Determinants of low anger control in patients with coronary artery disease

A low anger control has been associated to coronary artery disease (CAD). However, there is scarce information on predictors of low anger control in those patients. All patients scheduled for elective coronary angiography at a tertiary center for cardiology in South Brazil between 11/30/2009 and 02/03/2010 were considered eligible for inclusion. The inclusion criterion was the presence of significant CAD which was defined as the presence of a stenosis >50% in at least one major epicardial artery. Clinical and sociodemographic characteristics of the patients were registered, and anger aspects were assessed by the Spielberger's Anger Expression Inventory. The anger control score was categorized into quartiles, and the lowest quartil was considered and the first quartile (Low Anger Control) was compared with the others (Proper Anger Control). The medians were compared by the POISSON regression with adjustment for single and multiple robust variances. Three hundred and six patients with 60 ± 9 years old with angiographically proven CAD were included in this study. Our results showed that the younger, diabetic and patients with a family history of CAD presented lower medians for the anger control. Body Mass Index was also correlated with anger control. In the multivariate analysis, however, only family history for coronary artery disease was an independent risk factor for a low anger control. These results provide a better understanding of the relationship between anger control and CAD, and should help to consolidate the knowledge in this field and also help to plan further studies to investigate a cause-effect relationship

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Características Imuno-Histoquímicas de Trombos Coronarianos de Pacientes com Infarto do Miocárdio com Elevação de ST e Diabetes Mellitus: Estudo Piloto / Immunohistochemical Characteristics of Coronary Thrombi in Patients with ST-Elevation Myocardial Infarction and Diabetes Mellitus: Pilot Study

Introdução: No contexto do infarto agudo do miocárdio, o diabetes mellitus está associado à maior mortalidade. O objetivo deste estudo foi avaliar se existem, entre os diabéticos, peculiaridades no processo de aterotrombose que poderiam estar implicadas em maior risco para tal desfecho. Métodos: Estudo piloto, proveniente de coorte de pacientes com diagnóstico de infarto agudo do miocárdio com elevação do segmento ST submetidos à intervenção coronária percutânea primária e à tromboaspiração. Foram estudadas variáveis clínico-laboratoriais de cada caso. Os trombos foram analisados quanto às características histopatológicas e às expressões imuno-histoquímicas de CD34, CD61 e fator VIII. Resultados: Foram incluídos os primeiros dez pacientes portadores de diabetes mellitus com material disponível para análise, pareados por idade, sexo e tempo de evolução do infarto com dez pacientes sem diabetes mellitus. Não houve associação significativa entre as expressões imuno-histoquímicas de CD34, CD61 e fator VIII com relação às variáveis histopatológicas, laboratoriais e clínicas estudadas, inclusive com relação à presença de diabetes mellitus. Conclusões: Em análise preliminar, não foi possível demonstrar diferença significativa quanto à expressão da atividade de células endoteliais, da função plaquetária e da ativação da cascata de coagulação entre trombos de pacientes com e sem o diagnóstico de diabetes mellitus submetidos à intervenção coronariana primária...

Background: Diabetes mellitus is associated with increased mortality rates in the setting of acute myocardial infarction. The aim of this study was to evaluate whether there are peculiarities in the atherothrombotic process that might be implicated in increased risk for this outcome in patients with diabetes. Methods: Pilot study in a cohort of patients with ST-elevation acute myocardial infarction undergoing primary percutaneous coronary intervention and aspiration thrombectomy. Clinical and laboratory variables were evaluated in all of the cases. Thrombi were analyzed for histopathological features as well as immunohistochemical expression of CD34, CD61 and factor VIII. Results: Our sample included the first ten diabetic patients with material available for analysis, who were matched according to age, gender and time elapsed since myocardial infarction with ten patients without diabetes. There was no significant association between the immunohistochemical expression of CD34, CD61 and factor VIII with other histopathological, clinical and laboratory variables, including the presence of diabetes mellitus. Conclusions: In this preliminary analysis, it was not possible to demonstrate any significant difference in the expression of endothelial cell activity, platelet function and activation of the coagulation cascade between thrombi of patients with and without diabetes undergoing primary coronary intervention...