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https://www.readbyqxmd.com/read/29627944/complete-versus-culprit-only-revascularization-in-stemi-a-contemporary-review
#1
REVIEW
Daniel Y Lu, Ming Zhong, Dmitriy N Feldman
PURPOSE OF REVIEW: In ST-segment elevation myocardial infarction, urgent revascularization of the culprit coronary vessel and restoration of coronary flow is the goal of the initial management. However, obstructive non-culprit disease is frequently concomitantly found during initial angiography and portends a poor prognosis. Management of non-culprit lesions in ST-segment elevation myocardial infarction (STEMI) has been the subject of extensive debate. This review will examine the currently available evidence, with a specific focus on randomized clinical trials performed to date...
April 7, 2018: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29623168/stenting-in-primary-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction
#2
REVIEW
Sanjog Kalra, Hemal Bhatt, Ajay J Kirtane
The treatment of ST-segment elevation myocardial infarction (STEMI) has advanced dramatically over the past 30 years since the introduction of reperfusion therapies, such that mechanical reperfusion with primary percutaneous coronary intervention is now the standard of care. With STEMI, as with other forms of acute coronary syndrome, stent deployment in culprit lesions is the dominant form of reperfusion in the developed world and is supported by contemporary guidelines. However, the precise timing of stenting and the extent to which both culprit and non-culprit lesions should be treated continue to be active areas of study...
January 2018: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/29548521/the-utility-of-the-triage-electrocardiogram-for-the-detection-of-st-segment-elevation-myocardial-infarction
#3
Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29544939/circulating-microparticles-are-associated-with-clinical-severity-of-persistent-st-segment-elevation-myocardial-infarction-complicated-with-cardiogenic-shock
#4
A Sionis, R Suades, J Sans-Roselló, M Sánchez-Martínez, J Crespo, T Padró, J Cubedo, A Ferrero-Gregori, M Vila-Perales, A Duran-Cambra, L Badimon
BACKGROUND: Cardiogenic shock (CS) is the leading cause of death in patients admitted for acute myocardial infarction (MI). Despite the recent advances in reperfusion and medical treatment mortality remains unacceptably high. Whether cells of the blood compartment in CS-patients are activated and release microparticles (cMPs) that may be both messengers and biomarkers of cell damage is not known. We aimed to investigate the cMP subtypes and parental activated cells of ST-elevation MI (STEMI)-patients complicated by CS and that of non-CS STEMI-patients (non-CS) in order to identify a cMP signature that could aid CS patient's risk stratification...
May 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29543035/guideline-adherence-regarding-critical-time-intervals-in-the-german-chest-pain-unit-registry
#5
Mehrshad Vafaie, Matthias Hochadel, Thomas Münzel, Birgit Hailer, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Michael Haude, Sebastian Barth, Claus Schmitt, Harald Darius, Lars S Maier, Hugo A Katus, Jochen Senges, Evangelos Giannitsis
BACKGROUND: Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units. METHODS: From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29535061/four-step-protocol-for-disparities-in-stemi-care-and-outcomes-in-women
#6
Chetan P Huded, Michael Johnson, Kathleen Kravitz, Venu Menon, Mouin Abdallah, Travis C Gullett, Scott Hantz, Stephen G Ellis, Seth R Podolsky, Stephen W Meldon, Damon M Kralovic, Deborah Brosovich, Elizabeth Smith, Samir R Kapadia, Umesh N Khot
BACKGROUND: Women with STEMI receive suboptimal care and have worse outcomes than men. Whether strategies to reduce STEMI care variability impact disparities in the care and outcomes of women with STEMI is unknown. OBJECTIVES: We assessed the care and outcomes of men vs. women with STEMI before and after implementation of a comprehensive STEMI protocol. METHODS: On 7/15/14 we implemented: (1) emergency department catheterization lab activation, (2) STEMI Safe Handoff Checklist, (3) immediate transfer to an immediately available catheterization lab, and (4) radial first approach to percutaneous coronary intervention (PCI)...
March 7, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29521450/sustained-sex-based-treatment-differences-in-acute-coronary-syndrome-care-insights-from-the-american-heart-association-get-with-the-guidelines-coronary-artery-disease-registry
#7
Jacob A Udell, Gregg C Fonarow, Thomas M Maddox, Christopher P Cannon, W Frank Peacock, Warren K Laskey, Maria V Grau-Sepulveda, Eric E Smith, Adrian F Hernandez, Eric D Peterson, Deepak L Bhatt
BACKGROUND: Sex-based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care. Hypothesis Age is a modifier of temporal trends in sex-based differences in ACS care. METHODS: Among 104,817 eligible patients with ACS enrolled in the AHA GWTG-CAD registry between 2003-2008, care and in-hospital mortality were evaluated stratified by sex and age (<65 years and ≥65 years). Temporal trends within sex and age groups were assessed for two care processes: the percentage of patients with ST-elevation MI (STEMI) presenting to PCI capable hospitals with a door-to-balloon time ≤ 90 minutes (DTB90) and the proportion of eligible patients with ACS treated with aspirin within 24 hours of presentation...
