Efficacy of thrombectomy for acute myocardial infarction—Special focus on its efficacy according to different infarct-related arteries

AbstractAcute myocardial infarction (AMI) is a major public health problem. Cold winter weather increases the risk of AMI, but factors influencing susceptibility are poorly known. We conducted an individual-level case-crossover study of the associations between winter cold spells and the risk of AMI, with special focus on survival at 28 days and effect modification by age and sex. All 16,071 adult cases of AMI among the residents of the city of Kaunas in Lithuania in 2000–2015 were included in the study. Cold weather was statistically defined using the 5th percentile of frequency distribution of daily mean temperatures over the winter months. According to conditional logistic regression controlling for time-varying and time-invariant confounders, each additional cold spell day during the week preceding AMI increased the risk of AMI by 5% (95% CI 1–9%). For nonfatal and fatal cases, the risk increase per each additional cold spell day was 5% (95% CI 1–9%) and 6% (95% CI − 2–13%), respectively. The effect estimate was greater for men (OR 1.07, 95% CI 1.02–1.12) than for women (OR 1.02, 95% CI 0.97–1.08), but there was no evidence of effect modification by age. Evidence on factors increasing susceptibility is critical for targeted cold weather planning.

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Acute Myocardial Infarction During the COVID-19 Pandemic: An Update on Clinical Characteristics and Outcomes

Frontiers in Cardiovascular Medicine ◽

10.3389/fcvm.2021.648290 ◽

2021 ◽

Vol 8 ◽

Author(s):

Olga Toscano ◽

Nicola Cosentino ◽

Jeness Campodonico ◽

Antonio L. Bartorelli ◽

Giancarlo Marenzi

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Clinical Characteristics ◽

Hospital Admissions ◽

Healthcare Management ◽

Special Focus ◽

Medical Systems ◽

Respiratory Complications ◽

Dramatic Decline ◽

Emergency Medical Systems

The outbreak of coronavirus disease 2019 (COVID-19) has rapidly become a worldwide pandemic. On top of respiratory complications, COVID-19 is associated with major direct and indirect cardiovascular consequences, with the latter probably being even more relevant, especially in the setting of time-dependent cardiovascular emergencies. A growing amount of data suggests a dramatic decline in hospital admissions for acute myocardial infarction (AMI) worldwide during the COVID-19 pandemic, mostly since patients did not activate emergency medical systems because hospitals were perceived as dangerous places regarding the infection risk. Moreover, during the COVID-19 pandemic, patients with AMI had a significantly higher in-hospital mortality compared to those admitted before COVID-19, potentially due to late arrival to the hospital. Finally, no consensus has been reached regarding the most adequate healthcare management pathway for AMI and shared guidance on how to handle patients with AMI during the pandemic is still needed. In this review, we will provide an update on epidemiology, clinical characteristics, and outcomes of patients with AMI during the COVID-19 pandemic, with a special focus on its collateral cardiac impact.

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Extended dual antiplatelet therapy after acute myocardial infarction. Current evidence and future perspectives

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2019.1046 ◽

2019 ◽

Vol 89 (2) ◽

Cited By ~ 1

Author(s):

Nicola Cosentino ◽

Jeness Campodonico ◽

Valentina Milazzo ◽

Katia Celentano ◽

Marco Moltrasio ◽

...

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Antiplatelet Therapy ◽

Dual Antiplatelet Therapy ◽

Stable Coronary Artery Disease ◽

Scoring Systems ◽

Current Evidence ◽

Special Focus ◽

Early Assessment ◽

Increased Risk

Patients with acute myocardial infarction (AMI) are at increased risk of recurrent ischemic events after hospital discharge, despite optimal medical therapy. Current practice guidelines strongly encourage the early assessment of the residual ischemic risk in post-AMI patients, in order to identify those who may benefit from a prolonged dual antiplatelet therapy. To this end, some scoring systems have been proposed. However, most scores were developed for patients with stable coronary artery disease undergoing percutaneous coronary intervention. Moreover, nearly all failed to be implemented in everyday clinical practice, probably because of the perceived complexity due to the large number of incorporated variables. Therefore, the identification of the ideal AMI patient who can benefit from a prolonged (beyond 1 year after the index event) dual antiplatelet therapy remains to be clarified, especially when the bleeding risk associated with such therapy is considered. In this review, we summarize the current evidence on the prolonged use of dual antiplatelet therapy after AMI, with a special focus on recent advances regarding the identification of high-risk patients who may derive a favorable net clinical benefit from such a therapeutic strategy.

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An electron microscopic study of the intra-myocardial lesions in cases of acute myocardial infarction

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010008328x ◽

1978 ◽

Vol 36 (2) ◽

pp. 484-485

Author(s):

Masahiro Ono ◽

Kaoru Aihara ◽

Gompachi Yajima

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Coronary Vessels ◽

Vascular Wall ◽

Vascular Changes ◽

Electron Microscopic ◽

Main Trunk ◽

Mechanical Destruction ◽

Transmission Electron ◽

Myocardial Lesions

The pathogenesis of the arteriosclerosis in the acute myocardial infarction is the matter of the extensive survey with the transmission electron microscopy in experimental and clinical materials. In the previous communication,the authors have clarified that the two types of the coronary vascular changes could exist. The first category is the case in which we had failed to observe no occlusive changes of the coronary vessels which eventually form the myocardial infarction. The next category is the case in which occlusive -thrombotic changes are observed in which the myocardial infarction will be taken placed as the final event. The authors incline to designate the former category as the non-occlusive-non thrombotic lesions. The most important findings in both cases are the “mechanical destruction of the vascular wall and imbibition of the serous component” which are most frequently observed at the proximal portion of the coronary main trunk.

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