The impact of blood pressure on the risk of major bleeding complication after renal transplant biopsy

2021 ◽  
Author(s):  
Winston T. Wang ◽  
Anika G. Patel ◽  
Nan Zhang ◽  
Scott W. Young ◽  
J. Scott Kriegshauser ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Renal Transplant ◽  
Major Bleeding ◽  
Bleeding Complication ◽  
Major Bleeding Complication ◽  
The Impact ◽  
Transplant Biopsy

scholarly journals Incidence of Major Bleeding Complication of Warfarin Therapy in Japanese Patients With Atrial Fibrillation

2007 ◽  
Vol 71 (5) ◽  
pp. 761-765 ◽  
Author(s):  
Shinya Suzuki ◽  
Takeshi Yamashita ◽  
Takeshi Kato ◽  
Tadashi Fujino ◽  
Koichi Sagara ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Major Bleeding ◽  
Bleeding Complication ◽  
Warfarin Therapy ◽  
Japanese Patients ◽  
Major Bleeding Complication

Abstract 3000: Blood Pressure Imposes Different Cardiovascular Morbidity On Renal Transplant Candidates Depending On The Presence Of Concomitant Cardiovascular Disease Regardless Of Left Ventricular Function

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Luis Henrique W Gowdak ◽  
Flavio J de Paula ◽  
Luiz Antonio M Cesar ◽  
Eduardo M Krieger ◽  
Jose Jayme G De Lima
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Renal Transplant ◽  
Fold Increase ◽  
Arterial Disease ◽  
Left Ventricular ◽  
Lv Function ◽  
The Mean ◽  
Transplant Candidates ◽  
The Impact

Background: Renal transplant candidates (RTC) are at risk of cardiovascular disease (CVD) and events (MACE). We compared the impact of blood pressure on the incidence of MACE in RTC according to left ventricular (LV) function and the presence of CVD. Methods: 956 RTC (62% men, 53 ± 11 years) were divided according to the presence of CVD (CAD, heart failure, peripheral arterial disease, and/or stroke). LV ejection fraction (EF) was obtained by echo and the mean arterial pressure (MAP) calculated during the baseline visit. The composite incidence of fatal/non-fatal MACE was determined during a median follow-up of 24 months and its rate plotted for each MAP level for RTC with and without CVD; the best curve to fit the regression model was determined by the regression coefficient (R 2 ). Results: The incidence of MACE was 18.4% in the overall population. RTC with concomitant CVD had a 3-fold increase in the endpoint (31.9%) compared with RTC without CVD (11.3%) (P < 0.0001). As shown by the dark lines, in RTC with ( “J-shape” curve; R 2 = 0.91; P < 0.0001) or without CVD (linear; R 2 = 0.88; P < 0.0001), the MAP was associated with MACE. In the graph, the mean LVEF for each MAP level is represented by the bars (CVD[−]= white; CVD[+]= gray). There was no difference in the mean LVEF in RTC without CVD (P = 0.57), whereas in the group with CVD, the mean LVEF was lower in those with lower MAP (P = 0.014). Even so, in RTC with CVD and similar LVEF, those with a MAP between 101–120mmHg had the lowest rate of events. Conclusions: In RTC, blood pressure has a different impact on the occurrence of MACE depending on the presence of CVD. In RTC with CVD, this effect seems to be stronger at extreme levels of MAP, regardless of the LV function.

Bleeding Classification in Clinical Trials: Observer Variability and Clinical Relevance

1997 ◽  
Vol 78 (04) ◽  
pp. 1189-1192 ◽  
Author(s):  
Yvonne P Graafsma ◽  
Martin H Prins ◽  
Anthonie W A Lensing ◽  
Rob J de Haan ◽  
Menno V Huisman ◽  
...  
Keyword(s):  
Major Bleeding ◽  
Clinical Relevance ◽  
Area Under The Curve ◽  
Weighted Kappa ◽  
Clinical Severity ◽  
Minor Bleeding ◽  
Recent Trial ◽  
Bleeding Episodes ◽  
The Impact ◽  
Adjudication Committee

SummaryTo evaluate the bleeding classification in a recent trial on venous thrombosis treatment, a selection of reported bleeding episodes was adjudicated twice by an independent committee and graded by the treating physician and independent clinical experts on the clinical severity and impact on the patient’s life.The kappa values for the dichotomy major bleeding versus minor or no bleeding were 0.79 (95% CI, 0.57-1.0) for the agreement between the two members of the adjudication committee and 0.77 (95% CI, 0.52-1.0) for the agreement between both adjudication sessions. The kappa values for the dichotomy major or minor bleeding versus no bleeding were 0.42 and 0.44. The weighted kappa values for the agreement between the treating physician and the independent experts were 0.76 for the Clinical severity and 0.79 for the impact on the patient’s life (95% CI, 0.63-0.88 and 0.70-0.89). The association between the adjudication result expressed as major bleeding or minor or no bleeding and the Clinical grading by the treating physician resulted in an ROC curve with an area under the curve of 0.98 for the Clinical severity and 0.99 for the impact on the patient’s life. The dichotomy major or minor bleeding versus no bleeding resulted in areas under the curve of 0.70 and 0.66.In conCIusion, the applied criteria for major bleeding are reproducible and Clinically relevant. The criteria for minor bleeding are not reproducible and are less associated with the observed Clinical relevance.

scholarly journals The Impact of a Yearlong Diabetes Prevention Program-Based Lifestyle Intervention on Cardiovascular Health Metrics

