Indian Journal of Basic and Applied Medical Research; December 2013: Vol.-3, Issue-1 , 80-87 Original article : Effect of acute myocardial infarction on serum zinc level * DR. PRAVIN P. SHEKOKAR 1, DR. MRS. S. D. KAUNDINYA2 1Assistant Professor, Department of Physiology, Government Medical College, Akola, Collector Office Road, Akola. Pin 444001 (Maharashtra), India 2Professor & Head of Dept, Department of Physiology, Grant Government Medical College And Sir J.J. Hospital, Mumbai-8, India *Corrersponding author : Email: [email protected] Abstract: Introduction: Myocardial infarction is a common presentation of coronary artery disease. The diagnosis of acute myocardial infarction (AMI) is of vital importance from the management and prognosis point of view. Objective: The purpose of this study was to investigate serum zinc level in acute myocardial infarction patients and to correlate it with biochemical parameter SGOT. Methods: In the present study 30 patients suffering from acute myocardial ...
BACKGROUND: The Thrombolysis In Myocardial Infarction (TIMI) Risk Score has been shown to predict prognosis in acute coronary syndromes (ACS) comprised of unstable angina (UA) and non-ST segment elevation myocardial infarction (STEMI). We sought to evaluate the impact of newer antiplatelet and antithrombotic therapies for ACS, such as glycoprotein IIb/IIIa inhibitors (GPI) and low molecular weight heparin (LMWH), on in-hospital outcomes over time in patients (pts) with similar TIMI risk scores.. METHODS: The baseline demographics and clinical outcomes of pts with ACS (UA and non-STEMI) in 1998 (Group 1998) and 2000 (Group 2000) at a single large university medical center were compared using a prospectively collected database. In-hospital major adverse cardiac events (MACE) included death, MI, or recurrent angina that resulted in urgent revascularization. Risk was estimated by utilizing the TIMI Risk Score, which uses 7 predictor variables: age , 65 years, at least 3 risk factors for coronary ...
TY - JOUR. T1 - Non-ST-segment-elevation myocardial infarction among patients with chronic kidney disease. T2 - A propensity score-matched comparison of percutaneous coronary intervention versus conservative management. AU - Bhatia, Subir. AU - Arora, Shilpkumar. AU - Bhatia, Sravya M.. AU - Al-Hijji, Mohammed. AU - Reddy, Yogesh N.V.. AU - Patel, Parshva. AU - Rihal, Charanjit S.. AU - Gersh, Bernard J.. AU - Deshmukh, Abhishek. N1 - Publisher Copyright: © 2018 The Authors.. PY - 2018/3/20. Y1 - 2018/3/20. N2 - Background--Chronic kidney disease (CKD) remains an independent predictor of cardiovascular morbidity and mortality. CKD complicates referral for percutaneous coronary intervention (PCI) in non-ST-segment-elevation myocardial infarction (NSTEMI) patients because of the risk for acute kidney injury and the need for dialysis, with American College of Cardiology/American Heart Association guidelines underscoring the limited data on these patients. Methods and Results--Using the National ...
TY - JOUR. T1 - Subarachnoid hemorrhage simulating myocardial infarction. AU - De Marchena, Eduardo. AU - Pittaluga, Juan M.. AU - Ferreira, Alexandre C.. AU - Lowery, Maureen. AU - Romanelli, Renzo. AU - Morales, Azorides. PY - 1996/2/1. Y1 - 1996/2/1. N2 - We describe a patient with a subarachnoid hemorrhage that presented with electrocardiographic evidence of transmural myocardial infarction. The patient was found to have normal coronaries and on autopsy revealed generalized myocytolysis with no evidence of transmural myocardial infarction. This case illustrates the value of acute coronary angiography in patients with altered mental status and suspected myocardial infarction.. AB - We describe a patient with a subarachnoid hemorrhage that presented with electrocardiographic evidence of transmural myocardial infarction. The patient was found to have normal coronaries and on autopsy revealed generalized myocytolysis with no evidence of transmural myocardial infarction. This case illustrates the ...
TY - JOUR. T1 - Diabetes Mellitus and Cardiogenic Shock Complicating Acute Myocardial Infarction. AU - Echouffo Tcheugui, Justin. AU - Kolte, Dhaval. AU - Khera, Sahil. AU - Aronow, Herbert D.. AU - Abbott, J. Dawn. AU - Bhatt, Deepak L.. AU - Fonarow, Gregg C.. PY - 2018/7/1. Y1 - 2018/7/1. N2 - Background: Diabetes mellitus (diabetes) increases the risk of acute myocardial infarction, which can result in cardiogenic shock. Data on the relation of diabetes and the occurrence and prognosis of cardiogenic shock postacute myocardial infarction are scant. Methods: Among the National Inpatient Sample patients aged ≥18 years and hospitalized for acute myocardial infarction during the 2012-2014 period, we examined the association between diabetes and the incidence and outcomes of cardiogenic shock complicating acute myocardial infarction, using multivariable logistic and linear regression models. Results: Of 1,332,530 hospitalizations for acute myocardial infarction, 72,765 (5.5%) were complicated ...
TY - JOUR. T1 - Re. T2 - The Spillover Influence of Partners Education on Myocardial Infarction Incidence and Survival Respond. AU - Kilpi, Fanny. AU - Martikainen, Pekka. AU - Konttinen, Hanna. AU - Silventoinen, Karri. AU - Torssander, Jenny. AU - Kawachi, Ichiro. PY - 2018/7. Y1 - 2018/7. KW - DISEASE. KW - 3142 Public health care science, environmental and occupational health. U2 - 10.1097/EDE.0000000000000831. DO - 10.1097/EDE.0000000000000831. M3 - Letter. VL - 29. SP - E37-E37. JO - Epidemiology. JF - Epidemiology. SN - 1044-3983. IS - 4. ER - ...
Background: Chronic kidney disease (CKD) is a strong risk factor for cardiovascular events, and there are consistence evidences about worse short- and long-term outcomes in CKD patients with acute myocardial infarction. The aim of this study was to evaluate the effects and safety of triple antiplatelet therapy (aspirin plus clopidogrel plus cilostazol) in CKD patients with ST-elevation myocardial infarction (STEMI) compared with dual antiplatelet therapy (aspirin plus clopidogrel).. Methods and results: Among over 21,000 patients in Korean Acute Myocardial Infarction Registry (KAMIR) data, 5,138 STEMI patients who underwent successful primary percutaneous coronary intervention with drug-eluting stents were enrolled in this study. They were divided by estimated creatinine clearance (eCrCl); ≥ 60 ml/min (n=3,445; dual = 2169, triple = 1276) and , 60 ml/min (n=1693; dual = 1120, triple = 573). Various major adverse cardiac events including major bleeding at 12 months were evaluated. The triple ...
TY - JOUR. T1 - Comparison of delay times between Symptom onset of an acute ST-elevation myocardial infarction and hospital arrival in men and women ,65 years versus ≥65 years of age. T2 - Findings from the multicenter Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study. AU - Ladwig, Karl-Heinz. AU - Fang, Xiaoyan. AU - Wolf, Kathrin. AU - Hoschar, Sophia. AU - Albarqouni, Loai. AU - Ronel, Joram. AU - Meinertz, Thomas. AU - Spieler, Derek. AU - Laugwitz, Karl-Ludwig. AU - Schunkert, Heribert. N1 - Copyright © 2017 Elsevier Inc. All rights reserved.. PY - 2017/12/15. Y1 - 2017/12/15. N2 - Early administration of reperfusion therapy in acute ST-elevation myocardial infarctions (STEMI) is crucial to reduce mortality. Although female sex and old age are key factors contributing to an inadequate long prehospital delay time, little is known whether women ≥65 years are a particular risk population. Hence, we studied the interaction of sex and age (,65 ...
