EFFECT OF POLYMORPHISM OF APOE AND SLCO1B1 GENES ON THE COURSE OF MYOCARDIAL INFARCTION ASSOCIATED WITH ACUTE KIDNEY INJURY IN HOSPITAL AND LONG-TERM PERIODS

2018 ◽  
Vol 22 (6) ◽  
pp. 56-63
Author(s):  
A. V. Siverina ◽  
E. A. Skorodumova ◽  
V. A. Kostenko ◽  
L. P. Pivovarova ◽  
M. E. Malyshev ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Study Groups ◽  
Positive Trend ◽  
Average Value ◽  
Group I ◽  
Slco1b1 Gene ◽  
Group Ii

THE AIM:to assess the effect of APOE and SLCO1B1 gene polymorphism on the course of myocardial infarction (MI) associated with acute kidney injury (AKI) in hospital and long-term periods.PATIENTS AND METHODS:132 patients with МI were examined, which were divided into 2 groups: the first (I) – 68 patients with MI and AKI, the second (II) – 64 people with MI without AKI.RESULTS:In the distribution of genotypes, polymorphism of Leu28Pro of the APOE gene in the studied groups was revealed that LeuPro was more often inherited in patients of group I – 20,6 %, the average value of total cholesterol (TC) – 6,01±0,3 mmol/l, and low density lipoproteins (LDL) – 3,37±0,21 mmol/l, compared with patients of group II, where the LeuPro genotype – 6, 2 %, TC – 5,03±0,3 mmol/l, LDL – 2,38±0,3 mmol/l, p<0,05. A similar situation was typical for the polymor phism Val174Ala SLCO1B1 gene, where ValAla in patients of group I-26,5 %, in II-12,5 %, p<0.05. In heterozygotes I sample TC-5,59±0,3 mmol/l, and LDL – 3,30±0,14 mmol/l, in group II TC – 5,19±0,29 mmol/l, LDL – 2,75±0,23 mmol / l, p<0,05. The clinical picture of the hospital period in patients with MI and AKI, proceeded with the development of a greater number of complications, which reflected in the high mortality in group I – 16,2 %, in group II – 4,7 %, p<0,05. In the posthospital period, against the background of atorvastatin administration in both study groups, there was a positive trend of decrease in TC and LDL, but it was not possible to achieve the targets. Mortality in the long-term period in group I – 15,4 %, in group II-2,0 %, p<0.05.CONCLUSIONS:in patients with MI and AKI on the background of a more severe clinical course of the disease, both in hospital and in the long-term period, rare allelic variants of the genes APOE and SLCO1B1 were more often determined, which negatively affected the lipid profile.

scholarly journals In-Hospital Outcomes of Acute ST Elevation Myocardial Infarction in Patients with Acute Kidney Injury

2018 ◽  
Vol 11 (1) ◽  
pp. 59-66
Author(s):  
Md Mosharul Haque ◽  
M Atahar Ali ◽  
Mustafizul Aziz ◽  
Mohammad Ullah ◽  
Mohammad Anowar Hossain ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Mortality Rate ◽  
Serum Creatinine ◽  
Hospital Mortality ◽  
Independent Predictor ◽  
Kidney Injury ◽  
Group I ◽  
St Elevation ◽  
Group Ii

Background: Acute kidney injury (AKI) is a risk factor for long-term adverse outcomes, including acute myocardial infarction and death. The objective of this study was to find out in-hospital outcomes in patients with acute ST elevation myocardial infarction with acute kidney injury.Methods: A total 190 patients were included in this study and were equally divided into two groups, Group-I (with AKI) and Group-II (without AKI), according to absolute changes of serum creatinine level. AKI was defined as absolute changes in serum creatinine (SCr. at 48 hours’ minus admission SCr) and categorized as mild AKI (increase of 0.3 to <0.5 mg/d), moderate AKI (increase of 0.5 to <1.0 mg/dl), and severe AKI (increase of e”1.0 mg/dl) using Acute Kidney Injury Network (AKIN) criteria.Results: Overall in-hospital mortality rate was 14.7% in Group-I (mortality rate for those with mild, moderate, and severe AKI were 7%, 13.3%, and 31.8%) compared with 5.3% in Group-II. Regarding inhospital morbidities, significant arrhythmia (29.5%) was the most common complication followed by acute heart failure (18.9%), cardiogenic shock (12.6%), and mechanical complications (4.2%) which were more in Group-I compared to patients with Group-II. After adjustment of other risk variables, the multivariate logistic regression analysis revealed AKI remained an independent predictor of in-hospital mortality with adjusted odds ratios (OR) was 4.991 (95% confidence interval, 1.873-13.301).Conclusions: AKI is an independent predictor of in-hospital mortality and morbidity. It emphasizes the importance of efforts to identify risk factors and to prevent AKI during in-hospital management of acute STEMI patients.Cardiovasc. j. 2018; 11(1): 59-66

