Rates Of Fibrin Growth As A Predictor Of Acute Myocardial Infarction. A Prospective Blind Study

1981 ◽  
Author(s):  
D Joe Baughman ◽  
J B Kostis
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Risk Ratio ◽  
Thrombin Time ◽  
Lysis Time ◽  
Coagulation Tests ◽  
At Iii ◽  
Acute Mi ◽  
Artery Disease

A blind prospective coagulation profile was performed on 147 patients with coronary artery disease (CAD). Theprofile consisted of Prothrombin time (PT), the maximum rate of fibrin production (turbidity) when measuring the PT (PT Vmax), Activated Partial Thromboplastin time (APTT), APTT Vmax, Thrombin time (TT), TT Vmax, Fibrinogen (F), plasma and serum Antithrombin III (At-III), Lysis Time (LT) and Lipoproteins (LP). All clotting times and turbidities were measured using a BioData CP-7; At-III was measured as the loss of thrombin clotting activity; F was measured as the total thrombin clottable protein; LT was measured by a modified CLUE test; LP was measured as a heparin-Mg produced turbidity.During 41 months of follow-up, 12 patients developed a new myocardial infarction (MI), and had significantly higher APTT Vmax (7.46 ± .30U vs. 6.21 ± .09U, p=.0001); PT Vmax (7.83 ± .27U vs. 6.46 ± .10U, p=.0002); TT Vmax (5.33 ± .32U vs. 4.20 ± LOU, p=.0014); and F (339.6 ± 12.2 mg/dl vs. 292.76 ± 4.6 mg/dl, p=.003) than patients who did not. Out of 37 patients with the highest PT Vmax (upper 25%), 27% developed acute MI, while only 2 (1.8%) of the remaining 110 developed MI, giving a risk ratio of 15.4, p=.0001. Similarly, 9 out of 12 infarctions occurred in the upper 25% of APTT Vmax, giving a risk ratio of 8.9, p=0.0004. MI was also predicted by TT Vmax with a risk ratio of 5.9 (p=0.0004) and by fibrinogen with a risk ratio of 4.8 (p=0.0018). No relationship between MI and the other coagulation tests was noted. Thus, 1. rates of fibrin growth may predict the occurrence of MI in CAD, and 2. soluble coagulation parameters are important in the pathogenesis of acute myocardial infarction.

Angiographic profile and outcomes of Pakistani women with ST elevation myocardial infarction

2020 ◽  
pp. 1-13
Author(s):  
Sobia Masood ◽  
Kanwal Fatima Aamir ◽  
Khalid Naseeb ◽  
Quratulain Shaikh ◽  
Tahir Saghir ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Female Patients ◽  
Vessel Disease ◽  
Percutaneous Coronary ◽  
Artery Disease

Abstract Objective: To evaluate the angiographic profile and outcome of primary percutaneous coronary intervention in female patients with acute myocardial infarction. Method: The cross-sectional study was conducted at the National Institute of Cardiovascular Diseases, Karachi, from July 1, 2017, to March 31, 2018, and comprised female patients presenting with acute myocardial infarction who underwent primary percutaneous coronary intervention and got enrolled in the National Cardiovascular Data Registry. Follow-up calls were made 1 year post-intervention and outcomes were noted. Data was analysed using SPSS 21. Results: Of the 522 female patients with a mean age of 57.41±11.14 years, 334(64%) were hypertensive, 202(38.7%) diabetic, 16(3.1%) had a family history of coronary artery disease, and 9(1.7%) were smokers. Single-vessel disease was observed in 183(35.1%) patients, and three-vessel disease in 144(27.6%). Post-procedure thrombolysis in myocardial infarction flow (0-II) was observed in 29(5.6%) patients, bleeding in 2(0.4%), and in-hospital mortality was in 22(4.2%). Telephonic follow-up was successfully conducted in 436(87.5%) of the discharged patients, and, of them 15(3.4%) had expired and recurrence was reported by 10(2.3%) patients and 8(80%) of them underwent re-intervention. Conclusion: More than half the female patients had multi-vessel disease and bifurcation lesion was observed in more than three-fourth of the sample. Key Words: Coronary artery disease, Women, Percutaneous coronary intervention, Acute myocardial infarction, Angiography, Pakistan. Continuous...

scholarly journals Routine Oxygen Therapy Does Not Improve Health-Related Quality of Life in Patients With Acute Myocardial Infarction—Insights From the Randomized DETO2X-AMI Trial

