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https://www.readbyqxmd.com/read/28236545/air-pollution-and-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-angioplasty-a-direct-correlation
#1
Marco Zuin, Gianluca Rigatelli, Fabio dell'Avvocata, Claudio Picariello, Luca Conte, Lina Marcantoni, Paolo Cardaioli, Giovanni Zuliani, Loris Roncon
PURPOSE: The relationships between air pollutant concentration levels and admission for primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI) have never been assessed. METHODS: We retrospectively reviewed 4 consecutive years of medical and instrumental data (1st January 2012 to 1st March 2016) to identify patients admitted with STEMI and subsequently treated with primary PCI in our third referral center. Daily atmospheric pressure data (in hectopascal [hPa]) and air pollutant concentration levels were obtained from the regional meteorological service which had a monitoring site in our city (Rovigo, Italy)...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#2
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28191905/st-elevation-acute-myocardial-infarction-in-pregnancy-2016-update
#3
REVIEW
Sahar Ismail, Cynthia Wong, Priya Rajan, Mladen I Vidovich
Acute myocardial infarction (AMI) during pregnancy or the early postpartum period is rare, but can be devastating for both the mother and the fetus. There have been major advances in the diagnosis and treatment of acute coronary syndromes in the general population, but there is little consensus on the approach to diagnosis and treatment of pregnant women. This article reviews the literature relating to the pathophysiology of AMI in pregnant patients and the challenges in diagnosis and treatment of ST-elevation myocardial infarction (STEMI) in this unique population...
February 13, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28191743/manual-thrombectomy-efficiency-in-relationship-to-the-area-at-risk-in-patients-with-myocardial-infarction-with-timi-0-1-coronary-flow-insights-from-an-all-comers-registry
#4
André Luz, Inês Silveira, Bruno Brochado, Patrícia Rodrigues, Maria João Sousa, Raquel Santos, Maria Trêpa, Mário Santos, João Silveira, Severo Torres, Adelino F Leite-Moreira, Henrique Carvalho
OBJECTIVES: To review the effectiveness of manual thrombectomy (MT) in a series of patients with ST-elevation myocardial infarction (STEMI) exclusively presenting with TIMI 0-1 flow undergoing percutaneous coronary intervention (PCI), in accordance to the angiographically estimated area at risk (AAR). Second, to assess major in-hospital clinical events, emphasizing neurological outcomes. BACKGROUND: The routine utilization of MT in STEMI is not recommended. However, in recent trials, a significant proportion of patients had neither large thrombus burden nor a totally occluded coronary segment, neutralizing the expected benefits of MT...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28124201/hyperkalemia-masked-by-pseudo-stemi-infarct-pattern-and-cardiac-arrest
#5
Shareez Peerbhai, Luke Masha, Adrian DaSilva-DeAbreu, Abhijeet Dhoble
BACKGROUND: Hyperkalemia is a common electrolyte abnormality and has well-recognized early electrocardiographic manifestations including PR prolongation and symmetric T wave peaking. With severe increase in serum potassium, dysrhythmias and atrioventricular and bundle branch blocks can be seen on electrocardiogram. Although cardiac arrest is a worrisome consequence of untreated hyperkalemia, rarely does hyperkalemia electrocardiographically manifest as acute ischemia. CASE PRESENTATION: We present a case of acute renal failure complicated by malignant hyperkalemia and eventual ventricular fibrillation cardiac arrest...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28107455/staged-versus-one-time-complete-revascularization-with-percutaneous-coronary-intervention-in-stemi-patients-with-multivessel-disease-a-systematic-review-and-meta-analysis
#6
Zhenwei Li, Yijiang Zhou, Qingqing Xu, Xiaomin Chen
INTRODUCTION: In patients with acute ST-elevation myocardial infarction (STEMI), the preferred intervention is percutaneous coronary intervention (PCI).Whether staged PCI (S-PCI) or one-time complete PCI (MV-PCI) is more beneficial and safer in terms of treating the non-culprit vessel during the primary PCI procedure is unclear. We performed a meta-analysis of all randomized and non-randomized controlled trials comparing S-PCI with MV-PCI in patients with acute STEMI and MVD. METHODS: Studies of STEMI with multivessel disease receiving primary PCI were searched in PUBMED, EMBASE and The Cochrane Register of Controlled Trials from January 2004 to December 2014...
