scholarly journals The Pre- and Postoperative Prevalence and Risk Factors of ASA Nonresponse in Vascular Surgery

2021 ◽  
Vol 27 ◽  
pp. 107602962110447
Author(s):  
Alia Uzra Kazimi ◽  
Christian Friedrich Weber ◽  
Michael Keese ◽  
Wolfgang Miesbach
Keyword(s):  
Risk Factors ◽  
Vascular Surgery ◽  
Endovascular Aneurysm Repair ◽  
University Hospital ◽  
Frankfurt Am Main ◽  
Multiple Electrode Aggregometry ◽  
Total Prevalence ◽  
The University ◽  
Aneurysm Repair

Background An antiplatelet therapy with acetylsalicylic acid (ASA) is prescribed in the prevention of cardiovascular events, but around 24% of ASA takers are resistant to the treatment. Aim In this prospective, observational cohort study, we aimed to identify the prevalence and risk factors of ASA nonresponse in patients who underwent vascular surgery. Methods The study was conducted in the University hospital in Frankfurt am Main. In total, 70 patients were pre-treated with 100 mg of ASA per day and underwent either elective carotid thromboendarterectomy, femoral thromboendarterectomy or endovascular aneurysm repair of the abdominal aorta. The platelet function was measured on the first preoperative and the second or fourth postoperative day with the multiple electrode aggregometry by in-vitro stimulation with arachidonic acid (ASPItest) and thrombin receptor activating peptide 6 (TRAPtest). The primary end point was the in-vitro induced platelet aggregation in the ASPItest. If the ASPItest amounted ≥400 AU × min, the patients were categorized as ASA nonresponders. Results The total prevalence of ASA nonresponse in our study was 20% preoperatively and 35.7% postoperatively (p = 0.005). As significant predictors for ASA nonresponse, we demonstrated the area under the aggregation curve in the TRAPtest preoperatively (p = 0.04) and postoperatively (p = 0.02), and the two comorbidities arterial hypertension ( P < .001; rho 0.44) and diabetes mellitus (p = 0.04; rho 0.39), which are already well known to be associated with ASA nonresponse. Conclusion In conclusion, data of the study indicate a high incidence of perioperative, laboratory ASA nonresponse in patients undergoing vascular surgery.

scholarly journals Risk factors of secondary intervention for type II endoleaks in endovascular aneurysm repair: An 8-year single institution study

2019 ◽  
Vol 42 (1) ◽  
pp. 106-111 ◽  
Author(s):  
Up Huh ◽  
Chung Won Lee ◽  
Sung Woon Chung ◽  
Sang-pil Kim ◽  
Seunghwan Song ◽  
...  
Keyword(s):  
Risk Factors ◽  
Endovascular Aneurysm Repair ◽  
Type Ii ◽  
Single Institution ◽  
Secondary Intervention ◽  
Aneurysm Repair

scholarly journals Five-year survival after elective open and endovascular aortic aneurysm repair

2021 ◽  
pp. 145749692110487
Author(s):  
Jüri Lieberg ◽  
Karl G. Kadatski ◽  
Mart Kals ◽  
Kaido Paapstel ◽  
Jaak Kals
Keyword(s):  
Aortic Aneurysm ◽  
Survival Data ◽  
Endovascular Aneurysm Repair ◽  
National Registry ◽  
University Hospital ◽  
Current Evidence ◽  
Term Survival ◽  
All Cause Mortality ◽  
Aneurysm Repair

Background and objective: Current evidence suggests short-term survival benefit from endovascular aneurysm repair (EVAR) versus open surgical repair (OSR) in elective abdominal aortic aneurysm (AAA) procedures, but this benefit is lost during long-term follow-up. The aim of this study was to compare short- and mid-term all-cause mortality in patients with non-ruptured aneurysm treated by OSR and EVAR; and to assess the rate of complications and reinterventions, as well as to evaluate their impact on survival. Methods: The medical records of the non-ruptured AAA patients undergoing OSR or EVAR between 1 January 2011 and 31 December 2019 at Tartu University Hospital, Estonia, were retrospectively reviewed. We gathered survival data from the national registry (mean follow-up period was 3.7 ± 2.3 years). Results: A total of 225 non-ruptured AAA patients were treated operatively out of whom 95 (42.2%) were EVAR and 130 (57.8%) were OSR procedures. The difference in estimated all-cause mortality between the OSR and EVAR groups at day 30 was statistically irrelevant (2.3% vs 0%; p = 0.140), but OSR patients showed statistically significantly higher 5 year survival compared with EVAR patients (75.3% vs 50.0%, p = 0.002). Complication and reintervention rates for the EVAR and OSR groups did not differ statistically (26.3% vs 16.9%, p = 0.122; 10.5% vs 11.5%, p = 0.981, respectively). Multivariate analysis revealed that greater aneurysm diameter (p = 0.012), EVAR procedure (p = 0.016), male gender (p = 0.023), and cerebrovascular diseases (p = 0.028) were independently positively associated with 5-year mortality. Conclusions: Thirty-day mortality, and complication and reintervention rates for EVAR and OSR after elective AAA repair were similar. Although the EVAR procedure is an independent risk factor for 5-year mortality, higher age and greater proportion of comorbidities among EVAR patients may influence not only the choice of treatment modality, but also prognosis.

