Serum LOX-1, ADMA and hs-CRP as Biomarkers of Ischemic Heart Disease in Chronic kidney Disease Patients

Cardiovascular diseases are the leading cause of death both in the world and in the Russian Federation. The most significant contributors to the increase in mortality are arterial hypertension (AH) and ischemic heart disease (IHD). Dihydropyridine calcium channel blockers (CCBs) are the first line of treatment for these conditions. This is noted in the clinical guidelines for the diagnosis and treatment of AH and in the guidelines for the management of patients with chronic coronary syndromes. CCBs are a heterogeneous group of drugs that have both general and individual pharmacokinetic and pharmacodynamic properties. They are used in patients with AH and/or IHD, including those with concomitant diseases (diabetes mellitus, chronic kidney disease, bronchial asthma, chronic obstructive pulmonary disease, peripheral arterial disease). Felodipine is one of the CCBs. It has a combination of clinical effects, allowing the drug to be prescribed as a first-line therapy for AH, IHD and a combination of these diseases. This is noted in the registered indications for its use. This CCB has a sufficient evidence base of clinical trials demonstrating not only good antihypertensive and antianginal potential of the drug, but also the nephroprotection and cerebroprotection properties. The nephroprotective effect of felodipine is associated with a slowdown in the progression of chronic kidney disease, and the cerebroprotective effect is associated with a decrease in the risk of stroke and an improvement in cognitive functioning. The safety profile of felodipine is favorable: peripheral edema develops much less frequently. This is confirmed by the results of comparative studies. Felodipine is recommended for a wide range of patients with AH, IHD and their combination due to such clinical and pharmacological properties.

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Management of Ischemic Heart Disease in Patients with Chronic Kidney Disease

American Journal of Cardiovascular Drugs ◽

10.2165/00129784-200808040-00002 ◽

2008 ◽

Vol 8 (4) ◽

pp. 219-231

Author(s):

Arif Mutwali ◽

Liam G Glynn ◽

Donal Reddan

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Ischemic Heart

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Frequency of Ischemic Heart Disease in Patients of End Stage Renal Disease

10.53350/pjmhs211572059 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2059-2061

Author(s):

Muhammad Farhan Akhtar ◽

Hafiz Muhammad Waqas Siddque ◽

Talha Nazir ◽

Ubaid Khan

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Renal Disease ◽

Ischemic Heart Disease ◽

End Stage Renal Disease ◽

Ischemic Heart ◽

Maintenance Hemodialysis ◽

Stage Renal Disease ◽

End Stage

Introduction: The disease burden of Chronic Kidney Disease (CKD) is increasing every day and adding the burden on our healthcare system. Many patients are being treated by hemodialysis due to a very limited recourses available. Cardiovascular complications such as ischemic heart disease (IHD) are very common in patients who are being treated by hemodialysis and one of the leading causes of death in these patients. Objective: Frequency of IHD in the patients of ESRD. Methodology: Cross-sectional type of study was piloted for duration of three months from April 2019 to June 2019 in Nephrology Department Mayo Hospital Lahore. Eighty one patients were recruited who fulfilled the inclusion criteria i.e. patients suffering end stage renal disease on maintenance hemodialysis through non-probability, convenient sampling. A standard questionnaire was used to collect the data. All the data was analyzed by using SPSS (software package for statistical analysis) version 20. Results: The study was carried out among 81 patients with diagnosis of Chronic Kidney Disease on the maintenance hemodialysis. Most patients in study were falling in the range of 21-60 years. The study included 46 (56.8%) males and 35(43.2%) females. The frequency of Ischemic Heart Diseases in these patients was found to be 56.8% (46/81 cases). Conclusion: Both genders are equally affected. The frequency of IHD in patients of end stage renal disease who are on hemodialysis is observed to be high, but not as much high as observed in previous studies. Both genders are affected almost equally. Key Words: Ischemic Heart Disease, End stage renal disease, chronic kidney disease, Hemodialysis

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Attainment of Guideline-Directed Medical Treatment in Stable Ischemic Heart Disease Patients With and Without Chronic Kidney Disease

Cardiovascular Drugs and Therapy ◽

10.1007/s10557-019-06883-z ◽

2019 ◽

Vol 33 (4) ◽

pp. 443-451 ◽

Cited By ~ 3

Author(s):

Efstratios Koutroumpakis ◽

Elvira O. Gosmanova ◽

Heather Stahura ◽

Stephanie Jou ◽

Rabah Alreshq ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Medical Treatment ◽

Ischemic Heart ◽

Stable Ischemic Heart Disease

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Creation and outcome of arteriovenous fistula for hemodialysis: experience in a tertiary care hospital in Saurashtra, Gujarat

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20193137 ◽

2019 ◽

Vol 6 (4) ◽

pp. 1046

Author(s):

Mihir D. Pandya ◽

Archana D. Asher

Keyword(s):

