PubMed Health⌕ Search

Biomedical subjects

A Muscari

Publications and source records attributed to A Muscari.

At least 19 recordsLinked to original sources
PubMed2002

Different associations of C-reactive protein, fibrinogen and C3 with traditional risk factors in middle-aged men.

BACKGROUND: Some acute phase proteins are associated with both ischemic events and traditional risk factors. Since they are strongly interrelated, each of them partly reflects the characteristics of other proteins. This study was carried out to ascertain the specific preferential associations of some acute phase proteins with traditional risk factors for atherosclerotic disease. METHODS: High-sensitivity C-reactive protein, fibrinogen and C3-complement were assessed in 288 unselected men aged 55-64 years. Three multiple linear regression analyses were performed, in which each of the three acute phase proteins was considered the dependent variable of both traditional risk factors and the other two proteins. RESULTS: The three acute phase proteins strongly correlated with each other. Moreover, C-reactive protein was independently associated with triglycerides (P<0.0001), age (P=0.0130), body mass index (P=0.0179), and acute (P=0.0280) and chronic (P=0.0582) inflammations (R2=0.17). Fibrinogen was associated with alcohol consumption (inversely, P=0.0001) and smoking (P=0.0598) (R2=0.06). Finally, C3 was associated with insulin (P<0.0001), cholesterol (P=0.0001), sedentarity (P=0.0028), glucose (P=0.0077), and systolic blood pressure (P=0.0124) (R2=0.28). CONCLUSIONS: When simultaneously studied in multivariate analysis, acute phase proteins have different preferential associations with traditional risk factors, a probable consequence of their involvement in different cellular activations and metabolic processes.

Age Factors↗
PubMed2001

Short term effect of atorvastatin and vitamin E on serum levels of C3, a sensitive marker of the risk of myocardial infarction in men.

C3 complement is produced in response to macrophage activation and is a reliable marker of the risk of myocardial infarction in men. This study was designed to ascertain whether the treatment with atorvastatin, a powerful cholesterol lowering drug, and/or vitamin E, a natural antioxidant, may induce a short term decrease in serum C3 in subjects with persistently elevated levels. From an initial random sample of 1100 men aged 55-64 years, 140 subjects with 3 consecutive C3 measurements in the high tertile (>1.19 g/l) were selected. Those with total cholesterol <5.56 mmol/l were double blindly randomized in groups 1 (placebo, N = 28, G1) and 2 (vitamin E 600 IU/day, N= 30, G2). The subjects with total cholesterol values >5.56 mmol/l were randomized in groups 3 (placebo, N= 30, G3), 4 (atorvastatin 10 mg/day, N = 27, G4) and 5 (atorvastatin 10 mg/day + vitamin E 600 IU/day, N = 25, G5). After 3 months C3 levels were substantially unchanged in the first 4 groups, while in G5 a very significant decrement occurred: -0.070 g/l (5.2%); 95% CI 0.043-0.098; p <0.0001. "Normal" levels of C3 (< 1.19 g/l) were reached by 28% of G5 subjects. In G2 and G5 vitamin E levels increased by 60 and 36%, while in G4 they decreased by 23% (p < 0.0001), paralleling cholesterol and triglyceride fall. In all groups a progressive decrease in HDL cholesterol occurred (-17%, p < 0.0001). In conclusion, treatment with atorvastatin plus vitamin E for three months can lower persistently elevated C3 levels.

Anticholesteremic Agents↗
PubMed2001

HMG-CoA reductase inhibitors: Is the endothelium the main target?

Endothelial dysfunction is an early event in atherosclerosis and could be considered a response to the injury induced by major risk factors. There is evidence that endothelial dysfunction is intimately involved in the onset and the progression of cardiovascular disease through abnormalities in the production, release or degradation of endothelium-derived factors, mainly nitric oxide and endothelin 1. Several reports have shown that drugs of the statin class could have multiple beneficial effects related to endothelium-mediated vasoactive, antithrombotic, antiproliferative and anti-inflammatory actions. Thus, the question arises of whether endothelial cells are the main target of statin therapy, in the setting of both hypercholesterolemia and normocholesterolemia. Experimental and clinical studies are reported that could support this hypothesis.

