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Tiffany Patterson, Alexander Perkins, Gavin D Perkins, Tim Clayton, Richard Evans, Hanna Nguyen, Karen Wilson, Mark Whitbread, Johanna Hughes, Rachael T Fothergill, Joanne Nevett, Iris Mosweu, Paul McCrone, Miles Dalby, Roby Rakhit, Philip MacCarthy, Divaka Perera, Jerry P Nolan, Simon R Redwood
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a global public health issue. There is wide variation in both regional and inter-hospital survival rates from OHCA and overall survival remains poor at 7%. Regionalization of care into cardiac arrest centers (CAC) improves outcomes following cardiac arrest from ST elevation myocardial infarction (STEMI) through concentration of services and greater provider experience. The International Liaison Committee on Resuscitation (ILCOR) recommends delivery of all post-arrest patients to a CAC, but that randomized controlled trials are necessary in patients without ST elevation (STE)...
August 6, 2018: American Heart Journal
Munish Sharma, Rubinder Toor, Koroush Khalighi
Elevated troponin and atypical chest pain in the setting of septicemia and Type II Non ST elevation myocardial infarction is frequently encountered. These cases are not necessarily scheduled for emergent cardiac catheterization. High index of clinical suspicion and continuous in-patient cardiac monitoring with serial trending of cardiac enzymes are important in such cases. Subsequent sudden development of electrocardiogram changes requires prompt investigation with emergent coronary catheterization. These types of cases may be missed especially in females who present with atypical chest pain and in patients with Left bundle branch block...
July 10, 2018: Clinics and Practice
Akanksha Agrawal, Deepanshu Jain, Andre Dias, Vinicius Jorge, Vincent M Figueredo
BACKGROUND AND OBJECTIVES: Stress echocardiography is the current standard for cardiac risk stratification of patients undergoing orthotopic liver transplantation (OLT). We aim to evaluate the role of dobutamine stress echocardiography (DSE) in predicting perioperative major adverse cardiac event (MACE) in patients undergoing OLT. METHODS: This was a single-center retrospective study including 144 OLT patients. Of 144 patients, 118 had DSE. MACE included myocardial infarction (MI), heart failure (HF), cardiovascular and all-cause death 1 year after OLT...
April 25, 2018: Korean Circulation Journal
Syed Rafay Ali Sabzwari, Khurram Butt, Nimra Khan, Kailyn Mann, Tarick Sheikh, Chandra Bomma
Takotsubo cardiomyopathy (TCM), or apical ballooning syndrome, is a distinct nonischemic cardiomyopathy mimicking acute coronary syndrome. A 76-year-old female presented with ST elevation in the inferior lead and a troponin level of 0.81 ng/dL. An immediate coronary angiography showed non-obstructive coronary artery disease. A subsequent ventriculogram and echocardiogram showed anteroapical and distal inferior wall hypokinesis suggestive of TCM. Despite therapy with beta blocker, she was observed to have two significant sinus pauses, one eight-second, and a second 29-second pause...
June 5, 2018: Curēus
Gianni Dall'Ara, Simone Grotti, Elisa Conficoni, Armando Zammarchi, Ottorino Catapano, Filippo Ottani, Fabio Tarantino, Marcello Galvani
The recommended treatment for ST-segment elevation myocardial infarction (STEMI) is primary percutaneous coronary intervention (pPCI). However, in a non-negligible proportion of patients, pPCI is ineffective and the cardiologist must face the decision of how to achieve optimal myocardial reperfusion. Although the possibility of a rescue fibrinolytic strategy has not been evaluated yet in this clinical setting, it is a viable alternative to emergency cardiac surgery. We here report the case of a 60-year-old STEMI patient presenting with a coronary anatomy unsuitable for percutaneous mechanical revascularization, characterized by marked dilation and tortuosity of the proximal and middle epicardial segments...
September 2018: Giornale Italiano di Cardiologia
Donato Mele, Giovanni Andrea Luisi, Gabriele Pestelli, Vittorio Smarrazzo, Filippo Trevisan, Roberto Ferrari
Echocardiography is an imaging technique of paramount importance for the management of patients with ST-elevation myocardial infarction. In particular, this technique may be useful for diagnosis and is essential for prognosis and to guide drug therapy. The role in the recognition of mechanical complications and in the identification and management of other complications such as pericarditis and left ventricular thrombosis is also crucial. Finally, echocardiography offers important information for the prediction of the arrhythmic risk and the study of left ventricular remodeling...
