Dyslipoproteinemia and Migraine

PEDIATRICS ◽  
1986 ◽  
Vol 78 (5) ◽  
pp. 956-957
Author(s):  
CHARLES J. GLUECK
Keyword(s):  
Myocardial Infarction ◽  
Essential Hypertension ◽  
Family History ◽  
High Risk ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Cerebrovascular Accident ◽  
Peripheral Vascular ◽  
Parental History ◽  
History Of

In Reply.— Because the anatomic, biochemical, epidemiologic, nutritional, genetic, and clinical genesis of atherosclerosis is in childhood,1,2 it is important to consider models for sampling in childhood for the dyslipoproteinemias. At a minimum, I would recommend a family history-triggered high-risk strategy with sampling of all children whose parents had sustained premature (≤age 60 years) myocardial infarction, angina, cerebrovascular accident, or peripheral vascular disease.1,2 Second, all children with known parental dyslipoproteinemia should be sampled, as should all children with parental history of essential hypertension gout/hyperuricemia, and/or diabetes.

Abstract 067: Predictors of High-sensitivity C-reactive Protein Elevation Among Patients With Myocardial Infarction: Insights From VIRGO and TRIUMPH

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Mohammed Qintar ◽  
Puza P Sharma ◽  
Yuanyuan Tang ◽  
Philip Jones ◽  
Yashashwi Pokharel ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
High Sensitivity ◽  
Peripheral Vascular ◽  
C Reactive Protein ◽  
Reactive Protein ◽  
History Of ◽  
Multivariable Regression ◽  
Hs Crp

Background: Elevated hs-CRP is associated with worse cardiovascular outcomes in patients with acute myocardial infarction (AMI), but little is known about predictors of elevated hs-CRP after AMI. Methods: TRIUMPH and VIRGO are prospective AMI registries that assessed hs-CRP levels 30 days after AMI. TRIUMPH assessed hs-CRP levels at 6 months. Multivariable regression analysis was conducted to examine predictors of elevated hs-CRP [≥2.0 mg/L] at 30 days and at 6 months after an AMI (TRIUMPH only). Results: Of 3410 patients in both registries, 58.6% had elevated hs-CRP 30 days post AMI. Patients with elevated hs-CRP were more likely to be female, black, obese, smokers, to have had higher LDL-C at the time of their AMI, with more peripheral vascular disease and history of heart failure, and were less likely to have had a prior PCI (Table). In TRIUMPH, baseline hs-CRP ≥2 mg/L (n=1301) was significantly associated with elevated hs-CRP at 6 months (p<0.001). Patients with elevated hs-CRP at 6 months (n=407) were more likely to be black, obese, smokers, have peripheral vascular disease and have higher baseline hs-CRP. Conclusions: hs-CRP remains elevated in a large proportion of patients following AMI. We identified several predictors of elevated hs-CRP at 1 and 6 months post AMI. Further studies are needed to validate the findings and understand the utility of routine screening of hs-CRP in post AMI patients.

Abstract 100: Prevalence of Peripheral Vascular Disease Among Patients Using Cannabis, an Analysis of the 2014 National Inpatient Sample data

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Adeyinka C Adejumo ◽  
Samson Alliu ◽  
Tokunbo O Ajayi ◽  
Adegbala M Oluwole ◽  
Nnaemeka Onyeakusi ◽  
...  
Keyword(s):  
Family History ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Protective Factor ◽  
The United States ◽  
Bivariate Analysis ◽  
National Inpatient Sample ◽  
Peripheral Vascular ◽  
History Of ◽  
Anti Inflammatory

