bluuebunny/crossref_metadata_2025_split huggingface dataset:
Increased blood coagulation and platelet activation in patients with infective endocarditis and embolic events
Authors: Buyukasýk N. Semnur , Ileri Mehmet , Alper Aysin , Senen Kubilay , Atak Ramazan , Hisar Ismet , Yetkin Ertan , Turhan Hasan , Demirkan Deniz 
Published: June 2007

AbstractBackground: Inflammation‐induced procoagulant changes and alterations in platelet activity appear to play an important role in thromboembolic complications of infective endocarditis (IE).Hypothesis: The aim of this study was to investigate systemic coagulation activity, fibrinolytic capacity, and platelet activation in patients with IE with and without embolic events by measuring the plasma levels of prothrombin fragment 1+2 (PF1+2), thrombin‐antithrombin III complex (TAT), plasminogen activator inhibitor‐1 (PAI‐1), beta‐thromboglobulin (3‐TG), and platelet factor 4 (PF4), respectively.Methods: The study included 76 consecutive patients (female = 55, male = 21, mean age 26 years, range 8‐64 years) with definite IE according to the Duke criteria; of these, 13 (17.1%) had embolic events.Results: Plasma concentrations of PF1+2 (3.2 ± 1.3 vs. 1.7 ± 0.7 and 1.4 ± 0.7 nmol/l, p < 0.001, respectively) and TAT (7.3 ± 1.5 vs. 2.9 ± 1.2 and 2.2 ± 1.1 ng/ml, p < 0.001, respectively) were elevated in patients with embolic events compared with patients without embolic events and control subjects. Similarly, patients with embolic events had increased plasma levels of (3‐TG 63.3 ± 10.9 vs. 33.1 ± 11.6 and 19.1 ± 10.6 ng/ml, p < 0.001, respectively) and PF4 (106.0 ± 28.7 vs. 50.3 ± 16.7 and 43.0 ± 15.8 ng/ml, p < 0.001, respectively) compared with those without embolic events and the control group. Embolic patients also had higher PAI‐1 levels than nonembolic patients and healthy subjects (14.4 ± 6.4 vs. 8.6 ± 5.9 and 5.4 + 4.3 ng/ml, p = 0.002, respectively).Conclusion: Patients with IE and with subsequent thromboembolism have increased systemic coagulation activation, enhanced platelet activity/damage, and impaired fibrinolysis. The resulting imbalance produces a sustained hypercoagulable state, which contributes to the increased risk of thromboembolic events in this particular group.
The relation between preprocedural C‐reactive protein levels and early and late complications in patients with acute myocardial infarction undergoing interventional coronary angioplasty
Authors: Magadle R. , Hertz I. , Merlon H. , Weiner P. , Mohammedi I. , Robert D. 
Published: June 2007

AbstractBackground: Inflammation is an important feature of arteriosclerotic disease, and the vulnerability of coronary plaques in acute myocardial infarction (AMI) may be related to the levels of serum C‐reactive proteins (CRP). While some risk factors for early and late complications have been suggested, an accurate and definitive preprocedural risk stratiFICAtion of patients undergoing percutaneous transluminal coronary an‐gioplasty (PTCA) is still lacking.Hypothesis: The study was undertaken to investigate whether early and late complications after PTCA could be predicted by evaluation of baseline serum CRP levels in patients with AMI.Methods: Levels of serum CRP were measured in a total of 230 patients with AMI undergoing PTCA and provisional stent. They were divided into two groups: Group 1 (n = 48) with elevated CRP levels (≥5 mg/l) and Group 2 (n = 182) with normal CRP levels (< 5 mg/l).Results: There were no signiFICAnt differences in baseline clinical, angiographic, and procedural characteristics between the two groups. However, the incidence of in‐hospital adverse coronary events (reinfarction, coronary reocclusion, target vessel revascularization, and death) and severe left ventricular dysfunction was signiFICAntly higher in Group 1 (18.3 vs. 6.1%, p < 0.05 and 20.9 vs. 6.1%, p < 0.05, respectively). In addition, bailout stenting was performed more frequently in Group 1 than in Group 2 (60.4 vs. 36.3%, p < 0.005). No signiFICAnt late complications were noted. The serum levels of CRP were the only independent predictors of early adverse events.Conclusions: Preprocedural serum CRP level might be considered a powerful predictor of early but not late complications in patients undergoing PTCA/stent procedures.
Transforming growth factor β1genotype and change in left ventricular mass during antihypertensive treatment–results from the swedish irbesartan left ventricular hypertrophy investigation versus atenolol (Silvhia)
Authors: Hallberg Pär , Lind Lars , Billberger Katarina , Michaelsson Karl , Karlsson Julia , Kurland Lisa , Kahan Thomas , Malmqvist Karin , Öhman K. Peter , Nyström Fredrik , Liljedahl Ulrika , Syvänen Ann‐Christine , Melhus Håkan 
Published: June 2007