Animals↗
PubMed2001

Current thinking in statin therapy.

The HMG-CoA reductase inhibitors (statins) are now considered the most potent lipid-lowering drugs. Treatment with statins reduces both morbidity and mortality rates due to coronary artery disease. There is now increasing evidence that the clinical benefits obtained with statins cannot be solely attributed to a decrease in low-density lipoprotein (LDL) level. These drugs may also have beneficial effects on endothelial dysfunction, LDL oxidation, rheological and thrombogenic factors, cellular inflammation and plaque formation and stability. Further, there are differences among the various statins on these non-lipid variables. The biochemical effects of statins, as well as their clinical benefits, should be taken into consideration.

Cholesterol, LDL↗
PubMed2001

Conditional risk factors in men with previous myocardial infarction: relevance of C3 and homocysteine.

OBJECTIVE: To establish which traditional and conditional risk factors were effectively treated, and which remained active, in patients with previous myocardial infarction (PMI). METHODS AND RESULTS: In 47 PMI patients recently submitted to cardiological assessment and in 42 controls (50-70 years old men), traditional risk factors (total cholesterol, high-density lipoprotein cholesterol, blood glucose, blood pressure, cigarette smoking and body mass index) and the following variables were measured: fibrinogen, plasminogen activator inhibitor-1 (PAI-1), lipoprotein(a) [Lp(a)], total homocysteine, plasma folates, vitamin B12, high sensitivity C-reactive protein and C3 complement. Most patients were taking beta-blockers, ACE inhibitors and statins. Accordingly, patients had lower blood pressure and cholesterol values than controls. Moreover, they consumed less alcohol and coffee and did not differ from controls in cigarette smoking and body mass index. Conversely, patients had higher levels of homocysteine, fibrinogen, C3 complement and Lp(a), although of these factors only C3 and homocysteine remained significantly associated with PMI in multivariate analysis. C-reactive protein, PAI-1 and especially C3 often correlated with traditional risk factors in controls, but these correlations tended to disappear or reverse in PMI patients. Fibrinogen inversely correlated with alcohol consumption. Homocysteine correlated (inversely) with plasma folates only. Lp(a) did not correlate with any variable. CONCLUSIONS: Forty-seven patients with previous myocardial infarction displayed an excellent control of traditional risk factors, but they had higher mean C3 and homocysteine levels than the control group.

Aged↗
PubMed2000

Mortality rates and number of deaths from cardiovascular diseases in Italy from 1982 to 1993. A comparison with total and tumour data.

In this study the recent Italian trends in cardiovascular deaths and mortality are described and compared with the trends regarding total and tumour deaths and mortality. The data, collected from the National Institute of Statistics, are presented as total (T), tumour (TU), cardiovascular (CV), cerebrovascular (CVD), ischemic heart disease (IHD) standardized mortality (sm), non-standardized mortality (nsm) and absolute number of deaths (d), according to sex, age, and geographical area. Data on sm were available only for the age group <75 years old. In males, from 1982 to 1993, T-sm fell by 18%, TU-sm by 4%, CV-sm by 30%, CVD-sm by 38% and IHD-sm by 24%. In females, the decrements were generally greater: T-sm 20%, TU-sm 4%, CV-sm 35%, CVD-sm 39% and IHD-sm 28%. Since 1985/87, tumours have been the leading cause of mortality, in both sexes. By 1991/93, the highest rates of CV, CVD, IHD-sm were reported mostly in the South of Italy. Non-standardized mortality rates for tumours increased, and for cardiovascular diseases decreased, in both sexes and age groups (<75 and >/=75 years old). As for sm, in the group <75 years, old tumours have been the leading cause of mortality since 1985/87, but in the older age group CV-nsm has been more than twice TU-nsm. By 1991/93 in comparison with 1982/84, CV deaths have fallen by 6% (-28% in the age group <75 years, +3% in the age group >/=75 years), while TU deaths have grown by 17% (+3% in the age group <75 years, +45% in the age group >/=75 years). Considering all age groups, by 1991/93 the absolute number of CV-d (239.241) was much greater than the number of TU-d (151.908); overall, almost 70% of CV-d and 40% of TU-d took place in the older age group. For the near future, the rapid aging of the Italian population (from 1982/84 to 1991/93 there was a 40% increment in the population older than 75 years) is a relevant variable to take into account. Thus, despite the 'reassuring' fall in CV-sm and nsm, cardiovascular diseases are expected to remain the major cause of death and physical disability in adults.