Preoperative Low Serum Albumin Levels Increase the Requirement of Renal Replacement Therapy after Cardiac Surgery

2016 ◽  
Vol 19 (3) ◽  
pp. 123 ◽  
Author(s):  
Orhan Findik ◽  
Ufuk Aydin ◽  
Ozgur Baris ◽  
Hakan Parlar ◽  
Gokcen Atilboz Alagoz ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Regression Analysis ◽  
Cardiac Surgery ◽  
Renal Replacement Therapy ◽  
Serum Albumin ◽  
Replacement Therapy ◽  
Kidney Injury ◽  
Preoperative Serum ◽  
Group I ◽  
Group Ii

<strong>Background:</strong> Acute kidney injury is a common complication of cardiac surgery that increases morbidity and mortality. The aim of the present study is to analyze the association of preoperative serum albumin levels with acute kidney injury and the requirement of renal replacement therapy after isolated coronary artery bypass graft surgery (CABG).<br /><strong>Methods:</strong> We retrospectively reviewed the prospectively collected data of 530 adult patients who underwent isolated CABG surgery with normal renal function. The perioperative clinical data of the patients included demographic data, laboratory data, length of stay, in-hospital complications and mortality. The patient population was divided into two groups: group I patients with preoperative serum albumin levels &lt;3.5 mg/dL; and group II pateints with preoperative serum albumin levels ≥3.5 mg/dL.<br /><strong>Results:</strong> There were 413 patients in group I and 117 patients in group II. Postoperative acute kidney injury (AKI) occured in 33 patients (28.2%) in group I and in 79 patients (19.1%) in group II. Renal replacement therapy was required in 17 patients (3.2%) (8 patients from group I; 9 patients from group II; P = .018). 30-day mortality occurred in 18 patients (3.4%) (10 patients from group I; 8 patients from group II; P = .037). Fourteen of these patients required renal replacement therapy. Logistic regression analysis revealing the presence of lower serum albumin levels preoperatively was shown to be associated with increased incidence of postoperative AKI (OR: 1.661; 95% CI: 1.037-2.661; <br />P = .035). Logistic regression analysis also revealed that DM (OR: 3.325; 95% CI: 2.162-5.114; P = .000) was another independent risk factor for AKI after isolated CABG. <br /><strong>Conclusion:</strong> Low preoperative serum albumin levels result in severe acute kidney injury and increase the rate of renal replacement therapy and mortality after isolated CABG.

Long-term impact of acute kidney injury on prognosis in patients with acute myocardial infarction

2019 ◽  
Vol 283 ◽  
pp. 48-54 ◽  
Author(s):  
Georgios Chalikias ◽  
Levent Serif ◽  
Petros Kikas ◽  
Adina Thomaidis ◽  
Dimitrios Stakos ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Long Term Impact

Acute Kidney Injury and Long-term Prognosis After Acute Myocardial Infarction

2009 ◽  
Vol 169 (1) ◽  
pp. 87 ◽  
Author(s):  
Alberto Bouzas-Mosquera ◽  
José M. Vázquez-Rodríguez ◽  
Jesús Peteiro ◽  
Nemesio Álvarez-García
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Acute Kidney Injury ◽  
Kidney Injury ◽  
Long Term Prognosis

scholarly journals The Long-Term Results of ReLEX® SMILE Depending on the Degree of the Corrected Myopia

2020 ◽  
Vol 17 (4) ◽  
pp. 711-718
Author(s):  
O. A. Klokova ◽  
R. O. Damashauskas ◽  
S. V. Kostenev ◽  
E. N. Kalaidin
Keyword(s):  
Visual Acuity ◽  
Laser System ◽  
Study Groups ◽  
Individual Characteristics ◽  
Long Term Results ◽  
Efficiency Coefficient ◽  
Group Iii ◽  
Group I ◽  
Group Ii

