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STEMI elderly

Sheeren Khaled, Rajaa Matahen
BACKGROUND: Acute coronary syndrome (ACS) remains a leading cause of death in the United States. Numerous studies have shown that the degree of LV systolic dysfunction is a major if not the most important determinant of long-term outcome in ACS. OBJECTIVES: To identify the most important risk factors and other clinical predictors which might have impact on left ventricular ejection fraction in patients with ACS. RESULTS: The total patients (299) admitted to our center from July, 2015 till December, 2015; with established diagnosis of ACS were classified in to two groups: Group I: 193 patients with impaired LVEF <40% (64...
January 2018: Indian Heart Journal
Li Li, Yi Ma, Xiao-Ming Shang, Ye Hong, Jian-Hui Wang, Zheng Tan, Ya-Jun Wang, Xue-Bin Geng
BACKGROUND: Although a lot of studies have  shown serum uric acid (SUA) could be a marker of adverse prognosis in patients with acute myocardial infarction, the role of SUA as a risk factor for myocardial infarction is controversial. This study aimed to evaluate the association between hyperuricemia and short-term outcomes of elderly patients with acute ST-segment elevation myocardial infarction (STEMI). METHODS: Six hundred and seventy-three elderly patients (≥ 60 years) were divided into high-SUA-level group (group H: N = 168) and low-SUA-level group (group L: N = 505) according to the SUA levels on admission...
February 6, 2018: Aging Clinical and Experimental Research
Jose M de La Torre Hernandez, Joan A Gomez Hospital, Jose A Baz, Salvatore Brugaletta, Armando Perez de Prado, Jose A Linares, Ramón Lopez Palop, Belen Cid, Tamara Garcia Camarero, Alejandro Diego, Hipolito Gutierrez, Jose A Fernandez Diaz, Juan Sanchis, Fernando Alfonso, Roberto Blanco, Javier Botas, Javier Navarro Cuartero, Jose Moreu, Francisco Bosa, Jose M Vegas, Jaime Elizaga, Antonio L Arrebola, Felipe Hernandez, Neus Salvatella, Marta Monteagudo, Alfredo Gomez Jaume, Xavier Carrillo, Roberto Martin Reyes, Fernando Lozano, Jose R Rumoroso, Leire Andraka, Antonio J Dominguez
BACKGROUND: In elderly patients with ST elevated myocardial infarction (STEMI) and multivessel disease (MVD the outcomes related with different revascularization strategies are not well known. METHODS: Subgroup-analysis of a nation-wide registry of primary angioplasty in the elderly (ESTROFA MI+75) with 3576 patients over 75years old from 31 centers. Patients with MVD were analyzed to describe treatment approaches and 2years outcomes. RESULTS: Of 1830 (51%) with MVD, 847 (46%) underwent multivessel revascularization either in acute (51%), staged (44%) or both procedures (5%)...
December 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Jimmy Yee, Vishesh Kumar, Shenjing Li, Terezia Petraskova, Alex Pham, Julia Stys, Paul A Thompson, Marian Petrasko, Adam Stys, Tomasz Stys
OBJECTIVES: To analyze clinical factors associated with operator's preference in selection of femoral versus radial access for angiography and percutaneous intervention (PCI) procedures. BACKGROUND: There has been an increase in radial access in cardiac catheterization and PCI in the last few decades. METHODS: Data from 11 226 consecutive cardiac catheterization procedures were collected from Sanford University Medical Center (University of South Dakota, Sanford School of Medicine) from 2011 to 2015...
December 25, 2017: Journal of Interventional Cardiology
Rajat Sharma, Brett Hiebert, David Cheung, Davinder S Jassal, Kunal Minhas
The proportion of individuals >80 years of age constitute an increasing proportion of patients who present with ST-segment elevation myocardial infarction (STEMI). The objective of this study is to evaluate in-hospital outcomes and 1-year survival of very elderly patients who present with an STEMI and undergo primary percutaneous coronary intervention (pPCI). Between 2009 and 2015, individuals >80 years of age (very elderly patients) with an STEMI presenting at a single tertiary Canadian care center were included in the study...
January 1, 2017: Angiology
Khalid Qaderdan, Gerrit-Jan A Vos, Thomas McAndrew, Philippe Gabriel Steg, Christian W Hamm, Arnoud Van't Hof, Roxana Mehran, Efthymios N Deliargyris, Debra Bernstein, Gregg W Stone, Jurriën M Ten Berg
BACKGROUND: Since older age is a strong predictor of not only bleeding but also of ischemic events, understanding the risk:benefit profile of bivalirudin in the elderly undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation (STEMI) is important. For this, we aim to compare elderly with young patients, who all underwent pPCI for STEMI and randomly received either bivalirudin or heparin. METHODS: We performed a patient-level pooled analysis (n=5800) of two large randomized trials...
