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Myocardial Infarction Stabilization

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3301. Perioperative sympatholysis. Beneficial effects of the alpha 2-adrenoceptor agonist mivazerol on hemodynamic stability and myocardial ischemia. McSPI--Europe Research Group. (Abstract)

Perioperative sympatholysis. Beneficial effects of the alpha 2-adrenoceptor agonist mivazerol on hemodynamic stability and myocardial ischemia. McSPI--Europe Research Group. Mivazerol hydrochloride is a new alpha 2-adrenoceptor agonist. In vitro and animal studies have demonstrated both sympatholytic and antiischemic properties. To evaluate the safety and efficacy of mivazerol in patients during perioperative stress, this multicenter phase II clinical trial studied hemodynamic stability (...) , no rebound response occurred in the 12 h after discontinuation of mivazerol. The high-dose, low-dose, and placebo groups did not differ in the incidence of adverse cardiac outcomes (3%, 2%, and 8%, respectively) or the diagnosis of myocardial infarction (2%, 1%, and 6%, respectively).Continuous, 72-h perioperative administration of mivazerol to high-risk patients appears to be relatively safe, producing no significant hypotension or adverse events but some evidence of bradycardia not associated

1997 Anesthesiology Controlled trial quality: predicted high

3302. Cell transplantation preserves cardiac function after infarction by infarct stabilization: augmentation by stem cell factor. (Full text)

Cell transplantation preserves cardiac function after infarction by infarct stabilization: augmentation by stem cell factor. We hypothesized that implantation of adult mesenchymal stem cells after acute myocardial infarction mobilizes bone marrow precursor cells by activating the stem cell factor pathway, and that overdriving this pathway would enhance the beneficial effects of cell transplantation.After coronary ligation, medium, mesenchymal stem cells, or stem cell factor-overproducing (...) transplantation resulted in 2.0-fold smaller ventricular volumes (P = .001) and 2.0-fold reduced infarct scar area (P = .056), but had no effect on the volume of spared myocardium. Stem cell factor overproduction imparted greater functional benefit without inducing detectable histologic cardiomyocyte regeneration.Mesenchymal stem cell implantation after myocardial infarction facilitates functional cardiac regeneration without myocyte regeneration through augmentation of endogenous infarct repair, which

2005 Journal of Thoracic and Cardiovascular Surgery PubMed abstract

3303. Experimental and clinical pharmacology of bretylium tosylate in acute myocardial infarction: a 15-year journey. (Abstract)

. In a randomized hemodynamic study in acute myocardial infarction patients bretylium induced a significant decrease in heart rate, systolic and mean left ventricular pressures, and in systolic and mean aortic pressures. In addition, a parallel and significant decrease in total pulmonary and systemic resistances was seen, accompanied by decreases in tension time and left ventricular (delta P/delta V) indexes. Bretylium tosylate induces stabilization of electrical systole duration (QTc) in acute myocardial (...) Experimental and clinical pharmacology of bretylium tosylate in acute myocardial infarction: a 15-year journey. Experimental and clinical studies demonstrate the antifibrillatory effectiveness of bretylium tosylate: Experimental ventricular fibrillation induced either by electrical stimulation or by ischemia is prevented by bretylium. In 2,000 acute myocardial infarction patients who received bretylium prophylactically primary ventricular fibrillation occurred in less than 1% of cases

1987 Journal de pharmacologie

3304. Justification for intravenous magnesium therapy in acute myocardial infarction. (Abstract)

Justification for intravenous magnesium therapy in acute myocardial infarction. Recent studies have shown that patients with acute myocardial infarction (AMI) are magnesium-deficient and develop an additional transient decrease in serum magnesium concentrations (S-Mg c) during the acute phase of the infarct. Animal experiments, as well as studies on humans, have indicated that the acute decrease in S-Mg c as well as a more chronic magnesium (Mg) deficiency state are harmful to the myocardium (...) multifactorial; a direct depressive effect on the cardiac conducting system; a peripheral dilatory effect on the arteries, reducing the afterload on the myocardium; a reduced infarct size; an ion-stabilizing effect, maintaining stable intra and extracellular concentrations of potassium, sodium and calcium; an improved energy generation in the myocardium; and an inhibitory effect on platelet aggregation. No side-effects were observed in any of the clinical intervention studies. Against this background

