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https://www.readbyqxmd.com/read/28511806/st-segment-elevation-myocardial-infarction-could-be-the-primary-presentation-of-acute-aortic-dissection
#1
Qing-Yi Zhu, Shi Tai, Liang Tang, Wen Peng, Sheng-Hua Zhou, Zhen-Guo Liu, Xin-Qun Hu
BACKGROUND: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. METHODS: The records were reviewed for patients admitted to the large comprehensive university hospital for PCI due to STEMI from January 1, 2002 to January 1, 2017...
May 11, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28509893/spontaneous-coronary-artery-dissection-insights-from-histology-and-optical-coherence-tomography
#2
Sandeep K Krishnan, Alex Zhu, Brent Larson, Timothy D Henry, Suhail Dohad
Spontaneous coronary artery dissection (SCAD) is a well-known but infrequent cause of acute coronary syndrome (ACS), and often goes unrecognized. Although management of SCAD is, at times, controversial, when a patient presents with ACS, percutaneous coronary intervention (PCI) is frequently necessary. We present a patient with ST-segment elevation myocardial infarction (STEMI) with SCAD that illustrates two important points: use of intracoronary optical coherence tomography to guide PCI, and histologic assessment to provide a unique insight into the etiology of SCAD...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#3
Nathaniel Moulson, Stephen A LaHaye, Olivier F Bertrand, Jimmy MacHaalany
OBJECTIVES: To determine the role of warfarin (WF) prophylaxis in the prevention of left ventricular thrombus (LVT) formation and subsequent embolic complications following an anterior ST elevation myocardial infarction (STEMI) complicated by reduced left ventricular ejection fraction (LVEF) and wall motion abnormalities. BACKGROUND: The role of oral anticoagulation prophylaxis, in addition to dual antiplatelet therapy (DAPT), in the current era of percutaneous coronary intervention has not been well studied, despite being a class IIb recommendation in the AHA/ACC STEMI guidelines...
May 9, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28489781/clinical-characteristics-and-outcomes-of-patients-with-myocarditis-mimicking-st-segment-elevation-myocardial-infarction-analysis-of-a-case-series
#4
Shuang Wu, Yan-Min Yang, Jun Zhu, Huai-Bin Wan, Juan Wang, Han Zhang, Xing-Hui Shao
Acute myocarditis mimicking ST-segment elevation myocardial infarction (STEMI) is highly deceptive for an accurate diagnosis, and a systematic study is lacking with regard to the clinical features and prognosis of this distinct clinical entity.Patients with suspected STEMI and eventually diagnosed with myocarditis by cardiac magnetic resonance (CMR) from January 2012 to April 2016 at Fuwai Hospital were identified by reviewing medical records and electronic databases. Follow-up was conducted by clinical visits and phone contacts in a median duration of 17 months...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28485279/predicting-the-infarct-related-artery-in-stemi-from-the-surface-ecg-independent-validation-of-proposed-criteria
#5
Rob Eerdekens, Jose F Chavez, Justin M Fox, James D Flaherty, Lukas Rc Dekker, Nils P Johnson
AIMS: This study independently evaluated the diagnostic performance of electrocardiographic (ECG) criteria to predict the infarct related artery (IRA) in patients with an acute ST-segment elevation myocardial infarction (STEMI). While a number of ECG criteria have been proposed to predict the IRA in STEMI, many of these "rules" came from modestly sized populations and did not undergo external validation. Therefore, we evaluated popular criteria from the literature in an independent cohort...
May 9, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28470696/complete-versus-culprit-only-revascularisation-in-st-elevation-myocardial-infarction-with-multi-vessel-disease
#6
REVIEW
Claudio A Bravo, Sameer A Hirji, Deepak L Bhatt, Rachna Kataria, David P Faxon, E Magnus Ohman, Kevin L Anderson, Akil I Sidi, Michael H Sketch, Stuart W Zarich, Asishana A Osho, Christian Gluud, Henning Kelbæk, Thomas Engstrøm, Dan Eik Høfsten, James M Brennan
BACKGROUND: Multi-vessel coronary disease in people with ST elevation myocardial infarction (STEMI) is common and is associated with worse prognosis after STEMI. Based on limited evidence, international guidelines recommend intervention on only the culprit vessel during STEMI. This, in turn, leaves other significantly stenosed coronary arteries for medical therapy or revascularisation based on inducible ischaemia on provocative testing. Newer data suggest that intervention on both the culprit and non-culprit stenotic coronary arteries (complete intervention) may yield better results compared with culprit-only intervention...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28454639/shorter-door-to-balloon-st-elevation-myocardial-infarction-time-should-there-be-a-minimum-limit
#7
Sameh Askandar, Tamunoinemi Bob-Manuel, Pahul Singh, Rami N Khouzam
In ST-elevation myocardial infarction (STEMI) ischemic time is directly related to permanent myocardial damage and mortality. Therefore, it is crucial to restore myocardial perfusion rapidly. Door-to-balloon (DTB) time is defined as the duration between the arrival time of the patient to the medical facility until the time he or she is treated with percutaneous coronary intervention. Currently, DTB is the criterion that measures the quality of care provided to patients with STEMI at any given institution. It is well documented in the literature that longer DTB is associated with higher mortality; however, lowering DTB beyond current recommendations has not shown to decrease mortality rates...
