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Biomedical subjects

Hans Mickley

Publications and source records attributed to Hans Mickley.

22 records · Page 2Linked to original sources
PubMed2003

[Troponin elevation--differential diagnostic considerations and prognostic importance].

It has become increasingly evident that elevation of troponins can be demonstrated in other diseases than acute myocardial infarction. In this review we wanted to assess the prevalence and the clinical importance of troponin elevations in patients with mainly extra-cardiac organ manifestations. Only in chronic renal failure there appears to be evidence to support the conclusion that high levels of troponins are associated with an adverse clinical outcome. The mechanisms underlying the rise in troponins in non-cardiac diseases origin are unknown. One explanation could be that the patients involved have ischemic heart disease as co-morbidity. Severe stress caused by an acute non-cardiac clinical event may result in a minor leakage of myocardial markers. It is essential to perform a careful clinical evaluation in the case of patients with unexpected high levels of cardiac troponins.

Biomarkers↗
PubMed2002

[Incidence and treatment of sexual dysfunction in heart disease].

Several links have been established between sexual dysfunction and heart disease. Indeed, many risk factors for developing sexual dysfunction are shared by coronary artery disease: age, smoking, diabetes, hypertension, and hypercholesterolaemia. It should also be borne in mind that in men several cardiac drugs are responsible for erectile dysfunction (ED). Lastly it should be remembered that treatment of ED may be associated with cardiovascular side-effects. Data from the literature show that men with coronary artery disease, hypertension or diabetes have an up to fourfold higher risk of developing ED than have age-matched controls. Thiazide diuretics and beta-blockers are the most common drugs that produce ED. Current therapies for ED are safe and effective in the large majority of patients with cardiovascular disease. However, the concomitant use of nitrates and sildenafil may be life-threatening, and nitrate therapy is therefore contra-indicated in patients taking sildenafil--and vice versa.

Adult↗
PubMed2002

Improvement of risk-stratification by use of a new combination of Holter variables in survivors of myocardial infarction.

OBJECTIVE: Holter monitoring is one option in risk-stratification after acute myocardial infarction (MI). Measurements of heart rate variability (HRV), ventricular tachycardia (VT) and ST-segment elevation (ST upward arrow ) have been useful in predicting clinical outcome. We investigated if a combination of different Holter variables could optimize risk-stratification. DESIGN: One hundred and twenty-one men < 70 years old with a first MI were studied. Holter monitoring for 24 h was started 11 +/- 5 days after MI and analysed for HRV, VT and ST. Follow-up was 10-12 years with cardiac death as endpoint. RESULTS: Thirty-six patients were positive for > or = 1 Holter variable (HRV in 15, VT in 16, ST in 10). At follow-up 22 cardiac deaths had occurred. The prognostic sensitivity of individual Holter variables ranged from 23 to 36%, but increased to 64% if combined. The cardiac death rate in Holter positive patients (39%) was significantly higher than in Holter negative patients (9%) (p < 0.0001). CONCLUSION: By combining measurements of HRV, VT and ST the prognostic importance of Holter monitoring can be significantly improved. The patients can be stratified in a low-risk group with an annual mortality < 1% vs a high-risk group with a cardiac death rate around 40% over the following decade.

Aged↗