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1.
Medicine (Baltimore) ; 98(44): e17826, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689870

RESUMO

Current study was to evaluate the prevalence of guideline recommended medications adherence in myocardial infarction (MI) patients postpercutaneous coronary intervention (PCI) and the association of medication nonadherence and major adverse cardiovascular events (MACEs).MI patients who underwent PCI in the last 12 months were enrolled. Demographic and clinical characteristics were collected and guideline recommended medications were evaluated. Patients were divided into with and without MACEs groups.Compared to patients without MACEs, those with MACEs were older (54.8 ±â€Š16.4 vs 51.1 ±â€Š15.2 years), more likely to be smoker (40.2% vs 31.9%), have higher body mass index (BMI; 25.0 ±â€Š6.1 vs 23.8 ±â€Š5.7 kg/m), diabetes (47.5% vs 37.8%), ischemic stroke (34.4% vs 25.6%), and estimated lower glomerular filtration rate (85.4 ±â€Š9.6 vs 92.6 ±â€Š10.7 mL/minute/1.73 m). Patients with MACEs were also more likely to present with ST-elevation MI (STEMI; 54.1% vs 48.4%) and to undergo urgent PCI (62.3% vs 56.3%). Furthermore, patients with MACEs were less likely to adhere to dual antiplatelet therapy (77.9% vs 85.9%), renin-angiotensin system inhibitor (62.3% vs 69.7%), and beta-blocker (69.7% vs 72.8%) treatment. In unadjusted model, medication nonadherence was associated with 2-fold higher odds of MACEs. After adjustment for demographics, risk factors, comorbidities, and peri-PCI characteristics, medications nonadherence remained independently associated with MACEs, with odds ratio of 1.40 (95% confidence interval: 1.29-1.87).Medications adherence rate among MI patients post-PCI is suboptimal in China, which is independently associated with MACEs.


Assuntos
Fármacos Cardiovasculares/uso terapêutico , Doenças Cardiovasculares/epidemiologia , Adesão à Medicação/estatística & dados numéricos , Infarto do Miocárdio/tratamento farmacológico , Adulto , Idoso , China/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Prevalência
2.
Int Heart J ; 60(5): 1168-1175, 2019 Sep 27.
Artigo em Inglês | MEDLINE | ID: mdl-31484876

RESUMO

The aims of the present study were to investigate the effects of angiotensin receptor neprilysin inhibitors (ARNi) on the susceptibility of ventricular arrhythmias (VAs) in rats with myocardial infarction (MI) and to explore the related mechanisms.A total of 32 adult male Sprague-Dawley rats were divided into 3 groups: a control group, MI group, and MI+ARNi group. MI was generated by ligation of the left anterior descending coronary artery. ARNi was given at 68 mg/kg/day for 4 weeks after MI surgery. At 4 weeks after MI, electrical programmed stimulation (EPS) was performed in all groups for the evaluation of VAs, and echocardiography was used to evaluate cardiac function. Indicators of sympathetic neural remodeling and cardiac remodeling were detected to further explore the related mechanisms.Four weeks after MI, rats in the ARNi group exhibited low susceptibility of VAs in comparison with that in the MI group, which was coincident with the attenuation of sympathetic nerve remodeling, amelioration of cardiac fibrosis, and regulation of Cx43 expression.ARNi is effective in reducing VAs in rats with ischemic cardiomyopathy, which is associated with attenuating sympathetic nerve remodeling and myocardial fibrosis.


Assuntos
Conexina 43/metabolismo , Infarto do Miocárdio/tratamento farmacológico , Neprilisina/farmacologia , Taquicardia Ventricular/tratamento farmacológico , Remodelação Ventricular/efeitos dos fármacos , Animais , Biópsia por Agulha , China , Modelos Animais de Doenças , Ecocardiografia/métodos , Imuno-Histoquímica , Masculino , Contração Miocárdica/efeitos dos fármacos , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/patologia , Distribuição Aleatória , Ratos , Ratos Sprague-Dawley , Fatores de Risco , Taxa de Sobrevida , Sistema Nervoso Simpático/efeitos dos fármacos , Taquicardia Ventricular/diagnóstico por imagem
3.
Expert Rev Cardiovasc Ther ; 17(8): 605-623, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31389276

RESUMO

Introduction: Atherosclerotic coronary artery disease, in particular acute myocardial infarction (AMI), is a leading cause of morbidity and mortality globally. Percutaneous coronary intervention (PCI) is the mainstay of treatment for obstructive coronary artery disease and AMI through the restoration of TIMI III flow. Despite good macrovascular flow, the myocardium can remain hypoperfusion due to poor microvascular perfusion, and this is referred to as 'no-reflow'. Various treatments have been studied with variable success in both prevention and treatment of no-reflow. Areas covered: This review outlines the cutting-edge diagnostic investigations which have been explored in no-reflow, allowing a deeper understanding of mechanism and microvascular pathological processes involved in its genesis. These include utility of novel MRI techniques and perfusion echo in conjunction with traditional approaches. Detailed review has been undertaken of both pharmacological and non-pharmacological techniques to prevent and manage microvascular dysfunction associated with no-reflow. Particular attention was paid to the evolution and successes of various mechanical protection devices. Expert opinion: Most promising innovations in the diagnosis and management of no-reflow are evaluated, and future outlook is explored. Emerging advances in acute coronary syndrome have their findings applied a role in modifying the pathophysiology of no-reflow.


