scholarly journals Comparison of Efficacy and Safety of Recombinant Human Prourokinase and Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of Efficacy

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Yizhou Liu ◽  
Yulin Yang ◽  
Ying Li ◽  
Xiaoqing Peng
Keyword(s):  
Myocardial Infarction ◽  
Thrombolytic Therapy ◽  
Influencing Factors ◽  
Left Ventricular ◽  
Smoking History ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Observation Group ◽  
Efficacy And Safety ◽  
Related Factors

Objective. To compare the efficacy and safety of recombinant human prourokinase (rhPro-UK) and alteplase for thrombolytic therapy in acute ST-segment elevation myocardial infarction (STEMI) and to analyze the related factors affecting efficacy. Methods. From January 2017 to December 2019, 100 patients diagnosed with STEMI were selected and randomly divided into the control group (n = 50) and the observation group (n = 50). Based on conventional treatments, the control group was treated with alteplase, and the observation group was treated with rhPro-UK, and both were treated for 7 days. After treatment, the vascular recanalization, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF) were compared. The bleeding and major adverse cardiovascular events (MACE) were recorded in both groups. According to the patient’s vascular recanalization, it was divided into two subgroups: recanalization group and occlusion group. Multiple logistic regression models were used to analyze the related factors that affect the efficacy. Results. The recanalization rate of the observation group (96.00%) was higher than that of the control group (84.00%) ( P < 0.05 ). After treatment, LVDs and LVEDD in both groups were lower than those before treatment, and LVEF was higher than that before treatment. The LVDs and LVEDD in the observation group were lower than those in the control group, and the LVEF was higher than that in the control group ( P < 0.05 ). The incidence of bleeding in the observation group (2.00%) was lower than that in the control group (12.00%), and the incidence of MACE (4.00%) was lower than that in the control group (16.00%) ( P < 0.05 ). Univariate analysis showed that age, smoking history, diabetes history, myocardial infarction history, infarct location, and intravenous thrombolysis time were related to the efficacy after treatment ( P < 0.05 ). Multivariate logistic analysis showed that age, history of diabetes, vascular infarction site, and venous thrombolysis time were independent influencing factors after treatment ( P < 0.05 ). Conclusion. Both rhPro-UK and alteplase thrombolytic therapy can effectively recanalize blood vessels and improve the cardiac function of patients with STEMI. However, rhPro-UK has better effect than alteplase and is safer and worth promoting. The curative effect is related to age, diabetes history, vascular infarction site, and venous thrombolysis time.

scholarly journals Investigating the Effects of Dapagliflozin on Cardiac Function, Inflammatory Response, and Cardiovascular Outcome in Patients with STEMI Complicated with T2DM after PCI

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
LiMing Xue ◽  
Xian Yuan ◽  
Shuguang Zhang ◽  
Xia Zhao
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Cardiac Function ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Cardiovascular Outcome ◽  
Lipid Lowering ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Observation Group

