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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
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28511323/-impact-of-symptom-onset-to-first-medical-contact-time-on-the-prognosis-of-patients-with-acute-st-segment-elevation-myocardial-infarction
#6
T F Wei, B Zhao, P L Liu, X Y Feng, Z Zhang, Q X Shi, T S Gao, L Liu, J T Zhao, H Y Song, L F Liu, Y Q Liu, M M Rao, S L Wang
Objective: To investigate the impact of symptom onset to first medical contact (SO-to-FMC)time on the prognosis of patients with acute ST-segment elevation myocardial infarction(STEMI). Methods: The clinical data of 341 consecutive STEMI patients, who were hospitalized to our hospital and received primary percutaneous coronary intervention(PCI) from August 2011 to April 2016, were retrospectively analyzed. The patients were divided into ≤90 min group (201 cases) and >90 min group (140 cases) according to the SO-to-FMC time...
May 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28487063/reverse-left-ventricular-remodelling-in-st-elevation-myocardial-infarction-patients-undergoing-primary-percutaneous-coronary-intervention-incidence-predictors-and-impact-on-outcome
#7
Jeong Cheon Choe, Kwang Soo Cha, Eun Young Yun, Jinhee Ahn, Jin Sup Park, Hye Won Lee, Jun-Hyok Oh, Jeong Su Kim, Jung Hyun Choi, Yong Hyun Park, Han Cheol Lee, June Hong Kim, Kook Jin Chun, Taek Jong Hong, Youngkeun Ahn, Myung Ho Jeong, Shung Chull Chae, Young Jo Kim
BACKGROUD: We investigated reverse left ventricular remodelling (r-LVR), defined as a reduction of >10% in left ventricular end-systolic volume (LVESV) during follow-up, in ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: STEMI patients (n=1,237) undergoing PPCI with echocardiography at baseline and six-month follow-up were classified into r-LVR (n=466) and no r-LVR groups (n=771). The primary outcome was composite major adverse cardiac events (MACE; all-cause death, myocardial infarction, any revascularisation)...
March 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28473978/the-association-between-door-to-balloon-time-of-less-than-60-minutes-and-prognosis-of-patients-developing-st-segment-elevation-myocardial-infarction-and-undergoing-primary-percutaneous-coronary-intervention
#8
Fu-Cheng Chen, Yan-Ren Lin, Chia-Te Kung, Cheng-I Cheng, Chao-Jui Li
Background. The study aimed to verify the effect of primary percutaneous coronary intervention (PPCI) with <60 min door-to-balloon time on ST segment elevation myocardial infarction (STEMI) patients' prognoses. Methods. Outcomes of patients receiving PPCI with door-to-balloon time of <60 min were compared with those of patients receiving PPCI with door-to-balloon time 60-90 min. Result. Totally, 241 STEMI patients (191 with Killip classes I or II) and 104 (71 with Killip classes I or II) received PPCI with door-to-balloon time <60 and 60-90 min, respectively...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28460740/comparison-of-30-day-and-long-term-outcomes-and-hospital-complications-among-patients-aged-75-versus-%C3%A2-75%C3%A2-years-with-st-elevation-myocardial-infarction-undergoing-percutaneous-coronary-intervention
#9
Guy Topaz, Ariel Finkelstein, Nir Flint, Yacov Shacham, Shmuel Banai, Arie Steinvil, Yaron Arbel, Gad Keren, Lior Yankelson
Our aim was to evaluate the mortality rate and occurrence of complications in patients aged <75 versus ≥75 years with ST-elevation myocardial infarction (STEMI). We studied 1,657 consecutive patients with STEMI hospitalized in the cardiac intensive care unit during 2008 to 2014. All patients underwent primary percutaneous intervention, of which 292 (18%) were aged ≥75 years. Patient records were evaluated for in-hospital complications, 30-day mortality, and long-term mortality over a mean period of 3...
