1,720,967 research outputs found
Cardiac biomarkers in patients with ischemic heart disease enrolled in a cardiac rehabilitation program
Full text linkINTRODUZIONE: alcuni marcatori biochimici plasmatici, sia di natura lipidica che non, hanno dimostrato di avere un potere predittivo di eventi maggiori cardiovascolari, ma esistono pochi dati in letteratura sul loro ruolo e potere predittivo in prevenzione secondaria cardiovascolare. OBIETTIVO: lo scopo del nostro studio è stato quello di valutare l’esistenza di una associazione tra alcuni biomarcatori (UACR, PCR alta sensibilità, Nt-proBNP, Lp (a), ApoA e ApoB) ed il rischio cardiovascolare (endpoint primario combinato di mortalità cardiovascolare e riospedalizzazione) nel contesto di un programma di prevenzione secondaria e riabilitazione cardiologica (SPCRP). MATERIALI E METODI: 167 pazienti con sindrome coronarica acuta (ACS), 137 maschi (82%) e 30 femmine (18%), età media 59.8 ± 11 anni (32.5-78.5), sono stati arruolati in un programma annuale di prevenzione secondaria e riabilitazione cardiologica basato su counseling infermieristico, visite multispecialistiche ed attività fisica controllata. Prelievi ematochimici specifici (livelli plasmatici di TC, HDL C, LDL C, TG, Apo A, Apo B, hs-CRP, Nt-proBNP, Lp(a), UACR) e misure antropometriche di BMI e WHR sono stati eseguiti all'arruolamento, a 6 e 12 mesi. Un follow-up telefonico [mediana di 36.2 mesi (27.7 – 77.0)] ha permesso la raccolta dati a distanza. CONCLUSIONI: tra tutti i biomarcatori cardiaci considerati solo l' HDL C, Apo A e l' Nt-proBNP sono risultati predittori indipendenti di mortalità e riospedalizzazione cardiovascolare. Ulteriori studi sono necessari per meglio definire il valore prognostico di nuovi biomarcatori in prevenzione cardiovascolare secondaria.BACKGROUND: Several plasma lipid and non-lipid biomarkers have been shown to predict major cardiovascular events in population studies, but data on novel biomarkers in secondary prevention are sparse and there exists marked heterogeneity across trials. OBJECTIVE: Aim of our study was to determine whether temporary changes of traditional lipid and new lipid and non-lipid biomarkers like UACR, hs-CRP, Nt-proBNP, Lp(a), ApoA and ApoB, observed during a Secondary Prevention and Cardiac Rehabilitation Program (SPCRP), are associated to CV risk (primary combined end-point of cardiovascular mortality and re-hospitalization). MATERIALS AND METHODS: we enrolled 167 ACS patients, 137 males (82%) and 30 females (18%); mean age of participants was 59.8 ± 11 years (32.5-78.5). The 12-months SPCRP was based on nurse counselling, multispecialistic visits and controlled training. Serial blood samples (plasma levels of TC, HDL C, LDL C, TG, Apo A, Apo B, hs-CRP, Nt-proBNP, Lp(a), UACR), BMI and WHR were assessed at baseline, at 6 and 12 months. A telephonic follow up [median of 36.2 months (27.7 – 77.0)] was performed to collect data. CONCLUSIONS: Among all the cardiac biomarkers considered only HDL C, Apo a and Nt-proBNP resulted to be independent predictors of cardiovascular mortality and re-hospitalization. Prognostic value of novel biomarkers in secondary cardiovascular prevention needs further investigations
The dilemma of ischemia testing with different methods
No full textA 52-year-old man presented after one episode of effort angina, normal treadmill-ECG and clearly positive adenosine cardiac magnetic resonance (aCMR) for reversible perfusion defects in the left anterior descending coronary artery (LAD) territory. Contrast high-dose dipyridamole (0.84mg/kg/6min) stress-echocardiography (cSE) demonstrated normal myocardial perfusion and wall motion at rest, while perfusion defects were shown in the lateral and apical segments after
dipyridamole. Wall motion at stress was completely normal and stress/rest Doppler diastolic velocity ratio on the LAD demonstrated reduced flow reserve. In this case cSE was the provocative test
detecting both the LAD and circumflex obstructive lesions, thanks to myocardial perfusion analysis, while wall motion assessment was negative, not differently from treadmill-ECG, and aCMR
highlighted only the LAD disease
Anomalous origin of Left Coronary Artery from the Pulmonary Artery (ALCAPA): a rare presentation in late adulthood
No full textWe report a case of ALCAPA seen in one of the oldest patients ever reported
Les anti-agrégants plaquettaires dans les syndromes coronaires aigus : rapport bénéfice/risque
No full textRésuméLes traitements antithrombotiques, et particulièrement les anti-agrégants plaquettaires, sont au coeur de la prise en charge des syndromes coronaires aigus. Leur risque hémorragique potentiel constitue malheureusement le revers de la médaille de leur efficacité sur les événements ischémiques. Dans les choix thérapeutiques, il est donc essentiel d’évaluer la balance bénéfice/risque de ces différents traitements.SummaryAntithrombotic medications, particularly antiplatelet agents, are crucial in the management of patients with acute coronary syndromes. Their potential to increase the risk of bleeding, however, represents the downside of their remarkable efficacy in terms of prevention of ischaemic events. Careful assessment of the benefit/risk ratio of the medications that are currently available is therefore essential
Salute della donna & esercizio fisico
No full textSecondo l’Organizzazione Mondiale della Sanità, la sedentarietà provoca 1,9 milioni di morti annue. La costante pratica di esercizio fisico, al contrario, gioca un ben noto ruolo nel diminuire la morbilità e la mortalità in quasi tutti i tipi di malattie croniche. In questa disamina della letteratura si possono rintracciare contenuti sugli effetti dell’esercizio in diversi contesti fisiologici, con un’attenzione particolare al genere femminile, dovuta alle specifiche risposte della donna rispetto all’insorgenza e alla progressione delle patologie cardiovascolari, con un approfondimento sui livelli di attività fisica tra le donne italiane in relazione alle diverse fasi della loro vita.Alla luce di questa analisi, la scelta di un approccio clinico-preventivo legato al genere risulta essenziale per poter organizzare piani più dettagliati per la prevenzione, la cura e il mantenimento dei livelli di salute della donna
Study design and baseline characteristics of the national observational study of diagnostic and interventional cardiac catheterization by the French Society of Cardiology.
