Subject(s)
Coronary Disease/therapy , Data Collection/statistics & numerical data , Myocardial Infarction/therapy , Outcome and Process Assessment, Health Care/statistics & numerical data , Societies, Medical , Cause of Death , Clinical Trials as Topic/statistics & numerical data , Coronary Disease/mortality , Evaluation Studies as Topic , Humans , Myocardial Infarction/mortality , Risk Adjustment , Survival Rate , United StatesSubject(s)
Cardiac Catheterization , Cardiology , Myocardial Revascularization , Registries , HumansSubject(s)
Cardiovascular Diseases/drug therapy , Enzyme Inhibitors , Erectile Dysfunction/drug therapy , Piperazines , Cardiovascular Diseases/blood , Contraindications , Drug Interactions , Enzyme Inhibitors/adverse effects , Enzyme Inhibitors/pharmacokinetics , Enzyme Inhibitors/therapeutic use , Erectile Dysfunction/blood , Humans , Male , Metabolic Clearance Rate , Piperazines/adverse effects , Piperazines/pharmacokinetics , Piperazines/therapeutic use , Purines , Risk , Sildenafil Citrate , SulfonesSubject(s)
3',5'-Cyclic-GMP Phosphodiesterases/antagonists & inhibitors , Cardiovascular Diseases/therapy , Enzyme Inhibitors/therapeutic use , Erectile Dysfunction/drug therapy , Piperazines/therapeutic use , Cardiovascular Diseases/mortality , Cardiovascular Diseases/physiopathology , Coitus/physiology , Drug Interactions , Enzyme Inhibitors/adverse effects , Enzyme Inhibitors/pharmacokinetics , Erectile Dysfunction/physiopathology , Humans , Male , Piperazines/adverse effects , Piperazines/pharmacokinetics , Purines , Sildenafil Citrate , SulfonesABSTRACT
Coronary artery bypass graft patency was examined by contrast-enhanced computed tomography in 18 patients with perioperative myocardial infarction soon after surgery to determine the role of graft occlusion. Preoperative coronary angiograms were reviewed to assess native coronary disease and visible collateral channels in the distribution of the myocardial infarction. Perioperative myocardial infarction was diagnosed if creatine kinase-MB was elevated, characteristic electrocardiographic changes occurred and, in the majority of cases, the pyrophosphate scan was positive. Fourteen patients (78%) had patent grafts and perioperative myocardial infarction in the distribution of the grafted vessel. Four patients had an occluded graft with infarction in the distribution of the grafted vessel. Among the 14 patients with patent grafts, there was a significant difference (p less than 0.0005) in the degree of the mean (+/- standard deviation) diameter stenosis of 80 +/- 11% in native coronary vessels supplying the perioperatively infarcted myocardium versus a 55 +/- 12% mean diameter stenosis in the 23 bypassed native coronary vessels supplying noninfarcted myocardium. It is concluded that the majority of perioperative myocardial infarcts associated with coronary artery bypass operations are not caused by graft occlusion. The severity of coronary obstruction in the grafted vessel and the lack of collateral vessels to the region of perioperative infarction in patients with patent grafts suggests that an island of jeopardized myocardium exists that is subject to inadequate intraoperative preservation.
Subject(s)
Coronary Artery Bypass , Myocardial Infarction/etiology , Adult , Aged , Angiography , Clinical Enzyme Tests , Collateral Circulation , Coronary Angiography , Coronary Artery Bypass/adverse effects , Creatine Kinase/blood , Electrocardiography , Female , Heart/diagnostic imaging , Humans , Intraoperative Complications , Isoenzymes , Male , Middle Aged , Myocardial Infarction/complications , Myocardial Infarction/diagnosis , Radionuclide Imaging , Tomography, X-Ray ComputedABSTRACT
A comparison is made of the percentage compositions of major fatty acids in liver and testis phospholipids, liver and abdominal adipose tissue triglycerides, and liver sterol esters in male Fischer-344 rats administered a physiological saline control or a "smoking" dose of nicotine (1000 micro g base/kg/day, subcutaneously) for 2 or 22 months. Results indicate that there is no major trend, or significant difference, between nicotine- or saline-treated rats with respect to major fatty acid distribution. Some differences in fatty acid distribution in the various lipid fractions were found between young and old rats.
