Kardiol Pol
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Randomized Controlled Trial
Is transport with platelet GP IIb/IIIa inhibition for primary percutaneous coronary intervention more efficient than on-site thrombolysis in patients with STEMI admitted to community hospitals? Randomised study. Early results.
The advantage of primary percutaneous coronary intervention (pPCI) in the management of ST-elevation myocardial infarction (STEMI) over thrombolytic therapy has been demonstrated. However, an optimal medical treatment of STEMI patients admitted to regional hospitals without catheterisation facilities has not yet been established. Delay in initiation of pPCI resulting from transportation to the catheterisation laboratory may diminish the benefits of such therapy in comparison with thrombolysis administered in a regional hospital. Early initiation of therapy with platelet glycoprotein IIb/IIIa receptor inhibitor, which provides protection for the transportation, may be a reasonable solution to maintain the advantage of pPCI over thrombolysis alone in STEMI patients. ⋯ A strategy of invasive therapy involving transport with GP IIb/IIIa receptor inhibitor and pPCI in STEMI patients admitted to hospital without catheterisation facilities was found to be more effective than thrombolytic therapy alone employed in the regional hospitals.
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Inflammatory markers have been reported to be elevated in hypertension. ⋯ We conclude that inflammatory markers are elevated in HT with TOD and are not elevated in uncomplicated HT without TOD.
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Influence of pathogenetic factors on prognosis in patients with native valve infective endocarditis.
Despite improvement in medical care the incidence of infective endocarditis (IE) has not decreased. Positive blood cultures are one of the most important diagnostic criteria of IE. There are no uniform data regarding the influence of pathogenetic factors on prognosis. ⋯ In patients with native valve infective endocarditis: 1. The risk of early and late death is not related to the results of blood and valve cultures. 2. Staphylococcus aureus aetiology increases the risk of disease recurrence. 3. The risk of early death is significantly lower in patients treated with surgery.