ABSTRACT
Heparin and enoxaparin possess anti-inflammatory properties. We compared the effects of these drugs on inflammatory biomarkers in patients with ST-segment Elevated Myocardial Infarction [STEMI]. Thirty four patients with STEMI randomly separated in two groups and received standard doses of heparin and enoxaparin. The serum concentration of Serum Amyloid A [SAA], C-Reactive Protein [CRP], Interleukin [IL]-6. ferritin and Myeloperoxidase [MPO] were measured at baseline ,12 .24 and 48 hours after drug administration. Serum concentrations of SAA [P: 0.02], CRP [P: 0.02] and ferritin [P: 0.01] significantly reduced in heparin group during measurements compared to baseline, circulating levels of IL-6 [P: 0.002], SAA [P: 0.009], CRP [P: 0.01] were significantly decreased in enoxaparin group. The overall difference in inflammatory biomarkers between heparin and enoxaparin group was not significant. Both heparin and enoxaparine reduced serum levels of inflammatory biomarkers in patients with STEMI. This effect may provide additional clinical benefit of these drugs in the treatment of STEMI patients
ABSTRACT
This study was designed to explore the contribution of risk factors for coronary artery disease [CAD] in patients with indication for coronary angiography. Coronary angiography is defined as the radiographic visualization of the coronary vessels after injection of radio opaque contrast media. Despite the recognition of risk factors for CAD, the association between related risk factors and angiographic findings remains controversial. The aim of the present study was to explore the association between Gensini scores and major cardiovascular risk factors in patients with indications for coronary angiography. We retrospectively enrolled 495 patients who had been hospitalized at Dr. Shariati Hospital during September 2009 to September 2010 and had undergone coronary angiography. The patients were evaluated for the severity of coronary lesions on the angiogram by Gensini scoring system. The patients were also evaluated for the presence or absence of DM, hypertension, family history of cardiac diseases, low HDL, hyperlipoproteinemia, hypertriglyceridemia and cigarette smoking. Statistical analysis wad done to find any relationship between Gensini scores and cardiovascular risk factors. The study population consisted of 249 men [50.3%] and 245 woman [49.5%] with a mean age of 58.1 +/- 10.3 years. A positive correlation was found between age [P=0.04], sex [P=0.008], HDL [P=0.04] smoking [P=0.0001] and diabetes [P<0.013] with Gensini scores. In patients with indications of angiography, Gensini scores provide valuable prognostic information on cardiovascular risk factors. Age, sex, HDL, smoking and diabetes are related to the severity of coronary lesions on the angiograms
Subject(s)
Humans , Male , Female , Cardiovascular System , Risk Factors , Retrospective Studies , Lipoproteins, HDL , Smoking , Diabetes Mellitus , AngiographyABSTRACT
Left main coronary artery [LMCA] stenosis is a leading cause of mortality and morbidity in many countries. Metabolic syndrome [MS] is a risk factor for coronary artery disease [CAD]. The effects of MS on left main coronary artery stenosis are not well-defined. The aim of this study was to examine the effects of MS on left main coronary artery stenosis. A total number of 495 patients who underwent elective coronary angiography in the Catheter Laboratory of Cardiovascular in Shariati Hospital 2008-2010 were included in the study. MS definition was based on the National Cholesterol Education Program [NCEP]-Adult Treatment Panel III [ATP III] criteria. The stenosis in left main coronary arteries was determined by examining the coronary angiograms of the patients. The study population consisted of 249 [50.3%] men, and 246 [49.7%] women. The mean age of the participants was 58.01 +/- 10 years. MS was present in 86 [17.4%] of the patients based on NCEP-ATP III criteria. LMCA stenosis was seen in 25 [5%] patients. A positive correlation was found between MS and LMCA stenosis [r=0.305, P=0.012]. Moreover, a positive correlation was found between age [r=0.192, P=0.05], sex [r=0.334, P=0.007], smoking [r=0.336, P=0.01] and diabetes [r=0.253, P=0.03] and LMCA stenosis. The metabolic syndrome correlates with LMCA stenosis. LMCA stenosis and its correlation with MS is precipitated by high FBG, age, male sex, and smoking which may synergistically increase the risk for the disease
Subject(s)
Humans , Male , Female , Coronary Stenosis , Coronary Angiography , Smoking , Diabetes MellitusABSTRACT
Percutaneous transluminal coronary angioplasty [PTCA] is an effective method for revascularizing of stenotic coronary vessels. Lack of response to this treatment, either in symptomatic or asymptomatic patients, is usually due to incomplete revascularization, restenosis, and/or irreversibility of myocardial perfusion. Introduction of a noninvasive method with high predictive value for diagnosis of reversibility in ischemic myocardium is of high importance to determine the patients who will benefit from PTCA. Sixty patients with one or two vessel disease, who were candidates for PTCA and had a successful PTCA [proved by post-revascularization angiography], enrolled the study. For all patients myocardial perfusion within 6 months after PTCA. The predictive values of pre-PTCA scan for the diagnosis of reversibility and prediction of perfusion improvement after PTCA were evaluated. Perfusion improvement after PTCA was noted in 52 of 60 patients [86.7%]. The positive predictive value of pre-intervention MPI for diagnosis of reversibility was 94.3% and the corresponding negative predictive value was 71.4%. Myocardial perfusion imaging may play an important role for accurate prediction of perfusion improvement after percutaneous transluminal coronary angioplasty
ABSTRACT
The pharmacokinetic behavior of amikacin and predictive performance of Sawchuk-Zaske dosing method, have been prospectively evaluated in 31 [16 male, 15 female] critically ill septic patients of mean [ +/- SD] age of 58 +/- 23 years, mean ideal body weight of 59.6 +/- 6.4 kg, mean creatinine clearance of 52 +/- 21.5 ml/min, mean serum albumin of 3.1 +/- 0.5 mg/dl and median APACHE [acute physiology and chronic health evaluation] II score of 26 [with a range of 18 to 33]. In this cross-sectional study, critically ill patients who met the Bone criteria for spesis but had stable creatinine clearance [serum creatinine change <0.5 mg/dl of the baseline] received the ordered dose of amikacin in one hour infusions. Blood sample were collected 30 minute after the third dose, half an hour before the fourth dose which was 1.5 times of the predicted half life of amikacin after the third dose. Cirrhotic patients and patients with renal failure requiring any mode of dialysis were excluded. Vital signs were recorded at each time of blood sampling; serum Mg+, serum albumin and APACHE score were recorded at the time of the first blood sampling. Mean [ +/- SD] of the pharmacokinetic key parameters of amikacin in this population was as follow: Vd=0.390.045 l/kg; Ke=0.141 +/- 0.057 /h; half-life=5.7 +/- 2.06 h; Clearance=54.2 +/- 25.2 ml/min. There was a good correlation between Vd and serum albumin and also APACHE score II [r2=0.83, P=0.033;r2=0.82, P<0.001 respectively]. Mean measured peak and trough amikacin concentrations were 20.9 and 3.2 micro g/ml respectively which were significanthy different [P<0.05 paired t test] from levels, predicted by Sawchuk-Zaske method [33.5 and 4.6 micro g/ml respectively]. Ke, t0.5 and cledrane did not show any statistically significant changes [P>0.05 repeated measure test] amongst three times of blood sampling, but Vd was significanly different [P<0.05]. The overall predictive performance of Sawchuk-Zaske method was poor; in spite of good correlation between predicted and measured parameters when using pooled data