Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 17 de 17
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
Scand Cardiovasc J ; 53(5): 280-285, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31216908

RESUMO

Objectives. The main aim of the Aiming toWards Evidence baSed inTerpretation of Cardiac biOmarkers in patients pResenting with chest pain (WESTCOR-study) (Clinical Trials number NCT02620202) is to improve diagnostic pathways for patients presenting to the Emergency department (ED) with acute chest pain. Design. The WESTCOR-study is a two center, cross-sectional and prospective observational study recruiting unselected patients presenting to the ED with suspected non-ST elevation acute coronary syndrome (NSTE-ACS). Patient inclusion started September 2015 and we plan to include 2250 patients, finishing in 2019. The final diagnosis will be adjudicated by two independent cardiologists based on all available information including serial high sensitivity cardiac troponin measurements, coronary angiography, coronary CT angiography and echocardiography. The study includes one derivation cohort (N = 985) that will be used to develop rule out/rule in algorithms for NSTEMI and NSTE-ACS (if possible) using novel troponin assays, and to validate established NSTEMI algorithms, with and without clinical scoring systems. The study further includes one subcohort (n = 500) where all patients are examined with coronary CT angiography independent of biomarker status, aiming to assess the associations between biomarkers and the extent and severity of coronary atherosclerosis. Finally, an external validation cohort (N = 750) will be included at Stavanger University Hospital. Prospective studies will be based on the merged cohorts. Conclusion. The WESTCOR study will provide new diagnostic algorithms for early inclusion and exclusion of NSTE-ACS and insights in the associations between cardiovascular biomarkers, CT-angiographic findings and short and long-term clinical outcomes.

2.
Front Cardiovasc Med ; 5: 64, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29951487

RESUMO

Multiple biomarkers may predict short and long-term prognosis in patients with coronary heart disease, but their impact is limited when used in addition to established risk factors such blood pressure, cholesterol levels, diabetes mellitus, smoking as well as age and sex. Arteries are an integral part of the cardiovascular (CV) system. Arterial stiffness has been shown to be a predictor of cardiovascular events and mortality independent of traditional risk factors. It has also been shown that increased arterial stiffness may predict cardiovascular events in asymptomatic individuals without overt cardiovascular disease. Measuring arterial stiffness may, therefore, identify patients at risk at an early stage. Antihypertensive treatment has been shown to reduce arterial stiffness beyond its antihypertensive effect. Arterial stiffness could, therefore, be a surrogate marker of treatment that relates to prognosis. Arterial stiffness has mostly been used in research protocols, and its use as a prognostic indicator in clinical practice is still uncommon. Several methods exist that can determine parameters related to arterial stiffness, both local and in specific artery beds such as the aorta. In this brief review we present methods to evaluate arterial stiffness, their clinical utility, limitations and the advantages of a novel method, the Cardio-Ankle Vascular Index. Easier and more reproducible methods to evaluate arterial stiffness may increase the use of parameter as a risk factor for coronary heart disease in common clinical practice.

3.
Cardiology ; 138(2): 122-132, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28651249

RESUMO

OBJECTIVES: In the MITOCARE study, reperfusion injury was not prevented after administration of the mitochondrial permeability transition pore (mPTP) opening inhibitor, TRO40303, in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). The effects of TRO40303 on pro-inflammatory cytokines and acute-phase proteins were assessed. METHODS: STEMI patients (n = 163, mean age 62 years) with chest pain within 6 h before admission for pPCI were randomized to intravenous bolus of TRO40303 (n = 83) or placebo (n = 80) prior to reperfusion. We tested whether the groups differed in levels of IL-1ß, IL-6, IL-10, TNF, and high-sensitive C-reactive protein at various time points (0, 12, and 72 h) after PCI. Further, potential differences between groups in the change of biomarker levels between 0 and 72 h, 0 and 12 h, and 12 and 72 h were tested. RESULTS: There were no statistically significant differences between the two groups, neither in levels of pro-inflammatory cytokines nor in levels of acute-phase proteins, and there were no statistically significant differences in the change of biomarker levels between the groups considering the time intervals from 0 to 72 h, from 0 to 12 h, and from 12 to 72 h. CONCLUSION: The administration of the mPTP, TRO40303, prior to reperfusion does not alter the pharmacokinetics of pro-inflammatory cytokines or acute-phase proteins during the first 72 h after PCI.


