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https://www.readbyqxmd.com/read/28420670/confirmed-early-myocardial-rupture-in-a-patient-with-pulseless-electrical-activity-pea-following-late-presentation-of-st-elevation-myocardial-infarction
#1
Baskar Sekar, Joe Martins, Sanjiv Petkar
A 69 year old male, an ex-smoker, was admitted with ongoing chest pain of 11 hours duration. Past medical history included treated hypertension and gastro-oesophageal reflux disease. He delayed seeking medical attention as he assumed the pain to be due to indigestion and kept taking antacids without much symptomatic relief. Clinical examination on arrival was unremarkable. Admission 12 lead electrocardiogram (ECG) was diagnostic of a recent anterolateral myocardial infarction (MI) (Figure 1a). Bedside trans-thoracic echocardiogram (TTE) confirmed an established anterolateral MI (Video 1, Figure 1b)...
April 18, 2017: Echo Research and Practice
https://www.readbyqxmd.com/read/28413512/long-term-statin-use-before-primary-percutaneous-coronary-intervention-improves-treatment-outcomes-of-acute-myocardial-infarction
#2
Ruiwei Guo, Lixia Yang, Lihua Mu, Xianfeng Pan, Feng Qi
Numerous studies have reported that high-dose statin loading therapy prior to primary percutaneous coronary intervention (PPCI) improves the clinical outcomes of patients following acute myocardial infarction (AMI). However, little is known about the effects of long-term statin use prior to PPCI on such outcomes. Therefore, the aim of the present analysis was to clarify the effects of long-term statin use before PPCI on the treatment outcomes of patients following AMI. The records of 213 patients who had AMI and met the inclusion criteria were retrospectively reviewed...
April 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28400120/impact-of-point-of-care-pre-procedure-creatinine-and-egfr-testing-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-pci-the-pilot-statcreat-study
#3
Grigoris V Karamasis, James Hampton-Till, Firas Al-Janabi, Shah Mohdnazri, Michael Parker, Adam Ioannou, Rohan Jagathesan, Alagmir Kabir, Jeremy W Sayer, Nicholas M Robinson, Rajesh K Aggarwal, Gerald J Clesham, Reto A Gamma, Paul A Kelly, Kare H Tang, John R Davies, Thomas Keeble
BACKGROUND: Contrast-induced acute kidney injury (CI-AKI) is a recognised complication during primary PCI that affects short and long term prognosis. The aim of this study was to assess the impact of point-of-care (POC) pre-PPCI creatinine and eGFR testing in STEMI patients. METHODS: 160 STEMI patients (STATCREAT group) with pre-procedure POC testing of Cr and eGFR were compared with 294 consecutive retrospective STEMI patients (control group). Patients were further divided into subjects with or without pre-existing CKD...
April 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28376544/how-long-does-it-take-clopidogrel-and-ticagrelor-to-inhibit-platelets-in-patients-undergoing-primary-percutaneous-coronary-intervention-a-detailed-pharmacodynamic-analysis-time-course-of-platelet-reactivity-in-stemi-tops
#4
Thomas O Bergmeijer, Thea C Godschalk, Paul W A Janssen, Kim van den Berge, Nicoline J Breet, Johannes C Kelder, Christian M Hackeng, Jurriën M Ten Berg
Antiplatelet therapy plays a pivotal role in patients with an ST-segment elevation myocardial infarction (STEMI) to prevent further atherothrombotic events, such as stent thrombosis. Although the risk of stent thrombosis is highest in the first hours after primary percutaneous coronary intervention (pPCI), little is known about when an adequate level of platelet inhibition is achieved following a clopidogrel or ticagrelor loading dose in STEMI patients. Patients presenting with STEMI in whom pPCI was performed and who were loaded with 600 mg clopidogrel or 180 mg ticagrelor were eligible for enrolment in this nonrandomized, open label, single-center study...
