scholarly journals The secondary effect of the first wave of COVID-19 and its consequences on myocardial infarction care in a high volume Hungarian cardiovascular centre

Cor et Vasa ◽  
2021 ◽  
Vol 63 (3) ◽  
pp. 345-349
Author(s):  
Réka Skoda ◽  
Gábor Fülöp ◽  
Emese Csulak ◽  
Krisztina Danics ◽  
Klára Törő ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
High Volume ◽  
Secondary Effect

scholarly journals Long-Term Outcomes of Coronary and Carotid Artery Disease Revascularization in the FRIENDS Study

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Fabrizio Tomai ◽  
Anna Piccoli ◽  
Fausto Castriota ◽  
Luca Weltert ◽  
Bernhard Reimers ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cumulative Incidence ◽  
Carotid Artery Disease ◽  
High Volume ◽  
Cardiovascular Death ◽  
Long Term Outcomes ◽  
Major Cardiovascular Events ◽  
Long Term Follow Up ◽  
Artery Disease

Objectives. The aim of this study is to assess long-term-outcomes of patients with concomitant CAD and COD treated with different revascularization strategies. Background. Multisite artery disease is common and patients with combined disease have poor prognosis. The best therapeutic strategy for patients with concomitant carotid obstructive disease (COD) and coronary artery disease (CAD) remains controversial. Methods. This observational registry enrolled, between January 2006 and December 2012, 1022 consecutive patients from high volume institutions with concomitant CAD and COD suitable for endovascular, surgical, or hybrid revascularization in both territories selected by consensus of a multidisciplinary team. Results. The cumulative incidence of 5-year major cardiovascular events (MACCE) including cardiovascular death, myocardial infarction (MI), or stroke in the overall population was 12%. The incidence of 5-year MACCE was not statistically different in the surgical, endovascular, or hybrid patients group (10.1% vs. 13.0% vs. 13.2%, P = .257, respectively). However, the hybrid group exhibited rates of myocardial infarction, chronic kidney disease, and cumulative incidence of all clinical events higher than the surgical group. After propensity score matching, the incidence of 5-year MACCE was similar in the three groups (13.0% vs. 15.0% vs. 16.0%, p = .947, respectively). Conclusions. An individualized revascularization approach of patients with combined CAD and COD yields very good results at long-term follow-up, despite the high risk of this multilevel population even when the baseline clinical features are equalized.

Operator volume and outcomes of primary angioplasty for acute myocardial infarction in a single high-volume centre

2006 ◽  
Vol 7 (10) ◽  
pp. 761-767 ◽  
Author(s):  
Alessandro Politi ◽  
Mario Galli ◽  
Santino Zerboni ◽  
Riccardo Michi ◽  
Federico De Marco ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Volume ◽  
Primary Angioplasty

scholarly journals Impact of Center Volume on Outcomes in Myocardial Infarction Complicated by Cardiogenic Shock: A CULPRIT‐SHOCK Substudy

2021 ◽  
Author(s):  
Benedikt Schrage ◽  
Uwe Zeymer ◽  
Gilles Montalescot ◽  
Stephan Windecker ◽  
Pranas Serpytis ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiogenic Shock ◽  
High Volume ◽  
Baseline Risk ◽  
Volume Data ◽  
Center Volume ◽  
All Cause Mortality ◽  
Resuscitated Patients ◽  
The Impact

Background Little is known about the impact of center volume on outcomes in acute myocardial infarction complicated by cardiogenic shock. The aim of this study was to investigate the association between center volume, treatment strategies, and subsequent outcome in patients with acute myocardial infarction complicated by cardiogenic shock. Methods and Results In this subanalysis of the randomized CULPRIT‐SHOCK (Culprit Lesion Only PCI Versus Multivessel PCI in Cardiogenic Shock) trial, study sites were categorized based on the annual volume of acute myocardial infarction complicated by cardiogenic shock into low‐/intermediate‐/high‐volume centers (<50; 50–100; and >100 cases/y). Subjects from the study/compulsory registry with available volume data were included. Baseline/procedural characteristics, overall treatment, and 1‐year all‐cause mortality were compared across categories. n=1032 patients were included in this study (537 treated at low‐volume, 240 at intermediate‐volume, and 255 at high‐volume centers). Baseline risk profile of patients across the volume categories was similar, although high‐volume centers included a larger number of older patients. Low‐/intermediate‐volume centers had more resuscitated patients (57.5%/58.8% versus 42.2%; P <0.01), and more patients on mechanical ventilation in comparison to high‐volume centers. There were no differences in reperfusion success despite considerable differences in adjunctive pharmacological/device therapies. There was no difference in 1‐year all‐cause mortality across volume categories (51.1% versus 56.5% versus 54.4%; P =0.34). Conclusions In this study of patients with acute myocardial infarction complicated by cardiogenic shock, considerable differences in adjunctive medical and mechanical support therapies were observed. However, we could not detect an impact of center volume on reperfusion success or mortality.

scholarly journals Variability of discharge medical therapy for secondary prevention among patients with myocardial infarction with non-obstructive coronary arteries (MINOCA) in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255462
Author(s):  
Nathaniel R. Smilowitz ◽  
Rachel Dubner ◽  
Anne S. Hellkamp ◽  
Robert J. Widmer ◽  
Harmony R. Reynolds
Keyword(s):  
Myocardial Infarction ◽  
Secondary Prevention ◽  
Medical Therapy ◽  
Coronary Arteries ◽  
Clinical Data ◽  
High Volume ◽  
The United States ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction

Background Optimal medical therapy after myocardial infarction with nonobstructive coronary arteries (MINOCA; <50% stenosis) is uncertain. We evaluated variability in discharge prescription of angiotensin-converting enzyme inhibitors / angiotensin receptor blockers (ACEI/ARB) and beta-blockers (BB) to MINOCA patients between hospitals to assess physician equipoise about secondary prevention. Methods Patients with MINOCA between 2007–2014 were identified in the NCDR Chest Pain–MI Registry. Those with prior revascularization or missing demographic, angiographic, or medication data were excluded. Analysis was limited to high-volume hospitals with ≥20 MINOCA total discharges. Discharge prescriptions for ACEI/ARB and BB after MINOCA were analyzed for each hospital. Clinical data on left ventricular ejection fraction (LVEF), glomerular filtration rate (GFR), and diabetes mellitus status were extracted to identify other indications for ACEI/ARB or BB. Results Clinical data were available for 17,849 MINOCA patients, of whom 8,752 (49%) had LVEF <40%, GFR ≤60 mL/min, and/or diabetes. 5,913 patients without one of these indications for ACEI/ARB or BB were discharged from 156 high-volume hospitals. At discharge, ACEI/ARB was prescribed to between 16.0% and 88.8% of MINOCA patients (median 45.6%, IQR 38.0%-56.5%) and BB to between 28.0% and 97.5% (median 74.1%, IQR 64.7%-80.0%). Conclusion There is marked variability between hospitals in the proportions of patients receiving ACEI/ARB and BB after hospitalization for MINOCA, suggesting clinical equipoise about the routine use of these agents. Randomized clinical trials are necessary to establish the benefit of ACEI/ARB and BB to improve outcomes after MINOCA.

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