TY - JOUR. T1 - Sonothrombolysis in ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention. AU - MRUSMI Investigators. AU - Mathias, Wilson. AU - Tsutsui, Jeane M.. AU - Tavares, Bruno G.. AU - Fava, Agostina M.. AU - Aguiar, Miguel O.D.. AU - Borges, Bruno C.. AU - Oliveira, Mucio T.. AU - Soeiro, Alexandre. AU - Nicolau, Jose C.. AU - Ribeiro, Henrique B.. AU - Chiang, Hsu Po. AU - Sbano, João C.N.. AU - Morad, Abdulrahman. AU - Goldsweig, Andrew. AU - Rochitte, Carlos E.. AU - Lopes, Bernardo B.C.. AU - Ramirez, José A.F.. AU - Kalil Filho, Roberto. AU - Porter, Thomas R.. PY - 2019/6/11. Y1 - 2019/6/11. N2 - Background: Preclinical studies have demonstrated that high mechanical index (MI)impulses from a diagnostic ultrasound transducer during an intravenous microbubble infusion (sonothrombolysis)can restore epicardial and microvascular flow in acute ST-segment elevation myocardial infarction (STEMI). Objectives: This study tested the clinical ...
I read the article by Yang JH,et al with great interest, in which the authors compared 1-year prognostic impacts of angiotensin receptor blockers (ARBs) with angiotensin converting enzyme inhibitors (ACEIs) in patients with ST segment elevation myocardial infarction (STEMI) with preserved left ventricular systolic function who underwent primary percutaneous coronary intervention (PCI) [1]. I believe it would be appreciated if authors discuss the long-term survival benefit of ARBs before concluding that ARBs are as beneficial as ACEIs in STEMI patients with preserved left ventricular systolic function after PCI.. Although ARBs could be an alternative to ACEIs, a recent observational study using inverse probability of treatment weighting and propensity score matching methods revealed that patients treated with ACEIs had significantly lower long-term mortality compared with those treated with ARBs from 2 to 5 years after acute myocardial infarction [2]. This study also demonstrated that crude ...
According to data from randomized, controlled trials, primary percutaneous coronary intervention (PCI) is the treatment of choice for ST-segment elevation myocardial infarction (MI). In these trials, 1 life was saved and 2 other life-threatening complications, including stroke and reinfarction, were prevented for every 50 patients with ST-segment elevation MI treated with primary PCI rather than thrombolytic therapy. Only 1 major bleeding episode occurred.. How can these superior results be realized outside the context of randomized trials? We anticipate 4 obstacles to instituting primary PCI as the universal treatment of ST-segment elevation MI: 1) lack of timely availability, 2) technical expertise of center and operator, 3) the need to address patient subgroups that are not studied in randomized trials, and 4) comparisons of primary PCI to newer pharmacologic regimens.. We propose 3 strategies to increase the availability of this procedure: 1) perform primary PCI in qualified community ...
TY - JOUR. T1 - Atrial fibrillation and risk of ST-segment-elevation versus non-ST-segment-elevation myocardial infarction the Atherosclerosis Risk in Communities (ARIC) study. AU - Soliman, Elsayed Z.. AU - Lopez, Faye. AU - ONeal, Wesley T.. AU - Chen, Lin Y.. AU - Bengtson, Lindsay. AU - Zhang, Zhu Ming. AU - Loehr, Laura. AU - Cushman, Mary. AU - Alonso, Alvaro. PY - 2015/5/26. Y1 - 2015/5/26. N2 - Background-It has recently been reported that atrial fibrillation (AF) is associated with an increased risk of myocardial infarction (MI). However, the mechanism underlying this association is currently unknown. Further study of the relationship of AF with the type of MI (ST-segment-elevation MI [STEMI] versus non-ST-segment-elevation MI [NSTEMI]) might shed light on the potential mechanisms. Methods and Results-We examined the association between AF and incident MI in 14 462 participants (mean age, 54 years; 56% women; 26% blacks) from the Atherosclerosis Risk in Communities (ARIC) study who ...
List of Tables. Table 1: Clinical subtypes of Indication. Table 2: Risk Factors. Table 3: Prevalence cases (%) Region wise. Table 4: Sources used for forecasting the data. Table 5: Myocardial Infarction Global Epidemiology, (2013-2023). Table 6: Prevalent Cases of Myocardial Infarction (Ages =XX Years), US (2013-2023). Table 7: Prevalent Cases of Myocardial Infarction By Sex (Males & Females), US (2013-2023). Table 8: Prevalent Cases By Myocardial Infarction Sub-population, US (2013-2023). Table 9: Prevalent Cases of Myocardial Infarction (Ages =XX Years), United Kingdom (2013-2023). Table 10: Prevalent Cases of Myocardial Infarction By Sex (Males & Females), United Kingdom (2013-2023). Table 11: Prevalent Cases By Myocardial Infarction Sub-population, United Kingdom (2013-2023). Table 12: Prevalent Cases of Myocardial Infarction (Ages =XX Years), Germany (2013-2023). Table 13: Prevalent Cases of Myocardial Infarction By Sex (Males & Females), Germany (2013-2023). Table 14: Prevalent Cases By ...
TY - JOUR. T1 - Comparison of outcomes of patients with painless versus painful ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention. AU - Cho, Jae Yeong. AU - Jeong, Myung Ho. AU - Ahn, Young Keun. AU - Kim, Jong Hyun. AU - Chae, Shung Chull. AU - Kim, Young Jo. AU - Hur, Seung Ho. AU - Seong, In Whan. AU - Hong, Taek Jong. AU - Choi, Dong Hoon. AU - Cho, Myeong Chan. AU - Kim, Chong Jin. AU - Seung, Ki Bae. AU - Chung, Wook Sung. AU - Jang, Yang Soo. AU - Cho, Seung Yun. AU - Rha, Seung Woon. AU - Bae, Jang Ho. AU - Cho, Jeong Gwan. AU - Park, Seung Jung. PY - 2012/2/1. Y1 - 2012/2/1. N2 - There are few data available on the prognosis of painless ST-segment elevation myocardial infarction (STEMI). The aim of this study was to determine the incidence, clinical characteristics, and outcomes of painless STEMI. We analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) study, which enrolled 7,288 patients with STEMI (61.8 ± 12.8 years old, 74% men; ...
Aims. The TRA·CER trial compared vorapaxar, a novel platelet protease-activated receptor (PAR)-1 antagonist, with placebo in 12 944 patients with high-risk non-ST-segment elevation acute coronary syndromes (NSTE ACS). In this analysis, we explored the effect of vorapaxar on myocardial infarction (MI).. Methods and results. A blinded, independent central endpoint adjudication committee prospectively defined and classified MI according to the universal MI definition, including peak cardiac marker value (creatine kinase-MB [CK-MB] and/or troponin). Because the trial failed to meet its primary endpoint, these analyses are considered exploratory. During a median follow-up of 502 days, 1580 MIs occurred in 1319 patients. The majority (n = 1025, 64.9%) were type 1 (spontaneous) MI, followed by type 4a [percutaneous coronary intervention (PCI)-related] MI (n = 352; 22.3%). Compared with placebo, vorapaxar reduced the hazard of a first MI of any type by 12% [hazard ratio (HR), 0.88; 95% confidence ...
