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Acute Myocardial Infarctation

Martin Reindl, Sebastian Johannes Reinstadler, Christina Tiller, Hans-Josef Feistritzer, Markus Kofler, Alexandra Brix, Agnes Mayr, Gert Klug, Bernhard Metzler
OBJECTIVES: Cardiac magnetic resonance (CMR) is the gold-standard modality for the assessment of left ventricular (LV) remodeling in ST-elevation myocardial infarction (STEMI) patients. However, the commonly used remodeling criteria have never been validated for hard clinical events. We therefore aimed to define clear CMR criteria of LV remodeling following STEMI with proven prognostic impact. METHODS: This observational study included 224 patients suffering from acute STEMI...
December 13, 2018: European Radiology
Philip S Vendittelli, Bassent Botros, Howard S Rosman, Viren Govindaraju, Anwar Zaitoun, Tariq S Marroush
Coronary embolism (CE) is an uncommon and unique cause of acute myocardial infarction. In this report, we review 216 cases of CE including 2 new cases from our institution. The mean patient age was 52.5 years and 62% of the patients were males. Chest pain was the most common presenting symptom followed by dyspnea, and the most commonly affected vessel was the left anterior descending artery. Leading etiologies of the embolus were atrial fibrillation, septic emboli, and iatrogenic causes. Treatment approaches varied with thrombus aspiration being used in 30% of cases...
November 10, 2018: American Journal of the Medical Sciences
Karin Wildi, Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Patrick Badertscher, Desiree Wussler, Maria Rubini Giménez, Christian Puelacher, Jeanne du Fay de Lavallaz, Sebastian Dietsche, Joan Walter, Nikola Kozhuharov, Beata Morawiec, Òscar Miró, F Javier Martin-Sanchez, Sinthuri Subramaniam, Nicolas Geigy, Dagmar I Keller, Tobias Reichlin, Christian Mueller
BACKGROUND: The clinical availability of high-sensitivity cardiac troponin (hs-cTn) has enabled the development of several innovative strategies for the rapid rule-out of acute myocardial infarction (AMI). Due to the lack of direct comparisons, selection of the best strategy for clinical practice is challenging. METHODS: In a prospective international multicenter diagnostic study enrolling 3696 patients presenting with suspected AMI to the emergency department, we compared the safety and efficacy of 14 different hs-cTn-based strategies: hs-cTn concentrations below the limit of detection (LoD), dual-marker combining hs-cTn with copeptin, ESC 0 h/1 h-algorithm, 0 h/2 h-algorithm, 2 h-ADP-algorithm, NICE-algorithm, and ESC 0 h/3 h-algorithm, each using either hs-cTnT or hs-cTnI...
December 3, 2018: International Journal of Cardiology
Angelika Batzner, Barbara Pfeiffer, Anna Neugebauer, Diaa Aicha, Christoph Blank, Hubert Seggewiss
BACKGROUND: Alcohol-induced infarction for treatment of symptomatic hypertrophic obstructive cardiomyopathy (HOCM) was discussed as a risk factor for increased cardiac mortality during follow-up. OBJECTIVES: This study sought to report on long-term survival after echo-guided alcohol septal ablation (percutaneous transluminal septal myocardial ablation [PTSMA]) in symptomatic patients with HOCM. METHODS: Between May 2000 and June 2017, PTSMA with alcohol injection was performed in 952 patients (age 55...
December 18, 2018: Journal of the American College of Cardiology
Franziska Nairz, Christa Meisinger, Inge Kirchberger, Margit Heier, Christian Thilo, Bernhard Kuch, Annette Peters, Ute Amann
BACKGROUND: Sleep-related investigations in acute myocardial infarction (AMI) patients are rare. The aim of this study was to examine sex-specific associations of patient-reported sleep disturbances within 4 weeks before AMI and long-term survival. METHODS: From a German population-based, regional AMI registry, 2511 men and 828 women, aged 28-74 years, hospitalized with a first-time AMI between 2000 and 2008 and still alive after 28 days, were included in the study (end of follow-up: 12/2011)...
December 13, 2018: BMC Cardiovascular Disorders
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
Guangqiang Wang, Na Zhao, Chuanhuan Zhang, Shu Zhong, Xuexun Li
RATIONALE: The lambda-like ST-elevation electrocardiography (ECG) pattern is extremely rare in patients with type 2 myocardial infarction (T2MI) triggered by coronary spasm. When this ECG pattern appears, sudden cardiac death (SCD) caused by lethal ventricular arrhythmia may occur because clinicians do not pay sufficient attention to this phenomenon. PATIENT CONCERNS: We describe a 41-year-old man who presented with steep down-sloping ST-segment elevation, paroxysmal ventricular tachycardia, severe sinus bradycardia, and intermittent complete atrioventricular block on ECG during the sudden recurrence of clinical symptoms...
