Determinants of short and long door-to-balloon time in current primary percutaneous coronary interventions

Tsukui, Takunori; Sakakura, Kenichi; Taniguchi, Yousuke; Yamamoto, Kei; Wada, Hiroshi; Momomura, Shin‐ichi; Fujita, Hideo

doi:10.1007/s00380-017-1089-x

Cited by 33 publications

(42 citation statements)

References 31 publications

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“…In the present study, AMI was defined as persistent chest pain, elevation of cardiac enzymes (at least 2-fold increases from normal upper limit), and ST-segment elevation or depression in electrocardiograms [6,14,15]. Diagnostic ST elevation was defined as new ST elevation at the J point in at least 2 contiguous leads of 2 mm (0.2 mV) and others were defined as non-ST elevation [15]. Only ST elevation in aVR was not considered as ST-elevation myocardial infarction (STEMI).…”

Section: Definitionsmentioning

confidence: 99%

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

Yamamoto

Sakakura

Akashi

et al. 2020

Journal of Cardiology

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Background: Slow flow can be fatal in primary percutaneous coronary interventions for left main trunk (LMT)-acute myocardial infarction (AMI), however, risk factors for slow flow in LMT-AMI have not been well investigated. Intravascular ultrasound (IVUS) may help to stratify the high-risk lesion for slow flow in LMT-AMI. Methods: A total of 51 LMT-AMI were included as the study population, and were divided into the slowflow group (n = 22) and the non-slow-flow group (n = 29). Slow flow was defined as either transient or persistent Thrombolysis in Myocardial Infarction (TIMI) flow grade 2. Results: The incidence of in-hospital death was higher in the slow-flow group (27.3%) than the non-slowflow group (10.3%) without reaching statistical significance (p = 0.116). Although the reference diameter measured by angiography was not different between the two groups, the vessel diameter measured by IVUS was significantly longer in the slow-flow group (5.22 AE 0.69 mm) than in the non-slow-flow group (4.50 AE 0.47 mm) (p < 0.001). Multivariate logistic regression analyses revealed that the vessel diameter by IVUS (OR 27.487, 95%CI 3.975-190.062, p = 0.001) and the vessel area by IVUS (OR 1.458, 95%CI 1.160-1.832, p = 0.001) were significantly associated with slow flow. Conclusions: In LMT-AMI, the vessel diameter measured by IVUS was closely associated with slow flow, while the reference diameter measured by angiography was not associated with slow flow. IVUS would be important to find high-risk features for slow flow in LMT-AMI.

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Section: Definitionsmentioning

confidence: 99%

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

Yamamoto

Sakakura

Akashi

et al. 2020

Journal of Cardiology

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“…[13][14][15] Diagnostic ST elevation was defined as a new ST elevation at the J point in at least two contiguous leads of 2 mm (0.2 mV), and others were defined as not an ST elevation. 3) Hypertension was defined as a medical treatment for hypertension and/or a history of hypertension before admission. 13,14) Dyslipidemia was defined as total cholesterol levels "220 mg/dL or low-density lipoprotein cholesterol levels "140 mg/dL or medical treatment for dyslipidemia or a history of dyslipidemia.…”

Section: Study Patientsmentioning

confidence: 99%

“…A cute myocardial infarction (AMI) is the major cause of chronic heart failure 1) and is associated with morbidity and mortality. 2,3) Although AMI worsens both systolic and diastolic left ventricular function, 4) ejection fraction (EF) assessed by echocardiography is a simple and strong predictor of poor clinical outcomes after AMI. 5) Because depressed EF caused by AMI would be modified by various factors, including successful primary percutaneous coronary intervention (PCI), 6) EF in chronic phase of AMI may be a more important predictor of clinical outcomes compared with EF in acute phase of AMI.…”

