Cardiology
-
It was the aim of this study to investigate the effect of ZP123 on prolonged ventricular fibrillation (VF) in swine. ⋯ In prolonged VF, ZP123 could decrease the defibrillation threshold and improve the rate of successful defibrillation. However, it could not improve the rate of ROSC - which may be due to its side effect of decreasing VF(ma).
-
Randomized Controlled Trial Comparative Study
Intracoronary compared to intravenous abciximab in patients with ST segment elevation myocardial infarction treated with primary percutaneous coronary intervention reduces mortality, target vessel revascularization and reinfarction after 1 year.
Administration of the glycoprotein IIb/IIIa inhibitor abciximab to patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) improves outcome. Data have suggested that an intracoronary (IC) bolus might be superior to the standard intravenous (IV) administration. We have previously reported reduced short-term mortality and need for target vessel revascularization (TVR) with the IC route. We now present long-term data from our randomized trial on IC versus IV abciximab in pPCI-treated STEMI patients. ⋯ In pPCI-treated STEMI patients treated with abciximab, IC bolus administration resulted in a significant reduction in mortality, TVR and MI compared to IV bolus administration.
-
Functional coronary artery occlusion due to type A aortic dissection has rarely been reported in the literature. We report a case of aortic dissection presenting with anterior ST elevation. ⋯ An electrocardiogram after the operation revealed resolution of anterior ST elevation. The mechanism of initial anterior but not inferior ST elevation should be related to functional obstruction of the left main coronary artery by intimal flap and reciprocal ST-T change over inferior leads.
-
Comparative Study
Anemia and early mortality in patients with decompensation of chronic heart failure.
The possible independent effect of mild-to-moderate anemia (hemoglobin value not <9 g/dl) on the short-term mortality of patients with decompensation of NYHA class III/IV chronic heart failure has not been investigated yet. ⋯ Mild-to-moderate anemia seems not to contribute independently to short-term mortality in patients with decompensation of NYHA class III/IV chronic heart failure. An adverse concomitant baseline risk profile may have a key role in the induction of mild-to-moderate anemia and in the increased risk of death in these patients.
-
Contrast medium administration during imaging and therapeutic procedures can cause renal injury, partly due to ischemia. Therefore, we hypothesized that brief ischemia and reperfusion episodes applied at a distant site - multiple balloon inflations and deflations during angioplasty - may serve as a remote-conditioning (RC) stimulus and thereby protect against contrast-induced kidney injury. To test this hypothesis, we (1) utilized cases from a prior study in which patients undergoing emergent angioplasty for ST segment elevation myocardial infarction received either 1-3 balloon inflations (controls) or were 'conditioned' with multiple (≥4) inflations, and (2) assessed renal function for 3 days in patients with an estimated glomerular filtration rate (eGFR) of <90 ml/min/1.73 m(2) prior to revascularization (mild kidney disease). ⋯ In controls, this improvement was transient: eGFR subsequently decreased to 70 ± 14 ml/min/1.73 m(2) at day 3 (p < 0.05). In contrast, the RC group (despite receiving 25% more contrast volume) showed no functional decline at day 3 (80 ± 14 ml/min/1.73 m(2)). These results are consistent with remote ischemic conditioning providing a novel potential approach to attenuate contrast-associated renal injury.