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thrombolysis in acute myocardial infarction

Sun Young Choi, Moo Hyun Kim, Young-Rak Cho, Jong Sung Park, Kwang Min Lee, Tae-Ho Park, Sung-Cheol Yun
BACKGROUND: Dual antiplatelet therapy (DAPT) helps prevent ischemic events after coronary stenting but comes with an increased risk of bleeding. Several risk scores have been proposed for the management of patients receiving DAPT, but no standardized tool exists for the purpose. We sought to compare the performance of the new PRECISE-DAPT (Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy), CRUSADE (Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the American College of Cardiology/American Heart Association Guidelines), and ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) scores for the prediction of bleeding in Korean patients receiving DAPT...
December 2018: Circulation. Cardiovascular Interventions
Raffaele De Caterina, Peter Kelly, Pedro Monteiro, Jean Claude Deharo, Carlo de Asmundis, Esteban López-de-Sá, Thomas W Weiss, Johannes Waltenberger, Jan Steffel, Joris R de Groot, Pierre Levy, Ameet Bakhai, Wolfgang Zierhut, Petra Laeis, Paul-Egbert Reimitz, Paulus Kirchhof
AIM: Edoxaban, a nonvitamin K antagonist oral anticoagulant, is an oral factor Xa inhibitor approved for the prevention of stroke and systemic embolism in adult patients with atrial fibrillation and for the treatment and secondary prevention in adult patients with venous thromboembolism (VTE). This study details the design of the Edoxaban Treatment in routiNe clinical prActice for patients with Atrial Fibrillation in Europe (ETNA-AF-Europe) study - a postauthorization observational study, which is part of the postapproval plan for edoxaban agreed with the European Medicines Agency...
December 11, 2018: Journal of Cardiovascular Medicine
John Munkhaugen, Vidar Ruddox, Sigrun Halvorsen, Toril Dammen, Morten W Fagerland, Kjersti H Hernæs, Nils Tore Vethe, Eva Prescott, Svend Eggert Jensen, Olaf Rødevand, Jarle Jortveit, Bjørn Bendz, Henrik Schirmer, Lars Køber, Hans Erik Bøtker, Alf Inge Larsen, Kjell Vikenes, Terje Steigen, Rune Wiseth, Terje Pedersen, Thor Edvardsen, Jan Erik Otterstad, Dan Atar
BACKGROUND: Current guidelines on the use of β-blockers in post-acute myocardial infarction (MI) patients without reduced left ventricular ejection fraction (LVEF) are based on studies before the implementation of modern reperfusion and secondary prevention therapies. It remains unknown whether β-blockers will reduce mortality and recurrent MI in contemporary revascularized post-MI patients without reduced LVEF. DESIGN: BETAMI is a prospective, randomized, open, blinded end point multicenter study in 10,000 MI patients designed to test the superiority of oral β-blocker therapy compared to no β-blocker therapy...
October 25, 2018: American Heart Journal
Joon-Myoung Kwon, Kyung-Hee Kim, Ki-Hyun Jeon, Jinsik Park
BACKGROUND: Heart disease (HD) is the leading cause of global death; there are several mortality prediction models of HD for identifying critically-ill patients and for guiding decision making. The existing models, however, cannot be used during initial treatment or screening. This study aimed to derive and validate an echocardiography-based mortality prediction model for HD using deep learning (DL). METHODS: In this multicenter retrospective cohort study, the subjects were admitted adult (age ≥ 18 years) HD patients who underwent echocardiography...
December 4, 2018: Echocardiography
Mojtaba Ziaee, Sina Mashayekhi, Samad Ghaffari, Javad Mahmoudi, Parvin Sarbakhsh, Alireza Garjani
We assessed the prognostic value of serum levels of endocan in patients with the acute coronary syndrome (ACS) through its correlation with the Thrombolysis in Myocardial Infarction (TIMI) risk score and compared the possible association with clinical outcomes. In this prospective cross-sectional study, we enrolled 320 patients with documented ST-segment elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), or unstable angina (UA) who underwent diagnostic coronary angiography. Endocan was measured soon after admission in the emergency department...
