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STEMI,thrombolytic

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https://www.readbyqxmd.com/read/29686544/thrombolytic-use-in-the-region-around-amarillo-texas-in-patients-with-st-elevation-myocardial-infarction
#1
Kelly S McMaster, Totini Chatterjee, Drew McBrayer, David Brabham
Appropriate administration of thrombolytic therapy is particularly important for ST elevation myocardial infarction (STEMI) patients who are unable to access primary percutaneous coronary intervention (PCI) in a timely manner. We evaluated the current state of thrombolytic therapy in the Panhandle region of West Texas where access to primary PCI is poor. The medical records of 79 patients transferred from 20 outlying facilities to the two hospitals in Amarillo, Texas, for STEMI in 2016 were retrospectively evaluated for time of onset of chest pain, initial electrocardiogram findings, medication reconciliation, and any contraindications to thrombolytic therapy...
January 2018: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/29542414/clinical-presentation-quality-of-care-risk-factors-and-outcomes-in-women-with-acute-st-elevation-myocardial-infarction-stemi-an-observational-report-from-six-middle-eastern-countries
#2
Abdulla Shehab, Khalid F AlHabib, Akshaya Srikanth Bhagavathul, Ahmad Hersi, Hussam Alfaleh, Mostafa Q Alshamiri, Anhar Ullah, Khadim Sulaiman, Wael Almahmeed, Jassim Al Suwaidi, Alwai A Alsheikh-Ali, Haitham Amin, Mohammed Al Jarallah, Amar M Salam
BACKGROUND: Most of the available literature on ST-Elevated myocardial infarction (STEMI) in women was conducted in the developed world and data from Middle-East countries was limited. AIM: To examine the clinical presentation, patient management, quality of care, risk factors and in-hospital outcomes of women with acute STEMI compared with men using data from a large STEMI registry from the Middle East. METHODS: Data were derived from the third Gulf Registry of Acute Coronary Events (Gulf RACE-3Ps), a prospective, multinational study of adults with acute STEMI from 36 hospitals in 6 Middle-Eastern countries...
March 14, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29541260/risk-stratification-and-in-hospital-morality-in-patients-presenting-with-acute-coronary-syndrome-acs-in-bahrain
#3
Taysir S Garadah, Khalid Bin Thani, Leena Sulibech, Ahmed A Jaradat, Mohamed E Al Alawi, Haytham Amin
Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period...
2018: Open Cardiovascular Medicine Journal
https://www.readbyqxmd.com/read/29512096/predictive-value-of-cha2ds2-vasc-and-cha2ds2-vasc-hs-scores-for-failed-reperfusion-after-thrombolytic-therapy-in-patients-with-st-elevation-myocardial-%C3%A4-nfarction
#4
Salih Kilic, Umut Kocabas, Levent Hurkan Can, Oğuz Yavuzgil, Mustafa Çetin, Mehdi Zoghi
BACKGROUND: Thrombolytic therapy is recommended for patients with acute ST-segment elevation myocardial infarction (STEMI) who cannot undergo primary percutaneous coronary intervention within the first 120 min. The aim of this study wasz to demonstrate the value of CHA₂DS₂-VASc and CHA₂DS₂-VASc-HS scores in predicting failed reperfusion in STEMI patients treated with thrombolytic therapy. METHODS: A total of 537 consecutive patients were enrolled in the study; 139 had failed thrombolysis while the remaining 398 fulfilled the criteria for successful thrombolysis...
March 7, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29507028/stroke-thrombolysis-complicated-by-st-elevation-myocardial-infarction-stemi
#5
Mark Flower, James Harvey, Jonathan Hunter
An 84-year-old male Jehovah's Witness presented to the emergency department 1 hour after onset of left facial droop and left upper limb weakness. Thrombolytic stroke treatment was commenced as per local thrombolytic protocol with intravenous recombinant tissue plasminogen activator (rtPA) at 2 hours and 25 min following onset of symptoms. Almost immediately after rtPA infusion the patient reported chest pain and had ECG changes consistent with a diagnosis of anterior ST elevation myocardial infarction...
