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ST- Elevation myocardial infarction

Veemal V Hemradj, Jan Paul Ottervanger, Arnoud W van 't Hof, Jan Henk Dambrink, Marcel Gosselink, Elvin Kedhi, Harry Suryapranata
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS) has a poor prognosis. Recently published data suggested, however, that CS does not affect long-term mortality in hospital survivors of STEMI. We investigated whether this could be confirmed in a larger cohort. HYPOTHESIS: STEMI complicated by CS leads to worse long-term survival. METHODS: A prospective cohort study was performed in 7412 consecutive patients with STEMI treated by primary percutaneous coronary intervention (angioplasty)...
October 24, 2016: Clinical Cardiology
Luisa De Gennaro, Natale Daniele Brunetti, Massimo Ruggiero, David Rutigliano, Nicola Locuratolo, Matteo Di Biase, Pasquale Caldarola
Right coronary artery (RCA) occlusion in inferior acute myocardial infarction is usually heralded by ST-elevation both in inferior and in right precordial leads. We report the case of a 68-year-old male, who presented marked ST-elevation in inferior leads, mirrored by ST-depression in anterior-septal and lateral leads. Right precordial lead electrocardiogram unexpectedly showed ST-depression V1R-V5R leads. Coronary angiography showed mid-left anterior descending (LAD) coronary near-complete occlusion with distal wrapping LAD...
October 23, 2016: Acta Clinica Belgica
Alfonso Ielasi, Attilio Varricchio, Gianluca Campo, Massimo Leoncini, Bernardo Cortese, Paolo Vicinelli, Salvatore Brugaletta, Fortunato Scotto di Uccio, Azeem Latib, Maurizio Tespili
OBJECTIVES: To assess the feasibility and the clinical results following a prespecified bioresorbable vascular scaffold (Absorb BVS) implantation strategy in ST-elevation myocardial infarction (STEMI) patients. BACKGROUNDS: Concerns raised about the BVS safety in STEMI setting because a not negligible thrombosis rate was reported within 30 days and 12 months after implantation. Technical procedural issues related to the structural BVS features were advocated as probable causes for the thrombotic events...
October 24, 2016: Catheterization and Cardiovascular Interventions
YeongHo Choi, Yu Jin Lee, Sang Do Shin, Kyoung Jun Song, KyungWon Lee, Eui Jung Lee, Yu Jin Kim, Ki Ok Ahn, Ki Jeong Hong, Young Sun Ro
BACKGROUND: Timely transfer and percutaneous coronary intervention (PCI) with or without thrombolysis are recommended by the American Heart Association (AHA) to care for ST-segment elevation myocardial infarction (STEMI) patients who present first to a non-PCI-capable hospital. This study was to evaluate the impact on in-hospital mortality of the compliance with guidelines regarding to the time of PCI for patients with STEMI who were transferred to a capable PCI hospital. METHODS: We used the CArdioVAscular disease Surveillance data from November 2007 to December 2012 for this study...
September 16, 2016: American Journal of Emergency Medicine
Mustafa Topuz, Fahrettin Oz, Oguz Akkus, Omer Sen, Ayse Nur Topuz, Atilla Bulut, Suleyman Ozbicer, Sefa Okar, Mevlut Koc, Mustafa Gur
OBJECTIVE: We aimed to investigate the compliance of plasma apelin-12 levels to show angiographic properties and hospital MACE in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). MATERIAL AND METHODS: The association of apelin-12 levels with the N/L ratio on admission was assessed in 170 consecutive patients with primary STEMI undergoing primary PCI. All patient SYNTAX scores and thrombolysis in myocardial infarction (TIMI) flow grades were also assessed...
October 20, 2016: Perfusion
Richard J Hamilton, Vadim Keyfes, Sahil S Banka
BACKGROUND: Synthetic cannabinoids (SC) are recreational designer drugs intended to mimic delta-9-tetrahydrocannabinol while surreptitiously circumventing classification by the Drug Enforcement Administration. CASE REPORT: A 50-year-old black male arrived in the Emergency Department transported by Emergency Medical Services (EMS) for altered mental status after complaining of chest pain associated with smoking SCs. EMS found the patient with an empty foil pack labeled "Scooby Snax Limited Edition Blueberry Potpourri...
October 19, 2016: Journal of Emergency Medicine
Birga Maier, Katrin Wagner, Steffen Behrens, Leonhard Bruch, Reinhard Busse, Dagmar Schmidt, Helmut Schühlen, Roland Thieme, Heinz Theres
BACKGROUND: Assessment of quality of care in patients with myocardial infarction (MI) should be based on data that effectively enable determination of quality. With the need to simplify measurement techniques, the question arises whether routine data can be used for this purpose. We therefore compared data from a German sickness fund (AOK) with data from the Berlin Myocardial Infarction Registry (BMIR). METHODS: We included patients hospitalised for treatment of MI in Berlin from 2009-2011...
October 21, 2016: BMC Health Services Research
Gerard Pasterkamp, Hester M den Ruijter, Peter Libby
The concept of the 'vulnerable plaque' originated from pathological observations in patients who died from acute coronary syndrome. This recognition spawned a generation of research that led to greater understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events. In current practice, an increasing number of patients who survive their first event present with non-ST-segment elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-segment elevation (STEMI)...
October 20, 2016: Nature Reviews. Cardiology
Michelle Ma Kip, Lotte Mg Steuten, Hendrik Koffijberg, Maarten J IJzerman, Ron Kusters
Early health technology assessment can provide insight in the potential cost-effectiveness of new tests to guide further development decisions. This can increase their potential benefit but often requires evidence which is lacking in early test development stages. Then, expert elicitation may be used to generate evidence on the impact of tests on patient management. This is illustrated in a case study on a new triple biomarker test (copeptin, heart-type fatty acid binding protein, and high-sensitivity troponin [HsTn]) at hospital admission...
