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BACKGROUND: The effect of physiological circulatory changes during pregnancy on hypertrophic cardiomyopathy (HCM) has been reported with limited data. This study aimed to provide information regarding outcomes of pregnant women with HCM and to identify predictors of major adverse cardiac event (MACE). METHODS: A total of 45 pregnancies with HCM were retrospectively reviewed. The primary endpoint was a MACE that occurred within an 8week period after delivery, including maternal death, heart failure (HF), syncope, and malignant ventricular arrhythmias (VAs). Baseline and outcome data were analyzed for all patients. Patients with and without MACE were compared, and patients with obstructive HCM were compared with those who had non-obstructive HCM. The study population was divided into two subgroups of patients having or not having an implantable cardioverter defibrillator implantation (ICD). RESULTS: At least one MACE occurred in 11 patients (24.4%); six patients developed HF (13.3%), six had a ventricular tachyarrhythmia (13.3%), and two had syncope (4.4%). New York Heart Association functional class of ≥â¯II, presence of HF signs before pregnancy, increased left ventricular outflow tract (LVOT) gradient were significantly associated with MACE. Fatal VAs were seen during pregnancy in one of five HCM patients with ICD. In the ROC curve analysis, an LVOT gradient higher than 53.5â¯mmâ¯Hg predicted the presence of MACE with a sensitivity of 90.9% and a specificity of 73.5%. This study is the largest series in the literature representing pregnant women who had HCM and ICD. CONCLUSION: The current data suggest that HF and high LVOT gradients are important risk factors for the development of cardiac complications.
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Cardiomiopatía Hipertrófica , Insuficiencia Cardíaca , Taquicardia Ventricular , Humanos , Femenino , Embarazo , Mujeres Embarazadas , Estudios Retrospectivos , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/diagnóstico , Cardiomiopatía Hipertrófica/terapia , Arritmias Cardíacas/diagnóstico , Insuficiencia Cardíaca/complicaciones , Muerte Súbita Cardíaca/epidemiología , Muerte Súbita Cardíaca/prevención & control , Muerte Súbita Cardíaca/etiologíaRESUMEN
BACKGROUND: Carotid artery stenting is a minimally invasive, durable alternative treatment option, which is an alternative to the reference method, carotid endarterectomy, for patients with carotid artery stenosis; however, silent new ischemic cerebral lesions (SNICLs) after carotid artery stenting remain as a matter of concern. Hence, we aimed to assess the effect of complex vascular anatomy on silent new ischemic cerebral lesions in carotid artery stenting procedures. METHODS: We prospectively evaluated 122 patients (mean age: 69.5 ± 7.1 years, male:83) who underwent carotid artery stenting for carotid artery revascularization. The patients having symptomatic transient ischemic attack or stroke after carotid artery stenting were excluded. The presence of a new hyperintense lesions on diffusion-weighted imaging without any neurological findings was considered as the SNICL. Patients were classified into two groups as DWI-positive and DWI-negative patients. RESULTS: Among the study population, 32 patients (26.2%) had SNICLs. The DWI-positive group had a significantly higher common carotid artery (CCA)-internal carotid artery (ICA) angle, older age, more frequent history of stroke, a higher proportion of type III aortic arch, and longer fluoroscopy time than the DWI-negative group. High CCA-ICA angle was identified as one of the independent predictors of SNICL (OR (odds ratio) = 1.103 95%CI (confidence interval): (1.023-1.596); p = 0.034), and CCA-ICA angle higher than 34.5 degrees predicted SNICL with a sensitivity of 62.5% and a specificity of 62.2% (area under the curve: 0.680; 95% CI: 0.570 to 0.789; p = 0.003). CONCLUSIONS: The higher CCA-ICA angle may predict pre-procedure SNICL risk in carotid artery stenting and may have clinical value in the management of patients with carotid artery stenosis.
