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Stemi response

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
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
Sameer Mehta, Christopher Granger, Cindy Lee Grines, Alice Jacobs, Timothy D Henry, Ivan Rokos, Alexandra Lansky, Andreas Baumbach, Roberto Botelho, Alexandra Ferre, Isaac Yepes, Roopa Salwan, Jamshed Dalal, Jitendra Makkar, Neeraj Bhalla, Sundeep Mishra, Vinod Vijan, Shirish Hiremath
Our previous research found seven specific factors that cause system delays in ST-elevation Myocardial infarction management in developing countries. These delays, in conjunction with a lack of organized STEMI systems of care, result in inefficient processes to treat AMI in developing countries. In our present opinion paper, we have specifically explored the three most pertinent causes that afflict the seven specific factors responsible for system delays. In doing so, we incorporated a unique strategy of global STEMI expertise...
January 2018: Indian Heart Journal
Tetsuo Minamino, Shuichiro Higo, Ryo Araki, Shungo Hikoso, Daisaku Nakatani, Hiroshi Suzuki, Takahisa Yamada, Masaaki Okutsu, Kouji Yamamoto, Yasushi Fujio, Yoshio Ishida, Takuya Ozawa, Kiminori Kato, Ken Toba, Yoshifusa Aizawa, Issei Komuro
BACKGROUND: Erythropoietin (EPO) has antiapoptotic and tissue-protective effects, but previous clinical studies using high-dose EPO have not shown cardioprotective effects, probably because of platelet activation and a lack of knowledge regarding the optimal dose. In contrast, a small pilot study using low-dose EPO has shown improvement in left ventricular function without adverse cardiovascular events.Methods and Results:We performed a multicenter (25 hospitals), prospective, randomized, double-blind, placebo-controlled, dose-finding study to clarify the efficacy and safety of low-dose EPO in patients with ST-segment elevation myocardial infarction (STEMI) under the Evaluation System of Investigational Medical Care of the Ministry of Health, Labor and Welfare of Japan...
February 2, 2018: Circulation Journal: Official Journal of the Japanese Circulation Society
Guangxiao Li, Guoxian Qi, Bo Zhang, Bo Zhou, Bing Ma, Daming Jiang, Qiao He, Cong Ai, Huixu Dai, Ying Li, Jingpu Shi
We aimed to investigate the dose-response associations between chronic kidney disease (CKD), and short and long-term cardiovascular outcomes, to characterize these associations by drawing dose-response curves based on a Chinese rural ST-segment elevation myocardial infarction (STEMI) population.In all, 1067 patients with STEMI were consecutively enrolled from 12 secondary hospitals of China's Liaoning province (from June 2009 to June 2010 and January 2015 to December 2015). The follow-up was regularly performed by telephone...
December 2017: Medicine (Baltimore)
Yoshihiro Morino, Daisuke Terashita, Hiromasa Otake, Tatsuo Kikuchi, Tetsuya Fusazaki, Nehiro Kuriyama, Takahide Suzuki, Yoshiaki Ito, Kiyoshi Hibi, Hiroyuki Tanaka, Shozo Ishihara, Toru Kataoka, Takashi Morita, Yoritaka Otsuka, Takatoshi Hayashi, Kengo Tanabe, Toshiro Shinke
The use of cobalt-chromium everolimus-eluting stents (CoCr-EES) for ST-segment elevation myocardial infarction (STEMI) reduces the incidence of stent thrombosis compared with bare metal stents, and a substantial difference is apparent in the initial 2 weeks. However, vascular behavior during this early period remains unclear. This was a prospective study (MECHANISM-AMI-2W) to investigate early vascular responses in STEMI patients immediately after CoCr-EES implantation and at 2-week follow-up using frequency domain-optical coherence tomography (FD-OCT)...
January 9, 2018: Cardiovascular Intervention and Therapeutics
Novkovic Mirjana, Matic Dragan, Kusic-Tisma Jelena, Antonijevic Nebojsa, Radojkovic Dragica, Rakicevic Ljiljana
PURPOSE: Bleeding is one of the possible adverse events during clopidogrel therapy. The CYP2C19 gene is the most significant genetic factor which influences response to clopidogrel treatment. We aimed to examine the contribution of the CYP2C19 gene to bleeding occurrence during clopidogrel therapy in Serbian patients with ST segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: This case-control study included 53 patients who experienced bleeding and 55 patients without bleeding...
