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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
#1
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...
March 15, 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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/28228609/barriers-associated-with-door-to-balloon-delay-in-contemporary-japanese-practice
#5
Nobuhiro Ikemura, Mitsuaki Sawano, Yasuyuki Shiraishi, Ikuko Ueda, Hiroaki Miyata, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Yukihiko Momiyama, Taku Inohara, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min...
February 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#6
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/28147338/clinical-characteristics-and-improvement-of-the-guideline-based-management-of-acute-myocardial-infarction-in-china-a-national-retrospective-analysis
#7
Lechen Wang, You Zhou, Cheng Qian, Yanggan Wang
OBJECTIVE: This study is to document the clinical characteristics and improvement in management of acute myocardial infarction (AMI) in Chinese population. RESULTS: This study included 64,654 patients (23,805 patients in 2011, 40,849 patients in 2013), of which STEMI and NSTEMI account for 85.09% and 14.91%, respectively. From 2011 to 2013, significant improvement has been achieved in the recanalization rate of PCI (96.01% vs. 98.63%, P < 0.001) and in-hospital deaths (4...
January 29, 2017: Oncotarget
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#8
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28104044/procedural-variations-in-performing-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction
#9
REVIEW
Radhika M Mehta, Manyoo Agarwal, Ikechukwu Ifedili, Wael W Rizk, Rami N Khouzam
Multiple variations exist in performing a primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) among various cardiologists. These variations range from the choice of peripheral access artery (radial vs femoral), performance or time of complete angiography including left ventriculography, and nonculprit vessel angiography before or after intervening on the culprit vessel. The reasons for such variations include emphasis on door-to-balloon time, knowledge of cardiac anatomy before proceeding with pPCI, physician expertise, and the level of comfort with radial approach...
February 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28044391/initial-electrocardiogram-as-determinant-of-hospital-course-in-st-elevation-myocardial-infarction
#10
Michael A Millard, Vijaiganesh Nagarajan, Luke C Kohan, Robert C Schutt, Ellen C Keeley
BACKGROUND: A proportion of patients with ST elevation myocardial infarction (STEMI) have an initial electrocardiogram (ECG) that is nondiagnostic and are definitively diagnosed on a subsequent ECG. Our aim was to assess whether patients with a nondiagnostic initial ECG are different than those with a diagnostic initial ECG. METHODS: We collected demographic, ECG, medication, angiographic, and in-hospital clinical outcome data in consecutive patients undergoing primary percutaneous coronary intervention for STEMI at our institution from June 2009 to June 2013...
January 3, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28040280/management-and-outcome-of-patients-with-acute-myocardial-infarction-presenting-with-pacemaker-rhythm
#11
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/28025772/laparoscopically-assisted-proximal-gastrectomy-with-esophagogastrostomy-using-a-novel-open-door-technique-lapg-with-novel-reconstruction
#12
Kei Hosoda, Keishi Yamashita, Hiromitsu Moriya, Hiroaki Mieno, Akira Ema, Marie Washio, Masahiko Watanabe
Laparoscopy-assisted proximal gastrectomy (LAPG) with esophagogastrostomy using a novel "open-door" technique was introduced recently, with the aim of preventing gastroesophageal reflux. However, quantitate assessment of gastroesophageal reflux after this surgery has not been performed till date. The aims of the current study were to investigate the safety and feasibility of this operation and to elucidate the postoperative reflux status. Twenty consecutive patients (18 men) with (y)cStage I gastric cancer in the upper third of the stomach who underwent LAPG at Kitasato University Hospital from May 2015 through September 2016 were retrospectively reviewed...
