Correlation of infarct size with invasive hemodynamics in patients with ST-elevation myocardial infarction

2018 ◽  
Vol 92 (5) ◽  
pp. E333-E340 ◽  
Author(s):  
Allie E. Goins ◽  
Robert Rayson ◽  
Melissa C. Caughey ◽  
Michael Sola ◽  
Kiran Venkatesh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Invasive Hemodynamics

scholarly journals 541 Reperfusion Strategy and Infarct Size in ST-Elevation Myocardial Infarction (STEMI)

2020 ◽  
Vol 29 ◽  
pp. S280
Author(s):  
C. Said ◽  
A. Bland ◽  
S. Casinader ◽  
M. Parkinson ◽  
P. Bamford ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Reperfusion Strategy

Effect of remote ischemic conditioning on infarct size in patients with anterior ST-elevation myocardial infarction

2016 ◽  
Vol 181 ◽  
pp. 66-73 ◽  
Author(s):  
Dinos Verouhis ◽  
Peder Sörensson ◽  
Andrey Gourine ◽  
Loghman Henareh ◽  
Jonas Persson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
St Elevation Myocardial Infarction ◽  
Remote Ischemic Conditioning ◽  
Ischemic Conditioning ◽  
St Elevation

scholarly journals Metformin is associated with reduced myocardial infarct size in diabetic patients with ST elevation myocardial infarction

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P1309-P1309
Author(s):  
C. P. H. Lexis ◽  
W. G. Wieringa ◽  
B. Hiemstra ◽  
V. M. Van Deursen ◽  
E. Lipsic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
Myocardial Infarct ◽  
St Elevation Myocardial Infarction ◽  
Diabetic Patients ◽  
Myocardial Infarct Size ◽  
St Elevation

scholarly journals Temporal Course of Plasma Trimethylamine N-Oxide (TMAO) Levels in ST-Elevation Myocardial Infarction

2021 ◽  
Vol 10 (23) ◽  
pp. 5677
Author(s):  
Mohammad A. Almesned ◽  
Femke M. Prins ◽  
Erik Lipšic ◽  
Margery A. Connelly ◽  
Erwin Garcia ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Renal Function ◽  
Infarct Size ◽  
Impaired Renal Function ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Temporal Course ◽  
St Elevation

The gut metabolite trimethylamine N-oxide (TMAO) at admission has a prognostic value in ST-elevation myocardial infarction (STEMI) patients. However, its sequential changes and relationship with long-term infarct-related outcomes after primary percutaneous coronary intervention (PCI) remain elusive. We delineated the temporal course of TMAO and its relationship with infarct size and left ventricular ejection fraction (LVEF) post-PCI, adjusting for the estimated glomerular filtration rate (eGFR). We measured TMAO levels at admission, 24 h and 4 months post-PCI in 379 STEMI patients. Infarct size and LVEF were determined by cardiac magnetic resonance 4 months after PCI. TMAO levels decreased from admission (4.13 ± 4.37 μM) to 24 h (3.41 ± 5.84 μM, p = 0.001) and increased from 24 h to 4 months (3.70 ± 3.86 μM, p = 0.026). Higher TMAO values at 24 h were correlated to smaller infarct sizes (rho = −0.16, p = 0.024). Larger declines between admission and 4 months suggestively correlated with smaller infarct size, and larger TMAO increases between 24 h and 4 months were associated with larger infarct size (rho = −0.19, p = 0.008 and rho = −0.18, p = 0.019, respectively). Upon eGFR stratification using 90 mL/min/1.73 m2 as a cut-off, significant associations between TMAO and infarct size were only noted in subjects with impaired renal function. In conclusion, TMAO levels in post-PCI STEMI patients are prone to fluctuations, and these fluctuations could be prognostic for infarct size, particularly in patients with impaired renal function.

