2 research outputs found
The multiplicative interactions of leukocyte counts with some other risk factors enhance the prognostic value for coronary artery disease
Background: The markers of inflammation and (apo)lipoproteins are associated with coronary
artery disease (CAD). Simultaneous assessment of the risk factors has been proposed to
improve the diagnosis of CAD. The aim of this study was to examine the potential interactions
between leukocyte counts and other risk factors.
Methods: The markers of inflammation, (apo)(lipo)proteins, (non)electrolytes, hematological
parameters and classical risk factors, were determined in 264 clinically stable angiographically
documented subjects. The subjects were classified as CAD cases or controls according to the
results of coronary angiography.
Results: The frequency and severity of CAD, Framingham CAD scores, relative and absolute
risk for CAD and the prevalence of diabetes mellitus and smoking were significantly higher in
the third relative to the first tertile of leukocyte counts. Subjects with leukocyte counts in the
upper tertile had significant higher levels of serum glucose, triglyceride, hsC-reactive protein,
potassium, phosphorus and measured osmolality, and lower levels of apoAI, total protein,
albumin and the ratio of albumin/globulins. Analyses by bivariate correlation on differential
leukocyte counts showed that these associations are carried mostly by neutrophil, except for
diabetes, glucose and triglyceride which were due to lymphocyte counts. By constructing dummy
combined variables, high leukocyte counts accompanied by smoking, hypertension, diabetes,
and high levels of serum glucose, cholesterol, apoB and apoB/apoAI ratio, exhibited amplified
high risk for CAD.
Conclusions: The results show that leukocyte count does interact multiplicatively with smoking,
hypertension, diabetes, glucose, cholesterol, apoB and apoB/AI ratio. The simultaneous
assessment of leukocyte counts and interactive risk factors enhances the diagnosis of CAD.
(Cardiol J 2011; 18, 3: 246–253
Pharmacokinetic Parameters and Over-Responsiveness of Iranian Population to Propranolol
Purpose: Propranolol is the most widely
used treatment for cardiovascular diseases. Dosage range in our patients is
usually less than the amount mentioned in references. The aim of the present
study was to clarify whether pharmacokinetic differences are able to justify
the need for the fewer doses in our patients or not.
Methods: Twenty
healthy volunteers (10 male) at heart center of Mazandaran University of
Medical Sciences were studied. Samples of blood were collected before a single
oral dose (40 mg) of Propranolol. Blood samples were taken up to 9 hours after
dose. Total plasma concentration of Propranolol was
measured by HPLC. Population Pharmacokinetic analysis was performed using
population pharmacokinetics modeling software P-Pharm.
Results: The mean value for oral plasma
clearance (CL/F) was 126.59 ml/hr. The corresponding values for apparent volume of distribution
(V/F), t1/2 beta, maximum blood concentration (C
max), and time to reach the maximum blood concentration (T max) were 334.12
Lit, 1.98 hr, 40.25 ng/ml, and 1.68 hr, respectively. The observed mean values
of V/F of propranolol in the present study were comparable with those reported
in the literature. However, the mean values of CL/F of propranolol in current
study was significantly higher than those reported in other population
(P-value<0.001).
Conclusion: This study has confirmed that the pharmacokinetic
differences are not able to justify over-responsiveness of Iranian population
to propranolol. Pharmacodynamic differences in responding to beta blocker drugs
by Renin secretion or having a different sensibility to beta receptors might
play a role in making our population have a different response to propranolol