scholarly journals Mildronate in cardiology practice – current evidence, ongoing research, and future perspectives

2012 ◽  
Vol 11 (1) ◽  
pp. 96-103 ◽  
Author(s):  
V. P. Mikhin ◽  
Yu. M. Pozdnyakov ◽  
F. E. Khlebodarov ◽  
O. N. Koltsova
Keyword(s):  
Myocardial Infarction ◽  
Stable Angina ◽  
Current Evidence ◽  
Future Perspectives ◽  
Ongoing Research ◽  
Complex Therapy ◽  
Rehabilitation Period

The review discusses the benefits and various practical aspects of the new cardioprotector mildronate use in cardiology. The latest evidence on the mildronate role in complex therapy of patients with stable angina, or patients in the rehabilitation period after myocardial infarction, is summarised.

RESULTS OF ENDOVASCULAR MYOCARDIAL REVASCULARIZATION AND QUALITY OF LIFE IN SUCH PATIENTS AGED UNDER 40

2020 ◽  
pp. 44-57
Author(s):  
F.Z. Abdullaev ◽  
F.E. Abbasov ◽  
N.M. Babaev ◽  
L.S. Shikhieva ◽  
G.A. Amrakhova
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Coronary Artery ◽  
Stable Angina ◽  
Myocardial Revascularization ◽  
Overweight And Obesity ◽  
Panic Attacks ◽  
Recurrent Myocardial Infarction ◽  
Stent Diameter

The aim of the paper is to correlate the results of endovascular myocardial revascularization (EMR) in patients under 40 years of age with acute coronary syndrome (ACS) / stable angina, primary EMR age ≤35/36–40 and stent diameter. Materials and Methods. The authors examined 208 patients (24–40 years of age) with coronary artery disease: 157 patients (75.5 %) aged 36–40; 51 patients (24.5 %) aged ≤35. All in all, 165 (79.3 %) patients underwent EMR; 32 patients (15.4 %) underwent coronary artery bypass grafting; 11 patients (5.3 %) refused medical intervention. EMR results and the quality of life were studied in 126 patients (76.4 %) at 10–107 months of observation (62.5±2.6 months). Results. 84 patients with ACS (50.9 %) and 81 patients with stable angina (49.1 %) underwent EMR. There were no any peri-procedural complications. The authors observed 0 % hospital and 30-day mortality. The survival rate of patients for the period up to 9 years was 99.2 %; long-term mortality was 0.8 %; the constancy of results up to 1, 2 and 3 years of follow-up was 90.5 %, 84.1 % and 81.7 %, respectively, and up to 5–9 years it was 79.4 %. An active lifestyle was verified in 74.6 % of patients; a sparing lifestyle was observed in 25.4 %; 86.5 %, of patients returned to work; transient sexual disorders were found in 28.6% of patients. 83.3 % and 27.8 % of patients kept to drug therapy and dietary regimen. 34.1 % and 23.8 % of patients kept smoking and taking power drinks; overweight and obesity were observed in 23.8 % and 19 % of patients. Recurrent myocardial infarction (MI) / angina was verified in 23 % of patients; 20.6 % of patients underwent second EMR. 23 % of patients got depressed due to recurrent myocardial infarction / angina, while 18.3 % of patients were down due to the quarantine (COVID-19); 6.3 % suffered from panic attacks, for fear of recurrent anginous pain. Conclusion. Predictors of recurrent EMR and stability of results were: 1) ACS; 2) patients’ age (≤35); 3) history of MI, ejection fraction ≤35–40 %, diabetes; 4) stent diameter (<28 mm); 5) smoking and taking power drinks. The leading predictor was the aggressiveness of atherosclerosis and diabetes in persons under 40, causing: a) early stent dysfunction; b) native and “protected” coronary vessels damage in case of intact stents patency. Keywords: ischemic heart disease, young patients, risk profile, semiotics of coronary arteries, endovascular myocardial revascularization, quality of life. Цель. Корреляция результатов эндоваскулярных реваскуляризаций миокарда (ЭВРМ) у больных моложе 40 лет с острым коронарным синдромом (ОКС) / стабильной стенокардией, возрастом при первичной ЭВРМ ≤35 лет / 36–40 лет и диаметром стентов. Материалы и методы. Обследовано 208 больных ИБС в возрасте 24–40 лет: 157 (75,5 %) чел. – в возрасте 36–40 лет, 51 (24,5 %) – ≤35 лет. ЭВРМ выполнена 165 (79,3 %) больным, коронарное шунтирование – 32 (15,4 %), 11 (5,3 %) пациентов отказались от вмешательства. Исходы ЭВРМ и качество жизни изучены у 126 (76,4 %) больных на сроках 10–107 мес. (62,5±2,6 мес.) наблюдения. Результаты. ЭВРМ выполнена 84 (50,9 %) больным ОКС и 81 (49,1 %) больному стабильной стенокардией. Перипроцедурных осложнений не выявлено. Госпитальная и 30-дневная летальность составила 0 %. Выживаемость пациентов на сроках до 9 лет – 99,2 %; отдаленная летальность – 0,8 %; сохранность результатов до 1, 2 и 3 лет наблюдения составила соответственно 90,5, 84,1 и 81,7 %, до 5–9 лет – 79,4 %. Активный образ жизни верифицирован у 74,6 % обследованных, щадящий – у 25,4 %, возврат к работе – у 86,5 %, транзиторные сексуальные нарушения – у 28,6 %. Медикаментозную терапию и диетический режим питания соблюдали 83,3 и 27,8 % пациентов. Продолжали курить и принимать энергетические напитки 34,1 и 23,8 % обследованных; избыточный вес и ожирение сохранялись у 23,8 и 19 %. Рецидив инфаркта миокарда (ИМ) / стенокардии отмечен у 23 % пациентов; повторные ЭВРМ выполнены 20,6 % больным. Депрессию из-за рецидива ИМ / стенокардии отмечали 23 % пациентов, ввиду карантина (COVID-19) – 18,3 %; 6,3 % страдали паническими атаками, боясь повторения ангинозных болей. Выводы. Предикторами повторных ЭВРМ и стабильности результатов являются: 1) ОКС; 2) возраст ≤35 лет; 3) анамнез ИМ, фракция выброса ≤35–40 %, диабет; 4) диаметр стентов <28 мм; 5) курение и прием энергетических напитков. Ведущий предиктор – агрессивность атеросклероза и диабета у лиц не старше 40 лет, обусловливающих: а) раннюю дисфункцию стентов; б) при сохранной проходимости стентов – поражение нативных и «защищенных» коронарных сосудов. Ключевые слова: ишемическая болезнь сердца, молодые больные, профиль риска, семиотика коронарных артерий, эндоваскулярная реваскуляризация миокарда, качество жизни.