April 8, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28458558/impact-of-around-the-clock-in-house-cardiology-fellow-coverage-on-door-to-balloon-time-in-an-academic-medical-center
#10
Luke C Kohan, Vijaiganesh Nagarajan, Michael A Millard, Michael J Loguidice, Nancy M Fauber, Ellen C Keeley
OBJECTIVES: To assess if a change in our cardiology fellowship program impacted our ST elevation myocardial infarction (STEMI) program. BACKGROUND: Fellows covering the cardiac care unit were spending excessive hours in the hospital while on call, resulting in increased duty hours violations. A night float fellow system was started on July 1, 2012, allowing the cardiac care unit fellow to sign out to a night float fellow at 5:30 pm. The night float fellow remained in-house until the morning...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28454639/shorter-door-to-balloon-st-elevation-myocardial-infarction-time-should-there-be-a-minimum-limit
#11
Sameh Askandar, Tamunoinemi Bob-Manuel, Pahul Singh, Rami N Khouzam
In ST-elevation myocardial infarction (STEMI) ischemic time is directly related to permanent myocardial damage and mortality. Therefore, it is crucial to restore myocardial perfusion rapidly. Door-to-balloon (DTB) time is defined as the duration between the arrival time of the patient to the medical facility until the time he or she is treated with percutaneous coronary intervention. Currently, DTB is the criterion that measures the quality of care provided to patients with STEMI at any given institution. It is well documented in the literature that longer DTB is associated with higher mortality; however, lowering DTB beyond current recommendations has not shown to decrease mortality rates...
June 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28446493/hospital-performance-on-percutaneous-coronary-intervention-process-and-outcomes-measures
#12
Philip W Chui, Craig S Parzynski, Brahmajee K Nallamothu, Frederick A Masoudi, Harlan M Krumholz, Jeptha P Curtis
BACKGROUND: The Physician Consortium for Performance Improvement recently proposed percutaneous coronary intervention (PCI)-specific process measures. However, information about hospital performance on these measures and the association of PCI process and outcomes measures are not available. METHODS AND RESULTS: We linked the National Cardiovascular Data Registry (NCDR) CathPCI Registry with Medicare claims data to assess hospital performance on established PCI process measures (aspirin, thienopyridines, and statins on discharge; door-to-balloon time; and referral to cardiac rehabilitation), newly proposed PCI process measures (documentation of contrast dose, glomerular filtration rate, and PCI indication; appropriate indication for elective PCI; and use of embolic protection device), and a composite of all process measures...
April 26, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#13
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28400040/a-comparison-of-rescue-and-primary-percutaneous-coronary-interventions-for-acute-st-elevation-myocardial-infarction
#14
M B Faslur Rahuman, Jayanthimala B Jayawardena, George R Francis, Niraj Mahboob, Wasantha Kumara A H T, Aruna Wijesinghe, Rashan Haniffa, Ranithrie Ariyapperuma, Abbyramy Paramanayakam, Pubudu A De Silva
OBJECTIVE: To perform a comparative analysis of in-hospital results obtained from patients with acute ST elevation myocardial infarction (STEMI), who underwent rescue or primary percutaneous coronary intervention (PCI). The aim is to determine rescue PCI as a practical option for patients with no immediate access to primary PCI. METHODS: From the Cardiology PCI Clinic of the National Hospital of Sri Lanka (NHSL), we selected all consecutive patients presenting with acute STEMI </=24h door-to-balloon delay for primary PCI and </=72h door-to-balloon delay, (90min after failed thrombolysis) for rescue PCI, from March 2013 to April 2015 and their in-hospital results were analyzed, comparing rescue and primary PCI patients...
April 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28394005/-buddy-wire-for-facilitation-of-femoral-venous-access-for-cryoablation-a-preliminary-report
#15
Aleksander Maciąg, Michał Farkowski, Jan Ciszewski, Mariusz Pytkowski, Hanna Szwed
BACKGROUND: Some electrophysiological techniques, such as balloon cryoablation, involve the use of steerable sheaths of large diameter (outer diameter 15Fr or more). Their introduction to the femoral vein may be difficult, especially in patients who have had numerous venipunctures in this area. The authors describe a modification of typical venous access with the use of a "buddy wire" technique, facilitating the insertion of the cryoablation sheaths to the femoral vein. METHODS: A case-control study...
