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Myocardial Infarction Stabilization

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3321. Noninvasive assessment of speed and stability of infarct-related artery reperfusion: results of the GUSTO ST segment monitoring study. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. (Abstract)

myocardial infarction.Rapid resolution of ST segment elevation has been suggested as a noninvasive marker of infarct-related artery patency. We expected that patients treated with accelerated recombinant tissue-type plasminogen activator (rt-PA) would show a quicker recovery than that of other patients but that those treated with streptokinase would show greater stability of recovery.ST segment monitoring was initiated in 1,067 patients within 30 min of the start of thrombolysis and continued for > 18 h (...) Noninvasive assessment of speed and stability of infarct-related artery reperfusion: results of the GUSTO ST segment monitoring study. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries. The ST segment monitoring substudy of the Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (GUSTO-I) trial compared the speed and stability of ST segment recovery among four thrombolytic strategies for acute

1995 Journal of the American College of Cardiology Controlled trial quality: uncertain

3322. Impact of infarct-related artery flow on QT dynamicity in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Full Text available with Trip Pro

Impact of infarct-related artery flow on QT dynamicity in patients undergoing direct percutaneous coronary intervention for acute myocardial infarction. Complete coronary artery reperfusion in acute myocardial infarction (AMI) has been shown to significantly improve survival. Electrical stability may be the decisive mechanism for this beneficial effect. Because electrical stability is largely dependent on ventricular repolarization, we sought to determine the impact of a modern reperfusion (...) strategy (ie, direct percutaneous coronary intervention [PCI]) on QT dynamicity in AMI and examined its association with infarct-related artery flow.We prospectively investigated QT dynamicity in 128 patients undergoing direct PCI for a first AMI. Slopes and correlation coefficients of the linear QT/RR regression were determined in the time interval before reperfusion, within the initial hour after reperfusion, and within the remaining recording period from Holter ECG recordings, which were initiated

2003 Circulation

3323. [Captopril in acute myocardial infarct: its effect on infarct size and arrhythmias]. (Abstract)

[Captopril in acute myocardial infarct: its effect on infarct size and arrhythmias]. The effect of captopril on infarct size and arrhythmias was determined in a prospective, randomized, placebo-controlled double-blind study of 46 patients (9 women, 37 men; mean age 61 [38-86] years). Within 2-18 hours of entry into the study these patients received either a slow intravenous bolus injection of 2.5 or 5.0 mg captopril followed by a continuous infusion of 1.5-2.0 mg/h for a period of 48 hours (n (...) a favourable influence on infarct size and electrical stability which is additional to that provided by standard nitroglycerin treatment.

1992 Deutsche medizinische Wochenschrift (1946) Controlled trial quality: uncertain

3324. Improved speed and stability of ST-segment recovery with reduced-dose tenecteplase and eptifibatide compared with full-dose tenecteplase for acute ST-segment elevation myocardial infarction. Full Text available with Trip Pro

Improved speed and stability of ST-segment recovery with reduced-dose tenecteplase and eptifibatide compared with full-dose tenecteplase for acute ST-segment elevation myocardial infarction. This sub-study of the Integrilin and Tenecteplase in Acute Myocardial Infarction (INTEGRITI) trial evaluated of the impact of combination reperfusion therapy with reduced-dose tenecteplase plus eptifibatide on continuous ST-segment recovery and angiographic results.Combination therapy with reduced-dose (...) fibrinolytics and glycoprotein IIb/IIIa inhibitors for ST-segment elevation myocardial infarction improves biomarkers of reperfusion success but has not reduced mortality when compared with full-dose fibrinolytics.We evaluated 140 patients enrolled in the INTEGRITI trial with 24-h continuous 12-lead ST-segment monitoring and angiography at 60 min. The dose-combination regimen of 50% of standard-dose tenecteplase (0.27 microg/kg) plus high-dose eptifibatide (2 boluses of 180 microg/kg separated by 10 min

2004 Journal of the American College of Cardiology Controlled trial quality: uncertain

3325. Classification of systemic therapies for potential stabilization of the vulnerable plaque to prevent acute myocardial infarction. (Abstract)

Classification of systemic therapies for potential stabilization of the vulnerable plaque to prevent acute myocardial infarction. In this editorial, a classification of systemic therapies for potential plaque stabilization of vulnerable plaque to prevent acute myocardial infarction is proposed based on both biologic plausibility (a potential mechanism to explain the effect) and clinical evidence (i.e., whether the agent reduced acute myocardial infarction in well-designed clinical trials). All

2005 American Journal of Cardiology

3326. Stabilization of hypoxia inducible factor rather than modulation of collagen metabolism improves cardiac function after acute myocardial infarction in rats. (Abstract)

