Suppression of myocardial injury markers following percutaneous coronary interventions by pre-treatment with carvedilol

Retrospective studies and clinical trials have indicated that beta -receptor blockers have an influential role in improving survival and reducing risk of recurrent infarction in patients with myocardial infarction. However, there is still controversy regarding the effects of beta -receptor blockers on the markers of myocardial infarction following percutaneous coronary interventions [PCI]. The aim of this study was to evaluate the pre-treatment effect of Carvedilol on markers of myocardial injury in patients undergoing elective PCI. In this clinical trial patients undergoing elective PCI were categorized randomly in the Carvedilol group including 100 patients who received two doses of 12.5 mg, 6 and 12 hours prior to PCI, and the control group [105 patients]. Blood samples were obtained to analyse cardiac biomarker, 12 and 24 hours after PCI. The clinical features were not significantly different between the two groups. A increase in the level of Troponin I was observed in the control group 24 hours following PCI [P=0.042], whereas this rise in troponin I was slight and insignificant in the Carvedilol group [P>0.05]. some difference was observed between the two groups in regard to the level of CPK-MB after PCI [P=0.041]. The findings of our study indicate that pre-treatment with Carvedilol confers cardio-protection by limiting the rise of markers of myocardial injury following PCI

[Cardiac manifestation of normokatemic periodic paralysis in 21 years old male in Kermanshah]

Normokalemic periodic paralysis is an autosomal dominant disorder involving the abnormal function of skeletal muscle's voltage-gated alpha-subunits. It is characterized by paralysis attack of varying severity with concomitant normal serum potassium concentration. Although normokalemic periodic is well established in the literature, but its cardiac manifestations are very rare. We present 21 years old age male, which referred to Imam Ali hospital with severe palpitation, atypical angina and flaccid quadric paralysis. Electrocardiographic manifestation was first-degree AV block. Bijeminated ventricular extrasystole and severe ST-T change in pericardial leads. Initial potassium level was 4 meq/l, CPK and aldolase level was normal. Echocardiography and exercise test were normal. After four days administration of acetazolamide, his weakness was disappeared and ECG became normal. He discharged from hospital with normal neurological examination and effective treatment outcome