scholarly journals Left ventricle remodeling electrocardiography criteria of survival assessment in Q-wave myocardial infarction patients

2013 ◽  
Vol 94 (2) ◽  
pp. 168-175
Author(s):  
G M Khayrutdinova
Keyword(s):  
Myocardial Infarction ◽  
Overall Survival ◽  
Left Ventricle ◽  
Alcohol Intoxication ◽  
Heart Diseases ◽  
Survival Rates ◽  
Cardiac Events ◽  
Left Ventricle Remodeling ◽  
Q Wave

Aim. To study the survival in patients with Q-wave myocardial infarction depending on features of left ventricle remodeling on electrocardiography. Methods. 10-year overall survival and heart diseases associated survival rates depending on features of left ventricle remodeling on electrocardiography were studied in 87 patients who had survived an acute myocardial infarction with Q wave. The first group included 45 patients who fulfilled electrocardiographic criteria for left ventricle adaptive remodeling, the second group included 42 patients with electrocardiographic features of left ventricle maladaptive remodeling. The survival in both groups was estimated using the Kaplan-Meier’s curves. Results. There was a highly significant inverse relationship between age and survival rate of the patients with Q-positive myocardial infarction. 40 patients succumbed by the end of the observation period, among them - 20 (50%) due to heart diseases. 20 (50%) patients died from non-cardiac events, among them - ischaemic stroke, neoplasms and accidents (most common - alcohol intoxication, 5,8% each). Chronic heart failure was most common reason of death in both groups, and it prevailed in the group of patients with left ventricle maladaptive remodeling electrocardiographic features. According to the gained data, there were no significant differences observed in overall survival in both groups during the whole follow-up period. In assessment of survival associated with heart diseases, the differences close to the statistically significant were found. Conclusion. The comparison of the overall survival depending on left ventricle remodeling electrocardiographic features did not detect any reliable differences, while in case of heart diseases associated survival assessment differences close to the statistically significant were found.

scholarly journals Predictive Utility of NT-pro BNP for Infarct Size and Left Ventricle Function after Acute Myocardial Infarction in Long-Term Follow-Up

2013 ◽  
Vol 34 (3) ◽  
pp. 199-204 ◽  
Author(s):  
Paweł Kleczyński ◽  
Jacek Legutko ◽  
Tomasz Rakowski ◽  
Artur Dziewierz ◽  
Zbigniew Siudak ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Infarct Size ◽  
Left Ventricular ◽  
Left Ventricle Function ◽  
Left Ventricle Remodeling ◽  
Long Term Follow Up ◽  
Ventricle Function

PURPOSE: The aim of the study was to evaluate the utility of N-terminal pro-B-type natriuretic peptide (NT-pro BNP, pg/ml) assessment to predict infarct size and left ventricle function after ST-segment elevation myocardial infarction (STEMI) at long-term follow-up.METHODS: In 45 patients with first STEMI less than 3 hours from symptom onset treated with mechanical reperfusion NT-pro BNP was assessed early (at admission) and at 6 months. Cardiac magnetic resonance (CMR) parameters (delayed enhancement infarct size (IS, %), left ventricular end-diastolic (LVEDVI, ml/m2) and end-systolic (LVESVI, ml/m2) volume indexes) were assessed at 6 months.RESULTS: No significant correlation was found between baseline NT-pro BNP assessment and IS and left ventricle function after 6 months. There was a significant correlation between 6-month NT-pro BNP and IS (r= 0.65,p< 0.001) and left ventricle remodeling at 6 months (LVEDVI,r= 0.53,p= 0.001; LVESVI,r= 0.51,p= 0.002).CONCLUSIONS: Assessment of NT-pro BNP level 6 months after STEMI remains a good indicator of infarct size and left ventricle function at long-term follow-up.

