http://repository.usmf.md:80/xmlui/handle/20.500.12710/19621 The 4th International Medical Congress for Students and Young Doctors, May 17-19, 2012 2026-04-04T15:39:40Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/20356 MedEspera: The 4th International Medical Congress for Students and Young Doctors: abstract book, 2012 2012-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/20355 Cardiovascular risk estimation in patients with intraclinic atherosclerosis Dragan, Ion Introduction: Cardiovascular diseases are currently the leading cause of death in industrialized countries and are expected to become so in emerging countries by 2020. Among these, coronary artery disease (CAD) is the most prevalent manifestation and is associated with high mortality and morbidity. Quantitative assessment of risk is useful for clinical decision making. Several scores have been developed to estimate ischaemic and bleeding risks, with different outcomes and time frames (GRACE, TIMI, Duke). Objectives: Cardiovascular risk assessment in patients with unstable angina pectoris and their stratification for the appropriate management election. Materials and methods: The study was made in the period of december 2010 - april 2011 and included 80 patients with the diagnostic of unstable angina pectoris based on the clinical, electrocardiographic and échocardiographie evaluation. There have been assessed anginal syndromes, factors for cardiovascular risk, hemodynamic parameters at hospital admission, the results of the laboratory investigation. Duke score was calculated by the equation: Score = feature of angina x (1 + frequency of angina outbreaks/24h) + ST/T abnormalities. Depending on the total points, the risk was stratified in 3 groups: low, moderate, high. Results: The mean age of the patients included in the study was 60,72±0,89 years. Most of the patients showed angina pain at the admission. Clinical signs were dyspnoea (93,75%), palpitations (63,75%), presyncope. At the admission, 68,75% of the patients showed high blood pressure. Crucial risk factors were: arterial hypertension (91,25%), overweight/obesity (91,25%), dyslipidemia (38,75%), diabetes mellitus (28,75%). Echocardiographie atherosclerotic changes of aorta and valves were registered in 98,75% of cases. The assessment of Duke score has been established that 2,5% of the patients had low cardiovascular risk, 23,75% - moderate and 73,75% - high risk that correlates with a death rate of over 2% in one year. Patients with high risk were older, they required a longer hospitalization, they had higher blood pressure values and showed more pronounced changes in the lipid metabolism. Conclusions: Most of the patients with unstable angina pectoris have a high risk of cardiovascular events, which correlates with a death rate over 2% per year. Assessment of cardiovascular risk allows choosing of an adequate treatment (drug therapy or revascularization) which would increase the survival rate. 2012-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/20354 The influence of trimetazidine on the treatment of COPD associated with ischemic coronary artery disease Condaruc, Natalia Introduction: COPD associated with ischemic cardiopathy is not only a medical problem, but also a socio-economical one; its treatment still remains a current direction in contemporary medicine. The frequency of associated pathology is increasing and tends to affect younger people, of working age. Aim: To study the clinical efficacy of myocardial cytoprotector - trimetazidine (Preductal MB, France) and its use in the complex treatment of patients with COPD associated with ischemic cardiopathy. Objectives: 1. To study the influence of trimetazidine on clinical and paraclinical evolution of patients with COPD associated with ischemic cardiopathy. 2. Estimate the tolerance degree of trimetazidine in patients with COPD associated with ischemic cardiopathy. Material and methods: The study included 52 patients with II degree COPD, associated with ischemic cardiopathy (mean age 58,2±2,2 years) wich were divided into 2 similar groups. The basic group (n=26) received basic therapy combined with trimetazidine (70 mg/day), the control group (n=26) - only basic therapy. Diagnosis of COPD was set based on the GOLD criteria (2006) and the diagnosis of ischemic cardiopathy on the criteria developed by the Romanian Society of Cardiology (2004). The patients were investigated by ECG, Hollter, echocardiography, spirography, POL indexes: malonic dialdehyde (MDA), superoxide dismutase (SOD) and catalase. Results: Following the administration of combined therapy with trimetazidine it was found a significant decrease in the frequency of ischemic episodes by 33,6% (p <0,05) and in the frequency of dysrhythmias by 30,7% (p<0,05), while in the control group