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Primary PCI

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20 papers 0 to 25 followers Primary PCI in STEMI pts
https://www.readbyqxmd.com/read/27390938/culprit-lesion-only-versus-complete-multivessel-percutaneous-intervention-in-st-elevation-myocardial-infarction-a-systematic-review-and-meta-analysis-of-randomized-trials
#1
Pedro A Villablanca, David F Briceno, Daniele Massera, Ota Hlinomaz, Marissa Lombardo, Anna E Bortnick, Mark A Menegus, Robert T Pyo, Mario J Garcia, Farouk Mookadam, Harish Ramakrishna, Jose Wiley, Michela Faggioni, George D Dangas
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) in patients with concomitant multivessel (MV) coronary artery disease (CAD) is associated with poor outcomes. Percutaneous coronary intervention (PCI) of the culprit-lesion only (CLO) as compared with a MV PCI approach to revascularization remains uncertain. Our objective is to gain a better understanding of the efficacy and safety of CLO as compared with MV PCI in patients with STEMI by conducting an updated meta-analysis...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27746402/selective-use-of-contemporary-drug-eluting-stents-in-primary-angioplasty-for-st-elevation-myocardial-infarction-pooled-analysis-of-comfortable-ami-and-examination
#2
Andreas Baumbach, Dik Heg, Lorenz Räber, Miodrag Ostoijc, Salvatore Brugaletta, Julian W Strange, Thomas W Johnson, Peter Juni, Thomas Engstrøm, Patrick W Serruys, Manel Sabate, Stephan Windecker
AIMS: Selective use of DES only in patients at higher risk of MACE is common practice, particularly in health care systems with a large premium payable for DES. We aimed to identify subgroups of patients in which the use of BMS in primary percutaneous coronary intervention (PPCI) for STEMI can still be justified. METHODS AND RESULTS: We performed a patient-level pooled analysis of COMFORTABLE-AMI and EXAMINATION comparing contemporary DES with BMS in PPCI. A risk score was applied using three parameters: lesion length>15mm, vessel size <3mm, and diabetes mellitus...
October 18, 2016: EuroIntervention
https://www.readbyqxmd.com/read/26541905/factors-associated-with-infarct-related-artery-patency-before-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-from-the-fast-mi-2010-registry
#3
RANDOMIZED CONTROLLED TRIAL
Clotilde Bailleul, Etienne Puymirat, Nadia Aissaoui, François Schiele, Gregory Ducrocq, Pierre Coste, Didier Blanchard, Camille Brasselet, Meyer Elbaz, Philippe Gabriel Steg, Hervé Le Breton, Eric Bonnefoy-Cudraz, Gilles Montalescot, Yves Cottin, Patrick Goldstein, Jean Ferrières, Tabassome Simon, Nicolas Danchin
Early infarct-related artery (IRA) patency is associated with better clinical outcomes in patients with ST-elevation myocardial infarction (STEMI). Using the French Registry of ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) 2010 registry, we investigated factors related to IRA patency (thrombolysis in myocardial infarction [TIMI] 2/3 flow) at the start of procedure in patients admitted for primary percutaneous coronary intervention. FAST-MI 2010 is a nationwide French registry including 4,169 patients with acute MI...
January 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27825718/multivessel-versus-culprit-only-percutaneous-coronary-intervention-in-st-segment-elevation-acute-myocardial-infarction-analysis-of-an-8-year-registry
#4
Carlos Galvão Braga, Ana Belén Cid-Álvarez, Alfredo Redondo Diéguez, Ramiro Trillo-Nouche, Belén Álvarez Álvarez, Diego López Otero, Raymundo Ocaranza Sánchez, Santiago Gestal Romaní, Rocío González Ferreiro, José R González-Juanatey
INTRODUCTION AND OBJECTIVES: The optimal treatment of patients with multivessel coronary artery disease and ST-segment elevation acute myocardial infarction (STEMI) who undergo primary percutaneous coronary intervention (PCI) is controversial. The aim of this study was to access the prognostic impact of multivessel PCI vs culprit vessel-only PCI in real-world patients with STEMI and multivessel disease. METHODS: This was a retrospective cohort study of 1499 patients with STEMI diagnosis who underwent primary PCI between January 2008 and December 2015...
