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Anthony L Komaroff

Publications and source records attributed to Anthony L Komaroff.

At least 55 records · Page 3Linked to original sources
PubMed2004

High prevalence of metabolic syndrome among young women with nonfatal myocardial infarction.

OBJECTIVE: The aim of this study was to determine if the metabolic syndrome (MetS) or other risk factors might be common among young women with nonfatal myocardial infarction (MI). METHODS: A matched case-control study using a structured interview and questionnaires, plus analysis of conventional and nonconventional risk factors for MI in serum or plasma was carried out at a teaching hospital. Subjects were 40 women with nonfatal MI at or before age 45 and an equal number of age-matched, ethnicity-matched, and smoking-matched female control subjects. RESULTS: Cases and control subjects were not significantly different with regard to serum or plasma levels of homocysteine, anticardiolipin antibodies, beta(2)-glycoprotein I, prothrombin, folate, vitamin B(12), high-sensitivity C-reactive protein (CPR), fibrinogen, amyloid A, plasminogen activator inhibitor type 1 (PAI-1), or tissue plasminogen activator (tPA) antigen levels. Compared with matched controls, cases had a higher rate of obesity (37% vs. 12%, p = 0.02), a higher proportion of fasting glucose >/=110 mg/dl (9% vs. 1%, p = 0.01), and higher overall insulin resistance (27% vs. 5%, p = 0.007). Type 2 diabetes tended to be more common in cases (17% vs. 5%, p = 0.10). Cases were also more likely to be hypertensive (35% vs. 12%, p = 0.04) and dyslipidemic (80% vs. 42%, p = <0.001) and to have higher triglyceride levels (110 +/- 13 mg/dl vs. 96 +/- 12, p = 0.02). Overall, after controlling for weight, cases were 4.7 times more likely to have three or more diagnostic criteria of the MetS than matched controls: chi-square = 7.2, OR = 4.7, 95% CI (1.3, 25.3), p = 0.008. CONCLUSIONS: Although this study may have been underpowered to recognize the contribution of other risk factors, we found that the dominant predictor of nonfatal MI in young women was the MetS. Screening young women with central obesity for other parameters of the MetS may help reduce the risk of MI at an early age.

Adult↗
PubMed2004

By the way, doctor. When I read that President Clinton learned for the first time in early September that he had severe heart disease, I was shocked. His health must have been monitored as closely as anyone's. How could something this serious have escaped his doctors notice? An how can someone who looked so healthy and vigorous as he did in July at the Democratic Convention actually be living with an unrecognized disease that could take his life at any moment?

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Angina Pectoris↗
PubMed1992

A chronic illness characterized by fatigue, neurologic and immunologic disorders, and active human herpesvirus type 6 infection.

OBJECTIVE: To conduct neurologic, immunologic, and virologic studies in patients with a chronic debilitating illness of acute onset. DESIGN: Cohort study with comparison to matched, healthy control subjects. PATIENTS: We studied 259 patients who sought care in one medical practice; 29% of the patients were regularly bedridden or shut-in. MAIN OUTCOME MEASURES: Detailed medical history, physical examination, conventional hematologic and chemistry testing, magnetic resonance imaging (MRI) studies, lymphocyte phenotyping studies, and assays for active infection of patients' lymphocytes with human herpesvirus type 6 (HHV-6). MAIN RESULTS: Patients had a higher mean (+/- SD) CD4/CD8 T-cell ratio than matched healthy controls (3.16 +/- 1.5 compared with 2.3 +/- 1.0, respectively; P less than 0.003). Magnetic resonance scans of the brain showed punctate, subcortical areas of high signal intensity consistent with edema or demyelination in 78% of patients (95% CI, 72% to 86%) and in 21% of controls (CI, 11% to 36%) (P less than 10(-9)). Primary cell culture of lymphocytes showed active replication of HHV-6 in 79 of 113 patients (70%; CI, 61% to 78%) and in 8 of 40 controls (20%; CI, 9% to 36%) (P less than 10(-8], a finding confirmed by assays using monoclonal antibodies specific for HHV-6 proteins and by polymerase chain reaction assays specific for HHV-6 DNA. CONCLUSIONS: Neurologic symptoms, MRI findings, and lymphocyte phenotyping studies suggest that the patients may have been experiencing a chronic, immunologically mediated inflammatory process of the central nervous system. The active replication of HHV-6 most likely represents reactivation of latent infection, perhaps due to immunologic dysfunction. Our study did not directly address whether HHV-6, a lymphotropic and gliotropic virus, plays a role in producing the symptoms or the immunologic and neurologic dysfunction seen in this illness. Whether the findings in our patients, who came from a relatively small geographic area, will be generalizable to other patients with a similar syndrome remains to be seen.

Adult↗