Prehospital stratification and prioritisation of non-ST-segment elevation acute coronary syndrome patients (NSTEACS): the MARIACHI scale

Solà-Muñoz, Silvia; Jorge, Morales; Jiménez-Fàbrega, Xavier; Jiménez-Delgado, Sonia; Azeli, Youcef; Marsal, Josep Ramón; Jordan, Sara M.; Mauri, Josepa; Jacob, Javier

doi:10.1007/s11739-023-03274-z

Cited by 3 publications

(3 citation statements)

References 52 publications

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“…The conventional 12‐lead ECG is a widely accessible and noninvasive clinical tool. The assessment of ECG parameters plays a crucial role in the initial evaluation of patients with acute coronary syndrome (ACS), while also providing valuable prognostic information (Burak et al., 2019 ; Demandt et al., 2022 ; Karakayali et al., 2023 ; Solà‐Muñoz et al., 2023 ; Wagner et al., 2009 ). Most previous research studies have primarily concentrated on evaluating the clinical significance of ST segment depression in patients diagnosed with ACS (Demandt et al., 2022 ; Solà‐Muñoz et al., 2023 ; Wagner et al., 2009 ).…”

Section: Discussionmentioning

confidence: 99%

“…The assessment of ECG parameters plays a crucial role in the initial evaluation of patients with acute coronary syndrome (ACS), while also providing valuable prognostic information (Burak et al., 2019 ; Demandt et al., 2022 ; Karakayali et al., 2023 ; Solà‐Muñoz et al., 2023 ; Wagner et al., 2009 ). Most previous research studies have primarily concentrated on evaluating the clinical significance of ST segment depression in patients diagnosed with ACS (Demandt et al., 2022 ; Solà‐Muñoz et al., 2023 ; Wagner et al., 2009 ). However, in patients diagnosed with NSTE‐ACS, the occurrence of ST‐segment elevation in lead aVR was indicated to have a stronger correlation with LM/3VD in comparison to ST‐segment depression in other leads (Kosuge et al., 2009 , 2011 ; Misumida et al., 2016 ).…”

Section: Discussionmentioning

confidence: 99%

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Early predictors of severe left main and/or three‐vessel disease in patients with non‐ST‐segment elevation myocardial infarction: A dual‐center retrospective study

Huang,

Han,

Huang

et al. 2024

Noninvasive Electrocardiol

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BackgroundEarly detection of patients concomitant with left main and/or three‐vessel disease (LM/3VD) and high SYNTAX score (SS) is crucial for determining the most effective revascularization options regarding the use of antiplatelet medications and prognosis risk stratification. However, there is a lack of study for predictors of LM/3VD with SS in patients with non‐ST‐segment elevation myocardial infarction (NSTEMI). We aimed to identify potential factors that could predict LM/3VD with high SS (SS > 22) in patients with NSTEMI.MethodsThis dual‐center retrospective study included a total of 481 patients diagnosed with NSTEMI who performed coronary angiography procedures. Clinical factors on admission were collected. The patients were divided into non‐LM/3VD, Nonsevere LM/3VD (SS ≤ 22), and Severe LM/3VD (SS > 22) groups. To identify independent predictors, Univariate and logistic regression analyses were conducted on the clinical parameters.ResultsA total of 481 patients were included, with an average age of 60.9 years and 75.9% being male. Among these patients, 108 individuals had severe LM/3VD. Based on the findings of a multivariate logistic regression analysis, the extent of ST‐segment elevation observed in lead aVR (OR: 7.431, 95% CI: 3.862–14.301, p < .001) and age (OR: 1.050, 95% CI: 1.029–1.071, p < .001) were identified as independent predictors of severe LM/3VD.ConclusionThis study indicated that the age of patients and the extent of ST‐segment elevation observed in lead aVR on initial electrocardiogram were the independent predictive factors of LM/3VD with high SS in patients with NSTEMI.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Early predictors of severe left main and/or three‐vessel disease in patients with non‐ST‐segment elevation myocardial infarction: A dual‐center retrospective study

Huang,

Han,

Huang

et al. 2024

Noninvasive Electrocardiol

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“…Ambulances for patient transfer should have electrocardiographic monitoring, a defibrillator, at least one person with knowledge of basic and advanced cardiopulmonary resuscitation, and pharmacological therapy, including initiating antiplatelet therapy, supplementary oxygen if peripheral saturations are below 90%, sublingual nitrates for relief of ischemic symptoms, analgesic management with opioids (morphine) for persistent pain, and intravenous beta-blockers if the patient does not have signs of acute heart failure, has a systolic blood pressure greater than 120 mmHg, and has no other contraindications to improve myocardial oxygen consumption [30].…”

Section: Pre-hospital Treatmentmentioning

confidence: 99%

Acute coronary syndrome: Definition, pathophysiology, diagnosis, and management

Erick Alexander Cabrera Estrada,

Epitafio Rafael Mestre Sequeda,

Jairo Enrique Barcinilla Barros

et al. 2024

World J. Adv. Res. Rev.

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Acute coronary syndrome (ACS) represents the most severe form of presentation of ischemic heart disease and imposes a significant burden on morbidity and mortality worldwide, particularly in low- and middle-income countries. Within the clinical spectrum of coronary syndrome are ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), and unstable angina. Although primarily caused by atherosclerotic plaque thrombosis or non-atherosclerotic causes, its pathophysiological mechanisms are not fully understood. Currently, the main mechanisms include plaque rupture, plaque erosion, calcified nodules, and non-atherosclerotic causes such as coronary vasospasm. For ACS diagnosis, the electrocardiogram (ECG) is recommended primarily, along with high-sensitivity cardiac troponins (hs-cTn), following recommended algorithms to determine the testing interval. Non-invasive diagnostic tools such as echocardiography, computed tomography (CT), and cardiac magnetic resonance (CMR) are also available. These are mainly indicated in patients with inconclusive ECG and hs-cTn results and for establishing differential diagnoses. The management of ACS should be multidisciplinary, encompassing pharmacological, invasive techniques, and non-pharmacological approaches. It should be individualized considering each patient's characteristics.

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GAMe-BiLSTM: a novel modified metaheuristic deep learning technique for non-ST-segment elevation myocardial infarction classification

Patil,

Mohite-Patil,

Kalipindi

et al. 2024

Int. j. inf. tecnol.

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Prehospital stratification and prioritisation of non-ST-segment elevation acute coronary syndrome patients (NSTEACS): the MARIACHI scale

Cited by 3 publications

References 52 publications

Early predictors of severe left main and/or three‐vessel disease in patients with non‐ST‐segment elevation myocardial infarction: A dual‐center retrospective study

Early predictors of severe left main and/or three‐vessel disease in patients with non‐ST‐segment elevation myocardial infarction: A dual‐center retrospective study

Acute coronary syndrome: Definition, pathophysiology, diagnosis, and management

GAMe-BiLSTM: a novel modified metaheuristic deep learning technique for non-ST-segment elevation myocardial infarction classification

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