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thrombolysis in acute myocardial infarction

Hae Young Yang, Min Joo Ahn, Myung Ho Jeong, Youngkeun Ahn, Young Jo Kim, Myeong Chan Cho, Chong Jin Kim
Acute myocardial infarction (AMI) is a fatal cardiovascular disease, and mortality is relatively high; therefore, integrated assessment is necessary for its management. There are several risk predictive models, but treatment trends have changed due to newly introduced medications and the universal use of percutaneous coronary intervention (PCI). The author aimed to find out predictive factors of in-hospital mortality in Korean patients with AMI. A group of 13,104 patients with AMI enrolled in the Korea Acute Myocardial Infarction Registry-National Institute of Health (KAMIR-NIH) registry were divided into two groups...
January 2019: Chonnam Medical Journal
Alexandre Hideo-Kajita, Toby Rogers, Kyle Buchanan, Micaela Iantorno, Deepakraj Gajanana, Yuichi Ozaki, Kazuhiro Dan, Paul Kolm, Echo Brathwaite, Solomon Beyene, Gebremedhin Melaku, Yael Meirovich, Aaphtaab Dheendsa, Hector M Garcia-Garcia, Rebecca Torguson, Ron Waksman
Percutaneous coronary intervention (PCI) in patients with angiographic evidence of intracoronary thrombus is associated with in-hospital and 30-day adverse clinical outcomes. Cangrelor, a direct, rapid-onset acting intravenous P2Y12 receptor inhibitor, has been proved to be effective by reducing peri-PCI ischemic complications in subjects who underwent PCI. This study aimed to assess the angiographic and in-hospital clinical outcomes in all-comer patients receiving cangrelor immediately before PCI at a tertiary care center...
January 25, 2019: American Journal of Cardiology
Anand N Shukla, Ashwal A Jayaram, Dhaval Doshi, Priyanka Patel, Komal Shah, Alok Shinde, Harsh Ghoniya, Karthik Natarajan, Tarun Bansal
BACKGROUND: Myocardial infarction is among the leading causes of morbidity and mortality in young adults around the world. OBJECTIVES: In the YOUTH (Young Myocardial Infarction Study of the Western Indians) registry, we aimed to evaluate risk factor profile and angiographic outcomes of reperfusion therapies of infarct-related artery in young western Indians (≤40 years) having ST-segment elevation myocardial infarction. METHODS: A total of 1,179 consecutive patients aged ≤40 years who presented with ischemic heart disease from June 2012 to December 2014 were enrolled in the YOUTH registry...
February 4, 2019: Global Heart
Ali Muhammad, Egidija Bielskute, Paul C Guyler, Iris Q Grunwald
A rare case of acute choreoathetosis after acute stroke is presented. This 66-years-old, right-handed Caucasian woman presented with weakness of her right arm and right leg with dysarthria, which resolved by the time she arrived in the emergency department. No obvious focal sign apart from the abnormal choreoathetoid movement of the right arm and leg and of the neck was present. Her medical history included atrial fibrillation without anticoagulation. CT head was nil acute (Alberta Stroke Program Early CT Score of 10)...
January 29, 2019: BMJ Case Reports
Dilpreet Singh, Idrees Suliman, Iryna Chyshkevych, Nemer Dabage
BACKGROUND Acute chest pain is a common presentation in emergency departments worldwide. Ruling out acute coronary syndrome is essential in ensuring patient safety. Workup includes electrocardiogram (ECG) and cardiac biomarkers. Wellens syndrome is characterized by a history of chest pain, normal or minimally elevated biomarkers, no STEMI/Q-waves, and specific ECG changes. These changes consist of biphasic T waves in lead V2 and V3 or deep symmetrically inverted T waves in leads V1-V4. CASE REPORT A 55-year-old male presented to the emergency department with acute chest pain in a background of active smoking, hypertension, and hyperlipidemia...
January 28, 2019: American Journal of Case Reports
Yang Cao, Gary S Mintz, Mitsuaki Matsumura, Wenbin Zhang, Yongqing Lin, Xiao Wang, Akiko Fujino, Tetsumin Lee, Tadashi Murai, Masahiro Hoshino, Eisuke Usui, Yoshihisa Kanaji, Taishi Yonetsu, Tsunekazu Kakuta, Akiko Maehara
BACKGROUND/PURPOSE: Layered pattern (presumed to be healed plaque after a thrombotic event) can be observed by optical coherence tomography (OCT). We sought to assess the ability of OCT-detected plaque composition to predict acute side branch (SB) occlusion after provisional bifurcation stenting. METHODS: This is a retrospective observational study using pre-intervention OCT in the main vessel to predict Thrombolysis in Myocardial Infarction (TIMI) flow grade ≤1 in a SB (diameter ≥ 1...