Since indium-111 platelet scintigraphy for the detection of left ventricular thrombosis often shows considerable non-specific blood pool activity a subtraction method using simultaneous technetium-99m blood pool scintigraphy was undertaken in 11 subjects with well documented remote myocardial infarction, who served as positive or negative controls, and in 18 consecutive patients with acute myocardial infarction. The results were compared with those of cross sectional echocardiography. Thirteen patients had transmural myocardial infarction and the calculated count per pixel in the left ventricle of the subtracted indium-111 platelet scintigram was (mean (SD)) 0.28(0.35), but five patients with subendocardial myocardial infarction had a mean count of 0.04(0.06). In seven patients with transmural myocardial infarction (two anterior and five inferior) left ventricular thrombosis was detected by indium-111 platelet scintigraphy but in only one of these by cross sectional echocardiography. None of the ...
TY - JOUR. T1 - Longitudinal trends in the severity of acute myocardial infarction. T2 - A population study in Olmsted County, Minnesota. AU - Hellermann, Jens P.. AU - Reeder, Guy S.. AU - Jacobsen, Steven J.. AU - Weston, Susan A.. AU - Killian, Jill M.. AU - Roger, Véronique L.. PY - 2002/8/1. Y1 - 2002/8/1. N2 - The mechanisms of the decline in coronary heart disease mortality are not fully elucidated. In particular, little is known about the trends in severity of myocardial infarction, which may have contributed to the mortality decline. This study examines indicators of myocardial infarction severity including Killip class, electrocardiogram descriptors, and peak creatine kinase values in a population-based, myocardial infarction incidence cohort to test the hypothesis that the severity of myocardial infarction declined over time. Between 1983 and 1994, 1,295 incident cases of myocardial infarction (mean age, 67 (standard deviation, 6) years; 43% women) occurred in Olmsted County, ...
On- vs. off-hours admission of patients with ST-elevation acute myocardial infarction undergoing percutaneous coronary interventions: data from a tertiary university brazilian hospital
Introduction: ST Segment Elevation Myocardial Infarction (STEMI) is largely due to plaque rupture (60-70% of cases) and plaque erosion (30-40%). Coronary inflammation plays a pivotal role in rupture, but the pathophysiology of erosion is unknown. Autopsy studies have shown that inflammatory infiltrates are much less abundant in erosion compared to rupture. We explored the hypothesis that differences in intracoronary cytokines can be demonstrated in vivo in the early phase of STEMI in patients undergoing primary percutaneous coronary intervention (PPCI).. Methods: We recruited 40 STEMI patients undergoing PPCI with in less than 6 hours of chest pain in a single-centre observational study. Blood samples were taken from the infarct-related artery using thrombus aspiration. Culprit plaques were imaged using optical coherence tomography (OCT) before PCI and classified by two blinded observers. The expression profiles of 102 cytokines were measured using an array, and comparisons of the two ...
Emerging evidence indicate that progenitor stem cells derived from bone marrow can be used to improve cardiac function in acute myocardial infarction patients. There is a great potential for stem cell therapy, using a variety of cell precursors to contribute to new blood vessel formation and muscle preservation in the myocardial infarct zone. The administration of cells via an infusion through the infarct related artery appears to be feasible and result in a clinical effect in some studies. Across the globe AMI is the leading cause of morbidity and mortality. This cannot be prevented by optimal standard therapies i.e. balloon or stent dilation of the infarct vessels.. The study is a double blind, placebo controlled, randomized, multicenter trial. Male or female patients between 18-75 years with first incidence of Acute Myocardial Infarction(AMI) and LVEF less than or equal to 40% are included in the study. Patients who have undergone successful percutaneous intervention (PCI) within ≤ 24 hours ...
TY - JOUR. T1 - Assisted ventilation during bystander CPR in a swine acute myocardial infarction model does not improve outcome. AU - Berg, Robert A.. AU - Kern, Karl B.. AU - Hilwig, Ronald W.. AU - Ewy, Gordon A.. PY - 1997/1/1. Y1 - 1997/1/1. N2 - Background: Mouth-to-mouth rescue breathing is a barrier to the performance of bystander cardiopulmonary resuscitation (CPR). We evaluated the need for assisted ventilation during simulated single-rescuer bystander CPR in a swine myocardial infarction model of prehospital cardiac arrest. Methods and Results: Steel cylinders were placed in the mid left anterior descending coronary arteries of 43 swine. Two minutes after ventricular fibrillation, animals were randomly assigned to 10 minutes of hand-bag-valve ventilation with 17% oxygen and 4% carbon dioxide plus chest compressions (CC+V), chest compressions only (CC), or no CPR (control group). Standard advanced life support was then provided. Animals successfully resuscitated received 1 hour of ...
RRH: Rural and Remote Health. Published article number: 2013 - Thrombolysis for acute ST elevation myocardial infarction: a pilot study comparing results from GP led small rural health emergency departments with results from a physician led sub-regional emergency department
Objectives. This study was designed to reassess the prediction of recurrent nonfatal myocardial infarction in patients recovering from acute myocardial infarction after thrombolysis.. Background. Recurrent nonfatal myocardial infarction is a strong and independent predictor of subsequent mortality. Current knowledge of risk factors for nonfatal reinfarction is still largely based on data gathered before the advent of thrombolysis. Thus, this prospective study was planned to identify harbingers of nonfatal reinfarction in the postinfarction patients of the multicenter Gruppo Italiano per lo Studio della Sopravvivenza nellInfarto Miocardico (GISSI-2) trial.. Methods. Predictors of nonfatal reinfarction at 6 months were analyzed by multivariate technique (Cox model) in 8,907 GISSI-2 survivors of myocardial infarction with clinical follow-up, relying on a set of prespecified variables reflecting residual ischemia, left ventricular failure or dysfunction, complex ventricular arrhythmias, comorbidity ...
Methods All studies published on the risk of MI during OC2 and OC3 use were analysed. For DVT the Committee for Proprietary Medicinal Products public assessment report published in 2001 and more recent studies published on this topic were used. The estimates of odds ratios (OR) for risk of death from DVT or MI were extracted from the published manuscripts. ORs were used to calculate the aetiological fraction of risk for death from DVT and MI in the population; the relative impact of OC3 compared to OC2 use was expressed as an excess risk of death overall and by age group for French women.. ...
1. Aronson D, Nassar M, Goldberg T, Kapeliovich M, Hammerman H, Azzam ZS. The impact of body mass index on clinical outcomes after acute myocardial infarction. Int J Cardiol. 2010;145:476-480. doi: 10.1016/j.ijcard.2009.12.029 20096942. 2. Kang WY, Jeong MH, Ahn YK, Kim JH, Chae SC, Kim YJ, et al. Obesity paradox in Korean patients undergoing primary percutaneous coronary intervention in ST-segment elevation myocardial infarction. J Cardiol. 2010;55:84-91. doi: 10.1016/j.jjcc.2009.10.004 20122553. 3. Kragelund C, Hassager C, Hildebrandt P, Torp-Pedersen C, Kober L. Impact of obesity on long-term prognosis following acute myocardial infarction. Int J Cardiol. 2005;98:123-131. 15676176. 4. Lazzeri C, Valente S, Chiostri M, Attana P, Picariello C, Sorini Dini C, et al. Impact of age on the prognostic value of body mass index in ST-elevation myocardial infarction. Nutr Metab Cardiovasc Dis. 2013;23:205-211. doi: 10.1016/j.numecd.2012.05.013 22901842. 5. OBrien EC, Fosbol EL, Peng SA, Alexander KP, ...
