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Banach M, Serban C, Aronow WS, Rysz J, Dragan S, Lerma EV, Apetrii M, Covic A. Lipid, blood pressure and kidney update 2013. Int Urol Nephrol 2014; 46:947-61. [PMID: 24573394 PMCID: PMC4012155 DOI: 10.1007/s11255-014-0657-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Accepted: 01/28/2014] [Indexed: 12/24/2022]
Abstract
The year 2013 proved to be very exciting as far as landmark trials and new guidelines in the field of lipid disorders, blood pressure and kidney diseases. Among these are the International Atherosclerosis Society Global Recommendations for the Management of Dyslipidemia, European Society of Cardiology (ESC)/European Society of Hypertension Guidelines for the Management of Arterial Hypertension, American Diabetes Association Clinical Practice Recommendations, the Kidney Disease: Improving Global Outcomes Clinical Practice Guidelines for Managing Dyslipidemias in Chronic Kidney Disease (CKD) Patients, the American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults, the Joint National Committee Expert Panel (JNC 8) Evidence-Based Guideline for the Management of High Blood Pressure in Adults, the American Society of Hypertension/International Society of Hypertension Clinical Practice Guidelines for the Management of Hypertension in the Community, the American College of Physicians Clinical Practice Guideline on Screening, Monitoring, and Treatment of Stage 1-3 CKD and many important trials presented among others during the ESC Annual Congress in Amsterdam and the American Society of Nephrology Annual Meeting--Kidney Week in Atlanta, GA. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland,
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Franczyk-Skóra B, Gluba A, Banach M, Rysz J. Treatment of non-ST-elevation myocardial infarction and ST-elevation myocardial infarction in patients with chronic kidney disease. Arch Med Sci 2013; 9:1019-27. [PMID: 24482645 PMCID: PMC3902722 DOI: 10.5114/aoms.2013.39792] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Revised: 11/29/2013] [Accepted: 12/04/2013] [Indexed: 02/06/2023] Open
Abstract
Renal dysfunction is frequent in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Chronic kidney disease (CKD) is associated with very poor prognosis and is an independent predictor of early and late mortality and major bleeding in patients with NSTE-ACS. Patients with NSTE-ACS and CKD are still rarely treated according to guidelines. Medical registers reveal that patients with CKD are usually treated with too high doses of antithrombotics, especially anticoagulants and inhibitors of platelet glycoprotein (GP) IIb/IIIa receptors, and therefore they are more prone to bleeding. Drugs which are excreted mainly or exclusively by the kidney should be administered in a reduced dose or discontinued in patients with CKD. These drugs include enoxaparin, fondaparinux, bivalirudin, and small molecule inhibitors of GP IIb/IIIa inhibitors. In long-term treatment of patients after myocardial infarction, anti-platelet therapy, lipid-lowering therapy and β-blockers are used. Chronic kidney disease patients before qualification for coronary interventions should be carefully selected in order to avoid their use in the group of patients who could not benefit from such procedures. This paper presents schemes of non-ST and ST-segment elevation myocardial infarction treatment in CKD patients in accordance with the current recommendations of the European Society of Cardiology (ESC).
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Affiliation(s)
- Beata Franczyk-Skóra
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Poland
| | - Anna Gluba
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital of Lodz, Poland
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Olechnowicz-Tietz S, Gluba A, Paradowska A, Banach M, Rysz J. The risk of atherosclerosis in patients with chronic kidney disease. Int Urol Nephrol 2013; 45:1605-12. [PMID: 23483304 PMCID: PMC3844144 DOI: 10.1007/s11255-013-0407-1] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Accepted: 02/19/2013] [Indexed: 01/25/2023]
Abstract
BACKGROUND Chronic kidney disease (CKD) is becoming a serious health problem; the number of people with impaired renal function is rapidly rising, especially in industrialized countries. A major complication of CKD is cardiovascular disease. Accelerated atherosclerosis has been observed in early stages of renal dysfunction. The purpose of this study was to examine the relationship between the degree of renal insufficiency and both the prevalence and intensity of coronary artery disease (assessed on the basis of number of vessels with stenosis). METHODS 446 individuals with both serum creatinine >120 μmol/l (men) or >96 μmol/l (women) and acute coronary syndrome were included in the study. All patients included in this analysis underwent urgent coronarography. Data concerning glomerular filtration rate (GFR), number of vessels with stenosis, hypertension, lipid disorders, creatinine concentration, C-reactive protein, glucose and lipid profile were analyzed. RESULTS This study confirmed that moderate to severe renal impairment is associated with accelerated atherosclerosis. Moreover, patients with GFR values below 60 ml/min/1.73 m(2) are predisposed to accelerated, multivessel cardiovascular disease. CONCLUSIONS GFR seems to be an independent risk factor for multivessel cardiovascular disease. Due to the fact that patients with renal dysfunction are at high risk of cardiovascular events, they should obtain optimal treatment resulting not only in kidney protection but also in the elimination of cardiovascular risk factors.
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Affiliation(s)
| | - Anna Gluba
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland
| | - Anna Paradowska
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland
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Stępień M, Stępień A, Wlazeł RN, Paradowski M, Banach M, Rysz M, Rysz J. Obesity indices and adipokines in non-diabetic obese patients with early stages of chronic kidney disease. Med Sci Monit 2013; 19:1063-72. [PMID: 24280776 PMCID: PMC3852621 DOI: 10.12659/msm.889390] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Background The aim of this study was to estimate obesity parameters: waist circumference (WC), waist-to-hip ratio (WHR), weight-to-height ratio (WHtR), visceral adiposity index (VAI), body adiposity index (BAI), and serum adipokines (leptin, adiponectin, resistin) and their associations with estimated glomerular filtration rate (eGFR), serum creatinine, and microalbuminuria (MA) in patients with early stages of CKD and in non-CKD obese patients. Material/Methods 67 non-diabetic obese (BMI ≥30 mg/kg2) out-clinic patients (25 males, 42 females), aged from 36.5 to 64 years were divided into 2 groups: Group A (n=15) – patients with early stages of CKD (eGFR between 30 and 60 ml/min/1.73 m2 or with MA >20 mg/l in morning urine sample independently from GFR) and Group B – patients without chronic CKD (n=52). Results In Group A compared to Group B, BAI and leptin were higher (42.2±7.1 vs. 37.5±7.0; p<0.05 and 51.8±26.7 ng/mL vs. 35.3±24.9 ng/mL; p<0.05; respectively) and negative correlations occurred between eGFR and BAI (r=−0.709; p=0.003), leptin (r=−0.68; p=0.005), and resistin (r=−0.528; p<0.05). In Group B, negative correlations occurred between creatinine and VAI (r=−0.332; p<0.05), BAI (r=−0.619; p<0.0001), leptin (r=−0.676; p<0.0001), and adiponectin (r=−0.423; p=0.002), and between eGFR and resistin (r=−0.276; p<0.05). Conclusions BAI may be a valuable obesity parameter as a predictor of early stages of CKD in patients with obesity. Leptin may be an important pathogenic factor in obese patients with early stages of CKD. Resistin is associated with eGFR in obese patients, independently of CKD.
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Affiliation(s)
- Mariusz Stępień
- Department of Nephrology, Hypertension and Family Medicine, Medical University of ŁódŸ, ŁódŸ, Poland
- Corresponding Author: Mariusz Stępień, e-mail:
| | - Anna Stępień
- Department of Nephrology, Hypertension and Family Medicine, Medical University of ŁódŸ, ŁódŸ, Poland
| | | | - Marek Paradowski
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical Uniwersity of ŁódŸ, ŁódŸ, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of ŁódŸ, ŁódŸ, Poland
| | - Magdalena Rysz
- Student’s Scientific Academic Club, Medical University of ŁódŸ, ŁódŸ, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of ŁódŸ, ŁódŸ, Poland
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Bartnicki P, Fijałkowski P, Majczyk M, Błaszczyk J, Banach M, Rysz J. Effect of methoxy polyethylene glycol-epoetin beta on oxidative stress in predialysis patients with chronic kidney disease. Med Sci Monit 2013; 19:954-9. [PMID: 24201565 PMCID: PMC3829740 DOI: 10.12659/msm.884024] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Background There is data in the literature indicating increased oxidative stress in chronic kidney disease (CKD). Erythropoiesis-stimulating agents (ESAs), which are commonly used to treat anemia in patients with CKD, seem to have an antioxidant action, which could be a part of nephroprotection. The aim of the current study was to investigate the effect of a long half-life ESA, methoxy polyethylene glycol-epoetin beta (Mircera), on some markers of oxidative stress in predialysis patients with CKD. Material/Methods Peripheral blood was collected from 28 predialysis CKD patients 2 times, before Mircera treatment and after achieving target hemoglobin (Hb), and 15 healthy subjects (control group). Superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) activity in erythrocytes were measured according to commonly used methods as a function of the antioxidant defense system. To assess reactive oxygen species (ROS) production, malondialdehyde (MDA) concentration in erythrocytes and in plasma was measured according to a commonly used method. Results SOD, GSH-Px, and CAT activity were similar, but plasma and erythrocyte MDA concentrations were significantly higher in CKD patients before ESA treatment in comparison to the control group. SOD, GSH-Px, and CAT activity was significantly higher, but plasma and erythrocyte MDA concentrations were significantly lower, in CKD patients after ESA treatment in comparison to these patients before treatment. We did not find a significant correlation between Hb concentration and SOD, GSH-Px, and CAT activity and plasma, as well as erythrocyte MDA concentrations. Analysis of all investigated groups showed a significant negative correlation between Hb concentration and plasma MDA concentration. Conclusions Our results suggest that treatment of anemia with methoxy polyethylene glycol-epoetin beta may inhibit oxidative stress in predialysis patients with CKD by enhancing the antioxidant defense system and reducing ROS production.