Objective. To explore the effect of dapagliflozin on cardiac function, inflammation, and cardiovascular outcome in patients with ST-segment elevation myocardial infarction (STEMI) combined with type 2 diabetes (T2DM) after percutaneous coronary intervention (PCI). Methods. 70 patients with STEMI and T2DM were divided into the control group (n = 35) and the observation group (n = 35). Before surgery, patients in both groups were given conventional treatments such as coronary expansion, antiplatelet, anticoagulation, and thrombolysis, and PCI was performed. After the operation, both groups were given conventional antiplatelet, anticoagulation, lipid-lowering, and hypoglycemic treatments. On this basis, the observation group was treated with dapagliflozin tablets for 24 weeks. We observe and compare the left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF), myocardial enzyme spectrum, inflammatory reaction, and occurrence of adverse cardiovascular events (MACE) of the two groups of patients before and after treatment. Results. After treatment, the LVEDD and LVESD of the two groups were lower than those before treatment, and the observation group was lower than the control group (P < 0.05). The LVEF of both groups was higher than that before treatment, and the observation group was higher than the control group (P < 0.05). After treatment, the levels of two groups’ patients’ creatine kinase (CK), creatine kinase isoenzyme (CK-MB), and troponin I (cTnI) were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, the levels of serum myeloperoxidase (MPO), C-reactive protein (CRP), interleukin 6 (IL-6), and tumor necrosis factor-α (TNF-α) in the two groups were all lower than those before treatment, and the observation group patients were all lower than the control group (P < 0.05). After treatment, there was no statistical difference between the two groups of patients in cardiogenic death, recurrent myocardial infarction, and other adverse cardiovascular events (P > 0.05). But, the incidence of severe arrhythmia and heart failure in the observation group were both lower than those in the control group (P < 0.05). Kaplan–Meier survival curve analysis showed that the median survival time without MACE in the observation group was higher than that in the control group (P < 0.05). Conclusion. Dapagliflozin treatment for patients with STEMI combined with T2DM after PCI can improve cardiac function to certain extent, reduce inflammation, and will reduce the incidence of adverse cardiovascular outcomes.

Delivery of CD151 by Ultrasound Microbubbles in Rabbit Myocardial Infarction

Cardiology ◽  
2016 ◽  
Vol 135 (4) ◽  
pp. 221-227 ◽  
Author(s):  
Shao-Ling Yang ◽  
Ke-Qiang Tang ◽  
Jun-Jia Tao ◽  
Ai-Hong Wan ◽  
Yan-Duan Lin ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Function ◽  
Rabbit Model ◽  
Physiological Saline ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Therapeutic Effects ◽  
Ventricular Ejection Fraction ◽  
Cluster Of Differentiation

Objectives: We aimed to evaluate whether ultrasound (US) and microbubble-mediated delivery of Cluster of Differentiation 151 (CD151) could enhance the therapeutic effects of CD151 on myocardial infarction (MI). Methods: A rabbit model of MI was established by a modified Fujita method. Then, 50 MI rabbits were randomly divided into 5 groups, including G1 (CD151 plasmid and physiological saline in the presence of US); G2 (CD151 and Sonovue in the presence of US); G3 (CD151 and Sonovue in the absence of US); G4 (Sonovue in the absence of US), and a control group (physiological saline in the absence of US). After 14 days of treatment, the expression of CD151 was detected by Western blot. Besides, vessel density of peri-infarcted myocardium was measured by immunohistochemistry, and cardiac function was analyzed by echocardiography. Results: The rabbit model of MI was established successfully. CD151 injection increased the expression of CD151 and microvessel density in the myocardium of MI rabbits. Heart function was significantly improved by CD151, which exhibited increased left ventricular ejection fraction, left ventricular fractional shortening and a reduced Tei index. Besides, US Sonovue significantly increased the expression efficiency of CD151. Conclusion: US microbubble was an effective vector for CD151 delivery. CD151 might be an effective therapeutic target for MI.

Abstract 177: Ticagrelor, but not Clopidogrel, Protects the Heart Against Reperfusion Injury and Improves Remodeling After Myocardial Infarction

2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Yumei Ye ◽  
Jose R Perez-Polo ◽  
Manjyot K Nanhwan ◽  
Sven Nylander ◽  
Yochai Birnbaum
Keyword(s):  
Myocardial Infarction ◽  
Platelet Aggregation ◽  
Reperfusion Injury ◽  
Heart Function ◽  
Oral Treatment ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Coronary Artery Ligation ◽  
Ventricular Ejection Fraction

