Assessment of quality of care of patients with ST-segment elevation myocardial infarction

Hudzik, Bartosz; Budaj, Andrzej; Gierlotka, Marek; Witkowski, Adam; Wojakowski, Wojciech; Zdrojewski, Tomasz; Gil, Robert; Legutko, Jacek; Bartuś, Stanisław; Dudek, Dariusz; Gąsior, Mariusz

doi:10.1177/2048872619882360

Cited by 8 publications

(3 citation statements)

References 36 publications

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“…The cutoff value, sensitivity, and specificity of area strain were 23.2%, 0.915, and 0.828, respectively. Among them, the sensitivity and specificity of area strain were higher [15] . However, the current frame rate of 3D strain imaging is still not high enough, and some useful information may be lost.…”

Section: Discussionmentioning

confidence: 96%

The value of STE-LDDSE to detect viable myocardium

Qian,

Zhou,

Chen

et al. 2023

Preprint

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Objective To explore the value of speckle tracking echocardiography (STE) with low dose dobutamine stress echocardiography (LDDSE) for evaluation of viable myocardium (VM) in the acute ST-elevation myocardial infarction (STEMI) patients with or without type 2 diabetes mellitus (DM). Methods Eighty-five hospitalized patients with regional wall motion abnormalities (RWMA) according to routine echocardiography in STEMI, thirty patients with type 2 DM. All of them were underwent STE associated with LDDSE (STE-LDDSE) prior to coronary angiography and percutaneous coronary intervention (PCI). Every segment image was acquired and evaluated by wall-motion analysis. The images of STE-LDDSE were analyzed quantitatively for peak-systolic strain (S) and strain rate (Sr), the short axis of radial strain (RS), radial strain rate (RSr), circumferential strain (CS), circumferential strain rate (CSr) and the long axis of longitudinal strain (LS), longitudinal strain rate (LSr) by using the QLAB software. All patients underwent PCI within one week after completing STE-LDDSE examination, and echocardiograms were reviewed at 1, 3, and 6 months after surgery. Results A total of 183 regional wall motion abnormalities (RWMA) were detected in the DM group, of which 117 (63.93%) segments were viable myocardium; 357 RWMA were detected in non DM patients, of which 248 (69.47%) segments of viable myocardium were detected by echocardiography. The sensitivity, accuracy, and specificity of STE-LDDSE in detecting viable myocardium in DM group were 70.94%、77.45%、87.88% ; 92.31%、72.73% and 85.25% for LS and LSr. In the non DM group, the sensitivity, specificity, and accuracy of LS and LSr were 68.95%、92.66%、76.19% ; 77.42%、88.07% and 80.67%, respectively. Further parallel diagnostic tests were conducted on LS and LSr parameters. The sensitivity, specificity, and accuracy of detecting viable myocardium in the DM and non DM groups were 84.62%、45.45%、70.49%, 66.53%、63.30% and 65.55%, respectively, at rest; They were 84.62%、45.45%、70.49%, 66.53%、63.30% and 65.55%, respectively, during low dose dobutamine stress. Conclusion STE-LDDSE has a high value of detecting VM. Parallel diagnostic test for LS and LSr is the best choice in detecting VM in the patients with STEMI and is more sensitive for the patients with type 2 DM. It will be more effectively to guide the further treatment and to evaluate the prognosis of the STEMI patients.

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Section: Discussionmentioning

confidence: 96%

The value of STE-LDDSE to detect viable myocardium

Qian,

Zhou,

Chen

et al. 2023

Preprint

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“…Unfortunately, and inconsistently with current guidelines, the same 12-month DAPT period was most frequently recommended in patients on anticoagulants (in 61.6% of patients with STEMI and in 55.9% with NSTEMI). Less frequently, 6-month (in 18.2% of patients with STEMI and in 20.2% with NSTEMI) and 1–2-month periods (in 9.9% of patients with STEMI and in 14.6% with NSTEMI) were suggested [ 28 ].…”

Section: Hospital Discharge and Post-hospital Phasementioning

confidence: 99%

Antiplatelets in acute coronary syndrome in Poland – from guidelines to clinical practice

Tubek

Kuliczkowski

Gąsior

et al. 2021

pwki

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Acute coronary syndrome is a factor for poor prognosis and recurrent cardiovascular events. Adequate antiplatelet therapy is crucial in patients with the acute coronary syndrome for risk reduction. Such treatment is well described in four documents issued by the European Society of Cardiology, which precisely illustrate the use of antiplatelets in the settings of ST-elevated and non-ST elevated myocardial infarction. Despite its unquestioned role in the treatment of acute coronary syndrome, recent real-world-data from Polish registries reveal poor adherence to the guidelines-recommended antiplatelet treatment in Poland. Thus, we present here a comprehensive review of the use of antiplatelets in the settings of the acute coronary syndrome. Each phase of the treatment, i.e. pre-hospital, in-hospital and post-hospital, is discussed separately for a better understanding of the decision-making process at each step. We also present unpublished data from Polish registries (e.g. PL-ACS 2019, National Registry of Procedures of Invasive Cardiology, RECEPTOmetrPEX panel) regarding adherence to the guidelines-recommended treatment in Poland, thus highlighting the points of care which should be immediately improved. It has to be stressed here that careful assessment of ischaemic and bleeding risk has to be performed in each patient with acute coronary syndrome individually and repeated at successive phases of the treatment. Only such an approach allows for appropriate antiplatelet therapy tailoring.

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“…Data obtained from the Polish National Consultant in Cardiology show that 23 748 cases of STE-MI were recorded in Poland in 2018. Hudzik et al 12 presented data from the Polish Registry of ACS, which indicated that 8279 patients were admitted to hospital in 2018 due to STEMI, and 5.9% of them died during hospitalization. The optimization of STEMI treatment should be based on the fastest permanent restoration of patency to the coronary artery.…”

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confidence: 99%