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S Grautoff
The ECG is a very important diagnostic tool if an acute coronary syndrome is suspected. It should be performed immediately when medical staff contacts the patient. If an ST elevation myocardial infarction (STEMI) is diagnosed, immediate reperfusion of the occluded vessel should be the primary goal. Therefore, even subtle signs of an anterior wall infarction diagnosed by the ECG which lead to suspicion of complete occlusion of a coronary artery should be known and diagnosed by all physicians who may have contact with these types of patients...
October 18, 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
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
Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Martin Reindl, Gert Klug, Agnes Mayr, Johannes Mair, Werner Jaschke, Bernhard Metzler
OBJECTIVE: The utility of different biomarkers for the prediction of left ventricular remodelling (LVR) following ST-elevation myocardial infarction (STEMI) has been evaluated in several studies. However, very few data exist on the prognostic value of combined biomarkers. The aim of this study was to comprehensively investigate the prognostic value for LVR of routinely available biomarkers measured after reperfused STEMI. METHODS: Serial measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and high-sensitivity C reactive protein (hs-CRP) were performed in 123 patients with STEMI treated with primary percutaneous coronary intervention in this prospective observational study...
2016: Open Heart
Weixian Xu, Haiyi Yu, Hubing Wu, Siheng Li, Baoxia Chen, Wei Gao
OBJECTIVES: To measure plasma catestatin levels in patients with acute coronary syndrome and investigate whether there is an association between catestatin levels and long-term outcome. METHODS: Patients (n = 170) with suspected acute coronary syndrome who underwent emergency coronary angiography were enrolled, including 46 with acute ST-segment elevation myocardial infarction (STEMI), 89 with unstable angina pectoris (UAP), and 35 without coronary artery disease (CAD)...
September 29, 2016: Cardiology
Józefa Dąbek, Mariusz Bałys, Michał Majewski, Zbigniew T Gąsior
BACKGROUND: Patients with diabetes mellitus (DM) and acute myocardial infarction (AMI) are heterogeneous individuals with different clinical status compared to patients without DM. OBJECTIVES: The aim of this study was to analyze the group of diabetic patients with ST-segment elevation MI (STEMI) or non-ST-segment elevation infarction (NSTEMI) including risk factors, medical history, laboratory findings, advancement of coronary vessel atherosclerosis, and diagnostics and therapeutic modalities performed...
July 2016: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Jin-Chuan Yan, Yang Yan, Cui-Ping Wang, Liang-Jie Xu, Yi Liang
BACKGROUND: Acute myocardial infarction (AMI) is the most serious type of coronary heart disease. However, less than 30% of these patients have been treated effectively in China. Delayed treatment is a leading cause. This study aimed to evaluate a new regional cooperative model for improving the first medical contact-to-device time and the therapeutic effects on AMI patients. METHODS: A retrospective analysis of 458 ST-elevation myocardial infarction (STEMI) patients was performed...
July 2016: Journal of Geriatric Cardiology: JGC
Wei Huang, Gordon FitzGerald, Robert J Goldberg, Joel Gore, Richard H McManus, Hamza Awad, Molly E Waring, Jeroan Allison, Jane S Saczynski, Catarina I Kiefe, Keith A A Fox, Frederick A Anderson, David D McManus
The GRACE Risk Score is a well-validated tool for estimating short- and long-term risk in acute coronary syndrome (ACS). GRACE Risk Score 2.0 substitutes several variables that may be unavailable to clinicians and, thus, limit use of the GRACE Risk Score. GRACE Risk Score 2.0 performed well in the original GRACE cohort. We sought to validate its performance in a contemporary multiracial ACS cohort, in particular in black patients with ACS. We evaluated the performance of the GRACE Risk Score 2.0 simplified algorithm for predicting 1-year mortality in 2,131 participants in Transitions, Risks, and Actions in Coronary Events Center for Outcomes Research and Education (TRACE-CORE), a multiracial cohort of patients discharged alive after an ACS in 2011 to 2013 from 6 hospitals in Massachusetts and Georgia...
October 15, 2016: American Journal of Cardiology
Michal Kacprzak, Marzenna Zielinska
: Inflammation plays an important role on every stage of atherosclerosis. Myeloperoxidase (MPO), a leukocyte-derived enzyme that participates in the innate immunity, probably is involved in many stages of atherothrombosis. According to the recent studies, MPO is related with unfavorable outcome in patients with chest pain and acute coronary syndromes. Its role in prediction of outcomes after ST-segment elevation myocardial infarction (STEMI) remains unclear. The aim of the study was to assess if elevated MPO level is a predictor of long-term adverse cardiac events in patients with STEMI treated with primary percutaneous coronary intervention (pPCI)...
