In cases of pneumonia developing due to coronavirus disease 2019 (COVID-19), it has been shown that 71.4% of non-survivors and 0.6% of survivors had disseminated intravascular coagulation (DIC), and ...the majority of non-survivors had increased D-dimer level (1). TNF-α and IL-6 variants are also known to be risk factors for pneumonia-induced septic shock in intensive care patients (2). We believe that the ADP receptor inhibitor, ticagrelor, should be considered in the treatment of concomitant COVID-19 pneumonia and myocardial infarction (MI) because it may contribute to patient survival. There are three main reasons for this, considering the pathogenesis of COVID-19 pneumonia and the course of the disease. First, based on the subgroup analysis of the PLATO study, the initially identified pleiotropic effects of ticagrelor were evident such that sepsis and pulmonary infections were less common in individuals using ticagrelor.
Background: Heart failure (HF) is one of the leading causes of morbidity and mortality in the elderly. Early recognition, treatment, and elimination of potentially modifiable risk factors for HF are ...crucial for improving both survival and health-related life quality in those with HF. We aimed to investigate whether or not there is an association between olfactory function and the presence and severity of ischemic HF. Methods: The study included 40 patients with ischemic HF and 40 controls with coronary artery disease but without HF. All patients and controls underwent detailed physical and echocardiographic examinations. The Sniffin' Stick test was used to evaluate olfactory function. Results: Threshold-discrimination-identification (TDI) score was significantly lower in the patients with HF than in the controls (16.4 ± 7.8 vs. 33.3 ± 5.2, p ＜ 0.001). When patients with ischemic HF were categorized according to New York Heart Association (NYHA) class, the TDI scores were significantly higher in the patients with NYHA class 1 HF compared to those with NYHA class 3 HF (23.4 ± 0.9 vs. 8.8 ± 7.0, p ＜ 0.001).We also found a significant negative correlation between the TDI score and NYHA class (r = -0.769, p ＜ 0.001) and a positive correlation between the TDI score and left ventricular ejection fraction (r = 0.902, p ＜ 0.001). Conclusions: Olfactory function was severely impaired in the patients with ischemic HF in this study. In addition, olfactory dysfunction in the patients with ischemic HF was significantly correlated with the severity of HF.
Bypass graft surgery remains an important treatment option for left main and multi-vessel coronary artery disease. Approximately 2% of saphenous vein grafts are lost immediately after the coronary ...artery bypass graft operations, and 12% are lost in the first month due to thrombosis.
The aim of this study is to administer one anticoagulant and two antiplatelet agents in a way that locally affects the vein graft before the bypass operation and to thereby analyse their effects on early graft thrombosis.
Animal experimentation.
Since ticagrelor was used locally for the first time in this study, its efficacy with combinations of other drugs only Acetylsalicylic acid (ASA), ASA and Ticagrelor, ASA-Ticagrelor-Unfractionated Heparin (UFH) was examined on rats including control (untreated) and sham (pluronic gel) group (n=14 for each group). Before the tunica adventitia layer of the femoral veins was bypassed to the femoral artery, it was coated with the drug-eluting pluronic F-127 gel. The presence or absence of thrombus in the vein graft samples was recorded under light microscopy. In vein graft preparations where thrombus was detected, thrombus area (µm2) was calculated using Axiovision software. Immunohistochemical staining was performed with the anti-rat von Willebrand factor (VWF) polyclonal antibody kit.
In terms of presence of thrombus in the preparations, the number of the preparations containing thrombus was significantly lower in the ASA+Ticagrelor+UFH group compared to the ASA, control and sham groups, according to the comparisons made on the 1st and 3rd day (p=0.001 and p=0.02). VWF staining was significantly lower in the ASA+Ticagrelor+UFH group compared with that in the other groups on the 3rd day (p=0.005).
Locally effective ASA-Ticagrelor-UFH complex has been shown to significantly reduce thrombus formation in vein grafts in this experimental model. Local administration of these drugs, which are routinely administered orally just before stent implantations, on the vein graft before the bypass is performed can prevent the loss of vein grafts due to thrombus, thereby reducing the mortality and morbidity of these patients.
In this study, we aimed to investigate the awareness of patients with coronary artery disease (CAD) about secondary prevention and the channels through which they obtained information on this issue.
...A standard questionnaire including 45 questions was given to the patients (n=912) who were admitted to the cardiology outpatient clinics to investigate their secondary prevention awareness and lifestyle.
Of the participants, 508 (55.7%) stated that they knew the condition of their vessels after coronary angiography; 493 (54.1%) stated that they did not exercise; 299 stated that they did not follow any specific diet. Men were more frequently aware of all risk factors except diet, blood glucose, and blood pressure compared to women (p<0.001). Women were more frequently aware that blood glucose and blood pressure are risk factors for CAD compared to men (p<0.001). The high-income patient group was more aware of all the risk factors, except blood glucose compared to the low/medium income patient group (p<0.001). The frequency of awareness, except for blood glucose and antiplatelet drugs, increased as the education level increased (p<0.001). However, the frequency of awareness of blood glucose and antiplatelet drug use was higher in the literate/elementary school/secondary school group (p<0.001). In addition, it was concluded that patients' sexual life and psychological problems after being diagnosed with the disease were rarely questioned by cardiology specialists.
Awareness of patients with CAD about secondary prevention was found to be very low.
The chest pain classifications that are currently in use are based on studies that are several decades old. Various studies have indicated that these classifications are not sufficient for ...determining the origin of chest pain without additional diagnostic tests or tools. We describe a new chest pain scoring system that examines the relationship between chest pain and ischemic heart disease (IHD).
Cross-sectional study conducted in a tertiary-level university hospital and two public hospitals.
Chest pain scores were assigned to 484 patients. These patients then underwent a treadmill stress test, followed by myocardial perfusion scintigraphy if necessary. Coronary angiography was then carried out on the patients whose tests had been interpreted as positive for ischemia. Afterwards, the relationship between myocardial ischemia and the test score results was investigated.
The median chest pain score was 2 (range: 0-7) among the patients without IHD and 6 (1-8) among those with IHD. The median score of patients with IHD was significantly higher than that of patients without IHD (P = 0.001). Receiver operating characteristic analysis showed that the score had sensitivity of 97% and specificity of 87.5% for detecting IHD.
We developed a pre-test chest pain score that uses a digital scoring system to assess whether or not the pain was caused by IHD. This scoring system can be applied easily and swiftly by healthcare professionals and can prevent the confusion that is caused by other classification and scoring systems.
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