|p|The 12-lead surface electrocardiogram adjacent QTc dispersion, which is the maximum difference of corrected QT interval between two adjacent leads, is a simple method to determine regional variation in repolarization and refractoriness. The aim of this study is to evaluate adjacent QTc dispersion as a marker of susceptibility to ventricular arrhythmias after myocardial infarction. A total of 135 consecutive patients with acute myocardial infarction were enrolled in the study. Adjacent QTc, measured by lens magnifier, was calculated on the first, second and third days after acute myocardial infarction. On the second day after acute myocardial infarction, adjacent QTc dispersion was significantly greater in patients with ventricular arrhythmias (P < 0.001). Adjacent QTc dispersion on the first and fifth day after acute myocardial infarction was not associated with development of ventricular arrhythmias. On the second day after acute myocardial infarction, adjacent QTc dispersion is
No beneficial effect of intravenous enalaprilat followed by oral enalapril on mortality when administered within 24 hours post myocardial infarction. It is important to note in this study that follow-up was for 6 months only, possibly missing a late benefit due to ACE inhibitor therapy. The benefit of ACE inhibition appears most prominent for patients with anterior myocardial infarctions. This was a non-selective post myocardial infarction study without heart failure or left ventricular dysfunction on entry criterion. In ISIS-4 and GISSI-3, mortality improved by 0.46% and 0.8%, respectively, with risk reductions of 9% and 11%. In view of the risk of hypotension (20% in ISIS-4, compared with placebo 10%), very early ACE inhibition may benefit a highly selected subset of patients.. ...
Objective - The cause of increased post-AMI (acute myocardial infarction) mortality associated with depression remains poorly elucidated. The objective of this study was to examine the extent to which self-reported cardiac functional status accounted for depression-mortality associations following AMI.. Methods - Using a prospective cohort design (n = 1941), the authors obtained self-reported measures of depression and developed profiles of the patients pre-hospitalization cardiac risks, co-morbid conditions and drugs and revascularization procedures during or following index AMI hospitalization. To create these profiles, the patients self-reports were retrospectively linked to no less than 12 years worth of previous hospitalization data. Mortality rates 2 years after acute MI were examined with and without sequential risk adjustment for age, sex, income, cardiovascular risk, co-morbid conditions, selected process-of-care factors and self-reported cardiac functional status.. Results - ...
Whereas thrombus aspiration in patients with ST-elevation myocardial infarction (STEMI) is recommended by current guidelines, there are insufficient data to unequivocally support thrombectomy in patients with non-STEMI (NSTEMI). The Thrombus Aspiration in ThrOmbus containing culpRiT lesions in Non-ST-Elevation Myocardial Infarction (TATORT-NSTEMI) trial is a 400 patient, prospective, controlled, multicenter, randomized, open-label trial. The hypothesis is that under the background of early revascularization, adjunctive thrombectomy in comparison to conventional percutaneous coronary intervention (PCI) alone leads to less microvascular obstruction (MO) assessed by cardiac magnetic resonance imaging (CMR) in patients with NSTEMI. Patients will be randomized in a 1:1 fashion to one of the two treatment arms. The primary endpoint is the extent of MO assessed by CMR. Secondary endpoints include infarct size and myocardial salvage assessed by CMR, enzymatic infarct size as well as angiographic ...
Acute Myocardial infarction (AMI) at a young age (below 45 years) is rare and difficult to predict. We reported a fatal myocardial infarction from advanced atherosclerosis in a healthy young man who had no other major coronary risk factors except mild hypercholesterolemia. Thus, all available systemic risk scores identified him as a low risk candidate for developing a cardiovascular event. Autopsy revealed advanced atherosclerosis in all three major coronary arteries causing acute and old myocardial infarction. Thick epicardial adipose tissue and myocardial bridging of the mid left anterior descending artery were also noted. He frequently used etoricoxib to treat knee and back pain for consecutive five years. Potential mechanisms of sudden death from atherosclerosis, myo- cardial bridging, epicardial adipose tissue and selective COXIB are discussed in more detail below.. ...
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Title:Intracoronary Injection of Glycoprotein IIb/IIIa, Abciximab, as Adjuvant Therapy in Primary Coronary Intervention. VOLUME: 11 ISSUE: 2. Author(s):Andrea Rognoni, Alessadro Lupi, Chiara Cavallino, Roberta Rosso, Alessia Veia, Sara Bacchini and Angelo Sante Bongo. Affiliation:Coronary Care Unit and Catheterization Laboratory, Hospital Maggiore della Carita, Corso Mazzini 18, 28100 Novara, Italy.. Keywords:STEMI, Acute coronary syndrome, adjuvant therapy, bleeding, GP IIb/IIIa inhibitors, in - stent restenosis, no - reflow phenomenon, percutaneous coronary intervention, platelet, thrombosis.. Abstract:Acute coronary syndromes and, in paticular, ST - segment elevation myocardial infarction are the principle causes or mortality and morbidity in the industrialized countries. The manadgement of acute myocadial infarction is much debated in the literature; primary percutaneous coronary intervention is the treatment of choice. In the recent years there has been an increasing interest in the ...
The objectives are to examine if the excess risk of myocardial infarction from exposure to job strain is due to interaction between high demands and low control and to analyse what role such an interaction has regarding socioeconomic differences in risk of myocardial infarction. The material is a population-based case-referent study having...
Mahaffey KW, Held C, Wojdyla D, James S, Katus H, Husted S, Steg PG, Cannon CP, Becker R, Storey R, Khurmi N, Nicolau JC, Cheuk-Man Y, Ardissimo D, Budaj A, Morais J, Montgomery D, Himmelmann A, Harrington R, Wallentin L. Ticagrelor effects on myocardial infarction and the impact of event adjudication in the PLATO (Platelet Inhibition and Patient Outcomes) trial. Journal of the American College of Cardiology. 2014 ; 63( 11): 1493-1499 ...
Patients with symptoms suggestive of an acute myocardial infarction (MI) and having electrocardiographic evidence of an acute MI manifested by ST elevations (>1 mm in two contiguous leads afterto rule out coronary vasospasm) that is considered to rep
Patients with symptoms suggestive of an acute myocardial infarction (MI) and having electrocardiographic evidence of an acute MI manifested by ST elevations (>1 mm in two contiguous leads afterto rule out coronary vasospasm) that is considered to rep
Symptom-to-door time in ST segment elevation myocardial infarction: overemphasized or overlooked? Results from the AMI-McGill study. Can J Cardiol. 2008 Mar; 24(3):213-6 ...
Background. Acute myocardial infarction is a major cause of death and morbidity worldwide, both in women and in men. Up to the age of 70 the incidence of acute myocardial infarction is higher in men than in women. Although the incidence is lower in young women than in young men, young women are particularly vulnerable due to higher fatality rates. The lower incidence in women compared to men might underestimate womens risk. Women might also be less likely to identify themselves as possible sufferers and to take cardio-protective actions.. The treatment of acute myocardial infarction has changed dramatically the last decades and reperfusion therapy has great impact on myocardial damage. The most critical time of an acute myocardial infarction is the very early phase, as rapid treatment is significantly associated with reduced mortality. Time has therefore become an important issue regarding the patients prognosis. These patients often delay in seeking medical assistance, and this patient ...
