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Stemi response

Giovanni Luigi De Maria, Gregor Fahrni, Mohammad Alkhalil, Florim Cuculi, Sam Dawkins, Mathias Wolfrum, Robin P Choudhury, John C Forfar, Bernard D Prendergast, Tuncay Yetgin, Robert Jan van Geuns, Matteo Tebaldi, Keith M Channon, Rajesh K Kharbanda, Peter M Rothwell, Marco Valgimigli, Adrian P Banning
AIMS: Restoration of effective myocardial reperfusion by primary percutaneous coronary intervention (PPCI) in patients with ST-elevation myocardial infarction is difficult to predict. A method to assess the likelihood of a suboptimal response to conventional pharmacomechanical therapies could be beneficial. We aimed to derive and validate a scoring system that can be used acutely at the time of coronary reopening to predict the likelihood of downstream microvascular impairment in patients with STEMI...
November 20, 2016: EuroIntervention
Sara E Ali, Mohamed A Farag, Paul Holvoet, Rasha S Hanafi, Mohamed Z Gad
Discovery of novel biomarkers is critical for early diagnosis of acute coronary syndrome (ACS). Serum metabolite profiling of ST-elevation myocardial infarction (STEMI), unstable angina (UA) and healthy controls was performed using gas chromatography mass spectrometry (GC/MS), solid-phase microextraction coupled to gas chromatography mass spectrometry (SPME-GC/MS) and nuclear magnetic resonance ((1)H-NMR). Multivariate data analysis revealed a metabolic signature that could robustly discriminate STEMI patients from both healthy controls and UA patients...
November 8, 2016: Scientific Reports
Raffaele Piccolo, Gennaro Galasso, Ingo Eitel, Alberto Dominguez-Rodriguez, Allan Zeeberg Iversen, Youlan L Gu, Pedro Abreu-Gonzalez, Bart J G L de Smet, Giovanni Esposito, Stephan Windecker, Holger Thiele, Federico Piscione
Cigarette smokers with ST-segment elevation myocardial infarction (STEMI) may present different response to potent antithrombotic therapy compared to nonsmokers. We assessed the impact of smoking status and intracoronary abciximab in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). We pooled data from 5 randomized trials comparing intracoronary versus intravenous abciximab bolus in patients undergoing primary PCI. The primary end point was the composite of death or reinfarction at a mean follow-up of 292 ± 138 days...
September 13, 2016: American Journal of Cardiology
Jiri Parenica, Jiri Jarkovsky, Jan Malaska, Alexandre Mebazaa, Jana Gottwaldova, Katerina Helanova, Jiri Litzman, Milan Dastych, Josef Tomandl, Jindrich Spinar, Ludmila Dostalova, Petr Lokaj, Marie Tomandlova, Monika Goldergova Pavkova, Pavel Sevcik, Matthieu Legrand
INTRODUCTION: Cardiogenic shock (CS) patients are at a high risk of developing infectious complications; however, their early detection is difficult, mainly due to a frequently occurring non-infectious inflammatory response, which accompanies an extensive myocardial infarction or a post-cardiac arrest syndrome. The goal of our prospective study was to describe infectious complications in CS and the immune/inflammatory response based on a serial measurement of several blood-based inflammatory biomarkers...
September 29, 2016: Shock
Sanjiv Gupta, Madan Mohan Gupta
Percutaneous coronary intervention (PCI) is effective in opening the infarct related artery and restoring thrombolysis in myocardial infarction flow 3 (TIMI-flow 3) in large majority of ST-elevation myocardial infarction (STEMI). However there remain a small but significant proportion of patients, who continue to manifest diminished myocardial reperfusion despite successful opening of the obstructed epicardial artery. This phenomenon is called no-reflow. Clinically it manifests with recurrence of chest pain and dyspnea and may progress to cardiogenic shock, cardiac arrest, serious arrhythmias and acute heart failure...
July 2016: Indian Heart Journal
Dawod Sharif, Wisam Matanis, Amal Sharif-Rasslan, Uri Rosenschein
BACKGROUND: Myocardial stunning is responsible for partially reversible left ventricular (LV) systolic dysfunction after successful primary percutaneous coronary intervention (PPCI) in patients with acute ST-elevation myocardial infarction (STEMI). AIM: To test the hypothesis that early coronary blood flow (CBF) to LV systolic function ratios, as an equivalent to LV stunning index (SI), predict recovery of LV systolic function after PPCI in patients with acute STEMI...
August 20, 2016: Echocardiography
Bairong Chen, Liyun Luo, Weiping Zhu, Xiaoliang Wei, Songbiao Li, Yin Huang, Mao Liu, Xiufang Lin
The aim of this study is to determine miR-22 expression levels in peripheral blood mononuclear cells (PBMCs) of patients with coronary artery disease (CAD) and to investigate whether MCP-1 expression is regulated by miR-22. miR-22 expression in PBMCs from 60 CAD patients including stable angina pectoris (SAP) (n = 29), unstable angina pectoris (UAP) or non-ST elevation myocardial infarction (NSTEMI) (n = 17), or ST-elevation MI (STEMI) (n = 14) and 20 non-CAD subjects by real-time polymerase chain reaction (qRT-PCR)...
