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Prehospital STEMI

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https://www.readbyqxmd.com/read/29421001/thrombus-aspiration-and-prehospital-ticagrelor-administration-in-st-elevation-myocardial-infarction-findings-from-the-atlantic-trial
#1
Sinem Kilic, Enrico Fabris, Arnoud W J Van't Hof, Christian W Hamm, Frédéric Lapostolle, Jens Flensted Lassen, Anne Tsatsaris, Abdourahmane Diallo, Eric Vicaut, Gilles Montalescot
BACKGROUND: The potential interactions between prehospital (pre-H) ticagrelor administration and thrombus aspiration (TA) in patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) have never been studied. Therefore, we evaluated the potential benefit of TA and pre-H ticagrelor treatment in patients enrolled in the ATLANTIC trial (NCT01347580). METHODS: This analysis included 1,630 patients who underwent primary PCI...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29406393/trends-and-predictors-of-prehospital-delay-in-patients-undergoing-primary-coronary-intervention
#2
Gilad Margolis, Sevan Letourneau-Shesaf, Shafik Khoury, David Pereg, Natalia Kofman, Gad Keren, Yacov Shacham
OBJECTIVE: Delay in seeking medical care following symptom onset in patients with acute ST-elevation myocardial infarction (STEMI) is related to increased morbidity and mortality. Actual trends of prehospital delays in patients hospitalized with STEMI have not been well characterized. We evaluated trends in the length of time that had elapsed from symptom onset to hospital presentation among STEMI patients admitted to our hospital. PATIENTS AND METHODS: We retrospectively studied 2203 consecutive patients hospitalized for acute STEMI who underwent primary percutaneous coronary intervention (PCI) between January 2008 and December 2016...
February 5, 2018: Coronary Artery Disease
https://www.readbyqxmd.com/read/29383439/impact-of-generalized-anxiety-disorder-gad-on-prehospital-delay-of-acute-myocardial-infarction-patients-findings-from-the-multicenter-medea-study
#3
X Y Fang, D Spieler, L Albarqouni, J Ronel, K-H Ladwig
BACKGROUND: Anxiety has been identified as a cardiac risk factor. However, less is known about the impact of generalized anxiety disorder (GAD) on prehospital delay during an acute myocardial infarction (AMI). This study assessed the impact of GAD on prehospital delay and delay related cognition and behavior. METHODS: Data were from the cross-sectional Munich examination of delay in patients experiencing acute myocardial infarction (MEDEA) study with a total of 619 ST-elevated myocardial infarction (STEMI) patients...
January 30, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29336652/detection-of-stemi-using-prehospital-serial-12-lead-electrocardiograms
#4
Alain Tanguay, Johann Lebon, Lorraine Lau, Denise Hébert, François Bégin
OBJECTIVE: Repeated or serial 12-lead electrocardiograms (ECGs) in the prehospital setting may improve management of patients with subtle ST-segment elevation (STE) or with a ST-segment elevation myocardial infarction (STEMI) that evolves over time. However, there is a minimal amount of scientific evidence available to support the clinical utility of this method. Our objective was to evaluate the use of serial 12-lead ECGs to detect STEMI in patients during transport in a Canadian emergency medical services (EMS) jurisdiction...
January 16, 2018: Prehospital Emergency Care
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#5
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
February 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29276911/-comparison-of-direct-stenting-versus-stending-after-pre-dilation-in-st-elevation-myocardial-infarction
#6
V A Kuznetsov, I S Bessonov, I P Zyrianov, T I Zyrianova, S S Sapozhnikov, Y V Potolinskaya
AIM: To study was to assess in-hospital outcomes of direct coronary stenting (DS) compared with stenting after predilation (PD) in patients with ST-elevation myocardial infarction (STEMI). MATERIAL AND METHODS: Data were collected from all patients (n=1103) with STEMI subjected to primary PCI in Tyumen cardiology center from 2006 to 2014. The clinical and angiographic characteristics, in-hospital outcomes, as well as predictors of no-reflow phenomenon were analyzed...
November 2017: Kardiologiia
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#7
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29151401/evaluation-of-a-primary-care-paramedic-stemi-bypass-guideline
#8
Jonathan L Kwong, Garry Ross, Linda Turner, Chris Olynyk, Sheldon Cheskes, Adam Thurston, P Richard Verbeek
OBJECTIVE: Limited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline. METHODS: We reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria...
