Abstract
BACKGROUND AND AIMS
Ankle-brachial index (ABI) is a marker of peripheral arterial disease and is associated with increased cardiovascular morbidity and mortality. Structural alterations in ...the arterial walls lead to functional central haemodynamic changes, potentially impacting pulse wave reflection and, consequently, myocardial perfusion.
The aim of this study was to determine the association between ABI and subendocardial viability ratio (SEVR) as a non-invasive measure of coronary perfusion in chronic haemodialysis patients.
METHOD
We measured ABI using an automated non-invasive waveform analysis device (MESI®, Slovenia) and SEVR using applanation tonometry (Sphygmocor, Atcor Medical, Sydney, Australia). All the measurements were performed on a non-dialysis day and SEVR on the non-arteriovenous fistula (non-AVF) hand. ABI was calculated as the ratio between systolic blood pressure on the non-AVF hand and systolic blood pressure on the calves of both legs. Mean ABI of both sides was used in the statistical analysis.
RESULTS
A total of 29 patients (mean age 63.6 ± 10.5 years, 69.0% male) were included. In Table 1, descriptive parameters are presented.
Of those, 4 patients (13.8%) have an ABI <0.9 and the other 25 patients (86.2%) have a normal ABI between 0.9 and 1.3. Using the independent-samples T-test, patients with a lower ABI have a statistically significant lower SEVR compared with patients with normal ABI (109 versus 142%; P = 0.039).
CONCLUSION
Low ABI is independently associated with decreased subendocardial perfusion in chronic haemodialysis patients, suggesting that both methods of ABI and SEVR measurement may reflect an atherosclerotic process in peripheral and coronary arteries.
Summary
Background
Multiple sclerosis is an inflammatory disorder of the central nervous system. Inflammation may create high susceptibility to subclinical atherosclerosis. The purpose of this study ...was to compare subclinical atherosclerosis and the role of inflammatory cytokines between the group of patients with relapsing-remitting multiple sclerosis (RRMS) and healthy controls matched for age and sex.
Methods
The study group consisted of 112 non-diabetic and non-hypertensive RRMS patients treated with disease modifying drugs (DMD) and the control group was composed of 51 healthy subjects. The common carotid artery (CCA) intima media thickness (IMT) was investigated. Serum levels of risk factors for atherosclerosis and inflammatory cytokines were also determined.
Results
The mean CCA IMT (0.572 ± 0.131 mm vs. 0.571 ± 0.114 mm) did not differ (
p
> 0.05) between patients and controls. The RRMS patients’ CCA IMT was significantly correlated with serum interleukin 6 (IL-6) (
p
= 0.027), high-sensitivity C-reactive protein (hs-CRP) (
p
= 0.027), cystatin C (
p
< 0.0005), glucose (
p
= 0.031), cholesterol (
p
= 0.008), LDL (
p
= 0.021), erythrocyte sedimentation rate (
p
= 0.001) and triglyceride (
p
= 0.018) level. We fitted generalized linear models in order to assess the relationship between CCA IMT and IL‑6 with adjustment for sex and age. The obtained results showed that adjusted for age (
p
< 0.001) and sex (
p
= 0.048) IL‑6 serum levels statistically significantly (
p
= 0.009) predict CCA IMT only in the RRMS group.
Conclusion
The findings of the present study suggest that when treated with DMD RRMS might not be an independent risk factor for early atherosclerosis presenting with arterial wall thickening; however, the results suggest a significant association of IL‑6 serum levels with CCA IMT only in the RRMS group.
Summary
Background
Atherosclerosis is accelerated in patients with different stages of chronic renal failure. Renal dysfunction predicts mortality in patients with myocardial infarction and ...congestive heart failure. Less is known about the impact of renal dysfunction on mortality after ischemic stroke. The aim of the study was to investigate the impact of renal dysfunction on 1-year mortality.
Patients and methods
All 390 patients (207 men and 183 women) suffered from ischemic stroke in 1-year period were included in our study. Telephonic follow-up after 1 year was performed. The mean age of our patients was 71.0 ± 11.6 years, ranged from 36 to 96 years. Glomerular filtration rate (GFR) was calculated according to abbreviated Modification of Diet in Renal Disease formula. At admission and at discharge National Institutes of Health Stroke Scale (NIHSS) were performed.
Results
The mean GFR in our patients was 66.0 ± 20.68 ml/min/1.73 m
2
. There were 123 (31.5 %) deaths in 1-year period. Patients who died were older (
P
< 0.001), had higher NIHSS at admission and at discharge (both
P
< 0.001), higher high-sensitive C-reactive protein (
P
= 0.002), lower albumin (
P
< 0.001), lower GFR (
P
= 0.044), had more frequent atrial fibrillation (
P
< 0.001), and were less frequent actual smokers (
P
= 0.003). No differences in presence of diabetes and hypertension, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides between patients who died or survived were found. With Cox multivariable regression analysis age (
P
= 0.037), gender (
P
= 0.005), NIHSS at admission (
P
= 0.005) and discharge (
P
< 0.001), albumin (
P
= 0.005) and also GFR (
P
= 0.025) were predictors of 1-year mortality.
Conclusions
In patients with ischemic stroke, renal dysfunction (decreased GFR) was associated with 1-year mortality. GFR was independent predictor of mortality.
Background
Data on the relationship between gender and acute kidney injury (AKI) in patients with myocardial infarction (MI) undergoing percutaneous coronary intervention (PCI) are conflicting and ...inconclusive. The contrast volume-to-estimated glomerular filtration rate ratio (CV/GFR) was shown to predict AKI in patients with MI undergoing PCI. We assessed gender-based differences in AKI and evaluated the association between the CV/GFR and AKI in MI patients undergoing PCI.
Methods
We retrospectively studied 4675 consecutive patients with MI who underwent PCI between January 2007 and December 2015. The incidence of AKI and CV/GFR in men and women were compared. Data were analyzed using descriptive statistics.
Results
Women suffered more AKI than men 152 (10.5%) women suffered AKI compared to 252 (7.8%) men;
p
= 0.003. After adjustment for potential confounders, female gender was identified as an independent predictive factor for AKI. CV/GFR was higher in women (2.57 ± 1.95 in women vs. 2.25 ± 1.60 in men;
p
< 0.0001) and predicted AKI.
Conclusion
AKI occurs more often in women than men with MI undergoing PCI. Female gender independently predicted AKI in our analysis. A high CV/GFR denotes a group of patients who are at higher risk of AKI after PCI. CV/GFR was significantly higher in women, which may help to explain their worse outcome as regards AKI.
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