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Introduction : The Cardiovascular mortality in Diabetics is 2-4 times higher than in Non-diabetic population. But there is still controversy regarding Pre-diabetes (IFG and IGT) as a Cardiovascular Risk Factor. Aims and Objectives : In this study we aimed to investigate the early in-hospital mortality among Acute Myocardial Infarction (AMI) patients having Impaired Fasting Glucose (IFG) during the first 7 days of hospitalization. Materials and Methods: A total of 150 AMI patients were evaluated and followed up for their glycemic status and early in hospital mortality (first 7 days) at Burdwan Medical College, Burdwan, West Bengal. Result and Analysis: Mortality in patients having IFG (18%) was higher and as much as in DM (20%) compared to euglycemic (4%) patients but the mortality is not correlated with mean Fasting Plasma Glucose (FPG) level. Conclusion : IFG (ie, pre-diabetes) increases Cardiovascular mortality as much as diabetes. So, IFG may be a marker or risk factor for mortality but lowering FPG in AMI patients is unlikely to yield beneficial effect regarding mortality.
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Objective To evaluate the effect of multi-disciplinary team (MDT) on acute heart failure (AHF) complicated with respiratory failure after allograft nephrectomy. Methods MDT discussion was performed on a patient with hemorrhagic shock caused by sudden renal graft hemorrhage, who developed acute myocardial infarction (AMI) with AHF, acute pulmonary congestion, pulmonary infection and acute respiratory failure 2 weeks after allograft nephrectomy. And treatment plan was formulated and effect evaluation was conducted. Results Based on the opinions of MDT discussion, the patient was given nasal high-flow oxygen therapy, continuous veno-venous hemodiafiltration (CVVHDF) to reduce cardiac load, anticoagulant, dilating blood vessels, reducing myocardial oxygen consumption, improving myocardial remodeling, lipid regulation, anti-infection, nutritional support, and other comprehensive treatment. The clinical outcome of the patient was good and regular hemodialysis treatment was resumed. Conclusions Application of MDT pattern helps to formulate a comprehensive and effective individualized treatment plan for patients with AHF and respiratory failure after allograft nephrectomy, which can enhance clinical treatment effects and improve prognosis of patient.
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Interventional or thrombolytic therapy for acute myocardial infarction （AMI） has the effect of opening occluded coronary arteries. However， due to no myocardial regurgitation， ischemia/reperfusion injury and microvascular structure and function destruction， leading to myocardial fibrosis following AMI， ventricular remodeling， and even cardiac failure may occur. Collaterals doctrine is used to guide the investigation into traditional Chinese medicine pathogenesis and clinical treatment of myocardial fibrosis following AMI. Consequently， it proposes the pathogenesis characteristic of "Qi deficiency and blood stasis， collaterals obstruction" and medication principle of "dispersing and dredging"， to develop the formula of Tongxinluo. Fundamental and clinical researches have demonstrated it can effectively protect the structure and function of myocardial microvascular endothelial cells， improve no reflow and reperfusion injury， and inhibit myocardial fibrosis after AMI， which further supports scientific value of the collaterals doctrine.
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<b>Objective::Evaluate the effects of Danhong injection for perioperative percutaneous coronary intervention (PCI) on cardiac function and thrombolysis in myocardial infarction (TIMI) in patients with acute myocardial infarction (AMI). <b>Method::Computer retrieving CNKI, Wanfang database, VIP database, PubMed, CBM, Web of Science, The Cochrane Library, gathering Danhong injection in percutaneous coronary intervention perioperative application in the treatment of acute myocardial infarction clinic trials. The Cochrane risk evaluation is adopted to improve the quality of literature evaluation, with Revman 5.3 software for Meta-analysis. <b>Result::Participants included in 12 clinic trials contains a total of 1 131 patients, including 569 patients in Danhong treatment and 562 patients in control group. The results showed that compared with conventional treatment, Danhong injection treated patients had LVEF increased obviously [mean difference (MD)=6.62, 95% confidence interval (CI) (4.91, 8.34), <italic>P</italic><0.000 01], the number of TIMI class 3 patients significantly increased[relative risk (RR)=0.22, 95%CI(0.12, 0.41), <italic>P</italic><0.000 01], and BNP levels significantly decreased [MD=151.86, 95%CI (-247.00, -56.72), <italic>P</italic>=0.002]. <b>Conclusion::Danhong injection can improve the function of acute myocardial infarction after percutaneous coronary intervention.