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Isquemia Encefálica , Estenosis Carotídea , Anciano , Isquemia Encefálica/diagnóstico por imagen , Isquemia Encefálica/epidemiología , Isquemia Encefálica/etiología , Arterias Carótidas/cirugía , Estenosis Carotídea/cirugía , Estenosis Carotídea/terapia , Imagen de Difusión por Resonancia Magnética , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Stents , Resultado del TratamientoRESUMEN
Left atrial appendage (LAA) is a common site of thrombus formation especially in patients with atrial fibrillation (AF). Complete surgical LAA closure (cSLC) is the surgical aim, however incomplete surgical LAA closure (iSLC) is not rare. In this study, we aimed to evaluate the risk of thromboembolic complications (TEC) in AF patients with iSLC after mitral valve surgery. A total of 101 AF patients (mean age: 61.8 ± 11.8 years; male:32), who underwent surgical suture ligation during mitral valve surgery were enrolled in this retrospective study. All patients underwent transthoracic and transesophageal echocardiography (TEE) at least 3 months after surgery. The primary outcome was the occurrence of TEC including any ischemic stroke, transient ischemic attack, coronary or peripheral embolism. TEE examination revealed cSLC in 66 (65.3%) and iSLC in 35 patients (34.6%). A total of 12 TECs (11.9%) occurred during a mean follow-up time of 41.1 ± 15.6 months. TECs were found to be significantly higher in the iSLC group (25.7% vs 4.5%, p = 0.002). The prevalence of iSLC was significantly higher in patients with TEC (75 vs. 29.2%, p = 0.002). High CHA2DS2-VASc Score and iSLC were found to be independent predictors of TEC. Long term TEC free survival was found to be significantly decreased in patients with iSLC. The presence of iSLC was associated with a significantly increased risk of TEC in AF patients after mitral valve surgery. Routine intraoperative and postoperative screening for iSLC by TEE and long-term strict anticoagulation therapy are recommended in these patients.
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Apéndice Atrial , Fibrilación Atrial , Tromboembolia , Anciano , Apéndice Atrial/diagnóstico por imagen , Apéndice Atrial/cirugía , Fibrilación Atrial/cirugía , Ecocardiografía Transesofágica , Humanos , Masculino , Persona de Mediana Edad , Válvula Mitral/diagnóstico por imagen , Válvula Mitral/cirugía , Sistema de Registros , Estudios Retrospectivos , Tromboembolia/epidemiología , Tromboembolia/etiologíaRESUMEN
Right atrial appendage (RAA) aneurysm is a rare congenital cardiac abnormality thought to be caused by dysplasia of the muscular wall of the RA and RAA. Structural, contractile, or electrical atrial changes are associated with the onset and progression of atrial fibrillation. The RAA aneurysm can have various symptoms, such as thromboembolic complications. Diagnosis of RAA aneurysm greatly depends on imaging modalities, among which echocardiography is the most widely used one. Echocardiography is very effective in discovering the aneurysm, distinguishing it from other abnormalities such as pericardial cysts, Ebstein's anomaly and cor triatriatum, and detecting intracardiac thrombosis or blood flow limitations. Cardiac magnetic resonance imaging and computed tomography are important complementary examinations. They may provide more details on the neighboring structures of the aneurysm, especially when echocardiographic images are suboptimal.
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Apéndice Atrial , Anomalía de Ebstein , Aneurisma Cardíaco , Apéndice Atrial/diagnóstico por imagen , Ecocardiografía , Aneurisma Cardíaco/diagnóstico por imagen , Atrios Cardíacos/diagnóstico por imagen , HumanosRESUMEN
Endomyocardial fibrosis (EMF) is a globally unattended disease with significant rates of morbidity and mortality. It has a higher prevalence in tropical and subtropical countries compared to the rest of the world. Endomyocardial fibrosis can affect the atrioventricular valves, along with all four chambers of the heart, but spares the myocardium. Patients currently undergo symptomatic treatment with diuretics and vasodilators to enhance quality of life, although medical therapy alone is associated with poor prognosis. Hence, patients with severe symptoms prefer surgical treatment. Modern multimodality imaging, however, can help these definitions to be made more accurately.
