[ role of glucose-insulin-potassium therapy in the treatment of acute myocardial infarction: a review article]

Given the high prevalence and high mortality of cardiovascular disease, special attention should be paid to its treatment. Currently, the main treatment for ST-elevation myocardial infarction is restoring blood flow by dissolving the clot. In addition to this basic treatment, several pharmacologic agents have been studied during the past years. In this paper, clinical trials about glucose-insulin-potassium are discussed in addition to adjuvant treatment which has been suggested in recent years. All studies published in journals or presented at scientific conferences were searched in Elsevier, PubMed, Cochrane, and SID databases using relevant keywords. After quality control, eligible articles were included in the study. The results of this review article showed that studies on the effects of glucose-insulin-potassium treatment on mortality, cardiac enzyme levels, left ventricular ejection fraction, ST resolution, and inflammatory and oxidative biomarkers have been conflicting. But, generally, evidence from newer studies conducted on larger numbers of patients has shown ineffectiveness of glucose-insulin-potassium therapy. Currently, glucose-insulin-potassium therapy should not be recommended as an adjunct to thrombolytic therapy

Reciprocal ST-segment changes in acute myocardial infarction

The presence of ST depression in electrocardiogram of a patient with STEMI may represent a reciprocal electrical effect or true remote ischemia, which has prognostic value. This study was conducted to investigate the relationship between ischemic regions through coronary angiographic findings with reciprocal ST-segment changes in acute myocardial infarction. From March 2007 to May 2008, 55 consecutive patients with diagnosis of acute myocardial infarction who had reciprocal ST depressions in electrocardiogram and were candidate for coronary angiography were recruited in our study. The amount of ST-segment depression at 0.08 seconds after the J point in the reciprocal leads on admission 12-lead electrocardiograms of the patients were evaluated for the quantification of reciprocal ST depressions [mm]. Twenty five of 55 patients had anterior [45.5%] and 30 patients had inferior MI [54.5%].In inferior MI with 1VD, mean ST depression to mean ST elevation was 1.4. In inferior MI with multi vessel disease, mean ST depression to mean ST elevation was 2. In anterior MI with 1VD, mean ST depression to mean ST elevation was o.25. In anterior MI with multi vessel disease, mean ST depression to mean ST elevation was 0.48. Our result demonstrated a significant positive linear correlation between ST Depression/ST Elevation and the site and number of vessels with occlusion, indicating severe reciprocal ST depressions as a marker of extensive coronary artery disease

Percutaneous balloon pericardiotomy in a patient with recurrent pericardial tamponade

Malignancy is the leading cause of chronic pericardial effusion. Although maybe not life-threatening as the acute tamponade, by compressing cardiac cavities and adjacent organs, causes significant morbidity and discomfort for the patient. Its early diagnosis and effective and safe treatment would have significant role in improving the patint's quality of life and his life expectancy

There are various treament modalities with different success rate including,pericardiocentesis alone [average success rate of 47%] or with indwelling catheter drainage [78%], sclerotherapy [83%], external radiotherapy [69%], and surgery [success rete of 48-92% for different techniques], and Percutaneous balloon pericardiotomy [96%]

Percutaneous balloon pericardiotomy is a promising nonsurgical therapy, especially in malignant recurrent tamponade, in which after drainage of pericardial fluid through subxiphoid pericardiotomy, using a balloon catheter, a window is created in parietal pericardium

Generally it has the same early and late results as surgical Pericardiotomy, especially in malignancies, with less morbidity. But its role in the management of nonmalignant pericardial effusion is not clear. Here, in addition to introducing this method, we report successful treatment of a case of recurrent temponade with past history of treated gastric cancer

[Comparison of the prevalence and risk factors of coronary artery disease between 100 menopausal women with ischemic heart disease and 100 men, in cardiology center of Imam Reza Hospital-Mashhad Iran [2003-2004]]

Objective: to determine the total and gender - specific prevalence of coronary artery disease [CAD] - related risk factors in Cardiology Center of Emam Reza Hospital- Mashhad

Materials and Methods: a cross -sectional, descriptive study was conducted on 200 patients [100 menoposal women and 100 men] with ischemic heart disease. We consider four CAD - related risk factors [Hypertension, Diabetes mellitus, hyperlipidemia and Smoking] in assessment of these patients. Data sheets were filled e basis of the presence or absence of these risk factors. The results were analyzed using SPSS software

Results: in general, among the factors mentioned above, hypertension is the most common one [40% or 80/200] and after that, hyperlipidemia, smoking and diabetes come in sequence [31, 30, 21%]. Compared to men, HTN is more common in menoposal women [P<0.05] On the other hand, smoking is more common in men. [P<0.001]

Conclusion: according to our study, HTN is the most common risk factor in general. We also consider the role of smoking as the most common risk factor in men and also an important one with the same prevalence to diabetes in women.] So we really need to reinforce smoking cessation