December 2017: American Heart Journal
Sara Doimo, Patrizia Maras, Giulia Barbati, Enrico Fabris, Alessio Della Mattia, Kareem Salame, Giuseppe Gatti, Gianfranco Sinagra
BACKGROUND: Cardiac rehabilitation (CR) is a model of care proven to reduce mortality and morbidity in patients with coronary artery disease. The aim of this study is to describe the ambulatory CR model of the Cardiovascular Department of Trieste (Italy), analyzing the outcome of the population. METHODS: We analyzed clinical and instrumental characteristics of all consecutive patients after ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), coronary artery bypass graft with or without valve surgery (CABG/CABGV), or planned percutaneous coronary intervention (PCI), referred for CR from January 1, 2009, to December 31, 2015...
December 2017: Giornale Italiano di Cardiologia
Daniëlle C Eindhoven, Alexander D Hilt, Thomas C Zwaan, Martin J Schalij, C Jan Willem Borleffs
Background Following myocardial infarction, medication is, besides lifestyle interventions, the cornerstone treatment to improve survival and minimize the occurrence of new cardiovascular events. Still, data on nationwide medication adherence are scarce. This study assesses medical adherence during one year following myocardial infarction, stratifying per type of infarct, age and gender. Design Retrospective cohort study. Methods In The Netherlands, all inhabitants are by law obliged to have health insurance and all claims data are centrally registered...
January 1, 2017: European Journal of Preventive Cardiology
Irene R Dégano, Isaac Subirana, Danilo Fusco, Luigi Tavazzi, Inge Kirchberger, Dimitrios Farmakis, Jean Ferrières, Ana Azevedo, Marina Torre, Pascal Garel, Max Brosa, Marina Davoli, Christa Meisinger, Vanina Bongard, Carla Araújo, John Lekakis, Albert Francès, Conxa Castell, Roberto Elosua, Jaume Marrugat
BACKGROUND: Percutaneous coronary intervention (PCI) reduces mortality in most myocardial infarction (MI) patients but the effect on elderly patients with comorbidities is unclear. Our aim was to analyse the effect of PCI on in-hospital mortality of MI patients, by age, sex, ST elevation on presentation, diabetes mellitus (DM) and chronic kidney disease (CKD). METHODS: Cohort study of 79,791 MI patients admitted at European hospitals during 2000-2014. The effect of PCI on in-hospital mortality was analysed by age group (18-74, ≥75years), sex, presence of ST elevation, DM and CKD, using propensity score matching...
December 15, 2017: International Journal of Cardiology
Johanne Silvain, Lee S Nguyen, Vincent Spagnoli, Mathieu Kerneis, Paul Guedeney, Nicolas Vignolles, Kristel Cosker, Olivier Barthelemy, Claude Le Feuvre, Gérard Helft, Jean-Philippe Collet, Gilles Montalescot
OBJECTIVES: Contrast-induced acute kidney injury (CI-AKI) is a common and potentially severe complication in patients with ST elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). There is no consensus on the best definition of CI-AKI to identify patients at risk of haemodialysis or death. The objective of this study was to assess the association of CI-AKI, using four definitions, on inhospital mortality, mortality or haemodialysis requirement over 1-year follow-up, in patients with STEMI treated with pPCI...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
S Pichard, G Gibault-Genty, A Vienet-Legue, N Baron, R Convers-Domart, J L Georges, B Livarek
A 80-year-old man was admitted to catheterization room for an acute infero-lateral ST-elevation myocardial infarction (STEMI). Coronary angiography showed a thrombotic occlusion of the second left marginal branch, and normal other coronary arteries. The thrombo-embolic mechanism of the STEMI, and the infectious context in this patient who had had a transcatheter aortic valve implantation (TAVI) two months earlier, led us to suspect a bioprosthesis endocarditis. It was confirmed by transthoracic and transoesophageal echocardiography, which showed an aortic-mitral curtain abscess and aortic bioprosthesis vegetations, associated to Enterococcus faecalis bacteriemia...
