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https://www.readbyqxmd.com/read/28900621/using-a-cloud-computing-system-to-reduce-door-to-balloon-time-in-acute-st-elevation-myocardial-infarction-patients-transferred-for-percutaneous-coronary-intervention
#1
Chi-Kung Ho, Fu-Cheng Chen, Yung-Lung Chen, Hui-Ting Wang, Chien-Ho Lee, Wen-Jung Chung, Cheng-Jui Lin, Shu-Kai Hsueh, Shin-Chiang Hung, Kuan-Han Wu, Chu-Feng Liu, Chia-Te Kung, Cheng-I Cheng
BACKGROUND: This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB) time for ST segment elevation myocardial infarction (STEMI). METHODS: A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28898927/in-hospital-code-stemi-improves-door-to-balloon-time-in-patients-undergoing-primary-percutaneous-coronary-intervention
#2
Ji Quan Koh, David C Tong, Rumes Sriamareswaran, Allysha Yeap, Bryan Yip, Sam Wu, Padeepa Perera, Shyaman Menon, Saad Al Noaman, Jamie Layland
OBJECTIVE: Reducing time to reperfusion for ST-segment elevation myocardial infarction (STEMI) is essential in improving outcomes. Consequently, numerous strategies have been employed to reduce median door-to-balloon time (DTBT). METHODS: CODE STEMI is an ED physician-activated STEMI notification system. On activation, an announcement is made over the hospital's public announcement (PA) system. We prospectively analysed all in-hours STEMI patients who had primary percutaneous coronary intervention (PPCI) Pre-CODE STEMI (2014) and after CODE STEMI was implemented (2015)...
September 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28893379/comparison-of-outcomes-of-st-elevation-myocardial-infarction-treated-by-percutaneous-coronary-intervention-during-off-hours-versus-on-hours
#3
REVIEW
Tariq H Enezate, Jad Omran, Ashraf S Al-Dadah, Martin Alpert, Ehtisham Mahmud, Mitul Patel, Herbert D Aronow, Deepak L Bhatt
Previous studies have reported worse outcomes and longer door-to-balloon times (DBTs) in patients presenting with ST-elevation myocardial infarction (STEMI) after normal working hours, during weekends, and on holidays (off-hours) compared with normal business hours (on-hours). Recent studies, however, have reported similar outcomes regardless of presentation time. MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were queried from January 1990 through December 2016. Only studies comparing STEMI outcomes during off-hours versus on-hours with percutaneous coronary intervention were included...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28888267/sex-based-differences-in-quality-of-care-and-outcomes-in-a-health-system-using-a-standardized-stemi-protocol
#4
MULTICENTER STUDY
Janet Wei, Puja K Mehta, Elizabeth Grey, Ross F Garberich, Robert Hauser, C Noel Bairey Merz, Timothy D Henry
BACKGROUND: Recent data from the National Cardiovascular Data Registry indicate that women with ST-segment-elevation myocardial infarction (STEMI) continue to have higher mortality and reported delays in treatment compared with men. We aimed to determine whether the sex difference in mortality exists when treatment disparities are reduced. METHODS: Using a prospective regional percutaneous coronary intervention (PCI)-based STEMI system database with a standardized STEMI protocol, we evaluated baseline characteristics, treatment, and clinical outcomes of STEMI patients stratified by sex...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28886858/trends-and-impact-of-door-to-balloon-time-on-clinical-outcomes-in-patients-aged-75-75-to-84-and-%C3%A2-85-years-with-st-elevation-myocardial-infarction
#5
Matias B Yudi, Garry Hamilton, Omar Farouque, Nick Andrianopoulos, Stephen J Duffy, Jeffrey Lefkovits, Angela Brennan, Dharsh Fernando, Chin Hiew, Melanie Freeman, Christopher M Reid, Robynne Dakis, Andrew E Ajani, David J Clark
Guidelines strongly recommend patients with ST-elevation myocardial infarction (STEMI) receive timely mechanical reperfusion, defined as door-to-balloon time (DTBT) ≤90 minutes. The impact of timely reperfusion on clinical outcomes in patients aged 75-84 and ≥85 years is uncertain. We analysed 2,972 consecutive STEMI patients who underwent primary percutaneous coronary intervention from the Melbourne Interventional Group Registry (2005-2014). Patients aged <75 years were included in the younger group, those aged 75-84 years were in the elderly group and those ≥85 years were in the very elderly group...
