scholarly journals Disfunción tiroidea posexposición a medio de contraste yodado

2017 ◽  
Vol 2 (1) ◽  
pp. 5-9
Author(s):  
Cristian Iván García Rincón ◽  
Luz Yaneth Becerra Salazar ◽  
Germán Alberto Moreno Gómez ◽  
Henry Mauricio Arenas Quintero

La exposición a cantidades excesivas de yodo bloquea la actividad de la enzima peroxidasa tiroidea (TPO), un fenómeno conocido como efecto de Wolff-Chaikoff. Clínicamente, éste puede llevar a hipotiroidismo. Por el contrario, cuando un tirocito contiene valores bajos de yodo y es expuesto a elevadas concentraciones del mismo, aumenta de forma significativa la producción de hormona tiroidea, llevando frecuentemente a hipertiroidismo clínico y bioquímico, fenómeno conocido como efecto de Jod-Basedow. Tanto el hiper como el hipotiroidismo aumentan el riesgo de enfermedad arterial coronaria, miopatía ventricular izquierda, anormalidades electrofisiológicas, además de incrementar la mortalidad cardiovascular y por todas las causas.Abstract Exposure to excessive amounts of iodine blocks the activity of the enzyme thyroid peroxidase (TPO), a phenomenon known as Wolf-Chaikoff effect. Clinically, this effect can lead to hypothyroidism. On the other hand, when thyrocites have low iodine levels and are exposed to a high iodine concentration, they increase significantly their production of thyroid hormone thus leading to hyperthyroidism, a phenomenon known as Jod-Basedow effect. Both hypothyroidism and hyperthyroidism increase the risk of coronary artery disease, left cardiomyopathy, electrophysiological abnormalities, and all-cause mortality.

Pharmacology ◽  
2018 ◽  
Vol 103 (3-4) ◽  
pp. 111-113 ◽  
Author(s):  
Gabriele Cortellini ◽  
Domenico Lippolis ◽  
Silvia Amati ◽  
Giancarlo Piovaccari ◽  
Fabio Cortellini ◽  
...  

To date, aspirin desensitization is employed with patients with nonsteroidal anti-inflammatory drugs (NSAIDs) exacerbated respiratory diseases (NERD) or with aspirin or NSAIDs hypersensitive patients needing a stent procedure for coronary artery disease. On the other hand, few data exist regarding aspirin desensitization in other cardiological features and particularly we haven’t data on different NSAIDs desensitization. Only for NERD patients we have data on ketorolac use. We report an efficacious desensitization procedure for ibuprofen in urticaria/angioedema patient with pericarditis and myocarditis associated.


2021 ◽  
Vol 17 ◽  
Author(s):  
Azka Latif ◽  
Muhammad Junaid Ahsan ◽  
Noman Lateef ◽  
Vikas Kapoor ◽  
Hafiz Muhammad Fazeel ◽  
...  

: Red cell distribution width (RDW) serves as an independent predictor towards the prognosis of coronary artery disease (CAD) in patients undergoing percutaneous coronary intervention (PCI). A systematic search of databases such as PubMed, Embase, Web of Science, and Cochrane library was performed on October 10th, 2019 to elaborate the relationship between RDW and in hospital and long term follow up all-cause and cardiovascular mortality, major adverse cardiac events (MACE) and development of contrast-induced nephropathy (CIN) in patients with CAD undergoing PCI. Twenty-one studies qualified this strict selection criteria (number of patients = 56,425): one study was prospective, and the rest were retrospective cohorts. Our analysis showed that patients undergoing PCI with high RDW had a significantly higher risk of in-hospital all-cause mortality (OR 2.41), long-term all-cause mortality (OR 2.44), cardiac mortality (OR 2.65), MACE (OR: 2.16) and odds of developing CIN (OR: 1.42) when compared to the patients with low RDW. Therefore, incorporating RDW in the predictive models for the development of CIN, MACE, and mortality can help in triage to improve the outcomes in coronary artery disease patients who undergo PCI.