2017: PloS One
https://www.readbyqxmd.com/read/28105561/the-rise-and-fall-of-anticoagulation-with-bivalirudin-during-percutaneous-coronary-interventions-a-review-article
#7
REVIEW
Constantinos Andreou, Christos Maniotis, Michael Koutouzis
Bivalirudin is a direct thrombin inhibitor used during percutaneous coronary intervention (PCI). Treatment with bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPI) reduced bleeding complications, but resulted in higher rates of ischemic events, including acute stent thrombosis in ST segment elevation myocardial infarction (STEMI) patients. Thus, it may be considered a reasonable alternative antithrombotic agent in patients at high risk of bleeding undergoing PCI. However its superiority over heparin alone is questioned particularly in the era of novel antiplatelet agents and transradial PCI...
January 19, 2017: Cardiology and Therapy
https://www.readbyqxmd.com/read/28104044/procedural-variations-in-performing-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#8
REVIEW
Radhika M Mehta, Manyoo Agarwal, Ikechukwu Ifedili, Wael W Rizk, Rami N Khouzam
Multiple variations exist in performing a primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) among various cardiologists. These variations range from the choice of peripheral access artery (radial vs femoral), performance or time of complete angiography including left ventriculography, and nonculprit vessel angiography before or after intervening on the culprit vessel. The reasons for such variations include emphasis on door-to-balloon time, knowledge of cardiac anatomy before proceeding with pPCI, physician expertise, and the level of comfort with radial approach...
February 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28060863/the-systematic-evaluation-of-identifying-the-infarct-related-artery-utilizing-cardiac-magnetic-resonance-in-patients-presenting-with-st-elevation-myocardial-infarction
#9
Carine E Hamo, Igor Klem, Sunil V Rao, Vincent Songco, Samer Najjar, Edward G Lakatta, Subha V Raman, Robert A Harrington, John F Heitner
BACKGROUND: Identification of the infarct-related artery (IRA) in patients with STEMI using coronary angiography (CA) is often based on the ECG and can be challenging in patients with severe multi-vessel disease. The current study aimed to determine how often percutaneous intervention (PCI) is performed in a coronary artery different from the artery supplying the territory of acute infarction on cardiac magnetic resonance imaging (CMR). METHODS: We evaluated 113 patients from the Reduction of infarct Expansion and Ventricular remodeling with Erythropoetin After Large myocardial infarction (REVEAL) trial, who underwent CMR within 4±2 days of revascularization...
2017: PloS One
https://www.readbyqxmd.com/read/28045759/efficacy-and-safety-of-novel-oral-p2y12-receptor-inhibitors-in-st-segment-elevation-myocardial-infarction-patients-undergoing-pci-a-systematic-review-and-meta-analysis
#10
Jianjun Sun, Qian Xiang, Chao Li, Zining Wang, Kun Hu, Qiufen Xie, Yimin Cui
The efficacy and safety of novel oral P2Y12 receptor inhibitors (prasugrel and ticagrelor) are subjects of contention in ST-segment elevation myocardial infarction (STEMI) patients undergoing PCI, the optimal duration of therapy remains uncertain. We searched PubMed, Embase, Cochrane Library, CNKI, VIP, and WanFang Data to identify randomized controlled trials comparing novel oral P2Y12 receptor inhibitors to clopidogrel in STEMI patients undergoing PCI until February 2016. The primary efficacy and safety endpoint were all-cause mortality and major/minor bleeding...
