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https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#1
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29306465/prognostic-significance-of-qrs-fragmentation-and-correlation-with-infarct-size-in-patients-with-anterior-st-segment-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention-insights-from-the-infuse-ami-trial
#2
Björn Redfors, Ioanna Kosmidou, Aaron Crowley, Akiko Maehara, Ori Ben-Yehuda, Arslan Arif, José M Dizon, Gary S Mintz, Gregg W Stone
BACKGROUND: QRS fragmentation (fQRS) is believed to reflect myocardial scar formation in patients with coronary disease. Whether early formation of fQRS in patients with ST-segment elevation myocardial infarction (STEMI) treated with percutaneous coronary intervention (PCI) is correlated with infarct size and prognosis is unknown. We assessed the prognostic value of fQRS at 60min post-PCI and its correlation with infarct size in patients with anterior STEMI managed with primary PCI. METHODS: The INFUSE-AMI trial enrolled 452 patients with anterior STEMI undergoing primary PCI...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29287703/smartphone-transmission-of-electrocardiography-images-to-reduce-time-of-cardiac-catheterization-laboratory-activation
#3
Chun-Chieh Chao, Yi-Chun Chen, Chun-Ming Shih, Sen-Kuang Hou, Raghu R Seethala, Imoigele P Aisiku, Chuan-Chin Huang, Peter C Hou, Wei-Fong Kao
BACKGROUND: This retrospective study evaluated the use of a smartphone application to facilitate communication between the emergency physician (EP) and the interventional cardiologist in order to minimize the time to cardiac catheterization laboratory (CCL) activation and time to percutaneous coronary intervention (PCI). METHODS: We retrospectively collected pertinent time-points in the management of patients diagnosed with STEMI in the emergency department and their outcome...
December 26, 2017: Journal of the Chinese Medical Association: JCMA
https://www.readbyqxmd.com/read/29278352/impact-of-diagnostic-ecg-to-wire-delay-in-stemi-patients-treated-with-primary-pci-a-danami-3-substudy
#4
Lars Nepper-Christensen, Jacob Lønborg, Dan Eik Høfsten, Kiril Aleksov Ahtarovski, Kasper Kyhl, Christoffer Göransson, Lars Køber, Steffen Helqvist, Frants Pedersen, Henning Kelbæk, Niels Vejlstrup, Lene Holmvang, Thomas Engstrøm
AIMS: We evaluated the impact of delay from diagnostic pre-hospital electrocardiogram (ECG) to wiring of the infarct related vessel (ECG-to-wire) >120 minutes on cardiovascular magnetic resonance (CMR) markers of reperfusion success and clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI). METHODS AND RESULTS: We included 1492 patients in the analyses of clinical outcome. CMR was performed in 748 patients to evaluate infarct size and myocardial salvage...
December 26, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29275366/prognostic-value-of-new-generation-troponins-in-st-segment-elevation-myocardial-infarction-in-the-modern-era-the-ruti-stemi-study
#5
Germán Cediel, Ferran Rueda, Cosme García, Teresa Oliveras, Carlos Labata, Jordi Serra, Julio Núñez, Vicent Bodí, Marc Ferrer, Josep Lupón, Antoni Bayes-Genis
BACKGROUND: In ST-segment-elevation myocardial infarction (STEMI), troponins are not needed for diagnosis: symptoms and ECG data are sufficient to activate percutaneous coronary intervention. This study explored the prognostic value of new-generation troponins in a real-life cohort contemporarily treated for STEMI. METHODS AND RESULTS: We studied 1260 consecutive patients with primary STEMI treated with percutaneous coronary intervention between February 22, 2011, and August 31, 2015...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29181266/gender-differences-in-st-elevation-myocardial-infarction-stemi-time-delays-experience-of-a-public-health-service-in-salvador-brazil
#6
Andre R Duraes, Yasmin Sl Bitar, Ana Carolina T Freitas, Ivan Mp Filho, Beatriz C Freitas, Andre Ms Fernandez