AbstractBackground: Angiotensin II, via the angiotensin II type 1 (AT1) receptor, may mediate myocardial fibrosis and myocyte hypertrophy seen in hypertensive left ventricular (LV) hypertrophy through production of transforming growth factor β1(TGF‐β1); AT1‐receptor antagonists reverse these changes. The TGF‐(β1G + 915C polymorphism is associated with in‐terindividual variation in TGF‐ β1production. No study has yet determined the impact of this polymorphism on the response to antihypertensive treatment.Hypothesis: We aimed to determine whether the TGF‐ β1G + 915C polymorphism was related to change in LV mass during antihypertensive treatment with either an AT1‐receptor antagonists or a beta1 ‐adrenoceptor blocker. The polymorphism was hypothesized to have an impact mainly on the irbesartan group.Methods: We determined the association between the TGF‐β1genotype and regression of LV mass in 90 patients with essential hypertension and echocardiographically diagnosed LV hypertrophy, randomized in a double‐blind study to receive treatment for 48 weeks with either the AT1‐receptor antagonist irbesartan or the beta1 ‐adrenoceptor blocker atenolol.Results: Irbesartan‐treated patients who were carriers of the C‐allele, which is associated with low expression of TGF‐β1, responded with a markedly greater decrease in LV mass index (LVMI) than subjects with the G/G genotype (adjusted mean change in LVMI –44.7 g/m2vs. –22.2 g/m2, p = 0.007), independent of blood pressure reduction. No association between genotype and change in LVMI was observed in the atenolol group.Conclusions: The TGF‐ β1G + 915C polymorphism is related to the change in LVMI in response to antihypertensive treatment with the AT1‐receptor antagonist irbesartan.
Dynamic assessment of myocardial involvement in patients with end‐stage renal disease by ultrasonic tissue characterization and serum markers of collagen metabolism
Authors: Fatema Kaniz , Hirono Osamu , Masakane Ikuto , Nitobe Joji , Kaneko Kazuyoshi , Zhang Xuehua , Takeishi Yasuchika , Kubota Isao 
Published: June 2007

