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Suthar, Nilay, Chintal Vyas et Abhishek Raval. « A Study of ST-Elevation Acute Myocardial Infarction (STEMI) in Youngs ». Indian Journal of Applied Research 4, no 3 (1 octobre 2011) : 393–96. http://dx.doi.org/10.15373/2249555x/mar2014/123.
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Kurniawan, Paulus Rio, Andreas Arie Setiawan, Charles Limantoro et Ariosta Ariosta. « THE DIFFERENCES IN TROPONIN I AND CK-MB VALUES IN ACUTE MYOCARDIAL INFARCTION PATIENTS WITH ST ELEVATION AND WITHOUT ST ELEVATION ». DIPONEGORO MEDICAL JOURNAL (JURNAL KEDOKTERAN DIPONEGORO) 10, no 2 (31 mars 2021) : 138–44. http://dx.doi.org/10.14710/dmj.v10i2.29601.
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Background: Acute myocardial infarction includes STEMI and NSTEMI. In STEMI and NSTEMI, an increase in cardiac biomarkers especially troponin I and CK-MB are affected by the ischemic process. In STEMI thrombus blocks the entire artery lumen while in NSTEMI thrombus does not block the entire artery lumen. This can lead to different ischemic processes. Aim: To prove the differences in troponin I and CK-MB values in acute myocardial infarction patients with ST-elevation and without ST- elevation. Methods: An observational analytic study using a cross-sectional design was conducted between April and September 2020. The total sample of the study was 48 samples, consists of 25 samples with STEMI and 23 samples with NSTEMI. The normality test was analyzed using Shapiro-Wilk test. The difference test was analyzed using Mann-Whitney test. Results: Mean troponin I values of STEMI and NSTEMI patients were 30.40 ± 20.79 ng/mL; 1.38 ± 1.76 ng/mL, respectively. Mean CK-MB values in STEMI and NSTEMI patients were 386.12 ± 319.70 U/L; 42.39 ± 27.54 U/L, respectively. There were statistically significant differences in troponin I and CK-MB values (p respectively 0.00; 0.00) in STEMI patients compared to NSTEMI patients. Conclusion: There were differences in troponin I and CK-MB values between STEMI and NSTEMI patients. The troponin I and CK-MB values in STEMI patients were higher than in NSTEMI patients.
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Tucker, Bradley, et Sanjay Patel. « Acute Coronary Syndrome : Unravelling the Biology to Identify New Therapies ». Cells 11, no 24 (19 décembre 2022) : 4136. http://dx.doi.org/10.3390/cells11244136.
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Nambiar, Dr Supriya D. « Cardiac and Extra Cardiac Predictors and Complications of Acute Atrial Fibrillation Complicating ST Elevation Myocardial Infarction (STEMI) ST Elevation myocardial infarction Acute Atrial Fibrillation (STAAF) Study ». Journal of Medical Science And clinical Research 05, no 05 (23 mai 2017) : 22124–34. http://dx.doi.org/10.18535/jmscr/v5i5.139.
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Ikramullah, Syed, Aamna Khokhar, Muhammad Usman Ali, Bilal Mustafa, Syed Ahsan Raza et Iftikhar Ahmad. « Frequency of Vitamid Deficiency in Patients with Acute ST Elevation MI ». Pakistan Journal of Medical and Health Sciences 16, no 5 (29 mai 2022) : 1102–4. http://dx.doi.org/10.53350/pjmhs221651102.
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Objective: Vitamin D deficiency in individuals with acute ST Elevation is the goal of this study. Stud Design: Case control/Prospective study Place and Duration: Conducted at Islamabad medical and dental college, Islamabad. Duration was six months from 1st July, 2021 to 31st Dec, 2021. Methods: There were one hundred and six patients were presented in this study. ACS patients were included if they had ST elevation myocardial infarction (STEMI) or not if they had non-STEMI. Informed permission was obtained prior to obtaining demographic data on the enrolled patients. These demographics included age, sex, BMI, and any co-morbidities they may have. Patients were divided in two groups, group I had 53 patients had ST elevation myocardial infarction (STEMI) and group B had 53 patients without STEMI. Frequency of vitamin deficiency among both groups were assessed and compared. SPSS 24.0 was used to analyze complete data. Results: There were majority males 68 (64.2%) and 38 (35.8%) females among all patients. Mean age of the patients was 56.8±11.53 years with mean BMI 27.12±14.43 kg/m2 in group I and in group II mean age was 54.13±6.23 years and had mean BMI 25.7±10.51 kg/m2. Hypertension, diabetes mellitus, myocardial infarction and dyslipidemia were the commonest comorbidities found among all cases. Frequency of vitamin D deficiency in group I was higher found in 42 (79.2%) cases as compared to group II found in 22 (41.5%) cases with p value <0.004.Frequency of vitamin D insufficiency was also higher in patients with STEMI. Conclusion: Vitamin D deficiency and insufficiency were shown to be more common in individuals with acute coronary syndrome, including ST-elevation myocardial infarction (STEMI). People with ACS who had a vitamin D deficit were more likely to have an ST-elevation myocardial infarction (MI). Keywords:Acute coronary syndrome, ST elevation myocardial infarction (STEMI), Vitamin D Deficiency, Comorbidities
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Kireyev, Dmitriy, Huay Cheem Tan et Kian Keong Poh. « Management of Acute ST-Elevation Myocardial Infarction : Reperfusion Options ». Annals of the Academy of Medicine, Singapore 39, no 12 (15 décembre 2010) : 927–33. http://dx.doi.org/10.47102/annals-acadmedsg.v39n12p927.
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Primary percutaneous coronary intervention and thrombolysis remain therapies of choice for patients presenting with ST-segment elevation myocardial infarction (STEMI). Clinical outcome in the management of acute STEMI is dependent on myocardial reperfusion time and reperfusion strategies. Optimisation of these strategies should take into consideration logistical limitations of the local medical systems and the various patient profiles. We review the reperfusion strategies and its history in Singapore, comparing its clinical application with that in some developed Western countries. Key words: Acute Myocardial Infarction, Primary Percutaneous Coronary Intervention, ST segment Elevation Myocardial Infarction, Thrombolysis
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Ahmad, Munir, Muhammad Yasir et Asif Rahmat. « ACUTE ST ELEVATION MYOCARDIAL INFARCTION ». Professional Medical Journal 25, no 05 (10 mai 2018) : 777–83. http://dx.doi.org/10.29309/tpmj/2018.25.05.325.
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Objective: To determine the frequency of in-hospital outcomes in patients ofacute ST elevation myocardial infarction (STEMI) within five days of hospitalization with .70ST segment resolution 90 minutes post thrombolysis. Study Design: Case series. Place andDuration of Study: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad,from April, 2016 to October, 2016. Methodology: In 370 patients fulfilling the inclusion andexclusion criteria a baseline 12 lead electrocardiogram was recorded before initiation ofthrombolysis and at 90 minutes thereafter. Conventional contraindications to thrombolysis wereobserved and streptokinase 1.5 mu was administered by intravenous infusion over 60 minutes.Successful thrombolysis was taken as 70% or more ST elevation resolution at 90 minutes frombaseline electrocardiogram measured 80ms from J-point. Patients with successful thrombolysiswere observed for in-hospital clinical outcomes of recurrent angina, congestive cardiac failure,ventricular arrhythmia and death within five days of hospitalization. Results: Out of 370 cases,51.35 %( n=190) were male while 48.65 %( n=180) were female, 25.14 %( n=93) were between30-50 years of age while 74.86 %( n=277) were between 51-65 years of age, the mean agewas 54.98+5.96 years. Frequency of in-hospital outcome was recorded as 10.67 %( n=38) forcongestive cardiac failure, 14.59 %( n=54) for ventricular arrhythmia, 5.40 %( n=20) for mortalitywhile no case had recurrent angina. Conclusion: In-hospital outcome is better in patients of.70% ST resolution at 90 minutes post thrombolysis .This might assist in identification of lowrisk patients who can be discharged early and should not be considered for early invasivestrategy.
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Rashid, Shazia, Javed Anver Qureshi, Rukhshan Khurshid, Ismat Tahira, Sofia Shoukat et Uzma Faryal. « Interplay Between Adiponectin, Resistin, Lipoprotein (A) and Prognosis in Middle to old age Female Cases with ST / Non ST Elevation Myocardial Infarction ». Pakistan Journal of Medical and Health Sciences 16, no 8 (31 août 2022) : 627–29. http://dx.doi.org/10.53350/pjmhs22168627.
