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https://www.readbyqxmd.com/read/27887802/meta-analysis-of-clopidogrel-pretreatment-in-acute-coronary-syndrome-patients-undergoing-invasive-strategy
#1
Ramez Nairooz, Marco Valgimigli, Yogita Rochlani, Naga Venkata Pothineni, Sameer Raina, Partha Sardar, Debabrata Mukherjee, Srihari S Naidu, David M Shavelle
BACKGROUND: It is unknown whether pretreatment with clopidogrel in acute coronary syndrome (ACS) managed invasively, is superior to a strategy of administering clopidogrel in the cardiac catheterization laboratory at the time of percutaneous coronary intervention (PCI). Current practice guidelines do not endorse one strategy over the other. METHODS: A comprehensive literature search was done to identify all relevant studies comparing pretreatment with clopidogrel to administration in the cardiac catheterization laboratory at the time of PCI (no pretreatment)...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27848270/pathfinding-to-an-optimal-strategy-of-revascularization-at-primary-coronary-intervention-in-patients-with-multivessel-disease-a-network-meta-analysis-of-randomized-trials
#2
András Komócsi, Dániel Kehl, Fabrizio d'Ascenso, James DiNicolantonio, András Vorobcsuk
OBJECTIVES: In ST-segment elevation myocardial infarction (STEMI), current guidelines discourage treatment of the non-culprit lesions at the time of the primary intervention. Latest trials have challenged this strategy suggesting benefit of early complete revascularization. We performed a Bayesian multiple treatment network meta-analysis of randomized clinical trials (RCT) in STEMI on culprit-only intervention (CO) versus different timing multivessel revascularization, including immediate (IM), same hospitalization (SH) or later staged (ST)...
November 16, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#3
REVIEW
Cheuk-Kit Wong
Current guidelines on STEMI reperfusion management do not incorporate further electrocardiographic details over the presence of significant ST elevation. Fibrinolysis is considered an alternative therapy to primary PCI if there is a long PCI-related delay, but the 2 therapies should not be combined. Meanwhile, reperfusion for ischemic stroke has evolved on mechanistic understanding - reperfusion benefit being greatest in the patient with small "core" infarct and large ischemic "penumbra". Fibrinolysis is not regarded as an alternative to mechanical thrombectomy, and the 2 therapies can be combined...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27846009/association-between-hospital-practices-and-door-in-door-out-time-in-st-segment-elevation-myocardial-infarction
#4
Bryn E Mumma, James Eggert, Simon A Mahler, Michael C Kontos, Deborah B Diercks
BACKGROUND: Current guidelines suggest a "door-in-door-out" (DIDO) time of 30 minutes or shorter for patients with ST-segment elevation myocardial infarction (STEMI) who arrive at a STEMI referral hospital and are transferred to a STEMI-receiving center for primary percutaneous coronary intervention. Experts previously identified 18 system practices as critical for reducing DIDO times. The objective of this study was to describe how frequently these critical practices are used and to determine whether their use was associated with shorter DIDO times...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27821064/the-prognostic-utility-of-grace-risk-score-in-predictive-cardiovascular-event-rate-in-stemi-patients-with-successful-fibrinolysis-and-delay-intervention-in-non-pci-capable-hospital-a-retrospective-cohort-study
#5
Yotsawee Chotechuang, Arintaya Phrommintikul, Roungtiva Muenpa, Jayanton Patumanond, Tuanchai Chaichuen, Srun Kuanprasert, Noparat Thanachikun, Thanawat Benjanuwatra, Apichard Sukonthasarn
BACKGROUND: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital...
