Haralampos Milionis | University of Ioannina/Greece (original) (raw)

Papers by Haralampos Milionis

Objectives. Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mort... more Objectives. Rheumatoid arthritis (RA) associates with excessive cardiovascular morbidity and mortality. Hypertension (HT) contributes significantly to the development of cardiovascular disease (CVD). Little is known about the factors that influence blood pressure (BP) in patients with RA. In this study, we assessed the prevalence of HT in a secondary care cohort of RA patients, and aimed to identify factors associated

Expert opinion on biological therapy, 2015

Statins reduce low-density lipoprotein cholesterol (LDL-C) and are currently the mainstay in the ... more Statins reduce low-density lipoprotein cholesterol (LDL-C) and are currently the mainstay in the treatment of hyperlipidaemia and subsequently the prevention of atherosclerotic cardiovascular disease (CVD). Nevertheless, there is a need to further lower LDL-C, especially in subjects with severe forms of hypercholesterolaemia despite maximum doses of conventional drugs and/or in those intolerant to existing therapies. Emerging therapeutic approaches to lowering LDL-C involve blocking LDL-receptor degradation by serum proprotein convertase subtilisin kexin 9 (PCSK9). Human monoclonal antibodies that target PCSK9 and its interaction with the LDL-receptor (AMG145, REGN727 and RN316) have been tested in Phase I - III clinical trials for the treatment of hyperlipidaemia in patients at high CVD risk. These new agents are administered subcutaneously and have been shown to have major LDL-C and apoB lowering effects either alone or in combination with statins. These novel agents are generally...

Annals of gastroenterology : quarterly publication of the Hellenic Society of Gastroenterology, 2011

INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC INFLAMMATORY DISORDER WHICH ENCOMPASSES TWO FORMS O... more INFLAMMATORY BOWEL DISEASE (IBD) IS A CHRONIC INFLAMMATORY DISORDER WHICH ENCOMPASSES TWO FORMS OF INTESTINAL INFLAMMATION: ulcerative colitis and Crohn's disease. It is reported that inflammation, carotid intima media thickness, homocysteine and insulin resistance, parameters that are all associated with atherosclerosis, are increased in IBD. On the contrary, it seems that IBD patients exhibit low levels of low density lipoprotein cholesterol and total cholesterol. This review highlights the lipid profiles that occur in IBD patients and summarizes data of studies using regimens that may affect lipid metabolism in these patients.

Journal of cardiovascular pharmacology and therapeutics, 2008

Statins, in addition to their beneficial lipid modulation effects, exert a variety of several so-... more Statins, in addition to their beneficial lipid modulation effects, exert a variety of several so-called "pleiotropic" actions that may result in clinical benefits. Rosuvastatin, the last agent of the class to be introduced, has proved remarkably potent in reducing low-density lipoprotein cholesterol levels. At present, no large-scale primary or secondary prevention clinical trials document either its long-term safety or its effectiveness in preventing cardiovascular events. A substantial number of experimental and clinical studies have indicate favorable effects of rosuvastatin on endothelial function, oxidized low-density lipoprotein, inflammation, plaque stability, vascular remodeling, hemostasis, cardiac muscle, and components of the nervous system. Available data regarding the effects of rosuvastatin on renal function and urine protein excretion do not seem to raise any safety concerns. Whether the established "pleiotropy" and/or lipid-lowering efficacy of ro...

Angiology

The authors investigated the effects of rosuvastatin, beyond its lipid-lowering activity, on seve... more The authors investigated the effects of rosuvastatin, beyond its lipid-lowering activity, on several nonlipid metabolic variables, along with its safety and tolerability, in patients treated for primary hyperlipidemia. Patients (n = 55) with primary hyperlipidemia were open-label assigned to the recommended starting dose of rosuvastatin 10 mg/day, and serum metabolic variables were measured at baseline and after 8 and 20 weeks. Treatment with rosuvastatin produced significant reductions in total cholesterol, low-density lipoprotein cholesterol (LDL-C), apolipoprotein B, nonhigh-density lipoprotein cholesterol (non HDL-C), and triglyceride concentrations, whereas HDL-C, apolipoprotein A-I, and lipoprotein(a) levels did not change significantly from baseline. The LDL-C treatment target was achieved in 71% of patients. No significant variations in renal function parameters (serum creatinine and creatinine clearance), insulin resistance estimates, and serum concentrations of uric acid, ...

