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https://www.readbyqxmd.com/read/29779179/clinical-outcomes-of-complete-revascularization-using-either-angiography-guided-or-fractional-flow-reserve-guided-drug-eluting-stent-implantation-in-non-culprit-vessels-in-st-elevation-myocardial-infarction-patients-insights-from-a-study-based-on-a-systematic
#1
REVIEW
Alexandre Hideo-Kajita, Hector M Garcia-Garcia, Kayode O Kuku, Solomon S Beyene, Viana Azizi, Yael F Meirovich, Gebremedhin D Melaku, Aaphtaab Dheendsa, Echo J Brathwaite, Sameer Desale, Mohammad Soud, Kazuhiro Dan, Yuichi Ozaki, Ron Waksman, Michael Lipinski
Current guidelines recommend that percutaneous coronary intervention (PCI) should be restricted to the culprit vessel in ST elevation myocardial infarction (STEMI) patients with multi-vessel disease (MVD) and without cardiogenic shock. However, newer data suggests that performing complete revascularization (CR) in MVD patients may lead to better outcomes compared to intervention in the culprit vessel only. The aim of this meta-analysis is to examine the available data to determine if CR (using either angio- or fractional flow reserve guidance-FFR) following primary PCI in STEMI patients without cardiogenic shock impacts clinical outcomes...
May 19, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29768315/angiography-guided-multivessel-percutaneous-coronary-intervention-versus-ischemia-guided-percutaneous-coronary-intervention-versus-medical-therapy-in-the-management-of-significant-disease-in-non-infarct-related-arteries-in-st-elevation-myocardial-infarction
#2
Dhanuka Perera, Tom Crake, Victor Lee
BACKGROUND: In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non-infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear. METHODS: All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29731285/prehospital-acute-st-elevation-myocardial-infarction-identification-in-san-diego-a-retrospective-analysis-of-the-effect-of-a-new-software-algorithm
#3
Christanne Coffey, John Serra, Mat Goebel, Sarah Espinoza, Edward Castillo, James Dunford
BACKGROUND: A significant increase in false positive ST-elevation myocardial infarction (STEMI) electrocardiogram interpretations was noted after replacement of all of the City of San Diego's 110 monitor-defibrillator units with a new brand. These concerns were brought to the manufacturer and a revised interpretive algorithm was implemented. OBJECTIVES: This study evaluated the effects of a revised interpretation algorithm to identify STEMI when used by San Diego paramedics...
May 3, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29724744/measuring-outcome-differences-associated-with-stemi-screening-and-diagnostic-performance-a-multicentred-retrospective-cohort-study-protocol
#4
Maame Yaa A B Yiadom, Bryn E Mumma, Christopher W Baugh, Brian W Patterson, Angela M Mills, Gilberto Salazar, Mary Tanski, Cathy A Jenkins, Timothy J Vogus, Karen F Miller, Brittney E Jackson, Christoph U Lehmann, Stephen C Dorner, Jennifer L West, Thomas J Wang, Sean P Collins, Robert S Dittus, Gordon R Bernard, Alan B Storrow, Dandan Liu
INTRODUCTION: Advances in ST-segment elevation myocardial infarction (STEMI) management have involved improving the clinical processes connecting patients with timely emergency cardiovascular care. Screening upon emergency department (ED) arrival for an early ECG to diagnose STEMI, however, is not optimal for all patients. In addition, the degree to which timely screening and diagnosis are associated with improved time to intervention and postpercutaneous coronary intervention outcomes, under more contemporary practice conditions, is not known...
