scholarly journals Clinical outcomes in hypertension patients after coronary stenting due to exertional angina

2020 ◽  
Vol 25 (3) ◽  
pp. 3736
Author(s):  
R. N. Akhtereyev ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
Z. M. Galeeva
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Clinical Outcomes ◽  
Cerebrovascular Accident ◽  
Coronary Stenting ◽  
Class Iii ◽  
Acute Cerebrovascular Accident ◽  
Exertional Angina ◽  
Class Iv

Aim. To study clinical outcomes in hypertension patients after coronary stenting due to exertional angina.Material and methods. The study included 214 patients with class 3 stable angina and hypertension. All patients underwent coronary angiography followed by elective stenting. Clinical outcomes were assessed on average after 44 months of outpatient follow-up.Results. During the follow-up period, 43% of patients retained class III angina; the decrease in systolic (SBP) and diastolic blood pressure (DBP) was 18and 14-mm Hg, respectively. There were 35 cases of myocardial infarction (MI) in this category of subjects. We revealed that 57% of patients had a progression of angina: from class III to class IV; the decrease in SBP and DBP was 10and 18-mm Hg, respectively. There were 110 cases of MI and 10 cases of acute cerebrovascular accident in these patients.Conclusion. Inadequate control of SBP in patients after stenting due to stable exertional angina leads to a greater number of complications, mainly myocardial infarction.

scholarly journals Outcomes in patients with hypertension and type 2 diabetes receiving a stent for angina

2020 ◽  
Vol 25 (4) ◽  
pp. 3800
Author(s):  
R. N. Akhtereyev ◽  
A. S. Galyavich ◽  
L. V. Baleeva ◽  
Z. M. Galeeva
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Stent Insertion ◽  
Class Iii ◽  
Group 2 ◽  
Artery Disease ◽  
Group 1

Aim. To study the outcomes in hypertensive (HTN) patients receiving a stent for class III angina, depending on concomitant type 2 diabetes (T2D).Material and methods. The study included 295 patients aged 45 to 75 years. All patients underwent coronary angiography followed by elective stenting. Clinical outcomes were evaluated after outpatient follow-up (average 44 months). Patients were divided into two groups: group 1 — 214 patients with coronary artery disease (CAD) in combination with HTN; group 2 — 81 patients with CAD in combination with HTN and T2D.Results.In the group of patients without T2D, during the follow-up period, class III angina was observed in 92 patients (43%). The decrease in systolic blood pressure (BP) (SBP) and diastolic BP (DBP) in this subgroup was 18 and 14 mm Hg, respectively (p<0,001); 35 patients (38%) had myocardial infarction (MI). In the group of patients with T2D, class III angina was recorded in 60 patients (74,1%). The decrease in SBP and DBP in this subgroup was 19 and 12 mm Hg, respectively  (p<0,001). There were 58 cases of MI in this subgroup (96,7%).Conclusion.After stent insertion, patients with CAD, HTN and T2D still reporting class III angina were more likely to have MI than patients without T2D. This indicates a greater contribution of T2D to MI development, despite an equal decrease of SBP in patients with/without T2D.

Feasibility of hybrid telerehabilitation as component of a novel comprehensive care program after acute myocardial infarction in a one-year follow-up preliminary experience of a single center

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
E Piotrowicz ◽  
P Orzechowski ◽  
I Kowalik ◽  
R Piotrowicz
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Heart Rate ◽  
Functional Capacity ◽  
Care Program ◽  
Comprehensive Care ◽  
Monitoring Center ◽  
One Year

Abstract Funding Acknowledgements Type of funding sources: Public Institution(s). Main funding source(s): National Health Fund Background. A novel comprehensive care program after acute myocardial infarction (AMI) „KOS-zawał" was implemented in Poland. It includes acute intervention, complex revascularization, implantation of cardiovascular electronic devices (in case of indications), rehabilitation or hybrid telerehabilitation (HTR) and scheduled outpatient follow-up. HTR is a unique component of this program. The purpose of the pilot study was to evaluate a feasibility, safety and patients’ acceptance of HTR as component of a novel care program after AMI and to assess mortality in a one-year follow-up. Methods The study included 55 patients (LVEF 55.6 ± 6.8%; aged 57.5 ± 10.5 years). Patients underwent a 5-week HTR based on Nordic walking, consisting of an initial stage (1 week) conducted within an outpatient center and a basic stage (4-week) home-based telerehabilitation five times weekly. HTR was telemonitored with a device adjusted to register electrocardiogram (ECG) recording and to transmit data via mobile phone network to the monitoring center. The moments of automatic ECG registration were pre-set and coordinated with exercise training. The influence on physical capacity was assessed by comparing changes in functional capacity (METs) from the beginning and the end of HTR. Patients filled in a questionnaire in order to assess their acceptance of HTR at the end of telerehabilitation. Results HTR resulted in a significant improvement in functional capacity and workload duration in exercise test (Table). Safety: there were neither deaths nor adverse events during HTR. Patients accepted HTR, including the need for interactive everyday collaboration with the monitoring center. Prognosis all patients survived in a one-year follow-up. Conclusions Hybrid telerehabilitation is a feasible, safe form of rehabilitation, well accepted by patients. There were no deaths in a one-year follow-up. Outcomes before and after HTR Before telerehabilitation After telerehabilitation P Exercise time [s] 381.5 ± 92.0 513.7 ± 120.2 &lt;0.001 Maximal workload [MET] 7.9 ± 1.8 10.1 ± 2.3 &lt;0.001 Heart rate rest [bpm] 68.6 ± 12.0 66.6 ± 10.9 0.123 Heart rate max effort [bpm] 119.7 ± 15.9 131.0 ± 20.1 &lt;0.001 SBP rest [mmHg] 115.6 ± 14.8 117.7 ± 13.8 0.295 DBP rest [mmHg] 74.3 ± 9.2 76.2 ± 7.3 0.079 SBP max effort [mm Hg] 159.5 ± 25.7 170.7 ± 25.5 0.003 DBP max effort [mm Hg] 84.5 ± 9.2 87.2 ± 9.3 0.043 SBP systolic blood pressure, DBP diastolic blood pressure.

