Optimal blood pressure for prevention of cardiovascular (CV) events in patients with Type 2 diabetes mellitus (T2DM) remains uncertain and there is concern for increased risk with low diastolic blood pressure (DBP). This study analysed the association between blood pressure and CV outcomes in high-risk patients with T2DM.
Case reports of individuals with a single variant or a limited number of localized variants are plentiful; however, systematic, whole-body study of cerebral, axial, and peripheral arterial variants in a single anatomical donor is lacking. This case report describes widespread arterial variants in a single donor. We report several remarkable variants in this case and then, discuss these finding with regards to clinical relevance, prior vascular variant studies and embryologic development. Additionally, combined probability calculations reveal that the probability of possessing this constellation of arterial variants, by chance, is 0.0001. Given this low probability, we hypothesize that our donor had a propensity for developing arterial variants and further, that the presence of multiple variants is related to disruption in vascular developmental pathways during the embryonic period. Such information has direct clinical relevance, particularly during invasive diagnostic and surgical procedures.
Background: While the presence of vascular disease in multiple beds is associated with a well-established risk of major cardiovascular outcomes, the risk of adverse limb events in patients with PAD...
The TIMI-AF score predicts poor outcomes in patients with atrial fibrillation (AF) and guides selection of anticoagulant therapy by identifying clinical benefit of direct oral anticoagulants (DOACs) or vitamin K antagonists (VKA).Our objective was to determine the ability to predict cardiovascular events according to the TIMI-AF score in a real-world population.Retrospective observational study of VKA-naïve patients with AF was seen at a cardiology outpatient clinic in Spain between November 2012 and August 2014. We recorded adverse events (myocardial infarction, systemic embolism or stroke, major bleeding, and death).The study population comprised of 426 patients (50.7% men, mean age, 69 ± 14 years). The TIMI-AF score identified 372 patients (87.3%) with a low risk, 50 patients (11.7%) with an intermediate risk, and 4 patients (0.9%) with a high risk. After a mean follow-up of 423.4 ± 200.1 days, 37 patients (9%) experienced an adverse event. Patients with a TIMI-AF score ≥ 7 had a poorer cardiovascular prognosis (HR, 6.1; 95%CI, 3.2-11.7; P < 0.001). The area under the ROC curve of TIMI-AF was 0.755 (95%CI, 0.669-0.840; P < 0.001), which was greater than that of CHA2 DS2 VASc (0.641; 95%CI, 0.559-0.724; P = 0.004), HAS-BLED (0.666; 95%CI, 0.578-0.755; P < 0.001), and SAMeTT2 R2 (0.529; 95%CI, 0.422-0.636; P = 0.565). Similar results were obtained in relation to the net clinical outcome (life-threatening bleeding, disabling stroke, or all-cause mortality).The TIMI-AF risk score can identify patients who are at greater risk of cardiovascular events and a poor net clinical outcome with a better diagnostic yield than CHA2 DS2 VASc, HAS-BLED, and SAMeTT2 R2 .
Acute mortality for high-risk, or massive, pulmonary embolism (PE) is almost 30% even when treated using advanced therapies. This analysis assessed the safety and effectiveness of mechanical thrombectomy (MT) for high-risk PE.
