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ST-Elevation Myocardial Infarction

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https://www.readbyqxmd.com/read/28748958/new-and-revisited-approaches-to-preserving-the-reperfused-myocardium
#1
REVIEW
Robert A Kloner, David A Brown, Marie Csete, Wangde Dai, James M Downey, Roberta A Gottlieb, Sharon L Hale, Jianru Shi
Early coronary artery reperfusion improves outcomes for patients with ST-segment elevation myocardial infarction (STEMI), but morbidity and mortality after STEMI remain unacceptably high. The primary deficits seen in these patients include inadequate pump function, owing to rapid infarction of muscle in the first few hours of treatment, and adverse remodelling of the heart in the months that follow. Given that attempts to further reduce myocardial infarct size beyond early reperfusion in clinical trials have so far been disappointing, effective therapies are still needed to protect the reperfused myocardium...
July 27, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28748154/revascularization-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-urgent-or-staged
#2
EDITORIAL
Héctor Cubero-Gallego, Rafael Romaguera, Albert Ariza-Sole, Joan Antoni Gómez-Hospital, Angel Cequier
No abstract text is available yet for this article.
June 2017: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/28747945/the-impact-of-type-2-diabetes-mellitus-on-prognosis-in-patients-with-non-st-elevation-myocardial-infarction
#3
REVIEW
Katarzyna Birkner, Bartosz Hudzik, Mariusz Gąsior
Type 2 diabetes (T2D) is a recognized risk factor for acute coronary syndromes. There is currently no consensus concerning the intensification of antihyperglycemic treatment. According to the available guidelines, it seems that the goal is to achieve glycated hemoglobin (HbA1c) levels below 7% and avoid hypoglycemia. The choice of a revascularization method is influenced by many factors, such as the anatomy of the coronary arteries, severity of atherosclerosis, anatomical location of lesions, and presence of comorbidities...
June 2017: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28747397/changes-and-classification-in-myocardial-contractile-function-in-the-left-ventricle-following-acute-myocardial-infarction
#4
Hao Gao, Andrej Aderhold, Kenneth Mangion, Xiaoyu Luo, Dirk Husmeier, Colin Berry
In this research, we hypothesized that novel biomechanical parameters are discriminative in patients following acute ST-segment elevation myocardial infarction (STEMI). To identify these biomechanical biomarkers and bring computational biomechanics 'closer to the clinic', we applied state-of-the-art multiphysics cardiac modelling combined with advanced machine learning and multivariate statistical inference to a clinical database of myocardial infarction. We obtained data from 11 STEMI patients (ClinicalTrials...
July 2017: Journal of the Royal Society, Interface
https://www.readbyqxmd.com/read/28747040/glycative-and-oxidative-stress-are-associated-with-altered-thrombus-composition-in-diabetic-patients-with-st-elevation-myocardial-infarction
#5
Antonia Sambola, Marisol Ruiz-Meana, Ignasi Barba, Bruno García Del Blanco, José A Barrabés, G Y Lip, Úrsula Vilardosa, Sara Sansaloni, Pau Rello, David García-Dorado
BACKGROUND: The role of type 2 diabetes (T2DM) on composition of thrombus has not been fully characterized in patients with ST-elevation myocardial infarction (STEMI). AIMS: To elucidate the differences between diabetic and non-diabetic patients with STEMI in relation to the composition of coronary thrombus, and the potential association of these differences with glycated haemoglobin levels and markers of oxidative stress. METHODS: Intracoronary thrombi from consecutive thrombus aspiration procedures in STEMI patients, 25 diabetic and 28 non-diabetic, were analyzed by immunofluorescence with confocal microscopy...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28746519/single-derivation-fragmented-qrs-can-predict-poor-prognosis-in-successfully-revascularized-acute-stemi-patients
#6
Zulkif Tanriverdi, Huseyin Dursun, Tugce Colluoglu, Dayimi Kaya
Background: QRS fragmentation (fQRS) is classically defined as the presence of slurred QRS morphology in at least two contiguous leads, and its prognostic importance has been shown in ST elevation myocardial infarction (STEMI). However, no study has investigated the significance of single lead fQRS (sl-fQRS) in surface electrocardiography (ECG). Objectives: To evaluate whether sl-fQRS is as valuable as classical fQRS in patients with acute STEMI who had successful revascularization with primary percutaneous coronary intervention (pPCI)...