December 26, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/27993751/call-to-balloon-time-dashboard-in-patients-with-st-segment-elevation-myocardial-infarction-results-in-significant-improvement-of-the-logistic-chain
#13
Maaike P Hermans, Matthijs A Velders, Martin Smeekes, Olivier S Drexhage, Raymond W Hautvast, Timon Ytsma, Martin J Schalij, Victor A Umans
AIMS: Timely reperfusion with primary percutaneous coronary intervention (pPCI) in ST-segment elevation myocardial infarction (STEMI) patients is associated with superior clinical outcomes. Aiming to reduce ischemic time, an innovative system for home-to-hospital (H2H) time monitoring was implemented, which enabled real-time evaluation of ischemic time intervals, regular feedback and improvements in the logistic chain. The objective of this study was to assess the results after implementation of the H2H dashboard for monitoring and evaluation of ischemic time in STEMI patients...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27970395/tct-21-door-to-ecmo-before-door-to-balloon-early-implementation-of-ecmo-might-improve-the-survival-of-patients-with-stemi-complicated-by-refractory-cardiogenic-shock
#14
Chi-Cheng Huang, Pen-Chih Liao, Shin-Rong Ke, Jung-Cheng Hsu
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970368/tct-196-from-door-to-balloon-to-door-to-unload-a-transcriptomic-analysis-identifies-that-primary-unloading-globally-shifts-gene-expression-and-preserves-mitochondrial-integrity-within-the-infarct-zone-during-the-acute-phase-of-ami
#15
Michele Esposito, Yali Zhang, Gavin Schnitzler, Vikram Paruchuri, Xiaoying Qiao, Shiva Annamalai, Emily Mackey, Kevin Morine, Andrew Mullin, Tobias Rheude, Catalina Breton, Richard Karas, Noam Josephy, Navin Kapur
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27970336/tct-169-the-impact-of-a-door-to-balloon-time-of-less-than-30-minutes-on-the-in-hospital-mortality-in-patients-with-st-elevation-myocardial-infarction
#16
Takeshi Yamada, Yukio Mizuguchi, Akihiko Takahashi, Hiroki Shibutani, Sho Hashimoto, Norimasa Taniguchi, Shunsuke Nakajima, Tetsuya Hata
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27933193/outcomes-of-ischaemic-mitral-regurgitation-in-anterior-versus-inferior-st-elevation-myocardial-infarction
#17
Amgad Mentias, Mohammad Q Raza, Amr F Barakat, Elizabeth Hill, Dalia Youssef, Amar Krishnaswamy, Milind Y Desai, Brian Griffin, Stephen Ellis, Venu Menon, E Murat Tuzcu, Samir R Kapadia
BACKGROUND: Ischaemic mitral regurgitation (IMR) is a detrimental complication of ST elevation myocardial infarction (STEMI). OBJECTIVE: We sought to determine patient characteristics and outcomes of patients with IMR with focus on anterior or inferior location of STEMI. METHODS: All patients presenting with STEMI complicated by IMR to our centre who underwent primary percutaneous coronary intervention within the first 12 hours of presentation from 1995 to 2014 were included...
2016: Open Heart
https://www.readbyqxmd.com/read/27931553/change-in-left-ventricular-systolic-function-in-patients-with-st-elevation-myocardial-infarction-evidence-for-smoker-s-paradox-or-pseudo-paradox
#18
Burak Acar, Ozcan Ozeke, Sefa Unal, Mustafa Karakurt, Meryem Kara, Ozgur Kirbas, Fatih Sen, Ahmet Korkmaz, Dursun Aras, Sinan Aydogdu
BACKGROUND: The 'smoker's paradox' refers to the observation of favorable prognosis in current smokers following an acute ST elevation myocardial infarction (STEMI) in the era of fibrinolysis, however, several STEMI studies have demonstrated conflicting results in patients undergoing primary percutaneous coronary intervention (p-PCI). OBJECTIVE: Aim of the current study was to evaluate the impact of cigarette smoking on left ventricular function in STEMI patients undergoing p-PCI...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27930573/management-of-st-segment-elevation-myocardial-infarction-in-predominantly-rural-central-china-a-retrospective-observational-study
#19
MULTICENTER STUDY
You Zhang, Shuyan Yang, Xinyun Liu, Muwei Li, Weidong Zhang, Haiyan Yang, Dayi Hu, Chuanyu Gao, Guangcai Duan
The degree of adherence to current guidelines for clinical management of ST-segment elevation myocardial infarction (STEMI) is known in developed countries and large Chinese cities, but in predominantly rural areas information is lacking. We assessed the application of early reperfusion therapy for STEMI in secondary and tertiary hospitals in Henan province in central China.Data were retrospectively collected from 5 secondary and 4 tertiary hospitals in Henan concerning STEMI patients treated from January 2011 to January 2012, including management strategy, delay time, and inhospital mortality...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27928224/clinical-outcomes-of-elderly-south-east-asian-patients-in-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#20
Jieli Tong, Wen Wei Xiang, An Shing Ang, Wen Jun Sim, Kien Hong Quah, David Foo, Paul Jau Lueng Ong, Hee Hwa Ho
OBJECTIVE: To evaluate the clinical characteristics and in-hospital outcomes of elderly South-East Asian patients undergoing primary percutaneous coronary intervention (PPCI). METHODS: From January 2009 to December 2012, 1268 patients (86.4% male, mean age of 58.4 ± 12.2 years) presented to our hospital for ST-elevation myocardial infarction (STEMI) and underwent PPCI. They were divided into two groups: elderly group defined as age ≥ 70 years and non-elderly group defined as age < 70 years...
October 2016: Journal of Geriatric Cardiology: JGC
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