C-Reactive Protein Enhances IgG-Mediated Cellular Destruction Through IgG-Fc Receptors .

Antibody-mediated blood disorders ensue after auto- or alloimmunization against blood cell antigens, resulting in cytopenia. Although the mechanisms of cell destruction are the same as in immunotherapies targeting tumor cells, many factors are still unknown. Antibody titers, for example, often do not strictly correlate with clinical outcome.

Meta-Analysis Evaluating Calcium Channel Blockers and the Risk of Peripheral Arterial Disease in Patients With Hypertension.

Clinical studies have shown that calcium channel blockers (CCB) can mitigate the progression of atherosclerosis. Their role in the primary prevention of peripheral artery disease (PAD) is unclear. We conducted a meta-analysis of randomized control trials (RCT) to compare the impact of CCB on the incidence of PAD in patients with hypertension.

Quantification of myocardial blood flow with (82)Rb: Validation with (15)O-water using time-of-flight and point-spread-function modeling.

Background: We quantified myocardial blood flow with (82)Rb PET using parameters of the generalized Renkin-Crone model estimated from (82)Rb and (15)O-water images reconstructed with time-of-flight and point spread function modeling. Previous estimates of rubidium extraction have used older-generation scanners without time-of-flight or point spread function modeling. We validated image-derived input functions with continuously collected arterial samples.

The composition of ectopic lymphoid structures suggests involvement of a local immune response in cardiac allograft vasculopathy.

Background: Cardiac allograft vasculopathy (CAV) is a multifactorial pathology limiting the survival of cardiac transplants. The etiology of CAV is unclear, but antibody-mediated and cellular-mediated responses have been implicated. We, and others, have observed ectopic lymphoid structures (ELS) surrounding epicardial coronary arteries with CAV.

The effect of grape seed extract on cardiovascular risk markers: a meta-analysis of randomized controlled trials.

Recent animal studies have suggested that grape seed extract has beneficial effects on the cardiovascular system. Randomized trials in human beings have yielded conflicting results. The objective of this systematic review was to assess the effect of grape seed extract on changes in blood pressure, heart rate, lipid levels, and C-reactive protein (CRP) levels.

Mature fat cells in the myocardium of patients with tuberous sclerosis complex.

Aim: Routine abdominal CT scans in patients with tuberous sclerosis complex (TSC) showed characteristic fatty foci in the depicted caudal portions of the myocardium. The purpose of this study was to investigate if areas of abnormal myocardium in patients with TSC could also be found in post-mortem specimens.

Methods: A retrospective search of our histopathology database was performed to identify specimens of the heart of patients with TSC.

Focal fatty areas in the myocardium of patients with tuberous sclerosis complex: a unique finding.

With this collection of computed tomography and magnetic resonance images, we illustrate a recently described novel finding in the myocardium of patients with tuberous sclerosis complex.

Statistical models and patient predictors of readmission for acute myocardial infarction: a systematic review.

Background: Readmission after acute myocardial infarction (AMI) has been targeted for public reporting because it is a common, costly, and often preventable outcome. To assist in ongoing efforts to risk-stratify patients and profile hospitals through public reporting of performance measures, we conducted a systematic review to identify models designed to compare hospital rates of readmission or predict patients' risk of readmission after AMI and to identify studies evaluating patient characteristics associated with AMI readmission.

Methods And Results: We identified relevant English-language studies published between 1950 and 2007 by searching MEDLINE, Scopus, PsycINFO, and all 4 Ovid Evidence-Based Medicine Reviews.

Distal renal tubular acidosis in lymphoplasmacytic lymphoma Waldenström's macroglobulinemia: a case report.

We present a case of distal renal tubular acidosis and acute renal insufficiency in a patient with Waldenström's macroglobulinemia. Distal renal tubular acidosis has been described in hypergammaglobulinemia, but not in patients with Waldenström's macroglobulinemia. To our knowledge, this is the first report to describe a possible association between distal renal tubular acidosis and Waldenström's macroglobulinemia.

[Perioperative risk reduction in vascular surgery via cardio-protective medication].

Cardiovascular complications are the leading cause of death after noncardiac surgery. Preoperative identification of patients with underlying coronary artery disease is important, and appropriate treatment strategies should be implemented in these patients in order to reduce the risk of perioperative complications. Based on recent findings, preoperative risk stratification models have been developed to identify high-, intermediate- or low-risk patients; the concentration of natriuretic peptides is a promising new preoperative risk marker.

Comparison of outcome after myocardial infarction in patients with and without abnormalities on previous stress Tc-99m tetrofosmin myocardial perfusion imaging.

Background: Acute myocardial infarction (MI) can occur in patients with previously normal stress myocardial perfusion imaging (MPI). It is not known whether the prognosis of these patients differ from those with MI who had an abnormal MPI on an earlier testing. The aim of this study was to compare the outcome of patients who sustained a MI during follow-up after stress MPI based on the presence or absence of perfusion abnormalities on the earlier test.

Early and late outcome of left ventricular reconstruction surgery in ischemic heart disease.

A systematic review of the literature was performed to determine early and late mortality associated with left ventricular (LV) reconstruction surgery and to assess the influence of different surgical techniques, concomitant surgical procedures, clinical and hemodynamic parameters on mortality. The MEDLINE database (January 1980-January 2005) was searched and from the pooled data, hospital mortality and survival were calculated. Summary estimates of relative risks (RR) were calculated for the techniques that were used and for concomitant coronary artery bypass grafting (CABG) and mitral valve surgery.

Pre-operative risk assessment and risk reduction before surgery.

