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ST-Elevation Myocardial Infarction

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https://www.readbyqxmd.com/read/28343173/fast-track-protocols-using-highly-sensitive-troponin-assays-for-ruling-out-and-ruling-in-non-st-elevation-acute-coronary-syndrome
#1
Simona Ferraro, Alberto Dolci, Mauro Panteghini
The introduction of "highly sensitive" cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision...
March 27, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28340182/novel-targets-and-future-strategies-for-acute-cardioprotection-position-paper-of-the-european-society-of-cardiology-working-group-on-cellular-biology-of-the-heart
#2
Derek J Hausenloy, David Garcia-Dorado, Hans Erik Bøtker, Sean M Davidson, James Downey, Felix B Engel, Robert Jennings, Sandrine Lecour, Jonathan Leor, Rosalinda Madonna, Michel Ovize, Cinzia Perrino, Fabrice Prunier, Rainer Schulz, Joost P G Sluijter, Linda W Van Laake, Jakob Vinten-Johansen, Derek M Yellon, Kirsti Ytrehus, Gerd Heusch, Péter Ferdinandy
Ischaemic heart disease and the heart failure that often results, remain the leading causes of death and disability in Europe and worldwide. As such, in order to prevent heart failure and improve clinical outcomes in patients presenting with an acute ST-segment elevation myocardial infarction and patients undergoing coronary artery bypass graft surgery, novel therapies are required to protect the heart against the detrimental effects of acute ischaemia/reperfusion injury. During the last three decades, a wide variety of ischaemic conditioning strategies and pharmacological treatments have been tested in the clinic - however, their translation from experimental to clinical studies for improving patient outcomes has been both challenging and disappointing...
March 17, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/28337989/post-hoc-study-intravenous-hydration-treatment-in-chinese-patients-with-high-risk-of-contrast-induced-nephropathy-following-percutaneous-coronary-intervention
#3
Weijie Bei, Hualong Li, Kaiyang Lin, Kun Wang, Shiqun Chen, Xiaosheng Guo, Yong Liu, Ning Tan, Jiyan Chen
Contrast-induced nephropathy (CIN) develops after the injection of iodinated contrast media. This is a post hoc analysis of the data obtained from the TRUST study, which was a prospective, multicentre, observational study conducted to evaluate the safety and tolerability of the contrast medium iopromide in patients undergoing cardiac catheterization from August 2010 to September 2011 in China, conducted to explore the current status, trends and risk predictors of hydration treatment. The status of hydration to prevent CIN in each patient was recorded...
March 24, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#4
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337347/myocardial-infarction-after-endoscopic-removal-of-foreign-body
#5
Carola Maraboto, Florentino Lupercio, Ileana L Piña
The development of cardiac complications during or after endoscopic procedures is rare. However, mortality from myocardial ischemia, particularly in the elderly population, is elevated. We illustrate the rare case of a 79-year-old man with multiple cardiovascular risk factors who developed a non-ST elevation myocardial infarction (NSTEMI) after endoscopic removal of a foreign body. This case report summarizes a rare complication of a low-risk procedure and highlights the importance of considering this potential adverse event, particularly in patients with significant cardiovascular risk factors, to promote early diagnosis and proper treatment...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28334029/prognostic-power-of-global-2d-strain-according-to-left-ventricular-ejection-fraction-in-patients-with-st-elevation-myocardial-infarction
#6
Myung-Jin Cha, Hyun-Sook Kim, Seong Hwan Kim, Jae-Hyeong Park, Goo-Yeong Cho
BACKGROUNDS: We aimed to evaluate the predictive power of longitudinal and circumferential fibers according to left ventricular ejection fraction (LVEF) in successfully reperfused acute ST elevation myocardial infarction (STEMI) patients. METHODS: Total 691 patients (age 59±13, 20% female) underwent clinical evaluation and conventional and strain echocardiography (Global longitudinal strain (GLS), global circumferential strain (GCS)). The clinical outcome was defined as the composite of death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia...
