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Prehospital STEMI

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https://www.readbyqxmd.com/read/27894465/is-denial-a-maladaptive-coping-mechanism-which-prolongs-pre-hospital-delay-in-patients-with-st-segment-elevation-myocardial-infarction
#1
X Y Fang, L Albarqouni, A F von Eisenhart Rothe, S Hoschar, J Ronel, K-H Ladwig
OBJECTIVE: During an acute myocardial infarction, patients often use denial as a coping mechanism which may provide positive mood regulating effects but may also prolong prehospital delay time (PHD). However, empirical evidences are still sparse. METHODS: This cross-sectional study included 533 ST-elevated myocardial infarction (STEMI) patients from the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. Data on sociodemographic, clinical and psycho-behavioral characteristics were collected at bedside...
December 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27887720/prehospital-electrocardiographic-acuteness-score-of-ischemia-is-inversely-associated-with-neurohormonal-activation-in-stemi-patients-with-severe-ischemia
#2
Yama Fakhri, Mikkel Malby Schoos, Maria Sejersten, Mads Ersbøll, Nana Valeur, Lars Køber, Christian Hassager, Galen S Wagner, Jens Kastrup, Peter Clemmensen
BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia...
November 10, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27885888/cangrelor-in-combination-with-ticagrelor-provides-consistent-and-potent-p2y12-inhibition-during-and-after-primary-percutaneous-coronary-intervention-in-real-world-patients-with-st-segment-elevation-myocardial-infarction
#3
Moman A Mohammad, Pontus Andell, Sasha Koul, Stefan James, Fredrik Scherstén, Matthias Götberg, David Erlinge
Patients pretreated with ticagrelor with less than 1 hour from percutaneous coronary intervention (PCI) or receiving ticagrelor in cath lab were prospectively included and received cangrelor. Cangrelor was infused for 2 hours and platelet function was assessed as P2Y12 reactivity units (PRU) with the VerifyNow P2Y12 function assay before start of infusion, 15 min after the start of infusion, and 30 min after the end of infusion. A total of n = 32 patients with an average age of 68 (±13) years with n = 22 (69%) males were included...
November 25, 2016: Platelets
https://www.readbyqxmd.com/read/27858506/causes-of-prehospital-misinterpretations-of-st-elevation-myocardial-infarction
#4
Nichole Bosson, Stephen Sanko, Ronald E Stickney, James Niemann, William J French, James G Jollis, Michael C Kontos, Tyson G Taylor, Peter W Macfarlane, Richard Tadeo, William Koenig, Marc Eckstein
OBJECTIVES: To determine the causes of software misinterpretation of ST elevation myocardial infarction (STEMI) compared to clinically identified STEMI to identify opportunities to improve prehospital STEMI identification. METHODS: We compared ECGs acquired from July 2011 through June 2012 using the LIFEPAK 15 on adult patients transported by the Los Angeles Fire Department. Cases included patients ≥18 years who received a prehospital ECG. Software interpretation of the ECG (STEMI or not) was compared with data in the regional EMS registry to classify the interpretation as true positive (TP), true negative (TN), false positive (FP), or false negative (FN)...
November 18, 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#5
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27814743/prehospital-fibrinolysis-versus-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#6
Vincent Roule, Pierre Ardouin, Katrien Blanchart, Adrien Lemaitre, Julien Wain-Hobson, Damien Legallois, Joachim Alexandre, Rémi Sabatier, Paul Milliez, Farzin Beygui
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI), but its benefit over prehospital fibrinolysis (FL) is not clear. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials in which outcomes of patients with STEMI managed with FL early in the prehospital setting versus PPCI were compared. RESULTS: Compared with PPCI, FL was consistently associated with similar rates of short-term (30-90 days) death (relative risk [RR] 0...
