scholarly journals Time to Medical Management in Patients Presenting with Non-ST Elevation Myocardial Infarction: A Retrospective Analysis of Two Teaching Hospitals

2008 ◽  
Vol 2 ◽  
pp. CMC.S1056
Author(s):  
Darren R. Kagal ◽  
Omid Salehian
Keyword(s):  
Myocardial Infarction ◽  
Retrospective Analysis ◽  
Medical Management ◽  
St Elevation Myocardial Infarction ◽  
Teaching Hospitals ◽  
St Elevation

scholarly journals In-hospital mortality of cardiogenic shock complicating ST-elevation myocardial infarction in Malaysia: a retrospective analysis of the Malaysian National Cardiovascular Database (NCVD) registry

BMJ Open ◽  
2019 ◽  
Vol 9 (5) ◽  
pp. e025734 ◽  
Author(s):  
Padmaa Venkatason ◽  
Yong Z Zubairi ◽  
Wan Azman Wan Ahmad ◽  
Muhammad Imran Hafidz ◽  
Muhammad Dzafir Ismail ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Risk Reduction ◽  
Retrospective Analysis ◽  
Mortality Risk ◽  
St Elevation Myocardial Infarction ◽  
Invasive Therapy ◽  
St Elevation ◽  
National Cardiovascular

ObjectivesCardiogenic shock (CS) complicating ST-elevation myocardial infarction (STEMI) carries an extremely high mortality. The clinical pattern of this life threatening complication has never been described in Malaysian setting. This study is to investigate the incidence, clinical characteristics and outcome of STEMI patients with CS in our population.DesignA retrospective analysis of STEMI patients from 18 hospitals across Malaysia contributing to the Malaysian National Cardiovascular Database-acute coronary syndrome) registry (NCVD-ACS) year 2006–2013.Participants16 517 patients diagnosed of STEMI from 18 hospitals in Malaysia from the year 2006 to 2013.Primary outcome measuresIn-hospital and 30 day post-discharge mortality.ResultsCS complicates 10.6% of all STEMIs in this study. They had unfavourable premorbid conditions and poor outcomes. The in-hospital mortality rate was 34.1% which translates into a 7.14 times mortality risk increment compared with STEMI without CS. Intravenous thrombolysis remained as the main urgent reperfusion modality. Percutaneous coronary interventions (PCI) in CS conferred a 40% risk reduction over non-invasive therapy but were only done in 33.6% of cases. Age over 65, diabetes mellitus, hypertension, chronic lung and kidney disease conferred higher risk of mortality.ConclusionMortality rates of CS complicating STEMI in Malaysia are high. In-hospital PCI confers a 40% mortality risk reduction but the rate of PCI among our patients with CS complicating STEMI is still low. Efforts are being made to increase access to invasive therapy for these patients.

scholarly journals Clinical Characteristics, Medical Management and Outcomes of Patients with ST-Elevation Myocardial Infarction in Sanglah General Hospital, Denpasar, Bali, Indonesia

2017 ◽  
Vol 10 (3) ◽  
pp. 1197-1206
Author(s):  
I. Made Junior Rina Artha ◽  
I. Made Pande Dwipayana ◽  
Bagus Made Indrata Saputra ◽  
Dafsah Arifa Juzar ◽  
Sunarya Soerianata
Keyword(s):  
Myocardial Infarction ◽  
General Hospital ◽  
Medical Management ◽  
Clinical Characteristics ◽  
St Elevation Myocardial Infarction ◽  
St Elevation

scholarly journals Outcomes of medically managed patients with myocardial infarction

2018 ◽  
Vol 8 (6) ◽  
pp. 571-581 ◽  
Author(s):  
Padma Kaul ◽  
Anamaria Savu ◽  
Shereen Hamza ◽  
Merril L Knudtson ◽  
Kevin Bainey ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Medical Management ◽  
Lower Risk ◽  
Management Strategy ◽  
St Elevation Myocardial Infarction ◽  
Risk Of Mortality ◽  
St Elevation ◽  
Long Term Mortality

Aims: The purpose of this study was to compare outcomes associated with medical management of ST-elevation myocardial infarction and non-ST-elevation myocardial infarction patients presenting to hospitals with and without onsite catheterization facilities. Methods All patients ( n=25,921) with ST-elevation myocardial infarction ( n=10,563) or non-ST-elevation myocardial infarction ( n=15,358) in Alberta, Canada between April 2010–March 2016 were categorized according to availability of catheterization facilities at the hospital they presented to and their management strategy (medically managed without coronary angiography or medically managed after coronary angiography). Results: Overall, 51% presented to hospitals without catheterization facilities; and 34% were managed medically (18% without coronary angiography, and 16% after coronary angiography). Rates of medical management were higher at hospitals without versus those with catheterization facilities (43% vs. 24%, p<0.01). However, both the rate of presentation to hospitals without catheterization facilities (70% non-ST-elevation myocardial infarction, 24% ST-elevation myocardial infarction, p<0.01) and medical management (45% non-ST-elevation myocardial infarction, 18% ST-elevation myocardial infarction, p<0.01) differed by myocardial infarction type. The lack of catheterization facilities at the presenting hospital had no association with in-hospital mortality in patients medically managed without coronary angiography, but was associated with a lower risk of mortality among patients medically managed after coronary angiography. However, the latter benefit was restricted to non-ST-elevation myocardial infarction patients only (adjusted hazard ratio 0.43, 95% confidence interval: 0.25–0.76). Conclusion: The availability of catheterization facilities at the hospital at which non-ST-elevation myocardial infarction and ST-elevation myocardial infarction patients presented influenced their likelihood of being medically managed, but was not associated with adverse short- or long-term mortality outcomes.

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