There is increasing evidence that radiotherapy and some chemotherapeutic agents are associated with increased rates of CVD. Patients who have received treatment for cancer should be considered at higher risk of developing atherosclerosis and require increased monitoring, further investigation and earlier treatment than would be suggested by classical risk factor management strategies.
This pilot data support the usefulness of these composite biomarker panels in the prediction of severity and diagnosis of aGVHD in patients undergoing T-cell-depleted reduced intensity allogeneic HSCT.
AimsTo evaluate 99th percentile upper reference limits (URLs) and investigate ethnic differences for the Abbott Architect high-sensitivity cardiac troponin I (hs-cTnI) in a middle-aged to elderly cosmopolitan population.MethodsIn subjects without cardiovascular disease and after outlier exclusion, data on hs-cTnI from 149 white men, 150 white women, 150 South Asian (SA) men and 150 SA women in their sixth, seventh and eight decades were analysed. Each ethnicity–gender–decade subgroup consisted of 50 patients except white men in their sixth decade (n=49).ResultsThe overall, women and men hs-cTnI 99th percentile URLs were 22.1, 17.9 and 24.8 ng/L, respectively. Median (IQR) hs-cTnI was higher in men (2.7 (1.8–4.1) ng/L) than in women (1.9 (1.1–3.2) ng/L; p<0.001). White men (3.2 (2.2–4.4) ng/L) had higher hs-cTnI than SA men (2.5 (1.6–3.6) ng/L; p<0.001), white women (2.1 (1.3–3.3) ng/L; p<0.001) and SA women (1.6 (1.0–3.0) ng/L; p<0.001). Hs-cTnI in white women was similar to SA women (p=0.07) and SA men (p=0.07). Patients in the eighth decade had higher hs-cTnI (p<0.05) than those in sixth decade within each ethnicity–gender subgroup. Of significant associations, age had the greatest impact on hs-cTnI followed by gender and then ethnicity.ConclusionWe report white–SA differences in hs-cTnI in men and a similar trend in women. We confirm age and gender differences in hs-cTnI, irrespective of ethnicity. Further studies are required to determine whether ethnicity-specific age and gender 99th percentile URLs improve detection or exclusion of myocardial injury.
The authors evaluated the impact of genetic screening for familial hypercholesterolaemia (FH) in a lipid clinic cohort of patients with definite and possible FH as defined by the Simon Broome Register (SBR) criteria. Methods: Patients with a lipid clinic diagnosis of definite and possible FH based on the SBR criteria were referred to a nurse-led regional service for FH genetic testing. Findings: 140 patients were referred for genetic testing. Six had SBR-definite FH due to the presence of tendon xanthomata and 134 had SBR-possible FH. A monogenic FH mutation was detected in all six patients (100%) with SBR-definite FH and in 34 (25%) of patients with possible FH. Conclusion: The appropriate use of molecular genetics in a lipid clinic will greatly facilitate the management of hyperlipidaemia and cardiovascular risk since the management of FH patients (National Institute for Health and Care Excellence (NICE) Clinical Guideline 71) is different from non-FH patients (NICE Clinical Guideline 181).
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