G Ital Car<strong>di</strong>ol Vol 8 Suppl 2-5 2007 demonstrated the advantage of early abciximab administration on pre-PCI patency rate of the infarct related artery (IRA), resulting in improved myocar<strong>di</strong>al reperfusion and clinical outcome. It is not known whether early abciximab administration influences myocar<strong>di</strong>al reperfusion and functional recovery in the subgroup of patients without pre-PCI optimal recanalization of the IRA (TIMI 3). Methods. Out of the 210 consecutive pts enrolled, 174 (83%) showed pre-PCI TIMI flow rate 4, pre-hospital delay> 2 hrs, pretreatment delay >2 hrs, and age classes, were not significant. At 5-year follow-up, mortality resulted significantly correlated with IRV flow before PCI (log rank p=0.04). survival 1,0 0,9 0,8 0,7 0,6 0,5 SURVIVAL ACCORDING TO IVR PATENCY BEFORE PCI TIMI 3= 87% TIMI 2= 82% TIMI 0/1= 67% 0 20 40 60 80 follow up (months) Conclusions. In a real world population, when organizational characteristics and time delays significantly <strong>di</strong>ffer from RCT, a timely strategy of thrombolysis followed by PCI (facilitated or rescue) warrants a better IVR patency compared to the patients receiving a later pPCI, and this possibly explain the better 5-year survival. Infarto miocar<strong>di</strong>co acuto: stratificazione prognostica C92 ELEVATION OF GAMMA-GLUTAMYLTRANSFERASE LEVELS IN DIABETIC PATIENTS SUFFERING FROM AN ACUTE MYOCARDIAL INFARCTION: AN INDEX OF ADVERSE OUTCOME S. Patanè*, F. Marte*, G. Di Bella**, R. Romeo*** , G. D’Andrea****, R. Giuffrè*, A. Currò*, R. Parisi* *Car<strong>di</strong>ologia, Nuovo Presi<strong>di</strong>o Ospedaliero Cutroni Zodda-Barcellona P.D.G. (ME), AUSL 5 Messina, **Car<strong>di</strong>ologia Policlinico Univ. Messina, ***Car<strong>di</strong>ologia, Ospedale Giarre AUSL3, Catania, ****Diabetologia, Ospedale Milazzo AUSL 5, Messina Aim of the study. The pathophysiological dysfunction of protein kinases C (PKCs) signaling pathways underlies the molecular basis of several car<strong>di</strong>ovascular responses. In experimental models in obese <strong>di</strong>abetics animals significant inhibition of insulin-induced glucose uptake, significant increase of Reactive oxygen species (ROS),of basal glucose uptake and of activity of delta PKC have been reported.The hypothesis that increased glucose intake increases oxidative stress, which in turn promotes the activation of delta PKC and that ad<strong>di</strong>tional mechanisms may be operating to produce ROS under hyperglycemic con<strong>di</strong>tions, inclu<strong>di</strong>ng the formation of advanced glycation end products or activation of oxidases such as NADPH oxidase have been reported too. Gammaglutamyltransferase (GGT) regulates PKC activity and its physiologic role is to initiate the hydrolysis of extracellular glutathione (GSH). It has also been reported GGT iron-dependent LDL oxidation and that the products of the GGT irondependent reaction may themselves lead to increased free ra<strong>di</strong>cal production. There is some evidence from recent stu<strong>di</strong>es that GGT is independently associated with car<strong>di</strong>ovascular mortality. Aim of this study was to investigate if there were relations among higher GGT levels, ejection fraction and adverse car<strong>di</strong>ac events in <strong>di</strong>abetic patients with Acute Myocar<strong>di</strong>al Infarction (AMI) and without renal failure. Methods. We stu<strong>di</strong>ed, in a retrospective analysis,140 <strong>di</strong>abetic patients with AMI [94 patients with Non-ST-Segment Elevation Myocar<strong>di</strong>al Infarction (NSTEMI) and 36 patients with ST-Segment Elevation Myocar<strong>di</strong>al Infarction (STEMI)], <strong>di</strong>vided in two groups accor<strong>di</strong>ng to decrease of GGT (108 patients, named dGGT group) or elevation of GGT (32 patients, named eGGT group) during hospitalization for AMI. So we fixed a simple endpoint (Recurrent AMI, Heart Failure, Death) within ten months from hospitalization and a composite endpoint with at least a single adverse event. Results. We found significant correlations as follows: eGGT group (32pt) dGGT group (108pt) P value Recurrent AMI 34,375% (11/32pt) 5,555556% (6/108pt)
Comunicazioni rispetto a quelli fibrinogeno –, una minore prevalenza <strong>di</strong> coronarie esenti da stenosi (7% vs 24%, p = 0.01), una maggiore prevalenza <strong>di</strong> coronaropatia bivasale (28% vs 17%, p = 0.03), una maggiore prevalenza <strong>di</strong> coronaropatia trivasale (31% vs 20%, p = 0.04) e <strong>di</strong> interessamento critico del tronco comune (8% vs 3%, p = 0.03). I pazienti fibrinogeno + avevano inoltre un maggiore numero <strong>di</strong> lesioni coronariche prossimali (51/114 [45%] vs 34/80 [43%] lesioni coronariche, p
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