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Fibrosis Endomiocárdica , Ventrículos Cardíacos , Ecocardiografía , Fibrosis Endomiocárdica/complicaciones , Fibrosis Endomiocárdica/diagnóstico por imagen , Ventrículos Cardíacos/diagnóstico por imagen , Humanos , Miocardio , Calidad de VidaRESUMEN
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is significantly associated with high risk of fatal ventricular arrhythmias (VAs). Increased frontal QRST angle (fQRSTa), Tpe interval, and Tp-e/QTc ratio are described as ventricular repolarization parameters which are related to arrhythmias. In this study, we aimed to investigate the predictive value of these repolarization parameters for fatal VAs in patients with HCM. METHODS: A total of 127 HCM patients (mean age: 47.9⯱â¯12.6â¯years; male:79) were enrolled in this retrospective study. All patients underwent transthoracic echocardiography. Moreover, the last electrocardiograms within 3â¯months prior to the fatal VA documentation were assessed. The primary outcome was the occurrence of fatal VAs including sustained ventricular tachycardia and ventricular fibrillation which were documented from implantable cardioverter defibrillator records. RESULTS: There were documented fatal VAs in 37 (29.1%) patients during a mean follow-up time of 70.1⯱â¯22.6â¯months. The prevalence of fatal VAs was significantly higher in patients with fQRSTa ≥140 degrees (67.4 vs. 7.4%; pâ¯<â¯0.001) and in patients with Tp-e/QTc ratioâ¯≥â¯0.19 (61.5 vs. 6.7%; pâ¯<â¯0.001) as compared to others. High Tp-e/QTc ratio (hazard ratio: 1.564; 95% confidence interval: 1.086-4.796; pâ¯=â¯0.032) and high fQRSTa (hazard ratio: 1.864; 95% confidence interval: 1.106-8.745; pâ¯=â¯0.002) were found to be independent predictors of fatal VAs in HCM patients. CONCLUSIONS: Wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio may be associated with fatal VAs in HCM patients. In addition to traditional risk factors, these simple ECG parameters may provide valuable information during evaluation of sudden cardiac death risk in HCM patients.
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Cardiomiopatía Hipertrófica , Electrocardiografía , Adulto , Arritmias Cardíacas , Cardiomiopatía Hipertrófica/complicaciones , Cardiomiopatía Hipertrófica/diagnóstico , Muerte Súbita Cardíaca , Humanos , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Sistema de Registros , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Aortic prosthetic vascular graft infections (PVGI) are rare complications of the aortic surgery, with an incidence of 0.5%-6%. Although rare, they carry mortality rates as high as 25%-88%. Improvement in diagnostic imaging modalities in the last two decades, together with early diagnosis, aortic PVGI associated mortality was reduced. These imaging methods include transesophageal echocardiography (TEE), computed tomography angiography (CTA), and 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). In this case report, we focus mainly on three imaging modalities as TEE, CTA, and 18F-FDG PET/CT and showed their role in the assessment of aortic PVGI.
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Aorta Torácica/diagnóstico por imagen , Enfermedades de la Aorta/cirugía , Prótesis Vascular/efectos adversos , Imagen Multimodal/métodos , Infecciones Relacionadas con Prótesis/diagnóstico , Enfermedades de la Aorta/diagnóstico , Angiografía por Tomografía Computarizada/métodos , Diagnóstico Diferencial , Ecocardiografía Transesofágica/métodos , Humanos , Masculino , Persona de Mediana Edad , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodosRESUMEN
The early repolarization pattern and single coronary artery (SCA) anomaly are rare causes of sudden cardiac arrest. The relationship between the early repolarization pattern and idiopathic ventricular fibrillation has previously been reported. Here, we describe a case of an early repolarization pattern and L-IIB type of isolated SCA anomaly in a patient who suffered a sudden cardiac arrest.
