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thrombolysis in acute myocardial infarction

Otavio Berwanger, Magdy Abdelhamid, Thomas Alexander, Abdulmajeed Alzubaidi, Oleg Averkov, Philip Aylward, Eduardo Contreras Zúñiga, Sigrun Halvorsen, Ricardo Iglesias, Muhamad A Sk Abdul Kader, Mohammad Zubaid, Khalid F AlHabib
Primary percutaneous coronary intervention (PCI) is the preferred reperfusion method in patients with ST-segment elevation myocardial infarction (STEMI). In patients with STEMI who cannot undergo timely primary PCI, pharmacoinvasive treatment is recommended, comprising immediate fibrinolytic therapy with subsequent coronary angiography and rescue PCI if needed. Improving clinical outcomes following fibrinolysis remains of great importance for the many patients globally for whom rapid treatment with primary PCI is not possible...
August 11, 2018: Clinical Cardiology
Atsushi Sugiura, Ryuzo Abe, Takashi Nakayama, Noriyuki Hattori, Yoshihide Fujimoto, Toshiharu Himi, Koichi Sano, Shigeto Oda, Yoshio Kobayashi
AIM: While veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has been utilized to resuscitate and stabilize haemodynamics in patients of acute myocardial infarction (AMI) complicated by cardiac arrest (CA), it is essential to predict the possibility of weaning from ECMO to determine further strategies, including use of ventricular assist device. We aimed to determine predictors of successful weaning from VA-ECMO in the early phase of ECMO treatment. METHODS: We identified consecutive patients of AMI complicated by CA treated with VA-ECMO and percutaneous coronary intervention (PCI)...
August 3, 2018: Shock
Kiyoshi Hibi, Ken Kozuma, Shinjo Sonoda, Tsutomu Endo, Hiroyuki Tanaka, Hiroyuki Kyono, Ryoji Koshida, Takayuki Ishihara, Masaki Awata, Teruyoshi Kume, Kengo Tanabe, Yoshihiro Morino, Kengo Tsukahara, Yuji Ikari, Kenshi Fujii, Masao Yamasaki, Takeharu Yamanaka, Kazuo Kimura, Takaaki Isshiki
OBJECTIVES: The aim of this study was to evaluate the utility of distal protection during percutaneous coronary intervention (PCI) in patients with acute coronary syndromes at high risk for distal embolization. BACKGROUND: The results of previous clinical trials indicated that the routine use of distal protection in patients with ST-segment elevation myocardial infarction did not improve clinical outcomes. However, selective use of distal protection by means of a filter-based distal protection system has not been evaluated...
July 26, 2018: JACC. Cardiovascular Interventions
Islam ElSayed Shehata, Cheng-I Cheng, Pei-Hsun Sung, Ahmed S Ammar, Islam Abd El-Moneem El-Sherbiny, Islam Ghanem Ahmed Ghanem
BACKGROUND: Following acute ST elevation myocardial infarction (STEMI), restoration of large-vessel patency does not mean complete perfusion recovery. Little is known regarding the predictors of successful myocardial reperfusion for the STEMI patients undergoing pharmacologic and mechanical reperfusion strategies. AIM OF THE WORK: The aim of this clinical study was to find out the predictors of myocardial functional recovery following reperfusion of acute STEMI, represented by 3-month global longitudinal strain (GLS) value assessed by speckle tracking echocardiography...
August 2, 2018: Echocardiography
Sina Mashayekhi, Mojtaba Ziaee, Alireza Garjani, Parvin Sarbakhsh, Samad Ghaffari
BACKGROUND: Biomarkers possess important diagnostic and prognostic value in acute coronary syndromes (ACSs). Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) is one of the markers involved in atherosclerotic plaque vulnerability and rupture. OBJECTIVE: This study aimed to evaluate the prognostic value of sLOX-1 through its correlation with Thrombolysis in Myocardial Infarction (TIMI) risk score and its possible association with clinical outcomes in 2 major spectrums of ACS...
