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[PMID]:28450654
[Au] Autor:Setianto BY; Taufiq N; Hernawan H
[Ad] Endereço:Department of Cardiology and Vascular Medicine, Faculty of Medicine, Gadjah Mada University - Sardjito Hospital, Yogyakarta, Indonesia. Department of Internal Medicine, Faculty of Medicine, Gadjah Mada University - Sardjito Hospital, Yogyakarta, Indonesia. budyuls@gmail.com.
[Ti] Título:Left Circumflexus Coronary Artery Total Occlusion with Clinical Presentation as NSTEMI and Acute Pulmonary Oedema.
[So] Source:Acta Med Indones;49(1):52-56, 2017 Jan.
[Is] ISSN:0125-9326
[Cp] País de publicação:Indonesia
[La] Idioma:eng
[Ab] Resumo:Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the electrocardiogram to divide patients into ST-elevation acute myocardial infarction (STEMI) or non-ST-elevation acute myocardial infarction (NSTEMI)/unstable angina (UA). Patients with STEMI in the earliest time will receive reperfusion therapy to destruct occlusive thrombus. An ST segment elevation is the 'sine qua non' for diagnosing acute total coronary occlusion causing transmural myocardial infarction. Left circumflex coronary artery (LCx) occlusion is often categorized as NSTEMI because of the absence of significant ST-elevation on the 12 lead standard electrocardiogram. An ST segment elevation is presented in fewer than 50% of patients with LCx total occlusion, such that the reperfusion therapy is delayed. We reported a 77 years old woman whom being diagnosed with NSTEMI because a 12 lead electrocardiogram showed ST segment depression in lead V2-V5. On coronary angiography, we found a total occlusion in the LCx artery as the culprit lession.
[Mh] Termos MeSH primário: Síndrome Coronariana Aguda/complicações
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico
Edema Pulmonar/complicações
[Mh] Termos MeSH secundário: Idoso
Angiografia Coronária
Vasos Coronários/fisiopatologia
Eletrocardiografia Ambulatorial
Feminino
Seres Humanos
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180302
[Lr] Data última revisão:
180302
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170429
[St] Status:MEDLINE


  2 / 216 MEDLINE  
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[PMID]:29181952
[Au] Autor:Bønaa KH; Steigen T
[Ti] Título:Coronary angiography in non-ST-elevation acute myocardial infarction - whom and when?
[Ti] Título:Koronar angiografi ved akutt hjerteinfarkt uten ST-elevasjon - hvem og når?.
[So] Source:Tidsskr Nor Laegeforen;137(22), 2017 11 28.
[Is] ISSN:0807-7096
[Cp] País de publicação:Norway
[La] Idioma:eng; nor
[Mh] Termos MeSH primário: Angiografia Coronária/utilização
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem
[Mh] Termos MeSH secundário: Diagnóstico Precoce
Seres Humanos
Guias de Prática Clínica como Assunto
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1803
[Cu] Atualização por classe:180301
[Lr] Data última revisão:
180301
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171129
[St] Status:MEDLINE
[do] DOI:10.4045/tidsskr.17.0492


  3 / 216 MEDLINE  
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[PMID]:29351337
[Au] Autor:Ghasemi-Roudsari S; Al-Shimary A; Varcoe B; Byrom R; Kearney L; Kearney M
[Ad] Endereço:Department of Physics and Astronomy, University of Leeds, Leeds, United Kingdom.
[Ti] Título:A portable prototype magnetometer to differentiate ischemic and non-ischemic heart disease in patients with chest pain.
