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https://www.readbyqxmd.com/read/28320312/the-effect-of-an-electronic-cognitive-aid-on-the-management-of-st-elevation-myocardial-infarction-during-caesarean-section-a-prospective-randomised-simulation-study
#1
Michael St Pierre, Bjoern Luetcke, Dieter Strembski, Christopher Schmitt, Georg Breuer
BACKGROUND: Cognitive aids have come to be viewed as promising tools in the management of perioperative critical events. The majority of published simulation studies have focussed on perioperative crises that are characterised by time pressure, rare occurrence, or complex management steps (e.g., cardiac arrest emergencies, management of the difficult airway). At present, there is limited information on the usefulness of cognitive aids in critical situations with moderate time pressure and complexity...
March 20, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28283469/timely-reperfusion-in-stroke-and-myocardial-infarction-is-not-correlated-an-opportunity-for-better-coordination-of-acute-care
#2
Kori Sauser Zachrison, Deborah A Levine, Gregg C Fonarow, Deepak L Bhatt, Margueritte Cox, Phillip Schulte, Eric E Smith, Robert E Suter, Ying Xian, Lee H Schwamm
BACKGROUND: Timely reperfusion is critical in acute ischemic stroke (AIS) and ST-segment-elevation myocardial infarction (STEMI). The degree to which hospital performance is correlated on emergent STEMI and AIS care is unknown. Primary objective of this study was to determine whether there was a positive correlation between hospital performance on door-to-balloon (D2B) time for STEMI and door-to-needle (DTN) time for AIS, with and without controlling for patient and hospital differences...
March 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#3
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#4
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28207887/platelet-monocyte-derived-and-tissue-factor-carrying-circulating-microparticles-are-related-to-acute-myocardial-infarction-severity
#5
Gemma Chiva-Blanch, Kristian Laake, Peder Myhre, Vibeke Bratseth, Harald Arnesen, Svein Solheim, Lina Badimon, Ingebjørg Seljeflot
OBJECTIVE: Circulating microparticles (cMPs) are phospholipid-rich vesicles released from cells when activated or injured, and contribute to the formation of intracoronary thrombi. Tissue factor (TF, CD142) is the main trigger of fibrin formation and TF-carrying cMPs are considered one of the most procoagulant cMPs. Similar types of atherosclerotic lesions may lead to different types of AMI, although the mechanisms behind are unresolved. Therefore, we aimed to investigate the phenotype of cMPs found in plasma of ACS patients and its relation to AMI severity and thrombotic burden...
2017: PloS One
https://www.readbyqxmd.com/read/28169119/reperfusion-therapy-of-myocardial-infarction-in-mexico-a-challenge-for-modern-cardiology
#6
Carlos Martínez-Sánchez, Alexandra Arias-Mendoza, Héctor González-Pacheco, Diego Araiza-Garaygordobil, Luis Alfonso Marroquín-Donday, Jorge Padilla-Ibarra, Carlos Sierra-Fernández, Alfredo Altamirano-Castillo, Amada Álvarez-Sangabriel, Francisco Javier Azar-Manzur, José Luis Briseño-de la Cruz, Salvador Mendoza-García, Yigal Piña-Reyna, Marco Antonio Martínez-Ríos
Mexico has been positioned as the country with the highest mortality attributed to myocardial infarction among the members of the Organization for Economic Cooperation and Development. This rate responds to multiple factors, including a low rate of reperfusion therapy and the absence of a coordinated system of care. Primary angioplasty is the reperfusion method recommended by the guidelines, but requires multiple conditions that are not reached at all times. Early pharmacological reperfusion of the culprit coronary artery and early coronary angiography (pharmacoinvasive strategy) can be the solution to the logistical problem that primary angioplasty rises...
February 3, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28147338/clinical-characteristics-and-improvement-of-the-guideline-based-management-of-acute-myocardial-infarction-in-china-a-national-retrospective-analysis
#7
Lechen Wang, You Zhou, Cheng Qian, Yanggan Wang
OBJECTIVE: This study is to document the clinical characteristics and improvement in management of acute myocardial infarction (AMI) in Chinese population. RESULTS: This study included 64,654 patients (23,805 patients in 2011, 40,849 patients in 2013), of which STEMI and NSTEMI account for 85.09% and 14.91%, respectively. From 2011 to 2013, significant improvement has been achieved in the recanalization rate of PCI (96.01% vs. 98.63%, P < 0.001) and in-hospital deaths (4...
January 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28104044/procedural-variations-in-performing-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#8
REVIEW
Radhika M Mehta, Manyoo Agarwal, Ikechukwu Ifedili, Wael W Rizk, Rami N Khouzam
Multiple variations exist in performing a primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) among various cardiologists. These variations range from the choice of peripheral access artery (radial vs femoral), performance or time of complete angiography including left ventriculography, and nonculprit vessel angiography before or after intervening on the culprit vessel. The reasons for such variations include emphasis on door-to-balloon time, knowledge of cardiac anatomy before proceeding with pPCI, physician expertise, and the level of comfort with radial approach...
February 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#9
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28038863/association-of-remote-ischemic-peri-conditioning-with-reduced-incidence-of-clinical-heart-failure-after-primary-percutaneous-coronary-intervention
#10
Adetola Ladejobi, Max Wayne, Christian Martin-Gill, Francis X Guyette, Andrew D Althouse, Michael S Sharbaugh, Steven E Reis, Clifton W Callaway, John A Kellum, A J Conrad Smith, Catalin Toma, Oladipupo Olafiranye
BACKGROUND: Clinical heart failure (HF) occurs frequently after ST-segment elevation myocardial infarction (STEMI), and is associated with increased mortality. We assessed the impact of remote ischemic peri-conditioning (RIPC) during inter-facility air medical transport of STEMI patients on clinical HF following primary percutaneous coronary intervention (pPCI). METHODS: Data from Acute Coronary Treatment and Intervention Outcomes Network Registry®-Get With the Guidelines™ (ACTION Registry-GWTG) from two PCI-hospitals that are utilizing RIPC during inter-facility helicopter transport of STEMI patients for pPCI between March, 2013 and September, 2015 were used for this study...
