scholarly journals Recent Advances in the Treatment of ST-Segment Elevation Myocardial Infarction

Scientifica ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-13 ◽  
Author(s):  
Mun K. Hong
Keyword(s):  
Myocardial Infarction ◽  
Primary Angioplasty ◽  
Left Ventricular ◽  
Pharmacologic Therapy ◽  
Future Research ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Recent Advances ◽  
St Segment ◽  
Artery Disease

ST-segment elevation myocardial infarction (STEMI) represents the most urgent condition for patients with coronary artery disease. Prompt diagnosis and therapy, mainly with primary angioplasty using stents, are important in improving not only acute survival but also long-term prognosis. Recent advances in angioplasty devices, including manual aspiration catheters and drug-eluting stents, and pharmacologic therapy, such as potent antiplatelet and anticoagulant agents, have significantly enhanced the acute outcome for these patients. Continuing efforts to educate the public and to decrease the door-to-balloon time are essential to further improve the outcome for these high-risk patients. Future research to normalize the left ventricular function by autologous stem cell therapy may also contribute to the quality of life and longevity of the patients surviving STEMI.

scholarly journals Takotsubo Cardiomyopathy and Non-ST-Segment Elevation Myocardial Infarction: Predictors of Left Ventricular Dysfunction

2017 ◽  
Vol 11 ◽  
pp. 117954681771610
Author(s):  
Andrew Hinojos ◽  
Thomas E Vanhecke ◽  
Susan Enright ◽  
Nathan Elg ◽  
Kristina Gifft ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
Retrospective Case ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
Lv Dysfunction ◽  
St Segment ◽  
Artery Disease ◽  
Control Study

Background: Acute coronary syndrome (ACS) from non-ST-segment elevation myocardial infarction (NSTEMI) and Takotsubo (TK) cardiomyopathy present with similar initial clinical features and can result in left ventricular (LV) dysfunction and acute heart failure. Methods: This study was a retrospective case-control study that identified patients aged 18 years and older who presented with ACS and underwent cardiac catheterization. Results: There were a total of 321 patients in the TK group and 1031 patients in the NSTEMI group. There was significantly worse LV dysfunction in the TK group with average ejection fraction (EF) of 44.35% (±15.11%) versus NSTEMI with an average EF of 47.36% (±13.5%) ( P < .001). The presence of TK yielded of an odds ratio (OR) of 2.373 (95% confidence interval [CI]: 1.165-3.618) and presence of peripheral artery disease (PAD) yielded an OR of 2.053 (95% CI: 1.165-3.618). Conclusions: The presence of TK cardiomyopathy and PAD were independent predictors of patients who had LVEF of <35% and elevated B-type natriuretic peptide levels.

Abstract 2809: Absence of Flow-Limiting Coronary Artery Disease Among Patients Undergoing Emergent Cardiac Catheterization For ST Segment Elevation Myocardial Infarction in the National Cardiovascular Data Registry CathPCI Registry: Implications for Primary Angioplasty Programs

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Kalon K Ho ◽  
H. V Anderson ◽  
Richard E Shaw ◽  
Lloyd W Klein ◽  
James H Beachy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Cardiac Catheterization ◽  
Primary Angioplasty ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Data Registry ◽  
St Segment ◽  
Artery Disease ◽  
National Cardiovascular