September 2018: Giornale Italiano di Cardiologia
Salim Halabi, Awny Elias, Michael Goldberg, Hilal Hurani, Husein Darawsha, Sharon Shachar, Miti Ashkenazi
BACKGROUND: Door-to-balloon time (DTBT) ≤ 90 minutes has become an important quality indicator in the management of ST-elevation myocardial infarction (STEMI). We identified three specific problems in the course from arrival of STEMI patients at our emergency department to initiation of balloon inflation and determined an intervention comprised of specific administrative and professional steps. The focus of the intervention was on triage within the emergency department (ED) and on increasing the efficiency and accuracy of electrocardiography interpretation...
August 2018: Israel Medical Association Journal: IMAJ
Gabby Elbaz-Greener, Olga Bloch, Ilya Kumets, Alex Blatt, Micha J Rapoport
We previously demonstrated increased GLP-1 secretion during acute ST elevation myocardial infarction (STEMI) in non-diabetic (ND) patients. Whether the endogenous GLP-1 system response is different in patients with type 2 diabetes (T2D) during STEMI is unknown. Patients with STEMI (20 ND, 13 T2D) and three control groups: non-STEMI (14 ND,13 T2D), stable angina pectoris (SAP) (8 ND, 10 T2D) patients and healthy subjects (n=25) were studied. Plasma levels of total and active GLP-1 and soluble DPP-4 (sDPP4) were estimated by ELISA on admission and 24, 48 hours after percutaneous coronary intervention (PCI) in all patients...
August 6, 2018: Diabetes, Obesity & Metabolism
Mark Salter, Annabel Kenney
Monoamine oxidase inhibitors (MAOIs) are known to cause hypertensive crisis when combined with intake of tyramine, classically found in cheese. We present a case of MAOI-induced hypertensive crisis leading to significant troponin release after soft cheese intake. A 51-year-old lady presented with left-sided chest pain, palpitations and headache in the context of significant hypertension after eating soft cheese. She had a similar episode 2 month prior to this presentation, which resulted in a diagnosis of non-ST elevation myocardial infarction after a troponin of 2768 ng/L (Ref < 17 ng/L) with normal cardiac investigations and CT pulmonary angiogram...
August 6, 2018: Cardiovascular Toxicology
Binav Shrestha, Paritosh Kafle, Shivani Thapa, Suyash Dahal, Vijay Gayam, Alix Dufresne
Introduction. Myocardial infarction in the setting of anaphylaxis may result from the anaphylaxis itself or from the epinephrine used to treat the anaphylaxis. While cases of myocardial infarction due to large doses of intravenous epinephrine have previously been reported, myocardial infarction after therapeutic doses of intramuscular epinephrine is rarely reported. Case Report. A 23-year-old male presented with sudden onset of difficulty in swallowing and speech after eating takeout food. He was treated with intramuscular epinephrine for presumed angioedema following which he immediately developed chest tightness associated with ST elevation on electrocardiogram and elevated serum troponin...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Piotr Adamski, Katarzyna Buszko, Joanna Sikora, Piotr Niezgoda, Malwina Barańska, Małgorzata Ostrowska, Przemysław Paciorek, Eliano P Navarese, Diana A Gorog, Jacek Kubica
Ticagrelor is a state-of-the-art antiplatelet agent used for the treatment of patients with acute coronary syndromes (ACS). Unlike remaining oral P2Y12 receptor inhibitors ticagrelor does not require metabolic activation to exert its antiplatelet action. Still, ticagrelor is extensively metabolized by hepatic CYP3A enzymes, and AR-C124910XX is its only active metabolite. A post hoc analysis of patient-level (n = 117) pharmacokinetic data pooled from two prospective studies was performed to identify clinical characteristics affecting the degree of AR-C124910XX formation during the first six hours after 180 mg ticagrelor loading dose in the setting of ACS...