Assuntos
Doença da Artéria Coronariana/diagnóstico por imagem , Circulação Coronária , Infarto do Miocárdio/diagnóstico por imagem , Angiografia Coronária , Doença da Artéria Coronariana/tratamento farmacológico , Doença da Artéria Coronariana/cirurgia , Feminino , Humanos , Masculino , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/cirurgia , Intervenção Coronária Percutânea , Resultado do Tratamento
4.
Medicine (Baltimore) ; 98(32): e16370, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393346

RESUMO

Validated risk scoring systems in African American (AA) population are under studied. We utilized history, electrocardiogram, age, risk factors, and initial troponin (HEART) and thrombolysis in myocardial infarction (TIMI) scores to predict major adverse cardiovascular events (MACE) in non-high cardiovascular (CV) risk predominantly AA patient population.A retrospective emergency department (ED) charts review of 1266 chest pain patients where HEART and TIMI scores were calculated for each patient. Logistic regression model was computed to predict 6-week and 1-year MACE and 90-day cardiac readmission. Decision curve analysis (DCA) was constructed to differentiate between clinical strategies in non-high CV risk patients.Of the 817 patients included, 500 patients had low HEART score vs. 317 patients who had moderate HEART score. Six hundred sixty-three patients had low TIMI score vs. 154 patients had high TIMI score. The univariate logistic regression model shows odds ratio of predicting 6-week MACE using HEART score was 3.11 (95% confidence interval [CI] 1.43-6.76, P = .004) with increase in risk category from low to moderate vs. 2.07 (95% CI 1.18-3.63, P = .011) using TIMI score with increase in risk category from low to high and c-statistic of 0.86 vs. 0.79, respectively. DCA showed net benefit of using HEART score is equally predictive of 6-week MACE when compared to TIMI.In non-high CV risk AA patients, HEART score is better predictive tool for 6-week MACE when compared to TIMI score. Furthermore, patients presenting to ED with chest pain, the optimal strategy for a 2% to 4% miss rate threshold probability should be to discharge these patients from the ED.


Assuntos
Afro-Americanos , Doenças Cardiovasculares/etnologia , Dor no Peito/etnologia , Indicadores Básicos de Saúde , Hospitais Comunitários/estatística & dados numéricos , Adulto , Fatores Etários , Idoso , Doenças Cardiovasculares/mortalidade , Dor no Peito/etiologia , Dor no Peito/mortalidade , Eletrocardiografia , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Readmissão do Paciente , Estudos Prospectivos , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Índice de Gravidade de Doença , Terapia Trombolítica/estatística & dados numéricos , Troponina/sangue
5.
Biomed Khim ; 65(3): 231-238, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31258147

RESUMO

The goal of this study was to examine effects of a novel galanin receptor agonist GalR1-3 [bAla14, His15]-galanine 2-15 (G), obtained by automatic solid-phase synthesis, on the metabolic state of the area at risk and the size of acute myocardial infarction (MI) in rats in vivo and evaluate its toxicity in BALB /c mice. In anesthetized rats, regional ischemia was simulated by coronary artery occlusion and then coronary blood flow was restored. The peptide G was administered intravenously (i.v.) with a bolus after a period of regional ischemia in the dose range of 0.25-3.0 mg/kg. The sizes of MI and the activities of creatine kinase-MB (СK-MB) and lactate dehydrogenase (LDH) in blood plasma were estimated. The effect of administration of the optimal dose of G (1.0 mg/kg) on myocardial content of adenine nucleotides (AN), phosphocreatine (PCr), creatine (Cr) and lactate was studied. I.v. administration of G to rats at a dose of 1.0 mg/kg slightly affected hemodynamic parameters, but reduced MI size by 40% and decreased plasma LDH and CK-MB activity by the end of reperfusion compared to control. These effects were accompanied by a significant improvement in energy state of area at risk (AAR) - an increase in myocardial content of ATP, åAN, PCr and åCr, and combined with a decrease in myocardial lactate level compared with the control. Toxicity of peptide G was studied with a single intraperitoneal injection of 0.5-3.0% solution of the peptide substance to mice. The absence of signs of intoxication and death of animals after G injection in the maximum possible dose did not allow determining the value of the average lethal dose. The results indicate therapeutic potential of the peptide G for preventing myocardial ischemia and reperfusion injury and feasibility for further study of its pharmacological properties and mechanisms of action.


