Biomedical subjects

Dirk Sander

Publications and source records attributed to Dirk Sander.

21 records · Page 2Linked to original sources

PubMed2002

Reduced progression of early carotid atherosclerosis after antibiotic treatment and Chlamydia pneumoniae seropositivity.

BACKGROUND: Chlamydia pneumoniae (Cp) infection has been associated with atherosclerosis, and a beneficial effect of antibiotic therapy on future cardiovascular events was described. METHODS AND RESULTS: We evaluated the effect of roxithromycin therapy (150 mg twice daily for 30 days) on the progression of the intima-to-media thickness (IMT) of the common carotid artery using duplex ultrasonography in a prospective and randomized trial with a follow-up of 2 years in 272 consecutive patients with ischemic stroke aged over 55 years in whom the first IMT measurement and Cp testing (IgG and IgA) were performed at least 3 years before the roxithromycin treatment. Cp IgG antibodies (> or =1:64) were initially found in 123 (45%) patients and IgA antibodies (> or =1:16) in 112 (41%) patients. During the 3 years before antibiotic therapy, Cp-positive patients showed an enhanced IMT progression, even after adjustment for other cardiovascular risk factors (0.12 [95% CI, 0.11 to 0.14] versus 0.07 [0.05 to 0.09] mm/year; P<0.005). The 62 Cp-positive patients given roxithromycin showed a significantly decreased IMT progression after 2 years compared with the Cp-positive patients without therapy (0.07 [0.045 to 0.095] versus 0.11 [0.088 to 0.132] mm/year; P<0.01). No significant difference in the occurrence of future cardiovascular events was found between both groups during follow-up. No change of IMT was observed in Cp-negative patients given roxithromycin (n=74) compared with those without therapy (0.06 [0.03 to 0.09] versus 0.07 [0.05 to 0.09] mm/year). CONCLUSIONS: Our findings suggest a positive impact of antibiotic therapy on early atherosclerosis progression in Cp-seropositive patients with cerebrovascular disease.

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PubMed2002

Elevated C-reactive protein is associated with an increased intima to media thickness of the common carotid artery.

In this study, we analyzed the relationship between serum C-reactive protein (CRP) and the intima to media thickness (IMT) of the common carotid artery in 411 consecutive neurological inpatients (215 males, mean age 64.1 years). The CRP concentration was determined within 12 h and patients were subdivided according to the CRP level. Patients with an elevated CRP (n = 149) showed a significantly larger IMT [1.05 mm (95% confidence interval (CI) 1.02-1.09) vs. 0.92 mm (95% CI 0.89-0.94)]. Multivariate linear regression analysis revealed that an elevated CRP level, age, pack-years of smoking, body mass index, incidence of diabetes mellitus and ischemic stroke were independently associated with an increased IMT (p < 0.05).

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PubMed2002

Prognostic relevance of early serial C-reactive protein measurements after first ischemic stroke.

BACKGROUND AND PURPOSE: Recent studies described an association between elevated levels of C-reactive protein (CRP) and outcome after ischemic stroke. We investigated the impact of early serial CRP measurements in hyperacute ischemic stroke on long-term outcome. METHODS: One hundred twenty-seven consecutive patients without thrombolysis with a first ischemic stroke no more than 12 hours after symptom onset were examined. Serial CRP measurements were done at admission (CRP 1), within 24 hours (CRP 2), and within 48 hours (CRP 3) after symptom onset. In addition to several cerebrovascular risk factors, the 1-year outcome and the lesion volumes of initial diffusion-weighted images were determined. RESULTS: The CRP concentration increased significantly during the first 48 hours after symptom onset (CRP 1, 0.86 mg/dL [95% CI, 0.69 to 1.02]; CRP 2, 1.22 mg/dL [95% CI, 0.88 to 1.55]; CRP 3, 1.75 mg/dL [95% CI, 1.25 to 2.25]; P=0.003). Multiple logistic regression analysis identified Barthel Index score at admission and CRP 2 and 3 as independent predictors of an unfavorable outcome. Kaplan-Meier analysis revealed a significantly higher rate of end point events (adjusted odds ratio, 3.9 [95% CI, 1.4 to 10.7]; P=0.008) only in patients with elevated CRP 2 concentrations. CONCLUSIONS: The CRP level measured within 12 hours after symptom onset of an acute ischemic stroke is not independently related to long-term prognosis. In contrast, a CRP increase between 12 and 24 hours after symptom onset predicts an unfavorable outcome and is associated with an increased incidence of cerebrovascular and cardiovascular events.

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