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1.
Safety and effectiveness of the Catania Polyzene-F coated stent in real world clinical practice: 12-month results from the ATLANTA 2 registry.
Tamburino, C, Capodanno, D, Di Salvo, ME, Sanfilippo, A, Cascone, I, Incardona, V, Longo, G, Giacoppo, D, Capranzano, P, Sgroi, C, et al
EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology. 2012;(9):1062-8
Abstract
AIMS: The pivotal ATLANTA first-in-man study showed the promising safety and efficacy profile of the novel Catania™ stent in a population with ~20% American College of Cardiology/American Heart Association (ACC/AHA) type C coronary lesions. The ATLANTA 2 registry was designed to evaluate the 12-month safety and efficacy of the Catania stent in a broader real world scenario. METHODS AND RESULTS The ATLANTA 2 registry was a prospective, non-randomised, single-arm study of patients with symptomatic ischaemic heart disease and de novo lesions of native coronary arteries. A total of 300 patients (396 lesions) were recruited and 482 Catania stents were implanted. At 12 months, major adverse cardiac events were 8.8%, mainly driven by target lesion revascularisation (6.5%). Cardiac death and non-fatal myocardial infarction occurred in 2.5% and 0.7% of patients, respectively. Subacute definite or probable stent thrombosis was 0.7%. No late stent thrombosis was recorded. Compared with patients treated with drug-eluting stents or bare metal stents in the study period, those treated with Catania stents experienced similar outcomes at one year. CONCLUSIONS The 12-month results of the ATLANTA 2 registry confirmed the positive results of the ATLANTA first-in-man trial in a more complex population. A randomised trial is needed to assess the comparative value of the Catania stent over currently-used drug-eluting stents or bare metal stents.
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2.
[Effect of cytoflavin on the recovery of cognitive function after the cardiaс surgery with artificial blood circulation].
Kardash, OF, Shestakova, LG, Krachak, DI, Chernookiĭ, OG, Zasetskiĭ, AE, Ostrovskiĭ, IuP
Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova. 2011;(7):76-9
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3.
Persistent regional diastolic dysfunction after myocardial ischemia and the effect of statin treatment: assessment with two-dimensional radial strain rate.
Kim, HK, Chang, SA, Sohn, DW, Kim, DH, Kim, YJ, Oh, BH, Park, YB
Echocardiography (Mount Kisco, N.Y.). 2010;(3):244-52
Abstract
BACKGROUND Persistence of regional diastolic dysfunction after ischemic insult remains debatable. With speckle tracking echocardiography (STE), we sought to (1) prove the persistence of regional diastolic dysfunction, (2) assess the feasibility of applying persistent regional diastolic dysfunction to differentiating ischemic and nonischemic chest pain, and finally (3) examine statin effects on postischemic regional diastolic dysfunction. METHODS Nineteen patients with variant angina (VA) and 12 normal subjects were enrolled. Comprehensive echocardiographic examinations were performed before and 1 day after coronary angiography (CAG) with ergonovine provocation. Radial systolic (rSRsys) and diastolic (rSRdia) strain rates were obtained and averaged using standard segmentation models corresponding to the three major coronary territories assigned. RESULTS No significant changes in rSRsys and rSRdia values were observed for controls and in rSRsys for VA. However, rSRdia for VA demonstrated a weak, but significant, decrease from -2.25 +/- 0.71/sec to -2.04 +/- 0.71/sec (P = 0.003) 1 day after CAG. However, because of the wide overlap between rSRdia values in normal and ischemic segments for VA patients, predictability of remote ischemia based solely on the rSRdia was limited. Subgroup analysis according to statin prescription showed that statin administration contributed to the elimination of rSRdia reduction (-2.28 +/- 0.84/sec on pre-CAG vs. -2.29 +/- 0.77/sec on post-CAG, P = 0.72 for patients without statin premedication; -2.23 +/- 0.64/sec for pre-CAG vs. -1.88 +/- 0.65/sec for post-CAG, P = 0.002 for those without). Expectedly, rSRsys values showed no significant changes in all situations. CONCLUSIONS The presence and sustained nature of regional diastolic dysfunction can be demonstrated with STE. Statin minimized the persistence of regional diastolic dysfunction after an acute ischemia. Although the clinical usefulness of rSRdia by STE appears to be limited, its clinical utility requires further consideration, given the brevity of the ischemia provoked during CAG with ergonovine and the protracted regional diastolic dysfunction.
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4.
The efficacy and safety of extending the ischemic time with a modified cardioplegic technique for coronary artery surgery.