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Affiliation(s)
- Piotr Bartnicki
- Department of Nephrology, Hypertension and Family Medicine, Medical University, Łódź, Poland
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Awsiuk K, Budkowski A, Psarouli A, Petrou P, Bernasik A, Kakabakos S, Rysz J, Raptis I. Protein adsorption and covalent bonding to silicon nitride surfaces modified with organo-silanes: Comparison using AFM, angle-resolved XPS and multivariate ToF-SIMS analysis. Colloids Surf B Biointerfaces 2013; 110:217-24. [DOI: 10.1016/j.colsurfb.2013.04.030] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Revised: 04/15/2013] [Accepted: 04/17/2013] [Indexed: 01/08/2023]
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Franczyk-Skóra B, Gluba A, Banach M, Rozentryt P, Poloński L, Rysz J. Acute Coronary Syndromes in Patients with Chronic Kidney Disease. Curr Vasc Pharmacol 2013; 11:758-67. [DOI: 10.2174/1570161111311050013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 11/24/2011] [Accepted: 11/26/2011] [Indexed: 11/22/2022]
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Bartnicki P, Kowalczyk M, Rysz J. The influence of the pleiotropic action of erythropoietin and its derivatives on nephroprotection. Med Sci Monit 2013; 19:599-605. [PMID: 23872600 PMCID: PMC3724571 DOI: 10.12659/msm.889023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2013] [Accepted: 05/02/2013] [Indexed: 12/26/2022] Open
Abstract
Erythropoietin (EPO) is traditionally described as a hematopoietic cytokine or growth hormone regulating proliferation, differentiation, and survival of erythroid progenitors. The use of EPO in patients with chronic kidney disease (CKD) was a milestone achievement in the treatment of anemia. However, EPO involves some degree of risk, which increases with increasing hemoglobin levels. A growing number of studies have assessed the renoprotective effects of EPO in acute kidney injury (AKI) or CKD. Analysis of the biological effects of erythropoietin and pathophysiology of CKD in these studies suggests that treatment with erythropoiesis-stimulating agents (ESAs) may exert renoprotection by pleiotropic actions on several targets and directly or indirectly slow the progression of CKD. By reducing ischemia and oxidative stress or strengthening anti-apoptotic processes, EPO may prevent the development of interstitial fibrosis and the destruction of tubular cells. Furthermore, it could have a direct protective impact on the integrity of the interstitial capillary network through its effects on endothelial cells and promotion of vascular repair, or modulate inflammation response. Thus, it is biologically plausible to suggest that correcting anemia with ESAs could slow the progression of CKD. The aim of this article is to discuss these possible renoprotection mechanisms and provide a comprehensive overview of erythropoietin and its derivatives.
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Affiliation(s)
- Piotr Bartnicki
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Łódź, Łódź, Poland.
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Banach M, Malodobra-Mazur M, Gluba A, Katsiki N, Rysz J, Dobrzyn A. Statin Therapy and New-onset Diabetes: Molecular Mechanisms and Clinical Relevance. Curr Pharm Des 2013; 19:4904-12. [DOI: 10.2174/1381612811319270014] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2012] [Accepted: 12/24/2012] [Indexed: 11/22/2022]
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Barylski M, Nikfar S, Mikhailidis DP, Toth PP, Salari P, Ray KK, Pencina MJ, Rizzo M, Rysz J, Abdollahi M, Nicholls SJ, Banach M. Statins decrease all-cause mortality only in CKD patients not requiring dialysis therapy—A meta-analysis of 11 randomized controlled trials involving 21,295 participants. Pharmacol Res 2013; 72:35-44. [DOI: 10.1016/j.phrs.2013.03.007] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2013] [Revised: 03/20/2013] [Accepted: 03/20/2013] [Indexed: 12/17/2022]
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Michalska M, Rysz J, Pencina MJ, Zdrojewski T, Banach M. The knowledge and awareness of hypertension among patients with hypertension in central Poland: a pilot registry. Angiology 2013; 65:525-32. [PMID: 23650646 DOI: 10.1177/0003319713489166] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
We assessed the differences in the knowledge and level of awareness of hypertension among patients with hypertension from Central Poland; 248 (57.6% females) patients diagnosed with hypertension completed a questionnaire. Most (79%) of the patients were unaware of the optimal blood pressure (BP) range. The elderly patients did not know the symptoms of hypertension (23.7%), were not willing to make lifestyle changes (57%-65%), and had a poor awareness of hypertension therapy in the absence of symptoms (28.7%). Poor BP control occurred mainly in rural residents (10.7%) and in people with higher education (39.3%). Untreated patients with hypertension did not know the symptoms of hypertension (29.2%), rarely measured BP (37.5%), but were more likely to engage in regular physical activity (70.8%). Efforts should be made to improve knowledge of hypertension, especially among the rural population, the elderly patients, those with a low-education level, and in young males who had the highest BP.
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Affiliation(s)
- Marta Michalska
- Department of Hypertension, Medical University of Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Michael J Pencina
- Department of Biostatistics, Boston University, Harvard Clinical Research Institute, Boston, MA, USA
| | - Tomasz Zdrojewski
- Department of Hypertension and Diabetology, Medical University in Gdansk, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
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162
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Steckiph D, Calabrese G, Bertucci A, Mazzotta A, Vagelli G, Gonella M, Stamopoulos D, Manios E, Papachristos N, Grapsa E, Papageorgiou G, Gogola V, So B, Dey V, Spalding EM, Libetta C, Esposito P, Margiotta E, Maffioli P, Bonaventura A, Bianchi L, Romano D, Rampino T, De Rosa G, Mauric A, Haug U, Enzinger G, Kern-Derstvenscheg E, Sluga A, Ausserwinkler C, Beck W, Rosenkranz AR, Maheshwari V, Haroon S, Loy Y, Samavedham L, Rangaiah GP, Lau T, Stamopoulos D, Mpakirtzi N, Panagiotou M, Barbarousi D, Matsouka C, Grapsa E, Bunani AD, Kowalczyk M, Bartnicki P, Banach M, Rysz J, Lentini P, Zanoli L, Granata A, Contestabile A, Basso A, Berlingo G, Pellanda V, de Cal M, Grazia V, Clementi A, Insalaco M, Dell'Aquila R, Karkar A, Abdelrahman M, Martins AR, Parreira L, Duque AS, Rodrigues I, Baffoun AB, Youssfi MA, Sayeh A, Beji M, Ben Khadra R, Hmida J, Akazawa M, Horiuchi H, Hori Y, Yamada A, Satou H, Odamaki S, Nakai S, Satou K, Aoki K, Saito I, Kamijo Y, Ogata S, Ishibashi Y, Basso F, Wojewodzka-Zelezniakowicz M, Cruz D, Giuliani A, Blanca Martos L, Piccinni P, Ronco C, Potier J, Queffeulou G, Bouet J, Nilsson A, Sternby J, Grundstrom G, Alquist M, Ferraresi M, Di Vico MC, Vigotti FN, Deagostini M, Scognamiglio S, Consiglio V, Clari R, Moro I, Mongilardi E, Piccoli GB, Hancock V, Huang S, Nilsson A, Grundstrom G, Nilsson Ekdahl K, Calabrese G, Steckiph D, Bertucci A, Baldin C, Petrarulo M, Mancuso D, Vagelli G, Gonella M, Inguaggiato P, Canepari G, Gigliola G, Ferrando C, Meinero S, Sicuso C, Pacitti A, Stamopoulos D, Mpakirtzi N, Manios E, Afentakis N, Grapsa E, Tomo T, Matsuyama K, Nakata T, Ishida K, Takeno T, Kadota JI, Minakuchi J, Kastl J, Merello M, Boccato C, Giordana G, Mazzone S, Moscardo V, Kastl J, Giordana G, Reinhardt B, Knaup R, Kruger W, Tovbin D, Kim S, Avnon L, Zlotnik M, Storch S, Umimoto K, Shimamoto Y, Suyama M, Miyata M, Bosch Benitez-Parodi E, Baamonde Laborda EE, Perez G, Ramirez JI, Ramirez Puga A, Guerra R, Garcia Canton C, Lago Alonso MM, Toledo A, Checa Andres MD, Latif FE, Mochida Y, Matsumoto K, Morita K, Tsutsumi D, Ishioka K, Maesato K, Oka M, Moriya H, Hidaka S, Ohtake T, Kobayashi S, Ficheux A, Gayrard N, Duranton F, Guzman C, Szwarc I, Bismuth-Mondolfo J, Brunet P, Servel MF, Argiles A, Tsikliras N, Mademtzoglou S, Balaskas E, Zeid M, Mostafa A, Mowafy MN, Abdo EI, Al Amin OM, Ksiazek A, Zaluska W, Waniewski J, Debowska M, Wojcik-Zaluska A, Elias M, Francois H, Obada E, Lorenzo HK, Charpentier B, Durrbach A, Beaudreuil S, Imamovic G, Marcelli D, Bayh I, Hrvacevic R, Kapun S, Grassmann A, Scatizzi L, Maslovaric J, Daelemans R, Mesens S, Mohamed EA, Wafae A, Kawtar H, Mohamed Amine H, Driss K, Mohammed B. Extracorporeal dialysis: techniques and adequacy - A. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft116] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Nikolic D, Nikfar S, Salari P, Rizzo M, Ray KK, Pencina MJ, Mikhailidis DP, Toth PP, Nicholls SJ, Rysz J, Abdollahi M, Banach M. Effects of statins on lipid profile in chronic kidney disease patients: a meta-analysis of randomized controlled trials. Curr Med Res Opin 2013; 29:435-51. [PMID: 23427811 DOI: 10.1185/03007995.2013.779237] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE The available data on statin effects in chronic kidney disease (CKD) patients are still conflicting. We investigated the impact of short- and long-term statin therapy on lipid profiles in CKD patients requiring or not requiring dialysis. RESEARCH DESIGN AND METHODS Data from Scopus, PubMed, Web of Science, and the Cochrane Library from 1966 to May 2012 were searched for studies that investigated this effect. We included all randomized controlled clinical trials that investigated the impact of statin therapy on lipids and lipoproteins. RESULTS The final analysis included 16 trials with 3594 subjects. In CKD patients, statin therapy significantly reduced total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) (p < 0.003 for all comparisons), and the effect insignificantly intensified with duration of statin therapy (56.3 vs 66.8, 22.5 vs 24.1, and 53 vs 56.1 mg/dl, respectively). Comparing statin therapy for ≤ 3 and >3 months in CKD patients on dialysis, the magnitude of TC and LDL-C decreased (26.3 vs 25.9, and 42.2 vs 29.8 mg/dl, respectively, p > 0.05 for both), while TG increased modestly (4.5 vs 13.4 mg/dl). Short-term statin therapy increased high density lipoprotein cholesterol by a mean 0.7 mg/dl (p = 0.04), and long-term therapy was associated with a mean reduction of 2.4 mg/dL. CONCLUSIONS Statin therapy significantly modifies the lipid profile in CKD patients not on dialysis therapy (with the trend to be more effective with longer therapy), and have less beneficial effect in patients on dialysis with the trend to be less effective with longer duration of therapy.