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Objective: To investigate the value of serum miR-133a in early diagnosis and the assessment of 30-day incidence of cardiovascular adverse events in patients with acute myocardial infarction (AMI). Methods: Ninety patients with acute chest pain within 6 h were included, and 63 cases of AMI, 13 cases of unstable angina pectoris (UAP) and 14 cases of control (chest pain of other causes) were finally diagnosed. The levels of troponin I (cTnI), creatine kinase MB (CK-MB) and myoglobin (Mb) were measured by electrochemical fluorescence. Quantitative real-time PCR (qPCR) was used to detect the expression of miR-133a in the serum of patients immediately after admission and 24 h after percutaneous coronary intervention (PCI). The Gensini score of patients who underwent coronary angiography was recorded. The incidence of cardiovascular adverse events was observed within 30 days. Spearman correlation analysis, multivariate Logistic regression analysis and receiver operator characteristic curve (ROC curve) were used to analyze the corresponding data. Results: The expression of miR-133a in the AMI group was significantly higher than that in the UAP group and the control group (both P<0.05). Spearman correlation analysis showed that the expression of miR-133a was positively correlated with cTnI, CK-MB, MB level and Gensini scores (all P<0.05). Multivariate Logistic regression analysis showed that miR-133a and the history of coronary heart disease were independent risk factors for AMI. ROC curve showed that the area under the curve (AUC) of miR-133a in the diagnosis of AMI was 0.816 (95% CI 0.716-0.917), and the AUC of 30 days cardiovascular adverse event was 0.700 (95% CI 0.535-0.865). Conclusion: The expression of miR-133a in patients with AMI is significantly increased, which is expected to be a biomarker for early diagnosis of AMI. The expression level of miR-133a in serum may be related to the severity of coronary artery disease and short-term prognosis.
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Introduction: Hypertension is one of most commoncardiovascular disorder in clinical practice. It is also calledhigh blood pressure. Hypertension is well known risk factorfor cardiovascular, renal and cerebrovascular disease. Evenslightly rise elevated blood pressure lead to increase risk incardiovascular disease and strokes (CVD). Hypertensiveemergency is define as recent increase in blood pressure toa very high level (> 180 mmHg systolic and > 110 mmHgdiastolic) with target organ damage. Study aimed to evaluatethe modes of presentations, clinical profile and spectrum oftarget organ damage in patients with hypertensive emergency.Material and methods: This study was hospital basedprospective study. The present study was carried out in 100patients admitted in various medical wards in R.N.T. MedicalCollege Udaipur, Rajasthan over a period of eight months.Patients fulfilling the eligible criteria were included.Result: Among the 100 patients studied, 70 were males andthe male female ratio was 2.33:1. In the age distribution, 72%patients were found age more than 50 years and rest 28% wasless than 50 years. The commonest clinical presentation foundwas neurological deficits in 50% followed by dyspnoea in34% and chest pain in 10% patients.Conclusion: The present study done over hypertensiveemergencies patients conclude that majority of patientsbelonged to the fifth and sixth decades of age and of malesex. It was commonly observed in the patients knownhypertensive. Diabetes and dyslipidemias was commonassociation observed. Commonest mode of presentation wasneuro deficit and higher level of mean blood pressure at thetime of presentation may associated with worst out come
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@#<p style="text-align: justify;">A 31-year-old male, apparently well, presented with typical chest pain. His ECG showed ST-elevation from V1-V4 and echocardiogram revealed anteroseptal wall hypokinesia with an ejection fraction of 45%. Normal coronary arteries were seen on coronary angiogram. A thyroid function test showed elevated free T4 levels with suppressed thyroid stimulating hormone (TSH). Treatment with thionamides and beta-blockers improved symptoms. Upon review 4 months later he was well. Repeat echocardiogram showed good ejection fraction with no hypokinetic area.</p>
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ThyrotoxicosisABSTRACT
AIM To investigate the role of ginkgolide B on the ventricular wall motion and systolic function in acute myocardial infarction (AMI) patients after their revascularization.METHODS A total of 80 cases of AMI patients who underwent revascularization were divided into control group and ginkgolide B treatment group,with 40 patients per group.The two groups of patients both treated basically with routine western medicine were dosed with either placebo or ginkgolide B for 3 months.The cardiac function,normal myocardial percentages,ventricular wall motion,longitudinal peak systolic strain (LPSS) and rate (LPSSR) were evaluated by dobutamine stress echocardiography and these indexes were compared.RESULTS Compared to the control group,left ventricular ejection fraction (LVEF) (66.06 ± 8.39 vs.60.45 ± 13.35,P ＜0.05) and normal myocardial percentages (86.88 ±8.76 vs.79.84 ± 12.25,P ＜0.01) were significantly improved at the 2nd week in ginkgolide B treatment group,but no significant difference on ventricular wall motion was observed'between the two groups (P ＞ 0.05).For the patients with anterior wall AMI,the minus LPSS and LPSSR at basal,middle and apex segment were significantly improved at the 2nd week in ginkgolide B treatment group compared to the control group (P ＜ 0.05,P ＜ 0.01).Moreover,LPSS at apex segment was significantly improved at the 3rd month in ginkgolide B treatment group compared to the control group (P ＜ 0.05).For the patients with inferior wall AMI,minus LPSS at basal and apex segment were significantly improved at the 2nd week and the 3rd month in ginkgolide B treatment group compared to the control group (P ＜ 0.05),whereas minus LPSSR at basal and middle segment at the 2 nd week and basal segment at the 3rd month were significantly improved in ginkgolide B treatment group compared to the control group (P ＜0.05).CONCLUSION Revascularized AMI patients treated with ginkgolide B can expect an improved ventricular wall motion.
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@#BACKGROUND: Acute myocardial infarction is leading cause of global morbidity and mortality and major health care burden in worldwide. Previous studies demonstrated that restoration of myocardial tissue perfusion after primary PCI is significant factor of improved outcome. In Mongolia, studying long term effects of primary PCI in patients with AMI and its’ association with coronary blood flow, tissue Doppler imaging, left ventricular global strain pattern in speckle-tracking echocardiography and risk factors are essential in theoretical and clinical practice. AIMS: To determine long term effects of primary PCI in patients with AMI and its’ association with left ventricular strain pattern in speckle-tracking echocardiography, risk factors and patient prognosis. METHODS: We used prospective cohort study design. We were selected 414 patients with AMI who treated by primary PCI between 2015 and 2016 at the State Third Central Hospital. Echocardiographic examination was conducted on Philips iE33 xMATRIX ultrasound machine. The PCI was performed according to the MNS:6379-2013 standard. RESULTS: Mean age was 60±13 and majority of them were male 84% (n=347). Complete coronary perfusion (TIMI-3) was achieved in patients 88% (n=367) after primary PCI. There was weak, negative correlation between coronary TIMI flow grade and left ventricular global longitudinal strain (r=-0.183, CI 95% -0.289 to-0.066, p<0.001). In patients with incomplete coronary perfusion (TIMI<3), mortality rate was significantly higher during 24 months follow-up. After primary PCI, 24 months mortality was 9.9% (n=39). Cut-off value of left ventricular global longitudinal strain which predict long term (within 24 month follow-up) mortality was -12.93% (sensitivity 74.4%, specificity 74.3%). Mortality during 24 months follow-up was significantly different between left ventricular global longitudinal strain groups (log-rank test p<0.001) and mortality was higher in left ventricular global longitudinal strain ≥ -12.93% group. CONCLUSION: Coronary no-reflow phenomenon is associated with long term mortality in patients with AMI. In patients with AMI who treated by PCI, long term mortality is predictable with left ventricular global longitudinal (≥-12.93%, p<0.001) strain.
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Acute myocardial infarction (AMI) has a high mortality rate and poor prognosis for patients. The primary causes of death are arrhythmia and heart failure. For patients admitted because of myocardial infarction, various risk evaluations are initiated to foresee possible complications. The thrombolysis in myocardial infarction (TIMI) risk score, which can be used to predict the prognosis and the need for revascularisation, is the most convenient and commonly used system, but is inadequate for AMI patients on admittance. Fragmented QRS (fQRS) has been shown to be a valuable electrocardiographic (ECG) index for predicting the prognosis of patients with coronary heart disease. Also, fQRS is considered to predict an increased likelihood of a poor outcome and mortality in patients with coronary artery disease (CAD), even for some successfully revascularized AMI patients. So what would happen if fQRS and the TIMI risk score were combined? This study focused on the investigation of the short-term prognostic value of fQRS combined with the TIMI risk score for patients with AMI.
