Cardiovascular Deaths among CAPD Patients

1983 ◽  
Vol 3 (3_suppl) ◽  
pp. 23-26 ◽  
Author(s):  
George Wu
Keyword(s):  
Heart Disease ◽  
De Novo ◽  
Plasma Cholesterol ◽  
Hypertensive Heart Disease ◽  
Cardiovascular Complications ◽  
First Year ◽  
Antihypertensive Medications ◽  
Significant Difference ◽  
Artery Disease ◽  
Similar Risk

Forty-four of the 508 CAPD patients in Toronto died of cardiovascular complications during the period september 1977 -October 1982. More than 80% of these patients had evidence of ischemic or hypertensive heart disease before commencement of CAPD. The survival of CAPD patients, who were free of cardiac problems before starting CAPD, was significantly better than those who had angina pectoris, myocardial infarction or cardiomegaly at the onset of CAPD. The de novo incidence of ischemic heart disease in patients between ages 40 and 59 (n = 70) was 8.8% at the end of the first year, and 15%() at the end of the second year. These figures were comparable to those reported for hemodialysis patients but worse than those in nonuremic patients with similar risk factors. After starting CAPD, 68.2% of the initially hypertensive patients became normotensive without taking any medication, and 25.8%() became normotensive with a reduced dose of antihypertensive medications. There was no statistically significant difference between the mean fasting plasma cholesterol and triglyceride levels of patients with and those without coronary artery disease.

Risk Factors for Coronary Artery Disease in Children: Recognition, Evaluation, and Therapy

1980 ◽  
Vol 2 (5) ◽  
pp. 131-138
Author(s):  
C. J. Glueck ◽  
M. J. Mellies ◽  
R. C. Tsang ◽  
J. A. Morrison
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Eating Habits ◽  
Plasma Cholesterol ◽  
Saturated Fat ◽  
Cholesterol Levels ◽  
Chd Risk ◽  
Artery Disease ◽  
Atherosclerosis Prevention

PEDIATRIC GENESIS OF ATHEROSCLEROSIS Atherosclerosis results from a variety of pathophysiologic disturbances, some currently recognized, and many undoubtedly not yet recognized, which in aggregate are identified as risk factors. Genetic and environmental influences conjointly affect the incidence and the severity of these risk factors and, thus, coronary heart disease (CHD) risk. Prophylaxis should be designed to prevent or retard the development of arterial plaques. This suggests that diagnostic and preventive efforts should begin in childhood. Eating habits are also probably established in childhood, allowing their early modification. The atherosclerotic plaque appears to have its genesis in childhood. The data from wartime autopsies confirm the presence of mature atherosclerotic lesions by the end of the second decade and emphasize the importance of primary atherosclerosis prevention beginning in the first and second decades. While there are clearly genetic factors in CHD, variation in rates in differing geographic areas appears less likely to be related to genetic than to environmental differences. Marked differences in plasma cholesterol levels are found in children in different geographic areas, generally paralleling pediatric cholesterol and saturated fat intake and the incidence of adult coronary heart disease. The relationships of elevated total plasma cholesterol levels to the incidence of coronary heart disease are clearly established in adults.

Abstract 14559: Prognostic Utility of Cardiac Markers in Covid-19 Patients

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Ahmad Damati ◽  
Kok Hoe Delcos Chan ◽  
Iyad Farouji ◽  
Amr Al-ramahi ◽  
Patel Bhavic ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Univariate Analysis ◽  
Cardiovascular Complications ◽  
Hospitalized Patients ◽  
Multivariable Logistic Regression Analysis ◽  
Cardiac Markers ◽  
Significant Difference ◽  
The Us ◽  
Prognostic Utility ◽  
Artery Disease

