Comparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: A cross-sectional study

Günlü, Serhat; Demir, Muhammed

doi:10.1016/j.ajem.2022.05.021

Cited by 6 publications

(6 citation statements)

References 22 publications

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“…Zhelev et al reported that multivessel vessel disease might have an effect on the hemodynamic status [ 13 ]. Günlü and Demir reported that in case to treat with fibrinolytic agents, administration of tenecteplase in STEMI patients who received a loading dose with ticagrelor resulted in a significant reduction in major adverse cardiac events compared to alteplase [ 14 ]. In this study, patients with the NSTEMI and the Aslanger pattern tended to have a relatively high incidence of hemodynamic deterioration during revascularization procedures compared with those without the Aslanger pattern.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria

Miyauchi

Kuwazuru

Arikawa

et al. 2023

Cureus

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Background: ST-elevation is one of the most valuable electrocardiogram findings to diagnose acute myocardial infarction. However, more than a quarter of acute coronary occlusions are missed by this criterion, causing a delay in revascularization. Therefore, there should be awareness of the limitations of the current criteria and new electrocardiographic findings are required as a diagnostic tool to compensate for them. The Aslanger pattern is a specific electrocardiographic finding in acute inferior myocardial infarction with multivessel disease and allows the detection of inferior myocardial infarction that does not show ST-elevation, leading to rapid revascularization. However, in patients with the Aslanger pattern, the hemodynamic characteristics, such as the rate of shock and the use of mechanical circulatory support, as well as prognostic characteristics such as the in-hospital mortality rate, have not yet been clarified. Methods: In this study, we retrospectively surveyed the current practice on the basis of ST-elevation myocardial infarction (STEMI) criteria in patients with acute coronary artery occlusion presenting with inferior myocardial infarction. We examined the clinical characteristics of the Aslanger pattern. Results: Based on the STEMI criteria, 71.8% (51/72) of patients were diagnosed with STEMI from an acute electrocardiogram, and 28.2% (21/78) were diagnosed with non-STEMI. As expected, ruling out in all acute coronary artery occlusions using STEMI criteria alone was difficult. A total of 48% of patients with non-STEMI had the Aslanger pattern. In addition, 80% of patients with the Aslanger pattern had multivessel disease, 30% had the use of the mechanical circulatory support, and 20% had in-hospital mortality. Conclusion: This study suggests that the Aslanger pattern is useful not only for diagnosis, but also for predicting hemodynamic collapse and a poor prognosis. Therefore, we should share information on Aslanger pattern with other physicians and use this pattern in daily practice.

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Section: Discussionmentioning

confidence: 99%

Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria

Miyauchi

Kuwazuru

Arikawa

et al. 2023

Cureus

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“…Crea et al reported that platelet count, high-sensitivity C-reactive protein, and serum uric acid were higher in hypertensive patients with CSF than in the control group [ 21 ]. In recent studies, the TFC was substantially higher in patients with metabolic syndrome than in those without metabolic syndrome, with greater BMI values [ 22 , 23 ]. In our research, the non-dipper group had a significantly higher BMI than the dipper group.…”

Section: Discussionmentioning

confidence: 99%

Non-Dipper Blood Pressure Impact on Coronary Slow Flow in Hypertensive Patients With Normal Coronary Arteries

Özen¹,

Karahan²

2023

Cureus

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Objective: Coronary slow flow (CSF) is linked to myocardial ischemia, malignant arrhythmias, and cardiovascular mortality. On the other hand, hypertension (HTN) is an important risk factor for vascular disorders. There is limited research on the relationship between CSF and HTN. This study aimed to investigate TIMI frame count (TFC), which is an indicator of CSF, in dipper and non-dipper hypertensive individuals with normal coronary arteries.Methods: The study was conducted as a retrospective observational study. Patients diagnosed with CSF and dipper or non-dipper hypertension were included in this study. Blood tests were routinely conducted for all patients. ECG was conducted for each patient, and echocardiography was performed. Coronary artery images were obtained in the CAG laboratory. Blood pressure (BP) measurements were obtained from the ambulatory Holter records. The patients were separated into two groups based on ambulatory Holter monitoring. The relationship between CSF and HTN was also examined.Results: A total of 71 patients, comprising 25 women (37.2%) and 46 men (62.8%) with an average age of 52.75±9.42 years, were enrolled in the research. Based on ambulatory BP, the individuals were separated into two groups: non-dipper (n=36) and dipper (n=35). The pulse rate was significantly higher in the non-dipper group (p<0.001). In terms of mean systolic and diastolic blood pressure, there were no substantial differences across the groups (p = 0.326 and p = 0.654, respectively). The daytime mean systolic and diastolic BP did not significantly differ across the groups (p = 0.842 and p = 0.421). The dipper group had substantially lower nighttime systolic and diastolic BP values (p <0.001). The LAD, Cx, and RCA TIMI frame scores were significantly lower in the dipper group (p<0.001). Conclusion:In this study, non-dipper patients had a greater CSF rate than dipper.

