Aspirin, other antiplatelet agents, and anticoagulant drugs are used across a wide spectrum of cardiovascular and cerebrovascular diseases. A concomitant proton pump inhibitor (PPI) treatment is often prescribed in these patients, as gastrointestinal complications are relatively frequent. On the other hand, a potential increased risk of cardiovascular events has been suggested in patients treated with PPIs; in particular, it has been discussed whether these drugs may reduce the cardiovascular protection of clopidogrel, due to pharmacodynamic and pharmacokinetic interactions through hepatic metabolism.
View Article and Find Full Text PDFBackground: Although the prognosis of patients with Takotsubo syndrome (TTS) is relatively favorable, serious complications may occur. This study aimed to investigate the relationship between blood parameters and the occurrence of in-hospital complications.
Methods: Clinical charts of 51 patients with TTS were retrospectively evaluated, and data regarding blood parameters assessed during the first 24 hours of hospitalization were studied.
Background: Since 2010, the European Society of Cardiology has extended prescription criteria for oral antithrombotic therapy (OAT) in atrial fibrillation (AF). Direct oral anticoagulants (DOACs) were upgraded from an IIAa recommendation in 2012 to an IA in 2016. In real-world scenarios, however, OAC prescription is still suboptimal, mainly for DOACs.
View Article and Find Full Text PDFThe impact of phytochemicals, as green tea catechins, on body composition measures has become a relevant topic as ongoing epidemiological evidence suggests their potential role in weight loss. Although catechins have been shown to modulate fat and energy metabolism, clinical effects of green tea consumption still remain controversial. Given the role played by physical exercise in weight management, it is important to determine whether the association of catechins and exercise is able to improve outcomes over and above the beneficial effects of exercise alone.
View Article and Find Full Text PDFClassical risk factors only partially account for variations in cardiovascular disease incidence; therefore, also other so far unknown features, among which meteorological factors, may influence heart diseases (mainly coronary heart diseases, but also heart failure, arrhythmias, aortic dissection and stroke) rates. The most studied phenomenon is ambient temperature. The relation between mortality, as well as cardiovascular diseases incidence, and temperature appears graphically as a ''U'' shape.
View Article and Find Full Text PDFBackground: Conflicting results have been described in the scientific literature regarding the relationship between electrocardiographic parameters and complications in patients with Takotsubo syndrome (TTS). Aim of the present study was to investigate whether there is an association between markers of ventricular repolarization and major adverse cardiovascular events (MACE) during hospitalisation.
Methods: A retrospective chart review was conducted on a sample of patients with diagnosis of TTS, based on the fulfilment of the revised Mayo Clinic criteria.
Following acute exercise, normotensive and hypertensive subjects both undergo changes in hemostatic and fibrinolytic properties, but the hypertensive patient's response to exercise is exaggerated and prolonged, exposing them to increased cardiovascular risk during or immediately after unusual and strenuous exercise. Thrombotic complications are triggered by the activation of the autonomic sympathetic nervous system in a pathological milieu characterized by platelet α-adrenergic receptors with increased responsiveness to circulating catecholamine, altered platelet profile and function, abnormal hemostatic parameters, impaired fibrinolytic potential, and endothelial dysfunction. The recovery period is particularly dangerous for triggering adverse cardiovascular events because the balance between the thrombotic and fibrinolytic systems is temporarily shifted toward increased pro-coagulative activity.
View Article and Find Full Text PDFIn patients with hypertension, the triad represented by endothelial dysfunction, platelet hyperactivity, and altered fibrinolytic function disturbs the equilibrium between hemostasis and fibrinolysis and translates into a hypercoagulable state, which underlies the risk of thrombotic complications. This article reviews the scientific evidence regarding some biological effects of antihypertensive drugs, which can protect patients from the adverse consequences of hypertensive disease, improving endothelial function, enhancing antioxidant activity, and restoring equilibrium between hemostatic and fibrinolytic factors. These protective effects appear not to be mediated through blood pressure reduction and are not shared by all molecules of the same pharmacological class.