July 23, 2018: Journal of Emergency Medicine
Min Ma, Kai-Yue Diao, Zhi-Gang Yang, Ye Zhu, Ying-Kun Guo, Meng-Xi Yang, Yi Zhang, Yong He
Acute myocardial infarction (AMI) is recognized as being a life-threatening event. Both microvascular obstruction (MVO) and intramyocardial hemorrhage (IMH) have been recognized as poor prognostic factors in myocardial infarct (MI) since they adversely affect left ventricular remodeling. MVO refers to small vessels changes that prevent adequate tissue perfusion despite revascularization whereas IMH is a severe form of MVO. A limited number of studies have demonstrated the segmental intervention time and the clinical factors in the presence of MVO and IMH...
July 2018: Medicine (Baltimore)
Osama O Zaidat, Alicia C Castonguay, Rishi Gupta, Chung-Huan J Sun, Coleman Martin, William E Holloway, Nils Mueller-Kronast, Joey D English, Italo Linfante, Guilherme Dabus, Tim W Malisch, Franklin A Marden, Hormozd Bozorgchami, Andrew Xavier, Ansaar T Rai, Michael T Froehler, Aamir Badruddin, Thanh N Nguyen, M Asif Taqi, Michael G Abraham, Vallabh Janardhan, Hashem Shaltoni, Roberta Novakovic, Albert J Yoo, Alex Abou-Chebl, Peng R Chen, Gavin W Britz, Ritesh Kaushal, Ashish Nanda, Mohammad A Issa, Raul G Nogueira
BACKGROUND: Limited post-marketing data exist on the use of the Solitaire FR device in clinical practice. The North American Solitaire Stent Retriever Acute Stroke (NASA) registry aimed to assess the real world performance of the Solitaire FR device in contrast with the results from the SWIFT (Solitaire with the Intention for Thrombectomy) and TREVO 2 (Trevo versus Merci retrievers for thrombectomy revascularization of large vessel occlusions in acute ischemic stroke) trials. METHODS: The investigator initiated NASA registry recruited North American sites to submit retrospective angiographic and clinical outcome data on consecutive acute ischemic stroke (AIS) patients treated with the Solitaire FR between March 2012 and February 2013...
July 2018: Journal of Neurointerventional Surgery
Shelagh B Coutts, Eivind Berge, Bruce Cv Campbell, Keith W Muir, Mark W Parsons
Alteplase has been the mainstay of thrombolytic treatment since the National Institutes of Neurological Disorders and Stroke trial was published in 1995. Over recent years, several trials have investigated alternative thrombolytic agents. Tenecteplase, a genetically engineered mutant tissue plasminogen activator, has a longer half-life, allowing single intravenous bolus administration without infusion, is more fibrin specific, produces less systemic depletion of circulating fibrinogen, and is more resistant to plasminogen activator inhibitor compared to alteplase...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Caroline Haig, David Carrick, Jaclyn Carberry, Kenneth Mangion, Annette Maznyczka, Kirsty Wetherall, Margaret McEntegart, Mark C Petrie, Hany Eteiba, Mitchell Lindsay, Stuart Hood, Stuart Watkins, Andrew Davie, Ahmed Mahrous, Ify Mordi, Nadeem Ahmed, Vannesa Teng Yue May, Ian Ford, Aleksandra Radjenovic, Paul Welsh, Naveed Sattar, Keith G Oldroyd, Colin Berry
OBJECTIVES: The aim of this study was to mechanistically investigate associations among cigarette smoking, microvascular pathology, and longer term health outcomes in patients with acute ST-segment elevation myocardial infarction (MI). BACKGROUND: The pathophysiology of myocardial reperfusion injury and prognosis in smokers with acute ST-segment elevation MI is incompletely understood. METHODS: Patients were prospectively enrolled during emergency percutaneous coronary intervention...
