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https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#1
REVIEW
Cheuk-Kit Wong
Current guidelines on STEMI reperfusion management do not incorporate further electrocardiographic details over the presence of significant ST elevation. Fibrinolysis is considered an alternative therapy to primary PCI if there is a long PCI-related delay, but the 2 therapies should not be combined. Meanwhile, reperfusion for ischemic stroke has evolved on mechanistic understanding - reperfusion benefit being greatest in the patient with small "core" infarct and large ischemic "penumbra". Fibrinolysis is not regarded as an alternative to mechanical thrombectomy, and the 2 therapies can be combined...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27821064/the-prognostic-utility-of-grace-risk-score-in-predictive-cardiovascular-event-rate-in-stemi-patients-with-successful-fibrinolysis-and-delay-intervention-in-non-pci-capable-hospital-a-retrospective-cohort-study
#2
Yotsawee Chotechuang, Arintaya Phrommintikul, Roungtiva Muenpa, Jayanton Patumanond, Tuanchai Chaichuen, Srun Kuanprasert, Noparat Thanachikun, Thanawat Benjanuwatra, Apichard Sukonthasarn
BACKGROUND: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital...
November 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27793101/pulmonary-artery-compression-by-a-localized-epicardial-hematoma-in-a-patient-with-idiopathic-thrombocytopenic-purpura-after-percutaneous-coronary-intervention-a-case-report
#3
Satoshi Kawaguchi, Toshiharu Takeuchi, Naoyuki Hasebe
BACKGROUND: The most common complication of coronary artery perforation, a rare complication of percutaneous coronary intervention (PCI), is hemopericardium with cardiac tamponade. However, localized extra-coronary bleeding can lead to epicardial hematoma, which is a rare phenomenon. We report the case of an unusual delayed presentation of post-PCI hematoma with unrecognized guidewire perforation. CASE PRESENTATION: A 70-year-old man with idiopathic thrombocytopenic purpura (ITP) and a history of coronary artery bypass grafting (CABG) underwent PCI...
October 28, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27760229/demographics-management-strategies-and-problems-in-st-elevation-myocardial-infarction-from-the-standpoint-of-emergency-medicine-specialists-a-survey-based-study-from-seven-geographical-regions-of-turkey
#4
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
https://www.readbyqxmd.com/read/27734075/efficacy-of-prasugrel-administration-immediately-after-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction
#5
Ulrike Flierl, Florian Zauner, Jan-Thorben Sieweke, Christine Berliner, L Christian Napp, Jochen Tillmanns, Johann Bauersachs, Andreas Schäfer
Prasugrel, a potent thienopyridine, achieves stronger inhibition of platelet activation than clopidogrel. However, onset of inhibition is significantly delayed in patients with acute ST-elevation myocardial infarction (STEMI), as haemodynamic instability and morphine application seem to exhibit significant influence. Since rapid onset of effect was demonstrated in non-STEMI patients when prasugrel was administered only after percutaneous coronary intervention (PCI) without increasing cardiovascular event rates we assessed the efficacy of prasugrel loading immediately after PCI for STEMI instead of pre-loading before revascularisation...