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SUMMARY A seasonal pattern with winter peak in acute myocardial infarction incidence and cardiovascular disease risk factors is observed in studies worldwide. However, several previous studies have methodical limitations and few are performed in cold climate areas. The aim of this thesis is to assess the effect of season and meteorological factors on first-ever myocardial infarction and the seasonal variation in cardiovascular disease risk factors in a subarctic adult population with long-term follow-up, using appropriate methods with adjudicated outcomes and well-defined exposures. The population-based Tromsø Study consists of more than 40,000 individuals living in a subarctic climate in Northern Norway. The cohort members have been examined up to nine times in six repeated health surveys in the years between 1974 and 2008. Data on myocardial infarction and risk factors have been collected throughout follow-up. The thesis consists of three studies. The first study is an analysis of the ...
TY - JOUR. T1 - Risk stratification after acute myocardial infarction by means of exercise two-dimensional echocardiography. AU - Ryan, Thomas. AU - Armstrong, William F.. AU - ODonnell, Jacqueline A.. AU - Feigenbaum, Harvey. PY - 1987/12. Y1 - 1987/12. N2 - To determine whether exercise two-dimensional echocardiography contributes to the prognostic information provided by exercise testing in patients recovering from acute myocardial infarction, 40 patients were prospectively studies by means of pre- and postexercise echocardiography 10 to 21 days after myocardial infarction. Patients were followed for 6 to 10 months or until one of the following clinical end points occurred: death, recurrent myocardial infarction, unstable angina, or coronary artery bypass grafting. Results of treadmill exercise tests were negative in 13 of 20 patients with good clinical outcome (65% specificity) and positive in 11 of 20 patients with poor clinical outcome (55% sensitivity). The resting echocardiogram was ...
OBJECTIVE--The SAVE study showed that captopril improves mortality in patients with left ventricular dysfunction after myocardial infarction and that this benefit occurred even in patients with no clinically overt heart failure. On the basis of this, it seems important to identify correctly which patients have left ventricular dysfunction after a myocardial infarction. The objective was to compare various methods of identifying patients with left ventricular dysfunction (left ventricular ejection fraction, LVEF, , or = 40%) after acute myocardial infarction. The methods compared were echocardiography (quantitative and qualitative visual assessment), clinical evaluation (subjective assessment and three clinical score methods), and measurement of plasma concentrations of cardiac natriuretic peptide hormones (atrial and brain natriuretic peptides, ANP and BNP). DESIGN--Cross sectional study of left ventricular function in patients two to eight days after acute myocardial infarction. ...
Background and Objectives: Metabolic syndrome (MetS) is an important risk factor for cardiovascular disease. However, the clinical outcome of acute myocardial infarction (AMI) with MetS has not been well examined. The purpose of this study was to evaluate the clinical outcomes of AMI patients with MetS. Subjects and Methods: We evaluated a total of 6352 AMI patients who had successful percutaneous coronary interventions and could be identified for MetS between 2005 and 2008 at 51 hospitals participating in the Korea Acute Myocardial Infarction Registry. They were divided into 2 groups according to the presence of MetS: the MetS group (n=2493, 39.2%) versus the Non-MetS group (n=3859, 60.8%). In addition, 4049 AMI patients with high levels of low density lipoprotein-cholesterol (LDL-C) (��100 mg/dL) among them, were divided into the MetS group (n=1561, 38.6%) versus the Non-MetS group (n=2488, 61.4%). Results: In the overall population, there was no significant difference in 12-month the ...
Heart attack treatment may involve primary percutaneous transluminal coronary angioplasty (PTCA). Heart attack treatment information developed by physicians.
TY - JOUR. T1 - Survival of patients undergoing rescue percutaneous coronary intervention. AU - Burjonroppa, Sukesh C.. AU - Varosy, Paul D.. AU - Rao, Sunil V.. AU - Ou, Fang Shu. AU - Roe, Matthew. AU - Peterson, Eric. AU - Singh, Mandeep. AU - Shunk, Kendrick A.. PY - 2011/1. Y1 - 2011/1. N2 - Objectives This study sought to develop a tool for predicting an individuals risk of mortality following rescue percutaneous coronary intervention (PCI). Background Although fibrinolytic therapy is appropriate and improves survival for certain ST-segment elevation myocardial infarction patients, a substantial proportion suffer ongoing myocardial ischemia, a class I indication for emergent percutaneous coronary intervention (rescue PCI). Methods Using the National Cardiovascular Data Registry (NCDR), rescue PCI was defined as nonelective PCI following failed fibrinolysis in patients with continuing or recurrent myocardial ischemia. Multivariable logistic regression was used to determine mortality ...
Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation. Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. Fibrinolysis is not recommended in patients with non-ST elevation acute coronary syndrome;
TY - JOUR. T1 - What is the best anticoagulant therapy during primary percutaneous coronary intervention for acute myocardial infarction?. AU - Gurbel, Paul A.. AU - Navarese, Eliano Pio. AU - Tantry, Udaya S.. N1 - Publisher Copyright: Copyright © by Medycyna Praktyczna, Kraków 2015.. PY - 2015. Y1 - 2015. N2 - Both ST-segment elevation myocardial infarction and percutaneous coronary intervention (PCI) are associated with a highly prothrombotic state, and thrombin plays a critical role during occlusive clot generation and subsequent occurrence of an ischemic event. Therefore, a strategy of anticoagulation plus dual antiplatelet therapy has been regarded as de facto standard therapy during primary PCI (pPCI). Recently, there has been great controversy surrounding the role of bivalirudin versus unfractionated heparin in pPCI. Earlier, the results of the HORIZONS-AMI trial, particularly those regarding the long-lasting mortality benefit, provided a strong rationale for recommending bivalirudin ...
OBJECTIVES: This study sought to evaluate the effect of early intravenous metoprolol on left ventricular (LV) strain assessed with feature-tracking cardiovascular magnetic resonance (CMR). BACKGROUND: Early intravenous metoprolol before primary percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) portends better outcomes in the METOCARD-CNIC (Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction) trial. METHODS: A total of 197 patients with acute anterior STEMI who were enrolled in the METOCARD-CNIC trial (100 allocated to intravenous metoprolol before primary PCI and 97 control patients) were evaluated. LV global circumferential strain (GCS) and global longitudinal strain (GLS) were measured with feature-tracking CMR at 1 week and 6 months after STEMI and compared between randomization groups. RESULTS: Patients who received early intravenous metoprolol had significantly more preserved LV strain compared with the control patients ...
Arachidonic acid (AA), a precursor of prothrombotic eicosanoids, is potentially atherogenic, but epidemiologic data are scarce. We evaluated the hypothesis that increased AA in adipose tissue is associated with increased risk of nonfatal acute myocardial infarction (MI), and if so, whether this association is related to dietary or adipose tissue linoleic acid. We studied the association between AA and MI in 466 cases of a first nonfatal acute MI, matched on age, gender, and residence to 466 population controls. Fatty acids (FA) were assessed by GC in adipose tissue samples collected from all subjects. Odds ratios (OR) and 95% CI were calculated from multivariate conditional logistic regression models. Subjects in the highest quintile of adipose tissue AA (0.64% of total FA) had a higher risk of nonfatal acute MI than those in the lowest quintile (0.29% of total FA), after adjusting for potential confounders including (n-3) and trans FAs (OR=1.94, 95% CI: 1.07, 3.53, P for trend = 0.026). Adipose ...