Prognostic impact of SYNTAX II score in patients with cardiogenic shock complicating ST-elevation myocardial infarction: analysis of an 10-year all-comers registry

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Juskova ◽  
P Tasende Rey ◽  
B Cid Alvarez ◽  
B Alvarez Alvarez ◽  
J.M Garcia Acuna ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiogenic Shock ◽  
Independent Predictor ◽  
Coronary Intervention ◽  
Prognostic Impact ◽  
Cardiac Events ◽  
Prognostic Information ◽  
St Segment Elevation ◽  
All Cause Mortality

Abstract Background The SYNTAX II score (SS-II) can predict 4-year outcomes in patients with complex coronary artery disease and ST-segment elevation myocardial infarction (STEMI). Nonetheless, the prognostic value of SS-II for a cardiogenic shock (CS) in the setting of STEMI has not been assessed. Purpose This study aimed to investigate the predictive impact of SS-II in patients with CS complicating STEMI undergoing primary percutaneous coronary intervention, and whether SS-II adds prognostic information to predict major adverse cardiac events (MACE) and all-cause death in this population. Methods This prospective cohort study included 1965 consecutive patients with STEMI who underwent primary-PCI between January 2008 and December 2017. The cohort of patients with CS (n=153) was identified and divided into three groups based on SS-II tertiles [SS-II low tertile &lt;38 (n=51), ≥38 SS-II intermediate tertile &lt;47 (n=51), and SS-II high tertile ≥48 (n=51)]. Results Amongst the cohort of patients with CS mean age was 68.4±14.0 years, 69.2% were male and 51.6% presented with anterior STEMI (mean SSII was 45.1±14). In-hospital mortality was significantly higher in the high SS-II tertile (85.7% vs. 38.9% vs 24.4%, p≤0.001) compared with SS-II intermediate and low tertiles. During follow-up (median 2.5 years), SS-II was positively correlated with MACE (89.3% (high SS-II) vs. 52.8% (int SS-II) vs. 42.2% (low SS-II), p≤0.001), and with all-cause mortality (89.3% vs 44.4% vs 26.7%, p≤0.001). The SS-II was also an independent predictor of MACE (HR=1.042, 95% CI: 1.020–1.063, p=0.000) and all-cause mortality during follow-up (HR=1.056, 95% CI: 1.033–1.079, p=0.000) Conclusion In a real-world cohort of patients with STEMI related CS, the SS-II added important prognostic information, being an independent predictor of MACE and all-cause mortality during follow-up. Image 1 Funding Acknowledgement Type of funding source: None

scholarly journals Pericoronary fat inflammation and Major Adverse Cardiac Events (MACE) in prediabetic patients with acute myocardial infarction: effects of metformin

2019 ◽  
Vol 18 (1) ◽  
Author(s):  
Celestino Sardu ◽  
Nunzia D’Onofrio ◽  
Michele Torella ◽  
Michele Portoghese ◽  
Francesco Loreni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adipose Tissue ◽  
Artery Bypass ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
Metformin Therapy ◽  
Adverse Cardiac Events ◽  
Factor Α

Abstract Background/objectives Pericoronary adipose tissue inflammation might lead to the development and destabilization of coronary plaques in prediabetic patients. Here, we evaluated inflammation and leptin to adiponectin ratio in pericoronary fat from patients subjected to coronary artery bypass grafting (CABG) for acute myocardial infarction (AMI). Furthermore, we compared the 12-month prognosis of prediabetic patients compared to normoglycemic patients (NG). Finally, the effect of metformin therapy on pericoronary fat inflammation and 12-months prognosis in AMI-prediabetic patients was also evaluated. Methods An observational prospective study was conducted on patients with first AMI referred for CABG. Participants were divided in prediabetic and NG-patients. Prediabetic patients were divided in two groups; never-metformin-users and current-metformin-users receiving metformin therapy for almost 6 months before CABG. During the by-pass procedure on epicardial coronary portion, the pericoronary fat was removed from the surrounding stenosis area. The primary endpoints were the assessments of Major-Adverse-Cardiac-Events (MACE) at 12-month follow-up. Moreover, inflammatory tone was evaluated by measuring pericoronary fat levels of tumor necrosis factor-α (TNF-α), sirtuin 6 (SIRT6), and leptin to adiponectin ratio. Finally, inflammatory tone was correlated to the MACE during the 12-months follow-up. Results The MACE was 9.1% in all prediabetic patients and 3% in NG-patients. In prediabetic patients, current-metformin-users presented a significantly lower rate of MACE compared to prediabetic patients never-metformin-users. In addition, prediabetic patients showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to NG-patients (P < 0.001). Prediabetic never-metformin-users showed higher inflammatory tone and leptin to adiponectin ratio in pericoronary fat compared to current-metformin-users (P < 0.001). Remarkably, inflammatory tone and leptin to adiponectin ratio was significantly related to the MACE during the 12-months follow-up. Conclusion Prediabetes increase inflammatory burden in pericoronary adipose tissue. Metformin by reducing inflammatory tone and leptin to adiponectin ratio in pericoronary fat may improve prognosis in prediabetic patients with AMI. Trial registration Clinical Trial NCT03360981, Retrospectively Registered 7 January 2018