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Acute myocardial infarction (AMI) refers to ST-elevated myocardial infarction and non ST elevation myocardial infarction, is the known presentation of coronary artery disease. Study was planned to explore the interplay of the adipokines, resistin / lipoprotein (a) and prognosis in middle to old age female patients with ST / Non ST Elevation Myocardial Infarction. Material and Methods: A cross-sectional study was conducted on 150 middle to old age female patients with acute myocardial infarction (AMI). Consented patients were divided into 2 groups based on ST and Non ST elevation. Duration of study was six months from December 2015 to May 2016. Levels of adiponectin, lipoprotein (a) and resistin were measured. 50 healthy subjects matched for age and gender also participated in study. Results: Mean age of patients with NSTEMI was 58.89 while with STEMI was 50.59 years. Decreased levels of serum adinopectin, resistin and lipoprotein A was observed in female patients with NSTEMI in comparison with these parameters of STEMI, but significantly high level was seen in context of resistin. Positive correlation of age with serum adiponectin and resistin and a negative correlation of age with serum lipoprotein (a) was in female patients with STEMI and NSTEMI. Conclusion: Study found a direct interaction of adiponectin and resistin with strong prognosis of ST and weak prognosis of Non ST elevation of myocardial infarction; whereas lipoprotein (a) showed a strong indirect interaction with age in women with both STEMI and NSTEMI. Keywords: Adiponectin, lipoprotein (a), resistin, STEMI and NSTEMI.
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Hashmi, Syed Fasih Ahmed, Mashooq Ali Dasti, Nisar Ahmed Shah, Syed Saad Hussain, Munaza Gohar, Zul Farah et Syed Zulfiquar Ali Shah. « ST ELEVATION MYOCARDIAL INFARCTION ». Professional Medical Journal 22, no 05 (10 mai 2015) : 536–40. http://dx.doi.org/10.29309/tpmj/2015.22.05.1262.
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OBJECTIVE: To evaluate the frequency of hyponatremia and its prognosticimportance in ST elevation myocardial infarction. Period: Six months. Design: Case series.Setting: Tertiary care hospital Hyderabad. Methods: All the cases with ST elevation myocardialinfarction admitted in the CCU were recruited and evaluate for serum sodium level at admissionand then at 24, 48 and 72 hours. The data was analyzed in SPSS 16 and the frequency andpercentage was calculated. Results: One hundred patients with acute myocardial infarctionwere recruited and assessed for sodium level. The mean age ±SD of whole population was57.52±9.51 whereas in male and female population it was 58.72±7.53 and 53.84±7.93respectively. The sodium level was 130.21±3.42 and 127.41±4.21 in male and femalepopulation. The p-value was statistically significant (<0.01) in context to age and sex whereasthe age in context to hyponatremia is non significant (p=0.77). The hyponatremia and itsseverity was statistically significant in context to sex (p=0.04) and duration of the myocardialinfarction (p=0.03). The serum sodium level in context to duration of MI was also significant(p=0.03) whereas the mortality at the end of 30 days was 11% of which 02 patients had normalsodium level while the 09 had low sodium level (hyponatremia). Conclusion: Hyponatremia inpatients with acute STEMI is a important predictor of thirty days mortality.
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Koeth, Oliver, Uwe Zeymer, Rudolf Schiele et Ralf Zahn. « Inferior ST-Elevation Myocardial Infarction Associated with Takotsubo Cardiomyopathy ». Case Reports in Medicine 2010 (2010) : 1–4. http://dx.doi.org/10.1155/2010/467867.
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Takotsubo cardiomyopathy (TCM) is usually characterized by transient left ventricular apical ballooning. Due to the clinical symptoms which include chest pain, electrocardiographic changes, and elevated myocardial markers, Takotsubo cardiomyopathy is frequently mimicking ST-elevation myocardial infarction in the absence of a significant coronary artery disease. Otherwise an acute occlusion of the left anterior descending coronary artery can produce a typical Takotsubo contraction pattern. ST-elevation myocardial infarction (STEMI) is frequently associated with emotional stress, but to date no cases of STEMI triggering TCM have been reported. We describe a case of a female patient with inferior ST-elevation myocardial infarction complicated by TCM.
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SKS, Lairikyengbam. « Pharmaco-Invasive Therapy for Acute ST-Elevation Myocardial Infarction. - A Viable Alternative to Primary Percutaneous Coronary Intervention ». Clinical Cardiology and Cardiovascular Interventions 3, no 12 (25 novembre 2020) : 01–03. http://dx.doi.org/10.31579/2641-0419/098.
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Primary percutaneous coronary intervention (pPCI) is considered as the preferred treatment for acute ST-Elevation myocardial infarction (STEMI). However, its availability is limited to less than 10% in rural and sub urban population in India (1). Therefore, Pharmaco-Invasive Therapy (PIT) (Thrombolysis first followed by planned coronary stenting) as an alternative to pPCI for acute STEMI has more recently been explored. A retrospective observational study of 60 patients with acute STEMI treated at the Dedicated Heart Attack Treatment Centre of SKY Hospital & Research Centre, Imphal, India over a period of 2 years has shown that Pharmaco-Invasive Therapy improved survival of patients with acute STEMI to 100% and increased Left Ventricular Ejection Fraction (LVEF) by 5.08% at the time of discharge and may be used as a viable alternative to pPCI in the treatment of patients with acute STEMI when pPCI cannot be performed within recommended time.
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Manzur Barbur, Maria Carolina, Maria Cristina Martínez-Ávila Martínez-Ávila et Angélica Imitola Madero. « Acute ST-segment elevation myocardial infarction : to be or not to be ? » Archive of Clinical Cases 9, no 1 (10 janvier 2022) : 19–23. http://dx.doi.org/10.22551/2022.34.0901.10198.
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Calcium has a significant effect on cells in the myocardium, affecting conduction, intracellular signaling and contraction of muscle fibers. In fact, calcium levels could affect myocardial action potential and affect heart conduction. Hypocalcemia manifest on ECG with arrythmias or QT prolongation, in some extraordinary cases, it could present with variations in the ST segment, which requires the study of differential diagnoses of cardiac origin, such as acute myocardial infarction with ST elevation (STEMI) or pericarditis. We expose a case of a 28-year-old male patient who arrived at the emergency department with chest pain and was misdiagnosed with STEMI, after a complex process finally it was a severe hypocalcemia mimicking acute myocardial infarction.
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Sari, Enna Berkah, Nizam Zikri Akbar et Herman Hariman. « Immature Platelet Fraction (IPF) Levels in Acute Coronary Syndrome (ACS) Patients ». International Journal of Research and Review 8, no 8 (29 août 2021) : 682–88. http://dx.doi.org/10.52403/ijrr.20210890.
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Background: Acute Coronary Syndrome (ACS) is a major cardiovascular problem because it causes high hospital admissions and mortality rates. Acute Coronary Syndrome is divided into 3 (three), namely: unstable angina pectoris (UAP), myocardial infarction without ST segment elevation (NSTEMI), and myocardial infarction with ST segment elevation (STEMI). In addition to changes in biomarkers of heart injury, the platelet index (IPF = immature platelet fraction) will also change the level difference between STEMI with NSTEMI/UAP. Objective: To determine the differences in IPF levels of ACS patients with STEMI and NSTEMI/UAP Method: Observational analytic with cross sectional approach. The subjects of this study were 80 patients who came to the emergency installation of integrated heart center Emergency Room Haji Adam Malik Hospital Medan from May 2019 to September 2019 and was diagnosed with ACS (STEMI or NSTEMI/UAP). The sample in the study was the patient's venous blood and put it in an EDTA tube, then immediately checked the IPF value/level using the automatic hematology analyzer. Patients with heart failure or patients with thrombocytopenia were not included in this study. Results: In this study, the demographic characteristics of the ACS patients based on gender were male 77.5% STEMI and 87.5% NSTEMI/UAP while women 22.5% STEMI and 12.5% NSTEMI/UAP. The results of the STEMI patient's IPF levels Compared with NSTEMI/UAP, the median is 6.2 (3.5-16.8) VS 2.9 (0.7-12) with a p-value of 0.0001. Conclusion: The characteristics of ACS patients based on the results of sex were that there were more men with NSTEMI/UAP than those with STEMI. There was a significant difference in the IPF levels of STEMI with NSTEMI/UAP. Keywords: Immature Platelet Fraction (IPF), Acute Coronary Syndrome (ACS), ST-Segment Elevation Myocardial Infarction (STEMI), Non ST-Segment Elevation Myocardial Infarction (NSTEMI), Unstable Angina Pectoris (UAP).
