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Reperfusion InjuryReperfusionMyocardial ReperfusionMyocardial Reperfusion InjuryMyocardial InfarctionAngioplasty, Balloon, CoronaryTime FactorsMyocardial IschemiaElectrocardiographyPercutaneous Coronary InterventionMyocardiumIschemic Preconditioning, MyocardialThrombolytic TherapyCoronary CirculationIschemic PreconditioningFibrinolytic AgentsIschemiaTreatment OutcomeIschemic PostconditioningRats, WistarRats, Sprague-DawleyDisease Models, AnimalTime-to-TreatmentCreatine KinaseBrain IschemiaCoronary AngiographyEmergency Medical ServicesCardiotonic AgentsPerfusionPlatelet Aggregation InhibitorsPeroxidaseVentricular Function, LeftTransportation of PatientsCoronary ThrombosisHeartNecrosisPatient TransferMyocardial StunningMicrocirculationHemodynamicsDogsThrombectomyMitochondria, HeartCardioplegic SolutionsMalondialdehydeAcute Coronary SyndromeInfarction, Middle Cerebral ArteryNo-Reflow PhenomenonHospital MortalityMyocardial ContractionProspective StudiesCoronary VesselsHeart Arrest, InducedRegistriesIschemic Attack, TransientWarm IschemiaPlatelet Glycoprotein GPIIb-IIIa ComplexCoronary OcclusionStentsTissue Plasminogen ActivatorMyocytes, CardiacSuctionImmunoglobulin Fab FragmentsOrgan PreservationCardiovascular AgentsL-Lactate DehydrogenaseStreptokinaseRandom AllocationConstrictionDecanoic AcidsHydroxy AcidsCardiology Service, HospitalEnoxaparinOxidative StressRabbitsShock, CardiogenicTioproninProtective AgentsApoptosisMyocardial RevascularizationCreatine Kinase, MB FormMice, Inbred C57BLPredictive Value of TestsSuperoxide DismutaseOrgan Preservation SolutionsNeuroprotective AgentsTiclopidineVentricular PressureFree RadicalsAmbulancesFollow-Up StudiesBiological MarkersChi-Square DistributionDrug-Eluting StentsHemorrhageNitric OxideRegional Medical ProgramsFree Radical ScavengersModels, AnimalNeutrophil Infiltration
PercutaneousElevationAcute reperfusionTherapiesInfarctInfarctionApproach to reperfusionPPCIMyocardiumEarly reperfusionMortalityMethodsSymptomsOnsetNSTEMIFibrinolyticCatheterizationTherapyOutcomesInjuryMyocardial salvagePrimaryGuidelineCohortTreatmentHospitalsAnteriorCardioprotective2021ThrombolysisFibrinolyticsHospitalInferiorGuidelinesInterventionTimeACCF
Percutaneous23
Elevation27
  • INTRODUCTION: A reliable electrocardiographic predictor of ventricular fibrillation (VF) in patients with ST elevation myocardial infarction (STEMI) is lacking so far. (lu.se)
  • From 2008 to 2012, the authors collected ACTION-GWTG data reperfusion (restoration of blood flow to the heart) on 147,466 patients admitted for STEMI at 485 Mission: Lifeline in response to a ST-segment-¬elevation myocardial hospitals across 46 states, representing 656 systems of care. (cdc.gov)
  • Clinically, AIVR has been best studied in patients with acute ST-elevation myocardial infarction (STEMI). (medscape.com)
  • Objective To determine the impact of time-of-day onset of ST segment elevation myocardial infarction (STEMI) on infarct size. (bmj.com)
  • 36 studies reported mortality outcomes for 1 892 424 patients with acute myocardial infarction, and 30 studies reported door to balloon times for 70 534 patients with ST elevation myocardial infarction (STEMI). (bmj.com)
  • 1 It is important for primary care physicians to be able to diagnose and manage acute coronary syndrome (ACS), which comprises two clinical presentations: ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS). (aafp.org)
  • Faraday Pharmaceuticals published results from its Phase II trial of FDY-5301 for reperfusion injury after a ST-elevation myocardial infarction (STEMI) heart attack. (biospace.com)
  • Current American College of Cardiology/ American Heart Association and European Society of Cardiology guidelines for the care of ST-elevation myocardial infarction (STEMI) provide a strong endorsement of the use of beta-blocker therapy, and administration of beta-blocker therapy after STEMI is considered an important quality measure. (hcplive.com)
