Higher Rates of Current Smoking Status in Younger, Male and Non-Metropolitan Patients Presenting With ST-Elevation Myocardial Infarction to the John Hunter Hospital

2018 ◽  
Vol 27 ◽  
pp. S319
Author(s):  
S. Sugito ◽  
M. McGee ◽  
M. Al-Omary ◽  
A. Boyle
Keyword(s):  
Myocardial Infarction ◽  
Smoking Status ◽  
St Elevation Myocardial Infarction ◽  
Current Smoking Status ◽  
Current Smoking ◽  
John Hunter ◽  
St Elevation

Differences in characteristics, treatments and outcomes in patients with non-ST-elevation myocardial infarction: novel insights from four national European continuous real-world registries

2021 ◽  
Author(s):  
Robert Edfors ◽  
Tomas Jernberg ◽  
Christian Lewinter ◽  
Mai Blöndal ◽  
Jaan Eha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Smoking Status ◽  
St Elevation Myocardial Infarction ◽  
High Rate ◽  
Hospital Death ◽  
Aggregated Data ◽  
Crude Mortality Rate ◽  
Crude Mortality ◽  
Percutaneous Coronary ◽  
St Elevation

Abstract Aims To study baseline characteristics, in-hospital managements and mortality of non-ST-elevation myocardial infarction (NSTEMI) patients in different European countries. Methods and results NSTEMI patients enrolled in the national myocardial infarction (MI) registries [EMIR; n = 5817 (Estonia), HUMIR; n = 30 787 (Hungary), NORMI; n = 33 054 (Norway), and SWEDEHEART; n = 49 533 (Sweden)] from 2014 to 2017 were included and presented as aggregated data. The median age at admission ranged from 70 to 75 years. Current smoking status was numerically higher in Norway (24%), Estonia (22%), and Hungary (19%), as compared to Sweden (17%). Patients in Hungary had a high rate of diabetes mellitus (37%) and hypertension (84%). The proportion of performed coronary angiographies (58% vs. 75%) and percutaneous coronary interventions (38% vs. 56%), differed most between Norway and Hungary. Prescription of dual antiplatelet therapy at hospital discharge ranged from 60% (Estonia) to 81% (Hungary). In-hospital death ranged from 3.5% (Sweden) to 9% (Estonia). The crude mortality rate at 1 month was 12% in Norway and 5% in Sweden (5%), whereas the 1-year mortality rates were similar (20–23%) in Hungary, Estonia, and Norway and 15% in Sweden. Conclusion Cross-comparisons of four national European MI registries provide important data on differences in risk factors and treatment regiments that may explain some of the observed differences in death rates. A unified European continuous MI registry could be an option to better understand how implementation of guideline-recommended therapy can be used to reduce the burden of cardiovascular disease.

Abstract 19136: Association of Smoking With Myocardial Injury and Clinical Outcome in Patients Undergoing Mechanical Reperfusion for ST-Elevation Myocardial Infarction: Insights From Cardiovascular Magnetic Resonance Imaging

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Ingo Eitel ◽  
Sebastian Reinstadler ◽  
Charlotte Eitel ◽  
Georg Fuernau ◽  
Suazanne de Waha ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Magnetic Resonance ◽  
Clinical Outcome ◽  
Smoking Status ◽  
St Elevation Myocardial Infarction ◽  
Baseline Risk ◽  
Study Cohort ◽  
Myocardial Salvage ◽  
Area At Risk ◽  
St Elevation

Introduction: There is evidence suggesting a positive effect of cigarette smoking on myocardial tissue reperfusion and clinical outcomes in patients with myocardial infarction (“smoker’s paradox”). Hypothesis/Aim: We aimed to evaluate the relationship of smoking status with cardiac magnetic resonance (CMR)-determined myocardial salvage and damage as well as clinical outcome in patients undergoing primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI). Methods: This multicenter study included 727 consecutive STEMI patients reperfused within 12 hours after symptom onset. CMR imaging parameters (area-at-risk [AAR], infarct size [IS], myocardial salvage index [MSI], and microvascular obstruction [MVO]) were compared according to admission smoking status. Major adverse cardiac events (MACE) rates at 12 months after infarction were compared between groups. Results: In our study cohort 339 (46.6%) patients were current smokers. There was no difference in the extent of AAR (35[24-47] vs. 37[27-49] %LV, p=0.10), IS (16[8-25] vs. 17[10-26] %LV, p=0.21), MSI (53[29-70] vs. 52[34-71], p=0.47) or MVO (0[0-1.7] vs. 0[0-1.6] %LV, p=0.91) between smokers and non-smokers. Smokers had lower MACE (3.8% vs. 8.2%, p=0.01) and mortality (0.9% vs. 3.9%, p=0.01) rates. However, after adjustment for differences in baseline risk factors, smoking was no longer associated with MACE (HR=0.72, 95% CI 0.37 to 1.41, p=0.34) or mortality (HR=0.49, 95% CI 0.14 to 1.76, p=0.27). Conclusion: Smoking is not associated with PPCI efficacy (myocardial salvage) or irreversible myocardial damage in patients with acute STEMI. The lower MACE and mortality rates of smokers were entirely explained by differences in baseline risk characteristics, thus challenging the existence of a “smoker’s paradox”.