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Matte, Bruno da Silva, et Alexandre Damiani Azmus. « Acute Myocardial Infarction Caused by an Anomalous Right Coronary Artery Occlusion Presenting with Precordial ST Elevation ». Case Reports in Cardiology 2017 (2017) : 1–4. http://dx.doi.org/10.1155/2017/3972830.
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Acute coronary syndrome with precordial ST segment elevation is usually related to left anterior descending artery occlusion, although isolated right ventricular infarction has been described as a cause of ST elevation in V1–V3 leads. We present a case of a patient with previous inferior wall infarction and new acute ST elevation myocardial infarction (STEMI) due to proximal right coronary thrombotic occlusion resulting in right ventricular infarction with precordial ST elevation and sinus node dysfunction. The patient was treated with successful rescue angioplasty achieving resolution of acute symptoms and electrocardiographic abnormalities.
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Kalkan, Asim, Bora Cekmen, Behlul Bas, Mehmet Taylan Kocer, Ahmet Demirel et Bilge Deniz Tayfun. « Total Occlusion of the Left Descending and circumflex Coronary Artery without ST Elevation : the De Winter electrocardiographic pattern ». Acute Medicine Journal 19, no 3 (1 juillet 2020) : 159–61. http://dx.doi.org/10.52964/amja.0821.
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de Winter syndrome, or anterior ST segment elevation myocardial infarction (STEMI), constitutes 2% of acute myocardial infarctions. In contrast to classic ST segment elevation as seen with STEMI, it involves ST depression with precordial derivations and sharp waves. de Winter syndrome indicates critical narrowing of the left ascending coronary artery (LAD). Recognizing this presentation is important in terms of both mortality and morbidity. We present the case of a 71-year old patient presenting at the Emergency Department with chest pain, who had findings of de Winter syndrome on their ECG. Coronary angiography confirmed occlusions in the LAD and circumflex (CX) coronary arteries.
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Agrawal, Akanksha, Nuzhat Sayyida, Jorge Luis Penalver et Mary R. Ziccardi. « Acute Pancreatitis Mimicking ST-Segment Elevation Myocardial Infarction ». Case Reports in Cardiology 2018 (24 octobre 2018) : 1–3. http://dx.doi.org/10.1155/2018/9382904.
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Introduction. Electrocardiographic changes imitating myocardial ischemia have been occasionally reported in patients with intra-abdominal pathology including acute pancreatitis. Case Report. A 60-year-old man with no past medical history presented to the emergency department (ED) after a syncopal episode. In ED, his vitals were stable. His ECG showed sinus bradycardia at 53 beats per minute, peaked T waves, 1 mm ST-segment elevation in leads II, III, and aVF, and 2 mm ST elevation in V3 as shown in the figures. With the concern for STEMI, he was taken for left heart catheterization (LHC) emergently, showing nonobstructive coronary artery disease (CAD). His laboratory workup was remarkable for lipase of 25,304 IU/l (normal level 8–78 IU/l). His liver function test and triglyceride level were normal. Troponin was <0.01 ng/ml. A computed tomographic exam of the abdomen revealed acute interstitial pancreatitis with a small discrete fluid collection in the uncinate process. He was treated with aggressive intravenous fluid resuscitation and was discharged on day 3. Discussion. Intra-abdominal pathologies like acute pancreatitis can lead to transient ECG changes mimicking STEMI. It is important to use ECG clues, echocardiographic findings, and clinical judgement to avoid cardiac catheterization, contrast exposure, and associated health care costs.
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Intan, Ryan Enast, Fani Suslina Hasibuan, Parama Gandi et Firas F. Alkaff. « Gastric perforation mimicking ST-segment elevation myocardial infarction ». BMJ Case Reports 14, no 3 (mars 2021) : e237470. http://dx.doi.org/10.1136/bcr-2020-237470.
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ST-elevation myocardial infarction (STEMI) is one of the medical emergencies in cardiology with high morbidity and mortality rate which requires rapid response. In elderly patients, its presenting symptoms may be atypical which may cause the diagnosis of MI to be delayed or missed. Therefore, ST-segment elevation on ECG has become the main instrument for initial diagnosis. However, there are a variety of conditions mimicking the ECG changes of STEMI. We report a case of 70-year-old patient with acute peritonitis and pneumoperitoneum secondary to gastric perforation with dynamic ECG changes mimicking anteroseptal STEMI. After the surgery, the ECG dynamically reverted to normal. He was then discharged after 4 days without any remaining symptoms. Misinterpretation of ECG findings may lead to unnecessary aggressive intervention, costly management strategies and delay in appropriate treatment.
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Stengaard, Carsten, Jacob Thorsted Sørensen, Martin Bøhme Rasmussen, Morten Thingemann Bøtker, Claus Kjær Pedersen et Christian Juhl Terkelsen. « Prehospital diagnosis of patients with acute myocardial infarction ». Diagnosis 3, no 4 (1 décembre 2016) : 155–66. http://dx.doi.org/10.1515/dx-2016-0021.
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Meier, Pascal, Alexandra J. Lansky et Andreas Baumbach. « Almanac 2013 : acute coronary syndromes ». Seminars in Cardiovascular Medicine 19, no 2 (1 décembre 2013) : 30–38. http://dx.doi.org/10.2478/semcard-2013-0005.
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Summary Unstable coronary artery plaque is the most common underlying cause of acute coronary syndromes (ACS) and can manifest as unstable angina, non-ST segment elevation infarction (NSTE-ACS), and ST elevation myocardial infarction (STEMI), but can also manifest as sudden cardiac arrest due to ischaemia induced tachyarrhythmias. ACS mortality has decreased significantly over the last few years, especially from the more extreme manifestations of ACS, STEMI, and cardiac arrest. This trend is likely to continue based on recent therapeutic progress which includes novel antiplatelet agents such as prasugrel, ticagrelor and cangrelor.
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Peddi, Kanksha, Alexander L. Hsu et Tomas H. Ayala. « Infective Aortic Valve Endocarditis Causing Embolic Consecutive ST-Elevation Myocardial Infarctions ». Case Reports in Cardiology 2019 (14 octobre 2019) : 1–5. http://dx.doi.org/10.1155/2019/2487616.
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ST-elevation myocardial infarction (STEMI) is a rare and potentially fatal complication of infective endocarditis. We report the ninth case of embolic native aortic valve infective endocarditis causing STEMI and the first case to describe consecutive embolisms leading to infarctions of separate coronary territories. Through examination of this case in the context of the previous eight similar documented cases in the past, we find that infective endocarditis of the aortic valve can and frequently affect more than a single myocardial territory and can occur consecutively. Further, current treatment modalities for embolic infective endocarditis causing acute myocardial infarction are limited and unproven. This index case illustrates the potential severity of complications and the challenges in developing standardized management for such patients.
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Ratnaningsih, Tri, et Istiqomah Istiqomah. « Increased Mean Platelet Volume (MPV) in Patients with ST Elevation Myocardial Infarction (STEMI) Compared to Non-ST Elevation Myocardial Infarction (NSTEMI) Patients ». Medical Laboratory Technology Journal 6, no 2 (29 novembre 2020) : 145. http://dx.doi.org/10.31964/mltj.v6i2.320.
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Platelets are known to have a role major in the pathogenesis of atherothrombosis. More giant and hyperreactive platelets accelerate the formation of an intracoronary thrombus. An increased MPV as an indicator of larger and more reactive platelets represents a risk factor for overall vascular mortality, including myocardial infarction. This study aimed to identify the increase of Mean Platelet Volume in Patients with Acute Coronary Syndromes, especially in ST-elevation myocardial infarction and Non-ST-elevation myocardial infarction. Thus this parameter can be used as consideration for diagnosis and treatment decisions. This research is an analytic observational with a cross-sectional method. The subjects were patients with STEMI and NSTEMI who were hospitalized in ICCU Dr.Sardjito Hospital Yogyakarta. Thirty-four subjects STEMI and NSTEMI patients at Dr. Sardjito Hospital, consisting of 28 males (82,35%) and six women (17,65%) with a mean age of 55,5 ± 10,3 years. The results showed that MPV in AMI was higher in patients with STEMI than NSTEMI, but this difference is not significant (p = 0,091). This study concludes that MPV to be higher in patients with STEMI compared to NSTEMI. MPV may be used as a marker of myocardial infarction in clinically appropriate situations.
