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[Soluble selectins in myocardial infarction].
Lampka, M, Grabczewska, Z, Krajewska, M, Piskorska, E, Hołyńska-Iwan, I, Kubica, J
Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2013;(202):188-91
Abstract
UNLABELLED In myocardial infarction, the endothelial activation which induces leukocytes migration into the myocardial tissues, may play an important role in ischemic injury. Selectins, shedding from the surface of activated cells into bloodstream, maybe suggested as markers of endothelial activation and leukocytes stimulation. The aim of the study was evaluation. To evaluate serum soluble E- and P-selectin levels as endothelial activation marker and serum soluble L-selectin level as leukocytes stimulation marker in myocardial infarction. MATERIAL AND METHODS We examined 27 patients with acute myocardial infarction (AMI) The control group (K) consisted of 23 healthy subjects without symptoms of coronary artery disease. The concentration of soluble selectins (sE-, sP-, sL-selectin) were analyzed in venous blood serum. Results of routine laboratory tests: lipid levels, leukocyte count, prothrombin time were also included into statistical analysis. RESULTS A significant decrease in serum sL-selectin level was observed in patients with acute myocardial infarction compared to the control group. However, no difference was found in sE- and sP-selectin levels between the patient group and the control group. The sE-selectin level correlated positively with triglicerides level and inversely with HDL cholesterol level. There were a positive correlation between sP-selectin level and leukocyte count as well as inverse correlation between sP-selectin level and prothrombin time. The sL-selectin level correlated positively with leukocyte count. There were also a positive correlation between sP-selectin level and sE-selectin as well as sL-selectin levels. CONCLUSIONS The sE-selectin level increases with the severity of atherogenic changes in serum lipid profil, and sP-selectin level increases due to inflammatory and prothrombotic processes. The sL-selectin level is influenced by inflamamatory processes in the vascular wall. The sE- and sP-selectin levels, unchanged compared to the control group, do not reflect adequately the degree of endothelial activation. An decreased sL-selectin level may indicate functional depletion of leukocytes in patients with myocardial infarction and make it difficult to assess the degree of leukocytes stimulation.
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[Influences of different aspiration results by aspiration thrombectomy catheter in emergent percutaneous coronary intervention for patents with acute myocardial infarction].
Lian, H, Yang, JQ, Chen, ZJ
Zhonghua yi xue za zhi. 2011;(40):2845-8
Abstract
OBJECTIVE To evaluate the influences of different aspiration results by Diver C.E. aspiration thrombectomy catheter on myocardium perfusion and clinical outcomes during emergency PCI (percutaneous coronary intervention) for the patients with acute ST segment elevation myocardial infarction (STEMI). METHODS The patients undergoing emergent PCI and using Diver C.E. aspiration thrombectomy catheter with STEMI from July 2008 to February 2011 were enrolled into the study group. According to the aspiration results, they were divided into 2 groups: aspiration-positive group (n = 38) and aspiration-negative group (n = 28). And those undergoing routine PCI alone during the same period were enrolled into the control group (n = 66). The baseline profiles, immediate post-operative CAG (coronary angiography) and follow-up data were compared. RESULTS No significant baseline differences existed among 3 groups. Compared with the control group, all parameters significantly improved in the aspiration-positive group. But in the aspiration-negative group, the differences of slow flow/no-reflow and major adverse cardiovascular events (MACE) were insignificant (P > 0.05). Compared with the aspiration-negative group, cTFC (29 ± 9 vs 35 ± 11 frames, P < 0.05), ST segment (90% ± 20% vs 76% ± 25%, P < 0.05) and the peak serum levels of CK-MB (creatine kinase-MB) and TnT (troponin-T) [CK-MB: (201 ± 86) U/L vs (264 ± 93) U/L, P < 0.05; TnT: (41 ± 21) µg/L vs (60 ± 24) µg/L, P < 0.05] decreased significantly. But the differences in slow flow/no-reflow and MACE were insignificant (P > 0.05). CONCLUSION Application of Diver CE. during emergent PCI i.s both safe and efficacious for STEMI patients with heavier thrombus burden. It may improve distal myocardium perfusion and abate myocardial damage. The patients with positive aspiration results have better clinical outcome. But the efficacy of aspiration-negative patients needs further evaluations.
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Comparing two methods of rehabilitation for risk factor modification after a cardiac event.
Yates, BC, Heeren, BM, Keller, SM, Agrawal, S, Stoner, JA, Ott, C
Rehabilitation nursing : the official journal of the Association of Rehabilitation Nurses. 2007;(1):15-22
Abstract
Because fewer than half of cardiac patients in the United States enroll in cardiac rehabilitation (CR) programs, there is a critical need to test alternative strategies of delivering CR services. This study tested whether a home-based CR (home-CR) program was at least as effective as traditional-CR (trad-CR) in the modification of coronary heart disease risk factors from the beginning of CR (baseline) to 2 and 4 months later. A repeated measures non-inferiority quasi-experimental design was used to examine changes in risk factors. Participants selected which CR program, traditional versus home-based, in which to participate: 37 patients chose trad-CR and 24 patients chose home-CR. The following indicators of risk factors were measured: smoking, blood pressure, frequency of aerobic exercise, cholesterol, amount of dietary fat, frequency of anger, body mass index (BMI), and waist circumference. Home-CR was found to be as effective as trad-CR in modification of cardiac risk factors including BMI, waist circumference, blood pressure, frequency of aerobic exercise, total cholesterol, and a low fat diet. Home-CR was not as effective as trad-CR in reducing the frequency of anger. These findings provide support for an alternative method of delivering cardiac rehabilitation services.