2017: PloS One
https://www.readbyqxmd.com/read/28333976/early-diagnosis-of-acute-myocardial-infarction-using-high-sensitivity-troponin-i
#7
Johannes Tobias Neumann, Nils Arne Sörensen, Francisco Ojeda, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
OBJECTIVE: There is a clinical need for early and accurate diagnosis of acute myocardial infarction (AMI). Current European Society of Cardiology (ESC) guidelines recommend diagnosis of non-ST-elevation AMI based on serial troponin measurements. We aimed to challenge the ESC guidelines using 1) a high-sensitivity troponin I (hs-TnI) baseline cutoff, 2) an absolute hs-TnI change after 1 hour and 3) additional application of an ischemic ECG. METHODS: 1,516 patients with suspected AMI presenting to the emergency department were included...
2017: PloS One
https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#8
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329274/trichinella-nativa-outbreak-with-rare-thrombotic-complications-associated-with-meat-from-a-black-bear-hunted-in-northern-ontario
#9
Daniel Dalcin, Dante S Zarlenga, Nicholas C Larter, Eric Hoberg, Daniel A Boucher, Samuel Merrifield, Rachel Lau, Filip Ralevski, Karamjit Cheema, Kevin L Schwartz, Andrea K Boggild
Background: Although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have not been previously associated with Trichinella nativa infection. Methods: Patient interviews and medical chart reviews were conducted on 10 men who became ill following consumption of a common source of black bear meat. Trichinella serology on patient sera as well as PCR and larval identification of the meat samples was conducted. Results: All 10 exposed individuals developed an acute illness clinically compatible with trichinellosis, characterized by fever, abdominal pain, and diarrhea, along with eosinophilia ranging from 0...
February 22, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329196/diabetic-patients-with-acute-coronary-syndromes-in-contemporary-european-registries-characteristics-and-outcomes
#10
Maddalena Lettino, Pontus Andell, Uwe Zeymer, Petr Widimsky, Nicolas Danchin, Alfredo Bardaji, Jose A Barrabes, Angel Cequier, Marc J Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M Koul, Gilles Lemesle, Thomas F Lüscher, Christian M Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez Sendón, Petr Tousek, Franz Weidinger, Clive F M Weston, Azfar Zaman, Jin Li, J Wouter Jukema
Aims: Among patients with acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at particularly high risk of recurrent cardiovascular events and premature death. We aimed to provide a descriptive overview of unadjusted analyses of patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in contemporary registries in Europe. Methods and results: A total of 10 registries provided data in a systematic manner on ACS patients with DM (total n =28 899), and without DM (total n= 97 505)...
March 10, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28329036/predictive-value-of-plaque-morphology-assessed-by-frequency-domain-optical-coherence-tomography-for-impaired-microvascular-perfusion-after-elective-stent-implantation-the-intracoronary-electrocardiogram-study
#11
Hiroki Ikenaga, Satoshi Kurisu, Tsukasa Nakao, Shingo Kono, Yoji Sumimoto, Noriaki Watanabe, Takashi Shimonaga, Tadanao Higaki, Toshitaka Iwasaki, Naoya Mitsuba, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara
Aims: This study was undertaken to assess the association between plaque features at culprit lesions assessed by frequency-domain optical coherence tomography (FD-OCT) and impaired microvascular perfusion estimated by intracoronary electrocardiogram (IcECG) after elective percutaneous coronary intervention (PCI). Furthermore, we investigated whether IcECG could predict future cardiac events. Methods and results: This study consisted of 84 patients who underwent both FD-OCT and IcECG during PCI...
March 7, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28325719/near-death-by-milk-of-magnesia
#12
Ahmed Alaini, Carlos A Roldan, Karen Servilla, Elizabeth Sage Colombo
We report a case of hypermagnesemia associated with the use of milk of magnesia in a male patient with end-stage renal disease. After experiencing nausea and vomiting, he developed severe bradycardia and then asystole. Resuscitation efforts were successful; however, he developed atrial fibrillation with severe widening of the QRS and diffuse ST elevation, hypothermia, hypotension and apnoea requiring intubation. Initial diagnoses included ST-elevation myocardial infarction, cardiogenic and/or septic shock and hyperkalaemia...