Assuntos
Infarto do Miocárdio/patologia , Peptídeos/farmacologia , Receptores de Galanina/agonistas , Animais , Creatina Quinase Forma MB/sangue , Modelos Animais de Doenças , L-Lactato Desidrogenase/sangue , Camundongos , Camundongos Endogâmicos BALB C , Infarto do Miocárdio/tratamento farmacológico , Traumatismo por Reperfusão Miocárdica/tratamento farmacológico , Traumatismo por Reperfusão Miocárdica/patologia , Ratos
6.
BMC Health Serv Res ; 19(1): 501, 2019 Jul 18.
Artigo em Inglês | MEDLINE | ID: mdl-31319824

RESUMO

BACKGROUND: Cardiovascular disease remains the most common cause of death. However, effective and timely secondary care contributes to improved quality of life, decreased morbidity and mortality. This study analyzed the medical care of patients in a resource limiting country with a first presentation of acute myocardial infarction (AMI). METHODS: A cross-sectional retrospective study was conducted on first time AMI patients admitted between March 1st 2011 and March 31st 2015 to the only tertiary public hospital in a resource limiting country, Trinidad. Relevant data were obtained from all confirmed AMI patients. RESULTS: Data were obtained from 1106 AMI patients who were predominantly male and of Indo Trinidadian descent. Emergency treatment included aspirin (97.2%), clopidogrel (97.2%), heparin (81.3%) and thrombolysis (70.5% of 505 patients with ST elevation MI), but none of the patients had primary angioplasty. Thrombolysis was higher among younger patients and in men. There were no differences in age, sex, and ethnicity in all other treatments. Of the 360 patients with recorded times, 41.1% arrived at the hospital within 4 h. The proportion of patients receiving thrombolysis (door to needle time) within 30 min was 57.5%. In-patient treatment medication included: aspirin (87.1%), clopidogrel (87.2%), beta blockers (76.5%), ACEI (72.9%), heparin (80.6%), and simvastatin (82.5%). Documentation of risk stratification, use of angiogram and surgical intervention, initiation of cardiac rehabilitation (CR), and information on behavioral changes were rare. Electrocardiogram (ECG) and cardiac enzyme tests were universally performed, while echocardiogram was performed in 57.1% of patients and exercise stress test was performed occasionally. Discharge treatment was limited to medication and referrals for investigations. Few patients were given lifestyle and activity advice and referred for CR. The in-hospital death rate was 6.5%. There was a significantly higher relative risk of in-hospital death for non-use of aspirin, clopidogrel, simvastatin, beta blockers, and heparin, but not ACE inhibitors and nitrates. CONCLUSIONS: Medication usage was high among AMI patients. However, there was very minimal use of non-pharmacological measures. No differences were found in prescribed medication by age, sex, or ethnicity, with the exception of thrombolysis.


Assuntos
Recursos em Saúde/provisão & distribução , Infarto do Miocárdio/terapia , Adulto , Idoso , Estudos Transversais , Feminino , Pesquisa sobre Serviços de Saúde , Hospitalização , Hospitais Públicos , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Estudos Retrospectivos , Centros de Atenção Terciária , Trinidad e Tobago
7.
Tokai J Exp Clin Med ; 44(2): 29-30, 2019 Jul 20.
Artigo em Inglês | MEDLINE | ID: mdl-31250422

RESUMO

The newer generation non selective vasodilating beta adrenergic blocking agent Carvedilol, also has an alpha 1 adrenoceptor antagonistic effect and is widely used in treating various cardiovascular diseases. It is a selective alpha and non-selective beta blocker. It's side effects are vast and not limited to any particular organ system, the neuropsychiatric adverse effects include; somnolence, nervousness, sleep disorder, aggravated depression, vivid dreams, delirium, psychosis, impaired concentration, abnormal thinking, paroniria, and emotional lability. Hallucinations are rarely reported and as far as we know the only reported couple of cases were on metoprolol and propranolol, none has been reported with Carvedilol.


Assuntos
Antagonistas de Receptores Adrenérgicos alfa 1/efeitos adversos , Antagonistas Adrenérgicos beta/efeitos adversos , Carvedilol/efeitos adversos , Alucinações/induzido quimicamente , Antagonistas de Receptores Adrenérgicos alfa 1/uso terapêutico , Antagonistas Adrenérgicos beta/uso terapêutico , Carvedilol/uso terapêutico , Humanos , Hipertensão/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico
8.
Chem Commun (Camb) ; 55(44): 6193-6196, 2019 May 28.
Artigo em Inglês | MEDLINE | ID: mdl-31070620

RESUMO

Hydrogen sulfide (H2S) is an important signaling molecule with promising protective effects in many physiological and pathological processes. However, the study of H2S has been impeded by the lack of appropriate H2S donors that could mimic its slow-releasing process in vivo. Herein, we report the rational design, synthesis, and biological evaluation of a series of thioester-based H2S donors. These cysteine-activated H2S donors release H2S in a slow and controllable manner. Most of the donors comprising an allyl moiety showed significant cytoprotective effects in H9c2 cellular models of oxidative damage. The most potent donor 5e decreased the mitochondrial membrane potential (MMP) loss and lactate dehydrogenase (LDH) release in H2O2-stimulated H9c2 cells. More importantly, donor 5e exhibited a potent cardioprotective effect in an in vivo myocardial infarction (MI) mouse model by reducing myocardial infarct size and cardiomyocyte apoptosis. Taken together, our studies demonstrated that these new allyl thioesters are potential cardioprotective agents by releasing H2S.