scholarly journals Trends in the treatment of risk factors for stroke in a Czech stroke unit

Open Medicine ◽  
2015 ◽  
Vol 10 (1) ◽  
Author(s):  
Libor Simunek ◽  
Dagmar Krajickova ◽  
Oldrich Vysata ◽  
Martin Valis
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Stroke Risk ◽  
Beta Blockers ◽  
University Hospital ◽  
Stroke Recurrence ◽  
Channel Blockers ◽  
Motivation To Change ◽  
The University ◽  
Insulin Use

AbstractThe goal of this study is to evaluate therapeutic trends for several diseases that represent risk factors for stroke. The relative frequency of therapy with compounds that influence the risk factors for stroke was monitored in a group of 3,290 patients who were hospitalised in the Stroke Unit at the University Hospital in Hradec Kralove between 2005 and 2012. For most drugs monitored, the reasons for the significant decrease or increase in use were causes other than the reduction of stroke risk. Despite this finding, the majority of statistically significant changes had, according to review of comparative studies, a posi- tive effect on prevention of stroke. Motivation to change treatment of stroke risk factors, such as hypertension, diabetes mellitus and hypercholesterolemia, was mainly aimed at sufficient disease management with a minimum of adverse effects. On the other hand, optimization of stroke recurrence and economic factors were motivations to treatment changes in prevention with antiplatelets. Antidiabetics were associated with an increase in met- formin use and reduction in insulin use. For antihyperten- sives, the most significant reduction was associated with the use of diuretics, although calcium channel blockers and beta-blockers are also less used. Additionally, the use of the ACE inhibitor ramipril increased

scholarly journals Extended Half-Life Factor VIII/Factor IX Products: Assay Discrepancies and Implications for Hemophilia Management

2020 ◽  
Vol 40 (S 01) ◽  
pp. S15-S20
Author(s):  
Jens Müller ◽  
Georg Goldmann ◽  
Natascha Marquardt ◽  
Bernd Pötzsch ◽  
Johannes Oldenburg
Keyword(s):  
Factor Viii ◽  
Half Life ◽  
In Vitro Study ◽  
Factor Ix ◽  
University Hospital ◽  
Spiked Plasma ◽  
Structural Differences ◽  
The University ◽  
Life Factor

AbstractDue to structural differences between extended half-life (EHL) factor VIII (FVIII) or FIX products and equivalent plasma wild-type molecules used for assay calibration, reagent-dependent discrepancies during monitoring of FVIII- and FIX-replacement therapies with EHL products have been described. To assess the performance of available one-stage clotting and chromogenic substrate assays on the Siemens Atellica COAG 360 analyzer, an in vitro study using spiked plasma samples was performed. The described results confirm previously described findings and allowed allocation of each EHL product to an appropriate assay. In addition, corresponding EHL product–specific analytes were defined within the order entry system of the University Hospital Bonn. The requirement of product-specific FVIII and FIX assays complicates patient monitoring and demonstrates the need for both continuous education and communication between treating physicians and the coagulation laboratory.

scholarly journals Risk Factors of Pneumonia Associated with Mechanical Ventilation

2020 ◽  
Vol 17 (2) ◽  
pp. 656 ◽  
Author(s):  
Maria Kózka ◽  
Aurelia Sega ◽  
Katarzyna Wojnar-Gruszka ◽  
Agnieszka Tarnawska ◽  
Agnieszka Gniadek
Keyword(s):  
Risk Factors ◽  
Chronic Obstructive Pulmonary Disease ◽  
Hemorrhagic Shock ◽  
Pulmonary Disease ◽  
High Risk Group ◽  
University Hospital ◽  
Medical Documentation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
The University

Background: The hospitalization of patients treated in the intensive care unit (ICU) in 5–15% of cases is associated with the occurrence of a complication in the form of ventilator-associated pneumonia (VAP). Purpose: Retrospective assessment of risk factors of VAP in patients treated at ICUs in the University Hospital in Krakow. Methods: The research involved the medical documentation of 1872 patients treated at the ICU of the University Hospital in Krakow between 2014 and 2017. The patients were mechanically ventilated for at least 48 h. The obtained data were presented by qualitative and quantitative analysis (%). The qualitative variables were compared using the Chi2 test. Statistically significant was the p < 0.05 value. Results: VAP was demonstrated in 23% of all patients treated in ICU during the analyzed period, and this infection occurred in 13% of men and 10% of women. Pneumonia associated with ventilation was found primarily in patients staying in the ward for over 15 days and subjected to intratracheal intubation (17%). A statistically significant was found between VAP and co-morbidities, e.g., chronic obstructive pulmonary disease, diabetes, alcoholism, obesity, the occurrence of VAP and multi-organ trauma, hemorrhage/hemorrhagic shock, and fractures as the reasons for admitting ICU patients. Conclusions: Patients with comorbidities such as chronic obstructive pulmonary disease, obesity, diabetes, and alcoholism are a high-risk group for VAP. Particular attention should be paid to patients admitted to the ICU with multi-organ trauma, fractures, and hemorrhage/hemorrhagic shock as patients predisposed to VAP. There is a need for further research into risk factors for non-modifiable VAP such as comorbidities and reasons for ICU admission in order to allow closer monitoring of these patients for VAP.

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