November 4, 2016: Revista Española de Cardiología
https://www.readbyqxmd.com/read/26678635/culprit-vessel-versus-immediate-complete-revascularization-in-patients-with-st-segment-myocardial-infarction-a-systematic-review
#5
REVIEW
Frederick A Spencer, Nigar Sekercioglu, Manya Prasad, Luciane Cruz Lopes, Gordon H Guyatt
BACKGROUND: Guidelines suggest percutaneous intervention (PCI) of only the culprit artery in patients presenting with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease. However, recent randomized controlled trials (RCTs) suggest benefit to performing PCI of other stenotic vessels at the same time as culprit vessel PCI. METHODS: We conducted a systematic review with complete case meta-analysis and sensitivity analyses. Data sources included MEDLINE, EMBASE, Cochrane Register of Controlled Trials, and CINAHL from 1946 to March 2014; MEDLINE and EMBASE from March 2014 to March 2015; and scanning of literature for new studies until August 2015...
December 2015: American Heart Journal
https://www.readbyqxmd.com/read/25965708/the-third-danish-study-of-optimal-acute-treatment-of-patients-with-st-segment-elevation-myocardial-infarction-ischemic-postconditioning-or-deferred-stent-implantation-versus-conventional-primary-angioplasty-and-complete-revascularization-versus-treatment-of
#6
RANDOMIZED CONTROLLED TRIAL
Dan Eik Høfsten, Henning Kelbæk, Steffen Helqvist, Lene Kløvgaard, Lene Holmvang, Peter Clemmensen, Christian Torp-Pedersen, Hans-Henrik Tilsted, Hans Erik Bøtker, Lisette Okkels Jensen, Lars Køber, Thomas Engstrøm
BACKGROUND: In patients undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction, ischemic postconditioning has been shown to reduce infarct size, but the effect on clinical outcome has not been tested in a large randomized trial. In addition, deferring stent implantation in the infarct-related lesion 1 to 3 days after acute opening of the infarct-related artery could have protective effects, by reducing the risk of injury caused by distal embolization and microvascular obstruction...
May 2015: American Heart Journal
https://www.readbyqxmd.com/read/26520230/clinical-outcomes-in-patients-with-st-segment-elevation-myocardial-infarction-treated-with-everolimus-eluting-stents-versus-bare-metal-stents-examination-5-year-results-of-a-randomised-trial
#7
RANDOMIZED CONTROLLED TRIAL
Manel Sabaté, Salvatore Brugaletta, Angel Cequier, Andrés Iñiguez, Antonio Serra, Pilar Jiménez-Quevedo, Vicente Mainar, Gianluca Campo, Maurizio Tespili, Peter den Heijer, Armando Bethencourt, Nicolás Vazquez, Gerrit Anne van Es, Bianca Backx, Marco Valgimigli, Patrick W Serruys
BACKGROUND: Data for the safety and efficacy of new-generation drug-eluting stents at long-term follow-up, and specifically in patients with ST-segment elevation myocardial infarction, are scarce. In the EXAMINATION trial, we compared everolimus-eluting stents (EES) with bare-metal stents (BMS) in an all-comer population with ST-segment elevation myocardial infarction. In this study, we assessed the 5-year outcomes of the population in the EXAMINATION trial. METHODS: In the multicentre EXAMINATION trial, done in Italy, Spain, and the Netherlands, patients with ST-segment elevation myocardial infarction were randomly assigned in a 1:1 ratio to receive EES or BMS...
