Faculty of Medicine

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Language: search.filters.language.EnglishSubject: search.filters.subject.ST-elevation myocardial infarction

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    The prevalence and outcomes of transradial percutaneous coronary intervention for acute coronary syndrome. Analysis from the single-centre ISACS-TC Registry (International Survey of Acute Coronary Syndrome in Transitional Countries) (2010-12)
    (Oxford University Press (OUP), 2014-01-01)
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    Antov, Slobodan
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    The aims were to compare the prevalence and short-term outcomes of transradial (TRA) percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) in dedicated radial centre. This was a single-centre observational study of 3484 consecutively enrolled patients with ACS in a 3-year period (2010–12). There were 1648 patients with ST-elevation myocardial infarction (STEMI) and 1836 with non-ST-elevation ACS (NSTEACS). All patients underwent diagnostic coronary angiography within 24 h (STEMI) or within 72 h (NSTEACS). Percutaneous coronary intervention was performed in 84.9% patients (96.6% with STEMI and 74.9% with NSTEACS). Optimal medical treatment (OMT) only was recommended to 2.2% with STEMI and to 11.1% with NSTEACS. Coronary artery bypass graft (CABG) surgery was performed for 1.7% of STEMI and 14.1% of patients with NSTEACS (P < 0.0001). Most of the PCI procedures were performed through the wrist access (radial 97% and ulnar artery access 1.3%). There was high overall procedural success 98.5% (STEMI 99% and NSTEACS 97%). At 30 days, cardiovascular mortality was 4.7% in STEMI patients and 1.4% in patients with NSTEACS who were treated by PCI (P < 0.0001). Major adverse cardiac events defined as a composite of death, myocardial infarction, stroke, and non-CABG major bleeding and major access site complications at 30 days were higher in STEMI vs. NSTEACS patients (7.7 vs. 4.4%; P < 0.0001). Transradial access for PCI in a large cohort of unselected patients with ACS, is safe and feasible when performed by experienced radial operators. Patients with NSTEACS are more frequently treated with OMT and have higher referral rate to CABG in comparison with STEMI patients. There is higher 30 day mortality in patients with STEMI.
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    The Role of Interleukin-1 and Interleukin-6 in the Development of Acute Myocardial Infarction
    (2023-08-26)
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    Elizabeta Srbinovska-Kostovska
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    Slavica Josifovska
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    Certain cytokines as interleukin-1 (IL-1) and interleukin-6 (IL-6) are produced by the neutrophils and macrophages localized in the atheromatous plaques. The levels of circulating inflammatory cytokines IL-1 and IL-6 are found to be significantly increased in patients with ST-Segment Elevation Acute Myocardial Infarction (STEMI). In a group of 38 patients with STEMI, the levels of IL-1ß and IL-6 were determined in the coronary circulation (CC) by analysis of aspirates from the culprit lesions and the levels of these inflammatory markers in the systemic (peripheral) circulation (SC) during STEMI and six months after STEMI. Coronary angiography (CA) and percutaneous coronary intervention (PCI) were performed in all patients and the levels of cytokines were determined by the ELISA method. By examining the levels of IL-1ß and IL-6, the aim of this study was to determine their predictive value in short-term prognosis. In the acute phase (STEMI) there was a statistically significant difference between the mean values of IL-1ß (p=0, 000000) and IL-6 (p=0, 026204) in the samples of CC and SC, respectively. Results from the six months of follow-up showed that there were statistically no significant differences between the mean values of IL-1ß and IL-6 in the CC and SC. Moderate and low-positive correlation between the mean values of IL-1ß (r=0,6816; p=0,000) and IL-6 (r=0,4291; p=0,000) in CC and SC was observed at the sixth month of follow-up. In conclusion, our results confirm that IL-1ß and IL-6 are linked to the progression of Coronary Artery Disease (CAD) and should be considered as predictive markers.
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    A rare presentation of an elderly patient with acute lymphocytic leukemia and platelet count of zero associated with ST-elevation myocardial infarction, pulmonary thromboembolism in the setting of SARS-CoV 2: a case report
    (Springer Science and Business Media LLC, 2021-05-01)
    Hashemi, Arash
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    Gerges, Fady
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    Naqvi, Haseeb Raza
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    Moscatelli, Sara
    Novel coronavirus disease 2019 (COVID-19) is known to lead not only to severe acute respiratory syndrome, but also can result in thromboembolic events in both the venous and the arterial circulation by inducing coagulation disorders. The potential causes of coagulopathy are inflammation, platelet activation, endothelial dysfunction, and stasis. The thrombotic events including pulmonary embolism, deep venous thrombosis as well as intracatheter thrombosis are more likely to develop in patients infected with severe form of SARS-CoV-2 who are admitted to ICU. Furthermore, these events contribute to multi-organ failure.