scholarly journals Infusion therapy in treatment of patients with acute coronary syndrome

2020 ◽  
pp. 5-6
Author(s):  
I.R. Aghababyan ◽  
Yu.A. Ismoilova ◽  
Sh.Sh. Sadykova
Keyword(s):  
Acute Coronary Syndrome ◽  
Main Group ◽  
Left Ventricular Ejection ◽  
Control Group ◽  
Ventricular Extrasystole ◽  
Basic Therapy ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
The Third ◽  
St Segment

Objective. Introduction to the basic therapy of patients with acute coronary syndrome (ACS) without ST-segment elevation cardioprotective drug Tivorel (“Yuria-Pharm”) based on L-arginine and L-carnitine. Materials and methods. The present study was carried out in accordance with the requirements for clinical trials of drugs in the Department of Emergency Cardiology of the RSCEMPSF. Patients were admitted to the intensive care unit with a diagnosis of ACS without ST-segment elevation in the first 12 h after the onset of the disease. The study was carried out in two groups and included the following stages: screening and treatment period (10 days). The study involved 90 patients with ACS without ST segment elevation, who were allocated for treatment in the study and control groups in a 1:1 ratio. Patients of the study group, except for basic therapy (sublingual nitroglycerin, acetylsalicylic acid or clopidogrel, analgesics, β-adrenergic blockers or angiotensin-converting enzyme inhibitors), received the drug Tivorel 100 ml intravenously at a rate of 10 drops per minute for the first 10-15 min (then the rate of administration could be increased to 30 drops per minute) 1 time per day within 10 days. Control group patients were prescribed only basic therapy. Determination of markers of myocardial necrosis (troponin T), electrocardiography (ECG), echocardiography. Compulsory calculation of end-diastolic and end-systolic indices, left ventricular ejection fraction were performed. Results and discussion. It was found that the drug Tivorel, prescribed as part of complex therapy immediately after admission of patients to the hospital, improves the electrophysiological properties of the myocardium and prevents the appearance of temporary ECG disturbances, stabilizes the condition of patients. In patients of the main group, already in the first day after the development of acute myocardial infarction (AMI), late ventricular potentials were less often recorded, markers of the so-called arrhythmogenic substrate – 9.5 % compared to 18.7 % in patients in the control group. In the course of further observation, the prostate gland in the control group disappeared, and during treatment with Tivorel, it did not appear anymore. This suggests the presence of a pronounced anti-ischemic effect of the drug, which is also confirmed by clinical data. We have noted a reliably expressed positive dynamics of changes in the end part of the ventricular complex under the influence of therapy with Tivorel. Analysis of standard ECG and 24-hour monitoring data in a number of patients revealed rhythm disturbances. There were no significant differences between the groups in the frequency of occurrence of all manifestations of arrhythmic syndrome, both initially and after therapy, however, in the main group, during treatment, the number of cases of ventricular arrhythmias in the form of group ventricular extrasystole and ventricular tachycardia bursts significantly decreased. During the period of inpatient treatment, all patients showed positive clinical dynamics: a decrease in the frequency and severity of angina attacks, a decrease and stabilization of blood pressure, an increase in exercise tolerance. Already on the third day of treatment with the use of the study drug Tivorel, relapses of anginal pain occurred less frequently (21.9 % of cases in the main group and 33.0 % in the control group). At the same time, there was a decrease in the need for the use of nitroglycerin and narcotic analgesics in order to relieve recurrent pain syndrome (23.1 % and 35.3 % of cases, respectively). In addition, on the third day after the development of AMI in patients of the main compared with the control, a lower incidence of atrioventricular blockade was recorded (4.3 % and 13.6 %, respectively). In the course of the analysis of the entire hospital period, it was found that in patients receiving Tivorel, atrioventricular blockades occurred almost 3 times less often than in the control group. The frequency of registration of ventricular extrasystole decreased on the 7th (34.1 %) and 10th days (45.7 %) of the disease. Conclusions. The use of the drug Tivorel (“Yuria-Pharm”) in addition to basic therapy helps to optimize the management of ACS patients without ST-segment elevation. With complex treatment with the use of the drug Tivorel, a faster regression of clinical manifestations of ACS is observed. The use of Tivorel in ACS therapy without ST-segment elevation stabilizes the patient’s condition and reduces the incidence of complications.