2021 ◽  
Vol 8 ◽  
Author(s):  
Robin Hofmann ◽  
Tamrat Befekadu Abebe ◽  
Johan Herlitz ◽  
Stefan K. James ◽  
David Erlinge ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Oxygen Therapy ◽  
Ambient Air ◽  
Related Quality ◽  
Health Related ◽  
Acute Mi

Background: After decades of ubiquitous oxygen therapy in all patients with acute myocardial infarction (MI), recent guidelines are more restrictive based on lack of efficacy in contemporary trials evaluating hard clinical outcomes in patients without hypoxemia at baseline. However, no evidence regarding treatment effects on health-related quality of life (HRQoL) exists. In this study, we investigated the impact of routine oxygen supplementation on HRQoL 6–8 weeks after hospitalization with acute MI. Secondary objectives included analyses of MI subtypes, further adjustment for infarct size, and oxygen saturation at baseline and 1-year follow-up.Methods: In the DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial, 6,629 normoxemic patients with suspected MI were randomized to oxygen at 6 L/min for 6–12 h or ambient air. In this prespecified analysis, patients younger than 75 years of age with confirmed MI who had available HRQoL data by European Quality of Life Five Dimensions questionnaire (EQ-5D) in the national registry were included. Primary endpoint was the EQ-5D index assessed by multivariate linear regression at 6–10 weeks after MI occurrence.Results: A total of 3,086 patients (median age 64, 22% female) were eligible, 1,518 allocated to oxygen and 1,568 to ambient air. We found no statistically significant effect of oxygen therapy on EQ-5D index (−0.01; 95% CI: −0.03–0.01; p = 0.23) or EQ-VAS score (−0.57; 95% CI: −1.88–0.75; p = 0.40) compared to ambient air after 6–10 weeks. Furthermore, no significant difference was observed between the treatment groups in EQ-5D dimensions. Results remained consistent across MI subtypes and at 1-year follow-up, including further adjustment for infarct size or oxygen saturation at baseline.Conclusions: Routine oxygen therapy provided to normoxemic patients with acute MI did not improve HRQoL up to 1 year after MI occurrence.Clinical Trial Registration:ClinicalTrials.gov number, NCT01787110.

Short and Midterm Outcomes in Patients With Acute Myocardial Infarction: Results of the Nationwide TURKMI Registry

Angiology ◽  
2020 ◽  
pp. 000331972097530
Author(s):  
Mustafa Kilickap ◽  
Mustafa Kemal Erol ◽  
Meral Kayikcioglu ◽  
Ibrahim Kocayigit ◽  
Mesut Gitmez ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Mortality ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Acute Mi

This recent Turkish Myocardial Infarction registry reported that guidelines are largely implemented in patients with acute myocardial infarction (MI) in Turkey. We aimed to obtain up-to-date information for short- and midterm outcomes of acute MI. Fifty centers were selected using probability sampling, and all consecutive patients with acute MI admitted to these centers (between November 1 and 16, 2018) were enrolled. Among 1930 (mean age 62 ± 13 years, 26% female) patients, 1195 (62%) had non-ST segment elevation myocardial infarction (NSTEMI) and 735 (38%) had ST segment elevation myocardial infarction (STEMI). Percutaneous coronary intervention (PCI) was performed in 94.4% of patients with STEMI and 60.2% of those with NSTEMI. Periprocedural mortality occurred in 4 (0.3%) patients. In-hospital mortality was significantly higher in STEMI than in patients with NSTEMI (5.4% vs 2.9%, respectively; P = .006). However, the risk became slightly higher in the NSTEMI group at 1 year. Women with STEMI had a significantly higher in-hospital mortality compared with men (11.2% vs 3.8%; P < .001); this persisted at follow-up. In conclusion, PCI is performed in Turkey with a low risk of complications in patients with acute MI. Compared with a previous registry, in-hospital mortality decreased by 50% within 20 years; however, the risk remains too high for women with STEMI.

scholarly journals Quality of Life after Coronary Revascularization in Patients with Acute Myocardial Infarction

2016 ◽  
Vol 1 (1) ◽  
pp. 51-54
Author(s):  
Mihaela Susca ◽  
Monica Copotoiu ◽  
Horaţiu Popoviciu ◽  
Zsuzsanna Szőke ◽  
Balázs Bajka ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Coronary Revascularization ◽  
Self Care ◽  
Female Group ◽  
Limited Mobility ◽  
Acute Mi

