Objective: The aim of this study was to investigate the value of initial serum N-terminal pro-brain natriuretic peptide (NT-proBNP) concentrations in ST-segment elevation myocardial infarction (STEMI) patients for predicting ST-segment resolution (STR) after primary percutaneous coronary intervention (pPCI).
Patients And Methods: Consecutive STEMI patients (n = 218) who underwent pPCI were assigned to an STR group (≥ 50 % resolution) or a non-STR group (< 50 % resolution). All patients were followed up for 12 months, and major adverse cardiac events were recorded. Data related to the pPCI procedure, biochemical parameters, and cardiac markers were compared between the two groups. Predictive factors of non-STR were also identified.
Results: STR at 180 min after pPCI occurred in 202 patients (92.7 %). Compared to the STR group, patients in the non-STR group had a significantly lower left ventricular ejection fraction, a larger left ventricular end-diastolic dimension, and significantly higher serum concentrations of glycosylated hemoglobin and NT-proBNP. Multivariate logistic regression analysis indicated that a high serum NT-proBNP level in STEMI patients on hospital admission was the only independent predictive factor of non-STR after pPCI. An NT-proBNP concentration of ≥ 2,563.6 pg/ml had a sensitivity of 81.2 % and a specificity of 65.8 %.
Conclusions: Serum NT-proBNP concentrations in STEMI patients on hospital admission were useful in predicting non-STR after pPCI.
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http://dx.doi.org/10.1007/s00059-015-4309-0 | DOI Listing |
Cureus
December 2024
Internal Medicine, Weiss Memorial Hospital, Chicago, USA.
A previously healthy, 28-year-old man presented with a two-day history of diarrhea and chest pain, suggestive of infectious myocarditis. Initial workup revealed elevated troponin-I levels and diffuse ST-segment elevations on electrocardiogram (ECG). Transthoracic echocardiography showed a reduced left ventricular ejection fraction (40-45%), posteroinferior wall akinesis, and a small pericardial effusion.
View Article and Find Full Text PDFIndian Heart J
December 2024
Apollo Institute of Medical Sciences and Research, Jubilee Hills, Film Nagar, Hyderabad, Telangana, 500090.
Introduction: Various cardiovascular thrombo-embolic clinical entities use combined ATS for prevention and treatment. After PCI, AF patients are typically prescribed DOAC, DAPT/SAPT, as component of ATS to minimize stroke risk and treat pulmonary embolism and venous thromboembolism. Some small observational studies have shown that a combined ATS can clear small thrombi in LV dysfunction and/or apical aneurysms.
View Article and Find Full Text PDFCoron Artery Dis
December 2024
Department of Cardiology, National University Heart Centre.
Background: Pathological Q waves at presentation in ST segment elevation myocardial infarction (STEMI) have been associated with poorer clinical outcomes including heart failure. This observational study highlights the prognostic value of pathological Q waves at presentation in the Southeast Asian population.
Methods: Multiethnic Asian patients presenting with STEMI and treated with primary coronary intervention were recruited from 2015 to 2019.
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 PDFSemin Dial
December 2024
Nephrology, Dialysis and Kidney Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Extracorporeal therapies could be required for treatment of life-threatening severe acute intoxication. We present the case of an 82-year-old patient admitted to our Nephrology Unit because of metformin-associated lactic acidosis (MALA) and acute kidney injury (AKI stage III AKIN criteria). The patient also presented severe intoxication of digoxin and apixaban.
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