INTRODUCTIONRenal infarction is a rare and easily missed disease. There is even less meaningful information on renal infarction in the Asian population. Thus, the aim of this study was to clarify the clinical characteristics of the disease in Asian patients.

CLINICAL PICTUREOver a period of 10 years, 38 Chinese patients with renal infarction diagnosed by contract-enhanced CT or angiography were enrolled in this study. Their demographic data, clinical characteristics, laboratory and image results, risk factors or suspected causes, treatment and final outcomes were retrospectively reviewed. The results were also compared with the analogous Western data. The mean age of the sample population was 60.8 +/- 17.6 years, with patients aged over 50 years and males predominating. The most common symptoms/signs were abdominal (57.9%) and flank pain/tenderness (50%). Only 23.7% of patients had suffered previous thromboembolic events such as coronary or peripheral artery diseases, or cerebral infarction. Cardiogenic factors, such as atrial fibrillation, intra-cardiac thrombus, infective endocarditis and valvular heart disease, were the main causes of renal infarction (57.9%). The most common laboratory abnormalities were elevated serum LDH (92.1%) and proteinuria (76.3%). Only half of the cases involved haematuria at initial presentation.

TREATMENT AND OUTCOMEOne-third of the sample suffered renal impairment after the renal infarction. Overall mortality rate during admission was 13.2% (n = 5). The cause of death was usually not the renal infarction itself but rather the underlying disease and its complications. There was no difference in outcome for anticoagulation treatment with or without thrombolytics. Compared to their Western counterparts, the proportion of males (71.1% versus 48.3%) and bilateral renal infarctions (31.6% versus 12.4%) were significantly higher, and the percentage of leukocytosis (50% versus 85%) significantly lower in our Asian patients.

CONCLUSIONClinical presentation of renal infarction is usually non-specific and differs for Asian and Western populations. In our Asian patients, the most common clinical characteristics were abdominal pain/tenderness, flank pain/tenderness, elevated serum LDH and proteinuria. Early diagnosis and treatment are imperative because of the high rate of renal impairment and associated mortality. If this disease is suspected, contrast-enhanced CT is suggested to exclude or confirm renal infarction and anticoagulation alone is currently the favored treatment.

Abdominal Pain ; etiology ; Aged ; Cerebral Angiography ; Cohort Studies ; Female ; Flank Pain ; etiology ; Humans ; Infarction ; complications ; diagnostic imaging ; ethnology ; Kidney ; blood supply ; diagnostic imaging ; Male ; Middle Aged ; Retrospective Studies ; Taiwan ; Tomography, X-Ray Computed

BACKGROUNDPrior studies have demonstrated worse results of women in both hospital and short-term outcomes post-percutaneous coronary intervention. However, with advanced devices like drug-eluting stents (DESs) available, there are no consistent data revealing gender impact in outcome. This study examined whether gender affected hospital outcome and showed one-year single-center patient results of coronary stenting.

METHODSThe study group included 969 consecutive patients (250 women and 719 men) undergoing coronary stenting for stable or unstable angina. Clinical events were assessed for at least 1 year post-procedure.

RESULTSCompared to men, women were older, presented more often with diabetes, hypertension, dyslipidemia, and lower creatinine clearance rate (Ccr); they had less percutaneous transluminal coronary angioplasty (PTCA) history, smaller vessel size, and shorter lesions. The hospital major adverse cardiovascular event (MACE) rate was 2.8% of women and 0.97% of men (P = 0.037). The one-year MACE rate was 10.0% of women and 10.4% of men (P = 0.874). After adjusting other covariates, women still had significantly higher hospital MACE rates (P = 0.034) and odds ratios (0.18; 95% confidence interval: 0.036-0.874). In women (n = 250), there was no statistically significant difference in hospital or one-year MACE between bare metal stent (BMS) and DES groups. Meanwhile, in men (n = 719), DES had a significant one-year improvement of MACE compared to BMS (P = 0.004). The female hospital MACE rate was five times greater than male results. However, there were similar one-year outcomes between women and men. DES currently have an advantage in long-term outcome.

CONCLUSIONSCurrently, with the use of BMS and DES, adverse hospital post-procedure cardiovascular event rate has occurred more often in women than in men. However, the MACE rate differences between women and men resolved with one year follow-up.

Aged ; Angina Pectoris ; therapy ; Angina, Unstable ; therapy ; Angioplasty, Balloon, Coronary ; adverse effects ; Female ; Humans ; Male ; Middle Aged ; Sex Factors ; Treatment Outcome

Metabolic dysfunction-associated fatty liver disease (MAFLD) is an increasingly common liver disease worldwide. MAFLD is diagnosed based on the presence of steatosis on images, histological findings, or serum marker levels as well as the presence of at least one of the three metabolic features: overweight/obesity, type 2 diabetes mellitus, and metabolic risk factors. MAFLD is not only a liver disease but also a factor contributing to or related to cardiovascular diseases (CVD), which is the major etiology responsible for morbidity and mortality in patients with MAFLD. Hence, understanding the association between MAFLD and CVD, surveillance and risk stratification of MAFLD in patients with CVD, and assessment of the current status of MAFLD management are urgent requirements for both hepatologists and cardiologists. This Taiwan position statement reviews the literature and provides suggestions regarding the epidemiology, etiology, risk factors, risk stratification, nonpharmacological interventions, and potential drug treatments of MAFLD, focusing on its association with CVD.