Diabetes Mellitus ◽

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Arteriovenous Fistula ◽

Success Rate ◽

Ischemic Heart ◽

Early Failure ◽

Arteriovenous Fistulas

Background: Patients with chronic kidney disease require arteriovenous fistulas for hemodialysis. The aim of our study was to share our experience of creating arteriovenous fistulas for hemodialysis and to analyze the factors affecting the outcome of arteriovenous fistulas.Methods: This is a prospective study carried out in Guru Gobind Singh Government Hospital, Jamnagar from August 2013 to July 2015. All patients with chronic kidney disease in whom arteriovenous fistula was created surgically for hemodialysis were included in this study.Results: Maximum patients (34%) were in the age group of 51-60 years. 76% of the patients were males and 24% were females. Co morbid conditions like diabetes mellitus, hypertension and ischemic heart disease were present in 20%, 26%, and 16% of patients respectively. Success rate of arteriovenous fistulas in patients with diabetes mellitus, hypertension and ischemic heart disease was 30%, 69.2% and 25% respectively. Success rate of arteriovenous fistulas in patients without diabetes mellitus, hypertension and ischemic heart disease was 92.5%, 83.8% and 90.5% respectively. Early failure was present in 20% of the patients. Most common cause of early failure was thrombosis, which occurred in 8% of total patients. Other causes of early failure were wound infection, stenosis and aneurysm, which occurred in 6%, 4% and 2% patients respectively.Conclusions: Presence of diabetes mellitus and ischemic heart disease was associated with a higher risk of arteriovenous fistula failure. The success rate reported in our study was fairly acceptable.

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Comparison of medical comorbidities in Medicare patients treated by orthopaedic surgeons and neurosurgeons throughout the USA

Bone & Joint Open ◽

10.1302/2633-1462.16.bjo-2020-0032 ◽

2020 ◽

Vol 1 (6) ◽

pp. 257-260

Author(s):

Alexander Beschloss ◽

John Mueller ◽

Jon-Michael E Caldwell ◽

Alex Ha ◽

Joseph M Lombardi ◽

...

Keyword(s):

Heart Failure ◽

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Ischemic Heart ◽

Medical Comorbidities ◽

Orthopaedic Surgeons ◽

The Usa ◽

Medicare Patients

Aims Medical comorbidities are a critical factor in the decision-making process for operative management and risk-stratification. The Hierarchical Condition Categories (HCC) risk adjustment model is a powerful measure of illness severity for patients treated by surgeons. The HCC is utilized by Medicare to predict medical expenditure risk and to reimburse physicians accordingly. HCC weighs comorbidities differently to calculate risk. This study determines the prevalence of medical comorbidities and the average HCC score in Medicare patients being evaluated by neurosurgeons and orthopaedic surgeon, as well as a subset of academic spine surgeons within both specialities, in the USA. Methods The Medicare Provider Utilization and Payment Database, which is based on data from the Centers for Medicare and Medicaid Services’ National Claims History Standard Analytic Files, was analyzed for this study. Every surgeon who submitted a valid Medicare Part B non-institutional claim during the 2013 calendar year was included in this study. This database was queried for medical comorbidities and HCC scores of each patient who had, at minimum, a single office visit with a surgeon. This data included 21,204 orthopaedic surgeons and 4,372 neurosurgeons across 54 states/territories in the USA. Results Orthopaedic surgeons evaluated patients with a mean HCC of 1.21, while neurosurgeons evaluated patients with a mean HCC of 1.34 (p < 0.05). The rates of specific comorbidities in patients seen by orthopaedic surgeons/neurosurgeons is as follows: Ischemic heart disease (35%/39%), diabetes (31%/33%), depression (23%/31%), chronic kidney disease (19%/23%), and heart failure (17%/19%). Conclusion Nationally, comorbidity rate and HCC value for these Medicare patients are higher than national averages for the US population, with ischemic heart disease being six-times higher, diabetes two-times higher, depression three- to four-times higher, chronic kidney disease three-times higher, and heart failure nine-times higher among patients evaluated by orthopaedic surgeons and neurosurgeons. Cite this article: Bone Joint Open 2020;1-6:257–260.

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Abstract 3484: High Plasma Levels of Endogenous Free Dopamine Predict an Adverse Outcome in Patients with Heart Disease and Chronic Kidney Disease

Circulation ◽

10.1161/circ.118.suppl_18.s_434 ◽

2008 ◽

Vol 118 (suppl_18) ◽

Author(s):

Keita Sano ◽

Yasushi Kodama ◽

Mitsumasa Hirano ◽

Isao Takishima ◽

Aritaka Makino ◽

...