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Vasos Coronarios , Paro Cardíaco , Muerte Súbita Cardíaca/etiología , Electrocardiografía , Paro Cardíaco/etiología , Humanos , Fibrilación Ventricular/diagnósticoRESUMEN
BACKGROUND: Patients with intermediate-high risk pulmonary embolism (PE) who have acute right ventricular dysfunction and myocardial injury without overt hemodynamic compromise may be candidates for thrombolytic therapy (TT). In this study, we aimed to compare the clinical outcomes of low-dose prolonged TT and unfractionated heparin (UFH) in intermediate-high risk PE patients. METHODS: This study enrolled 83 (female: 45 [54.2%], mean age: 70.07±10.7 years) retrospectively evaluated patients with the diagnosis of acute PE who were treated with low-dose and slow-infusion of TT or UFH. The primary outcomes of the study were de-fined as a combination of death from any cause and hemodynamic decompensation, and severe or life-threatening bleeding. Secondary endpoints were recurrent PE, pulmonary hypertension, and moderate bleeding. RESULTS: The initial management strategy of intermediate-high risk PE was TT in 41 (49.4%) patients and UFH in 42 (50.6%) cases. Low-dose prolonged TT was successful in all patients. While the frequency of hypotension decreased significantly after TT (22 vs. 0%, P<0.001), it did not decrease after UFH (2.4 vs. 7.1%, p=0.625). The proportion of hemodynamic decompensation was significantly lower in the TT group (0 vs. 11.9%, p=0.029). The rate of secondary endpoints was significantly higher in the UFH group (2.4 vs. 19%, P=0.016). Moreover, the prevalence of pulmonary hypertension was significantly higher in UFH group (0 vs. 19%, p=0.003). CONCLUSION: Prolonged TT regimen with low dose, slow infusion of tissue plasminogen activator was found to be associated with a lower risk of hemodynamic decompensation and pulmonary hypertension in patients with acute intermediate-high-risk PE compared to UFH.
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Hipertensión Pulmonar , Embolia Pulmonar , Humanos , Femenino , Persona de Mediana Edad , Anciano , Anciano de 80 o más Años , Heparina/efectos adversos , Activador de Tejido Plasminógeno/efectos adversos , Heparina de Bajo-Peso-Molecular , Estudios Retrospectivos , Hipertensión Pulmonar/inducido químicamente , Hipertensión Pulmonar/tratamiento farmacológico , Embolia Pulmonar/tratamiento farmacológico , Embolia Pulmonar/inducido químicamente , Hemorragia/etiología , Terapia Trombolítica/efectos adversos , Anticoagulantes/efectos adversos , Resultado del TratamientoRESUMEN
OBJECTIVE: This study aimed to describe the eï¬ects of new academic criteria established in 2016 on the abstracts of the National Congress of the Turkish Society of Cardiology. METHODS: The abstracts presented at 13 consecutive annual congresses were obtained. A literature search was conducted with PubMed, Google Scholar, and Web of Science databases to analyze whether the abstract was published in a scientiï¬c journal. The study was divided into 2 time groups according to the new academic criteria published in 2016. Group 1 included 4828 abstracts accepted at National Congress of the Turkish Society of Cardiology between 2009 and 2016, while Group 2 included 2284 abstracts accepted at National Congress of the Turkish Society of Cardiology between 2017 and 2021. RESULTS: A total of 7112 abstracts were accepted for the 2009-2021 National Congress of the Turkish Society of Cardiology meetings scientiï¬c program. The publication rate (43.2% vs. 23.9%, P < 0.001), number of authors [7(5-9) vs. 4(3-6), P < 0.001], and rate of original investigation (72.3 vs. 56.5%, P < 0.001) were signiï¬cantly lower in group 2 than in group 1. Among the quality parameters of the journals in which the abstracts were published, the impact factor (0.59 ± 1.71 vs. 0.26 ± 1.09, P < 0.001), the rate of journals in science citation index or science citation index-expanded indexes (70.4 vs. 57.9%, P < 0.001), and the rate of the second or third-quartile class (24.2 vs. 16.1%, P < 0.001) were signiï¬cantly lower in group 2 as compared to group 1. Being in group 1 oral presentation, original investigation, and cardiac imaging were identiï¬ed as independent predictors for publication in scientiï¬c journals. CONCLUSION: This study showed that the 2016 new academic criteria negatively aï¬ected the publication processes of accepted abstracts in National Congress of the Turkish Society of Cardiology.
