ABSTRACT
BACKGROUND AND OBJECTIVES: Both carotid intima-media thickness (CIMT) and carotid plaque are important factors in the primary prevention of cardiac disease. However, it is unclear which one is more important for prognosis, especially in patients with coronary artery disease (CAD). SUBJECTS AND METHODS: In total, 1426 consecutive CAD patients, proven by angiography, were followed-up for a mean of 85 months. The study population was divided into four groups depending on the CIMT (> or =0.83 mm, >95 percentile in Korea) and the presence or absence of carotid plaque. RESULTS: Patients with carotid plaque and thick CIMT (n=237, 16.6%) had a higher prevalence of hypertension, diabetes mellitus, and dyslipidemia than those had plaque and thin CIMT (n=213, 14.9%), those without plaque and thick CIMT (n=265, 18.6%) and those without plaque and thin CIMT (n=711, 49.9%). The patients with carotid plaque and thick CIMT group had a higher cardiac mortality rate (20.7% vs. 13.1%, 9.4% and 3.9%, respectively, p<0.001) and higher major adverse cardiovascular events (MACE) including death, acute myocardial infarction, and stroke (27.8% vs. 18.8%, 15.5% and 9.3%, respectively, p<0.001) than any other groups. Multivariate Cox regression analysis showed that the presence of carotid plaque with thick CIMT had the highest hazard ratio (HR) compared to other groups (HR 2.23 vs. 1.81, 2.01) for cardiac mortality. Also, carotid plaque had a higher HR than CIMT for mortality (HR 1.56 vs. 1.37) and MACE (HR 1.54 vs. 1.36) in the total study population. CONCLUSION: Carotid plaque is a more important prognostic factor than CIMT in patients with CAD, and adding a thick CIMT to carotid plaque increases the prognostic power for cardiac events.
Subject(s)
Humans , Angiography , Carotid Intima-Media Thickness , Carotid Stenosis , Coronary Artery Disease , Diabetes Mellitus , Dyslipidemias , Follow-Up Studies , Heart Diseases , Hypertension , Mortality , Myocardial Infarction , Prevalence , Primary Prevention , Prognosis , Stroke , UltrasonographyABSTRACT
Bone marrow examination is useful in the diagnosis and staging of hematologic disease. This procedure is generally considered safe; however, there are several adverse events associated with bone marrow biopsy. The most frequent and serious adverse event is hemorrhage. Risk factors include coagulopathy, myeloproliferative disorders, and anticoagulant or antiplatelet medications. Most hemorrhage is local hematoma; however, infrequently retroperitoneal hemorrhage occurs. In the case of massive hemorrhage, operation or angiographic embolization may be required. We report on a case of retroperitoneal hemorrhage after bone marrow aspiration and biopsy in an essential thrombocythemia patient.
Subject(s)
Humans , Biopsy , Bone Marrow Examination , Bone Marrow , Diagnosis , Hematologic Diseases , Hematoma , Hemorrhage , Methods , Myeloproliferative Disorders , Risk Factors , Thrombocythemia, EssentialABSTRACT
Ovarian cancer is generally primary cancer and less frequently originates from metastasis from non-gynecological cancer. Ovarian metastasis from lung cancer represents only 2~4% of all ovarian metastatic cancers. We report a case of ovarian metastasis of non-small cell lung cancer with epidermal growth factor receptor mutation. The patient underwent cytoreductive surgery for the ovarian mass and erlotinib therapy for the metastatic lung cancer. Erlotinib therapy markedly decreased the size of lung mass.