Keyword(s):

Myocardial Infarction ◽

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Plasma Levels ◽

Sympathetic Activity ◽

Cardiac Death ◽

High Plasma ◽

Ischemic Heart

Sympathetic activity is heightened in chronic kidney disease (CKD). The increased sympathetic activity is a risk of future cardiovascular disease (CVD) events. Dopamine, a precursor of norepinephrine biosynthesis, is metabolized in the kidney and excreted into urine, and its plasma levels are increased in renal dysfunction. Thus, we examined whether plasma levels of endogenous dopamine may be related to future CVD events in patients with CKD. A total of 840 patients in stable condition with chronic heart disease (622 patients with ischemic heart disease and 218 with non-ischemic heart disease) (586 patients with GFR ≥ 60 ml/min/1.73 m 2 [normal/mild CKD]; 153 patients with 60 > GFR ≥ 30 [moderate CKD]; 101 patients with 30 > GRF [advanced CKD]) were prospectively followed-up for 5 years or until one of the following CVD events: cardiac death, non-fatal myocardial infarction, unstable angina pectoris requiring unplanned revascularization, worsening heart failure requiring hospitalization, or stroke. Plasma levels of endogenous free dopamine at entry were measured by high-performance liquid chromatography. Patients with a higher stage of CKD had higher dopamine levels than patients with a lower stage (63.0 ± 5.5, 45.0 ± 5.1, and 26 ± 1.2 pg/mL, respectively, ρ = 0.54, p < 0.0001 Spearman rank correlation test). During the follow-up period, 233 patients had CVD events (cardiac death in 54, myocardial infarction in 18, others events in 161) (113 events [19%] in normal/mild CKD, 64 [42%] in moderate CKD, and 56 [55%] in advanced CKD). In patients with moderate CKD and advanced CKD, higher dopamine levels (≥ 40 pg/mL, defined by ROC analysis) were the strongest predictor of CVD events (HR 2.1 and 3.3, 95% CI 1.2 – 3.7 and 1.5 – 7.2, p = 0.006 and 0.003, respectively) in a multivariate Cox hazards analysis using plasma norepinephrine and BNP levels, hypertension, and hyperlipidemia as covariates. In contrast, dopamine levels did not have predictive value in normal/mild CKD (HR 1.2, 95% CI 0.7 – 2.0, p = 0.5). High plasma levels of endogenous free dopamine are a risk factor for future CVD in patients with CKD independently of norepinephrine levels. Increases in plasma endogenous free dopamine levels may serve as a mechanistic link between CKD and CVD.

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Association between increased plasma ceramides and chronic kidney disease in patients with and without ischemic heart disease

Diabetes & Metabolism ◽

10.1016/j.diabet.2020.03.003 ◽

2020 ◽

Cited By ~ 2

Author(s):

A. Mantovani ◽

G. Lunardi ◽

S. Bonapace ◽

C. Dugo ◽

A. Altomari ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Ischemic Heart

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Type 2 Diabetes Mellitus and Impact of Heart Failure on Prognosis Compared to Other Cardiovascular Diseases

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.119.006260 ◽

2020 ◽

Vol 13 (7) ◽

Author(s):

Bochra Zareini ◽

Paul Blanche ◽

Maria D’Souza ◽

Mariam Elmegaard Malik ◽

Caroline Holm Nørgaard ◽

...

Keyword(s):

Chronic Kidney Disease ◽

Heart Disease ◽

Kidney Disease ◽

Ischemic Heart Disease ◽

Peripheral Artery Disease ◽

Ischemic Heart ◽

Peripheral Artery ◽

Risk Of Death ◽

Artery Disease

Background: Heart failure (HF) in patients with type 2 diabetes mellitus (T2D) has received growing attention. We examined the effect of HF development on prognosis compared with other cardiovascular or renal diagnoses in patients with T2D. Methods and Results: Patients with new T2D diagnosis patients were identified between 1998 and 2015 through Danish nationwide registers. At yearly landmark timepoints after T2D diagnosis, we estimated the 5-year risks of death, 5-year risk ratios, and decrease in lifespan within 5 years associated with the development of HF, ischemic heart disease, stroke, peripheral artery disease, and chronic kidney disease. A total of 153 403 patients with newly diagnosed T2D were followed for a median of 9.7 years (interquartile range, 5.8–13.9) during which 48 087 patients died. The 5-year risk ratio of death associated with HF development 5 years after T2D diagnosis was 3 times higher (CI, 2.9–3.1) than patients free of diagnoses (CI, 2.9–3.1). Five-year risk ratios were lower for ischemic heart disease (1.3 [1.3–1.4]), stroke (2.2 [2.1–2.2]), chronic kidney disease (1.7 [1.7–1.8]), and peripheral artery disease (2.3 [2.3–2.4]). The corresponding decrease in lifespan within 5 years when compared with patients free of diagnoses (in months) was HF 11.7 (11.6–11.8), ischemic heart disease 1.6 (1.5–1.7), stroke 6.4 (6.3–6.5), chronic kidney disease 4.4 (4.3–4.6), and peripheral artery disease 6.9 (6.8–7.0). HF in combination with any other diagnosis imposed the greatest risk of death and decrease in life span compared with other combinations. Supplemental analysis led to similar results when stratified according to age, sex, and comorbidity status, and inclusion period. Conclusions: HF development, at any year since T2D diagnosis, was associated with the highest 5-year absolute and relative risk of death, and decrease in lifespan within 5 years, when compared with development of other cardiovascular or renal diagnoses.

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