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P138 CARDIAC LIPOMA IN PATIENT WITH SYSTEMIC LIPOMATOSIS. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Primary adipose cardiac tumors are divided into two different entities: lipomatous hypertrophy of the interatrial septum (LHIS) and lipomas. Lipomas are usually benign masses of unknown pathogenesis. Currently few cases are reported in literature, with no differences in gender distribution.
Clinical Case
A 63–year–old patient presented to our emergency room complaining chest pain and dyspnea on exercise. Her medical history shows severe obesity, hypertention, past surgical removal of several systemic lipomas (uterus lipoma, right ovary lipoma, right thigh and leg lipoma, right forearm and wrist lipoma). A coronary angiography was performed showing the lack of angiographically significant lesions. On suspicion of microvascular angina, she began therapy with Ranolazine and Beta–blockers. Echocardiographic examination showed a lipomatous interatrial septum in the postero–superior tract with a maximum of 22.5mm thickness (image 1). At 12 months, chest CT and MRI scan showed a hyperintense mass on interatrial septum measuring 32x34mm. The formation, mainly protruding in the right atrium, does not obstruct the outlet of the hollow veins, nor the outlet of the pulmonary veins. No hemodynamic compromise and compression were detected. Last follow–up visit our patient presented dyspnea and chest pain, the echocardiogram showed a slight increase of the mass size (see image), with unchanged thicknesses and biventricular pump function.
Conclusions
In literature there is no evidence of malignant transformation of cardiac lipomas, however well–differentiated cell tumors can coexist with liposarcomas. There are no guidelines for the treatment of cardiac lipomas, radical resection is practiced in the majority of symptomatic patients and should be considered in all patients with cardiac lipoma. Asymptomatic lipomas can excessively grow up and infiltrate into the myocardium, resulting in negative outcomes to a possible subsequent resection. According to the worsening of the clinical course, the patient under consideration was referred for lipoma resection surgery.
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P134 A RARE CASE OF CARDIAC DIFFUSE LARGE CELL B LYMPHOMA: ECHOCARDIOGRAPHIC RESPONSE TO CHEMOTHERAPY. Eur Heart J Suppl 2022. [DOI: 10.1093/eurheartj/suac012.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Abstract
Introduction
Diffuse large B–cell lymphoma (DLBCL) is the most common subtype of non–Hodgkin‘s lymphoma in adults. Rituximab and Anthracycline–based chemotherapy are the standard treatment, complete remission (CR) is achived in approximately 67% of patients. About one third of patients have refractory disease or relapse after standard therapy, mostly within 5 years of achieving CR.
Clinical Case
A 62–year–old patient, current smoker, without previous cardiovascular diseases presented to our ER for dyspnea and asthenia. Medical history showed GBC–DLBCL at third stage that achieved CR with R–CHOP therapy and intrathecal prophylaxis. The ECG documented sinus tachycardia with normal ventricular repolarization. Arterial blood gas analysis showed a condition of respiratory distress (pO2 71 mmHg, pCO2 27 mmHg). For suspicion of pulmonary embolism, chest CT with contrast was done showing a bulky mass extending from the right atrium to the right ventricle, also involving the pericardial sac (image 1). Transthoracic echocardiography showed a bulky mass (area 31 cm2) occupying almost the entire right atrium (5.9 x 4.4 cm) and extended, through the tricuspid valve, into the right ventricle, displacing the interventricular septum (image 2). Endomyocardial biopsy confirmed the diagnosis of GBC–DLBCL cardiac recurrence. Assumed the good systolic function of the left ventricle and the age of the patient, chemotherapy debulking was performed with Gemcitabine, followed by R–CHOP and MTX. One month after therapy post–treatment Total Body CT shows a good response with no evidence on echocardiogram of pathological tissue in the right ventricle (image 3).