2022 ◽  
Vol 8 ◽  
Author(s):  
Younan Yao ◽  
Jin Liu ◽  
Bo Wang ◽  
Ziyou Zhou ◽  
Xiaozhao Lu ◽  
...  

Background: The prognostic value of elevated lipoprotein(a) [Lp(a)] in coronary artery disease (CAD) patients is inconsistent in previous studies, and whether such value changes at different low-density-lipoprotein cholesterol (LDL-C) levels is unclear.Methods and Findings: CAD patients treated with statin therapy from January 2007 to December 2018 in the Guangdong Provincial People's Hospital (NCT04407936) were consecutively enrolled. Individuals were categorized according to the baseline LDL-C at cut-off of 70 and 100 mg/dL. The primary outcome was 5-year all-cause death. Multivariate Cox proportional models and penalized spline analyses were used to evaluate the association between Lp(a) and all-cause mortality. Among 30,908 patients, the mean age was 63.1 ± 10.7 years, and 76.7% were men. A total of 2,383 (7.7%) patients died at 5-year follow-up. Compared with Lp(a) <50 mg/dL, Lp(a) ≥ 50 mg/dL predicted higher all-cause mortality (multivariable adjusted HR = 1.19, 95% CI 1.07–1.31) in the total cohort. However, when analyzed within each LDL-C category, there was no significant association between Lp(a) ≥ 50 mg/dL and higher all-cause mortality unless the baseline LDL-C was ≥ 100 mg/dL (HR = 1.19, 95% CI 1.04–1.36). The results from penalized spline analyses were robust.Conclusions: In statin-treated CAD patients, elevated Lp(a) was associated with increased risks of all-cause death, and such an association was modified by the baseline LDL-C levels. Patients with Lp(a) ≥ 50 mg/dL had higher long-term risks of all-cause death compared with those with Lp(a) <50 mg/dL only when their baseline LDL-C was ≥ 100 mg/dL.


2005 ◽  
Vol 14 (12) ◽  
pp. 15
Author(s):  
J.A. Iestra ◽  
D. Kromhout ◽  
Y.T. vaderSchouw ◽  
D.E.E. Grobbee ◽  
H.C. Boshuizen ◽  
...  

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Joost Besseling ◽  
Gerard K Hovingh ◽  
John J Kastelein ◽  
Barbara A Hutten

Introduction: Heterozygous familial hypercholesterolemia (heFH) is characterized by high levels of low-density lipoprotein cholesterol (LDL-C) and increased risk for premature coronary artery disease (CAD) and death. Reduction of CAD and mortality by statins has not been properly quantified in heFH. The aim of the current study is to determine the effect of statins on CAD and mortality in heFH. Methods: All adult heFH patients identified by the Dutch FH screening program between 1994 and 2014 and registered in the PHARMO Database Network were eligible. Of these patients we obtained hospital, pharmacy (in- and outpatient), and mortality records in the period between 1995 and 2015. The effect of statins (time-varying) on CAD and all-cause mortality was determined using a Cox proportional hazard model, while correcting for the use of other lipid-lowering therapy, thrombocyte aggregation inhibitors, antihypertensive and antidiabetic medication (all time-varying). Furthermore, we used inverse probability for treatment weighting (IPTW) to account for differences between statin-treated and untreated patients regarding history of CAD before follow-up, age at start of follow-up and age of screening, as well as body mass index, LDL-C and triglycerides. Results: Of the 25,479 identified heFH patients, 11,021 gave informed consent to obtain their medical records, of whom 2,447 could be retrieved. We excluded 766 patients younger than 18. The remaining 1,681 heFH patients comprised our study population and these had very similar characteristics as compared to the 23,798 excluded FH patients, e.g. mean (SD) LDL-C levels were 214 (74) vs. 203 (77) mg/dL. Among 1,151 statin users, there were 133 CAD events and 15 deaths during 10,115 statin treated person-years, compared to 17 CAD events and 9 deaths during 4,965 person-years in 530 never statin users (combined rate: 14.6 vs. 5.2, respectively, p<0.001). After applying IPTW to account for indication bias and correcting for use of other medications, the hazard ratio of statin use for CAD and all-cause mortality was 0.61 (0.40 - 0.93). Conclusions: In heFH patients, statins lower the risk for CAD and mortality by 39%.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Qais Radaideh ◽  
Mohammed Osman ◽  
Babikir Kheiri ◽  
Ahmad Al-Abdouh ◽  
mahmoud Barbarawi ◽  
...  

