Predictors of coronary intervention-related myocardial infarction in stable angina patients pre-treated with statins

A b s t r a c t I In nt tr ro od du uc ct ti io on n: : Peri-procedural myocardial infarction (PMI) is a frequent and prognostically important complication of percutaneous coronary intervention (PCI). This study was designed to determine the predictors of PMI in patients pre-treated with statins. M Ma at te er ri ia al l a an nd d m me et th ho od ds s: : A total of 418 stable angina pectoris patients taking statins and aspirin were included. All the patients underwent PCI. Serum concentrations of creatine kinase (CK-MB mass) and troponin I (TnI) were measured prior to and then within 16 to 24 hours after PCI. The incidence of PMI was assessed using the established criteria (≥ 3 times upper limit of normal). R Re es su ul lt ts s: : Four hundred and eighteen stable patients (63 ±10 years, 68% males) were treated by PCI. The technical success rate of PCI was 99%. The incidence of PMI based on CK-MB mass or TnI release was 12% (PMI group). There were no significant differences in baseline clinical and procedural characteristics between PMI and non-PMI groups except for the balloon inflation time (40 ±44 s vs. 26 ±27 s; p = 0.02) and the proportion of treated type C lesions (42% vs. 28%; p = 0.03). In multivariate analysis, the independent predictors of PMI were balloon inflation time (OR = 1.01; 95% CI 1.001-1.020; p = 0.02) and preprocedural level of C-reactive protein (OR = 1.38; 95% CI 1.059-1.808; p = 0.02). C Co on nc cl lu us si io on ns s: : These results suggest that C-reactive protein and balloon ischaemic time are independent predictors of PMI in stable angina patients pre-treated with statins

Diagnosis of hypertrophic cardiomyopathy with emphasis on genetic testing

Dizertační práce: Diagnostika hypertrofické kardiomyopatie se zaměřením na genetické vyšetření Autor: MUDr. Pavol Tomašov Obor: Fyziologie a patofyziologie člověka Abstract Introduction: Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiac disease with vast genetic and clinical heterogeneity. Genetic testing of HCM patients is important in determining the etiopathogenesis of the disease and is becoming an integral part of patient care. Aim: The aims of our work included the following implementation of genetic testing in HCM in both basic and clinical research: 1. To identify genetic variants in a novel candidate gene NEBL coding Z-disc protein nebulette in HCM patients. 2. To determine clinical and echocardiographic variables associated with the presence of mutations in the most common sarcomeric genes in the Czech population. 3. To find echocardiographic parameters useful in determining the genotype of relatives before the development of phenotype. Results: In a cohort of 95 patients with HCM we identified a novel genetic variant in a conserved spot of NEBL gene (p.H171R) in one patient. The variant was not found in a control population and was predicted to have a damaging effect on the protein's structure. In a cohort of 48 HCM patients tested for mutations in the most common sarcomeric..

Diagnosis of hypertrophic cardiomyopathy with emphasis on genetic testing

Dizertační práce: Diagnostika hypertrofické kardiomyopatie se zaměřením na genetické vyšetření Autor: MUDr. Pavol Tomašov Obor: Fyziologie a patofyziologie člověka Souhrn Úvod: Hypertrofická kardiomyopatie (HCM) je nejčastější monogenně dědičné onemocnění srdce s velkou genetickou i klinickou variabilitou. Genetické vyšetření pacientů s HCM je důležité k určení etiopatogeneze onemocnění a stává se součástí péče o pacienty a jejich příbuzné. Cíl: Cíle naší práce zahrnovaly následující použití genetického vyšetření pacientů s HCM v základním i klinickém výzkumu: 1. Identifikovat genetické varianty u pacientů s HCM v novém kandidátním genu NEBL pro protein Z-disků sarkomer nebulette. 2. Určit klinické a echokardiografické prediktory nálezu mutací v nejčastějších sarkomerických genech asociovaných s HCM u české populace. 3. Nalézt echokardiografické parametry schopné určit genotyp příbuzných pacientů s HCM před rozvojem fenotypu. Výsledky: V souboru 95 pacientů s HCM jsme u jednoho nemocného nalezli novou genetickou variantu v konzerovaném místě genu NEBL (p.H171R), která se nenacházela v kontrolní populaci a měla odhadovaný poškozující dopad na strukturu proteinu. V souboru 48 pacientů s HCM vyšetřených na přítomnost mutací v nejčastějších sarkomerických genech jsme nalezli významnou asociaci mezi nižším věkem...Dizertační práce: Diagnostika hypertrofické kardiomyopatie se zaměřením na genetické vyšetření Autor: MUDr. Pavol Tomašov Obor: Fyziologie a patofyziologie člověka Abstract Introduction: Hypertrophic cardiomyopathy (HCM) is the most common monogenic cardiac disease with vast genetic and clinical heterogeneity. Genetic testing of HCM patients is important in determining the etiopathogenesis of the disease and is becoming an integral part of patient care. Aim: The aims of our work included the following implementation of genetic testing in HCM in both basic and clinical research: 1. To identify genetic variants in a novel candidate gene NEBL coding Z-disc protein nebulette in HCM patients. 2. To determine clinical and echocardiographic variables associated with the presence of mutations in the most common sarcomeric genes in the Czech population. 3. To find echocardiographic parameters useful in determining the genotype of relatives before the development of phenotype. Results: In a cohort of 95 patients with HCM we identified a novel genetic variant in a conserved spot of NEBL gene (p.H171R) in one patient. The variant was not found in a control population and was predicted to have a damaging effect on the protein's structure. In a cohort of 48 HCM patients tested for mutations in the most common sarcomeric...Department of CardiologyKardiologická klinika2. lékařská fakultaSecond Faculty of Medicin