August 2016: Medicine (Baltimore)
Selami Doğan, Hüseyin Dursun, Hüseyin Can, Hülya Ellidokuz, Dayimi Kaya
BACKGROUND/AIM: The aim of this study was to determine the patient profile, treatment, and outcomes of a coronary care unit (CCU) by retrospective screening of 12-year patient records. MATERIALS AND METHODS: The data of 13,463 patients admitted to the CCU of a tertiary referral hospital between 1 January 1997 and 30 June 2008 were collected. The patients were assessed with respect to demographics, admission diagnosis, treatment, and outcomes. RESULTS: The mean age of patients was 61 ± 13 years (66...
2016: Turkish Journal of Medical Sciences
Tor Biering-Sørensen
BACKGROUND: The preservation of normal cardiac time intervals is intimately related to normal cardiac physiology and function. In the ailing myocardium, the cardiac time intervals will change during disease progression. As left ventricular (LV) systolic function deteriorates, the time it takes for myocardial myocytes to achieve an LV pressure equal to that of aorta increases, resulting in a prolongation of the isovolumic contraction time (IVCT). Furthermore, the ability of myocardial myocytes to maintain the LV pressure decreases, resulting in reduction in the ejection time (ET)...
August 2016: Danish Medical Journal
Ivan C Rokos, Karl Sporer, Paul B Savino, Mary P Mercer, Selinda S Shontz, Sarah Sabbagh, Renee Y Hsia
INTRODUCTION: California has been a global leader in regionalization efforts for time-critical medical conditions. A total of 33 local emergency medical service agencies (LEMSAs) exist, providing an organized EMS framework across the state for almost 40 years. We sought to develop a survey tool to quantify the degree and duration of ST-elevation myocardial infarction (STEMI) regionalization over the last decade in California. METHODS: The project started with the development of an 8-question survey tool via a multi-disciplinary expert consensus process...
September 2016: Critical Pathways in Cardiology
Edward Koifman, Roy Beigel, Romana Herscovici, Paul Fefer, Nurit Rozenberg, Avi Sabbag, Yitschak Biton, Amit Segev, Michael Shechter, Elad Asher, Shlomi Matetzky
INTRODUCTION: Information regarding immediate response to novel P2Y12 inhibitors in ST-elevation myocardial infarction (STEMI) is scarce and has been associated with adequate reperfusion. Recent studies have shown that the onset of anti-platelet effects of novel P2Y12 inhibitors in patients with STEMI might be slower and more variable than in stable coronary syndrome. We aimed to assess the predictors and significance of immediate platelet response to prasugrel loading in STEMI. METHODS: Platelet aggregation (PA) was prospectively evaluated in STEMI patients upon prasugrel loading and at primary percutaneous coronary intervention (PPCI)...
August 2016: Thrombosis Research
Tarun K Mittal, Luise Reichmuth, Ben Ariff, Praveen P G Rao, Aigul Baltabaeva, Shelley Rahman-Haley, Tito Kabir, Joyce Wong, Miles Dalby
OBJECTIVE: A proportion of patients with suspected ST-elevation myocardial infarction (STEMI) presenting for primary percutaneous coronary intervention (PPCI) do not have obstructive coronary disease and other conditions may be responsible for their symptoms and ECG changes. In this study, we set out to determine the prevalence and aetiology of alternative diagnoses in a large PPCI cohort as determined with multimodality imaging and their outcome. METHODS: From 2009 to 2012, 5238 patients with suspected STEMI were referred for consideration of PPCI...
November 1, 2016: Heart: Official Journal of the British Cardiac Society
Sean van Diepen, Wendimagegn G Alemayehu, Yinggan Zheng, Pierre Theroux, L Kristin Newby, Kenneth W Mahaffey, Christopher B Granger, Paul W Armstrong
Coronary plaque rupture mediating acute ST segment elevation myocardial infarction (STEMI) is associated with a systemic inflammatory response. Whether early temporal changes in inflammatory biomarkers are associated with angiographic and electrocardiographic markers of reperfusion and subsequent clinical outcomes is unclear. In the APEX-AMI biomarker substudy, 376 patients with STEMI had inflammatory biomarkers measured at the time of hospital presentation and 24 h later. The primary outcome was the 90-day composite of death, shock, or heart failure...
