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Biomedical subjects

Panagiotis Korantzopoulos

Publications and source records attributed to Panagiotis Korantzopoulos.

At least 19 recordsLinked to original sources

Metabolic syndrome and its components as predictors of all-cause mortality and coronary heart disease in type 2 diabetic patients.

BACKGROUND: There is no consistent evidence regarding the prognostic value of metabolic syndrome (MS) in predicting all-cause mortality and coronary heart disease (CHD) risk among type 2 diabetic patients. We sought to investigate whether individual or various combinations of MS components have a different predictive value than the presence of MS in this setting. METHODS: Six hundred type 2 diabetic patients (mean age 60.4+/-9 years, 54% males) without known CHD were prospectively followed-up for a mean period of 10.06 years. The presence of MS was examined using the National Cholesterol Education Program (NCEP) definition. Statistical analyses were performed using Kaplan-Meier estimator and Cox proportional Hazard models. RESULTS: MS was present in 62.4% of the patients while 142 died during follow-up. Significant predictors for all-cause mortality were the presence of MS (HR 1.75), sex (HR 1.69), age (HR 1.09), and diabetes duration (HR 1.02). Regarding CHD incidents, HDL (HR 0.98), systolic blood pressure (HR 1.01), sex (HR 2.05), and total cholesterol (HR 1.005) were significant predictors while the presence of MS was not. Subjects fulfilling the triad consisting of diabetes, hypertension, and low HDL or the combination of diabetes, hypertension, low HDL, and high triglyceride levels had the highest probability for developing CHD events (HR 1.79, 1.73, respectively). CONCLUSIONS: The presence of MS in type 2 diabetic patients without known CHD reduces the 10-year survival while specific combinations of its components have different impact on CHD risk.

Aged↗

The role of oxidative stress in the pathogenesis and perpetuation of atrial fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice representing a major health hazard. Owing to relative inefficacy and side effects of classic antiarrhythmic drugs, current interest has shifted to treatments that target AF substrate. Accumulating evidence suggests that there is a link between oxidative processes and AF. In atrial myocardium during AF, there is substantial oxidative damage that may contribute to atrial remodeling. Several pathophysiological changes that possibly associated with increased oxidative stress in AF have been proposed. These include changes in gene transcriptional profiles and mitochondrial DNA, increased activity of enzymes such as NAD(P)H oxidase and xanthine oxidase, inflammatory processes, activation of the renin-angiotensin system and others. Moreover, oxidative stress is involved in the pathophysiology of several predisposing factors and cardiovascular disorders that correspondingly associated with AF. Preliminary studies using dietary antioxidants such as vitamin C have shown promising results. More evidence has been obtained from studies examining agents with pleiotropic effects, including antioxidant, such as inhibitors of the renin-angiotensin system, statins, corticosteroids and carvedilol. Further investigations are needed in order to elucidate the impact of oxidative stress on atrial remodeling. The clarification of these processes in the setting of AF may lead to the development of novel therapeutic strategies.

Atrial Fibrillation↗

QT interval prolongation associated with venlafaxine administration.

A significant number of non-antiarrhythmic drugs including psychotropic agents have been shown to prolong cardiac repolarization increasing the risk for torsade de pointes ventricular tachycardia. We briefly describe a 60-year-old woman who admitted to the hospital due to hypertension and mild dyspnea having a prolonged QT interval (QTc: 582 ms). The patient had a known history of depression treated with venlafaxine. The QT interval normalised a few days after cessation of the antidepressant agent. This is the first report of venlafaxine-induced QT interval prolongation.

Cyclohexanols↗

Dual coronary artery fistula in a patient with aortic valve stenosis.

Bilateral coronary artery fistulae originating from both right and left coronary arteries are rare congenital abnormalities that, in the adult population, are often associated with other acquired cardiovascular diseases. We briefly describe a 63-year-old woman with a dual coronary artery fistula and severe aortic stenosis. Both anomalies were successfully corrected surgically.