Background : Many hospitals have established primary angioplasty programs with a goal of providing consistently timely reperfusion for patients with suspected acute ST segment elevation myocardial infarction (STEMI). As the locus of control for activation of the cardiac catheterization laboratory moves from the cardiologist to the emergency department and even to pre-hospital activation by emergency medical services, concerns have been raised about ``false positive” activations of the primary angioplasty team, yet there has been little data on the frequency of this occurence. Objective : We sought to estimate how often flow-limiting coronary artery disease (CAD) was NOT found among patients undergoing emergent cardiac catheterization in a large multi-center registry. Methods and Results : The National Cardiovascular Data Registry (NCDR) CathPCI Registry is a cardiac catheterization and angioplasty quality improvement and outcomes database with over 800 participating institutions. Among 131,211 patients undergoing emergent or salvage coronary angiography from 1/1/2005 -12/31/2006, 9.8% had no lesions of ≥50% diameter stenoses in the major epicardial coronary arteries. No angiographically visualized coronary stenoses at all were reported in 5.2% of these cases. Detailed data were not readily available on whether the primary indication for the procedure was suspected acute STEMI vs. other reasons such as hemodynamic instability or refractory arrhythmia. Conclusions : Among patients undergoing emergent or salvage diagnostic catheterizations nationwide in the NCDR CathPCI Registry, finding NO angiographically-apparent flow-limiting CAD was uncommon (<10%). While no clinical finding or test will perfectly discriminate STEMI from ``STEMI mimics”, current clinical practice appears to activate primary angioplasty teams with reasonable specificity.

scholarly journals Clinical and Angiographic Characteristics of Female Patients Undergoing Coronary Angiography in a Tertiary Hospital in Bangladesh

2019 ◽  
Vol 7 (1-2) ◽  
pp. 9-14
Author(s):  
Sahela Nasrin ◽  
F Aaysha Cader ◽  
M Maksumul Haq
Keyword(s):  
Myocardial Infarction ◽  
Coronary Angiography ◽  
Left Ventricular ◽  
Left Main ◽  
St Segment Elevation ◽  
Female Patients ◽  
Vessel Disease ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Artery Disease

Background & objective: Coronary artery disease (CAD) is increasingly prevalent among female population, particularly in South Asia, and a large number of female patients currently undergo coronary angiography for a variety of indications. The objective of this study was to investigate the clinical and angiographic characteristics of female patients undergoing coronary angiogram, in a tertiary cardiac center in Bangladesh. Methods: This retrospective observational study was conducted at Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh during the period from 1st September 2005 to 31st August 2016. A total of 7,627 female patients who underwent coronary angiography were included. Obstructive coronary artery disease (CAD) was defined as a stenosis ≥70% in at least one of the three major coronary arteries or a stenosis ≥50% in left main stem. Result: Nearly two-thirds (64.4%) of patients comprised of age group of 41-60 years with mean age of the patients being 55.4 ± 10.2 years. Unstable angina (38.2%) was the commonest indication for coronary angiography followed by stable ischemic heart disease (25.1%), non-ST segment elevation myocardial infarction (12.8%), ST segment elevation myocardial infarction (9.3%), left ventricular failure (7.5%), post-myocardial infarction angina (6%) and atypical chest pain (1.3%). Over three quarters were hypertensive 68.3% were diabetic and 29% and dyslipidemiac. Over 40% of the patients were overweight and 20% were obese. On trans-thoracic echocardiography, 65.2% had normal left ventricular (LV) systolic function; 17.6% and 9.9% had mild and moderate LV systolic dysfunction respectively. Nearly 30% had normal epicardial coronary arteries on angiography, while 17.4%, 16.5% and 37.2% had triple vessel disease (TVD), double vessel disease (DVD) and single vessel disease (SVD) respectively. Following angiography, 33.4% were advised PCI, 30.2% optimal medical management and 15.3% CABG. A few (3.2%) were advised for revascularization either by CABG or PCI. Conclusion: Unstable angina is the most common indication for coronary angiography among Bangladeshi females. A clustering of risk factors for CAD such as hypertension, diabetes and overweight or obesity are observed in them. Of the obstructive CADs, SVD is the most frequent finding, indicating that females undergoing CAG are likely to have diffuse CAD, although left main disease is not uncommon in this population. Further comparative studies with matched male population are recommended to find the differences in clinical and angiographic findings with respect to sex. Ibrahim Card Med J 2017; 7 (1&2): 9-14

