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https://www.readbyqxmd.com/read/29320987/effect-of-intracoronary-agents-on-the-no-reflow-phenomenon-during-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-a-network-meta-analysis
#1
Xiaowei Niu, Jingjing Zhang, Ming Bai, Yu Peng, Shaobo Sun, Zheng Zhang
BACKGROUND: Despite the restoration of epicardial flow after primary percutaneous coronary intervention (PPCI), myocardial reperfusion remains impaired in a significant proportion of patients. We performed a network meta-analysis to assess the effect of 7 intracoronary agents (adenosine, anisodamine, diltiazem, nicorandil, nitroprusside, urapidil, and verapamil) on the no-reflow phenomenon in patients with ST-elevation myocardial infarction (STEMI) undergoing PPCI. METHODS: Database searches were conducted to identify randomized controlled trials (RCTs) comparing the 7 agents with each other or with standard PPCI...
January 10, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29319393/sex-based-differences-in-discharge-disposition-and-outcomes-for-st-segment-elevation-myocardial-infarction-patients-within-a-regional-network
#2
James R Langabeer, Timothy D Henry, Raymond Fowler, Tiffany Champagne-Langabeer, Junghyun Kim, Alice K Jacobs
BACKGROUND: It is known that women with ST-segment elevation myocardial infarction (STEMI) have higher mortality in comparison to men. While the reasons for this sex-based difference are not completely understood, biologic differences and disparities in care have been implicated. Whether these differences persist within an urban, regional STEMI system of care with defined protocols is unclear. Our objective was to explore sex-related effects in outcomes in a large regional system of care...
January 10, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#3
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/29281605/trends-in-cardiovascular-risk-profiles
#4
REVIEW
Samir Kapadia
Outcomes for patients with coronary artery disease (CAD) have improved in the past 20 years likely due to advances in clinical care such as angiotensin-converting enzyme inhibitors, antiplatelet agents, and reduced time to cardiac cauterization procedures. But how have the risk factors for CAD changed in the past 2 decades? Analysis of nearly 4,000 patients with ST-elevation myocardial infarction (STEMI) at a tertiary care center found that patients presenting with acute STEMI are younger and more obese than in the past...
December 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/29275369/regional-call-911-emergency-department-protocol-to-reduce-interfacility-transfer-delay-for-patients-with-st-segment-elevation-myocardial-infarction
#5
Nichole Bosson, Terrence Baruch, William J French, Andrea Fang, Amy H Kaji, Marianne Gausche-Hill, Alisa Rock, David Shavelle, Joseph L Thomas, James T Niemann
BACKGROUND: We evaluated the first-medical-contact-to-balloon (FMC2B) time after implementation of a "Call 911" protocol for ST-segment-elevation myocardial infarction (STEMI) interfacility transfers in a regional system. METHODS AND RESULTS: This is a retrospective cohort study of consecutive patients with STEMI requiring interfacility transfer from a STEMI referring hospital, to one of 35 percutaneous coronary intervention-capable STEMI receiving centers (SRCs)...
December 23, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29242184/sex-differences-in-treatments-relative-survival-and-excess-mortality-following-acute-myocardial-infarction-national-cohort-study-using-the-swedeheart-registry
#6
Oras A Alabas, Chris P Gale, Marlous Hall, Mark J Rutherford, Karolina Szummer, Sofia Sederholm Lawesson, Joakim Alfredsson, Bertil Lindahl, Tomas Jernberg
BACKGROUND: This study assessed sex differences in treatments, all-cause mortality, relative survival, and excess mortality following acute myocardial infarction. METHODS AND RESULTS: A population-based cohort of all hospitals providing acute myocardial infarction care in Sweden (SWEDEHEART [Swedish Web System for Enhancement and Development of Evidence-Based Care in Heart Disease Evaluated According to Recommended Therapies]) from 2003 to 2013 was included in the analysis...
December 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29239074/barriers-to-the-use-of-emergency-medical-services-for-st-elevation-myocardial-infarction-determining-why-many-patients-opt-for-self-transport
#7
Mathew Mercuri, Katherine Connolly, Madhu K Natarajan, Michelle Welsford, J D Schwalm
RATIONALE, AIMS, AND OBJECTIVES: Access to timely ST-elevation myocardial infarction (STEMI) care is facilitated by paramedics and emergency medical services (EMS). However, a large proportion of STEMI patients do not access care through EMS. This study sought to identify patient-reported factors for their decision to use (or not use) EMS. METHODS: Semi-structured interviews were conducted with a sample of STEMI patients admitted to a large tertiary care centre between November 2011 and January 2012...