July 20, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28743786/outcomes-of-patients-presenting-with-clinical-indices-of-spontaneous-reperfusion-in-st-elevation-acute-coronary-syndrome-undergoing-deferred-angiography
#7
Paul Fefer, Roy Beigel, Shaul Atar, Doron Aronson, Arthur Pollak, Doron Zahger, Elad Asher, Zaza Iakobishvili, Nir Shlomo, Ronny Alcalai, Michal Einhorn-Cohen, Amit Segev, Ilan Goldenberg, Shlomi Matetzky
BACKGROUND: Few data are available regarding the optimal management of ST-elevation myocardial infarction patients with clinically defined spontaneous reperfusion (SR). We report on the characteristics and outcomes of patients with SR in the primary percutaneous coronary intervention era, and assess whether immediate reperfusion can be deferred. METHODS AND RESULTS: Data were drawn from a prospective nationwide survey, ACSIS (Acute Coronary Syndrome Israeli Survey)...
July 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28742647/the-dis-utility-of-a-change-in-troponin-i-for-diagnosis-of-non-st-segment-elevation-myocardial-infarction-in-an-observation-unit
#8
Iani Patsias, Benjamin Swanson, Michael Hudson, Sachin Parikh, Khaled Nour, Gordon Jacobsen, James McCord
BACKGROUND: Observation units (OUs) may be an efficient and effective setting to diagnose and risk stratify patients with coronary ischemia and myocardial infarction (MI). Given improved cardiac troponin I (cTnI) assays and expanded utilization of OUs, it is not uncommon for patients with mildly elevated cTnI to be evaluated in OUs. We investigated the serial cTnI results in OU patients to determine whether absolute or relative cTnI changes were useful for the diagnosis of MI. METHODS: This was a retrospective study of 260 patients placed in the OU from a single center in 2007, with an initial cTnI in the indeterminate range of 0...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742104/serum-neutrophil-gelatinase-associated-lipocalin-the-estimation-of-hospital-prognosis-in-patients-with-st-elevated-myocardial-infarction
#9
Victoria Karetnikova, Anastasia Osokina, Olga Gruzdeva, Evgenya Uchasova, Michael Zykov, Victoria Kalaeva, Vasiliy Kashtalap, Kristina Shafranskaya, Olga Barbarash
We aimed to assess the clinical significance of serum levels of neutrophil gelatinase-associated lipocalin (sNGAL) for predicting in-hospital outcomes in patients with ST-elevated myocardial infarction (STEMI). Patients admitted within 24 hours of developing STEMI clinical symptoms were evaluated for sNGAL on hospitalization days 1 and 12. Recurrent myocardial infarction, early post-infarction angina, acute cerebrovascular accident, and death were assessed as adverse outcomes during hospitalization. The actors associated with adverse outcome were evaluated using univariate and multivariate regression analysis...
2017: PloS One
https://www.readbyqxmd.com/read/28739614/apical-ballooning-takotsubo-syndrome-with-concurrent-st-segment-elevation-myocardial-infarction
#10
Mohsin A Hussain, Andrew T Cox, Rachel Bastiaenen, Abhiram Prasad
We present the case of a 61-year-old woman admitted with chest pain and an ECG demonstrating ST-segment elevation in the lateral leads. Emergency coronary angiography demonstrated an occluded obtuse marginal branch. Percutaneous intervention was unsuccessful as the lesion could not be crossed with a wire. Left ventriculography and transthoracic echocardiography demonstrated hypokinesis of the entire apex but preserved contractility of the basal segments, consistent with a diagnosis of apical ballooning syndrome (ABS)...
July 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28738677/quantitation-of-87-proteins-by-nlc-mrm-ms-in-human-plasma-workflow-for-large-scale-analysis-of-biobank-samples
#11
Melinda Rezeli, Karin Sjödin, Henrik Lindberg, Olof Gidlöf, Bertil Lindahl, Tomas Jernberg, Jonas Spaak, David Erlinge, György Marko-Varga
A multiple reaction monitoring (MRM) assay was developed for precise quantitation of 87 plasma proteins including the three isoforms of apolipoprotein E (APOE) associated with cardiovascular diseases using nanoscale liquid chromatography separation and stable isotope dilution strategy. The analytical performance of the assay was evaluated and we found an average technical variation of 4.7 % in 4 - 5 orders of magnitude dynamic range (≈ 0.2 mg/L to 4.5 g/L) from whole plasma digest. Here, we report a complete workflow, including sample processing adapted to 96-well plate format and normalization strategy for large-scale studies...
