was not associated\nwith sedentary screen time. Conclusions: Sedentary screen time is associated\nwith smaller left ventricular mass in White Maghreb, not in black sub-Saharan\nAfrican. The lack of association in blacks supports a potential qualitative difference\nin the cardiovascular consequences of sedentary screen based behavior....
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