Acute myocardial infarction (AMI)

Top PDF Acute myocardial infarction (AMI):

TítuloIn hospital mortality due to acute myocardial infarction: relevance of type of hospital and care provided: RECALCAR study

TítuloIn hospital mortality due to acute myocardial infarction: relevance of type of hospital and care provided: RECALCAR study

The objective of the RECALCAR project is to investigate the relationship between organizational and administrative aspects of the cardiology units of the Spanish National Health Service (NHS) and patient outcomes. Among other activities, RECALCAR has analyzed the episodes of discharges from NHS hospitals recorded in the minimum basic data set in 2009-2010. In this article, we report the results obtained from the use of the minimum basic data set concerning the relationship between the characteristics of the hospital, the care provided (clinical services and procedures), and the in-hospital mortality due to acute myocardial infarction (AMI).
Mostrar más

13 Lee mas

Vitamin D, precocious acute myocardial infarction, and exceptional longevity

Vitamin D, precocious acute myocardial infarction, and exceptional longevity

2 Recent studies have reported low circulating levels of 25-hydroxyvitamin D (25(OH)D), the biologically active form of vitamin D, in patients with cardiovascular disease (CVD) [1], hypertension [2], carotid atherosclerosis [3], atrial fibrillation [4], and heart failure [5]. Moreover, vitamin D deficiency has been associated with all-cause mortality [6,7] and predicts adverse cardiac events in patients with established CVD [8] or after acute myocardial infarction (AMI) [9]. In turn, vitamin D supplementation improves the modulation of autonomic tone [10].
Mostrar más

11 Lee mas

EMMPRIN targeted magnetic nanoparticles for In vivo visualization and regression of acute myocardial infarction

EMMPRIN targeted magnetic nanoparticles for In vivo visualization and regression of acute myocardial infarction

Inhibition of extracellular matrix (ECM) degradation may represent a mechanism for cardiac protection against ischemia. Extracellular matrix metalloproteinase inducer (EMMPRIN) is highly expressed in response to acute myocardial infarction (AMI), and induces activation of several matrix metalloproteinases (MMPs), including gelatinases MMP-2 and MMP-9. We targeted EMMPRIN with paramagnetic/fluorescent micellar nanoparticles conjugated with the EMMPRIN binding peptide AP-9 (NAP9), or an AP-9 scrambled peptide as a negative control (NAPSC). We found that NAP9 binds to endogenous EMMPRIN in cultured HL1 myocytes and in mouse hearts subjected to ischemia/reperfusion (IR). Injection of NAP9 at the time of or one day after IR, was enough to reduce progression of myocardial cell death when compared to Control and NAPSC injected mice (infarct size in NAP9 injected mice: 32% ± 6.59 vs Control: 46% ± 9.04 or NAPSC injected mice: 48%±7.64). In the same way, cardiac parameters were recovered to almost healthy levels (LVEF NAP9 63% ± 7.24 vs Control 42% ± 4.74 or NAPSC 39% ± 6.44), whereas ECM degradation was also reduced as shown by inhibition of MMP-2 and MMP-9 activation. Cardiac magnetic resonance (CMR) scans have shown a signal enhancement in the left ventricle of NAP9 injected mice with respect to non-injected, and to mice injected with NAPSC. A positive corre- lation between CMR enhancement and Evans-Blue/TTC staining of infarct size was calculated (R:0.65). Taken together, these results point to EMMPRIN targeted nanoparticles as a new ap- proach to the mitigation of ischemic/reperfusion injury.
Mostrar más

13 Lee mas

Effect of Personalized Nursing on The Success Rate,  Emotional Status, Complications and Nursing  Satisfaction of Pre-Hospital Emergency Care for  Patients with Acute Myocardial Infarction

Effect of Personalized Nursing on The Success Rate, Emotional Status, Complications and Nursing Satisfaction of Pre-Hospital Emergency Care for Patients with Acute Myocardial Infarction

