Aims The aim of this study was to determine the contemporary use of reperfusion therapy in the European Society of Cardiology (ESC) member and affiliated countries and adherence to ESC clinical practice guidelines in patients with ST-elevation myocardial infarction (STEMI). Methods and results Prospective cohort (EURObservational Research Programme STEMI Registry) of hospitalized STEMI patients with symptom onset <24 h in 196 centres across 29 countries. A total of 11 462 patients were enrolled, for whom primary percutaneous coronary intervention (PCI) (total cohort frequency: 72.2%, country frequency range 0–100%), fibrinolysis (18.8%; 0–100%), and no reperfusion therapy (9.0%; 0–75%) were performed. Corresponding in-hospital mortality rates from any cause were 3.1%, 4.4%, and 14.1% and overall mortality was 4.4% (country range 2.5–5.9%). Achievement of quality indicators for reperfusion was reported for 92.7% (region range 84.8–97.5%) for the performance of reperfusion therapy of all patients with STEMI <12 h and 54.4% (region range 37.1–70.1%) for timely reperfusion. Conclusions The use of reperfusion therapy for STEMI in the ESC member and affiliated countries was high. Primary PCI was the most frequently used treatment and associated total in-hospital mortality was below 5%. However, there was geographic variation in the use of primary PCI, which was associated with differences in in-hospital mortality.
Background In contrast with the setting of acute myocardial infarction, there are limited data regarding the impact of diabetes mellitus on clinical outcomes in contemporary cohorts of patients with chronic coronary syndromes. We aimed to investigate the prevalence and prognostic impact of diabetes according to geographical regions and ethnicity. Methods and results CLARIFY is an observational registry of patients with chronic coronary syndromes, enrolled across 45 countries in Europe, Asia, America, Middle East, Australia, and Africa in 2009–2010, and followed up yearly for 5 years. Chronic coronary syndromes were defined by ≥1 of the following criteria: prior myocardial infarction, evidence of coronary stenosis >50%, proven symptomatic myocardial ischaemia, or prior revascularization procedure. Among 32 694 patients, 9502 (29%) had diabetes, with a regional prevalence ranging from below 20% in Northern Europe to ∼60% in the Gulf countries. In a multivariable-adjusted Cox proportional hazards model, diabetes was associated with increased risks for the primary outcome (cardiovascular death, myocardial infarction, or stroke) with an adjusted hazard ratio of 1.28 (95% confidence interval 1.18, 1.39) and for all secondary outcomes (all-cause and cardiovascular mortality, myocardial infarction, stroke, heart failure, and coronary revascularization). Differences on outcomes according to geography and ethnicity were modest. Conclusion In patients with chronic coronary syndromes, diabetes is independently associated with mortality and cardiovascular events, including heart failure, which is not accounted by demographics, prior medical history, left ventricular ejection fraction, or use of secondary prevention medication. This is observed across multiple geographic regions and ethnicities, despite marked disparities in the prevalence of diabetes. ClinicalTrials identifier ISRCTN43070564
In this article we present brief overview of the subject of amyloidosis and involvement of the cardiovascular system, the criteria for diagnosis, principles of treatment, and the clinical case of cardiac amyloidosis.
urpose. The article presents the case of diagnostics in a female patient, without specific complaints, with a neuroendocrine tumor of the pancreas head. Early recognition of the tumor during the ultrasound examination with the use of new technology of ultrasound shear-wave elastography made it possible to carry out further examination and timely treatment.The early detection of neuroendocrine tumors still remains a complicated problem because of the large range of specialists to whom patients with tumors initially come. In a number of cases patients do not complain of anything or they have non-specific complains and most often they self thus losing the opportunity of timely early diagnostics and treatment.The ultrasound examination is one of the cheapest, quickest and safest methods of diagnostics, which undoubtedly can be used as a screening method and with the use of the advanced technologies such as the ultrasound shear wave elastography can help to make the early diagnostics of tumors more precise.Keywords: pancreatic neuroendocrine tumor, ultrasonography, ultrasound shear wave elastography, CT, PET Corresponding author: Munir G. T., e-mail: munir.tuhbatullin@tatar.ru 2017; 7 (4):164-170. DOI:10.21569/2222 7 (4):164-170. DOI:10.21569/ -7415-2017. For citation: Tukhbatullin M.G., Yangurazova A.E., Galeeva Z.M., Khamzina F.T. Neuroendocrine tumor of the pancreas head (a case report). REJR Received:11.10.17 Accepted: 30.10.17 НЕЙРОЭНДОКРИННАЯ ОПУХОЛЬ ГОЛОВКИ ПОДЖЕЛУДОЧНОЙ ЖЕЛЕЗЫТухбатуллин М.Г., Янгуразова А.Е., Галеева З.М., Хамзина Ф.Т.ель исследования. В статье представлен случай диагностики нейроэндо-кринной опухоли головки поджелудочной железы у пациентки без специфи-ческих жалоб. Ранняя диагностика опухоли на этапе ультразвукового иссле-дования с применением новой технологии -ультразвуковой эластографии сдвиговой волной -позволила провести дальнейшее обследование и своевременное опе-ративное лечение пациентки.Раннее выявление нейроэндокринных опухолей остается сложной проблемой из-за большого спектра специалистов, к которым первоначально обращаются больные с опухолью. В ряде случаев пациентов ничего не беспокоит или эти жалобы неспецифич-ны, пациенты чаще занимаются самолечением, что упускает возможности своевремен-ной ранней диагностики и лечения.Одним из самых дешевых, быстрых, безопасных методов диагностики является ультразвуковое исследование, которое, несомненно, подходит в качестве метода скри-нинга, а при использовании таких новейших технологий, как ультразвуковая эласто-графия сдвиговой волной, позволяет сделать раннюю диагностику образований более точной.Ключевые слова: нейроэндокринная опухоль поджелудочной железы, ультразву-ковое исследование, ультразвуковая эластография сдвиговой волной, компьютерная томография, позитронно-эмиссионная томография.
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