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STEMI,thrombolytic

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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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)...
April 18, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28367645/clinical-profile-management-and-outcome-in-patients-with-out-of-hospital-cardiac-arrest-and-st-segment-elevation-myocardial-infarction
#13
Abdul Rahman Arabi, Ashfaq Patel, Jassim Al Suwaidi, A A Gehani, Rajvir Singh, Hajar A Albinali
AIM OF THE STUDY: We studied the clinical profile, management, and outcomes of patients with out-of-hospital cardiac arrest (OHCA) with and without ST-elevation myocardial infarction (STEMI). METHODS: Retrospective analysis of the 20-year registry data (January 1991- June 2010) was conducted on patients with cardiac disease hospitalized at Hamad General Hospital and Qatar Heart Hospital, Doha, Qatar. RESULTS: A total of 987 patients with OHCA were admitted to the cardiology department during the study period; among them, 296 (30%) patients had STEMI...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28314876/effect-of-remote-ischemic-postconditioning-during-thrombolysis-in-stemi
#14
S Ghaffari, L Pourafkari, S Manzouri, N D Nader
BACKGROUND: Remote ischemic postconditioning (RIPC) is suggested to protect the myocardium against ischemia in various settings. However, the effect of RIPC in patients with acute ST-elevation myocardial infarction (STEMI) who undergo thrombolysis has yet to be examined. PATIENTS AND METHODS: In this single-center, randomized controlled trial, we examined the effect of RIPC on the resolution of ST-segment elevation (STR) in response to thrombolysis. Patients in the RIPC group had three cycles of 5‑min cuff inflation followed by 5‑min deflation to the upper arm...
March 17, 2017: Herz
https://www.readbyqxmd.com/read/28290859/-prognostic-significance-of-erythropoietin-in-patients-with-acute-coronary-syndrome
#15
M V Menzorov, A M Shutov, N V Larionova, A A Strakhov, D V Serova
AIM: to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS: Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/27955935/acute-myocardial-infarction-caused-by-left-atrial-myxoma-role-of-intracoronary-catheter-aspiration
#16
Ahmad Al-Fakhouri, Muhammad Janjua, Michele DeGregori
Acute ST-segment elevation myocardial infarction (STEMI) caused by left atrial myxoma is very rare. Catheter-based approaches or thrombolytic therapy are mostly the first step in the management of STEMI with less time delay. We report a case of acute anterior/lateral STEMI caused by a left atrial myxoma. The patient was successfully treated by intracoronary aspiration with an Export aspiration catheter, with excellent distal coronary flow. Intracoronary catheter aspiration in acute myocardial infarction caused by a left atrial myxoma may help to salvage the infarcting myocardium with less time delay...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27921405/thrombolytic-therapy-up-regulates-inflammatory-mediators-compared-to-percutaneous-coronary-intervention-pci
#17
Alireza Garjani, Bahram Sohrabi, Ali Akbar Movassaghpour, Sina Andalib, Mehriar Shokri, Bahar Taherkhanchi, Bahador Bagheri
The important role of reperfusion therapies in the treatment of acute myocardial infarction is well documented. However, reperfusion therapies can initiate inflammatory response and may damage the myocardium. The purpose of current study was to compare the effects of percutaneous coronary intervention and thrombolytic therapy on inflammatory markers in the setting of ST elevation myocardial infarction (STEMI). Eighty three patients with STEMI were enrolled in this study. 40 patients underwent percutaneous coronary intervention (PCI), and 43 patients received streptokinase (1...
August 2016: Iranian Journal of Allergy, Asthma, and Immunology
https://www.readbyqxmd.com/read/27904619/modeling-of-in-hospital-mortality-determinants-in-myocardial-infarction-patients-with-and-without-stroke-a-national-study-in-iran
#18
Ali Ahmadi, Arsalan Khaledifar, Koorosh Etemad
BACKGROUND: The data and determinants of mortality due to stroke in myocardial infarction (MI) patients are unknown. This study was conducted to evaluate the differences in risk factors for hospital mortality among MI patients with and without stroke history. MATERIALS AND METHODS: This study was a retrospective, cohort study; 20,750 new patients with MI from April, 2012 to March, 2013 were followed up and their data were analyzed according to having or not having the stroke history...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27881426/contemporary-trends-and-age-specific-sex-differences-in-management-and-outcome-for-patients-with-st-segment-elevation-myocardial-infarction
#19
MULTICENTER STUDY
Leonardo De Luca, Marco Marini, Lucio Gonzini, Alessandro Boccanelli, Gianni Casella, Francesco Chiarella, Stefano De Servi, Antonio Di Chiara, Giuseppe Di Pasquale, Zoran Olivari, Giorgio Caretta, Laura Lenatti, Michele Massimo Gulizia, Stefano Savonitto
BACKGROUND: Age- and sex-specific differences exist in the treatment and outcome of ST-elevation myocardial infarction (STEMI). We sought to describe age- and sex-matched contemporary trends of in-hospital management and outcome of patients with STEMI. METHODS AND RESULTS: We analyzed data from 5 Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive patients with STEMI. All the analyses were age- and sex-matched, considering 4 age classes: <55, 55 to 64, 65 to 74, and ≥75 years...
November 23, 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27858909/comparison-of-the-risk-of-left-ventricular-free-wall-rupture-in-taiwanese-patients-with-st-elevation-acute-myocardial-infarction-undergoing-different-reperfusion-strategies-a-medical-record-review-study
#20
COMPARATIVE STUDY
Rei-Yeuh Chang, Han-Lin Tsai, Ping-Gune Hsiao, Chao-Wen Tan, Chi-Pin Lee, I-Tseng Chu, Yung-Ping Chen, Cheng-Yun Chen
Ventricular free wall rupture (VFWR) is the second most common cause of death in patients with acute ST-elevation myocardial infarction (STEMI). Nevertheless, few reports have investigated the factors, including different treatment strategies, associated with VFWR in Taiwanese patients. Therefore, the aim of this study was to compare the risk of VFWR in Taiwanese patients with acute STEMI who had received primary percutaneous coronary intervention (PCI), rescue PCI, scheduled PCI, thrombolytic therapy, and pharmacologic treatment...
November 2016: Medicine (Baltimore)
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