Adult↗
PubMed2000

Relationship of serum C3 to fasting insulin, risk factors and previous ischaemic events in middle-aged men.

AIMS: Serum C3 is a powerful indicator of the risk of myocardial infarction, which correlates with body mass index, serum lipids and blood pressure. This study was performed to ascertain whether such correlations may be explained by an association of C3 with fasting insulin, and to assess comparatively the relationships of C3 and traditional risk factors to previous myocardial infarction. METHODS AND RESULTS: The fasting levels of C3, insulin, and the main risk factors were evaluated in 1090 unselected men aged 55-64 years, including 129 cases of previous ischaemic events (51 myocardial infarctions). In multivariate analysis C3 was associated with insulin (r=0.27, P<0.0001), cholesterol (r=0.18, P<0.0001), body mass index (r=0.13, P<0.0001), glucose (r=0.12, P=0.0001), systolic blood pressure (r=0.10, P<0.001), triglycerides (r=0.09, P<0.01) and HDL-cholesterol (r=-0.06, P<0.05). These variables explained 31% of the total C3 variance. Alcohol consumption and physical activity correlated inversely with C3, while no correlation was found with smoking and family history of myocardial infarction. C3 was associated with previous myocardial infarction and stroke, but not with angina pectoris and peripheral arterial disease. In logistic regression the variables associated with previous myocardial infarction were C3 (P=0.011), family history of myocardial infarction (P=0.018), ex-smoker status (P=0.020), age (P=0.025), glucose (P=0.028) and HDL-cholesterol (P=0.051, inverse relationship). CONCLUSIONS: The association of C3 with myocardial infarction persists retrospectively, and is more significant than any other association of traditional risk factors with previous myocardial infarction. Of the many variables associated with C3, fasting insulin is its main covariate, which suggests that C3 is a marker of a pro-atherogenic metabolic imbalance partly coinciding with insulin resistance.

Biomarkers↗
PubMed2000

Endothelial dysfunction in hypertension.

Endothelial cells release both relaxing and contracting factors that modulate vascular smooth muscle tone and also participate in the pathophysiology of essential hypertension. Endothelium-dependent vasodilation is regulated primarily by nitric oxide but also by an unidentified endothelium-derived hyperpolarizing factor and by prostacyclin. Endothelium-derived contracting factors include endothelin-1, vasoconscrictor prostanoids, angiotensin II and superoxide anions. Under physiological conditions, there is a balanced release of relaxing and contracting factors. The balance can be altered in cardiovascular diseases such as hypertension, atherosclerosis, diabetes and other conditions, thereby contributing to further progression of vascular and end-organ damage. In particular, endothelial dysfunction leading to decreased bioavailability of nitric oxide impairs endothelium-dependent vasodilation in patients with essential hypertension and may also be a determinant for the premature development of atherosclerosis. Different mechanisms of reduced nitric oxide activity have been shown both in hypertensive states and several cardiovascular diseases, and endothelial dysfunction is likely to occur prior to vascular dysfunction. Thus, the strategies currently used to improve endothelial dysfunction may result in decreased morbidity and mortality in hypertensive patients.

Angiotensin II↗
PubMed1998

Relationship between serum C3 levels and traditional risk factors for myocardial infarction.