scholarly journals Analysis of ticagrelor’s cardio-protective effects on patients with ST-segment elevation acute coronary syndrome accompanied with diabetes

Open Medicine ◽  
2019 ◽  
Vol 14 (1) ◽  
pp. 234-240 ◽  
Author(s):  
Dong-Tao Li ◽  
Shun-Bao Li ◽  
Jian-Yong Zheng ◽  
Hai-hong Tang ◽  
Yi-Gang Qiu ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Adverse Reactions ◽  
Left Ventricular ◽  
Control Group ◽  
Observation Group ◽  
Protective Effects ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome

AbstractBackgroundTo analyze the cardio-protective effects of ticagrelor in patients with acute coronary syndrome with S-T segment elevation.MethodsThe sample was 200 patients who had been diagnosed with acute coronary syndrome accompanied by diabetes Mellitus type II. Only patients having ST segment elevation before the treatment were included. Then, the subjects were further randomly divided into an observation group and a control group. The control group of 100 patients received clopidogrel; the observation group of 100 patients of ticagrelor. The serous creatine kinase CK-MB, functional cardiac indexes of left ventricular end diastolic diameter (LVDD), cardiac troponin I, ventricular ejection fraction, and relevant major adverse cardiovascular events (MACE) were compared between the two groups.ResultsOne month after a percutaneous coronary intervention (PCI) the observation group showed better results against angina, stent thrombosis, and all-cause mortality compared with those of the control subjects. Six months after treatment, both groups suffered adverse reactions. The number of patients who suffered adverse reactions in respiratory tract in the observation group was higher than in the control group. The inhibition of platelet aggregation IPA of ticagrelor was found to be significantly higher than clopidogrel, having a significant p value.ConclusionTicagrelor can effectively protect myocardial function for patients with ST-segment elevation acute coronary syndrome accompanied by diabetes and can reduce the incidence of adverse reactions..

scholarly journals DEATH CAUSES AND THEIR PREDICTION IN PATIENTS WITH THE ST SEGMENT ELEVATION ACUTE CORONARY SYNDROME AND PRE-HOSPITAL THROMBOLYSIS

2013 ◽  
Vol 12 (2) ◽  
pp. 52-57
Author(s):  
S. N. Morozov ◽  
A. I. Fedorov ◽  
K. S. Loskutova ◽  
A. L. Vertkin
Keyword(s):  
Acute Coronary Syndrome ◽  
Cause Of Death ◽  
Comparison Group ◽  
Main Group ◽  
Morphological Data ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Myocardial Rupture ◽  
Reperfusion Strategy

Aim.To assess effectiveness and safety of pre-hospital medical treatment in patients with acute coronary syndrome and ST segment elevation (ST-ACS) who are undergoing thrombolytic therapy (TLT); to identify TLT complications and the methods for their prediction.Material and methods.In total, the pre-hospital TLT effectiveness was assessed in 237 patients. The comparison group included 274 patients who did not undergo TLT, due to various reasons. The causes of death by Day 7–10 were analysed.Results.The leading cause of death was cardiogenic shock. In addition, in the main group, indirect myocardial rupture was a cause of death more often than in the comparison group (28% vs. 5,3%). Indirect myocardial rupture was associated with haemorrhagic complications of pre-hospital TLT. The proposed method for predicting TLT complications is based on the TIMI scale: 1–4 points suggest TLT safety; 4–5 points correspond to a higher risk of external myocardial rupture (11,6%), which implies the need to perform TLT under control of blood coagulation parameters; and ≥6 points denote the need to avoid pre-hospital TLT and use a mechanic reperfusion strategy.Conclusion.Among ST-ACS patients, mortality levels were 20,9%, which was 2,4 times higher than in the comparison group. In the main group, the morphological data obtained at autopsy demonstrated hemorrhagic myocardial transformation, which was associated with the high risk of indirect myocardial rupture (28,1%). In patients with pre-existing arterial hypertension and with the time from the ST-ACS onset of 2–3 hours, the risk of indirect myocardial rupture should be predicted, based on the TIMI scale. This will facilitate more effective assessment of the systemic TLT complication risk and selection of the optimal reperfusion strategy. 

