Corrected TIMI frame count does not predict 30-day adverse outcomes after reperfusion therapy for acute myocardial infarction

1999 ◽  
Vol 138 (4) ◽  
pp. 785-790 ◽  
Author(s):  
Deepak L. Bhatt ◽  
Stephen G. Ellis ◽  
Thomas B. Ivanc ◽  
Timothy Crowe ◽  
Eva Balazs ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Reperfusion Therapy ◽  
Adverse Outcomes ◽  
Timi Frame Count ◽  
Corrected Timi Frame Count

Abstract 9408: ST-Segment Elevation in Leads V5-6 Predicts In-Hospital Adverse Outcomes in Patients With Reperfused Inferior Acute Myocardial Infarction

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Masami Kosuge ◽  
Toshiaki Ebina ◽  
Kiyoshi Hibi ◽  
Kengo Tsukahara ◽  
Noriaki Iwahashi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Adverse Events ◽  
Reperfusion Therapy ◽  
Adverse Outcomes ◽  
Prognostic Impact ◽  
Inferior Wall ◽  
St Segment Elevation ◽  
Left Circumflex Artery ◽  
St Segment

Introduction: In inferior wall acute myocardial infarction (IWMI), ST-segment elevation in leads V5-6 (STE V5-6) is often observed, but its prognostic impact is unclear. Methods: We examined admission ECGs in 361 patients with a first IWMI who had TIMI 3 flow of the right coronary artery (RCA) or left circumflex artery (LCX) by reperfusion therapy within 6 hours after symptom onset. Patients were divided according to the presence (n=77) or absence (n=284) of STE V5-6 >2 mm, and the former was subdivided into the 2 groups according to the degree of STE in leads III and V6: STE:III>V6 (n=53) and STE:III≤V6 (n=24). The perfusion territory of the culprit artery was assessed by angiographic distribution score, and mega-artery was defined as a score ≥0.7. Results: Age, sex, time to admission, reperfusion therapy, or time to reperfusion was similar in the 3 groups. STE V5-6 was associated with mega-artery occlusion, larger infarction, and in-hospital adverse events (death, reinfarction, or heart failure). RCA occlusion was most common in STE V5-6 with STE:III>V6, whereas LCX occlusion, especially proximal LCX occlusion, was most common in STE V5-6 with STE:III≤V6. In multivariate analysis, STE V5-6 with STE:III>V6 (OR 2.90, 95%CI 1.10-7.02, p<0.01) and that with STE:III≤V6 (OR 3.63, 95%CI 1.58-8.96, p<0.01) were independent predictors of in-hospital adverse events. Conclusions: In reperfused IWMI, ST-segment elevation in leads V5-6 on admission ECG strongly predicts in-hospital adverse outcomes; furthermore, comparing the degree of ST-segment elevation in leads III and V6 is useful for predicting the culprit artery (i.e., RCA or LCX).

Increasing the Penetration of Primary Angioplasty in Europe

2012 ◽  
Vol 8 (1) ◽  
pp. 60 ◽  
Author(s):  
Zuzana Kaifoszova ◽  
Petr Widimsky ◽  
◽  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Treatment Guidelines ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
Success Factor ◽  
The Balkans ◽  
Life Saving ◽  
Percutaneous Coronary

