Management of ST Elevation Myocardial Infarction (STEMI) in Different Settings

Partow-Navid, Rod; Prasitlumkum, Narut; Mukherjee, Ashish; Varadarajan, Padmini; Pai, Ramdas G.

doi:10.1055/s-0041-1723944

Cited by 7 publications

(6 citation statements)

References 98 publications

(83 reference statements)

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“…The recruitment criteria were: (1) confirmed as angina pectoris; (2) aged over 18 years old; (3) voluntary for PB sample collection; (4) had cardiothoracic surgery, systemic immune diseases, inflammatory diseases, cancers, or hematologic malignancies. The study was permitted by Ethics Committee.…”

Section: Me Thodsmentioning

confidence: 99%

“…Over the past decade, the number of new STEMI cases is increasing in China annually, meanwhile, its mortality is constant 3 . Concerning the STEMI treatment, for patients with symptom onset within 12 h, percutaneous coronary intervention (PCI) is the preferred strategy to restore myocardial perfusion as soon as possible 4–6 . Unfortunately, the major adverse cardiac event (MACE) frequently occurs after PCI treatment, implying a poor prognosis in STEMI patients 7,8 .…”

Section: Introductionmentioning

confidence: 99%

“… 3 Concerning the STEMI treatment, for patients with symptom onset within 12 h, percutaneous coronary intervention (PCI) is the preferred strategy to restore myocardial perfusion as soon as possible. 4 , 5 , 6 Unfortunately, the major adverse cardiac event (MACE) frequently occurs after PCI treatment, implying a poor prognosis in STEMI patients. 7 , 8 Hence, it is meaningful to explore reliable biomarkers for monitoring MACE risk in PCI‐treated STEMI patients.…”

Section: Introductionmentioning

confidence: 99%

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The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

Yao

Jia

et al. 2022

Clinical Laboratory Analysis

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Objective Inflammatory cytokines modulate atherogenesis and plaque rupture to involve in ST‐segment elevation myocardial infarction (STEMI) progression. The present study determined eight inflammatory cytokine levels in 212 percutaneous coronary intervention (PCI)‐treated STEMI patients, aiming to comprehensively investigate their potency in estimating major adverse cardiac event (MACE) risk. Methods Serum tumor necrosis factor (TNF)‐α, interleukin (IL)‐1β, IL‐6, IL‐8, IL‐10, IL‐17A, vascular cell adhesion molecule‐1 (VCAM‐1), and intercellular adhesion molecule‐1 (ICAM‐1) of 212 PCI‐treated STEMI patients and 30 angina pectoris patients were determined using enzyme‐linked immunosorbent assay. Results TNF‐α (52.5 (43.9–62.6) pg/ml versus 46.4 (39.0–59.1) pg/ml, p = 0.031), IL‐8 (61.6 (49.6–81.7) pg/ml versus 46.7 (32.5–63.1) pg/ml, p = 0.001), IL‐17A (57.4 (45.7–77.3) pg/ml versus 43.2 (34.2–64.6) pg/ml, p = 0.001), and VCAM‐1 (593.6 (503.4–811.4) ng/ml versus 493.8 (390.3–653.7) ng/ml, p = 0.004) levels were elevated in STEMI patients compared to angina pectoris patients, while IL‐1β (p = 0.069), IL‐6 (p = 0.110), IL‐10 (p = 0.052), and ICAM‐1 (p = 0.069) were of no difference. Moreover, both IL‐17A high (vs. low) (p = 0.026) and VCAM‐1 high (vs. low) (p = 0.012) were linked with increased cumulative MACE rate. The multivariable Cox's analysis exhibited that IL‐17A high (vs. low) (p = 0.034) and VCAM‐1 high (vs. low) (p = 0.014) were independently associated with increased cumulative MACE risk. Additionally, age, diabetes mellitus, C‐reactive protein, multivessel disease, stent length, and stent type were also independent factors for cumulative MACE risk. Conclusion IL‐17A and VCAM‐1 high level independently correlate with elevated MACE risk in STEMI patients, implying its potency in identifying patients with poor prognoses.

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Section: Me Thodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

Yao

Jia

et al. 2022

Clinical Laboratory Analysis

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“…Concerning the treatment, reperfusion strategy with primary angiography is recommended over thrombolysis according to the guidelines, especially within 120 minutes after rst medical contact (27,28). However, in case that the patients still have ongoing symptoms from 12 to 72 hours or with unstable hemodynamics, this invasive procedure can still be considered (29). On the other hand, routine PCI of an occluded IRA in STEMI patients presenting >48 h after onset of symptoms and without persistent symptoms is not indicated (30,31).…”

Section: Discussionmentioning

confidence: 99%

The Contemporary Management and Coronary Angioplasty Outcomes in Young Patients with ST- Elevation Myocardial Infarction (STEMI) age < 40 years old: The Insight from Nation-wide Registry