December 28, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Tufan Çınar, Yavuz Karabağ, Veysel Ozan Tanık, Metin Çağdaş, İbrahim Rencüzoğulları, Ahmet Öz
OBJECTIVE: Contrast-induced acute kidney injury (CI-AKI) is a well-known and life-threating complication in patients with ST-elevation myocardial infraction (STEMI) after primary percutaneous coronary intervention (PCI). Several studies demonstrated that the Thrombolysis in Myocardial Infarction (TIMI) Risk Index (TRI) is a useful risk model in predicting early mortality in patients with acute coronary syndrome. The objective of the present study is to evaluate the predictive value of admission TRI for the occurrence of CI-AKI in patients with STEMI treated with primary PCI...
January 25, 2019: Acta Cardiologica
Kei Yamamoto, Kenichi Sakakura, Naoyuki Akashi, Yusuke Watanabe, Masamitsu Noguchi, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
In primary percutaneous coronary intervention (PCI), revascularization to the main branch is considered to be more important than that to the side branch. The purpose of the present study was to compare in-hospital clinical outcomes between sufficient and insufficient diagonal flow in patients with anterior ST-elevation acute myocardial infarction. A total of 229 left anterior descending artery (LAD)-AMI with final Thrombolysis in Myocardial Infarction (TIMI)-3 LAD flow were included, and divided into the sufficient diagonal flow group (TIMI-3 diagonal flow: n = 170) and the insufficient diagonal flow group (TIMI ≤ 2 diagonal flow: n = 59)...
January 18, 2019: Heart and Vessels
J Antonio Gutierrez, Hillary Mulder, W Schuyler Jones, Frank W Rockhold, Iris Baumgartner, Jeffrey S Berger, Juuso I Blomster, F Gerry R Fowkes, Peter Held, Brian G Katona, Kenneth W Mahaffey, Lars Norgren, William R Hiatt, Manesh R Patel
Importance: The effect of polyvascular disease on cardiovascular outcomes in the background of peripheral artery disease (PAD) is unclear. Objective: To determine the risk of ischemic events (both cardiac and limb) among patients with PAD and polyvascular disease. Design, Setting, and Participants: In this post hoc secondary analysis of the international Examining Use of Ticagrelor in Peripheral Artery Disease (EUCLID) trial, outcomes were compared among 13 885 enrolled patients with PAD alone, PAD + coronary artery disease (CAD), PAD + cerebrovascular disease (CVD), and PAD + CAD + CVD...
November 2, 2018: JAMA network open
Wenduo Zhang, Fusui Ji, Xue Yu, Xinyue Wang
BACKGROUND: Percutaneous coronary interventions (PCI) of bifurcation lesions is technically challenging and associated with lower success rates and higher frequency of adverse outcomes. In the present study, we aimed to evaluate the immediate and long-term treatment effect and adverse events of a new modified jailed-balloon technique on side branch (SB) during PCI on coronary bifurcation lesions. METHODS: This was a prospective study of 60 patients (49 males, 11 females, mean age 66 ± 10 years) with coronary bifurcation lesions treated at the Beijing Hospital between September 2014 and October 2015...
January 10, 2019: BMC Cardiovascular Disorders
E S Luboyatnikova, A R Kiselev, M V Komarova, V A Rodionova, E V Kapp, D V Duplyakov
Acute myocardial infarction (MI), the most severe complication of coronary artery disease, develops in 2-4% of patients with various malignancies. PURPOSE: to explore the specific properties of ST-segment elevation myocardial infarction (STEMI) course in patients with cancer and its effect on short-term outcome. MATERIALS AND METHODS: We included in this study 45 patients with STEMI and history of cancer hospitalized in the period from 01.01.2015 to 01.01.2017 (group I; 58% men, mean age 69...
December 25, 2018: Kardiologiia
Dong Zhang, Yuan He, Ruohua Yan, Dong Yin, Lei Feng, Bo Xu, Yuejin Yang, Chenggang Zhu, Kefei Dou
OBJECTIVES: To describe procedural details of the double rewire (DR) crush technique, a novel modified crush technique, and report the clinical outcomes of patients who underwent the procedure. BACKGROUND: In the management of complex bifurcation lesions, there is a need to use elective two-stent techniques that stent the side branch (SB) before main vessel (MV) stenting and keep SB open. METHODS: We studied 48 patients with 49 bifurcation lesions who underwent percutaneous coronary intervention (PCI) using the DR-crush technique between January and December 2013...
January 2, 2019: Catheterization and Cardiovascular Interventions
Kamal Sharma, Komal Shah, Sachin Patil, Riyaz Charaniya, Hussain Bhatia, Jayesh Meniya
Ventricular septal rupture (VSR) is an uncommon but potentially lethal complication of acute myocardial infarction (MI). Its prompt recognition is essential to permit timely institution of corrective measures. The present study was undertaken to assess the diagnostic accuracy of a novel and unique angiographic sign, the 'winking coronary sign (WCS)', for recognizing post-MI VSR. The WCS is defined as partial transient occlusion of the infarct-related culprit artery overlying the site of VSR during ventricular systole with near normal filling in the diastole...
