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https://www.readbyqxmd.com/read/28230176/antithrombotic-therapy-for-patients-with-stemi-undergoing-primary-pci
#1
REVIEW
Francesco Franchi, Fabiana Rollini, Dominick J Angiolillo
Antithrombotic therapy, including antiplatelet and anticoagulant agents, is the cornerstone of pharmacological treatment to optimize clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). Intravenous anticoagulant drugs available for PPCI include the indirect thrombin inhibitors unfractionated heparin and low-molecular-weight heparin, and the direct thrombin inhibitor bivalirudin. Intravenous antiplatelet drugs mainly include glycoprotein IIb/IIIa inhibitors and the P2Y12-receptor inhibitor cangrelor...
February 23, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28228609/barriers-associated-with-door-to-balloon-delay-in-contemporary-japanese-practice
#2
Nobuhiro Ikemura, Mitsuaki Sawano, Yasuyuki Shiraishi, Ikuko Ueda, Hiroaki Miyata, Yohei Numasawa, Shigetaka Noma, Masahiro Suzuki, Yukihiko Momiyama, Taku Inohara, Kentaro Hayashida, Shinsuke Yuasa, Yuichiro Maekawa, Keiichi Fukuda, Shun Kohsaka
BACKGROUND: Door-to-balloon (DTB) time ≤90 min is an important quality indicator in the management of ST-elevation myocardial infarction (STEMI), but a considerable number of patients still do not meet this goal, particularly in countries outside the USA and Europe.Methods and Results:We analyzed 2,428 STEMI patients who underwent primary PCI ≤12 h of symptom onset who were registered in an ongoing prospective multicenter database (JCD-KiCS registry), between 2008 and 2013. We analyzed both the time trend in DTB time within this cohort in the registry, and independent predictors of delayed DTB time >90 min...
February 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28226202/predictors-of-acute-myocarditis-in-complicated-scrub-typhus-an-endemic-province-in-the-republic-of-korea
#3
Jung Yeon Chin, Ki-Woon Kang, Kyung Min Moon, Jongwoo Kim, Yu Jeong Choi
Background/Aims: Scrub typhus is known as a self-limited infectious disease. Cardiac complication is uncommon and usually not life-threatening. Until now, few cases of fulminant myocarditis by scrub typhus have been reported. So, we investigated incidence and predictors of acute myocarditis in severe scrub typhus. Methods: We retrospectively reviewed 89 patients among 91 scrub typhus confirmed patients who examined an echocardiogram and cardiac biomarkers from 2005 to 2015 in the intensive care unit at our hospital...
February 23, 2017: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/28225386/acute-myocardial-infarction-and-antiphospholipid-antibody-syndrome-a-systematic-review
#4
Salik Nazir, Niranjan Tachamo, Saroj Lohani, Rittu Hingorani, Dilli R Poudel, Anthony Donato
BACKGROUND: Antiphospholipid antibody syndrome (APS) is a disorder associated with both arterial and venous thromboembolic disease, including acute myocardial infarction (AMI). Given that management with anticoagulants is critical and differs from usual AMI care, identification of key discriminators of patients with AMI with APS is important. METHODS: We performed an English-language systematic review of the literature of cases and case series of patients with AMI and APS from inception until 20 March 2016, collecting demographics, investigations, and outcomes...
February 20, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28224932/corrigendum-to-reduced-dose-tenecteplase-and-outcomes-in-elderly-st-segment-elevation-myocardial-infarction-patients-insights-from-the-strategic-reperfusion-early-after-myocardial-infarction-trial-am-heart-j-169-6-2015-890-898
#5
Paul W Armstrong, Yinggan Zheng, Cynthia M Westerhout, Fernado Rosell-Ortiz, Peter Sinnaeve, Yves Lambert, Renato D Lopes, Erich Bluhmki, Thierry Danays, Frans Van de Werf
No abstract text is available yet for this article.