Personalized nursing is a patient-centered whole-person treatment plan method(Bolton et al.,2020), which is a formal process for clinicians and patients to cooperate to create longitudinal treatment plans. It is a frequently mentioned tool for improving the quality of primary care for patients with complicated medical care and high demand, and is patient-centered(Edwards et al.,2017). Clinicians also carry out personalized treatment by reviewing the qualification criteria and baseline table of clinical trials, so as to apply the results of subgroup analysis in gestalt treatment or systematic evaluation as the clinical basis for treating specific patients (McAlister et al.,2017). Pre-hospital personalized emergency care belongs to personalized care. Since acute myocardial infarction has acute onset, nursing staff should arrive at the patient's location as soon as possible so as not to delay the “golden treatment time”. The results of this study also showed that personalized emergency care was more efficient and faster and had shorter hospitalization time. It is because our personalized nurses have received professional training to enhance their decision-making skills, which is helpful for nurses to make quick decisions and handle emergencies. Some studies have found that there is a correlation between the use of specialized emergency physicians' care mode and the reduction of transportation time, and the emergency specialized emergency physician model plays an important role in coping with the increasing number of patients who need to be transported by ambulance (Higashi et al.,2019). This can all reveal that professional personalized first aid care can reduce first aid time. Faster admission of patients to hospital may be related to good treatment results. Some studies showed that starting appropriate treatment as early as possible was related to improving prognosis, and that well- defined clinical programs have the potential to guide individual risk stratification and treatment decisions, thus possibly improving the nursing and treatment effects of patients (Schuetz et al.,2012). The results of this study also showed that personalized first aid care had a higher success rate of first aid, patients and their families were more willing to accept transfer, and the occurrence of complications of patients was less. The reason for this result may be the professionalism of the individualized nursing staff and the detection of all
Mostrar más

8 Lee mas

Relationship between obesity and NT-proBNP and the effect on prognosis of acute myocardial infarction

Relationship between obesity and NT-proBNP and the effect on prognosis of acute myocardial infarction

The N-terminal prodiuretic peptide which generates the 32-amino acid brain diuretic peptide, NT-proBNP, with more activity in a cleavage reaction (Madamanchi C. et al., 2014) In general, NT-proBNP exists in ventricular cardiomyocytes. If ventricular volume increases, wall tension increases, and cardiac stress increases, the myocardium will secrete more BNP in response to traction stimulation. Therefore, diagnosis of heart failure can be made clinically by detectin the level of BNP and specific extent of damage to cardiomyocytes could also be predicted (Zheng L.H. et al., 2014). Similarly, NT-proBNP could be applied as a single prognostic indicator for acute myocardial infarction and for early assessment of the patients’ condition. However, there are many factors affecting the plasma NT-proBNP levels. For instance: the patients with normal renal function will rapidly metabolize NT-proBNP within 120 minutes because of that NTproBNP is mainly cleared by renal metabolism, and more consideration should be given to patients with renal dysfunction; Sex and age could also influence NT-proBNP measurements, such as elderly female usually showed higher results compared elderly male and young patients, and this factor also needs to be taken into account (Darche F.F. et al., 2019). Previous research suggested that obesity also has an impact on the levels NT-proBNP. Data indicated
Mostrar más

5 Lee mas

A semiparametric Bayesian joint model for multiple mixed type outcomes: an application to acute myocardial infarction

A semiparametric Bayesian joint model for multiple mixed type outcomes: an application to acute myocardial infarction

We have presented a framework for semiparametric Bayesian modeling of mixed-type multiple outcomes for Acute Myocardial Infarction patients admitted to hospitals in Lombardy; we considered patients with STEMI diagnosis and treated with PTCA. Specifically, we have proposed a Bayesian nonparametric hierarchical model for clus- ter analysis, aimed at identifying hospital behavior that may affect the outcome at patient level. We have considered a conditional specification of the joint model for three responses: the door to balloon time (DB), the in-hospital survival and the sur- vival after 60 days from admission. The information on survival is available as binary outcomes. A different study based on survival times or in general time-to-event data might be of interest, and could possibly lead to different results. Nevertheless the analysis of the binary outcome of in-hospital and mid-term survival was one of the main study targets, as requested by clinicians. In fact, performance assessment in clin- ical practice is usually based on binary survival data, which is probably the reason why we have been asked to focus on these outcomes. Each conditional specification is a generalized linear model with random intercepts to account for hospital variability. We postulated a nonparametric prior for the random effects that incorporates dependence on a location indicator, which is used to explicitly differentiate among hospitals in or outside the city of Milano. The random effects are a sample from the Pitman-Yor process, more flexible than, yet encompassing the Dirichlet process prior. We have provided Bayesian estimates of the random effect parameters, predictive inference for the nonparametric components of the prior, and cluster estimates for the grouping of the hospitals as well.
Mostrar más

25 Lee mas

Cierre percutneo primario del defecto del tabique  interventricular postinfarto con el dispositivo de Amplatzer: resultados inmediatos y seguimiento a largo plazo