Background: Clopidogrel (C) and Ticagrelor (T) are P2Y12 ADP receptor antagonists. In addition, ticagrelor inhibits adenosine cell uptake. In PLATO trial T reduced the incidence of the primary composite endpoint myocardial infarction, stroke or cardiovascular death over C in patients with acute coronary syndromes. Previous data show that 7d pretreatment with T limits infarct size (IS) in rats. We compared the effects of C and T, administered just before reperfusion on IS. We also assessed the effect of T and C, administered just before reperfusion and/or 6w oral treatment on cardiac remodeling. Methods: Rats underwent 30min coronary artery ligation. 1) At 25min of ischemia rats received intraperitoneal (IP) vehicle, T (10 or 30mg/kg), or C (12.5mg/kg). Area at risk (AR) was assessed by blue dye and IS by TTC staining 24h after reperfusion. 2) Rats received vehicle without (sham) or with (control) coronary ischemia, T (30mg/kg) IP (TIP), T (300mg/kg/d) oral for 6w, started a day after reperfusion (TPO), TIP+PO (TIPPO), or C (12.5mg/kg IP +62.5mg/kg/d PO for 6w). LV dimensions and function was assessed by echo at 6w. Results: 1) AR was comparable among groups. IS was 45.3±1.7% of the AR in the control group. T10 (31.5±1.8%; p=0.001) and T30 (21.4±2.6% p<0.001) significantly reduced IS, whereas C (42.4±2.6%) had no effect. Platelet aggregation in the controls was 64.7±1.3% and was comparable in T30 (24.9±1.8%) and C (23.2±1.8%) at 2h post reperfusion. T30 increased Akt, eNOS and ER1/2 phosphorylation 4h after reperfusion, whereas C had no effect. 2) Platelet aggregation at 1w oral treatment was 59.7±3.2% in the control group and was comparable in TIPPO (18.1±1.3%) and C (17.4±0.7%). Left ventricular ejection fraction was 77.6±0.9%*, 44.8±3.5%, 69.5±1.6%*, 69.2±1.0%*, 76.3±1.2%*, and 37.4±3.7% in the sham, vehicle, TIP, TPO, TIPPO and C treated group, respectively (*p<0.001 vs. vehicle). Left ventricular diameters at diastole and systole showed the same pattern. Conclusions: T, but not C, administered just before reperfusion protects against reperfusion injury. Oral T (in combination or not with acute treatment just before reperfusion) treatment for 6w improves heart function. C, despite achieving similar degree of platelet inhibition had no effect on remodeling.

scholarly journals The effect of intracoronary infusion of bone marrow-derived mononuclear cells on all-cause mortality in acute myocardial infarction: the BAMI trial

2020 ◽  
Vol 41 (38) ◽  
pp. 3702-3710 ◽  
Author(s):  
Anthony Mathur ◽  
Francisco Fernández-Avilés ◽  
Jozef Bartunek ◽  
Ann Belmans ◽  
Filippo Crea ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Bone Marrow ◽  
Adverse Events ◽  
Left Ventricular ◽  
Phase Iii ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Intracoronary Infusion ◽  
All Cause Mortality

Abstract Aims  Bone marrow-derived mononuclear cell (BM-MNC) therapy may improve myocardial recovery in patients following acute myocardial infarction (AMI), though existing trial results are inconsistent. Methods and results  Originally an open-label, multicentre Phase III trial, BAMI was designed to demonstrate the safety and efficacy of intracoronary infusion of BM-MNCs in reducing the time to all-cause mortality in patients with reduced left ventricular ejection fraction (LVEF, ≤45%) after primary angioplasty (PPCI) for ST-elevation AMI. Unexpectedly low recruitment means the trial no longer qualifies as a hypothesis-testing trial, but is instead an observational study with no definitive conclusions possible from statistical analysis. In total, 375 patients were recruited: 185 patients were randomized to the treatment arm (intracoronary infusion of BM-MNCs 2–8 days after PPCI) and 190 patients to the control arm (optimal medical therapy). All-cause mortality at 2 years was 3.26% [6 deaths; 95% confidence interval (CI): 1.48–7.12%] in the BM-MNC group and 3.82% (7 deaths; 95% CI: 1.84–7.84%) in the control group. Five patients (2.7%, 95% CI: 1.0–5.9%) in the BM-MNC group and 15 patients (8.1%, CI : 4.7–12.5%) in the control group were hospitalized for heart failure during 2 years of follow-up. Neither adverse events nor serious adverse events differed between the two groups. There were no patients hospitalized for stroke in the control group and 4 (2.2%) patients hospitalized for stroke in the BM-MNC group. Conclusions  Although BAMI is the largest trial of autologous cell-based therapy in the treatment of AMI, unexpectedly low recruitment and event rates preclude any meaningful group comparisons and interpretation of the observed results.