[So] Source:PLoS One;13(1):e0191241, 2018.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Magnetocardiography (MCG) is a non-invasive technique used to measure and map cardiac magnetic fields. We describe the predictive performance of a portable prototype magnetometer designed for use in acute and routine clinical settings. We assessed the predictive ability of the measurements derived from the magnetometer for the ruling-out of healthy subjects and patients whose chest pain has a non-ischemic origin from those with ischemic heart disease (IHD). METHODS: MCG data were analyzed from a technical performance study, a pilot clinical study, and a young healthy reference group. Participants were grouped to enable differentiation of those with IHD versus non-IHD versus controls: Group A (70 IHD patients); Group B (69 controls); Group C (37 young healthy volunteers). Scans were recorded in an unshielded room. Between-group differences were explored using analysis of variance. The ability of 10 candidate MCG predictors to predict normal/abnormal cases was analyzed using logistic regression. Predictive performance was internally validated using repeated five-fold cross-validation. RESULTS: Three MCG predictors showed a significant difference between patients and age-matched controls (P<0.001); eight predictors showed a significant difference between patients and young healthy volunteers (P<0.001). Logistic regression comparing patients with controls yielded a specificity of 35.0%, sensitivity of 95.4%, and negative predictive value for the ruling-out of IHD of 97.8% (area under the curve 0.78). CONCLUSION: This analysis represents a preliminary indication that the portable magnetometer can help rule-out healthy subjects and patients whose chest pain has a non-ischemic origin from those with IHD.
[Mh] Termos MeSH primário: Cardiopatias/diagnóstico
Magnetocardiografia/instrumentação
Isquemia Miocárdica/diagnóstico
[Mh] Termos MeSH secundário: Síndrome Coronariana Aguda/diagnóstico
Idoso
Estudos de Casos e Controles
Dor no Peito/diagnóstico
Diagnóstico Diferencial
Feminino
Seres Humanos
Modelos Logísticos
Magnetocardiografia/estatística & dados numéricos
Masculino
Meia-Idade
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico
Projetos Piloto
Valor Preditivo dos Testes
[Pt] Tipo de publicação:CLINICAL STUDY; JOURNAL ARTICLE; RESEARCH SUPPORT, NON-U.S. GOV'T
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180221
[Lr] Data última revisão:
180221
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:180120
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0191241


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[PMID]:29381922
[Au] Autor:Liu Y; Islam SMS; Chow CK; Chen S; Siddiqui MU; Li Q; Lin KY; Wang K; Sun G; Zhou YL; Chen J; Brieger D
[Ad] Endereço:Department of Cardiology, Provincial Key Laboratory of Coronary Heart Disease, Guangdong Cardiovascular Institute, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China.
[Ti] Título:Immediate versus deferred stenting for patients undergoing primary or emergent percutaneous coronary intervention: Protocol for a systematic review and meta-analysis.
[So] Source:Medicine (Baltimore);96(47):e8477, 2017 Nov.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Primary or emergent percutaneous coronary intervention (PCI) with stenting is the standard treatment for patients with ST-segment elevation myocardial infarction (STEMI) or non-STEMI acute coronary syndromes (ACS) at high risk. The value of delayed stenting following balloon-facilitated reperfusion in these patients is largely unknown. METHODS AND ANALYSIS: This systematic review aims to assess whether delayed stenting (vs immediate stenting) improves angiographic and cardiovascular clinical outcomes for patients with STEMI or non-STEMI ACS undergoing primary or emergent PCI. The primary endpoint is adverse angiographic outcomes (no or slow coronary flow after final PCI), the main secondary endpoint includes a composite of long-term (≥6 months) all-cause mortality, recurrent ACS (recurrent myocardial infarction, unplanned revascularization of the target vessel, etc.), hospital admission for heart failure or any other cardiovascular cause. Relevant studies will be searched in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and other electronic databases. Two authors will independently screen studies for inclusion, consulting with a third author where necessary to resolve discrepancies. The risk of bias of included studies will be assessed using the Cochrane Collaboration risk of bias tool, and quality of evidence using the Grades of Recommendation, Assessment, Development and Evaluation (GRADE) approach. Results will be presented using risk ratios with 95% confidence interval (CI) for dichotomous outcomes and standardized mean differences with 95% CI for continuous outcomes. ETHICS AND DISSEMINATION: This systematic review and meta-analysis protocol will not require ethical approval. We will disseminate the findings of this systematic review and meta-analysis via publications in peer-reviewed journals.