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Aged , Female , Humans , Male , Electrocardiography , Myocardial Infarction , Mortality , Therapeutics , Percutaneous Coronary Intervention , Prognosis , Risk Assessment , Thrombolytic Therapy , MethodsABSTRACT
Objective To investigate the diagnostic value of High-Sensitive Troponin T(hs-TnT)in acute myocardial infarction(AMI). Methods One hundred and sixty nine patients with serum hs-TnT concentration≥0.014 μg/L in early hospitalization were enrolled in this study.The ROC curve was used to compare the concentra-tion of hs-TnT with four heart enzyme(CK,CK-MB,LDH,AST)on the diagnostic efficacy to AMI. The differ-ence of hs-TnT in different clinical data groups were investigated using Mann-Whitney U rank test.Then the correla-tion between hs-TnT and Gensini score of Coronary angiography was investigated using the Spearman rank correla-tion test.Results The concentration of hs-TnT in patients with chest pain was significantly higher than that in non-AMI group(P<0.05).The AUC of each ROC curve was hs-TnT(0.806)>CK-MB(0.792)>CK(0.780)>AST (0.704)> LDH(0.684). The optimal diagnostic point of hs-TnT was 0.152 ug/L(sensitivity 0.659,specificity 0.894,Yuden index 0.553).There was a positive correlation between hs-TnT and Gensini scores in men,age>65 years old and the chest tightness group(P < 0.05). Conclusion The hs-TnT is better than four heart enzyme in early diagnosis of AMI and benefit early treatment of AMI.
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The aim of this study is to develop creatine kinase isoenzyme MB (CK-MB) specific monoclonal antibodies (mAb), and characterize the monoclonal antibody and further development of quantitative detection assay for CK-MB. The BALB/c mice were immunized with purchased CK-MB antigen, then monoclonal antibodies were prepared according to conventional hybridoma technique and screened by indirect and capture ELISA method. To identify the epitopes and evaluate the classification, purchased creatine kinase isoenzyme MB (CK-MM/BB/MB) antigen was used to identify the epitopes, with immunoblotting and synthetic CK-MM and CK-BB in different linear epitope. A double antibody sandwich ELISA was applied to screen the mAb pairs for CK-MB detection, and the quantitative detection assay for CK-MB was developed. We used 74 cases of clinical specimens for comparison of our assay with Roche's CK-MB assay. We successfully developed 22 strains of hybridoms against CK-MB, these mAbs can be divided into linear, partial conformational CK-MB, CK-MM or CK-BB cross monoclonal antibody and CK-MB specific reaction with partial conformational monoclonal antibody, and CK-MB quantitative detection assay was developed by using partial conformational monoclonal antibody. The correlation coefficient factor r of our reagent and Roche's was 0.930 9. This study established a screening method for CK-MB partial conformational specific monoclonal antibody, and these monoclonal antibodies were analyzed and an established quantitative detection assay was developed. The new assay had a high concordance with Roche's.
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The aim of this study is to prepare and characterize cardiac troponin T (cTnT) monoclonal antibodies (mAb), and further develop a chemiluminescence quantitative detection assay for cTnT. BALB/c mice were immunized with recombinant cTnT antigen, and specific mAbs were prepared using conventional hybridoma technique and screened by indirect ELISA method. To identify the epitopes, several cTnT peptide fragments were synthesized or expressed by genetic engineering. A double antibody sandwich ELISA method was used to screen the mAb pairs for cTnT detection, and the automatic chemiluminescence detection assay for cTnT was developed. In total 220 clinical specimens were used for system comparison between our assay and Roche cTnT assay; further performance characteristics was evaluated by testing 238 clinical samples and 784 physical examination samples. We successfully screened 33 strains of hybridoms against cTnT, and the mAbs' epitopes were identified. Mab E16H8 and C8G11 with a detection limit of 10 pg/mL cTnT antigen were selected to develop the full automatic chemiluminescence quantitative assay. The correlation coefficient of our reagent with Roche's was 0.959 9, with a coincidence rate of 95%. The assay presented a sensitivity of 97.5%, and a specificity of 99.15% in detection of clinical samples. The cTnT concentration was less than 0.080 6 ng/mL in 99% of general population, which agrees with the definition of WHO on patients with acute myocardial infarction (AMI). In summary, we developed monoclonal antibodies against predominant epitopes for diagnostics of cTnT, and an automatic tubular chemiluminescence quantitative detection assay was further developed, which presents a high coincidence rate with Roche's.
