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Aruna Ramesh, Kenneth A LaBresh, Rhea Begeman, Bentley Bobrow, Teri Campbell, Nayanjeet Chaudhury, Marcia Edison, Timothy B Erickson, John D Manning, Bellur S Prabhakar, Pavitra Kotini-Shah, Naresh Shetty, Pamela A Williams, Terry Vanden Hoek
Background: A system of care designed to measure and improve process measures such as symptom recognition, emergency response, and hospital care has the potential to reduce mortality and improve quality of life for patients with ST-elevation myocardial infarction (STEMI). Objective: To document the methodology and rationale for the implementation and impact measurement of the Heart Rescue India project on STEMI morbidity and mortality in Bangalore, India. Study Design: A hub and spoke STEMI system of care comprised of two interventional, hub hospitals and five spoke hospitals will build and deploy a dedicated emergency response and transport system covering a 10 Km...
June 2018: Contemporary Clinical Trials Communications
Göksel Çinier, Ahmet İlker Tekkeşin, Duygu Genç, Ufuk Yıldız, Emrecan Parsova, Levent Pay, Bryce Alexander, Emrah Bozbeyoğlu, Ceyhan Türkkan, Ahmet Taha Alper, Adrian Baranchuk
INTRODUCTION: Interatrial block (IAB) is strongly associated with recurrence of atrial fibrillation (AF) in different clinical scenarios. Atrial fibrosis is considered the responsible mechanism underlying the pathogenesis of IAB. The aim of this study was to investigate whether IAB predicted AF at 12 months follow up in a population of patients with ST segment elevation myocardial infarction (STEMI). METHODS: Prospective, single center, observational study of patients presenting with ST-segment elevation myocardial infarction (STEMI) and referred to primary percutaneous coronary intervention (P-PCI)...
July 18, 2018: Clinical Cardiology
Samer Noaman, Cheng Yee Goh, Sara Vogrin, Angela L Brennan, Nick Andrianopoulos, Diem T Dinh, Jeffrey Lefkovits, Christopher M Reid, Antony Walton, Omar Al-Mukhtar, Sinjini Biswas, Dion Stub, Stephen J Duffy, Nicholas Cox, William Chan
OBJECTIVES: The objective of this study was to investigate the association of proximal and nonproximal location of culprit coronary lesions with clinical outcomes of patients presenting with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI). BACKGROUND: Proximal culprit lesion location in patients presenting with STEMI is associated with increased mortality when compared to distal culprit lesions in the thrombolytic era...
July 18, 2018: Catheterization and Cardiovascular Interventions
Eva Rumiz, Alberto Berenguer, Juan Vicente Vilar, Ernesto Valero, Lorenzo Facila, Andres Cubillos, Dario Sanmiguel, Pablo Almela, Salvador Morell
BACKGROUND: Optimal management strategy for patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD) still remains unclear, especially in the elderly population. The aim of this study was to assess long-term outcomes and predictors of morbi-mortality according to age in patients with a STEMI and MVD. METHODS: We prospectively included 381 consecutive patients with a STEMI who underwent primary angioplasty and showed MVD in the angiogram...
July 18, 2018: Catheterization and Cardiovascular Interventions
Hymie H Chera, Cristina A Mitre, Justin Nealis, Alex Mironov, Adam S Budzikowski
OBJECTIVES: ST-segment elevation myocardial infarction (STEMI) can be associated with many conduction disturbances including complete atrioventricular block (CAVB). CAVB complicating STEMI resulted in an increased mortality before the modern era of primary percutaneous coronary intervention (PCI). The aim of this study was to ascertain the rate and risk factors for CAVB in STEMI patients undergoing rapid reperfusion with PCI. METHODS: We analyzed 223 patients presenting with STEMI...
July 17, 2018: Cardiology
Chang-Zheng Gao, Qian-Qian Ma, Jing Wu, Rui Liu, Fen Wang, Jie Bai, Xiang-Jun Yang, Qiang Fu, Peng Wei
BACKGROUND/AIMS: Acute ST-segment elevation of myocardial infarction (STEMI) is the most severe type of acute coronary syndrome (ACS). Particular attention has been focused on studying the pathogenesis of STEMI, and how to prevent thrombosis, reduce inflammatory reaction, stabilize plaques and improve vascular endothelial functions to preserve the survived myocardium. This study aimed to compare the anti-inflammatory endothelium-protective effects, clinical prognosis, and relevant bleeding risks of ticagrelor versus clopidogrel in patients with STEMI who underwent urgent percutaneous coronary intervention (PCI) and provide certain experimental evidence and a theoretical basis for the selection of safe and effective drugs and their proper dosage, thereby further guiding clinical medication...