Primary percutaneous coronary intervention (PPCI) is recommended by the European Society of Cardiology (ESC) treatment guidelines as the preferred treatment for ST-elevation acute myocardial infarction (STEMI) whenever it is available within 90–120 minutes of the first medical contact. A survey conducted in 2008 in 51 ESC countries found that the annual incidence of hospital admissions for acute myocardial infarction is around 1,900 patients per million population, with an incidence of STEMI of about 800 per million. It showed that STEMI patients’ access to reperfusion therapy and the use of PPCI or thrombolysis (TL) vary considerably between countries. Northern, western and central Europe already have well-developed PPCI services, offering PPCI to 60–90 % of all STEMI patients. Southern Europe and the Balkans are still predominantly using TL. Where this is the case, a higher proportion of patients are left without any reperfusion treatment. The survey concluded that a nationwide PPCI strategy results in more patients being offered reperfusion therapy. To address the inequalities in STEMI patients’ access to life-saving PPCI, and to support the implementation of the ESC STEMI treatment guidelines in Europe, the Stent for Life (SFL) Initiative was launched jointly by the European Association of Percutaneous Cardiovascular Interventions (EAPCI) and EuroPCR in 2008. National cardiac societies from Bulgaria, France, Greece, Serbia, Spain and Turkey signed the SFL Declaration at the ESC Congress in Barcelona in 2009. The aim of the SFL Initiative is to improve the delivery of, and STEMI patients’ access to, life-saving PPCI and thereby reduce mortality and morbidity. Currently, 10 national cardiac societies support the SFL Initiative in their respective countries. SFL national action programmes have been developed and are being implemented in several countries. The formation of regional PPCI networks involving emergency medical services, non-percutaneous coronary intervention hospitals and PPCI centres is considered to be a critical success factor in implementing PPCI services effectively. This article describes examples of how SFL countries are progressing in implementing their national programmes, thus increasing PPCI penetration in Europe.

Assessment of Admission Time Cell Blood Count (CBC) Parameters in Predicting Post-primary Percutaneous Coronary Intervention TIMI Frame Count in Patients with ST-segment Elevation Myocardial Infarction

2020 ◽  
Vol 20 (3) ◽  
pp. 191-197
Author(s):  
Hossein Vakili ◽  
Isa Khaheshi ◽  
Amirsina Sharifi ◽  
Negin Nickdoost ◽  
Mohammad H. Namazi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Platelet Count ◽  
P Value ◽  
Primary Pci ◽  
Blood Samples ◽  
Timi Frame Count ◽  
Admission Time ◽  
No Reflow ◽  
Corrected Timi Frame Count ◽  
No Reflow Phenomenon

Objectives: In this study, we aimed to assess the value of admission time CBC parameters in predicting post-primary PCI corrected TIMI frame count. Background: Recent years have witnessed a large series of studies evaluating different laboratory variables to predict no-reflow phenomenon following primary PCI (PPCI) in patients with STEMI. However, a general agreement about the most reliable predictor of the no-reflow phenomenon is challenging and also intriguing. Methods: The current study concluded 208 consecutive patients who underwent primary PCI for ST-Elevation Myocardial Infarction (STEMI) from January 2014 to February 2016. Blood samples were obtained after taking ECG. Complete blood samples were collected and analyzed within 5 minutes from sampling. Post-PCI corrected Thrombolysis in Myocardial Infarction (TIMI) frame count was determined by one interventional cardiologist blinded to patients’ clinical data. The correlation between admission time blood parameters and post-primary PCI corrected TIMI frame count in patients with STEMI were assessed. Results: Corrected TIMI frame count was positively correlated with WBC count (R: 0.18, P-value: <0.01), neutrophil count (R: 0.34, P-value: <0.01), and platelet count (R: 0.23, P-value: <0.01) and negatively correlated with lymphocyte count (R: -0.2, P-value: <0.01). Multiple linear regression results demonstrated that corrected TIMI frame count was positively correlated with neutrophil count (P < 0·001) and platelet count (P < 0·001) and negatively correlated with lymphocyte count (p=0.004). Conclusion: High counts of WBC, neutrophil, and platelet and low count of lymphocyte may be predictors of no-reflow in STEMI patients undergoing PPCI. The clinical significance of such predictive parameters becomes clear as we consider the treatment approach in STEMI patients. Appropriate risk stratification leads to better treatment planning and allocation of resources.

