Latest & greatest articles for myocardial infarction

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Top results for myocardial infarction

41. Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction Full Text available with Trip Pro

Unloading the Left Ventricle Before Reperfusion in Patients With Anterior ST-Segment-Elevation Myocardial Infarction In ST-segment-elevation myocardial infarction (STEMI), infarct size correlates directly with heart failure and mortality. Preclinical testing has shown that, in comparison with reperfusion alone, mechanically unloading the left ventricle (LV) before reperfusion reduces infarct size and that 30 minutes of unloading activates a cardioprotective program that limits reperfusion (...) ). The primary safety outcome was a composite of major adverse cardiovascular and cerebrovascular events at 30 days. Efficacy parameters included the assessment of infarct size by using cardiac magnetic resonance imaging.All patients completed the U-IR (n=25) or U-DR (n=25) protocols with respective mean door-to-balloon times of 72 versus 97 minutes. Major adverse cardiovascular and cerebrovascular event rates were not statistically different between the U-IR versus U-DR groups (8% versus 12%, respectively

2019 EvidenceUpdates

42. Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction Full Text available with Trip Pro

Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction Experimental trials suggest improved outcome by mild therapeutic hypothermia for cardiogenic shock after acute myocardial infarction. The objective of this study was to investigate the hemodynamic effects of mild therapeutic hypothermia in patients with cardiogenic shock complicating acute myocardial infarction.Patients (n=40) with cardiogenic shock undergoing primary percutaneous coronary intervention without classic (...) hypothermia failed to show a substantial beneficial effect on cardiac power index at 24 hours in patients with cardiogenic shock after acute myocardial infarction.URL: https://www.clinicaltrials.gov . Unique identifier: NCT01890317.

2019 EvidenceUpdates

43. Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel Full Text available with Trip Pro

Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel Despite successful restoration of epicardial vessel patency with primary percutaneous coronary intervention, coronary microvascular injury occurs in a large proportion of patients with ST-segment-elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reported to increase plasma adenosine levels (...) , which might have a protective effect on the microcirculation. We investigated whether ticagrelor maintenance therapy after revascularized ST-segment-elevation myocardial infarction is associated with less coronary microvascular injury compared to prasugrel maintenance therapy.A total of 110 patients with ST-segment-elevation myocardial infarction received a loading dose of ticagrelor and were randomized to maintenance therapy of ticagrelor (n=56) or prasugrel (n=54) after primary percutaneous

2019 EvidenceUpdates

44. Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) – (4th Edition)

Management of Acute ST Segment Elevation Myocardial Infarction (STEMI) – (4th Edition) CLINICAL PRACTICE GUIDELINE: MANAGEMENT OF ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) 4 th EDITION 2019 NATIONAL HEART ASSOCIATION OF MALAYSIA MOH/P/PAK/420.19(GU)-eMANAGEMENT OF ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) 2019 2 STATEMENT OF INTENT This guideline was developed to be a guide for best clinical practice, based on the best available evidence at the time of development (...) . CPG Secretariat Health Technology Assessment Unit Medical Development Division Level 4, Block EI, Parcel E Government Offices Complex 62590 Putrajaya, Malaysia Available on the following websites: http://www.moh.gov.my http://www.acadmed.org.myMANAGEMENT OF ACUTE ST SEGMENT ELEVATION MYOCARDIAL INFARCTION (STEMI) 2019 3 MESSAGE FROM THE DIRECTOR GENERAL OF HEALTH The 1st Clinical Practice Guideline (CPG) on ST Elevation Myocardial Infarction (STEMI) was published in 2001 with a 2nd and 3rd update

2019 Ministry of Health, Malaysia

45. Efficacy and safety with ticagrelor in patients with prior myocardial infarction in the approved European label: insights from PEGASUS-TIMI 54. Full Text available with Trip Pro

Efficacy and safety with ticagrelor in patients with prior myocardial infarction in the approved European label: insights from PEGASUS-TIMI 54. In PEGASUS-TIMI 54, ticagrelor significantly reduced the risk of the composite of major adverse cardiovascular (CV) events by 15-16% in stable patients with a prior myocardial infarction (MI) 1-3 years earlier. We report the efficacy and safety in the subpopulation recommended for treatment in the European (EU) label, i.e. treatment with 60 mg b.i.d (...) in the ticagrelor group (7.9% KM rate vs. 9.6%), hazard ratio (HR) 0.80 [95% confidence interval (CI) 0.70-0.91; P = 0.001]. Ticagrelor also reduced the risk of all-cause mortality, HR 0.80 (0.67-0.96; P = 0.018). Thrombolysis in myocardial infarction major bleeding was more frequent in the ticagrelor group 2.5% vs. 1.1%; HR 2.36 (1.65-3.39; P < 0.001). The corresponding HR for fatal or intracranial bleeding was 1.17 (0.68-2.01; P = 0.58).In PEGASUS-TIMI 54, treatment with ticagrelor 60 mg as recommended