[Mh] Termos MeSH primário: Infarto do Miocárdio sem Supradesnível do Segmento ST/cirurgia
Intervenção Coronária Percutânea/mortalidade
Intervenção Coronária Percutânea/métodos
Infarto do Miocárdio com Supradesnível do Segmento ST/cirurgia
Stents
[Mh] Termos MeSH secundário: Hemodinâmica
Seres Humanos
Readmissão do Paciente
Ensaios Clínicos Controlados Aleatórios como Assunto
Projetos de Pesquisa
Fatores de Tempo
[Pt] Tipo de publicação:JOURNAL ARTICLE; META-ANALYSIS; REVIEW
[Em] Mês de entrada:1802
[Cu] Atualização por classe:180220
[Lr] Data última revisão:
180220
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:180201
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000008477


  5 / 216 MEDLINE  
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[PMID]:29247157
[Au] Autor:Abualnaja SA; Alrammah HM; Alsaif BA; Almulla MO; Alzahrani BA
[Ad] Endereço:Department of Internal Medicine, Imam Abdulrahman bin Faisal University, Dhahran, Saudi Arabia.
[Ti] Título:A Case of Subacute Bioresorbable Vascular Scaffold Thrombosis, What was Wrong?
[So] Source:Am J Case Rep;18:1343-1346, 2017 Dec 16.
[Is] ISSN:1941-5923
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents. CASE REPORT A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done. A week later, he came with non-ST segment elevation myocardial infarction due to an in-stent thrombosis. Procedures to open the LAD were done with multiple balloon angioplasties and aspiration thrombectomy, following aggressive dilatation there was a class-III perforation which was sealed by covered stent. A second look angiography was done which showed patent LAD and well expanded stents.  CONCLUSIONS Since several factors play a role in decision-making regarding the selection of patient in whom BVS usage can be beneficial, larger studies are needed. Moreover, the safety profile of BVS should be investigated thoroughly.
[Mh] Termos MeSH primário: Implantes Absorvíveis/efeitos adversos
Trombose Coronária/etiologia
Intervenção Coronária Percutânea
Stents/efeitos adversos
[Mh] Termos MeSH secundário: Adulto
Trombose Coronária/complicações
Seres Humanos
Masculino
Infarto do Miocárdio sem Supradesnível do Segmento ST/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180109
[Lr] Data última revisão:
180109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE


  6 / 216 MEDLINE  
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[PMID]:29245315
[Au] Autor:Içen YK; Koç M
[Ad] Endereço:Department of Cardiology, Adana Health Practices and Research Center, Health Sciences University, Adana, Turkey.
[Ti] Título:ST segment change and T wave amplitude ratio in lead aVR associated with coronary artery disease severity in patients with non-ST elevation myocardial infarction: A retrospective study.
[So] Source:Medicine (Baltimore);96(49):e9062, 2017 Dec.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Non-ST elevation myocardial infarction (NSTEMI) severity is difficult only with electrocardiogram (ECG). In most cases, NSTEMI patients are followed with cardiac enzymes without early invasive intervention if no severe chest pain exists in the emergency department (ED) or coronary intensive care unit (CICU).Our aim was to evaluate association between CAD severity and ST segment change in lead aVR (STaVR)/T wave amplitude in lead aVR (TAaVR) ratio in patients with NSTEMI.We included 306 patients with NSTEMI in the ED between 2015 and 2016. STaVR and TAaVR values were measured from 12-derivation ECG underwent on admission to the ED. The absolute values of STaVR and TAaVR were calculated and the following were obtained; ratio 1:|STaVR|/|TAaVR|, ratio 2:|TAaVR|/|STaVR|, and ratio 3: by dividing the variable with larger absolute value to other variable with smaller absolute value (|larger value|/|smaller value|). The SYNTAX score (SS) was calculated from coronary angiography in all patients.In analysis of the bivariate correlation between SS and ratios; significantly positive, strongly with ratio 3 (r = 0.692, P < .001), and only ratio 3 was determined to be an independent predictor for SS in linear regression analysis (OR: 0.642, 95% CI: 0.432-0.853, P = .001).Severity of CAD may be estimated by evaluating STaVR and TAaVR ratio in patients with NSTEMI.
