Supplementation with vitamin E alone is associated with reduced myocardial infarction: a meta-analysis.

Background And Aims: Previous meta-analyses of interventional trials with vitamin E provided negative results but it remains unclear if this vitamin has some influence on cardiovascular events when supplemented alone. The aim of this study was to compare the effect of vitamin E alone or in combination with other antioxidants on myocardial infarction.

Methods And Results: Pubmed, ISI Web of Science, SCOPUS and Cochrane database were searched without language restrictions.

Old And New Oral Anticoagulants In Management Of Atrial Fibrillation: A Double-Edged Sword For Women.

Atrial fibrillation (AF), one of the most prevalent supra-ventricular arrhythmia in adults, is related to a substantial increase in the risk of thromboembolic events requiring tailored preventive strategy. In AF, antithrombotic therapy should be individualized according to a careful decisionmaking process, taking in account the likely concomitant presence of risk factors for stroke and bleeding. Anticoagulation management is particularly challenging in women with AF, to the extent that female sex is incorporated in commonly used stratification schemes for both thromboembolic and bleeding risk evaluation.

Relationship between carotid intima-media thickness and non valvular atrial fibrillation type.

Objective: Carotid intima-media thickness (cIMT) is a surrogate marker of subclinical atherosclerosis and it is able to predict both coronary and cerebral vascular events. No data exist on the association between cIMT and non valvular atrial fibrillation (NVAF) type. We conduct this study with the aim to analyze the association between abnormal cIMT and NVAF type.

New oral anticoagulants for the treatment of acute venous thromboembolism: are they safer than vitamin K antagonists? A meta-analysis of the interventional trials.

New oral anticoagulants (NOACs) may represent an alternative to standard therapy with vitamin K antagonists (VKA). However, up to the present, it is unknown whether these drugs are safer than VKA. The aim of this study was to perform a meta-analysis of the interventional trials with NOACs vs VKA in patients with acute venous thromboembolism (VTE) to obtain the balance between clinical efficacy and complications.

Flow-mediated dilation is associated with cardiovascular events in non-valvular atrial fibrillation patients.

Background: Atrial fibrillation is associated with multiple atherosclerotic risk factors and predisposes to cardiovascular events (CVE). Endothelial dysfunction is associated with atherosclerosis and independently predicts CVE. The aim of the study was to evaluate the association between endothelial dysfunction, as assessed by flow-mediated dilation (FMD), and CVE in AF patients.

Digoxin treatment is associated with increased total and cardiovascular mortality in anticoagulated patients with atrial fibrillation.

Background: Some evidences suggest that the use of digoxin may be harmful inatrial fibrillation (AF) patients. The aim of the study was to investigate in a "real world" of AF patients receiving vitamin K antagonists (VKAs), the relationship between digoxin use and mortality.

Methods: Prospective single-center observational study including 815 consecutive non-valvular AF patients treated with VKAs.

Platelet activation is associated with myocardial infarction in patients with pneumonia.

Background: Troponins may be elevated in patients with pneumonia, but associations with myocardial infarction (MI) and with platelet activation are still undefined.

Objectives: The aim of this study was to investigate the relationship between troponin elevation and in vivo markers of platelet activation in the early phase of hospitalization of patients affected by community-acquired pneumonia.

Methods: A total of 278 consecutive patients hospitalized for community-acquired pneumonia, who were followed up until discharge, were included.

Incidence of myocardial infarction and vascular death in elderly patients with atrial fibrillation taking anticoagulants: relation to atherosclerotic risk factors.

Background: Recent findings suggest that patients with atrial fibrillation (AF), in addition being at thromboembolic risk, are at risk of myocardial infarction (MI). Our aim was to investigate predictors of MI and cardiovascular death in a cohort of patients with AF who were taking anticoagulants.

Methods: We prospectively followed up 1,019 patients with AF for a median of 33.

Serum NOX2 and urinary isoprostanes predict vascular events in patients with atrial fibrillation.

There are limited prospective data evaluating the role of urinary F2-IsoP and NOX2 as predictive markers in atrial fibrillation (AF). The aim of this study was to analyse the role of urinary prostaglandin PGF2alpha (8-iso-PGF2α) and NOX2, markers of systemic oxidative stress, in predicting cardiovascular (CV) events and mortality in anticoagulated non-valvular AF patients. This was a prospective study including 1,002 anticoagulated AF patients, followed for a median time of 25.

Mechanisms And Management Of Thrombo-Embolism In Atrial Fibrillation.

Atrial fibrillation (AF) is the most common cardiac arrhythmia in the general population and in patients with a history of cardiovascular disease. AF is becoming an outbreak particularly for the western countries as it increases with advancing age; furthermore, AF has a negative social impact because it is associated with stroke and myocardial infarction. Thrombosis generated in the left atrial appendage with ensuing embolism in the cerebral circulation is considered the most important cause of ischemic stroke.

Mediterranean diet reduces thromboxane A2 production in atrial fibrillation patients.

Background & Aims: Platelet activation plays a major role in cardiovascular events (CVEs). Mediterranean diet (Med-Diet) reduces the incidence of stroke and myocardial infarction but it is still unclear if it affects platelet activation. Aim of the study was to evaluate the effect of Med-Diet on the urinary excretion of 11-dehydro-thromboxane (Tx) B2, a marker of in vivo platelet activation, in patients with atrial fibrillation (AF).

