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Chronic kidney disease Pulmonary embolism

Tsung-Hang Kuo, Hsin-Yang Li, Sheng-Hsiang Lin
INTRODUCTION: Chronic kidney disease (CKD) increases risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). However, few studies have investigated the relationship between acute kidney injury (AKI) and risk of DVT and PE. Therefore, we conducted a nationwide longitudinal cohort study to determine whether patients with AKI are associated with increased risk of developing DVT and PE. METHODS: We included >30years-old inpatients (n=4734) receiving the diagnosis of AKI from 2000 to 2006 and their age-and sex-matched non-AKI inpatients using medical service in the same year (n=47...
January 6, 2017: Thrombosis Research
N Janus, I Mahé, V Launay-Vacher, J-P Laroche, G Deray
Anticoagulant agents have been approved by international regulatory agencies to prevent and treat venous thromboembolism (VTE). However, chronic kidney disease (CKD) is: (1) highly frequent in VTE patients; (2) strongly linked to VTE; and (3) a risk factor for cardiovascular morbidity/mortality and fatal pulmonary embolism. Therefore, an increasing number of patients are presented with CKD and VTE and more and more physicians must face the questions of the management of these patients and that of the handling of anticoagulant agents in CKD patients because of the pharmacokinetic modifications of these drugs in this population...
October 28, 2016: Journal des Maladies Vasculaires
P W Franks, N Atabaki-Pasdar
Obesity is a risk factor for a plethora of severe morbidities and premature death. Most supporting evidence comes from observational studies that are prone to chance, bias and confounding. Even data on the protective effects of weight loss from randomized controlled trials will be susceptible to confounding and bias if treatment assignment cannot be masked, which is usually the case with lifestyle and surgical interventions. Thus, whilst obesity is widely considered the major modifiable risk factor for many chronic diseases, its causes and consequences are often difficult to determine...
December 8, 2016: Journal of Internal Medicine
Oluseye Ogunmoroti, Norrina B Allen, Mary Cushman, Erin D Michos, Tatjana Rundek, Jamal S Rana, Ron Blankstein, Roger S Blumenthal, Michael J Blaha, Emir Veledar, Khurram Nasir
BACKGROUND: The American Heart Association introduced the Life's Simple 7 (LS7) metrics to assess and promote cardiovascular health. We examined the association between the LS7 metrics and noncardiovascular disease. METHODS AND RESULTS: We studied 6506 men and women aged between 45 and 84 years, enrolled in the Multi-Ethnic Study of Atherosclerosis. Median follow-up time was 10.2 years. Each component of the LS7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and blood glucose) was assigned points, 0 indicates "poor" category; 1, "intermediate," and 2, "ideal...
October 20, 2016: Journal of the American Heart Association
Anair Beverly, Ethan Y Brovman, Raymond J Malapero, Robert W Lekowski, Richard D Urman
OBJECTIVES: To determine the incidence, timing, risk factors for, and outcomes after unplanned reintubation following cardiac surgery in adults. DESIGN: Retrospective analysis of admission data from the American College of Surgeons National Surgical Quality Improvement Project Database, 2007-2013, inclusive. Univariate and multivariate analyses of risk factors and outcomes. PARTICIPANTS: A total of 18,571 patients, over 18 years of age, undergoing cardiac surgery...
December 2016: Journal of Cardiothoracic and Vascular Anesthesia
Salah A M Said, Rogier Nijhuis, Anita Derks, Herman Droste
BACKGROUND Cardiac resynchronization therapy (CRT) has been demonstrated to reduce morbidity and mortality in patients with advanced, drug-refractory heart failure. Procedure-related mortality is less than 1% in larger studies. Approximately10% of CRT patients have to undergo surgical revision because of infections, dislocations, or unacceptable electrical behavior manifested as high threshold, unstable sensing, or unwanted phrenic nerve stimulation. CASE REPORT A 70-year-old man with symptomatic congestive heart failure underwent implantation of a biventricular pacemaker on the left anterior chest wall in 2003 and pulse generator exchange in August 2009...
July 20, 2016: American Journal of Case Reports
Bülent Altınsoy, İbrahim İlker Öz, Tacettin Örnek, Fatma Erboy, Hakan Tanrıverdi, Fırat Uygur, Nejat Altintas, Figen Atalay, Müge Meltem Tor
INTRODUCTION: Glomerular filtration rate (GFR) and blood urea nitrogen (BUN) are important prognostic indicators for cardiovascular disease. However, data on the relationship between renal dysfunction (RD) and prognosis in patients with acute pulmonary embolism (APE) are limited. The estimated-GFR (eGFR), based on the Modification of Diet in Renal Disease (MDRD) equation, has been suggested as a possible prognostic marker in patients with APE; however, at present, the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation is thought to be more accurate than the MDRD equation for the estimation of RD...