Current pharmaceutical design, 2003

There is growing evidence that the components of the haemostatic system play a significant role i... more There is growing evidence that the components of the haemostatic system play a significant role in the development and progression of atherosclerosis and its complications. Lipid-lowering interventions have been associated with a significant reduction of morbidity and mortality. However, the improvement in cardiovascular risk seen in several clinical trials is incompletely explained by cholesterol reduction. Therefore, the benefit from lipid lowering drugs may involve non-lipid mechanisms. These include beneficial effects on the arterial wall, improved endothelial function and a favourable influence on blood rheology and thrombogenesis. In this review, we consider the influence of lipid-lowering interventions on rheological and haemostatic parameters as well as the potential clinical relevance of these effects.

Thyroid : official journal of the American Thyroid Association, 2003

The increased risk for ischemic heart disease (IHD) associated with subclinical hypothyroidism (S... more The increased risk for ischemic heart disease (IHD) associated with subclinical hypothyroidism (SH) has been partly attributed to dyslipidemia. There is limited information on the effect of SH on lipoprotein (a) [Lp(a)], which is considered a significant predictor of IHD. Serum Lp(a) levels are predominantly regulated by apolipoprotein [apo(a)] gene polymorphisms. The aim of our study was to evaluate the Lp(a) levels and apo(a) phenotypes in patients with SH compared to healthy controls as well as the influence of levothyroxine substitution therapy on Lp(a) values in relation to the apo(a) isoform size. Lp(a) levels were measured in 69 patients with SH before and after restoration of a euthyroid state and in 83 age- and gender-matched healthy controls. Apo(a) isoform size was determined by sodium dodecyl sulfate (SDS) agarose gel electrophoresis followed by immunoblotting and development via chemiluminescence. Patients with SH exhibited increased Lp(a) levels compared to controls (m...

Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2003

Acid-base and potassium disturbances are common in patients with uncontrolled diabetes mellitus .

CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne, Jan 16, 2002

Hyponatremia (serum sodium level less than 134 mmol/L) is a common electrolyte disturbance. Its h... more Hyponatremia (serum sodium level less than 134 mmol/L) is a common electrolyte disturbance. Its high prevalence and potential neurologic sequelae make a logical and rigorous differential diagnosis mandatory before any therapeutic intervention. A history of concurrent illness and medication use as well as the assessment of extracellular volume status on physical examination may provide useful clues as to the pathogenesis of hyponatremia. Measurement of the effective serum tonicity (serum osmolality less serum urea level) is the first step in the laboratory evaluation. In patients with normal or elevated effective serum osmolality (280 mOsm/kg or greater), pseudohyponatremia should be excluded. In the hypo-osmolar state (serum osmolality less than 280 mOsm/kg), urine osmolality is used to determine whether water excretion is normal or impaired. A urine osmolality value of less than 100 mOsm/kg indicates complete and appropriate suppression of antidiuretic hormone secretion. A urine so...

European journal of heart failure, 2002

Patients with severe decompensated congestive heart failure (CHF) commonly exhibit acid-base and ... more Patients with severe decompensated congestive heart failure (CHF) commonly exhibit acid-base and electrolyte disturbances mainly due to the activation of several neurohumoral mechanisms as well as to drugs regularly used in this population. Magnesium deficit is not infrequently observed in CHF patients but its pathophysiology remains less well-studied as compared with other electrolyte alterations, such as hypokalemia. However, there is evidence that early detection and correction of magnesium abnormalities could obviate potentially deleterious arrhythmogenic effects. To assess the incidence of magnesium level disorders and analyze the underlying pathophysiological mechanisms in patients with CHF. Eighty-six consecutive CHF patients (NYHA class III or IV) admitted to our hospital over a period of 5 years were studied. Patients with diabetes mellitus, liver or renal failure, and chronic obstructive lung disease were excluded. All patients received conventional treatment with digoxin,...