No full textThe national observational study of diagnostic and interventional cardiac catheterization (ONACI) is a prospective multicenter registry of the French Society of Cardiology including all interventional cardiology procedures performed from 2004. We aimed to evaluate "real-world" management of patients with coronary artery disease in France from this registry. The present study was focused on data collected from 2004 to 2008. Patient demographics and co-morbidities, invasive parameters, treatment options, and procedural techniques were prospectively collected. Patients were recruited from 99 hospitals (55% of patients were hospitalized in private clinics and 45% in public institutions). During a 5-year period, a total of 298,105 patients underwent coronary angiography and 176,166 patients underwent percutaneous coronary intervention. Diagnosis was acute coronary syndrome in 22%, stable angina or silent ischemia in 23%, and atypical chest pain in 9% of cases. Normal coronary arteries or nonsignificant coronary narrowing were found in 26% of patients. Radial access was increasingly used over the years regardless of the indication. The average number of percutaneous coronary interventions per procedure was 1.5 ± 0.7 (range, 1.3 ± 0.7 to 1.5 ± 0.7) and that of stents per procedure was 1.5 ± 0.8 (range, 1.5 ± 0.8 to 1.6 ± 0.8). Drug-eluting stents were used in 45% (range, 34% to 62%), increasing from 2004 to 2006, and then decreasing after the 2006 controversy. In conclusion, ONACI is one of the largest catheterization registries during this period, providing a detailed and comprehensive global description of the spectrum and management of patients with suspected coronary artery disease undergoing cardiac catheterization
Impact of Ventricular Fibrillation on In-Hospital Mortality and Long-Term Mortality After Myocardial Infarction: The FAST-MI Registry
No full textLittle data exists in the contemporary era on the impact of ventricular fibrillation (VF) at the acute stage of AMI on early and long-term outcomes. We analysed the impact of in-hospital VF on in-hospital mortality and 3-year survival in hospital survivors of the FAST-MI registry
Poorer Survival with Insulin Therapy at Discharge in Diabetic Patients with Acute Myocardial Infarction: The FAST-MI Registry
No full textThe role of insulin therapy after AMI is debated. We assessed 3-year survival in survivors of AMI with diabetes, according to the prescription of insulin at discharge. All patients were included in the FAST-MI registry
019: National observational study of diagnostic and interventional cardiac catheterization by the French Society of Cardiology (ONACI): study design and baseline characteristics
No full textBackgroundThe national observational study of diagnostic and interventional cardiac catheterization (ONACI) is a prospective multi-center registry of the French Society of Cardiology including all interventional cardiology procedures performed from 2004. We aimed to evaluate “real world” management of patients with coronary artery disease (CAD) in France from this registry.MethodsThe present study is focused on data collected between 2004 and 2008. Patient demographics and co-morbidities, invasive parameters, treatment options, and procedural techniques were prospectively collected. Patients were recruited in 99 hospitals (55% of patients were hospitalized in private clinics, 45% in public institutions).ResultsOver a 5-year period, a total of 298,105 patients underwent coronary angiography (CAG) and 176,166 patients underwent percutaneous coronary intervention (PCI). Diagnosis was acute coronary syndrome (ACS) in 22%, stable angina or silent ischemia in 23% and atypical chest pain in 9% of cases. Normal coronary arteries or not significant coronary lesions were found in 26% of patients. Radial access was increasingly used over the years regardless of the indication. The average number of PCI per procedure was 1.5±0.7 (range from 1.3±0.7 to 1.5±0.7) and those of stents per procedure were 1.5±0.8 (range from 1.5±0.8 to 1.6±0.8). Drug-eluting stents (DES) were used in 45% (range from 34 to 62%).ConclusionsCoronary anatomy is highly dependent on clinical presentation. Strategies to reduce the number of normal CAG performed for atypical chest pain should be developed. The management of ACS is associated with less radial access, more single PCI and fewer DES
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