Our experience with complete revascularization on beating heart in patients with acute coronary syndrome

2016 ◽  
Vol 24 (4) ◽  
pp. 666-671
Author(s):  
Erhan Kaya
Keyword(s):  
Acute Coronary Syndrome ◽  
Beating Heart ◽  
Complete Revascularization ◽  
Coronary Syndrome

scholarly journals Adverse Cardiac Remodelling after Acute Myocardial Infarction: Old and New Biomarkers

2020 ◽  
Vol 2020 ◽  
pp. 1-21 ◽  
Author(s):  
Alexander E. Berezin ◽  
Alexander A. Berezin
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Coronary Artery ◽  
New Technologies ◽  
Early Period ◽  
Cardiac Remodelling ◽  
Complete Revascularization ◽  
Coronary Syndrome

The prevalence of heart failure (HF) due to cardiac remodelling after acute myocardial infarction (AMI) does not decrease regardless of implementation of new technologies supporting opening culprit coronary artery and solving of ischemia-relating stenosis with primary percutaneous coronary intervention (PCI). Numerous studies have examined the diagnostic and prognostic potencies of circulating cardiac biomarkers in acute coronary syndrome/AMI and heart failure after AMI, and even fewer have depicted the utility of biomarkers in AMI patients undergoing primary PCI. Although complete revascularization at early period of acute coronary syndrome/AMI is an established factor for improved short-term and long-term prognosis and lowered risk of cardiovascular (CV) complications, late adverse cardiac remodelling may be a major risk factor for one-year mortality and postponded heart failure manifestation after PCI with subsequent blood flow resolving in culprit coronary artery. The aim of the review was to focus an attention on circulating biomarker as a promising tool to stratify AMI patients at high risk of poor cardiac recovery and developing HF after successful PCI. The main consideration affects biomarkers of inflammation, biomechanical myocardial stress, cardiac injury and necrosis, fibrosis, endothelial dysfunction, and vascular reparation. Clinical utilities and predictive modalities of natriuretic peptides, cardiac troponins, galectin 3, soluble suppressor tumorogenicity-2, high-sensitive C-reactive protein, growth differential factor-15, midregional proadrenomedullin, noncoding RNAs, and other biomarkers for adverse cardiac remodelling are discussed in the review.

scholarly journals A young female with double mechanical prosthetic heart valves presenting with coronary embolism-a rare case report

2020 ◽  
Vol 9 (1) ◽  
pp. 37-39
Author(s):  
Suman Adhikari ◽  
Ratna Mani Gajurel ◽  
Chandra Mani Paudel ◽  
Surya Devkota ◽  
Smriti Shakya ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Heart Valves ◽  
Young Patients ◽  
Young Female ◽  
Complete Revascularization ◽  
Prosthetic Heart Valves ◽  
Coronary Syndrome ◽  
Rare Case Report ◽  
History Of ◽  
Coronary Embolism

Coronary embolism, though uncommon, can occur in young patients with mechanical prosthetic heart valves. Coronary embolism has been reported in patients with prosthetic heart valves with or without thrombosis in literatures. It can cause acute coronary syndrome and lead to death if threshold of diagnosis of coronary embolism is not low. Here we report a case of coronary embolism in a 26 year old female with history of double mechanical prosthetic valve replacement, presenting to our centre with acute coronary syndrome. She was managed with thrombosuction establishing almost complete revascularization.  

scholarly journals 774 Young adults with acute coronary syndrome: still a long road ahead

2021 ◽  
Vol 23 (Supplement_G) ◽  
Author(s):  
Jessica Ielapi ◽  
Salvatore De Rosa ◽  
Giuseppe Deietti ◽  
Claudia Critelli ◽  
Giuseppe Panuccio ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Young Adults ◽  
Myocardial Revascularization ◽  
Young Patients ◽  
Clinical Profile ◽  
University Hospital ◽  
Complete Revascularization ◽  
Percutaneous Coronary Angioplasty ◽  
Coronary Syndrome ◽  
Magna Graecia

Abstract Aims Acute coronary syndrome (ACS) are a leading cause for mortality and morbility worldwide. Despite ACS usually affects the older population, it also occurs in younger individuals. Young ACS patients (YACS) have a significantly worse prognosis compared to their age-mates in the general population. Despite YACS are characterized by a different risk profiles compared to their older mates, many aspects still remain elusive. Aim of this study was to describe the clinical profile of young adults with Acute Coronary Syndrome. Methods and results Young patients (≤50 years) with the first diagnose of Acute Coronary Syndrome admitted to the Magna Graecia University Hospital were enrolled in the ongoing GENEPAMY registry. Over 7 years, a total of 675 eligible patients with Acute Coronary Syndrome aged 44 ± 8 years were included. Men accounted for 84.9% of all patients. Overall, 11.9% of patients had diabetes, 69.1% hypertension, 17.6% obesity, 93.6% dyslipidemia, while 75.5% were smokers. In the overall cohort, 44.1% were first diagnosed with STEMI, 45.9% with NSTEMI, while the remaining had been admitted for Unstable Angina. Cardiogenic shock was present at admission in 2.7% of cases. Multivessel disease was present in 39% of cases and was significantly less frequent in women (P < 0.001). Thrombolysis was administered as the initial treatment in 15.1% of cases but was ineffective in 66.7% of patients. Percutaneous coronary angioplasty was performed in 79.1% of patients, while 1.9% of patients underwent surgical myocardial revascularization. Spontaneous coronary dissection was present in 0.7% of men and 17.2% of women (P < 0.001). At admission, 98.9% of patients had been treated with ASA, 17.9% with clopidogrel, 49.1% with ticagrelor and 28.4% with prasugrel. A complete revascularization was achieved in 81.6% during the index hospitalization but was significantly more frequent in women compared to men (86.3% vs. 80.8; P < 0.001). Conclusions Our data highlight that YACS present a peculiar clinical profile. In particular, the high cardiovascular risk profile demands attention. Finally, despite most patients were men, young women with ACS present several relevant differences compared to men, needing a more careful clinical management.

scholarly journals Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome

2021 ◽  
Vol 10 (8) ◽  
pp. 1653
Author(s):  
Alberto Cordero ◽  
Elías Martínez Rey-Rañal ◽  
María J. Moreno ◽  
David Escribano ◽  
José Moreno-Arribas ◽  
...  
Keyword(s):  
Heart Failure ◽  
Acute Coronary Syndrome ◽  
Predictive Value ◽  
Negative Binomial ◽  
Negative Binomial Regression ◽  
Complete Revascularization ◽  
Predictive Capacity ◽  
Coronary Syndrome ◽  
Increased Risk ◽  
Incidence Risk

Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; p < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS.

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