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Affiliation(s)
- Dragana Nikolic
- BioMedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
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Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Gelev S, Toshev S, Trajceska L, Pavleska S, Selim G, Dzekova P, Shikole A, Ulu SM, Yilmaz F, Ahsen A, Akci A, Yuksel S, Mihaescu A, Olariu N, Avram C, Schiller O, Schiller A, Xiao DM, Niu JY, Gu Y, Drechsler C, van den Broek H, Vervloet M, Hoekstra T, Dekker F, Ketteler M, Brandenburg V, Turkvatan A, Kirkpantur A, Mandiroglu S, Afsar B, Seloglu B, Alkis M, Erkula S, GURBUZ H, Serin M, CALIK Y, Mandiroglu F, Balci M, Choi BS, Choi SR, Park HS, Hong YA, Chung BH, Kim YS, Yang CW, Kim YS, Park CW, Jung JY, Sung JY, Kim AJ, Kim HS, Lee C, Ro H, Chang JH, Lee HH, Chung W, Sezer S, Bal Z, Tutal E, Bal U, Erkmen Uyar M, Ozdemir Acar N, Karakas Y, Sahin G, Urfali F, Bal C, Akcar Degirmenci N, Sirmagul B, Janda K, Krzanowski M, Dumnicka P, Kusnierz-Cabala B, Sulowicz W, Balci M, Kirkpantur A, Mandiroglu S, Afsar B, Seloglu B, Alkis M, Serin M, CALIK Y, Erkula S, GURBUZ H, Mandiroglu F, Turkvatan A, Valtuille RA, Gonzalez MS, Casos ME, Yoshida T, Yamashita M, Hayashi M, Raikou VD, Tentolouris N, Makropoulos I, Kaisidis P, Boletis JN, Abdalla AA, Roche D, Forbes JF, Hannigan A, Hegarty A, Cronin CJ, Casserly LF, Stack AG, Guinsburg A, Raimann JG, Usvyat L, Kooman J, Marelli C, Etter M, Marcelli D, Levin NW, Kotanko P, Kim CS, Choi JS, Bae EH, Ma SK, Kim SW, Ryu JH, Lee S, Ryu DR, Kim SJ, Kang DH, Choi KB, Shoji T, Tsuchikura S, Shimomura N, Kakiya R, Tsujimoto Y, Tabata T, Emoto M, Nishizawa Y, Inaba M, Selim G, Stojceva-Taneva O, Tozija L, Georgievska-Ismail L, Gelev S, Dzekova-Vidimliski P, Trajceska L, Petronievic Z, Sikole A, Wu CJ, Pan CF, Chen HH, Lin CJ, Kim Y, Kim JK, Song YR, Kim SG, Kim HJ, Kuwahara M, Bannai K, Kikuchi K, Yamato H, Segawa H, Miyamoto KI, De Mauri A, Chiarinotti D, Ruva CE, David P, Capurro F, De Leo M, Han JH, Kim HR, Ko KI, Kim CH, Koo HM, Doh FM, Lee MJ, Oh HJ, Han SH, Yoo TH, Choi KH, Kang SW, Shibata K, Sohara H, Kuji T, Kawata S, Kogudhi N, Nishihara M, Satta H, Jung JY, Ro H, Lee C, Kim SM, Kim AJ, Kim HS, Chang JH, Lee HH, Chung W, Kramann R, Erpenbeck J, Becker M, Brandenburg V, Kruger T, Marx N, Floege J, Schlieper G, Power A, Fogarty D, Wheeler D, Kerschbaum J, Schwarz CP, Mayer G, Prajitno CW, Matsuzawa R, Matsunaga A, Ishii A, Abe Y, Yoneki K, Harada M, Takagi Y, Yoshida A, Takahira N, Sirch J, Pfeiffer S, Fischlein T, El-Nahid MS, Issac MS, Bal Z, Tutal E, Bal U, Erkmen Uyar M, Guliyev O, Sayin B, Sezer S, Bajari T, Hermann M, Gmeiner B, Regele H, Aumayr K, Gensberger ET, Scharrer S, Sengoge G, Novo A, Tania S, Anes E, Domingues A, Mendes E, Batista G, Viana J, Rroji M, Cafka M, Seferi S, Seiti J, Petrela E, Likaj E, Thereska N, Selim G, Stojceva-Taneva O, Tozija L, Georgievska-Ismail L, Gelev S, Dzekova-Vidimliski P, Trajceska L, Petronievic Z, Sikole A, Turkmen K, Ozcicek F, Erdur F, Turk S, Yeksan M, Tonbul H, Castellano S, Palomares I, Merello JI, Mandiroglu S, Torkvatan A, Balci M, Seloglu B, Alkis M, Serin M, Erkula S, Gurbuz H, Calik Y, Afsar B, Mandiroglu F, Kirkpantur A, Ulusal Okyay G, Okyay K, Polattas Solak E, Sahinaslan A, Pasaoglu O, Ayerden Ebinc F, Boztepe Derici U, Sindel S, Arinsoy T, Lee YK, Son SY, Choi MJ, Lee SM, Yoon JW, Koo JR, Noh JW, Vaziri ND, Matias P, Amaral T, Ferreira AC, Mendes M, Azevedo A, Jorge C, Aires I, Gil C, Ferreira A, Carretero Dios D, Merello Godino JI, Moran Risco JE, Castellano Gasch S, Schwermer K, Hoppe K, Klysz P, Radziszewska D, Sikorska D, Nealis J, Polcyn-Adamczak M, Zaremba-Drobnik D, Pawlaczyk K, Oko A, Mentese A, Yavuz A, Karahan C, Sumer A, Ozkan G, Ulusoy S, Yildiz G, Duman A, Aydin H, Yilmaz A, Hur E, Magden K, Cetin G, Candan F, Franczyk-Skora B, Gluba A, Kowalczyk M, Banach M, Rysz J, Novo A, Domingues A, Preto L, Sousa T, Mendes E, Batista G, Vaz J, Oue M, Kuragano T, Hamahata S, Fukao W, Toyoda K, Nakanishi T, Otsubo S, Tsuchiya K, Akiba T, Nitta K, Afsar B, Saglam M, Yuceturk C, Agca E, Tosic J, Djuric Z, Popovic J, Buzadzic I, Djuric P, Jankovic A, Dimkovic N, Simone S, Dell'Oglio MP, Ciccone M, Castellano G, Corciulo R, Balestra C, Giangrande M, Gigante M, Grandaliano G, Gesualdo L, Pertosa GP, Mohamed EA, Marouane B, Mohamed Reda EF, Aziz R, Hicham B, Youssef B, Abdennasser EK, Salaheddine T, Mohammed A, Hwang JC, Jiang MY, Lu YH, Wang CT, Grzegorzewska A, Cieszynski K, Niepolski L, Sowinska A, Abdallah E, Al-Helal B, Waked E, Abdel-Khalik A, Nabil M, El-Shanawany F, Tekce H, Kursat S, Bahadir Colak H, Aktas G, Ozcicek A, Turkmen K, Ozcicek F, Akbas E, Demirtas L, Ozbicer A, Cetinkay R, Capoglu I, Valocikova I, Valocik G, Vachalcova M, Kolesarova E, Nowak A, Friedrich B, Artunc F, Serra A, Breidthardt T, Twerenbold R, Peter M, Potocki M, Muller C. Cardiovascular complications in CKD 5D. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stępień M, Stępień A, Banach M, Wlazeł RN, Paradowski M, Rizzo M, Toth PP, Rysz J. New Obesity Indices and Adipokines in Normotensive Patients and Patients With Hypertension. Angiology 2013; 65:333-42. [DOI: 10.1177/0003319713485807] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
We compared the obesity parameters and selected adipokines—leptin, adiponectin, and resistin—in obese patients with hypertension and normotensive patients. A total of 67 nondiabetic obese outpatients were divided into 2 groups: A–hypertensive and B–normotensive. Serum levels of leptin, adiponectin, resistin, and insulin were measured. Weight, height, waist circumference, and hip circumference were measured to calculate waist-to-hip ratio (WHR), weight-to-height ratio, visceral adiposity index, and body adiposity index (BAI). Among patients with hypertension, significant positive correlations were observed between leptin and body mass index and BAI ( r = .31 and r = .63, respectively). In normotensive patients, leptin positively correlated with BAI ( r = .73, P < .01) and negatively with WHR ( r = −.55, P < .0001); adiponectin negatively correlated with WHR ( r = .38, P < .01) and BAI ( r = .52; P < .0001), and resistin negatively correlated with WHR ( r = −.36, P < .05). In conclusion, visceral obesity and leptin are associated with hypertension in obese patients.
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Affiliation(s)
- Mariusz Stępień
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Anna Stępień
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Rafał N. Wlazeł
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Lodz, Poland
| | - Marek Paradowski
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
| | - Manfredi Rizzo
- BioMedical Department of Internal Medicine and Medical Specialties, University of Palermo, Italy
- Euro-Mediterranean Institute of Science and Technology, Italy
| | - Peter P. Toth
- CGH Medical Center, Sterling, IL, USA
- University of Illinois College of Medicine, Peoria, IL, USA
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Medical University of Lodz, Lodz, Poland
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Marta M, Zanchetti A, Wong ND, Malyszko J, Rysz J, Banach M. Patients with prehypertension - do we have enough evidence to treat them? Curr Vasc Pharmacol 2013; 12:586-97. [PMID: 23627984 DOI: 10.2174/15701611113119990126] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2012] [Revised: 11/24/2012] [Accepted: 11/28/2012] [Indexed: 11/22/2022]
Abstract
In 2003, the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure established a definition of a new category of BP levels called 'prehypertension' (preHT) that included individuals with a systolic BP of 120-139 mm Hg or a diastolic BP of 80-89 mm Hg. Patients with preHT were considered to be at increased risk for progression to hypertension and in individuals with BP in the range 130/80 to 139/89 mmHg the risk of developing hypertension was twice as high as in subjects with lower values. Still then there has been a large debate whether the introduction of preHT was based on evidence and as a consequence, it was fully justified. It has been suggested that the term prehypertension may in many subjects create anxiety and a need for unnecessary medical visits and examinations. This group of patients is also very heterogeneous and it has been pointed out that subdividing preHT group into individuals with normal BP and high normal BP would much better correspond to the continuum of BP risk for CV disease. Finally, despite some data suggesting the potential benefits of antihypertensive therapy in patients with preHT (high normal BP), there are still no hard evidences on the outcome reduction by giving antihypertensive drugs in these individuals.
