Latest & greatest articles for myocardial infarction

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Top results for myocardial infarction

61. Meta-analysis Comparing Culprit Vessel Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction and Cardiogenic Shock

Meta-analysis Comparing Culprit Vessel Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction and Cardiogenic Shock Cardiogenic shock (CS) after a myocardial infarction continues to be associated with high mortality. Whether percutaneous coronary intervention (PCI) of noninfarct coronary arteries (multivessel intervention [MVI]) improves outcomes in CS after acute myocardial infarction (AMI) remains controversial. MEDLINE, Cochrane CENTRAL

2018 EvidenceUpdates

62. Relation of CHA2DS2VASC Score With Hemorrhagic Stroke and Mortality in Patients Undergoing Fibrinolytic Therapy for ST Elevation Myocardial Infarction

Relation of CHA2DS2VASC Score With Hemorrhagic Stroke and Mortality in Patients Undergoing Fibrinolytic Therapy for ST Elevation Myocardial Infarction Hemorrhagic stroke (HS) is a feared complication of Fibrinolytic therapy (FT). Risk assessment scores may help in risk stratification to reduce this complication. Patients (admissions) ≥18 years with a primary diagnosis of ST-elevation myocardial infarction (STEMI) who received systemic thrombolysis were extracted from Nationwide Inpatient Sample

2018 EvidenceUpdates

63. Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants. (PubMed)

Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants. To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age.Prospective population based study.UK Biobank.471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease.Incident (fatal and non-fatal) MI.5081 participants (1463 (28.8%) of whom were women) had MI over seven years' mean follow-up, resulting

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2018 BMJ

64. Evolocumab (Repatha) - In adults with established atherosclerotic cardiovascular disease (myocardial infarction, stroke or peripheral arterial disease)

Evolocumab (Repatha) - In adults with established atherosclerotic cardiovascular disease (myocardial infarction, stroke or peripheral arterial disease) Published 12 November 2018 Statement of advice SMC2133 evolocumab 140mg solution for injection in pre-filled syringe / 140mg solution for injection in pre-filled pen / 420mg solution of injection in cartridge (Repatha®) Amgen Ltd 5 October 2018 ADVICE: in the absence of a submission from the holder of the marketing authorisation evolocumab (...) (Repatha®) is not recommended for use within NHSScotland. Indication under review: In adults with established atherosclerotic cardiovascular disease (myocardial infarction, stroke or peripheral arterial disease) to reduce cardiovascular risk by lowering LDL-C levels, as an adjunct to correction of other risk factors: ? in combination with the maximum tolerated dose of a statin with or without other lipid- lowering therapies or, ? alone or in combination with other lipid-lowering therapies in patients

2018 Scottish Medicines Consortium

65. Timing of revascularization in patients with transient ST-segment elevation myocardial infarction: a randomized clinical trial

Timing of revascularization in patients with transient ST-segment elevation myocardial infarction: a randomized clinical trial Patients with acute coronary syndrome who present initially with ST-elevation on the electrocardiogram but, subsequently, show complete normalization of the ST-segment and relief of symptoms before reperfusion therapy are referred to as transient ST-segment elevation myocardial infarction (STEMI) and pose a therapeutic challenge. It is unclear what the optimal timing (...) of revascularization is for these patients and whether they should be treated with a STEMI-like or a non-ST-segment elevation myocardial infarction (NSTEMI)-like invasive approach. The aim of the study is to determine the effect of an immediate vs. a delayed invasive strategy on infarct size measured by cardiac magnetic resonance imaging (CMR).In a randomized clinical trial, 142 patients with transient STEMI with symptoms of any duration were randomized to an immediate (STEMI-like) [0.3 h; interquartile range (IQR

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2018 EvidenceUpdates

66. Can a Negative High-Sensitivity Troponin Result Rapidly Rule Out Acute Myocardial Infarction?

Can a Negative High-Sensitivity Troponin Result Rapidly Rule Out Acute Myocardial Infarction? TAKE-HOME MESSAGE A single, undetectable, high-sensitivity, cardiac troponin T (hs-cTnT) test in combination with a nonischemic ECG result may effectively rule out acute myocardial infarction in emergency department (ED) patients presenting greater than 3 hours after symptom onset. Can a Negative High-Sensitivity Troponin Result Rapidly Rule Out Acute Myocardial Infarction? EBEM Commentators Nathan M (...) . Overall acute myocardial infarc- tion prevalence was 15.4%. Of the total included patient population, 30.6% were classi?ed as being at low risk for acute myocardial infarction by a single negative hs-cTnT result and a nonischemic ECG result. Of these patients, 14 (0.5%) received a diagnosis of acute myocardial infarction. In 7 of these cases, the time between symptom onset and blood sam- pling was less than 3 hours. The pooled performance estimates for Performanceofhs

