Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0042373 (vascular disease)
 17,070 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first 350 patients having coronary surgery at Stanford Medical Center (excluding patients with aneurysmectomy or valve replacement) have been followed sequentially utilizing a computer-based information system. Our experience spans 72 months (900 patient-years), with an average follow-up of 30 months. Hospital mortality was 4.9%. Actuarial analysis revealed survival of 91% at 1 year and 80% at 6 years. Forty patients (11.5%) had 43 late myocardial infarctions, of which 5 were fatal. Analyses of selected patient subgroups revealed significantly poorer survival in patients with prior myocardial infarction (P less than 0.05), significant congestive heart failure, or mitral regurgitation (P less than 0.01). Survival in multigrafted (and multivessel) patients was not significantly different from survival in single-grafted (predominantly single-vessel) patients. Actuarial studies suggest improved survival in patients with multivessel disease after coronary artery surgery. Between an initial evaluation at 9 months postoperatively (range: 2 to 40 months) and the most recent evaluation after 30 months (range: 6 to 72 months), 13% of patients showed further clinical improvement, 47% were unchanged, while 40% deteriorated with respect to chest pain. We conclude that initial symptomatic benefits may not be maintained in late follow-up studies owing to progression of underlying vascular disease.
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PMID:Changes in survival and symptom relief in a longitudinal study of patients after bypass surgery. 108 Apr 47

This study was designed to compare the prevalence of obesity, high blood pressure, diabetic vascular disease, and risk factors in Black West Indians who had emigrated to Britain (WIB) with those in Whites in England and among diabetic Jamaicans in Jamaica. Seventy-seven consecutive WIB patients were matched for age, sex, known duration of diabetes, and type of treatment of diabetes with 74 Whites from the same diabetes clinic in England. In Jamaica, a systematic random sample (95 women, 36 men) was studied. There was no difference in age at diagnosis between WIBs and Jamaicans. Effort chest pain (possible angina) was less frequent in WIBs (9%) or Jamaicans (3%) than in Whites (25%). Cigarette smoking was more common in WIBs than in Whites but still low in Jamaicans. Body mass index was greatest in WIB women (85%), significantly more than in matched White (52%) or Jamaican women (45%); 40% of White men and WIB men were obese, significantly more than Jamaicans (15% obese). Systolic blood pressure was similar, but diastolic blood pressure was significantly greater in WIBs than in matched White subjects. The prevalence of casual hypertension was high (greater than 40%) in all groups, often despite treatment. Cataracts were significantly more frequent in WIB and Jamaican groups than in Whites. Total background retinopathy after correcting for duration of diabetes did not differ between groups, and there were no significant differences in other complication rates. Levels of HbA1 were lower in Whites than in the other groups. Regression analysis showed that systolic blood pressure was most consistently related to complications, particularly retinopathy, independent of ethnic group and duration.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Black West Indian and matched white diabetics in Britain compared with diabetics in Jamaica: body mass, blood pressure, and vascular disease. 358 77

Of 40 patients with obstructive pulmonary hypertension studied in Basle, Switzerland, during the period 1966-68, 32 had been taking an anorectic drug, aminorex fumarate. Rapidly progressing exertional dyspnoea, central chest pain, and syncope on effort were characteristic features. The absence of the usual causes of pulmonary vascular disease seems to suggest the possibility of drug-induced pulmonary hypertension. Further studies are necessary, however, to clarify the role of aminorex fumarate in this condition.
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PMID:Drug-induced pulmonary hypertension? 510 Apr 97

Tobacco smoke is a major cause of both cancer and vascular disease. Although its carcinogenic role via induction of DNA damage and mutation is well established, the mechanisms involved in vascular disease remain unclear. One possibility is that DNA damage causes smooth muscle cell proliferation in the intima of arteries, thereby contributing to atherothrombotic processes. The binding of chemicals to DNA is modulated by detoxification enzymes, including glutathione S-transferases (GST) and microsomal epoxide hydrolase (EPXH). We therefore examined whether polymorphisms in these genes influence risk of cardiovascular disease. Blood was obtained from 398 patients admitted for angiographic investigation of chest pain and 196 age- and sex-matched controls. Patients were subdivided into those with and without previous acute myocardial infarction (AMI). DNA was analyzed for deletions in the GSTM1 and T1 genes and for substitutions in EPXH and GSTP1 genes. The GSTM1 null genotype occurred at a significantly lower frequency in the AMI patient group (48%) compared both to patients with no history of AMI (59%) and to the control group (57.2%). When subjects were stratified for smoking status, a significant association was observed only in smokers, suggesting the polymorphism is more important in the presence of tobacco smoke exposure. The association remained significant after adjusting for age, sex, and stenosis (presence or absence). No significant associations were observed between the other genotypes and cardiovascular disease (chi(2) test; P>0.1). The results of this study indicate that the GSTM1 null genotype is protective against AMI, an effect that is more marked in smokers. However, further study is required in order to elucidate the as yet unexplained, mechanisms underlying this association.
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PMID:Glutathione S-transferase M1 null genotype is associated with a decreased risk of myocardial infarction. 1074 35