AbstractBackground: Congestive heart failure is the most common cause of mortality in patients with end‐stage renal disease (ESRD). However, noninvasive assessment for cardiac involvement in ESRD has not been established.Hypothesis: Assessment of ultrasonic tissue characterization and serum markers of collagen degradation is useful for defining myocardial involvement in ESRD.Methods: Cyclic variation of ultrasonic integrated back‐scatter of the ventricular septum (CV‐IBS) and the serum levels of free matrix metalloproteinase‐I (MMP‐I) and tissue inhibitor of metalloproteinase‐I (TIMP‐I) were measured in 30 patients with ESRD undergoing routine hemodialysis (HD) and in 40 patients with essential hypertension (HTN).Results: Compared with the group with HTN, ESRD (before HD) showed larger left ventricular (LV) mass index (217 ± 56 vs. 146 ± 45 g/m2, p < 0.01), worse LV diastolic function (E/A, 0.6 ± 0.2 vs. 0.9 ± 0.3, p < 0.05), smaller CV‐IBS (9.0 ± 1.3 vs. 12.4 ± 0.9 dB, p < 0.01), and larger TIMP‐I/MMP‐I (46 ± 10 vs. 34 ± 10, p < 0.05), in spite of the comparable ventricular wall thickness. Thus, these indices may possibly reflect myocardial interstitial fibrosis. After HD (after the improvement of myocardial interstitial edema), a negative linear relationship between CV‐IBS and TIMP‐I/MMP‐I was observed (r = −0.52, p< 0.05).Conclusions: Noninvasive assessment of ultrasonic tissue characterization and serum markers of collagen type I degradation may be a new diagnostic tool for defining myocardial interstitial fibrosis in patients with ESRD and LV hypertrophy.
Patterns of congenital heart disease in unoperated adults: A 20‐year experience in a developing country
Authors: Hannoush Hwaida , Tamim Hala , Younes Hussein , Arnaout Samir , Gharzeddine Walid , Dakik Habib , Obeid Mounir , Bitar Fadi F. 
Published: June 2007

AbstractBackground: The number of patients with congenital cardiac disease reaching adulthood is increasing steadily. Many adults with such disease face both medical and surgical difficulties.Hypothesis: This retrospective study was undertaken to assess the frequency and outcome of congenital heart disease (CHD) in unoperated adults.Methods: The charts of all patients with unoperated CHD, who were admitted to a tertiary care center in Beirut, Lebanon, between 1980 and 2000 were reviewed. Of these, 206 patients (52% men, age at admittance 18–71 years [32.8 ± 13.3 years]) with a diagnosis of CHD were evaluated. Atrial septal defect (ASD) was the most common cardiac malformation with a relative frequency of 53%, followed by ventricular septal defects (11%), tetralogy of Fallot (11%), aortic anomalies (7%), pulmonary stenosis (6%), and Ebstein anomaly (4%). Most patients were symptomatic upon presentation, with dyspnea on exertion being the most common presenting symptom. Twenty‐seven patients (13%) had cyanotic CHD. Of 179 acyanotic patients, 113 (63%), and 17 of 27 cyanotic patients (63%) underwent surgical intervention. In‐hospital surgical complications for the acyanotic group included cerebrovascu‐lar accident (2%) and heart block (1%). Total surgical mortality was 4 of 130 (3%). One patient with tetralogy of Fallot presented with endocarditis and died.Conclusion: Atrial septal defect is the most common defect reported in our experience; however, it occurs more frequently than that reported in the literature. Although most patients were symptomatic on presentation, their functional status was stable. Accordingly, their hospital course, whether managed medically or surgically, held a relatively low complication rate. This could be attributed to the uncomplicated nature of pathologies in our series. The surgical mortality and in‐hospital complications were slighter higher than those reported for similar lesions if repaired during childhood. This study reflects the relative frequency of various cardiac malformations in selected patients with “grown up” congenital heart disease (GUCH) and their natural survival pattern.
Lipoprotein(a): New insights into mechanisms of atherogenesis and thrombosis
Authors: Deb Arjun , Caplice Noel M. 
Published: June 2007

