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MS422 MARKERS OF SUCCESSFUL THROMBOLYTIC THERAPY DURING THE FIRST WEEK OF ACUTE MYOCARDIAL INFARCTION
78th EAS Congress
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
195
Results: One hundred seventy six patients were included; 11.3% of the study population were < or = 40 years of age; 37.5% were between 40−55 years and 51% were > 55. Of the study subjects, 48.4% were females and 51.6% were males. Family history of diabetes was present in 22% of the study population. A diagnosis of DM only (fasting plasma glucose levels of > 7.0 mmol/l) was made in 46.6% of the patients while 53.4% were diagnosed with DM and hypertension. Of the subjects with DM and hypertension, 44.4% were between 40−55 years while 62.8% were > 55 years. Conclusion: Our study indicates that hypertension is a common co occurrence in newly diagnosed diabetic patients. Increased vigilance, early identification and intensive management may work towards decreasing the risk of atherosclerotic burden in these patients.
Methods: Immediately after hospitalization the patients were given thrombolytic therapy (Aspirin, heparin, stpeptokinaza). Was studied QT interval dispersion (QTd) and variability of QT interval in precordial leads (QTdl). Result: The study showed that QTd and QTdl could be used for assessment of the risk of malignant arrythmias and effectiveness of throbolytic therapy in patients with acute Q-wave myocardial infarction because of ischemic localization during the first week. Conclusion: Based on the study results, it can be concluded that the values of QTd and QTdl may be predictors of malignant arrhythmias during the first week of miocardial infarction because of ischemic localization. QTd and QTdl are markers of successful thrombolytic therapy. Keywords: QT interval dispersion, Thrombolytic therapy.
MS420 DESIGNING A STUDY TO EVALUATE THE EFFECT OF APHERESIS IN PATIENTS WITH ELEVATED LIPOPROTEIN(a) U. Kassner. Stoffwechselcentrum Campus Virchow, Charite´ ¨ Universitatsmedizin Berlin, Berlin, Germany
MS423 TREATMENT OF ATHEROSCLEROSIS PATIENTS WITH TYPE 2 DIABETES BY SOYBEAN FLAVONOID SUPPLEMENTS AND INDAPAMIDE V. Kapetivadze, R. Tabukashvili, K. Tchaava, N. Gegeshidze, Z. Grigorashvili, I. Kapetivadze. Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia
Lipoprotein(a) [Lp(a)] is a risk factor for premature coronary artery disease. Lp(a) levels can not be sufficiently influenced neither by standard hypolipemic diet nor by drug therapy. Currently lipid apheresis is the only option to lower Lp(a) levels in patients with elevated Lp(a) and progressive CVD effectively. In the lipid-clinic at the Charite´ University hospital Berlin and other german apheresis centres exists longstanding positive experience with this therapeutic regimen. Lately in Germany lipid apheresis was accepted as a treatment of choice for patients with elevated Lp(a) levels > 60 mg/dl and progressive CVD. At the same time care providers were obliged to conduct a prospective trial to prove the efficacy of lipid apheresis for this indication. Therefore we designed a prospective, randomized, controlled trial to prove the hypothesis that lipid apheresis is a potent therapeutic option. MS421 CORRELATION STUDY OF MORPHOLOGICAL FEATURES OF SILENT AND VULNERABLE PLAQUES VS CLINICAL PARAMETERS OF PATIENTS AFTER CAROTID ENDARTERECTOMY V.S. Shishkina, S.V. Kashirina, V.N. Sirotkin, E.R. Andreeva, O.P. Ilyinskaya, E.M. Tararak. Cardiocenter, Moscow, Russia Background: To analyze peculiarities of histological composition of endarterectomy plaques in connection with patients’ anamnesis. Methods: Thirty-six patients were enrolled. Plaques of all patients were divided into 2 groups according to Lovett JK et al, 2005: group I, 26 vulnerable plaques; and group II, 10 silent plaques. All plaques were classified according to AHA classification. All morphometric assessments were blind with clinical parameters to find out correlations between morphological alterations in the artery and there clinical manifestations. Results: 71% of all carotid plaques were classified as vulnerable and 92% of them were complex (Type VI of AHA). 81% of them were excised from males age 60.3±7.6, 19% from female age 72.3±9.6. Stable plaques were: 40% typeVI, 20% typeIV, 20% typeVa, 10% typeVb and 10% typeVc. 