CNS spectrums, 2008

Current evidence from epidemiological, neuroimaging, pathological, pharmacotherapeutic, and clini... more Current evidence from epidemiological, neuroimaging, pathological, pharmacotherapeutic, and clinical studies indicate an association of Alzheimer's disease with risk factors of vascular atherosclerotic disease either in isolation or in aggregate. "Metabolic syndrome" (MetS) is the name for a clustering of risk factors for cardiovascular disease and type 2 diabetes that are of metabolic origin. These include central obesity, elevated plasma glucose, high blood pressure, atherogenic dyslipidemia, a prothrombotic state, and a proinflammatory state. In this article, we provide an overview of the relevant literature with regard to the relationship of Alzheimer's disease with MetS. Accumulating evidence suggests a "vascular hypothesis" to be related to the pathology of Alzheimer's disease. In the light of this evidence, clinician may consider lifestyle interventions toward an early and effective cardiovascular risk-factor management to reduce the cardiometa...

Appetite, 2014

The aim of the present work was to evaluate the combined role of eating behaviors and to investig... more The aim of the present work was to evaluate the combined role of eating behaviors and to investigate their effect on the likelihood of developing an acute coronary syndrome (ACS) or an ischemic stroke. During 2009-2010, 1000 participants were enrolled; 250 consecutive patients with a first ACS (83% males, 60 ± 12 years) and 250 control subjects, as well as 250 consecutive patients with a first ischemic stroke (56% males, 77 ± 9 years) and 250 controls. The controls were population-based and age-sex matched with the patients. Detailed information regarding their anthropometric data, medical records and lifestyle characteristics (dietary and smoking habits, physical activity, psychological state and eating practices -using a special questionnaire-) were recorded. Five eating behaviors were selected to compose an eating behavior score for the purposes of this work: adherence to the Mediterranean diet (using the MedDietScore), frequency of breakfast consumption, eating while being stres...

Journal of Cardiovascular Pharmacology and Therapeutics, 2007

Concerns have been raised because of observations of proteinuria associated with rosuvastatin tre... more Concerns have been raised because of observations of proteinuria associated with rosuvastatin treatment. In this open-label study, a potential dose-dependent effect was investigated of rosuvastatin on urinary protein excretion and renal function parameters in 90 hyperlipidemic patients randomly assigned to rosuvastatin 10 mg/day (n = 45) or 20 mg/day (n = 45). Urinary samples were collected from patients and 40 age- and gender-matched controls to determine electrolyte, uric acid, creatinine, and protein (total, albumin, IgG, and alpha1-microglobulin) levels at baseline and after 12 weeks. A dose-dependent increase in the excretion of alpha1-microglobulin (17.6% in rosuvastatin 10 vs 34.9% in rosuvastatin, 20 mg/day; P = .03 for the comparison between groups) was observed. A trend toward an increase in the estimated glomerular filtration rate was noted in only patients receiving 20 mg/day of rosuvastatin. These findings indicate that rosuvastatin treatment increases the urinary excretion of alpha1-microglobulin urinary excretion in a dose-dependent manner without adversely affecting renal function.

