Kardiol Pol
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Recurrent myocardial ischaemia and restenosis are more common in diabetic patients treated with primary percutaneous coronary intervention (PCI) due to an acute coronary syndrome (ACS) compared to patients without diabetes. Diabetes is also associated with increased residual platelet activity during dual antiplatelet treatment. In recent reports, platelet reactivity has been linked to outcomes after ACS. Appropriate platelet inhibition might lead to improved outcomes in this patient population. To this end, newest methods to evaluate platelet function may prove helpful. ⋯ Increased platelet reactivity evaluated by TRAP-induced aggregation is related to a higher rate of restenosis and recurrent ACS during a 6-month follow-up of diabetic STEMI patients treated with PCI.
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Case Reports
[Coronary-cameral fistulae drained into left ventricle causing acute coronary syndrome?].
Coronary-cameral fistulae are rare and predominantly congenital communication between the coronary arterial circulation and the chambers or great vessels of the heart, accounted for less than 0.4% of all congenital heart abnormalities. We presented a case of 47 year-old female with troponin positive acute coronary syndrome admitted to our coronary care unit in whom we diagnosed coronary-cameral fistulae which could cause myocardial ischaemia.
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Spinal cord stimulation (SCS) is a well known method of treatment used worldwide since the 80's of the last century. High efficiency of SCS was observed in the treatment of various types of pain. Promising clinical results were observed in the treatment of patients with refractory angina (RA). ⋯ The mechanism of action in RA is not well understood. It is known that SCS reduces the activity of the sympathetic nervous system, by which improves the coronary perfusion and oxygenation of the heart muscle. It is important that SCS does not mask the pain related to the infarct.