Introduction: SARS-CoV-2 infection has been associated with a multiple cardiovascular complications. It is not known if cardiac markers can be used for outcome prediction in the US population. Methods: We conducted a retrospective study on patients ≥ 18 years old with confirmed COVID 19, who were admitted to our hospital between 03/15/2020 and 05/25/2020. Individuals were included if they had a baseline troponin and brain natriuretic peptide (BNP) available, and if their outcome by the end of the study period was well defined as discharge alive, or deceased. Univariate and multivariate logistic regression methods were employed to identify the cardiac markers associated with mortality in COVID-19 patients. Results: The total number of confirmed COVID-19 hospitalized patients during the study period was 348, after excluding patients who did not have cardiac markers available, 233 patients were included in the study, 75 (32%) expired, and 158 (68%) were discharged alive. The median age was 65 years old, and ranged from 22 to 101 years old. 140 males and 93 females. Comorbidities were present in 201 (86%) patients, with hypertension (65%) being the most common, followed by obesity (55%), diabetes mellitus (DM) (44%) and coronary artery disease (27%). Mechanical ventilation was required for 61 patients of whom 42 expired. In univariate analysis, we found a significant difference in history of chronic kidney disease defined by eGFR <45ml/min (p=0.046), DM (p=0.043), initial SOFA (p=0.017), troponin (p=0.001), BNP (p=0.043), CRP (p=<0.0001), LDH (p=<0.0001) and ferritin (p=<0.0001) between survivors and non-survivors. With multivariable logistic regression analysis, the only values that had an odds of survival were a low troponin (odds ratio [OR] 0.17; 95% confidence interval [CI], 0.04-0.52), a low SOFA (OR 0.72, CI 0.50-0.94) and a low CRP (OR 0.87, CI 0.87-0.94). Conclusions: This retrospective cohort study of hospitalized patients with COVID-19 suggests an independent association of increased troponin as risk factor for death in COVID-19 patients. Cardiac troponin has been reported as potential prognostic marker in the China cohort. To our knowledge, we are first to demonstrate the utilization of troponin as mortality predictor in the US population.

Pregnancy in women with pre-existent ischaemic heart disease: a systematic review with individualised patient data

Heart ◽  
2019 ◽  
Vol 105 (11) ◽  
pp. 873-880 ◽  
Author(s):  
Heleen Lameijer ◽  
Luke J Burchill ◽  
Lucia Baris ◽  
Titia PE Ruys ◽  
Jolien W Roos-Hesselink ◽  
...  
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
High Risk ◽  
Ischaemic Heart Disease ◽  
Cardiovascular Complications ◽  
Patient Data ◽  
Pregnancy Risk ◽  
Neonatal Complications ◽  
Coronary Syndrome ◽  
Significant Difference

IntroductionStudies on pregnancy risk in women with ischaemic heart disease (IHD) have mainly excluded pregnancies in women with pre-existent IHD. There is a need for better information about the pregnancy risks in these women and their offspring.MethodsWe performed a systematic review searching the PubMed/MEDLINE public database for pregnancy in women with pre-existent IHD analysing the cardiac, obstetric and fetal/neonatal outcome of pregnancy in women with pre-existing IHD. Individual patient data were requested from large series. The primary outcome endpoints was a composite of ischaemic complications including maternal death, acute coronary syndrome and ventricular tachycardia.Results116 women with pre-existent IHD had 124 pregnancies including one twin pregnancy. They had a 21% chance of having an uncomplicated pregnancy (completed pregnancy without cardiovascular, obstetric or fetal/neonatal complications, n=26). Primary (ischaemic) endpoints occurred in 9% (n=11). Women with atherosclerosis had more cardiovascular complications compared with pregnancies in women with other underlying pathology for IHD (50%vs23%, P=0.02) but no significant difference in occurrence of primary endpoints (13% vs 9%, P=0.53). There were two maternal cardiac deaths (2%), one of which occurred in the 18th week of pregnancy and the other postpartum. Obstetric complications occurred in 58% (n=65) of pregnancies and fetal/neonatal complications in 42% (n=47).ConclusionPregnancies in women with pre-existing IHD are high-risk pregnancies. These women have a high risk of ischaemic cardiovascular complications including 2% maternal mortality. The risk of ischaemic complications is especially high among women with atherosclerotic coronary artery disease.