April 4, 2017: Seminars in Thrombosis and Hemostasis
https://www.readbyqxmd.com/read/28370496/role-of-deferred-stenting-in-patients-with-st-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#5
Giovanni Luigi De Maria, Mohammad Alkhalil, Evangelos K Oikonomou, Mathias Wolfrum, Robin P Choudhury, Adrian P Banning
OBJECTIVES: We conducted a meta-analysis of studies comparing deferred stenting strategy versus the conventional approach with immediate stenting in patients with ST elevation myocardial infarction. BACKGROUND: Deferring stent after mechanical flow restoration has been proposed as a strategy to reduce the risk of "no reflow" in patients with STEMI undergoing primary percutaneous coronary intervention (pPCI). Conflicting evidence is available currently, especially after the recent publication of three randomized clinical trials...
March 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28362665/comparing-mortality-between-fibrinolysis-and-primary-percutaneous-coronary-intervention-in-patients-with-acute-myocardial-infarction-a-systematic-review-and-meta-analysis-of-27-randomized-controlled-trials-including-11%C3%A2-429-patients
#6
Chandra M Yanamala, Pravesh K Bundhun, Anis Ahmed
OBJECTIVES: We aimed to improve the limitations encountered in previously published studies and then compare mortality in patients with acute myocardial infarction (AMI) who were treated with either fibrinolysis or a primary percutaneous coronary intervention (PPCI). METHODS: EMBASE, MEDLINE, and the Cochrane databases were searched for trials comparing fibrinolysis with PPCI in patients with AMI. The only endpoint that was assessed in this analysis was all-cause mortality...
June 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28315564/clinical-risk-scores-predict-procedural-complications-of-primary-percutaneous-coronary-intervention
#7
László Hadadi, Razvan Constantin Şerban, Alina Scridon, Ioana Şuş, Éva Katalin Lakatos, Zoltán Demjén, Dan Dobreanu
OBJECTIVE: The predictive value of five risk score models containing clinical (PAMI-PMS, GRACE-GRS, and modified ACEF-ACEFm-scores), angiographic SYNTAX score (SXS) and combined Clinical SYNTAX score (CSS) variables were evaluated for the incidence of three procedural complications of primary percutaneous coronary intervention (pPCI): iatrogenic coronary artery dissection, angiographically visible distal embolization and angiographic no-reflow phenomenon. METHODS: The mentioned scores and the incidence of procedural complications were retrospectively analyzed in 399 consecutive patients with acute ST-elevation myocardial infarction who underwent pPCI...
March 9, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28303647/ratio-of-systolic-blood-pressure-to-left-ventricular-end-diastolic-pressure-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-in-hospital-mortality-in-patients-with-st-elevation-myocardial-infarction
#8
Michael Sola, Kiran Venkatesh, Melissa Caughey, Robert Rayson, Xuming Dai, George A Stouffer, Michael Yeung
OBJECTIVE: To determine the ability of simple hemodynamic parameters obtained at the time of cardiac catheterization to predict in-hospital mortality following ST-elevation myocardial infarction (STEMI). BACKGROUND: Hemodynamic parameters measured at the time of primary percutaneous coronary intervention (PPCI) could potentially identify high-risk patients who would benefit from aggressive hemodynamic support in the Cardiac Catheterization laboratory. METHODS: This is a retrospective single-center study of 219 consecutive patients with STEMI...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28294854/-registry-of-acute-coronary-syndromes-record-3-characteristics-of-patients-and-treatment-during-initial-hospitalization
#9
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28278275/higher-incidence-of-hypotension-episodes-in-women-during-the-sub-acute-phase-of-st-elevation-myocardial-infarction-and-relationship-to-covariates
#10
Petr Kala, Tomas Novotny, Irena Andrsova, Klara Benesova, Maria Holicka, Jiri Jarkovsky, Katerina Hnatkova, Lumir Koc, Monika Mikolaskova, Tereza Novakova, Tomas Ondrus, Lenka Privarova, Jindrich Spinar, Marek Malik
OBJECTIVE: The introduction of primary percutaneous coronary intervention (PPCI) has modified the profile of ST elevation myocardial infarction (STEMI) patients. Occurrence and prognostic significance of hypotension episodes are not known in PPCI treated STEMI patients. It is also not known whether and/or how the hypotension episodes correlate with the degree of myocardial damage and whether there are any sex differences. METHODS: Data of 293 consecutive STEMI patients (189 males) treated by PPCI and without cardiogenic shock were analyzed...