Twenty children, aged 6 months to 13 years, with acute pericarditis admitted between 1987 and 1997 to a university hospital were analyzed retrospectively for their etiology, presentation, management, and prognosis. The most common types of pericarditis were purulent (40%), collagen vascular disease (30%), viral (20%), and neoplastic disease (10%). Most children presented with chest pain, fever, and tachypnea, but cardiac tamponade was not seen in any children. Staphylococcus aureus was the most frequent causative organism of purulent pericarditis and septic arthritis was the most common concurrent infection in the patients. Surgical drainage was performed for 11 cases, 9 underwent subxiphoid pericardial window, and 2 underwent thoracotomy. There was no constrictive pericarditis or reaccumulation of fluid after surgery. Two children died, one of staphylococcal septicemia and the other had a malignant mediastinal tumor. The remaining 18 made a complete recovery. We conclude that subxiphoid pericardial drainage is a simple, safe, and quick procedure and can be done easily in general hospitals by pediatric surgeons. The expensive facilities of cardiac surgeries are not needed.
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PMID:Acute pericarditis in childhood: a 10-year experience. 1086 14

C-reactive protein (CRP) is a protein whose concentration in serum is increased in response to inflammatory stimuli. Increased levels serve to identify organic disease, monitor disease activity and assist differential diagnosis. High values are observed early in bacterial infections, active rheumatoid disease, Crohn's disease, acute myocardial infarction and after major trauma. In patients with ischaemic chest pain, a raised CRP value on hospital admission is associated with an adverse prognosis. In apparently healthy individuals, a raised CRP value indicates an increased risk of developing atherosclerotic vascular disease, but also increased benefit from aspirin prophylaxis and treatment of hyperlipidaemia.
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PMID:C-reactive protein. 1140 13

Exhaled nitric oxide (eNO) is thought to arise principally from the airway epithelium. NO regulates smooth muscle tone, and abnormal activity of NO synthase has been implicated in coronary artery disease (CAD). Polymorphisms of endothelial constitutive NO synthase (ecNOS) may affect NO generation and be associated with CAD. It was hypothesised that a polymorphism, such as the ecNOS intron 4 polymorphism (ecNOS4a), affects the levels of eNO via airway epithelial NOS. eNO levels were measured in 53 patients with ischaemic chest pain who had previously been genotyped for ecNOS polymorphisms, with sample enrichment for the ecNOS4a allele. Subjects were also assessed for two other ecNOS polymorphisms (T-786C substitution in the promoter region, and G5557T in exon 7), variably associated with vascular disease. Those homozygous for the 'a' allele (ecNOS4a/a) had a lower mean eNO (9.0 ppb) than those who were heterozygous (ecNOS4a/b, 13.6 ppb), who in turn had a lower level than those homozygous for the wild-type ecNOS4b/b (16.1 ppb). No association of eNO levels was found with the other polymorphisms. Levels of eNO remained significantly lower in the ecNOSa/a subjects than in the ecNOSa/b and ecNOSb/b subjects, even when controlled for angiographic CAD, and smoking habit. In addition, all subjects with CAD had a significantly lower mean eNO (12.1 ppb) than subjects without angiographic CAD (19.9 ppb). In this selected population low levels of eNO were thus associated with presence of the ecNOS4a allele and also with CAD.
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PMID:Effect of ecNOS polymorphisms and coronary artery disease upon exhaled nitric oxide. 1189 44