March 24, 2016: Clinical and Applied Thrombosis/hemostasis
Catherine E Handy, Chintan S Desai, Zeina A Dardari, Mouaz H Al-Mallah, Michael D Miedema, Pamela Ouyang, Matthew J Budoff, Roger S Blumenthal, Khurram Nasir, Michael J Blaha
OBJECTIVES: This study sought to determine if coronary artery calcium (CAC) is associated with incident noncardiovascular disease. BACKGROUND: CAC is considered a measure of vascular aging, associated with increased risk of cardiovascular and all-cause mortality. The relationship with noncardiovascular disease is not well defined. METHODS: A total of 6,814 participants from 6 MESA (Multi-Ethnic Study of Atherosclerosis) field centers were followed for a median of 10...
May 2016: JACC. Cardiovascular Imaging
Hanane Khoury, Louis Lavoie, Sharon Welner, Kerstin Folkerts
BACKGROUND: Patients with a history of a cardiovascular (CV) disease are at high risk of suffering secondary major adverse cardiac events (MACE), namely death, nonfatal myocardial infarction (MI), stroke, symptomatic pulmonary embolism, CV and all-cause hospitalization, and bleeding. METHODS: A comprehensive review of the literature was conducted to review the epidemiology and burden of MACE in patients with coronary or peripheral arterial disease (CAD or PAD) in Europe and other ex-US regions...
April 2016: Cardiovascular Therapeutics
Farzin Ghiasi, Amin Ahmadpoor, Babak Amra
BACKGROUND: Pulmonary embolism (PE) is the most life-threatening form of venous thrombosis which causes the majority of mortalities in this category. Obstructive sleep apnea (OSA) has been indicated as one of the risk factors for thromboembolism because of hemostatic alterations. The present study was designed to seek for the relationship between OSA and 30-day mortality of patients with PE. MATERIALS AND METHODS: This prospective cohort study was conducted among 137 consecutive patients referred to hospital with symptoms of PE and preliminary stable hemodynamic...
July 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Brett J Carroll, Ravi V Shah, Venkatesh Murthy, Stephen A McCullough, Nosheen Reza, Sunu S Thomas, Tae H Song, Christopher H Newton-Cheh, Janice M Camuso, Thomas MacGillivray, Thoralf M Sundt, Marc J Semigran, Gregory D Lewis, Joshua N Baker, José P Garcia
Extracorporeal membrane oxygenation (ECMO) is an increasingly used supportive measure for patients with refractory cardiogenic shock (CS). Despite its increasing use, there remain minimal data regarding which patients with refractory CS are most likely to benefit from ECMO. We retrospectively studied all patients (n = 123) who underwent initiation of ECMO for CS from February 2009 to September 2014 at a single center. Baseline patient characteristics, including demographics, co-morbid illness, cause of CS, available laboratory values, and patient outcomes were analyzed...
November 15, 2015: American Journal of Cardiology
Jean Triscott, Susan Mercer, Peter George Jaminal Tian, Bonnie Dobbs
An 81-year-old woman with chronic kidney disease was on enoxaparin (1 mg/kg subcutaneously two times a day) for 4 months to manage pulmonary embolism. While admitted for diagnostic evaluation of frequent falls, transient ischaemic attacks and pain management, she developed vomiting, diarrhoea, melena and hypotension. Her estimated glomerular filtration rate decreased from an admission value of 34 mL/min/1.73 m2 to 13 mL/min/1.73 m2. CT scan showed retroperitoneal haematoma. She was placed in intensive care and stabilised with aggressive fluid replacement, blood transfusion, and discontinuation of enoxaparin and concomitant aspirin...
October 5, 2015: BMJ Case Reports
Radovan Malý, Jaroslav Malý
Venous thromboembolic disease which includes both venous thrombosis and pulmonary embolism, is a frequent and potentially fatal disease. Based on the introduction of low-molecular-weight heparins (LMWH) into practice it has been proved that outpatient treatment of venous thrombosis is effective and safe for a large number of patients with VTE. The growing volume of data on LMWH outpatient treatment in recent years shows that up to 50 % of patients with clinically stable pulmonary embolism can be treated at home...
May 2015: Vnitr̆ní Lékar̆ství
Elif Küpeli, Gaye Ulubay, Ilgaz Doğrul, Özlem Birben, Pınar Seyfettin, Aylin Özsancak Uğurlu, Füsun Öner Eyüboğlu, Mehmet Haberal
OBJECTIVES: Solid-organ transplant recipients can develop chronic hypercoagulation that increases the incidence of pulmonary embolism. Here, we evaluate the frequency of pulmonary embolism in solid-organ transplant recipients during the first 10 years after transplantation and evaluate the risk factors for its development. MATERIALS AND METHODS: The medical records of solid-organ transplant recipients who were treated between 2003 and 2013 were retrospectively reviewed...
