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myocardial infarction 4a type

Pierluigi Tricoci, L Kristin Newby, Robert M Clare, Sergio Leonardi, C Michael Gibson, Robert P Giugliano, Paul W Armstrong, Frans Van de Werf, Gilles Montalescot, David J Moliterno, Claes Held, Philip E Aylward, Lars Wallentin, Robert A Harrington, Eugene Braunwald, Kenneth W Mahaffey, Harvey D White
OBJECTIVES: In 13,038 patients with non-ST-segment elevation acute coronary syndrome undergoing index percutaneous coronary intervention (PCI) in the EARLY ACS (Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome) and TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) trials, the relationship between PCI-related myocardial infarction (MI) and 1-year mortality was assessed. BACKGROUND: The definition of PCI-related MI is controversial...
May 14, 2018: JACC. Cardiovascular Interventions
Michel Zeitouni, Johanne Silvain, Paul Guedeney, Mathieu Kerneis, Yan Yan, Pavel Overtchouk, Olivier Barthelemy, Marie Hauguel-Moreau, Rémi Choussat, Gérard Helft, Claude Le Feuvre, Jean-Philippe Collet, Gilles Montalescot
Aims: To assess the incidence, risk factors and prognosis of periprocedural myocardial infarction (MI) and myocardial injury in patients undergoing elective percutaneous coronary intervention (PCI). Methods and results: We included all consecutive patients who underwent elective PCI with a negative troponin level at admission from 1 January 2014 to 31 December 2015. The primary endpoint was defined as the composite of periprocedural MI (Type 4a MI), stent thrombosis (Type 4b MI), and myocardial injury according to the Third universal definition of MI...
April 1, 2018: European Heart Journal
Robert J Gil, Jacek Bil, Adam Kern, Tomasz Pawłowski
BACKGROUND: The optimal approach to coronary bifurcation treatment by percutaneous coronary intervention (PCI) is still a subject of debate, and dedicated bifurcation stents are one of the proposed solutions. AIM: The aim of this report was to assess the effectiveness and safety profile of a new dedicated bifurcation stent - sirolimus-eluting BiOSS LIM C® (Balton, Poland) at the first three months of a 12-month registry. METHODS: This is a two-centre registry, which enrolled patients with non-ST elevation acute coronary syndrome (NSTE-ACS) and stable angina...
2018: Kardiologia Polska
M Connolly, J Shand, M Kinnin, I Menown, M J Kurth, J Lamont, D Mc Eneaney
Background/Introduction: Type 4a myocardial infarction (MI) occurs when myocardial injury is combined with either symptoms suggestive of myocardial ischaemia, new left bundle branch block, angiographic loss of patency of a major artery or imaging suggestive of new loss of myocardium. Myocardial injury is defined as a rise of >5 x 99th upper reference limit (URL) of 14 ng/l (i.e. >70 ng/l) for highly sensitive troponin T (hsTnT) at 6 h if hsTnT was normal at baseline or >20% rise from 0 to 6 h if hsTnT was >14 ng/l at baseline...
January 1, 2018: QJM: Monthly Journal of the Association of Physicians
Rodrigo Morel Vieira de Melo, Whady Hueb, Cesar Higa Nomura, Expedito Eustáquio Ribeiro da Silva, Alexandre Volney Villa, Fernando Teiichi Costa Oikawa, Leandro Menezes Alves da Costa, Paulo Cury Rezende, Cibele Larrosa Garzillo, Eduardo Gomes Lima, Jose Antonio Franchini Ramires, Roberto Kalil Filho
OBJECTIVES: This study aimed to evaluate the amount and pattern of cardiac biomarker release after elective percutaneous coronary intervention (PCI) in patients without evidence of a new myocardial infarction (MI) after the procedure as assessed by cardiac magnetic resonance (CMR) with late gadolinium enhancement (LGE). BACKGROUND: The release of myocardial necrosis biomarkers after PCI frequently occurs. However, the correlation between biomarker release and the diagnosis of procedure-related MI type 4a has been controversial...
July 2017: Catheterization and Cardiovascular Interventions
Mustafa A Yılmaztepe, Gökay Taylan, Meryem Aktoz, Hanefi Y Gürlertop, Yüksel Aksoy, Fatih Özçelik, Kenan Yalta, Galip Ekuklu
INTRODUCTION: Myocardial injury after percutaneous coronary intervention (PCI) occurs in approximately 30% of procedures, and is related to worse prognosis. Effects of remote ischemic preconditioning (RIPC) on reperfusion injury have been investigated before, yielding conflicting results. AIM: To assess the impact of a single episode of RIPC on myocardial injury after elective PCI. MATERIAL AND METHODS: One hundred and four patients undergoing elective PCI, with normal baseline cardiac troponin-I (cTn-I) values, were randomized to two groups...