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The present study aimed to compare long-term outcomes of patients with Medina 0.1.0 left main (LM) bifurcation lesions treated by crossover stenting (COS) versus accurate ostial stenting (AOS). A total of 229 consecutive eligible patients with Medina 0.1.0 LM bifurcation lesions were enrolled and were stratified according to the stenting techniques. The primary end-point was major cardiovascular and cerebral events (MACCE), defined as the combination of all-cause death, target vessel related-myocardial infarction (MI), clinically driven target lesion revascularization (TLR), stroke, or stent thrombosis. COS and AOS were applied to 78 (34%) and 151 (66%) patients, respectively. During a mean of 40.6 ± 21.1 months of follow-up, the rate of MACCE (27.8 vs 12.8%; P=.007) was higher in patients treated with AOS than those treated with the COS technique, mainly driven by more frequent all-cause death (13.9 vs 3.8%, P = .013) and TLR (6.4 vs 15.9%; P = .029). In multivariable Cox regression analysis, AOS strategy was one of the independent predictors of MACCE (odds ratio: 2.166; 95% confidence interval, 1.080-4.340; P = .029). The current study suggests that COS was associated with a better long-term MACCE rate and lower all-cause mortality rate than AOS in patients with Medina 0.1.0 LM bifurcation disease.
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Comparison of clinical outcomes of double kissing crush (DKC) and mini-crush (MC) techniques in patients with complex coronary bifurcation lesions is lacking. This study sought to determine the clinical results of DKC and MC stenting techniques in mid-term follow-up. This retrospective study included a total of 269 consecutive patients with complex bifurcation lesions who underwent percutaneous coronary intervention; 132 (49%) of them were treated with MC technique, whereas 137 (51%) treated with DKC technique. The primary end point was target lesion failure (TLF), defined as the combination of cardiac death, target vessel myocardial infarction, or clinically driven target lesion revascularization. This is the first study to compare the cardiovascular outcomes of DKC and MC stenting techniques in patients with complex bifurcation lesions. The SYNTAX scores were similar in both groups (23 [20 to 30] vs 23 [19 to 28], p = 0.631)]. The number of balloons (6.31 ± 1.80 vs 4.42 ± 0.87, p <0.001) and guidewires (3.55 ± 0.83 vs 2.86 ± 0.74, p <0.001) used, fluoroscopy time (21.55 ± 7.05 vs 16.66 ± 4.19 minutes, p <0.001), and procedure time (80.42 ± 27.95 vs 69.61 ± 18.97 minutes, p <0.001) were significantly higher in the DKC group. The rate of composite TLF was similar in complex bifurcation patients treated with MC than those treated with the DKC technique (14% vs 12%, p = 0.453). Moreover, both groups had similar rates in terms of cardiac death or all-cause death, target vessel-related myocardial infarction, clinically driven target lesion revascularization, and stent thrombosis. In conclusion, the present study showed that both techniques of bifurcation treatment met high angiographic success with low complication and similar TLF rates.