November 15, 2016: International Journal of Cardiology
Satyavan Sharma, Nikhil Raut, Anil Potdar
AIM: Spontaneous coronary artery dissection (SCAD) is a less recognized cause of ST elevation myocardial infarction (STEMI) in clinical practice. The aim of this communication is to describe a case series in South Asian population and highlight on the long-term clinical outcomes on conservative management. METHODS: A retrospective analysis of data of five patients (6 instances) of SCAD managed in a tertiary care center during January 1994 to June 2015 was done. Clinical, angiographic, therapeutic, and follow-up data till end of June 2015 are analyzed...
July 2016: Indian Heart Journal
Olli A Kajander, Natalia Pinilla-Echeverri, Sanjit S Jolly, Ravinay Bhindi, Heini Huhtala, Kari Niemelä, Anthony Fung, Ram Vijayaraghavan, Dimitrios Alexopoulos, Tej Sheth
AIMS: Our aim was to compare stenosis severity and plaque content between STEMI culprit lesions with intact fibrous cap (IFC) and those with plaque rupture (PR) in a prospective study. METHODS AND RESULTS: We evaluated 93 patients undergoing OCT and thrombectomy as part of a prospective substudy of the TOTAL (ThrOmbecTomy versus PCI ALone) trial. Culprit lesion morphology was assessable by OCT in 70/93 (75.3%). IFC was found in 31 (44.3%), PR in 34 (48.6%) and calcified nodule in five (7...
August 20, 2016: EuroIntervention
Yen-Hung Lin, Cheng-Chin Kuo, Chii-Ming Lee, Chia-Hung Chou, Ying-Hsien Chen, Ji-Fan Yeh, Ching-Chang Huang, Chi-Shen Hung, Li-Yu Daisy Liu, Yi-Lwun Ho, Kenneth K Wu
BACKGROUND: Ventricular remodeling following myocardial infarction (MI) is closely associated with cyclooxygenase-2 (COX-2) expression. 5-methoxytryptophan (5-MTP) was reported to control COX-2 expression. OBJECTIVES: To investigeate the association between 5-MTP and post-MI left ventricular remodeling. METHODS: This prospective study enrolled 26 non-diabetic patients with first-time ST segment elevation myocardial infarction (STEMI), and 58 controls...
November 1, 2016: International Journal of Cardiology
Hang Zhao, Alex Pui-Wai Lee, Zheng Li, Zhiqing Qiao, Yiting Fan, Dongaolei An, Jianrong Xu, Jun Pu, Xuedong Shen, Heng Ge, Ben He
BACKGROUND: Intramyocardial hemorrhage (IMH) and microvascular obstruction (MVO) are two major mechanisms of reperfusion injury of the left ventricle after acute ST-segment elevation myocardial infarction (STEMI). The aim of this study was to assess the impact of IMH and MVO on left ventricular (LV) cardiac mechanics using two-dimensional speckle-tracking echocardiography during the acute phase of STEMI and on LV functional recovery. METHODS: Eighty-one patients with STEMI who received primary reperfusion therapy were prospectively studied...
October 2016: Journal of the American Society of Echocardiography
José Tuñón, Ignacio González-Hernández, Lucía Llanos-Jiménez, Joaquín Alonso-Martín, Juan M Escudier-Villa, Nieves Tarín, Carmen Cristóbal, Petra Sanz, Ana M Pello, Álvaro Aceña, Rocío Carda, Miguel Orejas, Marta Tomás, Paula Beltrán, Marta Calero Rueda, Esther Marcos, José María Serrano-Antolín, Carlos Gutiérrez-Landaluce, Rosa Jiménez, Jorge Cabezudo, Alejandro Curcio, Germán Peces-Barba, Emilio González-Parra, Raquel Muñoz-Siscart, María Luisa González-Casaus, Antonio Lorenzo, Ana Huelmos, Javier Goicolea, Borja Ibáñez, Gonzalo Hernández, Luis M Alonso-Pulpón, Jerónimo Farré, Óscar Lorenzo, Ignacio Mahíllo-Fernández, Jesús Egido
INTRODUCTION: Decreased plasma vitamin D (VD) levels are linked to cardiovascular damage. However, clinical trials have not demonstrated a benefit of VD supplements on left ventricular (LV) remodelling. Anterior ST-elevation acute myocardial infarction (STEMI) is the best human model to study the effect of treatments on LV remodelling. We present a proof-of-concept study that aims to investigate whether VD improves LV remodelling in patients with anterior STEMI. METHODS AND ANALYSIS: The VITamin D in Acute Myocardial Infarction (VITDAMI) trial is a multicentre, randomised, double-blind, placebo-controlled trial...
2016: BMJ Open
Xue-Bin Wang, Ya-di Han, Shrestha Sabina, Ning-Hua Cui, Shuai Zhang, Ze-Jin Liu, Cong Li, Fang Zheng
A previous genome-wide association study showed that a single nucleotide polymorphism (SNP) rs2107595 in histone deacetylase 9 (HDAC9) gene was associated with large artery stroke (LAS) in Caucasians. Based on the similar atherosclerotic pathogenesis between LAS and coronary artery disease (CAD), we aimed to evaluate the associations of SNP rs2107595 with CAD risk and the severity of coronary atherosclerosis in a Chinese Han population, and explore the potential gene-environment interactions among SNP rs2107595 and conventional CAD risk factors...