BACKGROUND: Delays in attending to ST-elevation myocardial infarction (STEMI) are indicators or markers of quality of health services. Several records suggest gender disparity in cardiac care as a contributor to the increased mortality among women. METHODS: We prospectively enrolled all consecutive STEMI patients who were transferred to our hospital from January through December 2015. The following variables were analyzed: Symptom-to-Door Time (SDT); Time to First ECG (TECG); Transfer Time to Referring Center (TTRC); and Door-to-Cath lab time (DCT)...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/29174706/electrocardiographic-scores-of-severity-and-acuteness-of-myocardial-ischemia-predict-myocardial-salvage-in-patients-with-anterior-st-segment-elevation-myocardial-infarction
#7
Yama Fakhri, Maria Sejersten, Mikkel Malby Schoos, Henrik Steen Hansen, Jean-Luc Dubois-Rande, Trygve S Hall, Alf-Inge Larsen, Svend Eggert Jensen, Henrik Engblom, Hakon Arheden, Jens Kastrup, Dan Atar, Peter Clemmensen
BACKGROUND: Terminal "QRS distortion" on the electrocardiogram (ECG) (based on Sclarovsky-Birnbaum's Grades of Ischemia Score) is a sign of severe ischemia, associated with adverse cardiovascular outcome in ST-segment elevation myocardial infarction (STEMI). In addition, ECG indices of the acuteness of ischemia (based on Anderson-Wilkins Acuteness Score) indicate myocardial salvage potential. We assessed whether severe ischemia with or without acute ischemia is predictive of infarct size (IS), myocardial salvage index (MSI) and left ventricular ejection fraction (LVEF) in anterior versus inferior infarct locations...
November 13, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29174099/smartphone-ecg-for-evaluation-of-st-segment-elevation-myocardial-infarction-stemi-design-of-the-st-leuis-international-multicenter-study
#8
Alejandro Barbagelata, Charles F Bethea, Harry W Severance, Robert J Mentz, David Albert, Gregory W Barsness, Viet T Le, Jeffrey L Anderson, T Jared Bunch, Frank Yanowitz, Benjamin Chisum, Brianna S Ronnow, Joseph B Muhlestein
In patients experiencing an ST-elevation myocardial infarction (STEMI), rapid diagnosis and immediate access to reperfusion therapy leads to optimal clinical outcomes. The rate-limiting step in STEMI diagnosis is the availability and performance of a 12-lead ECG. Recent technology has provided access to a reliable means of obtaining an ECG reading through a smartphone application (app) that works with an attachment providing all 12-leads of a standard ECG system. The ST LEUIS study was designed to validate the smartphone ECG app and its ability to accurately assess the presence or absence of STEMI in patients presenting with chest pain compared with the gold standard 12-lead ECG...
October 19, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29159569/determinants-of-short-and-long-door-to-balloon-time-in-current-primary-percutaneous-coronary-interventions
#9
Takunori Tsukui, Kenichi Sakakura, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Primary percutaneous coronary interventions (PCI) have been developed to improve clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). In primary PCI, the door-to-balloon time (DTBT) is closely associated with mortality and morbidity. The purpose of this study was to find determinants of short and long DTBT. From our hospital record, we included 214 STEMI patients, and divided into the short DTBT group (DTBT < 60 min, n = 60), the intermediate DTBT group (60 min ≤ DTBT ≤ 120 min, n = 121) and the long DTBT group (DTBT > 120 min, n = 33)...
November 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29153151/what-is-the-best-st-segment-recovery-parameter-to-predict-clinical-outcome-and-myocardial-infarct-size-amplitude-speed-and-completeness-of-st-segment-recovery-after-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#10
Wichert J Kuijt, Cindy L Green, Niels J W Verouden, Joost D E Haeck, Dan Tzivoni, Karel T Koch, Gregg W Stone, Alexandra J Lansky, Samuel Broderick, Jan G P Tijssen, Robbert J de Winter, Matthew T Roe, Mitchell W Krucoff
AIMS: ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. METHODS AND RESULTS: Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined...