1988 Magnesium research : official organ of the International Society for the Development of Research on Magnesium

3305. Glucose-insulin-potassium induced alterations in individual plasma free fatty acids in patients with acute myocardial infarction. (Abstract)

Glucose-insulin-potassium induced alterations in individual plasma free fatty acids in patients with acute myocardial infarction. Total and individual plasma free fatty acids (FFA) were measured on admission and over the next 4 days in 24 patients admitted to the hospital with chest pain and suspected acute myocardial infarction (AMI). In a prospective randomized fashion, the patients were either given an infusion of 300 gm of glucose, 50 units of insulin, and 80 mEq of KCl per liter at a rate (...) ). Arachidonic acid doubled in percentage of the total FFA value during G-I-K infusion (3.1% to 6.5%, P less than 0.002) and returned to the control value when it was stopped. Thus G-I-K infusion during AMI reduces the total level of plasma FFA while increasing the percent of arachidonic and decreasing the percent of linoleic acid, observations proposed to reflect improved membrane stability of the ischemic myocardium.

1981 American heart journal Controlled trial quality: uncertain

3306. Isosorbide dinitrate alone and in association with intra-aortic balloon counterpulsation in acute myocardial infarction. A clinical study by precordial ECG mapping. (Abstract)

treated with ISDN and IABCP. These findings seem to give evidence that the association of ISDN and IABCP may really be effective in reducing and stabilizing the ECG extent of ischemic myocardial injury in pts with transmural AMI without left ventricular failure; however this aggressive therapy cannot have a widespread indication until more reliable criteria for evaluating infarct size are available and larger randomized clinical trials performed. (...) Isosorbide dinitrate alone and in association with intra-aortic balloon counterpulsation in acute myocardial infarction. A clinical study by precordial ECG mapping. The effects of the association of Isosorbide Dinitrate (ISDN) and Intra-Aortic Balloon Counterpulsation (IABCP) on ECGphic signs (in 24-lead precordial maps) of myocardial damage were studied in 7 patients (pts) with anterior acute myocardial infarction (AMI) without cardiogenic shock and/or pulmonary congestion, admitted to the CCU

1982 Giornale italiano di cardiologia Controlled trial quality: uncertain

3307. Clinical intervention studies on magnesium in myocardial infarction. (Abstract)

Clinical intervention studies on magnesium in myocardial infarction. Patients with acute myocardial infarction (AMI) display a significant decrease in serum magnesium concentrations (S-Mg,c) during the initial 48 h after infarction. This decrease is not due to an increased renal magnesium loss, neither is it a dilution phenomenon. Consequently, a migration of Mg from the extracellular to intracellular space might take place, which probably is due to a catecholamine-induced increased lipolysis (...) , forming insoluble intracellular Mg soaps. As the Mg ion is crucial in maintaining the electrical stability of the myocardium, we found it rational to avoid this postinfarctional hypomagnesemia by administration of Mg. In a double-blind, placebo-controlled trial, 130 patients with AMI were randomly allocated to receive a total of 62 mmol magnesium chloride or placebo intravenously during the initial 48 h in hospital. Mg treatment was associated with a reduction in the acute mortality from 19

1989 Magnesium Controlled trial quality: predicted high

3308. Should the exercise test (ET) be performed at discharge or one month later after an episode of unstable angina or non-Q-wave myocardial infarction? (Abstract)

Should the exercise test (ET) be performed at discharge or one month later after an episode of unstable angina or non-Q-wave myocardial infarction? The diagnostic and prognostic value of symptom limited exercise tests (ET) performed before discharge and after one month were compared in men admitted to hospital after an episode of unstable angina or a non-Q-wave myocardial infarction (MI). A 'Positive ET' was defined as either a maximal work load below 100 W or ST-depression greater than (...) stabilized after an episode of unstable angina or non-Q-wave MI.