[Mh] Termos MeSH primário: Doença da Artéria Coronariana/fisiopatologia
Eletrocardiografia
Infarto do Miocárdio sem Supradesnível do Segmento ST/fisiopatologia
[Mh] Termos MeSH secundário: Biomarcadores/sangue
Angiografia Coronária
Doença da Artéria Coronariana/diagnóstico por imagem
Ecocardiografia
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem
Estudos Retrospectivos
Índice de Gravidade de Doença
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Biomarkers)
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180108
[Lr] Data última revisão:
180108
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:171217
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000009062


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[PMID]:29078214
[Au] Autor:Kahles F; Schuh A; Lehrke M; Burgmaier M; Marx N; Reith S
[Ti] Título:[Non-ST-Segment Elevation Myocardial Infarction Caused by Spontaneous Coronary Thrombosis by Intimal Rupture].
[Ti] Título:Akuter Vorderwandinfarkt durch Koronarthrombus aufgrund eines spontanen Intimaeinrisses..
[So] Source:Dtsch Med Wochenschr;142(22):1686-1689, 2017 Nov.
[Is] ISSN:1439-4413
[Cp] País de publicação:Germany
[La] Idioma:ger
[Ab] Resumo:We report on a 51-year-old male patient with thoracic pain of acute onset with radiation in the left arm. His cardiovascular risk factors include obesity, smoking and arterial hypertension. ECG showed no signs of ischemia. The blood test revealed increasing troponin (37 pg/ml; Norm < 14 pg/ml). Therefore we performed cardiac catheterization. The RIVA demonstrated a medial filling defect. Use of OCT imaging showed intimal rupture associated with thrombus. The lesion was stented with a drug eluting stent. We initiated a medication with aspirin, ticagrelor, metoprolol and simvastatin. Coronary thrombosis of our patient was caused by spontaneous coronary artery dissection (SCAD). SCAD is an important differential diagnosis in patients with ACS. Further prospective studies and guideline recommendations are needed in the future.
[Mh] Termos MeSH primário: Trombose Coronária
Anomalias dos Vasos Coronários
Infarto do Miocárdio sem Supradesnível do Segmento ST
Doenças Vasculares/congênito
[Mh] Termos MeSH secundário: Dor no Peito
Seres Humanos
Masculino
Meia-Idade
Fatores de Risco
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171028
[St] Status:MEDLINE
[do] DOI:10.1055/s-0043-118633


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[PMID]:29073657
[Au] Autor:McKee JL; Ferrier K
[Ad] Endereço:Registrar, Hutt Valley DHB, Wellington.
[Ti] Título:Is cardiomegaly on chest radiograph representative of true cardiomegaly: a cross-sectional observational study comparing cardiac size on chest radiograph to that on echocardiography.
[So] Source:N Z Med J;130(1464):57-63, 2017 Oct 27.
[Is] ISSN:1175-8716
[Cp] País de publicação:New Zealand
[La] Idioma:eng
[Ab] Resumo:AIMS: To determine whether or not cardiomegaly identified on chest radiograph (CXR) is indicative of true cardiomegaly as determined using echocardiography (echo) as the gold standard tool, and therefore whether or not cardiomegaly on CXR should be investigated further. METHODS: CXR and echocardiogram reports were reviewed for the presence of cardiomegaly in a population following non-ST segment elevation myocardial infarction (NSTEMI). Data was evaluated to determine whether cardiomegaly reported on CXR did indeed represent true cardiomegaly. Exploratory analysis was undertaken to determine whether or not Body Surface Area (BSA) was a significant explanatory variable. RESULTS: Data was collected for 244 patients. Thirty-nine were reported to have cardiomegaly on CXR, 22 of those also had cardiomegaly on echo, giving a true positive rate of 56% and a false positive rate of 44%. Fifty-five were reported to have cardiomegaly on echo, of which 33 (60%) did not have cardiomegaly identified on CXR. Sensitivity of CXR to identify cardiomegaly was 40% and specificity was 91% with a positive predictive value of 56% and negative predictive value of 84%. BSA does not appear to be a significant explanatory variable for the discrepancy between the CXR and echo estimates of cardiomegaly. CONCLUSIONS: In patients following an NSTEMI, the true positive rate of cardiomegaly identified on CXR is not too dissimilar to the false positive rate, thereby suggesting that reporting "cardiomegaly" based on CXR findings is inaccurate and rather reporting should simply focus on the cardiothoracic ratio and defining this as an enlarged cardiac silhouette rather than true cardiomegaly. In clinical practice the data indicates that the number needed to investigate to identify true cardiomegaly on echo is only two, thereby concluding that all patients post-NSTEMI with cardiomegaly on CXR should go on to have an echo, consistent with current national guidelines. As the study population were all post-MI, further study is necessary to evaluate whether this association holds true in a wider population.