December 4, 2018: Angiology
Doo Sun Sim, Myung Ho Jeong, Hyo Soo Kim, Hyeon Cheol Gwon, Ki Bae Seung, Seung Woon Rha, Shung Chull Chae, Chong Jin Kim, Kwang Soo Cha, Jong Sun Park, Jung Han Yoon, Jei Keon Chae, Seung Jae Joo, Dong Ju Choi, Seung Ho Hur, In Whan Seong, Myeong Chan Cho, Doo Il Kim, Seok Kyu Oh, Tae Hoon Ahn, Jin Yong Hwang
BACKGROUND: Potent P2Y12 blockers are preferred in patients with acute non-ST-segment elevation myocardial infarction (NSTEMI) undergoing percutaneous coronary intervention (PCI). However, the risk of bleeding remains a major concern. We assessed the association of potent P2Y12 blockers with ischemic and bleeding outcomes in patients with NSTEMI. METHODS: From the Korea Acute Myocardial Infarction Registry-National Institute of Health database, 4927 patients with NSTEMI receiving drug-eluting stents (DES) were divided into potent P2Y12 blocker (ticagrelor or prasugrel, n=901) and clopidogrel (n=3180) groups...
February 2019: Journal of Cardiology
Emrah Ipek, Mustafa Yolcu, Erkan Yildirim, Konca Altinkaynak, Saime Ozbek Sebin, Kamuran Kalkan, Oktay Gulcu, Emrah Ermis, Mustafa Ozturk
(1) To investigate the role of azurocidin, an antimicrobial protein, in patients with ST segment elevation myocardial infarction (STEMI). (2) This single-center prospective observational study included patients with STEMI and healthy age- and sex-matched control subjects. Baseline demographic, clinical and biochemical data were compared between the two groups. Azurocidin levels at baseline were determined using an enzyme-linked immunosorbent assay. Multivariate linear regression analysis with enter method was used to test the association between azurocidin and independent variables, such as the thrombolysis in myocardial infarction (TIMI) score, synergy between percutaneous coronary intervention with TAXUS and cardiac surgery score, global registry of acute coronary events score, Killip class, C-reactive protein (CRP), and creatinine kinase-myocardial band (CK-MB)...
November 29, 2018: International Journal of Molecular Sciences
Wen Hao, Shangxin Lu, Ruifeng Guo, Jingyao Fan, Lei Zhen, Shaoping Nie
Cardiac rupture (CR) is a complication of acute myocardial infarction (AMI) that is associated with a high mortality rate. This study aimed to identify the risk factors for CR in patients with AMI. Medline, Cochrane, EMBASE, and Google Scholar databases were searched for relevant literature published through September 16, 2018. Eligible studies included patients with AMI and compared factors between patients with and without CR. Sixteen studies were identified and included in the meta-analysis. Results revealed that female gender (pooled OR=2...
November 28, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Satoshi Honda, Kensaku Nishihira, Sunao Kojima, Misa Takegami, Yasuhide Asaumi, Makoto Suzuki, Masami Kosuge, Jun Takahashi, Yasuhiko Sakata, Morimasa Takayama, Tetsuya Sumiyoshi, Hisao Ogawa, Kazuo Kimura, Satoshi Yasuda
BACKGROUND: Antiplatelet therapy is a cornerstone of treatment following acute myocardial infarction (AMI). Recently, prasugrel, a new and potent antiplatelet agent, has been introduced in clinical practice. To date, however, real-world in-hospital and follow-up data in Japanese patients with AMI remain limited. OBJECTIVES: To examine ischemic and bleeding events in Japanese patients with AMI and the association between these events and antiplatelet therapy. METHODS: The Japan AMI Registry (JAMIR) is a multicenter, nationwide, prospective registry enrolling patients with AMI from 50 institutions...
November 23, 2018: Cardiovascular Drugs and Therapy
Y Chen, Y Song, J J Xu, X F Tang, H H Wang, P Jiang, L Jiang, R Liu, X Y Zhao, L J Gao, L Song, Y Zhang, J Chen, Z Gao, S B Qiao, Y J Yang, R L Gao, B Xu, J Q Yuan
Objective: To investigate the relationship between thrombolysis in myocardial infarction risk index(TRI) and the severity of coronary artery lesions and long-term outcome in acute myocardial infarction(AMI) patients undergoing percutaneous coronary intervention(PCI). Methods: A total of 1 663 consecutive AMI patients undergoing PCI between January and December 2013 in Fuwai hospital were prospectively included in this study. The severity of coronary artery lesions was evaluated using the SYNTAX score. Receiver operating characteristic(ROC) curve was used to analyze the optimal cut-off value of TRI on predicting all-cause mortality at 2 years after PCI...
