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Biomedical subjects

Neeraj Tandon

Publications and source records attributed to Neeraj Tandon.

6 recordsLinked to original sources
PubMed2005

Atorvastatin improves left ventricular systolic function and serum markers of inflammation in nonischemic heart failure.

OBJECTIVES: This study examined the effect of statin therapy on vascular markers of inflammation and echocardiographic findings in patients with nonischemic forms of cardiomyopathy. BACKGROUND: Despite advances in therapy, morbidity and mortality from heart failure (HF) remain high. We wished to determine whether treatment with atorvastatin affects left ventricular (LV) systolic function and markers of inflammation in patients with nonischemic HF. METHODS: A total of 108 patients with nonischemic HF and a left ventricular ejection fraction (LVEF) < or =35% were randomized to either atorvastatin 20 mg/day or placebo in a double-blinded fashion for a 12-month period. The LVEF and LV end-diastolic diameter (LVEDD) and left ventricular end-systolic diameter (LVESD) were determined by echocardiography. Serum markers of inflammation and oxidation were also measured. RESULTS: The LVEF increased from 0.33 +/- 0.05 to 0.37 +/- 0.04 (p = 0.01) in the atorvastatin group over the 12-month follow-up period, whereas those patients in the placebo group experienced a decline in ejection fraction during the same time period. In addition, LVEDD was reduced from 57.1 +/- 5.9 mm to 53.4 +/- 5.1 mm (p = 0.007) and LVESD was reduced from 42.4 +/- 3.8 mm to 39.1 +/- 3.8 mm (p = 0.02) in the cohort of patients treated with atorvastatin; these dimensions increased in the placebo group. There was an increase in erythrocyte superoxide dismutase (E-SOD) activity, and there were significant reductions in serum levels of high sensitivity C-reactive protein, interleukin-6 (IL-6), and tumor necrosis factor-alpha receptor II (TNF-alpha RII) in the atorvastatin group. CONCLUSIONS: The use of atorvastatin in patients with nonischemic HF improves LVEF and attenuates adverse LV remodeling. The effects on soluble levels of several inflammatory markers with atorvastatin suggest, in part, mechanisms by which statins might exert their beneficial effects in nonischemic HF.

Atorvastatin↗
PubMed2005

Statin therapy is associated with improved cardiovascular outcomes and levels of inflammatory markers in patients with heart failure.

BACKGROUND: We wished to determine whether the addition of statins affect cardiovascular events and markers of inflammation in patients with heart failure. METHODS AND RESULTS: A total of 446 patients with heart failure and ejection fraction < or =35% were followed in a prospective, nonrandomized fashion and were classified according to treatment with a statin. We determined all-cause mortality, cardiovascular morbidity, and serum markers of inflammation over a 24-month period. Statin therapy in patients with heart failure was associated with decreased all-cause mortality at 2 years compared with those not on statin therapy (15% versus 33%, P < .005) as well as hospitalizations for heart failure (22% versus 38%, P = .001) and nonfatal myocardial infarction (11% versus 15%, P < .001). In addition, statin therapy was associated with a decrease in serum levels of C-reactive protein (1.12 +/- 0.13 versus 1.47 +/- 0.11 mg/dL, P = .001), interleukin-6 (13.3 +/- 0.8 versus 17.3 +/- 1.4 ng/dL, P = .001), and tumor necrosis factor-alpha receptor II (24.3 +/- 1.0 versus 34.5 +/- 3.0 ng/dL, P = .001). CONCLUSION: The use of statin therapy in this nonrandomized trial was associated with a significant reduction in all-cause mortality and cardiac morbidity. In addition, the improvement in levels of several serum inflammatory markers with statin therapy suggests in part possible mechanisms by which these agents may exert their benefits.

Adult↗
PubMed2004

Comparison of intracoronary vs. intravenous administration of abciximab in coronary stenting.

There have been animal and human studies looking at intracoronary (IC) use of abciximab with good short-term clinical outcomes. There exists no data comparing intracoronary with intravenous (IV) administration of abciximab beyond 30 days. We compared the clinical outcomes between the IC (n = 101) and IV (n = 72) group of patients. Patients who had coronary stenting and received abciximab were included in the study. All the patients received the standard systemic bolus dose of abciximab 0.25 mg/kg either via the IC or IV route, followed by a 12-hr IV infusion at 0.125 microg/kg/min. The 6-month composite endpoint of death or myocardial infarction was slightly higher in the IV (13.9%) than in the IC group (5.9%; P = 0.04). The frequency of bleeding complications was similar in both groups. The IC bolus route of abciximab may be superior to the intravenous route. Prospective randomized trials are warranted to validate these findings.

Abciximab↗
PubMed2004

Native quadruple-valve endocarditis caused by Enterococcus faecalis.

We report the case of a patient with postoperative, hospital-acquired, quadruple-valve endocarditis caused by Enterococcus faecalis on presumed normal native valves. During a cervical laminectomy, the patient had a non-ST-elevation myocardial infarction that was treated conservatively. In the intensive care unit, the patient became febrile and developed a new 2/6 systolic murmur. Blood cultures grew E. faecalis, and the patient was given antibiotics. Postoperative transthoracic echocardiography and transesophageal echocardiography revealed vegetations on all 4 heart valves. Subsequently, the patient was moved to another facility and died. No autopsy was performed. E. faecalis is the third-most-common cause of bacterial endocarditis overall; however, it is rarely found in multiple-valve, hospital-acquired endocarditis. Although transthoracic echocardiography is a powerful diagnostic tool, transesophageal echocardiography increases the sensitivity and specificity to about 90%. In our patient, the diagnosis of native quadruple-valve endocarditis would not have not been made without the use of transesophageal echocardiography.

Cross Infection↗
PubMed2003

Coronary artery fistulas: case report and review of literature.

Congenital coronary artery fistula is a very rare malformation that may involve any or all coronary artery branches and any cardiac chamber. Elective closure of coronary artery fistulas by surgery or percutaneous transcatheter techniques is generally accepted in the presence of symptoms, but controversies exist in the management of asymptomatic patients. We describe a case where a fistulous communication was present between the proximal left anterior descending coronary artery and the pulmonary artery and provide a review of the available literature concerning management of patients with coronary artery fistulas.

Arteriovenous Fistula↗