Vascular Health and Risk Management最新文献

{"title":"Systemic Immune-Inflammation Index Predicts Prolonged Mechanical Ventilation and Intensive Care Unit Stay After off-Pump Coronary Artery Bypass Graft Surgery: A Single-Center Retrospective Study.","authors":"I Made Adi Parmana,&nbsp;Cindy Elfira Boom,&nbsp;Herdono Poernomo,&nbsp;Chairil Gani,&nbsp;Budi Nugroho,&nbsp;Riza Cintyandy,&nbsp;Lisa Sanjaya,&nbsp;Yudi Hadinata,&nbsp;Dian Raseka Parna,&nbsp;Dudy Arman Hanafy","doi":"10.2147/VHRM.S409678","DOIUrl":"https://doi.org/10.2147/VHRM.S409678","url":null,"abstract":"<p><strong>Purpose: </strong>Coronary artery disease (CAD) is the primary cause of mortality in developing countries. Off-pump coronary artery bypass grafting (OPCAB) offers more upside in revascularization by preventing cardiopulmonary bypass trauma and minimizing aortic manipulation. Even though cardiopulmonary bypass is not involved, OPCAB still causes a significant systemic inflammatory response. This study determines the prognostic values of the systemic immune-inflammation index (SII) towards perioperative outcomes in patients who underwent OPCAB surgery.</p><p><strong>Patients and methods: </strong>This was a single-center retrospective study at the National Cardiovascular Center Harapan Kita, Jakarta, using secondary data from electronic medical records and medical record archives of all patients who underwent OPCAB from January 2019 through December 2021. A total of 418 medical records were obtained, and 47 patients were excluded based on the exclusion criteria. The values of SII were calculated from preoperative laboratory data of segmental neutrophil count, lymphocyte count, and platelet count. Patients were divided into two groups based on the SII cutoff value of 878.056 x 10³/mm³.</p><p><strong>Results: </strong>The baseline SII values of 371 patients were calculated, among which 63 (17%) patients had preoperative SII values of ≥878.057 x 10³/mm³. High SII values were a significant predictor of prolonged ventilation (RR 1.141, 95% CI 1.001-1.301) and prolonged ICU stay (RR 1.218, 95% CI 1.021-1.452) after OPCAB surgery. A positive correlation was observed between SII and hospital length of stay after OPCAB surgery. From the receiver operating characteristic curve analysis, SII predicted prolonged ventilation duration, with an area under the curve of 0.658 (95% CI 0.575-0.741, p = 0.001).</p><p><strong>Conclusion: </strong>High preoperative SII values are capable of predicting prolonged mechanical ventilation and intensive care unit stay after OPCAB surgery.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"353-361"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0f/f2/vhrm-19-353.PMC10315149.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9799646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Palmitic Acid in the Co-Toxicity of Bacterial Metabolites to Endothelial Cells.","authors":"Marcin Choroszy,&nbsp;Kamila Środa-Pomianek,&nbsp;Magdalena Wawrzyńska,&nbsp;Mateusz Chmielarz,&nbsp;Edyta Bożemska,&nbsp;Beata Sobieszczańska","doi":"10.2147/VHRM.S408897","DOIUrl":"https://doi.org/10.2147/VHRM.S408897","url":null,"abstract":"<p><strong>Introduction: </strong>Metabolic endotoxemia most often results from obesity and is accompanied by an increase in the permeability of the intestinal epithelial barrier, allowing co-absorption of bacterial metabolites and diet-derived fatty acids into the bloodstream. A high-fat diet (HFD) leading to obesity is a significant extrinsic factor in developing vascular atherosclerosis. In this study, we evaluated the effects of palmitic acid (PA) as a representative of long-chain saturated fatty acids (LCSFA) commonly present in HFDs, along with endotoxin (LPS; lipopolysaccharide) and uremic toxin indoxyl sulfate (IS), on human vascular endothelial cells (HUVECs).</p><p><strong>Methods: </strong>HUVECs viability was measured based on tetrazolium salt metabolism, and cell morphology was assessed with fluorescein-phalloidin staining of cells' actin cytoskeleton. The effects of simultaneous treatment of endothelial cells with PA, LPS, and IS on nitro-oxidative stress in vascular cells were evaluated quantitatively with fluorescent probes. The expression of vascular cell adhesion molecule VCAM-1, E-selectin, and occludin, an essential tight junction protein, in HUVECs treated with these metabolites was evaluated in Western blot.</p><p><strong>Results: </strong>PA, combined with LPS and IS, did not influence HUVECs viability but induced stress on actin fibers and focal adhesion complexes. Moreover, PA combined with LPS significantly enhanced reactive oxygen species (ROS) production in HUVECs but decreased nitric oxide (NO) generation. PA also considerably increased the expression of VCAM-1 and E-selectin in HUVECs treated with LPS or IS but decreased occludin expression.