Smoking status and in-hospital outcomes of ST elevation myocardial infarction patients in a Brazilian public university hospital

2020 ◽  
Author(s):  
Alessandra Hofstadler Deiques Fleig ◽  
Isabella Brixner ◽  
Natalia Colissi ◽  
Alessandra Boesing ◽  
Andressa Seehaber ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Smoking Status ◽  
Public University ◽  
St Elevation Myocardial Infarction ◽  
University Hospital ◽  
Hospital Outcomes ◽  
St Elevation

Impact of comorbidities on peak troponin levels and mortality in acute myocardial infarction

Heart ◽  
2020 ◽  
Vol 106 (9) ◽  
pp. 677-685 ◽  
Author(s):  
Varun Sundaram ◽  
Kieran Rothnie ◽  
Chloe Bloom ◽  
Rosita Zakeri ◽  
Jayakumar Sahadevan ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Troponin ◽  
Reference Group ◽  
Smoking Status ◽  
Arterial Disease ◽  
St Elevation Myocardial Infarction ◽  
Chronic Obstructive ◽  
Comorbid Condition ◽  
St Elevation

ObjectivesTo characterise peak cardiac troponin levels, in patients presenting with acute myocardial infarction (AMI), according to their comorbid condition and determine the influence of peak cardiac troponin (cTn) levels on mortality.MethodsWe included patients with the first admission for AMI in the UK. We used linear regression to estimate the association between eight common comorbidities (diabetes mellitus, previous angina, peripheral arterial disease, previous myocardial infarction (MI), chronic kidney disease (CKD), cerebrovascular disease, chronic heart failure (CHF) and chronic obstructive pulmonary disease (COPD)) and peak cTn. Peak cTn levels were adjusted for age, sex, smoking status and comorbidities. Logistic regression and restricted cubic spline models were employed to investigate the association between peak cTn and 180-day mortality for each comorbidity.Results330 367 patients with ST elevation myocardial infarction and non-ST elevation myocardial infarction were identified. Adjusted peak cTn levels were significantly higher in patients with CKD (adjusted % difference in peak cTnT for CKD=42%, 95% CI 13.1 to 78.4) and significantly lower for patients with COPD, previous angina, previous MI and CHF when compared with patients without the respective comorbidities (reference group) (cTnI; COPD=−21.7%, 95% CI −29.1 to −13.4; previous angina=−24.2%, 95% CI −29.6 to −8.3; previous MI=−13.5%, 95% CI −20.6 to −5.9; CHF=−28%, 95% CI −37.2 to −17.6). Risk of 180-day mortality in most of the comorbidities did not change substantially after adjusting for peak cTn. In general, cTnI had a stronger association with mortality than cTnT.ConclusionsIn this nationwide analysis of patients presenting with AMI, comorbidities substantially influenced systemic concentrations of peak cTn. Comorbid illness is a significant predictor of mortality regardless of peak cTn levels and should be taken into consideration while interpreting cTn both as a diagnostic and prognostic biomarker.

Abdominaler Tumor nach anhaltendem Husten und entgleister Antikoagulation

Praxis ◽  
2010 ◽  
Vol 99 (1) ◽  
pp. 55-59
Author(s):  
Wandeler-Meyer ◽  
Bremerich ◽  
Christ
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Diagnostik Und Therapie ◽  
St Elevation

Wir berichten über eine 83-jährige Patientin mit einem STEMI (ST elevation myocardial infarction), welche unter der Thrombozytenaggregationshemmung und systemischen Antikoagulation ein Rektusscheidenhämatom nach einer Hustenattacke entwickelte. Die Patientin beklagte progrediente Schmerzen im linken Unterbauch, welche mit einer palpablen Raumforderung einhergingen und von einer Anämie begleitet waren. In der Abdomensonographie und der Computertomographie zeigte sich ein Rektusscheidenhämatom. Der Artikel erörtert Pathogenese, Klinik, Diagnostik und Therapie unter Berücksichtigung der aktuellen Literatur.

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