Assuntos
Proteínas da Fase Aguda/metabolismo , Citocinas/metabolismo , Oximas/administração & dosagem , Intervenção Coronária Percutânea , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Secoesteroides/administração & dosagem , Idoso , Biomarcadores/metabolismo , Método Duplo-Cego , Europa (Continente) , Feminino , Humanos , Cinética , Masculino , Pessoa de Meia-Idade , Proteínas de Transporte da Membrana Mitocondrial/antagonistas & inibidores , Traumatismo por Reperfusão Miocárdica/prevenção & controle , Resultado do Tratamento
4.
Eur Heart J ; 38(39): 2936-2943, 2017 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-28431003

RESUMO

Aims: Intracoronary infusion of autologous nucleated bone marrow cells (BMCs) enhanced the recovery of left ventricular ejection fraction (LVEF) after ST-segment elevation myocardial infarction (STEMI) in the randomised-controlled, open-label BOOST trial. We reassessed the therapeutic potential of nucleated BMCs in the randomised placebo-controlled, double-blind BOOST-2 trial conducted in 10 centres in Germany and Norway. Methods and results: Using a multiple arm design, we investigated the dose-response relationship and explored whether γ-irradiation which eliminates the clonogenic potential of stem and progenitor cells has an impact on BMC efficacy. Between 9 March 2006 and 16 July 2013, 153 patients with large STEMI were randomly assigned to receive a single intracoronary infusion of placebo (control group), high-dose (hi)BMCs, low-dose (lo)BMCs, irradiated hiBMCs, or irradiated loBMCs 8.1 ± 2.6 days after percutaneous coronary intervention (PCI) in addition to guideline-recommended medical treatment. Change in LVEF from baseline (before cell infusion) to 6 months as determined by MRI was the primary endpoint. The trial is registered at Current Controlled Trials (ISRCTN17457407). Baseline LVEF was 45.0 ± 8.5% in the overall population. At 6 months, LVEF had increased by 3.3 percentage points in the control group and 4.3 percentage points in the hiBMC group. The estimated treatment effect was 1.0 percentage points (95% confidence interval, -2.6 to 4.7; P = 0.57). The treatment effect of loBMCs was 0.5 percentage points (-3.0 to 4.1; P = 0.76). Likewise, irradiated BMCs did not have significant treatment effects. BMC transfer was safe and not associated with adverse clinical events. Conclusion: The BOOST-2 trial does not support the use of nucleated BMCs in patients with STEMI and moderately reduced LVEF treated according to current standards of early PCI and drug therapy.


Assuntos
Transplante de Medula Óssea/métodos , Infarto do Miocárdio com Supradesnível do Segmento ST/terapia , Células da Medula Óssea/efeitos da radiação , Método Duplo-Cego , Feminino , Raios gama , Humanos , Infusões Intralesionais , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Intervenção Coronária Percutânea , Transplante de Células-Tronco/métodos , Células-Tronco/efeitos da radiação , Transplante Autólogo , Resultado do Tratamento , Função Ventricular Esquerda/fisiologia
5.
J Am Coll Cardiol ; 64(22): 2318-26, 2014 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-25465417

