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Giosafat Spitaleri, Salvatore Brugaletta, Giancarla Scalone, Elisabetta Moscarella, Luis Ortega-Paz, Alberto Pernigotti, Josep Gomez-Lara, Angel Cequier, Andrés Iñiguez, Antonio Serra, Pilar Jiménez-Quevedo, Vicente Mainar, Gianluca Campo, Maurizio Tespili, Peter den Heijer, Armando Bethencourt, Nicolás Vazquez, Marco Valgimigli, Patrick W Serruys, Manel Sabaté
In patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI), lack of ST-segment resolution (STR) is associated with poor prognosis at short- and long-term follow-up. The aim of this study was to evaluate the role of STR on very long-term outcomes in patients with STEMI treated with pPCI included in the EXAMINATION (Evaluation of the Xience-V Stent in Acute Myocardial Infarction) trial. Patients were stratified according to the presence of STR < 50% and STR < 70% at the 30-minute post-pPCI electrocardiogram...
February 7, 2018: American Journal of Cardiology
Abdulla Shehab, Khalid F AlHabib, Akshaya Srikanth Bhagavathul, Ahmad Hersi, Hussam Alfaleh, Mostafa Q Alshamiri, Anhar Ullah, Khadim Sulaiman, Wael Almahmeed, Jassim Al Suwaidi, Alwai A Alsheikh-Ali, Haitham Amin, Mohammed Al Jarallah, Amar M Salam
BACKGROUND: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIM: To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries...
March 14, 2018: Current Vascular Pharmacology
Jasveen J Kandhai-Ragunath, Carine J M Doggen, Liefke C van der Heijden, Marlies M Kok, Paolo Zocca, Bjorn de Wagenaar, Cees Doelman, Harald T Jørstad, Ron J G Peters, Clemens von Birgelen
Knowledge about the changes in endothelial function after ST-elevation myocardial infarction (STEMI) is of substantial interest, but serial data are scarce. The aim of the present study was to noninvasively evaluate whether endothelial function, as assessed shortly after primary percutaneous coronary intervention (PPCI) for STEMI, may improve until 12-month follow-up. This prospective observational cohort study was performed in patients in the RESPONSE randomized trial who participated in a substudy and underwent noninvasive assessment of endothelial function at 1 (baseline), 6, and 12-month follow-up after treatment of a STEMI by PPCI...
March 14, 2018: Heart and Vessels
Zuoyan Wang, Na Liu, Lihui Ren, Licheng Lei, Huiming Ye, Jianjun Peng
BACKGROUND: The intracoronary high-thrombus burden during the primary percutaneous coronary intervention in patients with ST-elevation myocardial infarction (STEMI) can lead to poor outcomes. Monocytes have been described to play an important role in thrombotic disorders. OBJECTIVES: This study aimed to investigate the relationship between admission monocyte count and angiographic intracoronary thrombus burden in patients receiving primary percutaneous coronary intervention (PPCI)...
March 12, 2018: Arquivos Brasileiros de Cardiologia
Bangming Cao, Chi Zhang, Haipeng Wang, Ming Xia, Xiangjun Yang
Background: Whether upper arm remote ischemic postconditioning (RIPostC) exerts protection to kidney in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) remains unknown. Methods: Sixty-four patients with STEMI were randomized to PPCI + RIPostC (n=29) and PPCI (n=35) groups. RIPostC consisting of 4 cycles of 5 minutes occlusion/reperfusion by cuff inflation/deflation of the upper arm was started within 1 minute after the first balloon dilatation...
2018: Therapeutics and Clinical Risk Management
Rachel C Brierley, Maria Pufulete, Jessica Harris, Chiara Bucciarelli-Ducci, John P Greenwood, Stephen Dorman, Richard Anderson, Chris A Rogers, Barnaby C Reeves
OBJECTIVES: To determine whether it is feasible to set up a national registry, linking routinely collected data from hospital information systems (HIS), to investigate the role of cardiovascular magnetic resonance (CMR) in patients who activate the primary percutaneous coronary intervention (PPCI) pathway. DESIGN: Feasibility prospective cohort study, to establish whether: (1) consent can be implemented; (2) data linkage and extraction from multiple HIS can be achieved for >90% of consented patients; (3) local data can be successfully linked with hospital episode data (Hospital Episode Statistics, HES; Patient Episode Database for Wales, PEDW) for >90% of consented patients and (4) the proportion of patients activating the PPCI pathway who get a CMR scan is ≥10% in hospitals with dedicated CMR facilities...
