scholarly journals CRT-114 Echocardiographic Left Ventricular Hypertrophy Predicts In-hospital Heart Failure in Patients with Non-ST Elevation Myocardial Infarction

2015 ◽  
Vol 8 (2) ◽  
pp. S12
Author(s):  
Naoki Misumida ◽  
Akihiro Kobayashi ◽  
John Fox ◽  
Yumiko Kanei
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

Electrocardiographic Criteria for ST-Elevation Myocardial Infarction in Patients With Left Ventricular Hypertrophy

2012 ◽  
Vol 110 (7) ◽  
pp. 977-983 ◽  
Author(s):  
Ehrin J. Armstrong ◽  
Ameya R. Kulkarni ◽  
Prashant D. Bhave ◽  
Kurt S. Hoffmayer ◽  
John S. MacGregor ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular Hypertrophy ◽  
Ventricular Hypertrophy ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals Culprit vessel: impact on short-term and long-term prognosis in patients with ST-elevation myocardial infarction

Open Heart ◽  
2018 ◽  
Vol 5 (2) ◽  
pp. e000852 ◽  
Author(s):  
Artin Entezarjou ◽  
Moman Aladdin Mohammad ◽  
Pontus Andell ◽  
Sasha Koul
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
High Risk ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Clinical Event ◽  
Left Ventricular Ejection ◽  
Increased Risk ◽  
St Elevation ◽  
The Impact

BackgroundST-elevation myocardial infarction (STEMI) occurs as a result of rupture of an atherosclerotic plaque in the coronary arteries. Limited data exist regarding the impact of culprit coronary vessel on hard clinical event rates. This study investigated the impact of culprit vessel on outcomes after primary percutaneous coronary intervention (PCI) of STEMI.MethodsA total of 29 832 previously cardiac healthy patients who underwent primary PCI between 2003 and 2014 were prospectively included from the Swedish Coronary Angiography and Angioplasty Registry and the Registry of Information and Knowledge about Swedish Heart Intensive care Admissions. Patients were stratified into three groups based on culprit vessel (right coronary artery (RCA), left anterior descending artery (LAD) and left circumflex artery (LCx)). The primary outcome was 1-year mortality. The secondary outcomes included 30-day and 5-year mortality, as well as heart failure, stroke, bleeding and myocardial reinfarction at 30 days, 1 year and 5 years. Univariable and multivariable analyses were done using Cox regression models.ResultsOne-year analyses revealed that LAD infarctions had the highest increased risk of death, heart failure and stroke compared with RCA infarctions, which had the lowest risk. Sensitivity analyses revealed that reduced left ventricular ejection fraction on discharge partially explained this increased relative risk in mortality. Furthermore, landmark analyses revealed that culprit vessel had no significant influence on 1-year mortality if a patient survived 30 days after myocardial infarction. Subgroup analyses revealed female sex and multivessel disease (MVD) as significant high-risk groups with respect to 1-year mortality.ConclusionsLAD and LCx infarctions had a relatively higher adjusted mortality rate compared with RCA infarctions, with LAD infarctions in particular being associated with an increased risk of heart failure, stroke and death. Culprit vessel had limited influence on mortality after 1 month. High-risk patient groups include LAD infarctions in women or with concomitant MVD.

Abstract 16700: Mineralocorticoid Receptor Antagonist Utilization in Eligible Patients Post St-elevation Myocardial Infarction

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hamed Nazzari ◽  
Krishnan Ramanathan ◽  
Carolyn Taylor ◽  
Marc Deyell ◽  
Jasmine Grewal ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Mineralocorticoid Receptor ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Ejection ◽  
Mineralocorticoid Receptor Antagonist ◽  
Ventricular Ejection Fraction ◽  
St Elevation ◽  
The Mean

Background: Mineralocorticoid receptor antagonists (MRAs) have been shown to reduce the morbidity and mortality in patients with reduced left ventricular ejection fraction (LVEF) post myocardial infarction (MI). Canadian guidelines recommend a MRA in patients post MI with an LVEF of ≤40% and documented heart failure or diabetes before hospital discharge, in the absence of any contraindications. We sought to examine if discrepancies between guideline-based therapy and actual prescribing rates exists in the use of MRAs in acute ST-elevation myocardial infarction (STEMI) patients. Methods: Retrospective analysis of utilization rates of MRAs in eligible patients enrolled in the Vancouver Coastal Health Authority STEMI database between October 2007 and October 2014. Inclusion criteria were based on the EPHESUS trial, which included an LVEF <40% and documented heart failure or history of diabetes. Patients on dialysis or with a serum Cr >221 were excluded. Results: 2583 patients had a STEMI during the study period. 192 (7.4%) patients were determined to be eligible for MRA prescription at discharge, 32 were excluded due missing discharge prescription information. Of the remaining 160 patients, the mean age was 67.9, 71.3% were male, 72.5% had an anterior MI and the mean LVEF was 30.4%. During hospitalization 51.6% had clinical evidence of HF and 21.3% were diagnosed with cardiogenic shock. PCI was performed in 75.6% of those eligible and 11.3% underwent CABG, 11.9% were medically managed and 1.25% underwent thrombolysis as a final revascularization strategy. On discharge 98% were on ASA, 81.3% on a second anti-platelet agent, 96% were on a beta-blocker, 75.6% were on an ACEi, 15.6% were on an ARB, 99.4% were on a statin. Only 22 (13.8%) of eligible patients were discharged on an MRA. No significant clinical difference existed amongst those that received an MRA compared to those that did not. Conclusions: Despite a Class IA recommendation for the use of MRAs in this patient population, our study demonstrates that the majority of patients are not prescribed an MRA after STEMI. This demonstrates a large care gap between evidence based guidelines and clinical practice. The reasons for this discrepancy in practice patterns are unclear and will be the focus of further study.

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