scholarly journals Long-term results of stenting of long coronary artery stenosis with consecutive implantation of stents of different types with overlapping edges in patients with acute coronary syndrome without ST-segment elevation and multivessel coronary artery disease

2019 ◽  
Vol 10 (2) ◽  
pp. 53-59
Author(s):  
Aleksandr V. Bocharov ◽  
Leonid V. Popov
Keyword(s):  
Acute Coronary Syndrome ◽  
Bare Metal Stent ◽  
Long Term Results ◽  
Control Group ◽  
Bare Metal ◽  
Metal Stent ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Drug Coating

Introduction. In urgent interventional cardiology practice, combinations of drug-eluting stents and bare-metal stents are sometimes forced to treat extended stenosis in a clinic-dependent artery. Objective. A comparison of long-term results of treatment of patients with coronary heart disease and multivessel coronary lesions, which performed stenting of the clinic-dependent artery by two successive partially overlapping stents using stents of the 3rd generation with drug coating or a combination of the 3rd generation stent with drug coating and a bare-metal stent for acute coronary syndrome without St segment elevation and later — complete functional myocardial revascularization by endovascular method. Methods. The minimum overall length sentiremos section was made 55 mm. In main group included 32 patients for whom revascularization clinic-dependent artery performed endovascular intervention with the use of 2 stents 3-generation drug-coated sirolimus and biodegradable polymer implanted overlap. In 30 patients (control group), clinic-dependent artery revascularization was also performed by a combination of implanted overlap stents, one of which was a 3rd generation stent with sirolimus drug coating and biodegradable polymer, and the other was a bare-metal stent. There were no statistically significant differences between the groups in clinical, demographic and operational characteristics. Results. The analysis of the results revealed a significant difference between the groups in the frequency of repeated revascularization of the target artery, which were observed more often in the control group. Conclusion. When performing an extended stenting of the clinic-dependent artery in patients with acute coronary syndrome without ST segment elevation, overlapping of the drug-coated stent and the bare-metal stent should be avoided, since the antirestenotic effect of the drug-coated stent is leveled when overlapping with the bare-metal stent, but this strategy can be used in case of full coverage of the stenotic lesion or closure of the dissection.

Effect of recombinant human brain natriuretic peptide on patients with non-ST segment elevation acute coronary syndrome

2021 ◽  
Vol 7 (5) ◽  
pp. 3226-3231
Author(s):  
Wubin Wu ◽  
LiZhi Liu ◽  
Jiacai Chen
Keyword(s):  
Acute Coronary Syndrome ◽  
Human Brain ◽  
Brain Natriuretic Peptide ◽  
Natriuretic Peptide ◽  
Control Group ◽  
Study Group ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Elevation Acute Coronary Syndrome