TY - JOUR. T1 - Pentraxin 3 in unstable angina and non-ST-segment elevation myocardial infarction. AU - Matsui, Shigeru. AU - Ishii, Junichi. AU - Kitagawa, Fumihiko. AU - Kuno, Atsuhiro. AU - Hattori, Kousuke. AU - Ishikawa, Makoto. AU - Okumura, Masanori. AU - Kan, Shino. AU - Nakano, Tadashi. AU - Naruse, Hiroyuki. AU - Tanaka, Ikuko. AU - Nomura, Masanori. AU - Hishida, Hitoshi. AU - Ozaki, Yukio. PY - 2010/5/1. Y1 - 2010/5/1. N2 - Purpose: We prospectively investigated the prognostic value of pentraxin 3 (PTX3) in patients with unstable angina and non-ST-segment elevation myocardial infarction (UA/NSTEMI). Background: PTX3 may be a useful marker for localized vascular inflammation and damage to the cardiovascular system. Recent studies have shown that plasma PTX3 is elevated in patients with UA/NSTEMI; however, its prognostic value in UA/NSTEMI remains unclear. Methods: PTX3, high-sensitivity C-reactive protein (hsCRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP), and cardiac ...
TY - JOUR. T1 - Resuscitative endovascular balloon occlusion of the aorta during non-ST elevation myocardial infarction. T2 - A case report. AU - Curtis, Eleanor E.. AU - Russo, Rachel M.. AU - Nordsieck, Eric. AU - Johnson, Michael. AU - Williams, Timothy K.. AU - Neff, Lucas P.. AU - Hile, Lisa. AU - Galante, Joseph M. AU - Dubose, Joseph J.. PY - 2018/1/1. Y1 - 2018/1/1. N2 - Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a hemorrhage control technique that is increasingly being adopted for the management of noncompressible bleeding. In addition to limiting hemorrhage, REBOA increases blood flow to the heart, lungs, and brain. A small number of case reports and animal studies describe the use of REBOA to increase coronary perfusion during cardiopulmonary resuscitation. We report a case in which REBOA may have reversed ST-segment abnormalities during a Type II non-ST elevation myocardial infarction (NSTEMI) in a patient with previous trauma. We describe the presentation, ...
TY - JOUR. T1 - Echocardiography in acute myocardial infarction.. AU - Quinones, M. A.. PY - 1984/2. Y1 - 1984/2. N2 - Echocardiography has recently gained increasing popularity as a noninvasive technique to assess left ventricular function and regional wall motion in acute myocardial infarction. Detection of regional dyssynergy is possible in over 90 per cent of patients with acute infarction, allowing assessment of site and extent of involvement. Estimates of severity of left ventricular dysfunction on admission into the coronary care unit allow stratification of patients into risk categories in terms of acute and long-term prognosis. Complications of myocardial infarction such as right ventricular infarction, ventricular septal rupture, papillary muscle rupture, papillary muscle dysfunction, formation of mural thrombi, ventricular aneurysms, and pericardial effusion can be diagnosed echocardiographically at the bedside. This article discusses these applications as well as some of the ...
Amin AP, Salisbury AC, McCullough PA, et al. Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. Arch Intern Med. 2012;172:246-253. Available at: http://archinte.ama-assn.org/cgi/content/full/172/3/246.. Hsu RK, Hsu C. Acute kidney injury: comment on Trends in the incidence of acute kidney injury in patients hospitalized with acute myocardial infarction. Arch Intern Med. 2012;172:253-254.. Parikh CR, Coca SG, Wang Y, et al. Long-term prognosis of acute kidney injury after acute myocardial infarction. Arch Intern Med. 2008;168:987-995.. Aengus Murphy C, Robb SD, Weir RA, et al. Declining renal function after myocardial infarction predicts poorer long-term outcome. Eur J Cardiovasc Prev Rehabil. 2010;17:181-186.. Chertow GM, Burdick E, Honour M, et al. Acute kidney injury, mortality, length of stay, and costs in hospitalized patients. J Am Soc Nephrol. 2005;16:3365-3370.. Molitoris BA, Levin A, Warnock DG; et al, Acute Kidney Injury Network ...
It is now widely accepted that for patients with ST-segment elevation myocardial infarction (STEMI), primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy if it can be delivered in a timely fashion. Based on robust evidence documenting a relationship between time-to-reperfusion (defined either by time between symptom onset or hospital arrival and reperfusion) and mortality (1,2), the American College of Cardiology/American Heart Association guidelines recommend that STEMI patients undergo primary PCI with a balloon inflation or device time within 90 min of first medical contact (3). Moreover, in the most recent focused update of the STEMI guidelines, it is recommended that each community develop a STEMI system of care that includes: 1) a process for pre-hospital identification of STEMI and catheterization laboratory activation; 2) destination protocols for STEMI-receiving centers; and 3) transfer protocols for patients who arrive at STEMI referral centers and are ...
Summary Circulating procoagulant microparticles (MP) were measured as markers of vascular damage and prothrombotic risk in patients undergoing ST-segment myocardial infarction (STEMI) treated by primary percutaneous transluminal coronary angioplasty (PTCA) and additional GPIIb-IIIa antagonists. Cel...
Thesis, English, ASPIRATION THROMBECTOMY DURING PRIMARY PERCUTANEOUS CORONARY INTERVENTION AS ADJUNCTIVE THERAPY TO EARLY (IN AMBULANCE) ABCIXIMAB ADMINISTRATION IN PATIENTS WITH ACUTE ST ELEVATION MYOCARDIAL INFARCTION AN ANALYSIS from LEIDEN MISSION! ACUTE MYOCARDIAL INFARCTION TREATMENT OPTIMIZATION PROGRAM for Ahmed Tarek Abdel Hameed Nagib
Bed rest is an inherent part of treatment for acute myocardial infarction (AMI). In clinical practice this intervention is prescribed in different ways and for different lengths of time. Current guidelines recommend at least 12 hours bed rest following AMI. However the basis for these recommendations is unclear. This review found 15 trials which were generally outdated and of moderate to poor methodological quality. Bed rest ranging from 2 to 12 days appears to be as safe as longer periods of bed rest. No evidence was found to support the current bed rest recommendations of not more than 12 to 24 hours. The optimal duration of bed rest after AMI remains undetermined from the available evidence.. ...
ENGLISH ABSTRACT: A heart attack is a medical emergency and a life threatening disease. Patients with chest pain and a possible diagnosis of myocardial infarction require a detailed assessment and prompt medical management. The aim of the study was to determine the in-hospital delay in administrating thrombolytic therapy to patients with acute myocardial infarction (AMI) A mixed method with convergent parallel design was applied to the study. The population consisted of N=63 case notes of adult patients diagnosed with acute myocardial infarction and who had received thrombolytic therapy. The other population included (n=8) registered professional nurses working in the coronary care unit (CCU) of a tertiary hospital in the Western Cape. A record review was done using a data extraction form and semi-structured interview guide was used for data collection purposes. Reliability and validity was tested by the use of a nurse expert and a statistician. The nurse expert evaluated the data extraction ...
TY - JOUR. T1 - High Exercise Capacity Attenuates the Risk of Early Mortality After a First Myocardial Infarction. T2 - The Henry Ford Exercise Testing (FIT) Project. AU - Shaya, Gabriel E.. AU - Al-Mallah, Mouaz H.. AU - Hung, Rupert K.. AU - Nasir, Khurram. AU - Blumenthal, Roger S.. AU - Ehrman, Jonathan K.. AU - Keteyian, Steven J.. AU - Brawner, Clinton A.. AU - Qureshi, Waqas T.. AU - Blaha, Michael J.. PY - 2016/2/1. Y1 - 2016/2/1. N2 - Objective To examine the effect of objectively measured exercise capacity (EC) on early mortality (EM) after a first myocardial infarction (MI). Patients and Methods This retrospective cohort study included 2061 patients without a history of MI (mean age, 62±12 years; 38% [n=790] women; 56% [n=1153] white) who underwent clinical treadmill stress testing in the Henry Ford Health System from January 1, 1991, through May 31, 2009, and suffered MI during follow-up (MI event proportion, 3.4%; mean time from the exercise test to MI, 6.1±4.3 years). Exercise ...
