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Hilmi Alnsasra, Binyamin Ben-Avraham, Shmuel Gottlieb, Merav Ben-Avraham, Ran Kronowski, Zaza Iakobishvili, Ilan Goldenberg, Boris Strasberg, Moti Haim
High-grade atrioventricular block (HAVB) is a frequent complication of acute myocardial infarction (AMI) and is associated with increased morbidity and mortality. We aimed to evaluate the incidence, predictors, and prognostic significance of HAVB in a contemporary cohort of patients with AMI, in the recent era of early reperfusion. Patients with acute coronary syndromes (n=11,487) during the years 2000-2010 were included. Patients were divided into two groups: with HAVB (n=308, 2.7%) and without HAVB (n=11,179, 97...
March 7, 2018: Journal of Electrocardiology
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
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
Taysir S Garadah, Khalid Bin Thani, Leena Sulibech, Ahmed A Jaradat, Mohamed E Al Alawi, Haytham Amin
Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period...
2018: Open Cardiovascular Medicine Journal
Subir Bhatia, Shilpkumar Arora, Sravya M Bhatia, Mohammed Al-Hijji, Yogesh N V Reddy, Parshva Patel, Charanjit S Rihal, Bernard J Gersh, Abhishek Deshmukh
BACKGROUND: Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. METHODS AND RESULTS: Using the National Inpatient Sample to analyze hospitalizations in the United States from 2004 to 2014, we sought to assess PCI utilization and in-hospital outcomes in NSTEMI admissions with CKD...
March 10, 2018: Journal of the American Heart Association
Juan Sanchis, Albert Ariza-Solé, Emad Abu-Assi, Oriol Alegre, Fernando Alfonso, José Antonio Barrabés, José Antonio Baz, Antonio Carol, Pablo Díez Villanueva, Bruno García Del Blanco, Jaime Elízaga, Eduard Fernandez, Abel García Del Egido, Joan García Picard, Iván Gómez Blázquez, Joan Antoni Gómez Hospital, Rosana Hernández-Antolín, Cinta Llibre, Francisco Marín, David Martí Sánchez, Roberto Martín, Manuel Martínez Sellés, Gema Miñana, María José Morales Gallardo, Julio Núñez, Armando Pérez de Prado, Eduardo Pinar, Marcelo Sanmartín, Alessandro Sionis, Adolfo Villa, Jaume Marrugat, Héctor Bueno
INTRODUCTION AND OBJECTIVES: Although clinical guidelines recommend invasive management in non-ST-segment elevation myocardial infarction (NSTEMI), this strategy is underused in frail elderly patients in the real world. Furthermore, these patients are underrepresented in clinical trials and therefore the evidence is scarce. Our hypothesis is that an invasive strategy will improve prognosis in elderly frail patients with NSTEMI. METHODS: This will be a prospective, multicenter, randomized trial, in which the conservative and invasive strategies will be compared in patients meeting all of the following inclusion criteria: NSTEMI diagnosis, age ≥ 70 years, and frailty defined by a category ≥ 4 in the Clinical Frailty Scale...
March 7, 2018: Revista Española de Cardiología
Łukasz Lewicki, Janusz Siebert, Tomasz Koliński, Karolina Piekarska, Magdalena Reiwer-Gostomska, Radosław Targoński, Piotr Trzonkowski, Natalia Marek-Trzonkowska
BACKGROUND: Coronary artery disease (CAD) affects milions of people and can result in myocardial infarction (MI). Previously, mast cells (MC) have been extensively investigated in the context of hypersensitivity, however as regulators of the local inflammatory response they can potentially contribute to CAD and/or its progression. The aim of the study was to assess if serum concentration of MC proteases: carboxypeptidase A3, cathepsin G and chymase 1 is associated with the extension of CAD and MI...
