A Fork in the Road After STEMI: Rapid Recovery and Discharge or Cardiac Arrest and High Mortality

Mortality after ST elevation myocardial infarction (STEMI) has declined sharply over the last two decades as early reperfusion technology was improved and implemented. Systems of care designed for accurate pre-hospital diagnosis of STEMI and activation of cardiac catheterization laboratories (CCL) have decreased the time to revascularization of the coronary artery.1 –4 Simultaneously, percutaneous coronary intervention (PCI) has improved with enhanced techniques and multiple generations of stent technology increasing success rates and minimizing complications.
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: Editorial Source Type: research

Related Links:

CONCLUSIONS: In this sample of AMI, mortality in schizophrenia is increased, and treatment with revascularization reduces the HR of schizophrenia. The higher mortality rate yet similar survival benefit of revascularization among individuals with schizophrenia relative to those without suggests that increasing access to revascularization may reduce the elevated mortality observed in individuals with schizophrenia. PMID: 32013569 [PubMed - as supplied by publisher]
Source: Canadian Journal of Psychiatry - Category: Psychiatry Authors: Tags: Can J Psychiatry Source Type: research
CONCLUSIONS: Age and female gender are associated with lower CFR, and age with worse CFC in an angiographically non-obstructed coronary artery. CFC seems to be less sensitive to variations in clinical and hemodynamic parameters than CFR, and therefore is a promising tool in contemporary clinical decision making in the cardiac catheterization laboratory. PMID: 31951205 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Conclusion Compared with heparin plus GPI or bivalirudin plus GPI, bivalirudin monotherapy provides similar protection from ischemic events with less major bleeding at 30 days among patients with NSTE-ACS and positive biomarkers.
Source: Coronary Artery Disease - Category: Cardiology Tags: Adjunctive Pharmacology Source Type: research
Conclusions: Analysis shows a treatment disparity for ACS for symptomatic HIV patients only as symptomatic HIV affected patients received less aggressive catheterization and revascularization management after ACS, compared to control group. However, this effect was not present for the asymptomatic HIV patient group. PMID: 31633997 [PubMed - in process]
Source: Circulation - Category: Cardiology Authors: Tags: Circulation Source Type: research
In this study, we aimed to establish the relationship between LRPs detected by NIRS-intravascular ultrasound imaging at unstented sites and subsequent coronary events from new culprit lesions.MethodsIn this prospective, cohort study (LRP), patients from 44 medical centres were enrolled in Italy, Latvia, Netherlands, Slovakia, UK, and the USA. Patients with suspected coronary artery disease who underwent cardiac catheterisation with possible ad hoc percutaneous coronary intervention were eligible to be enrolled. Enrolled patients underwent scanning of non-culprit segments using NIRS-intravascular ultrasound imaging. The stu...
Source: The Lancet - Category: General Medicine Source Type: research
Percutaneous coronary intervention (PCI) has evolved dramatically, along with patient complexity. We studied trends in in-hospital mortality with changes in patient complexity over the last decade stratified by clinical presentation. The study population included all patients presenting to the cardiac catheterization lab between January 2009 and July 2018. Expected in-hospital mortality was calculated using the National Cardiovascular Data Registry (NCDR) CathPCI risk scoring system. Yearly mean in-hospital mortality rates (%) were plotted and smoothed by weighted least squares regression (LOESS) for each presentation: ST-...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Percutaneous coronary intervention (PCI) has evolved dramatically, along with patient complexity. We studied trends in in-hospital mortality with changes in patient complexity over the last decade stratified by clinical presentation. The study population included all patients presenting to the cardiac catheterization lab between January 2009 and July 2018. Expected in-hospital mortality was calculated using the National Cardiovascular Data Registry CathPCI risk scoring system. Yearly mean in-hospital mortality rates (%) were plotted and smoothed by weighted least squares regression for each presentation: ST-elevation myoca...
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conclusion The cost savings associated with a CCTA first strategy to evaluate chest pain were ~$1 200 244.10. For a self-insured health system such as the Chickasaw Nation, these are very important cost savings.
Source: Coronary Artery Disease - Category: Cardiology Tags: CT Angiography for CAD Source Type: research
ConclusionsBariatric surgery was associated with a significant reduction in the incidence of myocardial infarction as well as lower rates of coronary revascularization in a propensity-matched cohort of morbidly obese patients. Though the retrospective nature of this study may have introduced a degree of selection bias, these outcomes support increased utilization of bariatric surgery for the prevention of heart disease.Graphic abstract
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Publication date: August 2019Source: Canadian Journal of Cardiology, Volume 35, Issue 8Author(s): Lucas C. Godoy, Patrick R. Lawler, Michael E. Farkouh, Bronwyn Hersen, José C. Nicolau, Vivek RaoAbstractThe prevalence of diabetes mellitus (DM) is rising globally and in Canada. Besides being a risk factor for the development of coronary artery disease, DM is also a marker of poor prognosis in patients with acute coronary syndrome (ACS), increasing the risks for ischemic and bleeding complications. Patients with DM have a high prevalence of multivessel coronary artery disease (MVD) and robust evidence has supported co...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
More News: Angioplasty | Cardiac Catheterization | Coronary Angioplasty | Emergency Medicine | Heart Attack | Hospitals | Percutaneous Coronary Intervention