Modern approach to myocardial infarction: Determination of prognosis and therapy

1981 ◽  
Vol 101 (1) ◽  
pp. 75-85 ◽  
Author(s):  
Charles E. Rackley ◽  
Richard O. Russell ◽  
John A. Mantle ◽  
William J. Rogers ◽  
Silvio E. Papapietro
2021 ◽  
Author(s):  
Naeime Salandari-Jolge ◽  
Ali A. Ensafi ◽  
Behzad Rezaei

Dipyridamole is a prescribed medication used to treat cardiovascular diseases, angina pectoris, imaging tests for heart patients, and myocardial infarction. Therefore, high selectivity and sensitivity, low cost, and high-performance speed...


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Hromadka ◽  
Z Motovska ◽  
M Karpisek ◽  
O Hlinomaz ◽  
R Miklik ◽  
...  

Abstract Background Balancing the intensity and duration of antiplatelet therapy according to thrombotic risk is a fundamental need in order to optimize therapy effectiveness and safety. Incorporation of new predictors in thrombotic risk stratification is therefore of a crucial importance for antiplatelet therapy net clinical benefit. Purpose The present analysis aimed to evaluate the relation of miR-126-3p and miR-223-3p, new markers of platelet activation, in order to facilitate prediction of recurrent thrombotic events after acute myocardial infarction (AMI). Method The analysis included 598 patients (age median 62 years, men 77.8%) randomized in the Prague-18 study (ticagrelor vs. prasugrel in AIM treated with primary PCI). During the study follow up, 40.6% of patients switched to clopidogrel. Determination of miR was evaluated 24 hours after admission; miR-126-3p and miR-223-3p were normalized by miR-423-3p and miR-150-5p. Quantitative determination of selected miRNAs was performed with a novel microRNA immunoassay method. Selected miRNAs were compared with key efficacy endpoints (cardiovascular death, nonfatal MI and stroke), stent thrombosis and all hemorrhagic events, and analysed using univariate and multivariate logistic regressions. Results Increased values of miR-223-3p were significantly related to the occurrence of combined ischemic endpoint within 30 days [OR (95% CI) 15.739 (2.066; 119.932) p=0.008] and within one year [3.175 (1.40; 7.186) p=0.006]. Decreased ratio of miR-126-3P/miR-223-3p was significantly related to the occurrence of combined ischemic endpoint within 30 days [0.137 (0.031; 0.609) p=0.009] and one year [0.372 (0.169; 0.819) p=0.014]. MiRNAs were identified as independent predictors even after adjustment for confounding clinical predictors (Study arm, Switch to Clopidogrel, Age, Men, BMI, Smoking, History of Hyperlipidemia, Hypertension, DM, MI, PCI, CABG, Chronic heart failure, Chronic renal failure, Peripheral arterial disease, LBBB, RBBB, TIMI <3 after PCI, Number of diseased vessels >1, Stem disease, Suboptimal of failure of PCI, Time to hospital). Adjusted ORs (95% CI) are 11.828 (1.472; 98.011), p=0.022 and 2.394 (1.021; 5.610), p=0.045 for increased value of miR-223-3p and the occurrence of combined ischemic endpoint within 30 days and one year respectively; 0.151 (0.030; 0.757), p=0.022 and 0.407 (0.179; 0.925), p=0.032 for decreased ratio of miR-126–3P/miR-223-3p and the occurrence of combined ischemic endpoint within 30 days and one year respectively. No association between miRNA and bleeding complications was identified. Conclusion The miR-223-3p and miR-126-3p to miR-223-3p ratio are strong independent predictors of thrombotic ischemic events and can be used to stratify patients post AMI.