March 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28035135/complete-revascularization-of-simultaneous-multiple-culprit-lesions-in-a-septuagenarian-with-st-elevation-myocardial-infarction
#11
Ikechukwu A Ifedili, Tamunoinemi Bob-Manuel, Oluwaseyi Bolorunduro, Raza Askari, Uzoma N Ibebuogu
BACKGROUND ST-elevation myocardial infarction (STEMI) is usually caused by rupture of unstable plaque with thrombus formation and abrupt cessation of blood flow through a single coronary artery that is deemed the culprit. The simultaneous thrombotic occlusions of multiple coronary arteries in the setting of STEMI is a rare occurrence with implications for patient management and outcome not fully addressed in the current STEMI guidelines, although more recent studies suggest a benefit of complete revascularization compared to culprit vessel-only treatment in the setting of STEMI...
December 30, 2016: American Journal of Case Reports
https://www.readbyqxmd.com/read/27991651/oxygen-therapy-for-acute-myocardial-infarction
#12
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...
December 19, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27968766/indications-for-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-from-guidelines-to-practice
#13
C Boivineau, L Orion, J Dimet, E Boiffard
BACKGROUND: European guidelines on managing ST segment elevation myocardial infarction (STEMI) during the first 12hours recommend fibrinolysis when the time elapsing between the first medical contact and balloon time (FMCBT) is more than 120minutes. AIM: To assess the real-life clinical efficacy of guidelines on fibrinolysis in managing STEMI and identify obstacles to their everyday implementation. METHODS: An observational study based on a permanent registry of reperfusion strategies and timing among patients treated in a French general hospital for STEMI with chest pain lasting for less than two hours...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27968760/door-in-door-out-assessment-of-patients-admitted-with-acute-st-segment-elevation-myocardial-infarction-in-hospitals-without-catheterization-facilities
#14
S Clot, T Rocher, C Morvan, C Rubio, S Sainvoirin, P Usseglio, L Belle, V Descotes-Genon, G Vanzetto
BACKGROUND: Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a "door in - door out" (DI-DO) time≤30min. PURPOSE: To report DI-DO times in a registry of patients with acute STEMI. METHODS: The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27930573/management-of-st-segment-elevation-myocardial-infarction-in-predominantly-rural-central-china-a-retrospective-observational-study
#15
MULTICENTER STUDY
You Zhang, Shuyan Yang, Xinyun Liu, Muwei Li, Weidong Zhang, Haiyan Yang, Dayi Hu, Chuanyu Gao, Guangcai Duan
The degree of adherence to current guidelines for clinical management of ST-segment elevation myocardial infarction (STEMI) is known in developed countries and large Chinese cities, but in predominantly rural areas information is lacking. We assessed the application of early reperfusion therapy for STEMI in secondary and tertiary hospitals in Henan province in central China.Data were retrospectively collected from 5 secondary and 4 tertiary hospitals in Henan concerning STEMI patients treated from January 2011 to January 2012, including management strategy, delay time, and inhospital mortality...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27928226/achieving-timely-percutaneous-reperfusion-for-rural-st-elevation-myocardial-infarction-patients-by-direct-transport-to-an-urban-pci-hospital
#16
Charles-Lwanga K Bennin, Saif Ibrahim, Farah Al-Saffar, Lyndon C Box, Joel A Strom
BACKGROUNDS: ST-elevation myocardial infarction (STEMI) guidelines recommend reperfusion by primary percutaneous coronary intervention (PCI) ≤ 90 min from time of first medical contact (FMC). This strategy is challenging in rural areas lacking a nearby PCI-capable hospital. Recommended reperfusion times can be achieved for STEMI patients presenting in rural areas without a nearby PCI-capable hospital by ground transportation to a central PCI-capable hospital by use of protocol-driven emergency medical service (EMS) STEMI field triage protocol...
October 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27916154/cancer-history-portends-worse-acute-and-long-term-noncardiac-but-not-cardiac-mortality-after-primary-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction
#17
Feilong Wang, Rajiv Gulati, Ryan J Lennon, Bradley R Lewis, Jae Park, Gurpreet S Sandhu, R Scott Wright, Amir Lerman, Joerg Herrmann
OBJECTIVE: To define the effect of a history of cancer on in-hospital and long-term mortality after primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI). PATIENTS AND METHODS: In this retrospective cohort study of 2346 patients with STEMI enrolled in the Mayo Clinic PCI registry from November 1, 2000, through October 31, 2010, we identified 261 patients (11.1%) with a history of cancer. The in-hospital and long-term outcomes (median follow-up, 6...
December 2016: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/27887802/meta-analysis-of-clopidogrel-pretreatment-in-acute-coronary-syndrome-patients-undergoing-invasive-strategy
#18
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)...
February 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27848270/pathfinding-to-an-optimal-strategy-of-revascularization-in-primary-coronary-intervention-in-patients-with-multivessel-disease-a-network-meta-analysis-of-randomized-trials
#19
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 (RCTs) in STEMI on culprit-only intervention (CO) versus different timing multivessel revascularization, including immediate (IM), same hospitalization (SH) or later staged (ST)...
December 16, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#20
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...
January 15, 2017: International Journal of Cardiology
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