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acute STEMI

Hans-Josef Feistritzer, Ingo Eitel, Alexander Jobs, Suzanne de Waha-Thiele, Thomas Stiermaier, Mohamed Abdel-Wahab, Philipp Lurz, Sebastian J Reinstadler, Martin Reindl, Gert Klug, Bernhard Metzler, Steffen Desch, Holger Thiele
Data derived from several studies suggest a better survival in smokers with acute myocardial infarction, a phenomenon referred to as the 'smoker's paradox'. We aimed to investigate the association of smoking with cardiac magnetic resonance (CMR) imaging determined infarct severity and major adverse cardiac events (MACE) defined as the occurrence of death, reinfarction, and congestive heart failure at 12 months in patients with non-ST-elevation myocardial infarction (NSTEMI) reperfused by early percutaneous coronary intervention (PCI)...
February 15, 2019: International Journal of Cardiovascular Imaging
A H Tavenier, R S Hermanides, J P Ottervanger, S Rasoul, R J Slingerland, R Tolsma, S van Workum, E Kedhi, A W J van 't Hof
BACKGROUND: Fast and accurate platelet inhibition is an important therapeutic goal in the acute treatment of patients with ST-elevation myocardial infarction (STEMI). Platelet inhibitory effects induced by oral P2Y12-receptor antagonists are delayed in STEMI patients undergoing primary percutaneous coronary intervention (PCI) due to haemodynamic changes and delayed gastro-intestinal absorption. Concomitant use of opioids, although recommended in the American College of Cardiology/American Heart Association and European Society of Cardiology STEMI guidelines, further delays gastro-intestinal absorption...
February 14, 2019: Netherlands Heart Journal
Iain Mactier, Jonathan R Dalzell, David Carrick
CLINICAL INTRODUCTION: A 50-year-old woman presented with an inferoposterior ST-elevation myocardial infarction (STEMI) and underwent emergency percutaneous coronary intervention (PCI). Angiography revealed acute occlusion of the circumflex and right coronary (RCA) arteries. PCI was uncomplicated. Her medical history included asthma, hypertension and chronic sinusitis.Three months later, she presented with a non-STEMI (NSTEMI), and angiogram showed a new focal stenosis in the left anterior descending artery...
February 14, 2019: Heart: Official Journal of the British Cardiac Society
Shu-Jian Wei, Fang-Yun Luan, Da-Yu He, Feng Xu, Yu-Guo Chen
RATIONALE: Primary percutaneous coronary intervention (PPCI) is the most effective therapy for patients with an acute ST-segment elevation myocardial infarction (STEMI). However, up to half of STEMI patients suffer from coronary microvascular dysfunction, presenting as the slow flow or no-reflow phenomenon. PATIENTS CONCERNS: A 78-year-old man was admitted to the chest pain center with sudden chest pain and tightness for about an hour. DIAGNOSES: Electrocardiography demonstrated ST-segment elevation in leads II, III, aVF, and third-degree atrioventricular block...
February 2019: Medicine (Baltimore)
Graham C Wong, Michelle Welsford, Craig Ainsworth, Wael Abuzeid, Christopher B Fordyce, Jennifer Greene, Thao Huynh, Laurie Lambert, Michel Le May, Sohrab Lutchmedial, Shamir R Mehta, Madhu Natarajan, Colleen M Norris, Christopher B Overgaard, Michele Perry Arnesen, Ata Quraishi, Jean François Tanguay, Mouheiddin Traboulsi, Sean van Diepen, Robert Welsh, David A Wood, Warren J Cantor
Rapid reperfusion of the infarct-related artery is the cornerstone of therapy for the management of acute ST-elevation myocardial infarction (STEMI). Canada's geography presents unique challenges for timely delivery of reperfusion therapy for STEMI patients. The Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology STEMI guideline was developed to provide advice regarding the optimal acute management of STEMI patients irrespective of where they are initially identified: in the field, at a non-percutaneous coronary intervention-capable centre or at a percutaneous coronary intervention-capable centre...