November 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27812152/the-comparison-of-the-outcomes-between-primary-pci-fibrinolysis-and-no-reperfusion-in-patients-%C3%A2-75-years-old-with-st-segment-elevation-myocardial-infarction-results-from-the-chinese-acute-myocardial-infarction-cami-registry
#6
He Peiyuan, Yang Jingang, Xu Haiyan, Gao Xiaojin, Xian Ying, Wu Yuan, Li Wei, Wang Yang, Tang Xinran, Yan Ruohua, Jin Chen, Song Lei, Zhang Xuan, Fu Rui, Ye Yunqing, Dong Qiuting, Sun Hui, Yan Xinxin, Gao Runlin, Yang Yuejin
BACKGROUND: Only a few randomized trials have analyzed the clinical outcomes of elderly ST-segment elevation myocardial infarction (STEMI) patients (≥ 75 years old). Therefore, the best reperfusion strategy has not been well established. An observational study focused on clinical outcomes was performed in this population. METHODS: Based on the national registry on STEMI patients, the in-hospital outcomes of elderly patients with different reperfusion strategies were compared...
2016: PloS One
https://www.readbyqxmd.com/read/27792640/temporal-trends-in-care-and-outcomes-of-patients-receiving-fibrinolytic-therapy-compared-to-primary-percutaneous-coronary-intervention-insights-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-registry
#7
Ravi S Hira, Deepak L Bhatt, Gregg C Fonarow, Paul A Heidenreich, Christine Ju, Salim S Virani, Biykem Bozkurt, Laura A Petersen, Adrian F Hernandez, Lee H Schwamm, Zubin J Eapen, Michelle A Albert, Li Liang, Roland A Matsouaka, Eric D Peterson, Hani Jneid
BACKGROUND: Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysis within 30 minutes for those in those for whom timely transfer to a PCI-capable hospital is not feasible. METHODS AND RESULTS: We identified STEMI patients receiving reperfusion therapy at 229 hospitals participating in the Get With the Guidelines-Coronary Artery Disease (GWTG-CAD) database (January 1, 2003 through December 31, 2008)...
October 6, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27771225/the-impact-of-recommended-percutaneous-coronary-intervention-care-on-hospital-outcomes-for-interhospital-transferred-st-segment-elevation-myocardial-infarction-patients
#8
YeongHo Choi, Yu Jin Lee, Sang Do Shin, Kyoung Jun Song, KyungWon Lee, Eui Jung Lee, Yu Jin Kim, Ki Ok Ahn, Ki Jeong Hong, Young Sun Ro
BACKGROUND: Timely transfer and percutaneous coronary intervention (PCI) with or without thrombolysis are recommended by the American Heart Association (AHA) to care for ST-segment elevation myocardial infarction (STEMI) patients who present first to a non-PCI-capable hospital. This study was to evaluate the impact on in-hospital mortality of the compliance with guidelines regarding to the time of PCI for patients with STEMI who were transferred to a capable PCI hospital. METHODS: We used the CArdioVAscular disease Surveillance data from November 2007 to December 2012 for this study...
September 16, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27760229/demographics-management-strategies-and-problems-in-st-elevation-myocardial-infarction-from-the-standpoint-of-emergency-medicine-specialists-a-survey-based-study-from-seven-geographical-regions-of-turkey
#9
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
https://www.readbyqxmd.com/read/27714584/contemporary-management-of-st-segment-elevation-myocardial-infarction
#10
Ajay Yadlapati, Mark Gajjar, Daniel R Schimmel, Mark J Ricciardi, James D Flaherty
ST-elevation myocardial infarction (STEMI), which constitutes nearly 25-40 % of current acute myocardial infarction (AMI) cases, is a medical emergency that requires prompt recognition and treatment. Since the 2013 STEMI practice guidelines, a wealth of additional data that may further advance optimal STEMI practices has emerged. These data highlight the importance of improving patient treatment and transport algorithms for STEMI from non-primary percutaneous coronary intervention (PCI) centers. In addition, a focus on the reduction of total pain-to-balloon (P2B) times rather than simply door-to-balloon (D2B) times may further improve outcomes after primary PCI for STEMI...