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28224924/left-bundle-branch-block-in-patients-with-acute-myocardial-infarction-presentation-treatment-and-trends-in-outcome-from-1997-to-2016-in-routine-clinical-practice
#6
Paul Erne, Juan F Iglesias, Philip Urban, Franz R Eberli, Hans Rickli, René Simon, Thomas A Fischer, Dragana Radovanovic
BACKGROUND: Whether patients with acute myocardial infarction presenting with new or presumed new left bundle-branch block (LBBB) should be treated in the same way as those presenting with ST-elevation (STE) is still a matter of debate. METHODS: Data from 28,358 patients enrolled in AMIS Plus from 1997 to 2016 were analyzed to evaluate differences in treatment and outcome of patients presenting with LBBB (n=2295) or STE (n=26,090) on their initial electrocardiogram using descriptive statistics and multivariate logistic regression...
February 2017: American Heart Journal
https://www.readbyqxmd.com/read/28220768/arterial-structure-and-function-in-subjects-with-acute-coronary-syndrome-after-one-year-of-treatment
#7
Agata Schneider, Joanna Gawęcka, Andrzej Minczykowski, Tomasz Krauze, Przemysław Guzik, Jarosław Piskorski, James Heathers, Andrzej Wykrętowicz
INTRODUCTION    It is controversial whether the modification of arterial stiffness and intima-media thickness (IMT) is plausible in patients with clinically significant atherosclerosis.  OBJECTIVES    We evaluated the effects of the one-year pharmacological therapy on the arterial stiffness and IMT in survivors of non-ST elevation myocardial infarction (NSTEMI) who were treated according to the clinical guidelines.  PATIENTS AND METHODS    For this study 298 NSTEMI patients (median age 64 years; 85 females) were enrolled...
February 15, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28220031/trends-in-discharge-claims-for-acute-myocardial-infarction-among-patients-on-dialysis
#8
Gautam R Shroff, Shuling Li, Charles A Herzog
Analysis of a contemporary cohort of patients on dialysis revealed that mortality from acute myocardial infarction (AMI) has decreased, whereas the prevalence of AMI has increased markedly, particularly among patients with non-ST elevation myocardial infarction (NSTEMI). Using inpatient discharge diagnosis codes (1993-2008), we determined that proportions of AMI claims decreased in the primary position (from 65% to 52%) but increased in the secondary position (from 35% to 48%). Proportions of NSTEMI codes increased remarkably in both the primary and secondary positions...
February 20, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28219895/impact-of-practice-based-management-of-pa-pressures-in-2000-patients-implanted-with-the-cardiomems-sensor
#9
J Thomas Heywood, Rita Jermyn, David Shavelle, William T Abraham, Arvind Bhimaraj, Kunjan Bhatt, Fareed Sheikh, Eric Eichorn, Sumant Lamba, Rupinder Bharmi, Rahul Agarwal, Charisma Kumar, Lynne W Stevenson
Background -Elevated pulmonary artery (PA) pressures in patients with heart failure (HF) are associated with a high risk for hospitalization and mortality. Recent clinical trial evidence demonstrated a direct relationship between lowering remotely monitored PA pressures and HF hospitalization risk reduction using a novel implantable PA pressure monitoring system (CardioMEMS HF System, St Jude Medical). This study examines PA pressure changes in the first 2,000 US patients implanted in general practice use. Methods -De-identified data from the remote monitoring Merlin...
February 20, 2017: Circulation
https://www.readbyqxmd.com/read/28218629/fever-induced-brugada-pattern-misdiagnosed-as-an-acute-myocardial-infarction
#10
David Tadin, Roberto Quintal
The Brugada syndrome is a rare condition associated with increased risk of ventricular tachyarrhythmias and sudden cardiac death (SCD). The Brugada pattern on electrocardiogram (EKG) is known to be revealed by several precipitants including febrile illnesses. The appearance of a Brugada pattern on EKG with fever may indicate an elevated risk of arrhythmia or sudden cardiac death. We report a case in which the electrocardiographic abnormality of Brugada pattern induced by sepsis was initially misinterpreted as a ST-segment elevation myocardial infarction (STEMI)...