scholarly journals Frequency of Cardiovascular Complications and Its Association with Prognosis of COVID-19 Patients

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Hossein Mazaherpour ◽  
Masoumeh Soofian ◽  
Elham Farahani ◽  
Fatemeh Masfari Farahani ◽  
Ehsanollah Ghaznavi Rad ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Troponin I ◽  
Cardiovascular Complications ◽  
Cardiac Complications ◽  
Age Difference ◽  
Creatine Kinase Mb ◽  
Significant Difference ◽  
Artery Disease ◽  
Underlying Diseases ◽  
Electrocardiogram Ecg

Coronavirus disease 2019 (COVID-19) may lead to acute respiratory disease; cardiovascular, gastrointestinal, and coagulation complications; and even death. One of the major complications is cardiovascular disorders, including arrhythmias, myocarditis, pericarditis, and acute coronary artery disease. The aim of this study was to evaluate the frequency of cardiovascular complications and to determine its association with the prognosis of COVID-19 patients. In a prospective analytic study, 137 hospitalized COVID-19 patients were enrolled. During hospitalization, an electrocardiogram (ECG) was performed every other day, and laboratory tests such as cardiac troponin I (cTnI) and creatine kinase-MB (CK-MB) were done 0, 6, and 12 hours after admission. These tests were repeated for patients with chest pain or ECG changes. Patients were categorized into three groups (improved, complicated, and expired patients) and assessed for the rate and type of arrhythmias, cardiac complications, lab tests, and outcomes of treatments. There was no significant relationship among the three groups related to primary arrhythmia and arrhythmias during treatment. The most common arrhythmia during hospitalization and after treatment was ST-T fragment changes. There was a significant age difference between the three groups ( P = 0.001 ). There was a significant difference among the three groups for some underlying diseases, including diabetes mellitus ( P = 0.003 ) and hyperlipidemia ( P = 0.004 ). In our study, different types of arrhythmias had no association with patients’ outcomes but age over 60 years, diabetes mellitus, and hyperlipidemia played an important role in the prognosis of COVID-19 cases.

scholarly journals Spot Urine Protein Excretion in the First Year Following Kidney Transplantation Associates With Allograft Rejection Phenotype at 1-Year Surveillance Biopsies: An Observational National-Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Nika Kojc ◽  
Maja Frelih ◽  
Jadranka Buturović-Ponikvar ◽  
...  
Keyword(s):  
Cohort Study ◽  
Allograft Rejection ◽  
De Novo ◽  
First Year ◽  
Urine Protein ◽  
Spot Urine ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Significant Difference ◽  
National Cohort

