scholarly journals Changes in plasma sphingolipid levels against the background of lipid-lowering therapy in patients with premature atherosclerosis

2021 ◽  
Author(s):  
AA Rogozhina ◽  
AV Alessenko ◽  
IN Kurochkin ◽  
LO Minushkina ◽  
UA Gutner ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Statin Therapy ◽  
Plasma Lipids ◽  
Lipid Lowering ◽  
Premature Coronary Artery Disease ◽  
Lipid Lowering Therapy ◽  
Dynamic Changes ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Lipid-lowering drugs affect standard lipoproteins. However, we have no knowledge of changes in other plasma lipids upon treatment. The study was aimed to assess the dynamic changes in cholesterol, high- and low-density lipoproteins (HDL and LDL), triglycerides, and sphingolipids against the background of lipidlowering therapy in patients with premature coronary artery disease, atherosclerosis and hypercholesterolemia. A total of 18 patients were enrolled (the average age was 53 ± 6.7 years): in group 1, six patients received starting statin doses; group 2 included six patients, who failed to achieve LDL target levels against the background of treatment with starting statin doses, and received escalated statin doses; seven patients in group 3 failed to achieve LDL target levels against the background of treatment with maximum tolerated doses of statins and ezetimibe, and received alirocumab. Sphingolipid levels were assessed by mass spectrometry. In group 1, the decreased levels of ceramide Cer 14:1 (p = 0.046) and sphingomyelins SM 22:1, SM 22:0, SM 24:0 (p = 0.028) were observed. There were no significant changes in the levels of total cholesterol, LDL-C, HDL-C, and triglycerides. In group 2, the significantly decreased levels of total cholesterol (p = 0.028), LDL (p = 0.043), sphingomyelins SM 18:1, SM 24:1 and SM 26:1, and ceramide Cer 16:1 (p = 0.028) were observed. The level of Cer 22:1 significantly increased (p = 0.028). In group 3, total cholesterol decreased by 36.2%, and LDL-C (p = 0.018) decreased by 60.1% compared to baseline (ΔLDL-C = –2.67 ± 3.12); the elevated levels of ceramide Cer 22:1 (p = 0.028) were observed. It has been shown, that decreased sphingomyelin levels are associated with statin therapy and correlate with decreased levels of LDL-C. No significant dynamic changes in ceramides and ceramide risk against the background of statin therapy were observed, however, PCSK9 inhibitor added to therapy reduced the Cer 16:0/24:0 ratio.

scholarly journals The auto-call as an impactful technical tool in increasing adherence to lipid-lowering therapy and patient outcome in ambulatory settings: 1-year experience at tertiary cardiology center

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.V Fofanova ◽  
M.D Smirnova ◽  
F.T Ageev
Keyword(s):  
Patient Outcome ◽  
Treatment Adherence ◽  
Density Lipoprotein ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Technical Tool ◽  
Lowering Therapy ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Background Long-term adherence to lipid-lowering treatment is a challenge. Purpose To develop a technical tool, an auto-call program, aimed to increase patient adherence to lipid-lowering therapy, and patient outcome in ambulatory care. Methods 919 ambulatory patients were studied, divided to three groups: with low or moderate risk of developing atherosclerosis complications (Group 1); with high or very high risk of atherosclerosis complications, but without coronary artery disease (CAD) symptoms (Group 2); patients with symptomatic CAD (Group 3). At baseline, patients were invited to participate in the auto-call program (call-reminder to take the medication); the duration of study was 1 year. 663 patients (71.3%) consented to auto-calls received, 256 patients (28.7%) declined auto-calls. These two groups were comparable according to age, gender, the presence of comorbidities, the level of baseline adherence to lipid-lowering therapy, and the level of anxiety and depression. Treatment adherence was evaluated using Morisky-Green Medication Adherence Scale. Results Group 1. After 1 year, the auto-call group showed a significantly higher degree of decrease in low-density lipoprotein cholesterol, LDL-C (p=0.001) and triglyceride, TG (p=0.002), and increase in high-density lipoprotein cholesterol, HDL-C (p=0.03) compared to the auto-call rejection group. Group 2. After 1 year, the auto-call group showed a significantly higher degree of decrease in total cholesterol, TC (p<0.02) and LDL-C (p<0.01), and increase in HDL-C (p=0.2) compared to the auto-call rejection group. Moreover, in the auto-call group, the baseline TC level was higher (6.4±1.5 mmol/l vs 6.0±1.4 mmol/l, p=0.03). Group 3. After 1 year, the auto-call group showed a significantly higher degree of decrease in TC (p<0.005) and TG (p<0.05). The degree of decline in LDL-C was higher in the auto-call group (−25.9 (−27.3; −17.0) vs −20.1 (−21.3; −0.2), however, non-significant. After 1 year, treatment adherence increased in the total cohort from 1.91 score (1.80; 2.02) to 2.6 score (2.52; 2.80), p<0.000001. However, in Group 3, a significant increase in scores from 2.0 (1.9; 2.2) to 3.0 (2.6; 3.1) was observed only in the auto-call group (p<0.00001). In Group 1 and Group 2, the increase in adherence did not depend on the presence or absence of auto-calls. It should be noted that adherence to therapy in patients of Group 3 was significantly higher at baseline (2.0 (1.9; 2.2) than in Group 1 (1.7 (1.6; 1.9), p<0.005) and Group 2 (1.9 (1.7; 2.1), p<0.05), respectively. Conclusions Utilizing a high-tech auto-call reminder tool in patients with hyperlipidemia and CAD was associated with increased adherence to lipid-lowering therapy, which, in turn, resulted in significant decrease in LDL-C compared to patients who declined to participate in the auto-call program. Funding Acknowledgement Type of funding source: None