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Nency, Cahyu, Muhammad Kevin Surya et Andy Kurnia. « Gagal Jantung Akut sebagai Komplikasi Sindrom Koroner Akut ». Cermin Dunia Kedokteran 50, no 1 (4 janvier 2023) : 30–35. http://dx.doi.org/10.55175/cdk.v50i1.336.
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Gagal jantung akut adalah kondisi medis yang dapat mengancam nyawa ditandai dengan perburukan gejala dan tanda gagal jantung. Gagal jantung akut dapat disebabkan oleh sindrom koroner akut subset ST elevation myocardial infarction (STEMI). Perlu diagnosis yang cepat dan tata laksana yang tepat guna menurunkan risiko morbiditas, re-hospitalisasi, dan mortalitas gagal jantung akut.
Acute heart failure is a life-threatening condition characterized by worsening symptoms and signs of heart failure. Acute heart failure can occur with acute coronary syndrome with ST elevation myocardial infarction (STEMI). Rapid diagnosis and appropriate management is required to reduce its morbidity, re-hospitalization, and mortality.
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Thani, Khalid Bin, Fajer Al-Moosa, Eman Murad, Aisha Al-Moosa, Mohamed E. Alalawi et Hind Al-Sindi. « Stent Thrombosis after Rescue Percutaneous Coronary Intervention in Acute ST-Segment Elevation Myocardial Infarction ». Open Cardiovascular Medicine Journal 9, no 1 (29 décembre 2015) : 127–32. http://dx.doi.org/10.2174/1874192401509010127.
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Main Problem:To determine the incidence of coronary stent thrombosis (ST) in patients with acute ST segment elevation myocardial infarction (STEMI) after rescue percutaneous coronary intervention (PCI). Methods:An observational study looking at the incidence of ST in a middle-eastern population. A total of 510 consecutive patients presented with ST-segment elevation myocardial infarction (STEMI) were enrolled and underwent thrombolytic therapy with a total follow-up period of 2 years. Study outcomes were ST, death, re-infarction or acute coronary syndrome requiring coronary angiography and PCI. Results:A total of 510 patients enrolled, all diagnosed with STEMI and underwent thrombolytic therapy. Only 100 subjects underwent rescue PCI with intra-coronary stenting, including 54 patients with drug-eluting stent (DES) and 46 patients with bare metal stent (BMS). During the study period and follow-up, the overall rate of ST was 13.7%, definite ST occurred in 6 patients (5.5%), probable ST in 8 patients (7.3%), and possible ST in one patient (0.9%), including 0.9% acute ST, 0.9% sub-acute ST, 2.8% late ST and 8.3% very late ST. Patients with ST were likely to have prior PCI (p=0.001), prior coronary artery bypass grafting (CABG) (p=0.002) and history of heart failure (p=0.04). Conclusion:ST is infrequent event with major consequences in patients presenting with STEMI in the first 2 years after stent implantation.
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Jayaprasad, N., et Suresh Madhavan. « Pheochromocytoma Presenting As Acute Myocardial Infarction ». Nepalese Heart Journal 12, no 2 (15 septembre 2015) : 89–92. http://dx.doi.org/10.3126/njh.v12i2.13388.
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Pheochromocytomas are rare neuro-endocrine tumors arising from chromaffin cells of the sympathetic nervous system.Pheochromocytomacan have diverse clinical presentations, which makes the diagnosis often difficult. We present a case of adrenalpheochromocytoma presenting as acute ST elevation myocardial infarction (STEMI). Catecholamine surge in patients with pheochromocytoma can cause myocardial infarction in the absence of atherosclerotic coronary artery disease. Pheochromocytoma presenting as acute myocardial infarction is very rare and it occurs in young individuals. This is a rare case report of pheochromocytoma in an elderly male presenting with acute STEMI successfully treated by resection of tumor.Nepalese Heart Journal 2015;12(2):89-92
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Fiorentino, Francesca, Raquel Ascenção et Nicoletta Rosati. « Does acute myocardial infarction kill more people on weekends ? Analysis of in-hospital mortality rates for weekend admissions in Portugal ». Journal of Health Services Research & ; Policy 23, no 2 (avril 2018) : 87–97. http://dx.doi.org/10.1177/1355819617750687.
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Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011–2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes. We employed multivariable logistic regressions to determine the association between weekend admission and in-hospital mortality, controlling for episode complexity (through a severity index and acute comorbidities), demographic characteristics and hospital identifications. The association between the probability of a prompt surgery (within one day) and the day of admission was investigated to explore the possible delay of care delivery for patients admitted during weekends. Results Our results indicate that in-hospital mortality rates were not significantly higher for weekend admissions than for weekday admissions in both ST-elevation myocardial infarction (STEMI) and non-STEMI episodes. This result is robust to the inclusion of a number of potential confounding mechanisms. Patients admitted on weekends had lower probabilities of undergoing invasive cardiac surgery within the day after admission, but delay in care delivery during the weekend was not associated with worse outcomes in terms of in-hospital mortality. Conclusions There is no evidence for the existence of a weekend effect due to admission for acute myocardial infarction in Portugal, in both STEMI and non-STEMI episodes.
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Khan, Sayeedur Rahman, Fazila Tun Nesa Malik, Mir Nesaruddin Ahmed, Asim Kumar Biswas, Mainul Islam, Bivash Kumer Sheel, Sharmin Tahmina Khan, Hasan Mahmud Iqbal et Md Rafiqul Islam. « Comparison of Risk Factors & ; Angiographic Profiles between Young Patients with ST Segment Elevation Myocardial Infarction and Non-ST Segment Elevation Myocardial Infarction ». Bangladesh Heart Journal 36, no 2 (31 octobre 2021) : 124–32. http://dx.doi.org/10.3329/bhj.v36i2.56038.
Texte intégralRésumé :
Background: Coronary artery disease is the leading cause of death in the world. Advancing age is a well-recognized risk factor for acute myocardial infarction (AMI). Myocardial infarction is less common in young adults. Prevalence of acute coronary syndrome in young individuals is increasing progressively. These patients have different risk profile, presentation and prognosis. Early recognition and risk factor modification in this population sub-set is of key importance. Objectives: The purpose of the present study was to determine the differences in risk factors and coronary angiographic profile of young patients with ST-segment elevated myocardial infarction (STEMI) vs. those with non-ST-segment elevated myocardial infarction (NSTEMI). Methods: In this cross sectional analytical study total 135 patients (70 STEMI and 65 NSTEMI) aged ≤45 years were enrolled to see the differences of risk factors and angiographic profile. Results: The mean age of the study population was 39.39±5.12 years and the study showed male predominance (90.40 % was male and 9.60 % was female). Smoking/tobacco consumption was significantly higher in STEMI patients, whereas diabetes mellitus and hypertension were more prevalent in NSTEMI patients. The frequency of single vessel disease and involvement of left anterior descending artery was significantly higher in young STEMI patients. In case of young NSTEMI patients frequency of triple vessel disease, noncritical coronary artery disease and involvement of left circumflex coronary was significantly higher. The frequency of double vessel disease and involvement of left main coronary artery was also nonsignificantly higher in young NSTEMI patients. There was no significant difference regarding involvement of right coronary artery. Conclusion: There are significant differences between young STEMI and young NSTEMI patients in respect to risk factors and angiographic profile. Key words: Young patient, STEMI, NSTEMI, Risk factors, Coronary angiographic profile. Bangladesh Heart Journal 2021; 36(2): 124-132
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Wu, Gregory, Brianna Bockman et Jesse Perez. « Acute Myocardial Infarction Complicated by Very Severe Hypertriglyceridemia ». Case Reports in Acute Medicine 3, no 3 (17 novembre 2020) : 79–82. http://dx.doi.org/10.1159/000511065.
Texte intégralRésumé :
Hypertriglyceridemia (HTG) is the elevation of serum triglyceride levels above 150 mg/dL and is linked to complications such as pancreatitis and increased mortality risk. An uncommonly known co-presentation of HTG is acute ST-elevation myocardial infarction (STEMI), with the literature citing only one other case of acute STEMI complicated by very severe HTG. We report on a 36-year-old male with multiple comorbidities presenting with acute STEMI and elevated pancreatic enzymes suggestive of pancreatitis. A subsequent lipid profile revealed very severe HTG with a triglyceride level of 2,700 mg/dL. We discuss the pathogenesis, management, and screening guidelines of very severe HTG. Clinicians should be aware that acute STEMI complicated by HTG is rare and that earlier detection and intervention may allow for the prevention of life-threatening complications.