Introduction: Urine protein excretion is routinely measured to assess kidney allograft injury, but the diagnostic value of this measurement for kidney transplant pathology remains unclear. Here we investigated whether spot urine protein excretion in the first year following transplantation associates with allograft rejection phenotype at 1-year surveillance biopsies and de-novo occurrence of donor-specific antibodies (DSA).Patients and Methods: This prospective, observational national-cohort study included 139 non-sensitized patients who received a deceased donor kidney transplant between December 2014 and 2018. All patients received basiliximab induction and tacrolimus-based immunosuppression. Estimated protein excretion rate (ePER) was calculated monthly from spot urine protein-to-creatinine ratios. At 1-year, all recipients underwent surveillance graft biopsy and were screened for de-novo DSA. Screening-positive sera were subjected to single antigen bead (SAB) testing. The occurrence of de-novo DSA was determined based on SAB reactivity patterns using a mean fluorescence intensity threshold &gt;1,000.Results: Among the 139 study patients, 27 patients (19%) had histologic evidence of T cell-mediated rejection (TCMR), and 9 patients (7%) had histologic evidence of antibody-mediated rejection (AMR) at 1-year surveillance biopsy. One year after transplant, 19 patients (14%) developed de-novo DSA. Compared with patients without rejection and no de-novo DSA, mixed-effects linear regression analysis showed a significant difference in slope of ePER during the first year in patients with AMR and de-novo DSA at 1-year (46, 95% CI 25–68 mg/day/1.73 m2 per month and 34, 95% CI 20–49 mg/day/1.73 m2 per month, respectively). Patients with vascular TCMR also showed a significant difference in ePER slope over time compared with patients with non-rejection findings (31, 95% CI 9–52 mg/day/1.73 m2 per month). The discriminatory power of ePER for intragraft rejection processes was better in patients with AMR (AUC 0.95, 95% CI 0.90–0.99; P &lt; 0.001) than in those with TCMR (AUC 0.68, 95% CI 0.59–0.79; P = 0.002), with 89% sensitivity and 93% specificity for proteinuria &gt;550 mg/day/1.73m2.Conclusions: An increase in ePER in the first year following kidney transplantation associates with AMR, vascular TCMR and de-novo DSA at 1-year and may be used as a non-invasive clinical marker of intragraft endothelial cell injury.

scholarly journals Isolated Left Bundle Branch Block in a Toddler

2014 ◽  
Vol 2014 ◽  
pp. 1-3 ◽  
Author(s):  
Hitesh Agrawal ◽  
Frank Zimmerman ◽  
Zahra Naheed
Keyword(s):  
Heart Disease ◽  
Left Bundle Branch Block ◽  
Congenital Heart ◽  
Pediatric Population ◽  
Hypertensive Heart Disease ◽  
African American Female ◽  
Bundle Branch Block ◽  
Conduction Abnormality ◽  
Artery Disease

Left bundle branch block (LBBB) usually occurs as a postoperative complication from surgical correction of congenital heart disease and can be associated with hypertensive heart disease, coronary artery disease, myocarditis, and aortic valvular disease. Although isolated LBBB is a conduction abnormality found in some healthy adults, it has not been reported in pediatric population. We report a 2-year-old, healthy African American female who was incidentally discovered to have isolated LBBB that has persisted in a follow-up of 3 years.

scholarly journals Hostility, anger-in, rumination and aggressivity – major risk factors for coronary heart disease (CHD)

2015 ◽  
Vol 62 (1) ◽  
pp. 23-29
Author(s):  
Alexandru Chiţu ◽  
◽  
Ioan Bradu Iamandescu ◽  
◽  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Complex Traits ◽  
Plasma Cholesterol ◽  
Stress Hormones ◽  
Experimental Studies ◽  
Type A ◽  
Psychological Variables ◽  
Artery Disease ◽  
The Many

Friedman and Rosenman are highlighting behavioral type A as a major riskfactor for evolution worsening of myocardial infarction, was first and decisive step for clearly specifying the role of supportive psychosocial factors in etiopathogenesis of the coronary heart disease. Then, the reason that this type of behavior has been highlighted in other psychosomatic diseases (and even some healthy subjects) led to the need to fi nd other psychological variables – of personality, especially – associated with type A and convincing predictive value numerous epidemiological and experimental studies. In the last two decades has been it’s presence in some carriers of type A – which showed clinical and laboratory manifestations of coronary artery disease (including exploration angiographic coronary flow and computerized measurements) – this constant in varying degrees of complex traits emotional underpinning of increased aggression: hostility (cognitive and/or behavioral) – in particular internalized anger (anger-in) and ruminative anger. These variables have the correspondent psychological, somatic plan, vascular hyperreactivity to stress hormones (catecholamines and cortisol in particular) resulting in increased plasma cholesterol, myocardial oxygen consumption, the platelets aggregation etc. In essentially agressive featuters frequently expressed to the many distress “collected” by holders type A, pressed myocardium with pathophysiological changes specific for aggression.

Sign in / Sign up

Export Citation Format

Share Document