  • Rapid, complete, and sustained reperfusion of the infarct-related coronary artery is a cornerstone in the treatment of acute ST-elevation myocardial infarction (STEMI). (dovepress.com)
  • and others later in the hospitalization because their ST-segment elevation and symptoms resolved early (i.e. where acute reperfusion was not deemed necessary but subsequent PCI was pursued). (jointcommission.org)
  • Early reperfusion of the infarct-related coronary artery is an important issue in improvement of outcomes after ST-segment elevation myocardial infarction (STEMI). (eur.nl)
  • Acute MI includes both non-ST-segment-elevation myocardial infarction (NSTEMI) and ST-segment-elevation myocardial infarction (STEMI). (msdmanuals.com)
  • Objective To assess whether granulocyte colony-stimulating factor (G-CSF) treatment induces a sustained benefit on adverse remodelling in patients with large anterior ST-elevation myocardial infarction (STEMI) and left ventricular (LV) dysfunction after successful reperfusion. (bmj.com)
  • Paris, France - Aug. 30, 2011: Primary PCI is the best reperfusion therapy for patients presenting with acute ST-elevation myocardial infarction. (escardio.org)
  • ST-Elevation Myocardial Infarction (STEMI), results in death and disability due to damage to cardiac myocytes and decreased cardiac function. (hhs.gov)
  • Objectives The aim of this study was to investigate the clinical significance of native T1 values in remote myocardium in survivors of acute ST-segment elevation myocardial infarction (STEMI). (dundee.ac.uk)
  • Tricuspid regurgitation (TR) is associated with adverse prognosis in various patient populations, but currently no data is available about the prevalence and prognostic implication of TR in ST-segment elevation myocardial infarction (STEMI) patients. (ima.org.il)
  • p. 2474 ) sheds light on the question of whether hyperglycemia is the cause or effect of myocardial damage in patients with ST-segment elevation myocardial infarction (STEMI). (diabetesjournals.org)
  • Presence of microvascular obstruction (MVO) derived from cardiac magnetic resonance (CMR) imaging is among the strongest outcome predictors after ST-segment elevation myocardial infarction (STEMI). (biomedcentral.com)
  • Researchers reviewed data on 774 patients treated in 2013-2014 for a type of heart attack called ST-elevation myocardial infarction (STEMI) who lived in rural Minnesota, North Dakota and South Dakota. (eurekalert.org)
  • Does regression of ST-segment elevation in patients undergoing pharmaco invasive strategy adequately predict complete reperfusion? (escardio.org)
  • Less than half of U.S. hospitals meet guidelines for prompt treatment of ST-segment elevation myocardial infarction (STEMI). (biomedcentral.com)
  • Another, frustrating fact is that ST-elevation in the inferior leads (II, III, aVF) is typically seen with inferior STEMI and pericarditis. (rebelem.com)
  • Typically the vector of ST elevation in inferior STEMI is between 60° and 120° (between leads II and III). (rebelem.com)
  • PARTICIPANTS: Of note, 1129 patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) admitted to a single center over 36 months (between 2011 and 2014). (bvsalud.org)
  • Although the initial treatment of the different types of acute coronary syndrome (ACS) may appear to be similar, it is very important to distinguish whether the patient is having an ST-elevation MI (STEMI) or a non-STEMI (NSTEMI), because definitive therapies differ between these two types of MI. (medscape.com)
  • ST-segment elevation myocardial infarction (STEMI) is one of the highest-risk and highest-profile conditions we care for in the emergency department. (medscape.com)
Acute reperfusion1
  • Although not specifically addressed in the guidelines, LBBB plus hemodynamic instability or LBBB plus Sgarbossa criteria should probably still result in acute reperfusion therapy. (medscape.com)
Therapies2
  • 3 4 5 6 Higher mortality during off-hours may be attributed to a lower likelihood of receiving evidence based treatment or timely reperfusion therapies. (bmj.com)