December 19, 2017: European Journal of Clinical Pharmacology
Mathew Mercuri, Katherine Connolly, Madhu K Natarajan, Michelle Welsford, J D Schwalm
RATIONALE, AIMS, AND OBJECTIVES: Access to timely ST-elevation myocardial infarction (STEMI) care is facilitated by paramedics and emergency medical services (EMS). However, a large proportion of STEMI patients do not access care through EMS. This study sought to identify patient-reported factors for their decision to use (or not use) EMS. METHODS: Semi-structured interviews were conducted with a sample of STEMI patients admitted to a large tertiary care centre between November 2011 and January 2012...
December 13, 2017: Journal of Evaluation in Clinical Practice
Daan Aeyels, Peter R Sinnaeve, Marc J Claeys, Sofie Gevaert, Danny Schoors, Walter Sermeus, Massimiliano Panella, Ellen Coeckelberghs, Luk Bruyneel, Kris Vanhaecht
OBJECTIVE: Identification, selection and validation of key interventions and quality indicators for improvement of in hospital quality of care for ST-elevated myocardial infarction (STEMI) patients. METHODS AND RESULTS: A structured literature review was followed by a RAND Delphi Survey. A purposively selected multidisciplinary expert panel of cardiologists, nurse managers and quality managers selected and validated key interventions and quality indicators prior for quality improvement for STEMI...
December 13, 2017: Acta Cardiologica
Sinjini Biswas, Stephen J Duffy, Jeffrey Lefkovits, Nick Andrianopoulos, Angela Brennan, Antony Walton, William Chan, Samer Noaman, James A Shaw, Luke Dawson, Andrew Ajani, David J Clark, Melanie Freeman, Chin Hiew, Ernesto Oqueli, Christopher M Reid, Dion Stub
Over the last decade, systems of care for ST-elevation myocardial infarction (STEMI) have evolved to try to improve outcomes and timely access to percutaneous coronary intervention (PCI). There have also been advances in PCI techniques and adjunctive pharmacotherapies. In this study, we sought to determine temporal changes in practices and clinical outcomes of PCI in patients with STEMI. We prospectively collected data on 8,412 consecutive patients undergoing PCI for STEMI between 2005 and 2016 in the multicenter Melbourne Interventional Group registry...
February 1, 2018: American Journal of Cardiology
Janusz Kochman, Koltowski Łukasz, Mariusz Tomaniak, Jacek Jąkała, Klaudia Proniewska, Jacek Legutko, Tomasz Roleder, Arkadiusz Piertrasik, Adam Rdzanek, Wacław Kochman, Salvatore Brugaletta, Grzegorz Opolski, Evelyn Regar
AIMS: The aim of the study was to assess the vascular healing response after Absorb bioresorbable vascular scaffold (BVS) implantation in patients with ST segment elevation myocardial infarction (STEMI) utilizing truly serial optical coherence tomography (OCT) examination at baseline, 12- and 24-months. METHODS AND RESULTS: This is the single-centre, prospective, longitudinal study with baseline, 12- and 24-month OCT evaluation of 18 STEMI patients treated with 22 Absorb BVS implantation...
November 21, 2017: EuroIntervention
Christiana Schernthaner, Vera Paar, Bernhard Wernly, Rudin Pistulli, Ilonka Rohm, Christian Jung, Hans-Reiner Figulla, Attila Yilmaz, Janne Cadamuro, Elisabeth Haschke-Becher, P Christian Schulze, Uta C Hoppe, Michael Lichtenauer, Daniel Kretzschmar
Interleukin (IL)-16, a polypeptide cytokine, plays a crucial role in the inflammatory process, acting as a chemoattractant for peripheral immune cells and has been linked to various inflammatory diseases. However, its role in patients with acute myocardial infarction (AMI) is unclear.We retrospectively analyzed serum levels of IL-16 in blood of patients with (STEMI, n = 45) and without ST-segment elevation myocardial infarction (NSTEMI, n = 42) compared with controls with excluded coronary artery disease (n = 55)...
November 2017: Medicine (Baltimore)
Doo Sun Sim, Myung Ho Jeong
The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels...
