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Pharmaco-Invasive Strategy With Half-Dose Tenecteplase in Patients With STEMI: Prespecified Pooled Analysis of Patients Aged ≥75 Years in STREAM-1 and 2.
Circ Cardiovasc Interv
December 2024
Canadian VIGOUR Centre (K.R.B., R.C.W., Y.Z., T.T., E.L., C.M.W., P.W.A.), University of Alberta, Edmonton, Canada.
Background: In STREAM-1 (Strategic Reperfusion Early After Myocardial Infarction), excess intracranial hemorrhage occurred in patients aged ≥75 years receiving full-dose tenecteplase as part of a pharmaco-invasive strategy, whereas no further intracranial hemorrhage occurred after halving the tenecteplase dose. In STREAM-2 (Second Strategic Reperfusion Early After Myocardial Infarction), half-dose tenecteplase was an effective and safe pharmaco-invasive strategy in older patients with ST-segment-elevation myocardial infarction presenting within <3 hours, compared with primary percutaneous coronary intervention (PCI). We prespecified evaluating the efficacy and safety of a half-dose versus full-dose pharmaco-invasive strategy and compared the half-dose pharmaco-invasive strategy to primary PCI in patients aged ≥75 years.
View Article and Find Full Text PDFIn-Hospital Outcomes Associated With Initial Fibrinolysis Versus Primary Percutaneous Coronary Intervention Among Patients Residing in Rural Areas Presenting With ST-Segment Elevation Myocardial Infarction.
Hosp Pharm
November 2024
University of South Carolina School of Medicine Greenville, Greenville, SC, USA.
Fibrinolysis is more commonly used to manage ST-segment elevation myocardial infarction (STEMI) in rural versus urban areas. However, little is known about the outcomes associated with this treatment strategy in rural individuals. We sought to compare in-hospital outcomes associated with the use of fibrinolysis versus primary percutaneous coronary intervention (PCI) among patients residing in rural areas presenting with STEMI.
View Article and Find Full Text PDFSimple indices of infarct size post ST-Elevation Myocardial Infarction (STEMI) provides similar risk stratification to cardiac MRI.
PLoS One
November 2024
Department of Cardiology, Liverpool Hospital, Liverpool, NSW, Australia.
Introduction: Myocardial Infarct Size (IS) determined soon after ST-segment elevation myocardial infarction (STEMI) has prognostic significance, and can be assessed by cardiac biomarker levels, electrocardiographic (ECG) parameters, and imaging modalities (including echocardiography and cardiac magnetic resonance imaging [CMRI]).
Objectives And Methods: We evaluated methods of IS assessment, 12-lead ECG Selvester QRS scores and high-sensitivity Troponin T (hsTnT) levels measured ≥48hr (plateau phase of hsTnT elevation), compared to paired CMRIs and echocardiograms, in a prospective cohort of patients with STEMI undergoing percutaneous coronary intervention (PCI) during the index hospitalisation. Associations were determined between IS, as assessed by these methods, and 24-month major adverse cardiac events (MACE), a hierarchical composite of: death, stroke and hospitalization for heart failure.
An uncommon cause of a common disease: a case report of a rare cause of hypertension.
Eur Heart J Case Rep
October 2024
Department of Rheumatology, Apollo Hospitals Indore, Madhya Pradesh, 452010, India.
Background: Severe hypertension in young patients presents a significant diagnostic dilemma, and treatment can often be codified. Therefore, it is crucial to diagnose these cases for probable secondary hypertension. Common causes of secondary hypertension include large vessel vasculitis, renal artery stenosis, coarctation of the aorta, and endocrine disorders.
View Article and Find Full Text PDFArticle Synopsis
- The study investigates early-onset coronary artery disease (CAD) in individuals aged 45 or younger, focusing on factors affecting their health, symptoms, and treatment following ST-elevation myocardial infarction (STEMI).
- Conducted over six months with 100 STEMI patients, it found a mean age of 42.5 years, with most patients being male, and identified key risk factors such as smoking, obesity, and hypertension.
- The majority of cases involved chest discomfort, with the left anterior descending artery being most affected; treatment included various types of PCI and CABG, yet there were no recorded fatalities during the study.
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