Early vascular responses to ultrathin biodegradable polymer sirolimus-eluting stent for the treatment of st-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Y Oishi ◽  
T Shinke ◽  
H Tanaka ◽  
K Ogura ◽  
K Arai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Antiplatelet Therapy ◽  
St Elevation Myocardial Infarction ◽  
Current Generation ◽  
Vascular Responses ◽  
Post Procedure ◽  
St Elevation ◽  
Sirolimus Eluting Stent

Abstract Background Recent clinical study suggests newer-generation drug-eluting stents (DES) that combine ultrathin strut and nano-coating with biodegradable polymers sirolimus-eluting stent (BP-SES) could improve long-term clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) over current generation DES. However, safety profiles in very early phase have not been systematically addressed. Objective and method We exploratory investigate early vascular response following BP-SES implantation in patients with STEMI to reveal mechanism of the favorable clinical outcomes in recent studies using frequency domain-optical coherence tomography (FD-OCT). Consecutive twenty patients with STEMI who underwent FD-OCT immediately after primary PCI and were eligible for follow-up FD-OCT at 2 weeks after implantation were enrolled between June 2018 and November 2019. Results Twenty patients (age 62.7±11.3 years, male 85.0%) were enrolled with frequencies of hypertension (45.0%), diabetes mellitus (35.0%), dyslipidemia (55.0%) and smoking (80.0%). Aspiration catheter were used in all patients, and 1.13±0.34 stents were used. Only one patient (5.0%) received chronic antiplatelet therapy with aspirin prior to the onset of STEMI. All patients started to receive prasugrel as thienopyridine from this event and continued dual antiplatelet therapy for 2 weeks. The percentage of uncovered struts significantly decreased from post-procedure to 2W follow-up (69±18% post-procedure versus 30±11% at 2W follow up, p&lt;0.0001). Malapposed struts also decreased (5.6±5.7% post-procedure versus0.9±1.2% at 2W follow up, p&lt;0.0001).The average protrusion area of athero-thrombotic burden numerically decreased (0.37±0.19 at post-procedure versus 0.34±0.14 mm2 at 2W follow up, p=0.19) and its volume showed similar tendency (10.60±6.40 at post-procedure versus 9.36±5.14 mm3 at 2W follow up, p=0.19). Conclusion(s) This study firstly elucidated very early vascular responses following ultrathin strut BP-SES implantation in STEMI patients, showing early progression of strut coverage and resolution of athero-thrombotic materials. This technology may have a potential to overcome the current generation DESs in this clinical setting. Thrombus, uncovered and malapposed struts Funding Acknowledgement Type of funding source: None

scholarly journals Effect of Smartphone-Enabled Health Monitoring Devices vs Regular Follow-up on Blood Pressure Control Among Patients After Myocardial Infarction

2020 ◽  
Vol 3 (4) ◽  
pp. e202165 ◽  
Author(s):  
Roderick W. Treskes ◽  
Loes A. M. van Winden ◽  
Nicole van Keulen ◽  
Enno T. van der Velde ◽  
Saskia L. M. A. Beeres ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Blood Pressure Control ◽  
Health Monitoring ◽  
Pressure Control ◽  
Monitoring Devices

scholarly journals Blood Pressure Targets and Clinical Outcomes in Patients with Acute Myocardial Infarction

2017 ◽  
Vol 47 (4) ◽  
pp. 446 ◽  
Author(s):  
Hyukjin Park ◽  
Young Joon Hong ◽  
Jae Yeong Cho ◽  
Doo Sun Sim ◽  
Hyun Ju Yoon ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Myocardial Infarction ◽  
Clinical Outcomes ◽  
Blood Pressure Targets

scholarly journals Evolutionary and prognostic implications in patient with acute coronary syndrome and dysthyroidism

