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61.
Lemos PA Arampatzis CA Hoye A Daemen J Ong AT Saia F van der Giessen WJ McFadden EP Sianos G Smits PC de Feyter P Hofma SH van Domburg RT Serruys PW 《The American journal of cardiology》2005,95(2):167-172
Renal impairment is an important predictor of mortality after percutaneous coronary intervention and may increase the restenosis rate. However, the relation between restenosis and the risk of death in patients who have renal impairment remains unclear. We evaluated the incidences of repeat revascularization and mortality in patients who had renal impairment and those who did not and who received sirolimus-eluting stents or bare stents. A total of 1,080 consecutive patients treated for 1 year had available data to calculate baseline creatinine clearance. Patients received bare stents (first 6 months, n = 543) or sirolimus-eluting stents (last 6 months, n = 537) and were grouped according to the presence or absence of renal impairment (creatinine clearance <60 ml/min). Patients who had renal impairment had a higher mortality rate at 1 year (7.6% vs 2.5%, hazard ratio 3.14, 95% confidence interval 1.68 to 5.88, p <0.01), with no differences in mortality between patients who received bare stents and those who received sirolimus-eluting stents (hazard ratio 0.91, 95% confidence interval 0.49 to 1.68, p = 0.8). The incidence of target vessel revascularization decreased significantly in patients who were treated with sirolimus-eluting stents and did not have renal impairment (hazard ratio 0.59, 95% confidence interval 0.39 to 0.90, p = 0.01) and in those who had decreased renal function (hazard ratio 0.37, 95% confidence interval 0.15 to 0.90, p = 0.03). Thus, sirolimus-eluting stents compared with conventional stents decreased clinical restenosis in patients who had renal impairment. However, this benefit was not paralleled by a decrease in the risk of death in this population. It seems unlikely that restenosis could be a contributing factor that influenced the increased mortality of patients who had impaired renal function. 相似文献
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Abdullah SM Khera A Das SR Stanek HG Canham RM Chung AK Morrow DA Drazner MH McGuire DK de Lemos JA 《The American journal of cardiology》2005,96(9):1284-1289
Elevated plasma levels of B-type natriuretic peptide (BNP) and N-terminal pro-BNP (NT-pro-BNP) are seen in the setting of cardiac ischemia and are associated with adverse outcomes in patients with coronary artery disease. The mechanisms leading to natriuretic peptide elevation in patients with coronary artery disease, including the contribution of coronary atherosclerosis itself, have not been fully elucidated. Measurement of NT-pro-BNP, electron beam computed tomography, and cardiac magnetic resonance imaging were performed in 2,445 subjects from the Dallas Heart Study who were free of heart failure and renal insufficiency. Electron beam computed tomography-determined coronary artery calcium scores were categorized as none (<10), mild (> or =10 to <100), moderate (> or =100 to <400), and severe (> or =400). NT-pro-BNP levels increased significantly across increasing coronary artery calcium score categories (p <0.0001 for trend). In multivariate models adjusted for age, gender, race, body mass index, hypertension, history of myocardial infarction, angina, angiotensin-converting enzyme inhibitor use, beta-blocker use, left ventricular (LV) ejection fraction, and LV mass, higher coronary artery calcium scores remained independently associated with higher log NT-pro-BNP levels (p = 0.03). This association persisted in similar models excluding patients with low LV ejection fractions, LV hypertrophy, angina pectoris, and a history of myocardial infarction. In conclusion, these findings support the hypothesis that coronary atherosclerosis may directly influence the activation of the cardiac neurohormonal system. 相似文献
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Alexsandra R.m. Favacho Isabelle Roger Amanda K. Akemi Adonai A. Pessoa JR. Andrea G. Varon Raphael Gomes Daniela T. Godoy Sandro Pereira Elba R.s. Lemos 《Revista do Instituto de Medicina Tropical de S?o Paulo》2014,56(4):363-365
Bartonella henselae is associated with a wide spectrum of clinical
manifestations, including cat scratch disease, endocarditis and meningoencephalitis,
in immunocompetent and immunocompromised patients. We report the first molecularly
confirmed case of B. henselae infection in an AIDS patient in state
of Rio de Janeiro, Brazil. Although DNA sequence of B. henselae has
been detected by polymerase chain reaction in a lymph node biopsy, acute and
convalescent sera were nonreactive. 相似文献
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