[Mh] Termos MeSH primário: Cardiomegalia/diagnóstico por imagem
Ecocardiografia
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico por imagem
Radiografia Torácica
[Mh] Termos MeSH secundário: Idoso
Cardiomegalia/complicações
Estudos Transversais
Feminino
Seres Humanos
Masculino
Infarto do Miocárdio sem Supradesnível do Segmento ST/complicações
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171030
[Lr] Data última revisão:
171030
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171027
[St] Status:MEDLINE


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[PMID]:29023473
[Au] Autor:Adamski P; Sikora J; Laskowska E; Buszko K; Ostrowska M; Uminska JM; Sikora A; Skibinska N; Sobczak P; Adamska U; Rosc D; Kubica A; Paciorek P; Marszall MP; Navarese EP; Gorog DA; Kubica J
[Ad] Endereço:Department of Principles of Clinical Medicine, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
[Ti] Título:Comparison of bioavailability and antiplatelet action of ticagrelor in patients with ST-elevation myocardial infarction and non-ST-elevation myocardial infarction: A prospective, observational, single-centre study.
[So] Source:PLoS One;12(10):e0186013, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Data from available studies suggest that the presence of ST-elevation myocardial infarction (STEMI) may be associated with delayed and attenuated ticagrelor bioavailability and effect compared with non-ST-elevation myocardial infarction (NSTEMI). METHODS: In a single-center, prospective, observational trial 73 patients with myocardial infarction (STEMI n = 49, NSTEMI n = 24) underwent a pharmacokinetic and pharmacodynamic assessment after a 180 mg ticagrelor loading dose (LD). Ticagrelor and its active metabolite (AR-C124910XX) plasma concentrations were determined with liquid chromatography tandem mass spectrometry, and their antiplatelet effect was measured with the VASP assay and multiple electrode aggregometry. RESULTS: During the first six hours after ticagrelor LD, STEMI patients had 38% and 34% lower plasma concentration of ticagrelor and AR-C124910XX, respectively, than NSTEMI (ticagrelor AUC(0-6): 2491 [344-5587] vs. 3991 [1406-9284] ng*h/mL; p = 0.038; AR-C124910XX AUC(0-6): 473 [0-924] vs. 712 [346-1616] ng*h/mL; p = 0.027). STEMI patients also required more time to achieve maximal concentration of ticagrelor (tmax: 4.0 [3.0-12.0] vs. 2.5 [2.0-6.0] h; p = 0.012). Impaired bioavailability of ticagrelor and AR-C124910XX seen in STEMI subjects was associated with diminished platelet inhibition in this group, which was most pronounced during the initial hours of treatment. CONCLUSIONS: Plasma concentrations of ticagrelor and AR-C124910XX during the first hours after ticagrelor LD were one third lower in STEMI than in NSTEMI patients. This reduced and delayed ticagrelor bioavailability was associated with weaker antiplatelet effect in STEMI. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov identifier: NCT02602444 (November 09, 2015).