July 13, 2018: JACC. Cardiovascular Imaging
Ehsan Khan, David Brieger, John Amerena, John J Atherton, Derek P Chew, Ahmad Farshid, Marcus Ilton, Craig P Juergens, Nadarajah Kangaharan, Rohan Rajaratnam, Amy Sweeny, Darren L Walters, Clara K Chow
OBJECTIVE: To examine whether there are sex differences in the characteristics, management, and clinical outcomes of patients with an ST-elevation myocardial infarction (STEMI). Design, setting: Cohort study; analysis of data collected prospectively by the CONCORDANCE acute coronary syndrome registry from 41 Australian hospitals between February 2009 and May 2016. PARTICIPANTS: 2898 patients (2183 men, 715 women) with STEMI. MAIN OUTCOME MEASURES: Rates of revascularisation (percutaneous coronary intervention [PCI], thrombolysis, coronary artery bypass grafting [CABG]), adjusted for GRACE risk score quartile...
August 6, 2018: Medical Journal of Australia
Christopher Elnan Kvistad, Vojtech Novotny, Halvor Næss, Guri Hagberg, Hege Ihle-Hansen, Ulrike Waje-Andreassen, Lars Thomassen, Nicola Logallo
Background Stroke mimics are frequently treated with thrombolysis in clinical practice and thrombolytic trials. Although alteplase in stroke mimics has proven to be safe, safety of tenecteplase in stroke mimics has not been assessed in an ischemic stroke study setting. We aimed to assess clinical characteristics and safety of stroke mimics treated with thrombolysis in the Norwegian Tenecteplase Stroke Trial. We also aimed to identify possible predictors of stroke mimics as compared to patients with acute cerebral ischemia...
January 1, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Ana Teresa Timóteo, Jorge Mimoso
The Portuguese Registry of Acute Coronary Syndromes (ProACS) has completed 15 years of continuous and prospective activity. We present an overall picture of the data from this powerful tool. Up to 2016, 45 141 records were included, mostly male (71%), and with a mean age of 66 years. Baseline characteristics remained stable over the years. Of the overall population, 44% of cases were ST-elevation myocardial infarction (STEMI). Over the years there was a significant improvement in compliance with international guidelines, in terms of both diagnostic and therapeutic procedures, as well as for medication...
July 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
Koray Demirtaş, Çağri Yayla, Leyla Elif Sade, Aylin Yildirir, Mehmet Bülent Özin, Ayşegül Haberal, Ibrahim Haldun Müderrisoğlu
γ-Glutamyl transferase (GGT) participates in oxidative and inflammatory reactions inside the atheroma plaque and platelets. We evaluated whether platelet membrane γ-glutamyl transferase (Plt-GGT) activity is a predictor of major adverse cardiac events (MACEs) during 3 months follow-up of patients with acute coronary syndrome (ACS; MACE-3M). We included 105 patients who were hospitalized consecutively with the diagnosis of ACS. Patients with an MACE-3M were older, more likely to have hypertension, hyperlipidemia, family history of coronary artery disease(CAD), thrombolysis in myocardial infarction (TIMI) risk score >4, higher Plt-GGT and serum GGT activities, serum C-reactive protein level, and lower left ventricular ejection fraction (LVEF) when compared to those without MACE-3M (all P values ≤...
January 1, 2018: Angiology
C Michael Gibson, Bennett Levitan, William J Gibson, Megan K Yee, Sabina A Murphy, Zhong Yuan, Anjan K Chakrabarti, Michael Lee, Eugene Braunwald
BACKGROUND: Net clinical outcome analyses of acute coronary syndrome (ACS) mingle fatal or irreversible events with survivable or reversible events that vary significantly in clinical impact. OBJECTIVES: A comparison of efficacy and safety limited to fatal or irreversible ischemic and adverse or seriously harmful events is one way to assess net clinical outcome and risk-benefit overall, given the fact that these events have a similar clinical impact. METHODS: In the ATLAS ACS 2-TIMI 51 (Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome-Thrombolysis In Myocardial Infarction) trial of rivaroxaban in the secondary prevention of events among patients with ACS treated with aspirin plus clopidogrel or ticlopidine (clopidogrel/ticlopidine) or aspirin alone, fatal and irreversible efficacy events including nonbleeding cardiovascular death, myocardial infarction, and ischemic stroke were compared to fatal or irreversible safety events, including fatal and intracranial bleeding...
