Outcomes and effectiveness of bilateral percutaneous transluminal renal artery stenting in patients with critical bilateral renal artery stenosis

Background: The aim of this study was to assess the effects of percutaneous bilateral renal artery stenting in patients with atherosclerotic renal artery stenosis and in-hospital and 4 month outcome of the procedure, focusing on the changes in renal function and blood pressure. Methods: Five consecutive patients (mean age: 64.8 ± 9.7 years, 1 women) with bilateral renal artery stenoses underwent percutaneous interventions. We compared blood pressure, number of oral antihypertensive medications, and renal function changes preprocedure and postprocedure at 4 months follow-up. Results: A total of 5 bilateral atherosclerotic renal artery stenosis patients underwent percutaneous transluminal renal angioplasty and 10 stents were placed. Although systolic and diastolic blood pressures were significantly decreased in follow-up period, glomerular filtration rates were not significantly changed as compared with baseline data (p = 0.009, p = 0.008, p = 1.00, respectively). Also, the number of oral antihypertensive medications were significantly decreased at follow-up period (p = 0.03). Conclusions: Bilateral renal artery stenting provides a beneficial outcome such as stabilization of renal functions, significant improvement in blood pressure control and reduction in the number of oral antihypertensive medications at follow-up

Acute effects of oral melatonin administration on arterial distensibility, as determined by carotid-femoral pulse wave velocity, in healthy young men

The aim of the present study was to investigate the effects of melatonin administration on arterial distensibility by using carotid-femoral (aortic) pulse wave velocity (PWV) measurements in healthy young men. Ten men were studied (five men in the melatonin group and five men in the placebo group) by physicians. Carotid-femoral (aortic) PWV, blood pressure and plasma melatonin were measured in the supine position before and 60 min after oral administration of melatonin or placebo. Although carotid-femoral (aortic) PWV, systolic blood pressure and mean blood pressure were decreased, pulse wave propagation time and plasma melatonin levels were increased at 60 min after oral melatonin (1 mg) administration (P=0.04, P=0.04, P=0.04, P=0.04 and P=0.04, respectively). No significant differences were found between all parameters in the placebo group (P>0.05). In conclusion, these findings indicate that melatonin administration, compared with placebo, decreased carotid-femoral PWV and systolic blood pressure in the supine position in healthy young men. Administration of melatonin may have an inhibitory effect on sympathetic tone. © 2006 Pulsus Group Inc. All rights reserved

Interaction between thienopyridines and proton pump inhibitors

© 2014 Bentham Science Publishers.Adenosin diphospat (ADP) plays a crucial role in thrombus formation. Therefore its inhibition can control excess platelet generation to prevent cardiovascular events in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). One of ADP’s target receptors, P2Y12 has a limited tissue distribution and is therefore an attractive pharmacological target. Thienopyridines are class of drugs that specifically and irreversibly inhibit the P2Y12 receptor. Three generations exist and in most patients, they are administered in combination with aspirin. Because of possible gastro-intestinal toxicity, a proton pump inhibitor (PPI) is often concomitantly prescribed. However, several studies suspect an interaction between thienopyridines (in particular with clopidogrel) and PPIs which decreases the inhibition of platelet formation and thus enhances the risk for cardiac events. In this review, a concise overview of pharmacokinetic and pharmacodynamic properties of all thienopyridines is given and a critical discussion of the presumed interaction with PPIs is provided

Impairment of arterial distensibility in premenopausal women with systemic lupus erythematosus

Background and aim: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease affecting young women and is associated with increased frequency of atherosclerotic vascular diseases. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. This study aimed to investigate arterial distensibility using carotid-femoral (aortic) PWV measurements in premenopausal women with SLE

Arterial distensibility in Wegener's granulomatosis: a carotid-femoral pulse wave velocity study

Objective: The purpose of this study was to test the hypothesis; that chronic inflammation may impair vascular function and lead to an increase of arterial pulse wave velocity (PWV) in patients with Wegener's granulomatosis (WG)

Original articleImpairment of arterial distensibility in premenopausal women with systemic lupus erythematosus

