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https://www.readbyqxmd.com/read/28315564/clinical-risk-scores-predict-procedural-complications-of-primary-percutaneous-coronary-intervention
#1
László Hadadi, Razvan Constantin Şerban, Alina Scridon, Ioana Şuş, Éva Katalin Lakatos, Zoltán Demjén, Dan Dobreanu
OBJECTIVE: The predictive value of five risk score models containing clinical (PAMI-PMS, GRACE-GRS, and modified ACEF-ACEFm-scores), angiographic SYNTAX score (SXS) and combined Clinical SYNTAX score (CSS) variables were evaluated for the incidence of three procedural complications of primary percutaneous coronary intervention (pPCI): iatrogenic coronary artery dissection, angiographically visible distal embolization and angiographic no-reflow phenomenon. METHODS: The mentioned scores and the incidence of procedural complications were retrospectively analyzed in 399 consecutive patients with acute ST-elevation myocardial infarction who underwent pPCI...
March 9, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28286839/early-vs-late-coronary-angiography-and-intervention-following-thrombolytic-therapy-a-cohort-study
#2
Bahareh Feizi, Shahram Taghdisi, Jalil Etemadi, Amir Hossein Feizi, Setareh Asgarzadeh, Sepideh Kamal
INTRODUCTION: The precise time of using percutaneous coronary intervention (PCI) after fibrinolytic therapy for maximum efficiency and minimum side effects is still undetermined. Therefore, the present study was designed to compare the outcome of myocardial infarction (MI) patients who underwent surgical intervention (angiography and PCI) within 48 hours of thrombolytic therapy or after that. METHODS: The present study is a prospective cohort study aiming to compare the occurrence of no-reflow phenomenon, unstable angina, bleeding during intervention, and one month major adverse cardiac outcomes (recurrent MI, need for repeating surgical intervention, and mortality) between MI patents undergoing surgical intervention within the first 48 hours of or after 48 hours of thrombolytic therapy...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28275202/low-volume-resuscitation-for-hemorrhagic-shock-understanding-the-mechanism-of-peg-20k
#3
Valerie Plant, Dan Parrish, Ashley Limkemann, Paula Ferrada, Michel Aboutanos, Martin J Mangino
Hemorrhagic shock leads to cell and tissue swelling and no reflow from compressed capillaries. Cell impermeants, including polyethylene glycol-20,000 (PEG-20k), reverse ischemia-induced cell swelling, extend low volume resuscitation (LVR) time after shock, and increase tolerance to the low volume state. The purpose of this study was to explore the mechanisms of action of PEG-20k containing LVR solutions. We hypothesized that PEG-20k acts as both an oncotic agent and an impermeant in the microcirculation, which moves water out of the extracellular space and into the capillaries to affect peripheral capillary filling and enhanced perfusion during the low volume state...
March 8, 2017: Journal of Pharmacology and Experimental Therapeutics
https://www.readbyqxmd.com/read/28275065/deferred-versus-immediate-stenting-in-patients-with-st-segment-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis
#4
REVIEW
Jianzhong Qiao, Lingxin Pan, Bin Zhang, Jie Wang, Yongyan Zhao, Ru Yang, Huiling Du, Jie Jiang, Conghai Jin, Enlai Xiong
BACKGROUND: A number of studies have evaluated the efficacy of deferred stenting vs immediate stenting in patients with ST-segment elevation myocardial infarction, but the findings were not consistent across these studies. This meta-analysis aims to assess optimal treatment strategies in patient with ST-segment elevation myocardial infarction. METHODS AND RESULTS: We searched the PubMed, EMBASE, and the Cochrane Library for studies that assessed deferred vs immediate stenting in patients with ST-segment elevation myocardial infarction...
March 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28249084/effect-of-short-procedural-duration-with-bivalirudin-on-increased-risk-of-acute-stent-thrombosis-in-patients-with-stemi-a-secondary-analysis-of-the-horizons-ami-randomized-clinical-trial
#5
Hector Tamez, Duane S Pinto, Ajay J Kirtane, Claire Litherland, Robert W Yeh, George D Dangas, Roxana Mehran, Efthymios N Deliargyris, Guillermo Ortiz, C Michael Gibson, Gregg W Stone
Importance: Bivalirudin has been associated with reduced bleeding and mortality during primary percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI). However, increased rates of acute stent thrombosis (AST) have been noted when bivalirudin is discontinued at the end of the procedure, which is perhaps related to this medication's short half-life. Objectives: To evaluate the clinical effect of procedure duration on AST when either bivalirudin or heparin plus glycoprotein IIb/IIIa receptor inhibitor (GPI) is used...