2017: PloS One
https://www.readbyqxmd.com/read/28256426/temporal-trends-of-reperfusion-strategies-and-hospital-mortality-for-patients-with-stemi-in-percutaneous-coronary-intervention-capable-hospitals
#11
Dat T Tran, Robert C Welsh, Arto Ohinmaa, Nguyen X Thanh, Padma Kaul
BACKGROUND: The aim of this study was to examine temporal trends and provincial variations in reperfusion strategies and in-hospital mortality among patients presenting with ST-segment elevation myocardial infarction (STEMI) at hospitals in Canada capable of performing percutaneous coronary intervention (PCI). METHODS: We included patients aged ≥ 20 years who were hospitalized between fiscal years 2009 and 2013 in all provinces except Quebec. We categorized patients as receiving fibrinolysis (lysis), primary PCI (pPCI), or no reperfusion...
December 8, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28242607/invasive-assessment-of-the-coronary-microcirculation-in-reperfused-st-segment-elevation-myocardial-infarction-patients-where-do-we-stand
#12
Heerajnarain Bulluck, Nicolas Foin, Jack W Tan, Adrian F Low, Murat Sezer, Derek J Hausenloy
For patients presenting with an acute ST-segment-elevation myocardial infarction, the most effective therapy for reducing myocardial infarct size and preserving left ventricular systolic function is primary percutaneous coronary intervention (PPCI). However, mortality and morbidity remain significant. This is partly attributed to the development of microvascular obstruction, which occurs in around 50% of ST-segment-elevation myocardial infarction patients post-PPCI, and it is associated with adverse left ventricular remodeling and worse clinical outcomes...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28240997/improved-survival-of-patients-with-st-segment-elevation-myocardial-infarction-3-6-hours-after-symptom-onset-is-associated-with-inter-hospital-transfer-for-primary-percutaneous-coronary-intervention-pci-at-a-large-regional-st-segment-elevation-myocardial-infarction
#13
Xiangmei Zhao, Xianzhi Yang, Chuanyu Gao, Yingjie Chu, Lei Yang, Lixiao Tian, Lin Li
BACKGROUND This study sought to compare the 30-day and 1-year survival of patients diagnosed with ST-segment elevation myocardial infarction (STEMI), whose symptom onset to in-hospital first medical contact (IHFMC) was 3-6 h, who received either in-hospital thrombolysis (IHT) in the nearest county hospital or direct transfer to a larger hospital in Henan province, China for primary percutaneous coronary intervention (PPCI). MATERIAL AND METHODS Patients were allocated into 2 groups: one group received IHT in the local county hospital, whereas the other group were transferred to the PCI centers to receive PPCI...
February 27, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28237737/data-from-the-german-chest-pain-unit-registry-the-well-known-gap-between-knowledge-and-practice
#14
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/28237549/il-37-increased-in-patients-with-acute-coronary-syndrome-and-associated-with-a-worse-clinical-outcome-after-st-segment-elevation-acute-myocardial-infarction
#15
Kun Liu, Qiang Tang, Xinyuan Zhu, Xinchun Yang
BACKGROUND: IL-37 emerges as a natural suppressor of inflammatory responses. The potential role of IL-37 in the pathology of atherosclerosis is unclear. The purpose of this study was to assess IL-37 profile in acute coronary syndrome (ACS) and the prognostic role of this cytokine in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: In a case-control study, we prospectively enrolled 216 patients undergoing the first coronary angiography, which consisted of 5 groups: normal (n=57), stable angina (SAP, n=36), unstable angina (UAP, n=42), non-STEMI (n=36), STEMI (n=45)...
