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STEMI guidelines

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https://www.readbyqxmd.com/read/28797607/trends-and-clinical-outcomes-in-patients-undergoing-primary-percutaneous-revascularisation-for-st-elevation-myocardial-infarction-a-single-centre-experience
#1
Luke P Dawson, Josephine Warren, Juan Mundisugih, Viveka Nainani, William Chan, Dion Stub, Archer Broughton, Andrew J Taylor, Antony Walton, Stephen J Duffy, James A Shaw
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred therapy for patients presenting with ST-elevation myocardial infarction (STEMI). We reviewed patients undergoing PCI for STEMI over a six-year period to evaluate changes in procedural characteristics and clinical outcomes given recent changes to STEMI guidelines. METHODS: All patients presenting to the Alfred Hospital, a tertiary referral hospital, between 1 January 2010 and 31 December 2015 undergoing PCI for STEMI were identified...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28794118/utilization-characteristics-and-in-hospital-outcomes-of-coronary-artery-bypass-grafting-in-patients-with-st-segment-elevation-myocardial-infarction-results-from-the-national-cardiovascular-data-registry-acute-coronary-treatment-and-intervention-outcomes-network
#2
Yi Pi, Matthew T Roe, DaJuanicia N Holmes, Karen Chiswell, J Lee Garvey, Gregg C Fonarow, James A de Lemos, Kirk N Garratt, Ying Xian
BACKGROUND: There are limited data on the utilization and outcomes of coronary artery bypass grafting (CABG) among ST-segment-elevation myocardial infarction (STEMI) patients in contemporary practice. METHODS AND RESULTS: Using data from National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines between 2007 and 2014, we analyzed trends in CABG utilization and hospital-level variation in CABG rates...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28789568/temporal-trends-in-the-use-of-antiplatelet-therapy-in-patients-with-acute-coronary-syndromes
#3
María Asunción Esteve-Pastor, Juan Miguel Ruíz-Nodar, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Miriam Quintana-Giner, Andrea Véliz-Martínez, Antonio Tello-Montoliu, Vicente PerniasEscrig, Miriam Sandín Rollán, Nuria Vicente-Ibarra, Manuel Jesús MacíasVillanego, Elena Candela Sánchez, Luna Carrillo Alemán, Teresa Lozano, Mariano Valdés, Francisco Marín
BACKGROUND: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. PURPOSE: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. METHODS: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28759470/percutaneous-coronary-intervention-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease
#4
Michael P Thomas, Eric R Bates
PURPOSE OF REVIEW: This review aims to summarize recent reports on percutaneous coronary intervention (PCI) strategies for patients with ST-elevation myocardial infarction (STEMI) and multivessel coronary artery disease (CAD). RECENT FINDINGS: Recent randomized clinical trials and meta-analyses have suggested that patients with STEMI and multivessel CAD may benefit more from multivessel PCI (either multivessel primary PCI or staged PCI before hospital discharge) than culprit vessel-only primary PCI...
July 29, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28706594/disparity-in-st-segment-elevation-myocardial-infarction-practices-and-outcomes-in-arabian-gulf-countries-gulf-coast-registry
#5
Mohammad Zubaid, Wafa Rashed, Alawi A Alsheikh-Ali, Taysir Garadah, Najib Alrawahi, Mustafa Ridha, Mousa Akbar, Fahad Alenezi, Rashed Alhamdan, Wael Almahmeed, Hussam Ouda, Arif Al-Mulla, Fahad Baslaib, Abdulla Shehab, Abdulla Alnuaimi, Haitham Amin
OBJECTIVES: The objective of this study is to describe contemporary management and 1-year outcomes of patients hospitalized with ST-segment elevation myocardial infarction (STEMI) in Arabian Gulf countries. METHODS: Data of patients admitted to 29 hospitals in four Gulf countries [Bahrain, Kuwait, Oman, United Arab Emirates (UAE)] with the diagnosis of STEMI were analyzed from Gulf locals with acute coronary syndrome (ACS) events (Gulf COAST) registry. This was a longitudinal, observational registry of consecutive citizens, admitted with ACS from January 2012 to January 2013...
