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STEMI risk factor

Samantha Noll, Heidi Alvey, Namita Jayaprakash, Aniruddha Paranjpe, Joseph Miller, Michele L Moyer, Richard Nowak
INTRODUCTION: Current AHA/ACC guidelines on the management of ST-elevation myocardial infarction (STEMI) suggest that an ECG is indicated within 10minutes of arrival for patients arriving to the Emergency Department (ED) with symptoms concerning for STEMI. In response, there has been a creep towards performing ECGs more frequently in triage. The objectives of this study were to quantify the number of triage ECGs performed at our institution, assess the proportion of ECGs performed within current hospital guidelines, and evaluate the rate of STEMI detection in triage ECGs...
February 3, 2018: American Journal of Emergency Medicine
Jiannan Dai, Lei Xing, Haibo Jia, Yinchun Zhu, Shaotao Zhang, Sining Hu, Lin Lin, Lijia Ma, Huimin Liu, Maoen Xu, Xuefeng Ren, Huai Yu, Lulu Li, Yanan Zou, Shaosong Zhang, Gary S Mintz, Jingbo Hou, Bo Yu
Aims: Plaque erosion is a significant substrate of acute coronary thrombosis. This study sought to determine in vivo predictors of plaque erosion in patients with ST-segment elevation myocardial infarction (STEMI). Methods and results: A prospective series of 822 STEMI patients underwent pre-intervention optical coherence tomography. Using established diagnostic criteria, 209 had plaque erosion (25.4%) and 564 had plaque rupture (68.6%). Plaque erosion was more frequent in women <50 years when compared with those ≥50 years of age (P = 0...
March 13, 2018: European Heart Journal
A Sionis, R Suades, J Sans-Roselló, M Sánchez-Martínez, J Crespo, T Padró, J Cubedo, A Ferrero-Gregori, M Vila-Perales, A Duran-Cambra, L Badimon
BACKGROUND: Cardiogenic shock (CS) is the leading cause of death in patients admitted for acute myocardial infarction (MI). Despite the recent advances in reperfusion and medical treatment mortality remains unacceptably high. Whether cells of the blood compartment in CS-patients are activated and release microparticles (cMPs) that may be both messengers and biomarkers of cell damage is not known. We aimed to investigate the cMP subtypes and parental activated cells of ST-elevation MI (STEMI)-patients complicated by CS and that of non-CS STEMI-patients (non-CS) in order to identify a cMP signature that could aid CS patient's risk stratification...
May 1, 2018: International Journal of Cardiology
Rajkumar Doshi, Jay Shah, Varun Jauhar, Dean Decter, Rajiv Jauhar, Perwaiz Meraj
BACKGROUND: The aim of this study was to analyze the indications for using bare metal stents (BMSs) in hospitalizations with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). METHODS: The study cohorts were identified from the National Inpatient Sample database from 2010-2014 using appropriate, International Classification of Diseases, 9th Revision, Clinical Modification, diagnostic and procedural codes. RESULTS: A total of 123,487 hospitalizations were identified for this study...
March 12, 2018: Heart & Lung: the Journal of Critical Care
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
Jasveen J Kandhai-Ragunath, Carine J M Doggen, Liefke C van der Heijden, Marlies M Kok, Paolo Zocca, Bjorn de Wagenaar, Cees Doelman, Harald T Jørstad, Ron J G Peters, Clemens von Birgelen
Knowledge about the changes in endothelial function after ST-elevation myocardial infarction (STEMI) is of substantial interest, but serial data are scarce. The aim of the present study was to noninvasively evaluate whether endothelial function, as assessed shortly after primary percutaneous coronary intervention (PPCI) for STEMI, may improve until 12-month follow-up. This prospective observational cohort study was performed in patients in the RESPONSE randomized trial who participated in a substudy and underwent noninvasive assessment of endothelial function at 1 (baseline), 6, and 12-month follow-up after treatment of a STEMI by PPCI...
March 14, 2018: Heart and Vessels
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
Jungang Zhang, Yaxing Li, Qingzhen Zhao
BACKGROUND miR-23b overexpression can promote cardiomyocyte apoptosis and reduce cell growth under hypoxic conditions, suggesting that miR-23b acts as a biomarker for ST-elevation myocardial infarction (STEMI). The aim of this study was to investigate the effect of miR-23b on STEMI patients. MATERIAL AND METHODS We enrolled 80 eligible patients with STEMI and 60 control subjects. Blood samples were obtained at 6 h, 12 h, 24 h, 48 h, 3 days, and 7 days after the onset of symptoms. Another blood sample was collected before and after percutaneous coronary intervention (PCI)...