positive evolution was not statistically significant. It was determined a significant reduction of MDA by 1,85 (p<0,05), with the increase in SOD activity by 2,6 (p<0,05) and catalase by 1,5 (p<0,05), in the control group also being determined a positive, but insignificant, increase. It was determined the improvement of myocardial contractibility, the ejection fraction increasing by 11,8% (p<0.05), while in the control group the increase was insignificant. Respiratory function indexes in both groups improved, but there were no significant differences (p>0,l). During the study, the drug showed a good tolerance. Conclusion: Trimetazidine has a pronounced anti-ischemic, antiarrhythmic and antihypoxanth effect. The obtained results allow us to recommend the combined therapy with trimetazidine in the treatment of patients with COPD associated with ischemic cardiopathy. 2012-01-01T00:00:00Z http://repository.usmf.md:80/xmlui/handle/20.500.12710/20353 The role of cardiac markers TnI, CK- MB, LDG for prediction of survival in patients with acute myocardial infarction Cuciuc, V.; Cernit, V.; Grumeza, D.; Sandu, V.; Abraș, Marcel; Grib, A. Introduction: There is an increasing morbidity of patients with acute coronary syndrome (ACS) in the structure of population mortality. The most common risk factors in ACS group , which encompasses pathology of acute myocardial infarction (AMI) is hypertension. In 2000 the European Society of Cardiology and the ACC/AHA (American College of Cardiology/American Heart Association), recognized the pivotal role of biomarkers with elevations in their levels the “cornerstone” of diagnosis of AMI. Troponina I (Tnl), Creatine kinase MB isoenzyme (CK-MB), Lactat Dedhidrogenase (LDG), Myoglobin (MYO) - these are markers of cardiac injury. Established correlation in the levels of these markers would allow the prognosis of the survival chances of patients with AMI. Aims: The goal of this study is to examine the distribution of the biomarkers of cardiac cell injury and their association with the AMI mortality rate. Materials and methods: The research was performed retrospectively, based on the archive data of the Municipal Hospital Clinic “Sf. Treime”. It has involved 17 patients with diagnosis of AMI and hypertension, like risk factor. Our patients were tested in the laboratory, data were received using comprehensive testing platform “The Alere Triage Meter Pro”, using “Alere Triage Cardiac panel” of SANMEDICO company. This is an immunoassay, for quantitative measurements of MYO (ng/ml), CK-MB (ng/ml) and Tnl (ng/ml). The marker and the main criterion of patients selection was the Tnl below the 0.05 ng/ml. Results: Patients were diagnosed with AMI, according to WHO criteria. Total number of 17 patients were examined (100%), with an average age of 57 years, 7 of them were men (41.17%) and 10 - women (58.83%). Survived during the first 24 hours after hospitalization - 7 ps (41.17%), and 10 ps (58.83%) have died. It was detected CK-MB: 58.82% above the norm (10 ps), 41.12% in normal limits (7 ps); LDG: 52.94% above the norm (9 ps), 47.06% below the norm or in normal limits (8 ps); MYO: 52.94% above the norm (9 ps). Were identified arterial hypertension level 1 and 2 in all patients, 10 of them (58,82%) were identified with anterior extended MI, that corresponds to obstruction of left anterior descending artery (LAD) artery, 3 ps (17,64%) with circular MI, that corresponds to obstruction of circumflex (CX) artery, and 4 ps (23.53%) with diaphragmatic (inferior) MI, that corresponds in most cases to obstruction of right coronary artery (RCA). From the total number of patients, we identified 9 ps (52.94%) with narrow or wide QRS tachyarrhythmia. Discussion: The main questions in our study were: 1. Increased serum levels of which markers have been associated with evidence of reversible or irreversible cardiac injury (cell lesion)? 2. What major coronary artery is frequently involved in AMI, in our region? It has been demonstrated that testing for troponins initially on admission and repeatedly after 6 or 12 hours provides better risk stratification than preciously used algorithms based on ECG, CK-MB. Elevated levels of CK-MB, LDG and MYO denote a cardiac injury. In our cases they were associated with negative troponine results, which emphasize the reversible cardiac injury. Correlated with ECG data, which determine ST elevation lead V1-V4 (52.94%), infer damage of LAD artery. Conclusion: Study data estimate implying of LAD in the coronary artery pathology (58.82% cases of extended anterior MI), in condition of functionally compromised heart (52.94% of arrhythmias). Biomarkers values ranking shows the degree of cardiac injury. At the same time they allow the prognosis of the survival chances of patients with AML 2012-01-01T00:00:00Z