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https://www.readbyqxmd.com/read/28647440/optimal-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease-an-updated-large-scale-systematic-review-and-meta-analysis
#1
An Vu Nguyen, Le Van Thanh, Mohamed Gomaa Kamel, Sara Attia Mahmoud Abdelrahman, Mohamed El-Mekawy, Mohamed Ashraf Mokhtar, Aya Ashraf Ali, Nam Nguyen Nho Hoang, Nguyen Lam Vuong, Fatma Abd-Elshahed Abd-Elhay, Omer Abdelbagi Omer, Ahmed Abdou Mohamed, Kenji Hirayama, Nguyen Tien Huy
BACKGROUND: Our study aimed to compare three different percutaneous coronary intervention (PCI) approaches: culprit-only (COR) and complete (CR) revascularization - categorizing into immediate (ICR) or staged (SCR). METHODS: We searched 13 databases for randomized controlled trials. Articles were included if they compared at least two strategies. To have more studies in each analysis, an adjusted analysis was performed using person-years to incorporate follow-up durations and obtain pooled rate ratios (RR), with their corresponding 95% confidence interval...
June 11, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28642043/mitochondrial-cx43-an-important-component-of-cardiac-preconditioning
#2
REVIEW
Antonio Rodríguez-Sinovas, Marisol Ruiz-Meana, Amanda Denuc, David García-Dorado
Connexin 43 (Cx43) forms gap junction channels that are essential for the propagation of electrical depolarization in cardiomyocytes, but also with important roles in the pathophysiology of reperfusion injury. However, more recent studies have shown that Cx43 has also important functions independent from intercellular communication between adjacent cardiomyocytes. Some of these actions have been related to the presence of Cx43 in the mitochondria of these cells (mitoCx43). The functions of mitoCx43 have not been completely elucidated, but there is strong evidence indicating that mitoCx43 modulates mitochondrial respiration at respiratory complex I, production of radical oxygen species and ATP synthesis...
June 20, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28634037/clinical-benefit-of-drugs-targeting-mitochondrial-function-as-an-adjunct-to-reperfusion-in-st-segment-elevation-myocardial-infarction-a-meta-analysis-of-randomized-clinical-trials
#3
Gianluca Campo, Rita Pavasini, Giampaolo Morciano, A Michael Lincoff, C Michael Gibson, Masafumi Kitakaze, Jacob Lonborg, Amrita Ahluwalia, Hideki Ishii, Michael Frenneaux, Michel Ovize, Marcello Galvani, Dan Atar, Borja Ibanez, Giampaolo Cerisano, Simone Biscaglia, Brandon J Neil, Masanori Asakura, Thomas Engstrom, Daniel A Jones, Dana Dawson, Roberto Ferrari, Paolo Pinton, Filippo Ottani
AIMS: To perform a systematic review and meta-analysis of randomized clinical trials (RCT) comparing the effectiveness of drugs targeting mitochondrial function vs. placebo in patients with ST-segment elevation myocardial infarction (STEMI) undergoing mechanical coronary reperfusion. METHODS: Inclusion criteria: RCTs enrolling STEMI patients treated with primary percutaneous coronary intervention (PCI) and comparing drugs targeting mitochondrial function vs. placebo...
June 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28631760/-astronauts-asteroids-and-the-universe-of-antithrombotic-therapies-in-primary-percutaneous-coronary-intervention
#4
Leonardo De Luca, Antonino Granatelli
A sensation of self-awareness on the relativity of our certainties comes over looking to the huge amount of data on antithrombotic therapies assessed in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). This sensation can be compared to the so-called "overview effect", a cognitive shift in awareness reported by some astronauts during spaceflight, often while viewing the Earth from orbit. In this review we will mention drugs floated like meteors in the Universe of STEMI treatment and we will discuss the body of evidence on oral and intravenous antithrombotic therapies for patients undergoing pPCI...
June 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28623004/variable-methodological-quality-and-use-found-in-systematic-reviews-referenced-in-stemi-clinical-practice-guidelines
#5
Jared Scott, Benjamin Howard, Philip Sinnett, Michael Schiesel, Jana Baker, Patrick Henderson, Matt Vassar
BACKGROUND: The objective of this study was to assess the methodological quality and clarity of reporting of the systematic reviews (SRs) supporting clinical practice guideline (CPG) recommendations in the management of ST-elevation myocardial infarction (STEMI) across international CPGs. METHODS: We searched 13 guideline clearinghouses including the National Guideline Clearinghouse and Guidelines International Network (GIN). To meet inclusion criteria CPGs must be pertinent to the management of STEMI, endorsed by a governing body or national organization, and written in English...
