Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular d...Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.展开更多
Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortalit...Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortality of patients with end-stage renal disease （ESRD） is complicated due to the high frequency of risk factors in these patients. Some laboratory markers like homocysteine, albumin, cholesterol, triglycerides, LDL-cholesterol, and creatinine could be efficient in marking the risk of cardiovascular disease in these patients. We use Roche assay tests, based on routinely principles to determine this laboratory parameters used in the clinical laboratory. All laboratory parameters we measured on a biochemistry auto analyser Cobas Integra 400 at the clinical laboratory of University Hospital--Pleven. Using a statistical program a research was done on the quantitative characteristics and prognostic capabilities of homocysteine and other biochemical parameters. We determined the diagnostic specificity and sensitivity of our lab performance against vascular disease （heart attack or stroke） by ROC curves. For each of the observed values of biochemical parameters we calculated the diagnostic sensitivity and specificity. The threshold values for which the parameters have the highest sensitivity and specificity have been concluded. Summary of diagnostic value of parameters to judge the coefficient AUC--area under the curve, for cholesterol, LDL, triglycerides, albumin, it was a significant （P 〈 0.05）. Homocysteine and the rest of the studied by us laboratory parameters can be regarded as laboratory markers of choice for assessing the risk of heart attack or stroke in patients on dialysis.展开更多
文摘Frailty is a state of late life decline and vulnerability, typified by physical weakness and decreased physiologic reserve. The epidemiology and pathophysiology of frailty share features with those of cardiovascular disease. Gait speed can be used as a measure of frailty and is a powerful predictor of mortality. Advancing age is a potent risk factor for cardiovascular disease and has been associated with an increased risk of adverse outcomes. Older adults comprise approximately half of cardiac surgery patients, and account for nearly 80% of the major complications and deaths following surgery. The ability of traditional risk models to predict mortality and major morbidity in older patients being considered for cardiac surgery may improve if frailty, as measured by gait speed, is included in their assessment. It is possible that in the future frailty assessment may assist in choosing among therapies （e.g., surgical vs. percutaneous aortic valve replacement for patients with aortic stenosis）.
文摘Cardiovascular diseases constitute approximately 50% of deaths among dialysis patients in the USA and Europe. The increase in traditional and nontraditional cardiovascular risk factors in determining the high mortality of patients with end-stage renal disease （ESRD） is complicated due to the high frequency of risk factors in these patients. Some laboratory markers like homocysteine, albumin, cholesterol, triglycerides, LDL-cholesterol, and creatinine could be efficient in marking the risk of cardiovascular disease in these patients. We use Roche assay tests, based on routinely principles to determine this laboratory parameters used in the clinical laboratory. All laboratory parameters we measured on a biochemistry auto analyser Cobas Integra 400 at the clinical laboratory of University Hospital--Pleven. Using a statistical program a research was done on the quantitative characteristics and prognostic capabilities of homocysteine and other biochemical parameters. We determined the diagnostic specificity and sensitivity of our lab performance against vascular disease （heart attack or stroke） by ROC curves. For each of the observed values of biochemical parameters we calculated the diagnostic sensitivity and specificity. The threshold values for which the parameters have the highest sensitivity and specificity have been concluded. Summary of diagnostic value of parameters to judge the coefficient AUC--area under the curve, for cholesterol, LDL, triglycerides, albumin, it was a significant （P 〈 0.05）. Homocysteine and the rest of the studied by us laboratory parameters can be regarded as laboratory markers of choice for assessing the risk of heart attack or stroke in patients on dialysis.