Introduction: There has been a continuous debate about the survival benefit of percutaneous coronary intervention (PCI) for the management of patients with stable coronary artery disease (CAD) and moderate to severe ischemia. To address this, we performed a meta-analysis of RCTs comparing PCI plus MT vs. MT alone in stable CAD patients to evaluate endpoints of all-cause mortality, cardiovascular (CV) mortality, and MI in a larger cohort of patients with objective evidence of myocardial ischemia. Methods: An electronic database search was conducted for RCTs that compared PCI on top of MT versus MT alone. A random effects model was used to calculate relative risk (RR) and 95% confidence intervals (CIs). Results: A total of 7 RCTs with 10,043 patients with a mean age of 62.54 ± 1.56 years and a median follow up of 3.9 years were identified. Among patients with (CAD) and moderate to severe ischemia by stress testing, PCI didn’t show any benefit for the primary outcome of all-cause mortality compared to MT(RR = 0.85; 95% CI 0.646-1.12; p= 0.639). There was also no benefit in cardiovascular (CV) death (RR = 0.88 ; 95% CI 0.71-1.09; p =0.18) or myocardial infarction (MI) (RR = 0.271 ; 95% CI 0.782-1.087; P =0.327) in the PCI group as compared to MT. Conclusions: Among patients with (CAD) and evidence of moderate to severe ischemia by stress testing, PCI on top of MT appears to add no mortality benefit as compared to with MT alone.


2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
A Abdul Razzack ◽  
S Mandava ◽  
S Pothuru ◽  
S Adeel Hassan ◽  
D Missael Rocha Castellanos ◽  
...  

Abstract Funding Acknowledgements Type of funding sources: None. Background-Whether Coronary artery bypass grafting (CABG) confers a survival benefit in patients with diabetes mellitus(DM) and complex coronary artery disease (CAD), including left main CAD and multivessel coronary disease (MVD) after a follow up period ≥ 5 years remains unknown. Methods- Electronic databases (PubMed, Embase, Scopus, Cochrane) were searched from inception to December 12th 2020. Using a generic invariance weighted random effects model, Hazard ratios (HRs) and their 95% confidence intervals (CIs) from individual studies were converted to Log HRs and corresponding standard errors, which were then pooled. The primary outcome of interest was all-cause mortality and major adverse cardiac and cerebrovascular events (MACCE) which was defined as a composite of death, myocardial reinfarction and stroke at ≥ 5 years. Results-A total of 8 studies with 13336 participants(PCI = 6783, CABG = 6553)were included in our analysis. Mean age was 54.6 and 55.3 in the PCI-DES and CABG groups respectively. The 5-yr follow-up outcomes including all-cause mortality (HR 1.37; 95%CI 1.15-1.65; p = 0.0006, I2 = 0)and MACCE (HR 1.48; 95%CI 1.29-1.69; p &lt; 0.00001, I2 = 0) were significantly higher with PCI as compared to CABG. Furthermore, at &gt;5 year follow-up, all-cause mortality (HR 1.35; 95%CI 1.10-1.66; p = 0.004, I2 = 37) and MACCE (HR 1.98; 95%CI 1.85-2.12; p &lt; 0.00001, I2 = 0) had similar outcomes. Conclusion-Amongst patients with DM and Complex CAD ( left main/MVD), CABG was associated with improved long-term mortality and freedom from MACCEs as opposed to PCI-DES. CABG is the preferred revascularization strategy in patients with complex anatomic disease and concurrent diabetes. Abstract Figure.


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