Malnutrition and biological frailty are independent and complementary predictors of one-year mortality in women after primary angioplasty for ST-segment elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Arroyo-Espliguero ◽  
M.C Viana-Llamas ◽  
A Silva-Obregon ◽  
A Estrella-Alonso ◽  
C Marian-Crespo ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rate ◽  
Primary Angioplasty ◽  
Prognostic Impact ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Kaplan Meier ◽  
St Segment ◽  
One Year ◽  
The Impact

Abstract Background Malnutrition and sarcopenia are common features of frailty. Prevalence of frailty among ST-segment elevation myocardial infarction (STEMI) patients is higher in women than men. Purpose Assess gender-based differences in the impact of nutritional risk index (NRI) and frailty in one-year mortality rate among STEMI patients following primary angioplasty (PA). Methods Cohort of 321 consecutive patients (64 years [54–75]; 22.4% women) admitted to a general ICU after PA for STEMI. NRI was calculated as 1.519 × serum albumin (g/L) + 41.7 × (actual body weight [kg]/ideal weight [kg]). Vulnerable and moderate to severe NRI patients were those with Clinical Frailty Scale (CFS)≥4 and NRI&lt;97.5, respectively. We used Kaplan-Meier survival model. Results Baseline and mortality variables of 4 groups (NRI-/CFS-; NRI+/CFS-; NRI+/CFS- and NRI+/CFS+) are depicted in the Table. Prevalence of malnutrition, frailty or both were significantly greater in women (34.3%, 10% y 21.4%, respectively) than in men (28.9%, 2.8% y 6.0%, respectively; P&lt;0.001). Women had greater mortality rate (20.8% vs. 5.2%: OR 4.78, 95% CI, 2.15–10.60, P&lt;0.001), mainly from cardiogenic shock (P=0.003). Combination of malnutrition and frailty significantly decreased cumulative one-year survival in women (46.7% vs. 73.3% in men, P&lt;0.001) Conclusion Among STEMI patients undergoing PA, the prevalence of malnutrition and frailty are significantly higher in women than in men. NRI and frailty had an independent and complementary prognostic impact in women with STEMI. Kaplan-Meier and Cox survival curves Funding Acknowledgement Type of funding source: None

scholarly journals Analysis of risk factors for different subtypes of acute coronary syndrome

2021 ◽  
Vol 49 (5) ◽  
pp. 030006052110083
Author(s):  
Lei Zhang ◽  
Juledezi Hailati ◽  
Xiaoyun Ma ◽  
Jiangping Liu ◽  
Zhiqiang Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Brain Natriuretic Peptide ◽  
Left Ventricular ◽  
St Segment Elevation ◽  
Amino Terminal ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Aims To investigate the different risk factors among different subtypes of patients with acute coronary syndrome (ACS). Methods A total of 296 patients who had ACS were retrospectively enrolled. Blood and echocardiographic indices were assessed within 24 hours after admission. Differences in risk factors and Gensini scores of coronary lesions among three groups were analyzed. Results Univariate analysis of risk factors for ACS subtypes showed that age, and levels of fasting plasma glucose, amino-terminal pro-brain natriuretic peptide, and creatine kinase isoenzyme were significantly higher in patients with non-ST-segment elevation myocardial infarction (NSTEMI) than in those with unstable angina pectoris (UAP). Logistic multivariate regression analysis showed that amino-terminal pro-brain natriuretic peptide and the left ventricular ejection fraction (LVEF) were related to ACS subtypes. The left ventricular end-diastolic diameter was an independent risk factor for UAP and ST-segment elevation myocardial infarction (STEMI) subtypes. The severity of coronary stenosis was significantly higher in NSTEMI and STEMI than in UAP. Gensini scores in the STEMI group were positively correlated with D-dimer levels (r = 0.429) and negatively correlated with the LVEF (r = −0.602). Conclusion Different subtypes of ACS have different risk factors. Our findings may have important guiding significance for ACS subtype risk assessment and clinical treatment.

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