Shlomo Berliner

Tel Aviv Sourasky Medical Center, Tell Afif, Tel Aviv, Israel

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Publications (379)1077.18 Total impact

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    ABSTRACT: Background: Preclinical carotid atherosclerosis is associated with future risk of stroke. Data regarding the correlation between carotid atherosclerosis and biomarkers, which might predict the risk for the disease has been inconsistent and conflicting. Red blood cell distribution width (RDW) is also related to adverse clinical outcomes. Studies examining the relationship between RDW and preclinical and clinical carotid atherosclerosis were non-conclusive. Objective: To study the association between RDW and preclinical carotid atherosclerosis in a large heterogeneous cohort. Methods: Patients underwent Doppler ultrasound of the common carotid artery and Carotid Intima Media Thickness (CIMT). Advanced CIMT software analyzed over 100 samples in each exam. Blood samples for RDW were obtained on the same day. Logistic regression was used to evaluate the correlation between RDW and preclinical carotid atherosclerosis. Results: Five hundred and twenty-two consecutive patients were included, with a mean age of 6.6 ± 11. A cut-off value of 14.1% was used to differentiate between high and low RDW groups. The higher RDW group (RDW above 14.1%) was significantly older and with more cardiovascular risk factors. In a multivariate analysis, in all the patients including those treated by lipid modifying therapies, high RDW was significantly associated with advanced CIMT (OR = 2.35, CI 95% 1.28-4.30, p = 0.006). This association remained significant in subgroups of non-diabetic patients as well as patients not treated by lipid modifying drugs. RDW was also associated with significant carotid artery stenosis (OR = 1.77, CI 95% 1.12-2.82, p = 0.015). Conclusions: High RDW correlates with increased risk for preclinical and clinical carotid atherosclerosis.
    No preview · Article · Oct 2015 · Biomarkers
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    ABSTRACT: Background: Preliminary reports suggest that a small left atrium (LA) is associated with severe acute pulmonary embolisms (PE). This study used data derived from volumetric analyses of computerized tomographic pulmonary angiography (CTPA) to investigate whether a reduced LA volume can predict adverse outcome in a large series of patients with acute PE. Methods: We retrospectively analyzed 756 consecutive patients diagnosed with acute PE by non-gated CTPA between 1/2007-12/2010. Each CTPA was investigated with volumetric analysis software which automatically provides the volumes of the LA, right atrium (RA), right ventricle (RV), and left ventricle (LV). A classification tree divided the cardiac chamber volumes and ratios into categories according to mortality. Cox regression assessed the association between these categories and 30-day mortality after adjustment for age, gender and clinical background. Results: The final study group consisted of 636 patients who had successful volumetric segmentation and complete outcome data. Eighty-four patients (13.2%) died within 30 days of PE diagnosis. There was a higher mortality rate among patients with an LA volume ≤62 ml compared to those with LA volume >62 ml (19.6% vs 8.9%, respectively, hazard ratio [HR]=2.44, P < .001), an LV volume ≤67 ml (16.4% vs 8.3%, HR=1.8, P = .024) and an RA/LA volume ratio >1.2 (17% vs 9.4%, HR=2.1, P = .002). A reduced LA volume was the best predictor of adverse outcome. Conclusions: Decreased LA volume is associated with higher mortality and is the first among the various cardiac compartments to predict mortality in patients with acute PE.
    No preview · Article · Sep 2015 · Chest
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    ABSTRACT: Background: Anemia confers an adverse prognosis in patients with ST-elevation myocardial infarction (STEMI). Several mechanisms have been implicated in the etiology of anemia in this setting, including inflammation, blood loss, and the presence of comorbidities such as renal failure. Objectives: To evaluate the adequacy of bone marrow response as potentially reflected by elevation in blood and reticulocyte counts. Methods: Consecutive men with STEMI who underwent primary percutaneous intervention within 6 hours of symptom onset and who presented to our catheterization laboratory during a 36 month period were included in the study. The cohort was divided into quartiles according to hemoglobin concentration, and differences in clinical and laboratory characteristics between the groups were evaluated. Results: A total of 258 men with STEMI were recruited, 22% of whom suffered from anemia according to the World Health Organization classification (hemoglobin < 13 g/dl). Men in the lowest quartile of hemoglobin concentration presented with significantly lower white blood cell and platelet counts (9.6 ± 2.9 vs. 12.6 ± 3.6 ×103/μl, P < 0.001) and (231 ± 79 vs. 263 ± 8 ×103/μl, P < 0.01), respectively, despite higher inflammatory biomarkers (C-reactive protein and fibrinogen) compared with patients in the upper hemoglobin concentration quartile. Reticulocyte production index was not significantly higher in anemic patients, with a value of 1.8, 1.4, 1.5 and 1.6 in the ascending hemoglobin quartiles, respectively (P = 0.292). Conclusions: Anemic men with STEMI have relatively lower leukocyte and platelet counts as well as a reduced reticulocyte count despite higher inflammatory biomarkers. These findings might suggest inadequate bone marrow response.