scholarly journals Lipid-lowering therapy in outpatients of different ages with coronary artery disease

2020 ◽  
Vol 19 (5) ◽  
pp. 2654
Author(s):  
S. K. Zyryanov ◽  
S. B. Fitilev ◽  
A. V. Vozzhaev ◽  
I. I. Shkrebniova ◽  
N. N. Landyshev ◽  
...  
Keyword(s):  
Age Groups ◽  
Drug Combinations ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy ◽  
Prescription Rates ◽  
Group 3 ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim. To conduct a pharmacoepidemiologic analysis of lipid-lowering therapy (LLT) in outpatients of different ages with coronary artery disease (CAD).Material and methods. A total of 805 medical records of outpatients with CAD were analyzed in this pharmacoepidemiologic, cross-sectional study conducted at primary care facility of Moscow. The total sample of patients was divided into 3 age groups: group 1 — <65 years (n=267; 33,2%), group 2 — 65-74 years (n=305; 37,9%), group 3 — ≥75 years (n=233; 28,9%). Data on LLT (prescription rates, structure, intensity), prevalence of irrational drug combinations, lipid profile were collected. Statistical analysis was performed using SciPy 1.4.1, NumPy 1.18.4 for Python 3.73. Differences were considered significant at p<0,05.Results. LLT prescription rates were equally high in all ages — 92,9%, 85,9%, and 81,6% in groups 1, 2, and 3 respectively (p>0,05). Dual LLT was prescribed rarely (4,9%, 3,9%, 0,9%, respectively), especially in patients ≥75 years (p<0,05 for groups 1 and 3, p»0,05 for groups 2 and 3). Atorvastatin prevailed in all ages (p>0,05); patients ≥75 received rosuvastatin less often (p<0,05 for groups 1 and 3); simvastatin was more frequently prescribed to patients ≥65 years (p<0,05 for groups 1 and 2, 1 and 3). Prescription rate of high-intensity LLT was higher in group 1 (57,3%) compared with group 2 (40,1%; p<0,05) and group 3 (30,0%; p<0,01). Prevalence of polypharmacy (50,2%, 56,5%, 60,4%) and irrational drug combinations (34,0%, 38,1%, 43,3%) was comparable in all groups (p>0,05), as well as the proportion of patients not achieved target LDL-C <1,8 mmol/l (72,9%, 73,9%, 84,3%; p>0,05).Conclusion. The study demonstrated no significant influence of patient age on LLT prescription rates, LDL-C control, and prevalence of irrational drug combinations in outpatients with CAD. Rates of dual LLT, structure and intensity of statin therapies differed depending on age groups.

