Cardiovascular Diabetology: Clinical, Metabolic and Inflammatory Facets /

The prevalence of obesity, metabolic syndrome and diabetes - three links of the same ‘atherothrombotic chain’ - has reached pandemic proportions worldwide. As a result, our civilization is at war against a threatening enemy: cardio-diabetes. Several independent physiological processes underlie the clustering of cardio-diabetes, including central obesity, insulin resistance, dyslipidemia, inflammation, impaired glucose tolerance, and hypertension. Early detection is of overwhelming importance for public health. The complex and intimate relationship between cardiovascular disease and diabetes from basic science to clinical and therapeutic concerns is discussed in this outstanding book. Beginning with molecular, biochemical, inflammatory and cellular aspects, this publication continues with histological and pathophysiological issues, details particular problems in specific metabolic and clinical settings, and finally analyzes several aspects of clinical pharmacology focusing on the optimal management of combined dyslipidemia and non-insulin antidiabetic therapy in cardiac diabetic patients. This book will be a gain in knowledge for every cardiologist, diabetologist, specialist in internal medicine, nutritionalist, general physician and medical student.New insights into an issue of growing concernThe prevalence of obesity, metabolic syndrome and diabetes - three links of the same ‘atherothrombotic chain’ - has reached pandemic proportions worldwide. As a result, our civilization is at war against a threatening enemy: cardio-diabetes. Several independent physiological processes underlie the clustering of cardio-diabetes, including central obesity, insulin resistance, dyslipidemia, inflammation, impaired glucose tolerance, and hypertension. Early detection is of overwhelming importance for public health. The complex and intimate relationship between cardiovascular disease and diabetes from basic science to clinical and therapeutic concerns is discussed in this outstanding book. Beginning with molecular, biochemical, inflammatory and cellular aspects, this publication continues with histological and pathophysiological issues, details particular problems in specific metabolic and clinical settings, and finally analyzes several aspects of clinical pharmacology focusing on the optimal management of combined dyslipidemia and non-insulin antidiabetic therapy in cardiac diabetic patients. This book will be a gain in knowledge for every cardiologist, diabetologist, specialist in internal medicine, nutritionalist, general physician and medical student.Print version recor

The efficacy of colchicine in the treatment of recurrent pericarditis related to postcardiac injury (postpericardiotomy and postinfarcted) syndrome: A multicenter analysis

Background: Pericarditis related to the postcardiac injury syndrome (PCIS) following myocardial infarction or cardiac surgery is a troublesome and often recurrent clinical entity resistant to therapeutic interventions. The usefulness of colchicine in the prevention of recurrent PCIS has not been evaluated. Objective: We performed a cumulative analysis of available multicenter data with the aim of evaluating the efficacy of colchicine in the treatment of recurrent PCIS. Methods and Results: The study was designed as a multicenter all-cases analysis. Researchers who had published studies and case reports on colchicine treatment in recurrent pericarditis related to PCIS during the last 15 years were approached and asked to contribute all available cases to the database. There were 28 patients, 18 male (64%) and 10 female (36%), ranging in age from 21 to 82 years (mean 53 \ub1 15 years). PCIS pericarditis was secondary to pericardiotomy in 19 patients and infarction in 9. In 21 patients (75%), colchicine therapy was discontinued during follow-up and renewed only in the case of relapse. In these patients, the total period of treatment was summed up for analysis. 7 patients (25%) were taking colchicine as a permanent treatment, and no colchicine-free follow-up was documented. In total, 130 recurrences (mean 4.64 \ub1 3.7 per patient, range 2-16) were noted before colchicine therapy was initiated. During colchicine treatment (mean duration of treatment 16.6 \ub1 13.5 months), a significant reduction in the number of recurrences was observed. Only 5 of 28 patients (18%) presented with new recurrences (mean 0.25 \ub1 0.59 vs. 4.64 \ub1 3.7 per patient in the precolchicine period, p < 0.001). The mean follow-up period after colchicine discontinuation (data were available for 21 patients) was 31.9 \ub1 28 months; during follow-up, 13 patients (62%) remained recurrence free and 8 of them (38%) experienced relapses (mean 0.43 \ub1 0.6 per patient, p < 0.001 vs. precolchicine). Conclusions: It seems that colchicine may be effective in preventing new relapses in patients with recurrent pericarditis related to postcardiac injury both during active therapy and after its discontinuation