Predictive role of CHA2DS2-VASc score for cardiovascular events and death in patients with arterial hypertension and stable sinus rhythm

The review is devoted to the discussion of modern concepts of the role of renal dysfunction in the development of chronic myocardial dysfunction in the context of cardio-renal syndrome (RVC) type 4. At the beginning of the review, the definition of cattle is given, general questions of pathogenesis and diagnosis of the disease are addressed. It is indicated that in patients with the initial stage of CKD, cardiovascular disorders are already registered which in the late stages of development of renal dysfunction are the leading causes of death and the true severity of the disease in patients with renal dysfunction is associated with an increased risk of cardiovascular events, rather than an achievement terminal renal failure and requiring renal replacement therapy. The progression of renal pathology leads to damage to the heart through various mechanisms and factors, both traditional and non-traditional, some of which, at the culmination of the renal continuum, are the result of the dialysis procedure itself in patients with terminal renal dysfunction. Mechanisms for the development of congestive heart failure in type 4 cattle include pressure overload (arterial hypertension) and volume (anemia, edematous syndrome), which increase in proportion to the decrease in renal function. Increase in blood pressure, changes in intracardial hemodynamics, deterioration of arterial compliance contribute to the acceleration of cardiovascular events. The role of laboratory predictors of renal dysfunction in the progression of cardiovascular disorders is discussed. The general approaches of echocardiographic visualization of the heart cavities and its importance in the diagnosis of cardiovascular diseases are discussed. Special attention is paid to the development of pulmonary arterial hypertension, changes in the left and right ventricle of the myocardium with renal dysfunction.

Download Full-text

Meta-analysis of the association between sclerostin level and adverse clinical outcomes in patients undergoing maintenance haemodialysis

Therapeutic Advances in Chronic Disease ◽

10.1177/2040622320967148 ◽

2021 ◽

Vol 12 ◽

pp. 204062232096714

Author(s):

Sha-Sha Li ◽

Zhi-Qin Zhang ◽

Da-Wei He ◽

Ao-Lin He ◽

Qi-Feng Liu

Keyword(s):

Clinical Outcomes ◽

Cardiovascular Events ◽

Fixed Effects ◽

Meta Analysis ◽

Cochrane Library ◽

Maintenance Haemodialysis ◽

Dialysis Vintage ◽

All Cause Mortality ◽

Predictive Role

Background: Studies regarding the relationship of sclerostin (Scl) with clinical outcomes in patients undergoing maintenance haemodialysis have yielded controversial findings. This meta-analysis was performed to investigate the predictive role of Scl in this patient population. Methods: Several electronic medical databases (e.g. PubMed, Embase, Web of Science and Cochrane Library) were searched for eligible studies through December 20, 2019. Summary hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated based on Scr level (high or low) using a random or fixed effects model. Results: From among 641 initially screened publications, 16 eligible studies were included in this meta-analysis. A high Scl level was not associated with cardiovascular events [HR = 0.8 (95% CI, 0.42–1.35)] or all-cause mortality [HR = 0.93 (95% CI, 0.56–1.54)]. There was high heterogeneity, but no evidence of publication bias. Interestingly, a high Scl level was associated with reduced cardiovascular events [HR = 0.44 (95% CI, 0.29–0.69)] in the subgroup by shorter follow-up period or all-cause mortality [pooled HR = 0.58 (95% CI, 0.36–0.91)] by shorter dialysis vintage. Conclusion: This meta-analysis indicated that a high Scl level did not predict total clinical outcomes in patients undergoing maintenance haemodialysis despite survival benefits in the subgroups. The predictive role of Scl in these patients should be further evaluated in large prospective studies.

Download Full-text

The Predictive role of Neutrophil-to-Lymphocyte Ratio (NLR) and Mean Platelet Volume-to-Lymphocyte Ratio (MPVLR) for Cardiovascular Events in Adult Patients with Acute Heart Failure

Mediators of Inflammation ◽

10.1155/2021/6889733 ◽

2021 ◽

Vol 2021 ◽

pp. 1-12

Author(s):

Teeranan Angkananard ◽

Teeraporn Inthanoo ◽

Suchat Sricholwattana ◽

Nattapun Rattanajaruskul ◽

Arthit Wongsoasu ◽

...