January 3, 2017: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27991651/oxygen-therapy-for-acute-myocardial-infarction
#11
REVIEW
Juan B Cabello, Amanda Burls, José I Emparanza, Susan E Bayliss, Tom Quinn
BACKGROUND: Oxygen (O2) is widely used in people with acute myocardial infarction (AMI). Previous systematic reviews concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on heart ischaemia or infarct size. Our first Cochrane review in 2010 also concluded there was insufficient evidence to know whether oxygen should be used. Since 2010, the lack of evidence to support this widely used intervention has attracted considerable attention, prompting further trials of oxygen therapy in myocardial infarction patients...
19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27990795/thrombus-aspiration-in-stemi-patients-an-updated-systematic-review-and-meta-analysis
#12
Rafael A Meneguz-Moreno, J Ribamar Costa, Fabio H Oki, Ricardo A Costa, Alexandre Abizaid
INTRODUCTION: Clinical efficacy and safety of adjunctive thrombus aspiration (TA) in patients with ST-segment elevation myocardial infarction (STEMI) during percutaneous coronary intervention (PCI) remain controversial. EVIDENCE ACQUISITION: Twenty-five eligible randomized controlled trials were included to compare the use of thrombus aspiration (TA) with PCI and PCI-only for STEMI. The primary endpoint was major adverse cardiac events (MACE) according to study definitions...
December 16, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27983887/does-the-evidence-really-suggest-that-we-should-completely-revascularise-bystander-disease-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-angioplasty-why-we-still-need-more-definitive-trial-data-to-change-routine-practice
#13
REVIEW
Mark Mariathas, Bartosz Olechowski, Michael Mahmoudi, Nick Curzen
There remains considerable heterogeneity in the management of significant lesions in non culprit coronary arteries in STEMI patients undergoing primary percutaneous coronary intervention (PPCI). Three recent randomised trials have shown clinical outcome benefit in a complete revascularisation approach when compared to PPCI of the culprit artery alone. By contrast, observational data suggest that an aggressive complete revascularisation may not confer clinical benefit and may, in some cases, be harmful. Areas covered: In this review we discuss the three recent randomised trials that have advocated a complete revasculariation approach in addition to data available from registries...
February 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27882430/identification-of-cardiovascular-risk-factors-associated-with-bone-marrow-cell-subsets-in-patients-with-stemi-a-biorepository-evaluation-from-the-cctrn-time-and-latetime-clinical-trials
#14
Ariadna Contreras, Aaron F Orozco, Micheline Resende, Robert C Schutt, Jay H Traverse, Timothy D Henry, Dejian Lai, John P Cooke, Roberto Bolli, Michelle L Cohen, Lem Moyé, Carl J Pepine, Phillip C Yang, Emerson C Perin, James T Willerson, Doris A Taylor
Autologous bone marrow mononuclear cell (BM-MNC) therapy for patients with ST-segment elevation myocardial infarction (STEMI) has produced inconsistent results, possibly due to BM-MNC product heterogeneity. Patient-specific cardiovascular risk factors (CRFs) may contribute to variations in BM-MNC composition. We sought to identify associations between BM-MNC subset frequencies and specific CRFs in STEMI patients. Bone marrow was collected from 191 STEMI patients enrolled in the CCTRN TIME and LateTIME trials...
January 2017: Basic Research in Cardiology
https://www.readbyqxmd.com/read/27866018/intravenous-beta-blockers-in-st-segment-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#15
Lee H Sterling, Kristian B Filion, Renee Atallah, Pauline Reynier, Mark J Eisenberg
BACKGROUND/OBJECTIVES: The role of intravenous (IV) beta-blockers in conjunction with percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) remains unclear. We therefore conducted a meta-analysis to assess their role in the acute phase of STEMI. METHODS: We systematically searched the Cochrane Libraries, Medline, and EMBASE for RCTs comparing IV beta-blockers with inactive controls in STEMI patients undergoing PCI. The primary outcome was left ventricular ejection fraction (LVEF)...