OBJECTIVE: Serum C3, a complement component produced by macrophages, the liver and the adipose tissue, is associated with the risk of myocardial infarction in men. This study was performed to ascertain the relationships between serum C3 and traditional risk factors in an unselected population sample. METHODS AND RESULTS: A random population of 1,068 subjects (537 men and 531 women, 23 to 90 years old) was examined for risk factor assessment. Serum C3 was measured by nephelometry. C3 was independently associated with body mass index (P < 0.0005, especially in women), LDL-cholesterol (P = 0.0014 in men and 0.0215 in women), systolic blood pressure (P < 0.05) and, in women, with triglycerides (P = 0.0133) and blood glucose (P = 0.0383), as assessed by multivariate analysis (multiple linear regression). The overall R2 were 0.07 and 0.21 for men and women, respectively. Women over 50 years of age had significantly higher C3 levels, LDL-cholesterol and body mass index than younger women. The correlation of C3 with LDL-cholesterol was present after the age of 40 in men, and 2 decades later in women. CONCLUSIONS: These data show that serum C3 correlates with a cluster of conventional risk factors for myocardial infarction resembling insulin resistance. Such correlations may be either independent of, or mediated by the development of coronary atherosclerosis.

Adult↗
PubMed1998

The shape of enzymatic curves during acute myocardial infarction: relationship to the progression of necrosis and implications for thrombolysis.

BACKGROUND: During acute myocardial infarction, the ascending branch of creatine kinase curves has a sigmoidal course whose inflection point marks the maximum rate of enzymatic increase in serum. This study was performed to assess the relationship between these morphologic characteristics of creatine kinase curves and the progression of myocardial necrosis. METHODS AND RESULTS: In isolated rat hearts exposed to different degrees of ischemia (coronary flow of 0.6 or 0.2 ml/g/min), the total quantity of creatine kinase released in the effluent had a sigmoidal course similar to the ascending branch of the curves from patients with acute myocardial infarction. Other rat hearts were frozen (which causes maximum damage to cell structures), thawed and then perfused. The resulting enzymatic curves had a downward concave ascending trend, similar to the portion beyond the inflection point of sigmoidal curves (the rate of creatine kinase release was maximum at the onset of perfusion and then decreased progressively). Finally, in some experiments ischemic rat hearts were further damaged by the perfusion, at different times, with highly concentrated catecholamines and without oxygen and substrates. This damaging perfusate was able to increase the rate of creatine kinase release (p = 0.0001) only when it was started before the inflection point of enzymatic curves. In 25 creatine kinase curves from patients with acute myocardial infarction (19 men and 6 women, age range 42 to 68 years), who were not treated with thrombolysis, the time of inflection varied from 1 to 12 hours from the onset of symptoms, with a maximum frequency between the 7th and the 8th hour. CONCLUSIONS: Based on these data, a biological model with 3 compartments has been suggested to explain the shape of creatine kinase curves, according to which the inflection point would occur after the completion of myocardial necrosis. The variability of the time of inflection might account for the cases of beneficial late thrombolysis reported in literature.

Adult↗
PubMed1997

Blood pressure and intellectual function in elderly subjects.

OBJECTIVE: to assess the relationship between hypertension and cognitive function in elderly subjects. METHODS: 17 subjects with uncomplicated hypertension (nine male, eight female) and 27 control subjects with similar educational level and age (18 male, nine female) were studied. These individuals were recruited, according to strict selection criteria, from a random sample of 120 elderly subjects living in the community, who had a normal Mini Mental State score. An extensive neuropsychological test battery, sensitive to mild cognitive impairment, was administered in standard conditions to measure attention, concentration and judgement, psychomotor speed, memory and learning. Affective disorders were also evaluated. In all patients a computed tomography scan was performed. RESULTS: subjects with high blood pressure had lower mean levels of performance in attentional measures; tapping test (inhibition of incorrect answers), three words-three shapes test (attempts; incidental memory) and reaction time to multiple stimuli. They also scored worse in clusters 1 and 2 of the Hamilton rating scale for depression. Confluent white matter lesions were found in nine hypertensive subjects (52.9%) and five controls (18.5%; P = 0.0170). Lacunes were demonstrated in 11 hypertensive (64.7%) and four normotensive people (14.8%; P = 0.0007). In a multivariate analysis (logistic regression), three cognitive variables (tapping, Hamilton cluster 2 and Hamilton total score) remained significantly associated with hypertension, independently of the presence of cerebral lesions. CONCLUSIONS: in elderly otherwise normal hypertensive subjects, an attentional impairment may occur, which appears to be functional and possibly reversible rather than structural and progressive.

