10 results on '"Manousakis SJ"'
Search Results
2. The impact of circulating total homocysteine levels on long-term cardiovascular mortality in patients with acute coronary syndromes.
- Author
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Foussas SG, Zairis MN, Makrygiannis SS, Manousakis SJ, Patsourakos NG, Adamopoulou EN, Beldekos DJ, Melidonis AI, Handanis SM, Manolis AJ, Hatzisavvas JJ, and Argyrakis SK
- Subjects
- Acute Disease, Biomarkers blood, Electrocardiography, Female, Follow-Up Studies, Greece epidemiology, Humans, Male, Middle Aged, Nephelometry and Turbidimetry, Prognosis, Retrospective Studies, Risk Factors, Survival Rate trends, Syndrome, Time Factors, Coronary Disease blood, Coronary Disease mortality, Homocysteine blood
- Abstract
Background: To evaluate the possible independent impact of circulating total homocysteine (tHcy) levels on long-term cardiovascular mortality, in patients with either ST-segment elevation myocardial infarction (STEMI), or non-ST-segment elevation acute coronary syndromes (NSTE-ACS)., Methods: A total of 458 STEMI and 476 NSTE-ACS patients who presented consecutively, within the first 12 and 24 h of index pain respectively were studied. Each cohort was divided according to tertiles of circulating tHcy levels upon presentation. Early (30 days) and late (31 days through 5 years) cardiovascular mortality was the predefined study endpoint., Results: There was no difference in the risk of 30-day cardiovascular death among the tertiles of tHcy in patients with STEMI (7.2%, 8.5% and 12.4% for the first, second and third tertiles respectively; p(trend)=0.3) or NSTE-ACS (3.1%, 3.8% and 5.7% for the first, second and third tertiles respectively; p(trend)=0.5). Patients in the upper tHcy tertile were at significantly higher unadjusted risk of late (from 31 days trough 5 years) cardiovascular death than those in the other two tertiles in STEMI (23.4%, 27.9% and 41.8% for the first, second and third tertiles respectively; p(trend) <0.001), and NSTE-ACS (24.7%, 28.1% and 45.6% for the first, second and third tertiles respectively; p(trend) <0.001) cohorts. However, after adjustment for baseline differences, there was no significant difference in the risk of late cardiovascular death among tHcy tertiles in either cohort. When circulating tHcy levels were treated as a continuous variable, they were significantly associated with late cardiovascular death (p<0.001 for both cohorts) by univariate Cox regression analysis, but not by multivariate Cox regression analysis (p=0.8, and p=1 for STEMI and NSTE-ACS cohorts, respectively)., Conclusions: Based on the present data circulating tHcy levels determined upon admission do not serve as an independent predictor of long-term cardiovascular mortality in patients with either STEMI or NSTE-ACS.
- Published
- 2008
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3. The impact of hs C-reactive protein and other inflammatory biomarkers on long-term cardiovascular mortality in patients with acute coronary syndromes.
- Author
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Zairis MN, Adamopoulou EN, Manousakis SJ, Lyras AG, Bibis GP, Ampartzidou OS, Apostolatos CS, Anastassiadis FA, Hatzisavvas JJ, Argyrakis SK, and Foussas SG
- Subjects
- Aged, Biomarkers blood, Cohort Studies, Electrocardiography, Female, Fibrinogen analysis, Greece epidemiology, Humans, Interleukin-6 blood, Longitudinal Studies, Male, Middle Aged, Predictive Value of Tests, Risk Factors, Serum Amyloid A Protein analysis, Acute Coronary Syndrome immunology, Acute Coronary Syndrome mortality, C-Reactive Protein metabolism, Leukocyte Count
- Abstract
We evaluated whether high circulating levels of serum amyloid A (SAA), fibrinogen, interleukin-6 (IL-6) or leukocytes count (LC), can provide any additional predictive value over that provided by hs C-reactive protein (hs-CRP) for the incidence of 5-year cardiovascular mortality, in 458 and 476 consecutive patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndromes (NSTE-ACS), respectively. By 5 years the incidence of cardiovascular mortality was 37.3% and 35.5% in patients with STEMI and NSTE-ACS, respectively. Each of the study inflammatory biomarkers conferred independent to clinical risk predictors (and to cardiac troponin I) long-term prognostic information (all p<0.05), but only LC provided additional predictive value over that provided by hs-CRP, in either cohort (p<0.05). By multivariate Cox regression analysis, hs-CRP (p<0.001 for both cohorts) and LC (p=0.009 and p<0.001 for STEMI and NSTE-ACS, respectively) were the only inflammatory biomarkers independently associated with the incidence of 5-year cardiovascular mortality. According to the present results high circulating levels of LC but not of SAA, fibrinogen or IL-6 can provide additional long-term predictive value over that provided by hs-CRP in patients with acute coronary syndromes.