Abstract 436: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

2012 ◽  
Vol 32 (suppl_1) ◽  
Author(s):  
Amit Ladani ◽  
Karthik Challa ◽  
Sloane McGraw ◽  
Anupama Shivaraju ◽  
Adhir Shroff
Keyword(s):  
Total Cholesterol ◽  
Statin Therapy ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Percutaneous Coronary ◽  
Risk Patients ◽  
Core Measure ◽  
The Mean ◽  
Artery Disease

Background: Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease (CAD) management. The National Cholesterol Education Program - Adult treatment panel III (NCEP-ATP III) advises a minimum LDL level less than 100 mg/dL in patients with CAD and a recommended LDL less than 70 mg/dL for high risk patients. Statins remain the preferred agent for LDL reduction. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to January 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 933 unique patients had PCI during the study period. The mean total cholesterol decreased 18 mg/dL and the mean LDL decreased 15 mg/dL during 6 months follow-up (p< 0.001) (refer to table). The mean HDL did not differ significantly. The percent of patients at NCEP-ATP III guideline’s goal of LDL < 100 mg/dL increased from 58% pre-PCI to 74% post-PCI. Goal LDL < 70 mg/dL increased from 22 to 31% at 6 months. The use of statins increased from 69% to 89%. Conclusion: There were significant improvements in total cholesterol and LDL values at six months post-PCI, as well as the percentage of patients who met the NCEP-ATP III recommended goal of LDL cholesterol less than 100 mg/dL and the suggested goal of 70 mg/dL. At six months, there was an increase usage of statin therapy.

Patient adherence to statin therapy within 12 months after coronary stenting depending on regular or remote monitoring

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Osokina ◽  
A Filatova ◽  
A Potekhina ◽  
A Shchinova ◽  
S Provatorov
Keyword(s):  
Statin Therapy ◽  
Remote Monitoring ◽  
Ldl Cholesterol ◽  
Patient Adherence ◽  
Control Group ◽  
Cholesterol Levels ◽  
Outpatient Visits ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Abstract Funding Acknowledgements Type of funding sources: Other. Main funding source(s): Russian Ministry of Health Background. Low adherence to statins remains a challenge in the treatment of patients with cardiovascular diseases. Some patients who underwent coronary stenting (CS) are unavailable for regular follow-up with outpatient visits. The ability to remotely monitor patients after CS may facilitate adherence to treatment, achieve target low density lipoprotein (LDL) cholesterol levels and early detection of adverse events. We aimed to evaluate the adherence to statin therapy in patients after CS receiving remote monitoring or care with outpatient visits. Methods. We enrolled 279 consecutive stable CAD/silent myocardial ischemia patients (61.5 ± 9.5 years) who underwent CS. The patients were randomized into groups of regular outpatient visits (group 1, n = 96), remote monitoring (group 2, n = 95) and control group (group 3, n = 88). The visits (cardio exam and blood testing) and remote monitoring (videoconference, telephone care and blood tests interpretation) were performed at 1, 3, 6 and 12 months after CS for groups 1 and 2. Patients in the control group were cared by a physician at the residence place, the contact with the study coordinator was performed at baseline and 12 months after CS. Adherence to the prescribed medical therapy based on the four-item Morisky Green Levine Medication Adherence Scale was assessed at each contact with the study coordinator. Results. Patient adherence to statin therapy 12 months after CS was 53.6% for group 1, 55.8% for group 2 and 24.4% for group 3 (p &lt; 0.05 for group 3 versus groups 1 and 2). In group 1 26.9/36.5/31.7/37.4*/41.3*% of patients achieved target LDL level at baseline/1mo/3mo/6mo/12mo, respectively (р&lt;0.05 vs. baseline). In group 2 - 35.8/36.8/40.0/51.6*/57.9*% of patients (р&lt;0.05 vs. baseline). In group 3 25.5/28.2% of patients achieved target LDL level at baseline/12mo, respectively. The significant decrease in LDL cholesterol levels between baseline and 12mo values was observed in groups 1 and 2 (p &lt; 0.05). No differences were observed in group 3. Conclusion. The groups of patients receiving remote monitoring or care with outpatient visits demonstrate the same increase in the proportion of patients that achieved target LDL cholesterol levels within 12 months after CS. The remote monitoring is a safe strategy for improving and maintaining the adherence to statins in patients after CS.

