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Biomedical subjects

A N Samko

Publications and source records attributed to A N Samko.

At least 19 recordsLinked to original sources
PubMed2006

[In-hospital and remote results of the use of sirolimus coated coronary stent CYPHER].

Stents were implanted to 554 previously non-revascularized patients in 703 injured coronary segments; 32% of stented stenoses were complicated; 23% of patients received 2-4 stents. Immediate success was 100% with no cases of acute stent thrombosis. Rate of in-hospital subacute thrombosis and non-Q-wave myocardial infarction was 0.2%. Survival without restenosis, angina, myocardial infarction and repeat revascularization during follow up (mean duration 257+/-107 days) was 94%, restenosis rate -- 5.6%. Six patients with in-stent restenosis were successfully revascularized. All 108 patients followed for 27 months were alive by the end of this term.

Adult↗
PubMed2006

[Disturbances of thyroid function after coronary angiography].

Frequency of thyroid gland functional disturbances after introduction of iodine-containing radiographic contrast agents during coronary angiography was studied in 146 patients, residents of the zone of borderline iodine deficit. Frequency of thyroid pathology was high at baseline (39%). Functional state of the thyroid gland was assessed before and 1, 3, 6, 12 months after investigation. During first month after coronary angiography there were several new cases of thyrotoxicosis and hypothyroidism, as well as deterioration of preexisting functional disturbances of the thyroid. Patients with baseline pathology and functional disturbances of thyroid gland before conduction of coronary angiography should be included into risk group of development of iodine induced states.

Adult↗
PubMed2006

[Assessment of clinical course, prognosis and effectiveness of drug and nondrug treatment of patients with ischemic heart disease and occlusive coronary artery atherosclerosis (data of 5-year prospective follow-up)].

Data of 5-year prospective follow-up were used for assessment of clinical course, prognosis and effectiveness of drug and nondrug treatment of 202 patients with ischemic heart disease, occlusive coronary artery atherosclerosis and preserved left ventricular function. It was found that 5-year cardiovascular mortality and rate of nonfatal myocardial infarction did not differ significantly between groups of patients subjected to drug treatment only, transluminal balloon angioplasty, and coronary artery bypass grafting.

Adult↗
PubMed2005

Low daily dose of antioxidant probucol decreases incidence and severity of restenosis after transluminal coronary balloon angioplasty.

Antioxidant probucol in both high (1000 mg) and low (250 mg) daily doses effectively reduced manifestations of oxidative stress in patients with atherosclerosis (assessed by in vivo accumulation of lipoperoxides in atherogenic LDL). When probucol was administered in a dose of 250 mg/day for 7-10 days before transluminal balloon coronary angioplasty and then for 6 months after surgery, the incidence of restenosis decreased to 25% compared to 45% in the control (without probucol therapy). In the group of operated patients receiving probucol (250 mg/day for 6 months) the minimal artery lumen was significantly higher, and the degree of artery occlusion significantly lower than in the control group not treated with probucol.

Angioplasty, Balloon, Coronary↗
PubMed2005

[Markers of chronic inflammation in patients with ischemic heart disease with in-stent restenosis].

Concentrations of interleukins 6 and 10, tumor necrosis factor alpha, transforming growth factor beta and C-reactive protein were measured in 42 patients before and in remote period after coronary stenting. Patients with angiographically documented in-stent restenosis compared with those without restenosis had higher initial levels of interleukin 6 and more often discontinued therapy with statins.

Aged↗
PubMed2005

[Results of clinical trials of a novel glycoprotein IIb-IIIa antagonist framon in high-risk coronary angioplasty].

New glycoprotein (GP) IIb-IIIa antagonist preparation framon (Monafram), is the F(ab')(2) fragment of a monoclonal antibody FRaMon directed against GP IIb-IIIa. This preparation blocks GP IIb-IIIa binding with fibrinogen and inhibits platelet aggregation both in vitro and upon intravenous administration. Safety and ability of framon to prevent thrombotic complications in high risk coronary angioplasty (CA) was evaluated in the present study. FRAMON was injected intravenously into 153 patients just before the start of procedure as a single bolus at the dose of 0.25 mg/kg. Control group was formed of 126 patients who underwent angioplasty without GP IIb-IIIa blockers. After framon administration there were no allergic reactions or major bleedings, deep thrombocytopenia (< 50000/microl) developed in 1 patient (< 1%), and antibodies against framon were detected in less than 5% of patients. Number of unfavorable outcomes (cardiovascular death, myocardial infarction, angina recurrence) within 1 month after CA was 3 times higher in control group than in the group of patients treated with framon (11.4% and 3.3%, respectively, p = 0.018). The effect of framon was most strongly pronounced within the first day after procedure -- administration of the drug reduced number of acute thromboses from 6.5% to 0.7% (p = 0.013). Significant differences between numbers of end points was still preserved at 6 months after procedure (25.7 and 14.2% in control and framon groups, respectively, p = 0.023). The data obtained proved safety and clinical efficacy of framon administration in coronary angioplasty with high risk of thrombotic complications.