Objective: To investigate the effect of recombinant human brain natriuretic peptide on patients with non-ST segment elevation acute coronary syndrome. Methods: 80 patients with non-ST segment elevation acute coronary syndrome diagnosed and treated in our hospital from January 2017 to December 2019 were randomly divided into study group (n = 41) and control group (n = 39). All patients were treated with basal therapy, the control group was treated with isosorbide dinitrate, and the study group was treated with recombinant human brain natriuretic peptide on the basis of the control group. The changes of cardiac function indexes, renal function indexes and hemodynamic parameters before and after treatment were observed and compared between the two groups. Results: The total effective rate of the study group was 87.80%, which was significantly higher than that of the control group (69.23%) (P<0.05). There was no significant difference in left ventricular end-diastolic dimension (LVEDD), left ventricular end-systolic dimension (LVESD) and left ventricular ejection fraction (LVEF), hemodynamic parameters’ cardiac index (CI), central venous pressure (CVP), mean arterial pressure (MAP), systemic vascular resistance index (SVRI) and glomerular filtration rate (eGFR) between the two groups before treatment (P>0.05). After treatment, LVEDD, LVESD and SVRI were all decreased than that before treatment in the two groups, LVEF, CI, CVP, MAP and eGFR were higher than those before treatment (P<0.05), and LVEDD, LVESD and SVRI in the study group were lower than those in the control group, and LVEF, CI, CVP, MAP and eGFR were higher than those in the control group (P<0.05). Conclusion: Recombinant human brain natriuretic peptide is effective in the treatment of non-ST segment elevation acute coronary syndrome, which is beneficial not only for the recovery of cardiac function, but also for the improvement of hemodynamic staus and renal function.

PREDICTORS OF LONG-TERM ADVERSE PROGNOSIS IN PATIENTS WITH ACUTE CORONARY SYNDROME WITH ST-SEGMENT ELEVATION

2019 ◽  
Vol 25 (1) ◽  
pp. 22-27
Author(s):  
S. A Berns ◽  
Valeria A. Zakharova ◽  
E. A Shmidt ◽  
A. A Golikova ◽  
V. S Lynev ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Fatal Outcome ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Long Term Outcome ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Aim: Identification of predictors of unfavorable annual prognosis in patients with acute coronary syndrome with ST-segment elevation (STEMI). Material and methods: The study included 69 patients with STEMI who were hospitalized in the period from March 2014 to January 2017 in the hospital named after Zhadkevich. The follow-up period was 12±3 months after the index STEMI Longterm prognosis was established in 62 (89.8%) patients. Results: the fatal outcome was observed in 7 (11.3%) patients. Nonfatal myocardial infarction developed in 10 (16.2%), hospitalization with heart failure decompensation - in 5 (8%), nonfatal acute cerebrovascular accident - in 3 (4.8%) patients. Predictors of adverse prognosis were: age >60 years, level of brain natriuretic peptide (BNP) >29.2 pmol/l, C-reactive protein (CRP) >4.7 mg/l, left ventricular ejection fraction (LVF) 60 years and BNP level >29.2 pmol/l. Conclusion: Adverse factors affecting the long-term outcome of the disease (12±3 months after the STEMI) are: BNP level >29.2 pmol/l, CRP level >4.7 mg/l, LV FV value 60 years.

Plasma Catestatin in Patients with Acute Coronary Syndrome

Cardiology ◽  
2016 ◽  
Vol 136 (3) ◽  
pp. 164-169 ◽  
Author(s):  
Weixian Xu ◽  
Haiyi Yu ◽  
Hubing Wu ◽  
Siheng Li ◽  
Baoxia Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Major Adverse Cardiovascular Events ◽  
Control Group ◽  
Term Outcome ◽  
Long Term Outcome ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Artery Disease

