Physical influences on right ventricular infarction and cardiogenic shock in acute myocardial infarction.

AIM: To determine if complicated acute myocardial infarction (AMI) is related to specific cosmophysical activities. METHODS: The study group included 1170 patients who had undergone primary percutaneous coronary intervention (PCI) for AMI in 2000-2006. Geomagnetic and cosmic ray (neutron) activity (GMA, CRA) on the day of PCI were derived from international observatories. The findings were compared among patients with right ventricular infarction (RVI), cardiogenic shock, and uncomplicated AMI. RESULTS: Relative to the whole study period, the mean CRA was higher on days on which PCI was performed for RVI (n=123, 10.5%) (p = .0003) and cardiogenic shock (n=102, 8.72%) (p = .018). When the same artery was involved (LAD, RCA, CRX), CRA was significantly higher for complicated than for uncomplicated AMI (RVI group: p = .006, p = .00027, p = .014, c ardiogenic shock: p = .009, p = .029, p = .089, respectively). At the highest levels of GMA, more RVI cases were seen than cases of cardiogenic shock (p = .06). CONCLUSION: RVI and cardiogenic shock were associated with higher CRA than uncomplicated AMI. RVI occurred more often on days of high GMA than cardiogenic shock. Higher CRA may induce more myocardial damage in patients predisposed to AMI.

Clinical results of drug eluting stents compared to bare metal stents for patients with ST elevation acute myocardial infarction.

OBJECTIVE: To investigate the clinical outcomes in patients with ST segment elevation acute myocardial infarction (STEMI) treated with drug eluting stents (DES) versus a matched control group of patients with STEMI treated with bare metal stents (BMS). METHODS: This registry included 122 patients with STEMI undergoing primary coronary angioplasty with DES implantation at our institution. The control group consisted of 506 patients implanted with BMS, who were matched for age, infarct location, and diabetic status. The incidences of major adverse cardiac events (MACE) including target vessel/lesion revascularization (TVR/TLR) and stent thrombosis were assessed up to 12 months. RESULTS: Twelve months follow up showed a non-significant trend towards reduced deaths (3.3% versus 7.1%, P=0.1), significantly reduced recurrent MI (0.0% versus 6.1%, P=0.02), TVR (5.7% versus 15.2%, P=0.006) and TLR (2.5% versus 14.0%, P=0.004) events in the DES group as compared to BMS group. The composite incidences of MACE at 12 months follow-up was lower in the DES group (11.5%) as compared to the BMS group (21.3%, P=0.01). CONCLUSION: According to our experiences, the use of DES in STEMI is safe and effective as compared to BMS. DES was effective in reducing the incidence of restenosis outcomes and overall adverse cardiac events up to 12 months.