February 24, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#16
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28216475/the-effect-of-ticagrelor-administered-through-a-nasogastric-tube-to-comatose-patients-undergoing-acute-percutaneous-coronary-intervention-the-ticoma-study
#17
Hanna Ratcovich, Golnaz Sadjadieh, Hedvig B Andersson, Martin Frydland, Sebastian Wiberg, Nadia P Dridi, Jesper Kjaergaard, Lene Holmvang
AIMS: Patients in a coma after cardiac arrest may have adversely affected drug absorption and metabolism. This study, the first of its kind, aimed to investigate the early pharmacokinetic and pharmacodynamic effects of ticagrelor administered through a nasogastric tube (NGT) to patients resuscitated after an out of hospital cardiac arrest (OHCA) and undergoing primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Blood samples were drawn at baseline and at two, four, six, eight, 12, and 24 hours and then daily for up to five days after administration of a 180 mg ticagrelor loading dose (LD), followed by 90 mg twice daily in 44 patients...
February 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28207567/relationship-between-r-wave-peak-time-and-no-reflow-in-st-elevation-myocardial-infarction-treated-with-a-primary-percutaneous-coronary-intervention
#18
Metin Çağdaş, Süleyman Karakoyun, İbrahim Rencüzoğullari, Yavuz Karabağ, Mahmut Yesin, Mahmut Uluganyan, Mustafa O Gürsoy, İnanç Artaç, Doğan İliş, Süleyman Ç Efe, Onur Taşar
Coronary no-reflow (NR) is observed in nearly half of ST segment elevation myocardial infarction (STEMI) patients who undergo a primary percutaneous coronary intervention (pPCI) despite epicardial coronary vessel patency. Several methods used to define NR include thrombolysis in myocardial infarction grade, corrected thrombolysis in myocardial infarction frame count, myocardial blush grade, ST-segment resolution, contrast echocardiography, and MRI. The aim of our study was to evaluate the relationship between NR and R-wave peak time (RWPT) measured from infarct-related artery leads METHOD: We enrolled 282 consecutive STEMI patients treated with pPCI in Kafkas University Hospital from January 2014 to January 2015...
June 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28199043/diagnostic-performance-of-t1-and-t2-mapping-to-detect-intramyocardial-hemorrhage-in-reperfused-st-segment-elevation-myocardial-infarction-stemi-patients
#19
Heerajnarain Bulluck, Stefania Rosmini, Amna Abdel-Gadir, Anish N Bhuva, Thomas A Treibel, Marianna Fontana, Esther Gonzalez-Lopez, Manish Ramlall, Ashraf Hamarneh, Alex Sirker, Anna S Herrey, Charlotte Manisty, Derek M Yellon, James C Moon, Derek J Hausenloy
PURPOSE: To investigate the performance of T1 and T2 mapping to detect intramyocardial hemorrhage (IMH) in ST-segment elevation myocardial infarction (STEMI) patients treated by primary percutaneous coronary intervention (PPCI). MATERIALS AND METHODS: Fifty STEMI patients were prospectively recruited between August 2013 and July 2014 following informed consent. Forty-eight patients completed a 1.5T cardiac magnetic resonance imaging (MRI) with native T1 , T2 , and T2* maps at 4 ± 2 days...
February 15, 2017: Journal of Magnetic Resonance Imaging: JMRI
https://www.readbyqxmd.com/read/28181318/factors-influencing-the-degree-of-physician-pharmacist-collaboration-within-iraqi-public-healthcare-settings
#20
Ali Azeez Al-Jumaili, Mohammed D Al-Rekabi, William Doucette, Ahmed H Hussein, Hayder K Abbas, Furqan H Hussein
OBJECTIVES: Medication safety and effectiveness can be improved through interprofessional collaboration. The goals of this study were to measure the degree of physician-pharmacist collaboration within Iraqi governmental healthcare settings and to investigate factors influencing this collaboration. METHODS: This cross-sectional study was conducted in Al-Najaf Province using the Collaborative Working Relationship Model and Physician-Pharmacist Collaborative Instrument (PPCI)...
February 9, 2017: International Journal of Pharmacy Practice
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