February 2019: Canadian Journal of Cardiology
Xianjun Xue, Jing Kan, Jun-Jie Zhang, Nailiang Tian, Fei Ye, Song Yang, Hong Qu, Shao-Liang Chen
BACKGROUND: Differences in the predictors between ventricular septal rupture (VSR) and free wall rupture (FWR) have not been fully studied. Data on the prevalence and clinical outcome of heart rupture are limited. HYPOTHESIS: This study aimed to investigate heart rupture incidence and clinical results in patients with acute myocardial infarction (AMI). METHODS: Of 9265 AMI patients in the MOODY registry between March 1999 and October 2016, a total of 146 were studied...
January 23, 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Amer Harky, Mohamad Bashir, Ciaran Grafton-Clarke, Martin Lees, Sarah Fendius, Neil Roberts
Intraventricular conduction abnormalities following cardiac surgery have been thoroughly described, especially after valvular surgery. It is also widely known that several anesthetic factors can cause autonomic disturbances resulting in the unmasking of sinus node dysfunction, significant bradycardia, and cardiovascular collapse during the intraoperative period. However, little is known about asymptomatic episodes, especially those occurring prior to coronary artery bypass grafting (CABG). We report a rare occurrence of an intraventricular conduction defect that presented in an asymptomatic patient following non-ST-elevation myocardial infarction prior to urgent CABG...
July 2018: Journal of Tehran Heart Center
Raquel B Santos, Inês Silveira, Maria Trêpa, Bruno Brochado, Rui Magalhães, Patrícia Rodrigues, Maria J Sousa, André Luz, João Silveira, Aníbal Albuquerque, Severo Torres, Adelino F Leite-Moreira, Henrique Carvalho
AIM: Remote ischemic conditioning may reduce acute kidney injury (AKI) in patients undergoing a coronary intervention. As preinfarct angina (PIA) might act as a preconditioning stimulus in patients with ST-elevation myocardial infarction (STEMI), we aimed to study whether PIA reduces AKI in accordance to pre-existing chronic kidney disease. PATIENTS AND METHODS: We conducted a retrospective study including 891 consecutive STEMI patients who underwent primary coronary intervention from January 2008 to March 2016...
February 7, 2019: Coronary Artery Disease
Abhinav Sharma, Jie-Lena Sun, Yuliya Lokhnygina, Matthew T Roe, Tariq Ahmad, Nihar R Desai, Michael A Blazing
Risk prediction following acute coronary syndrome (ACS) remains challenging. Data-driven machine-learning algorithms can potentially identify patients at high risk of clinical events. The Improved Reduction of Outcomes: Vytorin Efficacy International Trial randomized 18,144 post-ACS patients to ezetimibe + simvastatin or placebo + simvastatin. We performed hierarchical cluster analysis to identify patients at high risk of adverse events. Associations between clusters and outcomes were assessed using Cox proportional hazards models...
January 25, 2019: American Journal of Cardiology
Nikolaos Spinthakis, Ying Gue, Mohamed Farag, Guogang Ren, Manivannan Srinivasan, Anwar Baydoun, Diana A Gorog
Impaired endogenous fibrinolysis is an adverse prognostic biomarker in acute coronary syndrome (ACS). Abnormally dense in vitro fibrin thrombi have been demonstrated in ACS patients and related to hypofibrinolysis using cumbersome, laboratory-based methods. We aimed to assess endogenous fibrinolysis using a point-of-care technique and relate this to clot architecture. From patients with ST-segment elevation myocardial infarction (STEMI), venous blood was drawn immediately on arrival to assess thrombotic status...
February 9, 2019: Journal of Thrombosis and Thrombolysis
Tarek A N Ahmed, Amr A Abdel-Nazeer, Ayman K M Hassan, Hosam Hasan-Ali, Amr A Youssef
BACKGROUND: Arrhythmias are considered one of the major causes of death in ST elevation myocardial infarction (STEMI), particularly in the early in-hospital phase. Pre-infarction angina (PIA) has been suggested to have a protective role. OBJECTIVES: To study the difference in acute electrocardiographic findings between STEMI patients with and without PIA and to assess the in-hospital arrhythmias in both groups. MATERIAL AND METHODS: We prospectively enrolled 238 consecutive patients with STEMI...