- Published
- 2007
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4. The significance of circulating levels of both cardiac troponin I and high-sensitivity C reactive protein for the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction.
- Author
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Foussas SG, Zairis MN, Makrygiannis SS, Manousakis SJ, Anastassiadis FA, Apostolatos CS, Patsourakos NG, Glyptis MP, Papadopoulos JK, Xenos DC, Adamopoulou EN, Olympios CD, and Argyrakis SK
- Subjects
- Aged, Biomarkers blood, Electrocardiography, Female, Fibrinolytic Agents therapeutic use, Follow-Up Studies, Humans, Logistic Models, Male, Middle Aged, Myocardial Infarction mortality, Prognosis, Proportional Hazards Models, Prospective Studies, Streptokinase therapeutic use, Treatment Failure, C-Reactive Protein analysis, Myocardial Infarction blood, Myocardial Infarction therapy, Thrombolytic Therapy, Troponin I blood
- Abstract
Objectives: To evaluate, using continuous 12-lead ECG ST-segment monitoring, the role of circulating levels of both cardiac troponin I (cTnI) and high-sensitivity C reactive protein (hs-CRP), on presentation, in the prediction of intravenous thrombolysis outcome in patients with ST-segment elevation myocardial infarction (STEMI)., Design and Setting: Prospective observational study in a tertiary referral centre., Patients: 786 consecutive patients with STEMI, who received intravenous thrombolysis in the first 6 h from index pain., Main Outcome Measures: The incidence of failed thrombolysis and of cardiac death by 30 days. Failed thrombolysis was defined as the absence of abrupt and sustained > or =50% ST-segment recovery in the first 90 min after the initiation of intravenous thrombolysis., Results: The incidence of failed thrombolysis and 30-day cardiac death was 57.4% and 11.8%, respectively. By multivariate logistic regression analysis according to tertiles of both cTnI (RR, 1.5; 95% CI 1.1 to 1.8, p = 0.004 for highest vs middle third; 2.2, 1.9 to 3.5, p<0.001 for highest vs lowest third; 1.5, 1.2 to 1.8, p = 0.001 for middle vs lowest third) and hs-CRP (RR, 2.0, 95% CI, 1.6 to 2.2; p<0.001 for highest vs middle third; 2.6, 2.1 to 3.5, p<0.001 for highest vs lowest third; 1.3, 1.2 to 1.7, p = 0.02 for middle vs lowest third), were independently associated with failed thrombolysis. Moreover, by multivariate Cox regression analysis according to tertiles of both cTnI (HR 1.2, 95% CI 1.1 to 1.8, p = 0.03 for highest vs middle third; 1.5, 1.2 to 2.2, p = 0.004 for highest vs lowest third; 1.1, 0.6 to 1.4, p = 0.6 for middle vs lowest third) and hs-CRP (HR1.2, 95% CI 1.1 to 1.6, p = 0.04 for highest vs middle third; 1.7, 1.3 to 2.6, p = 0.001 for highest vs lowest third; 1.1, 0.9 to 2.1, p = 0.1 for middle vs lowest third), were independently related with an increased risk of 30-day cardiac death., Conclusions: High circulating levels of both cTnI and hs-CRP are related with an independent increased risk of intravenous thrombolysis failure and 30-day cardiac death in patients who received intravenous thrombolysis in the first 6 h of STEMI.
