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Impact of the COVID-19 pandemic on emergency department utilization of initial fibrinolysis for the treatment of STEMI.
Am J Emerg Med
January 2025
From the University of South Carolina School of Medicine Greenville, Greenville, SC, United States of America. Electronic address:
Objective: Fibrinolysis is generally considered an alternative to percutaneous coronary intervention (PCI) for ST-Segment Elevation Myocardial Infarction (STEMI) when PCI is not immediately feasible. The COVID-19 pandemic may have impacted the timeliness of PCI. We sought to compare the rate of fibrinolysis use before vs.
View Article and Find Full Text PDFPremature Coronary Artery Disease Presenting as STEMI in a Teenager.
J Investig Med High Impact Case Rep
January 2025
LSU Health Shreveport, LA, USA.
An 18-year-old teenager with significant atherosclerotic cardiovascular disease (ASCVD) risk factors developed acute chest pain. His electrocardiogram showed inferior ST-segment elevations. Emergent coronary angiogram revealed complete thrombotic occlusion of the right coronary artery.
View Article and Find Full Text PDFPhysiology-Versus Angiography-Guided Complete Coronary Revascularization in STEMI Patients with Multivessel Disease: A Network Meta-Analysis.
J Clin Med
January 2025
Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy.
: In patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease (MVD), complete revascularization (CR) is recommended over culprit-only PCI to reduce adverse cardiovascular outcomes. However, the optimal strategy for CR, whether angiography (Angio)-guided or physiology-guided, remains uncertain. : This network meta-analysis included 14 randomized controlled trials (RCTs) with 11,568 patients to compare the efficacy of angio-guided CR, physiology-guided CR, and culprit-only PCI in reducing major adverse cardiovascular events (MACE), all-cause mortality, recurrent myocardial infarction (MI), cardiovascular (CV) death, and unplanned revascularization.
View Article and Find Full Text PDFPre-Hospital Point-of-Care Troponin: Is It Possible to Anticipate the Diagnosis? A Preliminary Report.
Diagnostics (Basel)
January 2025
UOC Emergenza Territoriale 118 Area Provinciale Aretina, Azienda USL Toscana Sud-Est, 52100 Arezzo, Italy.
: Thanks to the evolution of laboratory medicine, point-of-care testing (POCT) for troponin levels in the blood (hs-cTn) has been greatly improved in order to quickly diagnose acute myocardial infarction (AMI) with an accuracy similar to standard laboratory tests. The rationale of the HEART POCT study is to propose the application of the 0/1 h European Society of Cardiology (ESC) algorithm in the pre-hospital setting using a POCT device (Atellica VTLi). : This is a prospective study comparing patients who underwent pre-hospital point-of-care troponin testing (Atellica VTLi) with a control group that underwent standard hospital-based troponin testing (Elecsys).
View Article and Find Full Text PDFPrediction of microvascular obstruction from angio-based microvascular resistance and available clinical data in percutaneous coronary intervention: an explainable machine learning model.
Sci Rep
January 2025
Department of Cardiology, Nanjing Drum Tower Hospital, Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, Nanjing, 210008, China.
Angio-based microvascular resistance (AMR) as a potential alternative to the index of microcirculatory resistance (IMR) and its relationship with microvascular obstruction (MVO) and other cardiac magnetic resonance (CMR) parameters still lacks comprehensive validation. This study aimed to validate the correlation between AMR and CMR-derived parameters and to construct an interpretable machine learning (ML) model, incorporating AMR and clinical data, to forecast MVO in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI). We enrolled 452 STEMI patients from Nanjing Drum Tower Hospital between 2018 and 2022, who received both PPCI and CMR.
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