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https://www.readbyqxmd.com/read/27928224/clinical-outcomes-of-elderly-south-east-asian-patients-in-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction
#1
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
https://www.readbyqxmd.com/read/27925310/prognostic-factors-in-patients-with-stemi-undergoing-primary-pci-in-the-clopidogrel-era-role-of-dual-antiplatelet-therapy-at-admission-and-the-smoking-paradox-on-long-term-outcome
#2
Giovanni Ciccarelli, Emanuele Barbato, Marco Golino, Giovanni Cimmino, Jozef Bartunek, Luigi Di Serafino, Domenico Di Girolamo, Bernard De Bruyne, William Wijns, Paolo Golino
BACKGROUND: Several clinical and laboratory variables have an impact on the prognosis of STEMI patients undergoing PPCI; however, little is known about the role of ongoing DAPT at the time of the event and the smoking status as prognostic factors affecting the outcome of these patients. METHODS AND RESULTS: Seven-hundred and thirteen consecutive STEMI patients undergoing PPCI, admitted to the S. Anna and S. Sebastiano Hospital (Caserta, Italy) and to the OLV Clinic (Aalst, Belgium), between March 2009 and December 2011, were retrospectively enrolled...
December 7, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27899851/cutoff-value-of-admission-n-terminal-pro-brain-natriuretic-peptide-which-predicts-poor-myocardial-perfusion-after-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#3
Khairy Abdel-Dayem, Inas I Eweda, Ashraf El-Sherbiny, Marc O Dimitry, Wail Nammas
BACKGROUND: We explored the value of admission levels of N-terminal pro-brain natriuretic peptide (NTProBNP) that best predicts poor myocardial tissue perfusion following primary percutaneous coronary intervention (PPCI) in patients admitted with acute ST-segment-elevation myocardial infarction (STEMI). METHODS: We enrolled 90 consecutive patients admitted with acute STEMI who underwent PPCI and achieved post-procedural TIMI flow grade 3 in the infarct-related artery...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27891513/clinic-predictive-factors-for-insufficient-myocardial-reperfusion-in-st-segment-elevation-myocardial-infarction-patients-treated-with-selective-aspiration-thrombectomy-during-primary-percutaneous-coronary-intervention
#4
Jinfan Tian, Yue Liu, Xiantao Song, Min Zhang, Feng Xu, Fei Yuan, Shuzheng Lyu
Background. Insufficient data are available on the potential benefit of selective aspiration and clinical predictors for no-reflow in STEMI patients undergoing primary percutaneous coronary intervention (PPCI) adjunct with aspiration thrombectomy. Objective. The aim of our study was to investigate clinical predictors for insufficient reperfusion in patients with high thrombus burden treated with PPCI and manual aspiration thrombectomy. Methods. From January 2011 till December 2015, 277 STEMI patients undergoing manual aspiration thrombectomy and PPCI were selected and 202 patients with a Thrombolysis in Myocardial Infarction (TIMI) thrombus grade 4~5 were eventually involved in our study...
2016: BioMed Research International
https://www.readbyqxmd.com/read/27887720/prehospital-electrocardiographic-acuteness-score-of-ischemia-is-inversely-associated-with-neurohormonal-activation-in-stemi-patients-with-severe-ischemia
#5
Yama Fakhri, Mikkel Malby Schoos, Maria Sejersten, Mads Ersbøll, Nana Valeur, Lars Køber, Christian Hassager, Galen S Wagner, Jens Kastrup, Peter Clemmensen
BACKGROUND: Elevated levels of N-terminal pro brain natriuretic peptide (NT-proBNP) are associated with adverse cardiovascular outcome after ST elevation myocardial infarction (STEMI). We hypothesized that decreasing acuteness-score (based on the electrocardiographic score by Anderson-Wilkins acuteness score of myocardial ischemia) is associated with increasing NT-proBNP levels and the impact of decreasing acuteness-score on NT-proBNP levels is substantial in STEMI patients with severe ischemia...
November 10, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27884851/influence-of-preinfarction-angina-and-coronary-collateral-blood-flow-on-the-efficacy-of-remote-ischaemic-conditioning-in-patients-with-st-segment-elevation-myocardial-infarction-post-hoc-subgroup-analysis-of-a-randomised-controlled-trial
#6
Kasper Pryds, Morten Bøttcher, Astrid Drivsholm Sloth, Kim Munk, Michael Rahbek Schmidt, Hans Erik Bøtker
OBJECTIVES: Remote ischaemic conditioning (RIC) confers cardioprotection in patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI). We investigated whether preinfarction angina and coronary collateral blood flow (CCBF) to the infarct-related artery modify the efficacy of RIC. DESIGN: Post hoc subgroup analysis of a randomised controlled trial. PARTICIPANTS: A total of 139 patients with STEMI randomised to treatment with pPCI or RIC+pPCI...