November 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29121757/association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-suspected-stemi
#11
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29108788/peri-procedural-st-segment-resolution-during-primary-percutaneous-coronary-intervention-ppci-for-acute-myocardial-infarction-predictors-and-clinical-consequences
#12
Grigoris V Karamasis, Paul Russhard, Firas Al Janabi, Michael Parker, John R Davies, Thomas R Keeble, Gerald J Clesham
OBJECTIVE: ECG ST segment resolution (STR) has been used to assess myocardial perfusion in STEMI patients undergoing PPCI. However, in most of the studies ECGs recorded at different time points after the actual procedure have been used, limiting the options of therapeutic interventions while the patient is still in the catheterisation laboratory. The aim of this study was to investigate the presence and clinical consequences of intra-procedural STR during PPCI. METHODS: We analysed 12 lead ECGs recorded at the onset and the end of the PPCI procedure, measuring STR in the lead with maximum ST elevation on the initial recording...
October 5, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29064258/new-or-presumed-new-left-bundle-branch-block-in-patients-with-suspected-st-elevation-myocardial-infarction
#13
Vijaya K Pera, David M Larson, Scott W Sharkey, Ross F Garberich, Christopher J Solie, Yale L Wang, Jay H Traverse, Anil K Poulose, Timothy D Henry
AIMS: Using a comprehensive large prospective regional ST-elevation myocardial infarction (STEMI) system database, we evaluated the prevalence, clinical and angiographic characteristics, and outcomes in patients with ischemic symptoms and new or presumed new left bundle branch block (LBBB). We then tested a new hierarchical diagnosis and triage algorithm to identify more accurately new LBBB patients with an acute culprit lesion. METHODS AND RESULTS: From March 2003 to June 2013, 3903 consecutive STEMI patients were treated using the Minneapolis Heart Institute regional STEMI protocol including 131 patients (3...
February 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29054179/the-impact-of-systems-of-care-on-pharmacoinvasive-management-with-streptokinase-the-subgroup-analysis-of-the-tn-stemi-programme
#14
Deep Chandh Raja, Vijayakumar Subban, Suma M Victor, George Joseph, Viji Samuel Thomson, Kumaresan Kannan, Justin Paul Gnanaraj, Ganesh Veerasekar, Jose G Thenpally, Nandhini Livingston, Brahmajee K Nallamothu, Thomas Alexander, Ajit S Mullasari
OBJECTIVES: We evaluated the impact of implementation of the TN-STEMI programme on various characteristics of the pharmacoinvasive group by comparing clinical as well as angiographic outcomes between the pre- and post-implementation groups. METHODS: The TN-STEMI programme involved 2420 patients of which 423 patients had undergone a pharmacoinvasive strategy of reperfusion. Of these, 407 patients had a comprehensive blinded core-lab evaluation of their angiograms post-lysis and clinical evaluation of various parameters including time-delays and adverse cardio- and cerebro-vascular events at 1year...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29050736/-complicated-transcatheter-aortic-valve-endocarditis-with-abscess-and-pseudoaneurysm-value-of-the-ecg-gated-multidetector-computed-tomography-angiography
#15
S Pichard, G Gibault-Genty, A Vienet-Legue, N Baron, R Convers-Domart, J L Georges, B Livarek
A 80-year-old man was admitted to catheterization room for an acute infero-lateral ST-elevation myocardial infarction (STEMI). Coronary angiography showed a thrombotic occlusion of the second left marginal branch, and normal other coronary arteries. The thrombo-embolic mechanism of the STEMI, and the infectious context in this patient who had had a transcatheter aortic valve implantation (TAVI) two months earlier, led us to suspect a bioprosthesis endocarditis. It was confirmed by transthoracic and transoesophageal echocardiography, which showed an aortic-mitral curtain abscess and aortic bioprosthesis vegetations, associated to Enterococcus faecalis bacteriemia...