Assuntos
Cardiotônicos/farmacologia , Cardiotônicos/uso terapêutico , Ésteres/química , Sulfeto de Hidrogênio/química , Compostos de Sulfidrila/química , Animais , Linhagem Celular , Modelos Animais de Doenças , Peróxido de Hidrogênio/farmacologia , L-Lactato Desidrogenase/metabolismo , Potencial da Membrana Mitocondrial/efeitos dos fármacos , Camundongos , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/enzimologia , Infarto do Miocárdio/metabolismo , Estresse Oxidativo
9.
Ter Arkh ; 91(1): 108-113, 2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-31090381

RESUMO

The review presents current information on the role of NSAIDs in the development of cardiovascular disasters. The development of non-desirable cardiovascular effects and an increase in cardiovascular risk with the administration of NSAIDs, most experts assess in terms of the antagonistic effect on the platelet-vascular homeostasis of metabolites of COX-thromboxane A2 and prostaglandin I2 (prostacyclin). All the presented reviews confirming an increase in the risk of MI complications in the administration of NSAIDs, indicate the class-specificity of this undesirable effect, not homogeneous for different representatives of the group. Important clinical aspects of prescribing NSAIDs for patients with low and moderate cardiovascular risk are the clinical features of the patient and the individual set of risk factors for CVD. Such pharmacokinetic characteristics of NSAIDs as a short half-life, a high degree of binding to blood plasma albumins are indicative of greater safety of NSAIDs, but the final decision must be made based on the accumulated data of clinical trials and meta-analyzes. Keywords: nonsteroidal anti-inflammatory drugs, cardiovascular diseases, cardiovascular risk, lornoxicam, diclofenac sodium, thrombo-elastogram, myocardial infarction, stroke.


Assuntos
Anti-Inflamatórios não Esteroides/administração & dosagem , Anti-Inflamatórios não Esteroides/efeitos adversos , Doenças Cardiovasculares/tratamento farmacológico , Diclofenaco/administração & dosagem , Diclofenaco/efeitos adversos , Infarto do Miocárdio/tratamento farmacológico , Inibidores de Ciclo-Oxigenase 2/uso terapêutico , Humanos , Fatores de Risco
10.
Ter Arkh ; 91(1): 114-128, 2019 Mar 11.
Artigo em Inglês | MEDLINE | ID: mdl-31090382

RESUMO

The review presents the results of a number of experimental and clinical studies proving the prospects of using L-carnitine in the clinic of internal diseases. Due to the antioxidant and antihypoxant properties, the additional use of L-carnitine in addition to the main etiopathogenetic therapy is prescribed by cardiologists, nephrologists, neurologists, gerontologists. Experimental studies we conducted earlier showed no effect of L-carnitine on the activity of the P450 CYP 3A4 system, which reduces the likelihood of drug-drug interaction at the level of metabolism of drugs metabolized by P450 3A4. When using L-carnitine as part of complex pharmacotherapy, the drug has an increased safety profile in comorbid patients taking L-carnitine. Keywords: L-carnitine, P450 CYP 3А4, chronic heart failure, myocardial infarction, chronic renal failure, inter-drug interaction, antioxidant, antihypoxant.


Assuntos
Antioxidantes/farmacologia , Carnitina/farmacologia , Citocromo P-450 CYP3A/metabolismo , Cardiopatias/tratamento farmacológico , Insuficiência Cardíaca/etiologia , Coração/efeitos dos fármacos , Falência Renal Crônica/metabolismo , Infarto do Miocárdio/complicações , Antioxidantes/metabolismo , Carnitina/metabolismo , Carnitina/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/metabolismo , Humanos , Medicina Interna , Rim/efeitos dos fármacos , Rim/metabolismo , Masculino , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/metabolismo
11.
Molecules ; 24(10)2019 May 19.
Artigo em Inglês | MEDLINE | ID: mdl-31109132

RESUMO

Myocardial infarction (MI) remains one of the major causes of mortality around the world. A possible mechanism involved in myocardial infarction is the engagement of Toll-like receptors (TLRs). This study was intended to discover the prospective cardioprotective actions of ß-caryophyllene, a natural sesquiterpene, to ameliorate isoproterenol (ISO)-induced myocardial infarction through HSP-60/TLR/MyD88/NFκB pathway. ß-Caryophyllene (100 or 200 mg/kg/day orally) was administered for 21 days then MI was induced via ISO (85 mg/kg, subcutaneous) on 20th and 21st days. The results indicated that ISO induced a significant infarcted area associated with several alterations in the electrocardiogram (ECG) and blood pressure (BP) indices and caused an increase in numerous cardiac indicators such as creatine phosphokinase (CPK), creatine kinase-myocardial bound (CK-MB), lactate dehydrogenase (LDH), and cardiac tropinine T (cTnT). In addition, ISO significantly amplified heat shock protein 60 (HSP-60) and other inflammatory markers, such as TNF-α, IL-Iß, and NFκB, and affected TLR2 and TLR4 expression and their adaptor proteins; Myeloid differentiation primary response 88 (MYD88), and TIR-domain-containing adapter-inducing interferon-ß (TRIF). On the other hand, consumption of ß-caryophyllene significantly reversed the infarcted size, ECG and BP alterations, ameliorated the ISO elevation in cardiac indicators; it also notably diminished HSP-60, and subsequently TLR2, TLR4, MYD88, and TRIF expression, with a substantial reduction in inflammatory mediator levels. This study revealed the cardioprotective effect of ß-caryophyllene against MI through inhibiting HSP-60/TLR/MyD88/NFκB signaling pathways.