Stabilization of hypoxia inducible factor rather than modulation of collagen metabolism improves cardiac function after acute myocardial infarction in rats. Prolyl hydroxylase domain-containing enzymes (PHD) hydroxylate a proline residue that controls the degradation of hypoxia inducible factor (HIF). Hypoxia inhibits this hydroxylation thus increasing HIF levels. HIF is upregulated in ischemic tissues, growing tumors and in nonischemic, mechanically stressed myocardium. Pharmacological (...) inhibition of prolyl 4-hydroxylase (P4-H) stabilizes HIF-protein in vitro and may modulate collagen turnover. The aims of this study were to investigate whether inhibition of P4-H protects myocardium against ischemia, and whether the observed effects are related to modulation of collagen metabolism or due to the stabilization of HIF.Rats were treated with a specific P4-H inhibitor (P4-HI) or vehicle starting 2 days before induction of myocardial infarction (MI). Rats were investigated 7 or 30 days after

2006 European Journal of Heart Failure

3327. Src blockade stabilizes a Flk/cadherin complex, reducing edema and tissue injury following myocardial infarction Full Text available with Trip Pro

Src blockade stabilizes a Flk/cadherin complex, reducing edema and tissue injury following myocardial infarction Ischemia resulting from myocardial infarction (MI) promotes VEGF expression, leading to vascular permeability (VP) and edema, a process that we show here contributes to tissue injury throughout the ventricle. This permeability/edema can be assessed noninvasively by MRI and can be observed at the ultrastructural level as gaps between adjacent endothelial cells. Many of these gaps (...) contain activated platelets adhering to exposed basement membrane, reducing vessel patency. Following MI, genetic or pharmacological blockade of Src preserves endothelial cell barrier function, suppressing VP and infarct volume, providing long-term improvement in cardiac function, fibrosis, and survival. To our surprise, an intravascular injection of VEGF into healthy animals, but not those deficient in Src, induced similar endothelial gaps, VP, platelet plugs, and some myocyte damage. Mechanistically

2004 Journal of Clinical Investigation

3328. Effects of reperfusion obtained two to six months after acute myocardial infarction on myocardial electrical stabilization in patients with an occluded infarct-related coronary artery. (Abstract)

Effects of reperfusion obtained two to six months after acute myocardial infarction on myocardial electrical stabilization in patients with an occluded infarct-related coronary artery. To assess the changes in electrical stability markers in patients with previous myocardial infarction after very late reopening of the infarct-related artery, we studied QT dispersion, corrected-QT dispersion, and late potentials before and 1, 3, and 6 months after an attempt at late percutaneous coronary (...) after ST-elevation myocardial infarction confers significant electrical stabilization that may contribute to a better outcome in patients with patent infarct-related arteries.

2005 American Journal of Cardiology

3329. Effects of glycoprotein IIb/IIIa inhibition on clinical stabilization parameters in patients with unstable angina and non-Q-wave myocardial infarction. (Abstract)

Effects of glycoprotein IIb/IIIa inhibition on clinical stabilization parameters in patients with unstable angina and non-Q-wave myocardial infarction. Glycoprotein IIb/IIIa receptor inhibition prevents the major cardiac events and improves the prognosis of patients with acute coronary syndromes. The purpose of the study was to evaluate the effects of tirofiban on clinical stabilization parameters in patients with unstable angina (UA) and non-Q-wave myocardial infarction (MI). Eighty-three (...) . Tirofiban, in addition to heparin, provides earlier clinical stability and prevents major in-hospital cardiac events in patients with UA and non-Q-wave MI as compared to heparin therapy alone.

2003 Heart and vessels Controlled trial quality: uncertain

3330. Design of a randomized controlled trial of comprehensive rehabilitation in patients with myocardial infarction, stabilized acute coronary syndrome, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting: Akershus Comprehensive C Full Text available with Trip Pro

Design of a randomized controlled trial of comprehensive rehabilitation in patients with myocardial infarction, stabilized acute coronary syndrome, percutaneous transluminal coronary angioplasty or coronary artery bypass grafting: Akershus Comprehensive C OBJECTIVES: 1. To assess the long-term effectiveness of a comprehensive cardiac rehabilitation programme on quality of life and survival in patients with a large spectrum of cardiovascular diseases (myocardial infarction, acute coronary

2000 Current controlled trials in cardiovascular medicine Controlled trial quality: uncertain

3331. [Electric stability of the heart after myocardial infarction: role of anti-arrhythmia agents during postinfarction]. (Abstract)

[Electric stability of the heart after myocardial infarction: role of anti-arrhythmia agents during postinfarction]. Electrical instability of the heart after myocardial infarction threatens surviving patients with sudden death from a severe ventricular arrhythmia. These arrhythmic complications are usually the result of several factors: an arrhythmogenic substrate corresponding to the ischaemic myocardium, a trigger factor (usually a ventricular extrasystole) and other predisposing factors (...) ejection fraction and/or a ventricular arrhythmia on Holter monitoring identifies a high risk subgroup. Although the assessment of electrical instability is better than it used to be, pharmacological prevention remains disappointing. Class I antiarrhythmics are ineffective or dangerous. The efficacy of Class III antiarrhythmics is uncertain and only the betablockers seem to have any beneficial effects on this post-infarction electrical instability.

1992 Archives des maladies du coeur et des vaisseaux

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