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Treating Older Patients in Cardiogenic Shock With a Microaxial Flow Pump: Is It DANGERous?
J Am Coll Cardiol
November 2024
Department of Cardiology, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark; Department of Cardiology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern, Odense, Denmark. Electronic address:
Article Synopsis
- This study examines how age influences the effectiveness of microaxial flow pump (mAFP) treatment for patients suffering from ST-elevation myocardial infarction (STEMI) and cardiogenic shock (CS), using data from the DanGer Shock trial involving 355 participants.
- Findings reveal that mortality rates significantly increase with age, from 31% in the youngest group to 73% in the oldest, showing younger patients (<77 years) benefit more from mAFP treatment (lower mortality), while older patients (≥77 years) do not have the same advantage.
- The study also notes that complications were more common in the mAFP group, but overall, age significantly impacted survival outcomes, highlighting
Characteristics and in-hospital outcomes of female patients presenting with ST-segment-elevation myocardial infarction without standard modifiable cardiovascular risk factors.
Curr Probl Cardiol
December 2024
Department of Medicine, Stern Cardiovascular Foundation, Germantown, TN, USA.
Article Synopsis
- Standard Modifiable Cardiovascular Risk Factors (SMuRF), like hypertension and diabetes, are typically significant in causing atherosclerotic disease, but this study looks at female STEMI patients who lack those risk factors.
- Researchers analyzed data from over 200,000 STEMI admissions, finding that only 6.6% of patients were without any SMuRF, and these patients were generally older and more likely to be white.
- Interestingly, SMuRF-less patients had a higher in-hospital mortality rate (three times more likely) than those with SMuRF, even though they had fewer other heart-related conditions, highlighting the unique challenges in this group.
Impact of off-hours admissions in STEMI-related cardiogenic shock managed with microaxial flow pump - insights from J-PVAD.
EuroIntervention
August 2024
Department of Cardiovascular Medicine, St. Luke's International Hospital, Tokyo, Japan.
Article Synopsis
- ST-segment elevation myocardial infarction complicated by cardiogenic shock (STEMI-CS) has high mortality rates, especially for patients admitted during off-hours, known as the "off-hours effect."
- This study analyzed registry data of 1,207 patients treated with Impella, revealing that 42.1% of off-hours admissions resulted in death compared to 30.3% during on-hours.
- The research concluded that off-hours admissions were linked to a 60% increased risk of 30-day mortality, emphasizing the need for improved cardiovascular care and timely treatment during off-hours.
Outcomes of ST-Elevation Myocardial Infarction in Patients With Opioid Dependence: A National Inpatient Sample Study.
Cureus
July 2024
Cardiovascular Medicine, The University of Toledo Medical Center, Toledo, USA.
ST-segment elevation myocardial infarction (STEMI) is a critical condition characterized by the sudden obstruction of one or more coronary arteries, resulting in diminished blood flow to the heart muscle. This acute ischemic event demands swift and precise intervention to minimize myocardial damage and preserve cardiac function. Opioids, a class of potent analgesic medications, are frequently utilized in the management of STEMI-related chest pain.
View Article and Find Full Text PDFCoronary Embolism Among Patients With ST-Segment-Elevation Myocardial Infarction and Atrial Fibrillation: An Underrecognized But Deadly Association.
J Am Heart Assoc
May 2024
Department of Cardiology Université de Lorraine, CHRU-Nancy Nancy France.
Background: The prevalence and impact of coronary emboli (CE) in patients with ST-segment-elevation myocardial infarction (STEMI) and atrial fibrillation (AF) have not been specifically studied. The objective was to describe the clinical characteristics and outcomes of patients with AF and CE in a large series of patients with STEMI.
Methods And Results: We investigated 2292 consecutive patients with STEMI and among them 225 patients with AF: 46 patients with a STEMI related to CE (group A) and 179 patients with a STEMI related to an atherosclerotic cause (group B).
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