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Journal of Cardiology Cases Mar 2024Although debulking devices are very useful in modifying calcified plaques, their effectiveness is highly dependent on wire bias. In particular, in eccentric calcified...
UNLABELLED
Although debulking devices are very useful in modifying calcified plaques, their effectiveness is highly dependent on wire bias. In particular, in eccentric calcified bifurcation lesions, wire bias tends to be poor and needs to be corrected for adequate lesion preparation. A 67-year-old man was diagnosed with exertional angina pectoris. Coronary angiography showed a highly calcified eccentric lesion from the left main trunk to the left anterior descending artery. The patient refused coronary artery bypass surgery, therefore we decided to treat this complex bifurcation lesion with percutaneous coronary intervention. Initially, we performed reverse orbital atherectomy (OA) and sifted the guide wire position into the calcified plaque successfully. We continued with rotational atherectomy (RA) using a 2.0 mm burr and were able to obtain sufficient lumen without complications. Finally, the lesion was dilated with a cutting balloon and a drug-coated balloon to obtain a stent-like result. This case demonstrates that wire bias modification with reverse OA enables us to perform more aggressive and effective RA safely in eccentric calcified bifurcation lesions. This combination atherectomy can become an attractive approach in eccentric calcified bifurcation lesions.
LEARNING OBJECTIVE
Atherectomy devices are helpful for lesion modification in calcified lesions but their effectiveness is highly dependent on wire bias. If the wire bias can be intentionally moved to an optimal position, it can be a very effective procedure in the treatment of calcified lesions. Wire bias modification by reverse ablation with orbital atherectomy that we have demonstrated enables subsequent aggressive rotational atherectomy and this combination atherectomy can be an attractive approach in eccentric calcified lesions.
PubMed: 38481639
DOI: 10.1016/j.jccase.2023.11.006 -
BMC Primary Care Mar 2024Epidemiological studies often rely on self-reported health problems and validation greatly improves study quality. In a study of late effects after childhood cancer, we...
BACKGROUND
Epidemiological studies often rely on self-reported health problems and validation greatly improves study quality. In a study of late effects after childhood cancer, we validated self-reported cardiovascular problems by contacting general practitioners (GPs). This paper describes: (a) the feasibility of this approach; and (b) the agreement between survivor-reports and reports from their GP.
METHODS
The Swiss Childhood Cancer Survivor Study (SCCSS) contacts all childhood cancer survivors registered in the Swiss Childhood Cancer Registry since 1976 who survived at least 5 years from cancer diagnosis. We validated answers of all survivors who reported a cardiovascular problem in the questionnaire. Reported cardiovascular problems were hypertension, arrhythmia, congestive heart failure, myocardial infarction, angina pectoris, stroke, thrombosis, and valvular problems. In the questionnaire, we further asked survivors to provide a valid address of their GP and a consent for contact. We sent case-report forms to survivors' GPs and requested information on cardiovascular diagnoses of their patients. To determine agreement between information reported by survivors and GPs, we calculated Cohen's kappa (κ) coefficients for each category of cardiovascular problems.
RESULTS
We used questionnaires from 2172 respondents of the SCCSS. Of 290 survivors (13% of 2172) who reported cardiovascular problems, 166 gave consent to contact their GP and provided a valid address. Of those, 135 GPs (81%) replied, and 128 returned the completed case-report form. Survivor-reports were confirmed by 54/128 GPs (42%). Of the 54 GPs, 36 (28% of 128) confirmed the problems as reported by the survivors; 11 (9% of 128) confirmed the reported problem(s) and gave additional information on more cardiovascular outcomes; and seven GPs (5% of 128) confirmed some, but not all cardiovascular problems. Agreement between GPs and survivors was good for stroke (κ = 0.79), moderate for hypertension (κ = 0.51), arrhythmias (κ = 0.41), valvular problems (κ = 0.41) and thrombosis (κ = 0.56), and poor for coronary heart disease (κ = 0.15) and heart failure (κ = 0.32).