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Krisnasari, Imelda, Anna Fuji Rahimah, Sasmojo Widito et Cholid Tri Tjahjono. « Diastolic Dysfunction following Acute Myocardial Infarction with ST Segment Elevation ». Heart Science Journal 3, no 2 (30 avril 2022) : 3–9. http://dx.doi.org/10.21776/ub.hsj.2022.003.02.2.
Texte intégralRésumé :
ST segment elevation myocardial infarction (STEMI) caused by atherosclerotic vulnerable plaque rupture or plaque erosion, resulting in activation of the coagulation cascade. It causes a temporal sequence known as the “ischemic cascade,” which first involves the metabolic process, the diastolic dysfunction, and then systolic dysfunction. Diastolic dysfunction in STEMI patient is an independent predictor for long-term outcome. Rapid and early restoration of blood flow is critical to ensure cell recovery and prevent additional damage.
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Ullah, Zia, Aman Ullah et Mujeeb Alam Khan. « Incidence of Cardiogenic Shock Among Acute STEMI Cardiac Patients ». Pakistan Journal of Medical and Health Sciences 16, no 3 (26 mars 2022) : 775–77. http://dx.doi.org/10.53350/pjmhs22163775.
Texte intégralRésumé :
Coronary Artery disease is a serious health issue affecting both men and women thus becoming the leading cause of death globally. Aims: To determine the frequency of cardiogenic shock in patients with acute ST elevation myocardial infarction. Study Design: Cross-sectional comparative study. Methodology: All newly diagnosed acute ST elevation MI patients were included. Detailed history followed by detailed clinical examination was done. ECG and urinary output were measured to detect ICS. All this information was recorded on Performa. Statistical analysis: Data was analyzed using SPSS version 25. Cardiogenic shock was stratified among age and gender by applying chi square test. Results: Age as mean ± SD was 60 ± 1.26 years. Males were 68% while females were 32% enrolled in present study. Results showed that only 10% patients had cardiogenic shock while 90% were without it. Conclusion: It was concluded that the frequency of cardiogenic shock was low (10%) in patients with acute ST elevation myocardial infarction. Keywords: Cardiogenic Shock, Myocardial Infarction and Mortality.
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Lee, Wen-Hsien, Meng-Kuang Lee et Chih-Tsung Liu. « Acute pulmonary embolism concomitant with ST-elevation myocardial infarction in a patient with pancreatic cancer ». Case Reports in Internal Medicine 5, no 1 (5 mars 2018) : 43. http://dx.doi.org/10.5430/crim.v5n1p43.
Texte intégralRésumé :
Acute pulmonary embolism (PE) and ST-elevation myocardial infarction (STEMI) have different etiology; however, PE might be concomitant with STEMI in rarely seen patient cases. Here, we present a 62-year-old male with pancreatic cancer who had acute PE and STEMI.
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Копиця М. П., Кутя І. М. et Родіонова Ю. В. « ВАСКУЛОЕНДОТЕЛІАЛЬНИЙ ФАКТОР РОСТУ А ТА ПОЛІМОРФІЗМ G634C ГЕНА ВЕФР-A У ХВОРИХ ІНФАРКТОМ МІОКАРДА В ГОСТРИЙ ТА ВІДДАЛЕНИЙ ПЕРІОДИ ». World Science 2, no 8(36) (31 août 2018) : 11–17. http://dx.doi.org/10.31435/rsglobal_ws/30082018/6061.
Texte intégralRésumé :
Vascular endothelial growth factor A (VEGF-A) promotes the survival of endothelial cells during acute myocardial infarction, accelerates the development of collateral blood supply to ischemic myocardium, and affects the size diminishing of the necrotic lesion area. The synthesis of the VEGF- A in response to standard stimuli is different between people that is genetically determined. The aim was to study the association of polymorphous variants of the VEGF-A gene (G634C) with the dynamics of structural and functional parameters of left ventricle in patients with acute ST elevation myocardial infarction (STEMI) during a 6-month period.A significantly higher VEGF-A concentration was determined in the carriers of the GG genotype compared to the GC genotype (p = 0.047) in the acute period. It has been established that the genotype GC in patients with acute myocardial infarction ST-elevation (STEMI) is associated with more pronounced changes in the left ventricular geometry during the acute period. The GC genotype is associated with a better blood pressure control and a decrease in the left ventricle mass after 6 months’ observation.
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Mously, Haytham, Mohammed Wazzan, Ahmed Z. Alkhathlan et Indiresha Iyer. « Seizure-Associated ST Elevation Myocardial Infarction in Absence of Plaque Rupture ». Case Reports in Medicine 2018 (2018) : 1–4. http://dx.doi.org/10.1155/2018/6186521.
Texte intégralRésumé :
Acute coronary syndrome (ACS) is a very common cause of morbidity and mortality in the U.S. Here, we present a case of acute ST elevation myocardial infarction (STEMI) in the setting of seizure activity. In this rare case, we have data from optical coherence tomography (OCT) that showed no plaque disruption, showing the role of OCT in understanding the pathophysiology of STEMI and providing some ideas for the mechanism of this seizure-induced STEMI.
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DĂDÂRLAT-POP, Alexandra, Horea ROȘIANU, Renaldo POPTILE, Raluca TOMOAIA, Ruxandra BEYER et Adela ȘERBAN. « Can inflammatory biomarkers play a role in the inclusion of patients with acute myocardial infarction in cardiac rehabilitation programs ? » Balneo and PRM Research Journal 12, no 3 (1 septembre 2021) : 255–60. http://dx.doi.org/10.12680/balneo.2021.445.
Texte intégralRésumé :
Introduction: In spite of the enormous progress made over the last decades, acute coronary syndromes remain the leading cause of death globally. Inflammation plays an important role in coronary artery disease development. Although the role of inflammatory biomarkers in acute obstructive myocardial infarction is well established, there is no data regarding the potential differences between acute myocardial infarction (AMI) with ST segment elevation, AMI without ST segment elevation (NON-STEMI) and non-obstructive acute myocardial infarction (MINOCA), respectively. Also, it is well known that cardiac rehabilitation of acute myocardial infarction survivors significantly improves their long-term prognosis. Aim of the study: To asses the possible existing differences between patients with STEMI, NON-STEMI and MINOCA in terms of clinical and paraclinical parameters, especially inflammatory biomarkers. A second objective of our study was to describe the relationship between inflammatory, cardiac necrosis enzymes and left ventricle systolic function. Material and methods: The study included 35 adult patients admitted in the Cardiology service of the Niculae Stăncioiu Heart Institute, Cluj-Napoca with acute myocardial infarction. Demographic, clinical, echocardiographic and laboratory data were analyzed. Patients were divided into 3 groups, 19 patients (54.2%) were diagnosed with STEMI- group 1, 9 patients (25.7%) with NON-STEMI- group 2 and 7 patients (20%) with MINOCA- group 3, respectively. Dosage of serum inflammatory markers was performed on the day of admission. Results and conclusion: The most common associated cardiovascular risk factor was arterial hypertension (65.7% of patients). Markers of myocardial necrosis (CK, CK-MB, hs Troponin) were significantly higher in patients with STEMI (p <0.05) in comparison with NON-STEMI and MINOCA patients. Congestive heart failure was most frequently encountered in STEMI patients. hsCRP value was higher among patients with STEMI. The value of ESR was significantly higher among patients with NON-STEMI. Serial dosage of inflammation biomarkers in patients with recent acute myocardial infarction may serve as valuable risk stratification instruments and also for functional capacity and recovery status assessment in patients included in cardiac rehabilitation programs. Keywords: acute coronary syndrome; inflammatory biomarkers; non-obstructive acute myocardial infarction,
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Sachdewani, Raj Kumar, Lal Chand Dingra et Aijaz Hussain Memon. « ACUTE STEMI ». Professional Medical Journal 25, no 05 (10 mai 2018) : 759–63. http://dx.doi.org/10.29309/tpmj/2018.25.05.322.
