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STEMI risk factor

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https://www.readbyqxmd.com/read/29317977/stemi-due-to-big-ostial-left-main-thrombus-extending-into-aorta-challenging-situation-with-no-clear-guidelines
#1
Mohammady Shahin, Oliver Gaemperli, Patrick Siegrist, Jasmina Alibegovic
Extensive left main (LM) coronary artery thrombus is a rare and life-threatening angiographic finding with usual dramatic clinical presentation including hemodynamic instability and sudden cardiac death. The proper management of a big LM thrombus extending into aorta remains a challenging issue with no clear guidelines. In the following case report we present a 45-year-old patient with no apparent risk factors for coronary artery disease who presented with acute infero-lateral ST-elevation myocardial infarction (STEMI)...
December 2017: Cardiology Research
https://www.readbyqxmd.com/read/29316995/prehospital-modified-heart-score-predictive-of-30-day-adverse-cardiac-events
#2
Jason P Stopyra, William S Harper, Tyson J Higgins, Julia V Prokesova, James E Winslow, Robert D Nelson, Roy L Alson, Christopher A Davis, Gregory B Russell, Chadwick D Miller, Simon A Mahler
Introduction The History, Electrocardiogram (ECG), Age, Risk Factors, and Troponin (HEART) score is a decision aid designed to risk stratify emergency department (ED) patients with acute chest pain. It has been validated for ED use, but it has yet to be evaluated in a prehospital setting. Hypothesis A prehospital modified HEART score can predict major adverse cardiac events (MACE) among undifferentiated chest pain patients transported to the ED. METHODS: A retrospective cohort study of patients with chest pain transported by two county-based Emergency Medical Service (EMS) agencies to a tertiary care center was conducted...
January 10, 2018: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/29313561/relation-between-post-procedural-platelet-count-and-left-ventricular-aneurysm-in-patients-with-acute-anterior-st-elevated-myocardial-infarction-following-primary-percutaneous-coronary-intervention
#3
Zuoyan Wang, Lihui Ren, Na Liu, Jianjun Peng
BACKGROUND: Left ventricular aneurysm (LVA) relates to the worse prognosis of patients with myocardial infarction despite successful reperfusion treatment. There is no evidence of early detectable biomarkers to predict risk for the future development of LVA. The aim of our study was to investigate the possible predictive value of peri-procedural hematological parameters for the LVA. METHODS: A total of 281 patients with acute anterior ST-elevated myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PPCI) were enrolled...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29313268/trajectories-of-circulating-monocyte-subsets-after-st-elevation-myocardial-infarction-during-hospitalization-latent-class-growth-modeling-for-high-risk-patient-identification
#4
Shan Zeng, Li-Fang Yan, Yan-Wei Luo, Xin-Lin Liu, Jun-Xiang Liu, Zhao-Zeng Guo, Zhong-Wei Xu, Yu-Ming Li, Wen-Jie Ji, Xin Zhou
It remains unclear if the developmental trajectories of a specific inflammatory biomarker during the acute phase of ST-elevation myocardial infarction (STEMI) provide outcome prediction. By applying latent class growth modeling (LCGM), we identified three distinctive trajectories of CD14++CD16+ monocytes using serial flow cytometry assays from day 1 to day 7 of symptom onset in 96 de novo STEMI patients underwent primary percutaneous coronary intervention. Membership in the high-hump-shaped trajectory (16.8%) independently predicted adverse cardiovascular outcomes during a median follow-up of 2...