Abstract 5992: Comparison of 4 Years Efficacy and Durability of Sirolimus-Eluting Stent and Paclitaxel- Eluting Stent Deployment in Patients with Very Long Coronary Lesions: Multicenter Registry in Asia

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Sunao Nakamura ◽  
Hisao Ogawa ◽  
Jang-Ho Bae ◽  
Yeo Hans Cahyadi ◽  
Wasan Udayachalerm ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Stent Thrombosis ◽  
Late Stent Thrombosis ◽  
Cardiac Events ◽  
Stent Deployment ◽  
Very Late Stent Thrombosis ◽  
Coronary Lesion ◽  
Coronary Lesions ◽  
Sirolimus Eluting Stent

Aim : The aim of this study is to compare the 4 years safety and durability of Sirolimus-eluting stent (SES) and Paclitaxel-eluting stent (PES) deployment on the outcome of patients with very long coronary lesions (VLL). Methods : A prospective analysis of 656 patients 730 lesions (male 70.4%, mean age 66.9 yrs) with very long coronary lesion (≥40mm) (368 SES and 288 PES) in five high volume Asian centers after successful stenting in VLL was performed. Lesion locations of VLL were LAD 48.2% (SES 50.2%, PES 45.7%), LCX 18.5%, RCA 33.3%. Complete clinical follow-up to 4 years is being analyzed for all patients. Results : The baseline clinical characteristics between 2 groups were similar. At 4 years overall cardiac events of SES (16.3%) were lower than PES (24.0%) (p=0.03). See table for clinical results. Conclusion : The use of SES and PES in patients with very long coronary lesion was safe and feasible with low acute complication and low incidence of restenosis. SES showed lesser incidence of cardiac events (death, myocardial infarction, CABG and PCI) at 4 years clinical follow-up. SAT (sub acute stent thrombosis), LAST (late stent thrombosis: ~1year), VLAST (very late stent thrombosis: 1year~ 4years) MACE (death, myocardial infarction, CABG and PCI).

scholarly journals FEATURES OF LEFT VENTRICLE DIASTOLIC FUNCTION IN PATIENTS WITH NON Q-WAVE MYOCARDIAL INFARCTION AFTER PERCUTANEOUS INTERVENTION

2017 ◽  
Vol 9 (2) ◽  
pp. 44-50
Author(s):  
D A Khomyakova ◽  
S A Sayganov ◽  
Y N Grishkin
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Left Ventricle ◽  
Diastolic Function ◽  
Percutaneous Intervention ◽  
Infarct Related Artery ◽  
Group 2 ◽  
Grade 3 ◽  
Higher Sensitivity ◽  
Q Wave

