DIagnostic accuracy oF electrocardiogram for acute coronary OCClUsion resuLTing in myocardial infarction (DIFOCCULT Study).

Background: Although ST-segment elevation (STE) has been used synonymously with acute coronary occlusion (ACO), current STE criteria miss nearly one-third of ACO and result in a substantial amount of false catheterization laboratory activations. As many other electrocardiographic (ECG) findings can reliably indicate ACO, we sought whether a new ACO/non-ACO myocardial infarction (MI) paradigm would result in better identification of the patients who need acute reperfusion therapy.

Methods: A total of 3000 patients were enrolled in STEMI, non-STEMI and control groups.

A new electrocardiographic pattern indicating inferior myocardial infarction.

Background: We identified a specific pattern that does not display contiguous ST-segment elevation (STE), indicating acute inferior myocardial infarction (MI) with concomitant critical stenoses on the other coronary arteries. We sought to define the frequency, underlying anatomic substrate, diagnostic power and prognostic implications of this pattern.

Methods: One thousand patients with a diagnosis of non-STEMI were enrolled as the study group.

Does electrocardiogram help in identifying the culprit artery when angiogram shows both right and circumflex artery disease in inferior myocardial infarction?

Objective: In a subgroup of patients with inferior myocardial infarction (MI), both the right coronary artery (RCA) and circumflex coronary artery (Cx) show potentially culprit lesions, and angiography may be insufficient to determine which artery is responsible for the clinical presentation. Although many electrocardiographic (ECG) algorithms have been proposed for identifying the infarct-related artery in patients with inferior MI, it is unclear whether the current algorithms have the discriminative power to identify the real culprit artery in these patients.

Methods: The patients with the diagnosis of acute inferior MI and underwent coronary angiography were enrolled in the study.

Effect of acute kidney injury on long-term mortality in patients with ST-segment elevation myocardial infarction complicated by cardiogenic shock who underwent primary percutaneous coronary intervention in a high-volume tertiary center.

Objective: Acute kidney injury (AKI) is a reflection of both renal and cardiac reserve in patients with ST-segment elevation myocardial infarction (STEMI), but there is a lack of evidence related to the effect of AKI on long-term mortality in patients with STEMI. This study was an investigation of the prognostic value of AKI for long-term mortality in patients with STEMI complicated by cardiogenic shock (CS) and primary percutaneous coronary intervention (PPCI).

Methods: This retrospective analysis evaluated the long-term prognostic impact of AKI on 492 patients with STEMI complicated by CS who were treated with PPCI.

Hair whitening and obesity are independently related to ascending aorta dilatation in young-middle aged men.

Objective: Hair whitening (HW) is strongly linked with aging. Ascending aortic dilation (AAD) and HW share common etiologic factors. We investigated the association of HW with ascending aortic diameters.

Is the inferior ST-segment elevation in anterior myocardial infarction reliable in prediction of wrap-around left anterior descending artery occlusion?

Objective: In a subgroup of patients with the anterior wall myocardial infarction (MI), the electrocardiogram (ECG) records a concomitant inferior ST-segment elevation (STE), which is generally explained by a 'wrap-around' left anterior descending (LAD) artery occlusion. However, recent evidence indicates that this may be due to a distal LAD occlusion, which may be irrelevant to the LAD length. We investigated the relationship between inferior ST-T changes in anterior MI and the presence of a wrap-around LAD.

The established electrocardiographic classification of anterior wall myocardial infarction misguides clinicians in terms of infarct location, extent and prognosis.

Background: The currently used scheme for the classification of infarct location and extent in anterior myocardial infarction (MI) is intuitive rather than being evidence-based, and recent evidence suggests that it may be misleading both in anatomic and prognostic sense.

Material And Methods: Consecutive patients with the diagnosis of anterior MI were enrolled. All electrocardiograms (ECG) were first classified according to established scheme and then reassessed using newer criteria for angiographic site of occlusion.

An algorithm for the differentiation of the infarct territory in difficult to discern electrocardiograms.

Background: In a minority of the patients presenting with ST-segment elevation (STE) myocardial infarction (MI), electrocardiogram (ECG) may show a balanced STE in both anterior and inferior lead groups and may cause diagnostic confusion about involved myocardial territory. In this study, we sought ECG clues which may facilitate discriminating (1) MI location and then (2) culprit artery in patients with difficult-to-discern ECGs.

Material And Methods: Consecutive patients with the diagnosis of STEMI were scanned and patients with ECGs displaying both anterior and inferior STE were enrolled.

Outcomes of survivors of ST-segment elevation myocardial infarction complicated by out-of-hospital cardiac arrest: a single-center surveillance study.

Objective: The aim of the present study was to evaluate in-hospital and long-term outcomes of ST-segment elevation myocardial infarction (STEMI) survivors who experienced out-of-hospital cardiac arrest (OHCA) and underwent primary percutaneous coronary intervention (PCI) at a high-volume center within the STEMI network.

Methods: The records of 2681 consecutive STEMI patients who underwent primary PCI between January 2009 and December 2014 at a single center in the STEMI network were retrospectively analyzed. Patients with STEMI complicated by OHCA were compared with a reference group of STEMI patients who did not experience OHCA.

A Simplified Formula Discriminating Subtle Anterior Wall Myocardial Infarction from Normal Variant ST-Segment Elevation.

