Background: Arterial stiffness is a predictor of cardiovascular disease and is associated with atherosclerotic risk factors. The effects of atherosclerotic risk factors on vascular age and subsequent change were investigated in patients scored according to the cardio-ankle vascular index (CAVI).
Methods: Patients comprised 181 men and 116 women scored according to the CAVI twice at our center. All were divided into the following 3 groups based on vascular age as evaluated according their CAVI score: low vascular age (LVA); equivalent vascular age (EVA); or high vascular age (HVA). They were then divided into the following 3 groups by comparing vascular age evaluated one year later with that obtained at the initial evaluation: change upward; no change; or change downward. The mean values of atherosclerotic risk factors and changes were compared among each group. Atherosclerotic risk factors comprised atherosclerosis-related diseases (hypertension, dyslipidemia, and diabetes), age, height, weight, Body Mass Index (BMI) score, abdominal circumference, Risk Factor (RF) score (number of atherosclerotic risk factors), metabolic score (propensity to metabolic syndrome), blood pressure (BP), cholesterol, triglyceride, fasting blood sugar (FBS), HbA1c, and smoking score.
Results: In men, the LVA group showed a lower RF score, metabolic score, BP, FBS, and HbA1c, and a higher HDL-cholesterol (HDL-C) score. Vascular age changed upward with increasing HDL-C and downward with increasing abdominal circumference. In women, the LVA group showed a higher BMI score.
Conclusions: The effects of atherosclerotic risk factors on vascular age were greater in men. In women, the BMI score was associated with vascular age.
Background: Patients with gastrointestinal cancer tend to develop thrombotic diseases. Endoscopic submucosal dissection (ESD) to treat gastrointestinal lesions is thought to put patients at possible risk for thrombosis because the same posture must be maintained for long periods.
Objectives: We aimed to clarify the incidence of thrombosis and hypercoagulation after ESD to treat gastrointestinal neoplasms.
Methods: We selected 565 consecutive patients with esophageal (76 patients), gastric (274 patients) or colorectal (215 patients) neoplasms that were treated by ESD between April, 2010 and October, 2018. We determined the prevalence of thrombosis at six months after ESD from medical charts and compared plasma d-dimer values (when available) before and immediately after ESD.
Results: Thrombotic events did not arise in any patients after ESD. Pre- and postoperative ddimer was found in 100 patients. Values for d-dimer were high before, and significantly elevated after ESD in 24 and 35 of 100 patients, respectively. Multivariate analysis associated antithrombotic agents and age ≥75 years with high preoperative d-dimer values, and identified upper gastrointestinal lesions and underlying chronic kidney disease as significant factors related to elevated ddimer level.
Conclusions: We found that ESD is safe and that early-stage gastrointestinal cancer is not a high risk for thrombosis. Upper gastrointestinal lesions and chronic kidney disease seem to be predisposing factors for hypercoagulation states, indicating that endoscopists should consider the possibility of thrombosis after ESD in such patients.