Texte intégralRésumé :
Objectives: To find a relationship between acute ST elevation myocardialinfarction (STEMI) and two major risk factors i.e. diabetes type 2 and hypertension in adultpatients admitted in cardiology department of Ghulam Muhammad Mahar Medical CollegeSukkur. Study Design: Cross-sectional study. Study Setting: Department of Cardiology,Ghulam Muhammad Mahar Medical College Sukkur. Period: October 2016 to March 2017. 6months. Material and Methods: Total of 764 patients aged 18-80 years were included in thestudy population on bases of history of chest discomfort and sudden ST elevation MI (STEMI).Those patients with unstable angina and those cases which presented with Q waves wereexcluded from study population. Blood pressure and blood sample were taken and analyzedin the institution laboratory. Results: Off 764 anterior wall Myocardial infarction (includingextensive) was seen in 367(48%) while inferior wall Myocardial infarction (including RV andposterior) was recorded in 397(52%) of the study population. 118 (15.44%) were hypertensiveand also had diabetes off which 8.11% were female and chi square test reveals a relationshipbetween sex and diabetes and hypertension in the study population. Conclusion: A relationshipof hypertension and diabetes with STEMI is there. Primary prevention and proper screenprogram needs to be in place to identify the submerge part of the iceberg.
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Beckenbauer, Dominik, Valeria Martínez Pereyra et Peter Ong. « STEMI-Äquivalente im EKG – eine fallbasierte Darstellung ». DMW - Deutsche Medizinische Wochenschrift 145, no 05 (mars 2020) : 318–26. http://dx.doi.org/10.1055/a-0999-0101.
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AbstractThe 12-lead resting ECG remains an indispensable diagnostic tool in patients with acute chest pain. This is particularly important as the identification of ST-segment elevations leads to the diagnosis of ST-segment elevation myocardial infarction (STEMI) and subsequent, immediate coronary reperfusion (usually via primary PCI). However, correct interpretation of the 12-lead ECG in patients with acute chest pain remains challenging. Apart from “classical” ST-segment elevations there are several “equivalents” in the ECG pointing towards an acute coronary occlusion. Among these, hyperacute T-waves, subtle ST-segment elevations, ST-segment elevation in leads aVR/V1 with concomitant ST-segment depression in ≥ 8 other leads and high R-peak with positive T-waves combined with horizontal ST-segment depression in leads V1/V2 can be found. This article provides a case-based presentation of STEMI equivalents on the ECG in order to improve correct ECG interpretation and prognosis of such patients.
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Khorolets, E. V., S. V. Shlyk et L. A. Khaisheva. « HEART FAILURE PREDICTION MARKERS IN PATIENTS OF ACUTE MYOCARDIAL INFARCTION ». Journal of Volgograd State Medical University 76, no 4 (28 décembre 2020) : 56–61. http://dx.doi.org/10.19163/1994-9480-2020-4(76)-56-61.
Texte intégralRésumé :
The article is devoted to the study of the patients with acute ST-segment elevation myocardial infarction (STEMI) complicated by acute heart failure (AHF). Clinical data were assessed, including the level of stimulating growth factor (ST-2) and growth differentiation factor (GDF-15), depending on the degree of AHF classification of T. Killip. It has been established that ST-2 is a marker of AHF prognosis in STEMI patients at the hospital stage of treatment. GDF-15 reaches high valuesт in acute left ventricular failure.
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Jánosi, András, Péter Ofner, János Tomcsányi, Gábor Müller, Richárd Hável, Asma Réka Soczó, Timea Váradi et Tamás Ferenci. « A kórházi felvétel idején rögzített EKG jelentősége a szívinfarktus miatt kezelt betegek prognózisának meghatározásában ». Orvosi Hetilap 159, no 17 (avril 2018) : 677–81. http://dx.doi.org/10.1556/650.2018.31013.
Texte intégralRésumé :
Abstract: Introduction and aim: By using the database of the National Registry of Myocardial Infarction, the authors examine the prognosis of patients treated with acute myocardial infarction, in case of whom there was new or presumably new left bundle branch block (nLBBB) on the ECG recorded at hospitalization. Method: We recorded the details of 18 091 patients treated with acute myocardial infarction (AMI) between 1 January 2014 and 30 June 2015 in the National Registry of Myocardial Infarction. In case of 8334 patients, the clinical diagnosis was ST-elevation myocardial infarction (STEMI), whereas in 9757 cases it was non-ST elevation myocardial infarction (NSTEMI). In the STEMI population we examined the clinical characteristics and prognosis of patients with ST-elevation (n = 7937) and nLBBB (n = 397). We used the proportional hazards regression model (Cox-regression) to examine mortality. Results: In the AMI patient population, we found LBBB in 1274 cases (7%). In case of STEMI clinical diagnosis, the patients belonging to the nLBBB subpopulation (n = 397) were older, and the proportion of men and the occurrence of co-morbidities was higher than in case of those who had ST-elevation on their ECG recorded at hospitalization. The mortality rate of the LBBB population was higher than that of the ST-elevation patient population in both the 30-day (25.4% versus 12.4%) and the 1-year period (47.3 versus 19.9%). Percutaneous coronary intervention (PCI) had significantly lower mortality in both populations. In the course of a multifactorial analysis we verified the independent prognostic significance of LBBB: the hazard ratio compared to ST-elevation was 1.33 (95% confidence interval: 1.10–1.62), checked for gender, age, occurrence of PCI, systolic blood pressure, cardiac frequency, serum creatinine difference, and the details of five anamneses/co-morbidities. Conclusion: The admission ECG has prognostic significance. Patients with LBBB have poorer prognosis compared to patients with ST-elevation on admission ECG. Orv Hetil. 2018; 159(17): 677–681.
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Bouisset, Frédéric, Jean-Bernard Ruidavets, Jean Dallongeville, Marie Moitry, Michele Montaye, Katia Biasch et Jean Ferrières. « Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction ». Journal of Clinical Medicine 10, no 2 (7 janvier 2021) : 180. http://dx.doi.org/10.3390/jcm10020180.
Texte intégralRésumé :
Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with.
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Bouisset, Frédéric, Jean-Bernard Ruidavets, Jean Dallongeville, Marie Moitry, Michele Montaye, Katia Biasch et Jean Ferrières. « Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction ». Journal of Clinical Medicine 10, no 2 (7 janvier 2021) : 180. http://dx.doi.org/10.3390/jcm10020180.
Texte intégralRésumé :
Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with.
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Vidal-Calés, Pablo, Pedro L. Cepas-Guillén, Salvatore Brugaletta et Manel Sabaté. « New Interventional Therapies beyond Stenting to Treat ST-Segment Elevation Acute Myocardial Infarction ». Journal of Cardiovascular Development and Disease 8, no 9 (24 août 2021) : 100. http://dx.doi.org/10.3390/jcdd8090100.
Texte intégralRésumé :
Myocardial infarction remains the principal cause of death in Europe. In patients with ST-segment-elevation myocardial infarction (STEMI), a promptly revascularization with primary percutaneous intervention (PCI) has transformed prognosis in the last decades. However, despite increasing successful PCI procedures, mortality has remained unchanged in recent years. Also, due to an unsatisfactory reperfusion, some patients have significant myocardial damage and suffer left ventricular adverse remodeling with reduced function—all that resulting in the onset of heart failure with all its inherent clinical and socioeconomic burden. As a consequence of longer ischemic times, distal thrombotic embolization, ischemia-reperfusion injury and microvascular dysfunction, the resultant myocardial infarct size is the major prognostic determinant in STEMI patients. The improved understanding of all the pathophysiology underlying these events has derived to the development of several novel therapies aiming to reduce infarct size and to improve clinical outcomes in these patients. In this article, based on the mechanisms involved in myocardial infarction prognosis, we review the new interventional strategies beyond stenting that may solve the suboptimal results that STEMI patients still experience.
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Vondran, Maximilian, Tamer Ghazy, Terézia Bogdana Andrási et Ardawan Julian Rastan. « ST-Segment Elevation Myocardial Infarction and Right Atrial Myxoma ». Thoracic and Cardiovascular Surgeon Reports 11, no 01 (janvier 2022) : e33-e37. http://dx.doi.org/10.1055/s-0042-1749211.
Texte intégralRésumé :
Abstract Background Cardiac myxoma is the most common primary cardiac tumor. Although benign, it can cause life-threatening complications due to embolization. Case Presentation We describe an ST-elevation myocardial infarction (STEMI) involving a giant right atrial myxoma and persisting foramen ovale (PFO) in a 64-year-old male patient and report on emergency percutaneous interventional therapy and subsequent cardiac surgery to remove the right atrial myxoma. Conclusion A right atrial myxoma, combined with a PFO, can cause a STEMI. Therefore, every acute coronary syndrome patient should undergo ultrafast exploratory emergency echocardiography to protect the physician from unpleasant surprises.
