Olufemi E. Ajayi MD, Anthony O. Akintomide MD, Adegboyega Q. Adigun MD, Adesuyi A. L. Ajayi MD, PhD
{"title":"Left Ventricular Diastolic Function in Nigerian Patients with Essential Hypertension: A Retrospective Study to Compare Angiotensin Converting Enzyme Inhibitors, Calcium Channel Blockade or Their Combination","authors":"Olufemi E. Ajayi MD, Anthony O. Akintomide MD, Adegboyega Q. Adigun MD, Adesuyi A. L. Ajayi MD, PhD","doi":"10.1111/j.1753-5174.2008.00005.x","DOIUrl":"10.1111/j.1753-5174.2008.00005.x","url":null,"abstract":"<p><b>Background. </b> Hypertension in blacks imposes a greater left ventricular hypertrophy, and accelerated heart failure onset. We evaluated and compared the echocardiographically determined systolic and left ventricular diastolic functional indices in Nigerian hypertensive patients, associated with the chronic use of ACE inhibitors, Calcium channel blockers (CCB) or their combinations.</p><p><b>Methods. </b> Ejection fraction -EF, intraventricular relaxation time (IVRT), E/A peak velocity ratio, E wave deceleration time] as well as the left ventricular mass index (LVMI) was undertaken among 41 Nigerian patients with essential hypertension only, on treatment for 4–6 months prior. The 41 patients (aged 59 ± 10 years, 40% females) were divided into three groups; those receiving (i) ACE inhibitors; or (ii) CCB or (iii) combination of ACEI and CCB. All the three groups had a background of diuretic treatment for optimal blood pressure control.</p><p><b>Results. </b> There were no statistically significant differences in the mean LVMI or sitting blood pressure between treatment groups. E/A ratio for ACEI treatment was 1.06 ± 0.44, CCB 0.74 ± 0.19, and for ACEI + CCB 0.87 ± 0.26 (<i>F</i> = 3.29, <i>P</i> = 0.048 <span>anova</span>). The 95% confidence interval for the E/A ratio on ACEI was 0.8 to 1.33. The A wave duration time integral (AVVTi) were all abnormally large, but showed a significant between treatment group difference (<i>P</i> = 0.037, <span>anova</span>). The values were 21.9 ± 4.7 for ACEI, 25.3 ± 6.3 for CCB, and least at 20.1 ± 3.6 cm for the ACE + CCB combination. Similarly, the IVRT was lowest and <100 ms with ACEI + CCB being 93 ± 18 ms, ACEI 115 ± 23 ms, and CCB being 117 ± 22 ms (<i>F</i> = 4.92, <i>P</i> = 0.01, <span>anova</span>). The 95% CI for IVRT on ACEI + CCB was 82 to 104 ms. There were no between treatment group differences in systolic contractility, (fractional shortening or EF).</p><p><b>Conclusions. </b> The results indicate that use of an antihypertensive drug regime inclusive of an ACE inhibitor (±CCB) may be associated with greater salutary effect on indices of diastolic function, (E/A > 1, lower AVVTi, IVRT < 100 ms) even in the presence of an equivalent effect on systolic function and blood pressure.</p>","PeriodicalId":8181,"journal":{"name":"Archives of Drug Information","volume":"1 1","pages":"29-34"},"PeriodicalIF":0.0,"publicationDate":"2008-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1753-5174.2008.00005.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28715163","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}
Christopher P. Cannon MD, Cong Chen PhD, Sean P. Curtis MD, John Viscusi BS, Tuli Ahmed MS, Peter M. DiBattiste MD
{"title":"A Comparison of Cardiovascular Biomarkers in Patients Treated for Three Months with Etoricoxib, Celecoxib, Ibuprofen, and Placebo","authors":"Christopher P. Cannon MD, Cong Chen PhD, Sean P. Curtis MD, John Viscusi BS, Tuli Ahmed MS, Peter M. DiBattiste MD","doi":"10.1111/j.1753-5174.2007.00002.x","DOIUrl":"10.1111/j.1753-5174.2007.00002.x","url":null,"abstract":"<p><b>Objectives. </b> Selective cyclooxygenase (COX)-2 inhibitors are effective analgesic and anti-inflammatory agents with improved gastrointestinal safety and tolerability compared with traditional NSAIDs. However, data from long-term, placebo-controlled studies have shown an increased risk of thrombotic cardiovascular (CV) events for COX-2 inhibitors. Changes in levels of CV biomarkers are potentially useful surrogate measures of pathologic changes associated with CV risk.