Physiological and Pathological Vascular Aging

Aging is a risk factor for cardiovascular diseases. Through aging, blood vessels become stiffer, less elastic and, thus, with less ability to contract. The objectives of this chapter are to review (i) recent progresses in the characterization of physiological and pathological vascular aging and (ii) in vitro platforms to study vascular aging. Initially, we will discuss the causes and biomarkers of vascular aging. Then we will discuss the main characteristics related to physiological and pathological aging including (i) altered ECM remodeling (e.g. composition, mechanical properties, degradation, calcification of the ECM during aging), (ii) enhanced fibrosis (e.g. causes and mechanisms), (iii) vascular cell dysfunction triggered by chronic oxidative stress, inflammation or senescence, and (iv) altered responses of vascular cells to flow shear stress. Finally, we will discuss in vitro systems to study vascular aging, particularly the effect of biomechanics in aged cells as well as the effect of drugs during vascular aging

Safety of Nonsteroidal Anti-inflammatory Drugs in Major Gastrointestinal Surgery: A Prospective, Multicenter Cohort Study

Background Significant safety concerns remain surrounding the use of nonsteroidal anti-inflammatory drugs (NSAIDs) following gastrointestinal surgery, leading to wide variation in their use. This study aimed to determine the safety profile of NSAIDs after major gastrointestinal surgery. Methods Consecutive patients undergoing elective or emergency abdominal surgery with a minimum one-night stay during a 3-month study period were eligible for inclusion. The administration of any NSAID within 3 days following surgery was the main independent variable. The primary outcome measure was the 30-day postoperative major complication rate, as defined by the Clavien–Dindo classification (Clavien–Dindo III–V). Propensity matching with multivariable logistic regression was used to produce odds ratios (OR) and 95 % confidence intervals. Results From 9264 patients, 23.9 % (n = 2212) received postoperative NSAIDs. The overall major complication rate was 11.5 % (n = 1067). Following propensity matching and adjustment, use of NSAIDs were not significantly associated with any increase in major complications (OR 0.90, 0.60–1.34, p = 0.560). Conclusions Early use of postoperative NSAIDs was not associated with an increase in major complications following gastrointestinal surgery