July 25, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/28738484/-correlation-between-serum-inflammatory-cytokine-levels-and-fibrous-cap-thickness-of-fibrofatty-plaque-in-coronary-culprit-lesions
#12
Y Zhong, F Ye, W You, Z M Wu
Objective: To identify the correlation between serum inflammatory cytokine levels including high sensitive C reactive protein (hs-CRP) and lipoprotein associated phospholipase (Lp-PLA2) and the fibrous cap thickness of fibrofatty plaque in coronary culprit lesions. Methods: Clinical data of 117 patients with selective coronary artery angiography diagnosed coronary artery disease admitted to our hospital from January 2015 to January 2016 were retrospective analyzed. According to type of coronary disease, patients were divided into 3 subgroups: SAP group (containing 47 stable angina patients), UAP group (containing 52 unstable angina patients), and NSTEMI group(containing 18 acute non ST segment elevation myocardial infarction patients)...
July 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/28737526/serial-measurements-of-neutrophil-gelatinase-associated-lipocalin-prognostic-value-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-a-primary-percutaneous-coronary-intervention
#13
Yeong-Min Lim, Jae Youn Moon, Daniel Min, Sang-Hoon Kim, Woo-In Yang, Won-Jang Kim, Jung-Hoon Sung, In Jai Kim, Sang-Wook Lim, Dong-Hun Cha
BACKGROUND: There are no previous data on serial changes in neutrophil gelatinase-associated lipocalin (NGAL) levels in ST-segment elevation myocardial infarction (STEMI) patients before and after a primary percutaneous coronary intervention (pPCI). The aim of the present study was to evaluate the prognostic value of serial NGAL measurements in patients with STEMI treated by pPCI. MATERIALS AND METHODS: We identified 169 STEMI patients who underwent pPCI within 12 h of symptom onset and had plasma NGAL measurements before (pre-NGAL) and 6 h after (post-NGAL) pPCI...
July 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28737069/safety-of-radial-access-for-primary-percutaneous-intervention-in-patients-with-st-elevation-acute-myocardial-infarction-results-from-a-low-volume-center
#14
Yoshimasa Tsurumaki, Yumiko Haraguchi, Tomohiro Nakamura
Radial access for primary percutaneous coronary intervention (pPCI) in patients with ST-elevation acute myocardial infarction (STEMI) is recommended in high-volume experienced centers. This study investigated whether radial access for pPCI is safe even in a low-volume center. We performed radial access for pPCI in 171 patients. Major adverse cardiac events (total death, myocardial infarction, stroke) rate was 1.2%. The overall incidence of bleeding complications was 2.4%; there was no vascular complication at the access site...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28735289/prolonged-fever-after-st-segment-elevation-myocardial-infarction-and-long-term-cardiac-outcomes
#15
Chika Kawashima, Yasushi Matsuzawa, Eiichi Akiyama, Masaaki Konishi, Hiroyuki Suzuki, Katsutaka Hashiba, Toshiaki Ebina, Masami Kosuge, Kiyoshi Hibi, Kengo Tsukahara, Noriaki Iwahashi, Nobuhiko Maejima, Kentaro Sakamaki, Satoshi Umemura, Kazuo Kimura, Kouichi Tamura
BACKGROUND: The biphasic inflammation after ST-segment elevation myocardial infarction (STEMI) plays an important role in myocardial healing and progression of systemic atherosclerosis. The purpose of this study is to investigate the impact of fever during the first and second phases of post-STEMI inflammation on long-term cardiac outcomes. METHODS AND RESULTS: A total of 550 patients with STEMI were enrolled in this study. Axillary body temperature (BT) was measured and maximum BTs were determined for the first (within 3 days: max-BT1-3d) and second (from 4 to 10 days after admission: max-BT4-10d) phases, respectively...
