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Sertbas Y, Sertbas M, Okuroglu N, Ozturk MA, Abacar KY, Ozdemir A. Mean platelet volume changes before and after glycated hemoglobin (HbA 1c) improvement in a large study population. Arch Med Sci 2017; 13:711-715. [PMID: 28721136 PMCID: PMC5510507 DOI: 10.5114/aoms.2016.61900] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2016] [Accepted: 06/23/2016] [Indexed: 12/25/2022] Open
Abstract
INTRODUCTION Diabetes mellitus (DM) is a metabolic disorder associated with both microvascular and macrovascular complications. Mean platelet volume (MPV) is a marker of platelet activity, which plays a major role in the development of vascular complications of DM. The aim of this study is to compare the MPV levels before and after the decrease of glycated hemoglobin (HbA1c) levels in a large diabetic population. MATERIAL AND METHODS This was a retrospective study conducted on type 2 diabetic patients from the outpatient clinic for 1 year between 2014 and 2015 with the participation of 595 diabetic patients. RESULTS When we compared the basal and post-treatment values, a significant decrease of MPV and HbA1c levels was found (HbA1c: 9.41 ±1.98% vs. 7.43 ±1.29%, p < 0.001; MPV: 9.11 ±1.42 vs. 8.17 ±1.04, p < 0.001). There was also a positive correlation between the mean changes of MPV and HbA1c levels after the treatment (ΔMPV: 0.93 ±0.96 vs. ΔHbA1c: 1.96 ±1.43; p = 0.005, r = 0.115). When the participants were divided into two groups according to their basal HbA1c levels (group A: HbA1c ≤ 6.5% and group B: HbA1c > 6.5%), it was clearly seen that improvement of glucose levels led to a significant decrease in MPV levels in both groups. CONCLUSIONS The results of this study show that better glycemic control is associated with a significant decrease of MPV levels, regardless of whether the treatment modality is insulin or oral antidiabetic.
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Affiliation(s)
- Yasar Sertbas
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Meltem Sertbas
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Nalan Okuroglu
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Mehmet Akif Ozturk
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Kerem Yigit Abacar
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
| | - Ali Ozdemir
- Department of Internal Medicine, Fatih Sultan Mehmet Education and Research Hospital, Istanbul, Turkey
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Zeman M, Vecka M, Perlík F, Staňková B, Hromádka R, Tvrzická E, Širc J, Hrib J, Žák A. Pleiotropic effects of niacin: Current possibilities for its clinical use. ACTA PHARMACEUTICA 2016; 66:449-469. [PMID: 27749252 DOI: 10.1515/acph-2016-0043] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/02/2016] [Indexed: 12/28/2022]
Abstract
Niacin was the first hypolipidemic drug to significantly reduce both major cardiovascular events and mortality in patients with cardiovascular disease. Niacin favorably influences all lipoprotein classes, including lipoprotein[a],and belongs to the most potent hypolipidemic drugs for increasing HDL-C. Moreover, niacin causes favorable changes to the qualitative composition of lipoprotein HDL. In addition to its pronounced hypolipidemic action, niacin exerts many other, non-hypolipidemic effects (e.g., antioxidative, anti-inflammatory, antithrombotic), which favorably influence the development and progression of atherosclerosis. These effects are dependent on activation of the specific receptor HCA2. Recent results published by the two large clinical studies, AIM-HIGH and HPS2-THRIVE, have led to the impugnation of niacin's role in future clinical practice. However, due to several methodological flaws in the AIM-HIGH and HPS2-THRIVE studies, the pleiotropic effects of niacin now deserve thorough evaluation. This review summarizes the present and possible future use of niacin in clinical practice in light of its newly recognized pleiotropic effects.