April 2015: Experimental and Clinical Transplantation
Chad M Bailey, Christoph Troppmann, Jennifer Kuo, Michael S Wong
BACKGROUND: Patients with end-stage renal disease evaluated for renal transplantation are frequently declined secondary to obesity and decreased functional status. As a result, many of these patients lose weight intentionally in an effort to gain candidacy on the transplant waiting list. This frequently produces a panniculus encompassing the lower abdominal surgical site used for renal transplantation. These patients are declined for renal transplantation secondary to predictable wound-healing complications...
May 2015: Annals of Plastic Surgery
Alison Duncan, Simon Davies, Carlo Di Mario, Neil Moat
BACKGROUND: Valve-in-valve (ViV) transcatheter aortic implantation (TAVI) is an alternative to redo surgery for patients with a failing aortic bioprosthesis. A lack of anatomic markers may complicate the procedure. This study reports procedural and midterm outcomes of patients undergoing ViV-TAVI for failing stentless bioprostheses, at a single institution. METHODS: A total of 22 consecutive patients with failing homograft (n = 17), stented porcine valve (n = 3), aortic root bioprosthesis (n = 1), or native resuspended aortic valve (n = 1) (aged 74 ± 12 years; Society of Thoracic Surgeons 30-day predicted risk of mortality score: 14% ± 8%) were treated with ViV-TAVI, between 2007 and 2014...
July 2015: Journal of Thoracic and Cardiovascular Surgery
Corey M Coleman, Shaden Khalaf, Steven Mould, Oussama Wazni, Mohamed Kanj, Walid Saliba, Daniel Cantillon
BACKGROUND: Novel oral anticoagulant (NOAC) agents dabigatran, rivaroxaban, and apixaban are increasingly utilized as thromboembolic prevention for patients with atrial fibrillation undergoing direct current cardioversion (DCCV) with post hoc analyses of clinical trials suggesting satisfactory safety and efficacy. This study characterizes utilization, effectiveness, and complications of NOAC agents for stroke prophylaxis in the setting of DCCV. METHODS: Comparison of warfarin and NOAC agents as periprocedural anticoagulation for DCCV procedures performed at Cleveland Clinic from January 2009 through December 2013...
June 2015: Pacing and Clinical Electrophysiology: PACE
Manuel Martínez-Sellés, Emilio Bouza, Pablo Díez-Villanueva, Maricela Valerio, María Carmen Fariñas, Antonio J Muñoz-García, Josefa Ruiz-Morales, Juan Gálvez-Acebal, Isabel Antorrena, Jesús María de la Hera Galarza, Enrique Navas, Patricia Muñoz
AIMS: To describe the characteristics of infective endocarditis (IE) after transcatheter aortic valve implantation (TAVI). METHODS AND RESULTS: This study was performed using the GAMES database, a national prospective registry of consecutive patients with IE in 26 Spanish hospitals. Of the 739 cases of IE diagnosed during the study, 1.3% were post-TAVI IE, and these 10 cases, contributed by five centres, represented 1.1% of the 952 TAVIs performed. Mean age was 80 years...
February 2016: EuroIntervention
Alexander Bauer, Verena Limperger, Ulrike Nowak-Göttl
Chronic kidney disease is an established risk factor for arterial and venous thromboembolism (TE). Whereas the overall risk of TE in moderately decreased kidney function is approximately 2.5-fold higher compared to patients with normal renal function, the risk increase is 5.5-fold in patients with severe renal dysfunction. In patients with renal dysfunction and arterial thrombosis (OR: 4.9), malignancy (OR: 5.8) surgery (OR: 14.0) or thrombophilia (OR: 4.3) the risk to suffer from venous TE is higher compared to the risk associated to the baseline renal dysfunction alone...
May 10, 2016: Hämostaseologie
S M Hwang, J M Kuyava, J P Grande, K M Swetz
We present an unusual case of metastatic renal cell carcinoma (RCC) mimicking diverticulitis in a 76-year-old man with a 16-year history of chronic lymphocytic leukaemia (CLL) and a 2 cm left renal mass. The patient presented with severe abdominal pain and lower gastrointestinal bleeding with anticoagulation from recent pulmonary embolism. His clinical course was troubled by recurrent hospitalisations and complications that delayed investigations and potential treatments. Radiographic findings revealed stable CLL, mild sigmoid diverticulitis and a small renal mass...
January 7, 2015: BMJ Case Reports
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