2021 ◽  
Vol 12 ◽  
pp. 215013272110298
Author(s):  
Susan M. Devaraj ◽  
Bonny Rockette-Wagner ◽  
Rachel G. Miller ◽  
Vincent C. Arena ◽  
Jenna M. Napoleone ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Lifestyle Intervention ◽  
Prevention Program ◽  
Diabetes Prevention ◽  
Cardiovascular Health ◽  
Diabetes Prevention Program ◽  
Behavioral Risk ◽  
Community Based ◽  
The Impact

Introduction The American Heart Association created “Life’s Simple Seven” metrics to estimate progress toward improving US cardiovascular health in a standardized manner. Given the widespread use of federally funded Diabetes Prevention Program (DPP)-based lifestyle interventions such as the Group Lifestyle Balance (DPP-GLB), evaluation of change in health metrics within such a program is of national interest. This study examined change in cardiovascular health metric scores during the course of a yearlong DPP-GLB intervention. Methods Data were combined from 2 similar randomized trials offering a community based DPP-GLB lifestyle intervention to overweight/obese individuals with prediabetes and/or metabolic syndrome. Pre/post lifestyle intervention participation changes in 5 of the 7 cardiovascular health metrics were examined at 6 and 12 months (BMI, blood pressure, total cholesterol, fasting plasma glucose, physical activity). Smoking was rare and diet was not measured. Results Among 305 participants with complete data (81.8% of 373 eligible adults), significant improvements were demonstrated in all 5 risk factors measured continuously at 6 and 12 months. There were significant positive shifts in the “ideal” and “total” metric scores at both time points. Also noted were beneficial shifts in the proportion of participants across categories for BMI, activity, and blood pressure. Conclusion AHA-metrics could have clinical utility in estimating an individual’s cardiovascular health status and in capturing improvement in cardiometabolic/behavioral risk factors resulting from participation in a community-based translation of the DPP lifestyle intervention.

scholarly journals Paleolithic Diet—Effect on the Health Status and Performance of Athletes?

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 1019
Author(s):  
Barbara Frączek ◽  
Aleksandra Pięta ◽  
Adrian Burda ◽  
Paulina Mazur-Kurach ◽  
Florentyna Tyrała
Keyword(s):  
Blood Pressure ◽  
Body Mass ◽  
Positive Impact ◽  
Model Assessment ◽  
Paleolithic Diet ◽  
Short Term ◽  
Positive Effects ◽  
Short And Long Term ◽  
The Impact

The aim of this meta-analysis was to review the impact of a Paleolithic diet (PD) on selected health indicators (body composition, lipid profile, blood pressure, and carbohydrate metabolism) in the short and long term of nutrition intervention in healthy and unhealthy adults. A systematic review of randomized controlled trials of 21 full-text original human studies was conducted. Both the PD and a variety of healthy diets (control diets (CDs)) caused reduction in anthropometric parameters, both in the short and long term. For many indicators, such as weight (body mass (BM)), body mass index (BMI), and waist circumference (WC), impact was stronger and especially found in the short term. All diets caused a decrease in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG), albeit the impact of PD was stronger. Among long-term studies, only PD cased a decline in TC and LDL-C. Impact on blood pressure was observed mainly in the short term. PD caused a decrease in fasting plasma (fP) glucose, fP insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) and glycated hemoglobin (HbA1c) in the short run, contrary to CD. In the long term, only PD caused a decrease in fP glucose and fP insulin. Lower positive impact of PD on performance was observed in the group without exercise. Positive effects of the PD on health and the lack of experiments among professional athletes require longer-term interventions to determine the effect of the Paleo diet on athletic performance.

scholarly journals Firefighter hemodynamic responses to different fire training environments

2021 ◽  
pp. 1358863X2098760
Author(s):  
Elizabeth C Lefferts ◽  
Alexander J Rosenberg ◽  
Georgios Grigoriadis ◽  
Sang Ouk Wee ◽  
Stephen Kerber ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Oriented Strand Board ◽  
Hemodynamic Response ◽  
Strenuous Exercise ◽  
Training Environment ◽  
Time Interaction ◽  
Increased Risk ◽  
Fire Smoke ◽  
System Activation ◽  
The Impact

Firefighting is associated with an increased risk for a cardiovascular (CV) event, likely due to increased CV strain. The increase in CV strain during firefighting can be attributed to the interaction of several factors such as the strenuous physical demand, sympathetic nervous system activation, increased thermal burden, and the environmental exposure to smoke pollutants. Characterizing the impact of varying thermal burden and pollutant exposure on hemodynamics may help understand the CV burden experienced during firefighting. The purpose of this study was to examine the hemodynamic response of firefighters to training environments created by pallets and straw; oriented strand board (OSB); or simulated fire/smoke (fog). Twenty-three firefighters had brachial blood pressure measured and central blood pressure and hemodynamics estimated from the pressure waveform at baseline, and immediately and 30 minutes after each scenario. The training environment did not influence the hemodynamic response over time (interaction, p > 0.05); however, OSB scenarios resulted in higher pulse wave velocity and blood pressure (environment, p < 0.05). In conclusion, conducting OSB training scenarios appears to create the largest arterial burden in firefighters compared to other scenarios in this study. Environmental thermal burden in combination with the strenuous exercise, and psychological and environmental stress placed on firefighters should be considered when designing fire training scenarios and evaluating CV risk.

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