March 1, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28235809/management-and-outcome-of-patients-with-acute-coronary-syndrome-caused-by-plaque-rupture-versus-plaque-erosion-an%C3%A2-intravascular-optical-coherence-tomography-study
#6
Sining Hu, Yinchun Zhu, Yingying Zhang, Jiannan Dai, Lulu Li, Harold Dauerman, Tsunenari Soeda, Zhao Wang, Hang Lee, Chao Wang, Chunyang Zhe, Yan Wang, Gonghui Zheng, Shaosong Zhang, Haibo Jia, Bo Yu, Ik-Kyung Jang
BACKGROUND: Plaque rupture and erosion are the 2 most common mechanisms for acute coronary syndromes. However, the outcome of these 2 distinct pathologies in patients with acute coronary syndromes has never been studied. METHODS AND RESULTS: We retrospectively studied 141 patients with acute coronary syndromes who underwent optical coherence tomography (OCT) imaging of the culprit lesion prior to stenting from the Massachusetts General Hospital OCT Registry. Management (stent versus no stent), poststent OCT findings, and outcomes were compared...
February 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28216347/systemic-application-of-carbon-monoxide-releasing-molecule-3-protects-skeletal-muscle-from-ischemia-reperfusion-injury
#7
Aurelia Bihari, Gediminas Cepinskas, Thomas L Forbes, Richard F Potter, Abdel-Rahman Lawendy
OBJECTIVE: Ischemia-reperfusion (IR) is a limb- and life-threatening complication of acute limb ischemia and musculoskeletal trauma. Carbon monoxide-releasing molecules (CORMs) have recently been shown to protect microvascular perfusion and to reduce inflammation and injury in various ischemic animal models. The purpose of this study was to examine the effects of water-soluble CORM-3 on the extent of IR-induced muscle injury. METHODS: Wistar rats were randomized into three groups: sham (no ischemia), IR + CORM-3 (10 mg/kg intraperitoneally), and IR + inactive CORM-3 (iCORM-3; 10 mg/kg intraperitoneally)...
February 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28207567/relationship-between-r-wave-peak-time-and-no-reflow-in-st-elevation-myocardial-infarction-treated-with-a-primary-percutaneous-coronary-intervention
#8
Metin Çağdaş, Süleyman Karakoyun, İbrahim Rencüzoğullari, Yavuz Karabağ, Mahmut Yesin, Mahmut Uluganyan, Mustafa O Gürsoy, İnanç Artaç, Doğan İliş, Süleyman Ç Efe, Onur Taşar
Coronary no-reflow (NR) is observed in nearly half of ST segment elevation myocardial infarction (STEMI) patients who undergo a primary percutaneous coronary intervention (pPCI) despite epicardial coronary vessel patency. Several methods used to define NR include thrombolysis in myocardial infarction grade, corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, ST-segment resolution, contrast echocardiography, and MRI. The aim of our study was to evaluate the relationship between NR and R-wave peak time (RWPT) measured from infarct-related artery leads METHOD: We enrolled 282 consecutive STEMI patients treated with pPCI in Kafkas University Hospital from January 2014 to January 2015...
February 15, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28192257/anti-thrombotic-and-pro-fibrinolytic-effects-of-levosimendan-in-human-endothelial-cells-in-vitro
#9
Konstantin A Krychtiuk, Christoph Kaun, Philipp J Hohensinner, Stefan Stojkovic, Jacqueline Seigner, Stefan P Kastl, Andreas Zuckermann, Wolfgang Eppel, Sabine Rauscher, Rainer de Martin, Gerald Maurer, Kurt Huber, Johann Wojta, Walter S Speidl
AIMS: Levosimendan is an inodilator for the treatment of acute decompensated heart failure (HF). Data from clinical studies suggest that levosimendan is particularly effective in HF due to myocardial infarction. After acute revascularization, no reflow-phenomenon is a common complication that may lead to pump failure and cardiogenic shock. Our aim was to examine whether levosimendan interferes with the pro-thrombotic phenotype of activated endothelial cells in vitro. METHODS: Human heart microvascular endothelial cells (HHMEC) and human umbilical vein endothelial cells (HUVEC) were treated with interleukin-1β (IL-1β) (200U/mL) or thrombin (5U/mL) and co-treated with or without levosimendan (0...