March 5, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29479380/the-severity-of-coronary-arterial-stenosis-in-patients-with-acute-st-elevated-myocardial-infarction-a-thrombolytic-therapy-study
#6
Salih Kilic, Umut Kocabas, Levent Hurkan Can, Oguz Yavuzgil, Mehdi Zoghi
Background: It is widely believed that ST-elevated myocardial infarction (STEMI) generally occurs at the site of mild to moderate coronary stenosis. The aim of this study was to determine the degree of stenosis of infarct-related artery (IRA) in STEMI patients who underwent coronary angiography (CAG) after successful reperfusion with thrombolytic therapy (TT). Methods: A total of 463 consecutive patients between January 2008 and December 2013 with acute STEMI treated with TT were evaluated retrospectively...
February 2018: Cardiology Research
https://www.readbyqxmd.com/read/29459610/admission-troponin-i-and-post-thrombolytic-st-segment-resolution-in-prediction-of-early-risk-stratification-in-st-elevation-myocardial-infarction
#7
S A Islam, M A Bari, M Faruque, T K Bhawmik
The prognostic value of admission troponin I (tnI) levels and the resolution of the ST-segment elevation in ST-elevation myocardial infarction (STEMI) is well established. However, the combination of these two early available markers for predicting the risk of early mortality has not been evaluated yet. This prospective analytical study conducted in the department of Cardiology, Sir Salimullah Medical College and Mitford Hospital, Dhaka and NICVD, Dhaka, Bangladesh from March 2004 to February 2005. We have evaluated 80 patients with streptokinase treated STEMI who had both admission troponin I and ST-monitoring...
January 2018: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29416997/acute-coronary-syndrome-related-mortality-audit-in-a-teaching-hospital-at-port-blair-india
#8
Shiv Shankar Singh, Swapan Kumar Paul, Ranabir Pal, Pandurang Vithal Thatkar
Background: India has a growing trend of acute myocardial infarction (AMI) due to shifting lifestyle. Objective: To study the profile of patients died due to AMI and to find its risk correlates. Methods: A study was conducted on consecutive AMI cases admitted in the teaching hospital at Port Blair from April 2011 to March 2016. During inpatients management, outcomes were followed up from admission till discharge or expiry. Results: Of the total 491 cases, majority (75...
July 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29248881/three-vessel-coronary-artery-aneurysmal-disease-complicated-by-multivessel-thrombosis-and-cardiogenic-shock-the-saving-role-of-intracoronary-thrombolysis
#9
Luis Pablo Roldan, Chris Rowan, Mark Sheldon, Carlos A Roldan
The benefit of intracoronary thrombolytics in ST-elevation myocardial infarction (STEMI) is not well established. Mainstays of STEMI management include intravenous thrombolytics, percutaneous coronary interventions and surgical revascularisation. However, in cases of STEMI secondary to coronary artery aneurysmal disease (CAAD), standard treatment options may not be suitable due to high thrombus burden, perioperative risk and factors unique to each patient. Thus, STEMI management in CAAD can represent a therapeutically challenging clinical scenario...
December 15, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29209778/safety-and-efficacy-of-prourokinase-injection-in-patients-with-st-elevation-myocardial-infarction-phase-iv-clinical-trials-of-the-prourokinase-phase-study
#10
Linru Zhao, Zhiqiang Zhao, Xiaolu Chen, Jingyue Li, Jinping Liu, Guangping Li
To evaluate the safety and efficacy in terms of infarct-related artery (IRA) patency of prourokinase (proUK) injection within 6 h after symptom onset in patients with ST-elevation myocardial infarction (STEMI). A total of 1851 patients with acute myocardial infarction were enrolled to receive thrombolytic therapy with proUK. Qualifying patients were injected with 20 mg proUK intravenously followed by intravenous infusion of 30 mg proUK within 30 min. IRA was evaluated by coronary angiography at 120 min after thrombolysis...