Angioplasty, Balloon, Coronary↗
PubMed2005

[Long-term results of the use of TAIS coronary stent. Data of prospective follow-up for 18 months].

The stent was placed in 528 coronary artery segments (39% complicated lesions) in 448 patients with coronary artery disease and no previous invasive interventions. Immediate angiographic success was 99.8% with no case of acute thrombosis. Six months survival without restenosis, angina, and reintervention was 83%. Repeat angiography was carried out in 432 patients with 502 stented stenoses. Index of vessel diameter loss and level of restenosis were 0.32+/-0.26, and 15,6%, respectively. Fifty four patients with in-stent restenosis were subjected to successful repeat revascularization. Eighteen months survival without myocardial infarction and reintervention was 70%. The study demonstrated favorable effect of TAIS on 18 month rate of thrombosis and restenosis in patients with native atherosclerotic lesions.

Adult↗
PubMed2005

[Two-year results after implantation of a metallic stent EPHESOS in patients with coronary heart disease].

AIM: To evaluate two-year results of using a metallic stent EPHESOS in patients with native atherosclerotic lesion of coronary arteries (without prior interventions). MATERIAL AND METHODS: The stent was implanted to 731 patients. 53% had manifestations of unstable angina. 42% of the lesions were complicated. The length of the stenosis was 15.5 +/- 6.8 mm, 44% stenoses were long. RESULTS: The success of stenting was 99.6%. Cases of acute and subacute thrombosis were absent. Non-Q wave myocardial infarction in primary hospitalization developed in 4 patients. For 6 months, cardiovascular complications (death, angina, restenosis, repeated revascularization) occurred in 21%. Angiographic control follow-up of 6 months maximum covered 329 (45%) patients. Hemodynamically significant restenosis was detected in 18% patients. Cardiovascular complications for 24 months occurred in 39%. CONCLUSION: The EPHESOS stent has demonstrated a stable long-term effect on prevention of thrombosis and restenosis in the majority of patients with a relatively high risk of intervention.

Coronary Disease↗
PubMed2004

[Quantitative myocardial perfusion assessment with magnetic resonance imaging in patients with coronary artery disease].

AIM: To elucidate feasibility of the absolute myocardial blood flow (MBF), total coronary resistance (TCR), and myocardial blood flow reserve (MBFR) quantification using MRI in patients with coronary artery disease (CAD). MATERIAL AND METHODS: A total of 19 patients with angiographically documented CAD and 9 healthy subjects were studied by MRI using double-slice saturation-recovery Turbo-FLASH sequence for monitoring myocardial first pass kinetics of Gd-DTPA-BMA at rest and during hyperemia (dipyridamole 0.56 mg/kg). The signal intensity curves were acquired within ROI for perfusion beds of the three main coronary arteries (LAD, LCX and RCA) and left ventricle cavity. Eighty five myocardial segments were included in final analysis (group 1 - supplied by < > coronary arteries, n=26; group 2 - supplied by arteries with non-significant diameter stenoses <50%, n=27; group 3 - supplied by arteries with significant stenoses >/=50%, n=32). Sixteen segments were revascularized subsequently (PCI or CABG). One-compartment model and slope-method were used for flow calculation. Myocardial and blood signal intensities were converted to concentration of Gd-DTPA-BMA according to the < > calibration curve. RESULTS: MBF was similar in groups at baseline (group 1 - 0.98+/-0.54, group 2 - 1.24+/-0.53 and group 3 - 1.28+/-0.48 ml/g/min) but significantly lower in group 3 during hyperemia (2.57+/-1.23, 2.99+/-1.14 vs. 1,79+/-0.94 ml/g/min, p<0.05). MBFR (the ratio of flow during hyperemia to flow at baseline) was significantly lower in group 3 than in groups 2 and 1 (1.4+/-0.7 vs. 2.7+/-1.3 vs. 2.9+/-1.2, respectively, p<0.01). Receiver-operator characteristic analysis of MBFR (value </=1.6) revealed sensitivity and specificity of 81% and 85%, respectively, for detection of CAD as defined by quantitative coronary angiography (stenosis diameter >/=50%). TCR (mean arterial pressure divided by flow) significantly decreased (78.8+/-42.2 vs. 41.3+/-17.3 mm Hg ґ min ґ g/ml, p<0.01), MBF accordingly increased (1.61+/-0.77 vs. 2.58+/-0.91 ml/g/min, p<0.01) during hyperemia and MBFR < > (1.3+/-0.6 vs. 3.0+/-1.3, p<0.00l) in myocardial segments after revascularization. CONCLUSION: Absolute MBF and MBFR calculation by first-pass contrast perfusion MRI are feasible in patients with CAD before and after revascularization.