</p><p><strong>Conclusion: </strong>Palmitic acid enhances the toxic effect of metabolic endotoxemia on the vascular endothelium.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"399-409"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ea/41/vhrm-19-399.PMC10329449.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9800601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulmonary Valve Stenosis: From Diagnosis to Current Management Techniques and Future Prospects.","authors":"Federico Marchini,&nbsp;Sofia Meossi,&nbsp;Giulia Passarini,&nbsp;Gianluca Campo,&nbsp;Rita Pavasini","doi":"10.2147/VHRM.S380240","DOIUrl":"https://doi.org/10.2147/VHRM.S380240","url":null,"abstract":"<p><p>Pulmonary stenosis (PS) is mainly a congenital defect that accounts for 7-12% of congenital heart diseases (CHD). It can be isolated or, more frequently, associated with other congenital defects (25-30%) involving anomalies of the pulmonary vascular tree. For the diagnosis of PS an integrated approach with echocardiography, cardiac computed tomography and cardiac magnetic resonance (CMR) is of paramount importance for the planning of the interventional treatment. In recent years, transcatheter approaches for the treatment of PS have increased however, meaning surgery is a possible option for complicated cases with anatomy not suitable for percutaneous treatment. The present review aims to summarize current knowledge regarding diagnosis and treatment of PS.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"379-390"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/28/8e/vhrm-19-379.PMC10320808.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9809856","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anatomical Distribution Patterns of Peripheral Arterial Disease According to Patient Characteristics: A Unicentral Cohort Study.","authors":"Ibrahim Abobaker Alghanimi,&nbsp;Abdulaziz Mohammad Al-Sharydah,&nbsp;Afnan Amro Alqutub,&nbsp;Nehal Zeidan,&nbsp;Fatimah Bukhamseen,&nbsp;Alzahra Alradhi,&nbsp;Aqilah Taleb Alqassab,&nbsp;Mohammed Saad Al-Aftan","doi":"10.2147/VHRM.S416967","DOIUrl":"https://doi.org/10.2147/VHRM.S416967","url":null,"abstract":"<p><strong>Purpose: </strong>Peripheral arterial disease (PAD) is a common disease with multiple risk factors and affects patients worldwide. Several international studies have established correlations between anatomical topography/distribution of atherosclerosis and comorbidities in patients with PAD. In this cohort study, we aimed to analyze the patterns of atherosclerosis (site, distribution, and degree) in patients who underwent lower limb computed tomography angiography and arterial angiography by identifying the atherosclerotic plaque(s) that were possibly responsible for thrombi. Additionally, we aimed to determine any relationship between comorbidities and identified patterns.</p><p><strong>Patients and methods: </strong>Between January 2015 and January 2021, we retrospectively recruited 140 patients at King Fahd Hospital of the University of Saudi Arabia. Data collected included patient characteristics, risk factors, and metabolic disorders, such as hypertension (HTN), diabetes mellitus (DM), dyslipidemia, and chronic kidney disease. Patients with incomplete records or unavailable radiological images were excluded.</p><p><strong>Results: </strong>The infrapopliteal territory was the most common segment that was affected. HTN, DM, and dyslipidemia were found in 81.4%, 77.9%, and 62.9% of patients, respectively. Correlation analyses revealed that DM was the only independent metabolic disorder associated with a PAD distribution pattern in the femoropopliteal segment (p=0.039), thus denoting distal involvement. No significant association was found between PAD distribution and the severity of stenosis.</p><p><strong>Conclusion: </strong>Segmental involvement in PAD varies with the risk factors and metabolic comorbidities present in patients. DM is an independent predictor of the anatomical distribution of PAD. The identification of such an anatomical distribution is paramount for screening procedures, early detection of disease, and prevention of complications, particularly limb amputation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"447-457"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7c/e5/vhrm-19-447.PMC10361088.