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Determinants of Improvement of Mid-term Ejection Fraction in Patients with Acute Myocardial Infarction

et al. 2019

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Persistent severe left ventricular (LV) systolic dysfunction after acute myocardial infarction (AMI) is associated with increased morbidity and mortality, whereas mid-term recovery of LV systolic function after AMI is associated with better long-term outcomes. The purpose of this study was to investigate the determinants of mid-term improvement of LV ejection fraction (EF) in AMI patients. We included 210 AMI patients who had modified Simpson EF both at the index admission and mid-term follow up. The difference of EF between the index admission and mid-term follow-up was calculated in all study patients. The EF improvement group was defined as mid-term !10% EF increase compared with the index admission EF. Of 210 AMI patients, 46 (21.9%) were allocated to the EF improvement group and 164 (78.1%) to the non-EF improvement group. Brain natriuretic peptide (BNP) at the timing of admission was significantly greater in the EF improvement group (735.8 ± 1077.6 pg/mL) than in the non-EF improvement group (239.0 ± 419.8 pg/mL) (P < 0.001). Multivariate logistic regression analysis revealed that log10 BNP at the timing of admission (OR 3.36, 95% CI 1.69-6.66, P < 0.001) and left main trunk-left anterior descending artery (LM-LAD) as the infarct-related artery (OR 3.34, 95% CI 1.59-7.02, P = 0.001) were significantly associated with EF improvement. In conclusion, elevated BNP at the timing of admission and LM-LAD as the infarct-related artery were significantly associated with mid-term LVEF recovery. Our results support aggressive acute treatment for those severe AMI, because the possibility of mid-term LVEF recovery is greater compared with other AMI.

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“…Definition: The diagnosis of AMI required the following criteria: symptoms consistent with AMI, elevated cardiac enzymes including troponin T, troponin I, and/or creatinine kinase (at least two-fold increase from the normal upper limit), and ST-segment elevation or depression in electrocardiograms compatible with AMI. 14,15) 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 ST elevation myocardial infarction (STEMI). 15) The other AMI patients without ST elevation were defined as non-ST elevation myocardial infarction (NSTEMI).…”

mentioning

confidence: 99%

“…14,15) 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 ST elevation myocardial infarction (STEMI). 15) The other AMI patients without ST elevation were defined as non-ST elevation myocardial infarction (NSTEMI). Hypertension was defined as a medical treatment for hypertension and/or a history of hypertension before admission.…”

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confidence: 99%

Comparison of In-Hospital Clinical Outcomes of Acute Myocardial Infarction Between Nonagenarians and Octogenarians

et al. 2020

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Acute myocardial infarction (AMI) in the very elderly is associated with high morbidity and mortality. Although there are earlier studies regarding AMI in octogenarians, clinical evidences of AMI in nonagenarians are sparse. The aim of the present study was to compare in-hospital outcomes of AMI between octogenarians and nonagenarians. We included consecutive 415 very elderly (!80 years) with AMI and divided them into the nonagenarian group (n = 38) and the octogenarian group (n = 377). Clinical characteristics and in-hospital outcomes were compared between the two groups. Furthermore, we used propensity score matching to find the matched octogenarian group (n = 38). Percutaneous coronary interventions (PCI) to the culprit of AMI were similarly performed between the nonagenarian (86.8%) and octogenarian (87.0%) groups. The incidence of inhospital death in the nonagenarian group (10.5%) was similar to that in the octogenarian group (12.5%) (P = 0.487). After using the propensity score matching, the incidence of in-hospital death was less in the nonagenarian group (10.5%) than in the matched octogenarian group (18.4%) without reaching statistical significance (P = 0.328). The length of hospitalization was significantly shorter in the nonagenarian group [7.0 (4.0-9.0)] than in the matched octogenarian group [10.0 (6.5-15.0)] (P = 0.01). In conclusion, the in-hospital mortality of nonagenarians with AMI was comparable to that of octogenarians with AMI. In-hospital outcomes in nonagenarians with AMI may be acceptable as long as acute medical management including PCI to the culprit of AMI is performed.

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Determinants of short and long door-to-balloon time in current primary percutaneous coronary interventions

Cited by 33 publications

References 31 publications

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

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

Determinants of Improvement of Mid-term Ejection Fraction in Patients with Acute Myocardial Infarction

Comparison of In-Hospital Clinical Outcomes of Acute Myocardial Infarction Between Nonagenarians and Octogenarians

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