- Published
- 2007
- Full Text
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5. Continuous 12-lead electrocardiographic ST monitoring and long-term prognosis after successful coronary stenting.
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Zairis MN, Manousakis SJ, Adamopoulou EN, Makrygiannis SS, Glyptis MP, Beldekos DJ, Patsourakos NG, Olympios CD, Prekates AA, and Foussas SG
- Subjects
- Aged, Coronary Angiography, Coronary Disease diagnostic imaging, Creatine Kinase, MB Form blood, Female, Humans, Male, Middle Aged, Monitoring, Physiologic methods, Prognosis, Proportional Hazards Models, Prospective Studies, ROC Curve, Sensitivity and Specificity, Stents, Time Factors, Coronary Disease therapy, Electrocardiography
- Abstract
Background: The possible long-term prognostic value of transient ST ischemic episodes detected by continuous multilead electrocardiographic (ECG) monitoring after successful coronary stenting (CS) has not been thoroughly investigated., Methods: A total of 739 consecutive patients, who underwent a 24-hour, continuous 12-lead electrocardiographic (ECG) ST monitoring in the first day after successful CS, were studied. An ST ischemic episode was defined as a transient ST shift (depression or elevation) in any lead of > or = 0.10 mV compared with the reference ECG lasting for > or = 1 minute., Results: The incidence of the composite of death, nonfatal myocardial infarction, and recurrent angina by the first year was 28.7%. Patients with > or = 3 (defined by receiver operating characteristics analysis) ST ischemic episodes, detected by continuous 12-lead ECG ST monitoring, were at significantly higher risk for the 1-year composite primary end point than those with either 1 and 2 (52.7% vs 25.7%, hazard ratio [HR] 2.1, 95% CI 1.4-3.7, P < .001) or no (52.7% vs 25%, HR 2.2, 95% CI 1.2-2.9, P < .001) ST ischemic episodes. By multivariate Cox regression analysis, the occurrence of > or = 3 ST ischemic episodes in the first postprocedural day was independently associated with a significant increased risk of the 1-year composite primary end point (HR 1.9, 95% CI 1.4-3.9, P = .002)., Conclusions: The present study suggests that continuous 12-lead ECG ST monitoring in the first day after successful CS may serve as an affordable tool for the identification of patients with an increased risk of fatal or nonfatal ischemic complication during the first year after the procedure.
- Published
- 2006
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6. C-reactive protein and ST-segment monitoring by continuous 12-lead electrocardiogram in patients with primary unstable angina pectoris.
- Author
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Zairis MN, Ambrose JA, Papadaki OA, Manousakis SJ, Stefanidis AS, DeVoe MC, Handanis SM, Olympios CD, and Foussas SG
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- Aged, Analysis of Variance, Biomarkers blood, Blood Chemical Analysis, Cohort Studies, Female, Humans, Logistic Models, Male, Middle Aged, Monitoring, Physiologic methods, Multivariate Analysis, Myocardial Infarction blood, Myocardial Infarction diagnosis, Predictive Value of Tests, Probability, Prognosis, Prospective Studies, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Statistics, Nonparametric, Angina, Unstable blood, Angina, Unstable diagnosis, C-Reactive Protein analysis, Electrocardiography, Ambulatory methods
- Published
- 2003
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7. C-reactive protein and rapidly progressive coronary artery disease--is there any relation?