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Affiliation(s)
- Miroslav Zeman
- 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Marek Vecka
- 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - František Perlík
- Institute of Pharmacology, 1st Faculty of MedicineCharles University in Prague, Prague, Czechia
| | - Barbora Staňková
- 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czechia
| | - Robert Hromádka
- Research and Development Center, C2P s.r.o., Chlumec/n Cidlinou, Czechia
| | - Eva Tvrzická
- 4th Department of Medicine, 1st Faculty of Medicine, Charles University in PraguePrague, Czechia
| | - Jakub Širc
- Institute of Macromolecular, Chemistry, Academy of Sciences of the Czech Republic Prague, Czechia
| | - Jakub Hrib
- Institute of Macromolecular, Chemistry, Academy of Sciences of the Czech Republic Prague, Czechia
| | - Aleš Žák
- 4th Department of Medicine, 1st Faculty of Medicine, Charles University in Prague, Prague, Czechia
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O'Connell C, Horwood K, Nadamuni M. Correction of refractory thrombocytopenia and anemia following withdrawal of extended release niacin. Am J Hematol 2016; 91:E318. [PMID: 27012809 DOI: 10.1002/ajh.24371] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 03/12/2016] [Accepted: 03/17/2016] [Indexed: 11/10/2022]
Affiliation(s)
- Casey O'Connell
- Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases; Keck School of Medicine of USC; Los Angeles California
- Keck School of Medicine of USC; Los Angeles California
| | - Kristin Horwood
- Jane Anne Nohl Division of Hematology and Center for the Study of Blood Diseases; Keck School of Medicine of USC; Los Angeles California
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Banach M, Aronow WS, Serban MC, Rysz J, Voroneanu L, Covic A. Lipids, blood pressure and kidney update 2015. Lipids Health Dis 2015; 14:167. [PMID: 26718096 PMCID: PMC4696333 DOI: 10.1186/s12944-015-0169-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Accepted: 12/22/2015] [Indexed: 02/07/2023] Open
Abstract
The most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2015 were reviewed. In lipid research, the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) trial revalidated the concept "lower is better" for low density lipoprotein (LDL)-cholesterol as a target for therapy, increasing the necessity of treatment the high-risk patients to achieve LDL-C goals. After these results, ezetimibe might become the preferred additional drug in the combination therapy of lipid disorders because of oral dosage form and lower acquisition cost. However, for the statin-intolerant patients and those patients requiring essential reductions in LDL-C to achieve their goals, new therapies, including PCSK9 inhibitors remain promising drugs. In blood pressure research, American Heart Association (AHA)/American College of Cardiology (ACC) 2015 guidelines recommended a target for blood pressure below 140/90 mmHg in stable or unstable coronary artery disease patients and below 150/90 mmHg in patients older than 80 years of age, however the recent results of the Systolic Blood Pressure Intervention Trial (SPRINT) trial have suggested that there might be significant benefits, taking into account cardiovascular risk, for hypertensive patients over 50 without diabetes and blood pressure levels <120/80. In kidney research, reducing the progression of chronic kidney disease and related complications such as anemia, metabolic acidosis, bone and mineral diseases, acute kidney injury and cardiovascular disease is still a goal for clinicians.
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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.
