European journal of internal medicine
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Acute aortic syndromes (AASs) are severe conditions defined by dissection, hemorrhage, ulceration or rupture of the thoracic aorta. AASs share etiological and pathophysiological features, including long-term aortic tissue degeneration and mechanisms of acute aortic damage. ⋯ The natural history of AASs is dominated by engagement of ischemic, coagulative and inflammatory pathways at large, causing multiorgan damage. Medical treatment, multiorgan monitoring and outcome prognostication are therefore paramount, with internal medicine playing a key role in non-surgical management of AASs.
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Eur. J. Intern. Med. · Dec 2022
Association of lipoprotein(a) with all-cause and cause-specific mortality: A prospective cohort study.
A growing number of studies have demonstrated a causal association between lipoprotein(a) [Lp(a)] and atherosclerotic cardiovascular diseases (ASCVDs), but its association with all-cause and cause-specific mortality remains unclear. Therefore, this study aimed to explore the association of Lp(a) with all-cause and cause-specific mortality. ⋯ Lp(a) was associated with the risk of all-cause and CVDs-related mortality.
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Eur. J. Intern. Med. · Dec 2022
Etiological spectrum and outcome of fever and inflammation of unknown origin. Does symptom duration matter?
Evidence suggests that the symptom duration may affect the occurrence of certain fever (FUO) and inflammation (IUO) of unknown origin associated conditions. It is unclear if this could potentially guide diagnostic evaluations. We examined the association between symptom duration and diagnostic and prognostic outcomes in FUO/IUO. ⋯ The symptom duration may be used to guide the diagnostic workup among patients with FUO and IUO, in particular those with longstanding symptoms.
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Eur. J. Intern. Med. · Dec 2022
Functional and metabolic frailty predicts mortality in patients undergoing TAVI: Insights from the OBSERVANT II study.
Despite the prognostic role of frailty among elderly patients undergoing transcatheter aortic valve implantation (TAVI) is known, its assessment still represents a challenge due to the multitude of scales proposed in literature. The aim of this study was to define the prognostic impact of a simple combined frailty model including both functional and metabolic parameters in a large cohort of patients undergoing TAVI with new generation devices. ⋯ In a large real-world cohort of patients undergoing TAVI with new generation devices, combined functional and metabolic frailty had a significant and incremental impact on 1-year mortality.
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Eur. J. Intern. Med. · Dec 2022
High cardiovascular disease risk-associated with the incidence of Type 2 diabetes among prediabetics.
Prediabetes is a risk factor for developing Type 2 diabetes mellitus (T2D). We report on the first cohort study of the association between high cardiovascular diseases (CVD) risk with the incidence of T2D in prediabetics. First, estimate the direct effect of developing T2D on patients with prediabetes who have high CVDs risk; and 2) assess the potential increased risk of developing T2D mediated by statins. ⋯ Patients with prediabetes and high CVDs risk had a 24% higher chance of developing T2D. The high CVDs risk effect was mediated by statin therapy. Regular monitoring and counselling of prediabetics using statins is likely warranted to prevent the incidence of T2D.