Perioperative myocardial infarctions are the predominant cause of morbidity and mortality in patients undergoing noncardiac surgery. The pathophysiology of perioperative myocardial infarction is complex. Prolonged myocardial ischemia due to the stress of surgery in the presence of a hemodynamically significant coronary lesion, leading to subendocardial ischemia, and acute coronary artery occlusion after plaque rupture and thrombus formation contribute equally to these devastating events.

Methionine loading does not enhance the predictive value of homocysteine serum testing for all-cause mortality or major adverse cardiac events.

Background: Hyperhomocysteinaemia is independently associated with atherosclerotic disease. Methionine loading could improve the predictive value of hyperhomocysteinaemia by detecting mild disturbances in enzyme activity. The aims of this study were to determine the beneficial effect of methionine loading on the predictive value of homocysteine testing for long-term mortality and major adverse cardiac events (MACE).

Usefulness of preoperative oral glucose tolerance testing for perioperative risk stratification in patients scheduled for elective vascular surgery.

Patients scheduled for major vascular surgery are screened for cardiac risk factors using standardized risk indexes, including diabetes mellitus (DM). Screening in patients without a history of DM includes fasting glucose measurement. However, an oral glucose tolerance test (OGTT) could significantly improve the detection of DM and impaired glucose tolerance (IGT) and the prediction of perioperative cardiac events.

Impaired glucose regulation, elevated glycated haemoglobin and cardiac ischaemic events in vascular surgery patients.

Aims: Cardiac morbidity and mortality is high in patients undergoing high-risk surgery. This study investigated whether impaired glucose regulation and elevated glycated haemoglobin (HbA(1c)) levels are associated with increased cardiac ischaemic events in vascular surgery patients.

Methods: Baseline glucose and HbA(1c) were measured in 401 vascular surgery patients.

Elderly patients undergoing major vascular surgery: risk factors and medication associated with risk reduction.

This study assesses risk factors in elderly vascular surgery patients and to evaluate whether perioperative cardiac medication can reduce postoperative mortality rate. In a cohort study, 1693 consecutive patients > or =65 years undergoing major non-cardiac vascular surgery were preoperatively screened for cardiac risk factors and medication. During follow-up (median: 8.

Comparison with computed tomography of two ultrasound devices for diagnosis of abdominal aortic aneurysm.

Screening for abdominal aortic aneurysms (AAAs) in patients at risk will become more cost effective if a simple, inexpensive, and reliable ultrasound device is available. The aim of this study was to compare a 2-dimensional, handheld ultrasound device and a newly developed ultrasound volume scanner (based on bladder scan technology) with computed tomography (CT) for diagnosing AAA. A total of 146 patients (mean age 69 +/- 10 years; 127 men) were screened for the presence of AAAs (diameter >3 cm) using CT.

A prognostic risk index for long-term mortality in patients with peripheral arterial disease.

Background: Prognostic information in peripheral arterial disease (PAD) may provide the basis for optimal management strategies at an early stage. This study aimed to develop a prognostic risk index for long-term mortality in patients with PAD.

Methods: In a single-center observational cohort study, 2642 patients with an ankle-brachial index of 0.

Baseline natriuretic peptide levels in relation to myocardial ischemia, troponin T release and heart rate variability in patients undergoing major vascular surgery.

Background: This study was conducted to determine the association between baseline N-terminal pro-B-type natriuretic peptide (NT-proBNP) and myocardial ischemia, troponin T release and heart rate variability (HRV) in patients undergoing major vascular surgery.

Methods: In a prospective study, 182 vascular surgery patients were evaluated by clinical risk factors, dobutamine stress echocardiography and baseline NT-proBNP levels. Myocardial ischemia was detected by continuous 12-lead electrocardiographic monitoring starting 1 day before to 2 days after surgery.

Prognostic significance of renal function in patients undergoing dobutamine stress echocardiography.

Background: Dobutamine stress echocardiography (DSE) is used for risk stratification of patients with suspected coronary artery disease (CAD). However, the prognostic value of DSE among the entire strata of renal function has yet to be determined. We assessed the prognostic value of renal function relative to DSE findings.

Glycemic control, lipid-lowering treatment, and prognosis in diabetic patients with peripheral atherosclerotic disease.

Glycemic control may be an underestimated risk factor in diabetic patients with peripheral arterial disease (PAD). Chronic statin therapy may improve glycemic control and outcome in these patients. In an observational cohort study of 425 consecutive diabetic patients with PAD, chronic statin therapy was noted, the ankle-brachial index was measured, and serial glycemic hemoglobin (HbA(1c)) measurements were obtained.

Comparison of the incidences of cardiac arrhythmias, myocardial ischemia, and cardiac events in patients treated with endovascular versus open surgical repair of abdominal aortic aneurysms.

This study examines differences in cardiac arrhythmias, perioperative myocardial ischemia, troponin T release, and cardiovascular events between endovascular and open repair of abdominal aortic aneurysms (AAAs). Of 175 patients, 126 underwent open AAA repair and 49 underwent endovascular AAA repair. Continuous 12-lead electrocardiographic monitoring, starting 1 day before surgery and continuing through 2 days after surgery, was used for cardiac arrhythmia and myocardial ischemia detection.

Intensity of statin therapy in relation to myocardial ischemia, troponin T release, and clinical cardiac outcome in patients undergoing major vascular surgery.

Objectives: This study sought to examine whether higher statin doses and lower low-density lipoprotein (LDL) cholesterol are associated with improved cardiac outcome in vascular surgery patients.

Background: Statins may have cardioprotective effects during major vascular surgery.

Methods: In a prospective study of 359 vascular surgery patients, statin dose and cholesterol levels were recorded preoperatively.