scholarly journals Role of Intravenous β-Blockers in the Treatment of ST-Elevation Myocardial Infarction

Circulation ◽  
2007 ◽  
Vol 115 (23) ◽  
pp. 2904-2906 ◽  
Author(s):  
Eric R. Bates
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
St Elevation ◽  
Β Blockers

Role of Left Ventricular Dyssynchrony in Predicting Remodeling after ST Elevation Myocardial Infarction

2011 ◽  
Vol 29 (2) ◽  
pp. 165-172 ◽  
Author(s):  
Burak Turan ◽  
Fatih Yilmaz ◽  
Tansu Karaahmet ◽  
Kursat Tigen ◽  
Bulent Mutlu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Left Ventricular ◽  
St Elevation Myocardial Infarction ◽  
Left Ventricular Dyssynchrony ◽  
Ventricular Dyssynchrony ◽  
St Elevation

scholarly journals The risk of admission acute heart failure in ST-elevation myocardial infarction patients and air pollution with PM2.5

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
A Sinkovic ◽  
M Krasevec ◽  
D Suran ◽  
M Marinsek ◽  
A Markota
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Air Pollution ◽  
Acute Heart Failure ◽  
St Elevation Myocardial Infarction ◽  
Vascular Events ◽  
Limit Values ◽  
Predictive Role ◽  
St Elevation

Abstract Introduction Air pollution, in particular exposure to particulate matter fine particles of less than 2.5 microns in diameter (PM2.5), increases the risk of cardiovascular events. Short-term exposure (hours to few days prior) to increased PM2.5 levels even may help trigger ST-elevation myocardial infarction (STEMI) and heart failure exacerbation in susceptible individuals. The risk of vascular events is increased even in exposures below the current European air quality limit values (mean annual levels for PM2.5 less than 10μg/m3, 24-hour mean level less than 25μg/m3). Purpose To evaluate predictive role of PM2.5 levels ≥20 μg/m3 one day prior to hospital admission for the risk of admission acute heart failure (AAHF) in STEMI patients. Methods In 290 STEMI patients (100 women, 190 men, mean age 65.5±12.9 years), treated by primary percutaneous coronary intervention (PPCI) in 2018, we retrospectively registered the AAHF, defined as classes II-IV by Killip Kimbal classification. Additionally, we registered admission clinical data, potentially contributing to AAHF in STEMI patients such as gender, age ≥65 years, prior resuscitation, admission cTnI ≥5 μg/L (normal levels up to 0.045 μg/L), comorbidities, time to PPCI, and mean daily levels of PM2.5 ≥20 μg/m3 one day before admission. Mean daily, freely available, levels of PM2.5 were measured and registered by Chemical analytic laboratory of Environmental agency of Republic Slovenia. We evaluated the predictive role of admission data for admission AHF in STEMI patients. Results AAHF was observed in 34.5% of STEMI patients with the mean daily PM2.5 level 15.7±10.9 μg/m3 on the day before admission. PPCI was performed in 92.1% of all STEMI patients, in AAHF in 87.1% and in non-AAHF patients in 94.7% (p=0.037). AAHF in comparison to non-AAHF was associated significantly with female gender (50.5% vs 25.9%, p<0.001), age over 65 years (71.3% vs 45%, p<0.001), prior diabetes (33.7% vs 14.8%, p<0.001), left bundle branch block (LBBB) (10.9% vs 0.5%, <0.001), admission cTnI ≥5 μg/L (46.7% vs 25.9%, p<0.001) and mean daily levels of PM2.5 ≥20 μg/m3 one day before admission (31.7% vs 19%, p=0.020), but nonsignificantly with arterial hypertension, prior myocardial infarction, anterior STEMI and time to PPCI. Logistic regression demonstrated that significant independent predictors of AAHF were age over 65 years (OR 3.349, 95% CI 1.787 to 6.277, p<0.001), prior diabetes (OR 2.934, 95% CI 1.478 to 5.821, p=0.002), admission LBBB (OR 10.526, 95% CI 1.181 to 93.787, p=0.03), prior resuscitation (OR 3.221, 95% CI 1.336 to 7.761, p=0.009), admission cTnI ≥5μg/l (OR 2.984, 95% CI 1.618 to 5.502, p<0.001) and mean daily levels of PM2.5 ≥20 μg/m3 (OR 2.096, 95% CI 1.045 to 4.218, p=0.038) one day before admission. Conclusion Mean daily levels of PM2.5 ≥20μg/m3 one day before admission were among significant independent predictors of AAHF in STEMI patients. FUNDunding Acknowledgement Type of funding sources: None.

The selection of β-blocker after successful reperfusion in patients with ST-elevation myocardial infarction

Perfusion ◽  
2019 ◽  
Vol 35 (4) ◽  
pp. 338-347
Author(s):  
Ho-Jun Jang ◽  
Jon Suh ◽  
Sung Woo Kwon ◽  
Sang-Don Park ◽  
Pyung Chun Oh ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
St Elevation Myocardial Infarction ◽  
Target Vessel ◽  
Primary Intervention ◽  
Target Vessel Revascularization ◽  
Recurrent Myocardial Infarction ◽  
St Elevation ◽  
Β Blocker ◽  
Β Blockers ◽  
Selection Of

Background: The selection of β-blocker for survivors after primary intervention due to acute ST-elevation myocardial infarction seems crucial to improve the outcomes. However, rare comparison data existed for these patients. We aimed to compare the effectiveness of selective β-blockers to that of carvedilol in patients treated with primary intervention. Methods and results: Among the 1,485 patients in the “INTERSTELLAR” registry between 2007 and 2015, 238 patients with selective β-blockers (bisoprolol, nebivolol, atenolol, bevantolol, and betaxolol) and 988 with carvedilol were included and their clinical outcomes were compared for a 2-year observation period. In the clinical baseline characteristics, the unfavorable trends in the carvedilol group were high Killip presentation, lower ejection fractions, smaller diameters, and longer lengths of deployed stents. Although mortality (2.5% vs. 1.7%; p = 0.414) and the rate of stroke (0.8% vs. 0.6%; p = 0.693) were not different between groups, the rate of recurrent myocardial infarction (4.6% vs. 1.2%; p = 0.001) and of target vessel revascularization (4.2% vs. 0.9%; p < 0.001) were lower in the carvedilol group. After eliminating the difference by propensity matching, the similar outcome result was shown (all-cause death, 0.6% vs. 1.0%, p = 0.678; stroke, 0.6% vs. 1.2%, p = 0.479; myocardial infarction, 5.0% vs. 1.2%, p = 0.003; target vessel revascularization, 4.5% vs. 0.7%, p < 0.006) for 595 matched populations. The use of carvedilol was also determined to be an independent predictor for recurrent myocardial infarctions (hazard ratio = 0.305; p = 0.005; 95% confidence interval = 0.13-0.69). Conclusion: Use of a carvedilol in ST-segment myocardial infarction survivor is associated with lower recurrent myocardial infarction events. Thus, it might be the better choice of β-blocker for secondary prevention in ST-elevation myocardial infarction patients treated with primary percutaneous coronary intervention.

scholarly journals Role of coronary artery bypass grafting during the acute and subacute phase of ST-elevation myocardial infarction

2010 ◽  
Vol 18 (7) ◽  
pp. 348-354 ◽  
Author(s):  
Y. L. Gu ◽  
I. C. C. van der Horst ◽  
Y. L. Douglas ◽  
T. Svilaas ◽  
M. A. Mariani ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Coronary Artery Bypass ◽  
Artery Bypass ◽  
St Elevation Myocardial Infarction ◽  
Bypass Grafting ◽  
Artery Bypass Grafting ◽  
St Elevation
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