1,721,090 research outputs found
Cystatin C and Cardiovascular Risk
No full textPatients with chronic kidney disease (CKD) are at high risk for developing cardiovascular disease (CVD) and cardiovascular events. Cystatin C, a protease inhibitor synthesized in all nucleated cells, has been proposed as a replacement for serum creatinine for the assessment of renal function, particularly to detect small reductions in glomerular filtration rate. CONTENT: This report presents a review of the role of cystatin C as a predictor of cardiovascular risk. SUMMARY: Patients with higher circulating cystatin C concentrations appear to have an increased cardiovascular risk profile, i.e., they are older and have a higher prevalence of systemic hypertension, dyslipidemia, documented CVD, increased body mass index, and increased concentrations of C-reactive protein. Prospective studies have shown, in various clinical scenarios, that patients with increased cystatin C are at a higher risk of developing both CVD and CKD. Importantly, cystatin C appears to be a useful marker for identifying individuals at a higher risk for cardiovascular events among patients belonging to a relatively low-risk category as assessed by both creatinine and estimated glomerular filtration rate values. Of interest, elastolytic proteases and their inhibitors, in particular cystatin C, have been shown to be directly involved in the atherosclerotic process. Increased concentrations of cystatin C appear to be indicative of preclinical kidney disease associated with adverse outcomes. Clinical studies involving direct glomerular filtration rate measurements are required to ascertain both the true role of this promising marker in renal disease and whether atherogenic factors like inflammation can account for increases in cystatin C concentrations, thus explaining its predictive value in CV
[Cystatin C and cardiovascular risk.
No full textPatients with chronic kidney disease (CKD) are at high risk for developing cardiovascular disease (CVD) and cardiovascular events. Cystatin C, a protease inhibitor synthesized in all nucleated ceils, has been proposed as a replacement for serum creatinine for the assessment of renal function, particularly to detect small reductions in glomerular filtration rate. This report presents a review of the role of cystatin C as a predictor of cardiovascularis. Patients with higher circulating cystatin C concentrations appear to have an increased cardiovascular risk profile, i.e., they are older and have a higher prevalence of systemic hypertension, dyslipidemia, documented CVD, increased body mass index, and increased concentrations of C-reactive protein. Prospective studies have shown, in various clinical scenarios, that patients with increased cystatin C are at a higher risk of developing both CVD and CKI). Importantly, cystatin C appears to be a useful marker or identifying individuals at a higher risk of cardiovascular events among patients belonging ot a reltively lox-risk category as assessed by both creatinine and estimated glomerular filtration rate values. Of interest, elastolytic proteases and their inhibitors, in particular cystatin C, have been shown to be directly involved in the atherosclerotic process. Increases concentrations of cystatin C appear to be indicative of preclinical kidney disease associated with adverse outcomes. Clinical studies involving direct glomerular filtration rate measurements are required to ascertain both the true role of this promising marker in renal disease and whether atherogenic factors like inflammation can account for increases in cystatin C concentrations, thus explaing its predictive value in CVD
Cistatina C and rischio cardiovascolare
No full textPatients with chronic kidney disease (CKD) are at high risk for developing cardiovascular disease (CVD) and cardiovascular events. Cystatin C, a protease inhibitor synthesized in all nucleated cells, has been proposed as a replacement for serum creatinine for the assessment of renal function, particularly to detect small reductions in glomerular filtration rate. This report presents a review of the role of cystatin C as a predictor of cardiovascular risk. Patients with higher circulating cystatin C concentrations appear to have an increased cardiovascular risk profile, i.e., they are older and have a higher prevalence of systemic hypertension, dyslipidemia, documented CVD, increased body mass index, and increased concentrations of C-reactive protein. Prospective studies have shown, in various clinical scenarios, that patients with increased cystatin C are at a higher risk of developing both CVD and CKD. Importantly, cystatin C appears to be a useful marker for identifying individuals at a higher risk for cardiovascular events among patients belonging to a relatively low-risk category as assessed by both creatinine and estimated glomerular filtration rate values. Of interest, elastolytic proteases and their inhibitors, in particular cystatin C, have been shown to be directly involved in the atherosclerotic process. Increased concentrations of cystatin C appear to be indicative of preclinical kidney disease associated with adverse outcomes. Clinical studies involving direct glomerular filtration rate measurements are required to ascertain both the true role of this promising marker in renal disease and whether atherogenic factors like inflammation can account for increases in cystatin C concentrations, thus explaining its predictive value in CV
Prognostic Significance of Baseline White Blood Cell Count in Patients with Non-ST-Segment Elevation Acute Coronary Syndrome.