</p><p><b>Methods. </b> We randomized 433 patients with osteoarthritis to etoricoxib 90 mg once daily, celecoxib 200 mg twice daily, ibuprofen 800 mg three times daily, or placebo for 12 weeks. The hypothesis was that etoricoxib would be non-inferior or superior to placebo in effect on C-reactive protein (CRP), LDL-cholesterol, homocysteine, and fibrinogen.</p><p><b>Results. </b> Relative to placebo, etoricoxib was noninferior for effect on CRP (decreased 7.8% vs. placebo; 97.5% CI of the difference: −30.5, 22.4), LDL-C (−4.0% vs. placebo; 97.5% CI: −10.6, 3.2), homocysteine (−3.9% vs. placebo; 97.5% CI: −11.6, 4.6), and fibrinogen (−3.7% vs. placebo; 97.5% CI: −9.4, 2.3). Etoricoxib was not different from placebo, celecoxib, or ibuprofen for any biomarker.</p><p><b>Conclusion. </b> Etoricoxib was comparable to placebo, celecoxib, and ibuprofen for effects on the CV risk markers measured.</p>","PeriodicalId":8181,"journal":{"name":"Archives of Drug Information","volume":"1 1","pages":"4-13"},"PeriodicalIF":0.0,"publicationDate":"2008-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1753-5174.2007.00002.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28715162","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}
Yu Asanuma MD, PhD, Annette Oeser BS, Eran Stanley MD, David G. Bailey PhD, Ayumi Shintani PhD, C. Michael Stein MD
{"title":"Effects of C-reactive Protein and Homocysteine on Cytokine Production: Modulation by Pravastatin","authors":"Yu Asanuma MD, PhD, Annette Oeser BS, Eran Stanley MD, David G. Bailey PhD, Ayumi Shintani PhD, C. Michael Stein MD","doi":"10.1111/j.1753-5174.2007.00003.x","DOIUrl":"10.1111/j.1753-5174.2007.00003.x","url":null,"abstract":"<p><b>Objective. </b> C-reactive protein (CRP) and homocysteine are markers of cardiovascular risk that may have inflammatory effects. HMG coenzyme A reductase inhibitors (statins) have anti-inflammatory effects <i>in vitro,</i> but it is not clear if such responses <i>in vivo</i> are secondary to lipid lowering. We examined the hypothesis that CRP and homocysteine would stimulate cytokine release in human whole blood and that short-term treatment with a statin would inhibit it.</p><p><b>Methods. </b> The time course of IL-6 and MCP-1 production was determined in whole blood incubated with saline, 1 µg/mL lipopolysaccaride (LPS), 50 and 100 µM/L DL-homocysteine, and 5 µg/mL human recombinant CRP for 24 hours at 37°C under 5% CO<sub>2</sub> atmosphere. Cytokine responses were determined in blood drawn from 15 healthy volunteers before and after administration of pravastatin 40 mg daily for 2 days.</p><p><b>Results. </b> Both human recombinant CRP and LPS significantly increased the production of IL-6 and MCP-1 in whole blood samples more than 4-fold (<i>P</i> < 0.001) but homocysteine did not. Oral administration of pravastatin, 40mg daily for 2 days, decreased CRP-stimulated IL-6 production by approximately 20% (<i>P</i> = 0.02) 6 hours after incubation, but did not affect MCP-1 production (<i>P</i> = 0.69). Pravastatin treatment did not affect LPS-stimulated MCP-1 but increased IL-6 modestly.</p><p><b>Conclusions. </b> CRP stimulated the production of the proatherogenic mediators MCP-1 and IL-6 in human whole blood, but homocysteine did not. CRP-stimulated production of IL-6, but not MCP-1, was modestly attenuated by short-term treatment with pravastatin.</p>","PeriodicalId":8181,"journal":{"name":"Archives of Drug Information","volume":"1 1","pages":"14-22"},"PeriodicalIF":0.0,"publicationDate":"2008-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1753-5174.2007.00003.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28715105","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}
Young Hee Rho MD, Annette Oeser BS, Cecilia P. Chung MD, MPH, Jason D. Morrow MD, C. Michael Stein MD