Aortic Valve↗

Acute pancreatitis associated with brucellosis.

CONTEXT: Acute pancreatitis can be caused by a variety of infectious agents but it is regarded as an extremely rare complication of brucellosis. CASE REPORT: We briefly describe a 56-year-old man who presented with acute pancreatitis, fever, myalgia, and other clinical symptoms. Brucella melitensis was cultured from his blood. All clinical manifestations gradually resolved with the institution of intramuscular streptomycin and oral doxycycline therapy. CONCLUSION: Acute pancreatitis may rarely be a complication of infection with B. melitensis. In areas where brucellosis is endemic, it should be kept in mind that acute pancreatitis may result from infection with brucella organisms.

Acute Disease↗

Acute septic arthritis due to Streptococcus sanguis.

OBJECTIVE: To present a case of acute septic arthritis due to Streptococcussanguis, a member of the viridans group streptococci. CLINICAL PRESENTATION AND INTERVENTION: A 73-year-old woman presented with fever and increasing swelling and pain of the right knee several weeks after she had been treated for severe periodontal disease. Arthrocentesis yielded purulent synovial fluid. S. sanguis was isolated in synovial fluid cultures, and the patient was treated with intravenous cefotaxime for 3 weeks and repeated aspiration of the knee joint with gradual resolution of fever, joint swelling and effusion. CONCLUSION: Although S. sanguis is believed to be a rare cause of septic arthritis in native joints, it should be considered in the differential diagnosis of this disorder, especially in patients with recent treatment of severe dental caries and periodontal disease.

Acute Disease↗

Acute myocardial infarction with normal coronary arteries in a patient with Hodgkin's disease: a late complication of irradiation and chemotherapy.

We describe the case of a 31-year-old man who experienced an acute myocardial infarction 16 years after undergoing radiation and vinca alkaloid therapy for Hodgkin's disease. Even though coronary artery disease is a well-established complication after mediastinal radiation therapy, this adult patient had normal coronary angiographic results, with no traditional risk factors for coronary artery disease, and no hematologic or other abnormality associated with hypercoagulability.

Acute Disease↗

Spontaneous coronary artery dissection associated with oral contraceptive use: a case report and review of the literature.

Spontaneous coronary artery dissection (SCAD) represents a rare cause of acute coronary syndromes with complex pathohysiology. We briefly describe a 50-year-old woman, without traditional cardiovascular risk factors, hospitalized for an acute ST-elevation myocardial infarction and treated with thrombolytic therapy. Notably, the patient was on oral contraceptives for the past 10 years. Coronary angiography showed a dissection of the distal left anterior descending artery. She was treated conservatively and her clinical status improved without evidence of continuing ischemia, while a repeated catheterization 6 months later showed a complete resolution of the dissection. It has been speculated that the female hormones may be responsible for the increased incidence of SCAD among women particularly during the peripartum period or during the exogenous administration of such agents. A systematic review of the literature revealed 4 further cases reporting an association of SCAD with oral contraceptive use.

Aortic Dissection↗

Errors and pitfalls in the non-invasive management of atrial fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice while it has a significant impact on morbidity and mortality. The errors and pitfalls in the management of AF patients are not uncommon. These include errors in detection and management of the underlying conditions that promote and perpetuate the arrhythmia, in the selection and monitoring of antithrombotic treatment, in the selection of appropriate strategy for arrhythmia management (rate or rhythm control), in the cardioversion procedure, in the prevention of recurrence after cardioversion, in the acute or chronic control of heart rate, and in the monitoring of drug toxicities. The heterogeneity of the disease along with the diversity of current treatment options mainly account for these problems. Nevertheless, deep knowledge of the evidence-based therapeutic approaches, as well as the development of individualized therapeutic strategies, can substantially improve the effective management of such patients.

Atrial Fibrillation↗