1991 International journal of cardiac imaging Controlled trial quality: uncertain

3309. N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction. (Abstract)

N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction. Atrial natriuretic factor (ANF) is a peptide hormone secreted from cardiac atria in response to increased atrial pressure. Because of a longer half-life and greater stability, the N-terminal of ANF prohormone (N-terminal proANF) may be a better integrator of atrial peptide secretion than ANF itself. After myocardial infarction, elevation of ANF and other neurohormones has been (...) associated with a poor prognosis. However, when left ventricular ejection fraction (LVEF) and other important clinical variables are included in multivariate analysis, the independent predictive value of these neurohormones has been reduced markedly.To test the prognostic value of N-terminal proANF after myocardial infarction, its plasma concentration was measured a mean of 12 days after infarction in 246 patients in the Survival and Ventricular Enlargement (SAVE) Study. N-terminal proANF was a much

1994 Circulation

3310. Influence of acute alpha 1-adrenergic antagonism on heart rate variability in patients with old myocardial infarction. (Abstract)

Influence of acute alpha 1-adrenergic antagonism on heart rate variability in patients with old myocardial infarction. Decreased heart rate (HR) variation is a predictor of cardiac and arrhythmic death after myocardial infarction (MI). The present study examined the influence of alpha-adrenergic system on HR variation (HRV). A novel alpha 1-adrenergic antagonist, abanoquil (UK 52,046) was administered acutely to 27 patients with old MI in random placebo-controlled cross-over design. Abanoquil (...) changes in HRV were related by covariate analysis to the decrease in sinus interval and were not associated with an orthostatic decrease in blood pressure (BP) induced by abanoquil. The dominant effect of acute alpha 1-adrenergic antagonism appears to be a decrease in parasympathetic activity, although it may also stabilize sympathetic control of the heart. Thus, the autonomic nervous modification caused by alpha-adrenoceptor antagonists might be disadvantageous in treatment of patients at high risk

1994 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

3311. Assessment of therapeutic quality control in a long-term anticoagulant trial in post-myocardial infarction patients. (Abstract)

. The study population comprised 1700 post myocardial infarction patients. Treatment comprised 3725 patient-years. There were 61,471 INR assessments with target therapeutic level of 2.8-4.8. Acenocoumarol as well as phenprocoumon were employed. Therapeutic achievement in the first months of treatment was low: less than 60% of INR's were in range. Treatment stabilized after 6 months. Patients on acenocoumarol were within range 70% of the time compared to 80% for phenprocoumon. Method 3 is preferred because (...) Assessment of therapeutic quality control in a long-term anticoagulant trial in post-myocardial infarction patients. Various methods have been described to evaluate efficacy of anticoagulant therapy using the international normalized ratio (INR). We compared the following approaches: (1) total INR's or the most recent measurement; (2) percent time within therapeutic range, with INR changing directly or halfway between visits; and (3) total observation time assuming INR changing linearly

1994 Thrombosis and haemostasis Controlled trial quality: uncertain

3312. [The vertebrogenic aspect of hemodynamic adaptive differences in relation to the presence of concomitant arterial hypertension in patients with a history of myocardial infarct]. (Abstract)

specific features of formation of the phenomenon of structural adaptative stabilization (SAS). There were hemodynamic variations to a single procedure of manual therapy in relation to the extent of cardiac lesion. The single procedure of manual therapy was found to affect the patients with myocardial infarction concurrent with arterial hypertension and to transfer the latters to the general myocardial patient population without arterial hypertension. The manual impact on the vertebrogenic links (...) [The vertebrogenic aspect of hemodynamic adaptive differences in relation to the presence of concomitant arterial hypertension in patients with a history of myocardial infarct]. A total of 46 patients who had sustained myocardial infarction, including those with concurrent arterial hypertension were examined at polyclinic rehabilitation. The patients with myocardial infarction and those with myocardial and concurrent arterial hypertension proved to belong to various general populations having