Objectives: To measure plasma catestatin levels in patients with acute coronary syndrome and investigate whether there is an association between catestatin levels and long-term outcome. Methods: Patients (n = 170) with suspected acute coronary syndrome who underwent emergency coronary angiography were enrolled, including 46 with acute ST-segment elevation myocardial infarction (STEMI), 89 with unstable angina pectoris (UAP), and 35 without coronary artery disease (CAD). All patients were followed for 2 years to measure the occurrence of major adverse cardiovascular events (MACEs), including death from a cardiovascular cause, recurrent acute myocardial infarction, or hospital admission for heart failure or revascularization. Results: On average, the plasma catestatin levels in patients with STEMI (0.80 ± 0.62 ng/ml) and UAP (0.99 ± 0.63 ng/ml) were significantly lower than the levels seen in the control group with no evidence of CAD (1.38 ± 0.98 ng/ml; p = 0.001). In multivariable linear regression, body mass index, presence of hypertension, and type of CAD were independently related to the plasma catestatin level. However, there were no significant differences in MACEs between patients with high and low levels of catestatin. Conclusions: The plasma catestatin levels in patients with STEMI and UAP were lower than the levels seen in patients without CAD.

scholarly journals MIF mRNA Expression and Soluble Levels in Acute Coronary Syndrome

2018 ◽  
Vol 2018 ◽  
pp. 1-6 ◽  
Author(s):  
Emmanuel Valdés-Alvarado ◽  
Yeminia Valle ◽  
José Francisco Muñoz-Valle ◽  
Ilian Janet García-Gonzalez ◽  
Angelica Valdez-Haro ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Mrna Expression ◽  
Clinical Manifestations ◽  
Serum Levels ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Myocardial Infraction

Acute coronary syndrome (ACS) describes any condition characterized by myocardial ischaemia and reduction in blood flow. The physiopathological process of ACS is the atherosclerosis where MIF operates as a major regulator of inflammation. The aim of this study was to assess the mRNA expression of MIF gene and its serum levels in the clinical manifestations of ACS and unrelated individuals age- and sex-matched with patients as the control group (CG). All samples were run using the conditions indicated in TaqMan Gene Expression Assay protocol. Determination of MIF serum levels were performed by enzyme-linked immunosorbent assay and MIF ELISA Kit. ST-segment elevation myocardial infraction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) showed 0.8 and 0.88, respectively, less expression of MIF mRNA with regard to CG. UA and STEMI presented more expression than NSTEMI 5.23 and 0.68, respectively. Otherwise, ACS patients showed significant higher MIF serum levels (p=0.02) compared with CG. Furthermore, the highest soluble levels of MIF were presented by STEMI (11.21 ng/dL), followed by UA (10.34 ng/dL) and finally NSTEMI patients (8.75 ng/dL); however, the differences were not significant. These novel observations further establish the process of MIF release after cardiovascular events and could support the idea of MIF as a new cardiac biomarker in ACS.

scholarly journals CARDIOPROTECTION IN PATIENTS WITH ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION

2019 ◽  
Vol 8 (3) ◽  
pp. 52-59
Author(s):  
I. E. Vereshchagin ◽  
V. I. Ganyukov ◽  
I. N. Mamchur
Keyword(s):  
Acute Coronary Syndrome ◽  
Coronary Angiography ◽  
Succinic Acid ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Cardiac Events ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment

Aim To evaluate cardioprotective effects of combined intracoronary phosphocreatine and succinic acid administration after primary percutaneous coronary intervention (PCI) in patients with ST elevation acute coronary syndrome who were present within 12 hours of symptom onset.Methods Seven patients with STEMI presenting within 12 hours of onset of symptoms and thrombotic occlusion of the left anterior descending artery were included in the study. Evaluation of efficiency and safety was performed with the recording of major adverse cardiac events, evaluation of the procedure success, and the rate of composite endpoints.Results Six (85.7%) patients after primary PCI showed TIMI grade 3 flow on control coronary angiography. None complications had been reported after intracoronary administration of phosphocreatine and succinic acid. Acquired left ventricular aneurysms were found in two patients in the in-hospital period. One patient was readmitted with acute coronary syndrome without ST-segment elevation. Coronary angiography reported restenosis of the previously implanted stent. No definite increase in the left ventricular ejection fraction had been found in the in-hospital and long-term period.Conclusion There were no evidences on definite increase in myocardial contractility. The obtained results might partially be explained by the median symptom-to-balloon time over 400 minutes.

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