March 9, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29459218/clinical-and-angiographic-predictors-of-mortality-in-sudden-cardiac-arrest-patients-having-cardiac-catheterisation-a-single-centre-registry
#8
James Xu, Leia Hee, Andrew Hopkins, Craig P Juergens, Sidney Lo, John K French, Christian J Mussap
BACKGROUND: Immediate cardiac catheterisation (CC) is recommended in ST-elevation myocardial infarction (STEMI) following sudden cardiac arrest (SCA). Guidelines advise urgent CC for SCA patients without-STEMI, at clinician discretion. We examined the clinical and angiographic factors predicting mortality in SCA patients having CC. METHODS: Consecutive SCA patients having CC at Liverpool Hospital, Sydney (January 2011-September 2015) were retrospectively analysed...
February 8, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29458248/revascularization-strategies-in-stemi-with-multivessel-disease-when-and-how
#9
Gianpiero D'Amico, Marco Basile, Giuseppe Tarantini, Alfredo Marchese
Acute ST-segment elevation myocardial infarction (STEMI) typically arises from total occlusion of an epicardial coronary artery, most often due to atherosclerotic plaque rupture/erosion and subsequent thrombus formation. Granted this, important angiographic information for patients presenting with STEMI is not only about the status of infarct-related artery (IRA) but also about the atherosclerotic disease burden and disease severity of non-IRA vessels. Previous studies have reported that multivessel (MV) coronary artery disease (CAD) is found in approximately 50% of patients with STEMI undergoing primary percutaneous coronary intervention (PCI) [1,2]...
February 19, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29455786/examination-of-the-appropriate-timing-of-reperfusion-therapy-for-recent-myocardial-infarction-a-japanese-single-center-retrospective-study
#10
Yukio Mizuguchi, Hiroki Shibutani, Sho Hashimoto, Takeshi Yamada, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata, Akihiko Takahashi
BACKGROUND: The various guidelines clearly mention the treatment strategies for in patient of acute myocardial infarction (MI) presenting more than 24h from symptom onset (recent myocardial infarction, RMI). However, the appropriate timing of reperfusion for RMI is unclear. METHODS: We retrospectively evaluated 525 consecutive MI patients who underwent percutaneous coronary intervention (PCI) in our hospital between January 2008 and December 2012. RESULTS: Sixty RMI patients were more frequently associated with cardiac complications such as myocardial rupture (3...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29455776/confronting-system-barriers-for-st-elevation-mi-in-low-and-middle-income-countries-with-a-focus-on-india
#11
Sameer Mehta, Christopher Granger, Cindy Lee Grines, Alice Jacobs, Timothy D Henry, Ivan Rokos, Alexandra Lansky, Andreas Baumbach, Roberto Botelho, Alexandra Ferre, Isaac Yepes, Roopa Salwan, Jamshed Dalal, Jitendra Makkar, Neeraj Bhalla, Sundeep Mishra, Vinod Vijan, Shirish Hiremath
Our previous research found seven specific factors that cause system delays in ST-elevation Myocardial infarction management in developing countries. These delays, in conjunction with a lack of organized STEMI systems of care, result in inefficient processes to treat AMI in developing countries. In our present opinion paper, we have specifically explored the three most pertinent causes that afflict the seven specific factors responsible for system delays. In doing so, we incorporated a unique strategy of global STEMI expertise...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29417147/direct-oral-anticoagulants-in-addition-to-antiplatelet-therapy-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#12
Mauro Chiarito, Davide Cao, Francesco Cannata, Cosmo Godino, Corrado Lodigiani, Giuseppe Ferrante, Renato D Lopes, John H Alexander, Bernhard Reimers, Gianluigi Condorelli, Giulio G Stefanini
Importance: Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS. Objective: To evaluate the safety and efficacy of DOAC in addition to antiplatelet therapy (APT) after ACS, focusing on treatment effects stratified by baseline clinical presentation (non-ST-segment elevation ACS [NSTE-ACS] vs ST-segment elevation myocardial infarction [STEMI])...