1995 Voprosy kurortologii, fizioterapii, i lechebnoÄ­ fizicheskoÄ­ kultury

3313. Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction. Comparison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide. (Abstract)

Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction. Comparison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide. Elevated plasma levels of atrial natriuretic peptide (ANP) and the N-terminal fragment of the ANP prohormone (N-ANP) are associated with decreased left ventricular function and decreased long-term survival after acute myocardial infarction (AMI). Previous (...) prognostic indicators used in risk stratification after AMI because of its strong, independent association with long-term survival, enhanced in vitro stability, and simplicity of analysis.

1996 Circulation

3314. Patient and doctor delay in acute myocardial infarction: a study in Rotterdam, The Netherlands. (Full text)

more than 82 minutes. The ambulance arrived within 15 minutes in 90% of all 242 cases, while the time required for stabilization of the patient by the ambulance staff and transport to the hospital took a median of 15 minutes.Compared with earlier studies, patients with a myocardial infarction called for help sooner. However, it may take a considerable time before the general practitioner refers the patient to hospital. Further research is needed to design measures which will improve the diagnostic (...) Patient and doctor delay in acute myocardial infarction: a study in Rotterdam, The Netherlands. Early thrombolytic therapy for patients having a myocardial infarct size and improves survival.A study was undertaken to examine the components of pre-hospital delay in patients with retrospectively proven myocardial infarction.Data were gathered from 300 patients with a documented myocardial infarction admitted to three hospitals in Rotterdam, the Netherlands. Interviews were carried out

1995 The British Journal of General Practice PubMed abstract

3315. General practitioners and emergency treatment for patients with suspected myocardial infarction: last chance for excellence? (Full text)

the ambulance service but bypasses the general practitioner. Since the majority of telephone calls from people with suspected myocardial infarction are directed to general practitioners, a preferable alternative would be a 'stay and stabilize' strategy that uses the existing referral pattern and builds on general practitioners' medical education and skills. The role of the general practitioner in the management of patients with suspected myocardial infarction is discussed. (...) General practitioners and emergency treatment for patients with suspected myocardial infarction: last chance for excellence? Pre-hospital coronary care usually consists of a medically staffed coronary care ambulance going into the community from a hospital base, as pioneered in Northern Ireland. In today's medicopolitical and economic climate, this model is not viable in mainland United Kingdom. Current proposals seem to favour a 'scoop and run' policy for heart attack victims, that utilizes

1992 The British Journal of General Practice PubMed abstract

3316. Radiofrequency ablation of haemodynamically unstable ventricular tachycardia after myocardial infarction (Full text)

Radiofrequency ablation of haemodynamically unstable ventricular tachycardia after myocardial infarction To determine whether radiofrequency (RF) ablation might have a role in haemodynamically unstable ventricular tachycardia.10 patients with a history of ventricular tachycardia producing haemodynamic collapse in whom drug treatment had failed and device therapy was rejected underwent RF ablation of ventricular tachycardia in sinus rhythm. The arrhythmogenic zone was defined on the basis (...) stability. There were no clinical events during a mean (SD) follow up period of 23 (10) months in any of the nine patients defined as definite or possible successes.RF ablation for addressing haemodynamically unstable ventricular tachycardia opens the door for the wider use of catheter ablation for treating this arrhythmia.

