Efficacy of Long-Term Oral Beta-Blocker Therapy in Patients Who Underwent Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction With Preserved Left Ventricular Ejection Fraction: A Systematic Review and Meta-analysis

2021 ◽  
Vol 77 (1) ◽  
pp. 87-93
Author(s):  
Muhammad H. Maqsood ◽  
Mahboob Alam ◽  
Dan Atar ◽  
Yochai Birnbaum
Keyword(s):  
Meta Analysis ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
Blocker Therapy ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary

scholarly journals Relationship between the ST-Segment Resolution and Microvascular Dysfunction in Patients Who Underwent Primary Percutaneous Coronary Intervention

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Byung Gyu Kim ◽  
Sung Woo Cho ◽  
Jeong-Ha Ha ◽  
Hyo Seung Ahn ◽  
Hye Young Lee ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Primary Percutaneous Coronary Intervention ◽  
Microvascular Dysfunction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary

Objectives. Incomplete ST-segment elevation resolution (STR) occasionally occurs despite successful revascularization of epicardial coronary artery after primary percutaneous coronary intervention (PPCI). The aim of this study was to evaluate the relationship between the degree of STR and the severity of microvascular dysfunction. Methods. A total of 73 consecutive patients with ST-segment elevation myocardial infarction (STEMI) who underwent successful PPCI were evaluated. Serial 12-lead electrocardiography was performed at baseline and at 90 minutes after PPCI. Microvascular dysfunction was assessed by index of microvascular resistance (IMR) immediately after PPCI. Results. Patients were classified into 2 groups: 50 patients with complete STR (STR ≥50%) and 23 patients with incomplete STR (STR <50%). The incomplete STR group had a higher IMR value and lower left ventricular ejection fraction (LVEF), compared with the complete STR group. The degree of STR was significantly correlated with IMR (r = −0.416, P=0.002) and LVEF (r = 0.300, P=0.011). These correlations were only observed in patients with left anterior descending artery (LAD) infarction but not observed in patients with non-LAD infarction. A cutoff IMR value was 27.3 for predicting incomplete STR after PPCI. Conclusion. Incomplete STR after PPCI in patients with STEMI reflects the presence of microvascular and left ventricular dysfunction, especially in patients with LAD infarction.

scholarly journals Mortality predictors after percutaneous coronary intervention – a prospective single-center registry study

2020 ◽  
Vol 30 (3) ◽  
pp. 413-422
Author(s):  
László Hadadi ◽  
Paul Calburean ◽  
Paul Grebenisan ◽  
Victor Vacariu ◽  
Reka-Katalin Drincal ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiovascular Mortality ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
Coronary Syndrome ◽  
St Segment ◽  
Percutaneous Coronary

Objectives – To evaluate the predictors of three-year cardiovascular mortality after percutaneous coronary intervention (PCI) in a Romanian tertiary cardiovascular center. Methods – Consecutive patients treated by PCI in the Emergency Institute for Cardiovascular Diseases and Transplantation of Targu Mures were included prospectively in a local PCI Registry. Demographic, clinical, and procedural parameters of the patients enrolled in the year 2016 were statistically analyzed as possible predictors of three-year cardiovascular mortality post-PCI. Results – 1079 patients were included: 254 (23.5%) with ST-segment elevation acute myocardial infarction (STEMI), 278 (25.8%) with non-ST segment elevation acute coronary syndrome (NSTEACS) and 547 (50.7%) with chronic coronary syndrome (CCS). Three-year cardiovascular mortality was 20.1%, 10.8% and 5.7% after PCI for STEMI, NSTEACS and CCS, respectively. Cox proportional hazards regression evidenced as independent predictors of long-term mortality after PCI: low left ventricular ejection fraction (LVEF), renal dysfunction, presentation with cardiogenic shock or with cardiac arrest in the case of acute coronary syndromes, and the history of signifi cant valvular heart disease and low LVEF in the case of CCS (all p ≤0.01). Conclusions – Simple clinical variables but no procedural factors were the main predictors of 3-year cardiovascular mortality after PCI in this all-comers population.

scholarly journals A case of de Winter syndrome presenting with chest tightness

2021 ◽  
Vol 49 (7) ◽  
pp. 030006052110121
Author(s):  
Dongmei Jiang ◽  
Guosheng Fu
Keyword(s):  
Myocardial Infarction ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Chest Tightness ◽  
Total Occlusion ◽  
Ventricular Ejection Fraction ◽  
St Segment Elevation ◽  
St Segment ◽  
Percutaneous Coronary

de Winter syndrome, also termed anterior ST-segment elevation myocardial infarction (STEMI) equivalent, is estimated to be present in approximately 2% of patients with acute myocardial infarction, but is often under-recognized by clinicians. Therefore, de Winter syndrome is associated with increased morbidity and mortality. We report a 51-year-old man with typical chest tightness and a characteristic electrocardiographic pattern without classic ST-segment elevation, but with acute nearly total occlusion of the left anterior descending coronary artery. Although the patient presented as a non-STEMI case, the definite diagnosis of de Winter syndrome was made on the basis of clinical and electrocardiographic findings. The patient’s symptom of chest tightness was relieved immediately after acute percutaneous coronary intervention and the left ventricular ejection fraction had not deteriorated at 1 month of follow-up.

Early coronary angiography and percutaneous coronary intervention for out of hospital cardiac arrest survivors without ST-segment elevation: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Po Huang ◽  
Qingquan Liu ◽  
Yuhong Guo ◽  
Bo Li ◽  
Xiaolei Fang
Keyword(s):  
Meta Analysis ◽  
Coronary Intervention ◽  
Controlled Study ◽  
Short Term ◽  
St Segment Elevation ◽  
Randomized Controlled ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Hospital Cardiac Arrest

Abstract Objective: The meta-analysis aims to identify whether out of hospital cardiac arrest (OHCA) survivors of non ST-segment elevation (NSTE) can benefit from early coronary angiography (CAG) and percutaneous coronary intervention (PCI).Methods: The relevant studies from MEDLINE, Cochrane Library, Embase were searched by two independent investigators using a variety of keywords. Stata software (version 12.0, Stata Corp LP, College Station, TX, USA) was used for statistical analysis. Results: A total of 12 studies (9 observational studies, 1 cohort study and 2 randomized control trials) were identified and incorporated into the meta-analysis. For overall analysis, the strategy of early angiography was associated with decreased short-term (hospital discharged) mortality (RR=0.72, 95% CI=0.56-0.93, P=0.000) and long-term (follow up) mortality (RR=0.84, 95% CI=0.71-0.99, P=0.007). However, when analyzed in the subgroup of randomized controlled study, the strategy of early angiography didn’t have survival benefit in the randomized controlled study group for short-term mortality (RR=1.12, 95% CI=0.89-1.41, P=0.331) and long-term mortality (RR=1.06, 95% CI=0.85-1.32, P=0.572). Meanwhile, our analysis found that, if early CAG performed, PCI followed by CAG is not associated with hospital discharged mortality (RR=1.14, 95% CI=0.96-1.37, P=0.132) compared with CAG alone. No significant differences between the groups were found in the remaining secondary endpoints.Conclusion: Due to the observational nature of the studies available, we may consider that early CAG and PCI is not be recommended for patients with NSTE OHCA.

P1964Impact of successful coronary intervention for chronic total occlusion on long-term clinical outcome of patients with impaired and preserved left ventricular ejection fraction

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
H Tanaka ◽  
T Tada ◽  
Y Fuku ◽  
T Goto ◽  
K Kadota
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Chronic Total Occlusion ◽  
Coronary Intervention ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Total Occlusion ◽  
Ventricular Ejection Fraction ◽  
Percutaneous Coronary ◽  
Procedural Success

Abstract Background Successful recanalisation of percutaneous coronary intervention for chronic total occlusion lesions has been associated with improved survival. Purpose This study aimed to assess the impact of successful percutaneous coronary intervention for chronic total occlusion lesions on the long-term outcome of patients with impaired and preserved left ventricular ejection fraction (LVEF). Methods The study sample consisted of 842 consecutive patients (928 chronic total occlusion lesions) undergoing percutaneous coronary intervention at our institution between October 2005 and December 2009. We divided them into 3 groups by the degree of LVEF: less than 40% (severely reduced LVEF, n=140), 40% to 59% (moderately reduced LVEF, n=470), and 60% and above (normal LVEF, n=232). We evaluated mortality during the 10-year follow-up period the basis of procedural success and failure. Results The overall procedural success rate was 89.1%. Median follow-up duration was 7.9 years. The 10-year cumulative incidences of cardiac death in each degree of LVEF are shown in the Figure. Conclusions Successful recanalisation for chronic total occlusion lesions in patients with impaired LVEF may be associated with reduced cardiac mortality.

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