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BACKGROUND: A subset ofpatients found to have total occlusion of the culprit artery (TOCA), present with non-ST-segment elevation myocardial infarction (NSTEMI) and elevated biomarkers. The aim of this study is to assess the effect of the TOCA in patients presenting with NSTEMI. METHODS: This multicenter observational study was retrospectively conducted between 2015 and 2019. Thrombolysis in myocardial infarction (TIMI) flow grades 0-1 was defined as the TOCA. The primary end point included a combination of all-cause death, myocardial infarction, target vessel revascularization, stent thrombosis, and stroke. RESULTS: Of 3272 patients, TIMI 0-1 flow in the culprit artery was present in 488 (14.9%) patients. TOCA was more likely to be of thrombotic origin (54.1% vs. 10.3%; P < 0.001) and visible collaterals (22.5% vs. 4.4%; P < 0.001). The rates of 30-day (14.3% vs. 7.2%; P < 0.001) and 2-year (25% vs. 19.1%; P = 0.003) primary end points were significantly higher in TOCA patients. Fatal arrhythmias were remarkably higher at 30-day (8.6% vs. 4%; P < 0.001) and 2-year (9% vs. 5.2%; P = 0.001) follow-ups. Mechanical complications were also higher in patients with TOCA at 30 days (0.8% vs. 0.2%; P = 0.013). Moreover, TOCA (OR, 1.379; P = 0.001) was one of the independent predictors of MACCE in NSTEMI patients. CONCLUSION: The current data suggest that patients with TOCA in the context of NSTEMI are at higher risk of MACCE, fatal arrhythmias, and mechanical complications.
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Infarto del Miocardio , Infarto del Miocardio sin Elevación del ST , Intervención Coronaria Percutánea , Infarto del Miocardio con Elevación del ST , Trombosis , Humanos , Infarto del Miocardio sin Elevación del ST/diagnóstico por imagen , Infarto del Miocardio sin Elevación del ST/terapia , Infarto del Miocardio sin Elevación del ST/complicaciones , Vasos Coronarios/diagnóstico por imagen , Estudios Retrospectivos , Intervención Coronaria Percutánea/efectos adversos , Infarto del Miocardio/etiología , Infarto del Miocardio con Elevación del ST/complicaciones , Trombosis/etiología , Angiografía Coronaria , Resultado del TratamientoRESUMEN
BACKGROUND: Congenital coronary artery anomalies (CCAAs) have the potential for life-threatening complications, including malignant ventricular arrhythmias and sudden cardiac death (SCD). In this study, we aimed to evaluate the relationship between impaired repolarization parameters and poor cardiovascular clinical outcomes in patients with potentially serious CCAAs. METHODS: This retrospective study included 85 potentially serious CCAA patients (mean age: 54.7 ± 13.6 years; male:44) who were diagnosed with conventional and coronary computed tomography angiography (CCTA). All patients underwent transthoracic echocardiography and 12-lead surface electrocardiography. Cardiac events were defined as sustained ventricular tachycardia or fibrillation, syncope, cardiac arrest and SCD. RESULTS: The presence of interarterial course (IAC) was confirmed by CCTA in 37 (43.5%) patients. During a median follow-up time of 24 (18-50) months, a total of 11 (12.9%) patients experienced cardiac events. The presence of IAC was significantly more frequent and Tp-e interval, Tp-e/QTc ratio and frontal QRS/T angle (fQRSTa) were significantly greater in patients with poor clinical outcomes. Moreover, the presence of IAC, high Tp-e/QTc ratio and high fQRSTa were found to be independent predictors of poor clinical outcomes and decreased long-term cardiac event-free survival in these patients. A net reclassification index was +1.0 for the Tp-e/QTc ratio and +1.3 for fQRSTa which were confirmable for additional predictability of these repolarization abnormalities. CONCLUSION: Impaired repolarization parameters, including wider fQRSTa, prolonged Tp-e interval, and increased Tp-e/QTc ratio, and IAC may be associated with poor cardiovascular clinical outcomes in potentially serious CCAA patients.