South Asians living in Western societies show a greater risk of coronary artery disease (CAD) than the indigenous Caucasian population, probably related to the change to a Westernised lifestyle and an associated genetic susceptibility. Modulation of DNA damage and mutation caused by polymorphisms in detoxification enzymes, including the glutathione S-transferases (GSTs), is a well-established risk factor for tobacco-related carcinogenesis, and a similar change in cellular damage may be involved in the risk of vascular disease associated with tobacco smoking. In this study we examined whether polymorphisms in GST genes influence the risk of CAD in a case-control group of South Asians, following our recent observation of such an association in Caucasians from the same region of the UK. Blood was obtained from 170 patients of South Asian origin admitted for angiographic investigation of chest pain and from 203 controls. Patients were subdivided into those with and without previous acute myocardial infarction (AMI), and DNA was analysed for deletions in the GSTM1 and GSTT1 genes. An association was found between the prevalence of the GSTM1 null genotype and the risk of developing CAD in this study population. The frequency of the null genotype was 52.7% in healthy controls and 41.2% in patients (odds ratio [OR] 0.63, 95% confidence interval [95% CI] 0.42-0.95, p = 0.029). The effect was similar in subjects with or without a prior history of AMI. The association was also independent of smoking history, with both non-smokers and smokers showing a similar pattern of genotype distribution, the frequency of the null genotype being 51.2% in controls versus 37.0% in patients in 'never' smokers (OR 0.56, 95% CI 0.33-0.94, p = 0.037) and 60.0% in controls versus 46.2% in patients in 'ever' smokers (OR 0.57, 95% CI 0.25-1.28, p = 0.223). The association remained after adjusting for age, sex, body mass index and the presence or absence of stenosis. No significant associations were observed between the GSTT1 genotype and cardiovascular disease (chi(2) test, p > 0.1). The results of this study indicate that the GSTM1 null genotype is protective against both CAD and AMI. However, further study is required in order to elucidate the, as yet unexplained, mechanisms underlying this association.
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PMID:Association between the risk of coronary artery disease in South Asians and a deletion polymorphism in glutathione S-transferase M1. 1251 35

The significance of the risk factors and the rapid diagnosis of encephalic vascular disease (EVD) is the reason for this research, where the authors decided to register and analyze the non-medical people knowledge about these risk factors and the symptoms of this group of disease. For this purpose a questionnaire with questions about these facts was applied to 500 voluntaries without pre-selection, 72.6% of them with ages between 16-35 years old, and the answers analyzed by statistical methods. The authors recognized that the risk factors has a good level of knowledge by this population (87.8 % for hypertension, 76.8 % for smoking, 70.8 % for obesity, 68.7 % for sedentary persons, 66.7 % to stress, 66.3 % to alcohol ingest, 60.7 % for fat diet, 59 % to illicit drugs) while the signs and symptoms of EVD has a minor level of knowing and correction: lost sensitivity 70.3 %, headache 64.2 %, twisted mouth 59.5 %, lost or altered speech 57.5 %, dizziness 56 %, syncope 51.7 %, amaurosis 50.3 %, disequilibrium 45 %, deafness 31.2 %, weakness 41.1 %, nervousness 20.7%, chest pain 20.2 %, fatigue 15.3 % and tinnitus 18.9 %. According this data, the authors suggest that the correction or prevention of risk factors as well the precocious medical attention by the recognition of symptoms of EVD must be the object of public health programs.
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PMID:[Lay knowledge about stroke]. 1459 81

Mounting evidence from a growing body of epidemiologic studies demonstrates that patients with systemic lupus erythematosus (SLE) are at increased risk for the development of premature cardiovascular disease (CVD). However, awareness of accelerated atherosclerosis in young SLE patients, albeit growing, is still limited, as documented by the brief case presented. Inflammation is thought to play an important role in both the pathogenesis of SLE, as well as atherosclerotic vascular disease. Inflammatory processes that are shared by SLE and atherosclerotic disease include immune complex deposition and fixation, autoantibody binding, complement activation and CD40-CD40 ligand interaction. By examining the inflammatory mechanisms in common between SLE and atherosclerotic disease, we can come to a better understanding of the pathophysiology of the accelerated atherosclerotic process seen in patients with SLE and can gain insights into developing and instituting preventative and treatment strategies. In this article, we present a case of a young woman with SLE who presents with chest pain, followed by a review of inflammation-based pathogenic mechanisms that are shared by SLE and atherosclerotic cardiovascular disease.
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PMID:Premature atherosclerotic disease in systemic lupus erythematosus--role of inflammatory mechanisms. 1643 36


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