November 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29033166/early-peripheral-endothelial-dysfunction-predicts-myocardial-infarct-extension-and-microvascular-obstruction-in-patients-with-st-elevation-myocardial-infarction
#16
Sérgio Bravo Baptista, Mariana Faustino, Luís Brizida, José Loureiro, João Augusto, João Abecasis, Célia Monteiro, Paulo Leal, Maura Nédio, Pedro Farto E Abreu, Victor Gil, Carlos Morais
INTRODUCTION AND OBJECTIVES: The role of endothelial dysfunction (ED) in patients with ST-elevation myocardial infarction (STEMI) is poorly understood. Peripheral arterial tonometry (PAT) allows non-invasive evaluation of ED, but has never been used for this purpose early after primary percutaneous coronary intervention (P-PCI). Our purpose was to analyze the relation between ED assessed by PAT and both the presence of microvascular obstruction (MVO) and infarct extension in STEMI patients...
October 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29021273/improvement-in-care-and-outcomes-for-emergency-medical-service-transported-patients-with-st-elevation-myocardial-infarction-stemi-with-and-without-prehospital-cardiac-arrest-a-mission-lifeline-stemi-accelerator-study
#17
Kristian Kragholm, Di Lu, Karen Chiswell, Hussein R Al-Khalidi, Mayme L Roettig, Matthew Roe, James Jollis, Christopher B Granger
BACKGROUND: Patients with ST-elevation myocardial infarction (STEMI) with out-of-hospital cardiac arrest (OHCA) may benefit from direct transport to a percutaneous cardiac intervention (PCI) hospital but have previously been less likely to bypass local non-PCI hospitals to go to a PCI center. METHODS AND RESULTS: We reported time trends in emergency medical service transport and care of patients with STEMI with and without OHCA included from 171 PCI-capable hospitals in 16 US regions with participation in the Mission: Lifeline STEMI Accelerator program between July 1, 2012, and March 31, 2014...
October 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28994853/akut-ocklusion-av-cirkumflexa-kransart%C3%A3-ren-sv%C3%A3-r-att-uppt%C3%A3-cka-viktigt-att-titta-i-%C3%A2-d%C3%A3-da-vinkeln%C3%A2-p%C3%A3-ekg
#18
Thomas Lindow, Kjell Nikus, Olle Pahlm
Acute occlusion of the left circumflex coronary artery - in the »blind spot« of the ECG? Acute coronary artery occlusion should be treated with urgent revascularization. ECG is important in the triage of patients with acute coronary syndrome. ST deviation depends on the relation between the location of the transmural ischemia and the positive poles of the 12 ECG leads. In acute occlusion of the left circumflex artery, ST elevation in two contiguous leads is not always present. Instead, isolated ST depression in leads V1-V3 may be present and represents a »STEMI-equivalent« pattern...
October 10, 2017: Läkartidningen
https://www.readbyqxmd.com/read/28971117/data-on-association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-confirmed-stemi
#19
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
Data presented in this article relates to the research article entitled "Association between QRS duration on prehospital ECG and mortality in patients with suspected STEMI" (Hansen et al., in press) [1]. Data on the prognostic effect of automatically recoded QRS duration on prehospital ECG and presence of classic left and right bundle branch block in 1777 consecutive patients with confirmed ST segment elevation AMI is presented. Multivariable analysis, suggested that QRS duration >111 ms, left bundle branch block and right bundle branch block were independent predictors of 30 days all-cause mortality...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/28959003/st-elevation-myocardial-infarction-due-to-left-anterior-descending-artery-occlusion-presenting-primarily-with-otalgia
#20
Elhaitham K Ahmed, M Salim Alkodaymi, Mohammed Mohammed Soliman, Asaad Suliman Shujaa
BACKGROUND Myocardial infarction (MI) is one of the most serious conditions presenting to the Emergency Department. Typical/classical symptoms of MI include chest pain and tightness that is referred to the left arm. CASE REPORT We present a case of ST-elevation myocardial infarction (STEMI) with a primary atypical presentation of right ear pain. The patient was diagnosed with STEMI based on electrocardiogram (ECG) and cardiac markers. As a result, the patient underwent percutaneous intervention (PCI), which showed an occluded left anterior descending artery (LAD) compared to the previous reported studies with similar presentation in which the right coronary artery (RCA) was affected...
September 29, 2017: American Journal of Case Reports
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