Author(s):  
Aleksey Michailovich Chaulin ◽  
Duplyakov V Dmitry

Cardiovascular diseases have a leading role in terms of morbidity, mortality, and disability of the population, causing significant socio-economic damage to all countries of the world. This circumstance requires researchers to constantly seek for new biomarkers and improve methods for determining existing biomarkers, and search for new therapeutic targets to improve diagnostic and treatment strategies. Recently, there have been some important changes in laboratory diagnostics of patients with acute coronary syndrome, due to the introduction into the routine practice of new high and ultrasensitive methods for the determination of biomarkers of injury, specific to cardiac muscle tissue, namely cardiac troponins. A key advantage of highly sensitive immunochemical assays is the ability to detect cardiac troponins in the early stages of myocardial infarction. This allows making the optimal decision on the early choice and conduct of reperfusion therapy, which significantly improves the further prognosis of patients. Among the most significant generally recognised disadvantages of highly sensitive determination methods are low specificity and a huge variety of troponin immunoassays. The decrease in specificity is reflected in the fact that cardiac troponins are no longer considered the “gold standard” of diagnosis related to Acute Myocardial Infarction (AMI) (irreversible ischaemic damage to cardiomyocytes). As a result, any damage to the myocardium, even insignificant and reversible under physiological state (physical activity, stress) and several pathological conditions, can lead to an increase in serum levels of cardiac troponins and affect the accuracy of the diagnosis. Each method for the determination of cardiac troponins, among the existing wide variety of troponin immunoassays, possesses different analytical characteristics, and detects different concentrations of troponins in the same patient. This article provides a view of current data on the biology of cardiac troponins, and defines the analytical characteristics of new high-sensitive methods for the determination of cardiac troponins.


2021 ◽  
Vol 22 (3) ◽  
pp. 90-93
Author(s):  
L. V. Kremneva ◽  
◽  
O. V. Abaturova ◽  
N. Yu. Stogniy ◽  
S. N. Suplotov ◽  
...  

The modern approach to the treatment of patients with acute coronary syndrome without ST segment elevation on electrocardiogram (NSTEMI) involves the implementation of invasive interventions and the appointment of drug therapy. This literature review presents data on the features of drug treatment of patients with NSTEMI.


2021 ◽  
Vol 76 (5S) ◽  
pp. 533-538
Author(s):  
Natalia V. Orlova ◽  
Valerij V. Lomajchikov ◽  
Tatyana I. Bonkalo ◽  
Grigorij A. Chuvarayan ◽  
Yana G. Spiryakina ◽  
...  

Background. COVID-19 increases the risk of developing thromboembolic complications, including acute myocardial infarction, in the acute period of the disease. The long-term consequences of COVID-19 are poorly understood. At the same time, the available data on an increased risk of acute coronary syndrome after infectious diseases allow us to make an assumption about a similar risk in COVID-19. The aim of the study was to study the anamnestic and laboratory diagnostic data in patients with acute coronary syndrome after COVID-19. Methods. The study included 185 patients with acute coronary syndrome who were admitted to the State Clinical Hospital No. 13 in Moscow in the period from May to December 2020. 2 groups were identified: group 1 109 patients with ACS who had previously suffered COVID-19, group 2 76 patients with ACS without COVID-19 in the past. The patients were collected anamnesis, including: the fact of smoking and alcohol consumption, heredity, previous diseases, including diabetes mellitus, acute myocardial infarction, previously performed PCI. Information about the COVID-19 infection has been collected (the duration of the disease, the course of the disease). A clinical and laboratory examination was conducted, including the determination of body mass index (BMI), examination for antibodies to COVID-19, determination of the lipid profile level (total cholesterol, LDL, HDL, triglycerides), blood glucose level, C-RB. The analysis was performed on automatic biochemical analyzers Hitachi-902, 912 (Roche Diagnostics, Japan). All patients underwent coronary angiography. Results. In patients with ACS with previously transferred COVID-19, the development of the disease occurred at a younger age compared to patients without transferred COVID-19. Among the patients with COVID-19, body weight was significantly lower, there were fewer smokers, concomitant type 2 diabetes mellitus and transferred ONMC were less common. In laboratory parameters, lower triglyceride levels were observed in patients with ACS with COVID-19 compared with those of patients without COVID-19. In the laboratory parameters of blood clotting in patients with ACS with COVID-19, higher APTT, thrombin time, fibrinogen level, D-dimer were noted. The indicated laboratory parameters in the groups had statistically significant differences. In ACS patients with a previous COVID-19, compared with patients without COVID-19, the lesion of 2 or more coronary vessels was more common in the anamnesis. Conclusion. According to the results of our study, it was revealed that multivessel coronary artery damage in patients after COVID-19 in comparison with patients without COVID-19 develops significantly more often, while these patients are significantly less likely to have DM and previously suffered ONMC, the level of TG is significantly lower.


1971 ◽  
pp. 45-54
Author(s):  
H. C. Hemker ◽  
S. A. G. J. Witteveen ◽  
W. TH. Hermens ◽  
L. Hollaar

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