View Article and Find Full Text PDFBackground: Some electrocardiographic parameters are able to assess indirectly ventricular repolarisation homogeneity. It is consequently essential to discriminate between normal and abnormal values in clinical decision-making. Considering there is still not a consensus about normal cut-off values, the aim of this study was to document reference intervals in all age groups of a healthy population, providing for age- and sex-percentile tables, which can be used easily and quickly in clinical practice.
View Article and Find Full Text PDFAnn Noninvasive Electrocardiol
April 2012
Background: T peak-T end, QT peak/QT ratio and T peak-T end/QT ratio are markers able to test myocardial repolarization homogeneity, their increase has been related to a higher risk of ventricular tachyarrhythmias. These parameters have not yet been studied in left ventricular hypertrophy due to training. Aim of the research was to test the behavior of these variables in the athlete's heart during exercise.
View Article and Find Full Text PDFBackground: Seasonal peaks in cardiovascular disease incidence have been widely reported, suggesting weather has a role.
Design: The aim of our study was to determine the influence of climatic variables on angina pectoris hospital admissions.
Methods: We correlated the daily number of angina cases admitted to a western Sicilian hospital over a period of 12 years and local weather conditions (temperature, humidity, wind force and direction, precipitation, sunny hours and atmospheric pressure) on a day-to-day basis.
In addition to well-known electrocardiographic measurements, as QT, QT dispersion, and QT apex dispersion, new parameters such as Tpeak-Tend, Tpeak-Tend dispersion, and Tpeak-Tend/QT ratio have been recently introduced as indexes of increased arrhythmic risk. The aim of the present study was to test, in overweight and obese subjects not affected by conditions of comorbidity, the aforementioned markers of ventricular repolarization. We studied 60 athletic subjects with normal body weight (21 females and 39 males, BMI between 19 and 24, mean BMI 22.
View Article and Find Full Text PDFBackground: The quantity and intensity of physical activity required for the primary prevention of coronary heart disease remain unclear. Therefore, we examined the association between physical activity and coronary risk.
Methods: We studied 100 patients with chest pain, 78 men and 22 women, not older than 65 years, admitted to a coronary care unit.
Background: Beta-adrenoceptor antagonist (beta-blocker) therapy results in a significant improvement in left ventricular (LV) systolic function and prognosis in patients with chronic heart failure. Both carvedilol and nebivolol produce hemodynamic and clinical benefits in chronic heart failure, but it is unknown whether their peculiar pharmacologic properties produce different effects on LV function.
Objective: To assess the effects on LV function of nebivolol compared with carvedilol in patients with chronic heart failure and reduced LV systolic function.
A 64-year-old man manifested a stroke two years after restoration of sinus rhythm through a radiofrequency catheter ablation. Transesophageal echocardiography demonstrated the presence of a thrombus in the left atrial appendage. Left atrial volumes and different parameters of atrial emptying showed that, despite the persistence of the sinus rhythm, atrial mechanical function was severely impaired.
View Article and Find Full Text PDFBackground: Several studies suggest that fibrinogen may be considered an independent risk factor for coronary artery disease, but it is still on debate if we need its evaluation during an acute myocardial infarction (AMI) to prevent future fatal or non-fatal cardiovascular events. Therefore, we decided to investigate this field.
Methods: We studied 92 male patients with AMI, evaluating at admission age, body mass index, systolic blood pressure, cigarette smoking, ejection fraction, plasma levels of total cholesterol, triglycerides, fibrinogen, glycemia, and white blood cell count.
Background: Recent studies have shown a worse in-hospital outcome in hypertensive than in normotensive patients with acute myocardial infarction (AMI), which has been attributed to more frequent complications. The aim of this study was to investigate clinical patterns, risk factors, and in-hospital complications in hypertensive and normotensive patients with AMI.
Methods: Of 4994 consecutive patients with AMI admitted to the intensive care unit, hypertensive patients with first infarction (n = 915; mean age 68.