scholarly journals Primary versus secondary transport in patients with acute ST-segment elevation myocardial infarction, times and mortality rates

2017 ◽  
Vol 16 (1) ◽  
pp. 6-10
Author(s):  
Abdul Almawiri ◽  
Jan F. Vojáček ◽  
Ziad Albahri ◽  
Martin Jakl ◽  
Josef Šťásek
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rates ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Secondary Transport ◽  
St Segment

Comparison of Mortality Rates in Women Versus Men Presenting With ST-Segment Elevation Myocardial Infarction

2011 ◽  
Vol 107 (5) ◽  
pp. 651-654 ◽  
Author(s):  
Fabrizio D'Ascenzo ◽  
Anna Gonella ◽  
Giorgio Quadri ◽  
Giada Longo ◽  
Giuseppe Biondi-Zoccai ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Mortality Rates ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment

scholarly journals Impact of hyperglycemia on the results of percutaneous coronary interventions in patients with acute ST-segment elevation myocardial infarction

2017 ◽  
Vol 89 (9) ◽  
pp. 25-29 ◽  
Author(s):  
I S Bessonov ◽  
V A Kuznetsov ◽  
Yu V Potolinskaya ◽  
I P Zyrianov ◽  
S S Sapozhnikov
Keyword(s):  
Myocardial Infarction ◽  
Independent Predictor ◽  
Mortality Rates ◽  
Percutaneous Coronary Interventions ◽  
Cardiac Events ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Adverse Cardiac Events ◽  
Percutaneous Coronary

Aim. To investigate the impact of hyperglycemia on the results of percutaneous coronary interventions (PCIs) in patients with acute ST-segment elevation myocardial infarction (ASTEMI). Subjects and methods. A study group consisted of 511 patients with hyperglycemia (blood glucose level (BGL) ≥7.77 mmol/L) who underwent primary PCIs in the period from 2005 to 2015. A comparison group included 579 patients (BGL ≥7.77 mmol/L). Results. Assessment of the results of hospital interventions revealed that the mortality rates in patients with hyperglycemia proved to be higher than in those with normal BGL (6.5 and 2.6%, respectively; p=0.002). No differences were found in the rates of stent thrombosis (1 and 1.4%; p=0.541) and recurrent myocardial infarction (1.2 and 1.6%; p=0.591). Major adverse cardiac events, including death, recurrent infarction, and stent thrombosis, were more frequently determined in the hyperglycemic patients (7.6 and 4.3%; p=0.020). No-reflow phenomenon statistically significantly more frequently developed in the patients with hyperglycemia (6.8 and 3.3%; p=0.007). Binary logistic regression analysis showed that the presence of hyperglycemia served as an independent predictor of hospital mortality (odds ratio (OR) 2.6; 95% confidence interval (CI), 1.4 to 4.8; p=0.002). The application of a random probability sampling technique revealed that mortality remained statistically significantly higher in the hyperglycemic patients than in the normoglycemic individuals at admission (6.7 and 2.6%; р=0.011). Conclusion. PCIs in patients with ASTEMI and hyperglycemia are characterized by higher mortality rates and the risk of major adverse cardiac events. Admission hyperglycemia is an independent predictor of hospital mortality.

scholarly journals RELATIONSHIP BETWEEN DOOR-TO-BALLOON TIME AND CLINICAL EXPERIENCE LEVEL OF EMERGENCY DEPARTMENT PHYSICIANS

2021 ◽  
Author(s):  
Ercan AYDIN ◽  
Emre YILMAZ ◽  
Salih ŞAHİNKUŞ
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Mortality Rates ◽  
Experience Level ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Catheter Laboratory ◽  
The Mean ◽  
Door To Balloon

Background: This study aimed to investigate the relationship between the experience level of physicians who initially make a clinical diagnosis of patients with ST segment elevation myocardial infarction in the emergency department and door-to-balloon time (DBT). Material and methods: Between January and December 2018, the research group was selected randomly among 522 patients with ST elevation myocardial infarction who were immediately treated in the catheter laboratory. Angiography images were monitored from the patients’ records in the catheter laboratory. The time of admission to the emergency room was obtained using the hospital registration system. The experience level of physicians who initially clinically diagnosed patients in the emergency department was divided into three groups: medical practitioner (who did not receive emergency training), assistant physician (undergoing emergency medicine training), and emergency medicine specialist. Results: The study included 522 patients who underwent primary percutaneous intervention due to ST segment elevation myocardial infarction. The mean age was lower, and cardiogenic shock and mortality rates were lower in the group with DBT<60 /min compared with the group with DBT>60/min. In the expert group, the mean DBT was lower, but the cardiogenic shock and mortality rates were higher (p<0.05). Conclusions: The duration of DBT decreases as the experience level of the emergency physician increases, but randomization is required to determine its clinical benefit

Abstract P31: Long-Term Outcomes Among Nonagenarians with Non--ST-Segment Elevation Myocardial Infarction

2011 ◽  
Vol 4 (suppl_2) ◽  
Author(s):  
Renato D Lopes ◽  
DaJuanicia N Holmes ◽  
Tracy Y Wang ◽  
Matthew T Roe ◽  
Eric D Peterson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Hospital Mortality ◽  
Mortality Rates ◽  
P Value ◽  
Elderly Adults ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Kaplan Meier ◽  
St Segment ◽  
Mortality Table