May 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29716535/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-patients-with-acute-st-segment-elevation-myocardial-infarction-after-percutaneous-coronary-intervention-a-meta-analysis
#5
Sai Zhang, Jun Diao, Chunmei Qi, Jingjing Jin, Li Li, Xingjuan Gao, Lei Gong, Weiheng Wu
BACKGROUND: The neutrophil to lymphocyte ratio (NLR) is an indicator of systemic inflammation and a prognostic marker in patients with acute coronary syndrome (ACS). This study aims to investigate the value of NLR to predict the in-hospital and long-term prognosis in patients with ST segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) by meta-analysis. METHOD: The studies related to the prognosis of NLR and STEMI patients published in the Pubmed, Embase, and Ovid databases before June 2017 were retrieved...
May 2, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29687412/optimal-pharmacological-therapy-in-st-elevation-myocardial-infarction-a-review-a-review-of-antithrombotic-therapies-in-stemi
#6
REVIEW
R S Hermanides, S Kilic, A W J van 't Hof
Antithrombotic therapy is an essential component in the optimisation of clinical outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention. There are currently several intravenous anticoagulant drugs available for primary percutaneous coronary intervention. Dual antiplatelet therapy comprising aspirin and P2Y12 inhibitor represents the cornerstone treatment for STEMI. However, these effective treatment strategies may be associated with bleeding complications...
April 23, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29686544/thrombolytic-use-in-the-region-around-amarillo-texas-in-patients-with-st-elevation-myocardial-infarction
#7
Kelly S McMaster, Totini Chatterjee, Drew McBrayer, David Brabham
Appropriate administration of thrombolytic therapy is particularly important for ST elevation myocardial infarction (STEMI) patients who are unable to access primary percutaneous coronary intervention (PCI) in a timely manner. We evaluated the current state of thrombolytic therapy in the Panhandle region of West Texas where access to primary PCI is poor. The medical records of 79 patients transferred from 20 outlying facilities to the two hospitals in Amarillo, Texas, for STEMI in 2016 were retrospectively evaluated for time of onset of chest pain, initial electrocardiogram findings, medication reconciliation, and any contraindications to thrombolytic therapy...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29657235/reduction-in-door-to-balloon-time-with-training-for-effective-and-efficient-action-in-medical-service-better-process-teams-bp-at-a-community-hospital-in-japan
#8
Hiroki Isono, Tetsuhiro Maeno, Shigeyuki Watanabe
ST-elevation myocardial infarction (STEMI) is a fatal condition. Prompt primary percutaneous coronary intervention is associated with lower mortality. However, community hospitals in Japan lack human and medical resources, and implementation of the same strategies as those used in the USA, such as an on-call cardiologist at the hospital, to achieve a door-to-balloon time of ≤ 90 min appears particularly challenging. Therefore, we used Training for Effective and Efficient Action in Medical Service-Better Process (TEAMS-BP) to develop a new process and assessed its effectiveness in reducing door-to-balloon time...
2018: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/29651617/delayed-vs-immediate-stenting-in-stemi-with-a-high-thrombus-burden-a-systematic-review-and-meta-analysis
#9
B Sun, J Liu, H Yin, S Yang, Z Liu, T Chen, J Li, C Guo, Z Jiang
BACKGROUND: The results of several large-scale randomized controlled trials are controversial regarding the advantages of delayed stenting (DS) compared with immediate stenting (IS). We sought to determine whether DS has benefits for patients with ST-segment elevation myocardial infarction (STEMI) with a high thrombus burden compared with IS. METHODS: We systematically searched four electronic databases. Thrombolysis in Myocardial Infarction (TIMI) grade 3 flow, TIMI myocardial blush grade (TMBG), complete ST-segment resolution (>70%), major adverse cardiac events (MACE), and major bleeding complications were studied as outcomes...