Aspirin reload before elective percutaneous coronary intervention: impact on serum thromboxane b2 and myocardial reperfusion indexes.

Background: Microvascular obstruction seems to predict poor outcome in patients undergoing elective percutaneous coronary intervention (PCI), but the underlying mechanism is still unclear. We analyzed whether serum thromboxane B2, a stable metabolite of thromboxane A2, may be implicated in post-PCI microvascular obstruction.

Methods And Results: We enrolled 91 patients (74 males, 66±10 years) on chronic low-dose aspirin therapy (aspirin, 100 mg daily) scheduled for elective PCI and randomly assigned to receive aspirin reload (325 mg orally, n=46) or no reload (control group, n=45) ≥1 hour before elective PCI.

Different degrees of NADPH oxidase 2 regulation and in vivo platelet activation: lesson from chronic granulomatous disease.

Background: In vitro study showed that NADPH oxidase (NOx), the most important enzyme producing reactive oxygen species (ROS), plays a role in the process of platelet activation. However, it is unclear if changes in its activity affect platelet activation in vivo.

Methods And Results: In vivo and ex vivo experiments assessing platelet activation were investigated in healthy subjects, obese patients, and subjects with different low rates of NOx2 activity, namely X-linked chronic granulomatous disease (X-CGD) patients and X-CGD carriers.

Antioxidants for prevention of atrial fibrillation: a potentially useful future therapeutic approach? A review of the literature and meta-analysis.

Atrial fibrillation (AF) is a self-perpetuating arrhythmia which is dependent upon structural and functional changes elicited by atrial high rate activity. Shortening of atrial effective refractory period is the earliest functional change which characterizes atrial remodelling. Studies in humans demonstrated oxidant species overproduction in the cardiac specimens from patients with AF and a significant association between reactive oxidant species (ROS) formation and risk of AF.

Platelet NOX, a novel target for anti-thrombotic treatment.

There is a growing body of evidence to suggest that reactive oxidant species (ROS) including O2-, OH- or H2O2 act as second messengers to activate platelets via 1) calcium mobilisation, 2) nitric oxide (NO) inactivation, and 3) interaction with arachidonic to give formation of isoprostanes. Among the enzymes generating ROS formation NOX2, the catalytic core of NADPH oxidase (NOX), plays a prominent role as shown by the almost absent ROS production by platelets taken from patients with hereditary deficiency of NOX2. Experimental and clinical studies provided evidence that NOX2 is implicated in platelet activation.

Clinical Application of NOX Activity and Other Oxidative Biomarkers in Cardiovascular Disease: A Critical Review.

Significance: The oxidative stress theory of atherosclerosis is based on the assumption that the production of reactive oxidant species (ROS) by blood, as well as resident cells of the artery wall, elicits the formation of oxidized low-density lipoproteins (ox-LDL), which, in turn, promotes a series of inflammatory responses, ultimately leading to atherosclerotic plaque. This theory prompted the development of new laboratory methodologies that aimed at assessing the relationship between oxidative stress and clinical progression of human atherosclerosis.

Critical Issues: Markers assessing the oxidation of phospholipid and protein components of LDL were among the first to be developed.

Is NOX2 upregulation implicated in myocardial injury in patients with pneumonia?

In the present study, we tested the hypothesis that oxidative stress could be implicated in myocardial damage during the acute phase of pneumonia. NOX2 activation, the catalytic subunit of NADPH oxidase, and high-sensitivity cardiac troponin T (hs-cTnT) elevation have been analyzed in two hundred forty-eight consecutive patients hospitalized for community-acquired pneumonia. Serum NOX2-derived peptide (sNOX2-dp), a marker of NOX2 activation, and 8-isoprostaglandin F2α (8-iso-PGF2α), a marker of oxidative stress, were measured upon admission; serum hs-cTnT and ECG were measured every 12 and 24 h, respectively.

Antioxidant and antiplatelet effects of atorvastatin by Nox2 inhibition.

In recent years, it became evident that reactive oxygen species (ROS) are implicated in the thrombotic process. Statins are lipid-lowering agents able to lower serum cholesterol levels and retard atherosclerotic complications and their clinical sequelae. There is evidence that, among statins, atorvastatin may exert antiplatelet effects by interfering with redox signaling.

Is there a clinical role for oxidative stress biomarkers in atherosclerotic diseases?

Growing evidences suggest that reactive oxidant species (ROS) are involved in the pathogenesis and progression of the atherosclerotic diseases. Markers assessing the oxidation of LDL and formation of eicosanoids, such as isoprostanes, were among the first that were analyzed. More recently, new biomarkers, such as endogenous secretory receptor for AGEs have been suggested to play an oxidative role in specific atherosclerotic settings, such as diabetes.

Statins as regulators of redox signaling in platelets.

Significance: Reactive oxidant species (ROS) are highly reactive molecules produced by several cell lines including platelets and serve as second messenger for intracellular signaling. In recent years it became evident that ROS are also implicated in the thrombotic process. Statins are lipid lowering molecules which reduce serum cholesterol and retard atherosclerotic complication and its clinical sequelae.