Aged↗
PubMed1997

[Italian clinical cardiology research at the international level. Statistical data from the period 1983-1993].

Recent studies show that, among advanced countries, the rank of cardiological research finds Italy last for number of scientific publications and for gross expenditure on research and development. To assess more thoroughly the characteristics of Italian clinical cardiological research we examined, over the period 1983-1993, all original articles published by five important international cardiology journals (Circulation, American Heart Journal, American Journal of Cardiology, Journal of the American College of Cardiology and European Heart Journal). During the mentioned period the Italian contribution (743 articles over a total of 16375, mean prevalence of 4.5%) has increased from 3% in 1983-1985 to 5.8% in 1991-1993 (p < 0.0001). Taking into account that research often results from the joint-work of different centers, the 743 articles derived from 1056 contributions from just over 120 centers. Of these contributions 57% were from universities, 23% from hospitals, 19% from research institutes, and 1% from private foundations. The cooperation with foreign countries has steadily increased, particularly with the USA (45%) and with the European nations (42%). Within the first three names, the contribution of female Authors has increased from 7% in 1983-1985 to 16% in 1991-1993 (p = 0.0001). The mean prevalence of female Authors as last name was 4% and did not change with time. As to geographic distribution, 57% of the scientific publications comes from the North, 28% from the Centre, and 15% from the South. After adjusting these data for population size, the percentages were respectively 40, 46, and 14%. An index of productivity (the ratio between the number of scientific contributions from universities and research institutes and their funding) was highest in the North. The Italian scientific contribution to international cardiological research is not satisfactory, although it is significantly increasing; yet, this trend might worsen due to the shortage of funding. The collected data outline that in the three main national geographic areas, the distribution of funds and scientific productivity are markedly unbalanced.

Cardiology↗
PubMed1997

[Cardiac pacemaker and radiotherapy: a growing association. Report of a clinical case].

Cardiac pacing is increasingly common. In 1986, in the USA there were more than 500,000 pacemaker-implanted patients and at least 100,000 new pacemaker implants were performed, for a total of 3,000 pacemakers for million inhabitants. The increment in cardiac pacing is due to: a fall in cardiovascular mortality; increased elderly population, in which bradyarrhythmias are frequent; and the introduction of implantable cardioverter defibrillators (ICD). In 1992, in Italy, there were 30,500 deaths due to lung tumours and 10,900 deaths for breast malignancies. Both malignancies are more common in patients older than 65. Lung and breast cancer therapy involves the use of surgery, radiation, or chemotherapy, and often a combination of two or all three. In particular 40% of cancers are managed with radiotherapy. It is therefore likely that cancer patients may require radiotherapy at sites (lung, breast) where a pacemaker is implanted. The authors describe the finding on a chest radiogram of a one centimeter nodular mass at the right superior lobe almost completely hidden by the pacemaker. The modalities to proceed to radiotherapy, without damaging the sensitive pacemaker, are discussed.

Aged↗
PubMed1996

Silent lacunar infarcts in elderly patients with chronic non valvular atrial fibrillation.

