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Latest & greatest articles for myocardial infarction
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Association of genetically predicted testosterone with thromboembolism, heart failure, and myocardial infarction: mendelian randomisation study in UK Biobank. OBJECTIVE: To determine whether endogenous testosterone has a causal role in thromboembolism, heart failure, and myocardial infarction. DESIGN: Two sample mendelian randomisation study using genetic variants as instrumental variables, randomly allocated at conception, to infer causality as additional randomised evidence. SETTING (...) : Reduction by Dutasteride of Prostate Cancer Events (REDUCE) randomised controlled trial, UK Biobank, and CARDIoGRAMplusC4D 1000 Genomes based genome wide association study. PARTICIPANTS: 3225 men of European ancestry aged 50-75 in REDUCE; 392 038 white British men and women aged 40-69 from the UK Biobank; and 171 875 participants of about 77% European descent, from CARDIoGRAMplusC4D 1000 Genomes based study for validation. MAIN OUTCOME MEASURES: Thromboembolism, heart failure, and myocardial infarction
2019 Canadian Cardiovascular Society/Canadian Association of Interventional Cardiology Guidelines on the Acute Management of ST-Elevation Myocardial Infarction: Focused Update on Regionalization and Reperfusion Graham C. Wong AstraZeneca, Bayer None None Warren Cantor AstraZeneca, Bayer None None Sean Van Diepen None None None Chris Overgaard None None None Michelle Welsford None None None Laurie Lambert None None None Ata ur Rehman Quraishi None None None Craig Ainsworth None None None Michele (...) Medical None Canadian Cardiovascular Society Focused Update on the Management of ST-Elevation Myocardial Infarction in Canada Panel Member's Realtionships with Industry (RWI) Member Primary Panel The CCS is committed to preserving the scientific integrity of its Guidelines and Position Statements through transparency and management of relationships with industry (RWI). Panel members must disclose all relationships with industry regardless of relevance to the guideline topic (see below). When
Short-TErm Psychotherapy IN Acute Myocardial Infarction (STEP-IN-AMI) Trial: Final Results 30659815 2019 02 19 1555-7162 2019 Jan 17 The American journal of medicine Am. J. Med. Short-TErm Psychotherapy IN Acute Myocardial Infarction (STEP-IN-AMI) Trial: Final Results. S0002-9343(19)30053-1 10.1016/j.amjmed.2018.12.025 The purpose of this research was to assess whether short-term psychotherapy enhances long-term clinical outcomes in patients with a recent acute myocardial infarction (AMI (...) ). Patients ≤70 years old were randomized within 1 week of their AMIto short-term ontopsychological psychotherapy plus routine medical therapy vs routine medical therapy only. The primary composite outcome was defined as the combined incidence of new cardiovascular events (re-infarction, death, stroke, revascularization, life-threatening ventricular arrhythmias, and the recurrence of clinically significant angina) and clinically significant new comorbidities. Secondary outcome measures were: rates
Revised Cardiac Risk Index as a Predictor for Myocardial Infarction and Cardiac Arrest Following Posterior Lumbar Decompression 30005044 2019 01 11 1528-1159 44 3 2019 Feb 01 Spine Spine Revised Cardiac Risk Index as a Predictor for Myocardial Infarction and Cardiac Arrest Following Posterior Lumbar Decompression. E187-E193 10.1097/BRS.0000000000002783 A retrospective analysis of prospectively collected data. The aim of this study was to determine the ability of Revised Cardiac Risk Index (RCRI (...) to identify patients undergoing PLD from 2006 to 2014. Fifty-two thousand sixty-six patients met inclusion criteria. Multivariate and ROC analysis was utilized to identify associations between RCRI and postoperative complications. Membership in the RCRI=1 cohort was a predictor for myocardial infarction (MI) [odds ratio (OR) = 3.3, P = 0.002] and cardiac arrest requiring cardiopulmonary resuscitation (CPR) (OR = 3.4, P = 0.013). Membership in the RCRI = 2 cohort was a predictor for MI (OR = 5.9, P = 0.001
Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel 30586720 2019 01 28 1524-4539 139 5 2019 Jan 29 Circulation Circulation Evaluation of Microvascular Injury in Revascularized Patients With ST-Segment-Elevation Myocardial Infarction Treated With Ticagrelor Versus Prasugrel. 636-646 10.1161/CIRCULATIONAHA.118.035931 Despite successful restoration of epicardial vessel patency with primary (...) percutaneous coronary intervention, coronary microvascular injury occurs in a large proportion of patients with ST-segment-elevation myocardial infarction, adversely affecting clinical and functional outcome. Ticagrelor has been reported to increase plasma adenosine levels, which might have a protective effect on the microcirculation. We investigated whether ticagrelor maintenance therapy after revascularized ST-segment-elevation myocardial infarction is associated with less coronary microvascular injury
Usefulness of Triiodothyronine Replacement Therapy in Patients With ST Elevation Myocardial Infarction and Borderline/Reduced Triiodothyronine Levels (from the THIRST Study) 30638544 2019 01 14 1879-1913 2018 Dec 18 The American journal of cardiology Am. J. Cardiol. Usefulness of Triiodothyronine Replacement Therapy in Patients With ST Elevation Myocardial Infarction and Borderline/Reduced Triiodothyronine Levels (from the THIRST Study). S0002-9149(18)32210-0 10.1016/j.amjcard.2018.12.020 (...) The aim of the study was to investigate whether TH replacement therapy is safe and impact infarct size, left ventricular (LV) volumes and function in patients with acute myocardial infarction (AMI) and low T3 syndrome (LT3S). Thirty-seven AMI/LT3S patients were randomly treated or untreated with liothyronine (T3) therapy (maximum dosage 15 mcg/m 2 /die) in addition to standardized treatment (T3-treated group, n = 19; untreated group, n = 18). TH and thyroxine (TSH) during hospital stay and at 1-month
Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction 30026282 2019 01 21 1524-4539 139 4 2019 Jan 22 Circulation Circulation Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction. 448-457 10.1161/CIRCULATIONAHA.117.032722 Experimental trials suggest improved outcome by mild therapeutic hypothermia for cardiogenic shock after acute myocardial infarction. The objective of this study was to investigate the hemodynamic effects of mild therapeutic hypothermia (...) in patients with cardiogenic shock complicating acute myocardial infarction. Patients (n=40) with cardiogenic shock undergoing primary percutaneous coronary intervention without classic indications for mild therapeutic hypothermia underwent randomization in a 1:1 fashion to mild therapeutic hypothermia for 24 hours or control. The primary end point was cardiac power index at 24 hours; secondary end points included other hemodynamic parameters and serial measurements of arterial lactate. No relevant
Prospective, randomized trial of bioresorbable scaffolds vs. everolimus-eluting stents in patients undergoing coronary stenting for myocardial infarction: the Intracoronary Scaffold Assessment a Randomized evaluation of Absorb in Myocardial Infarction (IS 30520980 2019 01 07 1522-9645 40 2 2019 Jan 07 European heart journal Eur. Heart J. Prospective, randomized trial of bioresorbable scaffolds vs. everolimus-eluting stents in patients undergoing coronary stenting for myocardial infarction (...) : the Intracoronary Scaffold Assessment a Randomized evaluation of Absorb in Myocardial Infarction (ISAR-Absorb MI) trial. 167-176 10.1093/eurheartj/ehy710 Bioresorbable scaffolds (BRS) provide short-term coronary artery scaffolding and drug delivery. Although prior trials showed a higher rate of device failure compared with conventional drug-eluting stents (DES), only a single trial investigated patients undergoing percutaneous coronary intervention (PCI) for acute myocardial infarction (MI). We aimed to compare
Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial 30586721 2018 12 27 1524-4539 2018 Nov 11 Circulation Circulation Intraaortic Balloon Pump in Cardiogenic Shock Complicating Acute Myocardial Infarction: Long-Term 6-Year Outcome of the Randomized IABP-SHOCK II Trial. 10.1161/CIRCULATIONAHA.118.038201 The role of intraaortic balloon counterpulsation (IABP) in cardiogenic shock is still a subject (...) of intense debate despite the neutral results of the IABP-SHOCK II trial (Intraaortic Balloon Pump in Cardiogenic Shock II) with subsequent downgrading in international guidelines. So far, randomized data on the impact of IABP on long-term clinical outcomes in patients with cardiogenic shock complicating acute myocardial infarction are lacking. Furthermore, only limited evidence is available on general long-term outcomes of patients with cardiogenic shock treated by contemporary practice. The IABP-SHOCK