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Humans , Antibodies, Monoclonal , Allergy and Immunology , Enzyme-Linked Immunosorbent Assay , Epitopes , Allergy and Immunology , Hybridomas , Luminescent Measurements , Myocardial Infarction , Peptide Fragments , Sensitivity and Specificity , Troponin T , Allergy and ImmunologyABSTRACT
BACKGROUND: To evaluate the macrophage migration inhibitory factor and E-selectin levels in patients with acute coronary syndrome. MATERIALS/METHODS: We examined the plasma migration inhibitory factor and E-selectin levels in 87 patients who presented with chest pain at our hospital. The patients were classified into two groups according to their cardiac status. Sixty-five patients had acute myocardial infarction, and 22 patients had non-cardiac chest pain (non-coronary disease). We designated the latter group of patients as the control group. The patients who presented with acute myocardial infarction were further divided into two subgroups: ST-elevated myocardial infarction (n = 30) and non-ST elevated myocardial infarction (n = 35). RESULTS: We found higher plasma migration inhibitory factor levels in both acute myocardial infarction subgroups than in the control group. However, the E-selectin levels were similar between the acute myocardial infarction and control patients. In addition, we did not find a significant difference in the plasma migration inhibitory factor levels between the ST elevated myocardial infarction and NST-elevated myocardial infarction subgroups. DISCUSSION: The circulating concentrations of migration inhibitory factor were significantly increased in acute myocardial infarction patients, whereas the soluble E-selectin levels were similar between acute myocardial infarction patients and control subjects. Our results suggest that migration inhibitory factor may play a role in the atherosclerotic process. .
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Animals , Female , Mice , /metabolism , Interferon-gamma/metabolism , Mammary Neoplasms, Animal/immunology , Spheroids, Cellular/immunology , T-Lymphocytes, Cytotoxic/metabolism , T-Lymphocytes, Helper-Inducer/metabolism , Alginates , Antigens, Neoplasm/immunology , Antigens, Neoplasm/metabolism , Cell Line, Tumor , Cell Movement , Chitosan , /genetics , /immunology , Glucuronic Acid , Granzymes/metabolism , Hexuronic Acids , Immunity, Cellular , Interferon-gamma/genetics , Interferon-gamma/immunology , Mammary Neoplasms, Animal/genetics , Mammary Neoplasms, Animal/metabolism , Mammary Neoplasms, Animal/pathology , Spheroids, Cellular/metabolism , Spheroids, Cellular/pathology , T-Lymphocytes, Cytotoxic/immunology , T-Lymphocytes, Helper-Inducer/immunology , Tumor MicroenvironmentABSTRACT
Background: Coronary Artery Disease (CAD) remains the major cause of mortality and morbidity of mankind. Even though lot of advances are made in diagnosis, management and prevention of the disease. Coronary Artery Disease (CAD) is the leading cause of death in the United States, affecting over 5 million Americans. It is the most common cause of death in most western countries. Methods: This study was carried out in Intensive Coronary Care Unit (ICCU) of McGann hospital, Shimoga. The material of study consisted of 100 consecutive patients of Acute Myocardial Infarction (AMI) admitted to ICCU of McGann hospital from January 2014 to November 2014. Only patients who satisfied World Health Organization (WHO) definition for the diagnosis of AMI were selected for the study. Results: The age of patients in this study ranged from 24 years to 85 years. Mean age 52.91 ± 13.19 years. Out of 100 cases, 82 were males and 18 were female. The male to female ratio was 4.5:1. Among the 100 patients studied, 92 patients (92%) had atleast on of the risk factors mentioned above and 46 patients (46%) had more than one risk factors. 45 of the 96 patients (46.88%) percentage to the hospital within 6 hours of onset of chest pain. The pulse rate was within normal limits in 65 patients (65%). 26 patients (26%) had tachycardia at time of presentation and 9 patients (9%) had bradycardia. In 29 patients (29%) blood pressure was more than 140/90 mmHg and 15 patients (15%) had hypotension at time of presentation. In remaining 56 patients (56%) blood pressure was within normal limits. JVP was elevated in 6 patients (6%). 4 patients (4%) were in cardiogenic shock at the time of presentation and 13 patients (13%) were in left ventricular failure. Conclusion: There is need for early detection of risk factor to prevent the progression of coronary heart disease, need for creating awareness in the community regarding risk factors, symptoms and signs of acute myocardial infarction so that early referral can be done to coronary care unit to prevent morbidity and mortality in the community.