The purpose: prospective study of the long-term refractive and visual results of ReLEx® SMILE, depending on the degree of corrected myopia.Material and methods. The three study groups included 71 patients; the mean age was 26.48 ± 5.5 years. Group I consisted of 20 patients (39 eyes) mean SE –2.62 ± 0.87 D, group II — 26 patients (51 eyes), mean SE 4.68 ± 0.74 D, Group III — 25 patients (47 eyes), mean SE 6.88 ± 0.72 D. All patients underwent femtolaser correction of myopia using the ReLEx® SMILE method with the VisuMax™ laser system (Carl Zeiss Meditec AG).Results. Uncorrected visual acuity of 09 — 1.0 was noted in 34 eyes (87.2 %) in group I, in II — in 43 eyes (84.3 %), in 37 eyes (78.7 %) in group III. The efficiency coefficient was 1.0 in groups I — II and 0.89 in group III. There was no decrease in corrected visual acuity (CVA) during the correction of mild and moderate myopia, in group III it was recorded by 0.1 in two cases (4 %), by 0.2 in one case (2 %), the safety factor in I — II groups 1.0, in III 0,89. Two years after ReLEx® SMILE, refraction of ± 0.5 D from planned in the study groups was achieved, respectively, in 94.9, 88.2, 76.6 % of cases, ± 1.0 D in 100 % of cases in I, II groups, in 97 % of cases in III group. The predictability coefficient was 0.95 in group I, 0.88 in group II, and 0.77 in group III. Refractive regression compared with the results 1 month postoperatively was 0.08 D in group I, 0.1 D in group II, and 0.16 D in group III. Analysis of the long-term results of ReLEx® SMILE allows us to conclude: the method is safe and effective, provides high predictability of refractive results in correcting various degrees of myopia. Further study of the long-term results of the operation, the creation and use of nomograms, taking into account the individual characteristics of the cornea, will improve the predictability and stability of refractive results in the correction of high myopia. 

scholarly journals PCI in patients with ostium coronary artery lesions: three-year follow-up

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Maximkin ◽  
Z Shugushev ◽  
A Chepurnoy ◽  
O Safonova ◽  
A Mambetov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Target Lesion ◽  
Long Term Results ◽  
Coronary Artery Lesions ◽  
Total Frequency ◽  
Stent Restenosis ◽  
Group I ◽  
Group Ii

Abstract Aims To increase the effectiveness of percutaneous coronary interventions (PCI) in patients with ostium coronary artery lesions. Methods 170 patients were included in the study. Inclusion criteria: ostium atheroslerotic lesions of left arterial descending (LAD) or left circumflex (LCx) &gt;70% according to angiography and intravascular ultrasound (IVUS); myocardial ischemia according stress test and FFR measurement. All patients were randomized into 2 groups. In I group (n=85) according to IVUS, atherosclerotic plaque spread from the ostium of LAD and/or LCx to the left main coronary artery (LMCA), and in group II (n=85) - the plaque did not spread into the LMCA. In Group I all patients were initially treated with “Provisional T” stenting of the LMCA, and in Group II – precision stenting of the ostium LAD or LCx. Long-term results were evaluated on 24 and 48 months. Primary endpoints: frequency of MACE (death, MI, revascularizations). Results During hospitalization of complications associated with PCI was not, survival was 100% in all groups. The conversion to complete bifurcation stenting were in 5 patients from Group I and conversion to provisional stenting were in 3 patients from Group II. The long-term results after 24 months was observe in 70 patients from Group I and 72 patients, from Group II. Nonfatal myocardial infarction (MI) was observed in 2 (2.7%) of patients from group II and not in Group I. The incidence of hemodynamic significant stent restenosis and was observed in 4 patients (5.7%) in Group I, and in 7 patients (9.8%) in Group II (p&lt;0.05). The target lesion revascularization (TLR) was performed in 4 patients (5.7%) in Group I, and in 9 patients (12.5%) in Group II (p&lt;0.05). The total frequency of MACE in groups I and II was 4 (5.7%) and 9 (12.5%), respectively (p&lt;0.05). The survival was 100% in both groups. The long-term results after 48 months was observe in 58 patients from Group I and 54 patients, from Group II. All type of death registration in 1 patient from Group I and 2 patients from Group II. Nonfatal myocardial infarction (MI) was observed in 1 patient (1.7%) and 2 patients from Group II (3.7%) (p&gt;0.05). The incidence of hemodynamic significant stent restenosis was observed in 3 patients (5.7%) in Group I, and in 5 patients (9.3%) in Group II (p&lt;0.05). The target lesion revascularization (TLR) was performed in 4 patient (6.9%) in Group I, and in 7 patient (13%) in Group II (p&lt;0.05). The total frequency of MACE in groups I and II was 5 (8.6%) and 10 (18.5%), respectively (p&lt;0.05). The freedom from cardiac events (Kaplan-Maier analysis) was significant difference (92.5 in Group I and 84.5 in Group II (p&lt;0.05). Conclusions IVUS analysis of ostium stenosis of coronary arteries can help in choosing the optimal stenting technique, as well as reliably improve long-term PCI results. Patients after precision stenting of the ostium have worse long-term results, compared with patients after provisional T-stenting. Funding Acknowledgement Type of funding source: None

