One-Month Clinical Outcomes of ST-Elevation Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention at a High-volume Cardiac Tertiary Center: Routine Hours Versus Off-hours

Primary percutaneous coronary intervention (PCI) is the treatment of choice for patients with ST-elevation myocardial infarction (STEMI). We aimed to compare 1-month major adverse cardiac events (MACE) of patients undergoing primary PCI between 2 routine-hour and off-hour working shifts. In this cross-sectional study, 1791 STEMI patients were retrospectively evaluated who underwent primary PCI. The patients were classified into 2 groups of routine and off-hour according to the PCI start time and date [495 patients (27.7%) in routine-hour group; 1296 patients (72.3%) in off-hour group]. Cardiovascular risk factor, angiographic, procedural data, door-to-device time, and 1-month follow-up data of patients were compared between 2 groups. There was a statistical difference in door-to-device time between routine-hour and off-hour group [55 minutes (40–100 minutes) in off-hour group vs. 49 minutes (35–73 minutes) in routine-hour group; P ≤ 0.001]. However, most of the patients in both groups had door-to-device time ≤60 minutes. The frequency of 1-month MACE was 8.5% in off-hour group and 6.9% in routine-hour group (P = 0.260). After adjustment for possible confounders, the procedure result, in-hospital death, and 1-month MACE were not significantly different between both study groups. We found that STEMI patients treated with primary angioplasty during off-hour shifts had similar 1-month clinical outcomes to routine-hour shifts. Considering the high number of patie...
Source: Critical Pathways in Cardiology - Category: Cardiology Tags: Original Articles Source Type: research

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This study retrospectively enrolled 229 consecutive patients who had pPCI for acute STEMI within 2–7 days of symptom onset between January 2008 and December 2018. Patients were divided into no-reflow group (TIMI flow grade 0–2) and reflow group (TIMI flow grade 3). Predict ors of no-reflow were assessed by univariate and multivariate binary logistic regression analyses. Plasma D-dimer level can independently predict no-reflow in patients with STEMI who had pPCI within 2–7 days of symptom onset (OR 2.52 per 1 mg/L increase, 95% CI 1.16–5.47,p = 0.019). This finding indica...
Source: Journal of Cardiovascular Translational Research - Category: Cardiology Source Type: research
AbstractAimsUrgent revascularization is the mainstay of treatment in acute coronary syndrome (ACS) related cardiogenic shock (CS). The aim was to investigate the association of angiographic results with 90 ‐day mortality. Procedural complications of percutaneous coronary intervention (PCI) were also examined.Methods and resultsThis CardShock (NCT01374867) substudy included 158 patients with ACS aetiology and data on coronary angiography and complications during PCI procedure. Survival analysis was conducted with Kaplan –Meier curves and Cox regression analysis. Median age was 67 ± 11 years, and 77% were men....
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Short Communication Source Type: research
Abstract INTRODUCTION: There is limited literature on clinical outcomes following percutaneous coronary intervention (PCI) in Asian dialysis patients. We evaluated the angiographic characteristics and clinical outcomes of dialysis patients treated with PCI in an Asian society. METHODS: A retrospective analysis was performed of 274 dialysis patients who underwent PCI in a tertiary care institution from January 2007 to December 2012. Data on clinical and angiographic characteristics was collected. The primary endpoint was major adverse cardiac events (MACE), defined as a composite of cardiac death, acute myocar...
Source: Singapore Medical Journal - Category: General Medicine Authors: Tags: Singapore Med J Source Type: research
Authors: Hayase M, Yoda S, Hatta T, Hori Y, Monno K, Fujito H, Suzuki Y, Matsumoto N, Okumura Y Abstract Objective There is no report on the risk stratification of major cardiac events (MCEs) with a combination of the Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score and ischemic reduction detected with rest 201Tl and stress 99mTc-tetrofosmin myocardial perfusion single-photon-emission computed tomography (SPECT) after revascularization in Japanese patients with coronary artery disease (CAD). Methods This was a retrospective study. The patients were followed up to conf...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractDirect stenting (DS) without pre-dilatation of the culprit lesion might improve myocardial perfusion and prognosis in patients undergoing percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI); however, some studies report conflicting results. We investigated whether DS provides incremental myocardial benefits over conventional stenting (CS) in STEMI patients based on cardiac magnetic resonance imaging (CMR) measures. Reperfused patients who underwent CMR examinations within 1  week of STEMI onset were selected from a multicenter CMR registry of STEMI (NCT: 03768453). Patients were s...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
CONCLUSIONS: In this multi-center prospective study, the APTITUDE® BRS was shown to be safe and effective in the treatment of single coronary lesions at 24-months clinical follow up. PMID: 32149709 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
ConclusionIt is reasonable to ask patients for verbal IC in the acute phase of AMI. Most patients felt positively about being asked to participate and had knowledge of being enrolled in a scientific study. In addition they objected to providing IC after randomization and treatment.Trial registrationVALIDATE-SWEDEHEART European Union Clinical Trials Register: 2012-005260-10. ClinicalTrials.gov:NCT02311231. Registered on 8 Dec 2014.
Source: Trials - Category: Research Source Type: clinical trials
This study aims to investigate the clinical and angiographic characteristics of patients with spontaneous reperfusion in ST-segment elevation myocardial infarction (STEMI). A total of 519 patients with STEMI were enrolled in this study, who underwent primary percutaneous coronary intervention (PCI) treatments at Beijing Anzhen Hospital from January 2015 to December 2018. The patients were divided into 2 groups according to the TIMI flow grade before primary PCI, the non-spontaneous reperfusion group (TIMI flow grade 0–II) and the spontaneous reperfusion group (TIMI flow grade III). The incidence rate, the clinically...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
CONCLUSIONS: sST2 concentration have predictive value for LV remodeling on echocardiography in patients with STEMI who underwent primary PCI. However, sST2 concentration was not associated with short-term and long-term MACE. PMID: 32104902 [PubMed - as supplied by publisher]
Source: Cardiology Journal - Category: Cardiology Authors: Tags: Cardiol J Source Type: research
ConclusionsThe FAVOR III China study will be the first randomized trial to examine the effectiveness and cost-effectiveness of a QFR-guided versus an angiography-guided PCI strategy in CAD patients.
Source: American Heart Journal - Category: Cardiology Source Type: research
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