CONCLUSIONS
Despite excellent GP compliance, it was found unfeasible to validate self-reported cardiovascular problems via GPs because they do not serve as gatekeepers in the Swiss health care system. It is thus necessary to develop other validation methods to improve the quality of patient-reported outcomes.
Topics: Humans; Child; Cancer Survivors; Self Report; General Practitioners; Feasibility Studies; Neoplasms; Heart Failure; Hypertension; Thrombosis; Stroke
PubMed: 38459512
DOI: 10.1186/s12875-024-02322-7 -
Actas Espanolas de Psiquiatria Feb 2024There is a pressing need to identify pharmaceuticals that are both safe and efficacious, with lower toxicity, for the treatment of stable angina pectoris in individuals...
BACKGROUND
There is a pressing need to identify pharmaceuticals that are both safe and efficacious, with lower toxicity, for the treatment of stable angina pectoris in individuals suffering from coronary heart disease. The aim of this paper is to explore the therapeutic value of Shexiang Tongxin Dropping Pills in patients with stable angina pectoris of coronary heart disease complicated with cognitive impairment.
METHODS
200 patients with stable angina pectoris combined with cognitive dysfunction and coronary heart disease admitted to our hospital from January 2022 to June 2023 were retrospectively selected as the study objects. According to the treatment method, the subjects were divided into a control group and a study group, with 100 cases in each group. The control group received conventional oral Western medicine, and the study group underwent treatment with Shexiang Tongxin Dropping Pills in addition to traditional Western medicine. The course of treatment was eight weeks. The enhancement in angina pectoris, cognitive function level, self-care ability, and clinical efficacy of both groups were assessed by comparing the conditions before and after the treatment.
RESULTS
After treatment, the frequency and duration of angina pectoris attacks in both groups were significantly lower than before, and the study group was lower than the control group (p < 0.05). The Montreal Cognitive Assessment (MoCA) score of both groups was higher than before, and the score of the study group was significantly higher than that of the control group (p < 0.05). Neuropsychiatric Inventory (NPI) scores in both groups were significantly lower than before, and the scores of the study group were significantly lower than those of the control group (p < 0.05). Traditional Chinese Medicine (TCM) syndrome scores in both groups were significantly lower than before, and the scores of the study group were significantly lower than those of the control group (p < 0.05). After treatment, the total effective rate of the control group and the study group was 81.00% and 93.00%, respectively, and the total clinical effective rate of the study group was significantly higher than that of the control group (p < 0.05).
CONCLUSION
Shexiang Tongxin Dropping Pills can effectively reduce the incidence of angina pectoris in patients with stable angina pectoris complicated with coronary heart disease and cognitive dysfunction. It can also regulate the patient's neurological function, improve their cognitive level, and significantly improve clinical efficacy.
Topics: Humans; Angina, Stable; Retrospective Studies; Coronary Disease; Cognitive Dysfunction; Drugs, Chinese Herbal
PubMed: 38454898
DOI: No ID Found -
Cureus Feb 2024Campylobacter spp. is a widely recognized pathogen accountable for acute enteritis, frequently linked to sepsis, primarily attributed to C. jejuni. Instances of...
Campylobacter spp. is a widely recognized pathogen accountable for acute enteritis, frequently linked to sepsis, primarily attributed to C. jejuni. Instances of Campylobacter-induced cholecystitis are infrequent, with only a limited number of documented case reports. Acute cholecystitis has been sporadically documented to induce electrocardiographic alterations, occasionally simulating an acute coronary syndrome (ACS). Herein, we present an instance of cholecystitis induced by C. jejuni, posing a challenge in its differentiation from ACS due to electrocardiographic modifications. An 85-year-old Japanese male presented to our hospital with a complaint of chest discomfort lasting one hour. His medical history included hypertension, dyslipidemia, and effort angina pectoris, with a prior percutaneous coronary intervention. The chest discomfort, accompanied by pain and pressure, raised uncertainty about its similarity to a previous angina episode. Vital signs were in the normal range. Physical examination revealed no abnormal heart or lung sounds. Electrocardiography indicated a right bundle branch block and new ST-segment elevation in V2-3. Echocardiography, chest X-rays, and blood tests showed no abnormalities. Emergency coronary angiography revealed no stenosis. Post-angiography, chest discomfort persisted, and the patient developed fever and chills. Contrast-enhanced CT revealed gallbladder lithiasis, prompting suspicion of sepsis. C. jejuni was detected, and antimicrobial therapy resolved symptoms.
