BackgroundContrast-induced nephropathy (CIN) is a common complication of percutaneous coronary intervention (PCI). This study aimed to develop a new risk stratification score that is simpler and more practical than the standard Mehran risk score (MRS) in prediction of CIN after primary PCI in ST-segment elevation myocardial infarction (STEMI) patients.MethodsA prognostic prediction research with clinical risk score development was conducted. All STEMI patients who underwent primary PCI at the Central Chest Institute from June 1, 2017 to June 30, 2018 were included. Multivariable logistic regression analysis was used to identify independent predictors of CIN with a significant P value < 0.05. Logistic coefficients of each predictor were used for score weighting and transformation. Predictive performance was validated and compared between newly-derived risk score and the MRS by non-parametric receiver operating characteristic (ROC) regression.ResultsA total of 217 patients, 43 (19.8%) with CIN and 174 (80.2%) without CIN, were included for score derivation. A total of 13 potential predictors were explored under multivariable logistic regression model and were subsequently eliminated. The new risk score was based on three final predictors which were ejection fraction of less than 40%, triple-vessel disease as findings from angiogram, and the use of intra-aortic balloon pump (IABP). With only three predictor variables, the score predicted the risk of CIN with good discriminative ability (area under the receiver operating characteristic curve (AuROC): 0.83, 95% confidence interval (CI): 0.76 - 0.90) which was higher than that of the MRS (AuROC: 0.78, 95% CI: 0.69 - 0.87). The score was categorized into low-risk (positive predictive value (PPV): 9.9, 95% CI: 5.4 - 14.4) and high-risk (PPV: 56.5, 95% CI: 42.4 - 70.8) groups at the cut-off point of 2.ConclusionsThe newly developed score was proved to have good predictive performance with fewer numbers of predictors and could be practically applied for risk stratification of CIN in STEMI patients who required emergent primary PCI.

We investigated the changes in the oxidative stress and cardiovascular disease risk biomarkers, including the activity of the cardiac autonomic nervous system, in older adults with prehypertension following Riceberry rice bran oil supplementation. A total of 35 women aged 60 to 76 years with prehypertension were randomly allocated to two groups, one of which was supplemented with rice bran oil (n=18) and the other with Riceberry rice bran oil (n=17) at 1,000 mg daily for 8 weeks. Prior to and after the supplementation, oxidative stress and cardiovascular risk biomarkers (primary outcomes), heart rate variability, and blood pressure (secondary outcomes) were investigated. Results showed that plasma malondialdehyde, blood glutathione disulfide, and tumor necrosis factor-alpha levels were significantly decreased, and the ratio of reduced glutathione to glutathione disulfide significantly increased in both groups after supplementation (all P<0.05). No significant differences were observed between groups. Heart rate variability and blood pressure did not statistically significantly change subsequent to supplementation in either group and did not differ between groups. In conclusion, Riceberry rice bran oil supplementation for 8 weeks alleviates oxidative stress and inflammation in older adults with prehypertension to a similar extent as rice bran oil supplementation.

Background In this study, we aimed to measure the changes in the biomarkers of oxidative stress, cardiovascular disease risk, and the activity of the cardiac autonomic nervous system in older adults with prehypertension after supplementation with Riceberry rice bran oil. Methods In total, 35 women aged 60–76 years with prehypertension were randomly allocated to two groups, one of which was supplemented with rice bran oil (n = 18) and the other with Riceberry rice bran oil (n = 17) at 1,000 mg (500 mg × 2 capsules) daily for 8 weeks. The primary outcomes, including oxidative stress and cardiovascular risk biomarkers, and secondary outcomes, including heart rate variability and blood pressure, were determined before and after the 8-week supplementation. Results The levels of plasma malondialdehyde, blood glutathione disulfide, and tumor necrosis factor-alpha were significantly decreased, and the ratio of reduced glutathione to glutathione disulfide significantly increased in both groups after supplementation (all p < 0.05). No significant differences were noted between groups. Heart rate variability and blood pressure were not statistically significantly different after supplementation in both groups. Conclusions Supplementation with Riceberry rice bran oil for 8 weeks may attenuate oxidative stress and inflammation in older adults with prehypertension. The effects of a longer supplementation period or use in hypertensive persons should be further investigated, especially with regard to blood pressure and cardiac autonomic nervous system activity. Trial registration: This trial was registered March 22, 2019 at https://www.thaiclinicaltrials.org as TCTR20190322002.

Background: Intradialytic hypotension (IDH) is an important problem in end stage renal disease (ESRD). Therefore, this study aimed to assess the effect of pulmonary hypertension (PHT) on IDH among patients with ESRD using transthoracic echocardiography. Methods: In this prospective etiognostic study, transthoracic echocardiography was performed among patients with ESRD in Burapha University Hospital, Thailand. The hemodialytic flow chart data of patients in the hemodialysis unit was collected to ascertain whether these patients presented IDH. The baseline clinical hemodialysis profiles and echocardiographic findings were analyzed using univariate predictors of IDH. Multivariate logistic regression was used to identify independent predictors of IDH. Results: A total of 35 patients with ESRD were enrolled between June 2020 and March 2021. Of these, 16 had PHT (45.7%). The prevalence of IDH was 48.5%. All patients exhibited a normal left ventricular ejection fraction. No significant difference was observed of RVSP between frequent-IDH group and occasional-IDH group (45.33 ± 11.62 mmHg and 41.06 ± 13.78 mmHg, respectively, p=0.401). Using univariate analysis, being female, left ventricular mass index, left ventricular ejection fraction and PHT were significantly associated with IDH. No factors were indicated related to IDH occurrence using multivariate analysis. Nevertheless, female patients with ESRD presenting PHT illustrated a tendency to have IDH. This was evidenced by the risk ratio of being female and patients with PHT being 3.13 (95% CI: 0.74-13.30) and 2.18 (95% CI: 0.34-7.06), respectively. Conclusion: Patients with ESRD presenting PHT showed a higher tendency of developing IDH during hemodialysis than patients with ESRD without PHT. The difference however was statistically insignificant.