November 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Hua Yang, Bing Tang, Chen Hong Xu, Anis Ahmed
INTRODUCTION: Antiplatelet therapy is very important following percutaneous coronary intervention (PCI). New generation P2Y12 inhibitors (ticagrelor and prasugrel) might potentially replace clopidogrel for the treatment of post-interventional acute coronary syndrome (ACS). In this analysis, we aimed to systematically compare the post-interventional clinical outcomes and bleeding events observed with ticagrelor versus prasugrel in patients with type 2 diabetes mellitus (T2DM). METHODS: EMBASE, MEDLINE, the Cochrane Central Register of Controlled Trials, and www...
November 19, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
Emrah Ermis, Serkan Kahraman, Hakan Ucar, Sinem Ozbay Ozyılmaz, Samir Allahverdiyev
Simultaneous multivessel epicardial coronary artery thrombosis is an uncommon finding in acute ST-segment elevation myocardial infarction (STEMI). It generally leads to cardiogenic shock and sudden cardiac death in the hospital. We report a 42-year-old male patient presenting with acute anterior STEMI with triple coronary artery thrombosis. An emergency coronary angiogram showed total occlusion of the left anterior descending artery (LAD) with thrombus formation. At the same time, thrombus formations were also seen in the circumflex artery (CXA), the second obtuse marginal (OM2) branch, and the distal right coronary artery (RCA)...
December 2018: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
Sina Mashayekhi, Mojtaba Ziaee, Alireza Garjani, Parvin Sarbakhsh, Samad Ghaffari
No abstract text is available yet for this article.
October 31, 2018: Journal of Emergency Medicine
Simon Correa, David A Morrow, Eugene Braunwald, Richard Y Davies, Erica L Goodrich, Sabina A Murphy, Christopher P Cannon, Michelle L O'Donoghue
Background Cystatin C (Cys-C) is a marker of renal function that has shown prognostic value for cardiovascular risk stratification across different patient populations. The incremental value of Cys-C beyond established cardiac and renal biomarkers remains incompletely explored. Methods and Results SOLID - TIMI 52 (Stabilization of Plaques Using Darapladib-Thrombolysis in Myocardial Infarction 52; , NCT01000727) randomized patients ≤30 days post-acute coronary syndrome were treated with darapladib or placebo...
October 16, 2018: Journal of the American Heart Association
Shu Ning Yew, David Carrick, David Corcoran, Nadeem Ahmed, Jaclyn Carberry, Vannesa Teng Yue May, Margaret McEntegart, Mark C Petrie, Hany Eteiba, Mitchell Lindsay, Stuart Hood, Stuart Watkins, Andrew Davie, Ahmed Mahrous, Ify Mordi, Ian Ford, Keith G Oldroyd, Colin Berry
Background Invasive measures of microvascular resistance in the culprit coronary artery have potential for risk stratification in acute ST-segment-elevation myocardial infarction. We aimed to investigate the pathological and prognostic significance of coronary thermodilution waveforms using a diagnostic guidewire. Methods and Results Coronary thermodilution was measured at the end of percutaneous coronary intervention, (PCI) and contrast-enhanced cardiac magnetic resonance imaging (MRI) was intended on day 2 and 6 months later to assess left ventricular (LV) function and pathology...
August 7, 2018: Journal of the American Heart Association
Yoav Hammer, Zaza Iakobishvili, David Hasdai, Ilan Goldenberg, Nir Shlomo, Michal Einhorn, Tamir Bental, Guy Witberg, Ran Kornowski, Alon Eisen
Background Patients who have had an acute coronary syndrome ( ACS ) are at increased risk of recurrent cardiovascular events; however, paradoxically, high-risk patients who may derive the greatest benefit from guideline-recommended therapies are often undertreated. The aim of our study was to examine the management, clinical outcomes, and temporal trends of patients after ACS stratified by the Thrombolysis in Myocardial Infarction (TIMI) risk score for secondary prevention, a recently validated clinical tool that incorporates 9 clinical risk factors...