AbstractLipoprotein(a) (Lp[a]) continues to be a controversial molecule regarding its role in human vascular disease. Although the physiologic role of this molecule is still unclear, novel discoveries within the last few years have suggested numerous mechanisms whereby Lp(a) may contribute to atherosclerosis and its complications in human subjects. These effects may differentially occur in vascular tissue and circulating blood compartments. A complex interplay between tissue‐specific effects is probably more relevant to the pathogenicity of this molecule than one single effect alone. This review briefly describes the structure of Lp(a) in relation to its biochemical function, summarizing the current literature on various patho‐physiologic mechanisms of Lp(a)‐induced vascular disease and the role of cell and tissue‐specific effects in promoting atherogenesis and thrombosis.
Plasma vascular endothelial growth factor level is elevated in patients with multivessel coronary artery disease
Authors: Nakajima Kei , Tabata Shinji , Yamashita Takeshi , Kusuhara Masatoshi , Arakawa Koh , Ohmori Reiko , Yonemura Atsushi , Higashi Kenji , Ayaori Makoto , Nakamura Haruo , Ohsuzu Fumio 
Published: June 2007

AbstractBackground: Vascular endothelial growth factor (VEGF) has been implicated in both angiogenesis and ischemia. However, the relationship between plasma VEGF level and coronary artery disease remains unknown.Hypothesis: Plasma VEGF level may be associated with severe coronary artery disease and other cardiovascular risk factors.Methods: We examined plasma VEGF concentration and coronary risk factors in 73 patients who underwent coronary angiography and 70 apparently healthy control subjects. According to the number of the three major coronary vessels with significant (≥ 75%) stenosis, we divided the patients into two groups: the mild stenosis group (0‐ and single‐vessel disease, n = 36) and the severe stenosis group (double‐ and triple‐vessel disease, n = 37).Results: The log VEGF value of the severe stenosis group was significantly higher than that of the mild stenosis (p < 0.05) and control groups (p < 0.05). Furthermore, there was a significant positive trend in the log VEGF value according to the number of vessels with significant stenosis (p = 0.016). However, there was no significant difference in log VEGF value between the mild stenosis and control groups. Soluble vascular cellular adhesion molecule, soluble intracellular adhesion molecule, and other coronary risk factors were found to be associated with the presence of vessel stenosis.Conclusion: Unlike established coronary risk factors, the plasma VEGF level may be associated with only severe coronary ischemia such as multiple coronary vessel disease.
Gender as a risk factor for contrast nephropathy: Effects of hydration and N‐acetylcysteine
Authors: Gill Nikita K. , Piccione Elizabeth A. , Vido Diane A. , Clark Barbara A. , Shannon Richard P. 
Published: June 2007

AbstractBackground: In a few studies, N‐acetylcysteine has been shown to prevent contrast‐induced nephropathy in patients with chronic, stable renal failure undergoing elective procedures. Other studies have shown variable outcomes. Furthermore, the majority of prior studies have mainly studied men, and gender as a risk factor has not been studied.Hypothesis: The study sought to evaluate the effectiveness of N‐acetylcysteine and hydration in unselected patients with both acute and stable renal insufficiency (RI) undergoing urgent or elective cardiac or peripheral angiography.Methods: We evaluated records of 146 patients with RI undergoing angiography. We compared patients receiving periprocedure hydration and acetylcysteine with patients who were only hydrated or received no pretreatment. We evaluated the 48‐h change in serum creatinine between groups and further analyzed the effect of hydration and gender on outcomes.Results: Demographics and baseline creatinine were similar between groups. Post procedure, the creatinine increased significantly in both groups, but less so in the acetylcysteine group (control: 0.35 ± 0.08 mg/dl; acetylcysteine: 0.14 ± 0.04 mg/dl, p < 0.05). When the control group was further stratified by hydration, the increase in creatinine for the hydrated patients was only 0.17 ± 0.10 mg/dl compared with 0.54 ± 0.12 mg/dl in patients with inadequate hydration. In the control group, women were more likely to receive no preprocedural hydration (59 vs. 40%), had a bigger rise in creatinine, received less protection from hydration alone, but were equally well protected by hydration plus acetylcysteine. In the acetylcysteine group, change in creatinine for women was minimal (+ 0.14 ± 0.07 mg/dl) and not different from men (+ 0.15 ± 0.05).Conclusion: Unselected patients with acute and chronic RI had no benefit from acetylcysteine beyond that seen with hydration alone. Gender may be a risk factor for contrast‐induced nephropathy, with hydration offering less protection in women. Acetylcysteine (with hydration) seems to minimize the gender difference.
Characteristics of contemporary patients with hypertension and coronary artery disease
Authors: Cooper‐DeHoff Rhonda M. , Handberg Eileen M. , Cohen Jerome , Kowey Peter , Messerli Franz H. , Mancia Giuseppe , Cangiano Jose L. , Gaxiola Efrain , Garcia‐Barreto David , Hewkin Ann C. , Pepine Carl J. 
Published: June 2007