Keyword(s):

Heart Failure ◽

Mean Platelet Volume ◽

Cardiovascular Events ◽

Hospital Death ◽

Composite Outcome ◽

Platelet Volume ◽

Lymphocyte Ratio ◽

Predictive Role

Introduction. The inflammatory response plays a potential role for the pathogenesis and adverse outcomes of heart failure (HF). We aimed to explore the predictive role of baseline neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume-to-lymphocyte ratio (MPVLR) on cardiovascular events (CVEs) in patients hospitalized with acute HF. Materials and Methods. A retrospective cohort study was conducted in 321 patients with HF between January 2017 and December 2019. The association between their NLR, MPVLR, and combined NLR and MPVLR and CVEs, rehospitalization for HF, in-hospital death, and a composite outcome was explored by survival analysis using a Cox proportional hazard model. They were separately investigated and compared with the area under the receiver operating characteristics curve (AUC). Results. Up to the end of the 3-year follow-up, 96 (29.9%) had CVEs, 106 (33.0%) died, 62 (19.3%) were rehospitalized with HF, and 21 (6.5%) died during admission. The NLR and MPVLR were significantly associated with CVEs (adjusted HR for NLR ≥ 3.29 , 3.11; 95% CI, 1.98-4.89; MPVLR ≥ 8.57 , 2.86; 95% CI, 1.87-4.39), readmissions for HF (adjusted HR for NLR ≥ 3.58 , 2.70; 95% CI, 1.58-4.61; MPVLR ≥ 6.43 , 2.84; 95% CI,1.59-5.07), in-hospital mortality (adjusted HR for NLR ≥ 3.29 , 9.54; 95% CI, 2.19-41.40; MPVLR ≥ 8.57 , 7.87; 95% CI, 2.56-24.19), and composite outcome (adjusted HR for NLR ≥ 3.32 , 4.76; 95% CI, 3.29-6.89; MPVLR ≥ 7.07 , 3.64; 95% CI, 2.58-5.15). The AUC of NLR and MPVLR for CVEs were 0.67 (95% CI, 0.61-0.72) and 0.63 (95% CI, 0.58-0.69). Combined NLR and MPVLR increased the AUC to 0.77 (95% CI, 0.72-0.83) with statistical significance. Conclusion. The elevated NLR and MPVLR on admission in patients with acute HF were independently associated with worse CVEs, rehospitalization for HF, in-hospital death, and composite outcomes. These economical biomarkers should be considered in the management and follow-up care of patients with acute HF.

Download Full-text

Evaluating the risk of a rescue PCI after trombolysis intervention: Predictive role of arterial hypertension and metabolic syndrome

International Journal of Cardiology ◽

10.1016/j.ijcard.2009.09.459 ◽

2009 ◽

Vol 137 ◽

pp. S135

Author(s):

MARCO VATRANO ◽

ROBERTO CERAVOLO ◽

VINCENZO LAGANI ◽

CRISTINA NESTA ◽

FRANCESCO BORRELLO ◽

...

Keyword(s):

Metabolic Syndrome ◽

Arterial Hypertension ◽

Predictive Role

Download Full-text

Cell-Derived Microparticles and Acute Coronary Syndromes: Is there a Predictive Role for Microparticles?

Current Medicinal Chemistry ◽

10.2174/0929867327666191213104841 ◽

2020 ◽

Vol 27 (27) ◽

pp. 4440-4468 ◽

Cited By ~ 1

Author(s):

Effimia Zacharia ◽

Konstantinos Zacharias ◽

George-Angelo Papamikroulis ◽

Dimitrios Bertsias ◽

Antigoni Miliou ◽

...

Keyword(s):

Clinical Studies ◽

Acute Coronary Syndromes ◽

Cardiovascular Events ◽

Large Scale ◽

Coagulation Cascade ◽

Circulating Biomarkers ◽

Increased Risk ◽

Coronary Syndromes ◽

Predictive Role

Background: Despite the recent advances in the treatment of Acute Coronary Syndromes (ACS), patients with ACS are still exposed to an increased risk for adverse cardiovascular events, while their prognosis is difficult to determine. Experimental and clinical studies have shown that cell-derived Microparticles (MPs) are associated with the underlying pathophysiological processes that are responsible for atherogenesis and may be causally implicated in the induction of atherothrombosis. Objective: In the present article, we aimed to review the available evidence regarding the predictive role of MPs in patients with ACS. Results: Evidence suggests that endothelial MPs are associated with future adverse cardiovascular events in patients with ACS. Platelet-derived MPs have been excessively studied, since they have been found to trigger the coagulation cascade; however, their role as predictors of future cardiovascular events remains debatable. The role of red blood cell-derived MPs is more intriguing; they have been proposed as markers of ongoing thrombosis in patients with ACS, while previous studies have shown that they have anti-coagulant properties in healthy individuals. Leukocyte-derived MPs may also have a predictive role, although the studies regarding these are still limited. Last but not least, it was an interesting discovery that circulating MPs can provide information regarding the angiographic lesions in patients with ACS. Conclusion: The concept of MPs as potential circulating biomarkers in patients with ACS holds much promise. However, large-scale clinical studies are required to evaluate whether the measurement of plasma MPs could be of clinical significance and, thus, dictate a more aggressive treatment strategy in patients with high levels of circulating MPs.

Download Full-text