June 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28446521/comparison-of-ticagrelor-pharmacokinetics-and-pharmacodynamics-in-stemi-and-nstemi-patients-pinpoint-protocol-for-a-prospective-observational-single-centre-study
#8
Piotr Adamski, Małgorzata Ostrowska, Joanna Sikora, Karolina Obońska, Katarzyna Buszko, Magdalena Krintus, Grażyna Sypniewska, Michał Piotr Marszałł, Marek Koziński, Jacek Kubica
INTRODUCTION: The most common classification of acute myocardial infarction (AMI) is based on electrocardiographic findings and distinguishes ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI). Both types of AMI differ concerning their epidemiology, clinical approach and early outcomes. Ticagrelor is a P2Y12 receptor inhibitor, constituting the first-line treatment for STEMI and NSTEMI. According to available data, STEMI may be associated with lower plasma concentration of ticagrelor in the first hours of AMI, but currently there are no studies directly comparing ticagrelor pharmacokinetics or antiplatelet effect in patients with STEMI versus NSTEMI...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28440561/anterior-st-elevation-myocardial-infarction-induced-by-rituximab-infusion-a-case-report-and-review-of-the-literature
#9
K Sharif, A Watad, N L Bragazzi, E Asher, A Abu Much, Y Horowitz, M Lidar, Y Shoenfeld, H Amital
WHAT IS KNOWN AND OBJECTIVES: Rituximab is a chimeric monoclonal anti-CD20 antibody approved for the treatment of some lymphoid malignancies as well as for autoimmune diseases including rheumatoid arthritis (RA), idiopathic thrombocytopenic purpura (ITP) and vasculitis. Generally, rituximab is well tolerated; nevertheless, some patients develop adverse effects including infusion reactions. Albeit rare, these reactions may in some cases be life-threatening conditions. Rituximab cardiovascular side effects include more common effects such as hypertension, oedema and rare cases of arrhythmias and myocardial infarction...
June 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28390742/long-term-prognosis-of-atrial-fibrillation-in-st-elevation-myocardial-infarction-patients-undergoing-percutaneous-coronary-intervention
#10
Guy Topaz, Nir Flint, Arie Steinvil, Arik Finkelstein, Shmuel Banai, Gad Keren, Yacov Shacham, Lior Yankelson
BACKGROUND: Atrial fibrillation (AF) is a well-known complication in the setting of ST elevation myocardial infarction (STEMI). Data on the long-term prognostic implications of New-Onset AF (NOAF) complicating STEMI in the era of complete revascularization remains controversial. Our aim therefore was to evaluate the long-term prognosis of prior AF (pAF) and new-onset AF (NOAF) in STEMI patients undergoing percutaneous coronary intervention (PCI). METHODS: We studied 1657 consecutive STEMI patients hospitalized in the cardiac intensive care unit during 2008-2014...
March 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28384143/a-decade-of-improvement-in-the-management-of-new-zealand-st-elevation-myocardial-infarction-stemi-patients-results-from-the-new-zealand-acute-coronary-syndrome-acs-audit-group-national-audits-of-2002-2007-and-2012
#11
John M Elliott, Tom Kai Ming Wang, Greg D Gamble, Michael Ja Williams, Philip Matsis, Richard Troughton, Andrew Hamer, Gerry Devlin, Stewart Mann, Mark Richards, John K French, Harvey D White, Chris J Ellis
AIMS: To audit the management of ST-segment elevation myocardial infarction (STEMI) patients admitted to a New Zealand Hospital over three 14-day periods to review their number, characteristics, management and outcome changes over a decade. METHODS: The acute coronary syndrome (ACS) audits were conducted over 14 days in May of 2002, 2007 and 2012 at New Zealand Hospitals admitting patients with a suspected or definite ACS. Longitudinal analyses of the STEMI subgroup are reported...