December 13, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/29237337/key-interventions-and-quality-indicators-for-quality-improvement-of-stemi-care-a-rand-delphi-survey
#8
Daan Aeyels, Peter R Sinnaeve, Marc J Claeys, Sofie Gevaert, Danny Schoors, Walter Sermeus, Massimiliano Panella, Ellen Coeckelberghs, Luk Bruyneel, Kris Vanhaecht
OBJECTIVE: Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. METHODS AND RESULTS: A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI...
December 13, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29232970/primary-coronary-intervention-in-octogenarians-and-nonagenarians-with-st-segment-elevation-myocardial-infarction-a-canadian-single-center-perspective
#9
Rajat Sharma, Brett Hiebert, David Cheung, Davinder S Jassal, Kunal Minhas
The proportion of individuals >80 years of age constitute an increasing proportion of patients who present with ST-segment elevation myocardial infarction (STEMI). The objective of this study is to evaluate in-hospital outcomes and 1-year survival of very elderly patients who present with an STEMI and undergo primary percutaneous coronary intervention (pPCI). Between 2009 and 2015, individuals >80 years of age (very elderly patients) with an STEMI presenting at a single tertiary Canadian care center were included in the study...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/29228878/quality-assessment-in-belgian-st-elevation-myocardial-infarction-patients-results-from-the-belgian-stemi-database
#10
Marc J Claeys, Peter R Sinnaeve, Carl Convens, Philippe Dubois, Suzanne Pourbaix, Pascal Vranckx, Sofie Gevaert, Herbert De Raedt, Christophe Beauloye, Jean-Francois Argacha, Patrick Evrard, Patrick Coussement
The present report describes the quality of care, including in hospital mortality for more than 22.000 STEMI patients admitted in 60 Belgian hospitals for the period 2008-2016. We found a strong increase in the use of primary PCI over time, particularly for patients that were admitted first in a non-PCI capable hospital, reaching a penetration rate of >95%. The transition of thrombolysis to transfer for pPCI in the setting of a STEMI network was, however, associated with an increase of the proportion of patients with prolonged (>120 min) diagnosis-to-balloon time (from 16 to 22%), suggesting still suboptimal interhospital transfer...
December 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29223432/contemporary-risk-model-for-inhospital-major-bleeding-for-patients-with-acute-myocardial-infarction-the-acute-coronary-treatment-and-intervention-outcomes-network-action-registry%C3%A2-get-with-the-guidelines-gwtg-%C3%A2
#11
MULTICENTER STUDY
Nihar R Desai, Kevin F Kennedy, David J Cohen, Traci Connolly, Deborah B Diercks, Mauro Moscucci, Stephen Ramee, John Spertus, Tracy Y Wang, Robert L McNamara
BACKGROUND: Major bleeding is a frequent complication for patients with acute myocardial infarction (AMI) and is associated with significant morbidity and mortality. OBJECTIVE: To develop a contemporary model for inhospital major bleeding that can both support clinical decision-making and serve as a foundation for assessing hospital quality. METHODS: An inhospital major bleeding model was developed using the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG) database...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223429/predicting-risk-of-cardiac-events-among-st-segment-elevation-myocardial-infarction-patients-with-conservatively-managed-non-infarct-related-artery-coronary-artery-disease-an-analysis-of-the-duke-databank-for-cardiovascular-disease
#12
RANDOMIZED CONTROLLED TRIAL
Sameer A Hirji, Susanna R Stevens, Linda K Shaw, Erin C Campbell, Christopher B Granger, Manesh R Patel, Michael H Sketch, Tracy Y Wang, E Magnus Ohman, Eric D Peterson, J Matthew Brennan
BACKGROUND: Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit likely depends on the risk of future major adverse cardiovascular events (MACE). METHODS: Using data from Duke University Medical Center (2003-2012), we identified those at high risk for 1-year MACE among 664 STEMI patients with conservatively managed non-infarct-related artery (non-IRA) lesions...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#13
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29217152/advanced-cardiopulmonary-resuscitation-cpr-in-the-catheterization-laboratory-consensus-document-of-the-working-groups-of-1-cardiopulmonary-resuscitation-acute-cardiac-care-and-2-hemodynamic-and-interventional-cardiology-hellenic-cardiological-society
#14
George Latsios, George Mpompotis, Kostas Tsioufis, Kostas Toutouzas, Emmanouil Skalidis, Andreas Synetos, Dimosthenis Avramidis, Dimitris Tousoulis
The incidence of Cardiac (Cardio-Pulmonary) Arrest (CA) in the Catheterization Laboratory is not common. However, not only does it happen occasionally but its frequency tends to increase due to the increase in the overall number and complexity of interventions performed by interventional cardiologists. Therefore, certified knowledge and application of the ALS (Advanced Life Support) protocols by trained Catheterization Laboratory staff is imperative in many countries, by local Hospital standards and also by Law...