December 5, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29121757/association-between-qrs-duration-on-prehospital-ecg-and-mortality-in-patients-with-suspected-stemi
#11
Rikke Hansen, Martin Frydland, Ole Kristian Møller-Helgestad, Matias Greve Lindholm, Lisette Okkels Jensen, Lene Holmvang, Hanne Berg Ravn, Jesper Kjærgaard, Christian Hassager, Jacob Eifer Møller
BACKGROUND: QRS duration has previously shown association with mortality in patients with acute myocardial infarction treated with thrombolytics, less is known in patients with suspected ST segment elevation myocardial infarction (STEMI) when assessing QRS duration on prehospital ECG. Thus, the objective was to investigate the prognostic effect of QRS duration on prehospital ECG and presence of classic left and right bundle branch block (LBBB/RBBB) for all-cause mortality in patients with suspected STEMI...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29054179/the-impact-of-systems-of-care-on-pharmacoinvasive-management-with-streptokinase-the-subgroup-analysis-of-the-tn-stemi-programme
#12
Deep Chandh Raja, Vijayakumar Subban, Suma M Victor, George Joseph, Viji Samuel Thomson, Kumaresan Kannan, Justin Paul Gnanaraj, Ganesh Veerasekar, Jose G Thenpally, Nandhini Livingston, Brahmajee K Nallamothu, Thomas Alexander, Ajit S Mullasari
OBJECTIVES: We evaluated the impact of implementation of the TN-STEMI programme on various characteristics of the pharmacoinvasive group by comparing clinical as well as angiographic outcomes between the pre- and post-implementation groups. METHODS: The TN-STEMI programme involved 2420 patients of which 423 patients had undergone a pharmacoinvasive strategy of reperfusion. Of these, 407 patients had a comprehensive blinded core-lab evaluation of their angiograms post-lysis and clinical evaluation of various parameters including time-delays and adverse cardio- and cerebro-vascular events at 1year...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28905638/higher-risk-of-bleeding-in-asians-presenting-with-st-segment-elevation-myocardial-infarction-analysis-of-the-national-inpatient-sample-database
#13
Naoki Misumida, Gbolahan O Ogunbayo, Sun Moon Kim, Odunayo Olorunfemi, Ayman Elbadawi, Richard J Charnigo, Ahmed Abdel-Latif, Khaled M Ziada
Bleeding is a major complication in patients presenting with ST-segment elevation myocardial infarction (STEMI). Several studies suggested that Asians are more susceptible to bleeding when treated with antiplatelets, anticoagulants, and thrombolytic agents. In our study, we aimed to investigate the association between Asian ethnicity and bleeding events in patients who presented with STEMI. We analyzed the Nationwide Inpatient Sample database from 2002 to 2013 and identified patients hospitalized with a primary diagnosis of STEMI...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28875864/pulmonary-embolism-with-cardiac-arrest-a-stemi-patient-s-unexpected-course
#14
Zoë Piggott, Tomislav Jelic
We describe the successful use and complications of bolus-dose alteplase to treat strongly suspected pulmonary embolism (PE) with cardiac arrest in a patient initially presenting as ST-elevation myocardial infarcation (MI). Case description is followed by a review of the indications, safety, and dosing of systemic thrombolytic therapy for high-risk PE in the emergency department (ED). Diagnostic and therapeutic approach to PE in critically ill patients is also considered, including the potential utility of point-of-care ultrasound (PoCUS) in the ED...
September 6, 2017: CJEM
https://www.readbyqxmd.com/read/28843245/an-uncommon-complication-of-streptokinase-large-spontaneous-iliopsoas-hematoma
#15
Raheleh Aliabadi, Hassan Riahi Beni, Jila Nadjafi, Morteza Hassanzade, Mehrnaz Tabrizi, Mohsen Nasiri, Gandom Sedehi, Ali Pourmojarab
Streptokinase is a fibrinolytic agent that enhances plasmin activation and is used in selected patients with acute ST elevation myocardial infarction (STEMI). Similar to the other thrombolytics, a common side effect is bleeding, especially from venous puncture sites. Here, we present a case of acute anterior wall STEMI complicated by large spontaneous iliopsoas hematoma after streptokinase administration. With conservative management, the course of the disease was uneventful, and the patient was discharged with no symptom and no clinically important sequel...