Assuntos
Produtos Biológicos/farmacologia , Infarto do Miocárdio/tratamento farmacológico , Substâncias Protetoras/farmacologia , Sesquiterpenos/farmacologia , Receptores Toll-Like/metabolismo , Proteínas Adaptadoras de Transdução de Sinal , Animais , Pressão Sanguínea/efeitos dos fármacos , Creatina Quinase/metabolismo , Eletrocardiografia/efeitos dos fármacos , Isoproterenol/metabolismo , L-Lactato Desidrogenase/metabolismo , Masculino , Glicoproteínas de Membrana/metabolismo , Fator 88 de Diferenciação Mieloide/metabolismo , NF-kappa B/metabolismo , Ratos Sprague-Dawley
12.
BMJ Case Rep ; 12(4)2019 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-31040148

RESUMO

A 28-year-old man diagnosed with diabetes mellitus and systemic hypertension presented with a medical history of sudden onset retrosternal discomfort followed by loss of consciousness and generalised tonic clonic seizures. Examination revealed obesity, polysyndactyly and retinal pigment dystrophy. He was diagnosed to have acute myocardial infarction and left posterior watershed infarct. He was also diagnosed to have Bardet-Biedl syndrome based on clinical features. He was managed symptomatically and is currently doing well on regular follow-up in the outpatient clinic.


Assuntos
Anticoagulantes/uso terapêutico , Síndrome de Bardet-Biedl/fisiopatologia , Imagem por Ressonância Magnética , Infarto do Miocárdio/fisiopatologia , Obesidade/complicações , Adulto , Síndrome de Bardet-Biedl/complicações , Síndrome de Bardet-Biedl/diagnóstico por imagem , Síndrome de Bardet-Biedl/tratamento farmacológico , Humanos , Masculino , Infarto do Miocárdio/diagnóstico por imagem , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/etiologia , Neuroimagem , Resultado do Tratamento
13.
J Korean Med Sci ; 34(19): e145, 2019 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-31099195

RESUMO

BACKGROUND: Patients with acute myocardial infarction (AMI) have worse clinical outcomes than those with stable coronary artery disease despite revascularization. Non-culprit lesions of AMI also involve more adverse cardiovascular events. This study aimed to investigate the influence of AMI on endothelial function, neointimal progression, and inflammation in target and non-target vessels. METHODS: In castrated male pigs, AMI was induced by balloon occlusion and reperfusion into the left anterior descending artery (LAD). Everolimus-eluting stents (EES) were implanted in the LAD and left circumflex (LCX) artery 2 days after AMI induction. In the control group, EES were implanted in the LAD and LCX in a similar fashion without AMI induction. Endothelial function was assessed using acetylcholine infusion before enrollment, after the AMI or sham operation, and at 1 month follow-up. A histological examination was conducted 1 month after stenting. RESULTS: A total of 10 pigs implanted with 20 EES in the LAD and LCX were included. Significant paradoxical vasoconstriction was assessed after acetylcholine challenge in the AMI group compared with the control group. In the histologic analysis, the AMI group showed a larger neointimal area and larger area of stenosis than the control group after EES implantation. Peri-strut inflammation and fibrin formation were significant in the AMI group without differences in injury score. The non-target vessel of the AMI also showed similar findings to the target vessel compared with the control group. CONCLUSION: In the pig model, AMI events induced endothelial dysfunction, inflammation, and neointimal progression in the target and non-target vessels.


Assuntos
Endotélio/fisiologia , Imunossupressores/uso terapêutico , Inflamação/patologia , Infarto do Miocárdio/tratamento farmacológico , Neointima/patologia , Doença Aguda , Animais , Artérias/patologia , Contagem de Células Sanguíneas , Modelos Animais de Doenças , Stents Farmacológicos , Everolimo/química , Everolimo/uso terapêutico , Imunossupressores/química , Infarto do Miocárdio/patologia , Miocárdio/patologia , Suínos , Resultado do Tratamento
14.
Bull Exp Biol Med ; 166(6): 747-750, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31020589

RESUMO

Antithrombotic activity of a novel tricyclic derivative of diazepino[1,2-α]benzimidazole (DAB-15) was examined on the model of arterial thrombosis developed in rats without concomitant pathology and in rats with experimental myocardial infarction. DAB-15 demonstrated high antithrombotic efficacy in modeled thrombosis of carotid artery in rats without the concomitant pathology surpassing that of the reference drugs acetylsalicylic acid and clopidogrel by 5.1 and 4.8 times, respectively. In rats with experimental noncoronary myocardial infarction, DAB-15 increased the thrombus formation time by 86.2% in comparison with experimental control level in non-treated rats with similar myocardial infarction.