January 8, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29297192/higher-admission-glycaemia-independently-of-diagnosed-or-unrecognized-diabetes-mellitus-is-a-risk-factor-for-failed-myocardial-tissue-reperfusion-and-higher-mortality-after-primary-angioplasty
#5
Łukasz Kalińczuk, Kamil Zieliński, Jerzy Pręgowski, Jakub Przyłuski, Maciej Karcz, Paweł Bekta, Michał Ciszewski, Zofia Dzielińska, Adam Witkowski, Marcin Demkow
BACKGROUND: Admission hyperglycemia worsens reperfusion in ST-segment elevation myocardial infarction (STEMI). ST-segment elevation resolution parallels myocardial tissue reperfusion and predicts outcome of primary percutaneous coronary intervention (pPCI). METHODS: We investigated whether higher glycaemia on admission impairs tissue-level reperfusion after pPCI for STEMI, assessed with the single-lead Schröder method of ST-segment resolution analysis (maxSTE)...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29282471/association-of-coronary-vessel-characteristics-with-outcome-in-patients-with-percutaneous-coronary-interventions-with-incomplete-revascularization
#6
Edward L Hannan, Ye Zhong, Peter B Berger, Alice K Jacobs, Gary Walford, Frederick S K Ling, Ferdinand J Venditti, Spencer B King
Importance: Many studies have compared outcomes for incomplete revascularization (IR) among patients undergoing percutaneous coronary interventions (PCI), but little is known about whether outcomes are related to the nature of the IR. Objective: To determine whether some coronary vessel characteristics are associated with worse outcomes in patients with PCI with IR. Design, Setting, and Participants: New York's PCI registry was used to examine mortality (median follow-up, 3...
December 27, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29281605/trends-in-cardiovascular-risk-profiles
#7
REVIEW
Samir Kapadia
Outcomes for patients with coronary artery disease (CAD) have improved in the past 20 years likely due to advances in clinical care such as angiotensin-converting enzyme inhibitors, antiplatelet agents, and reduced time to cardiac cauterization procedures. But how have the risk factors for CAD changed in the past 2 decades? Analysis of nearly 4,000 patients with ST-elevation myocardial infarction (STEMI) at a tertiary care center found that patients presenting with acute STEMI are younger and more obese than in the past...
December 2017: Cleveland Clinic Journal of Medicine
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
#8
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/29226890/relationship-between-the-extent-of-coronary-artery-disease-and-in-stent-restenosis-in-patients-with-acute-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#9
Erkan Yıldırım, Murat Çelik, Uygar Çağdaş Yüksel, Barış Buğan, Yalçın Gökoğlan, Suat Görmel, Salim Yaşar, Mustafa Koklu, Atila İyisoy, Cem Barçın
OBJECTIVE: The pathophysiological mechanism of in-stent restenosis (ISR) is different from atherosclerosis of native coronary arteries. The aim of this study was to evaluate the relationship between ISR and the extent of coronary artery disease (CAD), and to identify other risk factors associated with ISR in ST-segment elevation myocardial infarction (STEMI) patients. METHODS: A total of 372 consecutive patients presenting with first acute STEMI who were successfully treated with primary percutaneous coronary intervention within 12 hours from the onset of symptoms and who had an angiographic follow-up at 3 months were included in the study...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29223432/contemporary-risk-model-for-inhospital-major-bleeding-for-patients-with-acute-myocardial-infarction-the-acute-coronary-treatment-and-intervention-outcomes-network-action-registry%C3%A2-get-with-the-guidelines-gwtg-%C3%A2
#10
MULTICENTER STUDY
Nihar R Desai, Kevin F Kennedy, David J Cohen, Traci Connolly, Deborah B Diercks, Mauro Moscucci, Stephen Ramee, John Spertus, Tracy Y Wang, Robert L McNamara
BACKGROUND: Major bleeding is a frequent complication for patients with acute myocardial infarction (AMI) and is associated with significant morbidity and mortality. OBJECTIVE: To develop a contemporary model for inhospital major bleeding that can both support clinical decision-making and serve as a foundation for assessing hospital quality. METHODS: An inhospital major bleeding model was developed using the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With the Guidelines (ACTION Registry-GWTG) database...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29217178/factors-associated-with-advanced-cardiac-care-in-prehospital-chest-pain-patients
#11
Adam Frisch, Kenneth J Heidle, Stephanie O Frisch, Ashar Ata, Brandon Kramer, Caroline Colleran, Jestin N Carlson
INTRODUCTION: Many patients transported by emergency medical services (EMS) may require advanced cardiac care but do not have ST-segment elevation (STEMI) on the initial prehospital EKG. We sought to identify factors associated with the need for advanced cardiac care in undifferentiated EMS patients reporting chest pain in the absence of STEMI on EKG. METHODS: We performed a retrospective analysis of all adult patients, reporting atraumatic chest pain from a single EMS agency, presenting to a single, urban hospital over a 10-year period...