April 2017: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/28696573/prognostic-implications-of-q-waves-at-presentation-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-an-analysis-of-the-horizons-ami-study
#6
Ioanna Kosmidou, Björn Redfors, Aaron Crowley, Bernard Gersh, Shmuel Chen, José M Dizon, Monica Embacher, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown. HYPOTHESIS: We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion...
July 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28660892/reperfusion-strategies-in-acute-myocardial-infarction-and-multivessel-disease
#7
REVIEW
Birgit Vogel, Shamir R Mehta, Roxana Mehran
Approximately 50% of patients with ST-segment elevation myocardial infarction (STEMI) have multivessel disease. The optimal reperfusion strategy in these patients is still uncertain. Whether percutaneous coronary intervention (PCI) of only the culprit vessel or a strategy of complete revascularization, either in a simultaneous or staged multivessel PCI approach, should be performed remains unclear. Although a large number of observational studies have mostly shown worse clinical outcomes associated with a multivessel PCI approach, increasing evidence from randomized controlled trials suggests that multivessel PCI is safe, while reducing the need for revascularization in selected patients, compared with culprit vessel-only PCI...
June 29, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28660806/antiplatelet-therapy-for-non-st-segment-elevation-myocardial-infarction-in-complex-real-clinical-scenarios-a-consensus-document-of-the-campania-nstemi-study-group
#8
Marino Scherillo, Plinio Cirillo, Dario Formigli, Giulio Bonzani, Paolo Calabrò, Paolo Capogrosso, Rosario Farina, Tonino Lanzillo, Franco Mascia, Ciro Mauro, Bernardino Tuccillo, Alessandro Bellis, Renato Bianchi, Giovanni Cimmino, Orlando Piro, Amelia Ravera, Fortunato Scotto di Uccio, Paolo Tammaro, Alfredo Vetrano, Bruno Trimarco
The incidence of ST-segment elevation myocardial infarction (STEMI) has significantly decreased. Conversely, the rate of non-STEMI (NSTEMI) has increased. Patients with NSTEMI have lower short-term mortality compared to patients with STEMI, whereas at long-term follow-up, the mortality becomes comparable. This might be due to the differences in baseline characteristics, including older age and a greater prevalence of comorbidities in the NSTEMI population. Although antithrombotic strategies used in patients with NSTEMI have been well studied in clinical trials and updated guidelines are available, patterns of use and outcomes in clinical practice are less well described...
August 2017: Angiology
https://www.readbyqxmd.com/read/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#9
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28625387/design-and-rationale-for-the-influenza-vaccination-after-myocardial-infarction-iami-trial-a-registry-based-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Ole Fröbert, Matthias Götberg, Oskar Angerås, Lena Jonasson, David Erlinge, Thomas Engstrøm, Jonas Persson, Svend E Jensen, Elmir Omerovic, Stefan K James, Bo Lagerqvist, Johan Nilsson, Amra Kåregren, Rasmus Moer, Cao Yang, David B Agus, Andrejs Erglis, Lisette O Jensen, Lars Jakobsen, Evald H Christiansen, John Pernow
BACKGROUND: Registry studies and case-control studies have demonstrated that the risk of acute myocardial infarction (AMI) is increased following influenza infection. Small randomized trials, underpowered for clinical end points, indicate that future cardiovascular events can be reduced following influenza vaccination in patients with established cardiovascular disease. Influenza vaccination is recommended by international guidelines for patients with cardiovascular disease, but uptake is varying and vaccination is rarely prioritized during hospitalization for AMI...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28625385/seasonal-and-circadian-variations-of-acute-myocardial-infarction-findings-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#11
MULTICENTER STUDY
Vijaiganesh Nagarajan, Gregg C Fonarow, Christine Ju, Michael Pencina, Warren K Laskey, Thomas M Maddox, Adrian Hernandez, Deepak L Bhatt
BACKGROUND: Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and circadian variations are equally present in warmer and colder regions. We investigated whether seasonal and circadian variations in acute myocardial infarction (AMI) are more prominent in colder northern states compared with warmer southern states...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28623012/p-wave-peak-time-a-novel-electrocardiographic-parameter-in-the-assessment-of-coronary-no-reflow
#12
Metin Çağdaş, Süleyman Karakoyun, İbrahim Rencüzoğulları, Yavuz Karabağ, Mahmut Yesin, Mustafa Ozan Gürsoy, İnanç Artaç, Doğan İliş, Süleyman Çağan Efe, Onur Taşar, Gürkan Karaca
OBJECTIVES: Coronary no-reflow (NR) following primary percutaneous coronary intervention (pPCI) is associated with worsened prognosis in patients with ST segment elevation myocardial infarction (STEMI). Despite rapid developments in cardiovascular area; there are limited data regarding prediction of NR before pPCI. P wave duration and dispersion (PWD, PWDIS, respectively) have been studied in STEMI patients and found to be associated with reperfusion success; however none of them has been found to predict NR before PCI...