November 2017: Korean Circulation Journal
Suzanne de Waha, Manesh R Patel, Christopher B Granger, E Magnus Ohman, Akiko Maehara, Ingo Eitel, Ori Ben-Yehuda, Paul Jenkins, Holger Thiele, Gregg W Stone
Aims: Microvascular obstruction (MVO) is the underlying cause for the no-reflow phenomenon in ST-segment elevation myocardial infarction (STEMI). The association between MVO assessed by cardiac magnetic resonance imaging (CMR) and prognosis has not been convincingly demonstrated. We sought to determine the relationship between MVO assessed early after primary percutaneous coronary intervention (PCI) in STEMI and all-cause mortality, hospitalization for heart failure (HF), and reinfarction...
July 28, 2017: European Heart Journal
Francesco Fracassi, Giampaolo Niccoli, Vincenzo Vetrugno, Michele Cauteruccio, Antonino Buffon, Ilaria Gatto, Igor Giarretta, Paolo Tondi, Roberto Pola, Filippo Crea
BACKGROUND: Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. METHODS: We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI...
October 1, 2017: European Heart Journal. Acute Cardiovascular Care
Juan F Iglesias, Marco Roffi, Sophie Degrauwe, Gioel Gabrio Secco, Adel Aminian, Stephan Windecker, Thomas Pilgrim
New-generation drug-eluting stents (DES) represent the current standard of care in patients undergoing percutaneous coronary intervention (PCI). Biodegradable polymer DES (BP-DES) were recently developed to overcome current limitations of newer-generation durable polymer DES (DP-DES) attributed to sustained inflammatory responses induced by permanent polymers. The Orsiro DES (Biotronik AG, Bülach, Switzerland) is a novel thin-strut cobalt-chromium sirolimus-eluting stent with biodegradable polymer that features some of the latest developments in DES technology...
September 19, 2017: Expert Review of Medical Devices
Benjamin Cross, Tawfiqur Rahman Choudhury, Mark Hindle, Gavin Galasko
A 45-year-old previously healthy man with minimal coronary artery disease on imaging presented with an acute MI after sustaining a wasp sting following previous non-eventful exposures throughout his life. This is the first case of Kounis syndrome with optical coherence tomography imaging and proven IgE wasp venom hypersensitivity. The Hymenoptera venom is composed of allergenic proteins and vasoactive amines which are responsible for venom toxicity. This patient also has a history of atopy giving a predisposition for developing IgE-mediated allergic reactions...
September 7, 2017: BMJ Case Reports
Jing Sun, Guo-Hong Yang, Jun-Xiang Liu, Xin-Lin Liu, Yong-Qiang Ma, Rui-Yi Lu, Ying-Ying Zhang, Shao-Bo Chen, Ji-Hong Zhao, Wen-Jie Ji, Xin Zhou, Yu-Ming Li
To investigate potential clinical characteristics associated with discordance between platelet vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) flow cytometry (FCM) assay and light transmission aggregometry (LTA) in defining high on-clopidogrel platelet reactivity (HPR) after ST-segment elevation myocardial infarction (STEMI). In this study, platelet responsiveness was measured by the above 2 methods simultaneously on day 1 and on day 6 of STEMI onset in 90 consecutive patients who underwent primary percutaneous coronary intervention...
January 2018: Clinical and Applied Thrombosis/hemostasis
Mariella Ecj Hassell, Wieneke Vlastra, Lourens Robbers, Alexander Hirsch, Robin Nijveldt, Jan Gp Tijssen, Albert C van Rossum, Felix Zijlstra, Jan J Piek, Ronak Delewi
OBJECTIVE: Left ventricular remodelling following a ST-segment elevated myocardial infarction (STEMI) is an adaptive response to maintain the cardiac output despite myocardial tissue loss. Limited studies have evaluated long term ventricular function using cardiac magnetic resonance imaging (CMR) after STEMI. METHODS: Study population consisted of 155 primary percutaneous coronary intervention treated first STEMI patients. CMR was performed at 4±2 days, 4 months and 24 months follow-up...
2017: Open Heart
Adam C Powell, Teresa L Rogstad, Uday U Deshmukh, Stephen E Price, Jeffrey D Simmons
BACKGROUND: Myocardial scarring resulting from cardiomyopathy with ischemic etiology may interfere with effective lead placement during implantation of multi-lead cardioverter-defibrillators for cardiac resynchronization therapy (CRT-D). Extensive scarring is known to be associated with poorer physiological and survival outcomes in patients who undergo CRT-D. HYPOTHESIS: Ischemic CRT-D recipients respond as well as nonischemic recipients, using hospital admission for heart failure (HF) as a measure of response...
November 2017: Clinical Cardiology
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