International journal of cardiology
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Comparative Study
Impact of plaque morphology on creatine kinase-MB elevation in patients with elective stent implantation.
The association between percutaneous coronary intervention (PCI) and subsequent myonecrosis has been widely recognized, and worse prognosis has been reported among patients with elevated post-PCI biomarkers. We used optical coherence tomography (OCT) to study the relationship between pre-PCI plaque morphology and post-PCI creatine kinase-MB (CK-MB) elevation. ⋯ TCFA and angiographically complex lesion morphology can predict post-PCI CK-MB elevation in patients treated with elective stent implantation. OCT may be useful in stratifying the risk for nonemergency stent implantation.
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Kounis syndrome is the concurrence of acute coronary syndromes with allergic conditions like anaphylaxis or anaphylactoid reactions. Cases of hypersensitivity to drugs-eluting-stent (DES) components able to cause serious clinical sequelae, like stent thrombosis have been reported recently. ⋯ To our knowledge this is the first description of intra-stent thrombosis associated with Kounis syndrome. The clinical implications and physiopathology of this association are discussed.
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Letter Comparative Study
Benefit of prostaglandin infusion in severe heart failure: preliminary clinical experience of repetitive administration.
Prostaglandin E1 (PGE1) is a potent vasodilating drug, which has been used in treatment of primary pulmonary hypertension. However intravenous PGE1 infusion may be of benefit and also has been proposed as a therapeutic tool in patients with end-stage heart failure. The aim of this prospective not randomized study was to assess the clinical and instrumental effects of this agent in patients with severe heart failure and pulmonary hypertension. ⋯ These preliminary data suggest that intermittent PGE1 infusion in patients with advanced congestive heart failure and high pulmonary pressure is able to improve NYHA mean class (p<0.05), ventricular contractility (LVEF p<0.001), pulmonary pressure and clinical data. It hasn't been associated to morbid events or increased risk of death.
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Letter Case Reports
ST-elevation myocardial infarction associated with acute ischemic stroke.
Randomized clinical studies have demonstrated that tissue plasminogen activator thrombolytic therapy improves functional outcomes. Recently the time window for tissue plasminogen activator thrombolytic therapy has been extended from 3 to 4.5 h after ischemic stroke onset, which will allow more ischemic stroke patients to benefit from this treatment. ⋯ We present a case of tissue plasminogen activator thrombolytic therapy in a 68-year-old Italian man admitted to the Emergency Department with heart failure, ischemic stroke and ST-elevation myocardial infarction. Also this case focuses attention on regression of ischemic stroke symptoms in STEMI patient treated with tissue plasminogen activator thrombolytic therapy.