Latest & greatest articles for myocardial infarction

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Top results for myocardial infarction

61. 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

62. 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

63. 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

64. 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. Full Text available with Trip Pro

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

2018 BMJ Controlled trial quality: predicted high

65. Combining High Sensitivity Cardiac Troponin I and Cardiac Troponin T in the Early Diagnosis of Acute Myocardial Infarction Full Text available with Trip Pro

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

2018 EvidenceUpdates

66. Impact of age on the performance of the ESC 0/1h-algorithms for early diagnosis of myocardial infarction Full Text available with Trip Pro

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

2018 EvidenceUpdates

67. Wearable Cardioverter-Defibrillator after Myocardial Infarction. Full Text available with Trip Pro

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

2018 NEJM Controlled trial quality: predicted high

68. 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

69. Prospective Validation of the 0/1-h Algorithm for Early Diagnosis of Myocardial Infarction Full Text available with Trip Pro

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

70. Fourth Universal Definition of Myocardial Infarction Full Text available with Trip Pro

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

2018 European Society of Cardiology

71. 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 Full Text available with Trip Pro

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

2018 EvidenceUpdates

72. Chest discomfort in a patient with dengue – is it an acute myocardial infarction? Full Text available with Trip Pro

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.

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

73. Supplemental Oxygen Protects Heart Against Acute Myocardial Infarction Full Text available with Trip Pro

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.

2018 Frontiers in cardiovascular medicine

74. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. Full Text available with Trip Pro

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

2018 NEJM Controlled trial quality: predicted high

75. Mangafodipir as a cardioprotective adjunct to reperfusion therapy: a feasibility study in patients with ST-segment elevation myocardial infarction. Full Text available with Trip Pro

Mangafodipir as a cardioprotective adjunct to reperfusion therapy: a feasibility study in patients with ST-segment elevation myocardial infarction. The aim of the present study was to examine the feasibility of applying the catalytic antioxidant mangafodipir [MnDPDP, manganese (Mn) dipyridoxyl diphosphate] as a cardioprotective adjunct to primary percutaneous coronary intervention (pPCI) in patients with ST-segment elevation (STE) myocardial infarction (STEMI). Both MnDPDP and a metabolite (Mn (...) , plasma biomarker releases were identical for the two groups. With placebo vs. MnDPDP, mean STE resolutions were 69.8 vs. 81.9% (P = 0.224) at 6 h and 73.1 vs. 84.3% (P = 0.077) at 48 h. Cardiac magnetic resonance revealed mean infarct sizes of 32.5 vs. 26.2% (P = 0.406) and mean left ventricular (LV) ejection fractions of 41.8 vs. 47.7% (P = 0.617) with placebo vs. MnDPDP. More LV thrombi were detected in placebo hearts (5 of 8) than MnDPDP-treated hearts (1 of 10; P = 0.011).Mangafodipir is a safe

2018 European heart journal. Cardiovascular pharmacotherapy Controlled trial quality: uncertain

76. Myocardial infarction

Myocardial infarction Top results for myocardial infarction - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look (...) like (#1 or #2) and (#3 or #4) Loading history... Population: Intervention: Comparison: Outcome: Population: Intervention: Latest & greatest articles for myocardial infarction The Trip Database is a leading resource to help health professionals find trustworthy answers to their clinical questions. Users can access the latest research evidence and guidance to answer their clinical questions. We have a large collection of systematic reviews, clinical guidelines, regulatory guidance, clinical trials

2018 Trip Latest and Greatest

77. Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction Full Text available with Trip Pro

Epinephrine Versus Norepinephrine for Cardiogenic Shock After Acute Myocardial Infarction Vasopressor agents could have certain specific effects in patients with cardiogenic shock (CS) after myocardial infarction, which may influence outcome. Although norepinephrine and epinephrine are currently the most commonly used agents, no randomized trial has compared their effects, and intervention data are lacking.The goal of this paper was to compare in a prospective, double-blind, multicenter (...) compared with norepinephrine, including an increase in cardiac double product (p = 0.0002) and lactic acidosis from H2 to H24 (p < 0.0001).In patients with CS secondary to acute myocardial infarction, the use of epinephrine compared with norepinephrine was associated with similar effects on arterial pressure and cardiac index and a higher incidence of refractory shock. (Study Comparing the Efficacy and Tolerability of Epinephrine and Norepinephrine in Cardiogenic Shock [OptimaCC]; NCT01367743

2018 EvidenceUpdates

78. High-Sensitivity Troponins and Outcomes After Myocardial Infarction Full Text available with Trip Pro

High-Sensitivity Troponins and Outcomes After Myocardial Infarction It remains unknown how the introduction of high-sensitivity cardiac troponin T (hs-cTnT) has affected the incidence, prognosis, and use of coronary angiographies and revascularizations in patients with myocardial infarction (MI).The aim of this study was to investigate how the incidence of MI and prognosis after a first MI was affected by the introduction of hs-cTnT.In a cohort study, the authors included all patients

2018 EvidenceUpdates

79. Myocardial infarction

Myocardial infarction Evidence Maps - Trip Database or use your Google+ account Turning Research Into Practice ALL of these words: Title only Anywhere in the document ANY of these words: Title only Anywhere in the document This EXACT phrase: Title only Anywhere in the document EXCLUDING words: Title only Anywhere in the document Timeframe: to: Combine searches by placing the search numbers in the top search box and pressing the search button. An example search might look like (#1 or #2) and (#3

2018 Trip Evidence Maps

80. Platelet MEKK3 regulates arterial thrombosis and myocardial infarct expansion in mice Full Text available with Trip Pro

Platelet MEKK3 regulates arterial thrombosis and myocardial infarct expansion in mice MAPKs play important roles in platelet activation. However, the molecular mechanisms by which MAPKs are regulated in platelets remain largely unknown. Real-time polymerase chain reaction and western blot data showed that MEKK3, a key MAP3K family member, was expressed in human and mouse platelets. Then, megakaryocyte/platelet-specific MEKK3-deletion (MEKK3-/- ) mice were developed to elucidate the platelet (...) formation following FeCl3-induced carotid artery injury. Interestingly, the tail bleeding time was normal in MEKK3-/- mice. Moreover, MEKK3-/- mice had fewer microthrombi, reduced myocardial infarction (MI) size, and improved post-MI heart function in a mouse model of MI. These results suggest that MEKK3 plays important roles in platelet MAPK activation and may be used as a new effective target for antithrombosis and prevention of MI expansion.© 2018 by The American Society of Hematology.

2018 Blood advances