[Clinical study of administration of abciximab--a monoclonal antibody to platelet glycoprotein IIb/IIIa in percutaneous intracoronary interventions]. / Klinicka studija o primeni monoklonskog antitela protiv IIb/IIIa glikoproteina trombocita--abciksimaba kod bolesnika sa perkutanom intrakoronarnom intervencijom.

During the last 10 years a new group of drugs was developed--platelet glycoprotein IIb/IIIa blockers that is nowadays largely and efficiently used as for the prevention of percutaneous coronary intervention complications as well as in the treatment of acute coronary syndromes. In the period February-June 2000--19 patients (18 males, 1 female, of average age 53.3 years) were administered Abciximab in the bolus dose of 10 mg immediately before the intervention and afterwards 10 mg by 12-hour infusion. All patients received aspirin and ticlopidine hydrochloride if the stent was introduced and heparin by the standard protocol. Elective intervention was done in 17 patients (non-Q infarction in 3 patients, unstable angina pectoris in 5 patients, postinfarction angina pectoris in 2 patients, acute myocardial infarction at least 1 month before the intervention in 6 patients and 1 patient with myocardiopathy) and in 2 patients the intervention was performed during the myocardial infarction. In 15 patients (79%) intracoronary stent was introduced and in 5 patients (21%) the intervention was performed on 2 arteries. Maximal immediate effect of the dilatation was achieved in 18 patients (94.7%). In the first 60 days of the follow-up 1 patient (5%) died of some other disease, and in no patients symptomatic myocardial ischemia was found. No adverse effects were observed.

Lipid peroxidation intensity and lipid status parameters in the estimation of the severity of ischemic heart disease.

Atherosclerotic changes on the coronary arteries are the basis of the ischemic heart disease. It is assumed that the initial changes in this process occur as a consequence of the lipid peroxidation in the vessel wall. We estimated this process through the level of malondialdehyde (MDA) in the serum of 86 patients in whom selective coronary angiography was done for the suspected ischemic heart disease. According to the number of the stenotic coronary arteries (stenosis greater than 50%), we divided the patients into four groups: the control group with normal coronary angiography finding, simple, double or triple vessel coronary disease. In all the patients we also estimated the other parameters of the lipid status (cholesterol, triglycerides, LDL, HDL, Apo-AI, Apo B) and atherogenic indices Apo-AI/Apo B, LDL/HDL and HDL/total cholesterol. No significant changes were observed in the lipid parameters between the control and experimental group. However, mean MDA level in the whole experimental group was 3.89 mumol/L, 3.93 mumol/L in triple vessel coronary disease, 3.83 mumol/L in double vessel and 3.92 mumol/L in single vessel disease group. The difference between all the experimental and the control group was highly significant (p < 0.001). We concluded that the level of MDA--lipid peroxidation index had the better correlation with the disease status than the other parameters of lipid status and the sensitive atherogenic indices.

[Analysis of antihypertensive therapy in patients before acute cerebral ischemic disease]. / Analiza antihipertenzivne terapije kod bolesnika sa akutnom ishemijskombolescu mozga pre neuroloskog dogadjaja.

The adequacy of therapeutic program for hypertensive disease in the patients with ischemic brain disease was analyzed in the study related to the administration of the drugs divided by the groups of antihypertensive drugs. The results had demonstrated that in over 50% patients the therapy had to be changed by introducing at least one hypertensive drug from the other group. In many cases were observed inadequate doses of antihypertensive drugs and the prescription of antihypertensive drug in minimal dose, although therapeutic response was not adequate. In significant number of cases (over 80%), the patients were irregularly taking the prescribed therapy, and only 18% had the regular controls. The results of this investigation indicated that on one side did not exist the adequate therapeutic program for hypertension control and on the other the significant number of patients irregularly used the proposed therapy and did not control the disease regularly.