Porapakkham,

Srimahach

et al. 2024

Preprint

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Background Cardiovascular disease (CVD) remains one of the major causes of death around the world in which ST elevation MI (STEMI) is in the lead. Although the mortality rate from STEMI seems to decline, this result might not be demonstrated in young adults who basically have different baseline characteristics and outcomes compared with older patients. Methods Data of the STEMI patients aged 18 years or older who underwent PCI during May 2018 to August 2019 from Thai PCI Registry, a prospective, multi-center, nationwide study, was included and aimed to investigate the predisposing factors and short-term outcomes of patients aged < 40 years compared with age 41–60, and > 61 years. Results Data of 5,479 STEMI patients were collected. The patients’ mean age was 62.6 (SD = 12.6) years, and 73.6% were males. There were 204, 2,154, and 3,121 patients in the youngest, middle, and oldest groups. The young patients were mainly male gender (89.2% vs 82.4% and 66.6%; p < 0.001), were current smokers (70.6%, 57.7%, 34.1%; p < 0.001), had BMI ≥ 25 kg/m2 more frequently (60.8%, 44.1%, 26.1%; p < 0.001), and had greater family history of premature CAD (6.9%, 7.2%, 2.9%; p < 0.001). The diseased vessel in the young STEMI patients was more often single vessel disease with the highest percentage of proximal LAD stenosis involvement. Interestingly, there were trends of higher events of cardioversion/defibrillation, procedural failure, procedural complications, and prolonged median hospital stay in both youngest and oldest groups compared to the middle-aged group. In-hospital death was found in 3.4% in the youngest group compared to 3.3% in the middle-aged patients and 9.2% in the older patients (p < 0.001). Conclusions STEMI in young patients is not uncommon nowadays. Although the mortality rate of PCI in real-world practice was low, young patients had a trend of having higher procedural failure and complications of PCI when compared with middle-aged group. Their major modifiable factors were smoking and obesity.; Therefore, encouraging young people to quit smoking and control weight might be essential to prevent STEMI in the young.

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“…In patients with myocardial ischemia symptoms, ST-elevation myocardial infarction (STEMI) is defined as the combination of persistent ST-segment elevation and the release of biomarkers of myocardial necrosis [ 1 ]. Percutaneous coronary intervention (PCI) is the main reperfusion strategy for eligible patients with STEMI [ 1 , 2 ], but the no-reflow phenomenon is an important cause of adverse PCI outcomes, ventricular remodelling, and poor cardiac function recovery after ischemia–reperfusion [ 3 ]. No-reflow significantly increases hospitalization and mortality rates.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for No-Reflow in Patients with ST-Elevation Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Case-Control Study

et al. 2022

Cardiology Research and Practice

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Background and Objectives. The no-reflow phenomenon is a poor prognosis for patients with ST-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI). The purpose of this study was to identify the risk factors for no-reflow in patients with STEMI who underwent PCI. Methods. This case-control study retrospectively reviewed the medical data of patients treated with primary percutaneous coronary intervention within 12 h after STEMI onset between January 2010 and January 2013 at the Department of Cardiology of the Beijing Anzhen Hospital. Results. A total of 902 patients were included in the analysis. The basic characteristics between the reflow and no-reflow groups were similar, except for time-to-hospital admission, heart rate, plasma glucose, high-sensitivity C-reactive protein (hsCRP)/prealbumin (PAB), neutrophil count, intraaortic balloon pump, and aspiration thrombectomy. The multivariable analysis showed that hsCRP/PAB (OR = 1.003, 95% CI: 1.000–1.006, P = 0.022 ), neutrophil count (OR = 1.085, 95% CI: 1.028–1.146, P = 0.003 ), plasma glucose levels (OR = 1.086, 95% CI: 1.036–1.138, P = 0.001 ), diabetes mellitus (OR = 0.596, 95% CI: 0.371–0.958, P = 0.033 ), Killip classification >1 (OR = 2.002, 95% CI: 1.273–3.148, P = 0.003 ), intraoperative intraaortic balloon pump (IABP) use (OR = 3.257, 95% CI: 1.954–5.428, P = 0.001 ), and aspiration thrombectomy (OR = 3.412, 95% CI: 2.259–5.152, P = 0.001 ) were independently associated with no-reflow. Conclusion. hsCRP/PAB, neutrophil count, plasma glucose levels, diabetes mellitus, Killip classification, intraoperative IABP use, and aspiration thrombectomy were independent risk factors for no-reflow in patients with STEMI.

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Management of ST Elevation Myocardial Infarction (STEMI) in Different Settings

Cited by 7 publications

References 98 publications

The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

The Contemporary Management and Coronary Angioplasty Outcomes in Young Patients with ST- Elevation Myocardial Infarction (STEMI) age < 40 years old: The Insight from Nation-wide Registry

Risk Factors for No-Reflow in Patients with ST-Elevation Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Case-Control Study

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Management of ST Elevation Myocardial Infarction (STEMI) in Different Settings

Cited by 7 publications

References 98 publications

The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

The abnormal level and prognostic potency of multiple inflammatory cytokines in PCI‐treated STEMI patients

The Contemporary Management and Coronary Angioplasty Outcomes in Young Patients with ST- Elevation Myocardial Infarction (STEMI) age &lt; 40 years old: The Insight from Nation-wide Registry

Risk Factors for No-Reflow in Patients with ST-Elevation Myocardial Infarction Who Underwent Percutaneous Coronary Intervention: A Case-Control Study

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The Contemporary Management and Coronary Angioplasty Outcomes in Young Patients with ST- Elevation Myocardial Infarction (STEMI) age < 40 years old: The Insight from Nation-wide Registry