Introduction: The most common cause of myocardial ischemia is atherosclerotic epicardial coronary artery disease, present in 90% of patients. Risk factors positively correlate with the onset, development and subsequent complications of atherosclerotic disease. Aim: Determine the percentage frequency of classic risk factors for coronary disease in patients with non-ST segment elevation myocardial infarction (NSTEMI), with regard to gender. Methods: A retrospective study was conducted on 600 respondents, treated for NSTEMI at the Clinic for Internal Medicine of the University Clinical Center (UKC) Tuzla, in the period from June 2016 to December 2019. Results: Overall, smoking was the leading risk factor (65%), followed by hypertension (58%), hyperlipoproteinemia (39%), overweight (33%), positive family burden (30%) and diabetes mellitus (19%). In male patients, the leading risk factor was smoking, rating at 74%, while in female patients -it was hypertension at 67%. In younger groups of patients leading risk factors were smoking and a positive family burden. Conclusion: With adequate prevention and treatment measures, a significant reduction in the prevalence of the cardiovascular disease can be achieved, since the risk factors for its development have long been known. Quitting smoking is one of the most effective secondary prevention measure since it reduces the reinfarction risk rate by 50%. Knowledge of coronary risks, as well as success in reducing them, can greatly contribute to patients' overall sense of contentment and significantly raise their self-confidence.
Background: The transfemoral (TF) arterial approach is still the most commonly used approach for performing diagnostic coronary angiography in most centers in the world as well as in Bosnia and Herzegovina. Recently, the transradial (TR) arterial approach has gained more and more supporters among interventional cardiologists. Objective: The aim of the study was to compare the duration of the procedure, the amount of delivered ionizing radiation, the amount of applied contrast agent, the frequency of procedural complications and patient comfort during coronary angiography performed via TR and TF arterial approach. Methods: The total sample of 240 respondents was divided into two groups in such a way that the first group consisted of 121 respondents who underwent coronary angiography using TR arterial approach, and the second group consisted of 119 respondents who underwent coronary angiography using TF arterial approach. The Mann-Whitney U test was used to verify the research objective. Results: The obtained research results showed that the duration of coronary angiography and the amount of radiation was greater when using TR arterial approach compared to TF approach. There is no statistically significant difference in relation to the amount of applied contrast medium and the frequency of complications between the two approaches. Periprocedural and postprocedural comfort was better in patents who underwent TR approach. Conclusion: The findings of this study show that diagnostic coronary angiography performed via the TR arterial approach is as safe for the patient as diagnostic coronary angiography performed via the TF arterial approach. With both approaches, there is no significant difference in the amount of contrast agent used nor in the frequency of complications. Procedure duration and radiation exposure are shorter when TF arterial approach i used, while patient comfort is better when the TR arterial approach is used.
The most significant discoveries in the area of heart failure are the recognition of natriuretic peptide system and its multiple effects on cardiac structure and function with special effect on its natriuretic and hemodynamic processes. First information’s that heart, beside its function as a mechanical pump also has an important endocrine functions, exists for over 50 years. Chemical structure of atrial natriuretic peptide has been identified in 1984. and four years later a brain natriuretic peptide has been discovered owning its name because it has been identified in pig brain. Primary site of brain natriuretic peptide synthesis in heart has been identified in 1991. Natriuretic peptides are neither neurohormones that influence body fluid homeostasis through natriuretic and diuretic effect; regulate vascular tone by decreasing angiotensine II level and they inhibit nor epinephrine synthesis and increase parasympathetic tone. They are natural antagonists of renin-angiotensine-aldosteron system, and they have a great role in inhibition of ventricular hypertrophy and remodeling, protective effects in endothelial dysfunction are important; they increase effects of nitrite oxide, inhibit lipid deposition in vascular wall and inhibit thrombocyte activation, regulate coagulation and fibrinolytic processes as well. Natriuretic peptides clinical use is in early evaluation of heart failure, prognostic stratification and detection of systolic and diastolic dysfunction of left ventricle, assessment of prognosis during patient monitoring period, differential diagnosis of dyspnea, treatment adjustment and dosage titration, assessment during hospital admittance and discharge and forecast and reduction of coronary events.
The aim of the research was to determine whether the age of the patient affects the duration of the procedure and the amount of ionizied radiation delivered when performing diagnostic coronary angiography. The research was conducted at the Clinic for Invasive Cardiology of the Public Health Institution "University Clinical Center" Tuzla in the period from December 2018. to January 2020. The research included a total sample of 240 respondents, average chronological age of 62.60 ± 9.22 years, ranging from 24 to 85 years. Out of a total of 240 respondents, in 121 respondents coronarny angiography was performed using transradial arterial approach and 119 by performing a transfemoral arterial approach. The total sample was divided into two subsamples of respondents. The first sub-sample consists of respondents up to 65 years of age, and the second sub-sample consists of respondents over 65 years of age. During each performance of coronary angiography, the duration of the procedure (in minutes and seconds) and the amount of radiation delivered during the procedure (in mGy) were measured. The research data were processed using the method of parametric and non- parametric statistics. The Mann-Whitney U test was used to verify the research objective. Based on the obtained research results, it can be concluded that in patients over 65 years of age, the duration of the coronary angiography procedure is longer, and is at the limit of statistical significance (p= 0.057). The amount of delivered radiation is higher in respondents over 65 years of age, but it is not statistically significant (p= 0.396). Keywords: Coronary angiography, coronary disease, procedure duration, age, amount of delivered radiation.
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