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Affiliation(s)
| | | | | | | | | | - Maciej Banach
- Department of Hypertension, WAM University Hospital in Lodz, Medical University of Lodz, Zeromskiego 113; 90-549 Lodz, Poland.
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Banach M, Nikfar S, Rahimi R, Bielecka-Dabrowa A, Pencina MJ, Mikhailidis DP, Narkiewicz K, Rysz J, Ray KK, Abdollahi M. The effects of statins on blood pressure in normotensive or hypertensive subjects--a meta-analysis of randomized controlled trials. Int J Cardiol 2013; 168:2816-24. [PMID: 23602289 DOI: 10.1016/j.ijcard.2013.03.068] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2012] [Revised: 02/26/2013] [Accepted: 03/27/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to investigate whether statin therapy is associated with blood pressure (BP)-lowering in patients with or without hypertension. BACKGROUND The beneficial effects of statins on the cardiovascular system may in part be related to effects beyond lipid-lowering. It has been suggested that statins may reduce BP; however the available data are still ambiguous and often conflicting. METHODS Data from Scopus, PubMed, Web of Science, and the Cochrane Central Register of Controlled Trials for the years 1966-January 2012 were searched for studies that investigated the effect of statins on BP in normotensive or in hypertensive subjects. We included all randomized controlled clinical trials that investigated this effect. Changes in systolic and diastolic BP were the key outcomes of interest. RESULTS The final analysis included 18 trials and 5628 subjects (4692 normotensive and 936 hypertensive patients) randomized to receive either statins or placebo. The weighted mean difference of systolic (∆SBP) and diastolic blood pressure (∆DBP) in normotensive patients for the 11 statin trials included were 0.03 (95% CI: -0.95-1.02; p = 0.95) and -0.28 (95% CI: -0.80-0.24; p = 0.29), respectively. For hypertensive patients treated with statins (8 trials) the weighted mean difference of ∆SBP and ∆DBP were 1.45 (95% CI: -0.49-3.39; p = 0.14) and -1.32 (95% CI: -3.93-1.28; p = 0.32) respectively. CONCLUSIONS Despite previous suggestions statin therapy in normotensive or hypertensive patients does not lead to significant reductions in systolic or diastolic BP.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland.
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Majewska E, Wittek N, Rysz J, Baj Z. The influence of uremic high cystatin C concentration on neutrophil apoptosis and selected neutrophil functions isolated from healthy subjects. Med Sci Monit 2013; 18:CR667-73. [PMID: 23111743 PMCID: PMC3560614 DOI: 10.12659/msm.883545] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
Background Cystatin C (cC) is a cysteine protease inhibitor that may influence immune response. Our aim was to test the effect of a high concentration of cC, characteristic for uremic patients, on neutrophil (PMN) apoptosis and respiratory burst, as well as the cC secretion from PMNs stimulated with proinflammatory cytokines. Material/Methods PMNs from 35 healthy volunteers aged 27–61 years were cultured in presence of cC, IL-1β or TNF-α. The percentage of apoptotic cells based on DNA depletion, Fas, FasL and caspase -3 expression were assessed. CC concentrations were determined by ELISA test. The influence of cC on spontaneous, fMLP-, PMA- or OZ-induced burst response of PMNs was tested using chemiluminescence. Results PMN cultured in the presence of cC resulted in a significant drop in apoptotic cell percentage (38% [11%; 65%]) compared both to control (70% [29%; 92%], and to the cells cultured with TNF-α (58% [24%; 85%]). These differences were not accompanied by Fas, FasL and caspase-3 expression changes. Spontaneous, fMLP- and PMA-stimulated oxidative burst of PMNs preincubated with cC were significantly downregulated. IL-1β markedly diminished and TNF-α significantly increased cC concentration in culture supernatants. Conclusions The presented results suggest that antiapoptotic activity of cC results from its inhibitory effect on ROS production. Thus, the higher concentration of cC characteristic for uremic patients may modulate acute inflammation through maintaining PMN longevity and inhibiting their respiratory burst and proinflammatory cytokine-related changes in cC release from PMNs.
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Affiliation(s)
- Ewa Majewska
- Department of Pathophysiology and Immunopathology of Exercise, Medical University, Lodz, Poland.
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Bielecka-Dabrowa A, Mikhailidis DP, Rizzo M, von Haehling S, Rysz J, Banach M. The influence of atorvastatin on parameters of inflammation left ventricular function, hospitalizations and mortality in patients with dilated cardiomyopathy--5-year follow-up. Lipids Health Dis 2013; 12:47. [PMID: 23566246 PMCID: PMC3641983 DOI: 10.1186/1476-511x-12-47] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Accepted: 03/31/2013] [Indexed: 12/22/2022] Open
Abstract
Background We assessed the influence of atorvastatin on selected indicators of an inflammatory condition, left ventricular function, hospitalizations and mortality in patients with dilated cardiomyopathy (DCM). Methods We included 68 DCM patients with left ventricular ejection fraction (LVEF) ≤40% treated optimally in a prospective, randomized study. They were observed for 5 years. Patients were divided into two groups: patients who were commenced on atorvastatin 40 mg daily for two months followed by an individually matched dose of 10 or 20 mg/day (group A), and patients who were treated according to current recommendations without statin therapy (group B). Results After 5-year follow-up we assessed 45 patients of mean age 59 ± 11 years - 22 patients in group A (77% male) and 23 patients in group B (82% male). Interleukin-6, tumor necrosis factor alpha, and uric acid concentrations were significantly lower in the statin group than in group B (14.96 ± 4.76 vs. 19.02 ± 3.94 pg/ml, p = 0.012; 19.10 ± 6.39 vs. 27.53 ± 7.39 pg/ml, p = 0.001, and 5.28 ± 0.48 vs. 6.53 ± 0.46 mg/dl, p = 0.001, respectively). In patients on statin therapy a reduction of N-terminal pro-brain natriuretic peptide concentration (from 1425.28 ± 1264.48 to 1098.01 ± 1483.86 pg/ml, p = 0.045), decrease in left ventricular diastolic (from 7.15 ± 0.90 to 6.67 ± 0.88 cm, p = 0.001) and systolic diameters (from 5.87 ± 0.92 to 5.17 ± 0.97, p = 0.001) in comparison to initial values were observed. We also showed the significant increase of LVEF in patients after statin therapy (from 32.0 ± 6.4 to 38.8 ± 8.8%, p = 0.016). Based on a comparison of curves using the log-rank test, the probability of survival to 5 years was significantly higher in patients receiving statins (p = 0.005). Conclusions Atorvastatin in a small dose significantly reduce levels of inflammatory cytokines and uric acid, improve hemodynamic parameters and improve 5-year survival in patients with DCM.
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Banach M, Rizzo M, Obradovic M, Montalto G, Rysz J, P. Mikhailidis D, R. Isenovic E. PCSK9 Inhibition - A Novel Mechanism to Treat Lipid Disorders? Curr Pharm Des 2013; 19:3869-77. [DOI: 10.2174/13816128113199990303] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Accepted: 12/25/2012] [Indexed: 11/22/2022]
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Gluba A, Mikhailidis DP, Lip GY, Hannam S, Rysz J, Banach M. Metabolic syndrome and renal disease. Int J Cardiol 2013; 164:141-50. [DOI: 10.1016/j.ijcard.2012.01.013] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Revised: 10/31/2011] [Accepted: 01/06/2012] [Indexed: 02/07/2023]
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Kozlowski D, Budrejko S, Raczak G, Rysz J, Banach M. Anticoagulant Prevention in Patients with Atrial Fibrillation: Alternatives to Vitamin K Antagonists. Curr Pharm Des 2013; 19:3816-26. [DOI: 10.2174/1381612811319210007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 12/25/2012] [Indexed: 11/22/2022]
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Awsiuk K, Budkowski A, Petrou P, Bernasik A, Marzec M, Kakabakos S, Rysz J, Raptis I. Model immunoassay on silicon surfaces: Vertical and lateral nanostructure vs. protein coverage. Colloids Surf B Biointerfaces 2013. [DOI: 10.1016/j.colsurfb.2012.10.047] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Wlazeł RN, Rysz J, Paradowski M. Examination of serum pregnancy-associated plasma protein A clinical value in acute coronary syndrome prediction and monitoring. Arch Med Sci 2013; 9:14-20. [PMID: 23515702 PMCID: PMC3598147 DOI: 10.5114/aoms.2013.33343] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2011] [Revised: 11/10/2011] [Accepted: 12/20/2011] [Indexed: 12/23/2022] Open
Abstract
INTRODUCTION Chronic vascular inflammatory process promotes and intensifies all atherogenic events. The aim of this research was to estimate the clinical value of pregnancy-associated plasma protein A (PAPP-A) measurement associated with plaque destabilization and rupture in prediction and monitoring of acute coronary syndromes (ACS) as well as to assess the predictive value of this biomarker in comparison to traditional myocardial infarction (MI) risk markers. MATERIAL AND METHODS The study included 119 patients in 2 investigated groups and one control group. PAPP-A assay was performed using manual ELISA kit, DRG. All other parameters were determined using automatic analyzers: Olympus and Dade Behring. RESULTS A statistically significant difference between PAPP-A concentration median value was found in the investigated group MI individuals' serum and control group individuals' serum (11.42 ng/ml and 7.22 ng/ml respectively, p = 0.003). PAPP-A assay had the highest specificity (83.3%) and sensitivity (53.8%), and therefore the highest clinical value. In patients with clinically and laboratory confirmed MI we proved that PAPP-A serum level is a clinically useful biomarker in ACS prediction, better than C-reactive protein (hsCRP) and fibrinogen (FBG) level. CONCLUSIONS The highest diagnostic efficiency for ACS prediction was proved for simultaneous panel assays consisting of 2-3 parameters (PAPP-A - hsCRP, PAPP-A - FBG, PAPP-A - hsCRP - FBG), while PAPP-A itself does not show characteristics necessary for it to be used as a biomarker for MI dynamic monitoring. It is possible that prothrombotic component is mainly responsible for repeated major adverse cardiac events, more than inflammatory process.
