Non-ST-segment elevation acute coronary syndrome in elderly patients and long-livers. Features of treatment. Literature review and case report

Despite the growing population of elderly people and long-livers every year, the treatment of acute coronary syndrome in these groups is not fully developed and is not regulated in clinical guidelines due to the lack of large randomized clinical trials. The article presents a literature review covering the following issues arising during clinical decision-making in the treatment of non-ST-segment elevation acute coronary syndrome in this group of patients: selection of invasive treatment strategy, scope of myocardial revascularization, appointment of dual antiplatelet therapy taking into account the bleeding risk, decreased renal function and senile asthenia. In addition, a case report of successful treatment of a 101-year-old female patient with non-ST-segment elevation myocardial infarction, who underwent percutaneous coronary intervention with stenting of infarct-related artery, was presented

Six-Coordinate Nitrito and Nitrato Complexes of Manganese Porphyrin

Reaction of small increments of NO2 gas with sublimed amorphous layers of Mn(II)(TPP) (TPP = meso-tetra-phenylporphyrinato dianion) in a vacuum cryostat leads to formation of the 5-coordinate monodentate nitrato complex Mn(III)(TPP)(η(1)-ONO2) (II). This transformation proceeds through the two distinct steps with initial formation of the five coordinate O-nitrito complex Mn(III)(TPP)(η(1)-ONO) (I) as demonstrated by the electronic absorption spectra and by FTIR spectra using differently labeled nitrogen dioxide. A plausible mechanism for the second stage of reaction is offered based on the spectral changes observed upon subsequent interaction of (15)NO2 and NO2 with the layered Mn(TPP). Low-temperature interaction of I and II with the vapors of various ligands L (L = O-, S-, and N-donors) leads to formation of the 6-coordinate O-nitrito Mn(III)(TPP)(L)(η(1)-ONO) and monodentate nitrato Mn(III)(TPP)(L)(η(1)-ONO2) complexes, respectively. Formation of the 6-coordinate O-nitrito complex is accompanied by the shifts of the ν(N═O) band to lower frequency and of the ν(N-O) band to higher frequency. The frequency difference between these bands Δν = ν(N═O) - ν(N-O) is a function of L and is smaller for the stronger bases. Reaction of excess NH3 with I leads to formation of Mn(TPP)(NH3)(η(1)-ONO) and of the cation [Mn(TPP)(NH3)2](+) plus ionic nitrite. The nitrito complexes are relatively unstable, but several of the nitrato species can be observed in the solid state at room temperature. For example, the tetrahydrofuran complex Mn(TPP)(THF)(η(1)-ONO2) is stable in the presence of THF vapors (∼5 mm), but it loses this ligand upon high vacuum pumping at RT. When L = dimethylsulfide (DMS), the nitrato complex is stable only to ∼-30 °C. Reactions of II with the N-donor ligands NH3, pyridine, or 1-methylimidazole are more complex. With these ligands, the nitrato complexes Mn(III)(TPP)(L)(η(1)-ONO2) and the cationic complexes [Mn(TPP)(L)2](+) coexist in the layer at room temperature, the latter formed as a result of NO3(-) displacement when L is in excess

Six-Coordinate Nitrato Complexes of Iron Porphyrins with Trans S-Donor Ligands.

The reaction of dimethyl sulfide (DMS) and tetrahydrothiophene (THT) with thin, amorphous layers of the nitrato complexes Fe(Por)(η2-O2NO) (Por = meso-tetraphenylporphyrinato dianion or meso-tetra- p-tolylporphyrinato dianion) at low temperature leads to formation of the corresponding six-coordinate complexes Fe(Por)(L)(η1-ONO2) (L = DMS, THT) as characterized by Fourier transform infrared and optical spectroscopy measurements. Adduct formation was accompanied by bidentate-to-monodentate linkage isomerization of the nitrato ligand, with the FeIII center remaining in a high-spin electronic state. These adducts are thermally unstable; warming to room temperature restores the initial Fe(Por)(η2-O2NO) species