ABSTRACT
The treatment of nonbacterial thrombotic endocarditis consists of anticoagulation, surgical consideration and treatment of the underlying disease, most commonly lupus or malignancy. We report a case of nonbacterial thrombotic endocarditis presumably caused by underlying ovarian carcinoma that was controlled with anticoagulation and resolved with chemotherapy and surgical resection of the malignancy.
ABSTRACT
We aimed to study the relationship between the C-reactive protein (CRP), albumin, and fibrinogen as cardiovascular risk factors in continuous ambulatory peritoneal dialysis (CAPD) patients, in the early stage of their therapy. The study included 21 CAPD patients as the study group (SG) and age- and sex-matched 21 healthy patients as the control group (CG). History and physical exam data were obtained for all cases, and demographic baseline characteristics were taken. Twelve-hour fasting serum levels of glucose, total cholesterol, HDL cholesterol, LDL cholesterol, triglyceride, total protein, albumin, hemoglobin, CRP, and fibrinogen were obtained. There was no statistically significant difference between the SG and CG in baseline characteristics, including age, sex, body mass index (BMI), smoking, and family history of cardiovascular disease. However, diabetes mellitus (DM) and hypertension (HTN) were significantly more common among the study group. The average total protein, albumin, and hemoglobin levels were significantly lower, and the CRP and fibrinogen levels were significantly higher (p < 0.001) in the SG. A positive correlation was seen (r = 0.443, p < 0.05) among CRP and fibrinogen levels in SG. There was no correlation among the other parameters in SG. For CG, there was no correlation seen for any studied parameters. When patients with and without cardiovascular disease (CVD) were compared, no correlation was seen between CRP and other parameters. A positive correlation of CRP and fibrinogen levels as cardiovascular risk factors was shown in early stage of CAPD patients. The CAPD patients with elevated levels of CRP and fibrinogen should receive close follow-up for cardiovascular disease prevention.
Subject(s)
C-Reactive Protein/analysis , Cardiovascular Diseases/diagnosis , Cardiovascular Diseases/etiology , Fibrinogen/analysis , Kidney Failure, Chronic/therapy , Peritoneal Dialysis, Continuous Ambulatory/adverse effects , Adolescent , Adult , Aged , Aged, 80 and over , Biomarkers/blood , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/metabolism , Case-Control Studies , Cholesterol, HDL/analysis , Cholesterol, LDL/analysis , Confidence Intervals , Coronary Disease/diagnosis , Coronary Disease/epidemiology , Coronary Disease/etiology , Female , Follow-Up Studies , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/diagnosis , Male , Middle Aged , Peritoneal Dialysis, Continuous Ambulatory/methods , Probability , Reference Values , Risk Factors , Severity of Illness Index , Statistics, NonparametricABSTRACT
AIM: The aim of this study was to evaluate the diagnostic value of serum C-reactive protein (CRP) level measurement in predicting coronary artery disease (CAD) that can be shown angiographically. METHODS: CRP levels were determined in the blood of 198 patients (patients group, PG) with angiographically documented coronary artery disease and compared with that of 85 patients (control group, CG) who had a clinical indication for coronary angiography but have no angiographically determined coronary artery stenosis, as well as with that of 41 healthy volunteers as a healthy control group (HG) who did not have any complaint and did not have coronary angiography. CRP levels were measured 24 hours prior to angiography in PG and CG patients, and in the morning after not having eaten for same time. Any coronary artery stenosis or plaque formation was defined as CAD. Severity of the disease was assessed by both the number of diseased vessels (0 to 3) and the degree of stenosis (<50% mild, 50-70% moderate and >70% severe). RESULTS: Receiver Operating Characteristics (ROC) curves of CRP in angiographically documented CAD group showed a diagnostic value of 0.659 in female patients, followed by 0.542 in male patients, in predicting CAD. CRP levels were found to be significantly different between groups, higher in PG (6.2 +/- 0.86 mg/L) than those of CG (3.7 +/- 0.92 mg/L) and HG (0.854 +/- 0.2 mg/L) (p<0.05). CRP levels were not associated with the number of diseased vessels, neither with the degree of the occlusion (p>0.05). Multiple logistic regression analysis after adjustment for the established coronary risk factors showed CRP as an independent discriminating risk factor for CAD. CONCLUSION: It is concluded that CRP measurement has a value in predicting the presence of angiographically documented CAD. However, CRP levels were not associated with the degree or severity of CAD.