November 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27580835/characteristics-treatment-and-in-hospital-outcomes-of-patients-with-stemi-in-a-metropolitan-area-of-a-developing-country-an-initial-report-of-the-extended-jakarta-acute-coronary-syndrome-registry
#7
Surya Dharma, Hananto Andriantoro, Ismi Purnawan, Iwan Dakota, Faris Basalamah, Beny Hartono, Ronaly Rasmin, Herawati Isnanijah, Muhammad Yamin, Ika Prasetya Wijaya, Vireza Pratama, Tjatur Bagus Gunawan, Yahya Berkahanto Juwana, Frits R W Suling, A M Onny Witjaksono, Hengkie F Lasanudin, Kurniawan Iskandarsyah, Hardja Priatna, Pradana Tedjasukmana, Uki Wahyumandradi, Adrianus Kosasih, Imelda A Budhiarti, Wisnoe Pribadi, Jeffrey Wirianta, Utojo Lubiantoro, Rini Pramesti, Diah Retno Widowati, Sissy Kartini Aminda, M Abas Basalamah, Sunil V Rao
OBJECTIVE: We studied the characteristics of patients with ST segment elevation myocardial infarction (STEMI) after expansion of a STEMI registry as part of the STEMI network programme in a metropolitan city and the surrounding area covering ∼26 million inhabitants. DESIGN: Retrospective cohort study. SETTING: Emergency department of 56 health centres. PARTICIPANTS: 3015 patients with acute coronary syndrome, of which 1024 patients had STEMI...
2016: BMJ Open
https://www.readbyqxmd.com/read/27512532/utilizations-and-perceptions-of-emergency-medical-services-by-patients-with-st-segments-elevation-acute-myocardial-infarction-in-abu-dhabi-a-multicenter-study
#8
Edward Lance Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
BACKGROUND: Data on the use of emergency medical services (EMS) by patients with cardiac conditions in the Gulf region are scarce, and prior studies have suggested underutilization. Patient perception and knowledge of EMS care is critical to proper utilization of such services. OBJECTIVES: To estimate utilization, knowledge, and perceptions of EMS among patients with ST-elevation myocardial infarction (STEMI) in the Emirate of Abu Dhabi. METHODS: We conducted a multicenter prospective study of consecutive patients admitted with STEMI in four government-operated hospitals in Abu Dhabi...
April 2016: Heart Views: the Official Journal of the Gulf Heart Association
https://www.readbyqxmd.com/read/27503306/-preclinical-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-in-a-rural-region
#9
T Viergutz, J Grüttner, T Walter, C Weiss, B Haaff, G Pollach, C Madler, T Luiz
BACKGROUND: In the current guidelines for the treatment of patients with ST-segment elevation myocardial infarction (STEMI), the European Society of Cardiology (ESC) recommends preclinical fibrinolysis as a reperfusion therapy if, due to long transportation times, no cardiac catheterisation is available within 90-120 min. However, there is little remaining in-depth expertise in this method because fibrinolysis is presently only rarely indicated. METHODS: In a rural area in southwestern Germany, where an emergency primary percutaneous coronary intervention was not routinely available within 90-120 min, 156 STEMI patients underwent fibrinolysis with the plasminogen activator reteplase, performed by trained emergency physicians...
September 2016: Der Anaesthesist
https://www.readbyqxmd.com/read/27425140/sex-differences-in-stemi-activation-for-patients-presenting-to-the-ed-1939
#10
Katherine Choi, Frances S Shofer, Angela M Mills
OBJECTIVE: The objective was to determine whether sex was independently associated with door to ST-elevation myocardial infarction (STEMI) activation time. We hypothesized that women are more likely to experience longer delays to STEMI activation than men. METHODS: We conducted a retrospective cohort study of adults ≥18 years who underwent STEMI activation at 3 urban emergency departments between 2010 and 2014. The Wilcoxon rank sum test and logistic regression were used to compare men and women regarding time to activation and proportion with times <15 minutes, respectively...
