P1761Distal transradial approach for primary percutaneous coronary intervention for patients with acute myocardial infarction: a multicentre study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Izumikawa ◽  
S Takeshita ◽  
T Yamada ◽  
Y Mizuguchi ◽  
N Taniguchi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Transradial Approach ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Distal Radial Artery

Abstract Background The distal transradial approach (dTRA) for coronary catheterisation is a newly introduced alternative to the conventional transradial approach. This technique is expected to decrease the incidence of haemorrhagic complications and improve patient comfort. However, limited data are available regarding the application of this technique in patients with acute myocardial infarction (AMI). This study investigated the feasibility and safety of the dTRA for primary percutaneous coronary intervention (PCI) in patients with AMI. Methods This study included patients with AMI who underwent primary PCI via the distal radial artery across 3 Japanese hospitals between January 2018 and January 2019. Patients' background, procedural characteristics, and clinical outcomes including the incidence of haemorrhagic complications were analysed. Results This study enrolled 95 consecutive patients with AMI, including 68 patients (71.6%) with ST-segment elevation myocardial infarction (STEMI), in whom distal radial artery puncture was attempted for primary PCI. The patients included 70 men (73.7%), and the mean age was 72.2±12.4 years. Among these patients, cannulation was successfully performed in 89 patients (93.7%). A 5-, 6-, or 7-French sheath (conventional or slender) was used in this study. Cannulation was performed using a forearm radial artery approach in patients in whom dTRA failed. PCI was successfully performed in all patients. The meantime to achieve haemostasis was 6.3±5.3 hours, and no major bleeding complications occurred. Based on The Early Discharge After Transradial Stenting of Coronary Arteries trial haematoma scale, grade I, II, and III subcutaneous haemorrhages were observed in 16 (16.8%), 4 (4.2%), and 1 patient (1.1%), respectively. No patient developed a haematoma > grade IV. In patients with STEMI, the mean door-to-balloon time was 39.4±31.9 min, and the mean puncture-to-balloon time was 19.7±14.2 min. Conclusions The distal radial approach is feasible and safefor primary PCI in selected patients with AMI.The application of the dTRA may serve as a less invasive strategy for the treatment of patients with AMI.

Thrombolytic Therapy in the Current ERA: Myocardial Infarction and Beyond

2018 ◽  
Vol 24 (4) ◽  
pp. 414-426 ◽  
Author(s):  
Patrick Proctor ◽  
Massoud A. Leesar ◽  
Arka Chatterjee
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ischemic Stroke ◽  
Thrombolytic Therapy ◽  
Coronary Intervention ◽  
Evidence Base ◽  
Primary Pci ◽  
Percutaneous Coronary

Thrombolytic therapy kick-started the era of modern cardiology but in the last few decades it has been largely supplanted by primary percutaneous coronary intervention (PCI) as the go-to treatment for acute myocardial infarction. However, these agents remain important for vast populations without access to primary PCI and acute ischemic stroke. More innovative uses have recently come up for the treatment of a variety of conditions. This article summarizes the history, evidence base and current use of thrombolytics in cardiovascular disease.

scholarly journals Effect of primary percutaneous coronary intervention on ventricular repolarization through evaluation of QT dispersion in patient with acute myocardial infarction

2018 ◽  
Vol 5 (2) ◽  
pp. 506
Author(s):  
Behzad Babapour ◽  
Bita Shahbazzadegan ◽  
Bahareh Khademi
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Ventricular Arrhythmia ◽  
Primary Percutaneous Coronary Intervention ◽  
Qt Dispersion ◽  
Coronary Intervention ◽  
Ventricular Repolarization ◽  
Primary Pci ◽  
Percutaneous Coronary

Background: Cardiovascular disease is the most common cause of death around the world. QT dispersion is one of the parameters that used for evaluation of ventricular arrhythmia. Primary PCI increases probability of coronary artery and reperfusion of the ventricular arrhythmia. The aim of this study was to determine effect of primary percutaneous coronary intervention (PCI) on ventricular repolarization through evaluation of QT dispersion in patient with acute myocardial infarction. Methods: In this pre-post test study, 77 patients with acute ST with elevated myocardial infarction under primary PCI were investigated. The ECG and ST dispersion before PCI and 24 hours after PCI were determined and then the amount of QTd was calculated. The repeated measurement ANOVA was used to compare QTd of pre- PCI treatment and QTd in 24 hours after PCI. Data analysis was performed using statistical software SPSS ver.17. Results: From 77 participants, 60 were male and 17 were female. 43 (55.8%) had a MI position in ANT, PRE, and EXT, 33 (42.9%) had in the INF, and only one person (1.3%) had a MI position in LAT. The results showed that mean QT dispersion in ECG, 24h after primary PCI, for most of measured variables was deceased compare to before primary PCI, but the difference was not significant. Conclusions: The amount of QTd 24 hours after PCI decreased but its decline was not significant. With regards to lack of convenience data, more researches are recommended in this field. 

scholarly journals The Comparison between the Outcomes of Streptokinase and Primary Percutaneous Coronary Intervention in Acute Myocardial Infarction

2017 ◽  
Vol 1 (2) ◽  
pp. 33-50
Author(s):  
Zarnab Tariq ◽  
Majid Kaleem
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Clinical Findings ◽  
Primary Pci ◽  
Cross Sectional ◽  
Percutaneous Coronary ◽  
Better Than

AbstractBackground: To compare between the outcomes of streptokinase and primary PCI in acute myocardial infarction. The inappropriate treatment, misdiagnosis, contraindications of procedures can result in complications of procedures and increased mortality of patients. The present study aimed to compare between the outcomes of streptokinase and primary percutaneous coronary intervention in acute myocardial infarction patients to minimize the death rates in MI patients.Methodology: The descriptive study was conducted at Gulab Devi Chest Hospital. All the samples were collected from cardiac department. A Performa was designed for recording the risk factors, ST elevation, clinical findings and lab results of the patients.Results: In this cross-sectional study of 100 patients, the mean age was 51.02+ 10.956. Male gender was predominant. There were more chances (67.00%) of acute LVF in streptokinase and less chances (21.00%) in primary PCI. According to this study, there was more chances (67.00%) of cardiogenic shock in streptokinase and less chances (21.00%) in primary PCI. In this study, there were equal chances of stroke in streptokinase and primary PCI. In this study there were more chances (28.00%) of bleeding from any site in streptokinase and less chances (0%) in primary PCI. According to results there were chances (24.00%) of renal failure in streptokinase and less chances (0%) in primary PCI. There were more chances (9.43%) of rescue PCI in streptokinase and less chances in primary PCI. In this study, there were more chances of arrhythmias (26.41%) in streptokinase patients and less chances in primary PCI. In this study, there were also more chances of death (1.92%) in streptokinase and less chance in primary PCI. So according to my study primary PCI was better than streptokinase with less complications.Conclusion: Primary PCI was better than streptokinase to cure the myocardial infarction and better to minimize the complications after procedure.

Comparison of contrast induced nephropathy definitions and in-hospital mortality in patients undergoing primary percutaneous coronary intervention for acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Jelic ◽  
Z Mehmedbegovic ◽  
D Milasinovic ◽  
M Radomirovic ◽  
A Pavlovic ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Hospital Mortality ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Contrast Induced Nephropathy ◽  
Timi Flow ◽  
Percutaneous Coronary

Abstract Background Contrast induced nephropathy (CIN) has been associated with increased mortality in patients with acute myocardial infarction (AMI). However, different definitions of CIN have so far been used. Purpose We aimed to compare predictive accuracy of the 2 contemporary CIN definitions in patients with AMI undergoing primary percutaneous coronary intervention (PCI). Method From a high-volume, single-centre, prospective registry, in a period from 2009–2019, we identified 7987 pts who underwent primary PCI for AMI in whom creatinine measurements were available for analysis. CIN incidence was evaluated according to relative creatinine increases of ≥25% (CIN25) and ≥50% (CIN50) from baseline levels within 72 hours after intervention. The primary end point was in-hospital mortality. Results Overall, 1116 (13.9%), and 345 (4.3%) patients developed CIN25, CIN50, respectively. Crude in-hospital mortality rate was 3.9% (312 pts) in the overall population. Both definitions were independently associated with in-hospital mortality (CIN25 adjusted odds ratio (OR) 4.2, 95% CI 2.7–6.6; p<0.001, and CIN 50 adjusted OR 8.2, 95% CI 4.9–13.9; p<0.001). Comparison of ROC curves showed that only the addition of the CIN50 (and not CIN25) definition to the combined model of clinical predictors of in-hospital mortality, which included pre-intervention TIMI flow 0–1, cardiogenic shock on admission, baseline creatinine clearance, prior stroke, chronic occlusion of non-culprit artery, post-intervention TIMI flow 3, left ventricular ejection fraction and procedure time, improved prognostic accuracy of the model (Figure 1). Conclusion Only acute kidney injury according to the CIN50 definition, but not the CIN25 definition, offers additional prognostic information above and beyond the combination of baseline predictors of in-hospital mortality in patients with AMI undergoing primary PCI. Figure 1 Funding Acknowledgement Type of funding source: None

Abstract 12203: Clinical Characteristics of Patients With Acute Myocardial Infarction Who Did Not Receive Primary Percutaneous Coronary Intervention in Japan -Report From the Miyagi-AMI Registry Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Kiyotaka Hao ◽  
Jun Takahashi ◽  
Kenta Ito ◽  
Yuanji Cui ◽  
Satoshi Miyata ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Registry Study ◽  
Percutaneous Coronary ◽  
Performance Rate

Background: In the current primary percutaneous coronary intervention (PCI) era, some patients in acute myocardial infarction (AMI) still do not undergo primary PCI in Japan. We thus aimed to elucidate the characteristics of AMI patients who did not receive primary PCI. Methods and Results: We analyzed the patients enrolled between 2002 and 2010 in the Miyagi-AMI Registry Study, where all AMI patients in the Miyagi prefecture have been prospectively registered for 34 years since 1979. Among a total of 8,640 patients with AMI (M/F 6205/2435, mean age 68.9±13.0 [SD] years), 1,879 (21.7%) did not receive primary PCI and their in-hospital mortality was significantly worse compared with those who received it (21.4% vs. 6.4%, P<0.01). Multivariate analysis demonstrated that female sex was significantly associated with non-performance of primary PCI [odds ratio (95% confidence intervals); 1.40(1.22-1.61), P<0.001], along with aging [1.01(1.01-1.02), P<0.001] and heart failure on admission [2.69(2.29-3.16), P<0.001]. When dividing by age, non-performance rate of primary PCI in female showed U-shaped prevalence, whereas it simply increased with aging in male (Figure A) . Importantly, female patients aged <80 years had a significantly higher non-performance rate of primary PCI compared with male patients, regardless of disease severity as evidenced by co-existing heart failure on admission (Figure B) . Conclusions: These results indicate that in the current PCI era, various factors, including aging, heart failure on admission and sex differences, are associated with non-performance of primary PCI, which remain to be resolved in order to further improve critical care of AMI.

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