RESUMO

BACKGROUND: Vorapaxar, a novel antiplatelet therapy, reduces thrombotic events in patients with a history of myocardial infarction (MI) or peripheral artery disease (PAD); however, because of an increased risk of intracranial hemorrhage, it is contraindicated in patients with a history of stroke. OBJECTIVES: The aim of this study was to investigate the incidence of new ischemic stroke and subsequent death or intracerebral hemorrhage in patients with MI or PAD and no cerebrovascular disease (CVD) treated with vorapaxar. METHODS: The TRA 2 °P-TIMI 50 (Trial to Assess the Effects of Vorapaxar in Preventing Heart Attack and Stroke in Patients With Atherosclerosis-Thrombolysis In Myocardial Infarction 50) was a randomized, double-blind, placebo-controlled trial of vorapaxar 2.5 mg daily in 26,449 patients with atherosclerosis, stratified by qualifying disease (MI, PAD, or CVD). A total of 20,170 patients with MI/PAD, but no CVD, were enrolled. RESULTS: In patients with MI/PAD and no prior stroke or transient ischemic attack, vorapaxar reduced first ischemic stroke (hazard ratio [HR]: 0.57, 95% confidence interval [CI]: 0.43 to 0.75; p < 0.001). The risk of hemorrhagic conversion after stroke (HR: 1.19, 95% CI: 0.49 to 2.91; p = 0.70) or death (HR: 1.09, 95% CI: 0.57 to 2.07; p = 0.79) during follow-up was not significantly increased with vorapaxar in patients who had a new ischemic stroke (n = 204). Although hemorrhagic stroke was increased (HR: 2.79, 95% CI: 1.00 to 7.73; p = 0.049), overall stroke was significantly reduced (HR: 0.67, 95% CI: 0.52 to 0.87; p = 0.002). CONCLUSIONS: Vorapaxar reduces ischemic stroke in patients with MI or PAD and no known CVD. There does not appear to be a significant increase in the risk of hemorrhagic conversion or death in patients who experienced a first ischemic stroke on vorapaxar. Although primary hemorrhagic stroke is increased, vorapaxar reduces the total incidence of stroke. (Trial to Assess the Effects of Vorapaxar (SCH 530348; MK-5348) in Preventing Heart Attack and Stroke in Patients With Atherosclerosis [TRA 2 °P-TIMI 50]; NCT00526474).


Assuntos
Isquemia Encefálica/tratamento farmacológico , Isquemia Encefálica/epidemiologia , Lactonas/administração & dosagem , Piridinas/administração & dosagem , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/epidemiologia , Idoso , Aterosclerose/diagnóstico , Aterosclerose/tratamento farmacológico , Isquemia Encefálica/diagnóstico , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/tratamento farmacológico , Receptores de Trombina/antagonistas & inibidores , Acidente Vascular Cerebral/diagnóstico , Resultado do Tratamento
6.
Resuscitation ; 81(4): 493-7, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20227005

RESUMO

Patients with pulseless electrical activity or refractory ventricular fibrillation have a very bad prognosis. Coronary angiography and angioplasty may be required to restore an effective circulation, but this must be performed whilst chest compressions are continued. The LUCAS chest compression device is suitable for this purpose. So far there are no reports on the effect of this device on coronary circulation in humans. We monitored the coronary perfusion pressure assessed invasively as the difference between the diastolic pressures at the coronary ostium and right atrium, and compared these pressures with coronary flow graded using the TIMI scale in 6 patients. In 4 out of 6 we found a satisfactory coronary artery perfusion pressure and TIMI grade 3 flow (normal) on coronary angiography. Two of these patients survived the first 24h. Two patients did not have a satisfactory perfusion pressure and adequate flow rate was not seen.


Assuntos
Reanimação Cardiopulmonar , Angiografia Coronária , Circulação Coronária/fisiologia , Adulto , Idoso de 80 Anos ou mais , Reanimação Cardiopulmonar/instrumentação , Humanos , Masculino , Pessoa de Meia-Idade
7.
Thromb J ; 8(1): 1, 2010 Jan 27.
Artigo em Inglês | MEDLINE | ID: mdl-20181026

