scholarly journals The viscosity and thrombocytic-aggregation disorders in patients, suffering myocardial infarction with the ST segment elevation

2021 ◽  
Vol 88 (3-4) ◽  
pp. 16-20
Author(s):  
D. Yu. Uzun ◽  
V. V. Lazoryshynets ◽  
K. S. Uzun
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
Blood Circulation ◽  
Compensatory Growth ◽  
Aggregation Process ◽  
St Segment Elevation ◽  
St Segment ◽  
Diagnostic Approaches ◽  
Aggregation Parameters ◽  
Persistent Elevation

Objective. Analysis of changes in viscosity and disorders of the thrombocytes-aggregation process under impact of various tactical, diagnostic and intervention approaches in patients, suffering myocardial infarction with persistent elevation of ST segment in presence of multivascular affection of coronary arteries. Materials and methods. In the investigation four tactical and treatment-diagnostic approaches were used through year of observation. Results. In patients, suffering myocardial infarction and persistent elevation of ST segment the hyperviscosity and hypercoagulation syndromes were revealed, which have manifested in first weeks by compensatory growth of thrombocytes quantity, the blood viscosity, level of fibrinogen and aggregation properties of thrombocytes. Conduction of additional more profound examination of coronary blood circulation and further application of postponed stenting of the infarction-dependent arteries have promoted lesser amplitude of fluctuations of all laboratory indices, than in other tactical and treatment approaches. Conclusion. Standard tactical and treatment-diagnostic principles in management of such category of patients do not permit to improve the state of the viscosity and coagulation-aggregation parameters principally, even while application of double antiaggregation therapy.

scholarly journals Electroangiographic Correlation of Simultaneous ST-Segment Elevations of Anterior and Inferior Segment: Who Is the Culprit?

2021 ◽  
pp. 263246362110155
Author(s):  
Pankaj Jariwala ◽  
Shanehyder Zaidi ◽  
Kartik Jadhav
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Index Case ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Inferior Segment ◽  
The Right ◽  
Proximal Occlusion

Simultaneous ST-segment elevation (SST-SE) in anterior and inferior leads in the setting of ST-segment elevation myocardial infarction is often confounding for a cardiologist and further more challenging is the angiographic localization of the culprit vessel. SST-SE can be fatal as it jeopardizes simultaneously a larger area of myocardium. This phenomenon could be due to “one lesion, one artery,” “two lesions, one artery,” “two lesions, two arteries,” or combinations in two different coronary arteries. We have discussed an index case where we encountered a phenomenon of SST-SE and coronary angiography demonstrated “two lesions, one artery” (proximal occlusion and distal critical diffuse stenoses of the wrap-around left anterior descending [LAD] artery) and “two lesions, two (different coronary) arteries” (previously mentioned stenoses of the LAD artery and critical stenosis of the posterolateral branch of the right coronary arteries). We have also described in brief the possible causes of this phenomena and their electroangiographic correlation of the culprit vessels.

scholarly journals 588 Prognostic impact of early vs. deferred angiography in MINOCA patients

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Matteo Armillotta ◽  
Angelo Sansonetti ◽  
Sara Amicone ◽  
Francesco Angeli ◽  
Michele Fabrizio ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Coronary Arteries ◽  
Optimal Timing ◽  
Prognostic Impact ◽  
Invasive Strategy ◽  
St Segment Elevation ◽  
St Segment ◽  
Significant Difference ◽  
All Cause Mortality

Abstract Aims Although an early invasive strategy (coronary angiography performed <24 h) is associated with a lower risk of recurrent/refractory ischaemia among patients with acute myocardial infarction (AMI) and obstructive coronary arteries, the optimal timing of invasive examination in patients with non-obstructive coronary arteries and non-ST-segment elevation presentation (NSTE-MINOCA) has not been explored. This study tested the hypothesis that, compared to early (<24 h) invasive strategy, deferred (≥24 h) coronary angiography has equivalent prognostic impact in patients with NSTE-MINOCA. Methods and results From 2016 to 2020, all consecutive MINOCA patients diagnosed according to the current ESC diagnostic criteria (angiographic conventional cut-off of < 50% coronary stenosis without a clinically apparent alternative diagnosis) and admitted to our Centre with non-ST-segment elevation myocardial infarction (NSTEMI) presentation were enrolled. Very high-risk NSTEMI patients have been excluded from the study. The prognostic value of an early (<24 h) vs. deferred (≥24 h) coronary angiography was assessed. All-cause mortality and a composite endpoint of all-cause mortality, stroke, re-hospitalization for heart failure, and myocardial re-infarction were evaluated. 198 NSTE-MINOCA patients were enrolled. MINOCA patients were more frequently females (64%) and the mean age was 68.6 ± 13.2 years. The median follow-up time was 26 (14–40) months. The total number of events was 54 (27.3%). Kaplan–Meier curves showed that there was no statistically significant difference (P = 0.88) between the two study groups depending on the time of invasive strategy adopted. Specifically, the rates of death (15% vs. 11.3%) and MACEs (28.3% vs. 25%) were similar in MINOCA patients undergoing early vs. deferred angiography. Conclusions We demonstrate for the first time that in the MINOCA population the prognosis was not influenced by an early vs. deferred coronary angiography, unlike in AMI patients with obstructive coronary arteries. These results add another piece to the puzzle and pave the way for the initial use of a non-invasive imaging strategy (e.g. Coronary-CT), mostly in patients with NSTEMI and high clinical suspicion of non-obstructive coronary arteries.

scholarly journals ST Segment Elevation Myocardial Infarction in Coronary Arteries with Massive Ectasy

2016 ◽  
Author(s):  
Ana Rita G. Francisco ◽  
José Duarte ◽  
Miguel Nobre Menezes ◽  
José Marques da Costa ◽  
Pedro Canas da Silva ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Arteries ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment
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