P16 Relationship of plasma long Pentraxin-3 concentration with clinical and angiographic outcomes of patients with acute ST-segment elevation myocardial infarction undergoing primary percutaneous coronary

2020 ◽  
Vol 41 (Supplement_1) ◽  
Author(s):  
N Y Sari ◽  
S Dharma ◽  
R Sukmawan ◽  
I Dakota ◽  
S V Rao
Keyword(s):  
Myocardial Infarction ◽  
Confidence Interval ◽  
Primary Pci ◽  
Pentraxin 3 ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Timi Flow ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Relationship Of

Abstract Background Inflammation has an important role for the progression of coronary plaque vulnerability to acute coronary thrombosis. Long pentraxin-3 (PTX3) is a sensitive marker of inflammation released upon exposure to primary inflammatory signals. Whether concentration of PTX3 affects coronary thrombus severity and impaired coronary flow in patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) is unknown. Purpose This study sought to evaluate the relationship of plasma PTX3 concentration with coronary thrombus severity and final TIMI flow after primary PCI in patients with acute STEMI. Methods We prospectively enrolled 335 consecutive patients with acute STEMI undergoing primary PCI between 1 January 2018 and 2 August 2018. Plasma PTX3 concentrations were measured at admission by ELISA method.  Results Compared to low PTX3 group (<0.33 ng/mL; N = 223), patients in the high PTX3 group (≥ 0.33 ng/mL; N = 112) had higher proportion of thrombus grade 4 and 5 on initial coronary angiogram (83% vs. 72%, p= 0.03), final TIMI flow <3 (66% vs. 51%, p= 0.01), incomplete ST segment resolution after primary PCI (85% vs. 72%, p= 0.002) and Killip classification II-IV at entry (34.8% vs. 13%, adjusted odds ratio= 3.38, p< 0.001). High PTX3 concentration was associated with an increased risk of 30-day mortality (adjusted hazard ratio= 3.41, 95% confidence interval, 1.27 to 9.11, p= 0.01).  Conclusion High plasma PTX3 concentration is associated with worse clinical and angiographic outcomes among patients undergoing primary PCI for STEMI. Further study is needed to eludicate whether PTX3 is a causal agent for adverse outcomes and whether therapies directed at reducing PTX3 levels are effective. Table 1. Variable Hazard ratio (95% confidence interval) P-value Long pentraxin-3 ≥0.33 ng/mL 3.41 (1.27 - 9.11) 0.01 Age >65 years 0.38 (0.11 - 1.41) 0.15 Male gender 0.43 (0.13 - 1.44) 0.16 Diabetes Mellitus 1.24 (0.44 - 3.52) 0.68 Hypertension 0.64 (0.23 - 1.80) 0.39 Baseline creatinine ≥1.3 mg/dL 4.06 (1.43 - 11.53) 0.009 TIMI risk score > 4 8.31 (2.69 - 25.59) < 0.001 Multivariable Cox regression analysis showing association between PTX3 concentration and selected confounding variables for all-cause death at 30 day.

scholarly journals The effect of heparin after primary percutaneous coronary intervention on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction

2020 ◽  
Vol 9 (11) ◽  
pp. 1636
Author(s):  
Mohammed Rouzbahani ◽  
Mohsen Rezaie ◽  
Nahid Salehi ◽  
Parisa Janjani ◽  
Reza Heidari Moghadam ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intervention Group ◽  
Coronary Intervention ◽  
Control Group ◽  
Short Term ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Timi Flow ◽  
St Segment ◽  
Percutaneous Coronary

Background: Doing percutaneous coronary intervention (PCI) in the first hours of myocardial infraction (MI) is effective in re-establishment of blood flow. Anticoagulation treatment should be prescribed in patients undergoing PCI to decrease the side effects of ischemia. The aim of this study is to determine the effect of heparin prescription after PCI on short-term clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI). Materials: This randomized clinical trial study was conducted at Imam Ali cardiovascular center at Kermanshah university of medical science (KUMS), Iran. Between April 2019 to October 2019, 400 patients with STEMI which candidate to PCI were enrolled. Patients randomly divided in two groups: intervention group (received 5,000 units of heparin after PCI until first 24 hours, every 6 hours) and control group (did not receive heparin). Data were collected using a checklist developed based on the study's aims. Differences between groups were assessed using independent t-tests and chi-square (or Fisher exact tests).Result: Observed that, mean prothrombin time (PT) (13.30±1.60 vs. 12.21±1.15, p<0.001) and partial thromboplastin time (PTT) (35.30±3.08 vs. 34.41±3.01, p=0.003) were significantly higher in intervention group compared to control group. Thrombolysis in myocardial infarction (TIMI) flow grade 0/1 after primary PCI was significantly more frequently in control group (5.5% vs. 1.0%, p=0.034). The mean of ejection fraction (EF) after PCI (47.58±7.12 vs. 45.15±6.98, p<0.001) was significantly higher in intervention group. Intervention group had a statistically significant shorter length of hospital stay (4.71±1.03 vs. 6.12±1.10, p<0.001). There was higher incidence of re-vascularization (0% vs. 3.0%; p=0.013) and re-MI (0% vs. 2.5%; p=0.024) in the control group.Conclusion: Performing primary PCI with receiving heparin led to improve TIMI flow and consequently better EF. Receiving heparin is associated with lower risk of re-MI and re-vascularization.