March 7, 2018: Cardiology Journal
Chun Shing Kwok, Mohammed Al-Dokheal, Sami Aldaham, Claire Rushton, Rob Butler, Tim Kinnaird, Azfar Zaman, M Justin Zaman, Adam Timmis, Mamas A Mamas
BACKGROUND: The effect of a weekend compared with a weekday hospital admission on patient outcomes after an acute coronary syndrome is unclear. This study aims to determine whether collectively there is a weekend effect in acute coronary syndrome. METHOD: We conducted a systematic review and meta-analysis of cohort studies examining the association between weekend compared to weekday admission at any time of the day and early mortality (in-hospital or 30-day). A search was performed on Medline and Embase and relevant studies were pooled using random effects meta-analysis for risk of early mortality...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Hsin-I Teng, Shih-Hsien Sung, Shao-Sung Huang, Ju-Pin Pan, Shing-Jong Lin, Wan-Leong Chan, Wen-Lieng Lee, Tse-Min Lu, Cheng-Hsueh Wu
OBJECTIVES: The purpose of this study was to assess the long-term clinical impact of revascularization of coronary concomitant coronary chronic total occlusion (CTO) in patients with Non-ST-segment elevation myocardial infarction (NSTEMI). BACKGROUND: CTO is associated with poorer prognosis in patients with NSTEMI. The evidence of revascularization of CTO in patients with NSTEMI is still conflicting. METHODS: Consecutive patients with NSTEMI and CTO who underwent percutaneous coronary intervention (PCI) within 72 h of admission from 2006 to 2015 were retrospectively recruited and analyzed...
March 1, 2018: Journal of Interventional Cardiology
Bryce Alexander, Sohaib Haseeb, Henri van Rooy, Gary Tse, Wilma Hopman, Manuel Martinez-Selles, Antoni Bayés de Luna, Göksel Çinier, Adrian Baranchuk
Background: Reduced P-wave voltage in lead 1 (PVL1) has been associated with atrial fibrillation (AF) recurrence.This study sought to determine the association between reduced PVL1 and AF in the NSTEMI population and the correlation between reduced PVL1 and interatrial block (IAB)/coronary artery disease (CAD). Methods: Data were recorded for clinical, echocardiographic, angiographic, electrocardiographic and outcome variables. Patients were followed for a minimum of one year...
December 2017: Journal of Atrial Fibrillation
Ivo Strebel, Raphael Twerenbold, Jasper Boeddinghaus, Roger Abächerli, Maria Rubini Giménez, Karin Wildi, Karin Grimm, Christian Puelacher, Patrick Badertscher, Zaid Sabti, Dominik Breitenbücher, Janina Jann, Farah Selman, Jeanne du Fay de Lavallaz, Nicolas Schaerli, Thomas Nestelberger, Claudia Stelzig, Michael Freese, Lukas Schumacher, Stefan Osswald, Christian Mueller, Tobias Reichlin
BACKGROUND: The cardiac electrical biomarker (CEB) is a novel electrocardiographic (ECG) marker quantifying the dipolar activity of the heart with higher levels indicating myocardial injury. METHODS: We prospectively enrolled 1097 patients presenting with suspected non-ST-elevation myocardial infarction (NSTEMI) to the emergency department (ED). Digital 12-lead ECGs were recorded at presentation and the CEB values were calculated in a blinded fashion. The final diagnosis was adjudicated by two independent cardiologists...
February 24, 2018: Annals of Noninvasive Electrocardiology
Carolina Malta Hansen, Tracy Y Wang, Anita Y Chen, Karen Chiswell, Deepak L Bhatt, Jonathan R Enriquez, Timothy Henry, Matthew T Roe
OBJECTIVES: The study sought to characterize patient- and hospital-level variation in early angiography use among non-ST-segment elevation myocardial infarction (NSTEMI) patients. BACKGROUND: Contemporary implementation of guideline recommendations for early angiography use in NSTEMI patients in the United States have not been described. METHODS: The study analyzed NSTEMI patients included in ACTION (Acute Coronary Treatment and Intervention Outcomes Network) registry (2012 to 2014) who underwent in-hospital angiography...
February 26, 2018: JACC. Cardiovascular Interventions
Iain Findlay, Tamsin Morris, Ruiqi Zhang, Colin McCowan, Sarah Shield, Brian Forbes, Alex McConnachie, Kenneth Mangion, Colin Berry
Aims: To implement secondary care electronic record linkage for patients hospitalised with suspected or known acute coronary syndrome (ACS) in a complex regional healthcare system and evaluate this e-Registry in terms of patterns of service delivery and 1-year outcomes. Methods and Results: Existing electronic hospital records were linked to create episodes of care using (1) a patient administration system, (2) invasive cardiovascular procedure referrals and (3) a catheter laboratory record...
February 16, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
Philippe Grieshaber, Tobias Schneider, Lukas Oster, Coskun Orhan, Peter Roth, Bernd Niemann, Andreas Böning
INTRODUCTION: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study aimed to specifically describe the effect of pIABC on outcomes of patients with acute myocardial infarction (AMI) undergoing CABG. METHODS: In 178 of 484 AMI patients (non-ST-segment elevation myocardial infarction [NSTEMI] or ST-segment elevation myocardial infarction [STEMI] ≤5 days before surgery) without cardiogenic shock who underwent CABG between 2008 and 2013, pIABC was initiated preoperatively...