December 4, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29198986/australian-trends-in-procedural-characteristics-and-outcomes-in-patients-undergoing-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#15
Sinjini Biswas, Stephen J Duffy, Jeffrey Lefkovits, Nick Andrianopoulos, Angela Brennan, Antony Walton, William Chan, Samer Noaman, James A Shaw, Luke Dawson, Andrew Ajani, David J Clark, Melanie Freeman, Chin Hiew, Ernesto Oqueli, Christopher M Reid, Dion Stub
Over the last decade, systems of care for ST-elevation myocardial infarction (STEMI) have evolved to try to improve outcomes and timely access to percutaneous coronary intervention (PCI). There have also been advances in PCI techniques and adjunctive pharmacotherapies. In this study, we sought to determine temporal changes in practices and clinical outcomes of PCI in patients with STEMI. We prospectively collected data on 8,412 consecutive patients undergoing PCI for STEMI between 2005 and 2016 in the multicenter Melbourne Interventional Group registry...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29189830/-ambulatory-cardiac-rehabilitation-in-trieste-protocols-of-intervention-activities-and-outcomes
#16
Sara Doimo, Patrizia Maras, Giulia Barbati, Enrico Fabris, Alessio Della Mattia, Kareem Salame, Giuseppe Gatti, Gianfranco Sinagra
BACKGROUND: Cardiac rehabilitation (CR) is a model of care proven to reduce mortality and morbidity in patients with coronary artery disease. The aim of this study is to describe the ambulatory CR model of the Cardiovascular Department of Trieste (Italy), analyzing the outcome of the population. METHODS: We analyzed clinical and instrumental characteristics of all consecutive patients after ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), coronary artery bypass graft with or without valve surgery (CABG/CABGV), or planned percutaneous coronary intervention (PCI), referred for CR from January 1, 2009, to December 31, 2015...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29185210/acute-kidney-injury-based-on-the-kdigo-criteria-among-st-elevation-myocardial-infarction-patients-treated-by-primary-percutaneous-intervention
#17
Gilad Margolis, Amir Gal-Oz, Sevan Letourneau-Shesaf, Shafik Khoury, Gad Keren, Yacov Shacham
BACKGROUND: Acute kidney injury (AKI) following acute ST elevation myocardial infarction (STEMI) is associated with adverse outcomes. The recently proposed KDIGO criteria suggested modifications to the consensus classification system for AKI, namely lowering the threshold of increase in absolute serum creatinine and extending the time frame for AKI detection to 7 days. We evaluated the incidence, risk factors, and long-term mortality associated with AKI as classified by the KDIGO definition in a large single center cohort of consecutive STEMI patients...
November 28, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29183704/reperfusion-of-myocardial-infarction-in-india-notions-for-m%C3%A3-xico
#18
Diego Araiza-Garaygordobil, Alexandra Arias-Mendoza, Carlos Martínez-Sánchez, Marco Antonio Martínez-Ríos, Mullasari S Ajit
In India and México, cardiovascular diseases are the first cause of death and potential years of life lost. Close similarities exist between these two countries when facing the difficulties to establish a universal reperfusion program for ST elevation myocardial infarction (STEMI). This paper describes the situation of STEMI treatment in both countries, and examines the lessons that Mexico's health care system could adopt from the recent advances accomplished by the STEMI initiative in India.
November 25, 2017: Archivos de Cardiología de México
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
#19
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/29151401/evaluation-of-a-primary-care-paramedic-stemi-bypass-guideline
#20
Jonathan L Kwong, Garry Ross, Linda Turner, Chris Olynyk, Sheldon Cheskes, Adam Thurston, P Richard Verbeek
OBJECTIVE: Limited evidence supports primary care paramedic (PCP) direct transport of ST-segment elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI). The goal of this study was to evaluate an urban-based PCP STEMI bypass guideline. METHODS: We reviewed consecutive Toronto Paramedic Services call reports between April 7, 2015, and May 31, 2016, regarding STEMI patients identified by PCPs. The primary outcome was patient assignment (stable versus unstable) according to guideline criteria...
November 20, 2017: CJEM
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