It is still debated whether non valvular atrial fibrillation (NVAF) may be responsible for "silent" lacunar lesions. The aims of our study were to compare the prevalence of subcortical lacunar infarctions in highly selected elderly subjects with or without NVAF, and to investigate the positive relationship of such lesions to the impairment in cognitive and physical functions. Thirty-eight patients with NVAF (mean age 80.6 years) were compared with 40 patients in sinus rhythm (mean age 80.4 years). Exclusion criteria were previous stroke or transient ischemic attacks, significant lesions of extracranial arteries, and any previous disease leading to cognitive impairment or potentially interfering with cognitive functions. A cranial computed tomogram was performed in every case, and the number of lacunae was recorded. Cognitive status and mood were assessed by means of Mini Mental Status Examination and the Geriatric Depression Scale, respectively. The number of impaired basic and instrumental activities of daily living (BADL e IADL) was also recorded. A significantly higher percentage of patients with lacunar lesions was detected in the NVAF group. The MMS score was lower in these patients, but did not reach significant levels. In univariate analysis, the presence of lacunae was found to be significantly associated with age, systolic blood pressure and atrial fibrillation, but, in a multiple logistic regression model, only age and atrial fibrillation retained a significant association. Similarly, in univariate analysis, a low MMS score was found to be related to age, systolic blood pressure, leukoaraiosis and both the presence and the number of lacunar lesions. In multivariate analysis, only age and the number of lacunae were significantly associated with a low MMS. It is concluded that in elderly patients NVAF is associated with subcortical ischemic lesions which may contribute to the impairment of cognitive function.

Aged↗
PubMed1995

Association of serum C3 levels with the risk of myocardial infarction.

PURPOSE: Serum complement and IgA levels have been found to be retrospectively associated with the presence of diffuse atherosclerosis. This study was performed to assess whether serum immunoglobulins and complement components are predictive of future ischemic events. PATIENTS AND METHODS: The baseline values of IgG, IgA, IgM, C3, and C4 were measured in the sera from a cohort of 860 inhabitants of the town of Brisighella, Italy. They were 444 men and 416 women, mean age 53.9 years (SD 12.4, range 23 to 84), who had not had any ischemic events (myocardial infarction [MI], angina pectoris, stroke, transient ischemic attack, or intermittent claudication) at the time of blood sampling in 1984. Their baseline values for the main recognized risk factors for atherosclerosis were known at baseline and for 4 years of follow-up. Multiple logistic regression analysis was performed for associations between ischemic events and immunologic variables (including serum IgG, IgA, IgM, C3, and C4) and risk factors for atherosclerosis (including age, sex, diastolic blood pressure, cigarette consumption, Quetelet index, total cholesterol, HDL cholesterol, triglycerides and blood glucose). RESULTS: During follow-up, 57 subjects experienced ischemic events, including 28 cases of coronary heart disease (17 MI and 11 angina pectoris). Of the immunologic variables studied, only serum C3 was found to be independently associated with ischemic events (P < 0.005 for any ischemic events, coronary heart disease, and MI). The population was divided into thirds according to C3 values. The cumulative incidence of MI was 7.1/1,000 in the low third, 10.6/1,000 in the middle third and 40.8/1,000 in the high third (risk ratio for high versus middle plus low = 4.2 after adjustment for age and sex; 95% CI 1.5 to 11.7). A separate analysis for the sexes showed that serum C3 was a particularly powerful predictor of MI in men. Men whose C3 levels were in the top third had a 72.6/1,000 incidence of MI while the incidence in the rest of the male population was 6.2/1,000 (risk ratio 10.7 after adjustment for age; 95% CI 2.3 to 49.0). When similar analyses were performed for angina pectoris, stroke, and intermittent claudication, no significant increase in risk was found to be associated with serum C3. CONCLUSION: C3 levels measured in sera from male subjects without previous ischemic events are independently associated with the risk of MI.

Adult↗
PubMed1995

Complement components and fibrinogen: correlations and association with previous myocardial infarction.

Serum complement levels have been found to be predictive of myocardial infarction up to 4 years before the acute event. To assess whether they are a marker of a hypercoagulable state, the serum or plasma levels of C3, C4, C3a, C4a, C1 inactivator, antithrombin III, protein S, protein C, fibrinogen and tissue plasminogen activator were measured in 31 patients with previous myocardial infarction and 33 controls (all males, 40-60 years old). C3, C4 and fibrinogen (which share the common characteristic of being acute phase proteins) were correlated and were associated with previous myocardial infarction, although this association persisted only for C4 in multivariate analysis. None of the coagulative variables directly involved in the complement system differed significantly in the two groups.

Adult↗