Cardiovascular & Haematological Disorders - Drug Targets - Volume 14, Issue 3, 2014

A paradigm shift is occurring in the way nephrologists evaluate patients with progressive chronic kidney disease for initiation of maintenance renal replacement therapy. Serum creatinine and serum creatinine-based equations used to calculate an estimated glomerular filtration rate (eGFR) are not accurate approximations of renal function at low levels. Further complicating matters is a trend toward early initiation of dialysis, on Read More

The development of simultaneous decompensation in cardiac and renal function is a common phenomenon in patients with congestive heart failure. Termed the cardiorenal syndrome (CRS), this joint deterioration in cardiac output and renal filtration is the result of a complex interplay of hemodynamic and neurohormonal factors. Recently, endothelial dysfunction, inflammation and uremia have been recognized as contrib Read More

Children and adolescents with chronic kidney disease (CKD) are at high risk for cardiovascular morbidity and mortality. This review provides a comprehensive overview of the possible risk factors for early atherosclerosis in children with CKD. Endothelial dysfunction, a precursor of atherosclerosis, starts early in renal disease, as indicated by increased carotid artery intima media thickness, carotid arterial wall stiffne Read More

Cardiovascular (CV) disease is the most common cause of mortality among kidney transplant candidates on the waiting-list and after kidney transplantation. The mechanisms of cardiovascular disease burden after transplant are multifactorial and the risk is largely determined by pre-transplant factors including CV disease and dialysis duration. Current pre-transplant cardiac evaluation protocols have proven to be inco Read More

One quarter of all hemodialysis patients will succumb to sudden cardiac death (SCD), a rate far exceeding that observed in the general population. A high prevalence of atherosclerotic coronary artery disease amongst patients with end-stage kidney disease (ESKD) partly explains this exaggerated risk. However, uremia and dialysis related factors are also of critical importance. Interventions aimed at preventing SCD ha Read More

Objective: To assess the efficacy of statin therapy on early stage chronic kidney disease through an overview of systematic reviews. Methods: We searched for systematic reviews of randomized clinical trials (RCT) on MEDLINE, Embase, Cochrane Library, CRD, and Scopus. Independent reviewers selected the studies and extracted the relevant data. We critically appraised the included systematic reviews with the AMSTAR Read More

The prevalence of chronic kidney disease (CKD) in the United States has increased in the last 20 years. As CKD and cardiovascular disease (CVD) are interrelated, it is important to note that trends in the prevalence of CKD and common risk factors it shares with CVD, such as hypertension and diabetes, are likely to affect the burden of both diseases in the future. While preventing and treating CVD is of high priority in the primar Read More

The introduction of drug-eluting stents (DES) has resulted in improvement rates of restenosis and the need for repeat revascularization. However, with widespread use of DES, which reaches more than 80% of used coronary stents, concern has been raised regarding the long-term safety of this technology. The development of newer anti-restenotic agents, polymeric coatings as well as stent platforms resulted in newer DES whic Read More

The interventional treatment of coronary artery disease was introduced in 1970`s by Andreas Grüntzig. The initial treatment strategy with plain old balloon angioplasty (POBA) was associated with high restenosis rates. The introduction of coronary stents, especially drug-eluting stents (DES) in 2002 has improved the results by lowering the rate of in-stent restenosis from 20-40% in the era of bare-metal stent (BMS) to 6-8%. Ho Read More

Antiplatelet therapy plays an important role in the treatment of patients suffering from acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) in order to prevent atherothrombotic events and restenosis or ischemic reocclusion, respectively. Moreover, stent implantation is often performed along with PCI to ensure that the arteries remain open. However, stent thrombosis ST i Read More

Stent thrombosis is a serious complication in stent era. It can be presented as death, cardiogenic shock or a large non-fatal myocardial infarction, usually with ST elevation. Risks of stent thrombosis, stent thrombosis incidence and predictors are controversial issues due to sparse and controversial data. But all attending physicians should have knowledge of the risk of stent thrombosis, predisposing and protective facto Read More

In case of coronary stenting in patients taking long-term oral anticoagulants (OAC), addition of both aspirin and clopidogrel in the drug regimen (so-called triple antiplatelet therapy) is recommended. However such triple therapy increases the risk of serious bleeding events. Comparative data on the efficacy and safety of the triple therapy versus therapy with a single antiplatelet agent and oral anticoagulants in case of coronary st Read More

Adenosin diphospat (ADP) plays a crucial role in thrombus formation. Therefore its inhibition can control excess platelet generation to prevent cardiovascular events in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI). One of ADP’s target receptors, P2Y12 has a limited tissue distribution and is therefore an attractive pharmacological target. Thienopyridines are class Read More