Clinical Outcome of Deep Vein Thrombosis Is Related to Thrombophilic Risk Factors

Deep vein thrombosis (DVT) and the associated possible complication of pulmonary artery embolism (LAE) represent a recognized reason for significant perioperative morbidity and mortality. There is a risk of pulmonary artery embolism through embolization. The aim of the study was to investigate the influence of various risk factors on the clinical outcome of the therapy, particularly regarding whether maintenance therapy offers a benefit in terms of the frequency of bleeding and thrombotic events. 80 patients were included, some of them retrospectively from July 2018. The observational period was set to 12 months after the DVT event. In the present sample with n = 80, with 57.5% men and 42.5% women (after 12 months of observation: n = 78), a success rate of the therapies administered of 89.7% was recorded. Only 8.9% showed partial recanalization. 3.8% of the patients had a relapse (also beyond the localization of the leg and pelvic veins) and 8.8% had a residual thrombus during the first 12 months of observation. In this study, BARC ( B leeding A cademic R esearch C onsortium) and HAS-BLED ( H ypertension, A bnormal renal and liver function, S troke, B leeding, L abile INR, E lderly, D rugs or alcohol) scores for identifying the risk of bleeding and Wells scores for assessing the risk of having a thrombosis were used. The Villalta score tested in this study showed significant correlations with residual thrombus ( P  < .001), recurrence within 12 months ( P  < .001), and the risk of bleeding ( P  < .001) and is capable to provide an assessment of the variables mentioned not only at the possible end of therapy but also at the start of anticoagulant therapy

The effect of spironolactone on diastolic function in haemodialysis patients

Heart failure with preserved ejection fraction (HFpEF) is highly prevalent in patients on maintenance haemodialysis (HD) and lacks effective treatment. We investigated the effect of spironolactone on cardiac structure and function with a specific focus on diastolic function parameters. The MiREnDa trial examined the effect of 50 mg spironolactone once daily versus placebo on left ventricular mass index (LVMi) among 97 HD patients during 40 weeks of treatment. In this echocardiographic substudy, diastolic function was assessed using predefined structural and functional parameters including E/e'. Changes in the frequency of HFpEF were analysed using the comprehensive 'HFA-PEFF score'. Complete echocardiographic assessment was available in 65 individuals (59.5 ± 13.0 years, 21.5% female) with preserved left ventricular ejection fraction (LVEF &amp;gt; 50%). At baseline, mean E/e' was 15.2 ± 7.8 and 37 (56.9%) patients fulfilled the criteria of HFpEF according to the HFA-PEFF score. There was no significant difference in mean change of E/e' between the spironolactone group and the placebo group (+ 0.93 ± 5.39 vs. + 1.52 ± 5.94, p = 0.68) or in mean change of left atrial volume index (LAVi) (1.9 ± 12.3 ml/