P5525Impact of clinical presentation at admission on long-term clinical outcomes in patients undergoing percutaneous coronary interventions - a contemporary registry data

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
L Piatek ◽  
L Zandecki ◽  
J Kurzawski ◽  
A Janion-Sadowska ◽  
M Zabojszcz ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Unstable Angina ◽  
Stable Angina ◽  
Clinical Presentation ◽  
P Value ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Abstract Background Both unstable angina (UA) and non-ST-segment elevation myocardial infarction (NSTEMI) are still classified together in non-ST-elevation acute coronary syndromes despite the fact they substantially differ in both clinical profile and prognosis. Purpose The aim of the present study was to evaluate contemporary clinical characteristics and outcomes of UA patients after percutaneous coronary intervention (PCI) in comparison with stable angina (SCAD) and myocardial infarction (NSTEMI as well as STEMI) in Swietokrzyskie District of Poland in years 2014–2017. Methods A total of 7'187 patients after PCI from ORPKI Registry (38% with diagnosis of UA) were included into the analysis. Impact of clinical presentation (UA, SCAD, NSTEMI, STEMI) on 3-year outcomes were determined. Results UA patients were older that SCAD but younger than NSTEMI individuals. Diabetes and hypertension were more often encountered into UA group than in NSTEMI but less often than in SCAD cases. In UA group the percentage of previous myocardial infarction (MI), PCI or coronary artery bypass grafting (CABG) was the highest among all analyzed groups. In 3-year observation the risk of death as well as myocardial infarction (MI) and major adverse cardiac events (MACE) in unstable angina after PCI was higher than in stable angina but considerably lower than in NSTEMI group. Multivariate analysis confirmed that prognosis in NSTEMI was substantially worse in comparison with UA (RR 1.365, 95% CI: 1.126–1.655, p=0.0015). On the contrary there were no difference in mortality risk between UA and SCAD patients (RR 1.189, 95% CI: 0.932–1.518, p=0.1620). Parallel results were observed in respect of MI and MACE. Independ predictors of death were: age, kidney disease, hypertension, diabetes, previous stroke or previous PCI. Multivariate logistic regression analyse Clinical presentation Death Myocardial infarction MACE RR 95% CI p-value RR 95% CI p-value RR 95% CI p-value NSTEMI/UA 1.365 1.126–1.655 0.0015 1.822 1.076–3.055 0.0260 1.514 1.267–1.807 <0.0001 NSTEMI/SCAD 1.624 1.251–2.109 0.0003 1.882 0.982–3.789 0.0568 1.604 1.275–2.094 <0.0001 UA/SCAD 1.189 0.932–1.518 0.1620 1.033 0.557–2.034 0.9219 1.060 0.855–1.323 0.6023 MACE, major adverse cardiac events; NSTEMI, non-ST-segment elevation myocardial infarction; UA, unstable angina; SCAD, stable angina. Conclusion Unstable angina accounted for 38% of all cases and was the most common diagnosis in patients that underwent PCI in that time. 3-year prognosis in UA was considerable better in comparison with NSTEMI. On contrary there was no difference in outcomes (death, MI, MACE) between UA and SCAD patients.