April 12, 2018: Herz
https://www.readbyqxmd.com/read/29627944/complete-versus-culprit-only-revascularization-in-stemi-a-contemporary-review
#10
REVIEW
Daniel Y Lu, Ming Zhong, Dmitriy N Feldman
PURPOSE OF REVIEW: In ST-segment elevation myocardial infarction, urgent revascularization of the culprit coronary vessel and restoration of coronary flow is the goal of the initial management. However, obstructive non-culprit disease is frequently concomitantly found during initial angiography and portends a poor prognosis. Management of non-culprit lesions in ST-segment elevation myocardial infarction (STEMI) has been the subject of extensive debate. This review will examine the currently available evidence, with a specific focus on randomized clinical trials performed to date...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29623168/stenting-in-primary-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction
#11
REVIEW
Sanjog Kalra, Hemal Bhatt, Ajay J Kirtane
The treatment of ST-segment elevation myocardial infarction (STEMI) has advanced dramatically over the past 30 years since the introduction of reperfusion therapies, such that mechanical reperfusion with primary percutaneous coronary intervention is now the standard of care. With STEMI, as with other forms of acute coronary syndrome, stent deployment in culprit lesions is the dominant form of reperfusion in the developed world and is supported by contemporary guidelines. However, the precise timing of stenting and the extent to which both culprit and non-culprit lesions should be treated continue to be active areas of study...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29589673/cardiac-rehabilitation-after-stemi
#12
Stefano Urbinati, Elisabetta Tonet
Cardiac rehabilitation is the most important evidence-based intervention for secondary prevention after STEMI, nevertheless, only a minority of patients may access to a cardiac rehabilitation programme. In this review the priority criteria for admission to cardiac rehabilitation and the main barriers that limit a larger involvement of the patients are discussed. Among the components of cardiac rehabilitation exercise is crucial and a tailored exercise training program and a tight monitoring of adherence to lifestyle recommendations are mandatory...
March 28, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29548521/the-utility-of-the-triage-electrocardiogram-for-the-detection-of-st-segment-elevation-myocardial-infarction
#13
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29541904/comparison-of-syntax-score-ii-efficacy-with-syntax-score-and-timi-risk-score-for-predicting-in-hospital-and-long-term-mortality-in-patients-with-st-segment-elevation-myocardial-infarction
#14
Yavuz Karabağ, Metin Çağdaş, Ibrahim Rencuzogullari, Süleyman Karakoyun, İnanç Artaç, Doğan İliş, Mahmut Yesin, Mesut Öterkus, Tayyar Gokdeniz, Cengiz Burak, Ibrahim Halil Tanboğa
SYNTAX score II (SS-II) has a powerful prognostic accuracy in patients with stable complex coronary artery disease who have undergone revascularization; however, there is limited data regarding the prognosis of patients with ST segment elevation myocardial infarction (STEMI). The aim of this study is to examine both the predictive performance of SS-II in determining in-hospital and long term mortality of STEMI patients and to compare SYNTAX score (SS) and TIMI risk score (TRS). Consecutive 1912 STEMI patients treated with primary percutaneous coronary intervention (p-PCI) retrospectively reviewed, and the remaining 1708 patients constituted the study population after exclusion...
March 14, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29537296/safety-of-early-discharge-after-primary-angioplasty-in-low-risk-patients-with-st-segment-elevation-myocardial-infarction-a-meta-analysis-of-randomised-controlled-trials
#15
Wei Gong, Aobo Li, Hui Ai, Han Shi, Xiao Wang, Shaoping Nie
Background Early discharge after successful primary angioplasty is common, but the evidence supporting the practice is still lacking. We therefore performed a meta-analysis assessing the safety of early discharge after primary angioplasty in low-risk patients with ST-segment elevation myocardial infarction (STEMI). Methods Randomised controlled trials were identified and extracted from PubMed, Embase, Cochrane Library databases and reference lists of relevant papers. Heterogeneity was analysed using the I2 test...