AbstractBackground: Despite a high prevalence of hypertension in the population with CAD, there are limited data describing the clinical characteristics and treatments, as well as their interrelations in these patients. This is particularly true for black and Hispanic patients who have been underrepresented in randomized CAD trials.Hypothesis: There exist racial and ethnic differences that define the characteristics of patients with both coronary artery disease (CAD) and hypertension.Methods: This report describes the characteristics of Caucasian, Hispanic, and black patients enrolled in the International Verapamil SR/trandolapril Study (INVEST), a prospective trial undertaken exclusively in patients with CAD and hypertension.Results: In all, 10,925 Caucasian, 8,045 Hispanic, and 3,029 black patients are described. An abnormal angiogram or documented myocardial infarction was observed more frequently in Caucasian patients (73%), while angina pectoris was more prevalent in Hispanic patients (87%). Diabetes and left ventricular hypertrophy were most common in black patients (33 and 29%, respectively), while hypercholesterolemia and prior revascularization (coronary artery bypass graft or angioplasty) were most common in Caucasian patients (64 and 41%, respectively). More than 60% of Hispanic and black patients were women—a unique characteristic for randomized CAD trials. Comparing race/ethnic cohorts, there were significant differences for all characteristics. More than 80% of patients in all race/ethnic groups were receiving antihypertensive therapy; however, only fewer than 25% had controlled blood pressure according to guidelines from the sixth report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.Conclusions: This high‐risk population of hypertensive patients with CAD has been undertreated and does not have well‐controlled B P. Race/ethnic differences were observed for clinical characteristics and medication use.
Dyslipidemia in patients with angiographically confirmed coronary artery disease—an opportunity for improvement
Authors: Khanal Sanjaya , Obeidat Omar , Lu Mei , Douthat Lori , Hudson Michael P. , Greenbaum Adam B. , Kugelmass Aaron , Weaver W. Douglas 
Published: June 2007

AbstractBackground: There are few data about lipid profiles in unselected patients with angiographically confirmed coronary artery disease (CAD).Hypothesis: The study was undertaken to investigate the demographics, clinical characteristics, angiographic findings, and baseline lipid status of 1,000 consecutive unselected patients with angiographically confirmed CAD.Methods: Between April 2001 and July 2002, we obtained informed consent and prospectively collected clinical characteristics, fasting lipid profiles, and angiographic results from 1,000 sequential patients with CAD confirmed by angiography.Results: In these patients with confirmed CAD, 78% had history of hyperlipidemia. Although 62% were receiving lip‐id‐lowering therapy, only 46% had a low‐density lipoprotein target of < 100 mg/dl, and only 20% had achieved all four National Cholesterol Education Program‐recommended lip‐id targets.Conclusions: Better strategies to ensure optimal lipid levels are required. One such method using computerized workflow is being evaluated in this population.
An oxidized low‐density lipoprotein receptor gene variant is inversely associated with the severity of coronary artery disease
Authors: Ohmori Reiko , Momiyama Yukihiko , Nagano Makoto , Taniguchi Hiroaki , Egashira Tohru , Yonemura Atsushi , Nakamura Haruo , Kondo Kazuo , Ohsuzu Fumitaka 
Published: June 2007