October 6, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27659885/the-effect-of-high-risk-st-elevation-myocardial-infarction-transfer-patients-on-risk-adjusted-in-hospital-mortality-a-report-from-the-american-heart-association-mission-lifeline-program
#11
Michael C Kontos, Tracy Y Wang, Anita Y Chen, Eric R Bates, Harold L Dauerman, Timothy D Henry, Steven V Manoukian, Matthew T Roe, Robert Suter, Laine Thomas, William J French
BACKGROUND: Hospital mortality is an important quality measure for acute myocardial infarction care. There is a concern that despite risk adjustment, percutaneous coronary intervention hospitals accepting a greater volume of high-risk ST elevation myocardial infarction (STEMI) transfer patients may have their reported mortality rates adversely affected. METHODS: The STEMI patients in the National Cardiovascular Data RegistryAcute Coronary Treatment Intervention Outcomes Network Registry-Get With the Guidelines from April 2011 to December 2013 were included...
October 2016: American Heart Journal
https://www.readbyqxmd.com/read/27654041/-postresuscitation-care
#12
H-C Mochmann
Witnessed collapse, bystander resuscitation and the use of automated external defibillators for defibrillatable arrhythmias, are recognized as strong predictors for a good prognosis after cardiac arrest. In addition, patient care after return of spontaneous circulation (ROSC), i.e. postresuscitation care, has been identified as an important factor for survival. It is necessary to differentiate between measures for treating the underlying cause of the cardiac arrest and measures for limiting reperfusion injury after global hypoxia and ischemia...
September 21, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/27601458/differences-in-short-and-long-term-outcomes-among-older-patients-with-st-elevation-versus-non-st-elevation-myocardial-infarction-with-angiographically-proven-coronary-artery-disease
#13
Amit N Vora, Tracy Y Wang, Anne S Hellkamp, Laine Thomas, Timothy D Henry, Abhinav Goyal, Matthew T Roe
BACKGROUND: Among older patients with acute myocardial infarction (MI), it remains uncertain whether there is a time-dependent difference in the risk of recurrent mortality and nonfatal cardiovascular and cerebrovascular events for those with ST-segment-elevation MI (STEMI) compared with those with non-ST-segment-elevation MI. METHODS AND RESULTS: Older patients ≥65 years with acute MI and significant coronary artery disease identified with coronary angiography from the ACTION Registry-GWTG (Get With the Guidelines) were linked to Medicare claims data from 2007 to 2010...
September 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27580741/pre-hospital-management-procedural-performance-and-outcomes-for-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-in-the-netherlands-insights-from-the-dutch-cohort-of-the-apposition-iii-trial
#14
N S Vos, G Amoroso, M J Grundeken, A J J Ijsselmuiden, R J M van Geuns, R Spaargaren, J G P Tijssen, K T Koch
AIM: The aim of this study was to achieve useful insights into pre-hospital management and procedural performance for ST-elevation myocardial infarction (STEMI) in the Netherlands by extrapolating patient characteristics, and procedural and clinical outcomes of the Dutch patient cohort from the APPOSITION-III trial. METHODS: This is a retrospective analysis from the APPOSITION-III trial with respect to the geographical borders of STEMI management. The APPOSITION-III trial was a European registry for the use of the STENTYS self-expandable stent in STEMI patients undergoing primary percutaneous coronary intervention (PPCI)...