June 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28623013/low-qrs-voltage-on-presenting-electrocardiogram-predicts-multi-vessel-disease-in-anterior-st-segment-elevation-myocardial-infarction
#16
Akihiro Kobayashi, Naoki Misumida, Shunsuke Aoi, Yumiko Kanei
BACKGROUND: Low QRS voltage was reported to predict adverse outcomes in acute myocardial infarction in the pre-thrombolytic era. However, the association between low voltage and angiographic findings has not been fully addressed. METHODS: We performed a retrospective analysis of patients with anterior ST-segment elevation myocardial infarction (STEMI). Low QRS voltage was defined as either peak to peak QRS complex voltage <1.0mV in all precordial leads or <0...
June 8, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28595202/vitamin-d-is-a-predictor-of-st-segment-resolution-and-infarct-size-following-thrombolysis-in-patients-with-acute-st-elevation-myocardial-infarction
#17
Ahmad Separham, Bahram Sohrabi, Leili Pourafkari, Nazli Sepasi, Samad Ghaffari, Naser Aslanabadi, Nader D Nader
OBJECTIVE: Vitamin D (VitD) insufficiency is linked to various chronic conditions, including cardiovascular disease. Aim of the present study was to examine role of serum VitD in resolution of ST segment elevation (STR) in response to thrombolytic therapy following acute ST elevation myocardial infarction (STEMI). METHODS: VitD was measured prospectively in all consecutive patients who were admitted with STEMI and received thrombolysis during the calendar year of 2014...
June 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28511806/stemi-could-be-the-primary-presentation-of-acute-aortic-dissection
#18
Qing-Yi Zhu, Shi Tai, Liang Tang, Wen Peng, Sheng-Hua Zhou, Zhen-Guo Liu, Xin-Qun Hu
BACKGROUND: Stanford type A aortic dissection (TAAD) may lead to coronary artery occlusion and malfunction. However, TAAD manifesting as acute ST-segment elevation myocardial infarction (STEMI) has not been studied. In the present study, we reported 8 TAAD cases with STEMI as the primary presentation, and analyzed their clinical characteristics and outcome. METHODS: The records were reviewed for patients admitted to the large comprehensive university hospital for PCI due to STEMI from January 1, 2002 to January 1, 2017...
November 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28489130/impact-of-coronary-intensive-care-unit-in-treatment-of-myocardial-infarction
#19
Marcia Cristina Todo, Carolina Marabesi Bergamasco, Paula Schmidt Azevedo, Marcos Ferreira Minicucci, Roberto Minoru Tanni Inoue, Marina Politi Okoshi, Sergio Rupp de Paiva, Leonardo Mamede Zornoff, Bertha Furlan Polegato
Introduction: The mortality rate attributed to ST-segment elevation myocardial infarction (STEMI) has decreased in the world. However, this disease is still responsible for high costs for health systems. Several factors could decrease mortality in these patients, including implementation of cardiac intensive care units (CICU). The aim of this study was to evaluate the effect of CICU implementation on prescribed recommended treatments and mortality 30 days after STEMI. Method: We performed a retrospective study with patients admitted to CICU between 2005 and 2006 (after group) and between 2000 and 2002, before CICU implementation (before group)...
March 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28417608/comparison-of-antithrombotic-agents-during-urgent-percutaneous-coronary-intervention-following-thrombolytic-therapy-a-retrospective-cohort-study
#20
Jaya R Mallidi, Peter Robinson, Paul F Visintainer, Amir S Lotfi, Scott Mulvey, Gregory R Giugliano
BACKGROUND: The optimal antithrombotic regimen for urgent percutaneous coronary interventions (PCI) following thrombolytic therapy for ST segment myocardial infarction (STEMI) is currently unknown. METHODS: We performed a retrospective analysis of all patients referred to our institution from January 2005 to July 2014 who underwent urgent PCI within 24 hr after receiving thrombolytic therapy. The patients were divided into three cohorts based on the anticoagulation strategy during PCI-bivalirudin, heparin alone or heparin plus Glycoprotein IIb/IIIa inhibitor (GPI)...
November 15, 2017: Catheterization and Cardiovascular Interventions
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