June 14, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28617684/non-infarct-related-artery-revascularization-in-st-segment-elevation-myocardial-infarction-patients-with-multivessel-disease
#6
Asim N Cheema, Shamir R Mehta, Subodh Verma, Akshay Bagai
PURPOSE OF REVIEW: Multivessel disease (MVD) is common in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) and is associated with significant risk of future cardiovascular (CV) events including short and longer-term mortality. In this review, we examine the pathophysiologic construct contributing to adverse prognosis of MVD in STEMI, relevant available evidence that currently guides the management of the noninfarct-related artery (IRA) stenosis and define the remaining knowledge gaps for future studies...
June 15, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28616566/the-effects-of-fibrinolytic-before-referring-stemi-patients-a-systematic-review-and-meta-analysis
#7
Pajaree Mongkhon, Piyameth Dilokthornsakul, Kanokkorn Tepwang, Kannika Tapanya, Chompoonut Sopitprasan, Pitchapat Chaliawsin, Surasak Saokaew
BACKGROUND: Accessibility of primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) in primary care settings is limited. Referring patients to PCI-capable hospitals might increase cardiac events. Hence, fibrinolytic injection before referring patients to PCI-capable settings decreases cardiac events, however, the effect of fibrinolytic injection before the referral has not been systematically evaluated. This study aimed to systematically review the effect of fibrinolytic injection before referring patients with STEMI to PCI-capable settings...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28616565/lactated-ringer-s-solution-for-preventing-myocardial-reperfusion-injury
#8
Takashi Koyama
Reperfusion of ischemic myocardium is crucial for salvaging myocardial cells from ischemic cell death. However, reperfusion itself induces various deleterious effects on the ischemic myocardium. These effects, known collectively as reperfusion injury, comprise stunned myocardium, reperfusion-induced arrhythmia, microvascular reperfusion injury, and lethal reperfusion injury. No approach has proven successful in preventing any of these injuries in the clinical setting. My colleagues and I recently proposed a new postconditioning protocol, postconditioning with lactate-enriched blood (PCLeB), for the prevention of reperfusion injury...
June 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28581998/controversies-in-the-management-of-st-elevation-myocardial-infarction-thrombin-inhibition
#9
REVIEW
Neeraj Shah, David Cox
Anticoagulation is essential in patients with ST elevation myocardial infarction (STEMI) to prevent further thrombosis and to maintain patency of the infarct-related artery after reperfusion. The various anticoagulant medications available for use in patients with STEMI include unfractionated heparin (UFH), low-molecular-weight heparin, fondaparinux, and bivalirudin, a direct thrombin inhibitor. The authors review the current anticoagulation strategies for patients with STEMI undergoing primary percutaneous coronary intervention (PCI), fibrinolysis, or no reperfusion...
October 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28581992/implementation-of-regional-st-segment-elevation-myocardial-infarction-systems-of-care-successes-and-challenges
#10
REVIEW
Christopher B Fordyce, Timothy D Henry, Christopher B Granger
Current guidelines recommend that communities create and maintain a regional system of ST-segment elevation myocardial infarction (STEMI) care that includes assessment and continuous quality improvement of emergency medical services and hospital-based activities. Availability and timely access is a challenge in many areas of the United States. This article reviews clinical trial data supporting the use of primary percutaneous coronary intervention as the optimal reperfusion strategy, and fibrinolysis as an option when this is not possible...
October 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28560714/clinical-presentation-and-echocardiographic-diagnosis-of-postinfarction-papillary-muscle-rupture-a-review-of-22-cases
#11
Bradley W Ternus, Sunil Mankad, William D Edwards, Rekha Mankad
BACKGROUND: Acute myocardial infarctions (AMI) continue to be common in the United States. Mechanical complications of AMI can lead to cardiogenic shock (CS) and death. The aim of this study was to review the cases of papillary muscle ruptures in the setting of myocardial infarctions at a tertiary care center, with a focus on the clinical presentation and echocardiographic diagnosis. METHODS: This was a retrospective study from January 1, 2000 through December 31, 2014...
May 30, 2017: Echocardiography
https://www.readbyqxmd.com/read/28551787/mechanistic-role-of-mptp-in-ischemia-reperfusion-injury
#12
Giampaolo Morciano, Massimo Bonora, Gianluca Campo, Giorgio Aquila, Paola Rizzo, Carlotta Giorgi, Mariusz R Wieckowski, Paolo Pinton
Acute myocardial infarction (MI) is a major cause of death and disability worldwide. The treatment of choice for reducing ischemic injury and limiting infarct size (IS) in patients with ST-segment elevation MI (STEMI) is timely and effective myocardial reperfusion via primary percutaneous coronary intervention (PCI). However, myocardial reperfusion itself may induce further cardiomyocyte death, a phenomenon known as reperfusion injury (RI). The opening of a large pore in the mitochondrial membrane, namely, the mitochondrial permeability transition pore (mPTP), is widely recognized as the final step of RI and is responsible for mitochondrial and cardiomyocyte death...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28511806/st-segment-elevation-myocardial-infarction-could-be-the-primary-presentation-of-acute-aortic-dissection
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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 3, 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
#19
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
#20
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
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