No full textNo abstract availabl
Balloon pulmonary angioplasty after pulmonary thromboendarterectomy
Full text link.Pulmonary thromboendarterectomy (PTE) is the treatment of choice for patients with chronic thromboembolic pulmonary hypertension (CTEPH) as it can remove the chronic, fibrotic, flow-limiting organized thrombi within the pulmonary arterial bed, addressing the primum movens of the disease (1). Despite significant improvement in all haemodynamic parameters, residual pulmonary hypertension (PH) is frequent after PTE, ranging from 17% to 31% (2,3). There is no clear definition of residual PH after PTE, and the actual incidence of this condition has been difficult to quantify. Usually, moderate residual PH is well tolerated by patients and, as shown by data from the United Kingdom cohort, clinically relevant residual PH after PTE mainly occur when the mean pulmonary arterial pressure (mPAP) is greater than 30–35 mmHg (3). The risk of persistent/recurrent PH in the long-term underlines the importance of a systematic patient follow-up, even after PTE. Balloon pulmonary angioplasty (BPA) has been developed as a compassionate procedure for symptomatic patients with CTEPH who are ineligible for surgery or with persistent/recurrent PH after PTE. BPA is not able to remove clots as PTE, but it is able to restore the flow by fragmenting the thrombotic and fibrotic material, resulting in hemodynamic and clinical improvement. Selection of good candidates for BPA, especially after PTE, includes a complete re-assessment of the patient with persistent symptomatic PH after PTE at least four to six months after surgery using high quality imaging techniques such as computed tomography pulmonary angiography (CTPA), selective pulmonary angiography (to provide fine details) and right heart catheterization (RHC) to assess the hemodynamic impairment. However, these imaging techniques are not widely available and require expertise
Predicting and improving outcomes of transcatheter aortic valve replacement in older adults and the elderly
No full textIntroduction: Indications for transcatheter aortic valve replacement (TAVR) are progressively extending
to younger and lower risk patients. In this scenario, minimizing periprocedural complications and
optimizing procedural result are both crucial to achieve an excellent long-term outcome.
Areas covered: In this review, we summarize the main strategies that can be adopted before, during,
and after TAVR to predict and prevent complications, to optimize procedural results and ultimately
improve outcomes, with an emphasis on more recent evidence, new devices, and new techniques.
Expert opinion: In the next future TAVR will probably represent the first treatment option for patients
affected by aortic valve stenosis who are candidates to receive a biological valve. Continuous refinement
of TAVR devices has been key to allow safer and most effective procedures and further progress is
expected. Development of new techniques and devices, such as ultrasound-guided puncture and
intravascular lithotripsy, will expand safety and eligibility to transfemoral procedures. Effective preemptive
measures for coronary occlusion have been developed. Open issues include cerebral protection,
re-access to coronary arteries, post-procedural management, and therapy
Left Ventricular Function After ST-Elevation Myocardial Infarction in Patients Treated With Primary Coronary Angioplasty and Abciximab or Tirofiban: Insights From the Facilitated Angioplasty with Tirofiban or Abciximab (FATA) Randomized Trial
No full textTranscatheter Aortic Valve Replacement for Pure Aortic Regurgitation in a Large and Noncalcified Annulus
No full textn.
Peripheral arterial disease and long-term mortality following acute coronary syndromes: insights from a large registry of unselected patients
No full text- …