November 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27866132/a-tool-for-predicting-the-outcome-of-reperfusion-in-st-elevation-myocardial-infarction-using-age-thrombotic-burden-and-index-of-microcirculatory-resistance-ati-score
#7
Giovanni Luigi De Maria, Gregor Fahrni, Mohammad Alkhalil, Florim Cuculi, Sam Dawkins, Mathias Wolfrum, Robin P Choudhury, John C Forfar, Bernard D Prendergast, Tuncay Yetgin, Robert Jan van Geuns, Matteo Tebaldi, Keith M Channon, Rajesh K Kharbanda, Peter M Rothwell, Marco Valgimigli, Adrian P Banning
AIMS: Restoration of effective myocardial reperfusion by primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction is difficult to predict. A method to assess the likelihood of a suboptimal response to conventional pharmacomechanical therapies could be beneficial. We aimed to derive and validate a scoring system that can be used acutely at the time of coronary reopening to predict the likelihood of downstream microvascular impairment in patients with STEMI...
November 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27844422/intracoronary-eptifibatide-during-primary-percutaneous-coronary-intervention-in-early-versus-late-presenters-with-st-segment-elevation-myocardial-infarction-a-randomized-trial
#8
Ayman Elbadawi, Gerald Gasioch, Islam Y Elgendy, Ahmed N Mahmoud, Le Dung Ha, Haitham Al Ashry, Hend Shahin, Mohamed A Hamza, Ahmed S Abuzaid, Marwan Saad
INTRODUCTION: The role of intracoronary (IC) eptifibatide in primary percutaneous coronary intervention (PPCI) for ST segment elevation myocardial infarction (STEMI) and whether time of patient presentation affects this role are unclear. We sought to evaluate the benefit of IC eptifibatide use during primary PCI in early STEMI presenters compared to late STEMI presenters. METHODS: We included 70 patients who presented with STEMI and were eligible for PPCI. On the basis of symptom-to-door time, patients were classified into two arms: early (<3 h, n = 34) vs late (≥3 h, n = 36) presenters...
November 14, 2016: Cardiology and Therapy
https://www.readbyqxmd.com/read/27842548/infarct-size-following-complete-revascularization-in-patients-presenting-with-stemi-a-comparison-of-immediate-and-staged-in-hospital-non-infarct-related-artery-pci-subgroups-in-the-cvlprit-study
#9
Jamal N Khan, Sheraz A Nazir, John P Greenwood, Miles Dalby, Nick Curzen, Simon Hetherington, Damian J Kelly, Daniel Blackman, Arne Ring, Charles Peebles, Joyce Wong, Thiagarajah Sasikaran, Marcus Flather, Howard Swanton, Anthony H Gershlick, Gerry P McCann
BACKGROUND: The CvLPRIT study showed a trend for improved clinical outcomes in the complete revascularisation (CR) group in those treated with an immediate, as opposed to staged in-hospital approach in patients with multivessel coronary disease undergoing primary percutaneous intervention (PPCI). We aimed to assess infarct size and left ventricular function in patients undergoing immediate compared with staged CR for multivessel disease at PPCI. METHODS: The Cardiovascular Magnetic Resonance (CMR) substudy of CvLPRIT was a multicentre, prospective, randomized, open label, blinded endpoint trial in PPCI patients with multivessel disease...
November 9, 2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27823693/serious-infections-among-unselected-patients-with-st-elevation-myocardial-infarction-treated-with-contemporary-primary-percutaneous-coronary-intervention
#10
Pedro Piccaro de Oliveira, Vinicius Gonzales, Renato D Lopes, Marcia Moura Schmidt, Silvia Garofallo, Rodrigo Pires Dos Santos, Luciana Carrion, Carlos Gottschall, Alexandre S Quadros
BACKGROUND: Contemporary studies assessing the frequency, characteristics, and outcomes of serious infections (SIs) in patients presenting a ST-elevation myocardial infarction are scarce. METHODS: Prospective cohort of consecutive patients undergoing primary percutaneous coronary intervention (pPCI). Serious infection was defined as the presence of infection that prolonged hospitalization. Community-acquired infection (CAI) was defined by SI diagnosed in the first 72 hours of hospitalization, whereas hospital-acquired infections (HAI) were those diagnosed after 72 hours of hospital admission...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27818473/plasma-lipoprotein-associated-phospholipase-a2-level-is-an-independent-predictor-of-high-thrombus-burden-in-patients-with-acute-st-segment-elevation-myocardial-infarction
#11
Xiangqi Wu, Yingqiang Zhang, Zhiming Wu, Wei You, Fengshuo Liang, Fei Ye, Shaoliang Chen
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent risk factor for plaque rupture and atherothrombotic events. However, the associations between serum Lp-PLA2 level and thrombus burden in ST-segment elevation myocardial infarction (STEMI) patients remain unknown.We consecutively enrolled 351 STEMI patients who underwent primary percutaneous coronary intervention (pPCI). Patients were assigned to a high thrombus burden (HTB) group (n = 230) and a low thrombus burden (LTB) group (n = 121). Baseline data were recorded during hospital admission...
