Clinical characteristics and in-hospital outcome in percutaneous coronary interventions with ST elevation myocardial infarction patients developing acute kidney injury

Aijaz, Saba; Ahmed, Naseer; Akhter, Zohaib; Sattar, Saadia; Lakhani, Shakir; Malik, Rehan; Pathan, Asad

doi:10.5455/jpma.23481

Cited by 7 publications

(9 citation statements)

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“…Further studies have shown variable findings and, depending upon the difference in patient selection, the percentage of occluded coronaries was found to be around 29% to 63%. 11 The reason for having higher OCA prevalence in our study might be a late presentation of patients to a medical facility, prior undetected MI, or missed STEMI due to a lack of early identification of ischemic heart disease.…”

Section: Discussionmentioning

confidence: 66%

Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Sharma¹,

Khanal²,

Shah

et al. 2023

J Nepal Med Assoc

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Introduction: Non-ST elevation myocardial infarction is frequently thought to be caused by incomplete blockage of the culprit artery, whereas ST elevation myocardial infarction is frequently thought to be caused by total occlusion of the culprit artery. The objective of the study was to find out the prevalence of occluded coronary arteries among non-ST elevation myocardial infarction patients department of cardiology of a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among non-ST elevation myocardial infarction patients in a tertiary care centre from 22 June 2020 to 21 June 2021 after taking ethical approval from the Institutional Review Committee [Reference number: 4271 (6-11) E2 076/077]. A total of 196 patients were included in the study by simple randomized sampling. Data on the patient’s clinical profile, angiographic findings, and in-hospital complications were recorded. Point estimate and 95% Confidence Interval were calculated. Results: Among 126 non-ST elevation myocardial infarction patients included in the study, the prevalence of occluded coronary artery was 41 (32.54%) (24.36-40.72, 95% Confidence Interval). Conclusions: The prevalence of occluded coronary arteries was similar to the studies done in similar settings.

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Section: Discussionmentioning

confidence: 66%

Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Sharma¹,

Khanal²,

Shah

et al. 2023

J Nepal Med Assoc

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“…They can be administered through multiple routes, including oral, intracoronary, or IV. 16 In the current study, nicorandil was used orally before PCI to prevent IRI.…”

Section: Discussionmentioning

confidence: 99%

“…6 In addition to MI diagnosis, these biomarkers also add to atherosclerosis progression, evaluation and prognosis of cardiac tissue function. 7,8 Cardiac biomarkers' concentrations alter with the period post-MI (Table 1).…”

Section: Introductionmentioning

confidence: 99%

Assessment of cardiac parameters after the administration of nicorandil before primary percutaneous coronary intervention

Ilyas,

Mudassar Noor,

Saleha Haroon

et al. 2024

J Pak Med Assoc

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Objectives: To assess cardiac troponin I and creatine kinase-myocardial band levels, electrocardiogram changes and major adverse cardiac events after treatment with nicorandil before primary percutaneous coronary intervention. Methods: The comparative, analytical study was conducted from October to November 2022 at the Pharmacology Department of Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan, in collaboration with the Rawalpindi Institute of Cardiology, Rawalpindi. The sample comprised ST-elevated myocardial infarction patients of either gender aged at least 30 years with an ejection fraction of at least 35% undergoing primary percutaneous coronary intervention. Participants were selected based on the above-mentioned inclusion and informed consent was taken before their enrolment in this research study. The sample was randomised into control group A receiving conventional acute coronary syndrome treatment, and intervention group B receiving nicorandil in addition to the conventional treatment. Cardiac troponin I and creatine kinase-myocardial band levels, electrocardiogram changes, and major adverse cardiac events noted and compared. Data was analysed using SPSS 26. Results: Of the 140 patients, 70(50%) were in each of the 2 groups. In group B, 60(85.7%) patients achieved a completely settled ST segment on electrocardiogram compared to 25(35.7%) in group A (p=0.001). There was a significant inter-group differences with respect to cardiac troponin I value 6 hours after percutaneous coronary intervention and major adverse cardiac events (p<0.05), but creatine kinase-myocardial band level was no significantly different between the groups (p=0.761). Conclusion: Prophylactic use of nicorandil in ST-elevated myocardial infarction patients decreased the incidence of reperfusion injury. Key Words: Nicorandil, Percutaneous coronary intervention, Ischaemic reperfusion injury.