Cierre percutneo primario del defecto del tabique interventricular postinfarto con el dispositivo de Amplatzer: resultados inmediatos y seguimiento a largo plazo

Introduction: The immediate surgical repair of a ventricular septal defect complicating acute myocardial infarction (VSD post- AMI) is associated with high mortality. The percutaneous closure device is safe and effective in patients with post-infarction VSD; we report the immediate and long term results in the use of the Am- platzer device in the primary closure of post infarction VSD. Mate- rial and methods: From June 2006 to January 2014, 17 patients carriers of post-infarction VSD underwent percutaneous Amplatzer closure with a mean age 66.8 ± 5.5, 82.4% in cardiogenic shock (CS), 35.3% were thrombolyzed (TT) in window, the average time to percutaneous closure of VSD 8.7 ± 5.8 days. Results: With a current monitoring of 13.25 ± 12.6 months procedural success were in 100% shunt (QP:QS) was reduced from 2.9 to 1.5 ± 0.40 ± 0.95 L/min p = 0.0001, 12 patients (70.6%) undergoing PTCA the culprit vessel post-closure of the VSD. Global mortality at 30 days was 52.9%, being higher in patients with CS versus 64.3 versus 0% no-CS p = 0.043 OR 2.8 (CI 95% 1.38-5.6). Conclusion: The pri- mary closure of postinfarction VSD is a very promising technique that can be performed with a high success rate and minimal com- plications and may be taken as an alternative to surgery. However despite being a less invasive technique remains high mortality very evident in patients in CS.
Mostrar más

8 Lee mas

16602420

16602420

The association between cerium status and risk of first acute myocardial infarction (AMI) was examined in a case-control study in 10 centres from Europe and Israel. Cerium in toenails was assessed by neutron activation analysis in 684 cases and 724 controls aged 70 years or younger. Mean concentrations of cerium were 186 and 173 lg/kg in cases and controls, respectively. Cerium was positively associated with low socio-economic status, smoking, mercury, zinc and scandium (p 6 0.001). Cases had significantly higher levels of cerium than controls after adjustment for age and centre (case-control ratio 1.074; 95% CI 1.002–1.151) and increased in further adjust- ment for other cardiovascular risk factors 1.085; 95% CI 1.025–1.149. The risk after adjustment for age and centre was higher with increasing cerium levels (p for trend = 0.02). After adjustment for BMI, history of hypertension, smoking, alcohol intake, diabetes, fam- ily history of CHD, b-carotene, lycopene, a-tocopherol, selenium, mercury and scandium, the OR for the highest quintile was 1.43 (95% CI 0.85–2.41; p-trend 0.08). When we applied this same model in non-smokers the odds ratios in the 4th and 5th quintiles of cerium as compared with the lowest were 2.09 (95% CI 1.05–4.16) and 2.81 (95% CI 1.21–6.52), respectively, p-trend 0.011. Our results suggest that toenail cerium levels may be associated with an increased risk of AMI, but more research is warranted to shed further light and fully understand the plausibility and public health implications of these findings.
Mostrar más

9 Lee mas

Anuario 2012: La terapia celular en la enfermedad cardiovascular  Las revistas de las Sociedades Nacionales presentan una seleccin de las investigaciones que han impulsado avances recientes en Cardiologa Clnica

Anuario 2012: La terapia celular en la enfermedad cardiovascular Las revistas de las Sociedades Nacionales presentan una seleccin de las investigaciones que han impulsado avances recientes en Cardiologa Clnica

step forward in identifying a viable source of stem/ progenitor cells that could contribute to new muscle after ischaemic heart disease and acute myocardial infarction (AMI). They demonstrated that in a mouse model the adult heart contains a resident progenitor cell population, which has the potential to become terminally differentiated cardiomyocytes after MI. Progenitor cells were primed with a peptide called thymosin β4 which induced embryonic reprogramming resulting in the mobilisation of this population and subsequent differentiation to give rise to de novo cardiomyocytes. Following experimentally induced MI, these cells were shown to migrate to the site of injury and then differentiate without any evidence of cellular fusion into structurally and functionally active cardio- myocytes. These cardiomyocytes showed evidence of gap junction formation with adjacent cells, synchro- nous calcium transients and the formation of opera- tional contractile apparatus. Despite a low overall fraction of these cells being present at the site of injury and a relatively poor overall efficiency of differentiation, serial MRI scans revealed significant improvements in ejection fraction, cardiac volumes and scar size in comparison with sham treated ani- mals. The pretreatment with thymosin β4 was crucial to these effects and may suggest a new strategy for promoting myocardial repair in humans.
Mostrar más

24 Lee mas

La era de la farmacogenómica el ejemplo del clopidogrel

La era de la farmacogenómica el ejemplo del clopidogrel

75. Dangas G, Mehran R, Guagliumi G, Caixeta A, Witzenbichler B, Aoki J, et al. Role of clopidogrel loading dose in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty: results from the HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) trial. J Am Coll Cardiol 2009; 54: 1438–1446. 76. Jeong YH, Hwang JY, Kim IS, Park Y, Hwang Sj, Lee SW, et al.