July 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28838603/effect-of-shorter-door-to-balloon-times-over-20-years-on-outcomes-of-patients-with-anterior-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#6
Amgad Mentias, Mohammad Q Raza, Amr F Barakat, Dalia Youssef, Russell Raymond, Venu Menon, Conrad Simpfendorfer, Irving Franco, Stephen Ellis, E Murat Tuzcu, Samir R Kapadia
Cardiovascular disease remains the most common cause of mortality. We studied the change in outcomes for anterior ST-elevation myocardial infarction (STEMI) between 1995 and 2014. Over the past 20 years, 1,658 patients presenting to our center with anterior STEMI underwent primary percutaneous coronary intervention within 12 hours of presentation. We divided these into 4 quartiles, 1995 to 1999 (n = 312), 2000 to 2004 (n = 408), 2005 to 2009 (n = 428), and 2010 to 2014 (n = 510). Across the 4 quartiles, mean age decreased (64...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28825567/cardiogenic-shock-with-st-segment-elevation-acute-coronary-syndrome-rena-shock-st
#7
Yanina Castillo Costa, Víctor M Mauro, Mauro García Aurelio, Carlos Barrero, Adrián Charask, Juan A Gagliardi
Cardiogenic shock (CS) in the setting of an ST-segment elevation myocardial infarction (STEMI) is a severe complication and constitutes one of the principal causes of death associated with this condition. The aim of this study was to describe the clinical characteristics, treatment strategies and hospital outcome of CS associated with STEMI in Argentina. The Argentine Registry of Cardiogenic Shock (ReNA-Shock) was a prospective and multicenter registry of consecutive patients with CS hospitalized in 64 centers in Argentina between July 2013 and May 2015...
2017: Medicina
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#8
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28743786/outcomes-of-patients-presenting-with-clinical-indices-of-spontaneous-reperfusion-in-st-elevation-acute-coronary-syndrome-undergoing-deferred-angiography
#9
Paul Fefer, Roy Beigel, Shaul Atar, Doron Aronson, Arthur Pollak, Doron Zahger, Elad Asher, Zaza Iakobishvili, Nir Shlomo, Ronny Alcalai, Michal Einhorn-Cohen, Amit Segev, Ilan Goldenberg, Shlomi Matetzky
BACKGROUND: Few data are available regarding the optimal management of ST-elevation myocardial infarction patients with clinically defined spontaneous reperfusion (SR). We report on the characteristics and outcomes of patients with SR in the primary percutaneous coronary intervention era, and assess whether immediate reperfusion can be deferred. METHODS AND RESULTS: Data were drawn from a prospective nationwide survey, ACSIS (Acute Coronary Syndrome Israeli Survey)...
July 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28716521/update-on-quality-of-care-in-hispanics-and-other-racial-ethnic-groups-in-the-united-states-discharged-with-the-diagnosis-of-acute-myocardial-infarction-in-2013
#10
Tomás Romero, Kristina L Greenwood, Dale Glaser
BACKGROUND: Disparities in Acute Myocardial Infarction (AMI) care and outcomes have been frequently reported in racial-ethnic minorities in the U.S. Some studies have attributed disparities in Hispanics and other minorities to lower quality of services at hospitals where they seek care. Current information from hospitals with large Hispanic representations and updated quality resources is needed. METHODS: Retrospective observational study of 839 AMI patients discharged in 2013 from three Southern California Hospitals (A, B, C) with tertiary cardiac care level...
July 8, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28710777/update-in-enteroscopy-new-devices-and-new-indications
#11
REVIEW
Tom G Moreels
The present review provides an update of the currently available (proto-) types of device-assisted enteroscopy (DAE). In recent years, newly designed double- and single-balloon enteroscopes have emerged. They aim to improve insertion depth into the small bowel, and they also allow more efficient endoscopic interventions. Nowadays, almost all conventional endoscopic procedures are feasible using DAE, opening the door to new indications. Recently, more data have become available on pediatric DAE, DAE-assisted colonoscopy, and DAE in patients with altered anatomy, including DAE-assisted endoscopic retrograde cholangiopancreatography and direct cholangioscopy...
July 14, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28696573/prognostic-implications-of-q-waves-at-presentation-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-an-analysis-of-the-horizons-ami-study
#12
Ioanna Kosmidou, Björn Redfors, Aaron Crowley, Bernard Gersh, Shmuel Chen, José M Dizon, Monica Embacher, Roxana Mehran, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: Presence of Q waves on the presenting electrocardiogram (ECG) in patients with ST-segment elevation myocardial infarction (STEMI) has been associated with worse prognosis; however, whether the prognostic value of Q waves is influenced by baseline characteristics and/or rapidity of revascularization based on the guideline-based metric of door-to-balloon time remains unknown. HYPOTHESIS: We hypothesized that Q waves in the presenting ECG will be predictive of long term mortality regardless of time to reperfusion...
July 11, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28684209/off-hours-presentation-does-not-affect-in-hospital-mortality-of-japanese-patients-with-acute-myocardial-infarction-j-minuet-substudy
#13
Manabu Ogita, Satoru Suwa, Hideki Ebina, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Satoshi Yasuda, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Masaaki Uematsu, Kazuhito Hirata, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Seiji Hokimoto, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Shiro Uemura, Tetsuya Toubaru, Keijiro Saku, Shigeru Oshima, Kunihiro Nishimura, Yoshihiro Miyamoto, Masaharu Ishihara
BACKGROUND: The association between patients with acute myocardial infarction (AMI) who present during off-hours and clinical outcomes has not been fully elucidated. METHODS: We investigated 3283 consecutive patients with AMI who were selected from a prospective, nationwide, multicenter registry (J-MINUET) database comprising 28 institutions in Japan between July 2012 and March 2014 to determine the current impact of off-hours presentation on in-hospital mortality among Japanese patients with AMI...
