Akutes Koronarsyndrom ohne ST-Hebung (NSTE-ACS)

Rupprecht, H J; Geeren, M.; Geeren, Monika; Weilemann, S; Schuster, H.-P.

doi:10.1007/s00059-018-4776-1

Cited by 5 publications

(6 citation statements)

References 4 publications

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“…The pathologic cause of STEMI is most often from occlusion of the coronary artery by thrombosis from plaque rupture. Whereas the most common cause of UA is reduced myocardial perfusion that results from coronary artery narrowing caused by a non-occlusive thrombus that developed on a disrupted atherosclerotic plaque without detectable cardiac biomarkers (19).…”

Section: Discussionmentioning

confidence: 99%

Lectin-Like OLR1 3′UTR Rs1050286 Gene Polymorphism and Plasma Oxidized-LDL in Coronary Artery Disease and Their Relation to Cardiovascular Risk and Outcomes

et al. 2022

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Background: Oxidized low-density lipoprotein (ox-LDL) has an important role in the genesis of coronary atherosclerosis. Lectin-like ox-LDL receptor 1 (OLR1) contributes to the uptake and internalization of ox-LDL. Genetic polymorphisms have been associated with coronary artery disease (CAD). Here we explore the association of plasma levels of ox-LDL and 3′ UTR OLR1 (rs1050286) SNP with CAD risk and inhospital adverse outcomes. Methods: A case-control study enrolled 192 patients with ST-segment elevation myocardial infarction (STEMI), 100 patients with unstable angina, and 100 healthy controls. Baseline, clinical characteristics, and risk scores of the patients were determined. Plasma ox-LDL and other biochemical variables were measured. All subjects are genotyped for OLR1 (rs1050286) by RT-PCR with TaqMan SNP genotyping assay. Results: Plasma ox-LDL was higher with enhanced sensitivity and specificity in identifying patients with STEMI and was found as a significant independent risk factor for CAD in those two groups. Levels of ox-LDL were increased with increasing poor prognostic factors in STEMI patients that are associated with an increased incidence of some adverse events and in-hospital mortality. Elevated STEMI risk was associated with T allele of OLR1 (rs1050286) (odds ratio of 4.9, 95% CI: 2.6-9.4, p< 0.001). STEMI patients who have T allele exhibited higher risk scores, coronary multivessel narrowing, and elevated incidence of in-hospital major adverse clinical events. Conclusions: These results suggest that plasma ox-LDL, as well as T allele of ORL-1 (rs1050286), is associated with the increased risk for developing STEMI and the associated adverse clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Lectin-Like OLR1 3′UTR Rs1050286 Gene Polymorphism and Plasma Oxidized-LDL in Coronary Artery Disease and Their Relation to Cardiovascular Risk and Outcomes

et al. 2022

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“…The latter occurs in parallel with a decrease in the contractile capacity of the left ventricle. According to the world literature, this relationship has been investigated in chronic heart failure [5,16,22], which has arisen against any background, and in acute myocardial infarction with ST segment elevation (STEMI) [6,12], in while at NSTEMI, there is virtually no data available and the available studies relate to the closest (within 28 days) forecast [8,9,13], while structural remodeling is considered by us in the context of a more distant forecast.…”

Section: Discussionmentioning

confidence: 99%

The ratio of structural and functional status of myocardium to plasma level of stimulating growth factor expressed by gene 2 in patients with myocardial infarction without ST segment elevation

Mezhiievska

2019

Biomed. and Biosoc. Anthrop.