RESUMO

BACKGROUND: The expression of pregnancy-associated plasma protein A (PAPP-A) was identified by immunohistochemistry (IHC) in culprit atherothrombotic plaque specimens harvested from patients admitted with ST-segment elevation myocardial infarction (STEMI). METHODS: The atherothrombotic samples were collected from a consecutive cohort consisting of 20 individuals admitted with STEMI to Stavanger University Hospital, Norway, from 2005-2006, presenting angiographically with an acute thrombotic occlusion of a coronary artery characterized by TIMI flow 0. The atherothrombotic plaques were obtained by aspiration thrombectomy during percutaneous coronary intervention within 12 hours from the onset of symptoms and prepared for IHC analysis. RESULTS: In the IHC analysis staining for PAPP-A occurred in the extracellular matrix of the plaques and no evidence of staining for PAPP-A was found in the thrombi. CONCLUSION: Our results indicate that in vivo PAPP-A is strongly expressed in atherothrombotic plaques harvested from patients admitted with STEMI, as documented by IHC. TRIAL REGISTRATION: biobankregisteret@fhi.no1846.

8.
Eur Heart J ; 30(16): 1978-85, 2009 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-19502624

RESUMO

AIMS: We studied the time-dependent relationships between microvascular obstruction (MO), infarct size, and left ventricular (LV) remodelling after acute myocardial infarction (MI). METHODS AND RESULTS: Forty-two consecutive patients with first-time ST-elevation MI, single-vessel disease, successfully treated with primary percutaneous coronary intervention (PCI) were included. Microvascular obstruction, infarct size, and LV remodelling were assessed by cardiac magnetic resonance. Cardiac magnetic resonance was performed at: 2 days, 1 week, 2 months, and 1 year following PCI. Microvascular obstruction was assessed by first-pass perfusion. Patients were divided into three groups according to the presence or absence of MO at 2 days and 1 week: no detectable MO at any time point (11 patients), MO detectable only at 2 days (16 patients), and MO detectable both at 2 days and 1 week (15 patients). In multivariable analysis adjusting for infarct size at 2 days, detectable MO at 1 week was an independent predictor (P = 0.003) of infarct size at 1 year follow-up, associated with adverse infarct healing, adverse LV remodelling, increased LV volumes, and lower ejection fractions when compared with the rest of the cohort. CONCLUSION: Microvascular obstruction is an important determinant of infarct healing. The effect of MO on infarct size translated into distinct patterns of LV remodelling during long-term follow-up.


Assuntos
Angioplastia Coronária com Balão , Oclusão Coronária/complicações , Infarto do Miocárdio/terapia , Complicações Pós-Operatórias/etiologia , Remodelação Ventricular/fisiologia , Biomarcadores/sangue , Oclusão Coronária/patologia , Oclusão Coronária/fisiopatologia , Feminino , Humanos , Masculino , Microcirculação/fisiologia , Pessoa de Meia-Idade , Infarto do Miocárdio/patologia , Infarto do Miocárdio/fisiopatologia , Complicações Pós-Operatórias/patologia , Complicações Pós-Operatórias/fisiopatologia , Estudos Prospectivos
9.
Int J Cardiol ; 127(2): 208-13, 2008 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-17765338

RESUMO

INTRODUCTION: After changing our treatment regimen from thrombolytic therapy to primary percutaneous intervention (PCI), we decided to perform a real-life retrospective comparison of the results obtained by thrombolytic therapy in 2000 with the results obtained by primary PCI in 2004 at our center which has no on-site cardiac surgery. METHODS: All patients admitted with ST-elevation myocardial infarction (STEMI) during 2000 and 2004 were included in our study. The charts were scrutinized by one of the authors to ensure accurate information on diagnostics and timing. Relevant data, which were predefined, were noted and compared in patients treated during the two time-periods. RESULTS: During the year of 2000, 197 patients were admitted with STEMI. Thrombolytics were administered to 138 of these patients. During 2004, 175 patients were admitted with STEMI and PCI was performed in 173 of these patients. Door-to-needle time was 28min and door-to-balloon time 80min, respectively. In-hospital mortality was significantly reduced from 2000 to 2004 (19.3% vs 8.6%, p=0.003). 30 day-mortality was likewise reduced from 21.3% to 8.6%, (p=0.0001), and this difference remained significant after excluding patients not receiving thrombolytics in the year 2000. In-hospital stay was reduced from 9.4 to 6.4 days, (p<0.001). None of the patients required transfer to a tertiary center for acute coronary artery bypass grafting. CONCLUSION: Initiation of a primary PCI program at a center without on site cardiac surgery is associated with a substantial increase in number of patients offered reperfusion therapy and a significant reduction in morbidity and mortality.


