Acute inferior myocardial infarction after electrical weapon exposure: case report and review of the literature.

The use of conducted electrical weapons (CEWs) by legal security forces and in civil society is rapidly increasing. While they are generally considered safe devices, and fatal complications are rare, it is possible to see a small number of complications. In the present case, we describe the detection of acute inferior myocardial infarction in a patient who experienced chest pain after being exposed to a CEW. In such cases, multiple factors should be considered, and the choice of treatment and follow-up should be decided accordingly.

The Association between Subclinical Hypothyroidism and Epicardial Adipose Tissue Thickness.

BACKGROUND AND OBJECTIVES: Subclinical hypothyroidism (SH) is considered to be a potential risk factor for cardiovascular disease. Epicardial adipose tissue (EAT) thickness is also closely related to cardiovascular disorders. The aim of this study was to evaluate whether SH is associated with higher EAT thickness. SUBJECTS AND METHODS: Fifty-one consecutive patients with SH and 51 healthy control subjects were prospectively enrolled into this trial. Thyroid hormone levels, lipid parameters, body mass index, waist and neck circumference, and EAT thickness measured by echocardiography were recorded in all subjects. RESULTS: Mean EAT thickness was increased in the SH group compared to the control group (6.7±1.4 mm vs. 4.7±1.2 mm, p<0.001). EAT thickness was shown to be correlated with thyroid stimulating hormone level (r=0.303, p=0.002). Multivariate logistic regression analysis revealed that EAT thickness was independently associated with SH {odds ratio (OR): 3.87, 95% confidence interval (CI): 1.92-7.78, p<0.001; OR: 3.80, 95% CI: 2.18-6.62, p<0.001}. CONCLUSION: Epicardial adipose tissue thickness is increased in patients with SH compared to control subjects, and this increase in EAT thickness may be associated with the potential cardiovascular adverse effects of SH.

Predictive Value of the No-Reflow Phenomenon and Epicardial Adipose Tissue for Clinical Outcomes After Primary Percutaneous Coronary Intervention.

INTRODUCTION: The determinants of clinical outcomes in patients with acute ST-elevation myocardial infarction (STEMI) are still being debated. The aim of this study was to investigate the prognostic value of the no-reflow phenomenon and epicardial adipose tissue (EAT) thickness for clinical outcomes in patients undergoing primary percutaneous coronary intervention (pPCI) for STEMI. METHODS: The present study prospectively included 114 consecutive patients (mean age 54 ± 10 years, 15 women) who underwent successful pPCI. Patients were divided into two groups according to the occurrence of the no-reflow phenomenon and further subdivided according to the tertile of EAT thickness (Group I <5.1 mm, Group II ≥5.1 mm). We assessed the composite and separate occurrence of major adverse cardiac events. RESULTS: Throughout the 3-year follow up, the number of admissions for heart failure was significantly higher in patients with no-reflow (n=5 [20%] vs. n=1 [1%], p=0.003) and in female patients (n=4 [26%] vs. n=2 [2%], p=0.004). In the subgroup analysis, group I patients with no-reflow showed a higher frequency of admission for heart failure (n=4 [44%] vs. n=1 [6%], p=0.04). However, multivariate logistic regression analysis demonstrated that only no-reflow and female sex independently predicted admission for heart failure (OR: 19.3, 95%CI: 1.4-269.7, p=0.03, and OR: 24.9, 95%CI: 2.2-288.8, p=0.01, respectively). CONCLUSION: No-reflow and female sex are independent predictors of admission for heart failure in the longterm follow up of patients with STEMI. However, EAT thickness is not associated with clinical outcomes after pPCI.