July 10, 2018: Journal of the American College of Cardiology
Wei Xia, Xiao-Yan Feng
BACKGROUND ST-segment elevation myocardial infarction (STEMI) is an acute and life-threatening disease. Adverse cardiac events (ACEs) are defined as cardiovascular death or worsening congestive heart failure in STEMI patients. The present study investigated the predictive role of fragmented QRS complex (fQRS) in risks of ACEs in STEMI. MATERIAL AND METHODS This study was a retrospective analysis involving patients who underwent percutaneous coronary intervention (PCI) or thrombolysis. STEMI patients were divided into the fQRS group (259 cases) and the non-fQRS group (161 cases)...
July 5, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Saibal Mukhopadhyay, Mitesh Kumar, Jamal Yusuf, Vinod Kumar Gupta, Sanjay Tyagi
BACKGROUND: "Coronary slow flow'' (CSF) is delayed vessel opacification in the absence of epicardial stenosis. Studies in different ethnic groups have found variable risk factors associated with CSF. AIM: of present study was to analyze the risk factors and angiographic profile of CSF in North Indian population, not studied till date. METHODS: 40 patients with CSF and 40 controls were studied. CSF was determined quantitatively by thrombolysis in myocardial infarction (TIMI) frame count method...
May 2018: Indian Heart Journal
A T Matthias, D K N de Silva, J Indrakumar, S B Gunatilake
OBJECTIVES: Physical inactivity is associated with high cardiovascular risk. The purpose of this study was to study physical activity levels of patients with acute coronary syndrome (ACS). METHODOLOGY: A total of 504 patients, from the Professorial Unit of the Colombo South Teaching Hospital completed the International Physical Activity Questionnaire (IPAQ). IPAQ is a validated questionnaire used internationally to objectively measure physical activity. Both the total volume and the number of sessions of activity are included in the IPAQ...
May 2018: Indian Heart Journal
Andriany Qanitha, Cuno S P M Uiterwaal, Jose P S Henriques, Abdul Hakim Alkatiri, Idar Mappangara, Ali Aspar Mappahya, Ilhamjaya Patellongi, Bastianus A J M de Mol
OBJECTIVE: To provide a detailed description of characteristics at hospital admission and clinical outcomes at 30-day and 6-month follow-up in patients hospitalised with coronary artery disease (CAD) in a poor South-East Asian setting. DESIGN: Prospective observational cohort study. SETTING: From February 2013 to December 2014, in Makassar Cardiac Center, Indonesia. PARTICIPANTS: 477 patients with CAD (acute coronary syndrome and stable CAD)...
June 27, 2018: BMJ Open
Z Zhang, W Li, W Wu, Q Xie, J Li, W Zhang, Y Zhang
BACKGROUND: There is no consensus on the use of thrombus aspiration (TA) in primary percutaneous coronary intervention (PPCI), and few studies have focused on the performance of tirofiban via TA catheter after PPCI. Our study investigated the clinical outcome of tirofiban injection through TA in acute ST-segment elevation myocardial infarction (STEMI) patients with large thrombus burden undergoing PPCI treatment. PATIENTS AND METHODS: The study comprised 122 STEMI patients who underwent TA during PPCI...
June 12, 2018: Herz
Alaa Quisi, Gökhan Alıcı
OBJECTIVE: This study aimed to evaluate the relationship between serum rheumatoid factor (RF) levels and no-reflow phenomenon in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: This single-center, cross-sectional study included a total of 318 consecutive patients who were diagnosed with STEMI and underwent primary PCI within 12 hours of the onset of symptoms. Baseline serum RF levels of all patients were measured...
June 26, 2018: Journal of Clinical Laboratory Analysis
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