  • There are no effective therapies to limit ischemia-reperfusion injury, which is caused by multiple pathways activated by rapid tissue reoxygenation and the generation of reactive oxygen species (ROS). (ox.ac.uk)
Infarct11
  • Previous experimental/simulation study suggested a terminal T-wave inversion (TTWI) in ischemia-related ECG leads corresponding to anterior infarct localization as an independent predictor of reperfusion VF (rVF). (lu.se)
  • Infarct size was largest in patients with STEMI onset in the dark-to-light transition period (6:00-noon), with an increase in peak CK and TnI concentrations of 18.3% (p=0.031) and 24.6% (p=0.033), respectively, compared with onset of STEMI in the 18:00-midnight period. (bmj.com)
  • Conclusions Significant circadian oscillations in infarct size were found in patients according to time-of-day of STEMI onset. (bmj.com)
  • The infarct size was found to be significantly larger with STEMI onset in the dark-to-light transition period (6:00-noon). (bmj.com)
  • These studies demonstrated a reduction in infarct size and improvement in clinical end points with early administration of intravenous beta-blocker therapy in animal models of STEMI as well as in patients presenting with STEMI. (hcplive.com)
  • 2 Paradoxically, reperfusion itself can enlarge the infarct size, by complex mechanisms collectively termed ischemia/reperfusion injury. (dovepress.com)
  • 3 In 2003, Zhao and et all published experimental data demonstrating a considerable reduction of infarct size by a reperfusion procedure termed ischemic postconditioning (IPost), consisting of brief, repetitive cycles of reperfusion and reocclusion, followed by sustained reperfusion. (dovepress.com)
  • Routine use of intra-aortic balloon counterpulsation (IABC) in STEMI patients who do not have cardiogenic shock does not reduce infarct size, according to a new trial. (jwatch.org)
  • Short-term cardiac stress, induced by ischemia-reperfusion (I/R) injury resulted in impaired left ventricular (LV) recovery and increased infarct size in heterozygous Hmox1-deficient (Hmox1 +/− ) mice [ 55 ]. (springer.com)
  • Elevated glucose is present in about half of all STEMI patients admitted to hospitals, and this hyperglycemia has been thought to increase the chance of reperfusion injury after treatment aimed at minimizing infarct size. (diabetesjournals.org)
  • Compared with STEMI patients with normal glucose levels, hyperglycemic patients had a larger average area at risk and larger final median infarct size. (diabetesjournals.org)
Infarction4
  • infarction (STEMI, a type of heart attack) can reduce the Over the 5-year period, there was a 26% increase in the use of size of the infarction and the incidence of mortality. (cdc.gov)
  • Conclusion This systematic review suggests that patients with acute myocardial infarction presenting during off-hours have higher mortality, and patients with STEMI have longer door to balloon times. (bmj.com)
  • In the Clopidogrel and Metoprolol in Myocardial Infarction Trial (COMMIT), 45,852 patients within 24 hours of suspected STEMI were randomized to intravenous and continued oral metoprolol or placebo. (hcplive.com)
  • Tocilizumab appears to improve myocardial salvage by helping tamp down the inflammatory overshoot that occurs during infarction and reperfusion. (the-hospitalist.org)
Approach to reperfusion1
PPCI6
  • Methods 464 patients with STEMI (63.0±11.9 years, 355 men) who underwent successful pPCI were enrolled and followed for 2.5 years. (bmj.com)
  • Conclusions Patients with STEMI receiving pPCI with lower apelin-12 are more likely to suffer MACEs in hospital and 2.5 years postprocedure, particularly in those with normal eGFR levels. (bmj.com)
  • Three distinct pathophysiological processes are critical in the development of 'no reflow' after PPCI for STEMI: distal embolization, ischemia-reperfusion injury, and individual susceptibility [ 4 ]. (biomedcentral.com)
  • We tested the feasibility, safety and potential utility of FDY-5301 as a treatment to limit ischemia-reperfusion injury, in patients with first-time STEMI undergoing emergency PPCI. (ox.ac.uk)