September 18, 2018: Journal of the American Heart Association
Ahmad Kamona, Scott Cunningham, Brian Addison, Gordon F Rushworth, Andrew Call, Charles Bloe, Alistair Innes, Raymond R Bond, Aaron Peace, Stephen James Leslie
INTRODUCTION: People who experience an ST-elevation myocardial infarction (STEMI) due to an occluded coronary artery require prompt treatment. Treatments to open a blocked artery are called reperfusion therapies (RTs) and can include intravenous pharmacological thrombolysis (TL) or primary percutaneous coronary intervention (pPCI) in a cardiac catheterisation laboratory (cath lab). Optimal RT (ORT) with pPCI or TL reduces morbidity and mortality. In remote areas, a number of geographical and organisational barriers may influence access to ORT...
October 2018: Rural and Remote Health
Victoria Tea, Marc Bonaca, Chekrallah Chamandi, Marie-Christine Iliou, Thibaut Lhermusier, Nadia Aissaoui, Guillaume Cayla, Denis Angoulvant, Jean Ferrières, François Schiele, Tabassome Simon, Nicolas Danchin, Etienne Puymirat
BACKGROUND: Full secondary prevention medication regimen is often under-prescribed after acute myocardial infarction. DESIGN: The purpose of this study was to analyse the relationship between prescription of appropriate secondary prevention treatment at discharge and long-term clinical outcomes according to risk level defined by the Thrombolysis In Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS-2P) after acute myocardial infarction. METHODS: We used data from the 2010 French Registry of Acute ST-Elevation or non-ST-elevation Myocardial Infarction (FAST-MI) registry, including 4169 consecutive acute myocardial infarction patients admitted to cardiac intensive care units in France...
October 24, 2018: European Journal of Preventive Cardiology
Andrew R Chapman, Kerrick Hesse, Jack Andrews, Kuan Ken Lee, Atul Anand, Anoop S V Shah, Dennis Sandeman, Amy V Ferry, Jack Jameson, Simran Piya, Stacey Stewart, Lucy Marshall, Fiona E Strachan, Alasdair Gray, David E Newby, Nicholas L Mills
BACKGROUND: High-sensitivity cardiac troponin assays can help to identify patients who are at low risk of myocardial infarction in the emergency department. We aimed to determine whether the addition of clinical risk scores would improve the safety of early rule-out pathways for myocardial infarction. METHODS: In 1935 patients with suspected acute coronary syndrome, we evaluated the safety and efficacy of 2 rule-out pathways alone or in conjunction with low-risk TIMI (Thrombolysis In Myocardial Infarction) (0 or 1), GRACE (Global Registry of Acute Coronary Events) (≤108), EDACS (Emergency Department Assessment of Chest Pain Score) (<16), or HEART (History, ECG, Age, Risk factors, Troponin) (≤3) scores...
October 16, 2018: Circulation
Frédéric Lapostolle, Arnoud W Van't Hof, Christian W Hamm, Olivier Stibbe, Patrick Ecollan, Jean-Philippe Collet, Johanne Silvain, Jens Flensted Lassen, Wim M J M Heutz, Leonardo Bolognese, Warren J Cantor, Angel Cequier, Mohamed Chettibi, Shaun G Goodman, Christopher J Hammett, Kurt Huber, Magnus Janzon, Béla Merkely, Robert F Storey, Jur Ten Berg, Uwe Zeymer, Muriel Licour, Anne Tsatsaris, Gilles Montalescot
BACKGROUND: Morphine adversely impacts the action of oral adenosine diphosphate (ADP)-receptor blockers in ST-segment elevation myocardial infarction (STEMI) patients, and is possibly associated with differing patient characteristics. This retrospective analysis investigated whether interaction between morphine use and pre-percutaneous coronary intervention (pre-PCI) ST-segment elevation resolution in STEMI patients in the ATLANTIC study was associated with differences in patient characteristics and management...
October 23, 2018: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
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