November 20, 2017: CJEM
https://www.readbyqxmd.com/read/29122276/comparison-of-delay-times-between-symptom-onset-of-an-acute-st-elevation-myocardial-infarction-and-hospital-arrival-in-men-and-women-65-years-versus-%C3%A2-65-years-of-age-findings-from-the-multicenter-munich-examination-of-delay-in-patients-experiencing-acute-myocardial
#9
MULTICENTER STUDY
Karl-Heinz Ladwig, Xiaoyan Fang, Kathrin Wolf, Sophia Hoschar, Loai Albarqouni, Joram Ronel, Thomas Meinertz, Derek Spieler, Karl-Ludwig Laugwitz, Heribert Schunkert
Early administration of reperfusion therapy in acute ST-elevation myocardial infarctions (STEMI) is crucial to reduce mortality. Although female sex and old age are key factors contributing to an inadequate long prehospital delay time, little is known whether women ≥65 years are a particular risk population. Hence, we studied the interaction of sex and age (<65 years or ≥65 years) and the contribution of chest pain to delay time during STEMI. Bedside interview data were collected in 619 STEMI patients from the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study...
December 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121757/association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-suspected-stemi
#10
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29021273/improvement-in-care-and-outcomes-for-emergency-medical-service-transported-patients-with-st-elevation-myocardial-infarction-stemi-with-and-without-prehospital-cardiac-arrest-a-mission-lifeline-stemi-accelerator-study
#11
Kristian Kragholm, Di Lu, Karen Chiswell, Hussein R Al-Khalidi, Mayme L Roettig, Matthew Roe, James Jollis, Christopher B Granger
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) with out-of-hospital cardiac arrest (OHCA) may benefit from direct transport to a percutaneous cardiac intervention (PCI) hospital but have previously been less likely to bypass local non-PCI hospitals to go to a PCI center. METHODS AND RESULTS: We reported time trends in emergency medical service transport and care of patients with STEMI with and without OHCA included from 171 PCI-capable hospitals in 16 US regions with participation in the Mission: Lifeline STEMI Accelerator program between July 1, 2012, and March 31, 2014...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28971117/data-on-association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-confirmed-stemi
#12
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
Data presented in this article relates to the research article entitled "Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI" (Hansen et al., in press) [1]. Data on the prognostic effect of automatically recoded QRS duration on prehospital ECG and presence of classic left and right bundle branch block in 1777 consecutive patients with confirmed ST segment elevation AMI is presented. Multivariable analysis, suggested that QRS duration >111 ms, left bundle branch block and right bundle branch block were independent predictors of 30 days all-cause mortality...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/28939567/association-between-gender-and-short-term-outcome-in-patients-with-st-elevation-myocardial-infraction-participating-in-the-international-prospective-randomised-administration-of-ticagrelor-in-the-catheterisation-laboratory-or-in-the-ambulance-for-new-st-elevation
#13
Dimitrios Venetsanos, Sofia Sederholm Lawesson, Joakim Alfredsson, Magnus Janzon, Angel Cequier, Mohamed Chettibi, Shaun G Goodman, Arnoud W Van't Hof, Gilles Montalescot, Eva Swahn
OBJECTIVES: To evaluate gender differences in outcomes in patents with ST-segment elevation myocardial infarction (STEMI) planned for primary percutaneous coronary intervention (PPCI). SETTINGS: A prespecified gender analysis of the multicentre, randomised, double-blind Administration of Ticagrelor in the catheterisation Laboratory or in the Ambulance for New ST elevation myocardial Infarction to open the Coronary artery. PARTICIPANTS: Between September 2011 and October 2013, 1862 patients with STEMI and symptom duration <6 hours were included...
September 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862963/delayed-care-and-mortality-among-women-and-men-with-myocardial-infarction
#14
Raffaele Bugiardini, Beatrice Ricci, Edina Cenko, Zorana Vasiljevic, Sasko Kedev, Goran Davidovic, Marija Zdravkovic, Davor Miličić, Mirza Dilic, Olivia Manfrini, Akos Koller, Lina Badimon
BACKGROUND: Women with ST-segment-elevation myocardial infarction (STEMI) have higher mortality rates than men. We investigated whether sex-related differences in timely access to care among STEMI patients may be a factor associated with excess risk of early mortality in women. METHODS AND RESULTS: We identified 6022 STEMI patients who had information on time of symptom onset to time of hospital presentation at 41 hospitals participating in the ISACS-TC (International Survey of Acute Coronary Syndromes in Transitional Countries) registry (NCT01218776) from October 2010 through April 2016...
August 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28827246/usage-of-ambulance-transport-and-influencing-factors-in-acute-coronary-syndrome-a-cross-sectional-study-at-a-tertiary-centre-in-china
#15
Jingjing Ma, Jiali Wang, Wen Zheng, Jiaqi Zheng, Hao Wang, Guangmei Wang, He Zhang, Feng Xu, Yuguo Chen
OBJECTIVES: The aim of this study was to explore the choice of transportation mode to hospital in patients with acute coronary syndrome (ACS) and to determine the factors influencing the use of ambulance. DESIGN, SETTING AND PARTICIPANTS: This cross-sectional study was conducted in a tertiary and teaching hospital in China. The study was carried out between 24 August 2015 and 24 July 2016. A total of 828 patients with ACS presented at the emergency department (ED) were included...