Conclusions
Cardiac DLBCL is a rare tumor with few cases reported in the literature. There is currently no standard therapy, particularly for those who are unsuitable for high–dose chemotherapy a/o autologous stem cell transplantation. The multidisciplinary cardiological and hematological approach has proved to be fundamental these patient‘s therapeutic management.
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Prospective randomized trial on radiation dose estimates of CT angiography in patients applying Iterative image reconstruction techniques - results of the PROTECTION V study. Eur Heart J 2013. [DOI: 10.1093/eurheartj/eht310.p4680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Crystallization, morphology, structure and miscibility of poly(ethylene oxide) based blends. ACTA ACUST UNITED AC 2011. [DOI: 10.1002/masy.19880160111] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Electrical Properties of Polymethylmethacrylate Polymer Dispersed Liquid Crystals*. J DISPER SCI TECHNOL 2007. [DOI: 10.1080/01932699908943871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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POLY(3-HYDROXYBUTYRATE)-BASED COPOLYMERS AND BLENDS: INFLUENCE OF A SECOND COMPONENT ON CRYSTALLIZATION AND THERMAL BEHAVIOR*. J MACROMOL SCI B 2007. [DOI: 10.1081/mb-100107554] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tensile Properties and Fracture Behaviour of Polycarbonate/PAN-based Carbon Fiber Composite. INT J POLYM MATER PO 2006. [DOI: 10.1080/00914039508012115] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Influence of intrachain trans double bonds on the melt crystallization of some linear polymers. J MACROMOL SCI B 2006. [DOI: 10.1080/00222347808212244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Thrombolysis in ST-segment elevation myocardial infarction: potential role of thin-slice computed tomography in the assessment of reperfusion and plaque characterization. Clin Cardiol 2006; 29:322. [PMID: 16881542 PMCID: PMC6654004 DOI: 10.1002/clc.4960290710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Abstract
Background—
Computed tomography has been shown to be useful in the evaluation of aortocoronary bypass grafts (CABG). This is the first prospective study to evaluate the accuracy of a new-generation scanner in the detection of patency and significant stenoses (>50% decrease in diameter) of venous and arterial grafts in patients with previous CABG.
Methods and Results—
In 96 patients (80 males, mean age 62 years) with previous CABG, a multislice computed tomography (MSCT) scan was performed (collimation 16×0.625 mm). Patients with atrial fibrillation, renal failure, severe respiratory disease, severe heart failure, heart rate >70 bpm despite therapy, or unstable angina were excluded. A total of 285 conduits implanted on the native coronary arteries at the time of CABG were evaluated. MSCT data were analyzed by 2 independent radiologists and compared with the results of conventional angiography. Three patients were excluded from analysis. All conduits were judged evaluable in 84 patients. Among these patients, MSCT correctly diagnosed 54 occluded grafts and 4 significant stenoses on the body of the grafts. Of the 17 significant anastomotic lesions, MSCT correctly diagnosed 15. For these 84 patients, diagnostic accuracy was 99%, sensitivity was 97%, and specificity was 100%. When all 93 patients were considered, the sensitivity of MSCT in diagnosing significant stenoses was 96%.
Conclusions—
MSCT with the new-generation scanner allows for accurate assessment of venous and arterial conduits in patients with previous CABG with a high degree of sensitivity and specificity. Exclusion criteria and radiation exposure remain limitations of the method.