2019 European heart journal. Cardiovascular pharmacotherapy Controlled trial quality: predicted high

46. Temporal Changes in Coronary Hyperemic and Resting Hemodynamic Indices in Nonculprit Vessels of Patients With ST-Segment Elevation Myocardial Infarction. (Abstract)

Temporal Changes in Coronary Hyperemic and Resting Hemodynamic Indices in Nonculprit Vessels of Patients With ST-Segment Elevation Myocardial Infarction. Percutaneous coronary intervention (PCI) of nonculprit vessels among patients with ST-segment elevation myocardial infarction (STEMI) is associated with improved clinical outcome compared with culprit vessel-only PCI. Fractional flow reserve (FFR) and coronary flow reserve are hyperemic indices used to guide revascularization. Recently (...) 0.86 [0.09]; P = .001) whereas coronary flow reserve increased (mean [SD], 2.9 [1.4] vs 4.1 [2.2]; P < .001). Hyperemic index of microcirculatory resistance decreased and resting microcirculatory resistance increased from the acute moment to follow-up. The decrease in distal pressure from rest to hyperemia was smaller at the acute moment vs follow-up (mean [SD], 10.6 [11.2] mm Hg vs 14.1 [14.2] mm Hg; P = .05). This blunted acute hyperemic response correlated with final infarct size (ρ, -0.29; P

2019 JAMA cardiology Controlled trial quality: uncertain

47. Platelet inhibition with standard versus lower maintenance dose of ticagrelor early after myocardial infarction (ELECTRA): a randomized, open-label, active-controlled pharmacodynamic and pharmacokinetic study. (Abstract)

Platelet inhibition with standard versus lower maintenance dose of ticagrelor early after myocardial infarction (ELECTRA): a randomized, open-label, active-controlled pharmacodynamic and pharmacokinetic study. Currently available data indicate that reduction of ticagrelor maintenance dose (MD) 1-3 years after acute myocardial infarction (AMI) not only provides sufficient platelet inhibition, but also can improve ticagrelor's safety profile. The aim of this study was to compare the antiplatelet

2019 European heart journal. Cardiovascular pharmacotherapy Controlled trial quality: uncertain

48. Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial Full Text available with Trip Pro

Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical (...) outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice.The IABP-SHOCK II trial is a multicenter, randomized, openlabel trial. Between 2009 and 2012, 600 patients with cardiogenic shock complicating acute myocardial infarction undergoing early revascularization were randomized to IABP versus control.Long-term follow

2019 EvidenceUpdates

49. Prospective, randomized trial of bioresorbable scaffolds vs. everolimus-eluting stents in patients undergoing coronary stenting for myocardial infarction: the Intracoronary Scaffold Assessment a Randomized evaluation of Absorb in Myocardial Infarction (IS Full Text available with Trip Pro

Prospective, randomized trial of bioresorbable scaffolds vs. everolimus-eluting stents in patients undergoing coronary stenting for myocardial infarction: the Intracoronary Scaffold Assessment a Randomized evaluation of Absorb in Myocardial Infarction (IS Bioresorbable scaffolds (BRS) provide short-term coronary artery scaffolding and drug delivery. Although prior trials showed a higher rate of device failure compared with conventional drug-eluting stents (DES), only a single trial investigated (...) patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI). We aimed to compare outcomes with BRS vs. DES in patients undergoing PCI for MI.We did a prospective, randomized, multicentre, non-inferiority, clinical trial of everolimus-eluting BRS vs. durable polymer everolimus-eluting stents (EES) in patients with acute MI. Patients were eligible for enrolment if they presented with ST-elevation MI, or non-ST-elevation MI with thrombosis visual at angiography

2019 EvidenceUpdates

50. Risk Estimation in Type 2 Myocardial Infarction and Myocardial Injury: The TARRACO Risk Score. Full Text available with Trip Pro

Risk Estimation in Type 2 Myocardial Infarction and Myocardial Injury: The TARRACO Risk Score. Despite adverse prognoses of type 2 myocardial infarction and myocardial injury, an effective, practical risk stratification method remains an unmet clinical need. We sought to develop an efficient clinical bedside tool for estimating the risk of major adverse cardiovascular events at 180 days for this patient population.The derivation cohort included patients with type 2 myocardial infarction (...) or myocardial injury admitted to a tertiary hospital between 2012 and 2013 (n = 611). The primary outcome was a major adverse cardiovascular event (death or readmission for heart failure or myocardial infarction). The score included clinical variables significantly associated with the outcome. External validation was conducted using the UTROPIA cohort (n = 401).The TARRACO Score included cardiac troponin (cTn) concentrations and 5 independent clinical predictors of adverse cardiovascular events: age

