scholarly journals Lack of prognostic significance for major adverse cardiac events of soluble suppression of tumorigenicity 2 levels in patients with ST-segment elevation myocardial infarction

2020 ◽  
Author(s):  
Min Kim ◽  
Dae In Lee ◽  
Ju-Hee Lee ◽  
Sang Min Kim ◽  
Sang Yeub Lee ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Prognostic Significance ◽  
Major Adverse Cardiac Events ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events

scholarly journals “Takotsubo effect” in patients with ST segment elevation myocardial infarction

2020 ◽  
Vol 9 (7) ◽  
pp. 711-720 ◽  
Author(s):  
Juan Lei ◽  
Jian Chen ◽  
Megha Dogra ◽  
Milena A Gebska ◽  
Suchith Shetty ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Anterior Wall ◽  
Major Adverse Cardiac Events ◽  
Left Ventricular Ejection ◽  
Takotsubo Syndrome ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events

Background Myocardial infarction can be a trigger of Takotsubo syndrome. We recently characterized imaging features of acute myocardial infarction-induced Takotsubo syndrome (“Takotsubo effect”). In this study, we investigate diagnostic and prognostic implications of Takotsubo effect in patients with anterior wall ST-segment elevation myocardial infarction. Methods We enrolled 111 consecutive patients who developed anterior wall ST-segment elevation myocardial infarction and received percutaneous coronary intervention, and studied systolic/diastolic function, hemodynamic consequences, adverse cardiac events, as well as 30-day and five-year outcomes in patients with and without Takotsubo effect. Results Patients with Takotsubo effect showed significantly worse average peak systolic longitudinal strain (–9.5 ± 2.6% vs –11.1 ± 3.6%, p = 0.038), left ventricular ejection fraction (38.5 ± 6.8% vs 47.7 ± 8.7%, p = 0.000) and myocardial performance index (0.54 ± 0.17 vs 0.37 ± 0.15, p = 0.000) within 48 h of myocardial infarction. There was no significant difference between the two groups in diastolic ventricular filling pressures, hemodynamic consequences, and 30-day rehospitalization and mortality (Gehan-Breslow-Wilcoxon test: p = 0.157). However, patients with Takotsubo effect developed more major adverse cardiac events (log-rank test: p = 0.019) when tested at the five-year follow-up. Cox regression analysis revealed that age, hypotension, tricuspid annular plane systolic excursion, and Takotsubo effect were independent prediction factors for five-year major adverse cardiac events. The Doppler/tissue Doppler parameter E/e’ correlated with MACE only in patients without Takotsubo effect. Conclusion Takotsubo effect secondary to anterior ST-segment elevation myocardial infarction predicts a worse long-term prognosis.

P3127Optimal revascularization strategy in non-ST-segment elevation myocardial infarction with multivessel coronary artery disease: staged vs. one-time vs. culprit-only revascularization

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Kim ◽  
Y Ahn ◽  
M H Jeong ◽  
D S Sim ◽  
Y J Hong ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Multivessel Coronary Artery Disease ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Artery Disease