Effect of Medication Co-payment Vouchers on P2Y12 Inhibitor Use and Major Adverse Cardiovascular Events Among Patients With Myocardial Infarction: The ARTEMIS Randomized Clinical Trial. Importance: Despite guideline recommendations, many patients discontinue P2Y12 inhibitor therapy earlier than the recommended 1 year after myocardial infarction (MI), and higher-potency P2Y12 inhibitors are underutilized. Cost is frequently cited as an explanation for both of these observations. Objective (...) : To determine whether removing co-payment barriers increases P2Y12 inhibitor persistence and lowers risk of major adverse cardiovascular events (MACE). Design, Setting, and Participants: Cluster randomized clinical trial among 301 hospitals enrolling adult patients with acute MI (June 5, 2015, through September 30, 2016); patients were followed up for 1 year after discharge (final date of follow-up was October 23, 2017), with blinded adjudication of MACE; choice of P2Y12 inhibitor was per clinician
Effect of Low-Dose Intracoronary Alteplase During Primary Percutaneous Coronary Intervention on Microvascular Obstruction in Patients With Acute Myocardial Infarction: A Randomized Clinical Trial. Importance: Microvascular obstruction commonly affects patients with acute ST-segment elevation myocardial infarction (STEMI) andis associated with adverse outcomes. Objective: To determine whether a therapeutic strategy involving low-dose intracoronary fibrinolytic therapy with alteplase infused (...) early after coronary reperfusion will reduce microvascular obstruction. Design, Setting, and Participants: Between March 17, 2016, and December 21, 2017, 440 patients presenting at 11 hospitals in the United Kingdom within 6 hours of STEMI dueto a proximal-mid-vessel occlusion of a major coronary artery were randomized in a 1:1:1 dose-ranging trial design. Patient follow-up to 3 months was completed on April 12, 2018. Interventions: Participants were randomly assigned to treatment with placebo (n
Platelet inhibition with standard versus lower maintenance dose of ticagrelor early after myocardial infarction (ELECTRA): a randomized, open-label, active-controlled pharmacodynamic and pharmacokinetic study. 30689800 2019 01 28 2055-6845 2019 Jan 23 European heart journal. Cardiovascular pharmacotherapy Eur Heart J Cardiovasc Pharmacother Platelet inhibition with standard versus lower maintenance dose of ticagrelor early after myocardial infarction (ELECTRA): a randomized, open-label, active (...) -controlled pharmacodynamic and pharmacokinetic study. 10.1093/ehjcvp/pvz004 Currently available data indicate that reduction of ticagrelor maintenance dose (MD) 1-3 years after acute myocardial infarction (AMI) not only provides sufficient platelet inhibition, but also can improve ticagrelor's safety profile. The aim of this study was to compare the antiplatelet effect of reduced and standard ticagrelor MD in stable patients beginning one month after AMI. In a single-centre, randomized, open-label
Association of the Hospital Readmissions Reduction Program With Mortality Among Medicare Beneficiaries Hospitalized for Heart Failure, Acute Myocardial Infarction, and Pneumonia. Importance: The Hospital Readmissions Reduction Program (HRRP) has been associated with a reduction in readmission rates for heart failure (HF), acute myocardial infarction (AMI), and pneumonia. It is unclear whether the HRRP has been associated with change in patient mortality. Objective: To determine whether the HRRP (...) was associated with a change in patient mortality. Design, Setting, and Participants: Retrospective cohort study of hospitalizations for HF, AMI, and pneumonia among Medicare fee-for-service beneficiaries aged at least 65 years across 4 periods from April 1, 2005, to March 31, 2015. Period 1 and period 2 occurred before the HRRP to establish baseline trends (April 2005-September 2007 and October 2007-March 2010). Period 3 and period 4 were after HRRP announcement (April 2010 to September 2012) and HRRP