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Influence of titanium dioxide on crystallization behavior of an ethylene-propylene copolymer. J Appl Polym Sci 2003. [DOI: 10.1002/app.13028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Miscibility and Thermal and Crystallization Behaviors of Poly(D-(-)-3-hydroxybutyrate)/Atactic Poly(methyl methacrylate) Blends. Macromolecules 2002. [DOI: 10.1021/ma00128a014] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Rheumatic fever recurrence: a possible cause of restenosis after percutaneous mitral valvuloplasty. ITALIAN HEART JOURNAL : OFFICIAL JOURNAL OF THE ITALIAN FEDERATION OF CARDIOLOGY 2001; 2:845-7. [PMID: 11770870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/17/2023]
Abstract
BACKGROUND We evaluated the occurrence of a rapid process of restenosis after percutaneous mitral valvuloplasty (PMV), initiated by the recurrence of acute rheumatic fever. Restenosis after PMV has been mainly related to a high echocardiographic score (> or = 8) indicating a severely compromised mitral valve apparatus. METHODS From 1986 to 1996, 120 patients underwent PMV by the transseptal approach at our Institution. The mean follow-up time was 58 +/- 32 months (range 3 months to 9 years). RESULTS Restenosis occurred in 10 patients (8.3%): in 4 restenosis was found within a relatively short period of time (1 to 3 months) following a documented recurrence of acute rheumatic fever; in the other 6 patients there was a gradual loss of the initial gain in the mitral valve area. CONCLUSIONS These data suggest two potential mechanisms of restenosis: 1) a more common slow process, due to turbulent flow-trauma on the mitral valve; 2) a rapid process that relates to valvulitis consequent to a recurrence of acute rheumatic fever. In consideration of the second possibility, after PMV prophylactic treatment may be warranted at least in those patients who are at high risk of streptococcal infection.
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Seropositivity against Chlamydia pneumoniae in patients with coronary atherosclerosis. Clin Cardiol 2000; 23:327-30. [PMID: 10803439 PMCID: PMC6655232 DOI: 10.1002/clc.4960230504] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/1999] [Accepted: 07/21/1999] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND Results of therapy in patients with unstable coronary syndromes with antibiotics directed against Chlamydia pneumoniae have been variable, perhaps due to the heterogeneity of patients in these trials. HYPOTHESIS The aim of the present study was to correlate the severity of coronary artery disease (CAD) with seropositivity against C. pneumoniae prospectively. METHODS We measured the frequency of seropositivity (IgG levels > or = 1/64 and IgA levels > or = 1/16 against Chlamydia pneumoniae) in 110 patients with CAD and in 49 controls. RESULTS As expected, traditional CAD risk factors were seen more often in patients with CAD than in controls. Mean values of total cholesterol (184 +/- 52 and 166 +/- 44 mg/dl, respectively) and triglyceride (143 +/- 60 and 112 +/- 63 mg/dl, respectively) in serum were significantly higher in patients with CAD than in controls (both p < 0.04). There were no significant differences between the two groups in serum high-density lipoprotein cholesterol (34 +/- 13 and 32 +/- 14 mg/dl, respectively) and lipoprotein (a) (Lp(a):241 +/- 247 and 223 +/- 263 mg/l, respectively) levels. The rate of IgG seropositivity was 52% (28/54) in patients with stable CAD, 41% (23/56) in patients with unstable CAD, and 35% in controls (p = NS). The rate of IgA seropositivity was 25% (14/54) in patients with stable CAD, 12% (6/49) in patients with unstable angina, and 12% (6/49) in controls (all p = NS). CONCLUSIONS Only a small percentage of patients with CAD demonstrate seropositivity against Chlamydia pneumoniae. Antibiotic therapy in these selected patients, but not in the remaining patients, may be considered rational. These considerations may underlie the failure to see consistent benefits of antibiotic therapy in patients with CAD.
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Woven coronary artery: differential diagnosis with diffuse intracoronary thrombosis. ITALIAN HEART JOURNAL : OFFICIAL JOURNAL OF THE ITALIAN FEDERATION OF CARDIOLOGY 2000; 1:306-7. [PMID: 10824733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Woven coronary malformation is characterized by the branching of a major epicardial coronary artery into thin channels which then merge again in a normal conduit. The angiogram can suggest a filling defect instead of a malformation and an undue coronary angioplasty could be performed determining some damage to the arterial wall. In this case report we describe a patient with a stenosis on the left anterior descending coronary artery and a woven coronary artery on the right coronary artery. In 1995 a coronary angioplasty was performed on the left anterior descending coronary artery. Four years later a coronary angiogram did not show any changes in the right coronary artery. In this patient the malformation did not induce any reduction in the coronary reserve as shown at cardiac scintigraphy. We need more information about the natural history of such a malformation.