March 2017: Vascular Pharmacology
https://www.readbyqxmd.com/read/28183461/management-of-no-reflow-phenomenon-in-the-catheterization-laboratory
#10
REVIEW
Shereif H Rezkalla, Rachel V Stankowski, Jennifer Hanna, Robert A Kloner
At the conclusion of a primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, and after the cardiologist makes certain that there is no residual stenosis following stenting, assessment of coronary flow becomes the top priority. The presence of no-reflow is a serious prognostic sign. No-reflow can result in poor healing of the infarct and adverse left ventricular remodeling, increasing the risk for major adverse cardiac events, including congestive heart failure and death...
February 13, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28180196/serial-transthoracic-coronary-doppler-shows-complete-reversibility-of-microvascular-obstruction-pattern-at-one-month-after-reperfused-acute-myocardial-infarction
#11
Camelia Diana Ober, Mihai Claudiu Ober, Adrian Corneliu Iancu
"No reflow" phenomenon is a common complication with significant prognostic repercussions after reperfused acute myocardial infarction. Previous studies have shown the feasibility and prognostic significance of coronary microcirculation assessment by transthoracic Doppler of left anterior descending artery (LAD). The aim of the study was to evaluate the time course of the coronary microcirculation status after acute anterior myocardial infarction reperfused by primary angioplasty with stent on LAD. MATERIAL AND METHODS: Twenty-three patients underwent transthoracic echocardiography at 3 days (M0) and one month (M1) after reperfusion, with LAD flow analysis (peak systolic and diastolic velocities, diastolic deceleration time and systolic flow reversal)...
January 31, 2017: Medical Ultrasonography
https://www.readbyqxmd.com/read/28177528/correlation-of-platelet-to-lymphocyte-ratio-plr-and-neutrophil-to-lymphocyte-ratio-nlr-with-timi-frame-count-in-stemi
#12
Hossein Vakili, Mahin Shirazi, Mahsa Charkhkar, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian
BACKGROUND: Impaired coronary artery reflow after primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction has been associated with post-intervention adverse effects. Thus finding an easily achievable index would be of great value to predict no-reflow phenomenon. In this regard, Platelet-to -Lymphocyte Ratio (PLR) and Neutrophil-to-Lymphocyte Ratio (NLR) have been introduced. In the present study, we aimed to investigate correlation of PLR and NLR with Thrombolysis In Myocardial Infarction (TIMI) frame count...
February 8, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28135002/ischemia-reperfusion
#13
Theodore Kalogeris, Christopher P Baines, Maike Krenz, Ronald J Korthuis
Ischemic disorders, such as myocardial infarction, stroke, and peripheral vascular disease, are the most common causes of debilitating disease and death in westernized cultures. The extent of tissue injury relates directly to the extent of blood flow reduction and to the length of the ischemic period, which influence the levels to which cellular ATP and intracellular pH are reduced. By impairing ATPase-dependent ion transport, ischemia causes intracellular and mitochondrial calcium levels to increase (calcium overload)...
December 6, 2016: Comprehensive Physiology
https://www.readbyqxmd.com/read/28123475/clinical-effect-of-preoperative-high-dose-atorvastatin-against-no-reflow-after-pci
#14
Wenbo Liu, Zhipeng Zou, Haipeng Jiang, Qiang Li, Fangming Guo, Zhen Wang, Hongguang Zhu
The aim of the present study was to evaluate the use of preoperative high-dose atorvastatin to prevent the no-reflow phenomenon after percutaneous coronary intervention (PCI). A total of 138 patients with ST-segment elevation myocardial infarction, admitted from March 2014 to January 2015, were enrolled and randomly divided into 3 groups of 46 individuals each. The groups included a control group in which patients were not treated with atorvastatin before PCI; a conventional-dose atorvastatin treatment group in which patients received a single dose of 20 mg at bedtime one day prior to PCI; and a high-dose atorvastatin treatment group in which patients were treated with 40 mg divided in two doses the day before PCI...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28108128/delayed-therapeutic-hypothermia-protects-against-the-myocardial-no-reflow-phenomenon-independently-of-myocardial-infarct-size-in-a-rat-ischemia-reperfusion-model
#15
Wangde Dai, Sharon Hale, Robert A Kloner
BACKGROUND: Adjunctive therapies, given in addition to reperfusion to reduce myocardial infarct size, have been disappointing based on clinical trials. New therapeutic targets independent of infarct size modification are needed. The no-reflow phenomenon occurs commonly after the infarct-related coronary artery is opened and predicts poor clinical outcome. We investigated the effects of a single application of delayed (post-reperfusion) therapeutic hypothermia (TH) in a rat model of coronary artery occlusion/reperfusion...