December 2018: Indian Heart Journal
Sanjeev Sanghvi, Rohit Mathur, Anil Baroopal, Aditya Kumar
BACKGROUND: The coronary slow flow phenomenon (CSFP) is an angiographic finding characterized by delayed distal vessel opacification in the absence of significant epicardial coronary stenosis. Although it is well-known to interventional cardiologists for approximately four decades, the etiopathogenesis still remains unclear. AIMS AND OBJECTIVES: In this study, we aimed to determine the clinical, demographic, risk factor and angiographic profile of patients with CSFP...
December 2018: Indian Heart Journal
Janina Stepinska, Izabela Wojtkowska, Lieven Annemans, Nicolas Danchin, Stuart J Pocock, Frans Van de Werf, Jesús Medina, Hector Bueno
OBJECTIVE: To analyse characteristics, management and outcomes of patients with acute coronary syndromes (ACS) receiving chronic oral anticoagulant (OAC) therapy enrolled in the EPICOR (long-tErm follow-uP of antithrombotic management patterns In acute CORonary syndrome patients) prospective, international, observational study of antithrombotic management patterns in ACS survivors (NCT01171404). METHOD: This post-hoc analysis evaluated the association between OAC use at baseline (OACb) and time from hospital admission to percutaneous coronary intervention (PCI) (tHA-PCI), pre-PCI thrombolysis in myocardial infarction (TIMI) 3 flow, stent type, length of hospitalisation, and clinical endpoints; death, non-fatal MI, and non-fatal stroke, a composite of these ± bleeding, over 2 years' follow-up...
December 27, 2018: Current Vascular Pharmacology
Henry Wamala, Leena Aggarwal, Anne Bernard, Ian A Scott
Introduction: We compared performance of nine risk scores for coronary heart disease (CHD) among patients presenting to an emergency department (ED) with undifferentiated chest pain of possible coronary origin. Methods: A retrospective study was undertaken of adult patients presenting with chest pain to atertiary hospital ED with no electrocardiographs or troponin results diagnostic of ischemic chest pain (ICP) or acute coronary syndrome at ED presentation, and no clearly evident noncoronary diagnosis...
2018: International Journal of General Medicine
YanFeng Ma, ChuHan Xiang, BuChun Zhang
BACKGROUND It is unclear whether high-dose atorvastatin pretreatment benefits acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI). To clarify this issue, we performed a meta-analysis of the published literature. MATERIAL AND METHODS Randomized controlled trials (RCTs) assessing high-dose atorvastatin pretreatment in ACS patients undergoing PCI were enrolled. Short-term major adverse cardiac events (MACEs), changes in serum high-sensitivity C-reactive protein (hs-CRP), peak creatine kinase-myocardial band (CK-MB) level, and thrombolysis in myocardial infarction (TIMI) grade 3 flow after PCI were studied as clinical outcomes...
December 23, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Gabriel Dotta, Francisco Antonio Helfenstein Fonseca, Maria Cristina de Oliveira Izar, Marco Tulio de Souza, Flavio Tocci Moreira, Luiz Fernando Muniz Pinheiro, Adriano Henrique Pereira Barbosa, Adriano Mendes Caixeta, Rui Manoel Santos Póvoa, Antônio Carlos Carvalho, Henrique Tria Bianco
BACKGROUND: Patients with ST-elevation acute myocardial infarction attending primary care centers, treated with pharmaco-invasive strategy, are submitted to coronary angiography within 2-24 hours of fibrinolytic treatment. In this context, the knowledge about biomarkers of reperfusion, such as 50% ST-segment resolution is crucial. OBJECTIVE: To evaluate the performance of QT interval dispersion in addition to other classical criteria, as an early marker of reperfusion after thrombolytic therapy...
December 17, 2018: Arquivos Brasileiros de Cardiologia
Joseph Allencherril, Mahboob Alam, Glenn Levine, Hani Jneid, Dan Atar, Robert A Kloner, Yochai Birnbaum
Acute myocardial infarction (MI) is still a large source of morbidity and mortality worldwide. Although early reperfusion therapy has been prioritized in the modern era of percutaneous coronary intervention and thrombolysis, attempts at incremental improvements in clinical outcomes by reducing MI size have not been successful so far. Herein, we review the studies that have evaluated immediate-onset antiplatelet therapy as attempts to improve meaningful clinical outcomes in ST-segment elevation MI (STEMI). Unfortunately, many of the adjunctive pharmacotherapies have proven to be disappointing...
December 18, 2018: Journal of Cardiovascular Pharmacology and Therapeutics
Maria Mirabela Manea, Dorin Dragoş, Emanuel Stoica, Adrian Bucşa, Ioana Marinică, Sorin Tuţă
RATIONALE: Acute ST-segment elevation myocardial infarction (STEMI) is a rare complication of acute ischemic stroke (AIS) during thrombolytic therapy. We report a case of STEMI occurring 40 minutes after thrombolytic therapy for AIS and discuss the possible mechanisms and therapeutic approaches. PATIENT CONCERNS: A 87-year-old woman with a history of arterial hypertension was admitted for acute onset of right-sided limb weakness 2 hours before arrival at the emergency department...
December 2018: Medicine (Baltimore)
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