{"title":"Drugs to Treat Systemic Lupus Erythematosus: Relationship between Current Use and Cardiovascular Risk Factors","authors":"Young Hee Rho MD, Annette Oeser BS, Cecilia P. Chung MD, MPH, Jason D. Morrow MD, C. Michael Stein MD","doi":"10.1111/j.1753-5174.2007.00004.x","DOIUrl":"10.1111/j.1753-5174.2007.00004.x","url":null,"abstract":"<p><b>Objectives. </b> Cardiovascular risk is increased in patients with systemic lupus erythematosus (SLE). Drugs used to treat SLE can modify traditional cardiovascular risk factors. We examined the effect of selected drugs used in the treatment of SLE on cardiovascular risk factors.</p><p><b>Methods. </b> We compared systolic and diastolic blood pressure, serum lipid concentrations, glucose, homocysteine, and urinary F<sub>2</sub>-isoprostane concentrations in 99 patients with lupus who were either current users or non-users of systemic corticosteroids, antimalarials, non-steroidal anti-inflammatory drugs (NSAIDs), COX-2 selective NSAIDs, azathioprine, and methotrexate. Multivariable adjustment was done with linear regression modeling using sex, age and disease activity (SLEDAI) as controlling variables.</p><p><b>Results. </b> Serum triglyceride concentrations were higher (135.1 ± 61.4 vs. 95.3 ± 47.5 mg/dL, adjusted <i>P</i> = 0.003) in patients receiving corticosteroids. Homocysteine concentrations were marginally higher in patients receiving methotrexate (adjusted <i>P</i> = 0.08). Current use of either NSAIDs or COX-2 inhibitors was not associated with increased cardiovascular risk factors. Current hydroxychloroquine use was not associated with significant alterations in lipid profiles.</p><p><b>Conclusions. </b> In a non-random sample of patients with SLE, current corticosteroid use was associated with increased triglyceride concentrations, but other drugs had little effect on traditional cardiovascular risk factors.</p>","PeriodicalId":8181,"journal":{"name":"Archives of Drug Information","volume":"1 1","pages":"23-28"},"PeriodicalIF":0.0,"publicationDate":"2008-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1753-5174.2007.00004.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28715106","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":"Archives of Drug Information—A New Approach to Publishing the Results of Drug Studies","authors":"C. Michael Stein MD","doi":"10.1111/j.1753-5174.2007.00001.x","DOIUrl":"10.1111/j.1753-5174.2007.00001.x","url":null,"abstract":"<p>Current scientific publishing uses a selective, slow, and adversarial editorial process to publish a minority of papers submitted, and thus maximize a journal's impact factor, a major measure of success. However, the results of many pharmaceutical industry studies are deemed low priority and are therefore difficult or impossible to publish in scientific journals. Society is poorly served because access to the results of these studies is in the public interest. <i>Archives of Drug Information</i> is an independent, online only journal that will publish papers that are free of bias and that provide new information about a drug. Articles that would not usually be published by traditional journals, for example articles reporting negative studies, studies reporting animal toxicity or Phase I human studies, or routine pharmacokinetic or drug interaction studies are welcome. The editorial process will be rapid and user friendly. The contents of the journal will be available freely to all. <i>Archives of Drug Information</i> will allow the pharmaceutical industry to publish the results of studies and make freely accessible to the public the results of research studies that would otherwise remain unavailable “on-file.” Making the results of studies available to the public is not only ethical and good scientific citizenship, but ultimately, also good business.</p>","PeriodicalId":8181,"journal":{"name":"Archives of Drug Information","volume":"1 1","pages":"1-3"},"PeriodicalIF":0.0,"publicationDate":"2008-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/j.1753-5174.2007.00001.x","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"28714113","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}