2019 EvidenceUpdates

51. Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. Despite guideline recommendations, many patients discontinue P2Y12 inhibitor therapy earlier than the recommended 1 year after myocardial infarction (MI), and higher-potency P2Y12 inhibitors are underutilized. Cost is frequently cited as an explanation for both of these observations.To determine whether removing

2019 JAMA Controlled trial quality: predicted high

52. Effect of Low-Dose Intracoronary Alteplase During Primary Percutaneous Coronary Intervention on Microvascular Obstruction in Patients With Acute Myocardial Infarction: A Randomized Clinical Trial. Full Text available with Trip Pro

Effect of Low-Dose Intracoronary Alteplase During Primary Percutaneous Coronary Intervention on Microvascular Obstruction in Patients With Acute Myocardial Infarction: A Randomized Clinical Trial. Microvascular obstruction commonly affects patients with acute ST-segment elevation myocardial infarction (STEMI) and is associated with adverse outcomes.To determine whether a therapeutic strategy involving low-dose intracoronary fibrinolytic therapy with alteplase infused early after coronary (...) infusion over 5 to 10 minutes. The intervention was scheduled to occur early during the primary PCI procedure, after reperfusion of the infarct-related coronary artery and before stent implant.The primary outcome was the amount of microvascular obstruction (% left ventricular mass) demonstrated by contrast-enhanced cardiac magnetic resonance imaging (MRI) conducted from days 2 through 7 after enrollment. The primary comparison was the alteplase 20-mg group vs the placebo group; if not significant

2019 JAMA Controlled trial quality: predicted high

53. Relationship between degree of heparin anticoagulation and clinical outcome in patients receiving potent P2Y12-inhibitors with no planned GPI during primary percutaneous coronary intervention in acute myocardial infarction - a VALIDATE-SWEDEHEART substudy (Abstract)

Relationship between degree of heparin anticoagulation and clinical outcome in patients receiving potent P2Y12-inhibitors with no planned GPI during primary percutaneous coronary intervention in acute myocardial infarction - a VALIDATE-SWEDEHEART substudy Heparin is the preferred choice of anticoagulant in percutaneous coronary intervention (PCI) for acute myocardial infarction (MI). An established dosage of heparin has not yet been determined, but treatment may be optimized through monitoring

2019 European heart journal. Cardiovascular pharmacotherapy Controlled trial quality: uncertain

54. Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. Full Text available with Trip Pro

Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality.To determine whether the HRRP was associated

2018 JAMA

55. Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. Full Text available with Trip Pro

Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. To study circadian rhythm aspects, national holidays, and major sports events as triggers of myocardial infarction.Retrospective observational study using the nationwide coronary care unit registry, SWEDEHEART.Sweden.283 014 cases of myocardial infarction reported to SWEDEHEART between 1998 and 2013. Symptom onset date was documented for all cases (...) , and time to the nearest minute for 88%.Myocardial infarctions with symptom onset on Christmas/New Year, Easter, and Midsummer holiday were identified. Similarly, myocardial infarctions that occurred during a FIFA World Cup, UEFA European Championship, and winter and summer Olympic Games were identified. The two weeks before and after a holiday were set as a control period, and for sports events the control period was set to the same time one year before and after the tournament. Circadian

2018 BMJ

56. Non-ST-elevation myocardial infarction

Non-ST-elevation myocardial infarction Non-ST-elevation myocardial infarction - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Non-ST-elevation myocardial infarction Last reviewed: February 2019 Last updated: December 2018 Summary Part of the acute coronary syndrome spectrum. Usually caused by a partial or near-complete occlusion of a coronary artery resulting in compromised blood flow to myocardium with subsequent (...) myocardial injury or infarction as demonstrated by elevation in troponin. There are differences in typical presentation between the sexes. Male patients typically present with chest pressure/discomfort lasting at least several minutes, at times accompanied by sweating, dyspnoea, nausea, and/or anxiety. Women present more commonly with middle/upper back pain or dyspnoea and similar associated symptoms. Symptoms are indistinguishable from those of unstable angina. However, non-ST-elevation myocardial

2018 BMJ Best Practice

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

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

58. Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants. Full Text available with Trip Pro

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

2018 BMJ

59. 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

60. Timing of revascularization in patients with transient ST-segment elevation myocardial infarction: a randomized clinical trial Full Text available with Trip Pro

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

2018 EvidenceUpdates