October 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27317481/stemi-notification-by-ems-predicts-shorter-door-to-balloon-time-and-smaller-infarct-size
#11
Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Eric Steinberg, Kathleen Kearney, John T Fox, Yumiko Kanei
BACKGROUND: Emergency medical services (EMS) transportation is associated with shorter door-to-balloon (DTB) time in patients with ST-segment elevation myocardial infarction (STEMI). In addition to EMS transportation, prehospital notification of STEMI by EMS to receiving hospital might be able to further shorten DTB time. We evaluated the impact of STEMI notification on DTB time as well as infarct size. METHODS: We performed a retrospective analysis of consecutive patients with anterior wall STEMI who underwent emergent coronary angiography...
August 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27250917/time-to-reperfusion-in-st-segment-elevation-myocardial-infarction-patients-with-vs-without-pre-hospital-mobile-telemedicine-12-lead-electrocardiogram-transmission
#12
Shoji Kawakami, Yoshio Tahara, Teruo Noguchi, Nobuhito Yagi, Yu Kataoka, Yasuhide Asaumi, Michio Nakanishi, Yoichi Goto, Hiroyuki Yokoyama, Hiroshi Nonogi, Hisao Ogawa, Satoshi Yasuda
BACKGROUND: Prehospital ECG improves survival following ST-segment elevation myocardial infarction (STEMI). Although a new International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations placed new emphasis on the role of prehospital ECG, this technology is not widely used in Japan. We developed a mobile telemedicine system (MTS) that continuously transmits real-time 12-lead ECG from ambulances in a prehospital setting...
June 24, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/27181187/electrocardiographic-diagnosis-of-st-segment-elevation-myocardial-infarction-an-evaluation-of-three-automated-interpretation-algorithms
#13
J Lee Garvey, Jessica Zegre-Hemsey, Richard Gregg, Jonathan R Studnek
OBJECTIVE: To assess the validity of three different computerized electrocardiogram (ECG) interpretation algorithms in correctly identifying STEMI patients in the prehospital environment who require emergent cardiac intervention. METHODS: This retrospective study validated three diagnostic algorithms (AG) against the presence of a culprit coronary artery upon cardiac catheterization. Two patient groups were enrolled in this study: those with verified prehospital ST-elevation myocardial infarction (STEMI) activation (cases) and those with a prehospital impression of chest pain due to ACS (controls)...
September 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27143908/mortality-in-primary-angioplasty-patients-starting-antiplatelet-therapy-with-prehospital-prasugrel-or-clopidogrel-a-1-year-follow-up-from-the-european-multiprac-registry
#14
Patrick Goldstein, Niccolò Grieco, Hüseyin Ince, Nicolas Danchin, Yvonne Ramos, Jochen Goedicke, Peter Clemmensen
AIM: MULTIPRAC was designed to provide insights into the use and outcomes associated with prehospital initiation of antiplatelet therapy with either prasugrel or clopidogrel in the context of primary percutaneous coronary intervention. After a previous report on efficacy and safety outcomes during hospitalization, we report here the 1-year follow-up data, including cardiovascular (CV) mortality. METHODS AND RESULTS: MULTIPRAC is a multinational, prospective registry of patients with ST-elevation myocardial infarction (STEMI) from 25 hospitals in nine countries, all of which had an established practice of prehospital start of dual antiplatelet therapy in place...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27127635/prehospital-and-in-hospital-use-of-healthcare-resources-in-patients-surviving-acute-coronary-syndromes-an-analysis-of-the-epicor-registry
#15
Lieven Annemans, Nicolas Danchin, Frans Van de Werf, Stuart Pocock, Muriel Licour, Jesús Medina, Héctor Bueno
OBJECTIVE: The aim of this report is to provide insight into real-world healthcare resource use (HCRU) during the critical management of patients surviving acute coronary syndromes (ACS), using data from EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) (NCT01171404). METHODS: EPICOR was a prospective, multinational, observational study that enrolled 10 568 ACS survivors from 555 hospitals in 20 countries in Europe and Latin America, between September 2010 and March 2011...
