Genetic Polymorphism of Angiotensin II Type 1 Receptors and Their Effect on the Clinical Outcome of Captopril Treatment in Arab Iraqi Patients with Acute Coronary Syndrome (Mid Euphrates)

Kounis syndrome or allergic myocardial infarction is an acute coronary syndrome in the course of an allergic reaction. In allergic patients in response to a specific condition - nourishment, inhalation, environmental substances, drug or insect bite there is an allergic reaction involving many different cells and mediators that can cause coronary artery spasm or initiate the process of rupture and activation of atherosclerotic plaque resulting in acute coronary syndrome. The paper describes a case of a young man with allergy to pollen and confirmed sensitization to nuts, who developed a full-blown anaphylactic shock after eating the nut mix and experienced a rapidly passing acute coronary syndrome with troponin up to 4.7 μg/L. An increased concentration of tryptase (15 μg/L), total IgE (> 3,000 IU/mL) and specific anti-nut IgE (55.1 kUA/L) were found. Based on the course of the disease and the results of allergic and cardiac tests, allergic type 1 myocardial infarction, i.e. caused by coronary artery spasm, was diagnosed. During the hospitalization, the patient’s condition improved quickly and after a few days he left the hospital without the signs of permanent damage to the heart muscle.

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Prediction of clinical outcome in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) using the TIMI risk score extended by N-terminal pro-brain natriuretic peptide levels

Wiener klinische Wochenschrift ◽

10.1007/s00508-007-0892-2 ◽

2007 ◽

Vol 119 (21-22) ◽

pp. 626-632 ◽

Cited By ~ 9

Author(s):

Rudolf Jarai ◽

Nelly Iordanova ◽

Robert Jarai ◽

Ferenc Jarai ◽

Annamaria Raffetseder ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Clinical Outcome ◽

Brain Natriuretic Peptide ◽

Natriuretic Peptide ◽

Risk Score ◽

Coronary Syndrome ◽

St Elevation ◽

Elevation Acute Coronary Syndrome ◽

Timi Risk Score

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Angiotensin-Converting Enzyme Inhibitors Versus Angiotensin II Receptor Blockers in Acute Coronary Syndrome and Preserved Ventricular Ejection Fraction

Angiology ◽

10.1177/0003319720946971 ◽

2020 ◽

Vol 71 (10) ◽

pp. 886-893

Author(s):

María Cespón-Fernández ◽

Sergio Raposeiras-Roubín ◽

Emad Abu-Assi ◽

Isabel Muñoz Pousa ◽

Berenice Caneiro Queija ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Angiotensin Ii ◽

Ejection Fraction ◽

Angiotensin Converting Enzyme ◽

Angiotensin Ii Receptor Blockers ◽

Converting Enzyme ◽

Angiotensin Ii Receptor ◽

Ventricular Ejection Fraction ◽

Coronary Syndrome ◽

Receptor Blockers

Angiotensin-converting enzyme inhibitor (ACEi) and angiotensin II receptor blockers (ARB) showed comparable survival results in patients with heart failure (HF) and reduced left ventricular ejection fraction (LVEF). However, there is lack of evidence of the comparative effectiveness in preserved LVEF patients after an acute coronary syndrome (ACS). The aim of this study was to evaluate whether the selection between ACEi and ARB in preserved LVEF after an ACS confers a prognostic benefit, based on real life results. We analyzed a cohort of 3006 contemporary patients with LVEF ≥40% after an ACS. A propensity score matching and Cox regression analysis were performed to assess the association between treatment and events (death, acute myocardial infarction [AMI], HF, and combined event) for a mean follow-up of 3.6 ± 2.1 years. We found no significant differences between ACEi/ARB for all-cause mortality (hazard ratio [HR] for ARB: 0.95, 95% CI: 0.70-1.29), AMI (HR for ARB: 1.34, 95% CI: 0.95-1.89), HF (HR for ARB: 1.11, 95% CI: 0.85-1.45), or combined end point (death, AMI and HF: HR for ARB: 1.14, 95% CI: 0.92-1.40). In conclusion, there are no prognostic differences between the use of ACEi and ARB in patients with LVEF ≥40% after ACS. Further prospective studies are needed to confirm our results.

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Optimal Medical Therapy on Top of Dual-Antiplatelet Therapy: 1-Year Clinical Outcome in Patients With Acute Coronary Syndrome: The START Antiplatelet Registry

Angiology ◽

10.1177/0003319719895171 ◽

2019 ◽

Vol 71 (3) ◽

pp. 235-241 ◽

Cited By ~ 1

Author(s):

Plinio Cirillo ◽

Luigi Di Serafino ◽

Vittorio Taglialatela ◽

Paolo Calabrò ◽

Emilia Antonucci ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Clinical Outcome ◽

Antiplatelet Therapy ◽

Medical Therapy ◽

Real World ◽

Dual Antiplatelet Therapy ◽

Optimal Medical Therapy ◽

Cerebrovascular Event ◽

Coronary Syndrome ◽

The Impact

Optimal medical therapy (OMT) at discharge is recommended after acute coronary syndrome (ACS). Few studies report the impact of OMT on long-term clinical outcome in a real-world scenario. We evaluated the impact of discharge OMT on top of dual-antiplatelet therapy (DAPT) on clinical outcome in the real-world ACS population of the Survey on anTicoagulated pAtients RegisTer ANTIPLATELET registry. The primary end point was major adverse cardiac and cerebrovascular event (MACCE), a composite of death, myocardial infarction, stroke, or target vessel revascularization. The co-primary end point was net adverse cardiac and cerebrovascular event (NACE), based on MACCE plus major bleeding. Consecutive patients with ACS with 1-year follow-up were enrolled. They were evaluated at discharge for the use of a β-blocker, angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers and statins. Optimal medical therapy was defined as the use of ≥2 of 3 medications. At multivariate analysis, both MACCE and NACE were significantly higher in non-OMT patients than in OMT patients (MACCE 18 [19] vs 59 [9], hazard ratio [HR] = 0.44 [0.26-0.75], P = .002, NACE 19 [20] vs 67 [10], HR = 0.47 [0.28-0.79], P = .004). In this real-world scenario, OMT at discharge on top of DAPT seems associated with a better clinical outcome compared with patients discharged on non-OMT.

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