ST elevation myocardial infarction

Choudhury, Tawfiq; West, Nick E.J.; El–Omar, Magdi

doi:10.7861/clinmedicine.16-3-277

Cited by 37 publications

(32 citation statements)

References 44 publications

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“…ST-segment elevation myocardial infarction (STEMI) refers to patients with coronary artery atherosclerosis and plaque shedding, resulting in blood vessel blockage, resulting in a decrease in the heart's own blood supply and leading to myocardial ischemic necrosis [ 1 , 2 ]. STEMI has the characteristics of rapid onset, rapid development, and high mortality rate.…”

Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety of Recombinant Human Prourokinase and Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of Efficacy

Liu

Yang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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Objective. To compare the efficacy and safety of recombinant human prourokinase (rhPro-UK) and alteplase for thrombolytic therapy in acute ST-segment elevation myocardial infarction (STEMI) and to analyze the related factors affecting efficacy. Methods. From January 2017 to December 2019, 100 patients diagnosed with STEMI were selected and randomly divided into the control group (n = 50) and the observation group (n = 50). Based on conventional treatments, the control group was treated with alteplase, and the observation group was treated with rhPro-UK, and both were treated for 7 days. After treatment, the vascular recanalization, left ventricular end-systolic diameter (LVESD), left ventricular end-diastolic diameter (LVEDD), and left ventricular ejection fraction (LVEF) were compared. The bleeding and major adverse cardiovascular events (MACE) were recorded in both groups. According to the patient’s vascular recanalization, it was divided into two subgroups: recanalization group and occlusion group. Multiple logistic regression models were used to analyze the related factors that affect the efficacy. Results. The recanalization rate of the observation group (96.00%) was higher than that of the control group (84.00%) ( P < 0.05 ). After treatment, LVDs and LVEDD in both groups were lower than those before treatment, and LVEF was higher than that before treatment. The LVDs and LVEDD in the observation group were lower than those in the control group, and the LVEF was higher than that in the control group ( P < 0.05 ). The incidence of bleeding in the observation group (2.00%) was lower than that in the control group (12.00%), and the incidence of MACE (4.00%) was lower than that in the control group (16.00%) ( P < 0.05 ). Univariate analysis showed that age, smoking history, diabetes history, myocardial infarction history, infarct location, and intravenous thrombolysis time were related to the efficacy after treatment ( P < 0.05 ). Multivariate logistic analysis showed that age, history of diabetes, vascular infarction site, and venous thrombolysis time were independent influencing factors after treatment ( P < 0.05 ). Conclusion. Both rhPro-UK and alteplase thrombolytic therapy can effectively recanalize blood vessels and improve the cardiac function of patients with STEMI. However, rhPro-UK has better effect than alteplase and is safer and worth promoting. The curative effect is related to age, diabetes history, vascular infarction site, and venous thrombolysis time.

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Section: Introductionmentioning

confidence: 99%

Comparison of Efficacy and Safety of Recombinant Human Prourokinase and Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of Efficacy

Liu

Yang

et al. 2021

Evidence-Based Complementary and Alternative Medicine

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“…1 ST-segment elevation myocardial infarction (STEMI) is caused by coronary atherosclerotic plaques obstructing the coronary arteries and is the most common and severe form of acute coronary syndrome in the elderly. 2,3 Patients with cardiovascular disease aged >80 years form a rapidly growing cohort and >20% of patients have received percutaneous coronary intervention (PCI) in real-word practice. 4…”

Section: Introductionmentioning

confidence: 99%

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

et al. 2019

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Objective To investigate what is the most appropriate strategy for patients with ST-segment elevation myocardial infarction (STEMI) aged ≥80 years in China. Methods This cohort study retrospectively enrolled patients with STEMI aged ≥80 years old and grouped them according to the treatment strategy that was used: a conservative treatment strategy or an invasive treatment strategy. Factors associated with whether to perform an invasive intervention, in-hospital death and a good prognosis were investigated using logistic regression analyses. Results A total of 232 patients were enrolled: conservative treatment group ( n = 93) and invasive treatment group ( n = 139). Patients in the invasive treatment group had a better prognosis and lower incidence of adverse events compared with the conservative treatment group. Advanced age, creatinine level and a higher Killip class were inversely correlated with whether to perform an invasive intervention, while the use of beta-receptor-blocking agents was a favourable factor for invasive treatment. Hypertension and a higher Killip class were risk factors for in-hospital death, while the use of beta-receptor-blocking agents and diuretics decreased the risk of in-hospital death. Conclusions An invasive treatment strategy was superior to a conservative treatment strategy in patients with STEMI aged ≥80 years.

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“…The clinical experience with the use of the 15-lead ECG is reportedly limited. Nonetheless, multiple studies have confirmed that the ECG diagnostic sensitivity and specificity for AMI is improved, and in doing so, facilitating the prompt application of the indicated reperfusion therapy (24). Moreover, the addition of the posterior leads offers more to the diagnosis of the posterior MI than the ECG changes on the V1-V3 leads (5, 6).…”

Section: Discussionmentioning

confidence: 99%

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

Vogiatzis¹,

Koulouris²,

Ioannidis³

et al. 2019

Acta Inform Med

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Introduction: The 12-lead ECG at admission of patients suffering from acute myocardial infarction (AMI) is mandatory for accurate diagnosis and prompt therapeutic measures, mainly reperfusion. It has been shown that recording additional ECG leads may improve the diagnostic accuracy and therefore, the prognosis of selected cases. Aim: The aim of the study was to assess the usefulness of the 15-lead ECG (12 classic plus 3 posterior leads) in the management of chest pain patients, especially when 12-lead ECG is not diagnostic of AMI. Methods: Total amount of 186 consecutive patients (127 men, 59 women, mean age 69.7±13.8 years) were admitted with an acute coronary syndrome. The initial ECG recorded the 12 classic leads, and subsequently, the 3 additional posterior leads. Demographic and clinical data, including ECG alterations and selected treatment strategy, were also studied. The cumulative impact of the 15-lead ECG on the diagnosis and management of AMI were, overall, evaluated. Results: The 12-lead ECG was diagnostic of ST-elevation AMI (STEMI) in 158 patients (Group A–84.5%) who were promptly reperfused. On the other hand, the interpretation of the posterior leads was required in 28 patients (Group B–15.1%) to establish the STEMI diagnosis warranting reperfusion therapy. Multivariate analysis illustrated that the 15-lead ECG was the only factor associated with achieving the STEMI diagnosis in non-conclusive 12-lead ECG cases (OR=2.43–p=0.04). Conclusion: The use of the 15-lead ECG contributes to a faster and more accurate diagnosis of STEMI, particularly in the Emergency Department, facilitating the prompt reperfusion therapy.

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ST elevation myocardial infarction

Cited by 37 publications

References 44 publications

Comparison of Efficacy and Safety of Recombinant Human Prourokinase and Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of Efficacy

Comparison of Efficacy and Safety of Recombinant Human Prourokinase and Alteplase in the Treatment of STEMI and Analysis of Influencing Factors of Efficacy

A retrospective study of an invasive versus conservative strategy in patients aged ≥80 years with acute ST-segment elevation myocardial infarction

The Importance of the 15-lead Versus 12-lead ECG Recordings in the Diagnosis and Treatment of Right Ventricle and Left Ventricle Posterior and Lateral Wall Acute Myocardial Infarctions

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