Assuntos
Angiografia Coronária/métodos , Anomalias dos Vasos Coronários/diagnóstico por imagem , Vasos Coronários/diagnóstico por imagem , Tomografia Computadorizada Multidetectores , Artéria Pulmonar/anormalidades , Artéria Pulmonar/diagnóstico por imagem , Adulto , Humanos , Masculino , Valor Preditivo dos TestesRESUMO
OBJECTIVE: To investigate the risk of major adverse cardiac events (MACE) in patients with a history of bare metal stent (BMS) restenosis who undergo subsequent bare metal stenting of a geographically distinct, de novo coronary lesion. METHODS: We conducted a retrospective review of 72 BMS procedures performed in geographically distinct, de novo coronary lesions in patients with a history of previous BMS placement at least 3 months prior to the second, index stent procedure. Patients with a history of in-stent restenosis (ISR) were compared with those who had no ISR in their initial stent. RESULTS: Restenosis in the initial BMS was associated with a significant increase in MACE after placement of the index BMS (OR 20.0, 95% CI 3.86-103.58, p < 0.0001). This association was independent of traditional clinical and angiographic risk factors for restenosis. CONCLUSIONS: Restenosis of a previously placed BMS is strongly associated with MACE after placement of a subsequent BMS in a de novo coronary lesion.
Assuntos
Doença da Artéria Coronariana/etiologia , Reestenose Coronária/complicações , Stents/efeitos adversos , Idoso , Idoso de 80 Anos ou mais , Doenças Cardiovasculares/complicações , Doenças Cardiovasculares/terapia , Reestenose Coronária/terapia , Estudos Transversais , Feminino , Hospitais Militares , Humanos , Modelos Logísticos , Masculino , Metais , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados UnidosRESUMO
Ephedra, also known as Ma Huang, was commonly used to enhance athletic performance, "fat burning", and weight loss before its removal from the United States in April 2004 due to acute adverse health reactions including lethal arrhythmias, stroke, vasoconstriction, and myocardial infarction. We report the case of a 29-year-old patient with acute myocardial infarction, secondary to coronary artery aneurysms and thrombosis who reported use of Ma Huang, Xenadrine(r)RFA, and Hydroxycut at recommended dosages for a combined total of approximately 2 years. Other causes of coronary artery aneurysm and hypercoagulability were ruled out. Our case exemplifies the long-term (as opposed to acute) danger of ephedrine products and the first case of coronary artery aneurysm associated with its use.
Assuntos
Dor no Peito/induzido quimicamente , Aneurisma Coronário/induzido quimicamente , Trombose Coronária/induzido quimicamente , Ephedra sinica/efeitos adversos , Preparações de Plantas/efeitos adversos , Adulto , Aneurisma Coronário/diagnóstico por imagem , Trombose Coronária/diagnóstico por imagem , Humanos , Masculino , Radiografia , UltrassonografiaRESUMO
We report a rare case of torsade de pointes, a polymorphic ventricular tachycardia associated with QT interval prolongation, caused by intravenous ciprofloxacin given for pneumonia in a 22-year-old healthy Marine. Although the risk for quinolone-associated torsade de pointes appears to be low, caution is still warranted when given in the presence of pre-existing QT prolongation.
