Effect of Chronic Kidney Diseases on Mortality among Digoxin Users Treated for Non-Valvular Atrial Fibrillation: A Nationwide Register-Based Retrospective Cohort Study.

PURPOSE: This study investigated the impact of chronic kidney disease on all-causes and cardiovascular mortality in patients with atrial fibrillation treated with digoxin. METHODS: All patients with non-valvular atrial fibrillation and/or atrial flutter as hospitalization diagnosis from January 1, 1997 to December 31, 2012 were identified in Danish nationwide administrative registries. Cox proportional hazard model was used to compare the adjusted risk of all-causes and cardiovascular mortality among patients with and without chronic kidney disease and among patients with different chronic kidney disease stages within 180 days and 2 years from the first digoxin prescription. RESULTS: We identified 37,981 patients receiving digoxin; 1884 patients had the diagnosis of chronic kidney disease. Cox regression analysis showed no statistically significant differences in all-causes (Hazard Ratio, HR 0.89; 95% confident interval, CI 0.78-1.03) and cardiovascular mortality (HR 0.88; 95%CI 0.74-1.05) among patients with and without chronic kidney disease within 180 days of follow-up period. No statistically significant differences was found using a 2 years follow-up period neither for all causes mortality (HR 0.90; 95%CI 0.79-1.03), nor for cardiovascular mortality (HR 0.87; 95%CI 0.74-1.02). No statistically significant differences was found comparing patients with and without estimated Glomerular Filtration Rate <30ml/min/1.73m2 and patients with different stages of chronic kidney disease, for all-causes and cardiovascular mortality within 180 days and 2 years from the first digoxin prescription. CONCLUSIONS: This study suggest no direct effect of chronic kidney disease and chronic kidney disease stages on all-causes and cardiovascular mortality within both 180 days and 2 years from the first digoxin prescription in patients treatment-naïve with digoxin for non-valvular atrial fibrillation

Effects of mast cell growth factor on Ara-C mediated acute myeloid leukemia cell killing.

Cell kinetic studies of acute myeloid leukemia (AML) have provided evidence for the presence of nonproliferating cells. Hemopoietic growth factors (GF) can regulate proliferation of leukemic cells, furnishing new possibilities for recruiting quiescent cells into the cycle and overcoming cytokinetic resistance in AML. To assess the role of the novel identified cytokine, mast cell growth factor (MGF), in enhancing cytosine arabinoside (Ara-C) cytotoxicity, we have primed AML blasts with MGF and then exposed these cells to the S phase specific agent Ara-C. Other growth factors such as PIXY, interleukin 3 (IL-3), granulocyte-macrophage colony stimulating factor (GM-CSF) and granulocyte CSF (G-CSF) and the combination of MGF plus PIXY were also tested. Cytokinetic changes and clonogenic growth of leukemic colony forming unit (CFU-L) cells in methylcellulose were used to detect proliferative and cytotoxic effects on AML blasts. Expression of MGF receptor, the c-kit protein, was also measured by flow cytometry. We report in this preliminary study that MGF is able to increase proliferation in 75% of the samples studied and enhance Ara-C cytotoxicity in some of these cases. When MGF proliferative activity was compared with other GFs, individual cases showed heterogeneity in response, although the combination of MGF plus PIXY was always the most effective