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28623004/variable-methodological-quality-and-use-found-in-systematic-reviews-referenced-in-stemi-clinical-practice-guidelines
#13
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
#14
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/28593057/clomiphene-associated-inferior-stemi-in-a-young-female-due-to-right-coronary-artery-dissection
#15
Feras Husain Abuzeyad, Eltigani Seedahmed Ibnaouf, Mudhaffar Al Farras
Nonatherosclerotic spontaneous coronary artery dissection (NA-SCAD) is an uncommon cause of myocardial infarction. It most commonly affects females in the perimenopausal age. NA-SCAD has been associated with many predisposing factors including pregnancy and hormonal therapy for both contraception and ovulation induction. The presented case is a previously healthy 41-year-old woman diagnosed with inferior ST-elevation myocardial infarction due to right descending coronary artery dissection associated with recent use of clomiphene monotherapy for ovulation induction (a previously fertile woman), which was not previously reported...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28581992/implementation-of-regional-st-segment-elevation-myocardial-infarction-systems-of-care-successes-and-challenges
#16
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/28554990/the-role-of-scube1-in-the-pathogenesis-of-no-reflow-phenomenon-presenting-with-st-segment-elevation-myocardial-infarction
#17
Hasan Ata Bolayır, Hakan Güneş, Tarık Kıvrak, Ömer Şahin, Dursun Akaslan, Recep Kurt, Aslı Bolayır, Oya İmadoğlu
OBJECTIVE: SCUBE1 [signal peptide-CUB (complement C1r/C1 s)-EGF (epidermal growth factor)-like domain-containing protein 1] might function as a novel platelet-endothelial adhesion molecule and play pathological roles in cardiovascular biology. Acute myocardial infarction is one of the most common causes of death in modern society. The concept of "no reflow" (NR) refers to a state of myocardial tissue hypoperfusion in the presence of a patent epicardial coronary artery. The main mechanisms of this phenomenon are thought to be high platelet activity and much thrombus burden...
May 24, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28537939/current-perspectives-on-revascularization-in-multivessel-st-elevation-myocardial-infarction
#18
Guy Witberg, Ran Kornowski
Up to 50% of patients presenting with ST elevation myocardial infarction (STEMI) are found to have multivessel coronary artery disease. These patients have a worse prognosis compared with the overall STEMI population. Two revascularization strategies are possible for these patients: treating the infarct-related artery percutaneous coronary intervention (IRA-PCI) only or achieving Complete revascularization (CR), either through an immediate multivessel PCI during the index angiography or during a second-staged procedure...
September 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28532775/prognostic-implications-of-mid-range-left-ventricular-ejection-fraction-on-patients-presenting-with-st-segment-elevation-myocardial-infarction
#19
Gilad Margolis, Shafik Khoury, Jeremy Ben-Shoshan, Sevan Letourneau-Shesaf, Nir Flint, Gad Keren, Yacov Shacham
The new European Society of Cardiology guidelines reclassified heart failure according to left ventricular ejection fraction, recognizing patients with mid-range EF (mrEF; 40% to 49%) as a distinct group. We sought to investigate the clinical profile, in-hospital outcomes, and long-term mortality of ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention who had mrEF. We conducted a retrospective study of 2,086 consecutive patients with STEMI between December 2007 and June 2016 who underwent primary percutaneous coronary intervention and had a comprehensive echocardiographic examination performed within 72 hours of hospital admission...
July 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28501493/prophylactic-warfarin-post-anterior-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#20
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
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