scholarly journals Early dynamic risk stratification with baseline troponin levels and 90-minute ST-segment resolution to predict 30-day cardiovascular mortality in ST-segment elevation myocardial infarction: Analysis from CLopidogrel as Adjunctive ReperfusIon TherapY (CLARITY) - Thrombolysis in Myocardial Infarction (TIMI) 28

2010 ◽  
Vol 159 (6) ◽  
pp. 964-971.e1 ◽  
Author(s):  
Matthew W. Sherwood ◽  
David A. Morrow ◽  
Benjamin M. Scirica ◽  
Songtao Jiang ◽  
Christoph Bode ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Risk Stratification ◽  
Cardiovascular Mortality ◽  
Reperfusion Therapy ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Dynamic Risk ◽  
St Segment

Unstable Angina and Other Acute Coronary Syndromes

2013 ◽  
Author(s):  
R Scott Wright ◽  
Joseph G Murphy
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Risk Stratification ◽  
Unstable Angina ◽  
The United States ◽  
Cardiac Biomarkers ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

Patients with coronary artery disease (CAD) present clinically when their disease enters an unstable phase known as an acute coronary syndrome (ACS), in which the cap of a previously stable atheromatous coronary plaque ruptures or erodes, which in turn activates a thrombotic cascade that may lead to coronary artery occlusion, myocardial infarction (MI), cardiogenic shock, and patient death. There are nearly 2 million episodes of ACS in the United States annually; it is the most common reason for hospitalization with CAD and is the leading cause of death in the developed world. ACS patients include those with unstable angina (UA), non–ST segment elevation myocardial infarction (non-STEMI), and ST segment elevation myocardial infarction (STEMI) and patients who die suddenly of an arrhythmia precipitated by coronary occlusion. The distinction among various ACS subgroups reflects varying characteristics of clinical presentation (presence or absence of elevated cardiac biomarkers) and the type of electrocardiographic (ECG) changes manifested on the initial ECG at the time of hospitalization. This chapter focuses on UA and non-STEMI. A graph outlines mortality risks faced by patients with varying degrees of renal insufficiency. An algorithm describes the suggested management of patients admitted with UA or non-STEMI. Tables describe the risk stratification of the patient with chest pain, categories of Killip class, examination findings of a patient with high-risk ACS, diagnosis of MI, causes of troponin elevation other than ischemic heart disease, initial risk stratification of ACS patients, and long-term medical therapies and goals in ACS patients. This review contains 2 highly rendered figures, 11 tables, and 76 references.

Abstract 169: Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Abhishek Sharma ◽  
Samin Sharma ◽  
Debabrata Mukherjee ◽  
Akash Garg ◽  
Carl Lavie ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Beta Blockers ◽  
Final Analysis ◽  
Reperfusion Therapy ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Standard Medical Therapy ◽  
St Segment ◽  
Early Use

Background: It remains unclear if early use of intravenous (IV) beta-blockers (iBB) improves clinical outcomes patients with ST-segment elevation myocardial infarction (MI; STEMI), especially among those who received reperfusion therapy. Objective: To evaluate effect of early iBB use on clinical outcomes among patients with STEMI. Methods: A systematic review of randomized control trials in MEDLINE, EMBASE, CINAHL, and Cochrane databases comparing early use (administered within 12 hours of presentation) of iBB with standard medical therapy/placebo among patients who presented with STEMI. The effect of iBB was assessed by stratifying studies into pre-reperfusion and reperfusion trials and pooled treatment effects were estimated using relative risk with Mantel-Haenszel risk ratio, using a random-effects model Results: Twenty-one studies (N=74,801) were selected for final analysis. Clinical outcomes at 30 days and 1 year are summarized in table below. Conclusion: In the current reperfusion era, early use of iBB in patients with STEMI was associated with reduction in the risk of recurrent MI and ventricular tachyarrhythmias without any significant reduction in all-cause or CV mortality or increase in the risk of cardiogenic shock.

scholarly journals Background and design of the ACCA–EAPCI registry on ST-segment elevation myocardial infarction of the European Society of Cardiology

2018 ◽  
Vol 8 (1) ◽  
pp. 63-67 ◽  
Author(s):  
Uwe Zeymer ◽  
Peter Ludman ◽  
Nicolas Danchin ◽  
Petr Kala ◽  
Aldo P Maggioni ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
European Society ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
Special Focus ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Esc Guidelines ◽  
European Society Of Cardiology

Treatment of patients with acute ST-segment elevation myocardial infarction has improved over past decades, with reperfusion therapy being the cornerstone in the acute phase. Based on the results of large randomised trials the current ST-segment elevation myocardial infarction guidelines of the European Society of Cardiology (ESC) recommend acute treatments and secondary prevention therapies. However, there are large variations between ESC countries in the treatment of patients presenting with ST-segment elevation myocardial infarction. Therefore the ESC has initiated a prospective registry to evaluate the current treatments and outcomes of these patients with a special focus on adherence to the ESC guidelines and on differences between countries and regions. This paper describes the methodology and design of the ST-segment elevation myocardial infarction registry conducted in collaboration of the Acute Cardiac Care Association and the European Association of Percutaneous Coronary Intervention.

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