October 13, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27725854/evaluation-of-myocardial-viability-in-old-myocardial-infarcted-patients-with-chf-delayed-enhancement-mri-vs-low-dose-dobutamine-stress-speckle-tracking-echocardiography
#6
Chaofan Wang, Shuguang Han, Tongda Xu, Fengli Wang, Xiaoping Wang, Jing Chen, Chunfeng Hu, Dongye Li
The aim of this study was to explore the significance of delayed enhancement magnetic resonance imaging (DE-MRI) combined with two-dimensional speckle tracking echocardiography (STE) and low dose dobutamine stress echocardiography (LDDSE) to assess viable myocardium (VM) in the patients with old myocardial infarction (OMI) associated with congestive heart failure (CHF). Thirty five hospitalized OMI patients with regional wall motion abnormalities and left ventricular ejection fraction (LVEF) < 50% were recruited based on routine echocardiography...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27720323/relationship-between-time-to-treatment-and-mortality-among-patients-undergoing-primary-percutaneous-coronary-intervention-according-to-korea-acute-myocardial-infarction-registry
#7
Hyun Kuk Kim, Myung Ho Jeong, Youngkeun Ahn, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Yang Soo Jang, Seung Woon Rha, Jang Ho Bae, Sung Soo Kim, Seung Jung Park
BACKGROUND: Despite large reductions in door-to-balloon times over the period, several studies from regional and national data showed that annual mortality rates were not decreased among patients who underwent primary percutaneous coronary intervention (PCI). However, these studies mostly focused on door-to-balloon time, and there was no consideration of total ischemic time in a trend of mortality. The aim of this study was to assess the annual trend between time to treatment and 1-month mortality among patients undergoing primary PCI...
October 6, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27701930/prasugrel-hydrochloride-for-the-treatment-of-acute-coronary-syndrome-patients
#8
Ashan Gunarathne, Shahana Hussain, Anthony H Gershlick
Dual antiplatelet therapy (DAPT) with aspirin combined with either a thienopyridine (clopidogrel or prasugrel) or acyclopentyl-triazolo-pyrimidine (ticagrelor) plays a vital role in the management of acute coronary syndrome (ACS) especially in those undergoing percutaneous coronary intervention (PCI) but even those being managed medically. Observational studies and some formal studies have shown patients on the standard dual antiplatelet regimen (clopidogrel and aspirin) continue to have further ischemic events and can suffer stent thrombosis...
October 4, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27526240/delayed-acute-subdural-hematoma-associated-with-percutaneous-coronary-intervention
#9
Nobuhiko Arai, Akiyoshi Nakamura, Masanao Tabuse, Hiromichi Miyazaki
BACKGROUND: Delayed acute subdural hematoma (DASH) is a subdural hematoma which is detected later. An initial computed tomography (CT) does not reveal any intracranial hemorrhage at all. Few patients of DASH after mild traumatic brain injury associated with percutaneous coronary intervention (PCI) have been published. PATIENT PRESENTATION: A 63-year-old woman presented with cardiac pulmonary arrest due to acute myocardial infarction and lethal arrhythmia. She had hit her head on the road...
September 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27511855/computational-modeling-of-micrometastatic-breast-cancer-radiation-dose-response
#10
Daniel L Smith, Bisrat G Debeb, Howard D Thames, Wendy A Woodward
PURPOSE: Prophylactic cranial irradiation (PCI) involves giving radiation to the entire brain with the goals of reducing the incidence of brain metastasis and improving overall survival. Experimentally, we have demonstrated that PCI prevents brain metastases in a breast cancer mouse model. We developed a computational model to expand on and aid in the interpretation of our experimental results. METHODS AND MATERIALS: MATLAB was used to develop a computational model of brain metastasis and PCI in mice...
September 1, 2016: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/27498373/renoprotection-by-remote-ischemic-conditioning-during-elective-coronary-revascularization-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#11
Chenghui Zhou, Yunseok Jeon, Patrick Meybohm, Alexander Zarbock, Paul Jeffrey Young, Lihuan Li, Derek J Hausenloy
BACKGROUND: Remote ischemic conditioning (RIC) has been recognized an emerging non-invasive approach for preventing acute kidney injury (AKI) in patients undergoing either elective coronary artery bypass graft (CABG) surgery or percutaneous coronary intervention (PCI). On the other hand, accumulating evidence has indicated the involving role of pre-CABG contrast usage for coronary angiography in post-surgery AKI risk. Along with the shortening time delay of CABG after coronary angiography, and the prevalent hybrid coronary revascularization (HCR), the AKI prevention by RIC has faced challenges following coronary revascuralization...