2018 Annals of Emergency Medicine Systematic Review Snapshots

67. In Patients With ST-Segment Elevation Myocardial Infarction, Which Fibrinolytic Agent Is the Safest and Most Effective?

In Patients With ST-Segment Elevation Myocardial Infarction, Which Fibrinolytic Agent Is the Safest and Most Effective? TAKE-HOME MESSAGE In patients with ST-segment elevation myocardial infarction (STEMI), when percutaneous coronary intervention is not an option, reperfusion therapy with the ?brinolytic agents tenecteplase, reteplase, or accelerated alteplase (90 minutes of infusion) plus parenteral anticoagulation has better overall safety and ef?cacy than other regimens. In Patients With ST (...) -Segment Elevation Myocardial Infarction, Which Fibrinolytic Agent Is the Safest and Most Effective? EBEM Commentators Ashis Shrestha, MD Department of General Practice and Emergency Medicine Patan Academy of Health Sciences Kathmandu, Nepal Darlene R. House, MD, MS Department of General Practice and Emergency Medicine Patan Academy of Health Sciences Kathmandu, Nepal Department of Emergency Medicine Indiana University School of Medicine Indianapolis, IN Julie L. Welch, MD Department of Emergency

2018 Annals of Emergency Medicine Systematic Review Snapshots

68. In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen?

In Patients With Acute Myocardial Infarction and No Hypoxemia, Does Oxygen Therapy Improve Outcomes Compared With No Supplemental Oxygen? TAKE-HOME MESSAGE Oxygen therapy does notreduce therisk of all-cause mortality,recurrent ischemia or myocardial infarction, heart failure, or arrhythmias compared with no supplemental oxygen therapy for patients with acute myocardial infarction and normal oxygen saturation. InPatientsWithAcuteMyocardialInfarctionandNo Hypoxemia, Does Oxygen Therapy Improve (...) , and the most common comorbidities were hypertension, hyperlipid- emia, diabetes, and smoking. Overall, there was no association between oxygen supplementa- tion with any bene?tinpatients with acute myocardial infarction (Table). Six studies reported all-cause mortality, 6 reported recurrent ischemia or myocardial infarction, 3 reported heart fail- ure, and 5 reported arrhythmia. Studies varied in quality, with no studies powered to detect a difference in clinically signi?- cant adverse cardiac events. De

2018 Annals of Emergency Medicine Systematic Review Snapshots

69. Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial. (PubMed)

Six months versus 12 months dual antiplatelet therapy after drug-eluting stent implantation in ST-elevation myocardial infarction (DAPT-STEMI): randomised, multicentre, non-inferiority trial. To show that limiting dual antiplatelet therapy (DAPT) to six months in patients with event-free ST-elevation myocardial infarction (STEMI) results in a non-inferior clinical outcome versus DAPT for 12 months.Prospective, randomised, multicentre, non-inferiority trial.Patients with STEMI treated (...) for an additional six months. All patients that were randomised were then followed for another 18 months (ie, 24 months after the primary PCI).The primary endpoint was a composite of all cause mortality, any myocardial infarction, any revascularisation, stroke, and thrombolysis in myocardial infarction major bleeding at 18 months after randomisation.A total of 1100 patients were enrolled in the trial between 19 December 2011 and 30 June 2015. 870 were randomised: 432 to SAPT versus 438 to DAPT. The primary

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2018 BMJ

70. Meta-Analysis Comparing Primary Percutaneous Coronary Intervention Versus Pharmacoinvasive Therapy in Transfer Patients with ST-Elevation Myocardial Infarction

