Background: Reperfusion injury offsets the beneficial effects of reperfusion therapy for ST-segment elevation myocardial infarction (STEMI). In our previous reports, postconditioning with lactate-enriched blood (PCLeB) induced excellent microcirculation recovery and less inflammation in STEMI patients. This study aimed to determine the in-hospital outcomes of STEMI patients treated using PCLeB.
Methods: Fifty-five consecutive STEMI patients were treated using PCLeB (Age 66.6±13.8years, 76.4% men) within 12h of symptom onset. In our modified postconditioning protocol, the duration of each brief reperfusion was prolonged from 10s to 60s in a stepwise manner. Lactated Ringer's solution (20-30mL) was injected directly into the culprit coronary artery at the end of each brief reperfusion and the balloon was quickly inflated at the lesion site, whereby lactate could be trapped inside the ischemic myocardium. Each brief ischemic period lasted 60s. After 7cycles of balloon inflation and deflation, full reperfusion was performed. Thereafter, stenting was performed and percutaneous coronary intervention (PCI) was completed.
Results: The mean corrected thrombolysis in myocardial infarction frame count was 20.1±10.1 after PCI completion. The mean peak serum creatine kinase and creatine kinase-MB levels were 2751±2227IU/L and 276±181IU/L respectively. None of the study patients died during their hospital stay or required continuation of oral diuretic or inotropic therapy for heart failure on discharge.
Conclusions: PCLeB led to zero in-hospital mortality and no overt heart failure on discharge in 55 consecutive STEMI patients undergoing reperfusion therapy.
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http://dx.doi.org/10.1016/j.ijcard.2016.06.176 | DOI Listing |
Cureus
December 2024
Interventional Cardiology, Lee Health, Fort Myers, USA.
Managing acute coronary syndrome (ACS) in patients with a recent history of gastrointestinal bleeding presents a unique and challenging clinical dilemma, necessitating a careful balance between minimizing ischemic risk and avoiding potentially life-threatening rebleeding. Standard treatment for ACS typically involves dual antiplatelet therapy (DAPT) to prevent recurrent thrombotic events. However, in patients with recent gastrointestinal hemorrhage or significant anemia, these therapies may substantially increase the risk of life-threatening bleeding, complicating the decision-making process and often leading to conservative management strategies.
View Article and Find Full Text PDFMedicine (Baltimore)
November 2024
Institute of Gerontology, Guangzhou Geriatric Hospital, Guangzhou Medical University, Guangzhou, China.
Rationale: Acute myocardial infarction (AMI) is the leading global cause of death from cardiovascular disease, and the mortality rate increases in the presence of comorbidities such as renal abscess. The treatment of AMI combined with renal abscess is challenging, especially in combination with urinary tract obstruction, as percutaneous coronary intervention (PCI) can lead to progression of the renal abscess and deterioration of renal function. Currently, there is no consensus on the treatment of renal abscess in AMI.
View Article and Find Full Text PDFRev Invest Clin
January 2025
Department of Immunology, Instituto Nacional de Cardiología Ignacio Chávez, Mexico City, Mexico.
Background: MiR-155 plays a role in inflammatory pathways and cardiovascular diseases, though its relationship with inflammation, atherosclerosis, and outcomes in ST-elevation myocardial infarction (STEMI) is not well established.
Objective: To investigate associations between miR-155 levels, inflammation, atherosclerotic burden, and major adverse cardiovascular events (MACE) in STEMI patients.
Methods: Sixty-nine STEMI patients and 16 healthy controls were recruited from a specialized university-affiliated cardiovascular center.
Health Sci Rep
January 2025
Yazd Cardiovascular Research Center, Non-communicable Diseases Research Institute Shahid Sadoughi University of Medical Sciences Yazd Iran.
Background And Aims: Mounting evidence have implicated that rs1801131 and rs1801133, located in the Methylenetetrahydrofolate reductase (MTHFR) gene, may emerge as novel biomarkers for coronary artery disease (CAD). The Synergy between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is also an appropriate predictor for revascularization strategy in patients with complex CAD. The aim of this study is to investigate the correlation between rs1801131 and rs1801133 with the severity of coronary lesions in patients with ST‑Elevation Myocardial Infarction (STEMI) and Non‑ST‑Elevation Myocardial Infarction (NSTEMI) based on the SYNTAX score.
View Article and Find Full Text PDFJ Soc Cardiovasc Angiogr Interv
December 2024
Division of Cardiovascular Medicine, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California.
Background: A minimum threshold activated clotting time (ACT) to guide heparin dosing during percutaneous coronary intervention (PCI) is associated with lower ischemic complications. However, data are variable regarding the risk of high ACT levels. The aim of this study was to assess the impact of peak procedural ACT on complications and mortality for transfemoral and transradial access PCI.
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