scholarly journals The effect of chronic infection foci in the mother on the development of acute kidney injury in premature infants with hemodynamically significant patent ductus arteriosus

2020 ◽  
pp. 13-18
Author(s):  
T.P. Borysova ◽  
◽  
O.U. Obolonska ◽  
◽  
Keyword(s):  
Acute Kidney Injury ◽  
Patent Ductus Arteriosus ◽  
Premature Infants ◽  
Ductus Arteriosus ◽  
Kidney Injury ◽  
Maternal Infection ◽  
Group Iii ◽  
Group I ◽  
Group Ii ◽  
Patent Ductus

Nephrogenesis may be disrupted antenatally because of chronic infection foci (CIF) in the mother, the development of chorioamnionitis, feto-placental insufficiency. As a result, in the postnatal period, the kidneys are more sensitive to hypoperfusion, which occurs in premature infants with hemodynamically significant patent ductus arteriosus (HSPDA) and can lead to the development of acute kidney injury (AKI). Purpose — to study the influence of CIF in the mother on the development of AKI in premature infants with HSPDA. Materials and methods. 74 premature infants (gestational age 29–36 weeks) who were treated in the Department of Anesthesiology and Neonatal Intensive Care MI «Dnepropetrovsk Regional Children's Clinical Hospital» Dnepropetrovsk Regional Council» were examined. Patients were divided into three groups depending on the presence of a patent ductus arteriosus (PDA) and its hemodynamic significance: Group I — 40 children with HSPDA, Group II — 17 children with PDA without hemodynamic disorders, Group III — 17 children with a closed ductus arteriosus. The presence of CIF in the mother was determined according to medical records, chorioamnionitis on the basis of histopathological examination of the placenta. Patients with HSPDA were divided into two subgroups: 28 children from mothers with CIF, 12 — without CIF. Clinical examination and treatment of premature infants was carried out according to generally accepted methods. Echocardiography with Doppler was performed at 5–11 hours of life and then daily to determine PDA, its size and hemodynamic significance. Diagnosis and stratification of the severity of AKI were performed according to the criteria of neonatal modification of KDIGO, for which the concentration of serum creatinine and diuresis were studied. Results. Chronic foci of infection were found in 28 (70.0%) mothers of group I, in 5 (29.4%) — group II, in 6 (35.2%) — group III. Chorioamnionitis in group I — 10 (25%) cases, in group II–ІII — 6 (17.6%). The presence of CIF in the mother caused a significant increase in the size of the PDA on the first day of life in the group of HSPDA against groups II–III: 2.61±0.861 (2.3; 2–3.5) mm against 1.79±0.365 (1.7; 1.5–2) mm, p<0.001. Patent arterial duct with a diameter of >2 mm on the first day of life in premature infants of group I from mothers with foci of infection was observed more often — 19 (67.9%) against 2(6.7%) of groups II–III (OR=10.56; CI: 1.9–58.53, p<0.005). Analysis of the incidence of AKI on the third day of life depending on HSPDA and the presence of CIF showed that 64.3% of preterm infants with HSPDA and maternal infection developed AKI — 6.6 times more often than in groups without HSPDA (OR=8.40; CI: 2.60–27.14; p<0.001), and 2.6 times more often compared to children of the subgroup HSPDA without recorded maternal infection (OR=5.40; CI: 1.18–24.65; p<0.03). On the background of HSPDA and CIF stage II–III AKI was observed in every third child. Comparative analysis within group I depending on the CIF revealed that the frequency of AKI for 10 days in the subgroup with infection was almost three times higher than the level of the subgroup without infection: 71.4% vs. 25.0% (OR=7.50; CI: 1.60–35.07; p<0.009). Conclusions. The presence of CIF in the mother is a risk factor for AKI in premature infants with HSPDA. Therefore, such children should be classified as at risk of developing AKI. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: acute kidney injury, chronic foci of maternal infection, hemodynamically significant patent ductus arteriosus, premature infants.

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