| 1. |
- Herlitz, Johan, 1949, et al.
(author)
-
Impact of early thrombolysis on chest pain score reflecting myocardial ischemia in relation to various markers of ischemic damage. TEAHAT Study Group.
- 1993
-
In: International journal of cardiology. - : Elsevier Ireland Ltd. - 0167-5273 .- 1874-1754. ; 41:2, s. 123-31
-
Journal article (peer-reviewed)abstract
- We randomized 352 patients with pain suggestive of acute myocardial infarction who were seen less than 3 h after onset of symptoms to either tissue plasminogen activator or placebo. The impact of treatment on chest pain score was assessed during the first 24 h and related to limitation of final myocardial damage as assessed by various indirect markers. The most marked effect of tissue plasminogen activator was observed in the chest pain score being reduced by 43% in the tissue plasminogen activator group as compared with placebo. Limitation of infarct size with tissue plasminogen activator reached the following percentage values when various methods were used: maximum serum lactate dehydrogenase I activity, 32%; vectorcardiography (QRS vector difference), 20%; electrocardiography (Palmeri score), 20%; ejection fraction, 9%. We conclude that early thrombolysis in acute myocardial infarction reduces the severity of chest pain by nearly 50%. The effect on chest pain is much more marked as compared with the effect on various markers of the final ischemic damage.
|
|
| 2. |
|
|
| 3. |
- Fu, Michael, 1963, et al.
(author)
-
Properties of G-protein modulated receptor-adenylyl cyclase system in myocardium of spontaneously hypertensive rats treated with adriamycin.
- 1994
-
In: International journal of cardiology. - 0167-5273. ; 44:1, s. 9-18
-
Journal article (peer-reviewed)abstract
- Properties of the receptor--G protein--adenylyl cyclase system were studied in spontaneously hypertensive rats (SHR) and age-matched normotensive Wistar-Kyoto rats (WKY) treated with adriamycin (ADR, 1 mg/kg per week) for 12 weeks. An identical dosing schedule caused a significantly greater decline in body weight gain and a marked elevation of plasma norepinephrine level in SHR than in WKY. A significant increase in the messenger RNA encoding Gi-alpha 2 was found in SHR+ADR group. The activity of the adenylyl cyclase stimulated by guanyliminodiphosphate [Gpp(NH)p] was decreased by 49% in SHR and 73% in SHR+ADR. However, stimulated activities of adenylyl cyclase by both sodium fluoride and forskolin remained unchanged. Functional level of stimulatory G-protein (Gs) as measured by reconstitution assay in sarcolemmal membrane was unaltered among different groups. Furthermore, the density of beta-adrenoceptor was significantly decreased without change of its affinity. Muscarinic receptors exhibited a three-site affinity distribution in SHR+ADR whereas other groups displayed only two-site affinity distribution. These results suggest that SHR exhibited a depressed myocardial adenylyl cyclase signaling system which may not be due to the functional uncoupling of beta-adrenoceptors from Gs but to the increased inhibitory G-protein (Gi) activity as demonstrated by the increased mRNA of Gi-alpha 2, increased inhibition of Gpp(NH)p-mediated adenylyl cyclase and the super high affinity for carbachol of the muscarinic receptors. Decreased beta-adrenoceptor density and functional alteration of Gi might be regarded as the predisposing factors for the increased susceptibility of myocardium of SHR to ADR.
|
|
| 4. |
- Karlson, Björn W., 1953, et al.
(author)
-
The prognosis of patients suspected of having acute myocardial infarction subsequent to its exclusion as the diagnosis.
- 1990
-
In: International journal of cardiology. - 0167-5273. ; 26:3, s. 251-7
-
Journal article (peer-reviewed)abstract
- This review of the literature concerns the prognosis of patients suspected of having myocardial infarction subsequent to its exclusion as the diagnosis. Several investigations show a surprisingly bad prognosis for patients in this category, almost comparable to that of patients with a confirmed infarction. When the results of the different studies are pooled, however, there is a significant difference between those patients with true infarction, and those in whom infarction was excluded, in terms of overall mortality (12% and 7%; P less than 0.0001) and the development of subsequent non-fatal infarction (11% and 6%; P less than 0.05) when the results are analysed for a period of follow-up of one year. The difference was significant even when both fatal and non-fatal infarctions were taken into account over the one-year period of follow-up (13% and 8%; P less than 0.0001). The analysis shows that electrocardiographic ST-T changes are a risk factor for coronary events, but the results are conflicting for other possible risk factors. The selection of patients varies between the different studies, which probably contributes to the different results reported. Prospective studies with well defined groups of patients large enough to permit analysis of subgroupings will be needed to resolve the outstanding questions.
|
|