Meta-Analysis Comparing Primary Percutaneous Coronary Intervention Versus Pharmacoinvasive Therapy in Transfer Patients with ST-Elevation Myocardial Infarction ST-elevation myocardial infarction patients presenting at non-percutaneous coronary intervention (PCI)-capable hospitals often need to be transferred for primary percutaneous coronary intervention (PPCI). This increases time to revascularization, leading to increased risk of in-hospital mortality. With recent focus on total ischemic time (...) rather than door-to-balloon time as the principal determinant of outcomes in ST-elevation myocardial infarction patients, pharmacoinvasive therapy (PIT) has gained attention as a possible improvement over PPCI in patients requiring transfer. Our objective was to observe how PIT stands against PPCI in terms of safety and efficacy. Electronic databases were searched for randomized controlled trials and observational studies comparing PPCI to PIT. PIT was defined as administration of thrombolytic drugs

2018 EvidenceUpdates

71. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction

Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction We aimed to evaluate the impact of age on the performance of the European Society of Cardiology (ESC) 0/1h-algorithms and to derive and externally validate alternative cut-offs specific to older patients.We prospectively enrolled patients presenting to the emergency department (ED) with symptoms suggestive of acute myocardial infarction in three large diagnostic studies. Final diagnoses were

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2018 EvidenceUpdates

72. Combining High Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction

Combining High Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction Combining 2 signals of cardiomyocyte injury, cardiac troponin I (cTnI) and T (cTnT), might overcome some individual pathophysiological and analytical limitations and thereby increase diagnostic accuracy for acute myocardial infarction with a single blood draw. We aimed to evaluate the diagnostic performance of combinations of high-sensitivity (hs) cTnI and hs-cTnT (...) for the early diagnosis of acute myocardial infarction.The diagnostic performance of combining hs-cTnI (Architect, Abbott) and hs-cTnT (Elecsys, Roche) concentrations (sum, product, ratio, and a combination algorithm) obtained at the time of presentation was evaluated in a large multicenter diagnostic study of patients with suspected acute myocardial infarction. The optimal rule-out and rule-in thresholds were externally validated in a second large multicenter diagnostic study. The proportion of patients

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2018 EvidenceUpdates

73. Wearable Cardioverter-Defibrillator after Myocardial Infarction. (PubMed)

Wearable Cardioverter-Defibrillator after Myocardial Infarction. Despite the high rate of sudden death after myocardial infarction among patients with a low ejection fraction, implantable cardioverter-defibrillators are contraindicated until 40 to 90 days after myocardial infarction. Whether a wearable cardioverter-defibrillator would reduce the incidence of sudden death during this high-risk period is unclear.We randomly assigned (in a 2:1 ratio) patients with acute myocardial infarction (...) ), and nonarrhythmic death in 1.4% and 2.2%, respectively (relative risk, 0.63; 95% CI, 0.33 to 1.19; uncorrected P=0.15). Of the 48 participants in the device group who died, 12 were wearing the device at the time of death. A total of 20 participants in the device group (1.3%) received an appropriate shock, and 9 (0.6%) received an inappropriate shock.Among patients with a recent myocardial infarction and an ejection fraction of 35% or less, the wearable cardioverter-defibrillator did not lead to a significantly

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2018 NEJM

74. ST-elevation myocardial infarction

ST-elevation myocardial infarction ST-elevation myocardial infarction - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  ST-elevation myocardial infarction Last reviewed: February 2019 Last updated: September 2018 Summary Presents with central chest pain that is classically heavy in nature, like a sensation of pressure or squeezing. Examination is variable, and findings range from normal to a critically unwell patient (...) in cardiogenic shock. ST-elevation myocardial infarction (STEMI) is suspected when a patient presents with persistent ST-segment elevation in 2 or more anatomically contiguous ECG leads in the context of a consistent clinical history. Creatine kinase-MB and cardiac-specific troponins confirm diagnosis. Treatment should, however, be started immediately in patients with a typical history and ECG changes, without waiting for laboratory results. Immediate and prompt revascularisation can prevent or decrease

2018 BMJ Best Practice

75. Fourth Universal Definition of Myocardial Infarction

Fourth Universal Definition of Myocardial Infarction We use cookies to enhance your experience on our website. By continuing to use our website, you are agreeing to our use of cookies. You can change your cookie settings at any time. Fourth universal definition of myocardial infarction (2018) | European Heart Journal | Oxford Academic Search Account Menu Menu Navbar Search Filter Mobile Microsite Search Term Close search filter search input Article Navigation Close mobile search navigation (...) Article navigation 14 January 2019 Article Contents Article Navigation Fourth universal definition of myocardial infarction (2018) Kristian Thygesen Corresponding authors. Kristian Thygesen, Department of Cardiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard, DK-8200 Aarhus N, Denmark. Tel: +45 78452262, Fax: +45 78452260, Email: ; . Search for other works by this author on: Joseph S Alpert Joseph S. Alpert, Department of Medicine, University of Arizona College of Medicine, 1501 N