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Acute myocardial infarction is one of the important reasons of death and unhealthiness in the world. The present study was undertaken to investigate the changes in serum lipids and lipoproteins in patients with acute myocardial infarction. The levels of lipid profile were significantly changed in the acute myocardial infarction patients. Acute myocardial infarction patients had significantly higher levels of total cholesterol, LDL-cholesterol, TG, Lipoprotein and lower level of HDL-cholesterol, as compared to the control subjects. We found a significant association of lipid profiles with acute myocardial infarction. Reduced serum HDL-cholesterol and increased Serum LDL, Serum TG, Lipoprotein (a), in our study subjects may be the effective reasonable lipid disorders in AMI patients.
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Objetivo: determinar el grado de preservación de la función cardíaca después de infarto agudo de miocardio (IAM), mediante la aplicación de fibrinolisis con previa administración de antiagregantes plaquetarios dentro de las primeras seis horas de evolución y establecer el número de pacientes que fueron sometidos a revascularización posterior a la fibrinolisis. Metodología: estudio observacional, prospectivo, realizado en el hospital regional del IESS Dr. Teodoro Maldonado Carbo, de Guayaquil; el tamaño muestral fue de 35 pacientes; quienes fueron sometidos a fibrinolisis luego de presentar infarto agudo de miocardio (con elevacióndel segmento ST). Debido a que la muestra fue homogénea se utilizaron como medidas estadísticas media aritmética, y desviación estándar. Además, prueba de Chi cuadrado para obtener el valor p. Resultados: de los 35 pacientes de la muestra, 28 (80 por ciento) fueronhombres y 7 (20 por ciento) mujeres. A todos los pacientes se los sometió a terapia fibrinolítica; en 20 (57 por ciento) el tratamiento resultó eficaz mientras que a 15 (43 por ciento), se les realizó revascularización con STENT. Se observó una mejoría de los valores de fracción de eyección diferencial, que compara los niveles después del tratamiento realizado, con 17 por ciento±7 para pacientes sometidos sólo a fibrinolisis y de 19 por ciento±12 a quienes se les realizó posteriormente revascularización con STENT. Conclusión: a partir de los resultados se puede concluir que la fibrinolisis como medida terapéutica en el manejo agudo del IAM mejora el grado de función cardíaca.
Aim: to determine the degree of perseveration of the cardiac function after an acute myocardial infarction (AMI), through the application of fibrinolysis with prior use of antiplatelet agents within the first six hours of development and to establish the number of patients who underwent a subsequent revascularization to fibrinolysis. Methodology: The prospective observational research took place at the Dr. Teodoro Maldonado Carbo IESS Regional Hospital of Guayaquil. The sample size was 35 patients; who underwent fibrinolysis after presenting an acute myocardial infarction (with ST segment elevation). Due to the homogeneous sample, Arithmetic Mean and Standard Deviation were used as statistical measures. In addition, Chi-squared test was used for the p value. Results: out of the 35 patients of the sample, 28 (80 percent) were male and 7 (20 percent) were women. All the patients weresubjected to a fibrinolytic therapy, in 20 (57 percent) of them the mentioned treatment was effective while 15 (43 percent) patients underwent a revascularization with STENT. An improvement of the values of the fraction of differential ejection was observed, which compares the levels after the treatment, with 17 percent±7 for patients undergoing only fibrinolysis, and 19 percent±12 who subsequently underwent a revascularization STENT. Conclusion: from the results it can be concluded that the fibrinolysis as a therapeutic measure in acute management of AMI improves the level of cardiac function.