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Affiliation(s)
- Rafał Nikodem Wlazeł
- Department of Laboratory Medicine and Clinical Biochemistry, Medical University of Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Marek Paradowski
- Department of Laboratory Medicine and Clinical Biochemistry, Medical University of Lodz, Poland
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Abstract
We compared adipokines and inflammatory markers in obese insulin-sensitive (group A, n = 16) and insulin-resistant (group B, n = 48) patients divided according to homeostasis model assessment of insulin resistance (HOMA-IR). Serum levels of adiponectin, leptin, resistin, high-sensitivity C-reactive protein, interleukin 6, and tumor necrosis factor α were measured. Weight, height, waist (WC) and hip circumferences, waist to hip ratio , weight to height ratio, visceral adiposity index (VAI), and body adiposity index (BAI) were measured. The WC and VAI were significantly higher in group B (113.9 ± 11.1 vs 105.3 ± 9.8 cm; P < .01 and 2.3 ± 1.1 vs 1.6 ± 0.9; P < .05, respectively), while serum adiponectin levels were higher in group A (24.5 ± 14.6 vs 15.1 ± 9.6 ng/mL; P < .005). The BAI strongly correlated with adiponectin and leptin in group B (r = .479; P < .001 and r = .705; P < .001). Insulin resistance is associated with visceral adiposity described by VAI and WC. The BAI may be a useful index in obese patients, especially with insulin resistance.
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Affiliation(s)
- Mariusz Stepien
- 1Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland
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Abstract
Cardiovascular deaths account for about 40% of all deaths of patients with chronic kidney disease (CKD), particularly those on dialysis, while sudden cardiac death (SCD) might be responsible for as many as 60% of SCD in patients undergoing dialysis. Studies have demonstrated a number of factors occurring in hemodialysis (HD) that could lead to cardiac arrhythmias. Patients with CKD undergoing HD are at high risk of ventricular arrhythmia and SCD since changes associated with renal failure and hemodialysis-related disorders overlap. Antiarrhythmic therapy is much more difficult in patients with CKD, but the general principles are similar to those in patients with normal renal function - at first, the cause of arrhythmias should be found and eliminated. Also the choice of therapy is narrowed due to the altered pharmacokinetics of many drugs resulting from renal failure, neurotoxicity of certain drugs and their complex interactions. Cardiac pacing in elderly patients is a common method of treatment. Assessment of patients’ prognosis is important when deciding whether to implant complex devices. There are reports concerning greater risk of surgical complications, which depends also on the extent of the surgical site. The decision concerning implantation of a pacing system in patients with CKD should be made on the basis of individual assessment of the patient.
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Affiliation(s)
- Beata Franczyk-Skóra
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Poland
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Malyszko J, Malyszko JS, Rysz J, Mysliwiec M, Tesar V, Levin-Iaina N, Banach M. Renalase, hypertension, and kidney - the discussion continues. Angiology 2012; 64:181-7. [PMID: 22969162 DOI: 10.1177/0003319712459212] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Hypertension and cardiovascular complications are very common in chronic kidney disease (CKD). Overactivation of sympathetic nervous system is also widely recognized in CKD. Renalase may play an important role in the control of blood pressure (BP) by its regulatory function of catecholamine metabolism. Renalase could be synthesized not only by the kidney but also by cardiomyocytes, liver, and adipose tissue. It probably exerts a hypotensive action, at least in animal models. Whether it metabolizes catecholamines remains to be proved. Another issue that remains to be resolved is the relationship between renalase and renal natriuresis and phosphaturia. In this review, the updated experimental and clinical data on renalase are presented and possible interactions with the endothelium are discussed. Renalase is "a new postulated therapeutic target." Proof of concept studies are needed to define the pathophysiological link between the kidney, sympathetic tone, BP, and cardiovascular complications.
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Affiliation(s)
- Jolanta Malyszko
- Department of Nephrology and Transplantology, Medical University in Bialystok, Bialystok, Poland.
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Kujawski K, Stasiak M, Rysz J. The evaluation of esophageal stenting complications in palliative treatment of dysphagia related to esophageal cancer. Med Sci Monit 2012; 18:CR323-9. [PMID: 22534713 PMCID: PMC3560635 DOI: 10.12659/msm.882739] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Background Esophageal cancer is the seventh-most frequent cause of cancer-related deaths and it is usually diagnosed at an inoperable stage. In palliative treatment, endoscopic and non-endoscopic methods are applied to reduce dysphagia in patients with neoplastic esophageal obstruction. Because of severe complications, non-endoscopic treatment (surgery, radiotherapy, brachytherapy and chemotherapy) is applied rarely. Within the endoscopic methods, only the use of endoprostheses yields long-term effects. The aim of this study was to evaluate the safety and efficacy of implantation of self-expandable esophageal stents in palliative treatment of dysphagia related to esophageal cancer. Material/Methods A total number of 46 patients (41 males and 5 females) were qualified to palliative implantation of coated self-expandable stent. The mean age of the patients was 67 years (from 51 to 78 years). In all patients, Evolution-type coated self-expandable stents were used. In all cases, 24 hours after the implantation, radiological examination was performed to assess the stent location. Results Severe, possibly life-threatening, complications constituted 28% of all the complications and occurred in 9% of the patients. Less severe complications occurred in 17% of the observed patients and were not life-threatening. Conclusions In patients with neoplastic esophageal stenosis, stenting with coated, self-expandable nitinol prostheses is a safe, effective and fast method of palliative dysphagia treatment.
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Affiliation(s)
- Krzysztof Kujawski
- Gastrointestinal Endoscopy Laboratory, WAM University Hospital, Medical University of Lodz, Lodz, Poland.
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Stępień M, Wlazeł RN, Paradowski M, Banach M, Rysz M, Misztal M, Rysz J. Serum concentrations of adiponectin, leptin, resistin, ghrelin and insulin and their association with obesity indices in obese normo- and hypertensive patients - pilot study. Arch Med Sci 2012; 8:431-6. [PMID: 22851996 PMCID: PMC3400908 DOI: 10.5114/aoms.2012.29397] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2012] [Revised: 06/05/2012] [Accepted: 06/11/2012] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Hypertension often coexists with obesity. Adipokines, ghrelin and insulin play important roles in the pathogenesis of both diseases. The aim of this study was to compare adiponectin, leptin, resistin, insulin and ghrelin mean serum concentrations and insulin resistance (HOMA-IR) in normo- and hypertensive patients with obesity. MATERIAL AND METHODS ALL INCLUDED PATIENTS WERE DIVIDED ON THE FOLLOWING GROUPS: non-diabetic hypertensive patients with class I obesity (group A, n = 21) and class II/III obesity (group B, n = 10), and normotensive obese (class I)patients (group C, n = 7). Correlations between obesity indices (body mass index [BMI], waist-to-hip ratio [WHR], waist circumference [WC]), HOMA-IR, and hormone and adipokine serum levels were also analyzed. RESULTS Leptin level and HOMA-IR were significantly higher in group B compared to group C (9.74 ±3.88 ng/ml vs. 4.53 ±3.00 ng/ml; p < 0.02 and 3.30 ±1.59 vs. 1.65 ±0.41; p < 0.02, respectively). A negative correlation between WC and adiponectin level (R = -0.6275; p < 0.01) and a positive correlation between WC and insulin concentration (R = 0.5122; p< 0.05) as well as with HOMA-IR (R = 0.5228; p < 0.02) were found in group A. Negative correlations between BMI and ghrelin level (R = -0.7052; p < 0.05), WHR and adiponectin level (R = -0.6912; p < 0.05) and WHR and leptin level (R = -0.6728; p < 0.05) were observed in group B. CONCLUSIONS Insulin resistance and leptin may be important pathogenic factors in hypertensive patients with severe obesity. Indices of abdominal obesity (WC, WHR) correlate better than BMI with HOMA-IR, insulin, adiponectin and leptin serum levels in hypertensive obese patients.