December 5, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29208886/coronary-angiography-findings-and-its-determinants-in-patients-presenting-with-acute-coronary-syndrome-a-descriptive-analysis-from-asian-population
#12
M Chourasiya, S Satheesh, R Selvaraj, B Jayaraman, A A Pillai
The aim was to study the angiographic profile in patients presented as acute coronary syndrome and its relation with risk factors and comparison between genders. This prospective observational study was performed on total 352 patients of acute coronary syndrome were analyzed for various risk factors, angiographic pattern in Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, South India from January 2015 to July 2016. Mean age of presentation was 52.62±11.63 years. Male were 271(77...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29193382/prediction-of-no-reflow-and-major-adverse-cardiovascular-events-with-a-new-scoring-system-in-stemi-patients
#13
Adil Bayramoğlu, Hakan Taşolar, Ahmet Kaya, İbrahim Halil Tanboğa, Mehmet Yaman, Osman Bektaş, Zeki Yüksel Günaydın, Vecih Oduncu
BACKGROUND: No-reflow is associated with a poor prognosis in STEMI patients. There are many factors and mechanisms that contribute to the development of no-reflow, including age, reperfusion time, a high thrombus burden, Killip class, long stent use, ejection fraction ≤40, and a high Syntax score. In this study, we aimed to evaluate the parameters associated with no-reflow prediction by creating a new scoring system. METHODS: The study included 515 consecutive STEMI patients who underwent PCI; 632 STEMI patients who had undergone PCI in another center were included in the external validation of the scoring system...
November 28, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29189830/-ambulatory-cardiac-rehabilitation-in-trieste-protocols-of-intervention-activities-and-outcomes
#14
Sara Doimo, Patrizia Maras, Giulia Barbati, Enrico Fabris, Alessio Della Mattia, Kareem Salame, Giuseppe Gatti, Gianfranco Sinagra
BACKGROUND: Cardiac rehabilitation (CR) is a model of care proven to reduce mortality and morbidity in patients with coronary artery disease. The aim of this study is to describe the ambulatory CR model of the Cardiovascular Department of Trieste (Italy), analyzing the outcome of the population. METHODS: We analyzed clinical and instrumental characteristics of all consecutive patients after ST-elevation myocardial infarction (STEMI), non-ST-elevation myocardial infarction (NSTEMI), coronary artery bypass graft with or without valve surgery (CABG/CABGV), or planned percutaneous coronary intervention (PCI), referred for CR from January 1, 2009, to December 31, 2015...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29185210/acute-kidney-injury-based-on-the-kdigo-criteria-among-st-elevation-myocardial-infarction-patients-treated-by-primary-percutaneous-intervention
#15
Gilad Margolis, Amir Gal-Oz, Sevan Letourneau-Shesaf, Shafik Khoury, Gad Keren, Yacov Shacham
BACKGROUND: Acute kidney injury (AKI) following acute ST elevation myocardial infarction (STEMI) is associated with adverse outcomes. The recently proposed KDIGO criteria suggested modifications to the consensus classification system for AKI, namely lowering the threshold of increase in absolute serum creatinine and extending the time frame for AKI detection to 7 days. We evaluated the incidence, risk factors, and long-term mortality associated with AKI as classified by the KDIGO definition in a large single center cohort of consecutive STEMI patients...
November 28, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/29185048/impaired-left-ventricular-diastolic-function-is-related-to-the-formation-of-left-ventricular-apical-thrombus-in-patients-with-acute-anterior-myocardial-infarction
#16
Ung Lim Choi, Jae-Hyeong Park, Byung Joo Sun, Jin Kyung Oh, Seok Woo Seong, Jae-Hwan Lee, Si Wan Choi, Jin-Ok Jeong, In Sun Kwon, In-Whan Seong
Left ventricular (LV) apical thrombus is a clinically important complication which can cause systemic embolization in patients with anterior acute myocardial infarction (AMI). Systolic dysfunction has been a risk factor for developing LV apical thrombus in AMI patients. However, the role of diastolic dysfunction in the development of LV apical thrombus in these patients is still unknown. We performed this study to evaluate whether diastolic dysfunction can influence the development of LV apical thrombus in anterior AMI patients...
