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thrombolysis in acute myocardial infarction

Enrico Fabris, Arnoud Van't Hof, Christian W Hamm, Frédéric Lapostolle, Jens Flensted Lassen, Shaun G Goodman, Jurriën M Ten Berg, Leonardo Bolognese, Angel Cequier, Mohamed Chettibi, Christopher J Hammett, Kurt Huber, Magnus Janzon, Béla Merkely, Robert F Storey, Uwe Zeymer, Warren J Cantor, Mathieu Kerneis, Abdourahmane Diallo, Eric Vicaut, Gilles Montalescot
OBJECTIVE: We investigated, in the contemporary era of ST-elevation myocardial infarction (STEMI) treatment, the influence of diabetes mellitus (DM) on cardiovascular outcomes, and whether pre-hospital administration of ticagrelor may affect these outcomes in a subgroup of STEMI patients with DM. BACKGROUND: DM patients have high platelet reactivity and a prothrombotic condition which highlight the importance of an effective antithrombotic regimen in this high-risk population...
October 9, 2018: Catheterization and Cardiovascular Interventions
S Pessinaba, Y D M Atti, K Yayehd, M B F Simwétaré, W Kaziga, Y M Afassinou, B Atta, M Pio, M Kpélafia, S Baragou, F Damorou
INTRODUCTION: The aim of this work was to describe the epidemiological, clinical, and therapeutic characteristics of acute coronary syndromes (ACS) in the cardiology department of Lome Campus University Hospital in Togo. METHODOLOGY: We conducted a prospective study that consistently included patients hospitalized from 2014 to 2017 for ACS, based on clinical, electrocardiographic, and laboratory findings. RESULTS: Of 1914 patients admitted to the department during the study period, 67 were admitted for ACS, for a 3...
August 1, 2018: Médecine et Santé Tropicales
Etienne L Couture, Paul Farand, Michel Nguyen, Catherine Allard, George A Wells, Samer Mansour, Stéphane Rinfret, Jonathan Afilalo, Mark Eisenberg, Martine Montigny, Simon Kouz, Marc Afilalo, Claude Lauzon, Jean-Pierre Dery, Philippe L'Allier, Erick Schampaert, Jean-Claude Tardif, Thao Huynh
BACKGROUND: Published data about nonagenarians with acute coronary syndrome (ACS) were mainly descriptive and limited by small sample sizes and unadjusted outcomes. We aim to describe the characteristics, management, and the impact of an invasive strategy on major adverse events in elderly patients hospitalized with ACS with focus on the nonagerians. METHODS AND RESULTS: We analyzed data collected as part of the AMI-OPTIMA study, a cluster-randomized study of knowledge translation intervention versus usual care on optimal discharge medications in patients admitted with ACS at 24 Canadian hospitals...
September 30, 2018: Catheterization and Cardiovascular Interventions
David D Berg, Stephen D Wiviott, Eugene Braunwald, Jianping Guo, KyungAh Im, Amir Kashani, C Michael Gibson, Christopher P Cannon, David A Morrow, Deepak L Bhatt, Jessica L Mega, Michelle L O'Donoghue, Elliott M Antman, L Kristin Newby, Marc S Sabatine, Robert P Giugliano
Aims: Although presenting features and early sequelae of non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are well described, less is known about longer-term risks and modes of death. The purpose of this study was to characterize modes of death following NSTE-ACS in clinical trial populations. Methods and results: We evaluated 66 252 patients with NSTE-ACS enrolled in 14 Thrombolysis in Myocardial Infarction (TIMI) trials, examining baseline characteristics and modes and timing of death...
September 20, 2018: European Heart Journal
Yingchun Zhang, Lingzhi Zhang, Hongzhi Zheng, Hongfen Chen
The effects of atrial fibrillation on complications and prognosis of patients receiving emergency percutaneous coronary intervention after acute myocardial infarction (AMI) were investigated. Eighty AMI patients treated with interventional vascular recanalization in the Affiliated Hospital of Weifang Medical University (Weifang, China) from July 2015 to October 2016 were selected, including 40 patients complicated with atrial fibrillation before operation (control group) and 40 patients without atrial fibrillation before operation (observation group)...
October 2018: Experimental and Therapeutic Medicine
Yuqing Zhang, Tingguo Shao, Lei Yao, Hong Yue, Zhiyu Zhang
Effects of tirofiban on stent thrombosis, high-sensitivity C-reactive protein (Hs-CRP), interleukin-6 (IL-6) and soluble intercellular adhesion molecule-1 (sICAM-1) after percutaneous coronary intervention (PCI) of acute myocardial infarction (AMI) were investigated. A total of 94 AMI patients receiving PCI in Shouguang City People's Hospital from January 2016 to September 2016 were selected and randomly divided into control (n=47) and observation group (n=47). The control group was treated with aspirin + clopidogrel before and after operation, while the observation group was treated with tirofiban based on the treatment of control group...
October 2018: Experimental and Therapeutic Medicine
Lanfang Zhang, Xiaoyong Qi, Xinwei Jia
BACKGROUND The aim of this study was to investigate the optimal route of administration of diltiazem in emergency PCI and to provide the best clinical treatment for ASTEMI patients. MATERIAL AND METHODS A total of 90 patients with ASTEMI treated in our hospital from January 2015 to January 2016 were selected. Prior to thrombus aspiration, a thrombus aspiration catheter was used to perform diltiazem injection at the distal end of the infarct-related artery (IRA). We chose the acute ST-elevation myocardial infarction (ASTEMI) patients treated with direct PCI to compare different administration routes of diltiazem...