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“…[5][6][7][8] Meta-analysis of studies looking at angiographic data of NSTEMI patients found that 25.5%-39% of NSTEMI patients have coronary artery occlusion and this is associated with increased short and long-term mortality. 5,9 There is also an increase in mortality in comparison to STEMI patients, as due to the lack of ST-elevation on the ECG, these patients may be mis-triaged and do not receive timely reperfusion therapy such as percutaneous coronary intervention (PCI) or thrombolysis. 10 There is no clear way to clinically distinguish between occlusive MI and nonocclusive MI before angiography as ST-elevation appears nonspecific for coronary artery occlusion and troponin is raised in any cause of myocardial necrosis or turnover regardless of coronary artery occlusion.…”

Section: Introductionmentioning

confidence: 99%

“…However, there is increasing evidence that there is a subset of NSTEMI patients who do have acute coronary artery occlusion 5–8 . Meta‐analysis of studies looking at angiographic data of NSTEMI patients found that 25.5%–39% of NSTEMI patients have coronary artery occlusion and this is associated with increased short and long‐term mortality 5,9 . There is also an increase in mortality in comparison to STEMI patients, as due to the lack of ST‐elevation on the ECG, these patients may be mis‐triaged and do not receive timely reperfusion therapy such as percutaneous coronary intervention (PCI) or thrombolysis 10 .…”

Section: Introductionmentioning

confidence: 99%

Using latent class analysis to identify clinical features of patients with occlusive myocardial infarction: Preangiogram prediction remains difficult

Knoery

McEwan

Manktelow

et al. 2022

Clinical Cardiology

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Background: Treatment decisions in myocardial infarction (MI) are currently stratified by ST elevation (ST-elevation myocardial infarction [STEMI]) or lack of ST elevation (non-ST elevation myocardial infarction [NSTEMI]) on the electrocardiogram.This arose from the assumption that ST elevation indicated acute coronary artery occlusion (OMI). However, one-quarter of all NSTEMI cases are an OMI, and have a higher mortality. The purpose of this study was to identify features that could help identify OMI.Methods: Prospectively collected data from patients undergoing percutaneous coronary intervention (PCI) was analyzed. Data included presentation characteristics, comorbidities, treatments, and outcomes. Latent class analysis was undertaken, to determine patterns of presentation and history associated with OMI.Results: A total of 1412 patients underwent PCI for acute MI, and 263 were diagnosed as OMI. Compared to nonocclusive MI, OMI patients are more likely to have fewer comorbidities but no difference in cerebrovascular disease and increased acute mortality (4.2% vs. 1.1%; p < .001). Of OMI, 29.5% had delays to their treatment such as immediate reperfusion therapy. With latent class analysis, while clusters of similar patients are observed in the data set, the data available did not usefully identify patients with OMI compared to non-OMI. Conclusion:Features between OMI and STEMI are broadly very similar. However, there was no difference in age and risk of cerebrovascular disease in the OMI/non-OMI group. There are no reliable characteristics therefore for identifying OMI versus non-OMI. Delays to treatment also suggest that OMI patients are still missing out on

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Clinical characteristics and in-hospital outcome in percutaneous coronary interventions with ST elevation myocardial infarction patients developing acute kidney injury

Cited by 7 publications

References 0 publications

Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Occluded Coronary Artery among Non-ST Elevation Myocardial Infarction Patients in Department of Cardiology of a Tertiary Care Centre: A Descriptive Cross-sectional Study

Assessment of cardiac parameters after the administration of nicorandil before primary percutaneous coronary intervention

Using latent class analysis to identify clinical features of patients with occlusive myocardial infarction: Preangiogram prediction remains difficult

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