March 14, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Lamiae Grimaldi-Bensouda, Nicolas Danchin, Jean Dallongeville, Bruno Falissard, Alain Furber, Yves Cottin, Laurent Bonello, Olivier Morel, Florence Leclercq, Etienne Puymirat, Fahmi Ghanem, Nicolas Delarche, Jacques Benichou, Lucien Abenhaim
OBJECTIVE: To compare ticagrelor and prasugrel with clopidogrel for recurrent fatal and non-fatal myocardial infarction (reMI) in real-life conditions. METHODS: Case-referent study using the Pharmacoepidemiological General Research eXtension (PGRx)-acute coronary syndrome (ACS) registry. Cases were patients with reMI from a cohort with index ACS or external to the cohort (same sites). Referents from the cohort, without recurrent event, were matched on index ACS type and date, age and sex with reMI cases...
March 13, 2018: Heart: Official Journal of the British Cardiac Society
Nizar Andria, Ali Nassar, Fabio Kusniec, Diab Ghanim, Dahud Qarawani, Erez Kachel, Khaled Taha, Offer Amir, Shemy Carasso
BACKGROUND: Coronary artery disease (CAD) has known risk factors. Individual risks related to specific ethnicities are complex and depend on genetic predisposition and lifestyle. OBJECTIVES: To compare the nature and prevalence of risk factors in Arab and non-Arab ethnic patients with symptomatic obstructive CAD referred for coronary angiography. METHODS: CAD, defined as coronary angiography with a ≥ 50% narrowing in ≥ 1 vessel, was diagnosed in 1029 patients admitted to a medical center between April 2014 and October 2015...
March 2018: Israel Medical Association Journal: IMAJ
Sourabh Aggarwal, Feng Xie, Robin High, Gregory Pavlides, Thomas R Porter
BACKGROUND: Although microvascular flow abnormalities have been observed following epicardial recanalization in acute ST-segment elevation myocardial infarction (STEMI), the prevalence and severity of these abnormalities in the current era of rapid percutaneous coronary intervention (PCI) has not been evaluated. The objective of this study was to assess microvascular perfusion (MVP) following successful primary PCI in patients with STEMI and how it affects clinical outcome. METHODS: In this single-center, retrospective study, 170 patients who successfully underwent emergent PCI for STEMI were assessed using real-time myocardial contrast echocardiography using a continuous infusion of intravenous commercial microbubbles (3% Definity)...
March 7, 2018: Journal of the American Society of Echocardiography
Jacob A Udell, Gregg C Fonarow, Thomas M Maddox, Christopher P Cannon, W Frank Peacock, Warren K Laskey, Maria V Grau-Sepulveda, Eric E Smith, Adrian F Hernandez, Eric D Peterson, Deepak L Bhatt
BACKGROUND: Sex-based differences in acute coronary syndrome (ACS) mortality may attenuate with age due to better symptom recognition and prompt care. Hypothesis Age is a modifier of temporal trends in sex-based differences in ACS care. METHODS: Among 104,817 eligible patients with ACS enrolled in the AHA GWTG-CAD registry between 2003-2008, care and in-hospital mortality were evaluated stratified by sex and age (<65 years and ≥65 years). Temporal trends within sex and age groups were assessed for two care processes: the percentage of patients with ST-elevation MI (STEMI) presenting to PCI capable hospitals with a door-to-balloon time ≤ 90 minutes (DTB90) and the proportion of eligible patients with ACS treated with aspirin within 24 hours of presentation...
March 9, 2018: Clinical Cardiology
Xiao-Ping Chen, Xiao-Sen Shang, Yan-Bin Wang, Zhi-Hua Fu, Yu Gao, Tao Feng
OBJECTIVE: To explore the correlation between growth differentiation factor 15 (GDF-15) -3148C/G polymorphism and the formation of collateral circulation in acute ST-elevation myocardial infarction (STEMI) in Han population of Taiyuan area. METHOD: The present study included 92 STEMI patients and 56 normal controls based on coronary angiography; STEMI group was divided into collateral group and non-collateral group according to Rentrop's grading method. Polymerase chain reaction (PCR) and DNA sequencing methods were used to detect and analyze the GDF-15 -3148C/G polymorphism in all participants...