February 9, 2019: Annals of Noninvasive Electrocardiology
Ashley Verburg, Jasper L Selder, Martin J Schalij, Mark J Schuuring, Roderick W Treskes
Cardiac rehabilitation is aimed at risk factor modification and improving quality of life. eHealth has a couple of potential benefits to improve this aim. The primary purpose of this review is to summarize available literature for eHealth strategies that have been investigated in randomized controlled trials in post-myocardial infarction (MI) patients. The second purpose of this review is to investigate the clinical effectiveness in post-MI patients. Areas covered: The literature was searched using PubMed. Randomized controlled trials (RCTs) describing interventions in patients that had experienced a ST-elevation myocardial infarction or non ST acute coronary syndrome were eligible for inclusion...
February 7, 2019: Expert Review of Cardiovascular Therapy
Felipe Díez-Delhoyo, Enrique Gutiérrez-Ibañes, Ricardo Sanz-Ruiz, María Eugenia Vázquez-Álvarez, Hugo González Saldívar, Allan Rivera Juárez, Fernando Sarnago, Manuel Martínez-Sellés, Javier Bermejo, Javier Soriano, Jaime Elízaga, Francisco Fernández-Avilés
BACKGROUND: Approximately half of the patients presenting with ST-segment-elevation myocardial infarction (STEMI) have multivessel disease. The physiology of the nonculprit artery has not been thoroughly studied to date. We sought to characterize the coronary physiology of the nonculprit artery in the early phase after STEMI and determine the real prevalence of microvascular and endothelial dysfunction. METHODS AND RESULTS: Patients with STEMI and another coronary artery lesion in a different territory were prospectively included in an observational single-center study...
February 2019: Circulation. Cardiovascular Interventions
Ashraf Reda, Mohamed Ashraf, Mahmoud Soliman, Hany Ragy, Ahmed El Kersh, Waleed Abdou, Tamer Mostafa, Mohammed Hassan, Elsayed Farag, Hazem Khamis, Moheb Wadie, Atef Elbahry, Sameh Salama, Ghada Kazamel, Mohammed Sadaka, Morsy Mostafa, Akram Abd El-Bary, Osama Sanad, Samir Rafla, Yaser Abd El-Hady, Mohammed Selim, Nabil Farag, Helmy El-Ghawaby, Hosam El-Araby, Sameh Emil, Morad Beshay, Ahmed Shawky, Mahmoud Yusef, Mohammed Abd El-Ghany, Awni Gamal, Yaser Baghdady, Taymour Mostafa, Mohammed Zahran, Khaled El Rabat, Ahmed Bendary, Amany El Shorbagy
BACKGROUND: Egypt is the most populous country in the Middle East and North Africa and has more than 15% of the cardiovascular deaths in the region, but little is known about the prevalence of traditional risk factors and treatment strategies in acute coronary syndrome (ACS) patients across Egypt. METHODS: From November 2015 to August 2017, data were collected from 1 681 patients with ACS in 30 coronary care centres, covering 11 governorates across Egypt, spanning the Mediterranean coast, Nile Delta and Upper Egypt, with a focus on risk factors and management strategies...
January 16, 2019: Cardiovascular Journal of Africa
Salvatore Cassese, Yuki Katagiri, Robert A Byrne, Salvatore Brugaletta, Fernando Alfonso, Lorenz Räber, Michael Maeng, Andres Iñiguez, Evgeny Kretov, Yoshinobu Onuma, Michael Joner, Manel Sabaté, Karl-Ludwig Laugwitz, Stephan Windecker, Adnan Kastrati, Patrick W Serruys
AIMS: Bioresorbable scaffolds (BRS) were conceived to ensure transient coronary artery support during antiproliferative drug delivery. However, the everolimus-eluting bioresorbable scaffold Absorb (Abbott Vascular, Santa Clara, CA, USA) was found inferior to everolimus-eluting metallic stents (EES) in moderately complex coronary anatomies. We sought to investigate whether the Absorb represents a valuable option for the percutaneous treatment of patients with ST-elevation myocardial infarction (STEMI)...
