Characteristics, treatment and in-hospital outcomes of patients with STEMI in a metropolitan area of a developing country: an initial report of the extended Jakarta Acute Coronary Syndrome registry

Dharma, Surya; Andriantoro, Hananto; Purnawan, Ismi; Dakota, Iwan; Basalamah, Faris; Hartono, Beny; Rasmin, Ronaly; Isnanijah, Herawati; Yamin, Muhammad; Wijaya, Ika Prasetya; Pratama, Vireza; Gunawan, Tjatur Bagus; Juwana, Yahya Berkahanto; Suling, Frits R.W.; Witjaksono, A M Onny; Lasanudin, Hengkie Frankie; Iskandarsyah, Kurniawan; Priatna, Hardja; Tedjasukmana, Pradana; Wahyumandradi, Uki; Kosasih, Adrianus; Budhiarti, Imelda A; Pribadi, Wisnoe; Wirianta, Jeffrey; Lubiantoro, Utojo; Pramesti, Rini; Widowati, Diah Retno; Aminda, Sissy Kartini; Basalamah, Mohammad; Rao, Sunil V.

doi:10.1136/bmjopen-2016-012193

Cited by 29 publications

(28 citation statements)

References 24 publications

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“…Recently, elective or primary PCI can significantly benefit to the patient with acute coronary syndrome [15][16][17]. Although the mortality of PCI perioperative is less than 3%, and gradually reduced, but allcause mortality in patients with coronary heart disease is still high [18,19]. The emergence of drug-eluting stents significantly reduced the risk of stenosis of coronary artery and the ratio of the essential for revascularization of coronary heart disease, but no-reflow or slow reflow of opening the infracted related artery in the post-operative patients weakened the benefit of PCI [20,21].…”

Section: Discussionmentioning

confidence: 99%

The Relationship between MMP-9 and Infarct Related Artery Reflow in Acute STEMI Patients

Guo¹,

Chai²,

Liu³

et al. 2017

J Diabetes Metab

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Objective: Atherosclerotic plaque rupture leading to coronary artery occlusion is the culprit event which underpins a majority of acute myocardial infarction, and Matrix metalloproteinases (MMPs) contribute to atherosclerotic plaque rupture by involving in extracellular matrix degradation and artificial balloon extrusion. Patients with ST-segment elevation myocardial infarction (STEMI) caused by plaque rupture are at high risk for slow reflow, but the relationship between reflow and MMP-9 remains unclear, especially in the real world of local plaque rupture. We investigated the association between the levels of matrix metalloproteinase-9 (MMP-9) in infarct-related arterial infusion and the risk of slow reflow in STEMI patients following percutaneous coronary intervention (PCI). Methods: 65 eligible acute STEMI patients undergoing successful PCI were included in the current study. Blood samples were obtained from the extraction catheter placed distal to the lesion during PCI. Plasma MMP-9 levels were determined by immunoassay method. Results: Using multiple logistic regression analysis, MMP-9 levels (OR 0.881, CI 0.791-0.981; P=0.021) was found to be a significant risk factor of slow flow together with HSCORE (OR=0.085, CI 0.014-0.506; P=0.007). ROC curve with area under the curve (0.740) and 95% confidence interval (0.607-0.872) revealed that lesion MMP-9 changes had an predictive value for no reflow(P=0.002). Conclusions:The present study indicated that plasma MMP-9 levels in the culprit coronary artery was associated with slow flow in patients with ST-elevation MI following successful primary PCI.

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Section: Discussionmentioning

confidence: 99%

The Relationship between MMP-9 and Infarct Related Artery Reflow in Acute STEMI Patients

Guo¹,

Chai²,

Liu³

et al. 2017

J Diabetes Metab

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“…The JAC registry has been set-up in the hospital since 2007 and currently is being used as the main source of data for measuring the performance of STEMI care in the region as part of the STEMI network program (Jakarta Cardiovascular Care Unit Network System). [8][9][10][11] All consecutive patients with acute coronary syndrome including STEMI were recorded in the database. The dataset consists of demographic and clinical characteristics, laboratory and primary PCI variables.…”