A 41-year-old male bodybuilder was admitted with acute inferior myocardial infarction. The patient had been using oxymetholone and methenolone to increase his performance for 15 years and quitted smoking three years before. He underwent successful primary percutaneous coronary intervention (PCI) and …
The discrepancy between the relatively better early outcomes and the similar or even worse long-term prognoses in patients with non-Q wave versus Q wave infarction has led to a more aggressive approach in the management of this group of patients ([3, 5, 10]). Our findings conflict somewhat with reports from the prethrombolytic era ([3-5, 9, 17-19]), in which 1-year mortality was similar or even higher in the non-Q wave infarction populations. The difference could be related to the heterogeneity of the populations, the definitions used and the use of thrombolysis ([3-9, 11]).. Another possible explanation for this disagreement is the initial ST segment deviation. In most studies of Q wave or non-Q wave infarction, the initial ST segment shift was seldom considered a prognostic marker. The observation that patients with initial ST segment depression have a worse prognosis than those with ST segment elevation and either Q wave or non-Q wave infarction ([20-23]), with the additional evidence that ...
The dilemma of refractory hypoxemia after inferior wall myocardial infarction. Proc (Bayl Univ Med Cent). 2018 Jan;31(1):67-69 Authors: Albaghdadi A, Teleb M, Porres-Aguilar M, Porres-Munoz M, Marmol-Velez A Abstract Patent foramen ovale (PFO) occurs in 25% of people. The decision on whether to close the PFO found after myocardial infarction and specifically right ventricular...
OBJECTIVES: Our goal was to validate myocardium at risk on T2-weighted short tau inversion recovery (T2-STIR) cardiac magnetic resonance (CMR) over time, compared with that seen with perfusion single-photon emission computed tomography (SPECT) in patients with ST-segment elevation myocardial infarction, and to assess the amount of salvaged myocardium after 1 week. BACKGROUND: To assess reperfusion therapy, it is necessary to determine how much myocardium is salvaged by measuring the final infarct size in relation to the initial myocardium at risk of the left ventricle (LV). METHODS: Sixteen patients with first-time ST-segment elevation myocardial infarction received (99m)Tc tetrofosmin before primary percutaneous coronary intervention. SPECT was performed within 4 h and T2-STIR CMR within 1 day, 1 week, 6 weeks, and 6 months. At 1 week, patients were injected with a gadolinium-based contrast agent for quantification of infarct size. RESULTS: Myocardium at risk at occlusion on SPECT was 33 +/- ...
Background In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation. Methods and Results Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6%), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI. Of the 212 patients presenting with clinical in-stent restenosis, 22 (10.4%) had MI (creatine kinase (CK) ≥2 × baseline with elevated CKMB). The remaining 190 (89.6%) patients had stable angina or evidence of ischemia by stress test without elevation of cardiac enzymes. Median interval between previous intervention and presentation for clinical in-stent restenosis was shorter for patients with MI than for non-MI patients (STEMI, 90 days; NSTEMI, 79 days; non-MI, 125 days; p=0.07). Diffuse in-stent restenosis was more frequent in MI patients ...
Background. Emerging evidence suggests that stem cells and progenitor cells derived from bone marrow can be used to improve cardiac function in patients after acute myocardial infarction. In this randomised trial, we aimed to assess whether intracoronary transfer of autologous bone-marrow cells could improve global left-ventricular ejection fraction (LVEF) at 6 months follow-up.. Methods. After successful percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction, 60 patients were randomly assigned to either a control group (n=30) that received optimum postinfarction medical treatment, or a bone-marrow-cell group (n=30) that received optimum medical treatment and intracoronary transfer of autologous bone-marrow cells 4·8 days (SD 1·3) after PCI. Primary endpoint was global left-ventricular ejection fraction (LVEF) change from baseline to 6 months follow-up, as determined by cardiac MRI. Image analyses were done by two investigators blinded for treatment ...
BACKGROUND: Chronic kidney disease is associated with increased risk of mortality. We examined the impact of moderate and severe renal insufficiency (RI) on short- and long-term mortality among unselected patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: From January 1, 2002 to December 31, 2010 all patients with STEMI treated with primary PCI were identified. The hazard ratio (HR) for death was estimated using a Cox regression model, controlling for potential confounders. RI was defined as creatinine clearance (CrCl) , 60 mL/min (moderate RI: CrCl ≤30 , 60 mL/min and severe RI: CrCl , 30 mL/min). RESULTS: The study cohort consisted of 4,116 patients of whom 898 (21.8%) had RI and 3,218 (78.2%) had a CrCl ≥ 60 mL/min. Compared to patients without RI, patients with RI were older, more often female and more likely to have diabetes mellitus, hypertension and to present with a higher Killip class.Among ...
Acute myocardial infarction (AMI) is one of the most deleterious conditions leading to cardiovascular diseases and mortality. The importance of an early and accurate diagnosis assures immediate medical treatments, which are fundamental to reduce mortality and improve prognoses. AMI is associated to an inflammatory response which includes the increase of circulating inflammatory cytokines, chemokines and immune cell activation. This study aimed to identify which are the very early immune-related biomarkers that may be used as predictors of myocardial infarction severity. In order to mimic the pathophysiological events involved in human myocardial infarction, a temporary occlusion (90 min) of the mid-left anterior descending coronary artery was performed in a swine animal model. Lymphocyte subsets analysis in peripheral blood revealed significant alterations in CD4+/CD8+ ratio and naïve and effector/memory T cell percentages at 1 h post-myocardial infarction. Changes in TH1/TH2-related cytokine, monocyte
Aims: IL-1b-3953 C,T and MMP-9-1562C,T variants have been shown to be linked to the development of myocardial infarction (MI), although previous studies have reported inconsistent results. The aim of the present study was to determine whether these genetic variations are associated with MI susceptibility in an Iranian population. Methods: In the current study, 117 patients with MI and 120 control group members were selected as participants. Peripheral blood samples were taken from all the subjects for genomic DNA extraction. Single nucleotide polymorphism (SNP) genotyping was performed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) assays. Results: Multiple logistic regression analysis revealed that the TT genotype of the IL-1b-3953 C,T polymorphism is associated with a significant MI protective effect in: the homozygote model after adjustment for MI risk factors (odds ratio OR]: 0.18, confidence interval 95% CI] = 0.04-0.72; p = 0.01); and also in the recessive ...
Background Recent trials in acute myocardial infarction indicate that intensive and early statin therapy that lowers low-density lipoprotein cholesterol (LDL-C) to ≤ 70 mg dL−1 is beneficial. The combination of statins with ezetimibe, a newly developed cholesterol-absorption inhibitor, can lead to a further reduction in LDL-C of up to 26%. In this study, we examined the rapidity and intensity of the lipid-lowering effect of ezetimibe co-administered with simvastatin immediately after myocardial infarction.. Materials and methods Sixty patients admitted for acute myocardial infarction were randomized to receive either simvastatin 40 mg (SIMVA), a combination of simvastatin 40 mg and ezetimibe 10 mg (EZE/SIMVA), or no lipid-lowering drugs (NLLD) and had their lipid levels assessed 2, 4 and 7 days later.. Results At baseline, cardiovascular risk factors were similar in all three groups [mean (SD) LDL-C of 141 (36) mg dL−1]. At days 2 , 4 and 7 there was no significant change in mean LDL-C ...