Background: Age is a key determinant of adverse acute events following non-ST-segment elevation myocardial infarction (NSTEMI), but the influence of age on longer-term outcomes in hospital survivors has yet to be explored. Methods: Our population included NSTEMI patients aged ≥65 years in the CRUSADE registry who were treated from 2/2003-12/2006 and linked to Medicare claims data for longitudinal follow-up. In-hospital and 1-year mortality rates (among hospital survivors calculated using the Kaplan-Meier method) are shown for nonagenarians and younger elderly-aged groups. Cox proportional hazard modeling was used to adjust for baseline characteristics, discharge medications, and procedures. Results: Of 36,711 NSTEMI hospital survivors aged ≥65 years, 58.8% (21586/36711) were 65-79 years old, and 7.6% (2794/36711) were ≥90 years old. Compared with younger elderly adults (ages 65-79), nonagenarians had lower prevalence of diabetes but higher prevalence of congestive heart failure, hypertension, prior stroke, and renal insufficiency (all p<0.0001). The qualifying NSTEMI was more likely to be a first cardiac event (no prior MI, PCI, or CABG) for nonagenarians than for younger elderly adults (59.7% [1669/2794] vs. 51.0% [11002/21586], p<0.0001). Nonagenarians were less likely to receive revascularization (10.3% [289/2794] vs. 56.7% [12238/21586], p<0.0001) and evidence-based discharge medicine, and had high mortality (Table). One-year mortality remained higher for nonagenarians after adjustment (HR 2.15, 95% CI 1.99-2.32, reference age 65-79). Conclusions: Nonagenarians with NSTEMI experience 2-fold higher mortality following discharge compared with younger elderly adults, with a mortality rate approaching 50% at 1 year. This hazard persists after adjustment, suggesting the role of unmeasured competing risks in this vulnerable population. Table. Discharge medication, in-hospital mortality, and 1-year mortality rates by age category Discharge medications (%) 65-79 Years 80-84 Years 85-89 Years ≥90 Years P-value Aspirin 94.9 19085/21586 93.2 6166/7324 92.6 4118/5007 91.2 2198/2794 <0.001 Clopidogrel 71.5 13677/21586 67.8 4205/7324 64.0 2643/5007 58.2 1220/2794 <0.001 Beta-blocker 92.1 18352/21586 91.7 6119/7324 92.3 4131/5007 92.2 2229/2794 0.942 Statin 80.9 16514/21586 74.2 5018/7324 67.1 2998/5007 56.0 1297/2794 <0.001 ACE inhibitor or ARBs 66.4 13624/21586 65.9 4493/7324 64.2 2891/5007 61.4 1477/2794 <0.001 In-hospital mortality 4.4 996/22582 7.1 560/7784 9.2 509/5516 11.1 348/3141 <0.001 1-year mortality 13.2 2853/21586 23.8 1740/7324 33.5 1676/5007 45.6 1275/2794 –

Hospital and long-term prognosis of patients with non-ST-segment elevation myocardial infarction

2008 ◽  
Vol 149 (45) ◽  
pp. 2115-2119 ◽  
Author(s):  
András Jánosi ◽  
Dániel Várnai ◽  
Zsófia Ádám ◽  
Adrienn Surman ◽  
Katalin Vas
Keyword(s):  
Diabetes Mellitus ◽  
Myocardial Infarction ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Long Term Prognosis

A szerzők 139, nem ST-elevációs infarktus miatt kezelt betegük adatait elemzik. Vizsgálják a betegek kórházi és késői prognózisát, egyes echokardiográfiás adatok prognózissal való összefüggését, valamint a kórházból elbocsátott betegek esetén a szekunder prevenció szempontjából ajánlott gyógyszeres kezelés gyakoriságát. Az utánkövetés a betegek 98%-ában sikeres volt, a bekövetkezett eseményekről, illetve az utánkövetés idején alkalmazott gyógyszeres kezelésről postai kérdőív útján szereztek adatokat. A nők átlagéletkora 78,6, a férfiaké 71,4 év volt. A kezelt betegeknél gyakori volt a társbetegségek (hypertonia, diabetes mellitus, korábbi ischaemiás szívbetegség) előfordulása. A kórházi kezelés időszakában 30 betegnél (22%) történt koronarográfia, és 29 betegnél revascularisatiós beavatkozásra is sor került. A kórházi halálozás 15% volt, az utánkövetés háromnegyed éve alatt 17%-os halálozást észleltek. A kórházban, illetve az utánkövetési idő alatt meghalt betegek szignifikánsan idősebbek voltak azoknál, akik életben maradtak. Egyes echokardiográfiás adatok (ejekciós frakció, végszisztolés átmérő, szegmentális falmozgászavar és a mitralis insufficientia nagysága) prognosztikus jelentőségűnek bizonyultak, mivel szignifikánsan különböztek az életben maradt és a meghalt betegek esetén. A kórházból elbocsátott betegek igen magas arányban részesültek a másodlagos prevenció szempontjából fontosnak ítélt gyógyszeres kezelésben (aszpirin, béta-blokkoló, ACE-gátló, statin). Az utánkövetés idején sem csökkent ezen gyógyszerek használatának aránya, ami a betegek jó compliance-ét igazolja.

Sign in / Sign up

Export Citation Format

Share Document