Assuntos
Angioplastia Coronária com Balão , Infarto do Miocárdio/mortalidade , Infarto do Miocárdio/terapia , Terapia Trombolítica/métodos , Idoso , Feminino , Mortalidade Hospitalar , Humanos , Tempo de Internação/estatística & dados numéricos , Masculino , Pessoa de Meia-Idade , Noruega/epidemiologia , Avaliação de Resultados (Cuidados de Saúde) , Modelos de Riscos Proporcionais , Estudos Retrospectivos
10.
Tidsskr Nor Laegeforen ; 127(2): 171-3, 2007 Jan 18.
Artigo em Norueguês | MEDLINE | ID: mdl-17237863

RESUMO

Congestive heart failure is a major health problem in the western world and the prevalence of patients with this diagnosis increases. About 2% of the adult population are affected; the majority are elderly, which represents a challenge when it comes to assessment and treatment. This article concerns the aetiology and diagnosis of congestive heart failure and provides a suggestion for guidelines. The proposed guidelines are aimed at primary, secondary and third line health care providers in Norway, and are based on previously published Norwegian guidelines and international guidelines. Hypertension and coronary artery disease account for 75-80% of known cases of congestive heart failure. The patient's history and risk factors must be investigated. Laboratory tests emphasising organ functions are important, and these should include measurement of B-type natriuretic peptide (BNP). Electrocardiograms and chest X-rays should be taken as well. All patients with suspected impaired left ventricular ejection fraction should undergo an echocardiographic examination. Invasive tests, and non-invasive imaging should be used for selected groups of patients only.


Assuntos
Insuficiência Cardíaca , Adulto , Idoso , Biomarcadores/sangue , Ecocardiografia , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/epidemiologia , Insuficiência Cardíaca/etiologia , Testes de Função Cardíaca , Humanos , Pessoa de Meia-Idade , Prognóstico , Fatores de Risco
11.
Tidsskr Nor Laegeforen ; 127(2): 174-7, 2007 Jan 18.
Artigo em Norueguês | MEDLINE | ID: mdl-17237864

RESUMO

The Working Group on Heart Failure of the Norwegian Society of Cardiology here presents a revised programme for the treatment of congestive heart failure. Possible surgical and percutaneous interventions should be considered, and non- pharmacological measures taken as indicated for each patient. ACE-inhibitors are the first-line pharmacological therapy in heart failure with reduced left ventricular ejection fraction (< 40%). Possible adverse effects on blood pressure, renal function and electrolytes necessitate close monitoring of these variables. Beta-blockers should be considered in patients with symptomatic heart failure. If ACE-inhibitors are not tolerated, an angiotensin- II-blocker can be the added. Diuretics should only be used as adjunctive therapy to ACE-inhibitors. Aldosterone antagonists have a proven effect on survival, but close monitoring of potassium levels is imperative. Especially in the elderly, the renal function and level of electrolytes must be monitored closely. Device therapy, such ac cardiac resynchronization therapy and implantable cardioverter defibrillators, are only indicated for selected patients. ACE-inhibitors, diuretics and beta-blockers are the drugs-of-choice for patients with congestive heart failure with preserved systolic function. Health care for patients with congestive heart failure must be well organized on different levels of care and with multidisciplinary teams involved. The goal is to reduce morbidity and mortality in the heart failure population. This programme is meant for primary, secondary and third line health care providers in Norway.