  • METHODS: STEMI patients (n = 120, median 62 years) presenting within 12 h of chest pain onset were randomized at 20 PPCI centers, in a double blind Phase 2 clinical trial, to receive FDY-5301 (0.5, 1.0 or 2.0 mg/kg) or placebo prior to reperfusion, to evaluate the feasibility endpoints. (ox.ac.uk)
  • CONCLUSIONS: Intravenous FDY-5301, delivered immediately prior to PPCI in acute STEMI, is feasible, safe, and shows potential efficacy. (ox.ac.uk)
Myocardium4
  • [ 7 ] Ischemia, reperfusion, hypoxia, drugs, and electrolyte abnormalities can all accelerate the phase 4 action potential depolarization rates in His-Purkinje fiber and myocardium, leading to faster spontaneous cell depolarization (enhanced automaticity). (medscape.com)
  • This coupled comorbidity of pathological ischemia and therapeutic reinjury of infarcted myocardium, namely, myocardial ischemia-reperfusion injury (MIRI), is particularly refractory to treatment [ 4 , 5 ]. (hindawi.com)
  • Background The pathophysiology and prognostic significance of remote myocardium in the natural history of STEMI is uncertain. (dundee.ac.uk)
  • The door-to-balloon time version of the time is muscle theory assumes a linear relationship between time to reperfusion and amount of myocardium salvaged. (emcrit.org)
Early reperfusion1
  • While effective early reperfusion of the criminal coronary artery after a confirmed AMI is the typical treatment at present, collateral myocardial ischemia-reperfusion injury (MIRI) and pertinent cardioprotection are still challenging to address and have inadequately understood mechanisms. (hindawi.com)
Mortality3
  • A diagnosis of STEMI and countries outside North America were associated with larger increase in mortality during off-hours. (bmj.com)
  • 1 However, in spite of revascularization and adjunctive medical treatment, mortality and morbidity after STEMI are still high. (dovepress.com)
  • After a 5-hour period in which outcomes remain relatively stable, myocardial reperfusion becomes suboptimal and mortality increases. (eur.nl)
Methods1
  • Methods A retrospective single-centre analysis of 811 patients with STEMI admitted between 2003 and 2009 was performed. (bmj.com)
Symptoms8
  • This group was evaluated for the risk factors, presenting symptoms, killip class, type of acute coronary syndrome (STEMI vs NSTEMI), time to presentation to hospital, treatment received (medical management/thrombolysis/PCI/CABG), cardiac arrhythmias, mean ejection fraction, HRCT chest (CORADS grading), any complications and immediate outcome. (scialert.net)
  • If there are clinical signs and symptoms of failure of the fibrinolytic agent to achieve reperfusion, then rescue PCI is performed to open the totally occluded artery. (wikidoc.org)
  • The strategy differs from facilitated PCI, a strategy in which the intent is to administer a fibrinolytic agent, and routinely perform PCI in the majority of patients even in the presence of or irrespective of signs and symptoms of successful fibrinolytic reperfusion. (wikidoc.org)
  • If there are clinical signs and symptoms of incomplete reperfusion, then adjunctive PCI is performed to further open a patent artery (one with TIMI grade 2 or 3 flow). (wikidoc.org)
  • An examination of the individual time intervals that occur from initial STEMI symptoms to PCI shows a pattern of greater delays in women than men, both before and after hospital arrival. (tctmd.com)
  • However, longer healthcare delays have been described even in women with typical symptoms, suggesting a healthcare worker bias may still exist with women perceived as lower risk for STEMI. (tctmd.com)
  • There was an average difference in reperfusion time of 60 minutes between the two treatment arms.In patients whose symptoms began less than 2 hours earlier, those who received PHF fared better than those who received PCI. (emcrit.org)