PubMed: 38449942
DOI: 10.7759/cureus.53608 -
The Journal of Invasive Cardiology Jun 2024A 55-year-old female patient with unstable angina and accelerated hypertension was planned for invasive coronary and renal angiogram.
A 55-year-old female patient with unstable angina and accelerated hypertension was planned for invasive coronary and renal angiogram.
Topics: Humans; Female; Middle Aged; Brachial Artery; Device Removal; Angioplasty, Balloon; Angina, Unstable; Equipment Failure; Coronary Angiography; Treatment Outcome
PubMed: 38446028
DOI: 10.25270/jic/24.00003 -
Journal of Human Hypertension Apr 2024Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it... (Randomized Controlled Trial)
Randomized Controlled Trial
Blood Pressure Variability (BPV) is associated with cardiovascular risk and serum uric acid level. We investigated whether BPV was lowered by allopurinol and whether it was related to neuroimaging markers of cerebral small vessel disease (CSVD) and cognition. We used data from a randomised, double-blind, placebo-controlled trial of two years allopurinol treatment after recent ischemic stroke or transient ischemic attack. Visit-to-visit BPV was assessed using brachial blood pressure (BP) recordings. Short-term BPV was assessed using ambulatory BP monitoring (ABPM) performed at 4 weeks and 2 years. Brain MRI was performed at baseline and 2 years. BPV measures were compared between the allopurinol and placebo groups, and with CSVD and cognition. 409 participants (205 allopurinol; 204 placebo) were included in the visit-to-visit BPV analyses. There were no significant differences found between placebo and allopurinol groups for any measure of visit-to-visit BPV. 196 participants were included in analyses of short-term BPV at week 4. Two measures were reduced by allopurinol: the standard deviation (SD) of systolic BP (by 1.30 mmHg (95% confidence interval (CI) 0.18-2.42, p = 0.023)); and the average real variability (ARV) of systolic BP (by 1.31 mmHg (95% CI 0.31-2.32, p = 0.011)). There were no differences in other measures at week 4 or in any measure at 2 years, and BPV was not associated with CSVD or cognition. Allopurinol treatment did not affect visit-to-visit BPV in people with recent ischemic stroke or TIA. Two BPV measures were reduced at week 4 by allopurinol but not at 2 years.
Topics: Humans; Blood Pressure; Ischemic Attack, Transient; Allopurinol; Hypertension; Ischemic Stroke; Uric Acid; Risk Factors; Blood Pressure Monitoring, Ambulatory
PubMed: 38438602
DOI: 10.1038/s41371-024-00906-5 -
Natural Products and Bioprospecting Mar 2024Scutellarin is widely distributed in Scutellaria baicalensis, family Labiatae, and Calendula officinalis, family Asteraceae, and belongs to flavonoids. Scutellarin has a... (Review)
Review
Scutellarin is widely distributed in Scutellaria baicalensis, family Labiatae, and Calendula officinalis, family Asteraceae, and belongs to flavonoids. Scutellarin has a wide range of pharmacological activities, it is widely used in the treatment of cerebral infarction, angina pectoris, cerebral thrombosis, coronary heart disease, and other diseases. It is a natural product with great research and development prospects. In recent years, with in-depth research, researchers have found that wild scutellarin also has good therapeutic effects in anti-tumor, anti-inflammatory, anti-oxidation, anti-virus, treatment of metabolic diseases, and protection of kidney. The cancer treatment involves glioma, breast cancer, lung cancer, renal cancer, colon cancer, and so on. In this paper, the sources, pharmacological effects, in vivo and in vitro models of scutellarin were summarized in recent years, and the current research status and future direction of scutellarin were analyzed.