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eleven-Year Outcomes of a Screening Project for Abdominal Aortic Aneurysm (AAA) in 65-Year-Old Men.","authors":"Saira Mauland Mansoor,&nbsp;Toril Rabben,&nbsp;Jonny Hisdal,&nbsp;Jørgen Joakim Jørgensen","doi":"10.2147/VHRM.S412954","DOIUrl":"https://doi.org/10.2147/VHRM.S412954","url":null,"abstract":"<p><strong>Objective: </strong>Since 2011, the Department of Vascular Surgery at Oslo University Hospital has offered screening for abdominal aortic aneurysm (AAA) to 65-year-old men living in Oslo, Norway. The aim of this study was to evaluate the effect of the screening project on AAA-related mortality and rupture and repair rates in the screened population.</p><p><strong>Methods: </strong>This cohort study included men that participated in AAA screening at the Department of Vascular Surgery at Oslo University Hospital in the period May 2011 to September 2019. All men with screen-detected AAA (aortic diameter ≥30 mm) and subaneurysmal aortic dilatation (aortic diameter 25-29 mm) were included. A stratified (1:1 with the subaneurysm group), randomized selection of men with normal aortic diameter (<25 mm) upon screening was also included. The follow-up data on events (ruptures, repairs, and deaths) after screening were collected retrospectively from patient electronic medical records at Oslo University Hospital, the National Population Register and the Norwegian Cause of Death Registry (CoDR).</p><p><strong>Results: </strong>In total, 2048 men were included, with a median follow-up time of 7.1 years (IQR 3.8). Among men with screen-detected AAA, 0.6% died of AAA-related causes (0.9 AAA-related deaths per 1000 person-years). The rupture rate was 0.3% among men with screen-detected AAA or subaneurysmal aortic dilatation, giving an incidence of 0.5 ruptures per 1000 person-years. The overall repair rate in the AAA group was 20.6% (36.1 repairs per 1000 person-years) and 0.6% (0.9 repairs per 1000 person-years) in the subaneurysm group.</p><p><strong>Conclusion: </strong>In a population screened for AAA, the incidence of rupture and the AAA-related mortality was very low. Almost one-fifth of the participants with screen-detected AAA underwent elective repair, representing a group that might have presented with rupture if untreated. These results indicate that screening is valuable in preventing AAA rupture and AAA-related mortality.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"459-467"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f8/b3/vhrm-19-459.PMC10361273.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9862515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Myocardial Ischemia and Revascularization by Percutaneous Coronary Intervention on Circulating Level of Soluble ST2.","authors":"Areej Alkhateeb,&nbsp;Hossam Eldin M Mahmoud,&nbsp;Mohammed Ak,&nbsp;Mohammed H Hassan,&nbsp;Abdel Rahim Mahmoud Muddathir,&nbsp;Ahmed G Bakry","doi":"10.2147/VHRM.S416206","DOIUrl":"https://doi.org/10.2147/VHRM.S416206","url":null,"abstract":"<p><strong>Background: </strong>The prognostic role of the soluble circulating suppression of tumorigenicity 2 marker (sST2) in different cardiovascular diseases (CVD) is still under investigation. This research aimed to assess the serum levels of sST2 in the blood of individuals with ischemic heart disease and its relation to disease severity, also to examine any changes in sST2 levels following a successful percutaneous coronary intervention (PCI) in those patients.</p><p><strong>Methods: </strong>A total of 33 ischemic patients and 30 non-ischemic controls were included. The plasma level of sST2 was measured using commercially available ELISA assay kit, at baseline and 24-48 h after the intervention in the ischemic group.</p><p><strong>Results: </strong>On admission, there was a significant difference between the group of acute/chronic coronary syndrome cases and controls regarding the sST2 plasma level (p < 0.001). There was an insignificant difference between the three ischemic subgroups at the baseline sST2 level (p = 0.38). The plasma sST2 level decreased significantly after PCI (from 20.70 ± 1.71 to 16.51 ± 2.43, p = 0.006). There was a modestly just significant positive correlation between the acute change in post-PCI sST2 level and the severity of ischemia as measured by the Modified Gensini Score (MGS) (r = 0.45, p = 0.05). In spite of the highly significant improvement in the coronary TIMI flow of ischemic group after PCI, there was insignificant negative correlation between the post- PCI delta change in the sST2 level and the post-PCI TIMI coronary flow grade.</p><p><strong>Conclusion: </strong>A significantly high plasma level of sST2 in patients with myocardial ischemia and controlled cardiovascular risk factors showed an immediate reduction after successful revascularization. The high baseline level of the sST2 marker and the acute post-PCI reduction was mainly related to the severity of ischemia rather than left ventricular function.