Browsing by Author "Lazić, Snežana (57140141800)"

Background/Aim. The fundamental objective of primary percutaneous coronary intervention (PCI) in myocardial infarction is to provide early, complete, and sustained flow in the occluded artery that has led to myocardial ischemia or necrosis. The aim of this study was to determine the predictive power of a combination of GRACE, SYNTAX I, and SYNTAX II scores in predicting major adverse cardiovascular events (MACE) and one-year mortality in patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) after primary PCI. Methods. The study included 400 patients who had their first acute myocardial infarction and underwent PCI. The patients were treated and followed for one year at the Clinical Hospital Center Zvezdara at the Department of Interventional Cardiology. By monitoring the defined clinical parameters, a comparative analysis of risk scores GRACE, SYNTAX I, and SYNTAX II was performed. Their sensitivity, specificity as well as predictive possibilities in predicting adverse outcomes were determined. Results. The incidence of MACE in our sample was 12.8%. Patients with STEMI entity had significantly higher values of GRACE, SYNTAX I, and SYNTAX II scores. The highest value for predicting the occurrence of MACE was shown by the SYNTAX II score (score value 29.3), with a sensitivity of 88.2% and a specificity of 76.8%. The GRACE score was a significant predictor of SYNTAX I and SYNTAX II scores. A two-way correlation was observed between the high score values of all three scores. Conclusion. The presented scores for the assessment of clinical and angiographic indicators showed good predictive power in assessing the outcome of adverse cardiovascular events in both clinical entities of acute myocardial infarction during one-year follow-up. By using the proposed scores to assess MACE, we can single out high-risk patients in order to prevent adverse events and reduce mortality. This suggests its suitability for clinical use in this patient population. © 2022 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.

Background/Aim: Interatrial conduction time is early marker of disturbed impulse propagation in adult with elevated blood pressure. The aim of our study was to evaluate significance of noninvasive echocardiographic marker of slow sinus impulse propagation (atrial conduction time) for the identification of persons with slightly elevated blood pressure and hypertension in adults. Methods: One hundred and forty nine adults with normal and elevated blood pressure were studied: 46 normotensive adults (group 1), 28 adults with elevated blood pressure and hypertension stage 1 (group 2) and 75 adults with hypertension stage 2 (group 3), based on the Joint National Committee 8 (JNC-8) hypertension guidelines. We studied P wave dispersion, reservoir function of the left atrium (LA), total emptying volume of the LA and total emptying fraction of the LA (LATEF). The atrial conduction time (ACT) was evaluated by the pulsed tissue Doppler, and expressed as interatrial and intraatrial conduction time. Results: The LATEF decreased progressively from the group 3 (64.8 ± 4.4%) to the group 2 (59.8 ± 5.2%) and the group 1 (55.6 ± 7.3%) (p < 0.001). The P wave dispersion (55.1 ± 9.8 ms vs. 46.8 ± 3.1 ms vs. 43.1 ± 2.6 ms; p < 0.01) and intra ACT were significantly prolonged only in the group 3 compared to the other groups (22.7 ± 11.0 ms vs. 8.4 ± 4.7ms vs. 5.6 ± 2.4 ms, respectively; p < 0.001). Inter ACT significantly increased from the group 1 to the group 2 and the group 3 (15.6 ± 3.9 ms vs. 24.6 ± 5.7 ms vs. 50.4 ± 20 ms, respectively; p < 0.05). Using a cut-off level of 19.5 ms, inter ACT could separate adults in the group 2 from the group 1 with a sensitivity of 85%, and specificity of 89% [area under receiver operating characteristic (ROC) curve 0.911]. Conclusion: Prolonged ACT estimated with the tissue Doppler may be useful for identification persons with slighty elevated blood pressure, and hypertension stage 1. © 2020 Inst. Sci. inf., Univ. Defence in Belgrade. All rights reserved.