Biochemical Markers with Low-grade Inflammation as Predictors of Thrombotic Events in Antiphospholipid Syndrome

The present cross-sectional observational study was made in family medicine offices of Timi� County, Romania. The aim of the study was to investigate the prevalence of urinary microalbumin excretion (MAU) in resistant systemic arterial hypertension (RH), to analyze patients� biochemical and clinical characteristics, and the predictive factors for MAU. From a total number of 347 patients, MAU was detected in 76 cases (21.9%). The microalbuminuria positive patients were older, with significant higher office systolic blood pressure (BP) (155 � 13.50 vs 148 � 12.40 mmHg, p [ 0.0001) and diastolic blood pressure (94 � 12.20 vs 88 � 14.6 mmHg, p = 0.0013), higher prevalence of left ventricular hypertrophy, diabetes mellitus, obesity, ischemic and peripheral arterial disease. MAU positive patients presented statistical significant differences in biochemical data concerning: fasting plasma glucose (FPG) (118.80 � 32.02 vs 108.01 � 26.01 mg/dL, p = 0.003), impaired glucose tolerance (IGT) (10.52 % vs 4.94 %), glycated hemoglobin (HbA1c) (6.56 � 0.98% vs 5.96 � 0.91%, p [ 0.001), reduced estimated glomerular filtration rate (eGFR) (56.10 � 15.4 vs 69.30 � 17.5 ml/min/1.73m2, p [ 0.001) and higher potassium levels (4.71 � 0.43 vs 4.59 � 0.44 mg/dL, p = 0.0378). No significant differences were noticed regarding LDL- and HDL-cholesterol, triglycerides, uric acid and serum creatinine. In a logistic multivariate analysis independent predictors for MAU were: systolic BP (odds ratio, OR = 1.024, 95% confidence interval, CI:1.011-1.039, p [ 0.001), HbA1c (OR = 1.324, 95% CI: 1.078-1.724, p = 0.008) and eGFR (OR = 0.989, 95% CI: 0.977-0.999, p = 0.01). Our findings suggest that an important part of RH patients have microalbuminuria and highlight the importance of controlling its predictors, in order to improve patients� outcome.

Section: Resultssupporting

confidence: 87%

Prevalence, Characteristics and Predictive Factors of Microalbuminuria in Resistant Systemic Arterial Hypertension

Gadau¹,

Ardeleanu²,

Folescu³

et al. 2018

“…Tissue pretreatment with glutaraldehyde or formaldehyde are factors that promote the calcification of the extracellular matrix because they have a certain toxicity and do not allow to fix uniformly all the constituent elements of this matrix [6,[13][14][15][16]. Similar effects of glutaraldehyde and its derivatives have been described for medical devices also in other fields of interventional procedures [17,18] Various studies have hypothesized that the inflammatory and the immunological responses [19][20][21] could also play a role in the mineralization process of bioprosthetic tissues. Antibodies against donor valvular tissue components have been found in patients with structural deterioration of the bioprosthesis.…”

Section: Resultsmentioning

confidence: 99%

Early Degeneration of Aortic Bioprosthetic Valves Chemical interactions, prevention and treatment

Oancea¹,

Cobzeanu²,

Tarus³

et al. 2019

Bioprosthetic heart valves ensure a better quality of life compared to mechanical valves but are prone to degeneration with leaflet calcification and tearing. Valvular leaflets mineralization process is initiated within interstitial cells devitalized by glutaraldehyde with formation of calcium phosphate hydroxyapatite crystals. The aim of the current paper is to analyse early bioprosthetic valve degeneration occurring in three patients that needed bioprosthetic valve explantation and reimplantation of a mechanical valve. The three patients, aged 29, 64 and 78 years presented early degeneration of the implanted valve at 30, 36 and 52 months after the intervention in the context of unavoidable risk factors like young age, chronic kidney disease and small stented valve. Computed tomography examination demonstrated calcifications of the bioprosthetic valve and histological examination confirmed the findings by identifying tissue degeneration with calcification in all cases. Early bioprosthetic valve degeneration is a serious issue in cardiovascular surgery and a major cause of valve failure requiring reintervention. Several methods could be used to delay degeneration like systemic therapy with general anti-calcification agents, the use of locally delivered drugs or tissue pretreatment with special substances (ethanol, nonionic detergents, tridecyl alcohol ethoxylate). No optimal decellularization method for all types of tissues has been yet discovered. In conclusion, early bioprosthetic valve degeneration is a reality that should be taken into account in high risk patients. Current tissue pretreatment with glutaraldehyde is not perfect as it accelerates degeneration with formation of hydroxyapatite calcifications. New methods are needed to achieve efficient decellularization while preserving the functional characteristics of the transplanted tissue.

“…Certain pregnant women are diagnosed with the socalled atypical preeclampsia (which does not involve hypertension or proteinuria) and their condition worsens unexpectedly [27]. The evaluation of the ratio of circulating angiogenic protein -sFlt-1/PlGF may contribute to differentiate preeclampsia manifested by hypertension or proteinuria from other conditions (systemic lupus erythematosus) [19,28,29]. The results obtained within this study have indicated a significant increase of the serum concentration corresponding to the sFLT-1 anti-angiogenic factor of more than 4 times for the PE group and of more than three times for the HTN group, compared to the control group.…”

Section: Results and Discussion Clinical And Laboratory Markersmentioning

confidence: 99%

The Role of Several Angiogenesis Peptides Markers in the Management of Hypertensive Pregnant Women

Mihălceanu¹,

Dimitriu²,

Lazar³

et al. 2018

The objectives of the research herein are to detect if the modifications of sFlt-1 and PlGF can be correlated with the clinical and biochemical status of the hypertensive pregnant woman and if the sFlt-1/PlGF ratio is a good predictor for preeclampsia in case of the investigated patients. In the study herein, 100 pregnant women were evaluated; they were distributed in the following groups: The group of pregnant women diagnosed with HTN at the time of hospital admission � including 50 pregnant women, of which 16 pregnant women presented medium and severe forms of preeclampsia and 34 pregnant women with pregnancy-induced hypertension and 50 pregnant women with normal pregnancy evolution as control group. We have performed hematological and biochemical tests, using serum samples from all analyzed patients and measured the serum concentrations of sFlt-1 and PlGF angiogenic factors. We found a significant correlation between the value of the arterial blood pressure, the proteinuria, the serum creatinine and the AST, on one hand, and the sFlt-1/PlGF ratio, on the other hand. The ROC curve has emphasized the fact that the proteinuria (AUC = 0.849), the AST (AUC = 0.664), the value of the arterial blood pressure SBP/DBP (AUC = 0.683/0.631), the serum creatinine (AUC = 0.674) and the sFlt-1/PlGF ratio, at a cut off value = 200, are effective preeclampsia predictors. Similarly, statistically significant increase (p = 0.001) of the sFlt-1 serum concentration in case of the pregnant women from the PE group (14365�6464 pg/mL) and from the PIH group (9892�8443 pg/mL), compared to the control group (3278�1444 pg/mL) and, respectively, a significant decrease (p = 0.003) of the PlGF pro-angiogenic marker for the group of pregnant women suffering from preeclampsia (119.30�56.63 pg/mL) and from PIH (129.12�21.41 pg/mL), compared to the control group (327.57�59.62 pg/mL). The results obtained within this research show that sFlt-1/PlGF ratio represents an effective preeclampsia predictor, confirming the fact that the study of the angiogenic factors may help to analyze the stratification of the risk degree in HTN pregnant women.