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Brankovskaya, E. Yu, L. V. Kartun, E. V. Hodosovskaya et N. P. Mitkovskaya. « ST-ELEVATION MYOCARDIAL INFARCTION AND ACUTE ISCHEMIC KIDNEY INJURY ». Emergency Cardiology and Cardiovascular Risks 4, no 2 (2020) : 979–85. http://dx.doi.org/10.51922/2616-633x.2020.4.2.979.
Texte intégralRésumé :
The aim of the study was to investigate specific clinical manifestations, homeostasis indices and parameters of the cardiovascular system in patients with acute ST-elevation myocardial infarction (STEMI) and acute ischemic kidney injury. Methods. 173 patients with STEMI participated in the study. The study group consisted of 111 patients with acute ischemic kidney injury associated with myocardial infarction (MI); 62 patients with MI and normal kidney function were enrolled in the comparison group. Clinical, anthropometric, laboratory, and instrumental diagnostic methods were used. Results. Compared with patients of the MI and normal kidney function group, those with MI and acute ischemic kidney injury had a higher average heart rate, required more prolonged vasopressor and/or inotropic therapy, and more frequently developed tachyarrhythmias with adverse prognostic impact and postinfarction aneurysms. The study revealed that patients of the MI and acute ischemic kidney injury group demonstrated more severe dilatation of the left ventricle (LV), more pronounced reduction in myocardial LV contractility according to echocardiography results; they developed multivessel coronary artery disease more frequently. Furthermore, patients of this group had a higher incidence of infarction-associated artery damage located in the proximal segments of major coronary arteries and more frequently developed thrombotic occlusion in the infarction-affected artery. Patients with MI and acute ischemic kidney injury had higher levels of inflammatory, myocardial necrosis, hemostasis and neurohormonal activation markers. Higher concentration of neutrophil gelatinase-associated lipocalin (uNGAL) was observed in patients with MI and acute ischemic kidney injury; moreover, in 14,1% of patients belonging to this group, elevated levels of this marker preceded the diagnostically significant increase in creatinine concentration and decrease in glomerular filtration rate. Conclusion. In patients with MI, the development of acute ischemic kidney injury was accompanied by more severe clinical manifestations, prognostically adverse indicators of early LV remodeling and coronary arteries disease, enhanced inflammatory processes and neuroendocrine system activity, as well as by elevated levels of myocardial necrosis and blood coagulation activity markers. The present study suggests applying uNGAL as an early marker of acute ischemic kidney injury in patients with MI.
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Wong, Chui King, Glen Chiang Hong Tan et Mohd Johar Jaafar. « An acute ST-elevation myocardial infarction which went viral ». Journal of Emergency Practice and Trauma 8, no 1 (30 novembre 2021) : 74–76. http://dx.doi.org/10.34172/jept.2021.27.
Texte intégralRésumé :
Objective: ST-elevations in electrocardiogram (ECG) secondary to an acute myocarditis may mimic ST-elevation myocardial infarction (STEMI). It is vital to distinguish between the two entities to avoid inappropriate clinical management and complications. Case Presentation: A previously well 19-year-old male presented with two episodes of central chest pain which were resolved spontaneously. His presentation was preceded by multiple episodes of vomiting, diarrhoea and abdominal pain. Physical examination was unremarkable except for a low-grade temperature of 37.7°C. The first ECG revealed ST-segment elevations in anterior leads without reciprocal changes. Serial ECGs showed increasing ST elevations and his cardiac markers were significantly raised. As the initial clinical presentation was potentially an acute coronary syndrome, he was instinctively treated with anti-platelets. Fortunately, this patient was not given thrombolysis as there were clinical suspicions of an acute myocarditis due to his young age, presence of viral symptoms, and absence of cardiac risk factors. Subsequent cardiac MRI confirmed the diagnosis of an acute myocarditis. Conclusion: An acute myocarditis is well known but less common presentation of viral infections. ST-segment elevations in ECG of any young patients with chest pain but without risk factors for acute coronary syndrome should always raise the suspicion of acute myocarditis especially in the presence of viral symptoms. Investigations such as cardiac magnetic resonance imaging (MRI) should be carried out emergently to distinguish both conditions.
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Cao, Guanglin, Zheng Zhao et Zesheng Xu. « Distribution Characteristics of ST-Segment Elevation Myocardial Infarction and Non-ST-Segment Elevation Myocardial Infarction Culprit Lesion in Acute Myocardial Infarction Patients Based on Coronary Angiography Diagnosis ». Computational and Mathematical Methods in Medicine 2022 (2 février 2022) : 1–7. http://dx.doi.org/10.1155/2022/2420586.
Texte intégralRésumé :
This research was aimed at exploring the application value of coronary angiography (CAG) based on a convolutional neural network algorithm in analyzing the distribution characteristics of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) culprit lesions in acute myocardial infarction (AMI) patients. Methods. Patients with AMI treated in hospital from June 2019 to December 2020 were selected as subjects. According to the results of an echocardiogram, the patients were divided into the STEMI group (44 cases) and the NSTEMI group (36 cases). All patients received CAG. All images were denoised and edge detected by a convolutional neural network algorithm. Then, the number of diseased vessels, the location of diseased vessels, and the degree of stenosis of diseased vessels in the two groups were compared and analyzed. Results. The number of patients with complete occlusion (3 cases vs. 12 cases) and collateral circulation (5 cases vs. 20 cases) in the NSTEMI group was significantly higher than that in the STEMI group, and the difference was statistically significant, P < 0.05 . There was a statistically significant difference in the number of lesions between the distal LAD (1 case vs. 10 cases) and the distal LCX (4 cases vs. 11 cases), P < 0.05 . There was a statistically significant difference in the number of patients with one lesion branch (1 vs. 18) and three lesion branches (25 vs. 12) between the two groups, P < 0.05 . The image quality after the convolution neural network algorithm is significantly improved, and the lesion is more prominent. Conclusion. The convolutional neural network algorithm has good performance in DSA image processing of AMI patients. STEMI and NSTEMI as the starting point of AMI disease analysis to determine the treatment plan have high clinical application value. This work provided reference and basis for the application of the convolutional neural network algorithm and CAG in the analysis of the distribution characteristics of STEMI and NSTEMI culprit lesions in AMI patients.
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Munteanu, Alice E., Cristina M. Calcan et Irina Florescu. « Evolution of mortality rates in ST elevation myocardial infarction ». Romanian Journal of Military Medicine 121, no 1 (1 avril 2018) : 7–10. http://dx.doi.org/10.55453/rjmm.2018.121.1.1.
Texte intégralRésumé :
The purpose of this paper is to provide information about mortality rate in patients undergoing primary angioplasty for STEMI. Cardiovascular diseases lead to one third of the deaths worldwide, surpassing the mortality rate produced by neoplasia, acute respiratory failure and diabetes mellitus all together. In the world, approximately 17 million die annually because of cardiovascular disease and every 5 seconds one is suffering from a myocardial infarction. In 2010, in our country was implemented a national program (RO-STEMI) to offer rapid interventional treatment for patients with STEMI, aligned to ESC Guidelines. At the beginning only small parts of the patients were transferred to the hospital in charge for STEMI, so, we chose to study patients from the second year of the program and from last year. We made a retrospective study, including patients with STEMI that reached our hospital for primary angioplasty in the first 12h after the debut of the symptoms, aiming to make a parallel between the in-hospital mortality rates at maximum one month after the primary PCI. In order to be included, the patients must present ST elevation and another 1 out of 3 criteria (clinical, echocardiographic and biological changes suggestive for myocardial infarction). The main target was to evaluate the evolution of early mortality rates post primary PCI after the changes in the ESC Guidelines and the progresses in the medical field. A secondary target was to correlate mortality rates with the presence of comorbidities or risk factors.
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J.Kadhim, Dheyaa, Kassim J.Al-Shamma et Adeeb G. Hussein. « Association of Admission Serum Resistin Level with Acute ST-Segment Elevation Myocardial Infarction in Iraqi Patients ». Iraqi Journal of Pharmaceutical Sciences ( P-ISSN 1683 - 3597 E-ISSN 2521 - 3512) 22, no 1 (28 mars 2017) : 90–96. http://dx.doi.org/10.31351/vol22iss1pp90-96.