February 1, 2018: Perfusion
Gopakumar Ks, Mathew Iype, Sunitha Viswanathan, A George Koshy, Prabha Nini Gupta, K Sivaprasad, V V Radhakrishnan
Chronic Total Occlusion (CTO) intervention is a challenging area in interventional cardiology. Presently about 70% of CTO interventions are successful. MATERIALS AND METHODS: This was a single center prospective study of a cohort of all patients undergoing percutaneous coronary intervention (PCI) as elective or adhoc procedure for CTO from August 2014 to June 2015. Only antegrade CTO interventions were included. In all patients the following data were recorded. RESULTS: A total of 210 (8...
January 2018: Indian Heart Journal
Ingo Eitel, Thomas Stiermaier, Torben Lange, Karl-Philipp Rommel, Alexander Koschalka, Johannes T Kowallick, Joachim Lotz, Shelby Kutty, Matthias Gutberlet, Gerd Hasenfuß, Holger Thiele, Andreas Schuster
OBJECTIVES: The aims of the study were to assess the prognostic significance of cardiac magnetic resonance myocardial feature tracking (CMR-FT) in a large multicenter study and to evaluate the most potent CMR-FT predictor of hard clinical events following myocardial infarction (MI). BACKGROUND: CMR-FT is a new method that allows accurate assessment of global and regional circumferential, radial, and longitudinal myocardial strain. The prognostic value of CMR-FT in patients with reperfused MI is unknown...
February 9, 2018: JACC. Cardiovascular Imaging
Priyadarshani Galappatthy, Vipula R Bataduwaarachchi, Priyanga Ranasinghe, Gamini K S Galappatthy, Maheshi Wijayabandara, Dinuka S Warapitiya, Mythily Sivapathasundaram, Thilini Wickramarathna, Upul Senarath, Sathasivam Sridharan, Chandrika N Wijeyaratne, Ruvan Ekanayaka
BACKGROUND: Ischaemic heart disease is the leading cause of in-hospital mortality in Sri Lanka. Acute Coronary Syndrome Sri Lanka Audit Project (ACSSLAP) is the first national clinical-audit project that evaluated patient characteristics, clinical outcomes and care provided by state-sector hospitals. METHODS: ACSSLAP prospectively evaluated acute care, in-hospital care and discharge plans provided by all state-sector hospitals managing patients with ACS. Data were collected from 30 consecutive patients from each hospital during 2-4 weeks window...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
Mandreker Bahall, Katija Khan
BACKGROUND: Outcomes following acute myocardial infarction (AMI) may result in death, increased morbidity, and change in quality of life (QOL). This study explores health-related QOL of first-time patients following AMI. METHODS: This cross-sectional study used a sample of patients with first-time AMI experienced between April 2011 and March 2015 at a tertiary health institution. Recruited patients belonged to different post-AMI periods: 2-10 weeks, 5-22 months, and > 22 months to 4 years post AMI...
February 13, 2018: Health and Quality of Life Outcomes
Yaser Jenab, Ebrahim Kassaian, Hamid Reza Pourhosseini, Mojtaba Salarifar, Arash Jalali, Azita Hajhossein Talasaz
BACKGROUND: Predictors of normal or near-normal coronary angiography (NONCAG) in patients with unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) and their importance regarding the prognosis are not understood. Accordingly, we determined these predictors as well as mortality risk factors at 2-year follow-up of UA/NSTEMI patients managed by the early invasive strategy. METHODS: We prospectively studied consecutive patients with UA/NSTEMI managed with the early invasive strategy at Tehran Heart Center, in 1-year period...
March 2018: Critical Pathways in Cardiology
Frank P Schmidt, Claus Schmitt, Matthias Hochadel, Evangelos Giannitsis, Harald Darius, Lars S Maier, Claus Schmitt, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Tommaso Gori, Jochen Senges, Thomas Münzel
BACKGROUND: Patients with non ST-segment elevation myocardial infarction (NSTEMI) represent the largest fraction of patients with acute coronary syndrome in German Chest Pain units. Recent evidence on early vs. selective percutaneous coronary intervention (PCI) is ambiguous with respect to effects on mortality, myocardial infarction (MI) and recurrent angina. With the present study we sought to investigate the prognostic impact of PCI and its timing in German Chest Pain Unit (CPU) NSTEMI patients...
March 15, 2018: International Journal of Cardiology
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