- Author
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Zairis MN, Manousakis SJ, Stefanidis AS, Vitalis DP, Tsanis EM, Hadjigeorgiou SM, Fakiolas CN, Pissimissis EG, Olympios CD, and Foussas SG
- Subjects
- Aged, Angioplasty, Balloon, Coronary, Coronary Angiography, Coronary Disease diagnostic imaging, Coronary Disease therapy, Disease Progression, Female, Humans, Male, Middle Aged, Multivariate Analysis, Risk Assessment, Risk Factors, C-Reactive Protein analysis, Coronary Disease blood
- Abstract
Background: High plasma C-reactive protein (CRP) levels have been associated with an unfavorable outcome in patients with coronary artery disease (CAD), and a direct participation of CRP in the atherosclerotic process has been postulated., Hypothesis: The aim of this study was to evaluate the possible relationship of high plasma CRP levels with the rapid progression of coronary atherosclerosis (RPCAD)., Methods: In all, 194 patients who were readmitted and underwent repeat coronary angiography because of recurrence of symptoms following successful percutaneous coronary intervention were studied. Median angiographic follow-up time was 6 months. Rapid progression CAD was defined as the presence of a new lesion, > 25% in luminal diameter stenosis, in a previously nondiseased vessel, or deterioration of a known, nontreated lesion by at least 25%., Results: By multivariate analysis, patients with high plasma CRP levels upon first admission were at higher risk of RPCAD. In particular, odds ration (OR) = 1.8; 95% confidence interval (CI) = 1.3-3.6; p value = 0.02 in patients with CRP = 0.5-2 mg/dl versus patients with CRP < 0.5 mg/dl, and OR = 7.1; 95% CI = 3.8-9.5; p value < 0.001 in patients with CRP > 2 mg/dl versus patients with CRP < 0.5 mg/dl., Conclusion: Increased plasma CRP levels could possibly identify patients at high risk for the development of RPCAD.
- Published
- 2003
- Full Text
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8. C-reactive protein levels on admission are associated with response to thrombolysis and prognosis after ST-segment elevation acute myocardial infarction.
- Author
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Zairis MN, Manousakis SJ, Stefanidis AS, Papadaki OA, Andrikopoulos GK, Olympios CD, Hadjissavas JJ, Argyrakis SK, and Foussas SG
- Subjects
- Analysis of Variance, Biomarkers blood, Female, Hospital Mortality, Humans, Male, Middle Aged, Myocardial Infarction mortality, Prospective Studies, Survival Analysis, Treatment Failure, C-Reactive Protein analysis, Myocardial Infarction blood, Myocardial Infarction drug therapy, Thrombolytic Therapy
- Abstract
Background: Several studies have shown the independent association of high plasma C-reactive protein (CRP) levels with an adverse prognosis in patients with acute myocardial infarction. However, the possible association of plasma CRP levels with response to thrombolysis and short- and long-term cardiac mortality has not been investigated. The aim of this study was to evaluate these possible associations., Methods: Three hundred nineteen consecutive patients who received intravenous thrombolysis because of ST-segment elevation acute myocardial infarction were prospectively studied. Patients were classified according to tertiles of plasma CRP levels on admission., Results: Patients at the top tertile had a significantly lower incidence of complete ST-segment resolution (third vs first, P <.001, third vs second, P =.009) or Thrombolysis In Myocardial Infarction (TIMI) 3 flow in the infraction-related artery (third vs first, P <.001, third vs second, P =.02), more compromised left ventricular function (third vs first, P =.02, second vs third, P =.04), greater inhospital mortality (third vs first, P =.03, third vs second, P =.06), and greater 3-year cardiac mortality (third vs first, P =.01, third vs second, P =.07)., Conclusions: Plasma levels of CRP on admission may be a predictor of reperfusion failure and of short- and long-term prognosis in patients with ST-segment elevation acute myocardial infarction.
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- 2002
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9. The impact of plasma levels of C-reactive protein, lipoprotein (a) and homocysteine on the long-term prognosis after successful coronary stenting: The Global Evaluation of New Events and Restenosis After Stent Implantation Study.
