PECULIAR FEATURES OF PTCA IN CORONARY PATIENTS WITH BIFURCATION LESIONS

The aim of the study was to analyse the clinical and angiographic results of bifurcational coronary balloon angioplasty and/or stenting depending on procedural variables and treatment method. The study included 56 patients with stable angina presenting bifurcational coronary lesions. The stent was implanted in main vessel in 32 patients. 24 patients were treated without stenting. Side branch angioplasty was performed in 16 stented and in 12 nonstented segments. All stenting procedures were performed using three ways: 1) so called «standard» manner without side branch protection during stenting, 2) elsewhere well described «jailed guidewire» technique and 3) hand9mounted two9balloons system proposed by K. Aroney. In 28 cases of successful bifurcational angioplasty an immediate clinical benefit was achieved. Among patients in whom side branch dilatation attempts have failed, 4 were finally free of symptoms, 6 have still demonstrated objective ischemic signs despite of considerable improvement in terms of angina functional class and 3 patients showed no clinical benefit. Conclusion: intact side branch ostium arising from main branch stenosis becomes compromised in large number of cases. 30% of side branch angioplasty attempts fail, of which the majority fall on stented main branch cases. Among types of bifurcation treatment, Aroney’s method showed the least effectiveness. Incomplete bifurcation reconstruction substantially decrease the clinical benefit in these patients. Key words: bifurcation lesion, coronary angioplasty, coronary stenting

QT DURATION AND DISPERSION IN ANGINA AND MYOCARDIAL INFARCTION

We have studied 176 men, including 84 with acute myocardial infarction (mean age 59,2±2,2), 92 (mean age 49,2±3,5) with angina of various functional classes. We have registered 12-lead ECG at rest (50 mm/sec) to all simultaneously. QT and QTc dispersion were calculated as the difference between their maximal and minimal durations in all the 12 leads. The prognostic role of QT dispersion as a marker of potentially life-threatening arrhythmias, is insufficient in the angina group. Unlike those, patient with acute myocardial infarction demonstrate a far greater role QT time parameters in predicting potentially life-threatening arrhythmias; with QT dispersion sensitivity and specificity (threshold > 50 msec) proved 82,2% and 85,8% respectively, and for QTc (threshold ≥ 70 msec) – 88,1% and 94,5%

THE INFLUENCE OF VHF ELECTROMAGNETIC RADIATION ON THE FREQUENCIES OF MOLECULAR SPECTRUM AND OXYGEN ABSORPTION ON BLOOD REOLOGICAL PROPERTIES IN STABLE ANGINA

The results of studing main features of influence of electromagnetic radiation of atmosphere oxygen molecular spectra of irradiation and absorption frequencies on whole blood rheology of patients with stable angina pectoris were present. The changes of rheological properties of whole blood samples of the patients with stable angina pectoris irradiated with electromagnetic radiation of atmosphere oxygen molecular spectra of irradiation and absorption frequencies depend on the time of treating, initial haematocrit level, fibrinogen concentration and arterial blood pressure

Effect of lycopene supplementation on cardiovascular parameters and markers of inflammation and oxidation in patients with coronary vascular disease

Oxidative stress and antioxidant deficiency play a pivotal role in initiation, development, and outcomes of cardiovascular disease. Pharmacokinetic parameters as well as the impact of highly bioavailable lycopene on cardiovascular variables, markers of inflammation and oxidation were investigated during a 30‐day clinical trial in patients with coronary vascular disease. The patients were randomized into two major groups and were supplemented with a single 7 mg daily dose of lycopene ingested either in the form of lactolycopene (68 patients) or in the form of lycosome‐formulated GA lycopene (74 patients). The endpoints included cardiovascular function parameters, serum lipids, and four markers of oxidative stress and inflammation. Ingestion of lycosome‐formulated lycopene increased serum lycopene levels by 2.9‐ and 4.3‐fold, respectively, after 2 and 4 weeks of the trial, whereas supplementation with lactolycopene upregulated serum lycopene by half‐fold only after 4 weeks of ingestion. Lycosome formulation of lycopene resulted by the end of the trial in a threefold reduction in Chlamydia pneumoniae IgG and reduction to the same degree of the inflammatory oxidative damage marker. The decrease in oxidized LDL caused by lycosome‐formulated lycopene was fivefold. Moreover, supplementation with lycosome‐formulated lycopene was accompanied by a significant increase in tissue oxygenation and flow‐mediated dilation by the end of the observational period. In contrast, lactolycopene did not cause any significant changes in the parameters studied. Therefore, enhanced bioavailability of lycopene promotes its antioxidant and anti‐inflammatory functions and endorses a positive effect of lycopene on cardiovascular system

Edoxaban versus warfarin in patients with atrial fibrillation

Contains fulltext : 125374.pdf (publisher's version ) (Open Access)BACKGROUND: Edoxaban is a direct oral factor Xa inhibitor with proven antithrombotic effects. The long-term efficacy and safety of edoxaban as compared with warfarin in patients with atrial fibrillation is not known. METHODS: We conducted a randomized, double-blind, double-dummy trial comparing two once-daily regimens of edoxaban with warfarin in 21,105 patients with moderate-to-high-risk atrial fibrillation (median follow-up, 2.8 years). The primary efficacy end point was stroke or systemic embolism. Each edoxaban regimen was tested for noninferiority to warfarin during the treatment period. The principal safety end point was major bleeding. RESULTS: The annualized rate of the primary end point during treatment was 1.50% with warfarin (median time in the therapeutic range, 68.4%), as compared with 1.18% with high-dose edoxaban (hazard ratio, 0.79; 97.5% confidence interval [CI], 0.63 to 0.99; P<0.001 for noninferiority) and 1.61% with low-dose edoxaban (hazard ratio, 1.07; 97.5% CI, 0.87 to 1.31; P=0.005 for noninferiority). In the intention-to-treat analysis, there was a trend favoring high-dose edoxaban versus warfarin (hazard ratio, 0.87; 97.5% CI, 0.73 to 1.04; P=0.08) and an unfavorable trend with low-dose edoxaban versus warfarin (hazard ratio, 1.13; 97.5% CI, 0.96 to 1.34; P=0.10). The annualized rate of major bleeding was 3.43% with warfarin versus 2.75% with high-dose edoxaban (hazard ratio, 0.80; 95% CI, 0.71 to 0.91; P<0.001) and 1.61% with low-dose edoxaban (hazard ratio, 0.47; 95% CI, 0.41 to 0.55; P<0.001). The corresponding annualized rates of death from cardiovascular causes were 3.17% versus 2.74% (hazard ratio, 0.86; 95% CI, 0.77 to 0.97; P=0.01), and 2.71% (hazard ratio, 0.85; 95% CI, 0.76 to 0.96; P=0.008), and the corresponding rates of the key secondary end point (a composite of stroke, systemic embolism, or death from cardiovascular causes) were 4.43% versus 3.85% (hazard ratio, 0.87; 95% CI, 0.78 to 0.96; P=0.005), and 4.23% (hazard ratio, 0.95; 95% CI, 0.86 to 1.05; P=0.32). CONCLUSIONS: Both once-daily regimens of edoxaban were noninferior to warfarin with respect to the prevention of stroke or systemic embolism and were associated with significantly lower rates of bleeding and death from cardiovascular causes. (Funded by Daiichi Sankyo Pharma Development; ENGAGE AF-TIMI 48 ClinicalTrials.gov number, NCT00781391.)