Association of Changes in Clinical Characteristics and Management With Improvement in Survival Among Patients With ST-Elevation Myocardial Infarction

Puymirat, Étienne

doi:10.1001/2012.jama.11348

Cited by 420 publications

(239 citation statements)

References 20 publications

(34 reference statements)

Supporting

Mentioning

196

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, STEMI was over six times more frequently diagnosed than in Pauley et al's [6] study, whilst the NSTEMI rate was similar. Another point worth noting is that, for example, Ferrara et al [18] and Puymirat et al [19] demonstrated that a greater proportion of STEMI was found in women whilst our analysis showed a greater proportion in men. Not just the study of 210 patients with acute coronary syndrome [18], Figure 1.…”

Section: Discussioncontrasting

confidence: 40%

Age- and gender-related peculiarities of patients with delirium in the cardiac intensive care unit

Šerpytis

Navickas

et al. 2017

Kardiol Pol

View full text Add to dashboard Cite

A b s t r a c t Background:The overall evidence base regarding delirium has been growing steadily over the past few decades. There has been considerable analysis of delirium concerning, for example, mechanically ventilated patients, patients in the general intensive care unit (ICU) setting, and patients with exclusively postoperative delirium. Nevertheless, there are few studies regarding delirium in a cardiovascular ICU (ICCU) setting and especially scarce literature about the particular features of delirium relating to patient age and gender. Aim:We aimed to determine particular features of delirium not induced by alcohol or other psychoactive substances, relating to patient age and gender in an ICCU setting.Methods: An observational cross-sectional study was conducted to evaluate patients with delirium in a Lithuanian ICCU. From a sample of 19,007 ICCU admissions, 337 (1.8%) had documented delirium diagnosed through liaison and consultation with a psychiatrist and were included in the final analysis. The obtained data was then evaluated and analysed according to patients' gender and four categorised age groups: < 65 years, 65-74 years, 75-84 years, and ≥ 85 years. Results:Female patients who experienced delirium demonstrated a higher prevalence of hypertension, hyponatraemia, heart failure, cardiac rhythm and conduction disorders, myocardial infarction (MI), and dementia. The men, who were on average seven years younger than the women, significantly more often had hypokalaemia, double-or triple-vessel coronary artery disease, and sepsis. Furthermore, MI, ST-segment elevated MI, and Killip class 4 were most frequent amongst patients less than 65 years of age. Moreover, the youngest patient group demonstrated the highest mortality. Conclusions:Our investigation presented a number of associated peculiarities related to gender and age. It was shown that delirium is a severe complication that more often affects men amongst patients < 65 years old and more frequently affects women in the age group of ≥ 85 years. Male patients < 65 years old, who develop delirium should be treated with more caution because they tend to have more serious forms of disorder and a poorer prognosis.

show abstract

Section: Discussioncontrasting

confidence: 40%

Age- and gender-related peculiarities of patients with delirium in the cardiac intensive care unit

Šerpytis

Navickas

et al. 2017

Kardiol Pol

View full text Add to dashboard Cite

show abstract

“…In this study, 30-day mortality occurred in 15 patients (3.6%), which is comparable with recent registry studies with primary PCI as the choice method of reperfusion [34]. Despite dramatically improved outcomes of AMI, which is a consequence of early reperfusion therapy, the prognosis of short-term patients is worse in STEMI compared with NSTEMI [35,36].…”

Section: Discussionsupporting

confidence: 84%

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

Khuyag¹,

Chimed²,

Baldandorj³

et al. 2017

Cent. Asian j. Med. Sci.

View full text Add to dashboard Cite

Objectives: Left ventricular (LV) systolic function is major predictor of outcome after acute myocardial infarction (AMI). In recent years, speckle-tracking echocardiography (STE) derived strain measurement has been demonstrated to directly reflect myocardial deformation patterns and to be superior to conventional echocardiographic measurements. Our study aimed to reveal the prognostic value of strain parameters for 30-day mortality in patients with ST elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Methods: We prospectively included patients with STEMI after primary PCI treatment. The primary endpoint was 30-day mortality. 2D STE was used to determine LV strain parameters. Results: 414 patients were selected. 30-day mortality occurred in 15 patients (3.6%). LV global longitudinal strain (GLS) was significantly impaired in the 30-day mortality group compared with survivors (-8.0±2.6% vs. -15.4±3.8%, p<0.001). Multivariate regression revealed that LV GLS was independently associated with 30-day mortality (OR 1.71, 95% CI 1.23-2.38, p<0.001). Adding GLS into the clinical and echocardiographic model improved model performance. Conclusion:The LV GLS parameter is an independent predictor of 30-day mortality in patients with STEMI after primary PCI treatment. Adding LV GLS into the prediction model improved its predictive performance.

