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J Invasive Cardiol ; 31(7): E226, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31257218


The treatment of coronary lesions caused by blunt chest trauma is controversial. To our knowledge, this is the first report of a coronary dissection related to blunt chest trauma evaluated with OCT and treated with a magnesium resorbable scaffold.

Artigo em Inglês | MEDLINE | ID: mdl-30383607


BACKGROUND: European Guidelines on Myocardial Revascularization recommend clopidogrel loading dose added to acetylsalicylic acid in elective percutaneous coronary interventions (PCI). However, there is few evidence supporting this recommendation and other P2Y12 inhibitors have not been tested in these patients. PURPOSE: To evaluate the effectiveness and safety of different loading doses of clopidogrel and ticagrelor in patients without double antiplatelet therapy and stable coronary disease (SCAD) undergoing elective PCI. METHODS: Retrospective study of 147 consecutive patients with SCAD undergoing elective PCI. Loading P2Y12 inhibitor doses evaluated were: clopidogrel 600 mg, clopidogrel 300 mg, clopidogrel 150 mg and ticagrelor 180 mg. We analyzed the occurrence of major adverse cardiovascular events (MACE) and periprocedural myocardial infarction (PMI). RESULTS: 125 patients were treated with clopidogrel (16 with clopidogrel 150 mg, 7 with clopidogrel 300 mg, 93 with clopidogrel 600 mg) and 21 with ticagrelor 180 mg at the catheterization laboratory. Ticagrelor group had a significantly lower post-procedural peak of troponin-I (0.7±3.4 vs 0.3±0.7 ng/ml; p=0.02). There were no differences between groups in terms of major bleeding and hemoglobin drop post PCI (0.6±0.8 vs 4±0.6; p=0.8). The median of follow up was 17 months (interquartile range 9-32.7). At the end of follow up, MACE rate was not different between groups. CONCLUSIONS: In patients without dual antiplatelet therapy undergoing elective PCI, the use of ticagrelor showed lower postprocedural myocardial injury without more bleeding complications.

J Med Case Rep ; 8: 280, 2014 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-25142684


INTRODUCTION: Chlorambucil is an alkylating agent used in combination with prednisolone for the treatment of idiopathic membranous nephropathy. Although chlorambucil is generally well-tolerated, it is a myelosuppresive drug that can cause several infections. CASE PRESENTATION: We report the case of an 81-year-old Caucasian male presenting with idiopathic membranous nephropathy who developed fever, cough, dyspnea, pulmonary infiltrates, and abdominal pain shortly after the initiation of treatment with chlorambucil and corticosteroids for nephropathy. Virology tests for infectious diseases revealed a recent cytomegalovirus infection. Antiviral treatment (ganciclovir) resulted in full remission. CONCLUSIONS: Cytomegalovirus infection should be considered in the differential diagnosis of respiratory symptoms and pulmonary infiltrates in patients treated with chlorambucil for nephrotic syndrome.

Alquilantes/efeitos adversos , Clorambucila/efeitos adversos , Infecções por Citomegalovirus/induzido quimicamente , Idoso de 80 Anos ou mais , Alquilantes/uso terapêutico , Clorambucila/uso terapêutico , Infecções por Citomegalovirus/diagnóstico , Glomerulonefrite Membranosa/tratamento farmacológico , Humanos , Masculino