Assuntos
Insuficiência Cardíaca/terapia , Agonistas Adrenérgicos beta/administração & dosagem , Adulto , Idoso , Bloqueadores do Receptor Tipo 1 de Angiotensina II/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/administração & dosagem , Diuréticos/administração & dosagem , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/cirurgia , Humanos , Pessoa de Meia-Idade , Marca-Passo Artificial , Planejamento de Assistência ao Paciente/organização & administração
12.
Am Heart J ; 152(5): 888-95, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17070152

RESUMO

BACKGROUND: Percutaneous coronary intervention (PCI) in nonemergent patients with coronary artery disease in hospitals without on-site cardiac surgery backup is still controversial. To prospectively evaluate a set of low procedural risk criteria for PCI, patients with stable or unstable angina were randomized to treatment in either a community hospital, which had all supportive services except for on-site cardiac surgery, or a regional surgical hospital 213 km away. METHODS AND RESULTS: During a 4-year period, 609 (57%) of 1064 consecutive patients with stable or unstable angina who underwent coronary angiography at a teaching community hospital in Norway fulfilled the predefined low-risk criteria for PCI. The patients were randomized to treatment at either the community hospital (n = 305) or at the regional hospital (n = 304). The angiographic success rate (96% at both hospitals) and number of major periprocedural complications (overall 0.3%) were equal at the 2 hospitals. In particular, there were no deaths or need for urgent transfer to cardiac surgery. At 6 months of clinical follow-up, there was a significant higher major adverse cardiac event rate rate at the community hospital, compared with the regional hospital (6.9% vs 2.3%, respectively, P = .03) because of more repeat target vessel revascularizations. Improvement in angina functional class and exercise capacity was similar in both groups. The excluded high-risk PCI patients had higher 6-month major adverse cardiac event compared with all low-risk patients (8.4% vs 4.3%, respectively, P = .01). CONCLUSION: Selected nonemergent patients can, based on angiography, safely undergo PCI at hospitals without cardiac surgery backup. The angiographic selection criteria identified high-risk patients, which had worsened outcome at 6 months of follow-up.


Assuntos
Angina Pectoris/terapia , Angioplastia Coronária com Balão , Idoso , Angina Pectoris/etiologia , Procedimentos Cirúrgicos Cardíacos , Angiografia Coronária , Doença da Artéria Coronariana/complicações , Doença da Artéria Coronariana/terapia , Procedimentos Cirúrgicos Eletivos , Feminino , Hospitais Comunitários , Humanos , Masculino , Pessoa de Meia-Idade , Noruega , Seleção de Pacientes , Complicações Pós-Operatórias , Estudos Prospectivos , Resultado do Tratamento
13.
Eur Heart J ; 27(18): 2177-83, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16882677

RESUMO

AIMS: Mortality in women following an acute myocardial infarction (AMI) is higher than in men, in that women are older and have more co-morbidity at the time of AMI. We evaluated short- and long-term sex-related differences in management and prognosis among high-risk patients following AMI. METHODS AND RESULTS: A total of 1575 women and 3902 men with AMI and heart failure, left ventricular dysfunction, or anterior Q waves, were recruited for participation in the OPTIMAAL trial and followed for 2.7+/-0.9 years in seven European countries. Symptomatic heart failure was more common in women when compared with men. Women were older, with more hypertension and diabetes mellitus. Fewer women were treated with thrombolytics (P<0.001 in all cases). Women had a 1.37-fold higher risks of death (P<0.001) during follow-up, but no differences were observed after adjusting for age. However, in-hospital mortality was significantly higher in women (4.89 vs. 2.54%; P<0.001) and a 1.57-fold higher risk of in-hospital death (P=0.006) persisted after adjusting for age and co-morbidities. CONCLUSION: Among high-risk patients with AMI, age-adjusted long-term survival was similar between sexes. However, adjusted in-hospital mortality was significantly higher in women. Higher short-term risk may warrant more rapid and appropriate management of women with AMI.