    No preview · Article · Aug 2015 · The Israel Medical Association journal: IMAJ
  • O. Raz · O. Rogowski · T. Rosenzweig · I. Shapira · S. Berliner · M. Boaz

    No preview · Article · Jul 2015 · Atherosclerosis
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    ABSTRACT: Introduction Fatigue is frequently reported by patients with Inflammatory Bowel Disease (IBD), despite disease remission. However, no previous intervention trial has studied this symptom. We tested the effects on fatigue in IBD patients from (i) individual advice to increase physical activity (PA) and/or (ii) supplementation with omega-3 fatty acids. Method Design:a randomised controlled 2 × 2 factorial study compared change-from-baseline scores in intervention and control groups. Primary outcome: change in FACIT-F (Functional Assessment of Chronic Illness Therapy – Fatigue) score; main secondary outcomes: change in fatigue survey scores including IBD-fatigue (IBD-F); PA by monitors (Actigraph, Pensacola, US); adverse effects. Eligibility: IBD remission; ≤2 portions oily fish/week; ≤ 60 min moderate-vigorous PA/week; no comorbidities causing fatigue; no depression. Interventions: exercise advice (15 min consultation) and fish oil supplement (2.97 g per day omega-3, “Take Omega 3”©, Edinburgh, UK); Controls: dietary consultation and placebo supplement. All patients received follow-up support (email, telephone). Results Over 640 IBD outpatients were screened: 74 of those eligible consented to inclusion and randomisation, 60 commenced the intervention, and 52 completed the study according to protocol. At baseline the four groups did not differ significantly (gender, age, disease location or past IBD activity, level of PA, or FACIT-F score). The only effect on fatigue from the primary outcome – significant deterioration in FACIT-F score (95% CI:-8.6-(-0.7); p = 0.02) – was with omega-3 supplement. Fatigue was however significantly reduced in the exercise groups, measured by IBD-F score (95% CI:-3.8-(-0.2); p = 0.03). There were no significant interactions between effects of exercise and fish oil on fatigue, or consistent trends in fatigue or PA levels across the various measures between the four groups. Only 1 treatment-related adverse event was reported (in exercise group), suggesting that neither exercise nor fish oil were associated with likelihood of occurrence of an adverse effect, including gastrointestinal symptoms. Conclusion The apparent worsening of fatigue with fish oil is unexplained. Exercise and fish oil, singly or in combination, were shown to be safe and generally well-tolerated in IBD patients. There was no evidence of adverse exercise-related effects on gut-related symptoms, and some evidence of improvement in fatigue. Hence, regular moderate-vigorous exercise may provide self-management options in IBD-related fatigue. Disclosure of interest A. McNelly Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, I. Nathan Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Dr Falk Pharma UK, M. Monte: None Declared, G. Grimble: None Declared, C. Norton Grant/ Research Support from: National Lottery in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Ferring; Shire, F. Bredin: None Declared, W. Czuber-Dochan Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Dr Falk Pharma UK; Ferring, S. Berliner Consultant for: Crohn’s and Colitis UK, M. Gay Consultant for: Crohn’s and Colitis UK, M. Darvell Employee of: Crohn’s and Colitis UK, H. Terry Employee of: Crohn’s and Colitis UK, A. Forbes Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Dr Falk Pharma UK; Warner-Chilcott; NPS.
