Risk assessment in patients with an acute ST-elevation myocardial infarction

Abstract

ST-elevation myocardial infarction (STEMI) is one of the leading causes of mortality and morbidity worldwide. While the survival after acute STEMI has considerably improved, mortality rate still remains high, especially in high-risk patients. Survival after acute STEMI is influenced by clinical characteristics such as age as well as the presence of comorbidities. However, during emergency care increasing access to tools such as the electrocardiogram, chest x-ray and echocardiography can provide additional information helping to further risk stratify patients. In the invasive setting, this can also include coronary angiography, invasive hemodynamic recordings and angiographic assessments of coronary flow and myocardial perfusion. We outline the common investigations used in STEMI and their role in risk assessment of patients with an acute STEMI.

Cardioprotective Effects of Nicorandil on Coronary Heart Disease Patients Undergoing Elective Percutaneous Coronary Intervention

“…MPO is a leukocyte enzyme that plays significant roles in regulating coronary inflammation and oxidative stress. It has been considered as a novel cardiac marker [ 40 ]. MDA is a well-accepted marker of lipid peroxidation and oxidative stress, and is used to indicate oxidative stress in the whole body [ 41 ].…”

Pengaruh Penerapan Program “CODE STEMI” terhadap Door to Balloon Time dan Major Adverse Cardiac Events Pasien ST Elevation Myocardial Infarction

“…Waktu reperfusi yang lebih lama menyebabkan peningkatan risiko infark berulang. 21 Berkurangnya fungsi sistolik ventrikel kiri dan tingginya kadar puncak troponin sesudah tindakan primary PCI merupakan prediktor independen terjadinya infark berulang. 22,23 Hasil ini tidak berbeda dari penelitian Lee, dkk.…”

Magnitude of ST-segment Elevation Is Associated with Increased Acute Inflammatory Response and Myocardial Scar in Patients with Acute Myocardial Infarction Undergoing pPCI

“…6 Several clinical and angiographic risk stratification systems have been developed for prediction of adverse events and mortality in these patients, without including contemporary laboratory or imaging biomarkers. 7,8 High-sensitivity C-reactive protein (hs-CRP) has been identified as a good predictive biomarker for adverse events and heart failure, and has shown reliable risk stratification in STEMI patients treated with PCI. [7][8][9] These findings have been validated in recent studies, which contributed to the development of risk prediction models for STEMI patients.…”

“…7,8 High-sensitivity C-reactive protein (hs-CRP) has been identified as a good predictive biomarker for adverse events and heart failure, and has shown reliable risk stratification in STEMI patients treated with PCI. [7][8][9] These findings have been validated in recent studies, which contributed to the development of risk prediction models for STEMI patients. 10 Interleukin 6 (IL-6), an important proinflammatory cytokine, is also identified as a biomarker for increased residual risk for adverse events in patients with MI and has been remarked as a potential target for anti-inflammatory therapy.…”