August 6, 2018: Scientific Reports
S A Berns, E A Shmidt, O A Nagirnyak, A V Klimenkova, M N Litvinova, T Y Sergeeva, O L Barbarash
PURPOSE: to study the role of clinical factors and treatment tactics in the development of adverse outcomes in patients with non-STelevation acute coronary syndrome (NSTEACS) for five years follow up. MATERIALS AND METHODS: The study included 415 patients with NSTEACS observed for 60±4 months from the date of discharge. Adverse events (AE) were unstable angina (UA), myocardial infarction (MI), ischemic stroke or patient's death. The favorable 5-year outcome was identified in 200, adverse outcome - in 178 patients...
July 2018: Kardiologiia
A D Erlikh
PURPOSE: to assess changes in the management of patient with ST-Elevation (STE) Acute Coronary Syndrome (ACS) which occurred during recent several years by means of comparing data from the series of Russian ACS registries RECORD - "old" (RECORD and RECORD-2, 2007-2011) and "new" (RECORD-3, 2015). RESULTS: Numbers of included patients were 967 and 868, proportion of invasive centers - 56 and 55 % in "old" and "new" registries, respectively...
July 2018: Kardiologiia
V A Brazhnik, L O Minushkina, M A Evdokimova, A S Galyavich, S N Tereshchenko, N A Koziolova, M G Glezer, A V Yagoda, E V Khorolets, E N Dankovtseva, O I Boeva, V O Konstantinov, D A Zateishchikov
PURPOSE: to analyze possible associations of clinical and genetic factors with development of ischemic stroke after exacerbation of ischemic heart disease (IHD). MATERIALS AND METHODS: The Russian multicenter study aimed at assessment of risk of unfavorable outcomes after exacerbation of IHD "Exacerbation of IHD: logical probabilistic ways to course prognostication for optimization of treatment" (meaning of Cyrillic acronym - oracle) was conducted in 16 centers of 7 cities in Russia...
July 2018: Kardiologiia
Rajkumar Doshi, Nirav Patel, Rajat Kalra, Harpreet Arora, Navkaranbir S Bajaj, Garima Arora, Pankaj Arora
BACKGROUND: Coronary chronic total occlusion (CTO) using percutaneous coronary intervention (PCI) presents a distinct challenge in the field of cardiology owing to multiple reasons including the increased risk of peri-procedural complications. We sought to explore rates of hospitalization, outcomes, use of mechanical circulatory support devices, and economic burden associated with single-vessel coronary CTO undergoing PCI for stable coronary artery disease (CAD). METHODS: The National Inpatient Sample spanning from 2008 through 2014 was queried to identify hospitalizations associated with single-vessel coronary CTO-PCI for stable CAD by excluding hospitalizations with ST-elevation and non-ST elevation myocardial infarction...
July 19, 2018: International Journal of Cardiology
Sarah Hugelshofer, Marco Roffi, Fabienne Witassek, Franz R Eberli, Thomas Pilgrim, Giovanni Pedrazzini, Hans Rickli, Dragana Radovanovic, Paul Erne, Sophie Degrauwe, Olivier Muller, Pier Giorgio Masci, Stephan Windecker, Juan F Iglesias
BACKGROUND: The benefits of manual thrombus aspiration (TA) during primary percutaneous coronary intervention (pPCI) for ST-elevation myocardial infarction (STEMI) remain uncertain. We assessed the influence of total ischemic time (TIT) on clinical outcomes among STEMI patients undergoing manual TA during pPCI. METHODS AND RESULTS: We conducted a retrospective study of patients enrolled in the Acute Myocardial Infarction in Switzerland Plus registry. STEMI patients undergoing pPCI with (TA group) or without (PCI-alone group) manual TA were stratified based on short (<3 hours), intermediate (3-6 hours), and long (>6 hours) TIT...
July 10, 2018: American Heart Journal
Tang-Meng Guo, Bei Cheng, Li Ke, Si-Ming Guan, Ben-Ling Qi, Wen-Zhu Li, Bin Yang
Coronary artery disease (CAD) is a multifactorial disease in which inflammation plays a central role. This study aimed to investigate the association of inflammatory markers such as the neutrophil to lymphocyte ratio (NLR), the Global Registry of Acute Coronary Events (GRACE) score with in-hospital mortality of elderly patients with acute myocardial infarction (AMI) in an attempt to explore the prognostic value of these indices for elderly AMI patients. One thousand consecutive CAD patients were divided into two groups based on age 60...
April 2018: Current medical science
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
Andrew I MacIsaac, Gemma Figtree
No abstract text is available yet for this article.
August 6, 2018: Medical Journal of Australia
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