2000 Heart PubMed abstract

3317. The angiotensin converting enzyme inhibitor perindopril improves survival after experimental myocardial infarction in pigs. (Abstract)

The angiotensin converting enzyme inhibitor perindopril improves survival after experimental myocardial infarction in pigs. In this randomized, blinded study the effect of the angiotensin converting enzyme inhibitor perindopril on electrical stability after myocardial infarction in pigs was compared to placebo. The left anterior descending artery was occluded for 45 min. Perindoprilat (0.06 mg/kg, n = 12) or saline (n = 12) was injected 15 min before reperfusion. Treatment was continued till (...) was comparable between survivors. The latter indicates that a comparable electrical stability 2 weeks after myocardial infarction is obtained in perindopril-treated pigs at a significantly higher survival rate.

1992 Journal of cardiovascular pharmacology Controlled trial quality: uncertain

3318. Is survival in acute myocardial infarction related to thrombolytic efficacy or the open-artery hypothesis? A controversy to be investigated with GUSTO. (Abstract)

was achieved in a time frame beyond that in which myocardial salvage could be expected. The "open-artery hypothesis" suggests that survival may be more dependent on improved left ventricular remodeling and healing, increased electrical stability, and better myocardial perfusion than on infarct size reduction. In an attempt to determine whether 90-min patency or 24-h patency is more predictive of survival, the Global Utilization of Streptokinase and t-PA for Occluded Coronary Arteries (GUSTO) trial (...) Is survival in acute myocardial infarction related to thrombolytic efficacy or the open-artery hypothesis? A controversy to be investigated with GUSTO. The reduction in morbidity and mortality associated with thrombolytic therapy in patients with acute myocardial infarction was initially attributed to early restoration of arterial patency, salvage of ischemic myocardium, and preservation of left ventricular function. Recombinant tissue plasminogen activator (rt-PA) was initially the favored

1992 Chest Controlled trial quality: uncertain

3319. The effect of statin therapy on ventricular late potentials in acute myocardial infarction. (Abstract)

cardiovascular event rates were also lower in statin group.Early use of pravastatin reduces the incidence of late potentials following thrombolytic therapy in acute myocardial infarction. Statin therapy also seems to be reducing the incidence of in-hospital ventricular arrhythmias. These beneficial effects of statins might be explained through prevention of new myocardial ischemic episodes due to early plaque stabilization or regulation of endothelial and platelet functions. (...) The effect of statin therapy on ventricular late potentials in acute myocardial infarction. To determine whether early statin therapy in acute myocardial infarction has any effect on ventricular late potentials which are considered as a noninvasive tool for evaluation of arrhythmogenic substrate.Study population consisted of prospectively enrolled 72 patients presenting with acute myocardial infarction (<6 h). Thirty-four of the patients were randomized to pravastatin (40 mg/day) on admission

2003 International journal of cardiology Controlled trial quality: uncertain

3320. ST segment resolution in ASSENT 3: insights into the role of three different treatment strategies for acute myocardial infarction. (Abstract)

ST segment resolution in ASSENT 3: insights into the role of three different treatment strategies for acute myocardial infarction. ASSENT 3 (Assessment of the Safety and Efficacy of a New Thrombolytic) demonstrated that the bolus fibrinolytic tenecteplase (TNK), combined with enoxaparin (ENOX) or abciximab (ABCX), substantially reduced ischemic complications of acute myocardial infarction as compared with unfractionated heparin (UH). We compared ST resolution in each of the three treatment (...) in reinfarction. Thirty day and one year mortality was greatest amongst those patients with <30% ST segment resolution in the TNK/ABCX group.More rapid and complete ST resolution occurs with half-dose TNK/ABCX whereas less reinfarction occurs amongst those patients with > or =70% ST resolution receiving either TNK/ABCX or TNK/ENOX. These data highlight two potentially complementary mechanisms of clinical benefit associated with different pharmacologic regimens in acute myocardial infarction, i.e. more rapid

2003 European heart journal Controlled trial quality: uncertain

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