Complete versus culprit-only revascularization in ST-elevation myocardial infarction and multivessel disease

Pasquale, Giuseppe Di; Filippini, Elisa; Pavesi, Pier Camillo; Tortorici, G; Casella, Gianni; Sangiorgio, Pietro

doi:10.1007/s11739-016-1419-5

Cited by 7 publications

(3 citation statements)

References 40 publications

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“…This approach significantly enhances survival rates in severe cases of pheochromocytoma‐associated cardiogenic shock. It is important to note that myocardial damage caused by pheochromocytoma is reversible, and timely intervention, including surgical treatment, offers curative possibilities 7 . In this case, the patient presented with life‐threatening cardiogenic shock as the primary symptom, and was promptly rescued by ECMO.…”

Section: Discussionmentioning

confidence: 95%

“…It is important to note that myocardial damage caused by pheochromocytoma is reversible, and timely intervention, including surgical treatment, offers curative possibilities. 7 In this case, the patient presented with life-threatening cardiogenic shock as the primary symptom, and was promptly rescued by ECMO. This not only prevented fatality but also facilitated subsequent treatments and increased the survival rate.…”

Section: -Methoxytyramine Metanephrine Methoxynorepinephrinementioning

confidence: 90%

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Continuous blood purification in patients with pheochromocytoma crisis: A case report

Zhong,

Zhu,

Wang

et al. 2023

Clinical Case Reports

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Key Clinical MessagePheochromocytoma crisis accompanied by multi‐organ failure necessitates prompt and comprehensive interventions, including VA‐ECMO, CRRT, and others. Successful laparoscopic tumor resection promotes favorable outcomes and recovery.AbstractPheochromocytoma crisis is commonly associated with high mortality, high surgical risk, and rapidly fatal complications. This article presented successful treatments and nursing experiences in a patient with pheochromocytoma who developed cardiogenic shock and multiple organ failure. We report a case study of a 32‐year‐old female patient who experienced pheochromocytoma crisis accompanied by multiple organ failure. Initial assessment of bedside echocardiography revealed an extremely low left ventricular ejection fraction of 8%. The patient was promptly resuscitated though tracheal intubation and venoarterial extracorporeal membrane oxygenation (VA‐ECMO), in conjunction with continuous renal replacement therapy (CRRT), alpha‐blockers, beta‐blockers, and other pharmacological interventions to manage blood pressure and heart rate. These interventions resulted in a remarkable increase in the left ventricular ejection fraction of 67%. However, the patient subsequently developed severe sepsis, which may have been caused by the intubation procedure, necessitating the discontinuation of VA‐ECMO while maintaining CRRT. Close monitoring of plasma catecholamine metabolite level, hemodynamic index, inflammatory marker, liver and kidney functions, and electrolytes during CRRT support allows for evaluating the efficacy of these measures and assessing the impact of CRRT on pheochromocytoma crisis. Eventually, the patient successfully underwent laparoscopic resection of a large pheochromocytoma, leading to favorable prognosis and a successful recovery. Continuous blood purification therapy can effectively eliminate catecholamines and their byproducts from the plasma, stabilize hemodynamics, improve heart, liver, and kidney functions, significantly reduce inflammatory cytokine levels significantly, and extend the surgical window for patients.

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Section: Discussionmentioning

confidence: 95%

Section: -Methoxytyramine Metanephrine Methoxynorepinephrinementioning

confidence: 90%

Continuous blood purification in patients with pheochromocytoma crisis: A case report

Zhong,

Zhu,

Wang

et al. 2023

Clinical Case Reports

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“…Different treatment strategies have been developed with controversies regarding their usefulness continuing. Previous observational and small randomized controlled trials have demonstrated conflicting results regarding the optimal treatment strategy (20). Specifically, complete vs. culprit-only revascularization has been compared.…”

Section: Discussionmentioning

confidence: 99%

Fibrinogen‑to‑albumin ratio predicts long‑term outcomes for patients with ST‑elevation myocardial infarction and multivessel disease: A prospective observational cohort study

et al. 2021

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The fibrinogen-to-albumin ratio index (FAR) is a valuable tool reflecting the systemic inflammation level and associated with the severity of coronary artery disease. However, the utility of the FAR in predicting the long-term prognosis of patients with ST-elevation myocardial infarction (STEMI) and multivessel disease has remained to be determined. A total of 424 patients diagnosed with STEMI and multivessel disease were recruited for the present study. They were given emergent percutaneous coronary intervention treatment and then completed a follow-up for primary (all-cause mortality) and secondary endpoints (major adverse cardiac events, including MI, stroke, emergent revascularization and rehospitalization due to heart failure). The association between FAR and the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score was investigated, while receiver operating characteristic curve analysis was adopted to assess the ability of the FAR to predict long-term outcomes. The long-term survival of high and low FAR groups was compared by drawing Kaplan-Meier survival curves. Multivariate Cox regression analysis was adopted to evaluate the risk factors of primary and secondary endpoints. The FAR was revealed to have a linear correlation with the SYNTAX score (y=0.022x+17.737; P=0.015). Furthermore, the FAR was a significant predictor of all-cause death with a cutoff value of 128.4 (area under the curve, 0.832; P<0.001). A significant difference was determined between the high FAR group and the low FAR group in terms of the proportion of patients with the primary endpoint (P<0.001) and secondary endpoint (P=0.001). It was demonstrated that the FAR was an independent risk factor for all-cause death of patients with STEMI and multivessel disease (hazard ratio, 1.029; 95% CI: 1.020-1.037; P<0.001). In summary, the FAR is a valuable biomarker associated with STEMI and may be useful in the prediction of the long-term prognosis of patients with STEMI and multivessel disease.

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Coronary angiography- or fractional flow reserve-guided complete revascularization in multivessel disease STEMI: A Bayesian hierarchical network meta-analysis

Archilletti

Ricci²,

Pelliccia³

et al. 2023

International Journal of Cardiology

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Complete versus culprit-only revascularization in ST-elevation myocardial infarction and multivessel disease

Cited by 7 publications

References 40 publications

Continuous blood purification in patients with pheochromocytoma crisis: A case report

Continuous blood purification in patients with pheochromocytoma crisis: A case report

Fibrinogen‑to‑albumin ratio predicts long‑term outcomes for patients with ST‑elevation myocardial infarction and multivessel disease: A prospective observational cohort study

Coronary angiography- or fractional flow reserve-guided complete revascularization in multivessel disease STEMI: A Bayesian hierarchical network meta-analysis

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