scholarly journals TERRITORIAL IMPACT ON CLINICAL OUTCOMES IN YOUNG POPULATION WITH ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION

2021 ◽  
Vol 54 (1) ◽  
pp. 97-106
Author(s):  
Kamran Ahmed Khan ◽  
Mahesh Kumar Batra ◽  
Dileep Kumar ◽  
Sajjad Ali ◽  
Vinesh Kumar ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Tobacco Use ◽  
Smokeless Tobacco ◽  
Proximal Segment ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Younger Age ◽  
Smokeless Tobacco Use

Objective: ST-segment elevation myocardial infarction (STEMI) at younger age though infrequent but very crucial entity, but there is dearth of available data, however, a rising trend has noticed recently in Asian countries. The aim was to see the territorial and clinical profile influence on overall outcomes of young individuals (≤35 years) with STEMI. Methodology: Patients with STEMI having age of ≤35 years during August 2020 to December 2020 were recruited and divided into left anterior descending artery (LAD)-culprit and non-LAD-culprit STEMI groups in this prospective observational study. Territorial angiographic and clinical characteristics were compared. Results: 1435 STEMI patients underwent coronary angiogram, 5.3% (94) were ≤35 years of age. LAD was culprit in 74.4% of STEMI mainly as a single vessel disease (SVD) involving the proximal segment as major territorial angiographic finding while 25.5% were non-LAD-culprit STEMI.  Obesity, smoking, smokeless tobacco use especially gutka, were frequent in LAD-culprit group. In-hospital and at 3 months mortality was 2.1% (2) and 7.1% (5) respectively, all related to LAD territory. Rate of safe discharges and back to routine was 97.2% vs.100% and 70% vs.79.1% (72), respectively were comparable in both groups. Conclusion: LAD predominantly its proximal segment is the commonest culprit territory in patients with STEMI in youth with significant association to obesity, smoking and smokeless tobacco use especially gutka. LAD-culprit STEMI is the major territorial determinant for mortality and heart failure, however, overall clinical outcomes were reasonably good and comparable with non-LAD-culprit STEMI considering alive discharges and back to routine life.

Abstract 169: Early Intravenous Beta-Blockers in Patients With ST-Segment Elevation Myocardial Infarction

2017 ◽  
Vol 10 (suppl_3) ◽  
Author(s):  
Abhishek Sharma ◽  
Samin Sharma ◽  
Debabrata Mukherjee ◽  
Akash Garg ◽  
Carl Lavie ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Clinical Outcomes ◽  
Beta Blockers ◽  
Final Analysis ◽  
Reperfusion Therapy ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
Standard Medical Therapy ◽  
St Segment ◽  
Early Use

Background: It remains unclear if early use of intravenous (IV) beta-blockers (iBB) improves clinical outcomes patients with ST-segment elevation myocardial infarction (MI; STEMI), especially among those who received reperfusion therapy. Objective: To evaluate effect of early iBB use on clinical outcomes among patients with STEMI. Methods: A systematic review of randomized control trials in MEDLINE, EMBASE, CINAHL, and Cochrane databases comparing early use (administered within 12 hours of presentation) of iBB with standard medical therapy/placebo among patients who presented with STEMI. The effect of iBB was assessed by stratifying studies into pre-reperfusion and reperfusion trials and pooled treatment effects were estimated using relative risk with Mantel-Haenszel risk ratio, using a random-effects model Results: Twenty-one studies (N=74,801) were selected for final analysis. Clinical outcomes at 30 days and 1 year are summarized in table below. Conclusion: In the current reperfusion era, early use of iBB in patients with STEMI was associated with reduction in the risk of recurrent MI and ventricular tachyarrhythmias without any significant reduction in all-cause or CV mortality or increase in the risk of cardiogenic shock.

Abstract 13993: Impact of Prasugrel Pretreatment and Timing of Coronary Artery Bypass Grafting on Clinical Outcomes of Patients With Non-ST-Segment Elevation Myocardial Infarction: From the Accoast Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Dariusz Dudek ◽  
Petr Widimsky ◽  
Leonardo Bolognese ◽  
Patrick Goldstein ◽  
Christian Hamm ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Coronary Artery ◽  
Clinical Outcomes ◽  
Artery Bypass ◽  
Bypass Grafting ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment ◽  
Cabg Patients ◽  
The Impact

Objectives: We evaluated the impact of prasugrel pretreatment and timing of coronary artery bypass grafting (CABG) on clinical outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI) undergoing CABG based on data from ACCOAST. Methods: We evaluated the impact of troponin, prasugrel pretreatment and CABG timing on clinical outcomes of NSTEMI patients undergoing CABG through 30 days from ACCOAST. Results: CABG patients versus PCI or medically managed patients were more often male, diabetic, had peripheral arterial disease and a higher GRACE score. By randomization assignment, 157 patients received a 30-mg loading-dose of prasugrel before CABG; 157 patients did not. CABG patients were grouped by tertiles of time from randomization to CABG; baseline characteristics in the Table. Patients in the lowest tertile had significantly more events (cardiovascular death, MI, stroke, urgent revascularization or glycoprotein IIb/IIIa bailout) and all TIMI major bleeds than those in the other 2 groups (p<0.045, p<0.002 respectively), but the patients in the higher 2 groups were not significantly different from each other. No difference was detected in all cause death among the 3 groups (p>0.39). A multivariate model evaluated 5 possible predictors of the composite endpoint of all cause death, MI, stroke and TIMI major bleeding. Time from randomization to CABG (HR 0.84 for each 1 hour of delay), left main disease presence (HR 1.76), and region of enrollment (Eastern Europe vs other, HR 3.83) were significant predictors but not prasugrel pretreatment or baseline troponin level ≥3xULN. Conclusions: In this group of high-risk patients presenting with NSTEMI, early surgical revascularization carried an increased risk of bleeding and ischemic complications, without impact on all-cause mortality. No impact of baseline troponin or prasugrel pretreatment (important factors influencing time of CABG) on clinical outcomes was confirmed.

Clinical outcomes and need for intensive care after non-ST-segment-elevation myocardial infarction

2020 ◽  
Vol 76 ◽  
pp. 58-63 ◽  
Author(s):  
Patrícia O. Guimarães ◽  
Márcio C. Sampaio ◽  
Felipe L. Malafaia ◽  
Renato D. Lopes ◽  
Alexander C. Fanaroff ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Intensive Care ◽  
Clinical Outcomes ◽  
St Segment Elevation ◽  
Segment Elevation Myocardial Infarction ◽  
St Segment
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