show abstract

“…Significant reductions in mortality were noted between 1995 and 2015, largely attributed to reductions in time from symptom onset to first medical contact, greater use of reperfusion therapy, continuous multilead ST-segment monitoring, frequent measurement of vital signs and guideline recommended pharmacotherapy. 3 The goal of pharmacological anti-ischemic therapy is to decrease myocardial oxygen demand (secondary to a decrease in heart rate, blood pressure, preload or myocardial contractility) or to increase myocardial oxygen supply (by administration of oxygen or through coronary vasodilatation). If, following treatment, the patient does not rapidly become free of ischemic signs or symptoms, immediate coronary angiography is recommended independently of ECG findings and cardiac troponin levels.…”

Section: Pharmacotherapy Of Acsmentioning

confidence: 99%

A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prospective unicentric study

Thaker¹,

Patel

2017

Int J Basic Clin Pharmacol

View full text Add to dashboard Cite

INTRODUCTIONCardiovascular diseases (CVDs) are the main cause of mortality globally and are the leading cause of death in India also. Several surveys conducted across the country over the past few decades have shown a rising prevalence of major risk factors for CVD in Asian population. The problem of increasing risk factors for CVD in India is because of lack of surveillance system, proper diagnosis and appropriate treatment. 1 ABSTRACT Background:The main objective of drug utilization research is to assess the rationality of drug use for specific disease. Long term survival in post-ACS patients depends largely on how well post ACS period is managed. Our aim is to record drug utilization pattern in post ACS patients after discharge and during follow-up visits. Methods: Prospective unicentric study was conducted in 200 patients suffering from ACS at Cardiology OPD of GCS Medical College, Hospital and Research Centre, Ahmedabad. Prescriptions issued to study subjects at the time of discharge and during follow-up who had recently suffered from ACS were intercepted after consultation and data recorded as per WHO guidelines as how to investigate drug use. Data were collected in the structured proforma (Case Record Form-CRF) which includes patient's demographic details, registration number, diagnosis and the drug prescribed. Each prescription was analyzed using WHO core prescribing indicators to evaluate the rationality of the prescriptions. Results: Out of 200, 104 (52%) suffered from unstable angina, 84(42%) suffered from STEMI and 12(6%) were suffered with NSTEMI. Male patients of 114(57%) were more prone to ACS than female patients of 86 (43%). Out of 200 patients, 193 (97%) received antiplatelet, 187 (94%) received antihypertensive, 184 (92%) received anticoagulants, 180 (90%) received lipid lowering drugs and 119 (60%) received Nitrates. As per WHO core prescribing indicators, the average number of drugs encountered per prescription was 7.96. The prescription showed a high usage of drugs from NLEM i.e. 72.20% in post-ACS patients. However the percentage of drugs prescribed by generic name was only 10.68%. The frequency of use of injectable preparations in post-ACS patients was found to be 17.84% which was in accordance with WHO reference value. Out of 17.84% injectable preparations, only 0.82% accounted for antibiotic injection. Conclusions: Although generic prescribing indicator shows a low range of usage, it is interesting to notice that prescription pattern has a high usage of drugs from NLEM (78.2%) in ACS. Thus present study provides valuable insight about the overall pattern of drugs used in post-Acute Coronary syndrome.

show abstract

Association of Changes in Clinical Characteristics and Management With Improvement in Survival Among Patients With ST-Elevation Myocardial Infarction

Cited by 420 publications

References 20 publications

Age- and gender-related peculiarities of patients with delirium in the cardiac intensive care unit

Age- and gender-related peculiarities of patients with delirium in the cardiac intensive care unit

Short-Term Prognostic Value of Strain Echocardiography in Patients with STEMI

A study of drug utilization pattern in post-acute coronary syndrome (ACS) patients at tertiary care teaching hospital: a prospective unicentric study

Contact Info

Product

Resources

About