Background and aim: Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease affecting young women and is associated with increased frequency of atherosclerotic vascular diseases. Pulse wave velocity (PWV) is an index of arterial stiffness and a marker of cardiovascular events. This study aimed to investigate arterial distensibility using carotid-femoral (aortic) PWV measurements in premenopausal women with SLE. Methods: We recruited 24 premenopausal women with SLE (SLE duration: 5.3±4.6 years) and 24 age- and sex-matched controls. Aortic PWV was determined by using an automatic device, the Complior Colson (France), which allowed on-line pulse wave recording and automatic calculation of PWV. Results: The carotid-femoral PWV (8.98±2.05 vs. 8.05±0.94 m/s), systolic blood pressure (117.08±17.12 vs. 106.87±11.96 mmHg), pulse pressure (45.62±11.91 vs. 38.33±9.04 mmHg), heart rate (81.41±9.20 vs. 71.12±10.32 beat/min) and serum glucose levels (89.68±8.12 vs. 73.80±10.72 mg/dl) were significantly higher in premenopausal women with SLE, as compared with control subjects (p=0.04, p=0.02, p=0.02, p=0.001, pWstęp i cel: Toczeń rumieniowaty układowy (ang. systemic lupus erythematosus, SLE) jest przewlekłą chorobą zapalną o podłożu autoimmunologicznym, która często występuje u młodych kobiet i jest związana ze zwiększoną częstością występowania miażdżycy naczyń. Prędkość fali tętna (ang. pulse wave velocity, PWV) jest miarą sztywności naczyń tętniczych i ma znaczenie prognostyczne w przewidywaniu wystąpienia powikłań sercowo-naczyniowych. Niniejsze badanie miało na celu ocenę podatności naczyń tętniczych u miesiączkujących kobiet z SLE. Metody: Badaniem objęto 24 miesiączkujące kobiety z SLE (czas trwania choroby 5,3±4,6 roku) i 24 kobiety zdrowe, dopasowane pod względem wieku do grupy SLE. Podatność aorty zmierzono za pomocą automatycznego urządzenia Complior Colson (Francja), które pozwala na jednoczesną rejestrację fali tętna i automatyczne obliczanie PWV. Wyniki: Wartości szyjno-udowego PWV (8,98±2,05 vs 8,05±0,94 m/s), skurczowego ciśnienia tętniczego (117,08±17,12 vs 106,87±11,96 mmHg), ciśnienia tętna (45,62±11,91 vs 38,33±9,04 mmHg), częstotliwości rytmu serca (81,41±9,20 vs 71,12±10,32 uderzeń/min) i stężenia glukozy (89,68±8,12 vs 73,80±10,72 mg/dl) były istotnie wyższe u kobiet z SLE niż w grupie kontrolnej (odpowiednio: p=0,04, p=0,02, p=0,02, p=0,001,

Stent thrombosis - mythy and facts

© 2014 Bentham Science Publishers.Stent thrombosis is a serious complication in stent era. It can be presented as death, cardiogenic shock or a large non-fatal myocardial infarction, usually with ST elevation. Risks of stent thrombosis, stent thrombosis incidence and predictors are controversial issues due to sparse and controversial data. But all attending physicians should have knowledge of the risk of stent thrombosis, predisposing and protective factors before and after the intervention. This issue is discussed in detail in this review

Triple antiplatelet therapy after PCI - should or could it be done?

© 2014 Bentham Science Publishers.In case of coronary stenting in patients taking long-term oral anticoagulants (OAC), addition of both aspirin and clopidogrel in the drug regimen (so-called triple antiplatelet therapy) is recommended. However such triple therapy increases the risk of serious bleeding events. Comparative data on the efficacy and safety of the triple therapy versus therapy with a single antiplatelet agent and oral anticoagulants in case of coronary stenting are very rare. Most studies show a decreased stroke and myocardial infarction risk, but an increased risk of bleeding events in case of triple therapy. There is general agreement that, when possible, the duration of triple therapy should be shortened followed by clopidogrel and an oral anticoagulant to minimize bleeding risk without increasing other adverse events. In patients with a high risk of bleeding, BMS should be used and triple therapy should be applied for only 1month, followed by one antiplatelet agent and oral anticoagulant. The WOEST study was the first study showing that therapy with clopidogrel and OAC is safe and reduces bleeding and mortality more effectively than triple therapy including aspirin in patients undergoing coronary stenting. Although the risk of bleeding increases with triple therapy as compared to OAC plus a single antiplatelet agent, the second treatment regimen cannot be recommended to all patients. However for those at the highest risk of bleeding it is not unreasonable to consider. Additional randomized studies are needed for the implementation of future treatment guidelines in patients with high risk for bleeding and thrombotic complications

Association of Endogenous Melatonin with Uric Acid and Traditional Cardiovascular Risk Factors in Healthy Young Male

Background. Uric acid may act as an antioxidant; high serum uric acid levels are often associated with cardiovascular disease, such as coronary artery disease. Melatonin plays a role as a direct free radical scavenger and indirect antioxidant. No study has examined the relationships between endogenous melatonin and uric acid in order to predict the risk of future cardiovascular disease in male so far. To better characterize a possible relationship, we studied the association of endogenous melatonin with uric acid and traditional cardiovascular risk factors such as plasma lipids, and glucose in healthy young male