March 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#13
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28325070/methotrexate-therapy-in-st-segment-elevation-myocardial-infarctions
#14
Daniel Medeiros Moreira, Maria Emilia Lueneberg, Roberto Leo da Silva, Tammuz Fattah, Carlos Antonio Mascia Gottschall
PURPOSE: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28321019/myocardial-infarction-in-a-young-man-with-nephrotic-syndrome
#15
Zhenliang Chu, Hang Zhu, Bin Zhang, Liqin Jiang
A 26-year-old man diagnosed with nephrotic syndrome (NS) 2 years previously presented with chest pain. An electrocardiogram (ECG) performed at a local hospital showed ST-elevation in chest leads. Cardiac troponin-I was significantly positive. Echocardiography revealed mild regional wall-motion abnormalities in the heart apex. Seven days later, angiography (CAG) revealed a thrombus in the left anterior descending branch (LAD). Tirofiban was injected into the LAD for thromboclasis. ECG after CAG showed the ST-segment was much lower than before...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28321000/the-effects-of-hydrogen-gas-inhalation-on-adverse-left-ventricular-remodeling-after-percutaneous-coronary-intervention-for-st-elevated-myocardial-infarction%C3%A3-first-pilot-study-in-humans
#16
Yoshinori Katsumata, Fumiya Sano, Takayuki Abe, Tomoyoshi Tamura, Taishi Fujisawa, Yasuyuki Shiraishi, Shun Kohsaka, Ikuko Ueda, Koichiro Homma, Masaru Suzuki, Shigeo Okuda, Yuichiro Maekawa, Eiji Kobayashi, Shingo Hori, Junichi Sasaki, Keiichi Fukuda, Motoaki Sano
BACKGROUND: Hydrogen gas inhalation (HI) reduced infarct size and mitigated adverse left ventricular (LV) remodeling in a rat model of acute myocardial infarction (AMI). We designed a prospective, open-label, rater-blinded clinical pilot study in patients experiencing ST-elevated MI (STEMI).Methods and Results:The 20 patients with an initial diagnosis of STEMI were assigned to either an HI group (1.3% H2with 26% oxygen) or a control group (26% oxygen). There were no HI-related severe adverse events...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320999/long-term-outcomes-of-non-st-elevation-myocardial-infarction-without-creatine-kinase-elevation%C3%A3-the-j-minuet-study
#17
Masaharu Ishihara, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Masashi Fujino, Satoshi Yasuda, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Masaaki Uematsu, Kazuhito Hirata, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Kenichi Tsujita, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Tetsuya Tobaru, Shigeru Oshima, Michikazu Nakai, Kunihiro Nishimura, Yoshihiro Miyamoto, Hisao Ogawa
BACKGROUND: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes.Methods and Results:Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320751/sex-and-outcomes-after-percutaneous-coronary-intervention-a-cause-for-concern-for-young-women-and-those-with-st-segment-elevation-myocardial-infarction
#18
EDITORIAL
Jacqueline E Tamis-Holland
No abstract text is available yet for this article.
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28320749/sex-differences-in-percutaneous-coronary-intervention-insights-from-the-coronary-angiography-and-pci-registry-of-the-german-society-of-cardiology
#19
Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Hans Martin Hoffmeister, Stefan Sack, Jochen Senges, Steffen Massberg, Anselm K Gitt, Uwe Zeymer
BACKGROUND: Several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures. METHODS AND RESULTS: Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease, non-ST elevation acute coronary syndromes, ST elevation myocardial infarction, and cardiogenic shock...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28320707/total-center-percutaneous-coronary-intervention-volume-and-30-day-mortality-a-contemporary-national-cohort-study-of-427%C3%A2-467-elective-urgent-and-emergency-cases
#20
Darragh O'Neill, Owen Nicholas, Chris P Gale, Peter Ludman, Mark A de Belder, Adam Timmis, Keith A A Fox, Iain A Simpson, Simon Redwood, Simon G Ray
BACKGROUND: The relationship between procedural volume and prognosis after percutaneous coronary intervention (PCI) remains uncertain, with some studies finding in favor of an inverse association and some against. This UK study provides a contemporary reassessment in one of the few countries in the world with a nationally representative PCI registry. METHODS AND RESULTS: A nationwide cohort study was performed using the national British Cardiovascular Intervention Society registry...
March 2017: Circulation. Cardiovascular Quality and Outcomes
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