January 23, 2016: Lancet
https://www.readbyqxmd.com/read/27576777/prasugrel-versus-ticagrelor-in-patients-with-acute-myocardial-infarction-treated-with-primary-percutaneous-coronary-intervention-multicenter-randomized-prague-18-study
#8
Zuzana Motovska, Ota Hlinomaz, Roman Miklik, Milan Hromadka, Ivo Varvarovsky, Jaroslav Dusek, Jiri Knot, Jiri Jarkovsky, Petr Kala, Richard Rokyta, Frantisek Tousek, Petra Kramarikova, Bohumil Majtan, Stanislav Simek, Marian Branny, Jan Mrozek, Pavel Cervinka, Jiri Ostransky, Petr Widimsky
BACKGROUND: No randomized "head-to-head" comparison of the efficacy and safety of ticagrelor vs. prasugrel has been published in the seven years since the higher efficacy of these newer P2Y12 inhibitors were first demonstrated relative to clopidogrel. METHODS: This academic study was designed to compare the efficacy and safety of prasugrel and ticagrelor in acute myocardial infarction (AMI) treated with primary or immediate percutaneous coronary intervention (PCI)...
August 30, 2016: Circulation
https://www.readbyqxmd.com/read/27585512/pci-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary%C3%A2-artery%C3%A2-disease
#9
REVIEW
Eric R Bates, Jacqueline E Tamis-Holland, John A Bittl, Patrick T O'Gara, Glenn N Levine
Recent randomized controlled trials have suggested that patients with ST-segment elevation myocardial infarction and multivessel coronary artery disease may benefit more from multivessel percutaneous coronary intervention (PCI) compared with culprit vessel-only primary PCI. The American College of Cardiology, American Heart Association, and Society for Cardiovascular Angiography and Interventions recently published an updated recommendation on this topic. The purpose of this State-of-the-Art Review is to accurately document existing published reports, describe their limitations, and establish a base for future studies...
September 6, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27600465/impact-of-initial-culprit-vessel-flow-on-infarct-size-microvascular-obstruction-and-myocardial-salvage-in-acute-reperfused-st-elevation-myocardial-infarction
#10
Alexander Joost, Thomas Stiermaier, Charlotte Eitel, Georg Fuernau, Suzanne de Waha, Steffen Desch, Holger Thiele, Ingo Eitel
Data on the impact of initial Thrombolysis In Myocardial Infarction (TIMI) flow in the culprit coronary artery on myocardial damage after ST-elevation myocardial infarction (STEMI) are limited. Aim of this multicenter study was, therefore, to elucidate the impact of TIMI flow grade before percutaneous coronary intervention (PCI) on infarct size (IS), myocardial salvage index (MSI), and microvascular obstruction (MVO) assessed by cardiac magnetic resonance (CMR) imaging in patients with STEMI. We enrolled 738 patients with STEMI reperfused by primary PCI within 12 hours after symptom onset at 8 centers...
November 1, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27609250/survival-after-varying-revascularization-strategies-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-a-pairwise-and-network-meta-analysis
#11
Giuseppe Tarantini, Gianpiero D'Amico, Sorin J Brener, Paola Tellaroli, Marco Basile, Alessandro Schiavo, Marco Mojoli, Chiara Fraccaro, Alfredo Marchese, Giuseppe Musumeci, Gregg W Stone
OBJECTIVES: The authors conducted a systematic pairwise and network meta-analysis to assess optimal treatment strategies in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease (MV-CAD) undergoing primary percutaneous coronary intervention (PCI). BACKGROUND: Patients with STEMI and MV-CAD have a worse prognosis than those with single-vessel CAD. The optimal revascularization strategy for these patients is uncertain...
September 12, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27534402/intracoronary-versus-intravenous-eptifibatide-during-percutaneous-coronary-intervention-for-acute-st-segment-elevation-myocardial-infarction-a-randomized-controlled-trial
#12
Hamid Reza Sanati, Ali Zahedmehr, Ata Firouzi, Melody Farrashi, Kamyar Amin, Mohammad Mehdi Peighambari, Farshad Shakerian, Reza Kiani
Although aspirin and clopidogrel seem to be quite enough during low risk percutaneous coronary intervention (PCI), the combination may need some reinforcement in complex situations such as primary PCI. By modifying the route and also the duration of administration, glycoprotein IIb/IIIa inhibitors might be a viable option. The aim of this study is to compare the benefits and disadvantages of three different methods of administration of eptifibatide in primary PCI population. Primary PCI candidates were randomized in three groups on which three different methods of administration of eptifibitide were tested: intravenous bolus injection followed by 12-h infusion (IV-IV), intracoronary bolus injection followed by intravenous infusion (IC-IV) and, only intracoronary bolus injection (IC)...