Coronary Angiography↗
PubMed2004

[Matrix metalloproteinases, C-reactive protein, and markers of thrombinemia in patients with stable angina and restenoses after percutaneous coronary interventions.].

AIM: To elucidate relationships between blood levels of matric metalloproteinases (MMP), C-reactive protein (CRP), markers of thrombinemia, and development of restenosis after percutaneous coronary interventions (PCI) in patients with stable angina. MATERIAL: Patients (n=78, mean age 55.7+/-0.9 years) after successful PCI. METHODS: MMP-2, MMP-9, CRP, prothrombin fragments 1 and 2, thrombin-antithrombin complex and plasminogen activator inhibitor antigen were measured in blood plasma taken before PCI. Repeat coronary angiography was carried out in 31 patients 6-8 months after PCI. Exercise ECG was used for diagnosis of restenosis in other patients. More than 1 mm ST depression in same ECG leads as before PCI was used as criterion of restenosis. RESULTS: Overall sings of restenosis were found in 28 patients (35.9%). Patients with and without restenosis had similar contents of prothrombin fragments 1 and 2, thrombin-antithrombin complex, plasminogen activator inhibitor antigen and CRP, while patients with restenosis had significantly higher levels of MMP 2 and 9 (r<0.05). At multifactorial analysis level of MMP-9 was independently related to development of restenosis. CONCLUSION: Elevated level of MP-9 has predictive value in relation to development of restenosis.

Angina, Stable↗
PubMed2004

[Achievements of invasive cardiology 2003. Part I.].

The authors present a review of research works completed or conducted in 2003 which according to their opinion contributed most to the rapidly progressing field of invasive/interventional cardiology. The year passed was characterized by wide introduction into clinical practice of stents coated with antirestenotic agents, substantial advances in pharmacological support and improvements of safety of coronary interventions, active studies of contrast induced nephropathy and assessment of novel devices for myocardial protection against distal embolism during interventions both on coronary arteries and vein grafts. Recent results of comparisons of mechanical and pharmacological myocardial reperfusion in acute ST-elevation myocardial infarction can be considered revolutionary for clinical cardiology. Part I of the review deals with invasive treatment of acute coronary syndrome and pharmacological support of coronary interventions.

Achievement↗
PubMed2004

[Achievements of Invasive Cardiology 2003. Part II.].

The authors present a review of research works completed or conducted in 2003 which according to their opinion contributed most to the rapidly progressing field of invasive/interventional cardiology. The year passed was characterized by wide introduction into clinical practice of stents coated with antirestenotic agents, substantial advances in pharmacological support and improvements of safety of coronary interventions, active studies of contrast induced nephropathy and assessment of novel devices for myocardial protection against distal embolism during interventions both on coronary arteries and vein grafts. Recent results of comparisons of mechanical and pharmacological myocardial reperfusion in acute ST-elevation myocardial infarction can be considered revolutionary for clinical cardiology. Part I of the review deals with invasive treatment of acute coronary syndrome and pharmacological support of coronary interventions.

Achievement↗
PubMed2003

[Immediate and long-term outcomes after "Ephesos" coronary stent implantation in patients with stable or unstable angina].

AIM: An open non-randomized trial was initiated to assess clinical and angiographic results of using the coronary stent "Ephesos" in 457 patients with stable or unstable angina pectoris and native coronary affections. MATERIAL AND METHODS: 268 stents have been implanted in 231 patients with stable angina (SA) and 271 stents--in 226 patients with unstable angina (UA). 46% lesions were complicated. The length of stenosis was 12.9 +/- 6.7 mm in the group SA and 14.1 +/- 7.4 mm in the group UA, 30% stenoses were long. RESULTS: Successful stenting was stated in 99% without cases of acute thrombosis. Non-fatal myocardial infarction took place in hospital in 1.3% of SA patients and in 2.6% of UA patients. Incidence of cardiac complications (death, recurrent angina pectoris, myocardial infarction, restenosis, repeated revascularization) for 6-month follow-up was 15.6% in SA group and 18.1% in UA group. At angiographic control, the index of vascular diameter loss made up 0.22 +/- 0.2 in SA group and 0.3 +/- 0.27 in UA group. Incidence of restenosis was 12 and 14%, respectively. 18-month follow-up found no differences in frequency of complications: 21.6 and 22.6% in groups SA and UA, respectively. CONCLUSION: Implantation of the stent "Ephesos" is effective in prevention of thrombosis and restenosis in patients with stable or unstable angina pectoris at high risk of intervention.

