Type of Anemia, Chronic Non-cardiovascular Illnesses, and Outcomes of Patients with ST-segment Elevation Myocardial Infarction.

Objectives: To assess the impact of different types of anemia and of concomitant non-cardiovascular chronic illnesses on outcomes of patients with ST-segment elevation myocardial infarction (STEMI) and baseline anemia admitted to the Intensive Cardiac Care Unit.

Methods: Based on the mean corpuscular volume, anemia was stratified into: microcytic (<80 fL), normocytic (≥80, <96 fL), and macrocytic (≥96 fL). Data on concomitant chronic non-cardiovascular illnesses including malignancies were carefully collected.

Long-term effects of brief hypoxia due to cardiac arrest: Hippocampal reductions and memory deficits.

Objective: To examine the effects of brief hypoxia (<7 min) due to cardiac arrest on the integrity of the brain and performance on memory and executive functions tasks.

Methods: Patients after out-of-hospital cardiac arrest (CA) (n = 9), who were deemed neurologically intact on discharge, were compared to matched patients with myocardial infarction (MI) (n = 9). A battery of clinical and experimental memory and executive functions neuropsychological tests were administered and MRI scans for all patients were collected.

Severe burns in a patient after out-of-hospital CPR.

We present a case of a patient after prolonged cardio-pulmonary resuscitation on hot asphalt, who suffered from first and second degree burns which worsened during hospitalization. The patient was treated with therapeutic hypothermia. Possible effect of therapeutic hypothermia on the course of burns is discussed.

Acute Kidney Injury After Primary Angioplasty: Is Contrast-Induced Nephropathy the Culprit?

Background: Acute kidney injury (AKI) following primary percutaneous coronary intervention (pPCI) is frequently interpreted as contrast-induced AKI but may result from other insults. We aimed to determine the causal association of contrast material exposure and the incidence of AKI following pPCI using a control group of propensity score-matched patients with ST-segment-elevation myocardial infarction who were not exposed to contrast material.

Methods And Results: We studied 2025 patients with ST-segment-elevation myocardial infarction who underwent pPCI and 1025 patients receiving fibrinolysis or no reperfusion who were not exposed to contrast material during the first 72 hours of hospital stay (control group).

Real-World Use of Novel P2Y12 Inhibitors in Patients with Acute Myocardial Infarction: A Treatment Paradox.

Objective: To assess the real-world use, clinical outcomes, and adherence to novel P2Y12 inhibitors.

Methods: We evaluated 1,093 consecutive acute myocardial infarction patients undergoing a percutaneous intervention. Patients were derived from a prospective, multicenter, nationwide registry and were followed for 30 days; 381 patients (35%) received clopidogrel, 468 (43%) received prasugrel, and 244 (22%) received ticagrelor.

Time Dependence of the Effect of Right Ventricular Dysfunction on Clinical Outcomes After Myocardial Infarction: Role of Pulmonary Hypertension.

Background: The clinical importance of right ventricular (RV) function in acute myocardial infarction is well recognized, but the impact of concomitant pulmonary hypertension (PH) has not been studied.

Methods And Results: We studied 1044 patients with acute myocardial infarction. Patients were classified into 4 groups according to the presence or absence of RV dysfunction and PH, defined as pulmonary artery systolic pressure >35 mm Hg: normal right ventricle without PH (n=509), normal right ventricle and PH (n=373), RV dysfunction without PH (n=64), and RV dysfunction and PH (n=98).

Conduction abnormalities during dipyridamole stress testing.

Pharmacological stress tests using dipyridamole are considered to be safe. However, cases of atrioventricular (AV) block have been reported. We retrospectively analyzed ECG at baseline and during dipyridamole stress tests of 2010 consecutive patients (patients with second or third degree AV block were excluded).

Heart failure in patients with diabetes undergoing primary percutaneous coronary intervention.

Introduction: Diabetes mellitus is associated with increased risk after acute coronary syndromes. Primary percutaneous coronary intervention is the most effective method of reperfusion for acute ST-elevation myocardial infarction and can limit the ischaemic damage to the left ventricle. However, there are few data on the impact of diabetes mellitus on the risk of heart failure following primary percutaneous coronary intervention.

Impact of functional mitral regurgitation on right ventricular function and outcome in patients with right ventricular infarction.

Right ventricular (RV) infarction is associated with increased mortality. Functional mitral regurgitation (FMR) may complicate inferoposterior infarction with RV involvement leading to pulmonary hypertension and increased RV afterload, potentially exacerbating RV remodeling and dysfunction. We studied 179 patients with inferior wall left ventricular (LV) ST-elevation myocardial infarction and RV infarction.

The relation between serum phosphorus levels and clinical outcomes after acute myocardial infarction.

Background: Elevated serum phosphorus levels have been linked with cardiovascular disease and mortality with conflicting results, especially in the presence of normal renal function.

Methods: We studied the association between serum phosphorus levels and clinical outcomes in 1663 patients with acute myocardial infarction (AMI). Patients were categorized into 4 groups based on serum phosphorus levels (<2.

Utility of pulmonary hypertension for the prediction of heart failure following acute myocardial infarction.

Pulmonary hypertension (PH) is usually perceived as a complication of established heart failure (HF) rather than as a predictor of HF or a marker of subclinical HF. PH may develop because of cardiac alterations that result in increased filling pressures after acute myocardial infarction (AMI). We hypothesized that PH might be a useful marker to predict the risk of HF after AMI.

Impact of platelet glycoprotein IIb/IIIa receptor inhibitors on renal function in patients with ST-segment elevation myocardial infarction treated with primary or rescue percutaneous coronary intervention.