2016: Open Heart
https://www.readbyqxmd.com/read/27028120/comparison-of-30-day-mortality-and-myocardial-scar-indices-for-patients-treated-with-prehospital-reduced-dose-fibrinolytic-followed-by-percutaneous-coronary-intervention-versus-percutaneous-coronary-intervention-alone-for-treatment-of-st-elevation-myocardial
#16
Amirreza Solhpour, Kay-Won Chang, Salman A Arain, Prakash Balan, Yelin Zhao, Catalin Loghin, James J McCarthy, H Vernon Anderson, Richard W Smalling
OBJECTIVES: We investigated whether prehospital, reduced dose fibrinolysis coupled with urgent percutaneous coronary intervention (FAST-PCI) reduces mortality and cardiac magnetic resonance (CMR) measures of infarct size, compared with primary percutaneous coronary intervention (PPCI), in patients with ST-elevation myocardial infarction (STEMI). BACKGROUND: Current standard therapy for STEMI is PPCI. However, FAST-PCI may shorten ischemic time (IT) and improve outcomes...
March 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26971239/evolution-and-impact-of-a-regional-reperfusion-system-for-st-elevation-myocardial-infarction
#17
Christopher B Fordyce, John A Cairns, Joel Singer, Terry Lee, Julie E Park, Richard A Vandegriend, Michele Perry, Wendy Largy, Min Gao, Krishnan Ramanathan, Graham C Wong
BACKGROUND: We describe the evolution of a regional system designed to provide primary percutaneous coronary intervention (pPCI) as the preferred method of revascularization for ST-elevation myocardial infarction (STEMI) and its impact on first medical contact (FMC)-to-device times and in-hospital outcomes. METHODS: Patients with STEMI presenting to the Vancouver Coastal Health Authority between June 2007 and January 2015 (N = 2503) were categorized according to 3 sequential phases: phase 1 = standardization of reperfusion algorithms; phase 2 = use of prehospital electrocardiograms; phase 3 = expedited interfacility transfer for pPCI...
December 19, 2015: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/26881815/characteristics-of-st-elevation-myocardial-infarction-patients-who-do-not-undergo-percutaneous-coronary-intervention-after-prehospital-cardiac-catheterization-laboratory-activation
#18
Paul I Musey, Jonathan R Studnek, Lee Garvey
OBJECTIVES: To assess the clinical and electrocardiographic characteristics of patients diagnosed with ST elevation myocardial infarction (STEMI) that are associated with an increased likelihood of not undergoing percutaneous coronary intervention (PCI) after prehospital Cardiac Catheterization Laboratory activation in a regional STEMI system. METHODS: We performed a retrospective analysis of prehospital Cardiac Catheterization Laboratory activations in Mecklenburg County, North Carolina, between May 2008 and March 2011...
March 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/26809927/outcomes-of-non-stemi-patients-transported-by-emergency-medical-services-vs-private-vehicle
#19
COMPARATIVE STUDY
Mary Colleen Bhalla, Jennifer Frey, Sarah Dials, Kristin Baughman
BACKGROUND: Non-ST-segment elevation myocardial infarctions (NSTEMIs) are more common but less studied than ST-segment elevation myocardial infarctions (STEMIs) treated by emergency medical services (EMS). OBJECTIVE: The purpose of this study was to evaluate the differences in baseline characteristics and outcomes of NSTEMI patients when arriving by EMS vs self-transport. METHODS: We performed a retrospective medical record review of 96 EMS patients and 96 self-transport patients with the diagnosis of NSTEMI based on billing code...
March 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26693262/prehospital-system-delay-in-patients-with-st-segment-elevation-myocardial-infarction-in-singapore
#20
Andrew Fu Wah Ho, Pin Pin Pek, Stephanie Fook-Chong, Ting Hway Wong, Yih Yng Ng, Aaron Sung Lung Wong, Marcus Eng Hock Ong
BACKGROUND: Timely reperfusion in ST-segment elevation myocardial infarction (STEMI) improves outcomes. System delay is that between first medical contact and reperfusion therapy, comprising prehospital and hospital components. This study aimed to characterize prehospital system delay in Singapore. METHODS: A retrospective chart review was performed for 462 consecutive STEMI patients presenting to a tertiary hospital from December 2006 to April 2008. Patients with cardiac arrest secondarily presented were excluded...
2015: World Journal of Emergency Medicine
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