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author:("marucci, R A")
1.  High sensitivity C-reactive protein predicts the development of new carotid artery plaques in older persons 
Background
Previous studies have shown that increased levels of C-reactive protein (CRP) predict cardiovascular events, including stroke, myocardial infarction and death from cardiovascular causes. Previous studies have also shown that increased levels of CRP are strong predictors of the progression of pre-existing carotid artery plaques. However, whether CRP is involved in the development of new plaques, that may or may not be associated with clinical events, in subjects with clean carotid arteries has been scarcely investigated
Methods
486 “InCHIANTI” Study participants (200 men and 286 women, 72% aged 65 years and over) free from carotid artery plaques at baseline, also underwent carotid artery scan three years later. We tested the association of baseline characteristics, cardiovascular risk factors and inflammatory markers with the development of new carotid artery plaques.
Results
Older participants were significantly more likely to develop new plaques. Independent of age, the relative risks of developing new plaques associated with heavy smoking and family history of atherosclerosis were 1.7 (95%CI 1.5-1.9) and 1.9 (95%CI 1.2-3.1), respectively. Participants with high (>3 microg/mL) and moderate (≥1 and ≤3 microg/mL) CRP levels had a relative risk of 2.2 (95%CI 1.9-2.6) and 1.9 (95%CI 1.6-2.3) respectively, when compared with subjects with low (<1 microg/mL) CRP levels. Surprisingly, risk factors such as hypertension, diabetes, dyslipidemia and overweight/obesity were not significantly predictors of the development of new carotid artery plaques.
Conclusions
High CRP levels independently predict the development of new plaques in older persons with carotid arteries free from atherosclerotic lesions.
doi:10.1016/j.numecd.2010.02.003
PMCID: PMC2941708  PMID: 20554169
C-reactive protein; atherosclerosis; carotid arteries; risk factors; older persons
3.  PAI‐1 and homocysteine, but not lipoprotein (a) and thrombophilic polymorphisms, are independently associated with the occurrence of major adverse cardiac events after successful coronary stenting 
Heart  2005;92(3):377-381.
Objective
To evaluate the role of factor V Leiden, prothrombin G20210A polymorphism, plasminogen activator inhibitor type 1 (PAI‐1) 4G/5G polymorphism, PAI‐1, homocysteine, and lipoprotein (a) (Lp(a)) in the occurrence of major adverse cardiac events (MACE) in patients with acute coronary syndromes who underwent coronary stenting.
Design
520 patients (375 men and 145 women) with acute coronary syndromes and 520 age and sex matched controls were enrolled. MACE were recorded for 109 patients. Heterozygosity for factor V Leiden, prothrombin G20210A polymorphism, and 4G/5G polymorphism did not significantly differ between patients with and without MACE. A significantly higher percentage of patients with increased homocysteine (28% v 19%, p < 0.001) and PAI‐1 concentrations (25% v 16%, p < 0.001) had MACE with respect to those who did not. In Kaplan‐Meier survival analysis, the overall risk of MACE was significantly higher among patients with increased PAI‐1 (p  =  0.006) and homocysteine concentrations (p  =  0.04). Cox regression analysis adjusted for age, sex, traditional cardiovascular risk factors, renal function, systolic left ventricular function, the number of stenosed vessels, and history of percutaneous coronary intervention or coronary artery bypass grafting showed that homocysteine (odds ratio 7.5, 95% confidence interval (CI) 1.1 to 57.7, p < 0.05) and PAI‐1 concentrations (odds ratio 5.3, 95% CI 1.2 to 23.8, p < 0.05) within the fifth quintile (with respect to the first) were significant and independent risk factors for the future occurrence of MACE.
Conclusions
Increased PAI‐1 and homocysteine concentrations are independent risk factors for MACE after successful coronary stenting, whereas Lp(a) and thrombophilic polymorphisms are not predictive.
doi:10.1136/hrt.2005.061895
PMCID: PMC1860841  PMID: 15994914
coronary stenting; MACE; genetic polymorphisms; homocysteine; PAI‐1
4.  Common bile duct obstruction secondary to infection with Candida. 
Journal of Clinical Microbiology  1978;7(5):490-492.
A patient is reported who had biliary tract obstruction secondary to infection of the common bile duct with Candida albicans, with the formation of a fungus ball. Treatment consisted of surgical removal of the fungus ball and drainage. Chemotherapy was not necessary. Ureteral obstruction through fungus ball formation, and even pulmonary fungus ball formation, has been attributed to candida, but this is the first case reported, to our knowledge, of bile duct obstruction.
Images
PMCID: PMC275030  PMID: 350898

Results 1-4 (4)