March 1, 2018: BMJ Open
Giorgio Baralis, Roberta Rossini, Giuseppe Musumeci
Reperfusion therapy for patients presenting with an acute ST-segment elevation myocardial infarction (STEMI) involves primary percutaneous coronary intervention (PPCI) and concomitant dual antiplatelet therapy (DAPT) with combination of a P2Y12 inhibitor and acetylsalicylic acid (ASA). Decision regarding DAPT can be challenging clinically in the modern era with the evolution of newer stents, more potent antiplatelet agents and novel anticoagulant drugs in addition to an older patient population with multiple comorbidities...
February 19, 2018: Minerva Cardioangiologica
Mohamed Farag, Nikolaos Spinthakis, Manivannan Srinivasan, Keith Sullivan, David Wellsted, Diana A Gorog
The emergency management of ST-elevation myocardial infarction (STEMI) involves treatment with dual-antiplatelet therapy (DAPT) and primary percutaneous coronary intervention (PPCI). Pain is generally treated with opiates, which may delay gastric transit and reduce DAPT absorption. We sought to assess the effect of morphine on reperfusion, infarct size and thrombotic status in 300 patients presenting for PPCI. Morphine was given in a non-randomized fashion as required by emergency teams en route to the heart attack centre...
February 14, 2018: Thrombosis and Haemostasis
Ken Parhar, Victoria Millar, Vasileios Zochios, Emilia Bruton, Catherine Jaworksi, Nick West, Alain Vuylsteke
Background: Outcomes for patients with ST-segment elevation myocardial infarction continue to improve, largely due to timely provision of reperfusion by primary percutaneous coronary intervention (PPCI). However, despite prompt and successful PPCI, a small proportion of patients require ventilatory and hemodynamic support in an intensive care unit (ICU). The outcome of these patients remains poorly defined. Methods: A retrospective review of all consecutive admissions post-PPCI pathway to a single ICU between January 2009 and May 2014 was performed...
2018: Journal of Intensive Care
Lohit Garg, Sahil Agrawal, Manyoo Agarwal, Mahek Shah, Aakash Garg, Brijesh Patel, Nayan Agarwal, Sudip Nanda, Abhishek Sharma, David Cox
Atrial fibrillation (AF) is a common co-morbidity among patients presenting with acute ST-segment elevation myocardial infarction (STEMI). Previously, small studies have reported an association between AF and poorer outcomes among patients with STEMI. We performed this study to investigate the impact of AF on in-hospital outcomes in patients with STEMI treated with primary percutaneous coronary intervention (PPCI) using a large national database. The study population constituted of patients 18 years and older with a primary discharge diagnosis of STEMI and who underwent PPCI...
March 15, 2018: American Journal of Cardiology
Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
Federico Fortuni, Marco Ferlini, Sergio Leonardi
Acute myocardial infarction (AMI) is a major cause of morbidity, mortality and disability worldwide. ST-segment elevation myocardial infarction (STEMI) accounts for 25-40% of AMI presentations. Arterial thrombosis due to atherosclerotic plaque rupture with formation of an occlusive thrombus, is the main cause of STEMI . Platelets and coagulation factors are the two principal elements involved in this process. The main goal of STEMI treatment is the early reperfusion. Prompt primary percutaneous coronary intervention (pPCI) together with an appropriate antithrombotic therapy are the treatment of choice in this setting...
February 1, 2018: Minerva Cardioangiologica
Gianluca Campo, Francesco Gallo, Giulia Bugani, Rita Pavasini, Massimo Fineschi
Reperfusion therapy of the infarct-related artery (IRA) with primary percutaneous coronary intervention (pPCI) is the cornerstone for the treatment of patients with ST-elevation myocardial infarction (STEMI). However, up to 30% of STEMI patients present a multi-vessel coronary artery disease. Several methods are now available for the assessment of functional severity of a coronary stenosis both for IRA and non culprit coronary lesions. The functional assessment of the IRA has mainly a prognostic implication in terms of major adverse cardiovascular events (MACEs), recovery of left ventricular function and evaluation myocardial viability...
February 1, 2018: Minerva Cardioangiologica
Metin Çağdaş, Süleyman Karakoyun, Mahmut Yesin, İbrahim Rencüzoğulları, Yavuz Karabağ, Mahmut Uluganyan, Mustafa Ozan Gürsoy, İnanç Artaç, Doğan İliş, Eray Atalay, Öznur Sadioğlu Çağdaş
Background: Monocyte to high-density-lipoprotein cholesterol ratio (MHR) simply reflects proatherogenic and antiatherogenic balance and high level of this ratio is associated with severity of coronary atherosclerosis and cardiac events. We investigated the association between MHR and coronary artery disease severity using SYNTAX score and SYNTAX score II (SSII) in ST-elevation myocardial infarction (STEMI) patients treated with primary percutaneous coronary intervention (pPCI). Methods: A total of 315 consecutive patients with STEMI who underwent pPCI from January 2014 to January 2016 were enrolled...