July 3, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28665907/exploring-the-relationship-between-volume-and-outcomes-in-hospital-cardiovascular-care
#14
James R Langabeer, Junghyun Kim, Jeffrey Helton
BACKGROUND: Management theories of learning and experience curve effects state that greater levels of scale produce learnings and improved performance. In cardiovascular care, guidelines suggest that high-volume facilities produce better patient outcomes; yet, there are contradictory findings from the few studies conducted. Our goals were to assess the volume-outcome relationship for interventional cardiovascular care. METHODS: We examined 9360 patients with ST-segment elevation myocardial infarction who underwent percutaneous intervention (PCI)...
July 2017: Quality Management in Health Care
https://www.readbyqxmd.com/read/28648416/primary-percutaneous-coronary-intervention-for-acute-st-elevation-myocardial-infarction-outcomes-and-determinants-of-outcomes-a-tertiary-care-center-study-from-north-india
#15
Gajendra Dubey, Sunil Kumar Verma, Vinay Kumar Bahl
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the current standard of care for acute ST elevation myocardial infarction (STEMI). Most of the data on primary PCI in acute STEMI is from western countries. We studied the outcomes of primary PCI for acute STEMI at a tertiary care center in North India. METHODS: Consecutive patients undergoing primary PCI for STEMI were prospectively studied during the period from February 2103 to May 2015. The outcomes assessed were all cause in hospital mortality, factors associated with mortality, major adverse cardiac and cerebrovascular event rate (composite of all cause in hospital mortality, non-fatal re infarction and stroke) and procedural complications...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28637970/impact-of-door-to-balloon-time-in-patients-with-st-elevation-myocardial-infarction-who-arrived-by-self-transport%C3%A3-acute-myocardial-infarction-kyoto-multi-center-risk-study-group
#16
Naotoshi Kodama, Takeshi Nakamura, Kenji Yanishi, Naohiko Nakanishi, Kan Zen, Tetsuhiro Yamano, Hirokazu Shiraishi, Takeshi Shirayama, Jun Shiraishi, Takahisa Sawada, Yoshio Kohno, Makoto Kitamura, Keizo Furukawa, Satoaki Matoba
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) who arrive at a hospital via self-transport reportedly have a delayed door-to-balloon time (DBT). However, the clinical impacts of delayed DBT on in-hospital mortality among such patients are not well known.Methods and Results:In total, 1,172 STEMI patients who underwent primary percutaneous coronary intervention between January 2009 and December 2013 from the Acute Myocardial Infarction (AMI) Kyoto Registry were analyzed...
June 20, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28625385/seasonal-and-circadian-variations-of-acute-myocardial-infarction-findings-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#17
MULTICENTER STUDY
Vijaiganesh Nagarajan, Gregg C Fonarow, Christine Ju, Michael Pencina, Warren K Laskey, Thomas M Maddox, Adrian Hernandez, Deepak L Bhatt
BACKGROUND: Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and circadian variations are equally present in warmer and colder regions. We investigated whether seasonal and circadian variations in acute myocardial infarction (AMI) are more prominent in colder northern states compared with warmer southern states...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28588811/minimization-of-door-to-balloon-time-for-st-elevation-acute-myocardial-infarction-a-case-report
#18
Naoyuki Akashi, Kenichi Sakakura, Kei Yamamoto, Yousuke Taniguchi, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
It is of utmost importance to minimize the door-to-balloon time for the initial treatment of ST-elevation acute myocardial infarction. In this case report, we made all kinds of efforts to minimize procedures in the emergency department (ED minimization) as well as in the catheter laboratory without sacrificing safety.
June 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28588172/primary-angioplasty-for-the-treatment-of-acute-st-elevated-myocardial-infarction-single-centre-experience
#19
K N Khan, M H Khan, R Rahman, M A Rashid, S Z Haque, Z Zakia
Worldwide primary angioplasty is a recommended strategy of reperfusion in patient with acute myocardial infarction as because it ensures reperfusion of the infarct-related vessels more than 90% whereas, with thrombolytics it is only 60-70%. This retrospective observational study includes all patients treated with primary angioplasty at United Hospital from Between March 2007 to January 2011. Total 114 consecutive patients with acute myocardial infarction were treated with primary angioplasty included. Those presented beyond 12 hours of onset of chest pain, in cardiogenic shock, resuscitate and intubated before the procedure were excluded from the study...
April 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28581993/time-to-treatment-focus-on-transfer-in-st-elevation-myocardial-infarction
#20
REVIEW
Juan Russo, Michel R Le May
In the modern ST-elevation myocardial infarction (STEMI) system, the use of electrocardiogram by emergency medical services (EMS) personnel and the option to bypass emergency departments on route to a PCI-capable hospital is of particular importance. Through training and a standardized referral process, EMS personnel can now accurately diagnose and refer STEMI patients directly to the catheterization laboratory of a percutaneous coronary intervention-capable hospital. Regional STEMI models have been implemented successfully across North America, resulting in palpable reductions in door-to-balloon time, morbidity, and mortality...
October 2016: Interventional cardiology clinics
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