2017: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Nicolas Meneveau, Geraud Souteyrand, Pascal Motreff, Christophe Caussin, Nicolas Amabile, Patrick Ohlmann, Olivier Morel, Yoann Lefrançois, Vincent Descotes-Genon, Johanne Silvain, Nassim Braik, Romain Chopard, Marion Chatot, Fiona Ecarnot, Hélène Tauzin, Eric Van Belle, Loïc Belle, François Schiele
BACKGROUND: No randomized study has investigated the value of optical coherence tomography (OCT) in optimizing the results of percutaneous coronary intervention (PCI) for non-ST-segment elevation acute coronary syndromes. METHODS: We conducted a multicenter, randomized study involving 240 patients with non-ST-segment elevation acute coronary syndromes to compare OCT-guided PCI (use of OCT pre- and post-PCI; OCT-guided group) to fluoroscopy-guided PCI (angiography-guided group)...
September 27, 2016: Circulation
Xiaoyu Yang, Hector Tamez, Carol Lai, Kalon Ho, Donald Cutlip
OBJECTIVES: To assess the incidence of and outcomes related to periprocedural (Type 4a) myocardial infarction (MI) in a cohort of patients undergoing percutaneous coronary intervention (PCI) for stable coronary disease or non ST-elevation acute coronary syndrome with stable or falling cardiac troponin levels. BACKGROUND: The 2012 Third Universal Definition for Type 4a MI has not been prospectively studied in routine clinical practice. METHODS: The study included 516 patients undergoing eligible PCI at a single institution...
April 2017: Catheterization and Cardiovascular Interventions
Ali Buturak, Aleks Değirmencioğlu, Fatih Bayrak, Tuncay Kırış, Hüseyin Karakurt, Ali Rıza Demir, Özgür Sürgit, Mehmet Ertürk
OBJECTIVE: Bioactive roles of adipokines in coronary atherosclerosis and acute coronary syndromes have been demonstrated previously. However, there is a lack of data regarding the relationship between serum adipokines and periprocedural myocardial injury (PMI) following elective percutaneous coronary intervention (PCI). Therefore, we aimed to investigate the association between serum adipokines and PMI related to elective PCI. METHODS: In total, 153 consecutive patients (aged 60...
December 2016: Anatolian Journal of Cardiology
Haitham Abu Sharar, Daniel Wohlleben, Mehrshad Vafaie, Arnt V Kristen, H Christian Volz, Raffi Bekeredjian, Hugo A Katus, Evangelos Giannitsis
AIMS: We sought to evaluate rates and mechanisms of myocardial injury and type 4a myocardial infarction (MI) after an elective diagnostic coronary angiography (CAG) as detected by high-sensitivity cardiac troponin T (hsTnT) assay. METHODS AND RESULTS: Cardiac troponin concentrations were measured in consecutive patients before and after undergoing an elective CAG -with or without coronary intervention (PCI)- using an hsTnT assay. The study population consisted of 545 patients: 320 (58...
June 20, 2016: EuroIntervention
Jørund Langørgen, Marta Ebbing, Jannicke Igland, Jan Erik Nordrehaug, Stein Emil Vollset, Anne Kask, Grethe S Tell, Ottar Nygård
OBJECTIVES: The third Universal 2012 definition of myocardial infarction (MI) has not been compared to the Universal 2007 definition with regard to the number of cases identified, classification and mortality. DESIGN: We examined potential MI events according to the two universal definitions in 1494 patients admitted to the University hospital during the 12 months. Patients were included either because of an MI discharge diagnosis (815 patients) or due to elevated troponin I levels without an MI discharge diagnosis (679 patients)...
August 2016: Scandinavian Cardiovascular Journal: SCJ
Ali Buturak, Aleks Degirmencioglu, Ozgur Surgit, Ali Rıza Demir, Huseyin Karakurt, Mehmet Erturk, Selcuk Yazıcı, Mustafa Serteser, Tugrul Norgaz, Sevket Gorgulu
INTRODUCTION: The new definition of periprocedural myocardial infarction (type 4a MI) excludes patients without angina and electrocardiographic or echocardiographic changes suggestive of myocardial ischemia even though significant serum troponin elevations occur following percutaneous coronary intervention (PCI). AIM: To evaluate the incidence and predictors of serum troponin rise following elective PCI in patients without clinical and procedural signs suggestive of myocardial necrosis by using a high-sensitivite troponin assay (hsTnT)...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
Qiang Wang, Dong Liang, Feng Wang, Weijie Li, Yaling Han, Wei Zhang, Yaning Xie, Weichuan Xin, Baili Zhou, Dongdong Sun, Feng Cao, Lize Xiong
Electroacupuncture pretreatment (EAP) safely protects the heart from ischemic injury, however, the efficacy of EAP for periprocedural myocardial injury after percutaneous coronary intervention (PCI) remains unclear. Our aim was to investigate whether EAP prior to PCI reduces post-PCI myocardial injury in patients with coronary artery disease (CAD). 388 patients (≥ 18 years old) with CAD, undergoing elective PCI were enrolled and randomized, out of those 204 went through the whole trial. EAP was conducted by 30-minute electrical stimulation through 4 electrodes attached to the Antiguan (PC6) and Ximen (PC4) acupoints in the forearm bilaterally 1-2h prior to PCI...
