scholarly journals Association of Hyperhomocysteinemia with Increased Coronary Microcirculatory Resistance and Poor Short-Term Prognosis of Patients with Acute Myocardial Infarction after Elective Percutaneous Coronary Intervention

2020 ◽  
Vol 2020 ◽  
pp. 1-8 ◽  
Author(s):  
Yang-Pei Peng ◽  
Ming-Yuan Huang ◽  
Yang-Jing Xue ◽  
Jia-Lin Pan ◽  
Cong Lin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Pearson Correlation ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Elective Percutaneous Coronary Intervention ◽  
Percutaneous Coronary

Background. This study aims to investigate the coronary microcirculatory resistance and prognosis of patients with acute myocardial infarction (AMI) concomitant with hyperhomocysteinemia (HHcy) after an elective percutaneous coronary intervention (PCI). Methods. A total of 101 patients that underwent elective PCI between May 2015 and July 2018 due to AMI were consecutively enrolled in this study. Patients were divided into a HHcy group (53) and a normal Hcy group (control; 48) based on their plasma homocysteine concentration. The characteristics of coronary angiography, the index of microcirculatory resistance (IMR) of infarct-related vessels (IRV), changes in left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF) before and after PCI, and the incidence of major adverse cardiovascular events (MACE) three months after PCI were compared between these groups. Results. Compared to the results from the Hcy group, the HHcy group had a higher IMR. The HHcy group had significantly higher LVEDd and a lower LVEF than the Hcy group 3 months after PCI. Additionally, the incidence of MACE at three months after PCI was higher in the HHcy group than in the Hcy group. Pearson correlation analysis revealed a positive correlation with IMR in the HHcy group. Furthermore, there was a difference in the LVEDd measured at one day after PCI and at three months after PCI in the HHcy group. Conclusion. AMI patients concomitant with HHcy that undergo elective PCI are prone to coronary microcirculatory dysfunction and have a poor cardiac function and poor prognosis at three months after PCI.

scholarly journals Community-Based Physical Rehabilitation After Percutaneous Coronary Intervention for Acute Myocardial Infarction

2021 ◽  
Vol 48 (2) ◽  
Author(s):  
Meiling Xiao ◽  
Yinjun Li ◽  
Xiaodan Guan
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Physical Rehabilitation ◽  
Left Ventricular Ejection ◽  
Community Based ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary

To determine whether a community-based physical rehabilitation program could improve the prognosis of patients who had undergone percutaneous coronary intervention after acute myocardial infarction, we randomly divided 164 consecutive patients into 2 groups of 82 patients. Patients in the rehabilitation group underwent 3 months of supervised exercise training, then 9 months of community-based, self-managed exercise; patients in the control group received conventional treatment. The primary endpoint was major adverse cardiac events (MACE) during the follow-up period (25 ± 15.4 mo); secondary endpoints included left ventricular ejection fraction, 6-minute walk distance, and laboratory values at 12-month follow-up. During the study period, the incidence of MACE was significantly lower in the rehabilitation group (13.4% vs 24.4%; P <0.01). Cox proportional hazards regression analysis indicated a significantly lower risk of MACE in the rehabilitation group (hazard ratio=0.56; 95% CI, 0.37–0.82; P=0.01). At 12 months, left ventricular ejection fraction and 6-minute walk distance in the rehabilitation group were significantly greater than those in the control group (both P <0.01), and laboratory values also improved. These findings suggest that community-based physical rehabilitation significantly reduced MACE risk and improved cardiac function and physical stamina in patients who underwent percutaneous coronary intervention after acute myocardial infarction.

scholarly journals Relationship between TRAIL and Left Ventricular Ejection Fraction in Patients with ST-Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

2018 ◽  
Vol 2018 ◽  
pp. 1-8
Author(s):  
Elena Teringova ◽  
Martin Kozel ◽  
Jiri Knot ◽  
Viktor Kocka ◽  
Klara Benesova ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Sfas Level

Background. Apoptosis plays an important role in the myocardial injury after acute myocardial infarction and in the subsequent development of heart failure. Aim. To clarify serum kinetics of apoptotic markers TRAIL and sFas and their relation to left ventricular ejection fraction (LVEF) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods. In 101 patients with STEMI treated with pPCI, levels of TRAIL and sFas were measured in series of serum samples obtained during hospitalization and one month after STEMI. LVEF was assessed at admission and at one month. Major adverse cardiovascular events (MACE, i.e., death, re-MI, and hospitalization for heart failure and stroke) were analysed during a two-year followup. Results. Serum level of TRAIL significantly decreased one day after pPCI (50.5pg/mL) compared to admission (56.7pg/mL), subsequently increased on day 2 after pPCI (58.8pg/mL), and reached its highest level at one month (70.3pg/mL). TRAIL levels on days 1 and 2 showed a significant inverse correlation with troponin and a significant positive correlation with LVEF at baseline. Moreover, TRAIL correlated significantly with LVEF one month after STEMI (day 1: r=0.402, p<0.001; day 2: r=0.542, p<0.001). On the contrary, sFas level was significantly lowest at admission (5073pg/mL), increased one day after pPCI (6370pg/mL), and decreased on day 2 (5548pg/mL). Significantly highest sFas level was marked at one month (7024pg/mL). sFas failed to correlate with LVEF at baseline or at one month. Both TRAIL and sFas showed no ability to predict improvement of LVEF one month after STEMI or a 2-year MACE (represented by 3.29%). Conclusion. In STEMI treated with pPCI, TRAIL reaches its lowest serum concentration after reperfusion. Low TRAIL level is associated with worse LVEF in the acute phase of STEMI as well as one month after STEMI. Higher TRAIL level appears to be beneficial and thus TRAIL seems to represent a protective mediator of post-AMI injury.

scholarly journals Effects of tirofiban and percutaneous coronary intervention in an old patient with acute myocardial infarction and cardiogenic shock

2010 ◽  
Vol 63 (1-2) ◽  
pp. 117-122
Author(s):  
Tibor Canji ◽  
Aleksandra Jovelic ◽  
Ilija Srdanovic ◽  
Milovan Petrovic ◽  
Gordana Panic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ejection Fraction ◽  
Cardiogenic Shock ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Severe Thrombocytopenia ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary

A 75 year old man presented in our institutiton with acute inferoposterior and right ventricular ST-segment elevation myocardial infarction and cardiogenic shock, 40 minutes after the pain onset. He was pretreated with 300 mg of aspirin, 600 mg of clopidogrel, and was taken to the catheterization laboratory. Door to needle time was 35 minutes. Primary percutaneous coronary intervention with bare-metal stent implantation first in infarct related right coronary artery, with subsequent high-bolus dose (25 fig/kg) tirofiban, and then in suboccluded RCx were done. The procedures were done during the cardio-pulmo-cerebral reanimation because of relapsing ventricular fibrillation, with final TIMI 3 coronary flow established. Subsequently, intraaortic balloon pump was inserted. Echocardiography taken on the second day showed globaly hypokinetic left ventricle, with 10% ejection fraction and competent valves. During the next three weeks of hospital follow-up, there were no major adverse cardiac events, a transient azotemia and fall in hemoglobin concentration without major bleeding, and no episodes of severe thrombocytopenia were recorded. After six months, the patient was without chest pains, 2/3 class according to the New York Heart Association, without major adverse events, and echocardiographic left ventricular ejection fraction increment for 30%.

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