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Arritmias Cardíacas/complicaciones , Vasos Coronarios/fisiopatología , Evaluación de Resultado en la Atención de Salud/estadística & datos numéricos , Adulto , Anciano , Arritmias Cardíacas/epidemiología , Arritmias Cardíacas/mortalidad , Ecocardiografía/métodos , Ecocardiografía/estadística & datos numéricos , Electrocardiografía/métodos , Electrocardiografía/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Evaluación de Resultado en la Atención de Salud/métodos , Estudios Retrospectivos , Factores de RiesgoRESUMEN
Carotid artery stenting has been a widely used interventional treatment method for the last 3 decades in the treatment of carotid artery stenosis. In the current literature, unlike major cardiovascular complications, less emphasis has been placed on carotid pseudoaneurysm (PA). A carotid artery PA can be caused by trauma, spontaneous infection, vasculitis, or it may be iatrogenic. However, the incidence of PA secondary to carotid stenting is extremely rare. Although it may be completely asymptomatic in rare instances, it usually progresses symptomatically (neck swelling, nerve compression, respiratory distress, hoarseness, dysphagia, and ischemic cerebrovascular events). Doppler ultrasound, contrast-enhanced computed tomography, and conventional angiography are the main diagnostic tools. Primary closure, including graft interposition, has been described as a surgical therapeutic option. An endovascular approach with placement of a covered or bare metal stent is an alternative treatment method to surgery.
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Traumatismos de las Arterias Carótidas/etiología , Estenosis Carotídea/cirugía , Stents/efectos adversos , Antibacterianos/uso terapéutico , Infartos del Tronco Encefálico/complicaciones , Traumatismos de las Arterias Carótidas/diagnóstico , Traumatismos de las Arterias Carótidas/tratamiento farmacológico , Estenosis Carotídea/complicaciones , Estenosis Carotídea/diagnóstico por imagen , Angiografía por Tomografía Computarizada/métodos , Quimioterapia Combinada , Terapia Antiplaquetaria Doble/métodos , Disnea/etiología , Procedimientos Endovasculares/efectos adversos , Resultado Fatal , Humanos , Enfermedad Iatrogénica , Masculino , Persona de Mediana Edad , Insuficiencia Respiratoria/complicaciones , Ruidos Respiratorios/etiología , Estenosis Traqueal/etiologíaRESUMEN
We have recently read with great interest the article by Teng P et al. entitled "Giant right coronary artery aneurysm mimicking a right intra-ventricular mass: a case report". We appreciate the authors for their reports describing the treatment of a giant right coronary aneurysm mimicking a right intra-ventricular mass. On the other hand, we believe that there are some major drawbacks that need to be addressed.
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Aneurisma Coronario , Puente de Arteria Coronaria , Vasos Coronarios , HumanosRESUMEN
Background: In addition to proinflammatory properties, eosinophils can stimulate platelet activation and enhance prothrombotic pathways. In this study, we aimed to investigate the association between the eosinophil percentage (EOS%) and major adverse cardiac events (MACE) in patients with ST-segment elevation myocardial infarction (STEMI). Methods: This study enrolled a total of 1,909 patients who were diagnosed with STEMI. Ventricular arrhythmia, reinfarction, the need for cardiopulmonary resuscitation, target vessel revascularization, congestive heart failure, and cardiovascular mortality during index hospitalization were defined as MACE. Results: Three hundred and eighty patients (19.7%) reached the combined endpoint with MACE. The rates of inhospital mortality and MACE were significantly higher in low EOS% group as compared to high EOS% group (4% vs. 1.1%, p < 0.01 and 32.8% vs. 11.3%, p < 0.01, respectively). On multivariate logistic regression analyses, EOS% (OR = 0.44, p < 0.01) was found to be one of the independent predictors of MACE. The EOS% lower than 0.60 on admission predicted inhospital MACE with a sensitivity of 68% and a specificity of 72% (AUC: 0.684, p < 0.01). Conclusions: Low EOS% on admission may be associated with high inhospital MACE in STEMI patients. EOS% may be used as a novel biomarker for risk stratification of these patients.