Abstract Background/Introduction Although optimal revascularization strategy in patients with ST-segment elevation myocardial infarction with multivessel coronary artery disease (MVD) was well established, there are few studies which investigated optimal revascularization strategy in non-ST-segment elevation myocardial infarction (NSTEM) with MVD. Purpose We investigated 2-year clinical outcomes according to strategy of revascularization in patients with NSTEMI and MVD. Methods Between November 2011 and October 2015, a total of 2474 patients with NSTEMI and MVD who underwent successful percutaneous coronary intervention were analyzed from the Korea Acute Myocardial Infarction Registry-National Institute of Health (staged 308, one-time 1043 and culprit-only 1123 patients). We did not include patients with left main disease and cardiogenic shock. Primary endpoint was major adverse cardiac events (MACE: the composite of cardiac death, myocardial infarction [MI] or target-vessel revascularization [TVR]) during 2-year follow-up (median 737 days [interquartile range 705–764]). We also analyzed the of all-cause mortality, stroke and non-TVR. Results Baseline characteristics such as age, gender, and prevalence of atherosclerotic risk factors between multivessel revascularization (MVR; staged or one-time revascularization) and CVR were similar. There was also no difference in symptom to balloon time in 2 groups. MACE occurred in 305 patients (12.3%) during 2-year follow-up. MVR could reduce incidence of MACE (10.2% vs. 14.9%; adjusted hazard ratio [HR] 1.50 for CVR, 95% confidence interval [CI] 1.20–1.88, p<0.001), all-cause death (8.4% vs. 12.1%; adjusted HR 1.45 for CVR, 95% CI 1.13–1.87, p=0.003) and non-TVR (1,9% vs. 7.0%; adjusted HR 3.99 for CVR, 95% CI 2.55–6.27, p<0.001). There was no difference in incidence of stroke between MVR and CVR. We also analyzed same analysis between staged and one-time revascularization. Complete revascularization was more achieved in one-time revascularization group compared to staged revascularization group (62.0% vs. 76.1%, p<0.001). In multivariate Cox-regression analysis, staged revascularization was not associated with improved clinical outcomes in terms of MACE (HR 0.74, 95% CI 0.50–1.09, p=0.126), all-cause death (HR 1.07, 95% CI 0.69–1.68, p=0.759), stroke (HR 1.75, 95% CI 0.68–4.52, p=0.245) and non-TVR (HR 2.56, 95% CI 0.75–8.68, p=0.132). Analysis by propensity score matching and inverse probability of treatment weighting did not significantly affect the results. Conclusions MVR reduced 2-year adverse cardiac events in patients with NSTEMI and MVD compared to CVR. However, staged revascularization was not superior to one-time revascularization for reducing MACE among NSTEMI patients with MVD who received MVR.

scholarly journals Impact of hyperglycemia on the results of percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction

2017 ◽  
Vol 89 (9) ◽  
pp. 25-29 ◽  
Author(s):  
I S Bessonov ◽  
V A Kuznetsov ◽  
Yu V Potolinskaya ◽  
I P Zyrianov ◽  
S S Sapozhnikov
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Mortality Rates ◽  
Percutaneous Coronary Interventions ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Aim. To investigate the impact of hyperglycemia on the results of percutaneous coronary interventions (PCIs) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Subjects and methods. A study group consisted of 511 patients with hyperglycemia (blood glucose level (BGL) ≥7.77 mmol/L) who underwent primary PCIs in the period from 2005 to 2015. A comparison group included 579 patients (BGL ≥7.77 mmol/L). Results. Assessment of the results of hospital interventions revealed that the mortality rates in patients with hyperglycemia proved to be higher than in those with normal BGL (6.5 and 2.6%, respectively; p=0.002). No differences were found in the rates of stent thrombosis (1 and 1.4%; p=0.541) and recurrent myocardial infarction (1.2 and 1.6%; p=0.591). Major adverse cardiac events, including death, recurrent infarction, and stent thrombosis, were more frequently determined in the hyperglycemic patients (7.6 and 4.3%; p=0.020). No-reflow phenomenon statistically significantly more frequently developed in the patients with hyperglycemia (6.8 and 3.3%; p=0.007). Binary logistic regression analysis showed that the presence of hyperglycemia served as an independent predictor of hospital mortality (odds ratio (OR) 2.6; 95% confidence interval (CI), 1.4 to 4.8; p=0.002). The application of a random probability sampling technique revealed that mortality remained statistically significantly higher in the hyperglycemic patients than in the normoglycemic individuals at admission (6.7 and 2.6%; р=0.011). Conclusion. PCIs in patients with ASTEMI and hyperglycemia are characterized by higher mortality rates and the risk of major adverse cardiac events. Admission hyperglycemia is an independent predictor of hospital mortality.

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