scholarly journals 2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion

2019 ◽  
Vol 35 (2) ◽  
pp. 107-132 ◽  
Author(s):  
Graham C. Wong ◽  
Michelle Welsford ◽  
Craig Ainsworth ◽  
Wael Abuzeid ◽  
Christopher B. Fordyce ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Interventional Cardiology ◽  
St Elevation Myocardial Infarction ◽  
Acute Management ◽  
Canadian Cardiovascular Society ◽  
Canadian Association ◽  
St Elevation

COMBINATION OF SST2 AND BNP IN PREDICTING THE MORTALITY OF ST- ELEVATION MYOCARDIAL INFARCTION

2016 ◽  
pp. 61-68
Author(s):  
Anh Tien Hoang ◽  
Thị Thanh Truc Tran ◽  
Thanh Nhan Vo
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Interleukin 1 ◽  
Interventional Cardiology ◽  
Serum Levels ◽  
St Elevation Myocardial Infarction ◽  
Cardiac Events ◽  
Cardiac Outcomes ◽  
Cardiology Department ◽  
St Elevation

Background: Serum levels of ST2 are associated with prognosis in nonischemic heart failure, but the predictive value of ST2 in patients with ST elevation myocardial infarction is unknown. Methods: The study included 38 STEMI patients at Interventional Cardiology department of Cho ray hospital. Correlation analysis was used to identify the relationship between the cardiac outcomes within 30 days from the onset of chest pain and sST2 value. Results: ST2 levels were measured in serum from 38 patients with STEMI. Baseline levels of ST2 were significantly higher in those patients who died (<35 ng/ml versus >35 ng/mL, P=0,01) or developed new congestive heart failure (< 35 ng/ml versus > 35 ng/mL, P=0.002) by 30 days. In an analysis of outcomes at 30 days by ST2 quartiles, both death (P=0.01) and the combined death/heart failure end point (p=0.001) showed a significant graded association with levels of ST2. Furthermore, when sST2 > 35 ng/ml and BNP > 500 pg/ml showed a tightly relationship with cardiac outcomes within 30 days (P<0,0001). Conclusions: Serum levels of the interleukin-1 receptor family member ST2 predict mortality and heart failure in patients with STEMI. These data suggest that ST2 and BNP are the useful biomarker in short-term prognosis of cardiac events in STEMI. Key words: sST2, BNP, STEMI, cardiac outcomes

Primary percutaneous coronary intervention for ST elevation myocardial infarction

2010 ◽  
pp. 253-277
Author(s):  
Zulfiquar Adam ◽  
Mark A. de Belder
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Interventional Cardiology ◽  
Coronary Intervention ◽  
Primary Angioplasty ◽  
St Elevation Myocardial Infarction ◽  
Pilot Studies ◽  
Percutaneous Coronary ◽  
St Elevation

One of the first reports on the use of intravenous thrombolysis in the treatment of acute myocardial infarction (AMI) was published 50 years ago when Fletcher and colleagues described the use of intravenous streptokinase to restore the patency of arteries occluded by thrombus. However, it was not until the early 1980s that the real impetus towards the ‘open artery’ concept was realised when an angiographic study defined the high prevalence of total coronary occlusion in the early hours of AMI. By this time, the era of interventional cardiology had begun and in 1978 there had already been pilot studies of mechanically opening the infarct-related artery (IRA) as well as selective use of intracoronary streptokinase. In 1983, Hartzler and colleagues reported a small case series on the feasibility of percutaneous transluminal coronary angioplasty (PTCA) during AMI in patients treated with and without prior thrombolysis. The use of angioplasty as the main means of opening an occluded vessel (i.e. instead of thrombolysis) was termed ‘primary angioplasty’ but now, in the era of intracoronary stents and other devices, is referred to as primary percutaneous coronary intervention (PPCI). During the early 1980s, interventional cardiology was in its infancy and with the lack of suitably trained operators and interventional facilities there was limited development of PPCI. Instead, a number of trials published in the mid-1980s demonstrated a significant benefit from intravenous thrombolytic therapy. A meta-analysis of nine trials with 58 600 patients showed a reduction in mortality at 35 days from 11.5% in control subjects to 9.6%. Although thrombolysis became a mainstream treatment, its limitations also became apparent and with the development of interventional techniques there was renewed interest in primary angioplasty. The simultaneous publication of the Primary Angioplasty in Myocardial Infarction (PAMI), Zwolle, and Mayo clinic trials in 1993 paved the way for PPCI as the preferred therapy for the treatment of ST elevation myocardial infarction (STEMI).

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