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Affiliation(s)
- Mariusz Stępień
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital, Lodz, Poland
| | - Rafał N. Wlazeł
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Poland
| | - Marek Paradowski
- Department of Laboratory Diagnostics and Clinical Biochemistry, Medical University of Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
| | - Magdalena Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital, Lodz, Poland
| | | | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital, Lodz, Poland
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181
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Usvyat LA, Raimann J, Thijssen S, van der Sande FM, Kooman J, Levin NW, Kotanko P, Von Gersdorff G, Schaller M, Bayh I, Etter M, Grassmann A, Guinsburg A, Kooman J, Lam M, Marcelli D, Marelli C, Scatizzi L, Tashman A, Thijssen S, Toffelmire T, Usvyat L, Van der Sande F, Wang Y, Levin NW, Barth C, Kotanko P, Moffitt T, Moffitt T, Hariton F, Devlin M, Garrett P, Hannon-Fletcher M, Ekramzadeh M, Sohrabi Z, Salehi M, Fallahzadeh MK, Ayatollahi M, Geramizadeh B, Hassanzadeh J, Sagheb MM, Beberashvili I, Beberashvili I, Sinuani I, Azar A, Kadoshi H, Shapiro G, Feldman L, Averbukh Z, Weissgarten J, Abe Y, Watanabe M, Ito K, Sasatomi Y, Ogahara S, Nakashima H, Saito T, Witt S, Kunze R, Guth HJ, Skarabis H, Kunze R, Vienken J, Nowak P, Wilk R, Mamelka B, Prymont-Przyminska A, Zwolinska A, Sarniak A, Wlodarczyk A, Rysz J, Nowak D, Trajceska L, Dzekova-Vidimliski P, Gelev S, Arsov S, Sikole A, Sonikian M, Dona A, Skarakis I, Metaxaki P, Chiotis C, Papoutsis I, Karaitianou A, Spiliopoulou C, Marcelli D, Tashman A, Guinsburg A, Grassmann A, Barth C, Marelli C, Van der Sande FM, Von Gersdorff G, Bayh I, Kooman J, Scatizzi L, Lam M, Schaller M, Etter M, Thijssen S, Toffelmire T, Wang Y, Usvyat LA, Kotanko P, Levin NW, Teta D, Teta D, Tappy L, Theumann N, Halabi G, Gauthier T, Mathieu C, Tremblay S, Coti P, Burnier M, Zanchi A, Martinez Vea A, Cabre C, Villa D, Munoz M, Vives JP, Arruche M, Soler J, Compte MT, Aguilera J, Romeu M, Giralt M, Barril G, Anaya S, Vozmediano C, Celayeta A, Novillo R, Bernal V, Beiret I, Huarte E, Martin J, Santana H, Torres G, Sousa F, Sanchez R, Lopez-Montes A, Tornero F, Uson J, Pousa M, Giorgi M, Rdez Cubillo B, Malhotra R, Malhotra R, Usvyat L, Abbas SR, Thjissen S, Carter M, Etter M, Tashman A, Guinsburg A, Grassmann A, Barth C, Marelli C, Van der Sande F, von Gersdorff G, Bayh I, Kooman J, Scatizzi L, Lam M, Schaller M, Toffelmire T, Wang Y, Marcelli D, Levin N, Kotanko P, Jens R, Tepel M, Katharina E, Andrea H, Simone F, Florian S, Slusanschi O, Garneata L, Moraru R, Preoteasa E, Barbulescu C, Santimbrean C, Klein C, Dragomir D, Mircescu G, Idorn T, Knop F, Holst JJ, Hornum M, Feldt-Rasmussen B, Son YK, An WS, Kim SE, Kim KH, Garneata L, Slusanschi O, Preoteasa E, Barbulescu C, Santimbrean C, Klein C, Mircescu G, Borrelli S, Minutolo R, De Nicola L, Conte G, De Simone W, Zito B, Guastaferro P, Nigro F, Bassi A, Leone L, Credendino O, Genualdo R, Capuano M, Iulianiello G, Auricchio MR, Sezer S, Bal Z, Tutal E, Erkmen Uyar M, Ozdemir Acar FN, Ribeiro S, Faria MS, Melo F, Sereno J, Freitas I, Mendonca M, Nascimento H, Fernandes J, Rocha-Pereira P, Miranda V, Mendonca D, Quintanilha A, Belo L, Costa E, Reis F, Santos-Silva A, Valtuille R, Casos ME, Fernandez EA. Nutrition, inflammation and oxidative stress - CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Fliser D, Shilo V, Covic A, Besarab A, Provenzano R, Duliege AM, Chen M, Tong S, Francisco C, Gao HY, Polu K, De Francisco AL, Macdougall I, Macdougall I, Schiller B, Locatelli F, Wiecek A, Francisco C, Tang H, Tong S, Chen M, Duliege AM, Polu K, Mayo M, Covic A, Macdougall I, Macdougall I, Casadevall N, Stead R, Taal M, Faller B, Karras A, Chen M, Tong S, Duliege AM, Rowell R, Polu K, Eckardt KU, Locatelli F, Dusilova Sulkova S, Arnaud S, Bruno P, Arnaud G, Dorina V, Eric A, Gerard M, Cases A, Portoles JM, Calls J, Martinez Castelao A, Sanchez-Guisande D, Segarra A, Tsubakihara Y, Tsubakihara Y, Saito A, Saito A, Saito A, Tsubakihara Y, Martinez-Castelao A, Martinez-Castelao A, Cases A, Fort J, Bonal J, Fulladosa X, Galceran JM, Torregrosa V, Coll E, Minutolo R, Cozzolino M, DI Iorio B, Polito P, Santoro D, Manenti F, Nappi F, Feriozzi S, Conte G, De Nicola L, Mikhail A, Provenzano R, Schiller B, Besarab A, Francisco C, Gao HY, Daley R, Tong S, Mayo M, Yang A, Polu K, Macdougall I, Wiecek A, Schiller B, Canaud B, Locatelli F, Yang A, Chen M, Polu K, Francisco C, Gao HY, Tong S, Duliege AM, Provenzano R, Locatelli F, Locatelli F, Provenzano R, Besarab A, Rath T, Yang A, Mayo M, Francisco C, Macdougall I, Bartnicki P, Baj Z, Majewska E, Rysz J, Fievet P, Assem M, Brazier F, Xu X, Soltani ON, Demontis R, Barsan L, Stancu S, Stancu S, Stanciu A, Capusa C, Petrescu L, Zugravu A, Mircescu G, Malyszko JM, Levin-Iaina N, Malyszko J, Glowinska I, Koc-Zorawska E, Slotki I, Mysliwiec M, Mircescu G, Mircescu G, Capusa C, Stancu S, Barsan L, Grabowski D, Blaga V, Dumitru D, Pchelin I, Shishkin A, Kus T, Usalan C, Tiryaki O, Chin HJ, Chae DW, Kim S, Bertram H, Keller F, Rumjon A, Wood C, Wilson P, Khakoo S, Chai MO, Macdougall IC, Nuria GF, Maria Asuncion F, Jose Maria MG, Carmen C, Paloma Leticia MM, Francisco Javier L, Moniek DG, De Goeij M, Yvette M, Diana G, Friedo D, Nynke H, Lezaic V, Miljkovic B, Petkovic N, Maric I, Vucicevic K, Simic Ogrizovic S, Djukanovic L, Cases A, Martinez-Castelao A, Fort A, Bonal J, Fulladosa X, Galceran JM, Torregrosa V, Coll E, DI Giulio S, DI Giulio S, Galle J, Kiss I, Herlitz H, Wirnsberger G, Claes K, Suranyi M, Guerin A, Winearls C, Addison J, D'souza M, Froissart M, Garrido P, Garrido P, Teixeira M, Costa E, Rodrigues-Santos P, Parada B, Belo L, Alves R, Teixeira F, Santos-Silva A, Reis F, Winearls C, Winearls C, DI Giulio S, Galle J, Kiss I, Herlitz H, Wirnsberger G, Claes K, Suranyi M, Guerin A, Addison J, D'souza M, Fouqueray B, Floris M, Conti M, Cao R, Pili G, Melis P, Matta V, Murgia E, Atzeni A, Binda V, Angioi A, Peri M, Pani A, Besarab A, Belo D, Diamond S, Martin E, Sun C, Lee T, Saikali K, Franco M, Leong R, Neff T, Yu KHP, Tiranathanagul K, Praditpornsilpa K, Katavetin P, Kanjanabuch T, Avihingsanon Y, Tungsanga K, Eiam-Ong S, Macdougall IC, Casadevall N, Percheson P, Potamianou A, Foucher A, Fife D, Vercammen E. Renal anaemia - CKD 1-5. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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183
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Abstract
Traditionally, erythropoietin (EPO) is described as a hematopoietic cytokine, regulating proliferation and differentiation and survival of the erythroid progenitors. The recent finding of new sites of EPO production and the wide spread distribution of EPO receptors (EPO-R) on endothelial cells, cardiomyocytes, renal cells as well as the central and peripheral nervous system raised the possibility that EPO may exert pleiotropic actions on several targets. Indeed studies (mainly preclinical) have documented protective, non-hematopoietic, abilities of EPO in a variety of tissue. However, the data obtained from clinical studies are more skeptical about these properties. This article provides a comprehensive overview of EPO and its derivatives.
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Affiliation(s)
- Mariusz Kowalczyk
- Department of Nephrology, Hypertension and Family Medicine, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
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184
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Stepien M, Rosniak-Bak K, Paradowski M, Misztal M, Kujawski K, Banach M, Rysz J. Waist circumference, ghrelin and selected adipose tissue-derived adipokines as predictors of insulin resistance in obese patients: preliminary results. Med Sci Monit 2012; 17:PR13-18. [PMID: 22037753 PMCID: PMC3539504 DOI: 10.12659/msm.882030] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The aim of the study was to estimate the association between anthropometric obesity parameters, serum concentrations of ghrelin, resistin, leptin, adiponectin and homeostasis model assessment (HOMA-IR) in obese non-diabetic insulin-sensitive and insulin-resistant patients. Material/Methods Study subjects included 37 obese (body mass index [BMI] ≥30 kg/m2) out-clinic patients aged 25 to 66 years. Insulin resistance was evaluated by HOMA-IR. Serum fasting concentrations of glucose, insulin, ghrelin, adiponectin, resistin and leptin were measured by using the ELISA method. Body weight, waist and hip circumferences were measured to calculate BMI and waist-to-hip ratio (WHR) values for all the patients. According to HOMA-IR, patients were divided into two groups: A, insulin sensitive (n=19); and B, insulin resistant (n=18). Results Patients with insulin resistance have greater mean waist circumference (WC) higher mean serum insulin level and leptin concentration, but lower concentrations of adiponectin and ghrelin. In the insulin-sensitive patient group we observed positive correlations between BMI and HOMA-IR, WC and HOMA-IR, and adiponectin and leptin, and negative correlations between ghrelin and HOMA-IR, WC and adiponectin, and WHR and adiponectin. In the insulin-resistant group, there was a positive correlation between resistin and ghrelin and a negative correlation between WHR and leptin. Conclusions Waist circumference, adiponectin, leptin and ghrelin are associated with insulin resistance and may be predictors of this pathology.
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Affiliation(s)
- Mariusz Stepien
- Department of Nephrology, Hypertension and Family Medicine, WAM University Hospital in Lodz, Lodz, Poland.
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185
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Abstract
Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Until recently, a rhythm control strategy for AF has been limited by drug toxicity and side-effects, and landmark AF trials have shown that such a strategy is not superior to a rate control one. New antiarrhythmic drugs, free of undesired effects, would enhance the rhythm control strategy, with the possibility of sinus rhythm restoration and maintenance. One of the promising drugs recently approved for clinical use is dronedarone. This drug has amiodarone-like antiarrhythmic and electrophysiological properties, despite it having a modified structure and lacking an iodine moiety. Thus, dronedarone lacks amiodarone's organ toxicity (including adverse thyroid and pulmonary effects). The efficacy of dronedarone has been investigated in several clinical trials, proving its effect in the prevention of AF recurrence, rate control in paroxysmal/persistent and permanent AF, reduction of cardiovascular hospitalization or death from any cause, and others. Indirect comparisons with amiodarone, as well as one head-to-head study of the two drugs, indicate that the relative safety of dronedarone may be at a cost of its lower antiarrhythmic efficacy compared with amiodarone.