November 28, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29153151/what-is-the-best-st-segment-recovery-parameter-to-predict-clinical-outcome-and-myocardial-infarct-size-amplitude-speed-and-completeness-of-st-segment-recovery-after-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#17
Wichert J Kuijt, Cindy L Green, Niels J W Verouden, Joost D E Haeck, Dan Tzivoni, Karel T Koch, Gregg W Stone, Alexandra J Lansky, Samuel Broderick, Jan G P Tijssen, Robbert J de Winter, Matthew T Roe, Mitchell W Krucoff
AIMS: ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. METHODS AND RESULTS: Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined...
November 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29151487/relationship-between-n-3-polyunsaturated-fatty-acids-and-extent-of-vessel-disease-in-patients-with-st-elevation-myocardial-infarction
#18
Takenobu Shimada, Kazushige Kadota, Haruki Eguchi, Kohei Osakada, Akimune Kuwayama, Masanobu Ohya, Katsuya Miura, Hidewo Amano, Shunsuke Kubo, Masatomo Ozaki, Yusuke Hyodo, Mitsuru Yoshino, Koshi Miyake, Yuichi Kawase, Noriyuki Ohashi, Suguru Otsuru, Hiroshi Tasaka, Seiji Habara, Takeshi Tada, Hiroyuki Tanaka, Takeshi Maruo, Yasushi Fuku, Harumi Katoh, Satoki Fujii, Tsuyoshi Goto, Kazuaki Mitsudo
A relationship between serum polyunsaturated fatty acids (PUFAs) and cardiovascular disease has been reported; however, the existence of a relationship between serum PUFAs and extent of vessel disease (VD) in patients with ST elevation myocardial infarction (STEMI) remains unclear.Between July 2011 and June 2015, 866 consecutive STEMI patients underwent emergent percutaneous coronary intervention, 507 of whom were enrolled and classified into three groups according to the initial angiograms: 1VD, 294 patients; 2VD, 110 patients; and 3VD/left main trunk disease (LMTD), 103 patients...
November 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29146994/usefulness-of-the-delta-neutrophil-index-to-predict-30-day-mortality-in-patients-with-st-segment-elevation-myocardial-infarction
#19
Taeyoung Kong, Tae Hoon Kim, Yoo Seok Park, Sung Phil Chung, Hye Sun Lee, Jung Hwa Hong, Jong Wook Lee, Je Sung You, Incheol Park
This study aimed to evaluate the association between the delta neutrophil index (DNI), which reflects immature granulocytes, and the severity of ST-elevation myocardial infarction (STEMI), as well as to determine the significance of the DNI as a prognostic marker for early mortality and other clinical outcomes in patients with STEMI who underwent reperfusion. This retrospective, observational cohort study was conducted using patients prospectively integrated in a critical pathway program for STEMI. We included 842 patients diagnosed with STEMI who underwent primary percutaneous coronary intervention (pPCI)...
November 16, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29146553/impact-of-marital-status-on-outcomes-following-st-segment-elevation-myocardial-infarction
#20
Moo Hyun Kim, Kwang Min Lee, Soo Jin Kim, So Yeon Kim, Jong Seong Park, Young Rak Cho, Kyungil Park, Tae Ho Park, Young Dae Kim, Victor Serebruany
BACKGROUND: Mood disorders, depression, and loneliness are established risk factors for thrombotic occlusions. Social relationships in general, and marital status in particular may play a role in predicting cardiovascular outcomes and survival after ST-segment elevation myocardial infarction (STEMI), but the evidence is inconclusive especially in Asians. METHODS: The Korean patients presented with STEMI (n=980) constituted married (n=780); or widowed, divorced, or single (WDS, n=200) groups...
July 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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