Aim: To make natural development more exact to state the value of scientific prognostication of dia- stolic dysfunction with acute myocardial infarction without Q-wave after percutaneous intervention.materials and methods: 95 patients were subjected to coronography and revascularization of in- farct-related artery. The patients were divided into 2 groups depending on angiographic results with single and multivessel affection. during first 48 hours from the beginning of the disease they were under ECHO examination.Results: Left ventricle affections dF data were revealed relatively to heaviness of affection in cor- onary vessels without reliable differences in local and global contractility. Primordialy the 1 group contained 14 (54%) patients of I grade dd, 5 (19%) with II grade, 1 (8%) with III grade, 6 (19%) without dd. A year later: 18 (70%) with I grade dd, 3 (12%) with II, patients with III grade were not redictered, 5 (18%) without dd. In group 2 within first 48 hours 37 (54%) patients had I grade,25 (36%) II grade, 7 (10%) III grade. In a year there were 46 (67%) with I grade, 13 (19%) II grade, 3 (4%) with III grade dd, 7 (10%) without dd.Conclusions: Obtained data indicate of a higher sensitivity dependently dF ischemia.In contrast to myocardial infarction group with coronary bloodstream fully restored within short terms, in group with multivessel affections a more heavy dd data preserved longer, in spite of infarct related artery revascularization. Also unfavourable events were revealed.

Abstract 12648: Deletion of 12/15 Lipoxygenase Improves Left Ventricle Function and Survival by Resolving Inflammation Post Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Vasundhara Kain ◽  
Kevin A Ingle ◽  
Janusz Kabarowski ◽  
Sumanth D Prabhu ◽  
Ganesh V Halade
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricle ◽  
Survival Rates ◽  
Coronary Artery Ligation ◽  
Artery Ligation ◽  
Lv Remodeling ◽  
Early Expression ◽  
Cox 2

12/15 lipoxygenase (LOX) is crucial in the inflammatory process leading to diabetes and atherosclerosis. However, the role of 12/15 LOX in myocardial infarction (MI) and left ventricle (LV) remodeling is unclear. We assessed the role of 12/15 LOX in resolving inflammation in post-MI LV remodeling. 8-12 weeks old C57BL/6J wild-type (WT; n=67) and 12/15 LOX (LOX –/– ; n=78) male mice were subjected to permanent coronary artery ligation surgery and monitored through day (d)1 and d5. No MI surgery mice were maintained as d0 naïve controls. LOX -/- mice showed higher survival rate, improved fractional shortening with reduced remodeling and edema index than WT at d1 and d5 post-MI (all p<0.05). LOX -/- mice showed increased Cxcl5 expression at d1 post-MI, consistent with stimulated neutrophil recruitment in the infarct region that was decreased at d5 compared to WT. LOX -/- mice infarct had increased expression of Ccl2 and Cxcl1, that stimulated an earlier recruitment of monocytes with increased macrophages population at d5 (all p<0.05) compared to WT. The altered kinetics of immune cells post-MI indicates a rapid resolving phase, through increase in alternative macrophage phenotypes with reduced collagen density in LOX -/- mice compared to WT mice at d5 post-MI. LOX -/- mice showed a coordinated COX-1 and COX-2 response at d1 post MI, leading to an evident increase in 5-LOX and hemoxygenase-1 (HO-1) at d5 post-MI. 12/15 LOX deletion enhanced the recruitment of alternative macrophages with secretion of HO-1 to resolve inflammation. In-vitro addition of LOX metabolite 12 hydroxyeicosatetraenoic acid to LOX -/- fibroblast induced early expression of COX-2 and 5-LOX compared to WT, indicating 5LOX role in resolution of inflammation. Post-MI increased expression of TIMP-1 and decrease in MMP-9 at d1 and α-SMA at d5 in LOX -/- mice suggested controlled differentiation of fibroblast-to-myofibroblast which is key event during ventricular tissue repair and resolving phase. This change is supported by increased expression of tgf-βi, ctgf and admats-2 (all P<0.05) at d5 post MI. In conclusion, absence of 12/15 LOX improves post-MI survival rates and attenuates LV dysfunction by resolving inflammation through coordination of 5-LOX and HO-1 as key inflammation resolving enzymes.

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