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Zairis MN, Ambrose JA, Manousakis SJ, Stefanidis AS, Papadaki OA, Bilianou HI, DeVoe MC, Fakiolas CN, Pissimissis EG, Olympios CD, and Foussas SG
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- Aged, Angina, Unstable blood, Biomarkers, Coronary Angiography, Coronary Artery Disease therapy, Coronary Restenosis blood, Disease Progression, Female, Humans, Male, Middle Aged, Prognosis, Proportional Hazards Models, ROC Curve, Risk Assessment, C-Reactive Protein analysis, Coronary Artery Disease blood, Homocysteine blood, Lipoprotein(a) blood
- Abstract
Objectives: The objective of this study was to evaluate the association of high plasma levels of either C-reactive protein (CRP), lipoprotein (a) (Lp[a]) or total homocysteine (tHCY) with the long-term prognosis after successful coronary stenting (CS)., Background: High plasma levels of either CRP, Lp(a) or tHCY may have an impact in coronary artery disease. However, long-term prospective data after coronary stenting (CS) are limited., Methods: Four-hundred and eighty-three consecutive patients with either stable or unstable coronary syndromes were followed for up to three years after successful CS. The composite of cardiac death, myocardial infarction or rehospitalization for rest unstable angina, whichever occurred first, was the prespecified primary end point. Moreover, the one-year incidence of clinical recurrence of symptoms, in-stent restenosis (ISR) and progression of atherosclerosis to a significant lesion (PTSL) were additionally evaluated. PTSL was defined as an increase by at least 25% in the luminal diameter stenosis of a known nonsignificant lesion (
or=70% luminal diameter stenosis)., Results: By the end of the follow-up, high plasma levels of either CRP or Lp(a) but not tHCY were independently associated with the primary end point. In particular, CRP >or=0.68 mg/dl (p < 0.001) or Lp(a) >or=25 mg/dl (p = 0.003) conferred a significantly increased risk. By 1 year, a CRP >or=0.68 mg/dl conferred a significantly increased risk for clinical recurrence of symptoms (p < 0.001) or PTSL (p < 0.001). None of the studied biochemical markers was related to ISR., Conclusions: High plasma levels of either CRP or Lp(a) but not tHCY may be associated with a higher incidence of late adverse events after successful CS. PTSL in vessels not previously intervened upon may play a significant role in the underlying pathophysiology as opposed to ISR. - Published
- 2002
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10. C-reactive protein and multiple complex coronary artery plaques in patients with primary unstable angina.
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Zairis MN, Papadaki OA, Manousakis SJ, Thoma MA, Beldekos DJ, Olympios CD, Festeridou CA, Argyrakis SK, and Foussas SG
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- Adult, Age Factors, Aged, Aged, 80 and over, Analysis of Variance, Angina, Unstable blood, Biomarkers analysis, C-Reactive Protein analysis, Cardiac Catheterization, Coronary Angiography, Coronary Artery Disease blood, Female, Humans, Logistic Models, Male, Middle Aged, Observer Variation, Probability, Prospective Studies, Risk Assessment, Sensitivity and Specificity, Severity of Illness Index, Sex Factors, Statistics, Nonparametric, Angina, Unstable diagnosis, C-Reactive Protein metabolism, Coronary Artery Disease diagnosis
- Abstract
The aim of this study was to investigate the possible association of plasma C-reactive protein (CRP) levels with the presence of angiographically multiple complex lesions (CLs) in patients with primary unstable angina (PUA). For the purpose of this study, 228 consecutive patients with PUA who underwent in-hospital catheterization were evaluated. Plasma CRP levels were measured upon patients' admission. Coronary plaques were classified as CL or non-CL according to Ambrose's criteria. There were 100 (43.9%) patients with no or one CL (=1) and 128 (56.1%) patients with multiple CLs (>/=2). Tertiles of plasma CRP levels upon admission were significantly associated with the number of CLs on angiographic studies. In particular there was a significant gradual increase in either the number of CLs, or the presence of apparently thrombus-containing CLs with increasing of CRP tertiles. By multivariate analysis CRP was independently associated with the presence of either multiple CLs (R.R.=1.8, 95%CI=1.5-2.2, P<0.001), or angiographically apparent thrombus-containing CLs (R.R.=1.4, 95%CI=1.2-1.7, P=0.03).High plasma levels of CRP may reflect a multifocal activation of the coronary tree in patients with PUA. This finding suggests a generalized inflammatory reaction throughout the coronary tree in these patients.
- Published
- 2002
- Full Text
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