scholarly journals The Association between Door-to-Balloon Time of Less Than 60 Minutes and Prognosis of Patients Developing ST Segment Elevation Myocardial Infarction and Undergoing Primary Percutaneous Coronary Intervention

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Fu-Cheng Chen ◽  
Yan-Ren Lin ◽  
Chia-Te Kung ◽  
Cheng-I Cheng ◽  
Chao-Jui Li
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Timi Flow ◽  
Recurrent Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Door To Balloon

Background. The study aimed to verify the effect of primary percutaneous coronary intervention (PPCI) with <60 min door-to-balloon time on ST segment elevation myocardial infarction (STEMI) patients’ prognoses. Methods. Outcomes of patients receiving PPCI with door-to-balloon time of <60 min were compared with those of patients receiving PPCI with door-to-balloon time 60–90 min. Result. Totally, 241 STEMI patients (191 with Killip classes I or II) and 104 (71 with Killip classes I or II) received PPCI with door-to-balloon time <60 and 60–90 min, respectively. Killip classes I and II patients with door-to-balloon time <60 min had better thrombolysis in myocardial infarction (TIMI) flow (9.2% fewer patients with TIMI flow <3, p=0.019) and 8.0% lower 30-day mortality rate (p<0.001) than those with 60–90 min. After controlling the confounding factors with logistic regression, patients with door-to-balloon time <60 min had lower incidences of TIMI flow <3 (aOR = 0.4, 95% CI = 0.20–0.76), 30-day recurrent myocardial infarction (aOR = 0.3, 95% CI = 0.10–0.91), and 30-day mortality (aOR = 0.3, 95% CI = 0.09–0.77) than those with 60–90 min. Conclusion. Door-to-balloon time <60 min is associated with better blood flow in the infarct-related artery and lower 30-day recurrent myocardial infarction and 30-day mortality rates.

scholarly journals Trends in reperfusion therapy for acute ST-segment elevation myocardial infarction in an academic PCI centre in the metropolitan area of a developing country

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Dharma ◽  
I Dakota ◽  
H Andriantoro ◽  
I Firdaus ◽  
I.G Limadhy ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Metropolitan Area ◽  
Coronary Intervention ◽  
Reperfusion Therapy ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Abstract Background Long-term reports on reperfusion therapy for acute ST-segment elevation myocardial infarction (STEMI) in developing countries are scarce. Purpose We reported changes in acute reperfusion therapy for STEMI that have been observed over time in an academic tertiary care percutaneous coronary intervention (PCI) centre that hosting a STEMI network in the large metropolitan area of Jakarta, Indonesia since 2010 and covering around 11 million inhabitants. Methods A retrospective analysis was performed in 6336 patients with STEMI who admitted to the emergency department of a PCI centre in 2008 (before STEMI network introduction), and during 2011 to 2018. Results Among STEMI patients admitted during 2011–2018 (mean age: 56±10 years, 86% male), 57.6% had anterior wall myocardial infarction, and 71.3% presented with Killip classification I. Compared with the period 2011–2014 (N=2766), patients who were admitted in the period 2015–2018 (N=3250) were receiving more primary percutaneous coronary intervention (PCI) (61.6% vs. 44.2%, P&lt;0.001) with shorter door-to-device time (median 72 min versus 97 min, P&lt;0.001), and less in-hospital fibrinolytic therapy (2.7% vs. 4.8%, P&lt;0.001). The percentage of STEMI patients who did not receive reperfusion treatment decreased from 51% to 35.5% (P&lt;0.001). In-hospital mortality declined from 10% in 2008 (before the STEMI network was initiated) and 8% in 2011 to 6.4% in 2018 (P for trends = 0.05). Multivariable analysis showed that primary PCI was significantly associated with better in-hospital survival (adjusted odds ratio, 0.52; 95% confidence interval, 0.42 to 0.65, P&lt;0.001). Conclusion The data indicate that the introduction of a STEMI network resulted in more patients receiving timely primary PCI and lower early mortality rates in recent years. Funding Acknowledgement Type of funding source: None

scholarly journals Comparison of shock index-based risk indices for predicting in-hospital outcomes in patients with ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052110005
Author(s):  
Guoyu Wang ◽  
Ruzhu Wang ◽  
Ling Liu ◽  
Jing Wang ◽  
Lei Zhou
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Index ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Shock Index ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary

Objective We aimed to determine whether the prognostic value of the shock index (SI) and its derivatives is better than that of the Thrombolysis In Myocardial Infarction risk index (TRI) for predicting adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). Methods A total of 257 patients with STEMI undergoing primary PCI from January 2018 to June 2019 were analyzed in a retrospective cohort study. The SI, modified shock index (MSI), age SI (age × the SI), age MSI (age × the MSI), and TRI at admission were calculated. Clinical endpoints were in-hospital complications, including all-cause mortality, acute heart failure, cardiac shock, mechanical complications, re-infarction, and life-threatening arrhythmia. Results Multivariate analyses showed that a high SI, MSI, age SI, age MSI, and TRI at admission were associated with a significantly higher rate of in-hospital complications. The predictive value of the age SI and age MSI was comparable with that of the TRI (area under the receiver operating characteristic curve: z = 1.313 and z = 0.882, respectively) for predicting in-hospital complications. Conclusions The age SI and age MSI appear to be similar to the TRI for predicting in-hospital complications in patients with STEMI undergoing primary PCI.

scholarly journals “Door-In to Door-Out” Delay in Patients with Acute ST-Segment Elevation Myocardial Infarction Transferred for Primary Percutaneous Coronary Intervention in a Metropolitan STEMI Network of a Developing Country

2019 ◽  
Vol 29 (01) ◽  
pp. 027-032
Author(s):  
Iwan Dakota ◽  
Surya Dharma ◽  
Hananto Andriantoro ◽  
Isman Firdaus ◽  
Siska Suridanda Danny ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Women Patients ◽  
Ischemia Time ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Total Ischemia

AbstractRoutine performance measures of primary percutaneous coronary intervention (PCI) within an ST-segment elevation myocardial infarction (STEMI) network are needed to improve care.We evaluated the door-in to door-out (DI–DO) delays at the initial hospitals in STEMI patients as a routine performance measure of the metropolitan STEMI network.We retrospectively analyzed the DI–DO time from 1,076 patients with acute STEMI who were transferred by ground ambulance to a primary PCI center for primary PCI between 4 October 2014 and 1 April 2019. Correlation analysis between DI–DO times and total ischemia time was performed using Spearman's test. Logistic regression analyses were used to find variables associated with a longer DI–DO time.Median DI–DO time was 180 minutes (25th percentile to 75th percentile: 120–252 minutes). DI–DO time showed a positive correlation with total ischemia time (r = 0.4, p < 0.001). The median door-to-device time at the PCI center was 70 minutes (25th percentile to 75th percentile: 58–88 minutes). Multivariate analysis showed that women patients were independently associated with DI–DO time > 120 minutes (odds ratio 1.55, 95% confidence interval 1.03 to 2.33, p = 0.03).The DI–DO time reported in this study has not reached the guideline recommendation. To improve the overall performance of primary PCI in the region, interventions aimed at improving the DI–DO time at the initial hospitals and specific threat for women patients with STEMI are possibly the best efforts in improving the total ischemia time.

scholarly journals Admission Glucose Levels and the Risk of Acute Kidney Injury in Nondiabetic ST Segment Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention

2015 ◽  
Vol 5 (3) ◽  
pp. 191-198 ◽  
Author(s):  
Yacov Shacham ◽  
Amir Gal-Oz ◽  
Eran Leshem-Rubinow ◽  
Yaron Arbel ◽  
Gad Keren ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Kidney Injury ◽  
Coronary Intervention ◽  
Primary Pci ◽  
St Segment Elevation ◽  
Glucose Levels ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Admission Glucose

Background: Hyperglycemia upon admission is associated with an increased risk for acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). However, the relation of this association to the absence of diabetes mellitus (DM) is less studied. We evaluated the effect of acute hyperglycemia levels on the risk of AKI among STEMI patients without DM who were all treated with primary PCI. Methods: We retrospectively studied 1,065 nondiabetic STEMI patients undergoing primary PCI. Patients were stratified according to admission glucose levels into normal (<140 mg/dl), mild (140-200 mg/dl), and severe (>200 mg/dl) hyperglycemia groups. Medical records were reviewed for the occurrence of AKI. Results: The mean age was 61 ± 13 years and 81% were males. Hyperglycemia upon hospital admission was present in 402 of 1,065 patients (38%). Patients with severe admission hyperglycemia had a significantly higher rate of AKI compared to patients with no or mild hyperglycemia (20 vs. 7 and 8%, respectively; p = 0.001) and had a significantly greater serum creatinine change throughout hospitalization (0.17 vs. 0.09 and 0.07 mg/dl, respectively; p = 0.04). In multivariate logistic regression, severe hyperglycemia emerged as an independent predictor of AKI (OR = 2.46, 95% CI 1.16-5.28; p = 0.018). Conclusion: Severe admission hyperglycemia is an independent risk factor for the development of AKI among nondiabetic STEMI patients undergoing primary PCI.

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