scholarly journals The Evaluation of Plasma and Leukocytic IL-37 Expression in Early Inflammation in Patients with Acute ST-Segment Elevation Myocardial Infarction after PCI

2015 ◽  
Vol 2015 ◽  
pp. 1-6 ◽  
Author(s):  
Xin Wang ◽  
Xiangna Cai ◽  
Lan Chen ◽  
Duanmin Xu ◽  
Jilin Li
Keyword(s):  
Myocardial Infarction ◽  
Healthy Volunteers ◽  
Venous Blood ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Hs Crp

Objective. Acute ST-segment elevation myocardial infarction (ASTEMI) is accompanied by increased expression of inflammation and decreased expression of anti-inflammation. IL-37 was found to be involved in the atherosclerosis-related diseases and increased in acute coronary syndrome. However, the level of IL-37 in blood plasma and leukocytes from patients with ASTEMI after percutaneous coronary intervention (PCI) has not been explored.Methods. We collected peripheral venous blood from consented patients at 12 h, 24 h, and 48 h after PCI and healthy volunteers. Plasma IL-37, IL-18, IL-18-binding protein (BP), and high sensitive C reaction protein (hs-CRP) were quantified by ELISA and leukocytic IL-37 and ICAM-1 by immunoblotting.Results. Plasma IL-37, IL-18, and IL-18 BP expression decreased compared to those in healthy volunteers while hs-CRP level was high. Both leukocytic IL-37 and ICAM-1 were highest expressed at 12 h point but significantly decreased at 48 h point.Conclusion. These findings suggest L-37 does not play an important role in the systematic inflammatory response but may be involved in leukocytic inflammation in ASTEMI after PCI.

scholarly journals Good Practices in the Clinical Management of Patients with Acute Coronary Syndrome: Retrospective Analysis in a Third-Level Hospital in Mexico

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Héctor E. Flores-Salinas ◽  
Fidel Casillas-Muñoz ◽  
Yeminia Valle ◽  
Cesar M. Guzmán-Sánchez ◽  
Jorge Ramon Padilla-Gutiérrez
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Heart Surgery ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Introduction and Objective. In Mexico, there has been an increase in the risk of cardiovascular disease due to rising life expectancy, westernized lifestyle, lack of prevention, and industrialized exposure. This article describes the pharmacological treatment, surgical interventions, and associated clinical complications in patients diagnosed with acute coronary syndrome (ACS) and their impact on in-hospital mortality frequency in a Cardiology Unit in Instituto Mexicano del Seguro Social. Methods. This is a retrospective study including male and female patients aged ≥18 years who were diagnosed with ACS. The collected data included demographic characteristics, risk factors, medications, electrocardiograms, surgical procedures, and in-hospital deaths. Results. There are at least 20% more diagnoses of ST-segment elevation myocardial infarction in this hospital compared to the latest national reports in Mexico. The most common risk factors were type 2 diabetes mellitus, hypertension, smoking, and dyslipidaemia. Diabetic patients with a clinical history of percutaneous coronary intervention had a higher risk of non-ST-segment elevation myocardial infarction than nondiabetics (OR: 2.34; p=0.013), also smoking patients with previous heart surgery than nonsmokers (OR: 7.73; p=0.0007). The average in-hospital mortality was 3.6% for ACS. Conclusions. There is a higher percentage of coronary interventionism and improvement in pharmacological treatment, which is reflected in lower mortality. The substantial burden of T2DM could be related to a higher number of cases of STEMI. Diabetics with precedent percutaneous coronary intervention and smokers with previous heart surgery have an increased risk of subsequent infarction.

scholarly journals Comorbidities and Percutaneous Coronary Intervention in Elderly Patients with Acute Coronary Syndrome

2021 ◽  
Vol 17 (2) ◽  
pp. 221-227
Author(s):  
M. Yu. Gilyarov ◽  
E. V. Konstantinova ◽  
M. R. Atabegashvili ◽  
T. D. Solntseva ◽  
D. A. Anichkov ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Elderly Patients ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Aim. To assess comorbidities in elderly patients with acute coronary syndrome (ACS) and to analyze patient subgroups with different treatment strategies in the Regional Vascular Center (RVC).Material and methods. The prospective study included 205 patients with confirmed ACS 75 years and older, the mean age was 81±4.9 years, and 68% were women. ST segment elevation myocardial infarction (STEMI) was diagnosed in 46 (22.4 %) patients, non-ST segment elevation myocardial infarction (NSTEMI) was diagnosed in 159 (77,6 %) patients. The Charlson Comorbidity Index (CCI) was calculated in every patient. Early outcomes were defined as those assessed during hospital stay. Late outcomes were assessed at 6 months after the discharge using phone calls and/or clinic visits. All patients provided written informed consent.Results. Percutaneous coronary intervention (PCI) was performed in 42% of patients. In patients with STEMI and NSTEMI PCI was performed in 73% and 32%, respectively. Mean CCI score was 7.9 points: 7.6 points in men and 8.04 in women. Patients with STEMI had higher CCI score than NSTEMI patients (p<0.01): 8.1 points and 7.1 points, respectively. Patients who underwent PCI had lower CCI score (7.2 points) than patients in non-PCI group (8.2 points; p<0.05). Patients with STEMI in PCI and non-PCI groups had significant difference in CCI score (p<0.05): 7.4 and 8.4 points, respectively. Mean CCI score in patients who died in hospital was 8.5 while discharged patients had 7.6 points (p<0.01). In 6 months 13 patients (6.3%) died, their mean age was 84.9 years, mean CCI was 9 points, PCI was performed in 3 (23%) patients.Conclusions. Elderly patients with ACS had high comorbidity level assessed by CCI score. Higher CCI score was associated with PCI non-performance in elderly patients. Elderly patients with STEMI had higher CCI score than patients with NSTEMI which was significantly associated with PCI non-performance. Patients who died in hospital or in 6 months after the ACS onset had higher CCI score than other elderly patients with ACS.

