Coronary artery disease: in the search for the Holy Gral

Jan Vojáček

Interv Akut Kardiol. 2004;3(2):59-60  

TIROFIBAN ADMINISTRATION BEFORE TRANSPORT TO DIRECT ANGIOPLASTY

Ivana Šantrůčková, Ivo Varvařovský, Aleš Herman, Vladimír Rozsíval, Petr Vojtíšek, Josef Málek, Ivana Kellnerová

Interv Akut Kardiol. 2004;3(2):67-69  

In a retrospective 9-month study, we evaluated angiographic parameters in patients treated with tirofiban before transport to direct PCI (group A, 24 patients) and in patients with standard treatment with aspirin and heparin alone (group B, 210 patients). Both groups were comparable in age, gender, presence of diabetes mellitus and previous myocardial infarction. Time from onset of chest pain to direct angioplasty was not different (4.4 hrs vs. 4.3 hrs, P=NS). There was no significant difference in TIMI flow before direct angioplasty (TIMI 0 66.7 % vs. 70.5 %, P=NS) nor after this procedure (TIMI 3 83.3 % vs. 92.8 %, P=NS)....

CLINICAL EXPERIENCES WITH CELLULAR THERAPY OF HEART FAILURE AND MYOCARDIAL INFARCTION

Juraj Fabián, Eva Goncalvesová

Interv Akut Kardiol. 2004;3(2):70-73  

Due to its ominous incidence, prevalence, and particularly for its poor prognosis, heart failure and advanced coronary artery disease stand in the centre of interest of many experimental and clinical researches. A substantial improvement of prognosis of patients with advanced systolic heart failure can be achieved only using therapeutic methods that have a decisive impact on the essence of chronic heart failure which is the loss of functioning cardiomyocytes. Cellular transplantation represents one of these approaches. The authors bring a short overview of cellular transplantation as a treatment prospect for the irreversible myocardial lesions. In...

PHARMACOLOGICAL TREATMENT OF ACUTE CORONARY SYNDROMES WITHOUT ST ELEVATIONS: FROM ASPIRIN TO FONDAPARINUX

František Holm, Zdeněk Šembera

Interv Akut Kardiol. 2004;3(2):74-78  

Acute coronary syndromes without ST elevations (nonSTE ACS) are caused by neoinclusive thrombosis of the coronary artery. Arterial atherothrombosis usually results from a cracked atheroma plate and includes platelet and plasmatic component of coagulation. The aim of pharmacological treatment is to influence activated platelets and plasma procoagulant activity. Several clinical studies have demonstrated the benefits of antithrombotic treatment by acetylsalicylic acid, clopidogrel and by blockers of platelet receptors IIb/IIIa. In nonSTE ACS anticoagulant therapy the non-fractionated heparins are replaced by low-molecular heparins. The new standard in...

BRUGADA SYNDROME AS A RISK OF SUDDEN CARDIAC DEATH

Sabina Krištofová, Karel Dvořák

Interv Akut Kardiol. 2004;3(2):79-82  

Brugada syndrome is a mostly inherited arrhytmogenic disease chracterized by the typical ECG patterns of ST-segment elevation in leads V1-3 often with incomplete right bundle-branch block, and an increased risk of sudden cardiac death as a result of ventricular fibrillation. In this summary article, the occurence of this syndrome, electrocardiografic diagnosis, ST- segment changes during ajmaline test, electrophysiological studies, prognosis and the possibilities of the treatmen is dealt with. It is an emphasized necessity of early diagnosis for correct examination and treatment of patients with Brugada syndrome.

ACUTE MYOCARDIAL INFARCTION IN PATIENTS WITH THE HISTORY OF CORONARY ARTERY BYPASS GRAFTING

Miroslav Brtko

Interv Akut Kardiol. 2004;3(2):83-85  

The patients with the history of coronary artery bypass grafting (CABG) admitted for acute myocardial infarction (AMI) have uncertain prognosis. These patients are mostly polymorbid, have low ejection fraction of the left ventricle and triple vessel disease. AMI has often atypical manifestation in these patients, is smaller and has worse prognosis. The patients with the history of CABG are less often treated by reperfusion therapy compared to the patients without the history of CABG. The prognosis is especially unfavourable, when the venous bypass is an infarct-related artery. The primary percutaneous coronary intervention achieves better results in...

