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https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#1
Saad Al Bugami, Jamilah Alrahimi, Abdullah Almalki, Farqad Alamger, Ahmed Krimly, Wail Al Kashkari
BACKGROUND: The purpose of this quality improvement project was to evaluate prospectively the causes of delay for patients with acute ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) upon arrival at the emergency department (ED) and implement recommendations to reduce delays and analyze the impact of recommendations to reduce the door-to-balloon (D2B) time in a newly established cardiac center (King Faisal Cardiac Center (KFCC))...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28184261/dual-antiplatelet-therapy-and-non-cardiac-surgery-evolving-issues-and-anesthetic-implications
#2
REVIEW
Jong Wook Song, Sarah Soh, Jae-Kwang Shim
Dual antiplatelet therapy (DAPT) consisting of aspirin plus a P2Y12 inhibitor (clopidogrel, prasugrel, or ticagrelor) is imperative for the treatment of acute coronary syndrome, particularly during the re-endothelialization period after percutaneous coronary intervention (PCI). When patients undergo surgery during this period, the consequences of stent thrombosis are far more serious than those of bleeding complications, except in cases of intracranial surgery. The recommendations for perioperative DAPT have changed with emerging evidence regarding the improved efficacy of non-first-generation drug (everolimus, zotarolimus)-eluting stents (DES)...
February 2017: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/28168845/beyond-restenosis-patients-preference-for-drug-eluting-or-bare-metal-stents
#3
Mohammed Qintar, Adnan K Chhatriwalla, Suzanne V Arnold, Fengming Tang, Donna M Buchanan, Ali Shafiq, Yashashwi Pokharel, Dave deBronkart, Javed M Ashraf, John A Spertus
OBJECTIVES: To assess patients' perspective about factors associated with stent choice. BACKGROUND: Drug eluting stents (DES) markedly reduce the risk of repeat percutaneous coronary intervention (PCI), but necessitate a longer duration of dual anti-platelet therapy (DAPT) as compared with bare metal stents (BMS). Thus, understanding patients' perspective about factors associated with stent choice is paramount. METHODS: Patients undergoing angiography rated, on a 10-point scale, the importance (1 = not important, 10 = most important) of avoiding repeat revascularization and avoiding the following potential DAPT drawbacks: bleeding/bruising, more pills/day, medication costs and delaying elective surgery...
February 7, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28134127/impact-of-presentation-and-transfer-delays-on-complete-st-segment-resolution-before-primary-percutaneous-coronary-intervention-insights-from-the-atlantic-trial
#4
Enrico Fabris, Arnoud Van't Hof, Christian W Hamm, Frédéric Lapostolle, Jens Flensted Lassen, Shaun G Goodman, Jurriën M Ten Berg, Leonardo Bolognese, Angel Cequier, Mohamed Chettibi, Christopher J Hammett, Kurt Huber, Magnus Janzon, Béla Merkely, Robert F Storey, Uwe Zeymer, Warren J Cantor, Hélène Rousseau, Eric Vicaut, Gilles Montalescot
AIMS: To identify predictors of complete ST-segment resolution (STR) pre-primary percutaneous coronary intervention (PCI) in patients enrolled in the ATLANTIC trial. METHODS AND RESULTS: ECGs recorded at the time of inclusion [pre-hospital (pre-H)-ECG] and in the catheterization laboratory before angiography (pre-PCI-ECG) were analysed by an independent core laboratory. Complete STR was defined as ≥70%. Complete STR occurred pre-PCI in 12.8% (204/1598) of patients and predicted lower 30-days composite MACCE (OR=0...
January 31, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28081269/morphine-does-not-affect-myocardial-salvage-in-st-segment-elevation-myocardial-infarction
#5
Hye Bin Gwag, Taek Kyu Park, Young Bin Song, Eun Kyoung Kim, Woo Jin Jang, Jeong Hoon Yang, Joo-Yong Hahn, Seung-Hyuk Choi, Jin-Ho Choi, Sang Hoon Lee, Yeon Hyeon Choe, Joonghyun Ahn, Keumhee Chough Carriere, Hyeon-Cheol Gwon
Recent studies have proposed intravenous (IV) morphine is associated with delayed action of antiplatelet agents in acute myocardial infarction. However, it is unknown whether morphine results in increased myocardial damage in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We investigated myocardial salvage index (MSI) to determine whether IV morphine affects myocardial injury adversely in STEMI patients undergoing primary PCI. 299 STEMI patients underwent contrast-enhanced magnetic resonance imaging a median of 3 days after PCI...
2017: PloS One
https://www.readbyqxmd.com/read/28040280/management-and-outcome-of-patients-with-acute-myocardial-infarction-presenting-with-pacemaker-rhythm
#6
Noemi Bertel, Fabienne Witassek, Milo Puhan, Paul Erne, Hans Rickli, Barbara Naegeli, Giovanni Pedrazzini, Jean-Christophe Stauffer, Dragana Radovanovic
BACKGROUND: Diagnosis of acute myocardial infarction (MI) is challenging in pacemaker patients. Little is known about this patient group. METHODS: Patients with MI enrolled in the Swiss national AMIS Plus registry between January 2005 and December 2015 were analyzed. All patients with either paced ventricular rhythm or sinus rhythm with intrinsic ventricular conduction (IVC) were included in this study. Outcomes using crude data and propensity score matching were compared between patients with pacemaker rhythm and patients with IVC...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27968766/indications-for-fibrinolysis-in-patients-with-st-segment-elevation-myocardial-infarction-from-guidelines-to-practice
#7
C Boivineau, L Orion, J Dimet, E Boiffard
BACKGROUND: European guidelines on managing ST segment elevation myocardial infarction (STEMI) during the first 12hours recommend fibrinolysis when the time elapsing between the first medical contact and balloon time (FMCBT) is more than 120minutes. AIM: To assess the real-life clinical efficacy of guidelines on fibrinolysis in managing STEMI and identify obstacles to their everyday implementation. METHODS: An observational study based on a permanent registry of reperfusion strategies and timing among patients treated in a French general hospital for STEMI with chest pain lasting for less than two hours...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27968760/door-in-door-out-assessment-of-patients-admitted-with-acute-st-segment-elevation-myocardial-infarction-in-hospitals-without-catheterization-facilities
#8
S Clot, T Rocher, C Morvan, C Rubio, S Sainvoirin, P Usseglio, L Belle, V Descotes-Genon, G Vanzetto
BACKGROUND: Many patients with acute ST-segment elevation myocardial infarction (STEMI) are admitted to emergency departments (EDs) of centres without percutaneous coronary intervention (PCI) facilities. The 2012 European Society of Cardiology guidelines recommend transfer to a PCI centre with a "door in - door out" (DI-DO) time≤30min. PURPOSE: To report DI-DO times in a registry of patients with acute STEMI. METHODS: The RESeau des Urgences CORonarienne (RESUCOR) is a permanent registry of patients admitted with acute STEMI in 16 hospitals in the north French Alps since 2002...
November 2016: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#9
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...
January 15, 2017: 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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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...
January 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/27701930/prasugrel-hydrochloride-for-the-treatment-of-acute-coronary-syndrome-patients
#16
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...
November 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27526240/delayed-acute-subdural-hematoma-associated-with-percutaneous-coronary-intervention
#17
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
#18
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
#19
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
#20
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
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