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2018 European Society of Cardiology

76. Clinical chemistry score versus high-sensitivity cardiac troponin I and T tests alone to identify patients at low or high risk for myocardial infarction or death at presentation to the emergency department (PubMed)

Clinical chemistry score versus high-sensitivity cardiac troponin I and T tests alone to identify patients at low or high risk for myocardial infarction or death at presentation to the emergency department Testing for high-sensitivity cardiac troponin (hs-cTn) may assist triage and clinical decision-making in patients presenting to the emergency department with symptoms of acute coronary syndrome; however, this could result in the misclassification of risk because of analytical variation (...) or laboratory error. We sought to evaluate a new laboratory-based risk-stratification tool that incorporates tests for hs-cTn, glucose level and estimated glomerular filtration rate to identify patients at risk of myocardial infarction or death when presenting to the emergency department.We constructed the clinical chemistry score (CCS) (range 0-5 points) and validated it as a predictor of 30-day myocardial infarction (MI) or death using data from 4 cohort studies involving patients who presented

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2018 EvidenceUpdates

77. Prospective Validation of the 0/1-h Algorithm for Early Diagnosis of Myocardial Infarction

Prospective Validation of the 0/1-h Algorithm for Early Diagnosis of Myocardial Infarction The safety of the European Society of Cardiology (ESC) 0/1-h algorithm for rapid rule-out and rule-in of non-ST-segment elevation myocardial infarction (NSTEMI) using high-sensitivity cardiac troponin (hs-cTn) has been questioned.This study aimed to validate the diagnostic performance of the 0/1-h algorithm in a large multicenter study.The authors prospectively enrolled unselected patients in 6 countries

2018 EvidenceUpdates

78. Chest discomfort in a patient with dengue – is it an acute myocardial infarction? (PubMed)

Chest discomfort in a patient with dengue – is it an acute myocardial infarction? Cardiovascular symptoms presenting in a patient with dengue fever may post a diagnostic dilemma. We describe a case of dengue myocarditis mimicking an acute myocardial infarction in a 56-year-old woman.

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2018 Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

79. Supplemental Oxygen Protects Heart Against Acute Myocardial Infarction (PubMed)

Supplemental Oxygen Protects Heart Against Acute Myocardial Infarction Myocardial infarction (MI), which occurs often due to acute ischemia followed by reflow, is associated with irreversible loss (death) of cardiomyocytes. If left untreated, MI will lead to progressive loss of viable cardiomyocytes, deterioration of cardiac function, and congestive heart failure. While supplemental oxygen therapy has long been in practice to treat acute MI, there has not been a clear scientific basis (...) . Myocardial oxygen tension (pO2), cardiac function and pro-survival/apoptotic signaling molecules were used as markers of treatment outcome. OxCy resulted in a significant reduction of infarct size and improvement of cardiac function. An optimal condition of 30-min OxCy with 95% oxygen + 5% CO2 under normobaric conditions was found to be effective for cardioprotection.

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2018 Frontiers in cardiovascular medicine

80. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. (PubMed)

Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. Although coronary computed tomographic angiography (CTA) improves diagnostic certainty in the assessment of patients with stable chest pain, its effect on 5-year clinical outcomes is unknown.In an open-label, multicenter, parallel-group trial, we randomly assigned 4146 patients with stable chest pain who had been referred to a cardiology clinic for evaluation to standard care plus CTA (2073 patients) or to standard care alone (...) (2073 patients). Investigations, treatments, and clinical outcomes were assessed over 3 to 7 years of follow-up. The primary end point was death from coronary heart disease or nonfatal myocardial infarction at 5 years.The median duration of follow-up was 4.8 years, which yielded 20,254 patient-years of follow-up. The 5-year rate of the primary end point was lower in the CTA group than in the standard-care group (2.3% [48 patients] vs. 3.9% [81 patients]; hazard ratio, 0.59; 95% confidence interval

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2018 NEJM