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  • 1
    Online Resource
    Online Resource
    Prognostic Impact of Non-Cardiac Comorbidities on Long-Term Prognosis in Patients with Reduced and Preserved Ejection Fraction following Acute Myocardial Infarction
    MDPI AG ; 2023
    In:  Journal of Personalized Medicine Vol. 13, No. 7 ( 2023-07-08), p. 1110-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 13, No. 7 ( 2023-07-08), p. 1110-
    Abstract: Background: We aimed to analyze the prevalence and long-term prognostic impact of non-cardiac comorbidities in patients with reduced and preserved left-ventricular ejection fraction (EF) following ST-elevation myocardial infarction (STEMI). Method: A total of 3033 STEMI patients undergoing primary percutaneous coronary intervention (pPCI) were divided in two groups: reduced EF 〈 50% and preserved EF ≥ 50%. The follow-up period was 8 years. Results: Preserved EF was present in 1726 (55.4%) patients and reduced EF was present in 1389 (44.5%) patients. Non-cardiac comorbidities were more frequent in patients with reduced EF compared with patients with preserved EF (38.9% vs. 27.4%, respectively, p 〈 0.001). Lethal outcome was registered in 240 (17.2%) patients with reduced EF and in 40 (2.3%) patients with preserved EF, p 〈 0.001. Diabetes and chronic kidney disease (CKD) were independent predictors for 8-year mortality in patients with preserved EF. In patients with reduced EF, CKD was independently associated with 8-year mortality. Conclusion: In patients who had reduced EF, the prevalence of non-cardiac comorbidities was higher than in patients who had preserved EF after STEMI. Only diabetes mellitus and CKD were independently associated with 8-year mortality in analyzed patients.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm13071110
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662248-8
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  • 2
    Online Resource
    Online Resource
    Successful Caesarean Section on Ticagrelor Treatment One Day after Primary Percutaneous Coronary Intervention
    MDPI AG ; 2023
    In:  Journal of Personalized Medicine Vol. 13, No. 9 ( 2023-08-30), p. 1344-
    Details
    In: Journal of Personalized Medicine, MDPI AG, Vol. 13, No. 9 ( 2023-08-30), p. 1344-
    Abstract: Caesarean section is a challenging intervention in patients treated with dual antiplatelet therapy. We present a case of a 32-year-old pregnant woman experiencing large acute myocardial infarction (MI) of the anterolateral wall, complicated by cardiogenic shock in the 38th week of pregnancy, and treated with drug-eluting stent implantation and dual antiplatelet therapy (DAPT) consisting of aspirin and ticagrelor. Less than 24 h after the MI delivery started, an urgent Caesarean section was indicated. As multiplate aggregometry testing showed a relatively insufficient level of ticagrelor platelet inhibition and a moderate level of aspirin platelet inhibition, a Caesarean section was performed without discontinuation of ticagrelor, which was decided due to the need for emergency surgery. Local hemostatic measures including administration of tranexamic acid were applied. The patient did not experience excessive bleeding. A healthy male baby was born. To the best of our knowledge, this is the first reported case of surgery in pregnant women treated with DAPT without ticagrelor discontinuation.
    Type of Medium: Online Resource
    ISSN: 2075-4426
    URL: Article
    DOI: 10.3390/jpm13091344
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662248-8
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  • 3
    Online Resource
    Online Resource
    Takotsubo Cardiomyopathy Precipitated By Thyroidectomy - A Case Report
    Walter de Gruyter GmbH ; 2021
    In:  Serbian Journal of Experimental and Clinical Research Vol. 22, No. 2 ( 2021-06-01), p. 181-185
    Details
    In: Serbian Journal of Experimental and Clinical Research, Walter de Gruyter GmbH, Vol. 22, No. 2 ( 2021-06-01), p. 181-185
    Abstract: Takotsubo cardiomyopathy (TC) is an acute cardiac condition triggered by emotional or physical stress. General anesthesia and sympathetic activation are possible triggers for TC. However, little is known about the role of sympathovagal activity in TC. In our report, we present a female patient, aged 62, who underwent thyroidectomy and at the end of the surgery developed cardiac complications. The patient had no chest pain, but had ST depression and negative T waves on the electrocardiogram (ECG). Cardiospecific enzyme troponin was elevated. Cardiac catheterization revealed unobstructed coronary arteries. Echo-cardiography revealed the enlargement of the left ventricle and ejection fraction of 40%. The patient was diagnosed with TC and dual antiplatelet therapy was introduced, a beta blocker and ACE inhibitor.It is possible that TC in perioperative period after thyroidectomy in this patient occured due to both sympathetic and parasympathetic activation. Probably, extraction of large thyroid induced vagal stimulation which resulted in hypotension and bradicardia. The patient was subsequently treated with adrenaline and atropine. In this case, sympathetic and parasympathetic activation in different intervals could result in the development of this condition.
    Type of Medium: Online Resource
    ISSN: 2335-075X , 1820-8665
    URL: Article
    DOI: 10.2478/sjecr-2018-0093
    Language: English
    Publisher: Walter de Gruyter GmbH
    Publication Date: 2021
    detail.hit.zdb_id: 2710266-X
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  • 4
    Online Resource
    Online Resource
    Use of Anticoagulant Therapy in Patients with Acute Myocardial Infarction and Atrial Fibrillation
    MDPI AG ; 2022
    In:  Medicina Vol. 58, No. 3 ( 2022-02-23), p. 338-
    Details
    In: Medicina, MDPI AG, Vol. 58, No. 3 ( 2022-02-23), p. 338-
    Abstract: The incidence of atrial fibrillation (AF) in acute coronary syndrome (ACS) ranges from 2.3–23%. This difference in the incidence of AF is explained by the different ages of the patients in different studies and the different times of application of both reperfusion and drug therapies in acute myocardial infarction (AMI). About 6–8% of patients who underwent percutaneous intervention within AMI have an indication for oral anticoagulant therapy with vitamin K antagonists or new oral anticoagulants (NOAC).The use of oral anticoagulant therapy should be consistent with individual risk of bleeding as well as ischemic risk. Both HAS-BLED and CHA2DS2VASc scores are most commonly used for risk assessment. Except in patients with mechanical valves and antiphospholipid syndrome, NOACs have an advantage over vitamin K antagonists (VKAs). One of the advantages of NOACs is the use of fixed doses, where there is no need for successive INR controls, which increases the patient’s compliance in taking these drugs. The use of triple therapy in ACS is indicated in the case of patients with AF, mechanical valves as well as venous thromboembolism. The results of the studies showed that when choosing a P2Y12 receptor blocker, less potent P2Y12 blockers such as Clopidogrel should be chosen, due to the lower risk of bleeding. It has been proven that the presence of AF within AMI is associated with a higher degree of reinfarction, more frequent stroke, high incidence of heart failure, and there is a correlation with an increased risk of sudden cardiac death. With the appearance of AF in ACS, its rapid conversion into sinus rhythm is necessary, and in the last resort, good control of heart rate in order to avoid the occurrence of adverse clinical events.
    Type of Medium: Online Resource
    ISSN: 1648-9144
    URL: Article
    DOI: 10.3390/medicina58030338
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
    detail.hit.zdb_id: 2088820-X
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