May 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29498538/weekend-effect-in-acute-coronary-syndrome-a-meta-analysis-of-observational-studies
#16
Chun Shing Kwok, Mohammed Al-Dokheal, Sami Aldaham, Claire Rushton, Rob Butler, Tim Kinnaird, Azfar Zaman, M Justin Zaman, Adam Timmis, Mamas A Mamas
BACKGROUND: The effect of a weekend compared with a weekday hospital admission on patient outcomes after an acute coronary syndrome is unclear. This study aims to determine whether collectively there is a weekend effect in acute coronary syndrome. METHOD: We conducted a systematic review and meta-analysis of cohort studies examining the association between weekend compared to weekday admission at any time of the day and early mortality (in-hospital or 30-day). A search was performed on Medline and Embase and relevant studies were pooled using random effects meta-analysis for risk of early mortality...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29492224/remote-ischemic-conditioning-improves-myocardial-parameters-and-clinical-outcomes-during-primary-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#17
Hai Liu, Li Fu, Xiangke Sun, Wei Peng, Zhiwei Chen, Yiliang Li
We conducted a systematic review and meta-analysis to evaluate the effects of remote ischemic conditioning on myocardial parameters and clinical outcomes in ST segment elevation acute myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention. Ten eligible randomized controlled trials with 1006 STEMI patients were identified. Compared with controls, remote ischemic conditioning reduced the myocardial enzyme levels (standardized mean difference =-0.86; 95% CI: -1.44 to -0.28; P = 0...
February 2, 2018: Oncotarget
https://www.readbyqxmd.com/read/29489461/simultaneous-venoarterial-extracorporeal-membrane-oxygenation-and-percutaneous-left-ventricular-decompression-therapy-with-impella-is-associated-with-improved-outcomes-in-refractory-cardiogenic-shock
#18
Sandeep M Patel, Jerry Lipinski, Sadeer G Al-Kindi, Toral Patel, Petar Saric, Jun Li, Fahd Nadeem, Thomas Ladas, Amer Alaiti, Ann Phillips, Benjamin Medalion, Salil Deo, Yakov Elgudin, Marco A Costa, Mohammed Najeeb Osman, Guilherme F Attizzani, Guilherme H Oliveira, Basar Sareyyupoglu, Hiram G Bezerra
Venoarterial extracorporeal membrane oxygenation (VA-ECMO) has been used for refractory cardiogenic shock; however, it is associated with increased left ventricular afterload. Outcomes associated with the combination of a percutaneous left ventricular assist device (Impella) and VA-ECMO remains largely unknown. We retrospectively reviewed patients treated for refractory cardiogenic shock with VA-ECMO (2014-2016). The primary outcome was all-cause mortality within 30 days of VA-ECMO implantation. Secondary outcomes included duration of support, stroke, major bleeding, hemolysis, inotropic score, and cardiac recovery...
February 27, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/29486712/acute-coronary-syndrome-secondary-to-allergic-coronary-vasospasm-kounis-syndrome-a-case-series-follow-up-and-literature-review
#19
Jing Li, Jingang Zheng, Yifeng Zhou, Xiaofei Liu, Wenhua Peng
BACKGROUND: Kounis syndrome (KS) is the concurrence of acute coronary syndrome associated with mast-cell and platelet activation in the setting of hypersensitivity and allergic or anaphylactic insults. Many drugs and environmental exposures had been reported as inducers, but various inducers and the mechanism of KS remained unknown till now. The widely used traditional Chinese medicine (TCM) as a potential sensitizer were scarcely reported to induce allergic vasospasm due to the ignorance of the linkage between traditional medicine allergy and vasospasm...
February 27, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29478085/transradial-artery-access-in-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-and-cardiogenic-shock
#20
REVIEW
Matthew S Schoenfeld, Ibrahim Kassas, Binita Shah
Early revascularization is the gold standard for management of patients with ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS). The use of transradial artery access (TRA) in percutaneous coronary intervention (PCI) has increased in recent years and has emerged as a safe and effective approach to PCI in high-risk patients, with advantages in reduced major bleeding events, other peri-procedural complications, and all-cause mortality when compared with transfemoral artery access (TFA). Multiple randomized clinical trials have demonstrated these advantages of TRA vs...
February 24, 2018: Current Treatment Options in Cardiovascular Medicine
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