PubMed: 38436812
DOI: 10.1007/s13659-024-00441-3 -
BMC Cardiovascular Disorders Mar 2024The present study aimed to respond to clinical question, can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?
BACKGROUND
The present study aimed to respond to clinical question, can prolonged P-R interval predict clinical outcomes in non-ST elevation acute coronary syndrome patients?
METHODS
This descriptive-analytical study was conducted on cardiac patients. All of the non-ST elevation acute coronary syndrome (NSTEACS) including non-ST elevation myocardial infarction (NSTEMI) and unstable angina patients included in the study. Then they divided into two groups: prolonged P-R interval and normal P-R interval. The patients who had a history of digoxin and calcium channel blocker use, using antiarrhythmic drugs, known valvular or congenital heart disease and connective tissue, unreadable P-R interval and cardiac block were excluded. Data were collected using the questionnaire consisted demographic data and clinical outcomes and a follow-up part was completed by one of the researchers.
RESULTS
Finally, 248 patients completed the study. The results showed both of the two groups had significant differences in terms of the history of myocardial infarction (MI) (p = 0.018), the level of high-density lipoprotein (HDL) (p = 0.004), heart rate (p = 0.042), inverted T wave (p = 0.017), anterior ST- segment depression (p = 0.008), normal report of coronary angiography (CAG) (p = 0.003), three vessels disease (p = 0.043), left main lesion (p = 0.045) and SYNTAX score (p = 0.032) based on the CAG report. The results of six-month follow-up showed although, the frequency of ischemic stroke, coronary artery disease (CAD) and cardiovascular death were higher in prolonged P-R interval groups. The chi-square test showed this difference was statistically non-significant (p > 0.05). The multivariate logistic regression model revealed non-significant relationships between prolonged P-R interval and SYNTAX score, significant CAD, three-vessel disease, inverted T wave, anterior ST depression, heart rate and HDL.
CONCLUSIONS
Based on the results of our study the six-month follow-up showed non-significant outcomes. Further studies are recommended to assess the long-term outcomes.
Topics: Humans; Acute Coronary Syndrome; Myocardial Infarction; Coronary Artery Disease; Angina, Unstable; Non-ST Elevated Myocardial Infarction; Coronary Angiography; Heart Block; Electrocardiography
PubMed: 38431589
DOI: 10.1186/s12872-024-03809-y -
Alternative Therapies in Health and... Mar 2024Stable angina pectoris (SAP) is an ischemic heart disease caused by coronary artery stenosis, which usually occurs during physical activity or emotional excitement. For...
BACKGROUND
Stable angina pectoris (SAP) is an ischemic heart disease caused by coronary artery stenosis, which usually occurs during physical activity or emotional excitement. For this type of angina pectoris, reducing the oxygen demand of the heart and increasing the coronary blood flow are the key goals of treatment.
OBJECTIVE
To analyze nicorandil's application effect and adverse reactions in patients with SAP.
METHODS
Sixty patients with stable angina pectoris admitted to our hospital from December 2020 to May 2022 were randomly selected and included in this study. They were divided into nicorandil group (n=30) and conventional group (n=30). The clinical efficacy, duration of chest pain, number of heart attacks per week, cardiac function indexes, improvement of exercise tolerance, occurrence of adverse reactions, and Seattle Angina Scale (SAQ) score were observed.
RESULTS
The effective rate of nicorandil group was 93.33%, which was much higher than that of conventional group (73.33%, P < .05). The results showed that the nicorandil group was significantly better than the conventional group in clinical efficacy, duration of chest pain, number of attacks per week, cardiac function index, improvement of exercise tolerance, occurrence of adverse reactions and SAQ score (P < .05).
CONCLUSIONS
Nicorandil can improve the clinical symptoms of SAP patients, significantly reduce the duration and frequency of chest pain attacks, and enhance cardiac function indicators. It can be used as an effective drug choice to reduce the frequency and intensity of angina pectoris attacks and is worthy of wide clinical application.
PubMed: 38430173
DOI: No ID Found