October 19, 2016: Journal of Evaluation in Clinical Practice
Antonio Zingarelli, Sara Seitun, Roberto Delfino, Alberto Valbusa, Manrico Balbi, Claudio Brunelli
No abstract text is available yet for this article.
December 2016: Minerva Cardioangiologica
Afsin Emre Kayipmaz, Orcun Ciftci, Cemil Kavalci, Emir Karacaglar, Haldun Muderrisoglu
BACKGROUND: This study aimed to explore the ST segment elevation myocardial infarction (STEMI) management practices of emergency medicine specialists working in various healthcare institutions of seven different geographical regions of Turkey, and to examine the characteristics of STEMI presentation and patient admissions in these regions. METHODS: We included 225 emergency medicine specialists working in all geographical regions of Turkey. We e-mailed them a 20-item questionnaire comprising questions related to their STEMI management practices and characteristics of STEMI presentation and patient admissions...
2016: PloS One
Ahmad Separham, Samad Ghaffari, Hossein Najafi, Reza Ghaffari, Mojtaba Ziaee, Hossein Babaei
Allopurinol may have protective effects over ischemic reperfusion injury and reduce infarct size. In this randomized study, we aimed to evaluate the impact of allopurinol in patients with acute ST elevation myocardial infarction (STEMI) undergoing thrombolytic therapy. Overall, 140 patients with STEMI were randomly assigned to receive 400 mg of allopurinol or placebo before treating with streptokinase. Then, study group received 100 mg of allopurinol daily for 28 days and placebo group received placebo for the same period...
October 2016: Journal of Cardiovascular Pharmacology
Giacomo Veronese, Federico Germini, Stella Ingrassia, Ombretta Cutuli, Valeria Donati, Luca Bonacchini, Maura Marcucci, Andrea Fabbri
BACKGROUND: Electrocardiogram (ECG) interpretation is widely performed by emergency physicians. We aimed to determine the accuracy of interpretation of potential ST-segment elevation myocardial infarction (STEMI) ECGs by emergency physicians. METHODS: Thirty-six ECGs resulted in putative STEMI diagnoses were selected. Participants were asked to focus on whether or not the ECG in question met the diagnostic criteria for an acutely blocked coronary artery causing a STEMI...
October 19, 2016: Acute Cardiac Care
Saeed Alipour Parsa, Isa Khaheshi, Mehdi Memaryan, Mohammadreza Naderian
To present an unusual case in order to clarify one of the most important differential diagnoses of ST-elevation myocardial infarction in a postmenopausal woman. A 72-year-old woman with asthma attack and retrosternal chest pain was presented to our emergency unit. She had used albuterol spray ten-times before admission due to accentuated dyspnea. Initial ECG revealed ST-segment elevation in leads V1-V6, I and aVL. Emergent coronary angiography indicated normal coronary arteries, and left ventriculography showed significant akinesia of apical segments...
October 19, 2016: Future Cardiology
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
Ahmed Farag, Aneesha Chauhan, Sunita Avinash, Chee K Liew, Jonas Eichhöfer, Anoop Chauhan
This case illustrates the complexities of performing a primary percutaneous intervention in a patient with chronic Type A aortic aneurysm and dissection with contraindications for surgical management. We also discuss the significant risk that the patient had to overcome to survive an undiagnosed aortic dissection and an acute ST elevation myocardial infarction.
April 2016: Aorta (Stamford, Conn.)
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
Waldemar Elikowski, Małgorzata Małek-Elikowska, Bartosz Kudliński, Paweł Skrzywanek, Sławomir Smól, Stanisław Rzymski
In typical takotsubo cardiomyopathy (TC) apical transient left ventricular dysfunction with concomitant ECG changes mimicking acute anterior myocardial infarction can be observed. Reverse TC (RTC) characterized by contractile disturbances in all basal and often simultaneous mid-ventricular segments is definitely less frequent. ECG pattern of RTC is less known. The authors present ECG findings in 5 cases of RTC in course of intracranial hemorrhage (ICH); 3 patients were diagnosed with subarachnoid hemorrhage (SAH) and the other two with intracerebral hemorrhage or subdural posttraumatic hematoma...
September 29, 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
Ching-Hui Huang, Chen-Ling Kuo, Ching-Shan Huang, Wan-Min Tseng, Ie Bin Lian, Chia-Chu Chang, Chin-San Liu
Exogenous administration of coenzyme Q10 (CoQ10) has been shown in experimental models to have a protective effect against ischemia-reperfusion injury. However, it is unclear whether follow-up plasma CoQ10 concentration is prognostic of left ventricular (LV) performance after primary balloon angioplasty in patients with acute ST segment elevation myocardial infarction (STEMI).We prospectively recruited 55 patients with STEMI who were treated with primary coronary balloon angioplasty. Plasma CoQ10 concentrations were measured before primary angioplasty (baseline) and 3 days, 7 days, and 1 month after STEMI using high-performance liquid chromatography...
August 2016: Medicine (Baltimore)
Jackson J Liang, Eric R Fenstad, Christopher D Janish, Lawrence J Sinak
Left ventricular non-compaction cardiomyopathy is a rare congenital cardiomyopathy, which usually presents early in life but may also manifest into adulthood. We present the case of an elderly woman with left ventricular non-compaction cardiomyopathy, which was discovered incidentally following an ST-elevation myocardial infarction.
October 18, 2016: Acute Cardiac Care
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