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Male , Female , Middle Aged , Angioplasty, Balloon, Coronary , Fibrinolysis , Myocardial Infarction , Chest Pain , Dyspnea , StentsABSTRACT
<b>Objective:</b> The purpose of this study was to evaluate the relationship between improvement of health-related quality of life (QOL) and participation in self-care activities and coronary risk factor management at 6 months after discharge for acute myocardial infarction (AMI) patients treated with percutaneous coronary intervention (PCI).<br><b>Methods:</b> A total of 118 patients were asked to complete the MOS 36-Item Short-Form Health Survey (SF-36) questionnaire at discharge and 6 months after discharge. The SF-36 consists of eight subscales: Physical Functioning (PF), Role Physical (RP), Bodily Pain (BP), General Health Perception (GH), Vitality (VT), Social Functioning (SF), Role Emotional (RE) and Mental Health (MH). We examined self-care activities and coronary risk factor management and related factors from SF-36 scores to measure quality of life (QOL) at discharge and 6 months after discharge.<br><b>Results:</b> The PF and BP scores at 6 months after discharge were significantly higher than those at discharge. Increasing PF and BP scores indicated improvement in ability to perform physical activities and absence of intense bodily pain that would interfere with activities of daily living or work. Improvement of PF in AMI patients treated with PCI was related to performing exercise after discharge and absence of diabetes mellitus. However, there were no related factors for BP.<br><b>Conclusion:</b> Our results indicated that exercise, as a self-care activity after discharge, for AMI patients treated with PCI may be related to the improvement of QOL.
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La angina inestable aguda y el infarto miocárdico sin elevación del segmento ST son dos grandes afecciones del síndrome coronario agudo. Su frecuencia se incrementa con los novedosos y rápidos procedimientos terapéuticos que mejoran la supervivencia del paciente coronario. La presente investigación expone las clasificaciones más actuales, la fisiopatología, las causas y sus mecanismos patogénicos, los hallazgos según la coronariografía y las categorías de riesgo según los elementos clínicos, enzimáticos y electrocardiográficos cuyos marcadores contribuyen al diagnóstico y al pronóstico de ambas dolencias. Se valoran los diagnósticos diferenciales, la conducta médica y el arsenal terapéutico disponible en los distintos estadios de la angina inestable aguda, del infarto, de la angina refractaria y de Prinzmetal. Finalmente se presenta un algoritmo que resume el tratamiento en el síndrome coronario agudo sin elevación del segmento ST
The acute unstable angina and the myocardial infarction without ST segment rise are two major affections of acute coronary syndrome. Its frequency is increases with the novel and fast therapeutical procedures improving the coronary patient survival. Present research shows the more current classifications, the pathophysiology, the causes and its pathogenic mechanisms, the findings according the coronarygraphy and the risk categories according to the clinical, enzymatic and electrocardiographic elements whose markers contributing to diagnosis and prognosis of both diseases. The differential diagnoses, the medical behavior and the therapeutical armamentarium available in the different stages of the acute unstable angina, of infarction, of refractory angina and or the Prinzmetal. Finally, an algorithm summarizing the treatment of the acute coronary syndrome without ST segment rise is presented
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Humans , Angina, Unstable/diagnosis , Angina, Unstable/drug therapy , Electrocardiography/methods , Myocardial Infarction/diagnosis , Myocardial Infarction/drug therapy , Risk FactorsABSTRACT
Aim To investigate the angiogenic promoting effect of Morinda officinalis How oligosaccharides(MOO) in the ischemic myocardium of rats after acute myocardial infarction(AMI).Methods 40 male Wistar rats were established into AMI model successfully and were randomly divided into 5 groups equally, i. e. the low, medium and high doses of MOO groups, the Shexiangbaoxin group and the model group. They were treated with different doses of the water fraction of the ethanolic extract of Radix morinda officinalis (0.7, 1.4, 2.8 mg·kg~(-1) ·d~(-1)), suspension liquid of Shexiangbaoxin Pill(30 mg·kg~(-1) ·d~(-1)) and distilled water with the same volume respectively.Besides, a sham operated group with 10 rats was set up for control. All rats were sacrificed after 6-week-treatment.The Ⅷ coagulation factor, vascular endothelial growth factor(VEGF) and basic fibroblast growth factor(bFGF) protein in ischemic myocardium of rats in each group were detected by immunohistochemistry assay.The microvessel density(MVD) was calculated. Gray values of protein expression of VEGF and bFGF in ischemic myocardium were calculated and analyzed by image analysis system.Results The MVD, the gray values of VGF and bFGF were higher in the medium and high doses of MOO groups than those in the model group(P <0.05), but still lower than those in the Shexiangbaoxin group(P <0.05). The MVD and the gray values of VEGF among 3 doses of MOO groups showed significant differences (P <0.05).Significant differences of gray value of bFGF were observed between small and middle doses of MOO groups, also between small and large doses of groups(P <0.05).Conclusion MOO can obviously promote angiogenesis in the ischemic myocardium of the rats after AMI.And up-regulating expressions of VEGF and bFGF protein in the ischemic myocardium may act as one of its angiogenic promoting mechanisms.