October 2016: Journal of Thrombosis and Thrombolysis
Riobaldo Cintra, Filipe A Moura, Luiz S F Carvalho, Mauricio Daher, Simone N Santos, Ana P R Costa, Valeria N Figueiredo, Joalbo M Andrade, Francisco A R Neves, Jose C Quinaglia E Silva, Andrei C Sposito
BACKGOUND: The favorable effects of insulin during myocardial infarction (MI) remain unclear due to the divergence between mechanistic studies and clinical trials of exogenous insulin administration. The rs7903146 polymorphism of the transcription factor 7-like 2 (TCF7L2) gene is associated with attenuated insulin secretion. METHODS: In non-diabetic patients with ST-elevation MI (STEMI), using such a model of genetically determined down-regulation of endogenous insulin secretion we investigated the change in plasma insulin, C-peptide, interleukin-2 (IL-2), C-reactive protein (CRP), and nitric oxide (NOx) levels between admission (D1) and the fifth day after MI (D5)...
June 2016: BBA Clinical
Leili Pourafkari, Ognjen Visnjevac, Samad Ghaffari, Nader D Nader
INTRODUCTION: The objective was to examine the role of statins in modulating post-STEMI inflammation and related mortality. METHODS: A total of 404 patients with STEMI were reviewed. Demographics, comorbidities, laboratory values, and outcomes were collected. The patients were grouped as STATIN and NOSTAT based on the use of statin drugs at the time of admission. Ninety-seven patients were receiving statin drugs. RESULTS: The patients in the STATIN group were more likely to be hypertensive (53...
2016: Journal of Cardiovascular and Thoracic Research
Gregg W Stone, Harry P Selker, Holger Thiele, Manesh R Patel, James E Udelson, E Magnus Ohman, Akiko Maehara, Ingo Eitel, Christopher B Granger, Paul L Jenkins, Melissa Nichols, Ori Ben-Yehuda
BACKGROUND: Prompt reperfusion in patients with ST-segment elevation myocardial infarction (STEMI) reduces infarct size and improves survival. However, the intuitive link between infarct size and prognosis has not been convincingly demonstrated in the contemporary era. OBJECTIVES: This study sought to determine the strength of the relationship between infarct size assessed early after primary percutaneous coronary intervention (PCI) in STEMI and subsequent all-cause mortality, reinfarction, and hospitalization for heart failure...
April 12, 2016: Journal of the American College of Cardiology
Sameer Saleem, Adnan Khan, Ihtesham Shafiq
OBJECTIVE: To study the effect of timing of thrombolytic therapy, cardiac risk factors and site of infarction on S.T. resolution post thrombolysis in STEMI patients. METHODS: This was a descriptive hospital based study conducted at the Hayatabad Medical Complex Peshawar. The duration of our study was 5 months from February 2015 to June 2015. Diagnosis of STEMI in symptomatic patients was based on the ECG recognized. Definition of Myocardial Infarction. Time from onset of chest pain to presentation of patients in emergency was noted through history of patients along with time of streptokinase...
January 2016: Pakistan Journal of Medical Sciences Quarterly
Jiannan Dai, Jinwei Tian, Jingbo Hou, Lei Xing, Shengliang Liu, Lijia Ma, Huai Yu, Xuefeng Ren, Nana Dong, Bo Yu
BACKGROUND: Cholesterol Crystals (ChCs) are recognized as a hallmark of advanced atherosclerotic lesions. Previous animal and histopathology studies have revealed that Cholesterol crystallization trigger a local inflammatory response and plaque rupture. We sought to investigate the in vivo relationship between ChCs and culprit lesion vulnerability in patients with acute coronary syndrome (ACS). METHODS: 206 culprit lesions from 206 patients with ACS who underwent optical coherence tomography (OCT) imaging were divided into 2 groups based on the presence or absence of ChCs...
April 2016: Atherosclerosis
Richard Pilbery, M Dawn Teare, Steve Goodacre, Francis Morris
BACKGROUND: The appropriate management of patients with ST-segment elevation myocardial infarction (STEMI) depends on accurate interpretation of the 12-lead ECG by paramedics. Computer interpretation messages on ECGs are often provided, but the effect they exert on paramedics' decision-making is not known. The objective of this study was to assess the feasibility of using an online assessment tool, and collect pilot data, for a definitive trial to determine the effect of computer interpretation messages on paramedics' diagnosis of STEMI...
July 2016: Emergency Medicine Journal: EMJ
Kevin R Bainey, Claudio Fresco, Yinggan Zheng, Sigrun Halvorsen, Antonio Carvalho, Miodrag Ostojic, Patrick Goldstein, Anthony H Gershlick, Cynthia M Westerhout, Frans Van de Werf, Paul W Armstrong
OBJECTIVE: Uncertainty exists concerning the relative merits of pharmacological versus mechanical coronary reperfusion in patients presenting early with ST-elevation myocardial infarction (STEMI) with extensive myocardium at risk. Accordingly, we investigated whether the extent of baseline ST-segment shift was related to the response of either reperfusion modality in patients with STEMI presenting within 3 h of symptoms. METHODS: We analysed baseline ECGs from 1859 patients enrolled in the STrategic Reperfusion Early After Myocardial Infarction (STREAM) trial...
April 2016: Heart: Official Journal of the British Cardiac Society
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