Primary signs of vasular inflammation in children with familial hypercholesterolemia

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
E Slastnikova ◽  
D.I Sadykova ◽  
L.F Galimova ◽  
N.E Usova
Keyword(s):  
Endothelial Function ◽  
Familial Hypercholesterolemia ◽  
Lipid Lowering ◽  
High Density Lipoproteins ◽  
Lipid Lowering Therapy ◽  
Premature Atherosclerosis ◽  
Reactive Protein ◽  
Heterozygous Familial Hypercholesterolemia ◽  
Group 2 ◽  
Group 1

Abstract   Familial hypercholesterolemia is one of the most common genetic diseases that leads to premature atherosclerosis. We investigated endothelial function in children with heterozygous familial hypercholesterolemia in order to detect the first signs of endothelial inflammation in non-invasive ways. In 57 children with heterozygous familial hypercholesterolemia (Group 1), endothelial function was studied by measuring levels of nitric oxide (NO), endothelin and hypersensitive C-reactive protein (hsCRP). All secondary causes that could lead to a change in these indicators were excluded. Children from Group 1 had no Clinical or ultrasound signs of atherosclerosis. No children from Group 1 were ever treated by statins or other lipid-lowering therapy. Results were compared with a group of children comparable in age and sex (Group 2). Average age of Group 1 was 9 years old ±2 months, Group 2 is 9 years old ±3 months. Average lipid values in Group 1: total cholesterol (TH) – 7.2±0.9 mmol/L, low density lipoproteins (LDL) – 4.7±0.7 mmol/L, triglycerides and high density lipoproteins (HDL) corresponded to normal. Group 2 average lipids: TH – 4.2±0.7 mmol/L, LDL – 2.3±0.4 mmol/L, the level of triglycerides and (HDL) corresponded to normal. Results The results in Group 1 were: NO 66.15±1.19 μmol/L, endothelin 0.418±0.121 pmol/L, hsCRP 0.25±0.1 mg/dl. They showed in Group 2: NO 39.15±0.15 μmol/L, endothelin 0.231±0.05 pmol/L, hsCRP 0.11±0.2 mg/dl. The results in group 1 were significantly higher (endothelin and hypersensitive reactive protein) and lower (NO) in terms of indicators. Conclusions There is significant difference in the levels of vasodilators, vasoconstrictors and hsCRP between Group 1 and Group 2, that means there are the signs of inflammation in the Children with no clinics of peripheral or coronary atherosclerosis. It can be used as biomarkers of premature atherosclerosis and can help to avoid it. Funding Acknowledgement Type of funding source: None

Lower levels of high-density lipoprotein cholesterol are associated with increased cardiovascular events in patients with acute coronary syndrome receiving contemporary lipid-lowering therapy

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Nakazawa ◽  
H Arashi ◽  
Y Inagaki ◽  
H Otsuki ◽  
J Yamaguchi ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Primary Endpoint ◽  
Cardiovascular Events ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Coronary Syndrome ◽  
Lowering Therapy ◽  
Group 3 ◽  
Group 1

Abstract Background This study aimed to elucidate whether high-density lipoprotein cholesterol (HDL-C) at 3-month follow-up for patients receiving contemporary lipid-lowering therapy after acute coronary syndrome (ACS) could predict cardiac events. Methods The HIJ-PROPER study was a multicenter, prospective, randomized trial comparing intensive lipid-lowering therapy (pitavastatin + ezetimibe) and conventional lipid-lowering therapy (pitavastatin monotherapy) after ACS. For the present analysis, the entire cohort was divided into three groups according to HDL-C levels at 3-month follow-up (Group 1, HDL-C ≤43 mg/dL; Group 2, 43–53.6 mg/dL; Group 3; HDL-C ≥53.6 mg/dL). Baseline characteristics and the incidence of the primary endpoint (a composite of all-cause death, non-fatal myocardial infarction, non-fatal stroke, unstable angina pectoris, or ischemia-driven revascularization) were compared among the three groups. Results The primary endpoint was reported in 34.8%, 30.1%, and 24.6% of patients in Groups 1, 2, and 3, respectively. The incidence of the primary endpoint was significantly higher in Group 1 than in Group 3 (hazard ratio [HR], 1.5; 95% confidence interval [CI], 1.19–1.9; p=0.001). Irrespective of the treatment regimen, Group 1 had a significantly higher rate of the primary endpoint than Group 3 (pitavastatin + ezetimibe therapy: HR, 1.6; 95% CI, 1.12–2.22; p=0.01 and pitavastatin monotherapy: HR, 1.4; 95% CI, 1.05–1.98; p=0.02). These trends remained even after adjustment for baseline characteristics and lipid profiles. Conclusions Lower levels of HDL-C at 3-month follow-up are associated with higher incidence of the cardiovascular events in patients with acute coronary syndrome receiving contemporary lipid-lowering therapy. HDL-C levels and Cardiovascular events Funding Acknowledgement Type of funding source: None

scholarly journals Lower‐Intensity Statins Contributing to Gaps in Care for Patients With Primary Severe Hypercholesterolemia