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[The effect of homocysteine on fibrinolytic system in human umbilical vein endothelial cells].
Zhou, LJ, Mei, YF, Jin, H, Wang, LF, Gao, QP, Li, SJ, Li, WM
Zhonghua xin xue guan bing za zhi. 2005;(9):810-4
Abstract
OBJECTIVES To investigate the relationship between homocysteine (Hcy) and the fibrinolytic system in acute myocardial infarction (AMI) and human umbilical vein endothelial cells (HUVEC). METHODS Cultured HUVEC was divided into 10 groups (0, 10, 50, 200, 500 micromol/L Hcy with or without 15 micromol/L of folic acid). There were 53 patients of acute myocardial infarction (AMI) and 48 healthy controls. The plasminogen activator inhibitor-1 (PAI-1) and activator of plasminogen (tPA) antigen levels in HUVEC's supernatant and plasma were measured with Elisa kit. Concentration of plasma Hcy was measured by reverse-phase high-performance liquid chromatography with precolumn derivatization and fluorometric detection in the patients and healthy controls. Total RNA was extracted using the guanidinium isothiocyanate method. The semi-quantification of PAI-1 and tPA mRNA in HUVEC was carried out by reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS (1) PAI-1 mRNA and secreted protein levels were both significantly enhanced by Hcy at the concentration of 500 micromol/L, compared with the control group (P < 0.05). (2) The tPA mRNA and antigen levels were decreased significantly at concentration of 500 micromol/L of Hcy, compared with that of 10 micromol/L Hcy (P < 0.05), but compared with the control group (0 micromol/L), the tPA mRNA and antigen levels of 10 micromol/L of Hcy were much higher (P < 0.05). (3) The addition of folic acid reduced PAI-1 but increased tPA at both mRNA and protein levels, which were both obvious at concentrations of 500 micromol/L Hcy, compared with only Hcy group (P < 0.05). (4) Hcy, tPA, and PAI-1 antigen levels were increased in AMI group. Hcy is a independent risk factor of AMI (P < 0.05). There weren't significant correlation between Hcy and tPA or Hcy and PAI-1 in both groups (P > 0.05), although the coefficient correlation was higher in patients than in controls. CONCLUSIONS These results suggested that hyperhomo-cysteinemia increased the incidence of thrombotic disease, which may be caused by decreasing the activity of fibrinolytic system, whereas, folic acid may be protective against the toxic action of Hcy.
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Effectiveness of tirofiban for failed thrombolysis during acute myocardial infarction.
Vetrano, A, Carotenuto, R, Corsini, F, Schioppa, M, Martone, A, Melorio, S, Sideri, F, Romano, S, Chieffo, C, Corsini, G
The American journal of cardiology. 2004;(7):914-6
Abstract
The clinical outcome of 48 consective patients with myocardial infarction who received tirofiban for unsuccessful thrombolysis was compared with that of 48 patients matched for age, gender, and infarct location who did not receive rescue treatment. Those who received tirofiban had more successful reperfusions, and there were few bleeding complications.
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Low blood glutathione levels in acute myocardial infarction.
Kharb, S
Indian journal of medical sciences. 2003;(8):335-7
Abstract
BACKGROUND Although experimental studies have demonstrated that reduced glutathione (GSH) is involved in cellular protection from deleterious effects of oxygen free radicals in ischaemia and reperfusion, there are controversial data on the correlation between levels of GSH and the ischaemic process. AIM: The present study was planned to evaluate erythrocyte GSH levels in patients with acute myocardial infarction (AMI). SETTING & DESIGN Erythrocyte GSH levels were determined in 22 patients with AMI and 15 age matched healthy volunteers served as control. MATERIAL & METHODS Erythrocyte GSH levels were measured by using Bentler in AMI and control patients. Also lipid profile was analyzed enzymatically in these subject. STATISTICS The values were expressed as means +/- standard deviation (SD) and data from patients and controls was compared using student's 't'-test. RESULTS AND CONCLUSION GSH levels were significantly decreased in AMI as compared to control (p<0.001). Also, total cholesterol and triglycerides were higher is AMI subjects (p<0.05). These finding suggest that depressed GSH levels may be associated with enhanced protective mechanism to oxidative stress in AMI.
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[Effectiveness and safety of amlodipine in secondary prevention in patients with myocardial infarction].
Bichan, NA, Tepliakov, AT
Klinicheskaia meditsina. 2002;(1):28-31
Abstract
Amlodipin (norvask) effectiveness was studied in 18 patients who survived primary Q-myocardial infarction. The 2-year treatment produced a positive effect in 66.6% patients, a negative one--in 11.1%. One patient died, a repeat non-fatal MI developed in 2 patients. Complications were registered in 1 patient. The drug reduced the number of angina attacks, amount of nitroglycerin (by 46.6 and 45.5%, respectively), the tolerance increased by 26.7, cardiac performance by 59.9%. It also led to a fall of both systolic and diastolic blood pressure (by 14.0 and 9.9%, respectively). Heart rate remained unchanged. Left ventricle underwent adaptive remodeling, myocardial ischemia diminished in the number of episodes and their duration. Frequent atrial and rare ventricular extrasystole disappeared in 1 patient.