Angina Pectoris↗
PubMed2003

[Quantitative assessment of right ventricular contractility by contrast angiography in healthy persons and patients with ischemic heart disease].

Absence of special programs for quantitative analysis of right ventricular volumes and function precludes precise evaluation of right ventriculography data. We used standard programs designed for analysis of left ventriculograms for evaluation of right ventricular volumes and function in 32 patients without and 20 patients with coronary artery disease. Left ventriculography and right angiography were carried out in 30- and 60-degree right and left anterior oblique projections, respectively. Average correction factors obtained by comparison of left and right ventricular stroke volumes were 0.9243+/-0.2887 and 0.8758+/-0.2232 for patients without and with coronary artery disease, respectively. Such conversion was considered to be simple and adequate method of adaptation of existing programs of quantitative analysis of angiograms for evaluation of right ventricular volumes and function.

Adult↗
PubMed2003

[Efficacy and safety of the TAIS coronary stent implantation: nine month multicenter study].

AIM: Assessment of clinical and angiographic results of a balloon-expandable steel matrix stent TAIS in patients with atherosclerosis of the coronary arteries with no history of previous interventions in the course of an open non-randomized multicenter trial. MATERIAL AND METHODS: The TAIS stent was implanted in 187 patients into 199 stenoses. 47% patients had clinical manifestations of unstable angina pectoris. 29% cases were complicated. The length of the stenoses reached 11.3 +/- 5.4 mm, 22% stenoses were prolonged. RESULTS: This coronary stenting was effective in 100% cases, neither acute nor subacute thromboses were seen. Myocardial infarction without occlusion of the stent developed in 3 patients. The incidence of cardial complications (death, angina, restenosis, repeated revascularization) in 6 month follow-up was 11.8%. An angiographic control in 6 months was made in 184 patients (194 stenoses). The vascular diameter loss index was 0.40 +/- 0.21, a restenosis level--10.7%. A logistic regression analysis has revealed significant correlations between the length of the stent and a target vascular diameter with subsequent restenosis. Repeated revascularization was performed in all the patients with stent restenosis. After control angiography cardiac complications developed in 13.9% patients. Nine month follow-up registered cardiac complications in 17.6% cases. CONCLUSION: The TAIS stent was found effective in prevention of thrombosis and restenosis in patients with a relatively high risk of intervention.

Adult↗
PubMed2002

Safety, inhibition of platelet aggregation and pharmacokinetics of Fab'2 fragments of the anti-glycoprotein IIb-IIIa monoclonal antibody FRaMon in high-risk coronary angioplasty.

The purpose of the study was to evaluate safety, effects on platelet aggregation and pharmacokinetics of F(ab')(2) fragments of anti-glycoprotein (GP) IIb-IIIa murine monoclonal antibody FRaMon (F(ab')(2) FRaMon) upon its intravenous administration in patients undergoing high-risk coronary angioplasty. Patients were treated before angioplasty with F(ab')(2) FRaMon at 0.2 mg/kg (n = 17) and 0.25 mg/kg (n = 12) bolus or with abciximab at 0.25 mg/kg bolus + 12 h infusion at 0.125 microg/kg per min (n = 29). F(ab')(2) FRaMon at both doses decreased platelet aggregation induced by 20 microM ADP to <10, <20, <40 and <70% of the predrug level at 1, 12, 24 and 72 h after injection, respectively. No significant differences were observed between F(ab')(2) FRaMon and abciximab antiaggregatory effects. In none of the patients did F(ab')(2) FRaMon cause allergic reactions, major bleedings or deep thrombocytopenia. Antibodies against F(ab')(2) FRaMon were detected in one patient. Free F(ab')(2) FRaMon was cleared from plasma within 12 h, while platelet-bound preparation occupied >95, 70-80 and 40-50% of GP IIb-IIIa at 1 and 12-24 h and 3 days after injection, respectively. Thrombotic complications within the first month after angioplasty in groups treated with F(ab')(2) FRaMon and abciximab were observed in one and two patients, respectively. The data obtained have shown that F(ab')(2) FRaMon at bolus administration to patients undergoing coronary angioplasty caused no serious side effects and at comparative dosage inhibited platelet aggregation with the same efficacy as abciximab at bolus + infusion administration.

Abciximab↗