    Full-text · Conference Paper · Jun 2015
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    ABSTRACT: Introduction Patients with inflammatory bowel disease (IBD) report fatigue in both quiescent (41%) and active disease (86%);1however, due to its subjective nature it is difficult to assess. Many different fatigue scales exist, although most have not been tested with IBD populations. Only one scale has been developed specifically for people with IBD.2We aimed to assess validity and reliability of three fatigue assessment scales in an IBD adult population and to determine factors correlated with fatigue. Method A cross-sectional study. Participants (n = 605) were randomly selected and completed questionnaires assessing fatigue, anxiety, depression, quality of life and IBD activity. A sub-group of responders (n = 70) were sent the same mailing 6 weeks later for test-retest. The fatigue scales used were: the Inflammatory Bowel Disease Fatigue (IBD-F), the Multidimensional Fatigue Inventory (MFI) and the Multidimensional Assessment Fatigue (MAF). Internal consistency was measured by Cronbach’s alpha and test-retest reliability by the intra-class correlation coefficient (ICC). Results 465 (77%) questionnaires were completed for the test and 69% for retest. All three scales are highly correlated (p < 0.001). Test-retest suggests good agreement for all scales’ total scores with ICC values of 0.74 and 0.83 (IBD-F Section 1 and 2), 0.74 (MAF) and 0.65–0.84 (MFI). Age, gender, bowel condition, anxiety, depression and IBDQ scores were significantly associated with level of fatigue (p < 0.001) for all three fatigue scales. Older patients had lower fatigue scores, females had higher scores than males, colitis patients had significantly lower scores than Crohn’s patients, patients with a higher level of anxiety and depression had higher fatigue scores and better IDBQ was associated with lower fatigue scores. Conclusion All three tested fatigue scales were found to be valid and reliable measures of IBD fatigue. Factors such as age, gender, bowel condition, quality of life, anxiety and depression are significantly associated with fatigue and should all be taken into account in the process of care delivery to people with IBD and fatigue. Disclosure of interest W. Czuber-Dochan Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Dr Falk Pharma UK, Ferring, C. Norton Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Ferring, Shire, P. Bassett: None Declared, S. Berliner Conflict with: Trustee for Crohn’s and Colitis UK, F. Bredin Grant/Research Support from: Service development awards from Shire and ferring, M. Darvell Employee of: Crohn’s and Colitis UK, A. Forbes Grant/ Research Support from: Big Lottery Fund in collaboration with Crohn’s and Colitis UK, Speaker Bureau of: Dr Falk UK, Warner-Chilcott, NPS, M. Gay Consultant for: Crohn’s and Colitis UK, Conflict with: Trustee for Crohn’s and Colitis UK, E. Ream: None Declared, H. Terry Employee of: Crohn’s and Colitis UK References
    No preview · Article · Jun 2015 · Gut
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    ABSTRACT: Fatigue is commonly reported by patients with inflammatory bowel disease (IBD), both in quiescent and active disease. Few fatigue scales have been tested in IBD. To assess three fatigue assessment scales in IBD and to determine correlates of fatigue. Potential participants (n = 2131) were randomly selected from an IBD organisation's members' database; 605 volunteered and were posted three fatigue scales: Inflammatory Bowel Disease Fatigue scale, Multidimensional Fatigue Inventory and Multidimensional Assessment Fatigue scale and questionnaires assessing anxiety, depression, quality of life (QoL) and IBD activity. The questionnaires were tested for stability over time with another group (n = 70) of invited participants. Internal consistency was measured by Cronbach's alpha and test-retest reliability by the intraclass correlation coefficient (ICC). Four hundred and sixty-five of 605 (77%) questionnaires were returned; of 70 invited, 48/70 returned test (68.6%) and 41/70 (58.6%) returned retest. The three scales are highly correlated (P < 0.001). Test-retest suggests reasonable agreement with ICC values between 0.65 and 0.84. Lower age, female gender, IBD diagnosis, anxiety, depression and QoL were associated with fatigue (P < 0.001) on univariable analysis. However, on multivariable analysis only depression and low QoL were consistently associated with fatigue, while female gender was associated on most scales. IBD diagnosis, age and other factors were not consistently associated with severity or impact of fatigue once other variables were controlled for. All three fatigue scales are likely to measure IBD fatigue adequately. Responsiveness to change has not been tested. Depression, poorer QoL and probably female gender are the major associations of fatigue in IBD. © 2015 John Wiley & Sons Ltd.