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Affiliation(s)
- Dariusz Kozlowski
- Department of Cardiology and Electrotherapy, Second Chair of Cardiology, Medical University of Gdansk, Poland
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186
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Awsiuk K, Bernasik A, Kitsara M, Budkowski A, Petrou P, Kakabakos S, Prauzner-Bechcicki S, Rysz J, Raptis I. Spectroscopic and microscopic characterization of biosensor surfaces with protein/amino-organosilane/silicon structure. Colloids Surf B Biointerfaces 2012; 90:159-68. [DOI: 10.1016/j.colsurfb.2011.10.017] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 09/24/2011] [Accepted: 10/11/2011] [Indexed: 10/16/2022]
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Otocka-Kmiecik A, Rysz J, Banach M. [Prodiabetic effect of statins--do we know the mechanisms of this phenomenon?]. Postepy Biochem 2012; 58:195-203. [PMID: 23214143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Statins are drugs with the unquestionable effectiveness in the reduction of low density lipoprotein cholesterol (LDL-C) and the cardiovascular risk with the acceptable safety profile. On the basis of the above statins are the most common used drugs worldwide. The present review is aimed to discuss the potential mechanisms of statins leading to occurrence of glucose metabolism disturbances through the influence on insulin secretion by the beta-cells of pancreatic islets and the cells' sensitivity on insulin. It might be a results of disadvantageous statin properties connected to the intensification of inflammation and oxidation within the pancreatic islets, and the influence on adipokines secretion by the fat tissue cells. However, it should be emphasized that despite the recommendations of US Food and Drug Administration suggesting to keep caution in connection to potentially prodiabetic statins' properties, this data need to be confirmed in large multicenter clinical trials with properly designed main endpoints.
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Affiliation(s)
- Aneta Otocka-Kmiecik
- Zakład Nadciśnienia Tetniczego, Katedra Nefrologii i Nadciśnienia Tetniczego, Uniwersytet Medyczny w Łodzi
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188
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Barylski M, Małyszko J, Rysz J, Myśliwiec M, Banach M. Lipids, blood pressure, kidney - what was new in 2011? Arch Med Sci 2011; 7:1055-66. [PMID: 22328891 PMCID: PMC3265000 DOI: 10.5114/aoms.2011.26620] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 11/10/2011] [Accepted: 12/10/2011] [Indexed: 01/12/2023] Open
Abstract
The year 2011 was very interesting regarding new studies, trials and guidelines in the field of lipidology, hypertensiology and nephrology. Suffice it to mention the new European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines on the management of dyslipidaemias, American College of Cardiology Foundation (ACCF)/American Heart Association (AHA) guidelines on hypertension in the elderly, and many important trials presented among others during the American Society of Nephrology (ASN) Annual Congress in Philadelphia and the AHA Annual Congress in Orlando. The paper is an attempt to summarize the most important events and reports in the mentioned areas in the passing year.
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Affiliation(s)
- Marcin Barylski
- Department of Internal Diseases and Cardiological Rehabilitation, Medical University of Lodz, Poland
| | - Jolanta Małyszko
- Department of Nephrology and Transplantology, Medical University of Bialystok, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Michał Myśliwiec
- Department of Nephrology and Transplantology, Medical University of Bialystok, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
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189
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Tryniszewski W, Gadzicki M, Górska-Chrząstek M, Rysz J, Maziarz Z. Bone metabolism assessment, bone metabolism index designation and the determination of its normal values range in young healthy women. Med Sci Monit 2011; 17:CR563-71. [PMID: 21959610 PMCID: PMC3539482 DOI: 10.12659/msm.881982] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Background Bone metabolism assessment requires the determination of bone mass and quality. The bone metabolism was assessed with the modified bone scintigraphy using 99mTc-MDP. The elaboration of radioisotopic method and program allowed for the assessment of bone metabolism, index of bone metabolism assay and definition of its normal values range with the possibility of clinical application. Material/Methods We examined 70 healthy young women with normal BMI, in which bone system was assessed with scintigraphic and densitometric examinations, and bone turnover markers definition together with hormonal and biochemical blood tests were performed. Group exclusion examinations were also performed, including basic, biochemical and hormonal blood tests, bone turnover markers and densitometric examinations with DXA technique. The scintigraphic examinations were performed using a gamma camera after 99mTc-MDP injection. After the application of the BONS method and program, the normal values range was determined with the STATISTICA 8 program. Results The normal results of basic, biochemical, hormonal and vascular tests were obtained. The examinations of bone turnover markers confirmed the balance between bone formation and bone resorption processes. The normal results of densitometric examinations excluded osteopeny or osteoporosis. The normal values range of IBM in young healthy women was between 84.08 and 105. Conclusions The elaborated BONS program and method allow for the quantitative assessment of bone quality and definition of IBM normal values range. The quantitative scintigraphic bone examinations provide an alternative to the bone markers examination for obtaining information about bone metabolism.
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Affiliation(s)
- Wiesław Tryniszewski
- Department of Radiological and Isotopic Diagnostics and Therapy, Medical University of Lodz, Lodz, Poland.
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190
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Waliszek M, Waliszek-Iwanicka A, Grycewicz T, Jurowski P, Banach M, Rysz J, Goch A. Prognostic value of plasma N-terminal pro-B-type natriuretic peptide concentration in patients with normal and impaired left ventricular systolic function undergoing surgery for abdominal aortic aneurysm. Arch Med Sci 2011; 7:642-7. [PMID: 22291800 PMCID: PMC3258789 DOI: 10.5114/aoms.2011.24134] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2010] [Revised: 11/17/2010] [Accepted: 12/28/2010] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Implantation of an aortic-bifemoral prosthesis is characterised by a high (> 5%) rate of perioperative cardiovascular events. The main aim of the study is to demonstrate the usefulness of the determination of NT-proBNP concentration as a method of risk stratification of left ventricular dysfunction in patients subjected to surgery for aortic-bifemoral prosthesis implantation. MATERIAL AND METHODS Forty consecutive patients were examined and subjected to aortic-bifemoral prosthesis implantation. The examined patients were divided into two groups: 1) with normal left ventricular systolic function and EF ≥ 58% (group I), 2) with left ventricular systolic dysfunction and EF < 58% (group II). RESULTS In group I the median EF before surgery was 69.5% and the concentration of NT-proBNP 141.5 pg/ml. On day 7 after surgery respective values were EF 65.5%, NT-proBNP 498.55 pg/ml. In group II the median EF before surgery was 54%, and NT-proBNP concentration 303.9 pg/ml. CONCLUSIONS The concentration of plasma NT-proBNP before surgery well correlated with left ventricular ejection fraction. The values of NT-proBNP > 303.9 pg/ml strongly correlated with increased risk of left ventricular systolic dysfunction after surgery and they seem to have high prognostic value for the occurrence of cardiovascular events in this group of patients. The determination of NT-proBNP level on day 7 after surgery strongly correlated with the decrease of left ventricular ejection fraction in patients after the prosthesis implantation. It is a valuable diagnostic and prognostic factor of circulatory system efficiency before making a decision to discontinue hospitalization.
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Affiliation(s)
- Marek Waliszek
- Cardiac Diagnostics Unit, M. Pirogow Provincial Specialist Hospital, Lodz, Poland
| | - Agnieszka Waliszek-Iwanicka
- Provincial Centre of Diabetology and Metabolic Diseases, M. Pirogow Provincial Specialist Hospital, Lodz, Poland
| | - Tomasz Grycewicz
- Department of Interventional Cardiology, Cardiodiabetology and Cardiac Rehabilitation, Medical University, Lodz, Poland
| | - Piotr Jurowski
- Department of Ophthalmology and Visual Rehabilitation, Medical University of Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Aleksander Goch
- Department of Cardiology and Cardiosurgery, Clinical Military Hospital, Bydgoszcz, Poland
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191
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Bielecka-Dabrowa A, Mikhailidis DP, Jones L, Rysz J, Aronow WS, Banach M. The meaning of hypokalemia in heart failure. Int J Cardiol 2011; 158:12-7. [PMID: 21775000 DOI: 10.1016/j.ijcard.2011.06.121] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2011] [Revised: 06/15/2011] [Accepted: 06/25/2011] [Indexed: 10/17/2022]
Abstract
Maintenance of normal potassium (K(+)) homeostasis has become an increasingly important limiting factor in the therapy of heart failure (HF). With the application of loop diuretics and digoxin, hypokalemia has become a frequent and feared side effect of treatment. Low serum K(+) in HF may be also a marker of increased neurohormonal activity and disease progression. To gain the maximum benefit from treatment, we need to individualize drug use and carefully monitor electrolytes. Symptomatic HF patients (New York Heart Association class III-IV) should be prescribed the lowest dose of diuretic necessary to maintain euvolemia. Mild hypokalemia may be corrected by the use of aldosterone receptor antagonists such as spironolactone or eplerenone. However, a more severe hypokalemia should preferably be corrected using K(+) supplement. Serum K levels should be frequently checked and maintained between 4.0 and 5.5 mEq/l (mmol/l).
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Abstract
INTRODUCTION Chronic heart failure (CHF) is the only major cardiovascular disease whose prevalence and incidence are thought to be increasing. Potassium balance may be lost both through the neurohormonal mechanisms involved in cardiovascular diseases and through the drugs used in their treatment. Avoiding both hypo- and hyperkalemia is difficult but beneficial in CHF. AREAS COVERED Aldosterone production is decreased in the elderly, diabetic patients, and those receiving drugs that block the production or action of renin and angiotensin II. As a result, these groups, as well as those with already impaired potassium excretion due to progressive age or disease-related decline in glomerular filtration rate, are particularly vulnerable to the development of hyperkalemia. EXPERT OPINION Evidence from several studies suggests that, in patients with CHF, serum potassium should be maintained between 4.0 and 5.5 mEq/L. To gain the maximum benefit from aldosterone antagonists it is necessary to individualize their use; it is also necessary to carefully monitor electrolytes.
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Affiliation(s)
- Agata Bielecka-Dabrowa
- Medical University of Lodz, WAM University Hospital in Lodz, Department of Hypertension, Zeromskiego 113, 90-549 Lodz, Poland
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Tryniszewski W, Kuśmierczyk J, Maziarz Z, Goś R, Mikhailidis DP, Banach M, Rysz J, Pesudovs K. Correlation of the severity of diabetic retinopathy and the heart muscle perfusion in patients with type 2 diabetes. J Diabetes Complications 2011; 25:253-7. [PMID: 21439854 DOI: 10.1016/j.jdiacomp.2011.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2009] [Revised: 02/08/2011] [Accepted: 02/15/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective was to investigate whether microvascular disturbances in patients with type 2 diabetes (DM) as defined by retinal examination predict the existence of macrovascular disturbances found on radioisotopic perfusion examinations of the heart muscle. MATERIALS AND METHODS A total of 100 patients with type 2 DM and an additional cardiovascular risk factor were enrolled in the study. All patients underwent comprehensive ophthalmologic examination, including fundus color photography and fluorescein angiography, and were divided into three groups: group 1 (NoDR): met the inclusion criteria but had no diabetic retinopathy; group 2 (NPDR): had signs of nonproliferative diabetic retinopathy; group 3 (PDR): had signs of preproliferative or proliferative diabetic retinopathy. After collecting general medical history and clinical data, patients underwent heart muscle perfusion studies. All patients followed a 48-h protocol heart muscle perfusion examination in the rest state as well as after the standardized exercise test. Single photon emission computed tomography examination was performed. RESULTS In the PDR group, the impairment of the heart muscle perfusion at stress and rest was more frequent than in the NPDR and NoDR groups. Analysis of the heart muscle perfusion results for the three groups showed a significant relationship with the severity of microvascular complications observed in eye fundus examinations. CONCLUSIONS Comprehensive ophthalmologic assessment of the progression of diabetic retinopathy in patients with type 2 DM may be an indicator of heart muscle perfusion disturbance.