2021 ◽  
Author(s):  
Wael E. Eid ◽  
Emma Hatfield Sapp ◽  
Elijah Flerlage ◽  
Joseph R. Nolan
Keyword(s):  
Medical Record ◽  
Electronic Medical Record ◽  
Treatment Guidelines ◽  
Primary Care Providers ◽  
Lipid Lowering ◽  
Moderate Intensity ◽  
Lipid Lowering Therapy ◽  
Care Providers ◽  
Group 2 ◽  
Group 1

Background Although severe hypercholesterolemia confers a 5‐fold increased long‐term risk for coronary artery disease, treatment guidelines may not be fully implemented, leading to underdiagnosis and suboptimal treatment. To further understand the clinical features and gaps in treatment approaches, we analyzed electronic medical record data from a midwestern US multidisciplinary healthcare system, between 2009 and 2020. Methods and Results We retrospectively assessed the prevalence, clinical presentation, and treatment characteristics of individuals currently treated with statin therapy having a low‐density lipoprotein cholesterol (LDL‐C) value that is either (1) an actual maximum electronic medical record–documented LDL‐C ≥190 mg/dL (group 1, n=7542) or (2) an estimated pretreatment LDL‐C ≥190 mg/dL (group 2, n=7710). Comorbidities and prescribed lipid‐lowering therapies were assessed. Statistical analyses identified differences among individuals within and between groups. Of records analyzed (n=266 282), 7% met the definition for primary severe hypercholesterolemia. Group 1 had more comorbidities than group 2. More individuals in both groups were treated by primary care providers (49.8%–53.0%, 32.6%–36.4%) than by specialty providers (4.1%–5.5%, 2.1%–3.3%). High‐intensity lipid‐lowering therapy was prescribed less frequently for group 2 than for group 1, but moderate‐intensity statins were prescribed more frequently for group 2 (65%) than for group 1 (52%). Conclusions Two percent of patients in our study population being treated with low‐ or moderate‐intensity statins have an estimated LDL‐C ≥190 mg/dL (indicating severe hypercholesterolemia), but receive less aggressive treatment than patients with a maximum measured LDL‐C ≥190 mg/dL.

scholarly journals Continuation or Discontinuation of Statin Therapy Did Not Influence Patient Outcomes after the Development of Acute Respiratory Distress Syndrome

2013 ◽  
Vol 2013 ◽  
pp. 1-8
Author(s):  
Seth R. Bauer ◽  
Simon W. Lam ◽  
Anita J. Reddy
Keyword(s):  
Acute Respiratory Distress Syndrome ◽  
Respiratory Distress Syndrome ◽  
Respiratory Distress ◽  
Statin Therapy ◽  
Distress Syndrome ◽  
Tertiary Care ◽  
Diagnosis Group ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

Background. The anti-inflammatory effects of statin therapy may be beneficial in the treatment and prevention of acute respiratory distress syndrome (ARDS). Objectives. Determine if continuation or discontinuation of prior statin therapy is associated with ventilator-free days (VFDs) at day 28 in patients with ARDS. Methods. Patients with ARDS admitted to the intensive care units of a tertiary care medical center were evaluated in this retrospective cohort study. Included patients were allocated to three groups: patients in whom statin therapy was given before and continued after ARDS diagnosis (Group 1), patients with statin therapy only before ARDS diagnosis (Group 2), and patients never exposed to statins (Group 3). Results. Of 244 patients evaluated, 187 were included; 17 (9.1%) patients in Group 1, 20 (10.7%) in Group 2, and 150 in Group 3. There were no differences among groups in APACHE II or SOFA scores. VFDs were not significantly different among groups (median 0 versus 4.5 versus 13.5 days, P=0.21). After adjustment for baseline characteristics, including propensity for statin administration, statin therapy was not associated with increased VFDs on linear regression. Conclusions. Exposure to statins before or after ARDS diagnosis was not associated with improved VFDs in this cohort of patients with ARDS.