August 21, 2017: BMJ Open
https://www.readbyqxmd.com/read/28679686/long-term-mortality-and-prehospital-tirofiban-treatment-in-patients-with-st-elevation-myocardial-infarction
#16
RANDOMIZED CONTROLLED TRIAL
Enrico Fabris, Sinem Kilic, Dirk A A M Schellings, Jurrien M Ten Berg, Mark W Kennedy, K Gerts van Houwelingen, Evangelos Giannitsis, Evelien Kolkman, Jan Paul Ottervanger, Christian Hamm, Arnoud W J Van't Hof
OBJECTIVE: We undertook a subgroup analysis of the On-TIME 2 (Ongoing Tirofiban In Myocardial infarction Evaluation 2), a placebo-controlled, double-blind, randomised trial, in order to evaluate the association between N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels and long-term (5 years) mortality and to investigate the effect of prehospital tirofiban administration on mortality in relation to NT-proBNP levels. METHODS: A total of 984 patients with ST elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) were randomised to either in ambulance tirofiban or placebo...
October 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28627230/relationship-between-community-hospital-versus-pre-hospital-location-of-randomisation-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-insights-from-the-stream-study
#17
Robert C Welsh, Patrick Goldstein, Peter Sinnaeve, Miodrag C Ostojic, Yinggan Zheng, Thierry Danays, Cynthia M Westerhout, Frans Van de Werf, Paul W Armstrong
AIMS: The STREAM study randomly assigned ST-elevation myocardial infarction (STEMI) patients to receive a pharmacoinvasive versus primary percutaneous coronary intervention reperfusion strategy. We assessed whether there was an association between outcomes based on randomisation at a community hospital versus a prehospital location. METHODS/RESULTS: Community hospital patients (358/1866 (19.2%)) were compared to prehospital patients and their outcomes categorised into pharmacoinvasive according to their treatment assignment...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28598044/a-study-of-prehospital-delay-patterns-in-acute-myocardial-infarction-in-an-urban-tertiary-care-institute-in-mumbai
#18
Ashar Khan, Milind Phadke, Yash Y Lokhandwala, Pratap J Nathani
OBJECTIVE: There is now increasing awareness about the need for early diagnosis in patients presenting with chest pain. Pre-hospital delay remains a major hurdle in the institution of early reperfusion therapy, which is crucial in salvaging 'at-risk' myocardium and reducing adverse cardiovascular events following ST elevation myocardial infarction (STEMI). This study aims to determine the incidence and the determinants of delayed presentation STEMI and the potential impact of such delay on adverse cardiovascular outcomes...
May 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28540982/gender-differences-in-factors-related-to-prehospital-delay-in-patients-with-st-segment-elevation-myocardial-infarction
#19
Hee Sook Kim, Kun Sei Lee, Sang Jun Eun, Si Wan Choi, Dae Hyeok Kim, Tae Ho Park, Kyeong Ho Yun, Dong Heon Yang, Seok Jae Hwang, Ki Soo Park, Rock Bum Kim
PURPOSE: The aim of our study was to investigate gender differences in factors related to prehospital delay and identify whether the knowledge of acute myocardial infarction symptoms affects this delay in Korean patients with ST-elevation myocardial infarction (STEMI). MATERIALS AND METHODS: A total of 350 patients (286 men, 64 women) with confirmed STEMI were interviewed to investigate socio-demographics, history of disease, symptom onset time, and factors that contributed to delayed decision time in seeking treatment and hospital arrival time from symptom onset...
July 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28489635/trends-in-sex-differences-in-clinical-characteristics-treatment-strategies-and-mortality-in-patients-with-st-elevation-myocardial-infarction-in-poland-from-2005-to-2011
#20
Lukasz Zandecki, Marcin Sadowski, Marianna Janion, Marek Gierlotka, Mariusz Gasior, Lech Polonski
INTRODUCTION: During the last decade, there has been an increased awareness of sex differences in the clinical characteristics, management, and mortality in myocardial infarction. Many previous studies have found that women with ST-elevation myocardial infarction (STEMI) have a poorer baseline risk profile, are less intensively treated, and have worse outcomes. OBJECTIVE: To evaluate whether sex disparities in STEMI have changed in recent years. METHODS: This is a retrospective analysis of data on 111 148 STEMI patients enrolled in the Polish Registry of Acute Coronary Syndromes between 2005 and 2011...
August 2017: Coronary Artery Disease
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