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27484905/the-effect-of-door-to-balloon-delay-in-primary-percutaneous-coronary-intervention-on-clinical-outcomes-of-stemi-a-systematic-review-and-meta-analysis-protocol
#12
Chee Yoong Foo, Daniel D Reidpath, Nathorn Chaiyakunapruk
BACKGROUND: Acute myocardial infarction (AMI) is a medical emergency in which sudden occlusion of coronary artery(ies) results in ischemia and necrosis of the cardiac tissues. Reperfusion therapies that aim at reopening the occluded artery remain the mainstay of treatment for AMI. Primary percutaneous coronary intervention (PCI), which enables the restoration of blood flow by reopening the occluded artery(ies) via a catheter with an inflatable balloon, is currently the preferred treatment for AMI with ST segment elevation (STEMI)...
2016: Systematic Reviews
https://www.readbyqxmd.com/read/27451348/symptom-to-balloon-time-is-a-strong-predictor-of-adverse-events-following-primary-percutaneous-coronary-intervention-results-from-the-australian-capital-territory-pci-registry
#13
Jaya Chandrasekhar, Paul Marley, Christopher Allada, Darryl McGill, Simon O'Connor, Moyazur Rahman, Ren Tan, Ata Doost Hosseiny, Bruce Shadbolt, Ahmad Farshid
BACKGROUND: Notwithstanding improvements in door-to-balloon time, adverse event rates after primary PCI have remained steady. We analysed the effect of symptom-to-balloon (STB) time, a reflection of total ischaemic time, on major adverse cardiovascular events (MACE) and explored predictors of prolonged STB time. METHODS: The study population included 1002 consecutive patients (22.4% women) with a mean age of 62.3±13.2 years, who underwent primary PCI during 2008-2014...
June 27, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27429583/thrombus-aspirated-from-patients-with-st-elevation-myocardial-infarction-association-between-3-nitrotyrosine-and-inflammatory-markers-insights-from-arteria-study
#14
Alberto Dominguez-Rodriguez, Pedro Abreu-Gonzalez, Luciano Consuegra-Sanchez, Pablo Avanzas, Alejandro Sanchez-Grande, Pablo Conesa-Zamora
Recent studies have demonstrated that inflammatory cells are a component that plays a role in thrombus formation in ST-elevation myocardial infarction (STEMI). 3-nitrotyrosine (3-NO2-Tyr), a specific marker for protein modification by nitric oxide-derived oxidants, is increased in human atherosclerotic lesions. The purpose of this study was to determine the possible association of inflammatory markers of coronary thrombi with nitroxidative stress. Intracoronary thrombus (n=51) and blood from the systemic circulation were obtained by thromboaspiration in 138 consecutive STEMI patients presenting for primary percutaneous coronary intervention (PCI)...
2016: International Journal of Medical Sciences
https://www.readbyqxmd.com/read/27411839/primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-in-nonagenarians
#15
Thibaut Petroni, Azfar Zaman, Jean-Louis Georges, Nadjib Hammoudi, Emmanuel Berman, Amit Segev, Jean-Michel Juliard, Olivier Barthelemy, Johanne Silvain, Rémi Choussat, Claude Le Feuvre, Gérard Helft
OBJECTIVE: To assess outcomes following primary percutaneous coronary intervention (PCI) for ST-segment elevation acute myocardial infarction (STEMI) in nonagenarian patients. METHODS: We conducted a multicentre retrospective study between 2006 and 2013 in five international high-volume centres and included consecutive all-comer nonagenarians treated with primary PCI for STEMI. There were no exclusion criteria. We enrolled 145 patients and collected demographic, clinical and procedural data...