Aims: Worsening renal function in patients undergoing percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) is associated with adverse clinical outcomes. We hypothesised that platelet glycoprotein IIb/IIIa receptor inhibitors (GPI) may decrease the rate of renal function deterioration in these patients through attenuation of platelet aggregation and the possible improvement of renal rheology and haemodynamics.

Methods And Results: Based on prospectively collected data, we analysed rates of renal function deterioration in 603 consecutive patients (mean age 58+/-13 years, males 82%) with STEMI treated with primary or rescue PCI.

The impact of body mass index on clinical outcomes after acute myocardial infarction.

Background: Several studies indicated that an elevated body mass index (BMI) is associated with a lower rate of mortality in patients with acute myocardial infarction (AMI). However, the existence of the obesity paradox in AMI patients remains controversial.

Methods: We examined the association of BMI and clinical outcomes in 2157 patient with AMI (mean follow-up of 26 months).

Incidence of early left ventricular thrombus after acute anterior wall myocardial infarction in the primary coronary intervention era.

Background: Rapid reperfusion has been shown to decrease mortality and improve left ventricular (LV) function. Previous studies have reported that LV thrombus (LVT) is a major complication of ST-segment elevation acute anterior wall myocardial infarction (AMI). There are little data on LVT in the current primary percutaneous coronary intervention (PPCI) era.

Predictors of outcome and the lack of effect of percutaneous coronary intervention across the risk strata in patients with persistent total occlusion after myocardial infarction: Results from the OAT (Occluded Artery Trial) study.

Objectives: This study sought to determine predictors of outcome and examine the influence of baseline risk on therapeutic impact of late mechanical opening of a persistently occluded infarct related artery after myocardial infarction in stable patients.

Background: Previous studies in patients with acute coronary syndromes suggest that the impact of infarct-related artery recanalization on clinical outcome is greatest in patients at highest risk.

Methods: Of 2,201 patients (age 58.

Identification of the gene causing long QT syndrome in an Israeli family.

Background: Long QT syndrome is an inherited cardiac disease, associated with malignant arrhythmias and sudden cardiac death.

Objectives: To map and identify the gene responsible for LQTS in an Israeli family.

Methods: A large family was screened for LQTS after one of them was successfully resuscitated from ventricular fibrillation.

Relation of statin therapy to risk of heart failure after acute myocardial infarction.

Recent studies suggest that statin therapy reduces hospitalizations for heart failure (HF). However, few data exist regarding the role of statins in preventing HF after acute myocardial infarction (AMI). In addition, the potential impact of left ventricular (LV) ejection fraction (EF) and coexisting functional mitral regurgitation (MR) on the efficacy of statin therapy was not considered.

Impact of red blood cell transfusion on clinical outcomes in patients with acute myocardial infarction.

Divergent views remain regarding the safety of treating anemia with red blood cell (RBC) transfusion in patients with acute coronary syndrome (ACS). We used a prospective database to study effect of RBC transfusion in patients with acute myocardial infarction (MI; n = 2,358). Cox regression models were used to determine the association between RBC transfusion and 6-month outcomes, incorporating transfusion as a time-dependent variable.

Troponin-positive, CK-MB-negative acute myocardial infarction: clinical, electrocardiographic and angiographic characteristics.

Objectives: We assessed the clinical, electrocardiographic (ECG) and angiographic characteristics of patients with acute coronary syndrome, increased troponin I (cTn-I) levels and normal creatine kinase levels.

Background: Cardiac troponins are part of the new definition of acute myocardial infarction by the European Society of Cardiology and the American College of Cardiology. However, there are limited data regarding the angiographic characteristics of these patients.

Serum blood urea nitrogen and long-term mortality in acute ST-elevation myocardial infarction.

Introduction: Renal dysfunction is associated with increased mortality in acute coronary syndromes and other cardiovascular diseases. The prognostic value of kidney dysfunction has been investigated using creatinine-based measures of renal function. Few data are available on the prognostic significance of blood urea nitrogen (BUN), a sensitive marker of hemodynamic alterations and renal perfusion.

Relation of C-reactive protein and new-onset atrial fibrillation in patients with acute myocardial infarction.

Recent studies have implicated systemic inflammation in the genesis and maintenance of atrial fibrillation (AF). A robust inflammatory response is an integral component of the response to tissue injury during acute myocardial infarction (AMI). However, there is no information concerning the association between inflammation and AF in patients with AMI.

Is functional improvement after myocardial infarction predicted with myocardial enhancement patterns at multidetector CT?

Purpose: To prospectively evaluate the sensitivity of myocardial early perfusion defects (EDs) and late enhancement (LE) at multidetector computed tomography (CT) following acute myocardial infarction (AMI) to predict segment myocardial dysfunction and myocardial functional recovery (MFR), by using echocardiography as the reference standard.

Materials And Methods: Institutional review board approval and informed consent were obtained. Twenty-six patients (25 men, one woman; mean age, 53 years+/-9 [standard deviation]), underwent baseline multidetector CT, coronary angiography, and echocardiography within a week of AMI and a follow-up echocardiography at 3 months.

Primary percutaneous coronary intervention after out-of-hospital cardiac arrest: patients and outcomes.

Background: The decision to perform primary percutaneous coronary intervention in unconscious patients resuscitated after out-of-hospital cardiac arrest is challenging because of uncertainty regarding the prognosis of recovery of anoxic brain damage and difficulties in interpreting ST segment deviations. In ST elevation myocardial infarction patients after OHCA, primary PCI is generally considered the only option for reperfusion. There are few published studies and no randomized trial has yet been performed in this specific group of patients.