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“…In a study conducted by O'Connor et al, it was reported that there were significant differences between the genders when the clinical and demographic characteristics of patients who underwent TAVR were compared [16]. Diabetes mellitus, high body mass index (BMI), previous myocardial infarction, prior percutaneous coronary intervention and low ejection fraction (EF), have been shown to be more common in male patients [17]. It has been shown that female patients have more advanced age, higher transvalvular gradient, higher pulmonary artery pressure, higher EF and smaller annulus values.…”

Section: Discussionmentioning

confidence: 99%

Gender differences in patients undergoing transcatheter aortic valve replacement: a cross-sectional study

Aktan

Ertaş

2022

Acta Medica Alanya

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Amaç: Transkateter aort kapak replasmanının (TAVR) cerrahiye uygun olmayan, yüksek riskli semptomatik şiddetli aort darlığı (AS) olan hastalar için etkili bir tedavi yöntemidir. TAVR’ de cinsiyete bağlı farklılıklar hala tartışılmaktadır. Bu çalışma ile kliniğimizde TAVR uygulanan hastalarda cinsiyetin klinik sonuçlar üzerine etkisini araştırmayı amaçladık. Yöntemler: Ocak 2015 ile Ocak 2022 tarihleri arasında TAVR yapılan ardışık 270 hasta çalışmaya dahil edildi. Aort stenozunu değerlendirmek için hastanın tıbbi öyküsünün yanı sıra transtorasik veya transözofageal ekokardiyografi ve bilgisayarlı toraks tomografisi bulguları incelendi. Semptomatik, yüksek riskli şiddetli aort darlığı tespit edilen hastalara kendiliğinden genişleyebilen Evolute-R cihazlarıyla işlem yapıldı. Hastalar taburculuk sonrası ilk bir yıl takip edildi. Takipler klinik ziyaretler ve telefon görüşmeleriyle gerçekleşti. Bulgular: Hastane içi mortalite (%5.4’e karşı %7.4 ; p=0.507), bir yıllık takipte ölüm (%14.9'e karşı %.13.1, p=0.681) ve bir yıllık takipte MACCE (%26.4'e karşı %23.8, p=0.627) oranları açısından kadın ve erkek cinsiyetleri arasında istatistiksel olarak anlamlı farklılık saptanmadı. Bir yıllık mortalite ve MACCE oranlarını içeren sağkalım analizi Kaplan-Meier eğrileri kullanıldı. Buna göre her iki cinsiyet arasında mortalite ve MACCE açısından istatistiksel olarak anlamlı farklılık saptanmadı ( sırasıyla; p= 0.910, Log-rank: 0.013; p =0.889, Log-rank: 0.019). Sonuç: TAVR yapılan hasta grubumuzda her iki cinsiyet arasında klinik sonlanımlar açısından önemli bir farklılık saptamadık. Son yıllarda cihaz ve prosedürle ilişkili gelişmelerle cinsiyetin klinik sonuçlar üzerine etkisi azaltılmıştır.

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Comparison of tenecteplase versus alteplase in STEMI patients treated with ticagrelor: A cross-sectional study

Cited by 6 publications

References 22 publications

Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria

Clinical Features of the Aslanger Pattern to Compensate for the Limitation of ST-Elevation Myocardial Infarction (STEMI) Criteria

Non-Dipper Blood Pressure Impact on Coronary Slow Flow in Hypertensive Patients With Normal Coronary Arteries

Gender differences in patients undergoing transcatheter aortic valve replacement: a cross-sectional study

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