Casalino, S, Tesler, UF, Novelli, E, Stelian, E, Renzi, L, Alessi, C, Lanzillo, G, Cerin, G, Diena, M
Journal of cardiac surgery. 2008;(5):444-9
Abstract
BACKGROUND AND AIM The need to intermittently discontinue the administration of cardioplegia in order to complete the surgical procedure is a major drawback of antegrade warm blood cardioplegia. An ischemic time of 15 minutes is generally considered safe based on empirical observation. The aim of this study was the evaluation of the efficacy and safety of an intermittent warm blood cardioplegia with intervals between administrations prolonged to 25 minutes. METHODS Ninety-seven patients undergoing primary elective coronary artery revascularization were prospectively randomized into two groups. The first, Intermittent Antegrade Warm Blood Cardioplegia (IAWBC) group, comprising 49 patients, received standard intermittent antegrade warm blood cardioplegia repeated every 15 minutes. The second, Modified Intermittent Antegrade Warm Blood Cardioplegia (M-IAWBC) group, comprising 48 patients, received intermittent antegrade warm blood cardioplegia supplemented with magnesium sulfate (MgSO(4)), delivered in volumes proportional to the ventricular mass and repeated every 25 minutes. The clinical outcomes were evaluated. The levels of creatine kinase-MB (CK-MB) isoenzyme, in addition to the echocardiographic assessment of septal dyskinesia and tricuspid annulus plane systolic excursion (TAPSE), have been used as markers of myocardial damage. RESULTS There were no statistically significant differences in clinical outcomes, need for inotropes and vasodilators, length of stay in the intensive care unit, and postoperative levels of CK-MB between the two groups. Likewise, postoperative echocardiographic assessment showed no relevant differences. CONCLUSIONS Administration of warm antegrade cardioplegic solution supplemented with MgSO(4), delivered in volumes proportional to ventricular mass every 25 minutes, provides adequate myocardial protection for coronary artery surgery.
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5.
[Clinical efficacy and safety of Zo-20 in patients with ischemic heart disease].
Mamatsashvili, M, Mdivani, I
Georgian medical news. 2008;(154):18-21
Abstract
Since their introduction in the late 1980s, the 3- hydroxy-3 -methilglutaryl coenzyme A (HMG -CoA) reductaze inhibitors or statins, have revolutionized the treatment of hyperlipidemia. Despite the well-recognized benefits of statins, there is evidence that low density lipoprotein cholesterol (LDL-C) reductions as specified by National Cholesterol Education Program (NCEP) are not being met. The aim of the study was to assess the efficacy of Zo-20 ("GMP", Georgia) in achieving the target level for LDL-C in patients with CAD and hypercholesterinemia. 100 patients received 20-40 mg Zo-20 during the 3 months period, all parameters of the blood plasma lipids and adverse events were monitored during the study. 78% of patients reached the target goal for LDL-C, using 28,2 mg Zo-20 daily. No serious adverse events associated with study drug treatment were revealed. Zo-20 seems to be very effective and safety in treatment of patients with CAD and lipid disorders.
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6.
[Effect of therapy with atorvastatin on parameters of postprandial lipemia and factors of inflammation in patients with ischemic heart disease].
Samoĭlenko, EIu, Naumov, VG, Tvorogova, MG, Ezhov, MV, Sergienko, IV, Kukharchuk, VV
Kardiologiia. 2007;(2):4-8
Abstract
Reaction of parameters of lipid transport system to standard fat load (J.Patsch method), C-reactive protein (CRP) and fibrinogen levels were studied in 30 patients with ischemic heart disease before and after 3 months of therapy with atorvastatin (10 mg/day). Atorvastatin therapy resulted in 25, 34, 17 and 16% lowering of concentrations of total cholesterol (CH), low density lipoprotein CH, triglycerides (TG), and apolipoprotein (apo) B, respectively, 6 and 9% elevation of high density lipoprotein CH and apo A-1 levels, respectively. Moreover atorvastatin improved although not completely normalized parameters of postprandial lipemia: significant lowering of baseline (-17%), 3 (-19%) and 6 hour (-14%) post load TG levels was noted. However relative TG elevation from baseline level to 3 and 6 hours after fat load did not change (+100 and 148% before, +95 and 156% after treatment, respectively). Changes of CRP (-22%) and fibrinogen (-8%) were not significant (p>0.05).
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7.
Real time myocardial contrast echocardiography during supine bicycle stress and continuous infusion of contrast agent. Cutoff values for myocardial contrast replenishment discriminating abnormal myocardial perfusion.