September 17, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Michael Perera, Leena Aggarwal, Ian A Scott, Bentley Logan
Purpose: To assess the extent to which accelerated diagnostic protocols (ADPs), compared to traditional care, identify patients presenting to emergency departments (EDs) with chest pain who are at low cardiac risk and eligible for early ED discharge. Patients and methods: Retrospective study of 290 patients admitted to hospital for further evaluation of chest pain following negative ED workup (no acute ischemic electrocardiogram [ECG] changes or elevation of initial serum troponin assay)...
2018: International Journal of General Medicine
Robert F Riley, Chadwick D Miller, Gregory B Russell, Elsayed Z Soliman, Brian C Hiestand, David M Herrington, Simon A Mahler
An initial electrocardiogram (ECG) and serial troponin measurements are both independently and incrementally predictive of acute coronary syndrome in patients presenting with undifferentiated chest pain in the Emergency Department (ED). However, it is unclear if serial (ECGs) add significant to the contemporary diagnostic evaluation of this patient group. The ASAP CATH study was a single center, prospective study that enrolled patients presenting to an ED with undifferentiated chest pain. In addition to standard clinical evaluation, serial ECGs were performed at 90-minute intervals to evaluate whether serial changes suggestive of ischemia developed (Q waves, ST elevation or depression, or T-wave inversion)...
August 1, 2018: American Journal of Cardiology
Richard Body
Chest pain accounts for approximately 6% of Emergency Department (ED) attendances and is the most common reason for emergency hospital admission. For many years, our approach to diagnosis has required patients to stay in hospital for at least 6-12 h to undergo serial biomarker testing. As less than one fifth of the patients undergoing investigation actually has an acute coronary syndrome (ACS), there is tremendous potential to reduce unnecessary hospital admissions. Recent advances in diagnostic technology have improved the efficiency of care pathways...
September 2018: Turkish Journal of Emergency Medicine
Takuya Hashimoto, Junya Ako, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Teruo Noguchi, Satoshi Yasuda, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Masaaki Uematsu, Kazuhito Hirata, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Kenichi Tsujita, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Shirou Uemura, Tetsuya Toubaru, Keijirou Saku, Shigeru Oshima, Michikazu Nakai, Kunihiro Nishimura, Yoshihiro Miyamoto, Hisao Ogawa, Masaharu Ishihara
It has been shown that the patency of an infarct-related artery (IRA) before primary percutaneous coronary intervention determines post-procedural success, better preservation of left ventricular function, and lower in-hospital mortality. However, the factors associated with pre-procedural Thrombolysis In Myocardial Infarction (TIMI) flow have not been fully investigated.The Japanese registry of acute Myocardial INfarction diagnosed by Universal dEfiniTion (J-MINUET) is a prospective multicenter registry conducted at 28 Japanese medical institutions between July 2012 and March 2014...
September 26, 2018: International Heart Journal
Kazuhiro Dan, Hector M Garcia-Garcia, Akira Shinoda, Ron Waksman
We described a case of successful stentless percutaneous coronary intervention (PCI) with Thrombolysis in Myocardial Infarction (TIMI) 3 flow in the right coronary artery (RCA) with diffuse large thrombus, and an algorithm of PCI strategy for the cases with similar clinical scenarios in the current PCI era. Theoretically, stentless PCI might be superior to PCI using a stent since it may prevent long-term issues of dual antiplatelet therapy, stent fracture, and stent thrombosis. In particular acute coronary syndrome with diffuse large thrombus in the RCA will make multiple stenting necessary which may be associated with worse outcomes due to distal coronary flow disorder...
August 23, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Samuel Lévy
Despite the bulk of anatomical and histologic evidence supporting the existence of three fascicules in the left branch of the His bundle, the concept of a bifascicular system proposed by Rosenbaum and his school has been adopted by the cardiological community as a practical teaching tool. Left anterior hemiblock (LAH) refers to block of the antero-superior branch of the left branch which is small and left posterior hemiblock (LPH) to block of the postero-inferior branch which is larger. The LAH is more common that the LPH and often associated with a complete right bundle branch block (RBBB)...
August 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
A A Kulesh, L I Syromyatnikova, Yu A Golosova, V V Shestakov
AIM: To evaluate neurological and functional outcomes of early stage of ischemic stroke, their determining factors and predictors of hemorrhagic transformation in patients who received thrombolysis. MATERIAL AND METHODS: A retrospective analysis of 147 patients, who underwent thrombolysis, and 127 patients, matched for basic parameters, who did not receive thrombolysis, was performed. Anamnesis, results of clinical examination, a spectrum of laboratory-instrumental parameters were evaluated...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Golnaz Sadjadieh, Thomas Engstrøm, Dan Eik Høfsten, Steffen Helqvist, Lars Køber, Frants Pedersen, Peter Nørkjær Laursen, Hedvig Bille Andersson, Lars Nepper-Christensen, Peter Clemmensen, Rikke Sørensen, Erik Jørgensen, Kari Saunamäki, Hans-Henrik Tilsted, Henning Kelbæk, Lene Holmvang
Most studies reporting bleedings in patients with ST-segment elevation myocardial infarction (STEMI) are reports from clinical trials, which may be unrepresentative of incidences in real-life. In this study, we investigated 1-year bleeding and mortality incidences in an unselected STEMI population, and compared participants with nonparticipants of a randomized all-comer clinical trial (The Third DANish Study of Optimal Acute Treatment of Patients with STEMI (DANAMI-3)). Hospital charts were read and bleedings classified according to thrombolysis in myocardial infarction (TIMI) and Bleeding Academic Research Consortium (BARC) criteria in 2,490 consecutive STEMI patients who underwent primary percutaneous coronary intervention in a single, large, and tertiary heart center...
July 19, 2018: American Journal of Cardiology
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...
August 27, 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...
October 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...
September 2018: Journal of Emergency Medicine
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