[Mh] Termos MeSH primário: Adenosina/análogos & derivados
Infarto do Miocárdio sem Supradesnível do Segmento ST/tratamento farmacológico
Inibidores da Agregação de Plaquetas/farmacocinética
Infarto do Miocárdio com Supradesnível do Segmento ST/tratamento farmacológico
[Mh] Termos MeSH secundário: Adenosina/sangue
Adenosina/farmacocinética
Adenosina/farmacologia
Idoso
Disponibilidade Biológica
Plaquetas/efeitos dos fármacos
Feminino
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio sem Supradesnível do Segmento ST/sangue
Inibidores da Agregação de Plaquetas/sangue
Estudos Prospectivos
Antagonistas do Receptor Purinérgico P2Y/farmacocinética
Antagonistas do Receptor Purinérgico P2Y/farmacologia
Infarto do Miocárdio com Supradesnível do Segmento ST/sangue
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (AR C124910XX); 0 (Platelet Aggregation Inhibitors); 0 (Purinergic P2Y Receptor Antagonists); GLH0314RVC (Ticagrelor); K72T3FS567 (Adenosine)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171013
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186013


  10 / 216 MEDLINE  
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[PMID]:28966314
[Au] Autor:Kim DW; Her SH; Park MW; Cho JS; Kim TS; Kang H; Sim DS; Hong YJ; Kim JH; Ahn Y; Chang K; Chung WS; Seung KB; Jeong MH; Rho TH
[Ad] Endereço:Division of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea.
[Ti] Título:Impact of Postprocedural TIMI Flow on Long-Term Clinical Outcomes in Patients with Acute Myocardial Infarction.
[So] Source:Int Heart J;58(5):674-685, 2017 Oct 21.
[Is] ISSN:1349-3299
[Cp] País de publicação:Japan
[La] Idioma:eng
[Ab] Resumo:This study aimed to evaluate the clinical prognostic implications of postprocedural Thrombolysis in Myocardial Infarction (TIMI) flow in acute myocardial infarction patients. A total of 2796 ST-elevation myocardial infarction (STEMI) and 1720 non ST-elevation myocardial infarction (NSTEMI) patients treated in 8 hospitals affiliated with the Catholic University of Korea and Chonnam National University Hospital were analyzed. The study populations were divided according to the final TIMI flow. The primary outcome were the major adverse cardiac events (MACE), defined as a composite of cardiac deaths (CD), nonfatal myocardial infarctions (MI), and target lesion revascularization (TLR). Over a median follow-up of 3.3 years (minimum 2 to maximum 5 years), MACE and CD occurred more frequently in STEMI patients with TIMI ≤ 2 group than those with TIMI 3 (MACE: adjusted hazard ratio [aHR], 1.962; 95% confidence interval [CI] 1.513 to 2.546, P < 0.001, CD: aHR, 3.154, CI 2.308 to 4.309, P < 0.001). However, there was no significant difference between the two subgroups in NSTEMI (aHR, 0.932; 95% CI 0.586 to 1.484, P = 0.087). In STEMI patients, good postprocedural TIMI flow after PCI was associated with favorable clinical outcomes. And the effect of poor TIMI flow in STEMI was on death, not the components of MACE. Meanwhile, postprocedural TIMI flow had no effect on long-term outcomes in NSTEMI patients.
[Mh] Termos MeSH primário: Circulação Coronária/fisiologia
Infarto do Miocárdio sem Supradesnível do Segmento ST/terapia
Intervenção Coronária Percutânea/métodos
Cuidados Pós-Operatórios/métodos
Sistema de Registros
Infarto do Miocárdio com Supradesnível do Segmento ST/terapia
Terapia Trombolítica/métodos
[Mh] Termos MeSH secundário: Angiografia Coronária
Feminino
Seguimentos
Seres Humanos
Masculino
Meia-Idade
Infarto do Miocárdio sem Supradesnível do Segmento ST/diagnóstico
Infarto do Miocárdio sem Supradesnível do Segmento ST/fisiopatologia
Valor Preditivo dos Testes
Estudos Prospectivos
Infarto do Miocárdio com Supradesnível do Segmento ST/diagnóstico
Infarto do Miocárdio com Supradesnível do Segmento ST/fisiopatologia
Fatores de Tempo
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; MULTICENTER STUDY; OBSERVATIONAL STUDY
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171102
[Lr] Data última revisão:
171102
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171003
[St] Status:MEDLINE
[do] DOI:10.1536/ihj.16-448



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