August 31, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27574379/spontaneous-coronary-artery-dissection-one-disease-variable-presentations-and-different-management-approaches
#15
REVIEW
Abdel Rahman A Al Emam, Ahmed Almomani, Syed A Gilani, Wissam I Khalife
Spontaneous coronary artery dissection (SCAD) is a rare cause of acute coronary syndrome. It occurs predominantly among younger females, typically in the absence of atherosclerotic coronary artery disease. Presentations vary greatly and this condition can be fatal. Given its rarity, there are no management guidelines. We present six patients with SCAD with different presentations and treatment approaches as examples in our literature review. Two patients presented with ST elevation myocardial infarction (STEMI), two with non-STEMI (NSTEMI), and two with cardiac arrest...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27503306/-preclinical-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-in-a-rural-region
#16
T Viergutz, J Grüttner, T Walter, C Weiss, B Haaff, G Pollach, C Madler, T Luiz
BACKGROUND: In the current guidelines for the treatment of patients with ST-segment elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) recommends preclinical fibrinolysis as a reperfusion therapy if, due to long transportation times, no cardiac catheterisation is available within 90-120 min. However, there is little remaining in-depth expertise in this method because fibrinolysis is presently only rarely indicated. METHODS: In a rural area in southwestern Germany, where an emergency primary percutaneous coronary intervention was not routinely available within 90-120 min, 156 STEMI patients underwent fibrinolysis with the plasminogen activator reteplase, performed by trained emergency physicians...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27497102/age-dependent-impact-of-new-esc-guideline-recommended-door-to-balloon-times-on-mid-term-survival-in-acute-st-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention
#17
Yu-Chen Wang, Ying-Ying Huang, Ping-Hang Lo, Kuan-Cheng Chang, Chu-Huang Chen, Ming-Fong Chen
BACKGROUND: To investigate the age-dependent impact of the superfast door-to-balloon (D2B) times of ≤60min as recommended by the new ESC Guideline for patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) on mid-term survival rates based on a single center registry dataset. PATIENTS AND METHODS: This study enrolled consecutive STEMI patients who underwent PPCI from Jan 1, 2009 through Sep 30, 2013...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27482000/regional-systems-of-care-demonstration-project-american-heart-association-mission-lifeline-stemi-systems-accelerator
#18
James G Jollis, Hussein R Al-Khalidi, Mayme L Roettig, Peter B Berger, Claire C Corbett, Harold L Dauerman, Christopher B Fordyce, Kathleen Fox, J Lee Garvey, Tammy Gregory, Timothy D Henry, Ivan C Rokos, Matthew W Sherwood, Robert E Suter, B Hadley Wilson, Christopher B Granger
BACKGROUND: Up to 50% of patients fail to meet ST-segment-elevation myocardial infarction (STEMI) guideline goals recommending a first medical contact-to-device time of <90 minutes for patients directly presenting to percutaneous coronary intervention-capable hospitals and <120 minutes for transferred patients. We sought to increase the proportion of patients treated within guideline goals by organizing coordinated regional reperfusion plans. METHODS: We established leadership teams, coordinated protocols, and provided regular feedback for 484 hospitals and 1253 emergency medical services (EMS) agencies in 16 regions across the United States...
August 2, 2016: Circulation
https://www.readbyqxmd.com/read/27358705/echocardiographic-predictors-for-left-ventricular-remodeling-after-acute-st-elevation-myocardial-infarction-with-low-risk-group-speckle-tracking-analysis
#19
Hyun-Min Na, Goo-Yeong Cho, Joo Myung Lee, Myung-Jin Cha, Yeonyee E Yoon, Seung-Pyo Lee, Hyung-Kwan Kim, Yong-Jin Kim, Dae-Won Sohn
BACKGROUND: We sought to assess echocardiographic predictors of left ventricular (LV) adverse remodeling after successfully reperfused acute ST elevation myocardial infarction (STEMI). LV remodeling is commonly found in STEMI patients and it may suggest adverse outcome in acute myocardial infarction. We sought to identify whether 2D strain and torsion be independent parameters for prediction of LV adverse remodeling. METHODS: We investigated 208 patients with low-risk STEMI patients who had follow up echocardiography at 6 or more months...
June 2016: Journal of Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/27328951/angiographic-findings-and-revascularization-success-in-patients-with-acute-myocardial-infarction-and-previous-coronary-bypass-grafting
#20
Florian Blachutzik, Stephan Achenbach, Monique Troebs, Jens Roether, Holger Nef, Christian Hamm, Christian Schlundt
Current guidelines recommend invasive coronary angiography and interventional revascularization in ST-elevation and Non-ST-elevation myocardial infarction (STEMI and NSTEMI). The aim of this study was to analyze culprit lesions and percutaneous coronary intervention (PCI) success in patients with previous coronary artery bypass grafting (CABG). We analyzed the data of 121 consecutive patients in whom coronary angiography was performed in the setting of STEMI or NSTEMI and who had previous CABG. Coronary angiograms were reviewed, and clinical data were evaluated...
August 15, 2016: American Journal of Cardiology
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