December 2018: Medicine (Baltimore)
Mariarita Stendardo, Melissa Bonci, Valeria Casillo, Rossella Miglio, Giulia Giovannini, Marco Nardini, Gianluca Campo, Alessandro Fucili, Piera Boschetto
OBJECTIVES: Return to work after acute myocardial infarction (AMI), a leading cause of death globally, is a multidimensional process influenced by clinical, psychological, social and occupational factors, the single impact of which, however, is still not well defined. The objective of this study was to investigate these 4 factors on return to work (RTW) within 365 days after AMI in a homogeneous cohort of patients who had undergone an urgent coronary angioplasty. PARTICIPANTS: We studied 102 patients, in employment at the time of AMI (88...
2018: PloS One
Felix Polten, Marc Reboll, Christian Widera, Tibor Kempf, Kerstin Bethmann, Priyanka Gupta, John Miglietta, A Pekcec, Jochen Tillmanns, Johann Bauersachs, Evangelos Giannitsis, Andreas Pich, Kai C Wollert
Myeloid-derived growth factor (MYDGF in humans, Mydgf in mice) is a secreted protein with previously unknown biological functions. In a recent study, Mydgf was shown to mediate cardiac repair after acute myocardial infarction (MI) in mice. Lack of a sensitive assay to measure MYDGF in the circulation has hampered its further investigation. Here, we developed a liquid chromatography/multiple reaction monitoring-mass spectrometry MYDGF assay, employing SDS-PAGE-based protein fractionation to deplete high-abundant proteins and a stable isotope-labeled synthetic standard peptide for quantification...
December 13, 2018: Analytical Chemistry
Navin K Kapur, Shiva Annamalai, Lara Reyelt, Samuel J Karmiy, Allen A Razavi, Sina Foroutanjazi, Aditya Chennojwala, Kiyotake Ishikawa
Heart failure is a major cause of global morbidity and mortality. Acute myocardial infarction (AMI) is a primary cause of heart failure due in large part to residual myocardial damage despite timely reperfusion therapy. Since the 1970's, multiple preclinical laboratories have tested whether reducing myocardial oxygen demand with a mechanical support pump can reduce infarct size in AMI. In the past decade, this hypothesis has been studied using contemporary circulatory support pumps. We will review the most recent series of preclinical studies in the field which led to the recently completed Door to Unload ST-segment Elevation Myocardial Infarction (DTU-STEMI) safety and feasibility pilot trial...
2018: F1000Research
Duo Zhao, Jing Zhao, Jiangbin Sun, Yanling Su, Jinfeng Jian, Huaan Ye, Jiawang Lin, Zongda Yang, Jiatao Feng, Zhiping Wang
The aim of the study was to investigate the expression of miR-155 in plasma and peripheral blood mononuclear cells (PBMCs), the effects of miR-155 on the apoptosis rate of PBMCs and the extent of coronary stenosis in coronary artery disease patients. Seventy chest pain patients were divided into three groups by symptoms, signs, auxiliary examination and coronary arteriography: 21 cases in the acute myocardial infarction group (AMI), 23 cases in the Angor pectoris group (AP) and 26 cases in the control group (CT)...
December 2018: Experimental and Therapeutic Medicine
Moman A Mohammad, Sofia Karlsson, Jonathan Haddad, Björn Cederberg, Tomas Jernberg, Bertil Lindahl, Ole Fröbert, Sasha Koul, David Erlinge
OBJECTIVES: To study circadian rhythm aspects, national holidays, and major sports events as triggers of myocardial infarction. DESIGN: Retrospective observational study using the nationwide coronary care unit registry, SWEDEHEART. SETTING: Sweden. PARTICIPANTS: 283 014 cases of myocardial infarction reported to SWEDEHEART between 1998 and 2013. Symptom onset date was documented for all cases, and time to the nearest minute for 88%...
December 12, 2018: BMJ: British Medical Journal
Jeanne du Fay de Lavallaz, Christian Puelacher, Giovanna Lurati Buse, Daniel Bolliger, Dominic Germanier, Reka Hidvegi, Joan Elias Walter, Raphael Twerenbold, Ivo Strebel, Patrick Badertscher, Lorraine Sazgary, Andreas Lampart, Jaqueline Espinola, Christoph Kindler, Angelika Hammerer-Lercher, Saranya Thambipillai, Lorenz Guerke, Katharina Rentsch, Andreas Buser, Danielle Gualandro, Marcel Jakob, Christian Mueller
OBJECTIVE: Recently, daytime variation in perioperative myocardial injury (PMI) has been observed in patients undergoing cardiac surgery. We aim at investigating whether daytime variation also occurs in patients undergoing non-cardiac surgery. METHODS: In a prospective diagnostic study, we evaluated the presence of daytime variation in PMI in patients at increased cardiovascular risk undergoing non-cardiac surgery, as well as its possible impact on the incidence of acute myocardial infarction (AMI), and death during 1-year follow-up in a propensity score-matched cohort...