2016: PloS One
Matej Samoš, Marián Fedor, František Kovář, Peter Galajda, Tomáš Bolek, Lucia Stančiaková, Jana Fedorová, Ján Staško, Peter Kubisz, Marián Mokáň
Background. The aim of this study was to validate the impact of type 2 diabetes (T2D) on the platelet reactivity in patients with acute ST elevation myocardial infarction (STEMI) treated with adenosine diphosphate (ADP) receptor blockers. Methods. A pilot prospective study was performed. Totally 67 patients were enrolled. 21 patients had T2D. Among all study population, 33 patients received clopidogrel and 34 patients received prasugrel. The efficacy of ADP receptor blocker therapy had been tested in two time intervals using light transmission aggregometry with specific inducer and vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) flow cytometry assay...
2016: Journal of Diabetes Research
Melinda Rezeli, Olof Gidlöf, Mikael Evander, Paulina Bryl-Górecka, Ramasri Sathanoori, Patrik Gilje, Krzysztof Pawłowski, Péter Horvatovich, David Erlinge, György Marko-Varga, Thomas Laurell
Extracellular vesicles (ECVs), including microparticles and exosomes, are submicrometer membrane vesicles released by diverse cell types upon activation or stress. Circulating ECVs are potential reservoirs of disease biomarkers, and the complexity of these vesicles is significantly lower compared to their source, blood plasma, which makes ECV-based biomarker studies more promising. Proteomic profiling of ECVs is important not only to discover new diagnostic or prognostic markers but also to understand their roles in biological function...
September 6, 2016: Analytical Chemistry
Giuseppe Di Tano, Giorgio Caretta, Renata De Maria, Marina Parolini, Laura Bassi, Sophie Testa, Salvatore Pirelli
OBJECTIVES: Despite modern reperfusion therapies, left ventricular remodelling (LVR) occurs frequently after an ST-elevated myocardial infarction (STEMI) and represents a strong predictor of mortality and heart failure. Galectin-3 (Gal-3), a novel biomarker involved in inflammation, tissue repair and fibrogenesis, might be a valuable predictor of LVR. METHODS: We enrolled consecutively admitted patients with a first anterior STEMI and left anterior descending artery occlusion treated by primary percutaneous coronary intervention (pPCI)...
July 27, 2016: Heart: Official Journal of the British Cardiac Society
Benjamin I Shepple, William A Thistlethwaite, Christopher L Schumann, Kwame O Akosah, Robert C Schutt, Ellen C Keeley
As part of a quality improvement project, we performed a process analysis to evaluate how patients presenting with type 1 non-ST elevation myocardial infarction (STEMI) are diagnosed and managed early after the diagnosis has been made. We performed a retrospective chart review and collected detailed information regarding the timing of the first 12-lead electrocardiogram, troponin order entry and first positive troponin result, administration of anticoagulation and antiplatelet medications, and referral for coronary angiography to identify areas of treatment variability and delay...
September 2016: Critical Pathways in Cardiology
Antonio Izzo, Renato Rosiello, Giuseppe Lucchini, Luca Tomasi, Paola Mantovani, Corrado Lettieri, Nicola Baccaglioni, Michele Romano, Francesca Buffoli, Beatrice Izzo, Roberto Zanini
AIMS: The aim of this study is to assess whether in S-T Elevation Myocardial Infarction (STEMI) a relationship between early administration of abciximab and Thrombolysis In Myocardial Infarction (TIMI) flow before and after primary percutaneous coronary intervention (PCI) in 960 consecutive patients exists. METHODS: From 1 February 2001 onward, in the Province of Mantua it has been operating a 'Cardiology Network for the Acute Infarction Care' having its Hub in the Central Coronary ICU/Cath Lab of Mantua Hospital and being its Spokes centers represented by the emergency rooms and Central Coronary ICUs of the four territorial hospitals...
July 22, 2016: Journal of Cardiovascular Medicine
G Andrikopoulos, D Terentes-Printzios, S Tzeis, C Vlachopoulos, C Varounis, N Nikas, J Lekakis, D Stakos, S Lymperi, D Symeonidis, D Chrissos, C Kyrpizidis, D Alexopoulos, S Zombolos, S Foussas, Α Κranidis, Κ Oikonomou, V Vasilikos, P Andronikos, Α Dermitzakis, D Richter, N Fragakis, I Styliadis, S Mavridis, C Stefanadis, P Vardas
INTRODUCTION: In view of recent therapeutic breakthroughs in acute coronary syndromes (ACS) and essential demographic and socioeconomic changes in Greece, we conducted the prospective, multi-center, nationwide PHAETHON study (An Epidemiological Cohort Study of Acute Coronary Syndromes in the Greek Population) that aimed to recruit a representative cohort of ACS patients and examine current management practices and patient prognosis. METHODS: The PHAETHON study was conducted from May 2012 to February 2014...
May 2016: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
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