August 17, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27125428/impact-of-a-single-universal-guiding-catheter-on-door-to-balloon-time-in-primary-transradial-coronary-intervention-for-st-segment-elevation-myocardial-infarction
#13
Sho Torii, Toshiharu Fujii, Tsutomu Murakami, Gaku Nakazawa, Takeshi Ijichi, Masataka Nakano, Yohei Ohno, Norihiko Shinozaki, Fuminobu Yoshimachi, Yuji Ikari
The purpose of this study is to determine reduction of door-to-balloon (D2B) time using a single universal guiding catheter (Ikari-Left catheter) in transradial approach. In this procedure, we can skip a total of five steps compared with a conventional procedure (two catheter insertions, two catheter removals, and one catheter engagement). Reducing total ischemic time is important to achieving a better outcome in primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI)...
April 28, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27053444/deferred-versus-conventional-stent-implantation-in-patients-with-st-segment-elevation-myocardial-infarction-danami-3-defer-an-open-label-randomised-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Henning Kelbæk, Dan Eik Høfsten, Lars Køber, Steffen Helqvist, Lene Kløvgaard, Lene Holmvang, Erik Jørgensen, Frants Pedersen, Kari Saunamäki, Ole De Backer, Lia E Bang, Klaus F Kofoed, Jacob Lønborg, Kiril Ahtarovski, Niels Vejlstrup, Hans E Bøtker, Christian J Terkelsen, Evald H Christiansen, Jan Ravkilde, Hans-Henrik Tilsted, Anton B Villadsen, Jens Aarøe, Svend E Jensen, Bent Raungaard, Lisette O Jensen, Peter Clemmensen, Peer Grande, Jan K Madsen, Christian Torp-Pedersen, Thomas Engstrøm
BACKGROUND: Despite successful treatment of the culprit artery lesion by primary percutaneous coronary intervention (PCI) with stent implantation, thrombotic embolisation occurs in some cases, which impairs the prognosis of patients with ST-segment elevation myocardial infarction (STEMI). We aimed to assess the clinical outcomes of deferred stent implantation versus standard PCI in patients with STEMI. METHODS: We did this open-label, randomised controlled trial at four primary PCI centres in Denmark...
May 28, 2016: Lancet
https://www.readbyqxmd.com/read/27048252/immediate-multivessel-revascularization-may-increase-cardiac-death-and-myocardial-infarction-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-coronary-artery-disease-data-analysis-from-real-world-practice
#15
Woo-Young Chung, Jae-Bin Seo, Dong-Hyun Choi, Young-Seok Cho, Joo Myung Lee, Jung-Won Suh, Tae-Jin Youn, In-Ho Chae, Dong-Ju Choi
BACKGROUND/AIMS: The best revascularization strategy for patients with both acute ST-elevation myocardial infarction (STEMI) and multivessel coronary disease (MVD) is still debatable. We aimed to compare the outcomes of multivessel revascularization (MVR) with those of culprit-only revascularization (COR). METHODS: A cohort of 215 consecutive patients who had received primary angioplasty for STEMI and MVD were divided into two groups according to whether angioplasty had been also performed for a stenotic nonculprit artery...