60% of them belong to male, 40% to female age 62.3±9.1 and 70.8±4.3 accordingly. Patients with plaques group I more often had ischemic heart disease (p < 0.05), transient ischemic attack (TIA) and/or stroke (p < 0.05), had greater degree of stenosis and surface defects, while patients with lesions group II − the disease of gastrointestinal tract (p < 0.05). Risks factors, such as smoking, hypertension, angina pectoris and myocardial infarction were more often observed in patients with plaques group I. Two groups of lesions significantly differed (p < 0.05) in plaque vascularisation, surface defects, internal thrombus, cholesterol, foam cells, calcium deposits. Conclusion: Patients with more pronounced cardiovascular events preferentially had plaques group I that should be take into consideration in the strategy of their treatment. Funding: RFBR-OFI-c-08-04-13753, contract-N/10-ATH-M. MS422 MARKERS OF SUCCESSFUL THROMBOLYTIC THERAPY DURING THE FIRST WEEK OF ACUTE MYOCARDIAL INFARCTION V. Kapetivadze, R. Tabukashvili, K. Tchaava, N. Gegeshidze, Z. Grigorashvili, I. Kapetivadze. Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia Objective: The goal of our study was to identify the importance of dispersion of ventricular repolarisation in predicting the course of the acute phase of myocardial infarction because of ischemic localization and initial effectiveness of thrombolytic therapy in patient with Q wave myocardial infarction during the first week after the onset of heart attack. For this purpose, 69 patients were enrolled and divided into three groups. I. Patients with acute myocardial infarction on an anterior wall (54±65 age group) (n = 28). II. Patients with acute myocardial infarction on the posterior wall (54±65 age group) (n = 26). III. Control group of healthy individuals without myocardial ischemia. (48±7 age group) (n = 15).
Objective: To study therapeutics action of treatment by soybean flavonoid supplements and Indapamide in atherosclerosis patients with type 2 diabetes. Methods: Were studied 42 patients atherosclerosis with type 2 diabetes. The patients were divided into 2 groups. Group I − experimental group − 30 patients and group II − control group − 12 patients. The patients of group I were given 200 mg soybean flavonoid and indapamid 2.5 mg a day; the patients of group II were additionally given Indapamide 2.5 mg/day. The patients were under investigation during 10 weeks. Before and after clinical observations were studied lipid range, the level of glucose in blood. Results: 10 weeks after clinical observations was obtained decrease of cholesterol. In patients of experimental group: TC by 7%, LDLC by 10%, TG by 9.4%, HDLC increase by 8%. In patients of control group after clinical observations was obtained decrease of cholesterol: TC by 3%, LDLC by 5.6%, TG by 6%, HDLC increase by 7%.The level of glucose in patients of I group before clinical observations was 8.7 mmol/l, after 4.8 mmol/l. in patients of II group the level of glucose before clinical observation was 8.5 mmol/l, after 6.2 mmol/l. Conclusions: Therefore, given of soybean flavonoids coupled with Indapamide in patients atherosclerosis with type 2 diabets are biologically active and give perspective use it in the treatment of the patients. MS424 THE EFFECT OF PAIN-FREE TREADMILL TRAINING ON LEVELS OF LACTATE DEHYDROGENASE AND CREATINE KINASE IN PATIENTS WITH INTERMITTENT CLAUDICATION P. Mika1 , R. Nowobilski1,2 , R. Januszek2 , H. Plutecka2 , M. Sanak2 , A. Szczeklik2 . 1 Departament of Clinical Rehabilitation, University School of Physical Education, 2 Departament of Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland Introduction: Episodes of ischemia-reperfusion occurring during repeated walking may lead to a local and systemic inflammatory response in patients with claudication. Regular treadmill training has been suggested as an effective means for improvement of walking ability and attenuation of inflammation in this group of patients. Aim: This study aimed to assess the effect of pain-free treadmill training on two [lactate dehydrogenase (LDH) and creatine kinase (CK)] hematological indicators of skeletal-muscle injury. Method: Fifty patients with peripheral occlusive arterial disease and intermittent claudication were randomly assigned into a treadmill-training program or a control group. The treadmill training consisting of repeated walking exercises to onset of claudication pain was conducted 3 times a week for 3 months. The painfree and maximal walking times, LDH and CK were assessed in both groups during treadmill test to maximum of claudication pain performed at baseline, after 6 weeks, and after 3 months period of the study. Results: The significant (p < 0.05) increases of LDH and CK levels were observed after treadmill tests in both groups of patients. The LDH and CK levels significantly (p < 0.05) decreased by 10.2% and 9.5%, respectively, while pain-free walking time and maximal walking time was prolonged by 115% and 74%, respectively, in the training group after 3 months of treadmill training. No significant changes in the above variables were observed in the controls. Conclusion: Three-month pain free treadmill training is associated with progressive normalization of LDH and CK in patients with claudication.