Abstract Background: The quality of life (QoL) in acute myocardial infarction (MI) patients can be improved using 3 therapeutic methods — surgical, pharmaceutical and physical. Study aim: We sought to assess the QoL in patients following an acute MI, with or without percutanous coronary intervention (PCI). Material and methods: A number of 54 patients with acute MI were included in the study. All subjects were asked to complete the EQ-SD questionnaire at baseline, and during the 12-month follow-up. The questionnaire consists of 2 parts: 1st part – assesses the mobility, self care, activities of daily life (ADL), pain, depression and anxiety; 2nd part – visual analogue scale (VAS) for the overall state. Patients were divided into 4 groups: Group 1 – all patients (n = 54); Group 2 – males (n = 40), Group 3 – female patients (n = 14), and Group 4 – patients who underwent a PCI procedure (n = 48). Blood pressure (BP) was also monitored. Results: The mean age was 66.54 years. There were no differences between the groups at baseline, and after 1 year regarding the BP. No differences were observed regarding the VAS (baseline p = 0.990; 12-month p = 0.991). Concerning the PCI vs. non-PCI groups, no differences were found in relation to mobility, self-care, ADL, pain and depression at baseline or after 12 months. For all groups at baseline, the limited mobility was positively correlated with impaired self-care (p = 0.041) and lower ADLs (p = 0.003). After 1 year, a limited mobility was associated with defective self-care (p <0.001) and decreased ADLs (p = 0.004) and there was an improvement in mobility (p = 0.0002) and self-care (p <0.0001), compared to baseline. The PCI group associated pain with depression at baseline (p <0.001) and limited mobility with lack of ADLs (p = 0.005). At 12 months, we observed an improvement in mobility, self-care (p <0.001), and the ADLs (p <0.001). The males showed a positive association between depression and pain (p <0.001) at baseline, but not after 1 year. Mobility was the only parameter that had improved during follow-up (p = 0.043). In the female group, pain (p = 0.015) and mobility (p = 0.033) had improved after 12 months. Conclusions: The QoL had improved in terms of mobility, self-care and new skills acquired after PCI. Both depression and pain were ameliorated in the male group, despite the lack of improvement on VAS for the overall state.

scholarly journals The outcomes of acute myocardial infarction patients comorbidity with hypertension and hyperhomocysteinemia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Jumei Yan ◽  
Jiamin Zhou ◽  
Jun Huang ◽  
Hongyu Zhang ◽  
Zilin Deng ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Hospital Stay ◽  
Vital Signs ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Major Adverse Cardiovascular Events ◽  
Ventricular Ejection Fraction ◽  
Artery Disease

AbstractThis study investigated the outcomes and major adverse cardiovascular events (MACEs) incurred by acute myocardial infarction (AMI) patients comorbiding with hypertension and hyperhomocysteinemia (HHcy) during hospitalization and 1-year follow-up. 648 consecutive AMI patients were divided into four categories: (1) hypertension with Hcy ≥ 15 µmol/L; (2) hypertension with Hcy < 15 µmol/L; (3) no-hypertension with Hcy ≥ 15 µmol/L; (4) no-hypertension with Hcy < 15 µmol/L. Information taken from these case files included gender, past medical history, vital signs, laboratory examination, electrocardiogram, coronary angiography, cardiac ultrasound, and medicine treatment. The primary endpoints were duration of coronary care units (CCU) stay, duration of in-hospital stay, and MACEs during follow-up. Our data show that hypertension and HHcy have a synergistic effect in AMI patients, AMI comorbiding with hypertension and HHcy patients had more severe multi-coronary artery disease and more frequent non-culprit coronary lesions complete clogging, had a higher prevalence of pro-brain natriuretic peptide, and significant decreases in the left ventricular ejection fraction. These patients had significant increases in the duration of CCU stay and in-hospital stay, had significant increase in the rate of MACEs, had significant decreases in the survival rate during follow-up.

scholarly journals Association between Serum Osteoprotegerin Levels and Severity of Coronary Artery Disease in Patients with Acute Myocardial Infarction

2021 ◽  
Vol 10 (19) ◽  
pp. 4326
Author(s):  
Yves Cottin ◽  
Rany Issa ◽  
Mourad Benalia ◽  
Basile Mouhat ◽  
Alexandre Meloux ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Coronary Artery ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Syntax Score ◽  
Acute Mi ◽  
Coronary Lesions ◽  
Artery Disease

