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Ioannis Lekatsas

Publications and source records attributed to Ioannis Lekatsas.

4 recordsLinked to original sources

Prognostic significance of microalbuminuria in non-diabetic patients with acute myocardial infarction.

BACKGROUND: The aim of this study was to examine whether the presence of microalbuminuria (20-200 microg/min) can predict in-hospital morbidity and mortality in non-diabetic patients with acute myocardial infarction. METHODS: Two hundred twenty-three (172 men and 51 women) non-diabetic patients with acute myocardial infarction were studied prospectively. The main outcome measures of the study were based on a comparison of in-hospital mortality and major non-fatal in-hospital events (pulmonary edema, post-infarction angina, infarct extension, mechanical complications, conduction disturbances and ventricular arrhythmias) between microalbuminuric and normoalbuminuric patients. RESULTS: A significant proportion of patients (33.6%) had microalbuminuria. Seventy-six patients (34%) developed an in-hospital event (fatal or non-fatal). Six patients (2.7%) with acute myocardial infarction died in the hospital. Patients with microalbuminuria had a higher mortality rate in comparison with normoalbuminuric patients (6.6% vs. 0.68%, p = 0.01). For non-fatal events, the incidence of pulmonary edema and ventricular arrhythmias was significantly higher in patients with microalbuminuria (14.6% vs. 3.4%, p < 0.001 and 12% vs. 3.4%, p = 0.01, respectively). The combined end-point of the total number of fatal and non-fatal events was significantly higher in patients with microalbuminuria (57.3% vs. 22.3%, p < 0.001). In multiple logistic regression analysis, microalbuminuria (p < 0.001) and ejection fraction (p = 0.01) were independently related to the occurrence of major in-hospital events. CONCLUSIONS: Microalbuminuria is a significant predictor of in-hospital morbidity and mortality in non-diabetic patients with acute myocardial infarction.

Aged↗

Microalbuminuria: a strong predictor of 3-year adverse prognosis in nondiabetic patients with acute myocardial infarction.

BACKGROUND: The aim of this study is to evaluate the significance of microalbuminuria (MA) as a 3-year prognostic index in nondiabetic patients with acute myocardial infarction (AMI). METHODS: One hundred seventy-five patients with AMI were followed prospectively for 3 years. The study end point was cardiac death or rehospitalization for an acute coronary event. RESULTS: Forty-two patients (24%) developed a new cardiac event during the follow-up. Microalbuminuria (P < .001), pulmonary edema during initial hospitalization (P < .001) and postinfarction angina (P = .0364), advanced age (P = .001), severe atherosclerosis (high Gensini score) (P = .036), ejection fraction <50% (P = .0013), history of bypass surgery (P = .0265), and early conservative management (P = .0214) were all associated with adverse prognosis. Cox proportional hazards regression analysis showed that MA was an independent predictor of 3-year adverse prognosis in all the models tested, with an adjusted relative risk for the development of a cardiac event ranging from 2.1 to 4.3. CONCLUSIONS: In nondiabetic patients with AMI, MA is a strong and independent predictor of an adverse cardiac event within the next 3 years.

Aged↗

Comparison of the extent and severity of coronary artery disease in patients with acute myocardial infarction with and without microalbuminuria.

The extent and severity of coronary atherosclerosis were compared between 43 microalbuminuric and 87 normoalbuminuric nondiabetic patients with acute myocardial infarction. Patients with microalbuminuria had significantly greater scores of the severity (Gensini score) and extent (Hamsten score) of coronary artery disease (p <0.001).

Age Distribution↗

Study of atrial function using echocardiographic automatic boundary detection following external or internal cardioversion for idiopathic atrial fibrillation.

INTRODUCTION: The aim of this study was to evaluate the validity of an echocardiographic method of automatic boundary detection (ABD) in the assessment of the degree of atrial dysfunction in patients who had undergone external or internal cardioversion for idiopathic atrial fibrillation. METHODS: The study population included 31 patients (mean age 48 +/- 6.5 years) with idiopathic atrial fibrillation. The patients were randomised into two groups: Group 1 (14 patients, 8 +/- 3.13 joules), where internal cardioversion was applied, and Group 2 (17 patients, 200-360 joules), where external cardioversion was used for restoration of sinus rhythm. During the following 24 hours the ABD method was used in both groups to assess the following functional indices for both the left and the right atrium: a) total fractional change of atrial area (delta1), b) passive change of atrial area (delta2), c) change of atrial area due to atrial contraction (delta3) and d) index of % atrial expansion (delta4). RESULTS: All patients in both groups were successfully cardioverted (100%, p: NS). Post-cardioversion indices delta1-delta4 for both left and right atria did not differ between the 2 groups (p:NS). A negative correlation was found between left atrial function as assessed by ABD and the mean energy in joules delivered through the catheter in each patient for successful cardioversion (r = -0.55 to r = -0.67 and p = 0.04 to p = 0.01). However, no relevant correlations were found for the right atrium (p:NS). CONCLUSIONS: 1) The atrial dysfunction which follows the cardioversion of idiopathic atrial fibrillation (atrial stunning) is not related to the type of cardioversion (internal or external). 2) The higher the amount of energy delivered during internal cardioversion, the greater the degree of left atrial dysfunction observed.

Atrial Fibrillation↗