November 2017: Annales de Cardiologie et D'angéiologie
M Sunamura, N Ter Hoeve, M L Geleijnse, R V Steenaard, H J G van den Berg-Emons, H Boersma, R T van Domburg
BACKGROUND: Hospital length of stay after acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) has reduced, resulting in more limited patient education during admission. Therefore, systematic participation in cardiac rehabilitation (CR) has become more essential. We aimed to identify patient-related factors that are associated with participation in and completion of a CR programme. METHODS: We identified 3,871 consecutive AMI patients who underwent pPCI between 2003 and 2011...
November 2017: Netherlands Heart Journal
Chi-Kung Ho, Fu-Cheng Chen, Yung-Lung Chen, Hui-Ting Wang, Chien-Ho Lee, Wen-Jung Chung, Cheng-Jui Lin, Shu-Kai Hsueh, Shin-Chiang Hung, Kuan-Han Wu, Chu-Feng Liu, Chia-Te Kung, Cheng-I Cheng
BACKGROUND: This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB) time for ST segment elevation myocardial infarction (STEMI). METHODS: A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process...
2017: BioMed Research International
Matias B Yudi, Garry Hamilton, Omar Farouque, Nick Andrianopoulos, Stephen J Duffy, Jeffrey Lefkovits, Angela Brennan, Dharsh Fernando, Chin Hiew, Melanie Freeman, Christopher M Reid, Robynne Dakis, Andrew E Ajani, David J Clark
Guidelines strongly recommend patients with ST-elevation myocardial infarction (STEMI) receive timely mechanical reperfusion, defined as door-to-balloon time (DTBT) ≤90 minutes. The impact of timely reperfusion on clinical outcomes in patients aged 75-84 and ≥85 years is uncertain. We analysed 2,972 consecutive STEMI patients who underwent primary percutaneous coronary intervention from the Melbourne Interventional Group Registry (2005-2014). Patients aged <75 years were included in the younger group, those aged 75-84 years were in the elderly group and those ≥85 years were in the very elderly group...
October 15, 2017: American Journal of Cardiology
Carl J Lavie, Ahmet Afsin Oktay, Richard V Milani
No abstract text is available yet for this article.
July 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
Paul Michael Haller, Bernhard Jäger, Serdar Farhan, Günter Christ, Wolfgang Schreiber, Franz Weidinger, Thomas Stefenelli, Georg Delle-Karth, Alfred Kaff, Gerald Maurer, Kurt Huber
BACKGROUND AND AIM: Our senescent society includes a growing number of elderly people suffering from ST-elevation myocardial infarction (STEMI); however, exactly this population is often underrepresented in randomized trials. Hence, our aim was to investigate the influence of age on patient characteristics, as well as short- and long-term outcome in the Vienna STEMI registry. METHODS: We included all patients of the Vienna STEMI registry (2003-2009). Patients were stratified into age cohorts (≤45, 46-59, 60-79 and ≥80 years, respectively)...
August 23, 2017: Wiener Klinische Wochenschrift
R S Tarasov, A M Kochergina, V I Ganyukov, V V Kashtalap, N A Kochergin, O L Barbarash
AIM: to assess safety and efficacy of single stage complete revascularization by multivessel stenting as primary percutaneous coronary intervention (pPCI) in elderly and middle aged patients with acute ST-elevation myocardial infarction (STEMI). MATERIAL AND METHODS: We included in this analysis data on 327 of 1690 STEMI patients who had undergone pPCI from 2009 to 2013. Age of 103 patients was more or equal 65 and of 224 less or equal 64 years. Multivessel stenting (MS) during pPCI was carried out in 26 and 65, while strategy of staged revascularization (SR) was implemented in 77 and 129 individuals among older and younger patients, respectively...
April 2017: Kardiologiia
Walid Jomaa, Imen Ben Ali, Sonia Hamdi, Mohamed A Azaiez, Aymen El Hraïech, Khaldoun Ben Hamda, Faouzi Maatouk
BACKGROUND: Anemia on admission is a powerful predictor of major cardiovascular events in patients presenting for acute coronary syndromes. We sought to determine the prevalence and prognostic impact of anemia in patients presenting for ST-elevation myocardial infarction (STEMI). METHODS: We analyzed data from a Tunisian retrospective single center STEMI registry. Patients were enrolled between January 1998 and October 2014. Anemic and nonanemic patients were compared for clinical and prognostic features and according to four prespecified hemoglobin level subgroups...
July 2017: Journal of the Saudi Heart Association
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
April 6, 2017: International Heart Journal
Nobuhiro Ikemura, Mitsuaki Sawano, Yasuyuki Shiraishi, Ikuko Ueda, Hiroaki Miyata, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Yukihiko Momiyama, Taku Inohara, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min...
February 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
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