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"411-420"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/47/8c/vhrm-19-411.PMC10332372.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10172584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Elevated Lp(a) Levels Correlate with Severe and Multiple Coronary Artery Stenotic Lesions.","authors":"Cynthia Al Hageh,&nbsp;Stephanie Chacar,&nbsp;Michella Ghassibe-Sabbagh,&nbsp;Daniel E Platt,&nbsp;Andreas Henschel,&nbsp;Hamdan Hamdan,&nbsp;Dominique Gauguier,&nbsp;Yara El Murr,&nbsp;Eman Alefishat,&nbsp;Elie Chammas,&nbsp;Siobhán O'Sullivan,&nbsp;Antoine Abchee,&nbsp;Moni Nader,&nbsp;Pierre A Zalloua","doi":"10.2147/VHRM.S394134","DOIUrl":"https://doi.org/10.2147/VHRM.S394134","url":null,"abstract":"<p><strong>Backgrounds and aims: </strong>The role of Lipoprotein(a) (Lp(a)) in increasing the risk of cardiovascular diseases is reported in several populations. The aim of this study is to investigate the correlation of high Lp(a) levels with the degree of coronary artery stenosis.</p><p><strong>Methods: </strong>Two hundred and sixty-eight patients were enrolled for this study. Patients who underwent coronary artery angiography and who had Lp(a) measurements available were included in this study. Binomial logistic regressions were applied to investigate the association between Lp(a) and stenosis in the four major coronary arteries. The effect of LDL and HDL Cholesterol on modulating the association of Lp(a) with coronary artery disease (CAD) was also evaluated. Multinomial regression analysis was applied to assess the association of Lp(a) with the different degrees of stenosis in the four major coronary arteries.</p><p><strong>Results: </strong>Our analyses showed that Lp(a) is a risk factor for CAD and this risk is significantly apparent in patients with HDL-cholesterol ≥35 mg/dL and in non-obese patients. A large proportion of the study patients with elevated Lp(a) levels had CAD even when exhibiting high HDL serum levels. Increased HDL with low Lp(a) serum levels were the least correlated with stenosis. A significantly higher levels of Lp(a) were found in patients with >50% stenosis in at least two major coronary vessels arguing for pronounced and multiple stenotic lesions. Finally, the derived variant (rs1084651) of the <i>LPA</i> gene was significantly associated with CAD.</p><p><strong>Conclusion: </strong>Our study highlights the importance of Lp(a) levels as an independent biological marker of severe and multiple coronary artery stenosis.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"31-41"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/6f/vhrm-19-31.PMC9871050.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10625556","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison Between First-Ever Ischemic Stroke in Young Adults in 1988-1997 and 2008-2017.","authors":"Mohamad Farah,&nbsp;Halvor Næss,&nbsp;Ulrike Waje-Andreassen,&nbsp;Beenish Nawaz,&nbsp;Annette Fromm","doi":"10.2147/VHRM.S398127","DOIUrl":"https://doi.org/10.2147/VHRM.S398127","url":null,"abstract":"<p><strong>Aim: </strong>To compare incidence of first-ever acute cerebral infarction, etiology and traditional risk factors in young adults 15-49 years in 1988-1997 and 2008-2017 in Hordaland County, Norway.</p><p><strong>Methods: </strong>Case-finding of young adults with acute cerebral infarction in 1988-1997 was done retrospectively by computer research from hospital registries in Hordaland County. Young adults with acute cerebral infarction living in the Bergen region in 2008-2017 were prospectively included in a database at Haukeland University Hospital. Traditional risk factors, etiology and modified Rankin scale score on discharge were registered.</p><p><strong>Results: </strong>Crude average incidence of acute cerebral infarction was 11.4 per 100.000 per year in 1988-1997 and 13.2 per 100.000 per year in 2008-2017 (P=0.04). The prevalence of prior myocardial infarction, angina pectoris, and dyslipidemia were lower in the 2008-2017 cohort (all P<0.05). Atherosclerosis was less common in the 2008-2017 cohort (P<0.001).</p><p><strong>Conclusion: </strong>The observed incidence of acute cerebral infarction in young adults increased from 1988-1997 to 2008-2017 in Hordaland County. Atherosclerosis was less common in the 2008-2017 cohort.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"231-235"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/aa/c3/vhrm-19-231.PMC10112465.