scholarly journals Benefit of primary percutaneous coronary interventions in the elderly with ST segment elevation myocardial infarction

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001169
Author(s):  
Daniel Fernández-Bergés ◽  
Irene R Degano ◽  
Reyes Gonzalez Fernandez ◽  
Isaac Subirana ◽  
Joan Vila ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
The Elderly ◽  
Acute Pulmonary Oedema ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Composite Event ◽  
St Segment ◽  
Percutaneous Coronary

ObjectivePrimary percutaneous coronary intervention (P-PCI) has demonstrated its efficacy in patients with ST segment elevation myocardial infarction (STEMI). However, patients with STEMI ≥75 years receive less P-PCI than younger patients despite their higher in-hospital morbimortality. The objective of this analysis was to determine the effectiveness of P-PCI in patients with STEMI ≥75 years.MethodsWe included 979 patients with STEMI ≥75 years, from the ATención HOspitalaria del Síndrome coronario study, a registry of 8142 consecutive patients with acute coronary syndrome admitted at 31 Spanish hospitals in 2014–2016. We calculated a propensity score (PS) for the indication of P-PCI. Patients that received or not P-PCI were matched by PS. Using logistic regression, we compared the effectiveness of performing P-PCI versus non-performance for the composite primary event, which included death, reinfarction, acute pulmonary oedema or cardiogenic shock during hospitalisation.ResultsOf the included patients, 81.5 % received P-PCI. The matching provided two groups of 169 patients with and without P-PCI. Compared with its non-performance, P-PCI presented a composite event OR adjusted by PS of 0.55 (95% CI 0.34 to 0.89).ConclusionsReceiving a P-PCI was significantly associated with a reduced risk of major intrahospital complications in patients with STEMI aged 75 years or older.

scholarly journals Clinical and Functional Dynamics of Physical Working Capacity and Psychological Adaptation in Patients with Acute Coronary Syndrome at the Stages of Rehabilitation

2019 ◽  
Vol 26 (3) ◽  
Author(s):  
Roksolana Nesterak ◽  
Sofia Bardashevska
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

The objective of the research was to analyze the effectiveness of using suggestive therapy in the patients with acute coronary syndrome by assessing the dynamics of the clinical condition and indicators of anxiety. Materials and Methods. There were examined 135 patients with non-ST-segment elevation myocardial infarction, 60 patients with the use of the conservative treatment and 75 patients who underwent percutaneous coronary intervention. The dynamics of objective indices, adaptation changes and anxiety indices in the groups of patients with traditional treatment and in the groups of patients with suggestive therapy in addition to the traditional rehabilitation measures, were analyzed. Results. Analyzing the dynamics of adaptive indices, it was determined that in the group of patients with non-ST-segment elevation myocardial infarction, who were performed conservative therapy, the dynamics was less significant, which is related to the general desadaptative syndrome. Changes in the group of patients undergoing percutaneous coronary intervention and suggestive therapy, with a decrease of blood pressure, heart rate, and a decrease in the index of functional changes from 3.78±0.15 points before the intervention up to 2.92±0.13 points after suggestive therapy (p<0.01) were more significant. In all groups of patients, high levels of reactive anxiety were observed at the beginning of treatment. As a result of treatment, a decrease in anxiety was noted, but more pronounced changes were seen in the group with the use of suggestive therapy (p<0.05). Conclusions. The use of suggestive therapy methods when treating the patients with acute coronary syndrome is an important intervention, that provides a comprehensive approach considering all the components, enhances the patients’ adaptive abilities in the rehabilitation phase, improves the quality and effectiveness of restorative treatment. The use of suggestive therapy at the rehabilitation stage improves the clinical course, reduces anginal manifestations, stabilizes blood pressure and increases exercise tolerance.

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