April 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28390745/effect-of-improved-door-to-balloon-time-on-clinical-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction
#16
Wei-Chieh Lee, Hsiu-Yu Fang, Huang-Chung Chen, Shu-Kai Hsueh, Chien-Jen Chen, Cheng-Hsu Yang, Hon-Kan Yip, Chi-Ling Hang, Chiung-Jen Wu, Chih-Yuan Fang
OBJECTIVE: Few studies have focused on the effects of an improved door-to-balloon time on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). The aim of this study was to explore the effect of improving door-to-balloon time on prognosis and to identify major predictors of mortality. METHODS: From January 2005 to December 2014, 1751 patients experienced STEMI and received primary percutaneous intervention in our hospital. During a 10-year period, the patients were divided into two groups according to the time period...
March 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28296641/root-cause-analysis-of-deaths-in-st-segment-elevation-myocardial-infarctions-treated-with-primary-pci-what-can-we-do-better
#17
Fredy El Sakr, Mohamad Kenaan, Daniel Menees, Milan Seth, Hitinder S Gurm
OBJECTIVE: Recent data demonstrate that mortality of patients with ST-elevation myocardial infarction (STEMI) has not changed despite dramatic reduction in door-to-balloon times. Identifying potential areas in care that can be further optimized to decrease mortality remains a priority. METHODS: We performed a root cause analysis of all patients who died following primary percutaneous coronary intervention (PCI) during index hospitalization from 2008 to 2013 at the University of Michigan...
May 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28296638/complete-versus-incomplete-angiography-prior-to-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction
#18
Kevin Stiver, Xu Gao, Satya Shreenivas, Konstantinos Dean Boudoulas, Ernie Mazzaferri, Nader Makki, Scott M Lilly
OBJECTIVES: Shorter reperfusion times in ST-elevation myocardial infarction (STEMI) are associated with improved survival. Prehospital strategies have been developed to minimize door-to-balloon (DTB) time, but few strategies within the catheterization laboratory itself have been evaluated. Incomplete angiography (IA) prior to percutaneous coronary intervention (PCI) is undertaken in clinical practice as a means to further reduce DTB time. We sought to determine whether or not those with STEMI who underwent IA prior to PCI had different preprocedural characteristics or post-PCI outcomes...
March 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28283469/timely-reperfusion-in-stroke-and-myocardial-infarction-is-not-correlated-an-opportunity-for-better-coordination-of-acute-care
#19
Kori Sauser Zachrison, Deborah A Levine, Gregg C Fonarow, Deepak L Bhatt, Margueritte Cox, Phillip Schulte, Eric E Smith, Robert E Suter, Ying Xian, Lee H Schwamm
BACKGROUND: Timely reperfusion is critical in acute ischemic stroke (AIS) and ST-segment-elevation myocardial infarction (STEMI). The degree to which hospital performance is correlated on emergent STEMI and AIS care is unknown. Primary objective of this study was to determine whether there was a positive correlation between hospital performance on door-to-balloon (D2B) time for STEMI and door-to-needle (DTN) time for AIS, with and without controlling for patient and hospital differences...
March 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28237737/data-from-the-german-chest-pain-unit-registry-the-well-known-gap-between-knowledge-and-practice
#20
EDITORIAL
Daniel Fernández-Bergés
In-hospital mortality of acute myocardial infarction with ST segment elevation remains high and is influenced by many factors, some of which are modifiable such as time to treatment initiation and modality of treatment. It is well established that reperfusion therapy is the gold-standard in the management of ST-elevation acute myocardial infarction. Despite recent developments and clear, comprehensible guidelines recommendations, it remains difficult to disseminate this knowledge to medical practitioners. The German Chest Pain Unit shows that the best door-to-balloon time is reached when patients contact the Emergency Medical Systems (EMS) directly, rather than when referred by the general practitioner (GP), or are transferred from another hospital, or present as a self-referral...
February 13, 2017: International Journal of Cardiology
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