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9385550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Characteristics and Predictors of Pulmonary Embolism in Patients Infected with COVID - 19 in Upper Egypt.","authors":"Ahmed Hussein,&nbsp;Ahmed M Khalaf,&nbsp;Laila A Alsharawy,&nbsp;Gomaa Abdelrazek,&nbsp;Mohammad Shafiq Awad","doi":"10.2147/VHRM.S403391","DOIUrl":"https://doi.org/10.2147/VHRM.S403391","url":null,"abstract":"<p><strong>Background: </strong>A little is known about the risk factors and predictors of pulmonary embolism (PE) in Coronavirus disease 2019 (Covid-19) infected patients. Therefore, we directed this study to investigate the predictors of PE in patients infected with Covid - 19 in Upper Egypt.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study on 297 patients infected with COVID-19, aged ≥ 18 years old. Suspicion of COVID-19 infection was based on the World Health Organization (WHO) criteria and confirmed by nasal and pharyngeal swab for real-time reverse transcriptase-polymerase chain reaction (RT-PCR) analysis. The patient was also determined to have COVID-19 when CT results that were thought to be typical for COVID-19 and clinical data that were compatible were present.</p><p><strong>Results: </strong>PE was diagnosed in 18.2% of patients. We found that the incidence of PE was significantly higher in older patients, females, those with higher BMI, hypertensive patients, diabetics, and patients with co-morbidities. Also, PE was significantly higher in patients presented with dyspnea, chest pain, longer duration of symptoms at hospital admission, and lower oxygen concentration. The mean serum Hb level, platelet count, TLC and absolute lymphocytic count were markedly reduced in those who had PE. All the patients who developed PE had a CO-RADS scale five on their CT chest scan. Age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients' characteristics associated with the development of PE after the multivariate regression analysis.</p><p><strong>Conclusion: </strong>PE is a common complication of Covid 19 infection. PE is associated with a variety of clinical and laboratory parameters in univariate analysis, but age > 65, BMI > 25, DM, and associated co-morbidities were the independent patients' characteristics associated with the development of PE in those infected with Covid-19.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"201-210"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/22/87/vhrm-19-201.PMC10084826.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9358924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolving Management and Treatment Options for Patients with Pulmonary Hypertension: Current Evidence and Challenges.","authors":"John W Swisher,&nbsp;Eric Weaver","doi":"10.2147/VHRM.S321025","DOIUrl":"https://doi.org/10.2147/VHRM.S321025","url":null,"abstract":"<p><p>Pulmonary hypertension may develop as a disease process specific to pulmonary arteries with no identifiable cause or may occur in relation to other cardiopulmonary and systemic illnesses. The World Health Organization (WHO) classifies pulmonary hypertensive diseases on the basis of primary mechanisms causing increased pulmonary vascular resistance. Effective management of pulmonary hypertension begins with accurately diagnosing and classifying the disease in order to determine appropriate treatment. Pulmonary arterial hypertension (PAH) is a particularly challenging form of pulmonary hypertension as it involves a progressive, hyperproliferative arterial process that leads to right heart failure and death if untreated. Over the last two decades, our understanding of the pathobiology and genetics behind PAH has evolved and led to the development of several targeted disease modifiers that ameliorate hemodynamics and quality of life. Effective risk management strategies and more aggressive treatment protocols have also allowed better outcomes for patients with PAH. For those patients who experience progressive PAH with medical therapy, lung transplantation remains a life-saving option. More recent work has been directed at developing effective treatment strategies for other forms of pulmonary hypertension, such as chronic thromboembolic pulmonary hypertension (CTEPH) and pulmonary hypertension due to other lung or heart diseases. The discovery of new disease pathways and modifiers affecting the pulmonary circulation is an ongoing area of intense investigation.</p>","PeriodicalId":23597,"journal":{"name":"Vascular Health and Risk Management","volume":"19 ","pages":"103-126"},"PeriodicalIF":2.9,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/89/fe/vhrm-19-103.PMC9990521.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9092113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}