Improved quality of life with cardiac rehabilitation for post-myocardial infarction patients in Korea

2007 ◽  
Vol 6 (3) ◽  
pp. 166-171 ◽  
Author(s):  
Jina Choo ◽  
Lora E. Burke ◽  
Kyung Pyo Hong
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Cardiac Rehabilitation ◽  
Exercise Capacity ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Ejection Fraction ◽  
Supervised Exercise

Background Health-related quality of life (HRQOL) has been used as a primary health outcome in cardiac rehabilitation programs (CRP). Aims This study aimed to evaluate the effects of an 8-week CRP on HRQOL and exercise capacity in myocardial infarction (MI) patients in Korea. Methods After matching on gender, age, and left ventricular ejection fraction, 60 subjects with a first acute MI were allocated to either a CRP group ( n =31) or a Control group ( n =29). The 8-week CRP included hospital-based, supervised exercise training (three times per week, average intensity of 65% VO2peak) and individual education sessions. The Control group was instructed on a home-based exercise regimen without contact during the 8 weeks. At baseline and 8 weeks, HRQOL was assessed by the Quality of Life Index (QLI)–cardiac version III; exercise capacity by a treadmill test. Results After adjusting for education level, the overall QLI, health/functioning and psycho/spiritual scores showed greater increases in the CRP group than the Control group ( p=.014, p=.016, and p=.036, respectively). We observed significant improvements in VO2peak ( p<.0001), anaerobic threshold ( p<.0001), and maximal exercise duration ( p<.0001) in the CRP group, compared to the Control group. Conclusions These findings suggest that the Korean CRP can lead to significant improvements in HRQOL outcomes and exercise capacity.

scholarly journals Effect of Metoprolol on Cardiac Function and Prognosis in Patients with Dilated Cardiomyopathy

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Huailing Su ◽  
Bin Li ◽  
Zhisheng Jia
Keyword(s):  
Cardiac Function ◽  
Dilated Cardiomyopathy ◽  
Adverse Reactions ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Observation Group ◽  
Significant Difference ◽  
Conventional Methods ◽  
The Difference

Objective: To investigate the effect of metoprolol on cardiac function and prognosis in patients with dilated cardiomyopathy. Methods: 100 patients with dilated cardiomyopathy treated in our hospital from January 2018 to December 2019 were randomly divided into control group (n = 50) and observation group (n = 50). The control group was treated with conventional methods, and the observation group was treated with conventional methods and metoprolol for 6 months. The cardiac function [left ventricular ejection fraction (LVEF), stroke volume (SV), cardiac output (CO)] and prognosis [Glasgow Outcome Scale (GOS) score] of the two groups before and at the end of 6 months of intervention were compared, and the incidence of adverse reactions of the two groups were compared. Results: After 6 months of treatment, the levels of LVEF, SV and CO in the two groups were higher than before treatment, and the comparison level between the observation group and the control group was higher, the difference was statistically significant (P  < 0.05);After 6 months of treatment, the GOS score of the observation group was higher than that of the control group, and the difference was statistically significant (P < 0.05);There was no significant difference in the total incidence of adverse reactions between the two groups (P > 0.05). Conclusion:  Metoprolol can improve the cardiac function and prognosis of patients with dilated cardiomyopathy, without increasing the incidence of adverse reactions.