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Effects of the addition of a graft copolymer of propylene with styrene on thermal behavior, crystallization, and morphology of isotactic polypropylene. J Appl Polym Sci 2000. [DOI: 10.1002/(sici)1097-4628(20000124)75:4<553::aid-app11>3.0.co;2-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Morphology, crystallization, and thermal behavior of isotactic polypropylene/polymethylmethacrylate blends: Effects of the addition of a graft copolymer of propylene with methylmethacrylate. J Appl Polym Sci 2000. [DOI: 10.1002/1097-4628(20010103)79:1<143::aid-app170>3.0.co;2-f] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Coronary sinus plasma beta endorphin levels in cardioischemic patients undergoing PTCA. JOURNAL OF MEDICINE 1999; 29:339-42. [PMID: 10503168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
Plasma beta-endorphin levels were studied in the coronary sinus of 8 patients undergoing percutaneous transluminal coronary angioplasty (PTCA). All the patients had ECG ischemic signs and pain during the inflation of the balloon. No significant changes in plasma beta-endorphin levels were observed during PTCA-induced ischemia. Baseline coronary sinus plasma beta-endorphin levels were found to be elevated when compared with peripheral ones which would suggest an accumulation of beta-endorphin in the ischemic heart.
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Morphology, crystallization, and thermal behavior of isotactic polypropylene/polystyrene blends: Effects of the addition of a graft copolymer of propylene with styrene. J Appl Polym Sci 1999. [DOI: 10.1002/(sici)1097-4628(19990613)72:11<1429::aid-app6>3.0.co;2-s] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Isotactic polypropylene/ethylene-co-propylene blends: Influence of the copolymer microstructure on rheology, morphology, and properties of injection-molded samples. J Appl Polym Sci 1999. [DOI: 10.1002/(sici)1097-4628(19990502)72:5<701::aid-app11>3.0.co;2-u] [Citation(s) in RCA: 23] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Stent implantation versus balloon angioplasty in chronic coronary occlusions: results from the GISSOC trial. Gruppo Italiano di Studio sullo Stent nelle Occlusioni Coronariche. J Am Coll Cardiol 1998; 32:90-6. [PMID: 9669254 DOI: 10.1016/s0735-1097(98)00193-4] [Citation(s) in RCA: 142] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES In this multicenter, randomized trial we evaluated whether stent implantation after successful recanalization of a chronic coronary occlusion reduced the incidence of restenosis. BACKGROUND Percutaneous transluminal coronary angioplasty (PTCA) in chronic total occlusions is associated with a higher rate of angiographic restenosis and reocclusion than PTCA in subtotal stenoses. Preliminary reports have suggested a decreased restenosis rate after stent implantation in coronary total occlusions. METHODS We randomly assigned 110 patients with recanalized total occlusion to Palmaz-Schatz stent implantation, followed by 1 month of anticoagulant therapy versus no other treatment. The primary end point was the minimal lumen diameter (MLD) of the treated segment at follow-up, as determined by quantitative angiography at a core laboratory. RESULTS Repeat coronary angiography was performed 9 months after the procedure in 88% of patients. The MLD (mean +/- SD) at follow-up was 1.74 +/- 0.88 mm in patients assigned to stent implantation and 0.85 +/- .75 mm in patients assigned to PTCA (p < 0.001). Stent implantation was associated with a lower incidence of restenosis (defined as diameter stenosis > or =50% at follow-up) (32% vs. 68%, p < 0.001) and reocclusion (8% vs. 34%, p = 0.003) than balloon PTCA. Likewise, stent-treated patients had less recurrent ischemia (14% vs. 46%, p = 0.002) and target lesion revascularization (5.3% vs. 22%, p = 0.038), but experienced a longer hospital stay. CONCLUSIONS Palmaz-Schatz stent implantation after successful balloon PTCA of chronic total occlusions improves the midterm angiographic and clinical outcome and could be the preferred treatment option in selected patients with occluded vessels.