scholarly journals Therapeutic Role of Tocilizumab in SARS-CoV-2-Induced Cytokine Storm: Rationale and Current Evidence

2021 ◽  
Vol 22 (6) ◽  
pp. 3059
Author(s):  
Corrado Pelaia ◽  
Cecilia Calabrese ◽  
Eugenio Garofalo ◽  
Andrea Bruni ◽  
Alessandro Vatrella ◽  
...  
Keyword(s):  
Review Article ◽  
Lung Damage ◽  
Current Evidence ◽  
Therapeutic Effects ◽  
Cytokine Storm ◽  
Future Perspectives ◽  
Pathogenic Role ◽  
Refractory Rheumatoid Arthritis ◽  
Life Threatening

Among patients suffering from coronavirus disease 2019 (COVID-19) syndrome, one of the worst possible scenarios is represented by the critical lung damage caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2)-induced cytokine storm, responsible for a potentially very dangerous hyperinflammatory condition. Within such a context, interleukin-6 (IL-6) plays a key pathogenic role, thus being a suitable therapeutic target. Indeed, the IL-6-receptor antagonist tocilizumab, already approved for treatment of refractory rheumatoid arthritis, is often used to treat patients with severe COVID-19 symptoms and lung involvement. Therefore, the aim of this review article is to focus on the rationale of tocilizumab utilization in the SARS-CoV-2-triggered cytokine storm, as well as to discuss current evidence and future perspectives, especially with regard to ongoing trials referring to the evaluation of tocilizumab’s therapeutic effects in patients with life-threatening SARS-CoV-2 infection.

scholarly journals Perioperative Systemic Treatment for Muscle-Invasive Bladder Cancer: Current Evidence and Future Perspectives

2021 ◽  
Vol 22 (13) ◽  
pp. 7201
Author(s):  
In-Ho Kim ◽  
Hyo-Jin Lee
Keyword(s):  
Bladder Cancer ◽  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Systemic Treatment ◽  
Checkpoint Inhibitors ◽  
Invasive Bladder Cancer ◽  
Current Evidence ◽  
Future Perspectives ◽  
Muscle Invasive Bladder Cancer ◽  
Muscle Invasive

Radical cystectomy is the primary treatment for muscle-invasive bladder cancer; however, approximately 50% of patients develop metastatic disease within 2 years of diagnosis, which results in dismal prognosis. Therefore, systemic treatment is important to improve the prognosis of muscle-invasive bladder cancer. Currently, several guidelines recommend cisplatin-based neoadjuvant chemotherapy before radical cystectomy, and adjuvant chemotherapy is recommended in patients who have not received neoadjuvant chemotherapy. Immune checkpoint inhibitors have recently become the standard treatment option for metastatic urothelial carcinoma. Owing to their clinical benefits, several immune checkpoint inhibitors, with or without other agents (including other immunotherapy, cytotoxic chemotherapy, and emerging agents such as antibody drug conjugates), are being extensively investigated in perioperative settings. Several studies for perioperative immunotherapy have shown that immune checkpoint inhibitors have promising efficacy with relatively low toxicity, and have explored the predictive molecular biomarkers. Herein, we review the current evidence and discuss the future perspectives of perioperative systemic treatment for muscle-invasive bladder cancer.