Assuntos
Azepinas/farmacologia , Benzimidazóis/farmacologia , Fibrinolíticos/farmacologia , Infarto do Miocárdio/tratamento farmacológico , Trombose/prevenção & controle , Animais , Animais não Endogâmicos , Aspirina/farmacologia , Azepinas/síntese química , Benzimidazóis/síntese química , Testes de Coagulação Sanguínea , Cloretos/administração & dosagem , Clopidogrel/farmacologia , Modelos Animais de Doenças , Compostos Férricos/administração & dosagem , Fibrinolíticos/síntese química , Masculino , Infarto do Miocárdio/sangue , Infarto do Miocárdio/patologia , Agregação Plaquetária/efeitos dos fármacos , Ratos , Trombose/sangue , Trombose/induzido quimicamente , Trombose/patologia
15.
Life Sci ; 227: 82-93, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31004658

RESUMO

AIMS AND METHODS: Acute myocardial infarction (AMI) is a common cardiovascular disease with high mortality. Astragaloside IV (AS-IV) was reported to have cardioprotective effect after AMI. We hypothesize that the cardioprotective role of AS-IV is exerted by enhancing angiogenesis via regulating PTEN/PI3K/Akt signaling pathway. To valid our hypothesis, AMI rats and human umbilical vein endothelial cells (HUVECs) were employed in our study. KEY FINDINGS: After treatment, cardiac function, survival rate, infarct size, pathological changes and fibrosis, cell apoptosis, ultrastructural changes, angiogenesis and expression of PTEN/PI3K/Akt signaling pathway were evaluated, respectively. In vitro study we detected proliferation, tube formation and signaling pathway activation of HUVECs treated with AS-IV, lentivirus overexpressed PTEN was employed to elucidate the potential mechanism. The results indicated that AS-IV administration significantly improved cardiac function and survival rate, limited infarct size, ameliorated pathological changes and fibrosis deposition, inhibited apoptosis, relieved ultrastructure injury and enhanced angiogenesis, PTEN/PI3K/Akt signaling pathway was activated simultaneously compared to the model group. In vitro study suggested that AS-IV treatment promoted cell proliferation and tube formation, and induced PTEN/PI3K/Akt signaling pathway activation. Importantly, overexpression of PTEN by lentivirus abolished AS-IV-induced angiogenesis. SIGNIFICANCE: Our study indicated that AS-IV could promote angiogenesis and cardioprotection after myocardial infarction. The mechanisms involve activation of PTEN/PI3K/Akt signaling pathway.


Assuntos
Infarto do Miocárdio/tratamento farmacológico , Saponinas/farmacologia , Triterpenos/farmacologia , Indutores da Angiogênese , Animais , Apoptose/efeitos dos fármacos , Cardiotônicos , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Células Endoteliais da Veia Umbilical Humana , Humanos , Masculino , Infarto do Miocárdio/metabolismo , Neovascularização Patológica/metabolismo , PTEN Fosfo-Hidrolase/efeitos dos fármacos , PTEN Fosfo-Hidrolase/metabolismo , Fosfatidilinositol 3-Quinases/efeitos dos fármacos , Fosfatidilinositol 3-Quinases/metabolismo , Proteínas Proto-Oncogênicas c-akt/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-akt/metabolismo , Ratos , Ratos Sprague-Dawley , Saponinas/metabolismo , Transdução de Sinais/efeitos dos fármacos , Triterpenos/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
16.
Life Sci ; 227: 187-192, 2019 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-31028802

RESUMO

AIMS: Myocardial injury (MI) is the principal cause of death from cardiovascular disease (CVD). The present study was conducted to investigate the ameliorative and antioxidant effects of cerebrolysin (CBL) on isoproterenol-induced MI in rats. METHODS: MI was induced in the rats by subcutaneously injecting 100 mg/kg of isoproterenol (ISO) in the first two days. The serum levels of creatine phosphokinase (CK-MB) and cardiac troponin I (cTnI) were measured on the third day to confirm MI. The post-treatment involved intraperitoneally injecting 5 ml/kg of CBL for 7 days. Nitric oxide (NO), malondialdehyde (MDA) in the heart tissue and catalase (CAT) and serum levels of superoxide dismutase (SOD) and glutathione peroxidase (GPX) were measured on the 10th day using the enzyme-linked immunosorbent assay (ELISA). Histopathological examinations of the heart tissue were also performed. FINDINGS: The present results suggested significant increases in CK-MB, cTnI, MDA and NO. A significant decrease was also observed in the ISO-treated rats in certain antioxidant enzymes, including CAT and GPX. CBL administration showed a significant ameliorative increase against the oxidative ISO-induced damage. Moreover, the histopathological findings showed lower levels of the infiltration of inflammatory cells and edema and vascular proliferation in the CBL-treated rats. SIGNIFICANCE: The present histopathological and biochemical findings attributed antioxidant properties to CBL in the rat myocardium and suggested protective effects on ISO-induced MI.