Automated Quantitative Technique of 3D Cardiac Anatomical Model for Evaluating Left Ventricular Systolic Function in Patients with Myocardial Infarction

2020 ◽  
Vol 10 (8) ◽  
pp. 1143-1148
Author(s):  
Yuanyuan Xing ◽  
Hongyuan Xue ◽  
Yuquan Ye
Keyword(s):  
Myocardial Infarction ◽  
Systolic Function ◽  
Left Ventricular Systolic Function ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Case Group ◽  
Ventricular Systolic Function ◽  
Anatomical Model ◽  
Quantitative Technique

This study intends to use 3D cardiac anatomical model automatic quantitative technique Heart Model (HM) to assess left ventricular systolic function in patients with myocardial infarction. Thirty patients with myocardial infarction (case group) and 32 healthy individuals (control group) were enrolled in this study.M-mode echocardiography (MME), two-dimensional echocardiography (2DE), 3D cardiac anatomical model (HM) and real-time 3D echocardiography (3DE) were used to collect echocardiographic images. Left ventricular systolic function parameters (LVEDV), left ventricular end-systolic volume (LVESV), and left ventricular ejection fraction (LVEF) were obtained from two post-surgical analysis of more than 5 years of experience. Compared to control group, MME, 2DE, HM, and 3DE were significantly higher in the LVEDV and LVESV cases and lower in the LVEF (P < 0 05). MME, 2DE, HM and 3DE were correlated and best correlation as found between HM and 3DE (P < 0 05). For the consistency of MME, 2DE, HM and 3DE, the best consistency was observed in the LVEF of HM and 3DE, and case group was lower than control (P < 0 05). In terms of repeatability of MME, 2DE, HM and 3DE, HM showed the best repeatability followed by MME. In comparison of the time of MME, 2DE, HM and 3DE, HM had shortest time (< 0 05). HM automatic quantitative technique can evaluate left ventricular systolic function in myocardial infarction patients, and it is simple, rapid and reproducible.

scholarly journals Elevated Plasma IL-38 Concentrations in Patients with Acute ST-Segment Elevation Myocardial Infarction and Their Dynamics after Reperfusion Treatment

2015 ◽  
Vol 2015 ◽  
pp. 1-10 ◽  
Author(s):  
Yucheng Zhong ◽  
Kunwu Yu ◽  
Xiang Wang ◽  
Xiaoya Wang ◽  
Qingwei Ji ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Troponin I ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Atheromatous Plaque ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Objective.Recent studies suggest that IL-38 is associated with autoimmune diseases. Furthermore, IL-38 is expressed in human atheromatous plaque. However, the plasma levels of IL-38 in patients with ST-segment elevation myocardial infarction (STEMI) have not yet to be investigated.Methods.On admission, at 24 h, at 48 h, and at 7 days, plasma IL-38, C-reactive protein (CRP), cardiac troponin I (cTNI), and N-terminal of the prohormone brain natriuretic peptide (NT-proBNP) levels were measured and IL-38 gene in peripheral blood mononuclear cells (PBMCs) was detected in STEMI patients.Results.The results showed that plasma IL-38 levels and IL-38 gene expression in PBMCs were significantly increased in STEMI patients compared with control group and were time dependent, peaked at 24 h. In addition, plasma IL-38 levels were dramatically reduced in patients with reperfusion treatment compared with control group. Similar results were also demonstrated with CRP, cTNI, and NT-proBNP levels. Furthermore, IL-38 levels were found to be positively correlated with CRP, cTNI, and NT-proBNP and be weakly negatively correlated with left ventricular ejection fraction (LVEF) in STEMI patients.Conclusions.The results indicate that circulating IL-38 is a potentially novel biomarker for patients with STEMI and IL-38 might be a new target for MI study.

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