201
￭ S-303 ￭
Lipoprotein (a) and Cadiovascular Outcome in Patient with Percutaneous Coronary Intervention
대구가톨릭대학병원
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박정원, 이진배, 홍승표, 이영수, 류재근, 최지용, 김기식
Objectives: To assess the relationship between baseline lipoprotein (a) [Lp (a)] levels and the development of subsequent major adverse cardiac event (MACE) in patient with coronary artery disease (CAD). Method: Patients were devided quiartile by baseline Lp (a) level. The relationship between lev- els of Lp(a) and major adverse cardiac event (MACE) in each group were evaluated. Results: Baseline total cholesterol (TC), LDL cholesterol, HDL cholesterol and ApoA were no significant difference by Lp(a) quartile. The mean triglyceride (TG) of first quartile was higher than other quartle (p
＜0.01) and the mean ApoB of fifth quartile was higher than other quartile (p＝0.02). MACE free survival of 3rd and 4th quartile group was lower than 2nd quartile group (p value were 0.04 and 0.03 respectively). Conclusions: Low Lp (a) was associated with high triglyceride (TG) level. High Lp(a) was associated with increased CV risk in patient with PCI.
1st quartile 2ndquartile 3rdquartile 4thquartile p-Value
TC (mg/dl) 180.0±33.8 181.9±41.0 187.7±40.1 182.8±39.3 0.22
TG mg/dl) 165.9±129.7 144.6±96.9 128.8±79.4 129.9±77.9 ＜0.01
HDL (mg/dl) 49.2±12.6 46.5±12.4 46.9±11.7 49.0±12.8 0.06
LDL (mg/dl) 115.7±32.4 118.9±38.3 120.2±34.9 124.9±35.8 0.06
ApoA (mg/dl) 137.3±24.0 132.2±26.0 132.8±23.3 134.3±23.6 0.12
ApoB (mg/dl) 81.8±21.7 82.7±22.9 83.4±23.3 88.1±21.6 0.02
￭ S-304 ￭
Stress induced cardiomyopathy caused by adrenal crisis with both severe adrenal hemorrhage
Departments of Cardiology, Daegu Catholic University Medical center
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Jung Won Park, Seung Pyo Hong, Young Soo Lee, Jin Bae Lee, Jae Kean Ryu, Ji Yong Choi, Kee Sik Kim
Introduction: Adrenal crisis is rapid and overwhelming intensification of chronic adrenal insufficiency. However, cardiomyopathy induced by adrenal crisis is very uncommon. Here, we report a case of stress induced cardiomyopathy during acute adrenal crisis due to adrenal hemorrhage. Case Report A 64-year-old woman patient was admitted, complaining of mental change & hypotension. Left ventriculography is showned at Fig.1. Abdomen CT was performed due to abdominal pain cause evaluation. CT finding is suspicious bilateral adrenal hemorrhage and partial infarction (Fig.2). So rapid ACTH stimulation study was performed for suspicious adrenal insufficiency. And involving additional findings, hypotension as intractable response to in- otropic drug & high basal ACTH level & continuous drowsy mentality & fever. Considering her status of stress-induced cardiomyopathy, we supposed she could be suffering an acute adrenal crisis. She responded to hydrocortisone. Later, the left ventricular wall motion abnormalities including apical segment to be also markedly improved after steroid administration, returned to normal. Discussion This case involves an unusual form of stress-induced cardiomyopathy related to adrenal hemorrhage. In the present case, primary adrenal insufficiency associated with adrenal hemorrhage could have been the precipitating physical stress. Although the initial presentation of stress-induced cardiomyopathy is acute and appears to be severe, the overall prog- nosis is excellent, the wall motion abnormality usually returns to normal.
