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https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
COMPARATIVE STUDY
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...
June 15, 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
#18
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
#19
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
#20
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
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