Complete revascularization in acute myocardial infarction: a clinical review

Saito, Yuichi; Kobayashi, Yoshio

doi:10.1007/s12928-022-00907-6

Cited by 15 publications

(8 citation statements)

References 83 publications

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“…A review of 21 related randomized controlled trials (RCTs) suggests that complete revascularization can reduce the incidence of MACCEs in patients with acute myocardial infarction, [7] which was similar to our outcome of the Cox regression. It is suggested that for patients at high risk of ischemia with multiple vessel lesions, complete revascularization should be performed while fully evaluating the characteristics of the lesions.…”

supporting

confidence: 75%

Effects of dual antiplatelet therapy de-escalation on the prognosis of acute coronary syndrome patients at high risk of ischemia who underwent percutaneous coronary intervention

Wang,

Li,

Lei

et al. 2024

Chinese Medical Journal

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supporting

confidence: 75%

Effects of dual antiplatelet therapy de-escalation on the prognosis of acute coronary syndrome patients at high risk of ischemia who underwent percutaneous coronary intervention

Wang,

Li,

Lei

et al. 2024

Chinese Medical Journal

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“…For instance, patients with AMI are likely to be older and have more comorbidities as shown in the present study, although they have an immediate therapeutic option such as primary percutaneous coronary intervention. 15 , 16 , 17 Differences in a diagnostic and therapeutic time frame may lead to different outcomes in patients with and without AMI. In this study, indeed, patients with AMI received the Impella earlier after hospital arrival than those without, suggesting that the devices were placed in an emergency situation in AMI than in non‐AMI.…”

Section: Discussionmentioning

confidence: 99%

Complications and Outcomes of Impella Treatment in Cardiogenic Shock Patients With and Without Acute Myocardial Infarction

Saito,

Tateishi,

Toda

et al. 2023

JAHA

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Background In patients with cardiogenic shock (CS), acute myocardial infarction (AMI) is the most common cause, and a percutaneous microaxial ventricular assist device (Impella, Abiomed, Danvers, MA) is a choice for temporary mechanical circulatory support. However, data are limited on complications and outcomes of Impella treatment in patients with CS with and without AMI. Methods and Results Using nationwide prospective registry data in Japan, we included a total of 2047 patients with CS in whom the Impella devices were successfully placed between February 2020 and December 2021. Patients were divided into 2 groups according to the primary indication for the Impella use: AMI versus non‐AMI. The primary end point was a composite of in‐hospital all‐cause death and major complications. Of the 2047 patients, the Impella was indicated for AMI in 1337 (65.3%). In the group without AMI, myocarditis was the leading cause of CS. Patients with AMI‐CS were older and more likely to have cardiovascular risk factors than those with non‐AMI‐CS. The rates of in‐hospital mortality (46.0% versus 43.9%, P =0.38) and major complications (35.2% versus 34.7%, P =0.85) were similar between the 2 groups. Overall, multivariable analysis identified older age, higher body mass index, previous transient ischemic attack or stroke, out‐of‐hospital cardiac arrest, and the Impella 5.0 as factors significantly associated with the primary end point. Conclusions The use of Impella in patients with and without AMI was related to similar clinical outcomes with high mortality and complication rates. Further studies are needed to identify patients who may benefit from the Impella devices in CS. Registration URL: https://www.umin.ac.jp/english . Identifier: UMIN000033603.

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“…A total of 137 patients were screened for this study according to predefined inclusion and exclusion criteria. All the patients who presented with STEMI within 12 hours of the onset of symptoms were included in this study for primary PCI (Saito and Kobayashi, 2023). Similarly, patients with increased frequency of intracoronary thrombus on angiographic imaging were also included in this study.…”

Section: Methodsmentioning

confidence: 99%

Comparative Analysis of Staged Versus Index Procedure Complete Revascularization in St-Elevation Myocardial Infarction

SHAH,

KHAN

2024

Biol Clin Sci Res J

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ST-elevation myocardial infarction (STEMI) is a critical condition that necessitates quick and efficient revascularization techniques. Recently, there has been a discussion on the best method for revascularization staged versus index procedure complete revascularization. The study compares the clinical outcomes of staged versus index procedure complete revascularization in ST-elevation myocardial infarction. This study is a prospective comparative analysis conducted at Ayub Teaching Hospital, Abbottabad. The patients were divided into two groups, with 40 participants in each group. Demographic data that included Smoking history, Diabetes mellitus, Dyslipidemia, Previous MI, and (LVEF) was recorded. Intraoperative and postoperative outcomes at 72 hours and six months were recorded. The quality of life was also assessed using SF-36 16. Data was entered and analyzed using SPSS (Statistical Package for the Social Sciences) version 24. P-values of ≤0.05 will be considered statistically significant. These findings suggest that in Group A, the frequency of "No reflow" (1 case) and "Abrupt closure" (0 instances) p=0.02) compared to Group B, where "No reflow" was observed in 2 cases and "Abrupt closure" in 1 case, (and (p=0.01), the investigation into post-operative outcomes, revealed no statistically significant differences between the two groups. P values ranged from 0.31 to 0.45, indicating comparable outcomes. After six months post-surgery, Group A demonstrated significantly better outcomes across various health-related domains than Group B, as indicated by the SF-36 questionnaire. In conclusion, index complete vascularization holds a distinct advantage over staged procedures. The observed differences across various health indicators highlight the potential clinical significance of prioritizing complete revascularization during the initial intervention.

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Complete revascularization in acute myocardial infarction: a clinical review

Cited by 15 publications

References 83 publications

Effects of dual antiplatelet therapy de-escalation on the prognosis of acute coronary syndrome patients at high risk of ischemia who underwent percutaneous coronary intervention

Effects of dual antiplatelet therapy de-escalation on the prognosis of acute coronary syndrome patients at high risk of ischemia who underwent percutaneous coronary intervention

Complications and Outcomes of Impella Treatment in Cardiogenic Shock Patients With and Without Acute Myocardial Infarction

Comparative Analysis of Staged Versus Index Procedure Complete Revascularization in St-Elevation Myocardial Infarction

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