AbstractBackground: A lectin‐like oxidized low‐density lipoprotein (LDL) receptor‐1 (LOX‐1) is the major receptor of oxidized LDL in endothelial cells. The expression of LOX‐1 was shown to be upregulated in atherosclerotic lesions. Recently, LOX‐1 gene polymorphism (G501C) was reported to be associated with myocardial infarction (MI).Hypothesis: Our study was undertaken to elucidate the association between this polymorphism and coronary artery disease (CAD).Methods: We evaluated LOX‐1 gene polymorphism using Invader assay in 586 patients undergoing coronary angiography.Results: Study patients were categorized into three groups: normal/minimal stenosis (≤25%) (n = 128); mild stenosis (26‐50%) (n = 39); and significant stenosis (> 50%) (n = 419). Of the 419 patients with significant stenosis, 163 had single‐vessel, 165 had double‐vessel, and 91 had triple‐vessel disease. Myocardial infarction was present in 171 patients. The frequency of LOX‐1 gene variants (C/C or C/G) was lower in patients with significant than in those with normal/minimal stenosis (36 vs. 49%, p < 0.01). The frequency of LOX‐1 gene variants did not differ between patients with and without MI (34 vs. 37%). However, a stepwise decrease in the frequency of such variants was found depending on the severity of CAD: 49% in normal/minimal stenosis, 41% in mild stenosis, 39% in single‐vessel, 35% in double‐vessel, and 32% in triple‐vessel disease. Multivariate analysis demonstrated LOX‐1 gene variants to be inversely associated with the presence of significant stenosis (odds ratio = 0.61; 95% confidence interval = 0.41‐0.92).Conclusions: The LOX‐1 gene variants at 501 were found to be inversely associated with the severity of CAD. This polymorphism may be modifying the severity of CAD.
Prognostic value of heterogeneity of ventricular repolarization in survivors of acute myocardial infarction
Authors: Batchvarov Velislav N. , Hnatkova Katerina , Poloniecki Jan , Camm A. John , Malik Marek 
Published: June 2007

AbstractBackground: The expansion of indications for implantation of cardioverter‐defibrillators (ICD) has enhanced the need for risk stratification of patients post myocardial infarction (MI), while the improved treatment of acute MI has decreased mortality and diminished the prognostic power of traditional risk variables.Hypothesis: Increased heterogeneity of ventricular repolarization quantified by TCRT (total cosine R‐to‐T, angular difference between spatial QRS and T loops, decreased with increase in repolarization heterogeneity) is an independent predictor of mortality in patients post MI.Methods: Left ventricular ejection fraction (EF), QRS duration on signal‐averaged ECG, number of ventricular ectopic beats (VE)/h, heart rate variability (HRV) triangular index, heart rate turbulence slope on 24‐h Holter recording, and TCRT were analyzed in 334 survivors of acute MI followed up for 41 ± 20 months.Results: In multivariate analysis, EF < 35% (relative risk [RR] 2.3, 95% confidence interval [CI] 1.1‐4.7, p = 0.023), VE > 10/h (RR 2.2, CI 1.0‐4.6, p = 0.044), HRV < 20 U (RR 2.2, CI 1.1‐4.5, p = 0.032), and TCRT < −0.896 (RR 4.3, CI 2.2‐8.5, p = 0.00001) were independent predictors of cardiac mortality (11%). Independent predictors of arrhythmic mortality (5%) were VE, HRV, and TCRT (RR 5.8, CI 2.1‐15.6, p = 0.0004). Cardiac and arrhythmic mortality of patients with both EF < 35% and TCRT < −0.896 were > 60 and > 30%, respectively, compared with 17 and 7% in those with only EF < 35% or TCRT < −0.896.Conclusion: Decreased TCRT, which reflects increased repolarization heterogeneity, is a strong and independent predictor of cardiac and arrhythmic death in patients post MI.