Atherosclerosis Supplements, 2006

in the primary end point (N=3086, HR=0.84, 95 % CI=0.70-1.0) was observed in atorvastatin-treated... more in the primary end point (N=3086, HR=0.84, 95 % CI=0.70-1.0) was observed in atorvastatin-treated patients vs placebo. In 1672 patients >65 years, a corresponding 14% RRR was observed (HR=0.86, 95% CI=0.70-1.07). in 1414 patients <65 years, there was a 22% RRR (HR=0.78, 95% CI=0.56-1.06). The treatment-by-age test for heterogeneity was not significant (P>0.5), indicating no evidence of difference in treatment effect by age. The number of strokes in the trim was small. However, in the placebo arm, stroke incidence was three-times higher among patients >65 years (2.1%) than patients <65 years (0.7%). The corresponding rates for MI in the placebo arm were 9.1% for the >65 group and 5.2% for the <65 group. Absolute risk reduction with atorvastatin was similar in patients < or >65 years (2.5% and 2.9%, respectively). The safety profile of atorvastatin was simibx in both age groups.

Neurology, 2015

Objective: We aimed to investigate the association between leukoaraiosis and long-term risk of st... more Objective: We aimed to investigate the association between leukoaraiosis and long-term risk of stroke recurrence adjusting for clinical scores developed and validated for the prediction of stroke risk, such as CHADS 2 (congestive heart failure, hypertension, age 75years,diabetesmellitus,andstrokeorTIA)andCHA2DS2−VASc(congestiveheartfailure,hypertension,age75 years, diabetes mellitus, and stroke or TIA) and CHA 2 DS 2 -VASc (congestive heart failure, hypertension, age 75years,diabetesmellitus,andstrokeorTIA)andCHA2DS2−VASc(congestiveheartfailure,hypertension,age75 years, diabetes mellitus, stroke or TIA, vascular disease, age 65-74 years, sex category).

Kidney International, 1999

Plasma and Lp(a)-associated PAF-acetylhydrolase activity in uremic patients undergoing different ... more Plasma and Lp(a)-associated PAF-acetylhydrolase activity in uremic patients undergoing different dialysis procedures.BackgroundPlatelet-activating factor (PAF) is a potent inflammatory mediator associated with several physiopathological conditions, including renal diseases. PAF is degraded to the inactive metabolite lyso-PAF by PAF-acetylhydrolase (PAF-AH), which is considered as a potent anti-inflammatory and anti-atherogenic enzyme associated with lipoproteins. In this study, we evaluated the plasma- and lipoprotein(a)

Cortex, 2007

Design A prospective study. Methods We estimated the impact of smoking cessation on long-term mor... more Design A prospective study. Methods We estimated the impact of smoking cessation on long-term mortality and the need for a revascularization procedure in 1027 patients undergoing a first-ever coronary artery bypass-grafting. Results and discussion Of the 640 active smokers, 44.7% continued smoking after CABG ('current smokers'), and 55.3% quit. During a 5310 patient-years follow-up, with never smokers as the reference group, current smokers (but not quitters) experienced a significant increase in total mortality (hazard ratio 2.6, 95% confidence interval 1.0-6.6) mainly owing to increased cardiovascular mortality (hazard ratio 4.8, 95% confidence interval 1.1-21.4), as well as increased need for a repeat revascularization procedure (hazard ratio 1.7, 95% confidence interval 1.0-2.9). Eur J Cardiovasc Prev Rehabil 14:448-450

European Journal of Internal Medicine, 2011

ObjectiveTo test the hypothesis that Helicobacter pylori infection is associated with a higher ra... more ObjectiveTo test the hypothesis that Helicobacter pylori infection is associated with a higher rate of documented cardiovascular disease (CVD) in subjects undergoing elective upper gastrointestinal endoscopy.

Koulouras and Miltiadis I. Matsagkas Eleni Arnaoutoglou, Nektarios Papas, Haralampos Milionis, Ge... more Koulouras and Miltiadis I. Matsagkas Eleni Arnaoutoglou, Nektarios Papas, Haralampos Milionis, George Kouvelos, Vasilios for postdischarge surveillance Post-implantation syndrome after endovascular repair of aortic aneurysms: need http://icvts.ctsnetjournals.org/cgi/content/full/11/4/449 located on the World Wide Web at: