Abstract Patients who have clinical evidence of hypertension (HT) after coronary artery bypass surgery (CABS) have a poor prognosis in expression of acute myocardial infarction (AMI), as one of the MACE. Unrelieved anxiety can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. The purpose of this study was to evaluate the effectiveness of music therapy on prognosis of patients with HT and AMI, after CABS. Methods 314 patients (males 78.4%, mean age 59.8±1.2 yrs) with AMI after previous CABS have been selected from the patients consecutively submitted from January 2003 to January 2019. HT was registered in 166 (53.0%) pts with AMI after previous CABS. All patients with HT were randomized and divided in 2 groups: Study group of 83 patients treated with music therapy and Control group of 83 patients with no music therapy. Each patient in study group underwent two sessions of medical therapy (12 minutes) in a day. Both groups were similar in baselines, post-AMI characteristics and post-AMI medical therapy. The plasma cytokine and catecholamine were measured in both groups. Results In the Study group, heart rate was significantly decreased by music therapy (p=0.0196). In the Control group, there were no significant changes in heart rate. Among cytokines (p=0.0160), plasma interleukin-6 (IL-6) (p=0.0179) in the Study group was significantly lower than those in the Control group, as well as plasma adrenaline (p=0.0162) and noradrenalin (p=0.0218) levels. Conclusion This study provides support for the use of musical therapy in patients with HT and AMI after previous CABS. The positive effects of music therapy, in these patients, are probably because of enhanced of parasympathetic activities and reduction of plasma cytokine and catecholamine levels. Funding Acknowledgement Type of funding sources: None.

Introduction/Objective. The aim of this study was to analyze the usefulness and accuracy of artificial neural networks in the prognosis of infarcted patients with previous myocardial surgical revascularization. Methods. The 13 predictor variables per patient were defined as a data set. All the patients were divided into two groups randomly: the training group and the test group, of 1090 patients each. The evaluation of the neural network performance was organized by using the original data, as well as the complementary test data, containing patient data not used for training the network. In generating the file of comparative results, the program compared the actual outcome for each patient with the predicted one. Results. All the results were compared with 2 ? 2 contingency table constructed from sensitivity, specificity, accuracy, and positive?negative prediction. The network was able to predict the outcome with the accuracy of 96.2%, sensitivity of 78.4%, specificity of 100%, positive predictivity of 100%, and negative predictivity of 96%. There was not efficient prognosis of infarcted patients previously operated on using linear discriminant analysis (accuracy 68.3%, sensitivity 66.4%, and positive predictivity 30.2%). Conclusion. This study suggest that a neural network was better for almost all parameters in outcome prognosis of infarcted patients with previous myocardial surgical revascularization.

The purpose of this study was to evaluate the effectiveness of music therapy for reduction of anxiety and pain in patients with hypertension (HT) and early post-infarction angina (EPA). Most studies have shown that EPA implies an unfavorable long-term prognosis among patients with acute myocardial

was observed in CKD compared to non-CKD patients (CKD: 220,4±11,7 vs. non CKD 203,6±7,7 PRUs; p=0,231).In CKD patients, platelet inhibition was again significantly reduced in the prasugrel (78,0±26,8 PRUs; p=0.002) and ticagrelor (70,3±8,0 PRUs; p<0,001) groups compared to clopidogrel (Figure).Parallel findings were observed with Multiplate and VASP tests.Conclusions: Despite prasugrel and ticagrelor achieve greater platelet inhibition than clopidogrel in CKD patients with an ACS, clopidogrel is still the most widely used P2Y12 inhibitor in this high-risk population.

the 2MACE score as predictor of major adverse cardiovascular events (MACEs). Methods: We analyzed anticoagulated AF patients who were prospectively recruited into the multicentre FANTASIIA registry. Patients were treated with oral anticoagulation with vitamin K antagonists or direct oral anticoagulants, at least 6 months prior to inclusion. We studied CV risk factors and history of vascular disease. Annual incidence of thromboembolic, MACE (composite of nonfatal MI/revascularization, HF and cardiovascular death) and mortality were recorded. Results: We studied 1,937 patients (55.7% male, mean 73.8±9.4 years). Dyslipidaemia was the most prevalent risk factor (85.9%) followed by hypertension (80.5%), diabetes (29.2%) and metabolic syndrome (54.1%). After a year of follow-up, there were 60 MACE, 84 patients died (35 of CV causes) and 15 patients with stroke. Patients with 2MACE score ≥3 had higher rates of stroke, thromboembolism, total mortality, cardiovascular mortality and MACE compared to 2MACE score<3. A 2MACE score ≥3 was significantly associated with MACE (HR 3.66, 95% CI 2.16–6.22; p<0.001). The predictive performance of 2MACE according to the ROC curve (c-statistic) was 0.676 (CI 0.608–0.745).

Objective: It is well known, that the restless legs syndrome (RLS) is a disorder of the part of the nervous system that causes an urge to move the legs. Because it usually interferes with sleep, it also is considered a sleep disorder. People with restless legs syndrome have uncomfortable sensations in their legs and an irresistible urge to move their legs to relieve the sensations. The sensations are usually worse at rest, especially when lying or sitting. The symptoms are generally worse in the evening and at night. For some people, symptoms may cause severe nightly sleep disruption that can significantly impair their quality of life. It is well known, too, that sleep disorders influenced early hypertension (HTA) expression. The aim of this study was to analyze can RLS be first prognostic sign of HTA expression in young people, less than 45 years of age. Design and method: From January 2013, we analyzed 256 consecutive patients (pts) with HT younger than 45 years of age. All pts were divided in two groups: Group RLS - 128 pts with RLS and HTA and Group non-RLS - 128 pts without RLS and with HTA (control group of pts). Results: At baseline Group RLS was slightly younger (p = 0.0589), with more men (p = 0.5676). Control group of pts had slightly more hyperlipidemia (p = 0.0566). There was no differences in heredity for HTA expression (p = 1.8846). Other baselines characteristics were similar in both groups of patients. There was no differences between groups in anxiety score (r = 0.12, p = 0.10). Conclusions: This study provides support for use of RLS as one of the first prognostic sign of HTA expression in young people, less than 45 years of age.

Objective: The prognosis of patients (pts) after coronary artery bypass surgery (CABS) has been noted in many studies, but there were no studies which analyzed prognosis of light-to-moderate alcohol consumers with hypertension (HTA) after prior CABS. This substudy of POP-HT study (PostOperative Prognosis-HyperTension study), aimed to evaluating the influence of light-to-moderate alcohol consumption on the HTA expression in patients after prior CABS. Design and method: The effect of light-to-moderate alcohol consumption was assessed in 328 pts with HTA after prior CABS (post bypass group) and control group of 540 pts with HTA and without prior CABS, who were followed from April 1988 to December 2015. Results: At baseline post bypass group was slightly younger (p = 0.0402), with more men (p = 0.4450) and with more pts with previous angina (p = 0.0440) and previous AMI (p = 0.0389). Control group of pts had more hyperlipidemia (p = 0.0404). Other baselines characteristics were similar in both groups of patients. After adjustment for cardiovascular risk factors by logistic regression, alcohol consumption displayed a protective effect against HTA in post bypass group of patients, but not in control group of pts. Conclusions: The effect of light-to-moderate alcohol consumption is associated with decreasing risk of HTA in pts with prior CABS, but not in pts without prior CABS. This effect of light-to-moderate alcohol consumption is probably because of decreasing of cholesterol, triglycerides and fibrinogen, as well as physiological changes in coronary arteries and decreasing in sympathetic nervous system activity.

Objective: Most studies have shown that early post-infarction angina (EPA) implies an unfavorable long-term prognosis among patients with acute myocardial infarction (AMI). Unrelieved anxiety combined with hypertension (HTA) can produce an increase in sympathetic nervous system activity leading to an increase in cardiac workload. The purpose of this study was to evaluate the effectiveness of music therapy for reduction of anxiety and pain in patients with HTA and EPA. Design and method: The effectiveness of music in reducing anxiety and pain during EPA attacks was tested using a two-group pretest–posttest experimental design with 220 patients with HTA and EPA. Patients were randomly assigned to receive 30 min of sedative music (N = 110) or treatment as usual (N = 110). Anxiety, pain sensation, and pain distress were measured with visual analogue scales at start of chest pain episodes and 30 min later. Results: Repeated measures MANOVA indicated significant group differences in anxiety, pain sensation, and pain distress from pretest to posttest (p = 0.0018). Post hoc dependent t-tests and univariate repeated measures ANOVA (p = 0.0184) indicated that in the sedative music, anxiety, pain sensation, and pain distress all decreased significantly (p = 0.0118), while in the treatment as usual group, no significant differences occurred. Independent t-tests indicated significantly less posttest anxiety, pain sensation, and pain distress in the sedative music group than in treatment as usual groups (p = 0.0208). Conclusions: Sedative music was more effective than treatment as usual in decreasing anxiety and pain in patients with HTA and EPA. Patients with HTA should have beneficial of using sedative music as an adjuvant to medication during EPA episodes.