Angiology
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Comparative Study
Cardiac troponin I increase after successful percutaneous coronary angioplasty: predictors and long-term prognostic value.
After successful percutaneous coronary interventions (PCI), elevations of cardiac enzymes are not rare, but it is still not clear whether those elevations are associated with adverse late outcome. The purpose of the study was to investigate the relation between cardiac troponin I (cTn-I) increase after successful percutaneous intervention and late outcome. The study consisted of 100 consecutive patients (mean age 56 +/-9.8, 84% male) who had successful elective coronary balloon angioplasty with or without stent implantation. ⋯ Overall, major cardiac events occurred in 9 patients (26%) in the troponin (+) group and in 13 patients (20%) in the troponin (-) group. Kaplan-Meier survival analysis showed that cTn-I elevation was not an important correlate of overall cardiac events (log-rank: 1.66, p=0.19). The authors conclude that postprocedural cTn-I elevation is related to unstable angina, stent implantation following predilation, and inflation pressure, and there is no association with minor myocardial injury occurring after successful percutaneous coronary intervention and late adverse cardiac events.
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Comparative Study
Accelerated wound healing: multidisciplinary advances in the care of venous leg ulcers.
The etiologies of venous leg ulcers have been well known for millennia, and yet there remains no simple solution to this very common problem. Achieving closure of venous leg ulcers is often a lengthy process that is further complicated by the presence of significant comorbidities. The authors present data on healing venous leg ulcers in a cohort of 231 patients, most of whom had 1 or more complicating factors. Our multidisciplinary and aggressive approach to healing venous leg ulcers is described and has resulted in an average healing time of 29 days, a significantly shorter duration of treatment than the reported average of 6 months.
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Tuberculous pseudoaneurysm of the aorta is a rare disease that is uniformly fatal if not treated properly. The authors present a case of a recurrent tuberculous false aneurysm of the descending thoracic aorta that was treated surgically with excision and primary repair of the lesion. To their knowledge, this is the first reported case of recurrent disease after a successful surgical treatment.
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Comparative Study
Visceral fat obesity contributes to the tortuosity of the thoracic aorta on chest radiograph in poststroke Japanese patients.
Tortuosity of the thoracic aorta on chest radiographs is characteristic of atherosclerotic disease. Aging and hypertension are associated with the tortuosity, but little is known about the influence of other atherosclerotic risk factors on this abnormality. The purpose of this study was to examine which atherosclerotic risk factors are determinants for tortuosity of the thoracic aorta. ⋯ Tortuosity of the thoracic aorta had a significant positive relationship with body mass index (BMI) (r = 0.397, p < 0.01), waist circumference (r = 0.360, p < 0.05), and the cardiothoracic ratio (CTR) (r = 0.526, p < 0.001), and a significant negative relationship with ankle-brachial pressure index (ABPI) (r = -0.360, p < 0.05). Stepwise regression analysis showed that waist circumference and CTR were independently correlated with increased tortuosity, whereas ABPI was negatively correlated with it. These results suggest that visceral fat obesity is a novel contributor to tortuosity of the thoracic aorta, which may be as shortening of the distance between aortic tethering points due to elevation of the diaphragm by excessive intraabdominal fat and as a consequence of aortic elongation due to arteriosclerosis caused by obesity-related metabolic disorders.
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A 38-year-old man presented with an acute anterior myocardial infarction (MI) and was subjected to thrombolysis. Echocardiography and cardiac catheterization revealed a mass in the left atrium that was considered to be a myxoma. ⋯ Histopathologic examination confirmed the diagnosis of the myxoma. Coronary embolism secondary to the myxoma was thought to be the cause of the MI.