Atherosclerosis Supplements 11, no. 2 (2010) 109–222
195
Results: One hundred seventy six patients were included; 11.3% of the study population were < or = 40 years of age; 37.5% were between 40−55 years and 51% were > 55. Of the study subjects, 48.4% were females and 51.6% were males. Family history of diabetes was present in 22% of the study population. A diagnosis of DM only (fasting plasma glucose levels of > 7.0 mmol/l) was made in 46.6% of the patients while 53.4% were diagnosed with DM and hypertension. Of the subjects with DM and hypertension, 44.4% were between 40−55 years while 62.8% were > 55 years. Conclusion: Our study indicates that hypertension is a common co occurrence in newly diagnosed diabetic patients. Increased vigilance, early identification and intensive management may work towards decreasing the risk of atherosclerotic burden in these patients.
Methods: Immediately after hospitalization the patients were given thrombolytic therapy (Aspirin, heparin, stpeptokinaza). Was studied QT interval dispersion (QTd) and variability of QT interval in precordial leads (QTdl). Result: The study showed that QTd and QTdl could be used for assessment of the risk of malignant arrythmias and effectiveness of throbolytic therapy in patients with acute Q-wave myocardial infarction because of ischemic localization during the first week. Conclusion: Based on the study results, it can be concluded that the values of QTd and QTdl may be predictors of malignant arrhythmias during the first week of miocardial infarction because of ischemic localization. QTd and QTdl are markers of successful thrombolytic therapy. Keywords: QT interval dispersion, Thrombolytic therapy.
MS420 DESIGNING A STUDY TO EVALUATE THE EFFECT OF APHERESIS IN PATIENTS WITH ELEVATED LIPOPROTEIN(a) U. Kassner. Stoffwechselcentrum Campus Virchow, Charite´ ¨ Universitatsmedizin Berlin, Berlin, Germany
MS423 TREATMENT OF ATHEROSCLEROSIS PATIENTS WITH TYPE 2 DIABETES BY SOYBEAN FLAVONOID SUPPLEMENTS AND INDAPAMIDE V. Kapetivadze, R. Tabukashvili, K. Tchaava, N. Gegeshidze, Z. Grigorashvili, I. Kapetivadze. Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia
Lipoprotein(a) [Lp(a)] is a risk factor for premature coronary artery disease. Lp(a) levels can not be sufficiently influenced neither by standard hypolipemic diet nor by drug therapy. Currently lipid apheresis is the only option to lower Lp(a) levels in patients with elevated Lp(a) and progressive CVD effectively. In the lipid-clinic at the Charite´ University hospital Berlin and other german apheresis centres exists longstanding positive experience with this therapeutic regimen. Lately in Germany lipid apheresis was accepted as a treatment of choice for patients with elevated Lp(a) levels > 60 mg/dl and progressive CVD. At the same time care providers were obliged to conduct a prospective trial to prove the efficacy of lipid apheresis for this indication. Therefore we designed a prospective, randomized, controlled trial to prove the hypothesis that lipid apheresis is a potent therapeutic option. MS421 CORRELATION STUDY OF MORPHOLOGICAL FEATURES OF SILENT AND VULNERABLE PLAQUES VS CLINICAL PARAMETERS OF PATIENTS AFTER CAROTID ENDARTERECTOMY V.S. Shishkina, S.V. Kashirina, V.N. Sirotkin, E.R. Andreeva, O.P. Ilyinskaya, E.M. Tararak. Cardiocenter, Moscow, Russia Background: To analyze peculiarities of histological composition of endarterectomy plaques in connection with patients’ anamnesis. Methods: Thirty-six patients were enrolled. Plaques of all patients were divided into 2 groups according to Lovett JK et al, 2005: group I, 26 vulnerable plaques; and group II, 10 silent plaques. All plaques were classified according to AHA classification. All morphometric assessments were blind with clinical parameters to find out correlations between morphological alterations in the artery and there clinical manifestations. Results: 71% of all carotid plaques were classified as vulnerable and 92% of them were complex (Type VI of AHA). 81% of them were excised from males age 60.3±7.6, 19% from female age 72.3±9.6. Stable plaques were: 40% typeVI, 20% typeIV, 20% typeVa, 10% typeVb and 10% typeVc. 60% of them belong to male, 40% to female age 62.3±9.1 and 70.8±4.3 accordingly. Patients with plaques group I more often had ischemic heart disease (p < 0.05), transient ischemic attack (TIA) and/or stroke (p < 0.05), had greater degree of stenosis and surface defects, while patients with lesions group II − the disease of gastrointestinal tract (p < 0.05). Risks factors, such as smoking, hypertension, angina pectoris and myocardial infarction were more often observed in patients with plaques group I. Two groups of lesions significantly differed (p < 0.05) in plaque vascularisation, surface defects, internal thrombus, cholesterol, foam cells, calcium deposits. Conclusion: Patients with more pronounced cardiovascular events preferentially had plaques group I that should be take into consideration in the strategy of their treatment. Funding: RFBR-OFI-c-08-04-13753, contract-N/10-ATH-M. MS422 MARKERS OF SUCCESSFUL THROMBOLYTIC THERAPY DURING THE FIRST WEEK OF ACUTE MYOCARDIAL INFARCTION V. Kapetivadze, R. Tabukashvili, K. Tchaava, N. Gegeshidze, Z. Grigorashvili, I. Kapetivadze. Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia Objective: The goal of our study was to identify the importance of dispersion of ventricular repolarisation in predicting the course of the acute phase of myocardial infarction because of ischemic localization and initial effectiveness of thrombolytic therapy in patient with Q wave myocardial infarction during the first week after the onset of heart attack. For this purpose, 69 patients were enrolled and divided into three groups. I. Patients with acute myocardial infarction on an anterior wall (54±65 age group) (n = 28). II. Patients with acute myocardial infarction on the posterior wall (54±65 age group) (n = 26). III. Control group of healthy individuals without myocardial ischemia. (48±7 age group) (n = 15).
Objective: To study therapeutics action of treatment by soybean flavonoid supplements and Indapamide in atherosclerosis patients with type 2 diabetes. Methods: Were studied 42 patients atherosclerosis with type 2 diabetes. The patients were divided into 2 groups. Group I − experimental group − 30 patients and group II − control group − 12 patients. The patients of group I were given 200 mg soybean flavonoid and indapamid 2.5 mg a day; the patients of group II were additionally given Indapamide 2.5 mg/day. The patients were under investigation during 10 weeks. Before and after clinical observations were studied lipid range, the level of glucose in blood. Results: 10 weeks after clinical observations was obtained decrease of cholesterol. In patients of experimental group: TC by 7%, LDLC by 10%, TG by 9.4%, HDLC increase by 8%. In patients of control group after clinical observations was obtained decrease of cholesterol: TC by 3%, LDLC by 5.6%, TG by 6%, HDLC increase by 7%.The level of glucose in patients of I group before clinical observations was 8.7 mmol/l, after 4.8 mmol/l. in patients of II group the level of glucose before clinical observation was 8.5 mmol/l, after 6.2 mmol/l. Conclusions: Therefore, given of soybean flavonoids coupled with Indapamide in patients atherosclerosis with type 2 diabets are biologically active and give perspective use it in the treatment of the patients. MS424 THE EFFECT OF PAIN-FREE TREADMILL TRAINING ON LEVELS OF LACTATE DEHYDROGENASE AND CREATINE KINASE IN PATIENTS WITH INTERMITTENT CLAUDICATION P. Mika1 , R. Nowobilski1,2 , R. Januszek2 , H. Plutecka2 , M. Sanak2 , A. Szczeklik2 . 1 Departament of Clinical Rehabilitation, University School of Physical Education, 2 Departament of Medicine, Jagiellonian University Collegium Medicum, Krakow, Poland Introduction: Episodes of ischemia-reperfusion occurring during repeated walking may lead to a local and systemic inflammatory response in patients with claudication. Regular treadmill training has been suggested as an effective means for improvement of walking ability and attenuation of inflammation in this group of patients. Aim: This study aimed to assess the effect of pain-free treadmill training on two [lactate dehydrogenase (LDH) and creatine kinase (CK)] hematological indicators of skeletal-muscle injury. Method: Fifty patients with peripheral occlusive arterial disease and intermittent claudication were randomly assigned into a treadmill-training program or a control group. The treadmill training consisting of repeated walking exercises to onset of claudication pain was conducted 3 times a week for 3 months. The painfree and maximal walking times, LDH and CK were assessed in both groups during treadmill test to maximum of claudication pain performed at baseline, after 6 weeks, and after 3 months period of the study. Results: The significant (p < 0.05) increases of LDH and CK levels were observed after treadmill tests in both groups of patients. The LDH and CK levels significantly (p < 0.05) decreased by 10.2% and 9.5%, respectively, while pain-free walking time and maximal walking time was prolonged by 115% and 74%, respectively, in the training group after 3 months of treadmill training. No significant changes in the above variables were observed in the controls. Conclusion: Three-month pain free treadmill training is associated with progressive normalization of LDH and CK in patients with claudication.