Role of N-terminal pro-B-Type Natriuretic Peptide in the prediction of outcomes in ST-elevation myocardial infarction complicated by cardiogenic shock

Publication date: Available online 12 July 2020Source: Indian Heart JournalAuthor(s): Yash Paul Sharma, Kewal Kanabar, Krishna Santosh, Ganesh Kasinadhuni, Darshan Krishnappa
Source: Indian Heart Journal - Category: Cardiology Source Type: research

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There are limited data on the outcomes of cardiogenic shock (CS) and cardiac arrest (CA) complicating ST-segment-elevation myocardial infarction (STEMI).
Source: Resuscitation - Category: Emergency Medicine Authors: Tags: Clinical paper Source Type: research
Purpose of review Early revascularization significantly improved the outcome of patients with cardiogenic shock following acute myocardial infarction (AMI). Nevertheless, the mortality remains substantial, ranging between 40 and 50% after 30 days. The present review summarizes the current evidence regarding revascularization strategies, vascular access site and concomitant antiplatelet and antithrombotic treatment in infarct-related cardiogenic shock. Recent findings On the basis of the SHOCK trial, early revascularization is the most relevant procedure to improve the outcome of patients with infarct-related cardiogen...
Source: Current Opinion in Critical Care - Category: Nursing Tags: CARDIOGENIC SHOCK: Edited by Alexandre Mebazaa Source Type: research
Purpose of review Data and interventional trials on vasopressor use during cardiogenic shock are scarce. Their use is limited by their side-effects and the lack of solid evidence regarding their effectiveness in improving outcomes. In the present article, we review the current use of vasopressor therapy during cardiogenic shock. Recent findings Two recent Cochrane analyses concluded that there was insufficient evidence to prove that any one vasopressor was superior to others in terms of mortality. A recent RCT and a meta-analysis on individual data suggested that norepinephrine may be preferred over epinephrine in pat...
Source: Current Opinion in Critical Care - Category: Nursing Tags: CARDIOGENIC SHOCK: Edited by Alexandre Mebazaa Source Type: research
AbstractPurpose of ReviewSpontaneous coronary artery dissection (SCAD) is an increasingly recognized entity leading to myocardial infarction especially in women. Multiple observational studies have been published in the recent years. This review summarizes the current body of knowledge and recent developments in SCAD epidemiology, presentation, diagnosis, and management.Recent FindingsContemporary series have estimated the incidence of SCAD to be up to ~  4% of all patients presenting with acute coronary syndrome (ACS). Fibromuscular dysplasia, hormonal therapy, multiparity, connective tissue disorders, and systemic...
Source: Current Atherosclerosis Reports - Category: Cardiology Source Type: research
We describe a patient with COVID-19, who presented with ST-elevation myocardial infarction and was treated with thrombolysis and anticoagulation. He was later found to have a significant persistent thrombus burden requiring thrombectomy and stent placement. Invasive hemodynamics on multiple high-dose pressers revealed a high cardiac output state with low systemic vascular resistance, consistent with distributive rather than cardiogenic shock. Our case illustrates that thrombolytic therapy alone may not be adequate in patients with STEMI and COVID-19, as well as the importance of early invasive hemodynamics in management of...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
This study sought  to evaluate long-term mortality and major adverse cardiac and cerebrovascular events (MACCE) in patients with cardiac arrest (CA) and cardiogenic shock (CS) complicating acute myocardial infarction (AMI). This was a retrospective cohort study using an administrative claims database. AMI patients f rom 01/01/2010-05/31/2018 were stratified into CA+CS, CA only, CS only and AMI alone cohorts. Outcomes of interest were long-term mortality and MACCE (death, AMI, cerebrovascular accident, unplanned revascularization) in AMI survivors.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractPurpose of ReviewMultivessel coronary artery disease is frequently encountered in patients undergoing primary percutaneous coronary intervention (PCI). Several moderate-sized randomized trials have suggested that complete revascularization of non-culprit stenoses in ST-elevation myocardial infarction (STEMI) patients without cardiogenic shock is associated with improved outcomes driven solely by a reduction in the risk of future revascularization.Recent FindingsThe Complete versus Culprit-only Revascularization to Treat Multi-vessel disease after Early PCI for STEMI (COMPLETE) trial recently showed that a complete ...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
Conclusion: The PDMPs level was increased from the day of admission to 30 days after discharge in patients with STEMI. The persistent increase in the PDMPs level in 30 days after the STEMI event was associated with the 30-day postdischarge MACE and trended toward increased MACE during the 90-day and 1-year follow-up. PMID: 32695505 [PubMed]
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research
This study aimed to clarify characteristics, treatment strategy, and in-hospital outcomes of RMI patients in the Tokyo CCU network database.Methods and Results:In total, 1,853 RMI and 12,494 AMI patients from the Tokyo CCU network database during 2013-2016 were compared. Both RMI and AMI were redefined by onset times of 2-28 days and ≤24 h, respectively. The RMI group had a higher average age (70.4±12.9 vs. 68.0±13.4 years, P
Source: Circulation Journal - Category: Cardiology Authors: Tags: Circ J Source Type: research
In Reply Dr Ravn and colleagues note several limitations of observational studies. The potential for unmeasured confounding and lack of hemodynamic and metabolic parameters were discussed in the article. Nonetheless, real-world studies, including our analysis, provide important insights into the performance of mechanical circulatory support devices in routine practice. Moreover, the association of intravascular microaxial LVAD use with significantly higher rates of in-hospital mortality and major bleeding compared with IABP among patients with acute myocardial infarction complicated by cardiogenic shock was consistent acro...
Source: JAMA - Category: General Medicine Source Type: research
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