MECHANICAL CARDIAC SUPPORT - THE FIRST USE IN CZECH REPUBLIC

Jiří Kettner, Jan Pirk, Ivan Netuka, Jiří Malý, Jaroslav Mašín, Aleš Březina

Interv Akut Kardiol. 2004;3(2):86-88  

The authors present the first implantation of biventricular assist device in Czech republic in a 58-year old men with end stage heart failure and multiple organ failure despite maximum medical therapy. During a week after placement was observed recovery of organ function and after 29 days the patient underwent successful orthotopic heart transplantation. Despite number complications (bleeding, infection, stroke) was achieved satisfactory graft and organ functions and after special rehabilitation support is patient in this time in home care.

EXPERIENCE WITH ADMINISTRATION OF ULTRASHORT-ACTING BETA-BLOCKER ESMOLOL TO PATIENTS WITH CONTRA­INDICATION FOR BETA-BLOCKER USE

Tomáš Janota, Jan Malík, Jan Šimek, Jaromír Hradec

Interv Akut Kardiol. 2004;3(2):89-91  

Beta-blockeres have several favourable effects like decreased metabolic demands of the heart, improved left ventricular filling, increased subendocardial perfusion, blood pressure lowering, antiarrhythmic effect, and increased ejection fraction  in patients with heart failure during long-term administration. On the other side, beta-blockers have also some adverse effects limiting their applicability. Bradyarrhythmias and shock are supposed to be absolute contraindications for their administration. Use of beta-blockers is not recommended in patients with bronchospasm as well as in patients with severe heart failure. According to our experience beta-blockers...

PRIMARY PCI IN A PATIENT WITH DEXTROCARDIA

Michal Paďour, Pavel Formánek, Petr Kmoníček, Petr Niederle, Radka Ouhrabková

Interv Akut Kardiol. 2004;3(2):92-93  

We present the case report of 83 years old woman with dextrocardia and situs solitus, in whom we have performed primary percutaneous coronary intervention (PCI) for acute ST elevation MI of inferior wall. Catherterzation technigue and angiografic images are compared with another successfull PCI-in that case in dextrocardia patient with situs inversus totalis. Anomalous „geometry“ of coronary arteries did not cause any major technical problem in performing the procedure.

CAN A FORCED DELAYED CORONARY ANGIOPLASTY CHANGE A PROGNOSIS PATIENT WITH MULTIPLE CORONARY IMPAIRMENT?

Václav Kopal, Cyril Chrástecký, Jindřich Palčík, Marek Richter

Interv Akut Kardiol. 2004;3(2):94-97  

The authors present the case of a patient with acute inferior myocardial infarction with the evolution of right ventricle infarction with multiple severe impairment of his coronary arteries, which was treated initially by i. v. thrombolysis, which was administered in the Internal Department of Medicine of a Community hospital. Coronary angiography was performed after 11 days because of prolonged hypotension and complete occlusion of right coronary artery was found.The left ventricular function improved immediately after coronary angioplasty with stenting. The case report from our practice illustrate benefit of coronary angioplasty in the „lost“...

XIVth PRAGUE WORKSHOP ON INTERVENTIONAL CARDIOLOGY INTERCATH 2004 - abstracts

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Interv Akut Kardiol. 2004;3(2)  

SYNERGY STUDY - LOW-MOLECULAR-WEIGHT HEPARIN IN THE EARLY INVASIVE THERAPY OF ACUTE CORONARY SYNDROME

Petr Janský

Interv Akut Kardiol. 2004;3(2):98-99  

SYNERGY study has proven that low-molecular-weight heparin enoxaparin is as effective as unfractionated heparin in patients with non-ST-segment elevation acute coronary syndrome treated by early invasive revascularization strategy.