January 2018: Acta Cardiologica Sinica
M Ali, S A Lange, T Wittlinger, G Lehnert, S Behrend, B Ziadeh, K Ali, S Sakellaropoulos, G Ganchev, A G Rigopoulos, M Noutsias
BACKGROUND: Although the incidence of acute myocardial infarction and in-hospital mortality after ST-elevation myocardial infarction (STEMI) has declined substantially in countries that have established primary percutaneous coronary interventions (pPCI) over the past two decades, coronary artery disease remains a major cause of morbidity and mortality worldwide. We aimed to examine whether the direct transfer of STEMI patients to the cardiac catheterization laboratory (CCL) had a prognostic effect on in-hospital mortality in patients who underwent pPCI after STEMI...
January 19, 2018: Herz
Eka Ginanjar, Yulianto Yulianto
The purpose of this case repots are to evaluate the role of ST elevation in aVR lead and to make analysis between both cases. There are some atypical electrocardiogram (ECG) presentations which need prompt management in patient with ischemic clinical manifestation such as ST elevation in aVR lead. In this case study, we report a 68-year old woman with chief symptoms of shortness of breath and chest discomfort. She was diagnosed with cardiogenic shock, with Killip class IV, and TIMI score of 8. The second case is a 57-year-old man with typical chest pain at rest which could not be relieved with nitrate treatment...
October 2017: Acta Medica Indonesiana
Metin Çağdaş, Süleyman Karakoyun, İbrahim Rencüzoğulları, Yavuz Karabağ, Mahmut Yesin, Yalçın Velibey, İnanç Artaç, Doğan İliş, Süleyman Çağan Efe, Onur Taşar, Halil İbrahim Tanboğa
OBJECTIVE: T-peak-T-end (TPE) interval, which represents the dispersion of repolarization, is defined as the interval between the peak and end of the T-wave, and is associated with increased malignant ventricular arrhythmia and sudden cardiac death (SCD) in patients with ST elevation myocardial infarction (STEMI). Although prolonged TPE interval is associated with poor short- and long-term outcomes, even in patients with STEMI treated with successful primary percutaneous coronary intervention (pPCI), clinical, angiographic, and laboratory parameters that affect TPE remain to be elucidated...
January 2018: Anatolian Journal of Cardiology
Adeel Shahzad, Vikram Khanna, Ian Kemp, Matthew Shaw, Christine Mars, Robert Cooper, Keith Wilson, Nick Curzen, Rod H Stables
AIMS: The HEAT-PPCI trial compared bivalirudin and unfractionated heparin in patients undergoing Primary PCI. We report pre-specified, secondary analyses comparing the effects of P2Y12 inhibiting agents on platelet reactivity and clinical events. METHODS AND RESULTS: All patients received pre-procedural oral anti-platelet therapy. During the early stages of the trial, the P2Y12 inhibitor of choice was prasugrel with some use of clopidogrel. Later, routine therapy switched to ticagrelor...
January 16, 2018: EuroIntervention
Mert İlker Hayıroğlu, Muhammed Keskin, Ahmet Okan Uzun, Ceyhan Türkkan, Ahmet İlker Tekkeşin, Ömer Kozan
BACKGROUND: Electrical phenomenon and remote myocardial ischemia are the main factors of ST segment depression in inferior leads in acute anterior myocardial infarction (AAMI). We investigated the prognostic value of the sum of ST segment depression amplitudes in inferior leads in patients with first AAMI treated with primary percutaneous coronary intervention. (PPCI). METHODS: In this prospective analysis, we evaluated the in-hospital prognostic impact of the sum of ST segment depression in inferior leads on 206 patients with first AAMI...
December 12, 2017: Journal of Electrocardiology
Madoka Sunamura, Nienke Ter Hoeve, Rita Jg van den Berg-Emons, Eric Boersma, Ron T van Domburg, Marcel L Geleijnse
Aims: We aimed to assess the effects of a multidisciplinary cardiac rehabilitation program (CR) on survival after treatment with primary percutaneous coronary intervention (pPCI) for acute coronary syndrome (ACS). Methods and results: Using propensity matching analysis, a total of 1,159 patients undergoing CR were 1:1 matched with ACS patients who did not undergo CR and survived at least 60 days. Kaplan-Meier analyses and multivariate Cox regression analysis were applied to study differences in survival...
January 9, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
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