International journal of cardiology
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Among patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI), those with multivessel disease have worse prognosis, mainly due to a higher frequency of cardiogenic shock (CS) at admission. The aim of this study was to identify clinical and angiographic characteristics of patients with STEMI, multivessel disease and CS at admission referred to primary PCI. ⋯ Among patients with STEMI and multivessel disease, CS is especially frequent in STEMI anterior, female gender, proximal culprit lesion, and chronic occlusion of other vessels.
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Early diagnosis and treatment are pivotal for patients with acute aortic dissection (AAD). D-dimer is a rule-out diagnostic test for pulmonary embolism but there is evidence that it may also be applicable to AAD. We evaluated plasma D-dimer, white cell blood count (WBC), C-reactive protein (CRP) and N-terminal pro-B-type natriuretic peptide (BNP) in 18 consecutive patients with established AAD, 21 consecutive patients with dilated ascending aortas scheduled for elective surgery and 8 normal subjects. ⋯ The WBC count was also significantly increased compared to the other groups (p<0.01). CRP and BNP values were significantly higher compared to normal controls but these parameters did not distinguish between AAD and chronic aneurysms. D-dimer can be used as a 'rule-out' test in patients with suspected AAD and seems useful in the discrimination between AAD and chronic uncomplicated aneurysms, unlike CRP and BNP plasma levels.
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Randomized Controlled Trial
One year outcomes after glucose-insulin-potassium in ST elevation myocardial infarction. The Glucose-insulin-potassium study II.
There are conflicting data concerning the effect of treatment with glucose-insulin-potassium (GIK) in ST segment elevation myocardial infarction (STEMI). Early studies showed beneficial effects of GIK, however, recent large sample size trials did not confirm this, or suggested only benefits in patients without heart failure. We aimed to evaluate long-term effects of GIK in patients with STEMI without signs of heart failure, all treated with reperfusion therapy. ⋯ In patients with STEMI without signs of heart failure treated with reperfusion therapy, GIK therapy offers no clinical benefit at 1 year.
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Letter Case Reports
Multiple papillary fibroelastomas of the aortic valve: case report.
Papillary fibroelastoma is the third most common primary tumor of the heart and most commonly involve the cardiac valves. Most papillary fibroelastomas do not cause symptoms and they are usually incidental findings by routine echocardiography or at autopsy. ⋯ Upon surgery, a tumor was found on each aortic cusp. Pathological findings of these tumors were consistent with those of papillary fibroelastoma.