February 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858909/comparison-of-the-risk-of-left-ventricular-free-wall-rupture-in-taiwanese-patients-with-st-elevation-acute-myocardial-infarction-undergoing-different-reperfusion-strategies-a-medical-record-review-study
#16
Rei-Yeuh Chang, Han-Lin Tsai, Ping-Gune Hsiao, Chao-Wen Tan, Chi-Pin Lee, I-Tseng Chu, Yung-Ping Chen, Cheng-Yun Chen
Ventricular free wall rupture (VFWR) is the second most common cause of death in patients with acute ST-elevation myocardial infarction (STEMI). Nevertheless, few reports have investigated the factors, including different treatment strategies, associated with VFWR in Taiwanese patients. Therefore, the aim of this study was to compare the risk of VFWR in Taiwanese patients with acute STEMI who had received primary percutaneous coronary intervention (PCI), rescue PCI, scheduled PCI, thrombolytic therapy, and pharmacologic treatment...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27858506/causes-of-prehospital-misinterpretations-of-st-elevation-myocardial-infarction
#17
Nichole Bosson, Stephen Sanko, Ronald E Stickney, James Niemann, William J French, James G Jollis, Michael C Kontos, Tyson G Taylor, Peter W Macfarlane, Richard Tadeo, William Koenig, Marc Eckstein
OBJECTIVES: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification. METHODS: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG. Software interpretation of the ECG (STEMI or not) was compared with data in the regional EMS registry to classify the interpretation as true positive (TP), true negative (TN), false positive (FP), or false negative (FN)...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27847262/the-angelmed-guardian-system-is-there-a-role-for-implantable-devices-for-early-detection-of-coronary-artery-occlusion
#18
Toby Rogers, Arie Steinvil, Rebecca Torguson, Ron Waksman
The AngelMed Guardian System is an implantable device similar to a single chamber pacemaker that continuously monitors the intracardiac electrogram for evidence of ST segment shift indicating acute coronary artery occlusion. The system aims to reduce time to presentation by alerting patients to present to a medical facility whether symptoms are present or not. In March 2016, the US Food and Drug Administration (FDA) assembled a meeting of the Circulatory System Devices Panel to review the results of the AngelMed for Early Recognition and Treatment of STEMI (ALERTS) pivotal trial and the accompanying premarket approval (PMA) application for regulatory approval of the AngelMed Guardian System in the US...
December 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27817218/risk-stratification-after-st-segment-elevation-myocardial-infarction
#19
REVIEW
Sergio Buccheri, Piera Capranzano, Antonio Condorelli, Matteo Scalia, Corrado Tamburino, Davide Capodanno
Risk stratification according to the timing of assessment, treatment modality and outcome of interest is highly advisable in patients with ST-elevation myocardial infarction (STEMI) to identify optimal treatment strategies, proper length of hospital stay and correct timing of follow-up. Areas covered: This review is an overview summarizing the characteristics and performance of available risk-scoring systems for STEMI. In particular, we sought to highlight the characteristics of STEMI cohorts used for derivation and validation of the available algorithms and appraise their discrimination ability, calibration and global accuracy...
December 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27816956/prognostic-value-of-glycated-hemoglobin-among-patients-with-st-segment-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#20
Guangxiao Li, Xiaowen Hou, Ying Li, Peng Zhang, Qiongrui Zhao, Juan Li, Jingpu Shi
Many studies have shown the prognostic significance of glycated hemoglobin (HbA1c) for overall coronary artery disease (CAD). But less is known about the role that HbA1c played in the prognosis of patients diagnosed with ST-segment elevation myocardial infarction (STEMI). Results from previous studies were controversial. Therefore, a meta-analysis was conducted to investigate whether admission HbA1c level was a predictor of short- and long-term mortality rates among patients diagnosed with STEMI. Relevant literatures were retrieved from the electronic databases up to March 2016...
November 7, 2016: Clinical Chemistry and Laboratory Medicine: CCLM
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