  • For at least 2 decades, we've been taught that patients presenting with cardiac symptoms plus a presumed-new left bundle branch block (LBBB) pattern on the ECG should be treated for STEMI and receive thrombolytic medications or immediate cardiac catheterization. (medscape.com)
Onset3
  • Time of STEMI onset was divided into four 6-hour periods in phase with circadian rhythms. (bmj.com)
  • Reperfusion therapy, preferably primary PCI, should be administered to eligible patients with STEMI and symptom onset within the previous 12 hours. (aafp.org)
  • Times were broken down into patient delays and healthcare system delays (prehospital and in-hospital), and then further broken down to include symptom onset, emergency medical services (EMS) call, first medical contact, ECG acquisition, departure to hospital, arrival at hospital, and reperfusion. (tctmd.com)
NSTEMI1
  • Distinction between NSTEMI and STEMI is vital as treatment strategies are different for these two entities. (msdmanuals.com)
Fibrinolytic3
  • In the absence of contraindications, fibrinolytic therapy should be administered to patients with STEMI at non-PCI-capable hospitals when the anticipated first medical contact to device time at a PCI-capable hospital exceeds 120 minutes. (aafp.org)
  • Facilitated PCI is defined as the intent to perform a PCI (either conventional balloon angioplasty or coronary stent placement) in the setting of STEMI following treatment with either a full dose or half dose of a fibrinolytic agent. (wikidoc.org)
  • Rescue PCI is defined as the intent to administer a fibrinolytic agent in the setting of STEMI, and the performance of PCI for failure of the fibrinolytic agents is unintended. (wikidoc.org)
Catheterization4
  • Hospital catheterization labs can be notified by EMS personnel in the field or by emergency physicians after receiving the transmitted ECG (electrocardiogram) indicating a STEMI heart attack from EMS, which reduces time to the PCI procedure. (eurekalert.org)
  • Medical record search was for "STEMI" which would exclude those patients who "rule in" by biomarkers and have coronary occlusion on subsequent catheterization. (rebelem.com)
  • The guidelines now have made it clear that unfractionated heparin is preferred for patients with STEMI who are going for emergent catheterization. (medscape.com)
  • The guidelines now give a Class I rating to the use of both therapeutic hypothermia and emergent cardiac catheterization for surviving victims of cardiac arrest who demonstrate STEMI on the ECG. (medscape.com)
Therapy3
  • Conclusions G-CSF therapy may be beneficial in attenuating ventricular remodelling subsequent to a large anterior STEMI in the long term. (bmj.com)
  • Despite advancements in restoring epicardial artery patency via reperfusion therapy, microvascular obstruction (MVO) limits cardiovascular recovery at the tissue level and results in poorer prognosis, including death. (hhs.gov)
  • Organisation of reperfusion therapy for STEMI in a developing country. (ui.ac.id)
Outcomes2
  • The opinion piece published in conjunction with this article by Dr. Eric Bates and Dr. Alice Jacobs (2), postulates that we have reached the nadir of door-to-balloon time and to further improve STEMI outcomes we must now focus on prehospital time. (emcrit.org)
  • A larger trial is justified to test the effects of FDY-5301 on acute ischemia-reperfusion injury and clinical outcomes. (ox.ac.uk)
Injury5
  • 3 In a previous study, different pharmacological principles that aimed to reduce ischemia/reperfusion injury failed to show effect. (dovepress.com)
  • The preclinical work focuses on animal models of myocardial ischemia-reperfusion injury, which is an experimental model for STEMI, as well as ex-vivo models of myocardial ischemia. (gu.se)
  • However, while myocardial reperfusion is well established, the process itself can trigger myocardial reperfusion injury by causing further cardiomyocyte death through multiple pathophysiological mechanisms [ 3 - 5 ]. (hindawi.com)
  • Conceptual diagram of the development and unknown mechanisms of myocardial ischemia-reperfusion injury. (hindawi.com)