Assuntos
Infarto do Miocárdio/mortalidade , Adulto , Idoso , Feminino , Insuficiência Cardíaca/mortalidade , Hospitalização/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Prognóstico , Fatores de Risco , Distribuição por Sexo , Análise de Sobrevida , Disfunção Ventricular Esquerda/mortalidade
14.
Int J Cardiol ; 109(3): 398-401, 2006 May 24.
Artigo em Inglês | MEDLINE | ID: mdl-16102858

RESUMO

Recently, attention has been focused on late complications related to drug eluting stents (DES) [Farb A, Burke AP, Kolodgie FD, Virmani R. Pathological mechanisms of fatal late coronary stent thrombosis in humans. Circulation 108 (2003) 1701-6; McFadden EP, Stabile E, Regar E, Cheneau E, Ong AT, Kinnaird T, et al. Late thrombosis in drug-eluting stents after discontinuation of platelet therapy. Lancet 364 (2004) 1519-21; Eisenberg MJ. Drug-eluting stents: some bare facts. Lancet 364 (2004) 1466-7, [1-3]. We present two cases with late stent thrombosis (LST) and one case with a stent-related aneurysm. All patients were treated with the paclitaxel coated stent (Taxus-R) which is the most commonly used DES in our department.


Assuntos
Angioplastia Coronária com Balão/efeitos adversos , Aneurisma Coronário/etiologia , Trombose Coronária/etiologia , Stents/efeitos adversos , Adulto , Sistemas de Liberação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
16.
Int J Cardiol ; 89(2-3): 197-205, 2003 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-12767543

RESUMO

AIMS: In patients with chronic heart failure plasma levels of N-terminal proatrial natriuretic peptide (Nt-proANP) correlate to cardiac filling pressures. The aim of the present study was to examine the relation between Nt-proANP plasma levels and echocardiographic indices of cardiac dysfunction in patients recruited from primary care. METHODS AND RESULTS: After clinical examination by the primary care physician, the patients were referred to one of two centres for echocardiography and blood sampling. In patients with mild to moderate symptoms of heart failure (n=52) and in asymptomatic patients with long-standing hypertension (n=46) or previous myocardial infarction (n=97), peptide levels were most closely related to parameters of left atrial wall stress. Patients who according to echocardiographic predefined criteria had diastolic or systolic dysfunction had two- and three-fold higher Nt-proANP than controls. According to receiver operating curve (ROC) analysis, Nt-proANP measurements were helpful in ruling out left ventricular systolic dysfunction, but not diastolic dysfunction. CONCLUSION: In patients with mild to moderate cardiac disease, Nt-proANP plasma concentration was related to increased atrial wall stress. Peptide measurement could assist in ruling out the presence of LV systolic dysfunction, but was otherwise of limited value when used for diagnostic subgrouping into echocardiographically determined function categories.


Assuntos
Fator Natriurético Atrial/metabolismo , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/metabolismo , Precursores de Proteínas/metabolismo , Disfunção Ventricular Esquerda/diagnóstico , Disfunção Ventricular Esquerda/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Fator Natriurético Atrial/sangue , Ecocardiografia , Feminino , Insuficiência Cardíaca/sangue , Insuficiência Cardíaca/complicações , Humanos , Hipertensão/sangue , Hipertensão/complicações , Hipertensão/metabolismo , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/sangue , Infarto do Miocárdio/complicações , Infarto do Miocárdio/metabolismo , Atenção Primária à Saúde , Precursores de Proteínas/sangue , Sístole , Disfunção Ventricular Esquerda/sangue , Disfunção Ventricular Esquerda/etiologia
17.
Artigo em Inglês | MEDLINE | ID: mdl-11806788

RESUMO

Long-term treatment with angiotensin-converting enzyme inhibitors reduces post-infarction morbidity and mortality in patients with left ventricular (LV) systolic dysfunction or symptomatic heart failure. Until recently, the effect of such treatment in patients with preserved LV function has not been known. The results from the Heart Outcome Prevention Evaluation trial have indicated that long-term treatment with ramipril leads to a significant reduction in cardiovascular events in patients with atherosclerotic disease, including those with prior myocardial infarction and preserved LV function. These results suggest that long-term angiotensin-converting enzyme inhibition should also be considered in post-infarction patients with normal cardiac function.

SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA