A Cardiac Multimarker Index Performs Better than Standard Markers to Diagnose Acute Myocardial Infarction

A nonlinear artificial neural network trained by backpropagation was applied to the diagnosis of acute myocardial infarction (coronary occlusion) in patients presenting to the emergency department with acute anterior chest pain. Three-hundred and fifty-six patients were retrospectively studied, of which 236 did not have acute myocardial infarction and 120 did have infarction. The network was trained on a randomly chosen set of half of the patients who had not sustained acute myocardial infarction and half of the patients who had sustained infarction. It was then tested on a set consisting of the remaining patients to which it had not been exposed. The network correctly identified 92% of the patients with acute myocardial infarction and 96% of the patients without infarction. When all patients with the electrocardiographic evidence of infarction were removed from the cohort, the network correctly identified 80% of the patients with infarction. This is substantially better than the performance reported for either physicians or any other analytical approach.

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Timing of Ischemic Onset Estimated From the Electrocardiogram is Better Than Historical Timing for Predicting Outcome After Reperfusion Therapy for Acute Anterior Myocardial Infarction: A Danish Trial in Acute Myocardial Infarction 2 (DANAMI-2) Substudy

Journal of Emergency Medicine ◽

10.1016/j.jemermed.2007.10.015 ◽

2008 ◽

Vol 34 (1) ◽

pp. 115

Author(s):

Brad Talley

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Reperfusion Therapy ◽

Anterior Myocardial Infarction ◽

Predicting Outcome ◽

Better Than

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The Use of Aspirin and Opiates by Dumfries and Galloway General Practitioners in the Management of Acute Myocardial Infarction

Scottish Medical Journal ◽

10.1177/003693309504000509 ◽

1995 ◽

Vol 40 (5) ◽

pp. 151-152

Author(s):

D.A. Strachan ◽

S. Robertson

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

General Practitioners ◽

Primary Diagnosis ◽

Royal Infirmary ◽

Regular Aspirin ◽

Medical Intensive Care ◽

Acute Event ◽

Heart Foundation ◽

Better Than

In March 1994 a study in the British Medical Journal indicated a low rate of administration of aspirin and opiates by general practitioners in cases of suspected myocardial infarction.1 A retrospective analysis was made of 120 consecutive admissions to the medical intensive care unit of Dumfries and Galloway Royal Infirmary, by general practitioners, with a primary diagnosis of acute myocardial infarction. Of these 120 cases, 24% were given aspirin by their G.P. prior to admission and 64% were given opiate (IV or IM). Thirty-three percent were already on regular aspirin and of these 18% received further aspirin prior to admission. These figures were considerably better than those previously quoted1 and they showed that prior regular aspirin therapy did influence the GPs' decision on further administration of aspirin in the acute event. A questionnaire sent to all GPs in Dumfries and Galloway revealed that 100% carried aspirin in their medical bags, 62% claimed to give aspirin to patients with suspected MI, 95% used a British Heart Foundation approved dose of aspirin2 and 83.3% administered the aspirin using one of the approved methods.3

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Influence of Cinepazide Maleate on Vascular Endothelial Function of Patients with Acute Myocardial Infarction

Advanced Emergency Medicine ◽

10.18686/aem.v4i3.1 ◽

2015 ◽

Vol 4 (3) ◽

pp. 1

Author(s):

Jiaming Niu ◽

Zhaoling Ma

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Endothelial Function ◽

Blood Serum ◽

Control Group ◽

Vascular Endothelial ◽

Observation Group ◽

Vascular Endothelial Function ◽

Before And After ◽

Better Than

Objective: To study influence of cinepazide maleate on vascular endothelial function of patients with acute myocardial infarction. Methods: 150 cases of patients with acute myocardial infarction were divided into the observation group and the control group, two groups were treated by conventional therapy about acute myocardial infarction, the observation group added 5%GS250 mL + cinepazide maleate 160 mg IV drip q.d, the control group added 5%GS250 mL IV drip q.d, the treatment course were 3 weeks, changes of vascular endothelial function and the blood serum no level before and after treatment were detected. Result: vascular endothelial function after treatment in observation group were obviously improved than that before treatment (p = 0.03) , blood serum no level was obviously increased (p ﹤ 0.05); about 3 weeks after treatment, vascular endothelial function in the observation group was obviously better than that of the control group (p = 0.04), the blood serum no level of the observation group was obviously higher than that of the control group (p ﹤ 0.05). Conclusion: Cinepazide maleate remarkably improves vascular endothelial function of patients with acute myocardial infarction.

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

The International Journal of Frontier Sciences ◽

10.37978/tijfs.v1i2.25 ◽

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.

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Sensitivity and specificity of cardiac troponin-T in diagnosis of acute myocardial infarction

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20170119 ◽

2017 ◽

Vol 4 (1) ◽

pp. 244 ◽

Cited By ~ 1

Author(s):

Dharmveer Sharma ◽

Poonam Gupta ◽

Sagar Srivastava ◽

Harshit Jain

Keyword(s):

Myocardial Infarction ◽

Acute Myocardial Infarction ◽

Cardiac Troponin ◽

Troponin I ◽

Striated Muscle ◽

Troponin T ◽

T Test ◽

Specific Marker ◽

Enzymatic Markers ◽

Better Than

Background: Myocardial Infarction is the irreversible necrosis of the heart muscle secondary to prolong lack of oxygen supply. Troponin T is a structurally bound protein found in striated muscle cells. They have rapidly attained central role in diagnosis, prognostication and planning of therapeutic strategies in MI patients. The objective of this study was to evaluate the status of Troponin T in MI patients and its role in diagnosis compare to normal subjects.Methods: The study was conducted at M. L .N. Medical College, Allahabad, Uttar Pradesh India. A total of 136 cases were included in our study. Out of these, 86 were patients of AMI and 50 were healthy controls. They were evaluated by measurement of various parameters including enzymatic markers such as CPK-MB, SGOT, LDH1, and LDH2 and non-enzymatic markers such as troponin-T and myoglobin. Apart from these, LDL, VLDL and HDL levels were also kept under evaluation.Results: Troponin-T test was better than CPK-MB or SGOT in diagnosing myocardial infarction. In our study, sensitivity (67.3%) and specificity (73.8%) of troponin-T test was higher than CPK-MB (56.2% and 45.7%) and SGOT (34.2% and 58.3%) respectively. Troponin-T test was better than CPK-MB or SGOT after 2 hours of onset of myocardial infarction. Troponin- T and I: both kind of evaluations are available and are well evaluated. However troponin T estimation is more standardized and thus more popular. The positivity of troponin-T test also varied with area of infarct.Conclusions: High LDL and VLDL were seen while at the same time HDL level was lowered. An Increase in the level of myoglobin (non-specific marker), Cardiac troponin I and T and among the enzymatic markers elevated levels of CPK-MB, LDH and SGOT were observed in patients of MI against the normal subjects. In case of LDH both LDH 1 and LDH 2 were observed and a flipped pattern was noted. Bedside troponin-T test is highly sensitive and specific in the diagnosis of acute myocardial infarction and can be used in emergency and ambulatory settings. Qualitative troponin-T test is reliable above serum level of ≥ 0.10 ng/ml.

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