September 1, 2015: International Journal of Cardiology
Kevin Liou, Nigel Jepson, Petrina Kellar, Ben Ng, Julia Isbister, Robert Giles, Daniel Friedman, Roger Allan, Antony Lau, Mark Pitney, Sze-Yuan Ooi
AIMS: This study aims to validate the joint ACCF/AHA/ESC/WHF Universal Definition of peri-procedural myocardial infarction (PMI) with high sensitivity troponin T (hsTnT). METHODS: A retrospective cohort study encompassing patients admitted to our institution between May 2012 and April 2013 was performed. RESULTS: 630 patients underwent percutaneous coronary interventions during the study period. Among them, 459 patients met the inclusion criteria and were eligible for analyses...
July 2015: Heart, Lung & Circulation
O Iu Mironova
An increase in the level of cardiac troponins and creatine kinase MB is sometimes observed even after angiographically and clinically uncomplicated percutaneous coronary interventions. This review article deals with the clinical and prognostic implications of type 4a myocardial infarction.
2014: Terapevticheskiĭ Arkhiv
Theodoros A Zografos, George D Katritsis, Ioannis Tsiafoutis, Nikolaos Bourboulis, Apostolos Katsivas, Demosthenes G Katritsis
Up to 1/3 of percutaneous coronary interventions (PCIs) are complicated by troponin release. Remote ischemic preconditioning (IPC) confers effective cardioprotection; however, a 30-minute remote IPC protocol may be difficult to implement during ad hoc PCI. This study was performed to assess the ability of a brief remote IPC protocol to attenuate cardiac troponin I (cTnI) release after ad hoc PCI. Ninety-four patients undergoing ad hoc PCI for stable coronary artery disease, with undetectable preprocedural cTnI, were recruited and randomized to receive remote IPC (induced by one 5-minute inflation of a blood pressure cuff to 200 mm Hg around the upper arm) or control after the decision for PCI was made...
June 15, 2014: American Journal of Cardiology
Xiaohan Xu, Yujie Zhou, Shengjie Luo, Weijun Zhang, Yingxin Zhao, Miao Yu, Qian Ma, Fei Gao, Hua Shen, Jianwei Zhang
There is conflicting evidence regarding the effectiveness of remote ischemic preconditioning (RIPC) in patients undergoing elective percutaneous coronary intervention (PCI). Therefore, we prospectively enrolled elderly patients with coronary heart disease (CHD) with diabetes mellitus (DM) undergoing elective drug-eluting stent (DES) implantation. They were randomized to receive RIPC within 2 hours before PCI (n = 102) or not (controls, n = 98). Baseline clinical characteristics were similar between the 2 groups...
September 2014: Angiology
Stephane Fournier, Serban Puricel, Beata Morawiec, Eric Eeckhout, Fabio Mangiacapra, Catalina Trana, Maxime Tapponnier, Juan F Iglesias, Vincent Michiels, Jean-Christophe Stauffer, Ahmed Beggah, Pierre Monney, Stéphanie Gobet, Pierre Vogt, Stéphane Cook, Olivier Muller
OBJECTIVES: To test if the time of day significantly influences the occurrence of type 4A myocardial infarction in elective patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Recent studies have suggested an influence of circadian rhythms on myocardial infarction size and mortality among patients with ST-elevation myocardial infarction. The aim of the study is to investigate whether periprocedural myocardial infarction (PMI) is influenced by the time of day in elective patients undergoing PCI...
March 2014: Chronobiology International
Issam D Moussa, Lloyd W Klein, Binita Shah, Roxana Mehran, Michael J Mack, Emmanouil S Brilakis, John P Reilly, Gilbert Zoghbi, Elizabeth Holper, Gregg W Stone
Numerous definitions have been proposed for the diagnosis of myocardial infarction (MI) after coronary revascularization. The universal definition for MI designates post procedural biomarker thresholds for defining percutaneous coronary intervention (PCI)-related MI (type 4a) and coronary artery bypass grafting (CABG)-related MI (type 5), which are of uncertain prognostic importance. In addition, for both the MI types, cTn is recommended as the biomarker of choice, the prognostic significance of which is less well validated than CK-MB...
October 22, 2013: Journal of the American College of Cardiology
Amani Kallel, Mohamed Hédi Sbaï, Yousra Sediri, Salem Abdessalem, Mohamed Sami Mourali, Moncef Feki, Rachid Mechmeche, Riadh Jemaa, Naziha Kaabachi
Controversial results regarding the association of eNOS gene (NOS3) polymorphisms with myocardial infarction (MI) have been reported. This study investigated the relationship of the -786T>C (rs2070744), 894G>T (rs1799983) and 4a4b polymorphisms of the NOS3 gene with the presence of MI in the Tunisian population. In addition, we also examined the association of NOS3 gene haplotypes with MI in Tunisian subjects. A total of 303 patients with MI and 225 controls were included in the study. The 894G>T and -786T>C single nucleotide polymorphisms were analyzed by PCR-RFLP, and 4a4b polymorphism just for PCR...
December 2013: Cytokine
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