January 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28218606/microvascular-dysfunction-following-st-elevation-myocardial-infarction-and-its-recovery-over-time-is-associated-with-short-and-long-term-cardiac-function
#11
Mariëlla E C J Hassell, Matthijs Bax, Martijn A van Lavieren, Robin Nijveldt, Alexander Hirsch, Lourens Robbers, Koen M Marques, Jan G P Tijssen, Felix Zijlstra, Albert C van Rossum, Ronak Delewi, Jan J Piek
AIMS: It is unclear whether microvascular dysfunction following ST-elevation myocardial infarction (STEMI) is prognostic for long-term left ventricular function (LVF). and whether recovery of the microvasculature status is associated with LVF improvement. METHODS AND RESULTS: In 62 patients, Coronary Flow Reserve (CFR) and Hyperemic Microvascular Resistance Index (HMRI) in the infarct related artery (IRA) was assessed by intracoronary Doppler flow measurements within 1 week and at 4 months...
February 21, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28218210/optimal-timing-of-surgical-revascularization-for-myocardial-infarction-and-left-ventricular-dysfunction
#12
Rong Wang, Nan Cheng, Cang-Song Xiao, Yang Wu, Xiao-Yong Sai, Zhi-Yun Gong, Yao Wang, Chang-Qing Gao
BACKGROUND: The optimal timing of surgical revascularization for patients presenting with ST-segment elevation myocardial infarction (STEMI) and impaired left ventricular function is not well established. This study aimed to examine the timing of surgical revascularization after STEMI in patients with ischemic heart disease and left ventricular dysfunction (LVD) by comparing early and late results. METHODS: From January 2003 to December 2013, there were 2276 patients undergoing isolated coronary artery bypass grafting (CABG) in our institution...
2017: Chinese Medical Journal
https://www.readbyqxmd.com/read/28217986/the-effects-of-remote-ischemic-conditioning-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-a-meta-analysis
#13
Jing Gao, Qingjie Chen, Fen Liu, Qian Zhao, Bangdang Chen, Yun Zhou, Qiang Zhao, Yitong Ma, Yining Yang
INTRODUCTION: Timely and successful reperfusion is effective at improving outcome in patients presenting with STEMI. However, abrupt restoration of blood flow may cause detrimental myocardial repercussion injury. Remote ischemic conditioning (RIC) is a potent activator of innate protection against ischemia-reperfusion injury. This study assessed remote ischemic conditioning in patients presenting with STEMI treated with primary PCI. EVIDENCE ACQUISITION: Relevant studies were identified through electronic literature search from PubMed, Medline, EMBASE, CNKI, WANFANG, and VIP...
February 17, 2017: Minerva Medica
https://www.readbyqxmd.com/read/28217615/type-1-brugada-pattern-electrocardiogram-induced-by-hypokalemia
#14
Thein Swe, Muhammad Hassan Dogar
Coved-type ST-segment elevation in the right precordial leads are the characteristics of Brugada syndrome, an inherited arrhythmogenic ion channel disease, which could lead to ventricular arrhythmia and sudden death. Hypokalemia alone may induce Type 1 Brugada pattern electrocardiogram (EKG), and the association has rarely been reported. We describe a patient with hypokalemia 2.9 mmol/L and the appearance of new right bundle branch block pattern with coved ST-segment elevations with inverted T wave in leads V1-V2...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28217227/cardiac-conduction-defects-and-brugada-syndrome-a-family-with-overlap-syndrome-carrying-a-nonsense-scn5a-mutation
#15
Hisaaki Aoki, Yoshihide Nakamura, Seiko Ohno, Takeru Makiyama, Minoru Horie
BACKGROUND: Phenotypes often differ even within family members carrying the same SCN5A mutation. We aimed to evaluate the genetic modifiers in a family with Brugada syndrome (BrS) and sick sinus syndrome (SSS) with an SCN5A mutation that causes the truncated alpha-subunit of cardiac Na channel protein. METHODS: To detect the genetic modifiers, we performed targeted panel sequencing of the coding region of 46 genes that are related to primary arrhythmia syndrome, by using a bench-top, next generation sequencer...
February 2017: Journal of Arrhythmia
https://www.readbyqxmd.com/read/28216215/direct-admission-versus-interhospital-transfer-for-primary-percutaneous-coronary-intervention-in-st-segment-elevation-myocardial-infarction
#16
Damian Kawecki, Marek Gierlotka, Beata Morawiec, Michał Hawranek, Mateusz Tajstra, Michał Skrzypek, Wojciech Wojakowski, Lech Poloński, Ewa Nowalany-Kozielska, Mariusz Gąsior
OBJECTIVES: This study sought to assess the influence of direct admission versus transfer via regional hospital to a percutaneous coronary intervention (PCI) center on time delays and 12-month mortality in ST-segment elevation myocardial infarction (STEMI) patients from a real-life perspective. BACKGROUND: Reduction of delays to reperfusion is crucial in a STEMI system of care. However, it is still debated whether direct admission to a PCI center is superior to interhospital transfer in terms of long-term prognosis...