May 2016: Korean Journal of Internal Medicine
https://www.readbyqxmd.com/read/27022254/periprocedural-temporary-pacing-in-primary-percutaneous-coronary-intervention-for-patients-with-acute-inferior-myocardial-infarction
#16
COMPARATIVE STUDY
You Mi Hwang, Chul-Min Kim, Keon-Woong Moon
OBJECTIVE: High-degree atrioventricular block (AVB), including complete AVB in acute inferior ST-elevation myocardial infarction (STEMI), is not uncommon. However, there is no study evaluating the clinical differences between patients who have undergone temporary pacing (TP) and patients who have not. The present study was designed to investigate whether TP has any prognostic significance in inferior STEMI complicated by complete AVB. METHODS: From January 2009 to December 2014, 295 consecutive patients diagnosed with inferior wall STEMI in a university hospital were reviewed...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27022882/ischemic-postconditioning-after-routine-thrombus-aspiration-during-primary-percutaneous-coronary-intervention-rationale-and-design-of-the-postconditioning-rotterdam-trial
#17
Tuncay Yetgin, Matthijs van Kranenburg, Tim Ten Cate, Dirk J Duncker, Menko-Jan de Boer, Roberto Diletti, Robert-Jan M van Geuns, Felix Zijlstra, Olivier C Manintveld
BACKGROUND: Whether ischemic postconditioning (IPOC) immediately after routine thrombus aspiration (TA) reduces infarct size (IS) in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI) has not been established. STUDY DESIGN: The POstconditioning Rotterdam Trial (PORT) is a dual-center, prospective, open-label, randomized trial with blinded endpoint evaluation enrolling 72 subjects with first-time STEMI, and an occluded infarct-related artery (IRA) without collaterals undergoing PPCI...
September 10, 2015: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/26951188/complete-versus-culprit-only-revascularization-in-st-elevation-myocardial-infarction-and-multivessel-disease
#18
REVIEW
Giuseppe Di Pasquale, Elisa Filippini, Pier Camillo Pavesi, Gianfranco Tortorici, Gianni Casella, Pietro Sangiorgio
In 30-60 % of patients presenting with ST-segment elevation myocardial infarction (STEMI), significant stenoses are present in one or more non-infarct-related arteries (IRA). This correlates with an increased risk of major adverse cardiac events (MACE). Current guidelines, do not recommend revascularization of non-culprit lesions unless complicated by cardiogenic shock or persistent ischemia after primary percutaneous coronary intervention (PCI). Prior observational and small randomized controlled trials (RCTs) have demonstrated conflicting results regarding the optimal revascularization strategy in STEMI patients with multivessel disease...
June 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/26934658/choosing-the-right-stent-for-patients-with-st-segment-elevation-myocardial-infarction-the-evidence-based-approach
#19
Artur Dziewierz, Dariusz Dudek
Primary percutaneous coronary intervention (PCI) with the implantation of new-generation drug-eluting stents (DES) is the preferred method of reperfusion in ST-segment elevation myocardial infarction (STEMI). More importantly, new-generation DES are recommended as the default option in all clinical conditions and lesion subsets. On the other hand, the interest in fully bioresorbable scaffolds (BRS) implantation, also in the setting of STEMI is growing. Also, dedicated stents technologies, i.e. mesh-covered stents and self-expanding stents may play role in the treatment of STEMI and thrombus containing lesions...
June 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/26920605/incidence-and-characteristics-of-inappropriate-and-false-positive-cardiac-catheterization-laboratory-activations-in-a-regional-primary-percutaneous-coronary-intervention-program
#20
MULTICENTER STUDY
Jonathan Lu, Akshay Bagai, Chris Buller, Asim Cheema, John Graham, Michael Kutryk, Jo-Ann Christie, Neil Fam
BACKGROUND: The implementation of regional primary percutaneous coronary intervention (PCI) programs has been critical in achieving timely intervention in patients with ST-segment elevation myocardial infarction (STEMI). However, 1 consequence has been inappropriate and false-positive cardiac catheterization laboratory (CCL) activations where either angiography is cancelled or no culprit lesion is found, respectively. METHODS: We performed a retrospective cohort study of 1,391 patients referred for primary PCI to a single academic center from November 2007 to August 2013...
March 2016: American Heart Journal
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