A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was as follows: is coronary artery bypass graft (CABG) surgery superior to percutaneous coronary intervention (PCI) in terms of in Show moreA best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was as follows: is coronary artery bypass graft (CABG) surgery superior to percutaneous coronary intervention (PCI) in terms of in-hospital mortality and morbidity and long-term outcomes in patients with acute myocardial infarction (MI)? A total of 104 papers were returned using the selected search. Of these, six represented the best evidence to answer the clinical question. The selection criteria were comparative studies with only PCI and CABG groups in patients with acute MI. Case reports, reviews, recommendations and studies on a specific population or out of the context of acute MI were excluded. The authors, journal, date and country ...
Periprocedural myocardial infarction enhances the predictive value of inflammatory biomarkers for patients with obstructive coronary artery disease after implantation of drug-eluting stent Anastasia Jesika,1 Zuo-Ying Hu,2 Jing Kan,3 Shao-Liang Chen2 1Nanjing Medical University, Nanjing, Peoples Republic of China; 2Department of Cardiology, Nanjing First Hospital, Nanjing Medical University, Nanjing, Peoples Republic of China; 3Nanjing Heart Center, Nanjing, Peoples Republic of China Objective: The present study aims to clarify the long-term clinical importance of interleukin (IL)-6 in predicting major adverse cardiac events (MACE) for an entire cohort of patients with coronary artery disease after implantation of a drug-eluting stent (DES), and its interplay with periprocedural myocardial infarction (PMI). Background: The correlation of proinflammatory biomarkers with occurrence of clinical events, including PMI and mortality, is controversial. Methods: IL-6 was measured in 1,991 patients at
Background: There are few studies which compare the efficacy and safety of the Resolute Onyx zotarolimus-eluting stent (O-ZES) and everolimus-eluting stent (EES) in patients with acute myocardial infarction (AMI). Therefore, the present study aimed to compare clinical outcomes of O-ZES and EES in patients with AMI undergoing successful percutaneous coronary intervention (PCI). Methods: From January 2016 to December 2016, the Korea Acute Myocardial Infarction Registry (KAMIR) enrolled 3,364 consecutive patients. Among them, O-ZES was used in 402 patients and EES was used in 1,084 patients. The primary endpoint was target lesion failure (TLF), as defined by composite of cardiac death, target vessel myocardial infarction (TV-MI), and ischemic driven-target lesion revascularization (ID-TLR) at 6 month clinical follow-up. Results: At 6 months, the incidence of TLF was not significantly different between O-ZES and EES group (4.0% vs. 3.9%, adjusted hazard ratio [HR] 1.17, 95% confidential interval ...
OBJECTIVES: Compare gender disparities in ST-elevation myocardial infarction (STEMI) regarding first medical contact (FMC) and prehospital delay times and explore factors associated with prehospital delay in men and women separately.. DESIGN: Cross-sectional study based on medical records and a validated questionnaire. Eligible patients were enrolled within 24 hours after admittance to hospital.. SETTING: Patients were included from November 2012 to January 2014 from five Swedish hospitals with catheterisation facilities 24/7.. PARTICIPANTS: 340 men and 109 women aged between 31 and 95 years completed the survey.. MAIN OUTCOME MEASURES: FMC were divided into five possible contacts: primary healthcare centre by phone or directly, national advisory nurse by phone, emergency medical services (EMS) and emergency room directly. Two parts of prehospital delay times were studied: time from symptom onset to FMC and time from symptom onset to diagnostic ECG.. RESULTS: Women more often called an advisory ...
BACKGROUND/AIM: Acute myocardial infarction (AMI) is associated with increased coagulation which in the presence of unstable atheroma or endothelial damage leads to occlusive coronary vessel thrombosis. AMI is usually characterized by increased levels of catecholamines. It is possible there may be a link between catecholamines and hypercoagulation, but this still remains to be determined. In the current study we sought to verify whether hypercoagulation is associated with hypersympathetic activity in AMI patients, and whether there is a correlation between increased Methoxyhydroxyphenylglycol (MOPEG) levels (a metabolite of catecholamines) and shorter APTT (a marker of hypercoagulation). RESULTS: Shorter APTT values were detected in the plasma of AMI patients, which had also increased MOPEG levels. A linear correlation between APTT and MOPEG values was observed. High levels of the coagulation marker prothrombin (fragments 1+2) were also found. CONCLUSION: Shortened APTT demonstrates ...
TY - JOUR. T1 - Characteristics and prognosis of patients with suspected acute myocardial infarction and elevated MB relative index but normal total creatine kinase. AU - Lloyd-Jones, Donald M.. AU - Camargo, Carlos A.. AU - Giugliano, Robert P.. AU - Walsh, Craig R.. AU - ODonnell, Christopher J.. PY - 1999/11/1. Y1 - 1999/11/1. N2 - MB Leak patients who develop an elevated MB relative index with a normal total creatine kinase (CK) level are not as well characterized as those who have diagnostic enzyme elevations in the setting of ST elevation (↑) or non-ST↑ acute myocardial infarction (AMI). During a 1-year period, we studied all patients hospitalized in an urban academic hospital with suspected AMI who developed an elevated MB relative index within 24 hours of presentation. Of 595 patients, 44% had MB Leak, 34% had non-ST↑ AMI and 22% had ST↑ AMI. Patients with MB Leak and non-ST↑ AMI were significantly older than those with ST↑ AMI (mean ages 69, 71, and 63 years, ...
Objectives The aim of this study was to examine the level of agreement between acute instantaneous wave-free ratio (iFR) measured across nonculprit stenoses in patients with ST-segment elevation myocardial infarction (STEMI) and iFR measured at a staged follow-up procedure. Background Acute full revascularization of nonculprit stenoses in STEMI is debated and currently guided by angiography. Acute functional assessment of nonculprit stenoses may be considered. Methods Immediately after successful primary culprit intervention for STEMI, nonculprit coronary stenoses were evaluated with iFR and left untreated. Follow-up evaluation with iFR was performed at a later stage. iFR ,0.90 was considered hemodynamically significant. Results One hundred twenty patients with 157 nonculprit lesions were included. Median acute iFR was 0.89 (interquartile range [IQR]: 0.82 to 0.94; n = 156), and median follow-up iFR was 0.91 (interquartile range: 0.86 to 0.96; n = 147). Classification agreement was 78% between ...
TY - JOUR. T1 - Joint effect of physical activity and body mass index on mortality for acute myocardial infarction in the elderly. T2 - Role of preinfarction angina as equivalent of ischemic preconditioning. AU - Abete, Pasquale. AU - Cacciatore, Francesco. AU - Della Morte, David. AU - Mazzella, Francesca. AU - Testa, Gianluca. AU - Galizia, Gianluigi. AU - De Santis, Domenico. AU - Longobardi, Giancarlo. AU - Ferrara, Nicola. AU - Rengo, Franco. PY - 2009/2/1. Y1 - 2009/2/1. N2 - BACKGROUND: Preinfarction angina (PrA), clinical equivalent of ischemic preconditioning, confers protection against in-hospital mortality for acute myocardial infarction (AMI) in adult but not in elderly patients. This study aims to examine the interaction between physical activity and body mass index (BMI) in preserving the cardioprotective effect of PrA in elderly patients with AMI. DESIGN: Elderly patients (≥65 years old) with AMI admitted to Coronary Care Unit. METHODS: Elderly patients with AMI were ...
Comparison of drug-eluting stents versus bare-metal stents for treating ST-segment elevation myocardial infarction. JACC Cardiovasc Interv. 2008 Jun; 1(3):227-32 ...