  • Conclusions Reperfusion injury and inflammation early post-MI was associated with remote zone T1, which in turn was independently associated with LV remodeling and adverse cardiac events post-STEMI. (dundee.ac.uk)
Myocardial salvage1
  • Exenatide, which has been shown to have a cardioprotective effect in patients with STEMI, was used in the new study to evaluate the cardioprotective effects of this glucose-lowering treatment in 210 STEMI patients with and without diabetes, as well as the effect of hyperglycemia on area at risk and myocardial salvage index. (diabetesjournals.org)
Primary5
  • The aim of this study was to test if terminal T-wave inversion (TTWI) at admission ECG (before reperfusion) can serve as a predictor of ventricular fibrillation during reperfusion (rVF) in patients with anterior STEMI undergoing primary PCI. (lu.se)
  • In contrast, some patients with STEMI may undergo a PCI during hospitalization that is not considered primary. (jointcommission.org)
  • It still continues to be used as the primary reperfusion treatment in a number of countries where primary PCI facilities are not imminently available. (wikidoc.org)
  • A Randomized, double-blind, dose ranging clinical trial of intravenous FDY-5301 in acute stemi patients undergoing primary PCI. (ox.ac.uk)
  • Between November 2006 and January 2007, we conducted a cross-sectional study of all U.S. hospitals that joined the D2B Alliance as of June 2007 (n = 915), all of which perform primary PCI for patients with STEMI. (biomedcentral.com)
Guideline2
  • 1 This article focuses on the treatment of ACS based on the 2013 American College of Cardiology Foundation (ACCF) /AHA guideline for the management of STEMI 4 and the 2014 ACC/AHA guideline for the management of NSTE-ACS. (aafp.org)
  • 6 The atherosclerotic cardiovascular disease risk estimator is available online and in mobile app format at http://my.americanheart.org/cvrisk calculator and at http://www.cardiosource.org/en/Science-And-Quality/Practice-Guidelines-and-Quality-Standards/2013-Prevention-Guideline-Tools.aspx . (aafp.org)
Cohort1
  • We aimed to investigate the comparative predictive values of different biomarkers for the occurrence of MVO in a large cohort of reperfused STEMI patients. (biomedcentral.com)
Treatment2
  • This is not a discussion of the treatment options for STEMI but merely a comparison of PCI and thrombolytics to demonstrate the non-linear effect of time on myocardial necrosis. (emcrit.org)
  • EMS continues to be viewed as only a 'ride' but utilizing EMS as part of the healthcare system not only allows for treatment from the time they arrive at your door, but also has been proven to shorten time to reperfusion treatment faster. (eurekalert.org)
Hospitals4
  • These data are used to provide reports to hospitals and regional systems of care, allowing them to assess their performance and improve the quality of STEMI-related care. (cdc.gov)
  • Mission: Lifeline, "one of the largest quality improvement efforts in STEMI ever attempted," is a voluntary AHA-led program for hospitals that began in 2008. (cdc.gov)
  • The data included STEMI patients from 19 hospitals participating in Mission: Lifeline, an American Heart Association initiative to improve STEMI systems of care. (eurekalert.org)
  • As of 2007, many hospitals had implemented few of the key strategies to reduce D2B time, suggesting substantial opportunity to improve care for patients with STEMI. (biomedcentral.com)
Anterior1
  • Patients with anterior wall STEMI also had significantly larger infarcts than those with STEMI in other locations. (bmj.com)
Cardioprotective1
  • If confirmed, these results may have a significant impact on the interpretation of clinical trials of cardioprotective strategies in STEMI. (bmj.com)
20211
  • Although patient delays are important, we found that the largest component of time delay in women with STEMI was actually healthcare system delays (prehospital system and hospital delays)," write Julia Stehli, MD (Monash University, Melbourne, Australia), and colleagues in the paper, which was published online June 22, 2021, in the Journal of the American Heart Association . (tctmd.com)