March 1, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29402689/patient-provider-and-environmental-factors-associated-with-adherence-to-cardiovascular-and-cerebrovascular-clinical-practice-guidelines-in-the-emergency-department
#13
Stacy A Trent, Michael A Johnson, Erica A Morse, Edward P Havranek, Jason S Haukoos
OBJECTIVES: Myocardial infarction and stroke are two of the leading causes of death in the U.S. Both diseases have clinical practice guidelines (CPGs) specific to the emergency department (ED) that improve patient outcomes. Our primary objectives were to estimate differences in ED adherence across CPGs for these diseases and identify patient, provider, and environmental factors associated with adherence. METHODS: Design: Retrospective study at 3 hospitals in Colorado using standard medical record review...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29393606/choice-of-vascular-access-in-primary-pci
#14
Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29387508/does-frequency-of-st-segment-elevation-myocardial-infarction-presentation-impact-quality-of-care
#15
Alex N Mazurek, Paul R Atkinson, Jaroslav Hubacek, Mark McGraw, Sohrab Lutchmedial
Objectives The volume of ST-Segment Elevation Myocardial Infarctions (STEMIs) presenting to an emergency department (ED) has been shown to affect treatment quality measures and patient outcomes. Almost half of ST-elevation-myocardial-infarction (STEMI) patients in New Brunswick (NB) present directly to community hospitals. This study seeks to determine if the quality of care received by STEMI patients presenting to EDs in NB is related to the volume of STEMI presentations at that center.  Methods This retrospective registry-based study used data from the STEMI database at the New Brunswick Heart Centre (NBHC), identifying 1196 cases of STEMI in NB, Canada, between December 2010 and April 2013...
November 26, 2017: Curēus
https://www.readbyqxmd.com/read/29371870/persian-registry-of-cardiovascular-disease-prove-design-and-methodology
#16
Mahshid Givi, Nizal Sarrafzadegan, Mohammad Garakyaraghi, Ghasem Yadegarfar, Masoumeh Sadeghi, Alireza Khosravi, Amir Hossein Azhari, Mohammad Reza Samienasab, Davood Shafie, Mohammad Saadatnia, Hamidreza Roohafza, Navid Paydari, Azam Soleimani, Mohsen Hosseinzadeh, Seyed Abdulah Ahmadi, Leila Dehghani, Jamshid Najafian, Elham Andalib, Javad Shahabi, Mohammad Reza Sabri
BACKGROUND: Our aim was to create and establish a database called "Persian Registry Of cardioVascular diseasE (PROVE)" in order to be used for future research and in addition, as a tool to develop national guidelines for diagnosis, treatment, and prevention of cardiovascular disease (CVD). In this paper, the design and methodology of the PROVE pilot study will be discussed, launched in Isfahan, Iran, in 2015-2016. METHODS: Through establishing PROVE, patients' data were collected from hospitals and outpatient clinics prospectively or retrospectively and followed up for a maximum of three years based on the type of CVDs...
September 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29361856/catheterization-laboratory-activations-and-time-intervals-for-patients-with-pre-hospital-ecgs
#17
Josephine Muhrbeck, Jonas Persson, Claes Hofman-Bang
OBJECTIVE: The use of pre-hospital ECGs (PH-ECG) reduces time to reperfusion for patients with ST-segment elevation myocardial infarction (STEMI). The feasibility of reperfusion therapy within 60 minutes for hospitals with 24/7 PCI capability has been questioned, and current guidelines have set time targets to 90 minutes. Our primary objective was to investigate the proportion of false-positive catheterization laboratory activations by PH-ECG. Our secondary objective was to describe the time intervals from first medical contact to reperfusion and to establish the proportion of patients receiving reperfusion within 60 minutes...
January 23, 2018: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/29356080/striving-to-meet-targets-for-ideal-treatment-of-acute-myocardial-infarction-in-brazil-data-from-the-midwest-region
#18
Gustavo Carvalho, Salvador Rassi, Enio Guérios, Fernando A M Curado, Ana Tereza Bastos
OBJECTIVES: To evaluate the systematic chain of care for patients with acute ST-elevation myocardial infarction (STEMI) referred for primary angioplasty in a capital city in Midwestern Brazil. BACKGROUND: Acute myocardial infarction is recognized as an important cause of morbidity and mortality and as a public health problem worldwide. Early specialized care is crucial for a good prognosis. METHODS: All STEMI patients receiving care through the public health system at two tertiary care centers from March 2012 to June 2014 were retrospectively analyzed...
January 21, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29346126/complete-revascularization-for-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-meta-analysis-of-randomized-trials
#19
Gani Bajraktari, Haki Jashari, Pranvera Ibrahimi, Fernando Alfonso, Fisnik Jashari, Gjin Ndrepepa, Shpend Elezi, Michael Y Henein
INTRODUCTION: Despite the recent findings in randomized clinical trials (RCTs) with limited sample sizes and the updates in clinical guidelines, the current available data for the complete revascularization (CR) in hemodynamically stable patients with ST-segment elevation myocardial infarction (STEMI) at the time of primary percutaneous coronary intervention (PCI) are still contradictory. AIM: The aim of this meta-analysis of the existing RCTs was to assess the efficacy of the CR versus revascularization of infarct-related artery (IRA) only during primary PCI in patients with STEMI and multivessel disease (MVD)...
May 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29317977/stemi-due-to-big-ostial-left-main-thrombus-extending-into-aorta-challenging-situation-with-no-clear-guidelines
#20
Mohammady Shahin, Oliver Gaemperli, Patrick Siegrist, Jasmina Alibegovic
Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI)...
December 2017: Cardiology Research
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