8 Lee mas

Effects of Verapamil on Indexes of Heart Rate Variability After Acute Myocardial Infarction

Effects of Verapamil on Indexes of Heart Rate Variability After Acute Myocardial Infarction

was obtained from every patient. Between 5 and 10 days after acute MI, all patients underwent two 24- hour Holter recordings in random order (Figure 1). One recording was performed after 4 days of treat- ment with verapamil retard (180 mg twice daily) and the other was performed under baseline conditions, either before the start of administration of verapamil or after a drug-free period of $ 4 days. Nitrates and heparin were administered to patients with appropriate clinical indications, but such drugs and dosages were not changed during the entire study period to mini- mize possible differential effects on both Holter re- cordings.
Mostrar más

5 Lee mas

Hemorragia intramiocrdica en el infarto miocrdico con reperfusin espontnea

Hemorragia intramiocrdica en el infarto miocrdico con reperfusin espontnea

Objective. The presence of intramyocardial hemorrhage (IMH) is frequent in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary interven- tion (PPCI). We aim for the presence IMH using cMRI in pa- tients who presented AMI and did not undergo PPCI or thrombolysis. Cardiac magnetic resonance has proven to be a highly sensitive method for detect its presence in the ischemic damaged tissue. Material and methods. Patients admitted with diagnosis of ST elevation myocardial infarction > 24 h after initial presentation and without reperfusion therapy were enrolled in the study. All patients underwent cardiac magnetic resonance for detecting edema, microvascular ob- struction and intramyocardial hemorrhage, followed by coro- nary angiography. Results. Seven male patients, with median age of 53 years, were enrolled. Cardiac magnetic resonance showed that all patients had microvascular obstruction and edema. Two of them had intramyocardial hemorrhage in as- sociation with spontaneous reperfusion demonstrated by an- giography. Conclusion. The results of our study show that in patients with acute myocardial infarction, intramyocardial hemorrhage occurs not only after therapeutic, but also after spontaneous reperfusion. This is the first time that its pres- ence is demonstrated by cardiac magnetic resonance.
Mostrar más

6 Lee mas

Initial complications and factors related to prehospital mortality in acute myocardial infarction with ST segment elevation.

Initial complications and factors related to prehospital mortality in acute myocardial infarction with ST segment elevation.

The main limitations of the study are that it drew its data from a single database and was performed retrospectively, which limits its fi ndings to the study population and period. However, it included a large unselected and representative sample, regis- tered prospectively, and its results were consistent with those of recent studies performed elsewhere. The mortality rate reported here only refers to patients receiving EMS attention during the prehospital phase. The study did not include patients who died without receiving such assistance. This group of patients usually receive a generic diagnosis of cardiac arrest as the cause of death, without precise identi fi cation of the actual aetiology. Historically it is assumed that the ultimate cause of out-of-hospital cardiac arrest in four out of fi ve cases is of cardiac origin, primarily acute ischaemic heart disease, 26 27 but the only way to obtain rigorous con fi rmation of this would be to perform postmortem diagnoses in population-based series.
Mostrar más

6 Lee mas

Experiencia con el uso del stent bioactivo cubierto con titanio xido ntrico comparado con stent liberador de zotarolimus en pacientes no diabticos portadores de cardiopata isqumica: anlisis comparativo y seguimiento a 12 meses

Experiencia con el uso del stent bioactivo cubierto con titanio xido ntrico comparado con stent liberador de zotarolimus en pacientes no diabticos portadores de cardiopata isqumica: anlisis comparativo y seguimiento a 12 meses

oxide coated stents versus paclitaxel eluting stents in acute myocardial infarction) comparó el BAS contra un SLF liberador de Paclitaxel (PES) a un seguimiento a 12 meses informán- dose una incidencia de ECVM del 10.3% en BAS y el 12.8% en PES demostrando que pacientes con IAM tanto del grupo de BAS versus PES tuvieron resultados clínicos simi- lares a 12 meses; sin embargo, en el segui- miento clínico completo de TITAX AMI a 24 meses mostró diferencias significativas en la incidencia de ECVM siendo del 11.2% en el grupo BAS versus del 21.8% en el grupo del PES p = .004. Con lo que queda demostrado que los resultados clínicos entre BAS y el SLF con paclitaxel son similares a 12 meses de seguimiento pero con diferencia significativa a los 24 meses en favor de stent bioactivo en cuanto a ECVM. 13,14
Mostrar más

12 Lee mas

evolucion electrocardiografica.

evolucion electrocardiografica.

