Relation of Adiponectin to Cardiovascular Events and Mortality in Patients With Acute Coronary Syndrome.

The association between serum adiponectin levels and cardiovascular events, particularly how adiponectin predicts the development of cardiovascular events and mortality in acute coronary syndrome (ACS) patients remains unresolved. Hence, we aimed to determine whether higher adiponectin levels predict cardiovascular events and mortality in these patients. Regression analyses were performed to clarify adiponectin's ability to predict cardiovascular events and mortality among 1,641 ACS patients. Subgroup analyses were performed according to gender, age, and body mass index (BMI). The primary end point was a composite of the first all-cause death, nonfatal myocardial infarction, or nonfatal stroke event. The secondary end point was all-cause death. Hazard ratios for the primary and secondary end points per 5-µg/ml increase in adiponectin levels were 1.31 (95% confidence interval [CI], 1.13 to 1.47; p = 0.0007) and 1.32 (95% CI, 1.13 to 1.51; p = 0.001), respectively. Higher adiponectin levels were associated with increased cardiovascular events in men, patients aged ≥65 years, and those with BMI <25 kg/m2. In conclusion, higher adiponectin levels were associated with increased cardiovascular events and all-cause mortality in ACS patients. Its predictive ability might be limited in women, patients aged <65 years, and patients with BMI ≥25 kg/m2.

Successful Retrieval of a Dismembered Central Venous Catheter Stuck to the Right Pulmonary Artery Using a Stepwise Approach.

Recent advances in anticancer chemotherapy have resulted in an increase in the number of patients requiring a central venous port catheter, and the incidence of catheter pinch-off syndrome has been increasing. Catheter pinch-off syndrome is a rare and unusual complication. It is difficult to retrieve dislodged catheters from the pulmonary artery, especially if the catheter is stuck to the peripheral pulmonary artery. We herein describe the successful removal of a catheter stuck in the pulmonary artery with a stepwise approach. First, a pigtail catheter was used to tug the dislodged catheter in order to free the unilateral end. Then, a gooseneck snare was used to catch and pull the catheter out of the patient. The key to success is to free the end of the catheter.

Thyroid Echography-induced Thyroid Storm and Exacerbation of Acute Heart Failure.

Hyperthyroidism and thyroid storm affect cardiac circulation in some conditions. Several factors including trauma can induce thyroid storms. We herein describe the case of a 57-year-old woman who experienced a thyroid storm and exacerbation of acute heart failure on thyroid echography. She initially demonstrated a good clinical course after medical rate control for atrial fibrillation; however, thyroid echography for evaluating hyperthyroidism led to a thyroid storm and she collapsed. A multidisciplinary approach stabilized her thyroid hormone levels and hemodynamics. Thus, the medical staff should be prepared for a deterioration in the patient's condition during thyroid echography in heart failure patients with hyperthyroidism.

The usefulness of a perfusion balloon in a case of late stent thrombosis that caused simultaneous double vessel occlusion.

Simultaneous stent thrombosis in different coronary arteries requires rapid management. A 70-year-old man experienced simultaneous stent thrombosis at the left anterior descending and circumflex arteries. We used a perfusion balloon to prevent thrombus production at the left anterior descending artery, and completed percutaneous coronary intervention at the left circumflex artery in 10 min. The perfusion balloon was dilated during the procedure. In both vessels, Thrombolysis in myocardial infarction flow grade 3 was achieved after balloon deflation. Thus, use of a perfusion balloon for simultaneous double vessel occlusion helped avoid the need for redundant stent placement and shortened the procedure time.