• Title/Summary/Keyword: atherosclerotic cardiovascular diseases

Search Result 36, Processing Time 0.023 seconds

The Necessity for Coronary Angiography in Atherosclerotic Arterial Obstruction in the Lower Extremities and the Clinical Features of Accompanied Coronary Arterial Diseases (죽상동맥경화성 하지동맥폐쇄증에서 관상동맥조영술의 필요성 및 동반되는 관상동맥 질환의 양상)

  • Lee Jae-Wook;Yeom Wook;Park Young-Woo;Shin Hwa-Kyun;Won Yong-Soon
    • Journal of Chest Surgery
    • /
    • v.39 no.8 s.265
    • /
    • pp.619-625
    • /
    • 2006
  • Background: Peripheral arterial disease is frequently accompanied with systemic arteriosclerosis and more than half of the cause of deaths is due to the development of coronary arterial disease. Moreover, it is known that the most frequent cause of death after a bypass surgery of chronic arterial obstruction is heart related complications. Especially in patients with atherosclerotic arterial obstruction in the lower extremities who had no history of heart disease or had no presenting symptoms of ischemic heart disease showed a high rate of postoperative mortality and for this reason we suggest preoperative evaluation in these patients to evaluate whether or not coronary arterial disease is accompanied. Material and Method: Since Feb. 2001 to Oct. 2004, we analyzed 52 patients who were operated on for atherosclerotic arterial obstruction in the lower extremities, with the exception of patients with a past history of heart disease or symptoms of ischemic heart disease. They underwent on the same day a coronary and femoral angiography for evaluation of accompanying coronary arterial disease. Of among these patients, we compared those who received bypass surgery of the arteries of the peripheral extremities alone to those who underwent combined coronary artery bypass surgery. Result: 63% of the reported cases of atherosclerotic arterial obstruction in the lower extremities were accompanied with coronary arterial disease. Old age, hypertension, diabetes mellitus, smoking, and hypercholesterolemia are known risk factors for arteriosclerosis and of these, only old age and hypertension had statistically significance in patients with severe atherosclerotic arterial obstruction in the lower extremities accompanied with coronary arterial disease. Diabetes, smoking, and hypercholesterolemia showed no statistical significance in this group. With the increase in severity of the range and the degree of atherosclerotic arterial obstruction, coronary arterial disease is frequently accompanied and its severity also increased. Patients who received both peripheral artery and coronary artery bypass surgery showed no difference in the period of hospitalization and ICU stay period compared with patients who received bypass surgery of the arteries of the lower extremities alone. Conclusion: Patients with atherosclerotic arterial obstruction in the lower extremities without symptoms of ischem to evaluate coronary arterial disease for active treatment, especially in the patients with old age, hypertension and high AVD scores.

Isolated Bypass to the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

  • Jun, Hee Jae
    • Journal of Chest Surgery
    • /
    • v.46 no.2
    • /
    • pp.146-149
    • /
    • 2013
  • Mesenteric ischemic symptoms appear only when two of the three major splanchnic arteries from the abdominal aorta are involved. Recently, we encountered a case of chronic mesenteric ischemia in a 50-year-old female patient caused by atherosclerotic obstruction of the celiac trunk and superior mesenteric artery. She was treated with a retrograde bypass graft from the right common iliac artery to the superior mesenteric artery (SMA) in a C-loop configuration. Complete revascularization is recommended for treatment of intestinal ischemia. When the celiac trunk is a not suitable recipient vessel, bypass grafting to the SMA alone appears to be both an effective and durable procedure for treating intestinal ischemia.

Current Status and Application Prospects of Anti-Atherosclerotic Active Biomaterials (항동맥경화 활성 바이오소재 개발 연구 동향 및 활용 전망)

  • Seunghee Kim;Jeongho Lee;Hah Young Yoo
    • Korean Chemical Engineering Research
    • /
    • v.62 no.2
    • /
    • pp.133-141
    • /
    • 2024
  • Atherosclerosis, a disease with high morbidity and mortality worldwide, is a chronic inflammatory disease that is a major cause of cardiovascular diseases such as stroke and myocardial infarction. Atherosclerosis is characterized by the accumulation of lipid deposits in the arteries, forming atheromas. This leads to the narrowing of the arteries and thrombosis. Recently, the need to develop bio-derived anti-atherosclerotic materials has been highlighted with concerns about the side effects of synthetic therapeutics. Accordingly, related research (such as the discovery of biomaterials for the improvement and treatment of atherosclerosis and the identification of mechanisms) has been actively conducted. Biomaterials including polysaccharides, polyphenols, and coenzyme Q10 have been reported to inhibit or delay symptoms by modulating factors involved in the development of atherosclerosis. For biomaterials with superior activity, in vivo anti-atherosclerotic activity has been confirmed. In this review, the pathogenesis of atherosclerosis was investigated, and the current status and application prospects of biomaterials with anti-atherosclerotic activity were proposed.

Optimal Target Low-density Lipoprotein Level for Reducing the Risk of Atherosclerotic Cardiovascular Diseases: A Systematic Review and Meta-analysis

  • Min-Gyo Jang;Yeung-Eun Son;Hye Duck Choi;Junwoo Kim;Tae-Eun Kim;Kwang-Hee Shin
    • Korean Journal of Clinical Pharmacy
    • /
    • v.33 no.4
    • /
    • pp.270-277
    • /
    • 2023
  • Background: As per guidelines for treating dyslipidemia, the recommended low-density lipoprotein cholesterol (LDL-C) level in extremely high-risk patients, including those with coronary artery diseases is <55 mg/dL. Although this recommendation has been adopted in the guidelines for dyslipidemia in various countries, there is limited evidence of its efficacy in reducing cardiovascular diseases (CVDs), especially among East Asian patients. This study aimed to investigate whether an LDL-C value below 55 mg/dL is associated with decreased risk of CVDs. Methods: Seven clinical trials including 50,970 patients that compared intensive lipid-lowering therapy with less therapy or placebo in patients who had >6 months of follow-up, those with a sample size of ≥150 were selected as the final literature for analysis. Risk ratios (RR) using random effects were represented with 95% confidence intervals (CI) for the reliability of the results. Results: An LDL-C level of <55 mg/dL was related to significantly reduced events of major CVDs (RR: 0.88; 95% CI: 0.80-0.98) and myocardial infarction (RR: 0.81; 95% CI: 0.73-0.90) and a reduced risk of ischemic stroke (RR 0.79; 95% CI 0.69-0.89, mean follow-up=2 years). However, an LDL-C level below 55 mg/dL did not reduce the incidence of CVD in intensive therapy in East Asian patients. Conclusions: A goal LDL-C value below 55 mg/dL was identified to be related to a decreased risk of developing CVD. However, the relation to LDL-C below 55 mg/dL with a decreased risk of CVD was not observed in East Asian patients.

A clinical report of cerebral infarction patient with schizophrenia (전증(癲證)을 동반한 졸중풍(卒中風) 환자 치험1례)

  • Oh, Kyong-Min;Yang, Dong-Ho;Kim, Bo-Kyong
    • Journal of Oriental Neuropsychiatry
    • /
    • v.18 no.3
    • /
    • pp.209-224
    • /
    • 2007
  • Metabolic syndrome consists of several risk factors of metabolic origin like elevated blood pressure, abdominal obesity, elevated triglyceride concentrations, decreased HDL-cholesterol concentrations, and elevated fasting glucose. It appear to directly increase the development of atherosclerotic cardiovascular diseases which leading to cardiovascular diseases in later life. This 39 years female patient was diagnosed schizophrenia at the age of 17. but she didn't take reasonable treatments. during 20 years, she stayed in home and lived unsuited life with her family. As a result she gains heavy weight and centeral obesity, diabetic mellitus and hypertention, and developed cerevral vascular accident twice. This patient was treated with herb medication, acupuncture, western medication, psychotherapy primarily in focusing of pre-illness state(未病) as well as the stagnation of phelm. During 140 days of treatment from admission, before 2nd attack tbe patient showed improvement of Lt. hemiparesis but after second attack improved a little. And symptom of schizophrenia improved considerably. Also diet habit changed.

  • PDF

Clinical Analysis of Arterial Bypass on the Atherosclerotic Occlusive Disease in Lower Extremities (폐쇄성 하지동맥 경화증에서 동맥 우회술의 임상적 고찰)

  • Park, Sung-Hyuk; Youm, Wook
    • Journal of Chest Surgery
    • /
    • v.30 no.2
    • /
    • pp.195-199
    • /
    • 1997
  • From Dec. 1992 to Dec. 1995, 20 patients with atherosclerotic occlusive disease in the lower extremities underwent arter al bypass surgery. The age of the patients ranged between 46 and 77 years(mean .60.8 years) and the most prevalent incidence was in the 7th decades. The mean follow up period was 18.8 months ranging from 4 to 36 months. Associated diseases were diabetus mellitus(25%), hypertension (35%), cerebrovascular accident(25%), and acute myocardial infarction(5%). Disabling intermittent claudifcation(35%), resting pain(20%) or ischemic gangrene(or ulceration)(45%) were operative indications. Aorto-bifemoral bypass in 4 cases, aorto-single femoral bypass in 2 cases, Aorto-bifemoral bypass and femoropopliteal bypass in 3 cases, aorto-single femoral bypass and femoropopliteal bypass in 1 case, femoropopliteal bypass in 4 cases, femorotibial bypass in 1 case, popliteotibial bypass 4 cases and femorofemoral bypass in 1 case were the surgical approches. Early thrombosis(2 cases) and wound infection(2 case) were main complication. Postoperative complication rate was 20% . Postoperative patency rates re 92.6% at 6 months, 84.2% at 1 year, 75.4% at 2 years and 69.4% at 3 years.

  • PDF

Triglyceride-Rich Lipoproteins and Novel Targets for Anti-atherosclerotic Therapy

  • Reiner, Zeljko
    • Korean Circulation Journal
    • /
    • v.48 no.12
    • /
    • pp.1097-1119
    • /
    • 2018
  • Although elevated serum low-density lipoprotein-cholesterol (LDL-C) is without any doubts accepted as an important risk factor for cardiovascular disease (CVD), the role of elevated triglycerides (TGs)-rich lipoproteins as an independent risk factor has until recently been quite controversial. Recent data strongly suggest that elevated TG-rich lipoproteins are an independent risk factor for CVD and that therapeutic targeting of them could possibly provide further benefit in reducing CVD morbidity, events and mortality, apart from LDL-C lowering. Today elevated TGs are treated with lifestyle interventions, and with fibrates which could be combined with omega-3 fatty acids. There are also some new drugs. Volanesorsen, is an antisense oligonucleotid that inhibits the production of the Apo C-III which is crucial in regulating TGs metabolism because it inhibits lipoprotein lipase (LPL) and hepatic lipase activity but also hepatic uptake of TGs-rich particles. Evinacumab is a monoclonal antibody against angiopoietin-like protein 3 (ANGPTL3) and it seems that it can substantially lower elevated TGs levels because ANGPTL3 also regulates TGs metabolism. Pemafibrate is a selective peroxisome proliferator-activated receptor alpha modulator which also decreases TGs, and improves other lipid parameters. It seems that it also has some other possible antiatherogenic effects. Alipogene tiparvovec is a nonreplicating adeno-associated viral vector that delivers copies of the LPL gene to muscle tissue which accelerates the clearance of TG-rich lipoproteins thus decreasing extremely high TGs levels. Pradigastat is a novel diacylglycerol acyltransferase 1 inhibitor which substantially reduces extremely high TGs levels and appears to be promising in treatment of the rare familial chylomicronemia syndrome.

Surgical Result of Coronary Artery Bypass Grafting - The Effect of Pre and Intraoperative Procedures (관동맥 우회술의 수술성적-수술전 처치 및 수술수기의 영향에 관한 연구)

  • Kim, Young-Tae;Hong, Jong-Myun;Chae, Hurn
    • Journal of Chest Surgery
    • /
    • v.26 no.2
    • /
    • pp.141-147
    • /
    • 1993
  • A total of 40 patients having a diagnosis of atherosclerotic coronary arterial disease were analysed on the operative outcomes according to variables as follows: 1) preoperative risk factors such as age, sex, CCS (Canadian Cardiovascular Society) functional class, type of angina, number of diseased vessel, presence of left main coronary artery stenosis, previous history of habitual smoking and presence of other medical diseases (diabetes mellitus, essential hypertension), 2) preoperative management such as intravenous infusion of nitroglycerine, preoperative IABP (intra-aortic balloon pump) support and whether the operation was scheduled as emergency or not, 3) intraoperative variables such as infusion method and composition of cardioplegic solutions, number of distal anastomosis, use of internal mammary artery, total cardiopulmonary bypass time and total cross clamp time. Complications included operative death in 12.5%, perioperative myocardial infarction in 25.0% and perioperative arrhythmia in 17.5%. Nineteen perioperative variables were analyzed to identify risk factors for these end points. For operative death, presence of left main coronary artery stenosis (p = 0.056) and cardiopulmonary bypass time (p = 0.029) were significant in the univariate analysis, but presence of left main coronary artery lesion (p = 0.011, $\chi$$^2$= 6.45) and abscence of preoperative of IABP support (p = 0.069, $\chi$$^2$ = 3.30) were independent predictor in multivariate analysis (stepwise linear logistic regression).

  • PDF

Epitope specificity of Porphyromonas gingivalis heat shock protein for T-cell and/or B-cell in human atherosclerosis (동맥경화증에서 T-세포 및 B-세포에 대한 Porphyromonas gingivalis 열충격 단백의 항원 결정 부위 특이성 연구)

  • Bak, Jung-Gyu;Kim, Sung-Jo;Choi, Jeom-Il
    • Journal of Periodontal and Implant Science
    • /
    • v.33 no.2
    • /
    • pp.179-191
    • /
    • 2003
  • Since periodontal infections are suggested as risk factors for the development of cardiovascular diseases, the present study was performed to evaluate the T cell immune responses specific to Pophylomonas gingivalis(P. gingivalis) heat shock protein(hsp) 60 and T-cell and B-cell epitope specificities for P. gingivalis hsp60 in atherosclerosis. Anti-P, gingivalis IgG antibody titers were elevated in all patients. We could establish P. gingivalis hsp-specific T cell lines from the atheroma lesions, a mixture of $CD4^+$ and $CD8^+$ cells producing the cytokines characteristic of both Th1 and Th2 subsets. of 108 overlapping synthetic peptides spanning whole P. gingivalis hsp60 molecule, ten peptides with common epitopes specificities for both T-cell and B-cell were identified. it was concluded that P. gingivalis hsp60 might K involved in the immunoregulatory process of atherosclerotic diseases with epitope specificities.

The Comparison of Carotid Artery Intima-media Thickness and Plaque Characteristics between Patients with ST-elevation Myocardial Infarction and Coronary Artery Chronic Total Occlusion

  • Choi, Sun Young;Park, Jong Sung
    • Biomedical Science Letters
    • /
    • v.21 no.4
    • /
    • pp.198-207
    • /
    • 2015
  • ST-segment elevation myocardial infarction (STEMI) and chronic total occlusion (CTO) of coronary artery are well-known atherosclerotic vascular diseases. However, the difference of intima-media thickness and plaque characteristics of carotid arteries between STEMI and CTO patients were not directly compared in previous studies. Medical records of a total of 158 (101 STEMI, 57 CTO) patients, who underwent carotid artery ultrasonography, were selected for the analysis. The baseline characteristics, ultrasonography findings, and clinical outcomes of the two groups were compared. The prevalence of hypertension, diabetes mellitus, and dyslipidemia was significantly higher in CTO patients. Carotid intima-media thickness ($0.97{\pm}0.13$ vs. $0.78{\pm}0.17cm$, P < 0.0001) and number of plaques ($2.2{\pm}1.0$ vs. $1.7{\pm}1.2$, P < 0.0001) were greater in CTO than STEMI patients. Multiple (${\geq}3$) or echogenic plaques were more frequently observed in CTO patients. During the median follow-up duration of 27 months, major adverse cardiovascular events occurred in 31% of CTO and 14% of STEMI patients (P = 0.008). We found that, compared with STEMI, CTO patients have higher burden of carotid artery atherosclerosis associated with more comorbid diseases and poor clinical outcomes.