November 4, 2016: International Heart Journal
https://www.readbyqxmd.com/read/27814743/prehospital-fibrinolysis-versus-primary-percutaneous-coronary-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#12
Vincent Roule, Pierre Ardouin, Katrien Blanchart, Adrien Lemaitre, Julien Wain-Hobson, Damien Legallois, Joachim Alexandre, Rémi Sabatier, Paul Milliez, Farzin Beygui
BACKGROUND: Primary percutaneous coronary intervention (PPCI) is the preferred reperfusion strategy in patients with ST-elevation myocardial infarction (STEMI), but its benefit over prehospital fibrinolysis (FL) is not clear. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials in which outcomes of patients with STEMI managed with FL early in the prehospital setting versus PPCI were compared. RESULTS: Compared with PPCI, FL was consistently associated with similar rates of short-term (30-90 days) death (relative risk [RR] 0...
November 5, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27813282/renal-protection-using-remote-ischemic-peri-conditioning-during-inter-facility-helicopter-transport-of-patients-with-st-segment-elevation-myocardial-infarction-a-retrospective-study
#13
Oladipupo Olafiranye, Adetola Ladejobi, Max Wayne, Christian Martin-Gill, Andrew D Althouse, Michael S Sharbaugh, Francis X Guyette, Steven E Reis, John A Kellum, Catalin Toma
OBJECTIVE: To assess the impact of remote ischemic peri-conditioning (RIPC) during inter-facility air medical transport of ST-segment elevation myocardial infarction (STEMI) patients on the incidence of acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI). BACKGROUND: STEMI patients who receive pPCI have an increased risk of AKI for which there is no well-defined prophylactic therapy in the setting of emergent pPCI. METHODS: Using the ACTION Registry-GWTG, we evaluated the impact of RIPC applied during inter-facility helicopter transport of STEMI patients from non-PCI capable hospitals to 2 PCI-hospitals in the United States between March, 2013 and September, 2015 on the incidence of AKI following pPCI...
December 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27792640/temporal-trends-in-care-and-outcomes-of-patients-receiving-fibrinolytic-therapy-compared-to-primary-percutaneous-coronary-intervention-insights-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-registry
#14
Ravi S Hira, Deepak L Bhatt, Gregg C Fonarow, Paul A Heidenreich, Christine Ju, Salim S Virani, Biykem Bozkurt, Laura A Petersen, Adrian F Hernandez, Lee H Schwamm, Zubin J Eapen, Michelle A Albert, Li Liang, Roland A Matsouaka, Eric D Peterson, Hani Jneid
BACKGROUND: Timely reperfusion after ST-elevation myocardial infarction (STEMI) improves survival. Guidelines recommend primary percutaneous coronary intervention (PPCI) within 90 minutes of arrival at a PCI-capable hospital. The alternative is fibrinolysis within 30 minutes for those in those for whom timely transfer to a PCI-capable hospital is not feasible. METHODS AND RESULTS: We identified STEMI patients receiving reperfusion therapy at 229 hospitals participating in the Get With the Guidelines-Coronary Artery Disease (GWTG-CAD) database (January 1, 2003 through December 31, 2008)...
October 6, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27753599/external-validity-of-a-contemporaneous-primary-percutaneous-coronary-intervention-trial-in-patients-with-acute-st-elevation-myocardial-infarction-insights-from-a-single-centre-investigation
#15
Ernest Spitzer, Susanne Hadorn, Thomas Zanchin, Kyohei Yamaji, Aris Moschovitis, Thomas Pilgrim, Stefan Stortecky, Peter Jüni, Dik Heg, Stephan Windecker, Lorenz Räber
AIMS: Randomised controlled trials (RCTs) represent the most robust source of evidence-based medicine. However, the generalisability of RCTs is limited by the inclusion of selected populations. We sought to assess the external validity of a contemporary trial including patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS AND RESULTS: Patients presenting to Bern University Hospital during the inclusion period of the COMFORTABLE AMI trial were divided into three groups: RCT participants (41%), eligible not included (17...
