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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
#1
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
#2
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
#3
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
#4
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
#5
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...
December 27, 2016: 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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
https://www.readbyqxmd.com/read/27814743/prehospital-fibrinolysis-versus-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#13
Vincent Roule, Pierre Ardouin, Katrien Blanchart, Adrien Lemaitre, Julien Wain-Hobson, Damien Legallois, Joachim Alexandre, Rémi Sabatier, Paul Milliez, Farzin Beygui
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI), but its benefit over prehospital fibrinolysis (FL) is not clear. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials in which outcomes of patients with STEMI managed with FL early in the prehospital setting versus PPCI were compared. RESULTS: Compared with PPCI, FL was consistently associated with similar rates of short-term (30-90 days) death (relative risk [RR] 0...
November 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27797464/bioresorbable-vascular-scaffolds-for-the-treatment-of-coronary-artery-disease-clinical-outcomes-from-randomized-controlled-trials
#14
David G Rizik, James B Hermiller, Dean J Kereiakes
The permanent metal prosthesis common to bare metal stents (BMS) as well as both first- and second-generation drug-eluting stents (DES) following treatment of coronary artery disease represents a long-lasting substrate for late adverse coronary events including restenosis, thrombosis, and neoatherosclerosis. Following resorbtion, bioresorbable scaffolds (BRS) may eliminate this nidus and improve late outcomes through restoration of the vessel to more normal vascular structure and function. BRS represents a single platform which incorporates the mechanical features of metallic stents to provide safe and effective revascularization, suppression of restenosis and prevention of constrictive remodeling with long-term restoration of the treated vessel to a more natural state...
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27727197/cardiogenic-shock-and-access-site-choice
#15
Samir B Pancholy, Gaurav Patel, Sukrut P Nanavaty, Maitri S Pancholy
Transradial access (TRA) has increased in utilization, although operators have been reluctant to use TRA in patients presenting with cardiogenic shock (CS). Experienced TRA operators have started using TRA in CS patients, although the literature is scant. Several datasets have included CS patients in their study population, while others have systematically excluded CS patients when comparing outcomes with TRA to transfemoral access (TFA). In this review, we have compiled the existing literature describing outcomes of patients presenting with CS who underwent PCI using TRA versus TFA...
February 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27683739/impact-of-direct-cardiovascular-laboratory-activation-by-emergency-physicians-on-false-positive-activation-rates
#16
Julian Ck Tay, Liou Wei Lun, Zhong Liang, Terrance Sj Chua, Swee Han Lim, Aaron Sl Wong, Marcus Eh Ong, Kay Woon Ho
INTRODUCTION: Door-to-balloon (DTB) time is critical to ST elevation myocardial infarction (STEMI) patients' survival. Although DTB time is reduced with direct cardiovascular laboratory (CVL) activation by emergency physicians, concerns regarding false-positive activation remain. We evaluate false-positive rates before and after direct CVL activation and factors associated with false-positive activations. MATERIALS AND METHODS: This is a retrospective single centre study of all emergency CVL activation 3 years before and after introduction of direct activation in July 2007...
August 2016: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/27640933/patients-without-st-elevation-after-return-of-spontaneous-circulation-may-benefit-from-emergent-percutaneous-intervention-a-systematic-review-and-meta-analysis
#17
Michael G Millin, Angela C Comer, Jose V Nable, Peter V Johnston, Benjamin J Lawner, Nathan Woltman, Matthew J Levy, Kevin G Seaman, Jon Mark Hirshon
INTRODUCTION: The American Heart Association recommends that post-arrest patients with evidence of ST elevation myocardial infarction (STEMI) on electrocardiogram (ECG) be emergently taken to the catheterization lab for percutaneous coronary intervention (PCI). However, recommendations regarding the utility of emergent PCI for patients without ST elevation are less specific. This review examined the literature on the utility of PCI in post-arrest patients without ST elevation compared to patients with STEMI...
September 15, 2016: Resuscitation
https://www.readbyqxmd.com/read/27635857/developing-program-performance-measures-for-rural-emergency-medical-services
#18
John Gale, Andrew Coburn, Karen Pearson, Zachariah Croll, George Shaler
BACKGROUND: The development of measures to monitor and evaluate the performance and quality of emergency medical services (EMS) systems has been a focus of attention for many years. The Medicare Rural Hospital Flexibility Program (Flex Program), established by Congress in 1997, provides grants to states to implement initiatives to strengthen rural healthcare delivery systems, including better integration of EMS into those systems of care. OBJECTIVE: Building on national efforts to develop EMS performance measures, we sought to identify measures relevant to the rural communities and hospitals supported by the Flex Program...
September 16, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27617370/contemporary-management-of-st-elevation-myocardial-infarction
#19
REVIEW
Ashleigh Dind, Usaid Allahwala, Kaleab N Asrress, Sanjit S Jolly, Ravinay Bhindi
Recent advances have caused a major shift in the way ST-elevation myocardial infarctions are managed. This review explores the pharmacological and interventional techniques that have evidence for improving outcomes and the landmark trials that have sparked change. The new P2Y12 inhibitors, ticagrelor and prasugrel, have been shown to be superior to clopidogrel in STEMI patients undergoing primary percutaneous coronary intervention. Concurrently, many technical aspects of percutaneous coronary intervention have been further clarified by trial data, with bare-metal stents, routine thrombus aspiration and femoral access showing evidence of inferiority...
February 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27609250/survival-after-varying-revascularization-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-pairwise-and-network-meta-analysis
#20
Giuseppe Tarantini, Gianpiero D'Amico, Sorin J Brener, Paola Tellaroli, Marco Basile, Alessandro Schiavo, Marco Mojoli, Chiara Fraccaro, Alfredo Marchese, Giuseppe Musumeci, Gregg W Stone
OBJECTIVES: The authors conducted a systematic pairwise and network meta-analysis to assess optimal treatment strategies in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV-CAD) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Patients with STEMI and MV-CAD have a worse prognosis than those with single-vessel CAD. The optimal revascularization strategy for these patients is uncertain...
September 12, 2016: JACC. Cardiovascular Interventions
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