Thrombolysis1
Fibrinolytics1
  • Based on the results of these trials and in the absence of the data to the contrary, it is clear that routine intravenous beta-blockers have no value in the management of STEMI patients who are treated with fibrinolytics. (hcplive.com)
Hospital7
  • 2013 guidelines for managing STEMI recommend that "all communities should create and maintain a regional system of STEMI care that includes assessment and continuous quality improvement of emergency medical services (EMS) and hospital-based activities. (cdc.gov)
  • Patients with STEMI should be transferred to a PCI-capable hospital for angiography after successful fibrinolysis. (aafp.org)
  • Only 5 patients (23.8%) in the STEMI group presented to the hospital within the window period. (scialert.net)
  • Delays in time from arrival at a PCI-capable hospital to reperfusion occurred despite similar numbers of men and women being transported to a PCI-capable, "from which we can infer that a STEMI or at least an acute coronary syndrome was suspected in all of these patients," they add. (tctmd.com)
  • The assumption was that this study would prove that all the resources invested had proved their worth, including training an army of cardiologists to be on 24 hour call and mobilizing a pre-hospital system to quickly and effectively deliver our chest pain patients to certified STEMI centers which were equipped with state of the art cath labs designed to be ready for action at a moments notice. (emcrit.org)
  • Their unique capabilities to delivery lifesaving care en-route to the hospital should not be underestimated. (eurekalert.org)
  • The American Heart Association created Mission: Lifeline to enhance existing STEMI systems of care and integrate out-of-hospital cardiac resuscitation and other life-saving techniques into these systems to improve patients' chances for survival. (eurekalert.org)
Inferior4
  • Time was so valuable in the first few hours that the delay to intervention involved in performing PCI is important enough to make tPA (overall an inferior choice for reperfusion) superior or equivalent to PCI. (emcrit.org)
  • Is This an Inferior STEMI or Pericarditis? (rebelem.com)
  • One specific set of diagnoses that can be very difficult to distinguish from each other is inferior STEMI vs Pericarditis. (rebelem.com)
  • Inferior STEMI groups were significantly longer than pericarditis group (Difference of 26.2msec). (rebelem.com)
Guidelines1
  • In EM Viewpoints in 2010 , we questioned that practice, and now new LBBB has finally been removed from the guidelines as an indication for emergent reperfusion. (medscape.com)
Intervention1
  • For patients with STEMI and cardiogenic shock, IABC remains a frequently used intervention. (jwatch.org)
Time4
  • A significant inverse correlation was detected in G-CSF patients between the number of circulating CD34 cells at 30 days after reperfusion and the 3-year absolute and indexed LVEDV (ρ=−0.71, 95% CI −0.90 to −0.30, and ρ=−0.62, −0.86 to −0.14, respectively), or their change over time (r=−0.59, −0.85 to −0.11, and r=−0.55, −0.83 to −0.06, respectively). (bmj.com)
  • Some things specific to female STEMI presentation such as nausea, radiation of pain, and shortness of breath may "lead to an initial misdiagnosis at the time of EMS phone call and the delay in EMS call-to-FMC seen in women," the researchers note. (tctmd.com)
  • As far back as ISIS 2 (3), it was shown that the time is muscle theory is only true in the hyper-acute phase of a STEMI. (emcrit.org)
  • Early in the disease process (within the first 2 hours) the difference between the interventions is far less, because in this stage of a STEMI time actually does matter and the small delay to get to the cath lab has an effect. (emcrit.org)
ACCF1
  • Every few years, the American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) jointly revise their recommendations for management of patients with STEMI. (medscape.com)