October 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27746402/selective-use-of-contemporary-drug-eluting-stents-in-primary-angioplasty-for-st-elevation-myocardial-infarction-pooled-analysis-of-comfortable-ami-and-examination
#16
Andreas Baumbach, Dik Heg, Lorenz Räber, Miodrag Ostoijc, Salvatore Brugaletta, Julian W Strange, Thomas W Johnson, Peter Juni, Thomas Engstrøm, Patrick W Serruys, Manel Sabate, Stephan Windecker
AIMS: Selective use of DES only in patients at higher risk of MACE is common practice, particularly in health care systems with a large premium payable for DES. We aimed to identify subgroups of patients in which the use of BMS in primary percutaneous coronary intervention (PPCI) for STEMI can still be justified. METHODS AND RESULTS: We performed a patient-level pooled analysis of COMFORTABLE-AMI and EXAMINATION comparing contemporary DES with BMS in PPCI. A risk score was applied using three parameters: lesion length>15mm, vessel size <3mm, and diabetes mellitus...
October 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27736028/effect-of-intravenous-and-intracoronary-melatonin-as-an-adjunct-to-primary-percutaneous-coronary-intervention-for-acute-st-elevation-myocardial-infarction-results-of-the-melatonin-adjunct-in-the-acute-myocardial-infarction-treated-with-angioplasty-maria-trial
#17
Alberto Dominguez-Rodriguez, Pedro Abreu-Gonzalez, Jose M de la Torre-Hernandez, Julia Gonzalez-Gonzalez, Tamara Garcia-Camarero, Luciano Consuegra-Sanchez, Maria Del Mar Garcia-Saiz, Ana Aldea-Perona, Tirso Virgos-Aller, Agueda Azpeitia, Russel J Reiter
The MARIA randomized trial evaluated the efficacy and safety of melatonin for the reduction of reperfusion injury in patients undergoing revascularization for ST-elevation myocardial infarction (STEMI). This was a prespecified interim analysis. A total of 146 patients presenting with STEMI within 6 hours of chest pain onset were randomized to receive intravenous and intracoronary melatonin (n=73) or placebo (n=73) during primary pecutaneous coronary intervention (PPCI). Primary endpoint was myocardial infarct size as assessed by magnetic resonance imaging (MRI) at 6±2 days...
October 13, 2016: Journal of Pineal Research
https://www.readbyqxmd.com/read/27696665/a-mechanism-for-stroke-complicating-thrombus-aspiration
#18
Eddie D Brown, James C Blankenship
We propose a mechanism of how stroke may be caused by thrombus aspiration during primary percutaneous coronary intervention (PPCI), and how it may be technique-dependent. Two recent meta-analyses report increased risk of stroke in patients undergoing routine thrombus aspiration during STEMI and the value of this technique has been controversial. The mechanism of stroke has not been fully explained. This case demonstrates 2 mechanisms by which aspiration might cause thrombus embolization. We recommend that if thrombus aspiration is performed during PPCI for STEMI, it should be done selectively and carefully...
October 3, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27683405/intracoronary-nitrite-suppresses-the-inflammatory-response-following-primary-percutaneous-coronary-intervention
#19
Daniel A Jones, Rayomand S Khambata, Mervyn Andiapen, Krishnaraj S Rathod, Anthony Mathur, Amrita Ahluwalia
OBJECTIVE: Recent work suggests that intracoronary nitrite reduces myocardial infarct size following primary percutaneous coronary intervention (PPCI) for acute myocardial infarction (AMI), although the exact mechanisms are unclear. We explored the effects of nitrite on reperfusion-induced inflammation, by assessing the levels of specific pro-inflammatory mediators, chemokines and adhesion molecules in plasma and circulating cell subtypes as exploratory end points in the NITRITE-AMI cohort...
September 28, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27666173/symptom-onset-to-balloon-time-st-segment-resolution-and-in-hospital-mortality-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-in-china-from-china-acute-myocardial-infarction-registry
#20
Fei Song, Mengyue Yu, Jingang Yang, Haiyan Xu, Yanyan Zhao, Wei Li, Dewei Wu, Zhifang Wang, Qingsheng Wang, Xiaojin Gao, Yang Wang, Rui Fu, Yi Sun, Runlin Gao, Yuejin Yang
Animal and imaging study evidence favors early reperfusion for acute myocardial infarction. However, in clinical trials, the effect of symptom-onset-to-balloon (S2B) time on clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) has been inconsistent. Moreover, there are few data regarding the ischemic time in China. A total of 3,877 consecutive patients with STEMI with available S2B time undergoing pPCI from January 2013 to September 2014 at 108 hospitals that participated in the China Acute Myocardial Infarction registry were included and stratified into 3 S2B groups: <6 hours, 6 to 12 hours, >12 hours S2B time was tested in multivariate logistic regression analyses as an independent risk factor of mortality (primary outcome), major adverse cardiovascular and cerebrovascular events (MACCE), and impaired myocardial perfusion (secondary outcomes)...
November 1, 2016: American Journal of Cardiology
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