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2.
Cureus ; 16(6): e63288, 2024 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-39070318

RESUMEN

Management of acute coronary syndrome (ACS), cerebrovascular accident (CVA), and pulmonary embolism (PE) necessitates prompt intervention, as delayed treatment may lead to severe consequences. Each of these conditions presents significant challenges and carries a high risk of morbidity and mortality. We present the case of an 86-year-old female with a history of stage 4 urothelial carcinoma metastasized to the lungs, who presented to the emergency department (ED) with acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), and bilateral PE. We propose the term "multi-organ thromboembolic crisis" (MOTEC) to streamline the communication and management approach for patients experiencing critical thromboembolic events affecting multiple organ systems.

3.
Nat Commun ; 11(1): 4432, 2020 09 04.
Artículo en Inglés | MEDLINE | ID: mdl-32887874

RESUMEN

Spontaneous coronary artery dissection (SCAD) is a non-atherosclerotic cause of myocardial infarction (MI), typically in young women. We undertook a genome-wide association study of SCAD (Ncases = 270/Ncontrols = 5,263) and identified and replicated an association of rs12740679 at chromosome 1q21.2 (Pdiscovery+replication = 2.19 × 10-12, OR = 1.8) influencing ADAMTSL4 expression. Meta-analysis of discovery and replication samples identified associations with P < 5 × 10-8 at chromosome 6p24.1 in PHACTR1, chromosome 12q13.3 in LRP1, and in females-only, at chromosome 21q22.11 near LINC00310. A polygenic risk score for SCAD was associated with (1) higher risk of SCAD in individuals with fibromuscular dysplasia (P = 0.021, OR = 1.82 [95% CI: 1.09-3.02]) and (2) lower risk of atherosclerotic coronary artery disease and MI in the UK Biobank (P = 1.28 × 10-17, HR = 0.91 [95% CI :0.89-0.93], for MI) and Million Veteran Program (P = 9.33 × 10-36, OR = 0.95 [95% CI: 0.94-0.96], for CAD; P = 3.35 × 10-6, OR = 0.96 [95% CI: 0.95-0.98] for MI). Here we report that SCAD-related MI and atherosclerotic MI exist at opposite ends of a genetic risk spectrum, inciting MI with disparate underlying vascular biology.


Asunto(s)
Anomalías de los Vasos Coronarios/genética , Genes Relacionados con las Neoplasias , Infarto del Miocardio/genética , Enfermedades Vasculares/congénito , Proteínas ADAMTS/genética , Enfermedades de las Arterias Carótidas/complicaciones , Enfermedades de las Arterias Carótidas/genética , Cromosomas/genética , Estudios de Cohortes , Enfermedad de la Arteria Coronaria/genética , Femenino , Displasia Fibromuscular/complicaciones , Displasia Fibromuscular/genética , Estudio de Asociación del Genoma Completo , Humanos , Proteína 1 Relacionada con Receptor de Lipoproteína de Baja Densidad/genética , Masculino , Metaanálisis como Asunto , Proteínas de Microfilamentos/genética , Factores de Riesgo , Enfermedades Vasculares/genética
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