| | - Wilbert S Aronow
- Department of Medicine, New York Medical College, Valhalla, NY, USA
| | - Maria-Corina Serban
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Jacek Rysz
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Zeromskiego 113, 90-549, Lodz, Poland
| | - Luminita Voroneanu
- Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore. T. Popa, University of Medicine and Pharmacy, Iasi, Romania
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore. T. Popa, University of Medicine and Pharmacy, Iasi, Romania
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Serban MC, Banach M, Mikhailidis DP. Clinical implications of the IMPROVE-IT trial in the light of current and future lipid-lowering treatment options. Expert Opin Pharmacother 2015; 17:369-80. [PMID: 26559810 DOI: 10.1517/14656566.2016.1118055] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION A residual risk of morbidity and mortality from cardiovascular (CV) disease remains despite statin therapy. This situation has generated an interest in finding novel approaches of combining statins with other lipid-lowering agents, or finding new lipid and non-lipid targets, such as triglycerides, high-density lipoprotein cholesterol (HDL-C), non-HDL-C, proprotein convertase subtilisin/kexin type 9 (PCSK9) gene, cholesterol ester transfer protein (CETP), lipoprotein (a), fibrinogen or C-reactive protein. AREAS COVERED The recent results from the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) demonstrated an incremental clinical benefit when ezetimibe, a non-statin agent, was added to simvastatin therapy. EXPERT OPINION The results from IMPROVE-IT revalidated the concept that low-density lipoprotein cholesterol (LDL-C) levels are a clinically relevant treatment goal. This trial also suggested that further decrease of LDL-C levels (53 vs. 70 mg/dl; 1.4 vs. 1.8 mmol/l) was more beneficial in lowering CV events. This "even lower is even better" evidence for LDL-C levels may influence future guidelines and the use of new drugs. Furthermore, these findings make ezetimibe a more realistic option to treat patients with statin intolerance or those who cannot achieve LDL-C targets with statin monotherapy.
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Affiliation(s)
- Maria-Corina Serban
- a Department of Epidemiology , University of Alabama at Birmingham , Birmingham , USA.,b Department of Functional Sciences, Discipline of Pathophysiology , "Victor Babes" University of Medicine and Pharmacy , Timisoara , Romania
| | - Maciej Banach
- c Department of Hypertension, Chair of Nephrology and Hypertension , Medical University of Lodz , Lodz , Poland
| | - Dimitri P Mikhailidis
- d Department of Clinical Biochemistry, Royal Free Campus, University College London Medical School , University College London (UCL) , London , UK
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Affiliation(s)
- N Papanas
- Second Department of Internal Medicine, Diabetes Clinic, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
| | - E Maltezos
- Second Department of Internal Medicine, Diabetes Clinic, Democritus University of Thrace, University Hospital of Alexandroupolis, Greece
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Banach M, Aronow WS, Serban C, Sahabkar A, Rysz J, Voroneanu L, Covic A. Lipids, blood pressure and kidney update 2014. Pharmacol Res 2015; 95-96:111-25. [PMID: 25819754 DOI: 10.1016/j.phrs.2015.03.009] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Revised: 03/14/2015] [Accepted: 03/15/2015] [Indexed: 12/22/2022]
Abstract
This paper is an effort to review all the most important studies and guidelines in the topics of lipid, blood pressure and kidney published in 2014. Irrespective of advances, the options for improving simultaneous hypercholesterolemia and hypertension management (as well as its complication - chronic kidney disease) remain a problem. Recommending hypolidemic, hypotensive and kidney disease drugs to obtain therapy targets in cardiovascular, diabetic, elderly and kidney disease (=high risk) patients might strengthen risk factor control, improve compliance and the therapy efficacy, and in the consequence reduce the risk of cardiovascular events and mortality rate. That is why the authors have decided to summary and discuss the recent scientific achievements in the field of lipid, blood pressure and kidney.
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Affiliation(s)
- Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland.
| | - Wilbert S Aronow
- Department of Medicine, New York Medical College, Valhalla, NY, USA
| | - Corina Serban
- Department of Functional Sciences, Discipline of Pathophysiology, "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania
| | - Amirhossein Sahabkar
- Biotechnology Research Center, Mashhad University of Medical Sciences, Mashhad, Iran; Metabolic Research Centre, Royal Perth Hospital, School of Medicine and Pharmacology, University of Western Australia, Perth, Australia
| | - Jacek Rysz
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Poland
| | - Luminita Voroneanu
- Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore. T. Popa, University of Medicine and Pharmacy, Iasi, Romania
| | - Adrian Covic
- Nephrology Clinic, Dialysis and Renal Transplant Center, C.I. Parhon University Hospital and Grigore. T. Popa, University of Medicine and Pharmacy, Iasi, Romania
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