December 2017: Revista da Associação Médica Brasileira
Yong Zhang, HongXia Cao, Pin Jiang, HaiQin Tang
BACKGROUND: Acute myocardial infarction (AMI) is one of the leading causes of death and physical disability worldwide. However, the development of community- based cardiac rehabilitation (CR) in AMI patients is hysteretic. Here, we aimed to evaluate the safety and efficacy of CR applied in the community in AMI patients who underwent percutaneous coronary intervention (PCI). METHODS: A total of 130 ST-segment elevated myocardial infarction (STEMI) patients after PCI were randomly divided into 2 groups in the community, rehabilitation group (n = 65) and control group (n = 65)...
February 2018: Medicine (Baltimore)
Philippe Grieshaber, Tobias Schneider, Lukas Oster, Coskun Orhan, Peter Roth, Bernd Niemann, Andreas Böning
INTRODUCTION: Prophylactic intra-aortic balloon counterpulsation (pIABC) is recommended for high-risk patients undergoing coronary artery bypass grafting (CABG) surgery. Criteria for high-risk patients benefiting from pIABC are unclear. This study aimed to specifically describe the effect of pIABC on outcomes of patients with acute myocardial infarction (AMI) undergoing CABG. METHODS: In 178 of 484 AMI patients (non-ST-segment elevation myocardial infarction [NSTEMI] or ST-segment elevation myocardial infarction [STEMI] ≤5 days before surgery) without cardiogenic shock who underwent CABG between 2008 and 2013, pIABC was initiated preoperatively...
February 1, 2018: Perfusion
Sheeren Khaled, Rajaa Matahen
BACKGROUND: Acute coronary syndrome (ACS) remains a leading cause of death in the United States. Numerous studies have shown that the degree of LV systolic dysfunction is a major if not the most important determinant of long-term outcome in ACS. OBJECTIVES: To identify the most important risk factors and other clinical predictors which might have impact on left ventricular ejection fraction in patients with ACS. RESULTS: The total patients (299) admitted to our center from July, 2015 till December, 2015; with established diagnosis of ACS were classified in to two groups: Group I: 193 patients with impaired LVEF <40% (64...
January 2018: Indian Heart Journal
Lovic, Dragan B Djordjevic, Ivan S Tasic, Ivana P Nedeljkovic
AIMS: The aim of this study is to evaluate the impact of metabolic syndrome (MetS) on clinical severity and long term prognosis in patients with myocardial infarction with ST segment elevation (STEMI). METHODS: We examined 507 patients with STEMI who were admitted for primary percutaneous coronary intervention classified according to the presence of MetS using American Heart Association and the National Heart, Lung and Blood Institute definition. After applying these criteria, the patients were categorized in patients with MetS and without MetS...
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Ching-Yu Julius Chen, Tzu-Ching Yang, Christopher Chang, Shao-Chun Lu, Po-Yuan Chang
BACKGROUND: Homocysteine has been long considered a risk factor for atherosclerosis. However, cardiovascular events cannot be reduced through homocysteine lowering by B vitamin supplements. Although several association studies have reported an elevation of serum homocysteine levels in cardiovascular diseases, the relationship of homocysteine with ST-segment elevation myocardial infarction (STEMI) is not well established. METHODS: We prospectively enrolled STEMI patients who were consecutively admitted to an intensive care unit following coronary intervention in a single medical center in Taiwan...
February 13, 2018: BMC Cardiovascular Disorders
Farzin Brian Boudi, Nicholas Kalayeh, Mohammad Reza Movahed
OBJECTIVE: Acute coronary syndrome is frequently complicated by rhythm disturbances, yet any association between high-density lipoprotein (HDL) cholesterol levels and arrhythmias in the setting of non-ST-segment elevation myocardial infarction (non-STEMI) is uncertain. The goal of this study was to evaluate any association between HDL-cholesterol levels and arrhythmias in the setting of non-STEMI. METHODS: Retrospective data from Phoenix Veterans Affair Medical Center records were utilized for our study...
January 1, 2018: Journal of Intensive Care Medicine
Nurliyana Juhan, Yong Z Zubairi, A S Zuhdi, Zarina Mohd Khalid, Wan Azman Wan
BACKGROUND: Coronary artery disease (CAD) is one of the leading causes of death in Malaysia. However, the prevalence of CAD in males is higher than in females and mortality rates are also different between the two genders. This suggest that risk factors associated with mortality between males and females are different, so we compared the clinical characteristics and outcome between male and female STEMI patients. OBJECTIVES: To identify the risk factors associated with mortality for each gender and compare differences, if any, among ST-elevation myocardial infarction (STEMI) patients...
January 2018: Annals of Saudi Medicine
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