January 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28104481/identification-of-the-potentially-arrhythmogenic-substrate-in-the-acute-phase-of-st-segment-elevation-myocardial-infarction
#16
Diego Penela, Juan Acosta, David Andreu, Jose T Ortiz-Perez, Xavier Bosch, Rosario J Perea, Teresa M de Caralt, Juan Fernández-Armenta, David Soto-Iglesias, Susana Prat-Gonzalez, Roger Borràs, Lluis Mont, Vanessa Hervas, Manuel Morales-Ruiz, Wladimiro Jiménez, Aurea Mira, Jim Donnelly, Okan Ekinci, Luis Lasalvia, Antonio Berruezo
BACKGROUND: Predicting sudden cardiac death risk in the first months after ST-segment elevation myocardial infarction (STEMI) remains challenging. OBJECTIVE: The purpose of this study was to investigate the ability of late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) to identify the potentially arrhythmogenic substrate and its temporal evolution after STEMI. METHODS: One hundred consecutive patients with a first STEMI were included...
January 17, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28100342/-the-effect-on-myocardial-perfusion-and-clinical-outcome-of-intracoronary-nicorandil-injection-prior-to-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction
#17
Z Q Wang, M X Chen, D L Liu, W X Zheng, X Z Cao, H Chen, M F Huang, Z R Luo
Objective: To investigate the effect of intracoronary administration of nicorandil prior to primary percutaneous coronary intervention (PPCI) on myocardial perfusion and short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Methods: A total of 158 patients with STEMI undergoing PPCI from January 2014 to December 2015 in Fuzhou General Hospital were enrolled consecutively in this prospective controlled randomized trial. Patients were assigned into three groups with random number table: the nicorandil group (patients received intracoronary administration of 6 mg nicorandil after guide wire or balloon successfully crossed the target lesion, n=53), the nitroglycerin group (patients received intracoronary administration of 300 μg nitroglycerin after after guide wire or balloon successfully crossed the target lesion, n=52) and the control group(patients received routine treatment, n=53)...
January 25, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28088914/diverse-functions-and-mechanisms-of-pericytes-in-ischemic-stroke
#18
Shuai Yang, Huijuan Jin, Yiyi Zhu, Yan Wan, Lingqiang Zhu, Bo Hu
Pericytes are mural cells embedded in the basement membrane of microvessels. Because of such a unique position in the blood-brain barrier (BBB) and neurovascular unit (NVU), they receive, orchestrate and process signals from their neighboring cells to generate diverse neurovascular functions, including regulation of capillary hemodynamics, BBB permeability, clearance of toxic metabolites, angiogenesis, neuroinflammation and stem cell activity. During the different stages of ischemic stroke, pericytes play different roles: 1) On the hyperacute phase of stroke, pericytes constriction and death may be a cause of the no-reflow phenomenon in brain capillaries; 2) During the acute phase, pericytes detach from microvessels and participate in inflammatory-immunological response, resulting in the BBB damage and brain edema...
January 12, 2017: Current Neuropharmacology
https://www.readbyqxmd.com/read/28087914/-atorvastatin-improves-reflow-after-percutaneous-coronary-intervention-in-patients-with-acute-st-segment-elevation-myocardial-infarction-by-decreasing-serum-uric-acid-level
#19
Ling Yan, Lu Ye, Kun Wang, Jie Zhou, Chunjia Zhu
Objective: To investigate the effect of atorvastatin on reflow in patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) and its relation to serum uric acid levels. Methods: One hundred and fourteen STEMI patients undergoing primary PCI were enrolled and randomly divided into two groups:55 cases received oral atorvastatin 20 mg before PCI (routine dose group) and 59 cases received oral atorvastatin 80 mg before PCI (high dose group). According to the initial serum uric acid level, patients in two groups were further divided into normal uric acid subgroup and hyperuricemia subgroup...
May 25, 2016: Zhejiang da Xue Xue Bao. Yi Xue Ban, Journal of Zhejiang University. Medical Sciences
https://www.readbyqxmd.com/read/28057364/deferred-versus-conventional-stent-implantation-in-patients-with-acute-st-segment-elevation-myocardial-infarction-an-updated-meta-analysis-of-10-studies
#20
Joo Myung Lee, Tae-Min Rhee, Haseong Chang, Chul Ahn, Taek Kyu Park, Jeong Hoon Yang, Young Bin Song, Seung-Hyuk Choi, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND: We sought to evaluate safety and efficacy of the deferred stenting versus immediate stent implantation of infarct-related arteries in patients with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: A meta-analysis using random-effects models were conducted. The primary outcome, major adverse cardiac events (MACE), was a composite of all-cause mortality, myocardial infarction (MI), any unplanned target vessel revascularization (TVR), and hospitalization due to cardiac cause...
March 1, 2017: International Journal of Cardiology
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