July 17, 2018: Cellular Physiology and Biochemistry
Ebru Golcuk, Kivanc Yalin, Cansu Selcan Akdeniz, Erhan Teker, Başak Teker, Veysel Sabri Hancer, Ibrahim Altun, Murat Sezer, Reyhan Diz Kucukkaya, Aytac Oncul
Introduction: Glycoprotein Ibα (GPIbα) receptor is the chief molecule responsible for initial platelet adhesion to the subendothelium. A thymidine to cytosine single nucleotide substitution at position -5 from the ATG start codon characterizes the Kozak sequence polymorphism. The Kozak sequence polymorphism may increase the surface expression of GPIbα and contribute to thrombogenesis. We evaluated the allele frequencies of GPIbα Kozak sequence polymorphism in the Turkish population and examined the relationship between GPIbα Kozak sequence polymorphism and early-onset acute coronary syndrome (ACS)...
June 2018: Archives of Medical Science: AMS
Bartłomiej Orlik, Krzysztof Milewski, Kamil Derbisz, Michał Jelonek, Patrycja Chrząszcz, Sonia Beil, Adam Młodziankowski, Wojciech Picheta, Piotr P Buszman, Paweł E Buszman
Introduction: Most clinical trials related to bioresorbable vascular scaffold (BVS) technology are limited to a highly selected patient population. Aim: To evaluate early and long-term clinical outcomes of the Absorb everolimus-eluting BVS compared to the everolimus-eluting metallic XIENCE V stent in routine clinical practice. Material and methods: This is a multicenter, retrospective propensity score-matched comparative study, comprising 76 patients treated with a bare metal stents (BMS) and 501 with a XIENCE stent...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Ana Teresa Timóteo, Jorge Mimoso
The Portuguese Registry of Acute Coronary Syndromes (ProACS) has completed 15 years of continuous and prospective activity. We present an overall picture of the data from this powerful tool. Up to 2016, 45 141 records were included, mostly male (71%), and with a mean age of 66 years. Baseline characteristics remained stable over the years. Of the overall population, 44% of cases were ST-elevation myocardial infarction (STEMI). Over the years there was a significant improvement in compliance with international guidelines, in terms of both diagnostic and therapeutic procedures, as well as for medication...
July 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
János Tomcsányi
A case of ST-segment elevation myocardial infarction (STEMI) is presented with pathologic transient Q-waves in the precordial leads disappearing after percutaneous coronary intervention (PCI). Orv Hetil. 2018; 159(29): 1208-1209.
July 2018: Orvosi Hetilap
Bernadette Aliprandi-Costa, Lucy Morgan, Lan-Chi Snell, Mario D Souza, Leonard Kritharides, John French, David Brieger, Isuru Ranasinghe
BACKGROUND: Increased access to reperfusion for ST elevation myocardial infarction (STEMI) has contributed to reduced mortality internationally. We describe temporal trends in pre-hospital care, in-hospital management and outcomes of the STEMI population in Australia. METHODS: Temporal trends with multiple regression analysis on the management and outcomes of STEMI patients enrolled across 46 Australian hospitals in the Australian cohort of the Global Registry of Acute Coronary Events (GRACE) and the Cooperative National Registry of Acute Coronary Care Guideline Adherence and Clinical Events (CONCORDANCE) between February 1999 and August 2016...
June 11, 2018: Heart, Lung & Circulation
Juan Zhang, Fei Xu, Xiao-Bo Liu, Shao-Jie Bi, Qing-Hua Lu
BACKGROUND/AIM: Rho kinase is a downstream effector of Rho GTPase that is known to regulate various pathological processes. The aim of this study was to evaluate the regulation of Rho kinase activity in leukocytes in patients with ischemia/reperfusion (I/R) injury. PATIENTS AND METHODS: We investigated 38 patients with acute ST-segment elevation myocardial infarction (STEMI), 26 patients with atherosclerosis (AS) and 22 normal subjects. All patients underwent coronary angiography (CAG) and all STEMI patients received primary percutaneous coronary intervention (PPCI) of the left anterior descending artery (LAD) within 12 h after chest pain on-set...
July 1, 2018: Perfusion
Lisa Riesinger, Michael Saemisch, Markus Nickmann, Heiko Methe
Bone marrow-derived endothelial progenitor cells (EPC) are released into the peripheral blood in situations of vascular repair/angiogenesis. Regulation of vascular repair and angiogenesis by EPC depends not only on the number of circulating EPC but also on their functionality. As endothelial cells can act as antigen-presenting cells in coronary artery disease (CAD), we postulated that EPC can be immune activated here as well. CD34+ -EPC were isolated from peripheral blood of patients with ST-elevation myocardial infarction (STEMI, n = 12), non-STEMI/unstable angina (UA, n = 15), and stable CAD (SA, n = 18)...