Benign variant (BV) ST-segment elevation (STE) is present in anterior chest leads in most individuals and may cause diagnostic confusion in patients presenting with chest pain. Recently, 2 regression formulas were proposed for differentiation of BV-STE from anterior ST-elevation myocardial infarction (MI) on the electrocardiogram, computation of which is heavily device-dependent. We hypothesized that a simpler visual-assessment-based formula, namely (R-wave amplitude in lead V4 + QRS amplitude in V2) - (QT interval in millimeters + STE60 in V3), will be noninferior to these formulas.

Association between high on-treatment platelet reactivity to clopidogrel and hepatosteatosis in patients undergoing elective stent implantation.

Objective: The present study is an investigation of the association between high on-treatment platelet reactivity to clopidogrel (HTPRC) and hepatosteatosis in patients who had elective stent implantation due to coronary artery disease.

Methods: A total of 190 consecutive patients who underwent an elective coronary stent implantation due to coronary artery disease were prospectively enrolled in the study. Eligible patients were given a 300 mg loading dose of clopidogrel before percutaneous coronary intervention.

Interatrial block as a predictor of atrial fibrillation in patients with ST-segment elevation myocardial infarction.

Introduction: Interatrial block (IAB) is strongly associated with recurrence of atrial fibrillation (AF) in different clinical scenarios. Atrial fibrosis is considered the responsible mechanism underlying the pathogenesis of IAB. The aim of this study was to investigate whether IAB predicted AF at 12 months follow-up in a population of patients with ST segment elevation myocardial infarction (STEMI).

A tale of two formulas: Differentiation of subtle anterior MI from benign ST segment elevation.

Background: It may sometimes be difficult to differentiate subtle ST-segment elevation (STE) due to anterior myocardial infarction (MI) from benign variant (BV) STE. Recently, two related formulas were proposed for this purpose. However, they have never been tested in an external population.

Clinical characteristics and outcomes of acute coronary syndrome patients with intra-aortic balloon pump inserted in intensive cardiac care unit of a tertiary clinic.

Objective: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients.

Predictors of In-Hospital Mortality in Patients With ST-Segment Elevation Myocardial Infarction Complicated With Cardiogenic Shock.

Background: ST-segment elevation myocardial infarction (STEMI) complicated with cardiogenic shock (CS) remains as an unresolved condition causing high morbidity and mortality despite advances in medical treatment and coronary intervention procedures. In the current study, we evaluated the predictors of in-hospital mortality of STEMI complicated with CS.

Methods: In this retrospective study, we evaluated the predictive value of baseline characteristics, angiographic, echocardiographic and laboratory parameters on in-hospital mortality of 319 patients with STEMI complicated with CS who were treated with primary percutaneous coronary intervention.

Predictive value of SYNTAX score II for clinical outcomes in cardiogenic shock underwent primary percutaneous coronary intervention; a pilot study.

SYNTAX Score II (SSII) connects clinical variables with coronary anatomy. We investigated the prognostic value of SSII in patients with ST segment elevated myocardial infarction (STEMI) complicated with cardiogenic shock treated with primary percutaneous coronary intervention (PPCI). In this retrospective analysis, we evaluated the in-hospital prognostic impact of SSII on 492 patients with STEMI complicated with cardiogenic shock treated with PPCI.

A patient presenting with acute heart failure: A dilemma of diagnosis.

Acute dyspnea is a major complaint of patients admitted to cardiology and emergency departments (ED). Acute dyspnea can be life-threatening, and is seen in cases of asthma, pulmonary embolism, acute heart failure and myocardial infarction. The present case is that of a 32-year-old man admitted to the ED with orthopnea position and agitation.

Left Ventricular Perforation Due to Radiofrequency Catheter Ablation for Incessant Ventricular Tachycardia in a Post-Myocardial Infarction Patient.

Left ventricular (LV) myocardial perforation is a rare complication following ventricular tachycardia (VT) ablation with radiofrequency (RF); this complication should be diagnosed and treated promptly. LV free wall rupture after elective RF ablation for sustained VT refractory to medical treatment is rarely reported in the medical literature. Herein we discuss an interesting case which contributes to the ongoing literature, regarding a patient who developed LV perforation due to RF ablation for VT which was resistant to pharmacotherapy and repeated cardioversion attempts after acute myocardial infarction.

The first six-month clinical outcomes and risk factors associated with high on-treatment platelet reactivity of clopidogrel in patients undergoing coronary interventions.

Objective: This study attempted to fill the gaps in evidence related to response to clopidogrel treatment in the Turkish population. The study aimed to determine the prevalence, associated risk factors, and clinical outcomes of high on-treatment platelet reactivity (HTPR) of clopidogrel in patients undergoing percutaneous coronary intervention (PCI) in a tertiary cardiovascular hospital in Turkey.

Methods: In this prospective studied a total of 1.

Neurologic outcome in patients with cardiac arrest complicating ST elevation myocardial infarction treated by mild therapeutic hypothermia: The experience of a tertiary institution.

Objective: Therapeutic hypothermia improves neurologic prognosis after cardiac arrest. The aim of this study was to report clinical experience with intravascular method of cooling in patients with cardiac arrest resulting from ST-segment elevation myocardial infarction (STEMI).

Methods: Thirteen patients (11 male, 2 famele; mean age was 39.

786T/c endothelial nitric oxide synthase gene polymorphism and coronary collateral circulation.

Introduction: In this study, we investigated the association between -786T/C polymorphism of the endothelial nitric oxide (NOS3) gene in which thymidine is replaced by a cytosine at nucleotide -786 (rs 2070744) and coronary collateral circulation (CCC) in patients with stable coronary artery disease.

Materials And Methods: 286 patients having a critical stenosis (> 95%) in at least one major epicardial coronary vessel were included in the study. CCC was defined according to the Rentrop classification (R).