Miszalski-Jamka, T, Kuntz-Hehner, S, Schmidt, H, Hammerstingl, C, Tiemann, K, Ghanem, A, Troatz, C, Lüderitz, B, Omran, H
Echocardiography (Mount Kisco, N.Y.). 2007;(6):638-48
Abstract
BACKGROUND Myocardial contrast echocardiography (MCE) is a new imaging modality for diagnosing coronary artery disease (CAD). OBJECTIVE The aim of our study was to evaluate feasibility of qualitative myocardial contrast replenishment (RP) assessment during supine bicycle stress MCE and find out cutoff values for such analysis, which could allow accurate detection of CAD. METHODS Forty-four consecutive patients, scheduled for coronary angiography (CA) underwent supine bicycle stress two-dimensional echocardiography (2DE). During the same session, MCE was performed at peak stress and post stress. Ultrasound contrast agent (SonoVue) was administered in continuous mode using an infusion pump (BR-INF 100, Bracco Research). Seventeen-segment model of left ventricle was used in analysis. MCE was assessed off-line in terms of myocardial contrast opacification and RP. RP was evaluated on the basis of the number of cardiac cycles required to refill the segment with contrast after its prior destruction with high-power frames. Determination of cutoff values for RP assessment was performed by means of reference intervals and receiver operating characteristic analysis. Quantitative CA was carried out using CAAS system. RESULTS MCE could be assessed in 42 patients. CA revealed CAD in 25 patients. Calculated cutoff values for RP-analysis (peak-stress RP >3 cardiac cycles and difference between peak stress and post stress RP >0 cardiac cycles) provided sensitive (88%) and accurate (88%) detection of CAD. Sensitivity and accuracy of 2DE were 76% and 79%, respectively. CONCLUSIONS Qualitative RP-analysis based on the number of cardiac cycles required to refill myocardium with contrast is feasible during supine bicycle stress MCE and enables accurate detection of CAD.
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8.
[Effect of statin therapy on dynamics of vascular endothelial growth factor and fibroblast growth factor in patients with ischemic heart disease].
Sergienko, IV, Semenova, AE, Masenko, VP, Ezhov, MV, Gabrusenko, SA, Kukharchuk, VV, Belenkov, IuN
Kardiologiia. 2007;(8):4-7
Abstract
The aim of our study was to assess the influence of rosuvastatin on coronary angiogenesis. 30 male patients with chronic coronary heart disease and total cholesterol level > 5.2 mmol/l were treated with rosuvastatin 10 mg daily during 3 months. The serum level of total cholesterol (TC), LDL-cholesterol (LDL-C), HDL-cholesterol (HDL-C), triglycerides (TG) as well as C-reactive protein (CRP) and interleukin-6 (IL-6), vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) were measured initially and in 3 months. There was the significant decreasing of TC, LDL-C and TG concentrations. IL-6 and CRP serum levels were also decreased after rosuvastatin therapy. Three months of treatment resulted to significant decrease of VEGF with no changes of bFGF levels. The correlation was not found between CRP and VEGF levels and between IL-6 and VEGF levels. Also there was no correlation between the degree of decreasing CRP and VEGF, and IL-6 and VEGF. So we have shown significant decreasing of VEGF serum levels on rosuvastatin therapy. It could be possible mechanism of plaque stabilization in patients with coronary heart disease.
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9.
Intra-coronary high-dose CD34+ stem cells in patients with chronic ischemic heart disease: a 12-month follow-up.
Boyle, AJ, Whitbourn, R, Schlicht, S, Krum, H, Kocher, A, Nandurkar, H, Bergmann, S, Daniell, M, O'Day, J, Skerrett, D, et al
International journal of cardiology. 2006;(1):21-7
Abstract
Current stem cell protocols for ischemic heart disease are limited by the small numbers of cells that can be obtained by bone marrow aspirate. To increase myocardial delivery of bone marrow stem cells in patients with chronic ischemic heart disease (CIHD), we used granulocyte colony stimulating factor (G-CSF) for bone marrow mobilization of CD34+ cells, enabling intracoronary infusion of large numbers of CD34+ stem cells. Patients with CIHD (n = 5) demonstrated significantly reduced numbers of CD34+ cells mobilized by G-CSF in comparison to age-matched controls. Sustained reduction in anginal symptoms and improvement in quality of life scores was seen in all patients following infusion of cells. Moreover, mean collateral flow grade at 12-month follow-up angiography significantly improved, indicating sustained myocardial neovascularization. No proliferative retinopathy was induced and no in-stent restenosis seen. However, in two patients with documented increase in collateral flow, complications arose, one developing an acute coronary syndrome and the other a lentigo maligna. These results demonstrate the feasibility of G-CSF mobilization, leukapheresis and intracoronary transfer of CD34+ stem cells in patients with CIHD, but longer-term studies are required to ensure that this protocol is safe and effective.
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10.
Myocardial ischemia induced by nebulized fenoterol for severe childhood asthma.
Zanoni, LZ, Palhares, DB, Consolo, LC
Indian pediatrics. 2005;(10):1013-8
Abstract
We examined for myocardial ischemia induced by continuous inhalation of fenoterol in children with severe acute asthma. Thirty children with severe acute asthma were evaluated for signs of myocardial ischemia when treated with 0.5 mg kg dose (maximum 15 mg) of inhaled fenoterol for one hour. The heart rate was measured before and after inhalation. Cardiac enzymes (creatine kinase, creatine kinase MB fraction and troponin levels) were measured at admission and 12 hours later. An EKG was recorded before inhalation was started and immediately after its completion to detect the presence of any evidence of myocardial ischemia. All patients developed significant increase in heart rate. Six patients showed EKG changes compatible with myocardial ischemia, despite normal enzyme levels. Patients with severe acute asthma show tachycardia and may show EKG changes of myocardial ischemia.