July 12, 2018: Heart and Vessels
Gabby Elbaz-Greener, Maneesh Sud, Oran Tzuman, Marina Leitman, Zvi Vered, Nissan Ben-Dov, Uri Oron, Alex Blatt
BACKGROUND: Low-level laser therapy (LLLT) has photobiostimulatory effects on stem cells and may offer cardioprotection. This cell-based therapy may compliment primary percutaneous coronary intervention (PPCI) in patients with ST-segment elevation myocardial infarction (STEMI). OBJECTIVE: In this randomized control trial, our primary objective was to determine the safety and feasibility of LLLT application to the bone marrow in patients with STEMI undergoing PPCI...
July 12, 2018: Journal of Interventional Cardiology
Masahiro Shimoda, Hirohiko Ando, Kazuhiro Naito, Akihiro Suzuki, Shinichiro Sakurai, Yusuke Nakano, Akiyoshi Kurita, Katsuhisa Waseda, Hiroaki Takashima, Kenta Murotani, Tadayuki Uetani, Tetsuya Amano
BACKGROUND: Despite the revolution of coronary stents, there remain concerns about the risk of stent thrombosis, especially in patients with ST-elevation myocardial infarction (STEMI). The present study compared early vascular healing as a contributing factor to reducing stent thrombosis between Xience everolimus-eluting stents (X-EES) and Synergy everolimus-eluting stents (S-EES) in patients with STEMI.Methods and Results:The present study included 47 patients with STEMI requiring primary percutaneous coronary intervention with X-EES (n=25) or S-EES (n=22)...
July 11, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Maryam Sotoudeh Anvari, Mojgan Tavakoli, Masoumeh Lotfi-Tokaldany, Mohammadali Broumand, Omid Rezahosseini, Elham Hakki-Kazzazi, Arash Jalali
Background: Standard coagulation screening tests are important constituents of basic examinations in clinical laboratories. There is no clear evidence of a relation between the type of clinical presentation and coagulation parameters in patients with suspected coronary artery disease. Methods: This cross-sectional study included 539 patients who underwent coronary angiography in Tehran Heart Center between November 2012 and January 2013. Patients presented with ST-segment-elevation myocardial infarction (STEMI), non-STEMI, unstable angina, or stable angina...
January 2018: Journal of Tehran Heart Center
Korhan Soylu, Ali Ekber Ataş, Mustafa Yenerçağ, Murat Akçay, Onur Şeker, Gökhan Aksan, Okan Gülel, Mahmut Şahin
Inadequate expansion of coronary stents is associated with stent thrombosis in early stage and with stent restenosis in later stages. Postdilatation (postD) performed using non-compliant balloons improves stent expansion. However, use of this ballooning strategy in primary percutaneous coronary intervention (PPCI) has not been evaluated adequately. Patients who presented with ST segment elevation myocardial infarction (STEMI) and underwent PPCI were included in the present study. Patients were randomized into two groups as those for whom postD was performed (n=62) and those for whom postD was not performed (n=62)...
July 11, 2018: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
Maneesh Sud, Vijay S Chauhan, Mina Madan
In patients with suspected ST elevation myocardial infarction, it is of paramount importance to identify artifacts on the resting electrocardiogram that may be erroneously interpreted as ST segment deviations in order to prevent administration of potentially harmful pharmacotherapy and invasive coronary angiography. In this case report, we describe a pervasive square wave artifact, not previously reported, that was misdiagnosed as ST segment elevation by computer software and initial physician interpretation...
July 2018: Journal of Electrocardiology
Mat Goebel, Luke Busico, Greg Snow, Joseph Bledsoe
BACKGROUND: Limited work has established an objective measure of ECG quality that correlates with physician opinion of the study. We seek to establish a threshold of acceptable ECG data quality for the purpose of ruling out STEMI derived from emergency physician opinion. METHODS: A panel of three emergency physicians rated 240 12-Lead ECGs as being acceptable or unacceptable data quality. Each lead of the ECG had the following measurements recorded: baseline wander, QRS signal amplitude, and artifact amplitude...
July 2018: Journal of Electrocardiology
Kimmo Koivula, Markku Eskola, Juho Viikilä, Jyrki Lilleberg, Heini Huhtala, Yochai Birnbaum, Kjell Nikus
BACKGROUND: Grade 3 ischemia (G3I) in the 12‑lead electrocardiogram (ECG) predicts poor outcome in patients with ST-elevation myocardial infarction (STEMI). The outcome of G3I in "real-life" patient cohorts is unclear. METHODS: The aim of the study was to establish the prognostic significance of grade 2 ischemia (G2I), G3I and the STEMI patients excluded from ischemia grading (No grade of ischemia, NG) in a real-life patient population. We assessed in-hospital, 30-day and 1-year mortality as well as other endpoints...
July 2018: Journal of Electrocardiology
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