ABSTRACT
BACKGROUND AND OBJECTIVES: Statin therapy after percutaneous coronary intervention (PCI) has been associated with reduced major adverse cardiovascular events (MACE). However, it has been less clear as to whether statin therapy before acute coronary syndrome (ACS) is beneficial. We studied the effect of previous statin therapy, initiated > or =1 month before PCI, on the outcome of patients with ACS who had undergone early invasive strategies. SUBJECTS AND METHODS: We stratified 479 consecutive patients with ACS who had undergone PCI, according to preprocedural statin administration as follows: previous statin-treated patients (statin group, n=237) and statin-naive patients (control group, n=242). The incidence of periprocedural myocardial infarction (MI) and in-hospital MACE was assessed. RESULTS: The incidence of Braunwald class III angina and MI presentation were significantly lower in the statin group than in the control group. Angiographic and procedural characteristics were similar between the two groups; however, slow/no reflow phenomenon occurred more frequently in the control group. After PCI, the incidence of periprocedural MI was higher in the control group than in the statin group (6.6% vs. 2.1%, p=0.016). Multivariate analysis revealed that no prior use of statin {odds ratio (OR)=2.8; 95% confidence interval (CI)=1.1-7.2; p=0.038), procedural complication (OR=4.0; 95% CI=1.5-10.5; p=0.004), stent overlap (OR=4.7; 95% CI=1.3-16.4; p=0.015), and old age (OR=3.2; 95% CI=1.2-8.0; p=0.016) were independent predictors for in-hospital MACE. CONCLUSION: Previous statin therapy before ACS was associated with milder clinical presentation and lower incidence of in-hospital MACE after early invasive strategies. The beneficial outcome is attributable to a significant reduction in periprocedural MI after PCI.
Subject(s)
Humans , Acute Coronary Syndrome , Angioplasty , Incidence , Multivariate Analysis , Myocardial Infarction , Percutaneous Coronary Intervention , Stents , Treatment OutcomeABSTRACT
Takotsubo cardiomyopathy, also called stress-induced cardiomyopathy, usually occurs in patients with severe emotional or physiologic stress. The prognosis is favorable, and the wall motion abnormlities normalize within weeks. However, stress-induced cardiomyopathy is rarely assosicated with left ventricular thrombus and thromboembolic complications. Here, we report a case of stress-induced cardiomyopathy with left ventricular thrombus that embolized to cause cerebral infarction.
Subject(s)
Humans , Cardiomyopathies , Cerebral Infarction , Prognosis , Takotsubo Cardiomyopathy , ThrombosisABSTRACT
The mainstay of diagnosing scrub typhus is through serologic testing. However, because of the delay of several days from the onset of the illness to the increase in the antibody titer, diagnosis can be difficult in the early stage of the illness. The aim of this study was to determine the clinical usefulness of adenosine deaminase activity (ADA) in diagnosing scrub typhus. A total of 104 patients were enrolled during the study period. Of these patients, 59 patients were diagnosed with scrub typhus and the mean serum ADA level was 46.7+/-11.6 U/L. High serum ADA levels strongly supported the diagnosis of scrub typhus, especially in patient without eschar. The remaining 44 patients did not have scrub typhus and 95% (42/44) of them had normal serum ADA levels. Therefore, evaluating serum ADA level could help diagnose patients with acute febrile disease such as scrub typhus, especially in its early stage of disease progression.
Subject(s)
Humans , Adenosine , Adenosine Deaminase , Disease Progression , Orientia tsutsugamushi , Scrub Typhus , Serologic TestsABSTRACT
The mainstay of diagnosing scrub typhus is through serologic testing. However, because of the delay of several days from the onset of the illness to the increase in the antibody titer, diagnosis can be difficult in the early stage of the illness. The aim of this study was to determine the clinical usefulness of adenosine deaminase activity (ADA) in diagnosing scrub typhus. A total of 104 patients were enrolled during the study period. Of these patients, 59 patients were diagnosed with scrub typhus and the mean serum ADA level was 46.7+/-11.6 U/L. High serum ADA levels strongly supported the diagnosis of scrub typhus, especially in patient without eschar. The remaining 44 patients did not have scrub typhus and 95% (42/44) of them had normal serum ADA levels. Therefore, evaluating serum ADA level could help diagnose patients with acute febrile disease such as scrub typhus, especially in its early stage of disease progression.
Subject(s)
Humans , Adenosine , Adenosine Deaminase , Disease Progression , Orientia tsutsugamushi , Scrub Typhus , Serologic TestsABSTRACT
Pseudoaneurysm due to cancer is uncommon generally and is extremely rare in lung cancer. We report two cases of false aneurysms due to lung cancer that spontaneously regressed upon chemotherapy without intervention. Both patients had squamous cell carcinoma of the lung and the diagnosis of a pseudoaneurysm was made using computed tomography. There was no evidence of severe bronchial hemorrhage and the psuedoaneurysms were small and well-encased. Chemotherapy was performed and the pseudoaneurysms resolved.