In-vivo evaluation of the effect of cyanoacrylate on prosthetic vascular graft infection – does cyanoacrylate increase the severity of infection?

VASA ◽  
2020 ◽  
Vol 49 (4) ◽  
pp. 281-284
Author(s):  
Atıf Yolgosteren ◽  
Gencehan Kumtepe ◽  
Melda Payaslioglu ◽  
Cuneyt Ozakin
Keyword(s):  
Vascular Graft ◽  
Graft Infection ◽  
Vascular Graft Infection ◽  
Group 4 ◽  
Significant Difference ◽  
Group 3 ◽  
Group 2 ◽  
Prosthetic Vascular Graft Infection ◽  
Group 1

Summary. Background: Prosthetic vascular graft infection (PVGI) is a complication with high mortality. Cyanoacrylate (CA) is an adhesive which has been used in a number of surgical procedures. In this in-vivo study, we aimed to evaluate the relationship between PVGI and CA. Materials and methods: Thirty-two rats were equally divided into four groups. Pouch was formed on back of rats until deep fascia. In group 1, vascular graft with polyethyleneterephthalate (PET) was placed into pouch. In group 2, MRSA strain with a density of 1 ml 0.5 MacFarland was injected into pouch. In group 3, 1 cm 2 vascular graft with PET piece was placed into pouch and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. In group 4, 1 cm 2 vascular graft with PET piece impregnated with N-butyl cyanoacrylate-based adhesive was placed and MRSA strain with a density of 1 ml 0.5 MacFarland was injected. All rats were scarified in 96th hour, culture samples were taken where intervention was performed and were evaluated microbiologically. Bacteria reproducing in each group were numerically evaluated based on colony-forming unit (CFU/ml) and compared by taking their average. Results: MRSA reproduction of 0 CFU/ml in group 1, of 1410 CFU/ml in group 2, of 180 200 CFU/ml in group 3 and of 625 300 CFU/ml in group 4 was present. A statistically significant difference was present between group 1 and group 4 (p < 0.01), between group 2 and group 4 (p < 0.01), between group 3 and group 4 (p < 0.05). In terms of reproduction, no statistically significant difference was found in group 1, group 2, group 3 in themselves. Conclusions: We observed that the rate of infection increased in the cyanoacyrylate group where cyanoacrylate was used. We think that surgeon should be more careful in using CA in vascular surgery.

Abnormal Haemostasis and Blood Viscosity in Malignant Hypertension

1984 ◽  
Vol 52 (03) ◽  
pp. 253-255 ◽  
Author(s):  
C Isles ◽  
G D O Lowe ◽  
B M Rankin ◽  
C D Forbes ◽  
N Lucie ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Viscosity ◽  
Renal Damage ◽  
Antithrombin Iii ◽  
Plasma Viscosity ◽  
Malignant Hypertension ◽  
Fibrin Deposition ◽  
Group 3 ◽  
Group 2 ◽  
Group 1

SummaryWe have previously shown abnormalities of haemostasis suggestive of intravascular coagulation in patients with malignant hypertension, a condition associated with retinopathy and renal fibrin deposition. To determine whether such abnormalities are specific to malignant hypertension, we have measured several haemostatic and haemorheological variables in 18 patients with malignant hypertension (Group 1), 18 matched healthy controls (Group 2), and 18 patients with non-malignant hypertension (Group 3) matched for renal pathology, blood pressure and serum creatinine with Group 1. Both Groups 1 and 3 had increased mean levels of fibrinogen, factor VIIIc, beta-thrombo- globulin, plasma viscosity and blood viscosity (corrected for haematocrit); and decreased mean levels of haematocrit, antithrombin III and platelet count. Mean levels of fast antiplasmin and alpha2-macroglobulin were elevated in Group 1 but not in Group 3. We conclude that most blood abnormalities are not specific to malignant hypertension; are also present in patients with non-malignant hypertension who have similar levels of blood pressure and renal damage; and might result from renal damage as well as promoting further renal damage by enhancing fibrin deposition. However increased levels of fibrinolytic inhibitors in malignant hypertension merit further investigation in relation to removal of renal fibrin.

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