Christmas, national holidays, sport events, and time factors as triggers of acute myocardial infarction: SWEDEHEART observational study 1998-2013. OBJECTIVES: To study circadian rhythm aspects, national holidays, and major sports events as triggers of myocardial infarction. DESIGN: Retrospective observational study using the nationwide coronary care unit registry, SWEDEHEART. SETTING: Sweden. PARTICIPANTS: 283 014 cases of myocardial infarction reported to SWEDEHEART between 1998 and 2013 (...) . Symptom onset date was documented for all cases, and time to the nearest minute for 88%. INTERVENTIONS: Myocardial infarctions with symptom onset on Christmas/New Year, Easter, and Midsummer holiday were identified. Similarly, myocardial infarctions that occurred during a FIFA World Cup, UEFA European Championship, and winter and summer Olympic Games were identified. The two weeks before and after a holiday were set as a control period, and for sports events the control period was set to the same time
Non-ST-elevation myocardial infarction Non-ST-elevation myocardial infarction - Symptoms, diagnosis and treatment | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search Non-ST-elevation myocardial infarction Last reviewed: November 2018 Last updated: December 2018 Summary Part of the acute coronary syndrome spectrum. Usually caused by a partial or near-complete occlusion of a coronary artery resulting in compromised blood flow to myocardium with subsequent (...) myocardial injury or infarction as demonstrated by elevation in troponin. There are differences in typical presentation between the sexes. Male patients typically present with chest pressure/discomfort lasting at least several minutes, at times accompanied by sweating, dyspnoea, nausea, and/or anxiety. Women present more commonly with middle/upper back pain or dyspnoea and similar associated symptoms. Symptoms are indistinguishable from those of unstable angina. However, non-ST-elevation
Meta-analysis Comparing Culprit Vessel Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction and Cardiogenic Shock 30420183 2018 11 13 1879-1913 2018 Oct 26 The American journal of cardiology Am. J. Cardiol. Meta-analysis Comparing Culprit Vessel Only Versus Multivessel Percutaneous Coronary Intervention in Patients With Acute Myocardial Infarction and Cardiogenic Shock. S0002-9149(18)31966-0 10.1016/j.amjcard.2018.09.039 Cardiogenic shock (CS (...) ) after a myocardial infarction continues to be associated with high mortality. Whether percutaneous coronary intervention (PCI) of noninfarct coronary arteries (multivessel intervention [MVI]) improves outcomes in CS after acute myocardial infarction (AMI) remains controversial. MEDLINE, Cochrane CENTRAL, and Scopus databases were searched for original studies comparing MVI with culprit-vessel intervention (CVI) in AMIpatients with multivessel disease and CS. Risk ratios (RRs) and 95% confidence
Relation of CHA2DS2VASC Score With Hemorrhagic Stroke and Mortality in Patients Undergoing Fibrinolytic Therapy for ST Elevation Myocardial Infarction 30415795 2018 11 12 1879-1913 2018 Oct 18 The American journal of cardiology Am. J. Cardiol. Relation of CHA 2 DS 2 VASC Score With Hemorrhagic Stroke and Mortality in Patients Undergoing Fibrinolytic Therapy for ST Elevation Myocardial Infarction. S0002-9149(18)31955-6 10.1016/j.amjcard.2018.10.003 Hemorrhagic stroke (HS) is a feared (...) complication of Fibrinolytic therapy (FT). Risk assessment scores may help in risk stratification to reduce this complication. Patients (admissions) ≥18 years with a primary diagnosis of ST-elevation myocardial infarction (STEMI) whoreceived systemic thrombolysis were extracted from Nationwide Inpatient Sample database and stratified and compared based on CHA 2 DS 2 VASC score 0 to 3, 4 to 6, and 7 to 9 as low, intermediate and high risk, respectively. The primary outcomes of interest were HS
Sex differences in risk factors for myocardial infarction: cohort study of UK Biobank participants. OBJECTIVES: To investigate sex differences in risk factors for incident myocardial infarction (MI) and whether they vary with age. DESIGN: Prospective population based study. SETTING: UK Biobank. PARTICIPANTS: 471 998 participants (56% women; mean age 56.2) with no history of cardiovascular disease. MAIN OUTCOME MEASURE: Incident (fatal and non-fatal) MI. RESULTS: 5081 participants (1463 (28.8 (...) %) of whom were women) had MIover seven years' mean follow-up, resulting in an incidence per 10 000 person years of 7.76 (95% confidence interval 7.37 to 8.16) for women and 24.35 (23.57 to 25.16) for men. Higher blood pressure indices, smoking intensity, body mass index, and the presence of diabetes were associated with an increased risk of MIin men and women, but associations were attenuated with age. In women, systolic blood pressure and hypertension, smoking status and intensity, and diabetes were