2021 ◽  
Vol 16 (2) ◽  
pp. 225-233
Author(s):  
Eleonora DRĂGAN ◽  
◽  
Maria Suzana GUBERNA ◽  
Cătălina Liliana ANDREI ◽  
Crina-Julieta SINESCU ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Acute Coronary Syndrome ◽  
Heart Disease ◽  
C Reactive Protein ◽  
St Segment Elevation ◽  
Reactive Protein ◽  
Coronary Syndrome ◽  
St Segment

Purpose. The study aims to determine the impact of dysthyroidism on the severity and type of coronary lesion, on vascular function, as well as on the morbidity and mortality of patients with acute coronary syndrome, by finding predictive markers that can be translated into preventive measures that contribute substantially to reduce the number of newly diagnosed patients with coronary heart disease. Methods. We introduced in the study 100 patients recently diagnosed with acute coronary syndrome, without history of ischemic heart disease or thyroid disease, hospitalized in the Cardiology Clinic of the “Bagdasar-Arseni“ Emergency Clinical Hospital Bucharest, for the interventional treatment of acute coronary syndrome. The studied patients were hospitalized between November 2014 and April 2015, with regular follow-up of up to 5 years (telephone or direct interview, conducted at 6 months, 12 months, 24 months, 36 months, 48 months, 60 months), with an average period follow-up of 1006 days, evaluated clinically, bio-humorally, by echocardiography, explored with coronary angiography with the calculation of the SYNTAX score and with the performance of electrocardiogram and pulse wave. The obtained data were integrated in Excel sheets and statistically processed with the Python program. Results. The mortality rate in the patient group was 7% (7 deaths). Descriptively, of the deceased, 6 patients (86%) were male, and as thyroid status 1 hyperthyroid patient (14%), 3 hypothyroid patients (43%) and 3 patients (43%) normothyroid. There were 4 deaths (8%) in the group of patients with unstable angina and 3 deaths (8%) in the group of patients with myocardial infarction without ST-segment elevation. There were no deaths in the group of patients with acute myocardial infarction with ST-segment elevation. At follow-up, 41 patients (41%) were readmitted. Re-hospitalization was influenced by elevated values of mean blood pressure, diastolic blood pressure and C-reactive protein, unicoronary atherosclerotic disease and unstable angina at admission. At follow-up, the development of noncardiac events was noted in the evolution of patients, diabetes mellitus occurring in the majority, in almost a quarter of patients (22 patients, respectively 24% developed diabetes over time), 34% (19 patients) in euthyroidism and 8% (3 patients) dysthyroidism. Discussions. Predictive factors for the readmission of the patient with acute coronary syndrome are highlighted the following: increased level of C-reactive protein (p = 0.017), tricoronary vascular damage (p = 0.01), diastolic blood pressure greater than 80 mmHg (p = 0.025), and euthyroid status (p = 0.04). The probability of death for the patient with acute coronary syndrome rises to 66% in the presence of severe systolic dysfunction of the left ventricle (p = 0.006), and to 61% in the case of elevated values of hs troponin I (p = 0.008). In our study, the presence of dysthyroidism in the patient with acute coronary syndrome has a protective role in the development of diabetes in the first 5 years (p = 0.025). Conclusion. Dysthyroidism is associated with increased morbidity and mortality from cardiovascular disease.

scholarly journals Tight versus standard blood pressure control on the incidence of myocardial infarction and stroke: An observational retrospective cohort study in the general ambulatory setting

2020 ◽  
Author(s):  
Bumsoo Park ◽  
Katarzyna Budzynska ◽  
Nada Almasri ◽  
Sumaiya Islam ◽  
Fanar Alyas ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Blood Pressure ◽  
Multivariate Analysis ◽  
Heart Association ◽  
Pressure Control ◽  
Ambulatory Setting ◽  
Stroke Incidence ◽  
Independent Risk Factors ◽  
Definition Of

Abstract Background: The 2017 American College of Cardiology and American Heart Association guideline defined hypertension as blood pressure (BP) ≥ 130/80 mmHg compared to the traditional definition of ≥ 140/90 mmHg. This change raised much controversy. We conducted this study to evaluate incidences of myocardial infarction (MI) and stroke comparing tight (TBPC) and standard BP control (SBPC). Methods: The data were collected and analyzed in 2018. We retrospectively identified hypertensive patients for 1 year at our institution who were classified by BP rate across 3 years into 2 groups of TBPC (< 130 mmHg) and SBPC (130-139 mmHg). We compared the incidence of new MI and stroke between the 2 groups across a 2-year follow-up. Multivariate analysis was done to identify independent risk factors. Results: Of 5640 study patients, the TBPC group showed significantly less incidence of stroke compared to the SBPC group. No differences were found in MI incidence between the 2 groups. Multivariate analysis showed that increased age independently increased the incidence of both MI and stroke, and TBPC independently decreased the incidence of stroke but not of MI. Conclusions: Our observational study suggests that TBPC may be beneficial in less stroke incidence compared to SBPC but it didn’t seem to affect the incidence of MI. Our study is limited by its retrospective design with potential confounders.

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