Background. Osteoprotegerin (OPG), a glycoprotein of the tumour necrosis factor (TNF) superfamily, is one of the main biomarkers for vascular calcification. Aim. We aimed to evaluate the association between serum OPG levels and extent of coronary lesions in patients with acute myocardial infarction (MI). Methods. Consecutive patients hospitalized for an acute MI who underwent coronary angiography were included. SYNTAX score was calculated to assess the severity of coronary artery disease. The population was analysed in low (5 (3–6)), medium (11 (9–13)) and high (20 (18–23)) tertiles of SYNTAX score. Results. Among the 378 patients included, there was a gradual increase in age, rate of diabetes, anterior wall location, and a reduction in left ventricular ejection fraction across the SYNTAX tertiles. OPG levels significantly increased across the tertiles (962 (782–1497), 1240 (870–1707), and 1464 (1011–2129) pg/mL, respectively (p < 0.001)). In multivariate analysis, OPG [OR(CI95%): 2.10 (1.29–3.49) 0.003], were associated with the high SYNTAX group, beyond hypercholesterolemia, CV history and reduced glomerular filtration rate. Conclusion. We found an association between OPG levels and coronary lesions complexity patients with acute MI.

Abstract 3745: Asymmetric Dimethylarginine and Mortality after Acute Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marianne Zeller ◽  
Claudia Korandji ◽  
Jean-Claude Guilland ◽  
Pierre Sicard ◽  
Catherine Vergely ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
High Performance ◽  
Serum Levels ◽  
Competitive Inhibitor ◽  
Cardiovascular Risk Prediction ◽  
Acute Mi ◽  
The Mean ◽  
Traditional Risk Factors

Background . From a prospective cohort of patients with acute myocardial infarction (MI), we aimed to analyse the predictive value of ADMA concentrations on mortality at 1 year follow-up. ADMA is an endogenous competitive inhibitor of NO synthases. Patients . Blood samples from 204 consecutive patients hospitalised for acute MI < 24 hr were taken on admission. Serum levels of ADMA, its stereoisomer, symmetric dimethylarginine (SDMA), were determined using high-performance liquid chromatography and fluorescence. Results . The mean (SD) ADMA level was 1.07(0.37) μmol/L. ADMA was positively related to age, homocysteine, SDMA and L-arginine. The glomerular filtration rate (GFR) showed a trend toward an inverse relation with ADMA. ADMA concentrations showed a trend towards a higher level in women than in men (p=.101) and were lower in current smokers vs past or non smokers (p=0.022). Baseline ADMA and SDMA levels were higher in patients who had died than in patients who were alive at 1 year follow-up (respectively 1.22(1.06–1.54) vs 0.98(0.78–1.24), p=0.012 and 0.77(0.54–1.03) vs 0.47(0.35–0.64), p<0.001). By Cox stepwise multivariate analysis, high levels of ADMA were one of the strongest predictors for mortality (HR(95%CI), 6.63(2.55–17.21)), even when adjusted for potential confounders, such as biological and clinical factors, and reperfusion. In contrast, SDMA failed to independently predict the outcome (HR(95%CI): 1.88(0.33–10.70). Conclusion . Our study suggests that measurement of ADMA levels at baseline improves cardiovascular risk prediction after acute MI, beyond traditional risk factors and biomarkers. ADMA may thus constitute a novel and useful marker for risk stratification in acute MI.

scholarly journals Proposal for a standardized discharge letter after hospital stay for acute myocardial infarction

2019 ◽  
Vol 9 (7) ◽  
pp. 788-801
Author(s):  
Francois Schiele ◽  
Gilles Lemesle ◽  
Denis Angoulvant ◽  
Michel Krempf ◽  
Serge Kownator ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Primary Care Physicians ◽  
Healthcare Providers ◽  
Therapeutic Targets ◽  
Lipid Lowering ◽  
Routine Practice ◽  
Discharge Letter ◽  
Acute Mi

In patients admitted for acute myocardial infarction, the communication and transition from specialists to primary care physicians is often delayed, and the information imparted to subsequent healthcare providers (HCPs) may be sub-optimal. A French group of cardiologists, lipidologists and diabetologists decided to establish a consensus to optimize the discharge letter after hospitalization for acute myocardial infarction. The aim is to improve both the timeframe and the quality of the content transmitted to subsequent HCPs, including information regarding baseline assessment, procedures during hospitalization, residual risk, discharge treatments, therapeutic targets and follow-up recommendations in compliance with European Society of Cardiology guidelines. A consensus was obtained regarding a template discharge letter, to be released within two days after patient’s discharge, and containing the description of the patient’s history, risk factors, acute management, risk assessment, discharge treatments and follow-up pathway. Specifically for post acute MI patients, tailored details are necessary regarding the antithrombotic regimen, lipid-lowering and anti-diabetic treatments, including therapeutic targets. Lastly, the follow-up pathway needs to be precisely mentioned in the discharge letter. Additional information such as technical descriptions, imaging, and quality indicators may be provided separately. A template for a standardized discharge letter based on 8 major headings could be useful for implementation in routine practice and help to improve the quality and timing of information transmission between HCPs after acute MI.

scholarly journals Relation between Apolipoprotein E Gene Polymorphism and Severity of Coronary Artery Disease in Acute Myocardial Infarction

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Zülküf Karahan ◽  
Murat Uğurlu ◽  
Berzal Uçaman ◽  
Ali Veysel Uluğ ◽  
İlyas Kaya ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery Disease ◽  
Acute Myocardial Infarction ◽  
Gene Polymorphism ◽  
Gensini Score ◽  
Acute Mi ◽  
Artery Disease ◽  
E4 Allele ◽  
The Relationship ◽  
Apoe Gene Polymorphism

Apolipoprotein E (ApoE) is a plasma protein and associated with cholesterol transport system. In several studies, the relationship between ApoE gene polymorphism and severity of coronary artery disease (CAD) has been shown. However, the relationship between ApoE gene polymorphism and severity of CAD in patients with acute myocardial infarction (MI) has not been well known. The aim of this study is to investigate the relation between ApoE polymorphism and severity of CAD in patients with acute MI by using the Gensini Score. In this study, 138 patients were admitted to cardiology clinic with diagnosis of acute MI, and angiographic assessment was performed using the Gensini Score. Blood samples were obtained from all patients in the first day. The patients with ApoE34 genotype had high Gensini scores. Besides, the patients with E4 allele carriers were associated with high Gensini score compared with the patients without E4 allele carriers (p:0,22). The patients with E4 allele carriers were associated with higher LDL cholesterol and total cholesterol compared with the patients without E4 allele carriers (p:0,001andp:0,03, resp.). There were no statistically significant differences between ApoE genotypes and severity of CAD by using the Gensini Score. But, the patients with E4 allele carriers were associated with high lipid levels.

scholarly journals Increased mortality risk in diabetic patients discharged from hospital with insulin therapy after an acute myocardial infarction: Data from the FAST-MI 2005 registry

2017 ◽  
Vol 8 (3) ◽  
pp. 218-230 ◽  
Author(s):  
Vincent Bataille ◽  
Jean Ferrières ◽  
Nicolas Danchin ◽  
Etienne Puymirat ◽  
Marianne Zeller ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Female Gender ◽  
Diabetic Patients ◽  
Killip Class ◽  
All Cause Mortality ◽  
History Of ◽  
Artery Disease ◽  
Insulin Use

Background: Merits of insulin use for diabetes treatment in patients with advanced atherosclerosis are debated. This observational study conducted in diabetic patients after an acute myocardial infarction aimed to assess whether insulin prescription at discharge (IPD) was related to all-cause mortality during follow-up. Methods: Subjects were diabetic patients admitted in intensive- or coronary-care units for acute myocardial infarction (consecutively recruited in 223 centres in France) and discharged alive from the hospital, with or without an IPD. Vital status after five years was obtained and the relationship between insulin prescription at discharge and survival was studied. Results: Overall, 1221 diabetic patients were discharged alive and 38% had an IPD. Factors independently related to IPD were female gender, hospitalization in a public hospital, duration of diabetes, HbA1c level, smoking, peripheral artery disease, history of coronary heart disease and Killip class. After adjustment, IPD was independently related to all-cause mortality after five years of follow-up (adjusted hazard ratio = 1.72 (1.42–2.09), p<0.001). This increased mortality in subjects with IPD was also observed in propensity matched analyses, when subjects actually treated or actually not treated with insulin at discharge were compared in two groups matched on their computed probability of having had insulin prescribed. Conclusions: Insulin was preferably prescribed in seriously affected patients, regarding diabetes and cardiovascular risk. However, insulin prescription at discharge was associated with increased all-cause mortality after extensive adjustments for confounders. These results suggest possible intrinsic harmful effects of insulin in high-risk diabetic patients after myocardial infarction.

Sign in / Sign up

Export Citation Format

Share Document