Assuntos
Aminoácidos/farmacologia , Coração/efeitos dos fármacos , Infarto do Miocárdio/tratamento farmacológico , Aminoácidos/metabolismo , Animais , Antioxidantes/farmacologia , Catalase/metabolismo , Glutationa Peroxidase/metabolismo , Isoproterenol/farmacologia , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Malondialdeído/metabolismo , Infarto do Miocárdio/patologia , Miocárdio/metabolismo , Óxido Nítrico/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Ratos , Ratos Wistar , Superóxido Dismutase/metabolismo
17.
Medicine (Baltimore) ; 98(16): e15256, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31008964

RESUMO

BACKGROUND: In recent years, with the enormous advances in the field of cardiac intervention technology, the survival rate of patients with acute myocardial infarction (AMI) has been improved significantly. However, the risk of arrhythmias and heart failure remains very high in AMI patients for long-term prognosis. Chinese herbal medicine (CHM) is more and more used in the treatment of AMI because of its good curative effect and less side effects. The target of this research is to analyze the efficacy and safety of Astragalus (Huangqi) preparation in the treatment of AMI by meta-analysis and also to provide a better evidence for clinical practice. METHODS: Seven databases will be searched in this study: The Cochrane Library, PubMed, Web of Science, the Chinese National Knowledge Infrastructure (CNKI), the Chinese Scientific Journal Database (CSJD), the Chinese Biomedical Literature Database (CBM), and Wanfang DATA. The following search terms will be used: (Huangqi OR Huang Qi OR Astragalus OR radix astragali) AND (acute myocardial infaction OR myocardial infaction OR AMI) AND (randomized controlled trial OR RCT OR randomized). No language limitations and the searches will be conducted up to March, 2019. INCLUSION CRITERIA: randomized controlled trial (RCT) of Astragalus (Huangqi) preparation in patients with AMI. Main outcome measures will be left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV), left ventricular ejection fraction (LVEF), left ventricular mass index (LVMI), recanalization rate, mortality rate, incidence of reperfusion arrhythmias, postinfarction angina pectoris, and re-infarction rate. Secondary outcome indicators were the incidence of adverse reactions and the effective rate of traditional Chinese medicine (TCM) treatment. Two independent reviewers will filter the literature and extract data which based to the Cochrane manual. The relevant data, including bias risk assessment, data synthesis, subgroup analysis, meta-analysis, and final meta-analysis, will be analyzed with RevMan 5.3 software. The funnel diagram will be used to evaluate the reported deviation, and the Egger test will be used to evaluate the symmetry of the funnel graph. RESULTS: This systematic review study will provide a clear basis for evaluating the efficacy and safety of Astragalus (Huangqi) preparation with the treatment of AMI. CONCLUSION: This study will provide an up-to-date evidence for evaluating the efficacy and safety of Astragalus (Huangqi) preparation. PROSPERO REGISTRATION NUMBER: CRD42019124843.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Infarto do Miocárdio/tratamento farmacológico , Medicamentos de Ervas Chinesas/efeitos adversos , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto
18.
Genet Test Mol Biomarkers ; 23(5): 316-324, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30942616

RESUMO

Objective: Perindopril is an angiotensin-converting enzyme (ACE) inhibitor that is commonly used in the treatment of Chinese Han patients with acute myocardial infarction (AMI). However, there have been few studies on whether polymorphisms of the ACE gene affect the efficacy of perindopril or the prognosis of AMI patients. The purpose of this study was to analyze the relationship among the ACE rs121912703 (C>T), rs767880620 (C>A), and rs397514689 (C>T) gene polymorphisms and the prognosis of AMI patients and the clinical efficacy of perindopril in the treatment of AMI. Methods: The ACE genotypes at the rs121912703, rs767880620, and rs397514689 loci in 225 AMI patients treated with perindopril were determined by polymerase chain reaction/Sanger sequencing. Differences in cardiac structure, functional indicators, hemodynamic parameters, and related laboratory indicators were detected before and after treatment. Results: After administration of perindopril, improved ventricular remodeling in AMI patients with wild-type ACE was better than in patients with the ACE rs121912703, rs767880620, and rs397514689 minor variant alleles. The patients harboring wild-type ACE had lower systolic blood pressure and diastolic blood pressure than the patients harboring the minor variant alleles (p < 0.01). The contents of serum ACE and Ang II (angiotensin II) in AMI patients carrying the wild-type ACE alleles were lower than those of patients harboring any of the minor variant alleles (p < 0.01). The 3-year survival time of AMI patients carrying the wild-type ACE alleles was markedly greater compared with AMI patients carrying the mutant genes (p < 0.01). Conclusion: Mutations at the ACE rs121912703, rs767880620, and rs397514689 loci affect the efficacy of perindopril on ventricular remodeling and hemodynamics in Chinese Han AMI patients. The 3-year survival of AMI patients harboring the variant alleles is less than that of the patients harboring the wild-type gene.