Background: Despite being illegal in most countries, cannabis is highly utilised by a growing number of individuals for recreational purposes worldwide. With its increasing legalisation in many states across the United States, the effects of cannabis on different body systems are expected to rise. Its association with peripheral vascular disease (PVD) remains ambiguous. Objective: To examine if there is a difference in prevalence of PVD amongst patients who use cannabis when compared to non-users. Methods: Using the 2014 National Inpatient Sample database (N=7,071,762), we identified patients with and without a diagnosis of PVD. We also identified patients using cannabis (nondependent and dependent users) and non-users. We performed the univariate and bivariate analysis. After we had composed the crude models, we adjusted for every known risk factor for PVD. These factors included age, gender, tobacco, hypercholesterolemia, coronary artery disease (CAD), cerebrovascular vessel disease (CVD), hypertension, diabetes, renal failure, alcohol, obesity, race, insurance type, average income at the location of residence, and family history of PVD/CVD/CAD. Results: In our total 7,071,762 sample, 98.27% (6,949,339) are non-users, 1.54% (108,910) are nondependent users and 0.19% (13,513) are dependent users. About 3.75% (264,920) of the patients had a diagnosis of PVD versus 96.25% (6,806,842) without a diagnosis of PVD. The odds of PVD is 20% less among nondependent users when compared to nonusers (AOR 0.80[0.76-0.85]). Furthermore, dependent users have a 55% reduced odds of developing PVD when compared to nonusers (AOR 0.45[0.35-0.57]) showing a dose-response relationship. The in-group comparison showed that dependent users were 44% less likely to have PVD when compared to non-dependent users (AOR: 0.56[0.44-0.72]). Overall, the odds of PVD remain significantly high among patients who uses tobacco (AOR 1.97 [1.95-1.99]), diabetes (AOR 1.54 [1.53-1.55]), hypercholesterolemia (AOR 1.46 [1.45-1.47]), family history of PVD/CVD/CAD (AOR 1.03 [1.01-1.05]), personal history of CAD (AOR 2.55 [2.53-2.57]). Conclusions: Cannabis is an independent protective factor against PVD. Molecular biology evidence shows that cannabis contains various bioactive agents. Beta-caryophyllene (out of many) preferentially binds to CB-2 receptors on immune cells causing an anti-inflammatory response. We believe that more molecular studies targeting such receptors or isolating such anti-inflammatory compounds in cannabis might be useful in the treatment of vascular disease.

Abstract 101: Gender Has Differential Effects on Non-Hemorrhagic Stroke Outcomes

2015 ◽  
Vol 8 (suppl_2) ◽  
Author(s):  
Justin Pieper ◽  
Michael Ashamalla ◽  
Daniel Sedhom ◽  
Neil Yager ◽  
Ketan Ghate ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Renal Insufficiency ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Hemorrhagic Stroke ◽  
Peripheral Vascular ◽  
Stroke Outcomes ◽  
History Of ◽  
Artery Disease

Background: We sought to examine the relationship between gender, age, co-morbidities, and outcomes in patients with non-hemorrhagic stroke. Materials and methods: Retrospective chart review was performed on 517 consecutive non-hemorrhagic stroke patients (48% women, 20% with diabetes, 26.8% with CAD, 38% with dyslipidemia, 62.2% with HTN, 4.2% with peripheral vascular disease, 4.7% with renal insufficiency) treated at a single academic medical center. Results: Younger patients were more likely to be men (age<50 55%, 51-60 58.3%, 61-70 59.6%; p<0.05) while older patients were likely to be women (age 71-80 54.9%, >80 56.6; p<0.05). Accordingly, the subsequent analysis stratified the cohort into two groups, <70 and >70 years old. Regardless of age, men had a higher prevalence of CAD (age <70, 25.2% vs 18.8% in women, and age >70, 43.7% vs. 23.1% in women; p<0.05) and dyslipidemia (age <70, 43.4% vs 32.5% in women and age >70, 44.8% vs. 30.6% in women; p=.05). There were no significant gender based differences in BMI, prevalence of diabetes, hypertension, peripheral vascular disease, or chronic renal insufficiency. The mean follow up duration was 47.3+/-0.9 months. Gender did not affect mortality in patients younger than 70 years old (15.5% men vs. 15.6% women.) However in patients of age >70 mortality was significantly increased in men (50.5% in men vs. 41.7% in women; chi-squared p<0.001, log-rank p<0.0001, Figure). In logistic regression analysis, when compared to women younger than 70 years old, men of the same age had similar mortality (HR 1.0; 95%CI 0.5-1.9, p=0.980); while age greater than 70 conferred 4-5 fold increased risk of mortality (HR 3.9; 95%CI 2.1-7.0, p<0.0001 in women, and HR 5.5; 95%CI 3.0-10.3, p<0.0001 in men). When gender and age were accounted for, history of coronary artery disease and/or dyslipidemia did not affect the outcomes. Conclusion: Men with non-hemorrhagic stroke were more likely to have dyslipidemia and history of coronary artery disease. This, however, did not translate into increased mortality in younger men. Gender appears to have a differential effect on non-hemorrhagic stroke outcomes which warrants future investigation.