July 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28734913/uncovered-culprit-plaque-ruptures-in-patients-with-st-segment-elevation-myocardial-infarction-assessed-by-optical-coherence-tomography-and-intravascular-ultrasound-with-imap
#16
Mikkel Hougaard, Henrik Steen Hansen, Per Thayssen, Lisbeth Antonsen, Lisette Okkels Jensen
OBJECTIVES: This study assessed the incidence and course of healing of uncovered plaque ruptures (PR) following primary percutaneous coronary intervention. BACKGROUND: The infarct-related occlusion is frequently located at the lesion site with maximum thrombus burden, whereas the culprit PR may be situated more proximally or distally. METHODS: Uncovered PR in segments adjacent to the stent were identified by optical coherence tomography and intravascular ultrasound using iMap (Boston Scientific, Marlborough, Massachusetts) within 48 h and after 12 months...
July 13, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28733995/incidence-predictors-and-clinical-outcomes-of-early-stent-thrombosis-in-acute-myocardial-infarction-patients-treated-with-primary-percutaneous-coronary-angioplasty-insights-from-the-university-of-ottawa-heart-institute-stemi-registry
#17
Kuljit Singh, Mohammed Rashid, Derek Y So, Christopher A Glover, Michael Froeschl, Benjamin Hibbert, Aun-Yeong Chong, Alexander Dick, Marino Labinaz, Michel Le May
BACKGROUND: Early stent thrombosis (ST) remains an important complication of primary percutaneous intervention (PCI). To date, our information on angiographic and clinical predictors of early ST in ST-segment elevation myocardial infarction (STEMI) patients treated with primary PCI is limited. METHODS: We tried to evaluate the incidence, predictors, and outcomes of early ST in real-world patients treated with primary PCI. We identified all the patients presenting with STEMI between June 2004 and January 2011 who underwent primary PCI as the primary mode of revascularization...
July 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28733630/plasma-dipeptidyl-peptidase-4-activity-is-associated-with-left-ventricular-systolic-function-in-patients-with-st-segment-elevation-myocardial-infarction
#18
Jing Wei Li, Yun Dai Chen, Yu Qi Liu, Jin Da Wang, Wei Ren Chen, Ying Qian Zhang, Qiang Ma
Plasma dipeptidyl-peptidase-4 activity (DPP4a) is inversely associated with left ventricular function in patients with heart failure (HF) or diabetes. However, the association between DPP4a and left ventricular function in ST-segment elevation myocardial infarction (STEMI) patients has not been reported. We studied this association in 584 consecutive STEMI patients at a tertiary referral center from July 2014 to October 2015. DPP4a and plasma N-terminal prohormone of B-type natriuretic peptide (NT-proBNP) levels were quantified by enzymatic assays...
July 21, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28733364/magnetic-resonance-imaging-of-myocardial-strain-after-acute-st-segment-elevation-myocardial-infarction-a-systematic-review
#19
Kenneth Mangion, Christie McComb, Daniel A Auger, Frederick H Epstein, Colin Berry
The purpose of this systematic review is to provide a clinically relevant, disease-based perspective on myocardial strain imaging in patients with acute myocardial infarction or stable ischemic heart disease. Cardiac magnetic resonance imaging uniquely integrates myocardial function with pathology. Therefore, this review focuses on strain imaging with cardiac magnetic resonance. We have specifically considered the relationships between left ventricular (LV) strain, infarct pathologies, and their associations with prognosis...
August 2017: Circulation. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28733072/early-myocardial-edema-after-acute-myocardial-infarction-is-stable-and-not-bimodal-in-humans-evidence-from-a-large-cmr-multicenter-study
#20
Thomas Stiermaier, Holger Thiele, Ingo Eitel
BACKGROUND: Experimental data reported a temporal pattern of myocardial edema following acute myocardial infarction (AMI). Therefore, the aim of this study was to assess the time course of myocardial edema in a large population of patients with ST-segment elevation myocardial infarction (STEMI). METHODS: Myocardium at risk (MAR), infarct size (IS) and myocardial salvage index (MSI) were compared according to the time between infarction and cardiovascular magnetic resonance (CMR) imaging in a large multicenter STEMI cohort (n=795)...
July 18, 2017: International Journal of Cardiology
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