Assuntos
Infarto do Miocárdio/genética , Peptidil Dipeptidase A/genética , Perindopril/farmacologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Inibidores da Enzima Conversora de Angiotensina , Grupo com Ancestrais do Continente Asiático/genética , Biomarcadores Farmacológicos/sangue , China , Grupos Étnicos/genética , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/tratamento farmacológico , Perindopril/metabolismo , Polimorfismo Genético/genética , Resultado do Tratamento
19.
Rev. medica electron ; 41(2): 357-367, mar.-abr. 2019. tab
Artigo em Espanhol | LILACS, CUMED | ID: biblio-1004273

RESUMO

RESUMEN Introducción: el infarto agudo de miocardio es una de las formas más graves de cardiopatía isquémica. Representa un problema de salud de relevancia mundial. Se realizó un estudio descriptivo con el objetivo de determinar el comportamiento de pacientes portadores de infarto agudo del miocardio tratados por trombolisis en el Hospital Provincial Docente "Amalia Simoni", de Camagüey, en el período comprendido desde 2013 a 2015. Objetivo: determinar el comportamiento de pacientes portadores de infarto agudo de miocardio, tratados por trombolisis en el Hospital Provincial Docente "Amalia Simoni", de Camagüey. Materiales y métodos: la muestra la conformó los 146 pacientes que ingresaron, en el período antes mencionado, en el Servicio de Gariatría, Hospital Provincial Docente "Amalia Simoni". Se emplearon métodos de estadística descriptiva y se determinó la frecuencia y el porcentaje. Resultados: reveló un predominio de hombres entre 60 y 79 años, con antecedentes de hipertensión arterial y en un elevado porcentaje de fumadores, clasificados en Killip Kimball I y II, con excelentes resultados los tratados antes de las 3 h, y con complicaciones inmediatas sobre el músculo cardiaco. Conclusiones: el tratamiento trombólitico es muy efectivo en las 3 h primeras del comienzo de los síntomas.


ABSTRACT Introduction: the myocardial acute infarct is one of the forms of the ischemic heart disease, being a health problem around the world. The authors carried out a descriptive study with the objective of determining the behavior of patients suffering a myocardial acute infarct treated by thrombolysis in the Teaching Provincial Hospital "Amalia Simoni", of Camagüey, in the period from 2013 to 2015. Objective: to determine the behavior of patients suffering a myocardial acute infarct treated by thrombolysis in the Teaching Provincial Hospital "Amalia Simoni", of Camagüey. Material and methods: the simple was formed by all the 146 patients who entered the Teaching Provincial Hospital "Amalia Simoni" in the before-mentioned period with a diagnosis of myocardial acute infarct. Descriptive statistic methods were used and frequency and percentage were determined. Results: the study showed the predominance of men aged 60-79 years, with antecedents of arterial hypertension and a high number of cigarette smokers, classified in Killip&Kimball I and II. The patients treated before 3 hours passed showed excellent results, and with immediate complications on the heath muscle. Conclusions: thrombolytic treatment is very effective in the first 3 hours after the symptoms beginning.


Assuntos
Humanos , Estreptoquinase/uso terapêutico , Terapia Trombolítica/mortalidade , Infarto do Miocárdio/complicações , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/fisiopatologia , Infarto do Miocárdio/tratamento farmacológico , Infarto do Miocárdio/epidemiologia , Epidemiologia Descritiva , Estudo Observacional
20.
Mol Med Rep ; 19(6): 4569-4578, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30942413

RESUMO

Previous studies suggest that granulocyte colony­stimulating factor (G­CSF) can promote bone marrow derived progenitor cells to mediate cardiovascular repair, potentially reversing mechanical dysfunction in chronic ischaemic heart disease and post myocardial infarction. Two models were used in the present study both using a surgical ameroid constrictor to induce arterial stenosis. The first model used the carotid artery of rabbits. They were divided into high fat diet (inducing atherosclerosis) or normal fat diet (control) groups. Each was subdivided into surgical exposure group without constrictor, ameroid constrictor receiving normal saline or receiving G­CSF 15 µg/kg/day. Endothelial markers of endothelial nitric oxide synthase and endothelin 1 were increased by the use of ameroid constrictor in both atherosclerotic and non­atherosclerotic mice, however were not further altered by G­CSF. Scanning electron microscopy indicated that ameroid constrictor application altered endothelial morphology from an oval shape to a round shape and this was more prominent in the atherosclerotic compared with the non­atherosclerotic group. G­CSF injection increased the number of endothelial cells in all groups. The second model used the left coronary artery of pigs. They were equally divided into following groups, receiving normal saline (control), G­CSF 2.5 µg/kg/day (low dose), 5 µg/kg/day (medium dose) and 10 µg/kg/day (high dose) for 5 days. G­CSF at a low or high dose worsened intimal hyperplasia however at a medium dose improved it. In conclusion, G­CSF had no effect in a rabbit carotid artery model of atherosclerosis. Its effects on the porcine heart were dose­dependent; arterial disease worsened at a low or high dose, but improved at a medium dose.


Assuntos
Fator Estimulador de Colônias de Granulócitos/farmacologia , Animais , Artérias Carótidas/efeitos dos fármacos , Vasos Coronários/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Células Endoteliais/efeitos dos fármacos , Células Endoteliais/metabolismo , Endotelina-1/metabolismo , Coração/efeitos dos fármacos , Masculino , Infarto do Miocárdio/tratamento farmacológico , Isquemia Miocárdica/tratamento farmacológico , Óxido Nítrico Sintase Tipo III/metabolismo , Coelhos , Suínos , Fator de Necrose Tumoral alfa/metabolismo , Fator A de Crescimento do Endotélio Vascular/metabolismo
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