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Affiliation(s)
- Wiesław Tryniszewski
- Department of Radiological and Isotopic Diagnostics and Therapy, Medical University of Lodz, Poland.
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Banach M, Michalska M, Kjeldsen SE, Małyszko J, Mikhailidis DP, Rysz J. What should be the optimal levels of blood pressure: Does the J-curve phenomenon really exist? Expert Opin Pharmacother 2011; 12:1835-44. [PMID: 21517698 DOI: 10.1517/14656566.2011.579106] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION The blood pressure (BP) J-curve debate has lasted for over 30 years and we still cannot definitively answer all the questions. However, recent studies suggest that BP should be reduced carefully in patients with hypertension and coronary artery disease. BP should not fall below 110 - 115/70 - 75 mmHg, because this may be associated with more cardiovascular events. AREAS COVERED A retrospective analysis of the INVEST Trial and the results of the BP arm of the ACCORD Trial shows that care is needed in patients with hypertension and diabetes. Although the ACCORD BP Trial suggests important benefits connected with the significant reduction of stroke in patients being treated intensively, it also shows the lack of advantage of such therapy on each main and other additional endpoints. The ACCORD Trial also confirmed the increased risk of adverse events that might appear when intensive treatment was used in this group of patients. EXPERT OPINION Most available studies were observational and randomized trials (BBB, HOT, ACCORD BP), do not have or have lost their statistical power and were inconclusive. Further studies are therefore needed to provide definitive conclusions on the subject. In the meantime, it seems that in high-risk patients with hypertension, it is necessary to carefully select those who might suffer adverse events and those who may benefit from intensive BP lowering.
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Affiliation(s)
- Maciej Banach
- Medical University of Lodz, WAM University Hospital in Lodz, Department of Hypertension, Zeromskiego 113, 90-549 Lodz, Poland.
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Barylski M, P. Mikhailidis D, Ciebiada M, Rysz J, Banach M. Gender Differences in the Treatment of Ischemic Heart Disease. Curr Pharm Des 2011; 17:1059-69. [DOI: 10.2174/138161211795656936] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 03/02/2011] [Indexed: 11/22/2022]
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Stepień M, Banach M, Jankowski P, Rysz J. Clinical implications of non-invasive measurement of central aortic blood pressure. Curr Vasc Pharmacol 2011; 8:747-52. [PMID: 20626340 DOI: 10.2174/157016110793563852] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2010] [Accepted: 03/19/2010] [Indexed: 11/22/2022]
Abstract
Central arterial systolic blood pressure is a very important factor in the pathophysiology of cardiovascular diseases. Central arterial pressure is a better predictor of cardiovascular risk than peripheral brachial blood pressure. Measurement of central blood pressure is useful for a diagnosis of spurious systolic hypertension in young people. Antihypertensive drugs have a different impact on central blood pressure, for example angiotensin converting enzyme inhibitors, antagonists of angiotensin II receptors, calcium channel blockers more effectively lower central blood pressure than betablockers, despite all of those drugs (including beta-blockers) having a similar impact on peripheral pressure. This mechanism may be responsible for the beneficial effect of some antihypertensive drugs on cardiovascular end points observed in clinical trials, despite a low peripheral hypotensive effect. However, further clinical trials are required to provide more evidence for the prognostic and therapeutic implications of the measurement of central blood pressure before adopting its routine application in clinical practice.
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Affiliation(s)
- Mariusz Stepień
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Lodz, Poland
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Bielecka-Dabrowa A, Aronow WS, Rysz J, Banach M. Current place of beta-blockers in the treatment of hypertension. Curr Vasc Pharmacol 2011; 8:733-41. [PMID: 20626337 DOI: 10.2174/157016110793563861] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Accepted: 03/07/2010] [Indexed: 11/22/2022]
Abstract
Hypertension represents the most common cardiovascular risk factor, affecting more than 25% of the adult population in developed societies. Although beta-blockers have been previously shown to effectively reduce blood pressure and have been used for hypertension treatment for over 40 years, their effect on cardiovascular morbidity and mortality in hypertensive patients remains controversial and their use in uncomplicated hypertension is currently still under debate. According to the previous recommendations beta-blockers should not be preferred as first-line therapy in hypertension patients. This review summarizes the current knowledge on application of beta-blockers in patients with hypertension and discusses the most recent guidelines of the European Society of Hypertension (2009) on beta-blockers applications.
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Luzak B, Boncler M, Rywaniak J, Wilk R, Stanczyk L, Czyz M, Rysz J, Watala C. The effect of a platelet cholesterol modulation on the acetylsalicylic acid-mediated blood platelet inhibition in hypercholesterolemic patients. Eur J Pharmacol 2011; 658:91-7. [PMID: 21371451 DOI: 10.1016/j.ejphar.2011.02.026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2010] [Revised: 01/27/2011] [Accepted: 02/17/2011] [Indexed: 11/27/2022]
Abstract
Aspirin (acetylsalicylic acid, ASA) is widely used in the prevention of cardiovascular disease, but its beneficial effects may be restrained in some individuals, where the reduced ability of ASA to protect against arterial thrombotic events is observed. We analyzed the influence of the treatment with atorvastatin (10mg/day) on the platelet sensitivity to ASA monitored under in vitro conditions in hypercholesterolemic patients. The associations between plasma or platelet cholesterol parameters and the ASA-mediated inhibition of platelet reactivity or the extent of platelet protein acetylation by ASA were estimated in the patients treated with atorvastatin for 1, 3, or 6 months. Out of 27 patients, in 17 individuals platelets appeared significantly more sensitive to 50 μM ASA in arachidonic acid- or collagen-induced whole blood aggregation following 1 month atorvastatin therapy (inhibition by 60.9 ± 5.6% vs. 48.8 ± 5.4%, P<0.05 for 0.5mM arachidonic acid, 40.8 ± 2.9% vs. 27.0 ± 4.1%, P<0.05 for 1 μg/ml collagen), and this effect lasted for 3 and 6 months, remaining in a weak, although significant, relation to the reduction of platelet cholesterol content (R(S)=-0.277, P<0.002 for arachidonic acid, R(S)=-0.197, P<0.02 for collagen). It was, however, not dependent upon either antiplatelet action or plasma lipid-lowering activity of atorvastatin. In addition, in about 50% of patients, we noticed that ASA (50 μM) significantly and time-dependently diminished thromboxane B(2) concentration in atorvastatin-treated patients. The ASA-induced acetylation of platelet proteins significantly increased in the course of atorvastatin therapy and was associated with reduced platelet cholesterol (R(S)=-0.598, P<0.0001). In conclusion, statin therapy may improve platelet sensitivity to ASA in some hypercholesterolemic patients. This effect may extend beyond the action of atorvastatin as merely a lipid-lowering agent. The mechanisms of resistance of some patients to such a combined ASA-statin treatment remain to be elucidated.
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Affiliation(s)
- Boguslawa Luzak
- Department of Haemostasis and Haemostatic Disorders, Medical University of Lodz, Poland
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Bielecka-Dąbrowa A, Hannam S, Rysz J, Banach M. Malignancy-associated dyslipidemia. Open Cardiovasc Med J 2011; 5:35-40. [PMID: 21660223 PMCID: PMC3109950 DOI: 10.2174/1874192401105010035] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2010] [Revised: 01/05/2011] [Accepted: 01/06/2011] [Indexed: 11/29/2022] Open
Abstract
Cholesterol and triglycerides, important lipid constituents of cell, are essential to carry out several vital physiological functions. Lipids might be associated with cancers because they play a key role in the maintenance of cell integrity. The pathway for cholesterol synthesis may also produce various tumorigenic compounds and cholesterol serves as a precursor for the synthesis of many sex hormones linked to increased risk of various cancers. In some malignant diseases, blood cholesterol undergoes early and significant changes. The mechanism for the link between cancer and cholesterol remains controversial. The dates from studies are confusing because both hypolipidemia and hypercholesterolemia might be connected with malignancy. Not only cancers but also antineoplastic therapies have an influence on lipid profile. There are also dates suggesting that antihyperlipemic drugs might nfluenced malignancy.
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Affiliation(s)
| | - Simon Hannam
- Department of Child Health, King's College London School of Medicine, London, UK
| | - Jacek Rysz
- Deprtament of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
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Kazmierski J, Kowman M, Banach M, Fendler W, Okonski P, Banys A, Jaszewski R, Rysz J, Sobow T, Kloszewska I. The use of DSM-IV and ICD-10 criteria and diagnostic scales for delirium among cardiac surgery patients: results from the IPDACS study. J Neuropsychiatry Clin Neurosci 2011; 22:426-32. [PMID: 21037128 DOI: 10.1176/jnp.2010.22.4.426] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Diagnostic accuracy of different diagnostic systems in estimating the incidence of delirium among surgery patients has not been investigated to date. Therefore, the authors evaluated the frequency of delirium according to DSM-IV and ICD-10 criteria and the cutoff values of the Memorial Delirium Assessment Scale (MDAS) and Delirium Index in 563 patients undergoing cardiac surgery. DSM-IV criteria were found as more inclusive, while ICD-10 criteria were more restrictive in establishing a diagnosis of postoperative delirium. The cutoff scores of 10 on the MDAS and 7 on the Delirium Index were optimal to the presence or absence of delirium.
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Affiliation(s)
- Jakub Kazmierski
- Department of Old Age Psychiatry and Psychotic Disorders, Medical University of Lodz, Lodz, Poland.
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