scholarly journals Hepatocyte Turnover in Chronic HCV-Induced Liver Injury and Cirrhosis

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Nikolaos P. Karidis ◽  
Ioanna Delladetsima ◽  
Stamatios Theocharis
Keyword(s):  
Current Evidence ◽  
Hepatocellular Injury ◽  
Ongoing Research ◽  
Molecular Events ◽  
Parenchymal Liver ◽  
B Virus ◽  
Multistep Process ◽  
Differential Gene ◽  
Chronic Hcv ◽  
Hepatocyte Death

Chronic hepatitis C virus (HCV) infection may eventually lead to progressive liver fibrosis and cirrhosis through a complex, multistep process involving hepatocyte death and regeneration. Despite common pathogenetic pathways present in all forms of liver cirrhosis irrespective of etiology, hepatocyte turnover and related molecular events in HCV-induced cirrhosis are increasingly being distinguished from even “similar” causes, such as hepatitis B virus- (HBV-) related cirrhosis. New insights in HCV-induced hepatocellular injury, differential gene expression, and regenerative pathways have recently revealed a different pattern of progression to irreversible parenchymal liver damage. A shift to the significant role of the host immune response rather than the direct effect of HCV on hepatocytes and the imbalance between antiapoptotic and proapoptotic signals have been investigated in several studies but need to be further elucidated. The present review aims to comprehensively summarize the current evidence on HCV-induced hepatocellular turnover with a view to outline the significant trends of ongoing research.

Oral field cancerization: current evidence and future perspectives

2012 ◽  
Vol 16 (2) ◽  
pp. 171-180 ◽  
Author(s):  
Punnya V. Angadi ◽  
J. K. Savitha ◽  
Sanjay S. Rao ◽  
Y. Sivaranjini
Keyword(s):  
Field Cancerization ◽  
Current Evidence ◽  
Future Perspectives

Five-Year Follow-Up of the Medicine, Angioplasty, or Surgery Study (MASS)

Circulation ◽  
1999 ◽  
Vol 100 (suppl_2) ◽  
Author(s):  
Whady A. Hueb ◽  
Paulo Rogério Soares ◽  
Sérgio Almeida de Oliveira ◽  
Shiguemituzo Ariê ◽  
Rita Helena A. Cardoso ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Medical Treatment ◽  
Medical Therapy ◽  
Stable Angina ◽  
Coronary Angioplasty ◽  
Bypass Surgery ◽  
Random Assignment

Background —Although coronary angioplasty and myocardial bypass surgery are routinely used, there is no conclusive evidence that these interventional methods offer greater benefit than medical therapy alone. This study is intended to evaluate, in a prospective, randomized, and comparative analysis, the benefit of the 3 current therapeutic strategies for patients with stable angina and single proximal left anterior descending coronary artery stenosis. Methods and Results —In a single institution, 214 patients with stable angina, normal ventricular function, and severe proximal stenosis (>80%) on the left anterior descending artery were selected for the study. After random assignment, 70 patients were referred to surgical treatment, 72 to angioplasty, and 72 to medical treatment. The primary end points were the occurrence of acute myocardial infarction or death and presence of refractory angina. After a 5-year follow-up, these combined events were reported in only 6 patients referred to surgery as compared with 29 patients treated with angioplasty and 17 patients who only received medical treatment ( P =0.001). However, no differences were noted in relation to the occurrence of cardiac-related death in the 3 treatment groups ( P =0.622). No patient assigned to surgery needed repeat operation, whereas 8 patients assigned to angioplasty and 8 patients assigned to medical treatment required surgical bypass after the initial random assignment. Surgery and angioplasty reduced anginal symptoms and stress-induced ischemia considerably. However, all 3 treatments effectively improved limiting angina. Conclusions —Bypass surgery for single-vessel coronary artery disease is associated with a lower incidence of medium-term and long-term events as well as fewer anginal symptoms than that found in the patients who underwent angioplasty or medical therapy. In this study, coronary angioplasty was only superior to medical strategies in relation to the anginal status. However, the 3 treatment regimens yielded a similar incidence of acute myocardial infarction and death. Such information should be useful when choosing the best therapeutic option for similar patients.

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