December 12, 2018: Heart: Official Journal of the British Cardiac Society
Claus Kjær Pedersen, Carsten Stengaard, Hanne Søndergaard, Karen Kaae Dodt, Jakob Hjort, Morten Thingemann Bøtker, Christian Juhl Terkelsen
BACKGROUND: Suspicion of acute myocardial infarction (AMI) is among the most common reasons for admission to hospital in Denmark. Owing to this suspicion, an estimated 50,000 patients are admitted every year. Only 15-20% are finally diagnosed with AMI, whereas 40% are discharged after rule-out of AMI and without initiation of any treatment or need for further admission. In patients discharged after rule-out, the current diagnostic protocol, using consecutive troponin measurements, results in an average length of stay (LOS) of 8-12 h...
December 12, 2018: Trials
Yan Gao, Nanette H Bishopric, Hong-Wei Chen, Jiang-Tao Li, Yu-Lang Huang, He-Xun Huang
BACKGROUND: In the era of primary percutaneous coronary intervention (PPCI), the incidence of post-cardiac injury syndrome (PCIS) in patients with acute myocardial infarction (AMI) following PPCI has become less common. However, the intrinsic pathogenesis of this medical condition remains largely uncertain. Unlike the prior reports, the present paper provides new mechanistic clues concerning the pathogenesis of PCI-related PCIS. CASE PRESENTATION: A 45-year-old male with AMI had developed an early onset of PCIS at 3 h after PPCI...
December 12, 2018: BMC Cardiovascular Disorders
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
Giovanni Malanchini, Giulio Giuseppe Stefanini, Margherita Malanchini, Federico Lombardi
AIMS: An increased mortality risk during weekend hospital admission has been consistently observed. In the present study, we evaluated whether the current improvement in management of acute coronary syndromes (ACS) has reduced this phenomenon. METHODS AND RESULTS: We extracted data from the Italian National Healthcare System Databank of 80 391 ACS admissions in the region of Lombardia between 2010 and 2014. ICD-9 codes were used to assess the diagnosis. We performed a multiple logistic regression analysis to compare the mortality rates between weekend and weekday admissions...
December 11, 2018: Journal of Cardiovascular Medicine
Gary J Doherty, Dochka Davidson, Han H Wong, Helen M Hatcher
Trabectedin is used routinely in the palliative management of patients with advanced soft tissue sarcoma. It is not generally considered to be cardiotoxic, and there is no specific caution for its use in patients with a history of cardiac disease or risk factors. Here, we report six cases from a single academic centre where life-threatening cardiotoxicity occurred acutely during treatment with trabectedin. These patients had a median age of 72.5 years (range: 68-81) at presentation with cardiotoxicity, significantly higher than the median ages of patients treated with trabectedin in clinical trials...
January 2019: Anti-cancer Drugs
Christoph B Olivier, Hillary Mulder, William R Hiatt, W Schuyler Jones, F Gerry R Fowkes, Frank W Rockhold, Jeffrey S Berger, Iris Baumgartner, Peter Held, Brian G Katona, Lars Norgren, Juuso Blomster, Manesh R Patel, Kenneth W Mahaffey
Importance: Patients with peripheral artery disease (PAD) are at high risk for myocardial infarction (MI). Objective: To characterize the incidence and types of MI in a PAD population, identify factors associated with MI, and determine the association of MI with cardiovascular mortality and acute limb ischemia. Design, Setting, and Participants: The Study Comparing Cardiovascular Effects of Ticagrelor and Clopidogrel in Patients With Peripheral Artery Disease (EUCLID) was a double-blind randomized clinical trial conducted at 811 sites in 28 countries that randomized 13 885 patients with symptomatic PAD to monotherapy with ticagrelor or clopidogrel...
December 12, 2018: JAMA Cardiology
Beata Morawiec, Brygida Przywara-Chowaniec, Piotr Muzyk, Mariusz Opara, Lam Ho, Lui Chun Tat, Olivier Muller, Ewa Nowalany-Kozielska, Damian Kawecki
Background: Clinical short-term risk stratification is a recommended approach in patients with chest pain and possible acute myocardial infarction (AMI) to further improve high safety of biomarker-based rule-out algorithms. The study aim was to assess clinical performance of baseline concentrations of high-sensitivity cardiac troponin T (hs-TnT) and copeptin and the modified HEART score (mHS) in early presenters to the emergency department with chest pain. Methods: This cohort study included patients with chest pain with onset maximum of 6 h before admission and no persistent ST-segment elevation on electrocardiogram...
2018: Disease Markers
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