February 5, 2019: EuroIntervention
Gabriela Borrayo-Sánchez, Martín Rosas-Peralta, Erick Ramírez-Arias, Guillermo Saturno-Chiu, Joel Estrada-Gallegos, Rodolfo Parra-Michel, Hugo R Hernandez-García, Ernesto A Ayala-López, Rafael Barraza-Felix, Andrés García-Rincón, Débora Adalid-Arellano, Guillermo Careaga-Reyna, José L Lázaro-Castillo, Lidia E Betancourt-Hernández, Rocío Camacho-Casillas, Martha Hernández-Gonzalez, Germán Celis-Quintal, Beatriz Villegas-González, Marco Hernández-Carrillo, Zaria M Benitez Arechiga, Abelardo Flores-Morales, Ana C Sepúlveda-Vildosola
INTRODUCTION: Mexico is the country with the highest mortality due to acute myocardial infarction in adults older than 45 years old according to the OECD (28 vs. 7.5% of the average). The first real-world study, RENASCA IMSS, showed a high-risk population at 65%, but 50% without reperfusion strategies. The aim was to describe the clinical presentation, treatment, and outcomes of acute coronary syndromes at the IMSS. METHODS: RENASCA IMSS is a nation-wide, prospective, longitudinal-cohort study...
February 1, 2019: Archives of Medical Research
Ammar Ashoori, Hamidreza Pourhosseini, Saeed Ghodsi, Mojtaba Salarifar, Ebrahim Nematipour, Mohammad Alidoosti, Ali-Mohammad Haji-Zeinali, Yones Nozari, Alireza Amirzadegan, Hassan Aghajani, Arash Jalali, Zahra Hosseini, Yaser Jenab, Babak Geraiely, Negar Omidi
We aimed to demonstrate the clinical utility of CHA2DS2-VASc score in risk assessment of patients with STEMI regarding adverse clinical outcomes particularly no-reflow phenomenon. We designed a retrospective cohort study using the data of Tehran Heart Center registry for acute coronary syndrome. The study included 1331 consecutive patients with STEMI who underwent primary angioplasty. Patients were divided into two groups according to low and high CHA2DS2-VASc score. Angiographic results of reperfusion were inspected to evaluate the association of high CHA2DS2-VASc score and the likelihood of suboptimal TIMI flow...
February 1, 2019: Medicina
Osman Karaarslan, Macit Kalçık, Volkan Çamkıran, Sinan Eliaçık, Çağlar Alp, Yusuf Karavelioğlu
ST-elevation myocardial infarction (STEMI) due to septic coronary embolism is a rare complication of infective endocarditis (IE) and is associated with high mortality rates. When common signs of IE are often overlooked on admission, the diagnosis may be established through complications, which may cause prominent symptoms. Here, we report a case of native mitral valve endocarditis with an unusual presentation with STEMI and concomitant ischemic stroke, which was due to multiple coronary and cerebral septic embolisms...
September 2018: Interventional Medicine & Applied Science
Yi-Heng Li, Yu-Wei Chiu, Jun-Jack Cheng, I-Chang Hsieh, Ping-Han Lo, Meng-Huan Lei, Kwo-Chang Ueng, Fu-Tien Chiang, Shih-Hsien Sung, Jen-Yuan Kuo, Ching-Pei Chen, Wen-Ter Lai, Wen-Lieng Lee, Jyh-Hong Chen
Background: Patients with acute coronary syndrome (ACS), including ST segment elevation myocardial infarction (STEMI) and non-ST segment elevation (NSTE)-ACS have a significant risk of morbidity and mortality. This study evaluated the practice patterns of ACS care in Taiwan from 2005 to 2018. Methods: Data from two nationwide ACS registries (2008-2010 and 2012-2015) were used. ACS patients who received percutaneous coronary interventions (PCIs) during admission were compared between the two registries...
January 2019: Acta Cardiologica Sinica
Gestur Thorgeirsson, Birna Bjorg Masdottir, Thorarinn Gudnason, Maria Heimisdottir
BACKGROUND: Marked changes in the epidemiology of acute coronary syndromes (ACS) have been observed over the last few decades in the Western Hemisphere. Incidence rates of ACS in Iceland 2003-2012 are presented. METHODS: All patients with unstable angina (UA), non ST-elevation myocardial infarction (NSTEMI) and ST-elevation myocardial infarc-tion (STEMI) admitted to Landspitali were included in the study. Data were obtained from hospital records and changes during the period were examined...
February 2019: Læknablađiđ
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