Section: Jac Registrymentioning

confidence: 99%

Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI

et al. 2019

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The association of hyperglycemia at admission and final thrombolysis in myocardial infarction (TIMI) flow with 1-year mortality of patient with acute ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) has not much been explored. We evaluated the association of hyperglycemia and final TIMI flow with 1-year mortality in patients with acute STEMI who underwent primary PCI.We retrospectively analyzed 856 patients with STEMI who underwent primary PCI in a tertiary care academic center between January 2014 and July 2016. Based on the receiver operating characteristics curve, the cutoff used for hyperglycemia in this study was greater than or equal to 169 mg/dL. Cox proportional hazard model was used to determine the association of hyperglycemia and TIMI flow with 1-year mortality.Compared with patients with lower blood glucose level (<169 mg/dL; n = 549), a greater proportion of patients who presented with hyperglycemia (≥169 mg/dL; n = 307) had final TIMI flow 0 to 1 (3.3 vs. 0.5%; adjusted odds ratio = 5.58, 95% confidence interval [CI] 1.30–23.9, p = 0.02). Hyperglycemia was associated with an increased risk for 1-year mortality (adjusted hazard ratio [HR]= 2.0, 95% CI: 1.13–3.53, p = 0.017). Multivariable Cox regression showed that the interaction of hyperglycemia and final TIMI flow 0 to 1 was associated with an elevated risk for 1-year mortality (adjusted HR= 9.4, 95% CI: 2.34–37.81, p = 0.002).A higher proportion of patients with acute STEMI who presented with hyperglycemia had final TIMI flow 0 to 1 after primary PCI. The interaction of hyperglycemia and final TIMI flow 0 to 1 was associated with an increased risk for 1-year mortality. This study suggests that aggressive control of hyperglycemia prior to primary PCI may facilitate better angiographic and clinical outcomes after primary PCI. Clinical Trial Registration Clinicaltrials.gov Identifier number: NCT02319473.

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“…It is currently estimated that 7% to 12% of STEMI patients >75 years of age develop CS. [7][8][9] The continuous development of STEMI networks has led not only to a dramatic decrease in STEMI-related mortality, but also to an increase in the frequency of severely complicated cases who survive to be transferred to a tertiary center for advanced life-saving treatments. 10 As a result of effective STEMI networks, more and more patients with complex multivessel disease, high-risk coronary lesions or delayed presentation arrive in the catheterization laboratory.…”

Section: Cardiogenic Shock In Acute Myocardial Infarction -A Very Higmentioning

confidence: 99%

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

Iancu

Dregoesc

Solomoneanu

et al. 2018

Journal of Cardiovascular Emergencies

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Patients with acute myocardial infarction (AMI) complicated with cardiogenic shock (CS) present one of the highest mortality rates recorded in critical care. Mortality rate in this setting is reported around 45-50% even in the most experienced and well-equipped medical centers. The continuous development of ST-segment elevation acute myocardial infarction (STEMI) networks has led not only to a dramatic decrease in STEMI-related mortality, but also to an increase in the frequency of severely complicated cases who survive to be transferred to tertiary centers for life-saving treatments. The reduced effectiveness of vasoactive drugs on a severely altered hemodynamic status led to the development of new devices dedicated to advanced cardiac support. What’s more, efforts are being made to reduce time from first medical contact to initiation of mechanical support in this particular clinical context. This review aims to summarize the most recent advances in mechanical support devices, in the setting of CS-complicated AMI. At the same time, the review presents several modern concepts in the organization of complex CS centers. These specialized hubs could improve survival in this critical condition.

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Characteristics, treatment and in-hospital outcomes of patients with STEMI in a metropolitan area of a developing country: an initial report of the extended Jakarta Acute Coronary Syndrome registry

Cited by 29 publications

References 24 publications

The Relationship between MMP-9 and Infarct Related Artery Reflow in Acute STEMI Patients

The Relationship between MMP-9 and Infarct Related Artery Reflow in Acute STEMI Patients

Association of Hyperglycemia and Final TIMI Flow with One-Year Mortality of Patients with Acute ST-Segment Elevation Myocardial Infarction Undergoing Primary PCI

A Long-Forgotten Tale: The Management of Cardiogenic Shock in Acute Myocardial Infarction

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