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Abstract
OBJECTIVE To study human myocardial ultrastructural changes after carbon monoxide (CO) poisoning inducing reversible cardiac failure. DESIGN CASE REPORT clinical, functional and morphologic findings. SETTINGS Public university-affiliated hospital and electron microscopy laboratory. PATIENT A 25-yr-old woman with functional evidence of cardiac failure after acute CO poisoning. INTERVENTIONS Hyperbaric and intensive care treatment over 10 days. Scintigraphic and cardiac angiography with endomyocardial biopsy. MEASUREMENTS AND MAIN RESULTS Scintigraphy with 99mTc hexakis 2-methoxy-2-isobutyl isonitrile (sestaMIBI) showed an uptake defect in the left anterior descending artery territory. The cardiac angiography demonstrated a slight hypokinesis of the superior two thirds of the anterior wall and of the septal region with completely normal coronary angiograms. Electron microscopy of left ventricular biopsies showed slight ultrastructural changes in the myocytes. In addition, large glycogen deposits were mostly associated with swollen mitochondria. The patient was discharged in good clinical condition on day 10. CONCLUSIONS Presence of glycogen deposits associated with abnormal mitochondria may be signs of the incapability of myocardial cells in utilizing energy substrata. In the presence of normal myocardial perfusion, our findings are consistent with the presence of a stunned myocardium-like syndrome. Early recognition and treatment of this clinical syndrome allow the prevention of myocardial infarction.
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Structure of isotactic polypropylene/ hydrogenated oligo(cyclopentadiene) blends: 1. Polypropylene-rich blends. POLYMER 1998. [DOI: 10.1016/s0032-3861(97)00441-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Orientation and properties of sequentially drawn films of an isotactic polypropylene/ hydrogenated oligocyclopentadiene blend. POLYMER 1997. [DOI: 10.1016/s0032-3861(96)00996-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Miscibility and Crystallization of Poly(β-hydroxybutyrate) and Poly(p-vinylphenol) Blends. Macromolecules 1997. [DOI: 10.1021/ma960615+] [Citation(s) in RCA: 175] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Small angle scattering study of the structure of isotactic polypropylene-hydrogenated oligo(cyclopentadiene) blends. J Mol Struct 1996. [DOI: 10.1016/s0022-2860(96)09271-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Atrial natriuretic peptide release during myocardial ischemia induced by percutaneous transluminal coronary angioplasty. Am Heart J 1996; 132:698-9. [PMID: 8800048 DOI: 10.1016/s0002-8703(96)90261-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Concurrent nitroglycerin administration reduces the efficacy of recombinant tissue-type plasminogen activator in patients with acute anterior wall myocardial infarction. Am Heart J 1995; 130:692-7. [PMID: 7572574 DOI: 10.1016/0002-8703(95)90065-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The aim of this study was to evaluate the impact of concurrent nitroglycerin administration on the thrombolytic efficacy of recombinant tissue-type plasminogen activator (rTPA) in patients with acute anterior myocardial infarction (AMI). Sixty patients (53 men, 7 women; mean age 54 +/- 7 years) with AMI entered the study. Thirty-three patients were randomized to receive rTPA alone (100 mg in 3 hours) (group A) and 27 to receive rTPA plus nitroglycerin (100 micrograms/min) (group B). Time from the onset of chest pain and delivery of rTPA was similar in the two groups of patients. Patients in group A had signs of reperfusion more often than the patients in group B (25 of 33 or 75.7% vs 15 of 27 or 55.5%, p < 0.05). Time to reperfusion was also shorter in group A than in group B (19.6 +/- 9.4 minutes vs 37.8 +/- 5.9 minutes, p < 0.05). Group B had a greater incidence of in-hospital adverse events (9 of 27 vs 5 of 33, p < 0.05) and a higher incidence of coronary artery reocclusion (8 of 15 or 53.3% vs 6 of 25 or 24%, p < 0.05). Peak plasma levels of rTPA antigen were higher in group A compared with group B (1427 +/- 679 vs 512 +/- 312 ng/ml, p < 0.01). In conclusion, concurrent nitroglycerin administration reduces the thrombolytic efficacy of rTPA in patients with AMI probably by lowering the plasma levels of rTPA antigen. The diminished efficacy of rTPA is associated with an adverse outcome.