Texte intégralRésumé :
Human resistin is an adipokine, with a possible link to coronary heart disease.A few studies were done about resistin in acute phase of ST-segment elevation myocardial infarction (STEMI) especially in Iraqi patients. Accordingly we design a study to investigate the association between resistin concentration and acute phase of STEMI in Iraqi patients.
The present study was carried out at Al-Yarmouk Teaching Hospital from December 2011 until June 2012. Serum resistin levels were measured in 50 patients with acute STEMI (mean age: 58.16 ± 11.73 years) at the first 12 hours of admission and 34 normal controls (mean age: 53.98 ± 15.46 years) matched for age, sex and other risk factors.
Resistin level in patients with acute STEMI (13.08 ng/mL) was significantly higher than that of the control group (5.31 ng/mL) (p < 0.0001). The study revealed a significant negative correlation between serum resistin level and serum adiponectin level among patients.
Key words: Resistin, acute ST-segment elevation myocardial infarction, adipokines
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Abu Fanne, Rami, Michael Kleiner Shochat, Avraham Shotan, Aharon Frimerman, Emad Maraga, Naama Amsalem, Yaniv Levi et Simcha R. Meisel. « Acute diagonal-induced ST-elevation myocardial infarction and electrocardiogram-guidance in the era of primary coronary intervention : New insights into an old tool ». European Heart Journal : Acute Cardiovascular Care 9, no 8 (1 février 2019) : 827–35. http://dx.doi.org/10.1177/2048872619828291.
Texte intégralRésumé :
Background: Previous studies, published before the advent of primary reperfusion, described the electrocardiographic features of ST-segment elevation myocardial infarction (STEMI) caused by total diagonal artery occlusion, as demonstrated at pre-discharge coronary angiography. We aimed to assess the electrocardiographic and echocardiographic features in STEMI unequivocally attributed to a diagonal lesion in the era of primary coronary intervention. Methods: The electrocardiograms and echocardiograms of patients sustaining STEMI caused by diagonal artery involvement were compared with those of patients with STEMI attributed to proximal or mid left anterior descending artery (LAD) lesions. ST-segment deviations were measured at four different points in each lead and analyzed against TIMI flow and SNuH score. The electrocardiographic and echocardiographic features of each group were mapped. Results: In contrast to previous studies claiming an ever-present incidence of at least 1-mm ST-segment elevation in leads I and aVL with diagonal STEMI, we report 86% of any ST-elevation in leads I, aVL and V2 (64–71% for ST-elevation >1 mm). Both higher SNuH score and pre-intervention TIMI flow were associated with larger lateral ST-elevations (85.7% and 86.4–95.5%, respectively). Higher prevalence of ST-depression in the inferior leads reflecting reciprocal changes was observed in patients with diagonal-induced STEMI (57–76% vs. 24–51% in LAD obstructions, p <0.05). Conclusion: The most sensitive and predictive sign for acute ischemia was any degree of ST-deviation measured 1 mm beyond the J point. ST-elevations in I, aVL and V2, sparing V3-V5, strongly favor isolated diagonal lesion. Proximal LAD lesion lacking ST-segment elevations in leads I and aVL is primarily due to wraparound LAD anatomy.
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Lucaci, Laurențiu. « ST Segment Elevation ». Romanian Journal of Cardiology 32, no 2 (1 juin 2022) : 47–78. http://dx.doi.org/10.2478/rjc-2022-0014.
Texte intégralRésumé :
Abstract As the earliest indirect sign of an acute coronary occlusion arriving against non-operative collateral heart vessels, the unabating ST segment elevation accounts for the acute coronary syndrome asking for mandatory and immediate reperfusion therapy. The geography of the ST segment elevations usually enables one to identify the culprit artery and to guess its likely occlusion site, as pivotal pieces of the necessary vital risk forecasting, along with somehow expected occurring arrhythmias. Aside from the classical ST segment elevation myocardial infarction (STEMI) pattern, a handful of distinctive non-ST elevation appearances of the acute coronary occlusion also need imperative reperfusion therapy, thus qualifying themselves as STEMI equivalents. The early forthcoming of ST elevation during an acute transmural ischaemic episode, as well as the wide availability of the electrocardiogram, make it an invaluable diagnostic tool. Yet many confounding factors are able to limit the diagnostic sensibility of ST elevation (as for example its customary absence in the conventional leads in some cases of circumflex artery occlusion, or the casual mutual cancellation of the transmural ST vectors from opposite ventricular walls), the accuracy of the electrocardiographic localisation of the occlusion site (due to coronary anatomic variants, concomitant new or old coronary lesions elsewhere, previous coronary artery bypass grafts), as well as its specificity for transmural ischaemia (by virtue of a well-known manifold of non-ischaemic causes). While the STEMI patient must be offered undelayed reperfusion therapy, the non-ischaemic ST elevation one should be kept away from the haemorrhagic risk of a useless invasive procedure.
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Iqbal, Shahriar, M. Saiful Bari, MA Bari, Mirza Md Nazrul Islam, M. Abdullah Al Shafi Majumder, Zahidul Islam, Gana Pati Aditya et al. « A Comparative Study of St Segment Resolution between Diabetic and Non-Diabetic ST Segment Elevation Myocardial Infarction Patients following Streptokinase Thrombolysis ». Cardiovascular Journal 11, no 2 (27 février 2019) : 118–22. http://dx.doi.org/10.3329/cardio.v11i2.40411.
Texte intégralRésumé :
Background: One of the most effective and used (in our settings) methods of reperfusion of ST elevation myocardial infarction (STEMI) is administration of streptokinase (SK) infusion. This study was conducted with the aim to compare ST segment resolution between diabetic and non-diabetic patients with ST segment elevation myocardial infarction after thrombolysis by streptokinase.
Methods: A total of 100 patients with ST elevation myocardial infarction with or without diabetes mellitus were studied from December 2016 to November 2017. Among these half of patients were diabetic while rests were non-diabetic. Streptokinase was administered to all patients. Resolution (reduction) of elevated ST segment was evaluated after 90 min of streptokinase administration.
Results: Failed reperfusion (<30% ST resolution) was significantly higher in diabetic as compared to nondiabetic patients (42% vs. 12%, p <0.001). In hospital complications were more in diabetic patients who has failed reperfusion following streptokinase thrombolysis. Cardiogenic shock occurred in 44% and acute LVF in 30% patients and EF (46.54%) was significantly lower in diabetic patients and higher number of diabetic patients had prolong hospital stay than non-diabetic patients with STEMI.
Conclusion: The outcome of thrombolytic therapy is adversely affected by diabetes mellitus in patients with ST-elevation myocardial infarction.
Cardiovasc. j. 2019; 11(2): 118-122
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Tsang, Michael, et Sanjit Jolly. « Interventional Strategies in Thrombus Management for ST Elevation Myocardial Infarction ». Interventional Cardiology Review 10, no 1 (2015) : 35. http://dx.doi.org/10.15420/icr.2015.10.1.35.
Texte intégralRésumé :
The major limitation of modern primary percutaneous coronary intervention (PPCI) is distal embolisation of thrombus and microvascular obstruction. Microvascular flow, as measured by myocardial blush grade (MPG), predicts mortality after PPCI. Despite initial enthusiasm, current evidence does not support routine use of Intracoronary over intravenous glycoprotein 2b3a inhibitors during PPCI for ST elevation myocardial infarction (STEMI) to improve clinical outcomes. Manual thrombectomy (MT) improves MPG and reduces distal embolisation in meta-analyses of small trials. A single-centre trial (N=1071), the Thrombus aspiration during percutaneous coronary intervention in acute myocardial infarction study (TAPAS) trial showed a mortality reduction, which led guidelines to recommend routine manual aspiration. However, the largest randomised trial (Thrombus aspiration in ST-elevation myocardial infarction in Scandinavia [TASTE] trial, N=7021) showed no difference in mortality and only trends towards reduction in myocardial infarction (MI) and stent thrombosis. The TASTE trial had much lower than expected mortality and so was likely underpowered for modest but important treatment effects (20–30 % RRR). The Thrombectomy with PCI versus PCI alone in patients with STEMI undergoing primary PCI (TOTAL) trial (N=10,700) will determine if MT reduces important clinical events during PPCI. Thrombus management remains an important area of research in STEMI.