February 9, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28216061/outcomes-after-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-caused-by-ectatic-infarct-related-arteries
#17
Vimalraj Bogana Shanmugam, Peter J Psaltis, Dennis T L Wong, Ian T Meredith, Yuvaraj Malaiapan, Wally Ahmar
BACKGROUND: There is minimal published data on outcomes of patients presenting with ST elevation myocardial infarction (STEMI) due to an ectatic infarct-related artery (EIRA). The aim of this study was to analyse the clinical characteristics and outcomes of these patients presenting for primary percutaneous coronary intervention (P-PCI) in comparison with non-EIRA. METHODS: Of the 1834 patients who presented at our institution for P-PCI between February 2008 and November 2013, 25 (1...
February 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28215415/diagnostic-and-prognostic-value-of-lead-avr-during-exercise-testing-in-patients-suspected-of-having-myocardial-ischemia
#18
Max Wagener, Roger Abächerli, Ursina Honegger, Nicolas Schaerli, Gil Prêtre, Raphael Twerenbold, Christian Puelacher, Germaine Sunier, Philipp Reddiess, Maria Rubini Gimenez, Karin Wildi, Jasper Boeddinghaus, Thomas Nestelberger, Patrick Badertscher, Zaid Sabti, Ramun Schmid, Remo Leber, Dayana Flores Widmer, Samyut Shrestha, Ivo Strebel, Damian Wild, Stefan Osswald, Michael Zellweger, Christian Mueller, Tobias Reichlin
We aimed to assess the diagnostic and prognostic value of ST-segment deviation in aVR, a lead often ignored in clinical practice, during exercise testing and to compare it to the most widely used criterion of ST-segment depression in V5. We enrolled 1,596 patients with suspected myocardial ischemia referred for nuclear perfusion imaging undergoing bicycle stress testing. ST-segment amplitudes in leads aVR and V5 were automatically measured. The presence of inducible myocardial ischemia was the diagnostic end point and adjudicated based on nuclear perfusion imaging and coronary angiography...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28214506/comparison-of-the-extent-of-coronary-artery-disease-in-patients-with-versus-without-interatrial-block-and-implications-for-new-onset-atrial-fibrillation
#19
Bryce Alexander, Jimmy MacHaalany, Brandon Lam, Henri van Rooy, Sohaib Haseeb, Adrian Kuchtaruk, Benedict Glover, Antoni Bayés de Luna, Adrian Baranchuk
Interatrial block (IAB) represents delay or block of conduction between the atria. IAB has been shown to predict the development or recurrence of atrial fibrillation (AF) in various clinical scenarios. Few studies have examined the correlation between coronary artery disease and the prevalence of IAB and its impact on AF. The aim of this study was to determine if specific coronary artery lesions (location and number) are associated with the presence of IAB and development of new-onset AF. Retrospective analysis of patients presenting with non-ST-segment elevation myocardial infarction (NSTEMI) to our institution...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28214080/clinical-outcome-and-correlates-of-coronary-microvascular-obstruction-in-latecomers-after-acute-myocardial-infarction
#20
Rocco A Montone, Giampaolo Niccoli, Silvia Minelli, Francesco Fracassi, Vincenzo Vetrugno, Cristina Aurigemma, Francesco Burzotta, Italo Porto, Carlo Trani, Filippo Crea
AIMS: Microvascular obstruction (MVO) is associated with a worse prognosis in patients with ST-elevation myocardial infarction (STEMI) treated by primary percutaneous coronary intervention (PCI). However, data about incidence, clinical outcome and correlates of MVO in latecomers after STEMI are still lacking. METHODS: We prospectively enrolled consecutive patients that were latecomers after STEMI (symptoms onset >12h) undergoing PCI. We performed an angiographic analysis to assess the occurrence of MVO [defined as TIMI flow grade ≤2 or 3 with a myocardial blush grade <2]...
February 12, 2017: International Journal of Cardiology
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