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Coronary heart disease remains one of the leading causes of temporary and persistent disability, invalidization and mortality in economically developed countries and is one of the most pressing problems in cardiology. Myocardial infarction is the most common manifestation of coronary heart disease and one of the main causes of the disability and mortality of the working population. The aim is to evaluate the structural and functional status of the myocardium in patients with acute myocardial infarction without ST segment elevation, depending on the plasma level of growth factor-stimulating factor expressed by gene 2 (ST2). 90 patients with acute myocardial infarction without ST segment elevation from 38 to 79 years old were examined. Among them, 60 (66.7%) male patients. Echocardiography assessed the structural and functional status of the myocardium. By enzyme-linked immunosorbent assay determined ST2 levels in blood plasma. It has been determined that myocardial infarction without ST segment elevation is associated with more severe structural left ventricular remodeling, left atrial overload, and decreased left ventricular contractility. In patients, myocardial infarction without ST segment elevation is associated with an increase in cases of left ventricular concentric hypertrophy. Analysis of the nature of diastolic transmitral blood flow showed a significant increase in cases of blood flow by type of pseudonormalization (43.5% versus 8.7%). Therefore, the data obtained showed that in patients with myocardial infarction without ST segment elevation, ST2 elevation was associated with a more frequent manifestation of diastolic transmitral blood flow by type of pseudonormalization. Patients with myocardial infarction without ST segment elevation showed a predominance of systolic dysfunction in the group with relatively high levels of ST2 in the blood plasma, and no significant differences in remodeling types were found in all study groups.

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“…Myocardial infarction (MI) often manifests itself atypically e.g., dyspnea, cardiac arrhythmias, abdominal pain and autonomic dysregulation. The last is observed especially in women, the elderly and patients with diabetes mellitus or chronic renal insufficiency ( 13 , 14 ). In addition, acute MI can lead to syncope, consciousness disturbance and cerebral dysfunction following hemodynamic collapse ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Case report: Interdisciplinary treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease requiring bypass surgery

et al. 2023

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BackgroundAcute myocardial infarction (MI) frequently leads to consciousness disturbance following hemodynamic collapse. Therefore, MI can occur together with upper cervical spine trauma. Herein, we report the successful treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease (CAD).Case presentationA 70-year-old patient presented in our emergency outpatient clinic after a hemodynamic collapse without neurological deficits or heart-related complaints. Computed tomography (CT) scan of the cervical spine revealed a dislocated odontoid fracture Anderson and D'Alonzo type II and an unstable Gehweiler type III injury (Jefferson's fracture). An intradiploic arachnoid cyst in the posterior wall of the posterior fossa was a coincident radiological finding. Furthermore, coronary angiography confirmed three-vessel CAD with high-grade coronary artery stenosis. Indication for upper cervical spine surgery and bypass surgery was given. An interdisciplinary team of neurosurgeons, cardiothoracic surgeons and anesthesiologists evaluated the patient's case to develop the most suitable therapy concept and alternative strategies. Finally, in first step, C1-C2 fusion was performed by Harms technique under general anesthesia with x-ray guidance, spinal neuronavigation, Doppler ultrasound and cardiopulmonary monitoring. Cardiothoracic surgeons were on standby. One month later bypass surgery was performed uneventfully. Follow-up CT scan of cervical spine revealed intraosseous screw positioning and beginning fusion of the fractures. The patient did not develop neurological deficits and recovered completely from both surgeries.ConclusionsTreating complex C1/C2 fractures with concomitant severe CAD requiring treatment is challenging and carries a high risk of complications. To our knowledge, the literature does not provide any guidelines regarding therapy of this constellation. To receive upper cervical spine stability and to prevent both, spinal cord injury and cardiovascular complications, an individual approach is required. Interdisciplinary cooperation to determine optimal therapeutic algorithms is needed.

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Akutes Koronarsyndrom ohne ST-Hebung (NSTE-ACS)

Cited by 5 publications

References 4 publications

Lectin-Like OLR1 3′UTR Rs1050286 Gene Polymorphism and Plasma Oxidized-LDL in Coronary Artery Disease and Their Relation to Cardiovascular Risk and Outcomes

Lectin-Like OLR1 3′UTR Rs1050286 Gene Polymorphism and Plasma Oxidized-LDL in Coronary Artery Disease and Their Relation to Cardiovascular Risk and Outcomes

The ratio of structural and functional status of myocardium to plasma level of stimulating growth factor expressed by gene 2 in patients with myocardial infarction without ST segment elevation

Case report: Interdisciplinary treatment of complex C1/C2 fractures in a patient with concomitant three-vessel coronary artery disease requiring bypass surgery

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