April 7, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28381115/remote-ischemic-conditioning-for-patients-with-stemi
#12
Michael Rahbek Schmidt, Mathis Ersted Rasmussen, Hans Erik Bøtker
ST-segment elevation myocardial infarction (STEMI) remains a leading cause of death and morbidity, despite declining incidence and improved short-term outcome in many countries. Although mortality declines in developed countries with easy and fast access to optimized treatment, development of heart failure often remains a challenge in survivors and still approaches 10% at 1 year. Rapid admission and acute interventional treatment combined with modern antithrombotic pharmacologic therapy frequently establish complete reperfusion and acutely stabilize the patient, but the reperfusion itself adds further to the damage in the myocardium compromising the long-term outcome...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28377232/comparison-of-safety-and-efficacy-of-unfractionated-heparin-versus-bivalirudin-in-patients-undergoing-percutaneous-coronary-intervention
#13
Ahmed Rehmani, Chris Judkins, Alan Whelan, Michael Nguyen, Carl Schultz
BACKGROUND: Anti-platelet and anti-coagulant adjunctive therapies are associated with a clinically significant increased risk of major bleeding. We retrospectively assessed in hospital major adverse clinical events (MACE) and major bleeding in patients undergoing percutaneous coronary intervention (PCI) who received either unfractionated heparin (UFH) or bivalirudin. METHOD: Consecutive patients undergoing PCI for acute coronary syndrome (ACS) at Fremantle Hospital from August 2008 to December 2013 were identified...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28370496/role-of-deferred-stenting-in-patients-with-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#14
Giovanni Luigi De Maria, Mohammad Alkhalil, Evangelos K Oikonomou, Mathias Wolfrum, Robin P Choudhury, Adrian P Banning
OBJECTIVES: We conducted a meta-analysis of studies comparing deferred stenting strategy versus the conventional approach with immediate stenting in patients with ST elevation myocardial infarction. BACKGROUND: Deferring stent after mechanical flow restoration has been proposed as a strategy to reduce the risk of "no reflow" in patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). Conflicting evidence is available currently, especially after the recent publication of three randomized clinical trials...
March 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28367010/prehospital-delay-and-time-to-reperfusion-therapy-in-st-elevation-myocardial-infarction
#15
Linsha George, Lakshmi Ramamoorthy, Santhosh Satheesh, Rama Prakasha Saya, D K S Subrahmanyam
BACKGROUND: Despite efforts aimed at reducing the prehospital delay and treatment delay, a considerable proportion of patients with ST elevation myocardial infarction (STEMI) present late and receive the reperfusion therapy after unacceptably long time periods. This study aimed at finding out the patients' decision delay, prehospital delay, door-to-electrocardiography (ECG), door-to-needle, and door-to-primary percutaneous coronary intervention (PCI) times and their determinants among STEMI patients...
April 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28362646/the-de-winter-ecg-pattern-morphology-and-accuracy-for-diagnosing-acute-coronary-occlusion-systematic-review
#16
Niall P Morris, Richard Body
The De Winter ECG pattern has been reported to indicate acute left anterior descending coronary artery occlusion and is often considered to be an 'ST elevation myocardial infarction (STEMI) equivalent'. We aimed to investigate the morphology of the 'De Winter ECG pattern' and evaluate the test characteristics of the De Winter pattern for the diagnosis of acute coronary occlusion. We identified papers through the Medline, EMBASE and COCHRANE databases and screened for bias using QUADAS-2. First, measurements were recorded from every ECG reported in the literature and aggregated...
March 30, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28343607/bioresorbable-vascular-scaffold-during-st-elevation-myocardial-infarction-a-systematic-review
#17
REVIEW
Fabien Picard, Quentin de Hemptinne, Robert Avram, Hung Q Ly, Philippe L L'Allier, Jean-François Tanguay
BACKGROUND: The bioresorbable vascular scaffold (BVS) represents a novel technology designed to overcome the long-term limitations of metallic coronary stent implantation in percutaneous coronary intervention. In this context, primary percutaneous coronary intervention in ST-elevation myocardial infarction (STEMI) could be a preferred scenario for BVS implantation. Nevertheless, data on efficacy and safety are lacking in this specific subset of patients. METHODS: We conducted a systematic review to examine the safety and efficacy of BVS use in STEMI patients...
April 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#18
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28299676/bioresorbable-scaffolds-for-coronary-stenosis-when-and-how-based-upon-current-studies
#19
REVIEW
Alexandre Abizaid, J Ribamar Costa
PURPOSE OF REVIEW: First-generation bioresorbable scaffolds (BRS), largely represented by the poly-l-lactic acid (PLLA) ABSORB (Abbott Vascular, Temecula, Illinois, US), have demonstrated, in low to moderate lesion complexity, similar efficacy to current generation metallic drug-eluting stents. However, a trend toward more device thrombosis has been observed, especially when the scaffolds are used in off-label situations. In this review, we address the most relevant drawbacks of these devices and, based on the available scientific data, we visit the scenarios where there is more uncertainty about their indication, trying to identify the lesions/patients to whom this technology should be voided at its current stage of development...
March 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28296641/root-cause-analysis-of-deaths-in-st-segment-elevation-myocardial-infarctions-treated-with-primary-pci-what-can-we-do-better
#20
Fredy El Sakr, Mohamad Kenaan, Daniel Menees, Milan Seth, Hitinder S Gurm
OBJECTIVE: Recent data demonstrate that mortality of patients with ST-elevation myocardial infarction (STEMI) has not changed despite dramatic reduction in door-to-balloon times. Identifying potential areas in care that can be further optimized to decrease mortality remains a priority. METHODS: We performed a root cause analysis of all patients who died following primary percutaneous coronary intervention (PCI) during index hospitalization from 2008 to 2013 at the University of Michigan...
May 2017: Journal of Invasive Cardiology
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