SERUM-INSULIN IN ESSENTIAL HYPERTENSION AND IN PERIPHERAL VASCULAR DISEASE

The Lancet ◽  
1966 ◽  
Vol 287 (7451) ◽  
pp. 1336-1337 ◽  
Author(s):  
T.A. Welborn ◽  
A. Breckenridge ◽  
A.H. Rubinstein ◽  
C.T. Dollery ◽  
T.Russell Fraser
Keyword(s):  
Essential Hypertension ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Serum Insulin ◽  
Peripheral Vascular

Microangiopathy as a Prognostic Indicator in Diabetic Patients Suffering from Acute Myocardial Infarction

1992 ◽  
Vol 37 (2) ◽  
pp. 44-46 ◽  
Author(s):  
H.B. Brown ◽  
N.R. Waugh ◽  
P.E. Jennings
Keyword(s):  
Myocardial Infarction ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Cardiac Failure ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Peripheral Vascular ◽  
Hospital Outcome ◽  
Diabetic Clinic ◽  
Diabetic Treatment

Diabetic patients have an increased mortality following myocardial infarction (MI) due to left ventricular failure rather than larger infarcts or dysrhythmias. As this may be due to diabetic microangiopathy affecting the myocardium, we have examined the case records of diabetic clinic patients admitted to the Coronary Care Unit (CCU) with proven MI and compared the hospital outcome of those with and without retinopathy or nephropathy, i.e. markers for generalised microangiopathy. Sixty four consecutive records were traced, for the period when diabetic treatment policy was standardised in CCU, 24 patients had retinopathy (7 proteinuria). When compared to non-retinopathy patients they had similar ages 67 ±12 yr [± SD] v 63 ± 9yr) but were of longer duration of diabetes p<0.05). There were no differences between the groups in size or site of infarct, previous infarct or hypertension history, blood glucose on admission or diabetic treatment before or after admission. Death occurred in 29% of retinopathy patients compared to 3% of non-retinopathy patients (p<0.01). Cardiac failure complicated 75% of retinopathy patients and 25% of non-retinopathy patients (p<0.001). Dysrhythmia occurred in 50% and 33% of patients respectively (P=NS). Nine patients had clinical peripheral vascular disease and five of these died. This study, of a selected group of diabetic clinic attenders admitted to CCU with acute MI, demonstrates that microangiopathy and peripheral vascular disease are important prognostic factors in determining hospital outcome as these patients are at increased risk of cardiac failure and death.

scholarly journals Intestinal thromboangiitis obliterans: Consequence of a delay in diagnosis

2020 ◽  
Author(s):  
Swastik Sourav Mishra ◽  
Tushar Subhadarshan Mishra ◽  
Suvradeep Mitra ◽  
Pankaj Kumar
Keyword(s):  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Elevated Serum ◽  
Thromboangiitis Obliterans ◽  
Prior History ◽  
Peripheral Vascular ◽  
Buerger’S Disease ◽  
Buerger's Disease ◽  
Diffuse Abdominal Pain ◽  
History Of

Abstract Background: Thromboangiitis obliterans (TAO) or Buerger’s disease is a form of peripheral vascular disease in young male smokers. The involvement of the intestine occurs only about 2% of the cases. Symptoms of peripheral vascular disease usually precede intestinal manifestations, although the latter can sometimes be the index presentation. The cessation of smoking usually, though not necessarily, prevents the progression of the disease and visceral involvement.Case presentation: Our patient presented with diffuse abdominal pain along with bouts of vomiting and loose motions. He was a known smoker with a prior history of amputation of the right foot, four years before. Physical examination revealed abdominal distension and diffuse tenderness and guarding. An omental band attached to the tip of the appendix was discovered at the initial exploration along with dilated proximal bowel loops, for which a release of the omental band along with appendectomy was done. He developed an enterocutaneous fistula on the sixth postoperative day for which the abdomen was re-explored which revealed multiple segmental perforation in the jejunum and two subcentimetric perforation adjacent to each other in the distal ileum. Resection of the affected jejunal segment was performed followed by Roux-en-Y gastrojejunosotomy and distal ileostomy. A feeding jejunostomy was also performed. The bleeding from the cut ends was unsatisfactory. The patient however had persistent feculent discharge from the wound for which a third exploration was done which revealed a leak from the gastrojejunostomy and feeding jejunosotomy sites, both of which were repaired primarily. However, the patient developed septicemia with persistently elevated serum lactate levels which progressed to refractory septic shock and ultimately succumbed to the illness on 23rd postoperative day of the index surgery.Conclusion: Acute abdomen in a young man, who is a chronic smoker and having an antecedent history of amputation of some part of an extremity for a nontraumatic cause should raise the suspicion of Buerger’s disease of the intestine. Although it is a progressive disease and things are already late by the time intestinal symptoms manifest, early detection may give some scope of salvage and decreasing morbidity and mortality.

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