Association of slow flow with clinical factors in intravascular ultrasound-guided percutaneous coronary intervention for patients with left main trunk-acute myocardial infarction

Yamamoto, Kei; Sakakura, Kenichi; Akashi, Naoyuki; Watanabe, Yûsuke; Seguchi, Masaru; Taniguchi, Yousuke; Wada, Hiroshi; Momomura, Shin‐ichi; Fujita, Hideo

doi:10.1016/j.jjcc.2019.06.008

Cited by 7 publications

(5 citation statements)

References 37 publications

(41 reference statements)

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“…Meanwhile, the atherosclerotic plaque in young patients is dominated by cellular fibrous tissue, which is often accompanied by intraplaque adipocytes and extracellular lipid accumulation, and a lower incidence of calcification. In this study, it was found through CAG that young patients mostly had single-branch lesions, generally involving the anterior descending branch, followed by the circumflex branch and the right coronary artery [ 16 ]. In contrast, the middle-aged and elderly patients had predominantly multibranch lesions with higher stenosis and establishment of collateral circulation than young patients.…”

Section: Discussionmentioning

confidence: 99%

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Liu

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Epidemiological evidence suggests that the incidence of acute myocardial infarction (AMI) among people under 40 years of age has an increasing trend in recent years. Smoking, hypertension, diabetes mellitus, family history, and gender (male) are considered as classic risk factors for CHD, but the pathogenesis of CHD in young people is not exactly the same. Moreover, the relationship between the pattern of coronary artery disease and risk factors in young patients with acute myocardial infarction is inconclusive. In this study, we retrospectively studied the clinical data of 150 AMI patients treated in our hospital from January 2020 to May 2021. The patients were divided into the young group and elderly group according to the difference in age. The number of coronary artery lesions, the degree of coronary artery stenosis, the distribution dominance typing, the position of the lesions, and the presence of collateral circulation were observed and compared between the two groups. Multivariate logistic regression analysis was used to investigate the risk factors affecting coronary artery lesions in young patients with AMI. The results showed that the number of coronary lesions in young patients with AMI was mainly single-vessel, and the dominant type of distribution was mainly right dominant type. The stenosis degree is lighter than that of elderly patients, and the incidence of collateral circulation is lower than that of elderly patients, but the position of the lesions has no obvious regular. Smoking, staying up late, HDL-C, and LDL-C/ApoB were independent factors affecting the number of coronary artery lesions, and the changes of HDL-C and LDL-C/ApoB had an important influence on the degree of coronary stenosis in young patients. This provides a new idea for clinical treatment.

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Section: Discussionmentioning

confidence: 99%

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Liu

Zhang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…17) Hypertension was defined as systolic blood pressure (SBP) > 140 mmHg, diastolic blood pressure (DBP) > 90 mmHg, or medical treatment for hypertension. 18) Untreated hypertension was defined as SBP > 140 mmHg or DBP > 90 mmHg without medical treatment for hypertension. Diabetes mellitus was defined as hemoglobin A1c (HbA1 c) !6.5% or treatment for diabetes mellitus.…”

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confidence: 99%

Comparison of Clinical Characteristics of Acute Myocardial Infarction Between Young (< 55 Years) and Older (55 to < 70 Years) Patients

et al. 2021

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Although the incidence of acute myocardial infarction (AMI) has been decreasing in the elderly, it has been increasing in the young, especially in Japan. A social impact of AMI would be greater in the young, because loss of the young directly influences social activities such as business, child-raising, and tax payment. The aim of this study was to identify the specific characteristics of young AMI patients. We retrospectively included 408 consecutive AMI patients < 70 years of age, divided into a young group (< 55 years: n = 136) and an older group (55 to < 70 years: n = 272). The prevalence of overweight was greater in the young group (58.5%) than in the older group (40.7%) (P = 0.001). The frequency of current smokers was higher in the young group (67.6%) than in the older group (44.9%) (P < 0.001). Although the prevalence of hypertension was lower in the young group (66.7%) than in the older group (77.2%) (P = 0.017), that of untreated hypertension was greater in the young group (40.4%) than in the older group (27.2%) (P = 0.007). Furthermore, the prevalence of untreated dyslipidemia was greater in the young group (45.0%) than in the older group (26.6%) (P < 0.001). In conclusion, the young AMI patients had more modifiable risk factors such as obesity, smoking, untreated hypertension, and untreated dyslipidemia than the older patients. There is an unmet medical need for the prevention of AMI in the young generation.

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“…Diagnostic ST elevation was defined as new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV), and the AMI patients with ST elevation were diagnosed as STEMI [ 8 ]. Hypertension was defined as systolic blood pressure (SBP) > 140 mmHg, diastolic blood pressure > 90 mmHg, or medical treatment for hypertension [ 9 ]. Diabetes mellitus was defined as hemoglobin A1c ≥ 6.5% or treatment for diabetes mellitus [ 10 ].…”

Section: Methodsmentioning

confidence: 99%

Comparison of in-hospital death following ST-elevation myocardial infarction between secondary emergency and tertiary emergency

Yoshida

Sakakura

Yamamoto

et al. 2020

Cardiovasc Interv and Ther

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In most areas in Japan, patients with ST-elevation myocardial infarction (STEMI) would be transferred to the secondary hospitals or tertiary hospitals according to the judgement of emergency medical service (EMS) staff members. We hypothesized that in-hospital outcomes would be worse in STEMI patients judged as tertiary emergency than in those judged as secondary emergency, which may support the judgement of the current EMS systems. The purpose of this study was to compare in-hospital outcomes of STEMI between patients judged as secondary emergency and those judged as tertiary emergency. We included 238 STEMI patients who were transferred to our institution using EMS hotline, and divided those into the secondary emergency group ( n = 106) and the tertiary emergency group ( n = 132). The primary endpoint was in-hospital death. The prevalence of shock was significantly higher in the tertiary emergency group than in the secondary emergency group (32.6% vs. 10.4%, p < 0.001). The GRACE score was significantly higher in the tertiary emergency group than the secondary emergency group [146 (118–188) vs. 134 (101–155), p < 0.001]. The incidence of in-hospital death was significantly higher in the tertiary emergency group than in the secondary emergency group (8.0% vs. 2.1%, p = 0.014). The multivariate logistic regression analysis revealed that the tertiary emergency was significantly associated with in-hospital death (OR 3.52, 95% CI 1.24–10.02, p = 0.018) after controlling age and gender. In conclusion, the tertiary emergency was significantly associated with in-hospital death. Our results might validate the judgement of levels of emergency by local EMS staff members.

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Association of slow flow with clinical factors in intravascular ultrasound-guided percutaneous coronary intervention for patients with left main trunk-acute myocardial infarction

Cited by 7 publications

References 37 publications

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Clinical Study on Characteristics and Risk Factors of Coronary Artery Lesions in Young Patients with Acute Myocardial Infarction

Comparison of Clinical Characteristics of Acute Myocardial Infarction Between Young (< 55 Years) and Older (55 to < 70 Years) Patients

Comparison of in-hospital death following ST-elevation myocardial infarction between secondary emergency and tertiary emergency

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