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This prospective study included 586 consecutive patients admitted with STEMI to the Cardiology Clinic of the County Emergency Clinical Hospital of Tîrgu Mureș, between January 1
The ISSTE score calculated at baseline, immediately before the primary percutaneous coronary intervention, was significantly higher in Group 2 as compared to Group 1 (1...
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... mean population age was significantly higher in the nonsurvivor group compared to survivors (61.4 ± 11.7 years in Group 1 vs. 70.5 ± 10.7 years in Group 2, p <0.0001) ( Table 1). There was no significant difference between the study groups in respect to gender (p = 0.8), the presence of hy- pertension (p = 0.9), smoking status (p = 0.4), obesity (p = 0.1) and previous myocardial infarction (p = 0.6). ...
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Background:
In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI), a patent infarct-related artery (IRA) on initial angiography is defined as spontaneous reperfusion (SR).
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Objectives
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Citations
... 5 The integrated ST-segment elevation score (ISSTE) is an effective marker of myocardial injury in patients undergoing pPCI and has been associated with in-hospital mortality. 6 Several clinical and angiographic risk stratification systems have been developed for prediction of adverse events and mortality in these patients, without including contemporary laboratory or imaging biomarkers. 7,8 High-sensitivity C-reactive protein (hs-CRP) has been identified as a good predictive biomarker for adverse events and heart failure, and has shown reliable risk stratification in STEMI patients treated with PCI. ...
... Previous studies have demonstrated that the ISSTE score is associated with mortality rates in the acute phase of a revascularized STEMI. 6 In our study, the mean The analysis of large randomized trials concluded that infarct size determined by CMR is associated with adverse events, heart failure, and mortality in STEMI patients, and is suggested as a possible endpoint for clinical studies. 20 Various validated CMR parameters possess valuable information for an incremental risk stratification of STEMI patients. ...
Background: The integrated ST segment elevation score (ISSTE) score objectively quantifies the ECG changes before and after primary percutaneous coronary intervention (pPCI) for ST segment elevation myocardial infarction (STEMI). The inflammatory response is a major component in scar formation and remodeling process of the myocardial tissue following myocardial infarction (MI). Cardiac magnetic resonance imaging (CMR) precisely quantifies the cardiac function and assesses the pattern of the myocardial scar tissue. The aim of the study was to evaluate the relations between the ISSTE score and: (1) acute inflammatory biomarkers and (2) extent of the myocardial scar determined by CMR in STEMI treated with pPCI. Material and methods: One hundred thirty STEMI patients were included in the study, who underwent pPCI in the first 12 hours from symptom debut. ISSTE-1 was calculated at presentation and 2 hours following pPCI (ISSTE-2). Inflammatory biomarkers were determined at admission and day 5, followed by LGE-CMR at 4 weeks, with quantification of cardiac function and extent of infarct size (IS) and transmurality. Patients were divided in low and high ISSTE groups based on the median values. Results: No significant differences were noted in terms of CMR parameters or inflammatory biomarkers and between the groups with low or high ISSTE-1. Significantly higher levels of day-5 hs-CRP (p = 0.03) and day-1 IL-6 (p = 0.02), MMP-9 (p = 0.05) were recorded in high ISSTE-2 groups. LV IS mass (23.11 ± 5.31 vs. 57.94 ± 8.33, p = 0.001), percentage (13.55 ± 6.22 vs. 27.15 ± 7.12, p = 0.001) and transmurality (p = 0.001) was significantly higher in ISSTE-2 group. ISSTE-2 significantly correlated with LV IS mass (r = 0.391, p
... The technique is based on the photometric analysis of the pulse wave in the fingernail, requiring a systolic blood pressure of more than 85 mmHg. Therefore, clinical situations in which the patients present hypovolemia, low blood pressure, CS, or other types of shock associated with decreased tissular perfusion, can impair the evaluation of ventilatory status using this method.89 Tissular hypoperfusion is the most common event that proceeds multiple organ dysfunction during shock.90 ...
Cardiogenic shock remains the leading cause of death in patients hospitalized for acute myocardial infarction, despite many advances encountered in the last years in reperfusion, mechanical, and pharmacological therapies addressed to stabilization of the hemodynamic condition of these critical patients. Such patients require immediate initiation of the most effective therapy, as well as a continuous monitoring in the Coronary Care Unit. Novel biomarkers have been shown to improve diagnosis and risk stratification in patients with cardiogenic shock, and their proper use may be especially important for the identification of the critical condition, leading to prompt therapeutic interventions. The aim of this review was to evaluate the current literature data on complex biomarker assessment and monitoring of patients with acute myocardial infarction complicated with cardiogenic shock in the Coronary Care Unit.
... ST-segment resolution is a surrogate for tissue level reperfusion, illustrating the no-reflow phenomenon after primary PCI, and the lack of ST-segment regression after PCI has been proved to be a predictor for in-hospital mortality rates.66,67 EAT And mAjor AdvErsE cArdiovAsculAr EvEnTsEpicardial fat might provide supplementary evidence regarding future cardiac events in patients with acute coronary syndromes. ...
Background: This systematic review seeks to evaluate the role of epicardial adipose tissue (EAT), quantified either by thickness, assessed by transthoracic echocardiography, or by volume, assessed by cardiac computed tomography (CT), in the follow-up of patients with acute coronary syndromes (ACS). Method: One-hundred forty-four articles were screened, from which 56 were reviewed in full-text. From those, 47 studies were excluded for the following reasons: they did not meet the inclusion criteria; they were either reviews or meta-analyses; the study cohorts included only stable coronary artery disease patients; they did not state a clear and concise study design, endpoints, or follow-up. The final draft included nine studies for systematic evaluation. Results: Of the 2,306 patients included in the review, 170 underwent cardiac CT while the remaining 2,136 underwent transthoracic echocardiography for the measurement of EAT. The analysis found that the EAT thickness was significantly associated with major adverse cardiovascular events (MACE) rates during hospitalization (OR: -1.3, 95% CI: 1.05-1.62, p = 0.020) and at three years (HR: 1.524, 95% CI: 1.0-2.2, p = 0.038). The included studies found that EAT was correlated with the following clinical and angiographic risk scores for ACS: GRACE (r = 0.438, p