Abstract 16538: Circulating Ketone Levels are Associated With Myocardial Infarct Size and Left Ventricular Function in Patients Presenting With St-Elevation Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Marie Sophie L de Koning ◽  
B. D Westenbrink ◽  
Solmaz Assa ◽  
Dirk J van Veldhuisen ◽  
Robin P Dullaart ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Infarct Size ◽  
Ventricular Function ◽  
Myocardial Infarct ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Myocardial Infarct Size ◽  
St Elevation

Background: Circulating ketone bodies (KB) are increased in patients with heart failure, corresponding with increased utilization of KB as a cardiac fuel. Whether circulating KB are increased in patients presenting with ST-elevation myocardial infarction (STEMI) and whether this is associated with infarct size is unknown. Methods: KB were measured in 379 non-diabetic participants of the Glycometabolic Intervention as Adjunct to Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction (GIPS) III trial (Clinicaltrial.gov Identifier: NCT01217307). Non-fasting plasma concentrations of the KB beta-hydroxybutyrate, acetoacetate, acetone were measured at presentation, 24 hours and 4 months after STEMI presentation using nuclear magnetic resonance spectroscopy. Associations of circulating KB with myocardial infarct size and left ventricular ejection fraction (both detected with MRI at 4 months after STEMI) were determined using multivariable linear regression analyses. Results: Circulating KB were higher at baseline (total KB 520 [315-997](median [IQR], μmol/L), compared to 206 [174-246] at 24 hours and 166 [143-201] at 4 months ( P <0.001 for all)). KB at 24 hours were positively associated with enzymatic infarct size, HbA1C and beta-blocker use. KB at 24 hours were independently associated with MRI outcomes at 4 months. Higher KB was associated with larger myocardial infarct size (total KB: standardized β=0.17, 95%-confidence interval (CI) (0.04-0.31), P =0.012) and lower ejection fraction (standardized β=-0.15, 95%-CI (-0.29- -0.009), P =0.037). Conclusion: Circulating KB are increased in patients with STEMI and are independently associated with myocardial infarct size and left ventricular function after 4 months of follow-up. The increase in circulating KB may reflect maladaptive changes of myocardial metabolism during the acute phase.

Abstract 3008: Intracoronary Compared with Intravenous Bolus Abciximab Application in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Coronary Intervention The randomized Leipzig Immediate PercutaneouS Coronary Intervention Abciximab i.v. versus i.c. in ST-Elevation Myocardial Infarction Trial (LIPSIAbciximab-STEMI)

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Holger Thiele ◽  
Kathrin Schindler ◽  
Josef Friedenberger ◽  
Ingo Eitel ◽  
Georg Fürnau ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Infarct Size ◽  
Microvascular Obstruction ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Bolus Administration ◽  
Cardiac Events ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary ◽  
St Elevation

Background Abciximab reduces major adverse cardiac events in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention (PCI). Intracoronary bolus application of abciximab results in high local drug concentrations and may be more effective than standard intravenous bolus application for reduction of infarct size, no-reflow and improvement in perfusion. Methods Patients undergoing primary PCI were randomized to either intracoronary (n=77) or intravenous (n=77) bolus administration of abciximab with subsequent 12 hour intravenous infusion. Primary endpoint was infarct size and extent of microvascular obstruction assessed by delayed enhancement magnetic resonance. Secondary endpoints were ST-resolution at 90 minutes, Thrombolysis in Myocardial Infarction (TIMI)-flow and perfusion grade post PCI, and the occurrence of major adverse cardiac events within 30 days. Results The primary endpoint infarct size could be reduced by absolute 7% (17.7% i.c. versus 24.7% i.v., p=0.005). Similarly, the extent of microvascular obstruction was significantly smaller in i.c. patients in comparison to i.v. patients (p=0.02). Myocardial perfusion measured as early ST-segment resolution was significantly improved in i.c. patients with an absolute ST-resolution of 76±23% versus 64±31% (p=0.009). The TIMI flow after PCI was not different between treatment groups (p=0.51), but there was a trend towards an improved perfusion grade (p=0.12). There was a trend towards a higher major adverse cardiac event rate after intravenous versus intracoronary abciximab application (15.6% versus 5.2%, p=0.06; relative risk 3.00; 95% confidence intervals 0.94 –10.80). Conclusions: Intracoronary bolus administration of abciximab is superior to standard intravenous treatment with respect to infarct size, extent of microvascular obstruction, and perfusion in primary PCI. An adequately powered trial for major adverse cardiac event reduction is warranted.

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