October 15, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27404373/feasibility-of-hybrid-off-pump-artery-bypass-grafting-and-transaortic-transcatheter-aortic-valve-implantation-a-case-series
#16
Imthiaz Manoly, Ragheb Hasan, Andrew Brazier, Vasim Farooq, Thomas Thompson, Devinda Karunaratne, Heather Naylor, Douglas Fraser
INTRODUCTION: Patients with complex coronary artery disease and severe aortic stenosis unsuitable for conventional cardiac surgery pose a significant treatment challenge. This is especially difficult for patients where percutaneous revascularization is technically very challenging and/or would not offer as complete revascularisation compared to surgical revascularisation. In addition, patients who are unsuitable for transfemoral transcatheter aortic valve implantation (TAVI) pose an additional technical challenge, particularly with dual antiplatelet therapy (DAPT) following percutaneous coronary intervention (PCI)...
July 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27385296/re-admissions-for-delayed-complications-after-cytoreductive-surgery-and-hipec
#17
J Spiliotis, E O Argiriou, E Vafias, V Manou, N Vaos, A Datsis, E Efstathiou
BACKGROUND: Peritoneal metastasis (PM) is currently treated with the complex procedure of cytoreductive surgery and hyperthermic intra-peritoneal chemotherapy (CRS + HIPEC). This procedure presents high morbidity and mortality rates, but they have only been examined in the immediate post-operative period. The aim of our study is to present, describe and analyze the post-operative events, secondary to a cytoreductive surgery and HIPEC procedure that occurs after the patients' discharge from the hospital...
April 2016: Acta Chirurgica Belgica
https://www.readbyqxmd.com/read/27372605/alexithymia-affects-the-time-from-symptom-onset-to-calling-the-emergency-system-in-stemi-patients-referred-for-primary-pci
#18
Luigi Meloni, Roberta Montisci, Valentina Pippia, Federica Sancassiani, Mauro G Carta
BACKGROUND: STEMI programs have been found to reduce the time to reperfusion but do not address the time delay caused by patients. In this study we sought to assess whether and to what extent alexithymia, defined as the inability to recognize and describe somatic feelings appropriately, impacts on this delay. METHODS: Ninety-five STEMI patients referred by the Emergency Medical System (EMS) to our hospital for primary percutaneous coronary intervention were studied...
September 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27364755/factors-associated-with-ineligibility-for-pci-differ-between-inpatient-and-outpatient-st-elevation-myocardial-infarction
#19
Brian E Jaski, Christopher E Grigoriadis, Xuming Dai, Richard D Meredith, Bryan C Ortiz, George A Stouffer, Lorie Thomas, Sidney C Smith
OBJECTIVES: Without early revascularization, both inpatient and outpatient STEMIs have poor outcomes. Reasons for denying PCI for STEMI, however, remain uncertain. This single-center retrospective cohort study compares factors and outcomes associated with ineligibility for PCI between inpatients and outpatients following ST-elevation myocardial infarction (STEMI). METHODS: A total of 1,759 STEMI patients between June 2009 and January 2015 were assessed. Individual medical records were reviewed to obtain reasons for PCI ineligibility for STEMI patients who did not receive reperfusion therapy...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27350014/inter-facility-transfer-vs-direct-admission-of-patients-with-st-segment-elevation-acute-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#20
Kenji Nakatsuma, Hiroki Shiomi, Takeshi Morimoto, Yutaka Furukawa, Yoshihisa Nakagawa, Kenji Ando, Kazushige Kadota, Takashi Yamamoto, Satoru Suwa, Minoru Horie, Takeshi Kimura
BACKGROUND: Inter-facility transfer for primary percutaneous coronary intervention (PCI) from referring facilities to PCI centers causes a significant delay in treatment of ST-segment elevation acute myocardial infarction (STEMI) patients undergoing primary PCI. However, little is known about the clinical outcomes of STEMI patients undergoing inter-facility transfer in Japan. METHODS AND RESULTS: In the CREDO-Kyoto acute myocardial infarction (AMI) registry that enrolled 5,429 consecutive AMI patients in 26 centers in Japan, the current study population consisted of 3,820 STEMI patients who underwent primary PCI within 24 h of symptom onset...
July 25, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
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