Purpose: The purpose of the study was to evaluate parameters that characterize patients with myocardial reinfarction as compared to patients with a first infarction in clinical practice, and possibly to determine their clinical outcome.
Methods: The 60 minutes Myocardial Project is a German multicentre prospective observational study in which 136 hospitals are participating. Fourteen thousand, nine hundred and eighty consecutive patients with acute Q wave myocardial infarction were included from July 1992 to September 1994.
Results: Out of these 14,980 patients, there were 2854 (19%) with reinfarction and 12,126 (81%) with a first infarction. Patients with a reinfarction arrived at the hospital 24 min earlier than patients with a first infarction (pre-hospital delay 156 vs 180 min; P < 0.001); the door-to-needle time with reinfarction was longer (38 vs 30 min; P < 0.001); however, patients with reinfarction were older (69 vs 66 years; P < 0.001), had a lower rate of a diagnostic first ECG (54 vs 71%; P < 0.001) and received thrombolytic therapy less frequently than patients with a first infarction (46 vs 52%; P < 0.001). A low number of patients received primary PTCA ( n = 205) since only a few hospitals offered a primary PTCA service at the time the study was performed. In patients with reinfarction, there were more reasons as to why thrombolytic therapy was not given (24 vs 21%; P < 0.001). Left bundle branch block occurred more frequently in patients with reinfarction (15 vs 8%; P < 0.001). The intra-hospital course in patients with reinfarction was associated with an increase of complications and intra-hospital death (23 vs 15%; P < 0.001.
Conclusions: Although reinfarction patients arrived earlier at hospital than patients with a first infarction, the former received thrombolytic therapy less frequently than the latter. Patients with reinfarction were older, more frequently had a non-diagnostic ECG on admission and had a higher rate of contraindications against thrombolytic therapy.
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http://dx.doi.org/10.1053/euhj.1997.0864 | DOI Listing |
Acta Med Indones
October 2024
1. Division of Psychosomatic and Palliative, Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 2. Clinical Epidemiology in Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia.
Background: Acute coronary syndrome (ACS) and depression are related to each other. Detection and proper treatment of these conditions can improve functional ability and quality of life. However, there is still controversy in this population regarding the use, safety, and efficacy of antidepressant pharmacotherapy.
View Article and Find Full Text PDFAngiology
January 2025
Department of Cardiology, Faculty of Medicine, Hacettepe University, Ankara, Turkey.
We aimed to investigate the association between systemic inflammation and the left ventricular global function index (LVGFI) and evaluate the diagnostic performance of LVGFI for MACEs across the acute coronary syndrome (ACS) spectrum. A total of 1697 patients (794 with ST-segment elevation myocardial infarction [STEMI] and 903 with non-STEMI [NSTEMI]) were evaluated. The LVGFI was calculated using echocardiography.
View Article and Find Full Text PDFArq Bras Cardiol
January 2025
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP - Brasil.
Background: Acute coronary syndrome (ACS) is one of the leading causes of mortality worldwide. Knowing the predisposing factors is essential for preventing it.
Objectives: To describe the etiological and epidemiological characteristics of the population with ACS admitted to an emergency room in the State of São Paulo.
J Mol Cell Cardiol Plus
December 2024
Department of Pathology, Amsterdam University Medical Center (AUMC), location AMC and VUmc, Amsterdam, the Netherlands.
Background And Objectives: Structural and functional changes in the intramyocardial microcirculation increase the risk of myocardial infarction (MI). This study investigated intramyocardial perivascular fibrosis and pro-fibrotic cellular transitions in deceased acute and subacute MI patients to explore their involvement in the pathogenesis of MI.
Methods: Left ventricular tissue (LV) was obtained from the infarction area of autopsied patients with acute-phase MI (3-6 h; = 24), subacute-phase MI (5-14 days; = 12), and noninfarcted controls ( = 14).
J Saudi Heart Assoc
November 2024
National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan.
Objectives: This study aimed to determine the distribution of coronary collaterals (CC) as per the Rentrop Collateral Score (RCS) among patients with ST-segment elevation myocardial infarction (STEMI) and its impact on in-hospital and 30-day mortality after primary percutaneous coronary intervention (PCI).
Methods: In this study, a selected sample of consecutive STEMI patients was assessed for the development of CC as per the RCS classification. An RCS grade of 2 or 3 was taken as the presence of CC with either partial or complete filling of the infarct-related artery (IRA).
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