    No preview · Article · May 2015 · Alimentary Pharmacology & Therapeutics
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    ABSTRACT: A single self-rated health (SRH) assessment is associated with clinical outcome and mortality, but the biological process linking SRH with immune status remains incompletely understood. To examine the association between SRH and inflammation in apparently healthy individuals. Our analysis included 13,773 apparently healthy individuals attending the Tel Aviv Sourasky Medical Center for periodic health examinations. Estimated marginal means of the inflammation-sensitive biomarkers [i.e., highly sensitive C-reactive protein (hs-CRP) and fibrinogen] for the different SRH groups were calculated and adjusted for multiple potential confounders including risk factors, health behavior, socioeconomic status, and coexistent depression. The group with the lowest SRH had a significantly higher atherothrombotic profile and significantly higher conentrations of all inflammation-sensitive biomarkers in both genders. Hs-CRP was found to differ significantly between SRH groups in both genders even after gradual adjustments for all potential confounders. Fibrinogen differs significantly according to SRH in males only, with low absolute value differences. A valid association exists for apparently healthy individuals of both genders between inflammation-sensitive biomarker levels and SRH categories, especially when comparing levels of hs-CRP. Our findings underscore the importance of assessing SRH and treating it like other markers of poor health.
    No preview · Article · Apr 2015 · The Israel Medical Association journal: IMAJ
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    ABSTRACT: Recent international terror outbreaks notably involve long-term mental health risks to the exposed population, but whether physical health risks are also anticipated has remained unknown. Here, we report fear of terror-induced annual increases in resting heart rate (pulse), a notable risk factor of all-cause mortality. Partial least squares analysis based on 325 measured parameters successfully predicted annual pulse increases, inverse to the expected age-related pulse decline, in approximately 4.1% of a cohort of 17,380 apparently healthy active Israeli adults. Nonbiased hierarchical regression analysis among 27 of those parameters identified pertinent fear of terror combined with the inflammatory biomarker C-reactive protein as prominent coregulators of the observed annual pulse increases. In comparison, basal pulse primarily depended on general physiological parameters and reduced cholinergic control over anxiety and inflammation, together indicating that consistent exposure to terror threats ignites fear-induced exacerbation of preexisting neuro-immune risks of all-cause mortality.
    Full-text · Article · Dec 2014 · Proceedings of the National Academy of Sciences
  • Yaron Arbel · Shlomo Berliner · Shmuel Banai

    No preview · Article · Dec 2014 · The Canadian journal of cardiology
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    ABSTRACT: Past studies examining the effects of the metabolic syndrome (MS) on prognosis in postangiography patients were limited in size or were controversial in results. The aim of the study was to examine the association of the MS and the risk for long-term mortality in a large cohort of patients undergoing coronary angiography for various clinical indications. Medical history, physical examination, and laboratory values were used to diagnose patients with the MS. Cox regression models were used to analyze the effect of MS on long-term all-cause mortality. We prospectively recruited 3,525 consecutive patients with a mean age of 66 ± 22 years (range 24 to 97) and 72% men. Thirty percent of the cohort had MS. Patients with MS were more likely to have advanced coronary artery disease and acute coronary syndrome (p <0.001). Patients with MS had more abnormalities in their metabolic and inflammatory biomarkers regardless of their clinical presentation. A total of 495 deaths occurred during a mean follow-up period of 1,614 ± 709 days (median 1,780, interquartile range 1,030 to 2,178). MS was associated with an increased risk of death in the general cohort (hazard ratio [HR] 1.27, 95% confidence interval [CI] 1.01 to 1.56, p = 0.02). MS had a significant effect on mortality in stable patients (HR 1.55, 95% CI 1.1 to 2.18, p = 0.01), whereas it did not have a significant effect on mortality in patients with acute coronary syndrome (HR 1.11, 95% CI 0.86 to 1.44, p = 0.42). In conclusion, MS is associated with increased mortality in postangiography patients. Its adverse outcome is mainly seen in patients with stable angina. Copyright © 2014 Elsevier Inc. All rights reserved.