The combined impact of Type D personality and depression on cardiovascular events after acute myocardial infarction

2021 ◽  
pp. 1-11
Author(s):  
Yini Wang ◽  
Xueqin Gao ◽  
Zhenjuan Zhao ◽  
Ling Li ◽  
Guojie Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Significant Risk ◽  
Type D Personality ◽  
Adverse Outcomes ◽  
Combined Effect ◽  
Continuous Variables ◽  
Type D

Abstract Background Type D personality and depression are the independent psychological risk factors for adverse outcomes in cardiovascular patients. The aim of this study was to examine the combined effect of Type D personality and depression on clinical outcomes in patients suffering from acute myocardial infarction (AMI). Methods This prospective cohort study included 3568 patients diagnosed with AMI between February 2017 and September 2018. Type D personality and depression were assessed at baseline, while the major adverse cardiac event (MACE) rate (cardiac death, recurrent non-fatal myocardial infarction, revascularization, and stroke) and in-stent restenosis (ISR) rate were analyzed after a 2-year follow-up period. Results A total of 437 patients developed MACEs and 185 had ISR during the follow-up period. The Type D (+) depression (+) and Type D (+) depression (−) groups had a higher risk of MACE [95% confidence interval (CI) 1.74–6.07] (95% CI 1.25–2.96) and ISR (95% CI 3.09–8.28) (95% CI 1.85–6.22). Analysis of Type D and depression as continuous variables indicated that the main effect of Type D, depression and their combined effect were significantly associated with MACE and ISR. Moreover, Type D (+) depression (+) and Type D (+) depression (−) emerged as significant risk factors for MACE and ISR in males, while only Type D (+) depression (+) was associated with MACE and ISR in female patients. Conclusions These findings suggest that patients complicated with depression and Type D personality are at a higher risk of adverse cardiovascular outcomes. Individual assessments of Type D personality and depression, and comprehensive interventions are required.

The effect of preloading statins prior to primary reperfusion on in-hospital mortality risk in a contemporary large-scale cohort of patients with ST-elevation myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
R Fu ◽  
C.X Song ◽  
X.D Li ◽  
Y.J Yang
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Risk ◽  
Large Scale ◽  
Reperfusion Therapy ◽  
St Elevation Myocardial Infarction ◽  
Control Group ◽  
Funding Source ◽  
St Elevation

Abstract Background The benefit of statins in secondary prevention of patients stabilized after acute coronary syndrome (ACS) has been well established. However, the benefit of preloading statins, i.e. high-intensity statins prior to reperfusion therapy remains unclear. Most previous studies included all types of ACS patients, and subgroup analysis indicated the benefit of preloading statins was only seen in ST-elevation myocardial infarction (STEMI) patients who underwent percutaneous coronary intervention (PCI). However, the sample size of subgroup population was relatively small and such benefit requires further validation. Objective To investigate the effect of loading dose of statins before primary reperfusion on 30-mortality in patients with STEMI. Methods We enrolled patients in China Acute Myocardial Infarction (CAMI) registry from January 2013 to September 2014. CAMI registry was a prospective multicenter registry of patients with acute acute myocardial infarction in China. Patients were divided into two groups according to statins usage: preloading group and control group. Patients in preloading group received loading does of statins before primary reperfusion and during hospitalization. Patients in control group did not receive statins during hospitalization or at discharge. Primary outcome was in-hospital mortality. Baseline characteristics, angiographic characteristics and outcome were compared between groups. Propensity score (PS) matching was used to mitigate baseline differences between groups and examine the association between preloading statins on in-hospital mortality risk. The following variables were used to establish PS matching score: age, sex, classification of hospitals, clinical presentation (heart failure at presentation, cardiac shock, cardiac arrest, Killip classification), hypertension, diabetes, prior angina, prior myocardial infarction history, prior stroke, initial treatment. Results A total of 1169 patients were enrolled in control group and 6795 in preloading group. A total of 833 patients (334 in control group and 499 in preloading group) died during hospitalization. Compared with control group, preloading group were younger, more likely to be male and present with Killip I classification. The proportion of hypertension and diabetes were higher in preloading group. After PS matching, all the variables used to generate PS score were well balanced. In the PS-matched cohort, 30-day mortality risk was 26.3% (292/1112) in the control group and 11.9% (132/1112) in the preloading group (p&lt;0.0001). Conclusions The current study found preloading statins treatment prior to reperfusion therapy reduced in-hospital mortality risk in a large-scale contemporary cohort of patients with STEMI. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Chinese Academy of Medical Sciences

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