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Effectiveness of prolonged low dose recombinant tissue-type plasminogen activator for refractory unstable angina. J Am Coll Cardiol 1995; 25:1295-9. [PMID: 7722124 DOI: 10.1016/0735-1097(95)00002-l] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES The aim of the present study was to evaluate the effectiveness of prolonged administration of thrombolytic therapy with low doses of recombinant tissue-type plasminogen activator (rt-PA) in patients with refractory unstable angina. BACKGROUND Intracoronary thrombosis is often the cause of instability in patients with unstable angina. Thrombolytic therapy has been tested in these patients with conflicting results. METHODS Sixty-seven patients with unstable angina refractory to standard antianginal therapy were randomized to receive, in addition to the common antianginal therapy, either rt-PA (0.03 mg/kg body weight per h for 3 consecutive days) plus heparin (to achieve activated clotting time of 250 to 400 s) (36 patients, group A) or the same dose of heparin plus placebo (31 patients, group B). RESULTS No major bleeding was observed in either group of patients. One patient in group A and four in group B (2.7% vs. 12.9%, p < 0.01) developed acute myocardial infarction during the hospital period. Eight patients in group B underwent emergency coronary artery surgery or angioplasty because of worsening of symptoms. Group A patients had a significant reduction in the occurrence of chest pain compared with those in group B (95% confidence interval -7.2 to -2.1 episodes/3 days, p < 0.01). Patients in group B had a greater number of episodes of transient myocardial ischemia (237 vs. 103, p < 0.01) and a longer total ischemic burden (114 +/- 23 vs. 45.6 +/- 8.9 min/day, p < 0.01) than group A patients. After a mean follow-up of 14 +/- 6 months, group A patients were more frequently angina free and had a lower incidence of readmission to the hospital than group B patients. CONCLUSIONS The combination of heparin and protracted administration of rt-PA at low doses is effective in stabilizing and reducing in-hospital adverse events in patients with unstable angina refractory to antianginal therapy.
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Influence of spinning velocity on mechanical and structural behavior of PET/nylon 6 fibers. J Appl Polym Sci 1995. [DOI: 10.1002/app.1995.070550106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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The influence of HOCP oligomer on the crystallization and morphology of iPP/HDPE blends. Polym Bull (Berl) 1995. [DOI: 10.1007/bf00312920] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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High density polyethylene/hydrogenated oligo(cyclopentadiene) blends: Phase structure, thermal and mechanical properties. ACTA ACUST UNITED AC 1994. [DOI: 10.1002/polb.1994.090321209] [Citation(s) in RCA: 21] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Thermoplastic elastomers from iPP/EPR blends: Crystallization and phase structure development. J Appl Polym Sci 1994. [DOI: 10.1002/app.1994.070530402] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Thermal and structural analysis and crystallization behavior of new poly(ether-alkyl) oxadiazoles. ACTA ACUST UNITED AC 1994. [DOI: 10.1002/polb.1994.090320907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Thermodynamics of poly(ethylene oxide)-poly(methyl methacrylate) blends: prediction of miscibility based on the corresponding-states theory. POLYMER 1994. [DOI: 10.1016/0032-3861(94)90134-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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