    No preview · Article · Nov 2014 · The American Journal of Cardiology
  • O. Raz · O. Rogovsky · T. Rosenzweig · I. Shapira · S. Berliner

    No preview · Article · Sep 2014
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    ABSTRACT: Background An increased serum glucose level in patients with acute coronary syndrome (ACS) is associated with adverse clinical outcome. This hyperglycemia has been attributed, at least in part, to acute stress reaction. Our objective was to determine whether hyperglycemia is a stress-related phenomenon or whether it represents a more sustained and possibly significant background dysglycemia.HypothesisHyperglycemia in patients undergoing coronary angiography is related to background dysglycemia.Methods Blood samples were obtained at the time of cardiac catheterization. Patients with hemoglobin A1c >6.5% were excluded to avoid patients with chronic glucose levels above 135 mg/dL. A logistic regression model was created to assess the influence of different variables on hyperglycemia (glucose levels above 140 mg/dL). We also evaluated the effect of glucose levels above 140 mg/dL on major adverse cardiovascular events (MACEs) up to 36 months.ResultsThere were 2554 consecutive patients prospectively recruited. Serum glucose levels above 140 mg/dL was a strong predictor of MACE (hazard ratio: 2.2, 95% confidence interval [CI]: 1.3-3.6, P = 0.002). Both diabetes mellitus and ACS were associated with hyperglycemia (glucose levels above 140 mg/dL). Nevertheless, the incidence of hyperglycemia was doubled in diabetic patients (odds ratio [OR]: 9.4, 95% CI: 3.9-22.4, P < 0.001) compared with patients with ACS (OR: 4.6, 95% CI: 2.3-9.0, P < 0.001). Combining both conditions was associated with a high likelihood of elevated glucose levels (OR: 15.5, 95% CI: 7.4-32.9, P < 0.001).Conclusions Hyperglycemia in patients undergoing cardiac catheterization is a strong predictor of adverse outcome. It is mainly related to background dysglycemia and to a lesser extent to the acute stress accompanying ACS.
    Full-text · Article · Aug 2014 · Clinical Cardiology
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    ABSTRACT: Introduction High RDW values are associated with adverse prognosis in many clinical conditions including short and medium term outcome of patients with ST Elevation Myocardial Infarction (STEMI). The aim of the present study was to evaluate the association between RDW and long term mortality in STEMI patients undergoing primary angioplasty (PPCI). Material and methods A cohort of 535 STEMI patients undergoing PPCI were divided into two groups (RDW > 14%, RDW ≤ 14%) using CHAID and CART methods. The association between RDW and 5-year all-cause mortality was assessed using Cox’s proportional hazards analysis. Results A total of 37 patients died during follow up of 5 years (mean: 1059, median: 1013, range 2–2130 days). RDW > 14% was associated with increased risk of all-cause mortality (HR = 5, CI 95% 2.7– 9.9, p < 0.001). In multivariate analysis, RDW > 14 remained significantly associated with increased risk for all-cause mortality (HR = 3.8, CI 95% 1.8– 7.99, p < 0.001). Patients with RDW above 14% did not have lower ejection fraction, higher CPK or more conventional risk factors. Conclusion RDW value above 14 is independently associated with increased long term all-cause mortality in patients with STEMI undergoing PPCI.
    No preview · Article · Aug 2014 · Thrombosis Research
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    ABSTRACT: Background Sub-clinical systemic inflammation has been implicated in the pathophysiology of obesity. In addition to impacting body weight, dietary modification may modulate markers of inflammation. Methods Overweight/obese adults were recruited to an eight-week dietary intervention characterized by energy restriction and increased complex carbohydrate intake. Blood samples for inflammatory and metabolic markers as well as anthropometric measurements were taken before and following the intervention. Results The study included 72 overweight or obese participants (BMI 31.8±5.8 kg/m2). Significant reductions from baseline weight, BMI, waist and hip circumference were observed following dietary intervention. Levels of inflammatory markers hs-CRP, ESR, WBC, and ICAM decreased significantly from baseline following the 8-week intervention. Metabolic measures including serum triglycerides, total and low density lipoprotein cholesterol significantly declined from baseline. Insulin and HOMA-IR declined in the subgroup of hyperinsulinemic participants. Conclusion An energy-restricted diet rich in complex carbohydrates is associated with weight loss, reduction of inflammatory markers and improved metabolic profile.
    Full-text · Article · Jul 2014 · Bioactive Carbohydrates and Dietary Fibre
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    ABSTRACT: Fatigue is one of the top complaints in inflammatory bowel disease (IBD) with 40% of patients in remission and 86% in active condition reporting fatigue.(1) However patients report that their complaints of fatigue are often not addressed in clinical consultations.(2) This study aimed to gain an understanding of healthcare practitioners' (HCPs) perception of IBD fatigue as experienced by people with IBD.