Abstract Acute myocardial infarction (AMI) is a not uncommon diagnosis in the emergency department. During ST-segment elevation AMI (STEMI), the electrocardiogram (ECG) typically follows a progression of abnormality, beginning with hyperacute T waves and culminating with ST-segment elevation; pathologic Q waves can appear early and/or late in the process. Other findings include T-wave inversion and ST-segment depression which can occur before, during, or after the STEMI event. The evolution of ECG through these changes can occur rapidly after coronary artery occlusion. The emergency physician should be aware of the ECG findings that characterize the evolution of an STEMI with a sound understanding of the associated pathophysiology and clinical implication. This review discusses the changing ECG during an AMI. The pathogenesis of these findings is discussed. Finally, the clinical implications at each stage are reviewed.
Mostrar más

13 Lee mas

Myocardial Rupture in Acute Myocardial Infarction: Mechanistic Explanation Based on the Ventricular Myocardial Band Hypothesis

Myocardial Rupture in Acute Myocardial Infarction: Mechanistic Explanation Based on the Ventricular Myocardial Band Hypothesis

In all three cases, the ventricular rupture was correlated with the distribution of the segments of the VMB. In case 1 (60-year-old female) with anterior myocardial infarction and complex rupture of the IVS, the trans- esophageal echocardiogram (TEE) showed a separa- tion of the descending and ascending segments of the myocardial band due to a septal hemorrhagic dissec- tion. Figure 5 shows the correlation of the TEE with the segments of the VMB marked in a porcine specimen.

5 Lee mas

directrices y evidencias en antiagregación

directrices y evidencias en antiagregación

En otro estudio, HORIZONS-AMI (Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction), en el que se aleatorizó a más de 3000 pacientes con SCACEST referidos a ICP primario a un tratamiento con bivalirudina o con heparina más un anti-GPIIb/IIIa.

5 Lee mas

El ndice leucoglucmico es un predictor de mortalidad por todas las causas al ao en pacientes cubanos con infarto agudo de miocardio con elevacin del segmento ST

El ndice leucoglucmico es un predictor de mortalidad por todas las causas al ao en pacientes cubanos con infarto agudo de miocardio con elevacin del segmento ST

The results from this work support the theoretical and practical basis of the leuko-glycaemic index as a predictor of adverse events per year, in the context of acute myocardial infarction. Its simplicity, wide availability, low cost and the fact of being part of the paraclinical routine examinations performed at ad- mission, in patients with acute coronary syndrome, further support its potential application in early risk stratification. Future larger samples multi-center studies are necessary to confirm our observations, as well as the prognostic capacity of the leucogly- caemic index in association with risk scales.
Mostrar más

27 Lee mas

Cambio conceptual sobre infarto agudo del miocardio en estudiantes de ciencias de la salud

Cambio conceptual sobre infarto agudo del miocardio en estudiantes de ciencias de la salud

Cambio conceptual sobre infarto agudo del miocardio en estudiantes de ciencias de la salud.. Conceptual change on acute myocardial infarction among health sciences students.[r]

7 Lee mas

Estado del arte de la tromblisis intracoronaria

Estado del arte de la tromblisis intracoronaria

2. American College of Emergency Physicians; Society for Cardiovascular Angiography and Interventions, O’Gara PT, Kushner FG, Ascheim DD, Casey DE Jr, Chung MK, de Lemos JA et al. 2013 ACCF/AHA guideline for the management of ST-elevation myocardial infarction: a report of the American College of Cardiology Founda- tion/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2013; 61 (4): e78-e140. 3. Hochman JS, Sleeper LA, Webb JG, Sanborn TA, White HD, Talley JD et al. Early revascularization in acute myocardial infarction complicated by cardiogenic shock. N Eng J Med. 1999; 341 (9): 625-634. 4. Armstrong PW, Gershlick AH, Goldstein P, Wilcox R,
Mostrar más

6 Lee mas

Show all 779 documents...