    No preview · Article · Jun 2014 · Gut
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    ABSTRACT: Background: Neutrophil/lymphocyte ratio (NLR) is a novel biomarker that can single out individuals at risk for vascular events. We assessed whether NLR provides additive prognostic value in patients with ST-elevation myocardial infarction (STEMI). Methods: NLR was computed from the absolute values of neutrophils and lymphocytes from the complete blood count of patients who underwent primary coronary angioplasty for STEMI. The cohort was divided into 2 groups according to NLR (NLR ≥ 6.5%, NLR < 6.5%) using χ(2) automatic interaction detection. The association between NLR and in-hospital clinical complications and left ventricular ejection fraction (EF) was assessed using logistic regression. The association between NLR, 30-day and 5-year all-cause mortality were analyzed using Cox regression models, adjusting for potential clinical, metabolic, and inflammatory confounders. Results: In a group of 538 consecutive STEMI patients, high NLR (NLR ≥ 6.5%) was independently associated with increased 30-day and 5-years mortality rates (odds ratio, 15.8; 95% confidence interval, 1.6-154; P = 0.018; and hazard ratio, 2.2; 95% confidence interval, 1.04-4.8; P = 0.039, respectively). High NLR was also independently associated with lower EF (49 ± 8 vs 46 ± 8; P < 0.001) and fewer hospital complications. Conclusions: In patients presenting with STEMI, high NLR was independently associated with lower EF, fewer hospital complications, and higher mortality rates up to 5 years. NLR value appears additive to conventional risk factors and commonly used biomarkers.
    No preview · Article · May 2014 · The Canadian journal of cardiology
  • Assi Milwidsky · Shlomo Berliner
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    ABSTRACT: Many patients with cardiovascular diseases are anemic to some extent. Anemia is a well-known prognostic marker for negative outcome in a variety of atherosclerotic and hearts diseases. The detrimental outcome of anemic patients with cardiovascular diseases may be a consequence of the anemia, for instance as a pro-ischemic condition. However, anemia may indicate a pro-thrombotic and pro-inflammatory condition which contributes to the progression of cardiovascular diseases in general and atherosclerosis in particular. In this review we investigate the association between anemia and cardiovascular diseases, its mechanisms and how to utilize it for better understanding, prediction and treatment.
    No preview · Article · May 2014 · Harefuah
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    Preview · Article · Apr 2014 · Journal of the American College of Cardiology
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    ABSTRACT: Background Neutrophil/lymphocyte ratio (NLR) is a novel biomarker that can single out individuals at risk for vascular events. We assessed whether NLR provides additive prognostic value in patients with ST elevation myocardial infarction (STEMI). Materials and methods NLR was computed from the absolute values of neutrophils and lymphocytes from the complete blood count of patients undergoing primary coronary angioplasty for STEMI. The cohort was divided into 2 groups according to NLR (NLR ≥6.5%, NLR<6.5%) using CHAID and CART methods. The association between NLR and in-hospital clinical complications and left ventricular ejection fraction (EF) was assessed by logistic regression. The association between NLR, 30 days and 5-year all-cause mortality were analyzed using Cox regression models, adjusting for potential clinical, metabolic, and inflammatory confounders. Results In a group of 538 consecutive STEMI patients, high NLR (NLR ≥6.5%) was independently associated with increased 30-day and 5-years mortality rates (OR= 15.8, CI 95% 1.6 – 154, p=0.018, and HR=2.2, CI 95% 1.04-4.8, p=0.039, respectively). High NLR was also independently associated with lower EF (49 ± 8 vs. 46 ± 8, p<0.001) and in hospital complications. Conclusion In patients presenting with STEMI, high neutrophil/lymphocyte ratio is independently associated with lower EF, in hospital complications, and higher mortality rates up to 5 years. NLR value appears additive to conventional risk factors and commonly used biomarkers.
    Full-text · Article · Apr 2014 · The Canadian journal of cardiology

Publication Stats

5k Citations
1,077.18 Total Impact Points

Institutions

  • 1994-2015
    • Tel Aviv Sourasky Medical Center
      • • Division of Internal Medicine
      • • Hematology
      • • Dana-Dwek Children's Hospital
      • • Institute of Gastroenterology
      Tell Afif, Tel Aviv, Israel
  • 1980-2015
    • Tel Aviv University
      • • Department of Internal Medicine
      • • Sackler Faculty of Medicine
      • • Department of Pathology
      Tell Afif, Tel Aviv, Israel
  • 2007
    • Università di Pisa
      Pisa, Tuscany, Italy
  • 1996
    • Rabin Medical Center
      Tell Afif, Tel Aviv, Israel