STEMI care 2021: Addressing the knowledge gaps

Yıldız, Mehmet; Wade, Spencer R.; Henry, Timothy D.

doi:10.1016/j.ahjo.2021.100044

Cited by 8 publications

(8 citation statements)

References 68 publications

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“…21,22 There were remarkable reductions in STEMI activations worldwide with substantial decrease in use of coronary angiography and PCI, longer door-toballoon and total ischemic times, and increased risk of mechanical complications. [21][22][23][24][25][26] In parallel, we observed a remarkable increase in In parallel with previous observations, 10,11 we found that late presenters were more likely to be older, female, and have a high cardiovascular risk profile. It is likely that atypical ischemic symptoms, known to be common in these patients, may delay seeking care.…”

Section: Methodssupporting

confidence: 87%

“…National and local actions to mitigate the pandemic, such as lockdown restrictions, social isolation with substantial fear of infection, and deferral of routine health care, subsequently resulted in unintended consequences in STEMI care 21,22 . There were remarkable reductions in STEMI activations worldwide with substantial decrease in use of coronary angiography and PCI, longer door‐to‐balloon and total ischemic times, and increased risk of mechanical complications 21–26 . In parallel, we observed a remarkable increase in late presenters (almost doubled) during the early phase of the Covid‐19 pandemic in 2020.…”

Section: Discussionmentioning

confidence: 74%

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Frequency and outcomes of STEMI patients presenting between 12 and 24 h after symptom onset: Late‐presenting STEMI

Griffin

Yıldız

Bradley

et al. 2022

Cathet Cardio Intervent

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Objectives To assess the characteristics and prognosis of ST‐elevation myocardial infarction (STEMI) patients, presenting between 12 and 24 h after symptom onset, in contemporary regional STEMI systems of care in the United States. Background Previous observational studies have been inconsistent regarding the benefit of primary percutaneous coronary intervention (PCI) compared with conservative management for late‐presenting STEMI patients and the majority of randomized trials are from the fibrinolytic era. Methods Using a two‐center registry‐based cohort from March 2003 to December 2020, we evaluated the frequency, clinical characteristics, and outcomes of STEMI patients, stratified by symptom onset to balloon time: <3, 3−6, 6−12, and 12−24 h (late presenters). Results Among 5427 STEMI patients with available symptom onset time, 6.2% were late presenters, which increased to 11% during the early phase of the Covid‐19 pandemic. As symptom onset to balloon time increased, patients were more likely to be older, female, and have a history of hypertension and diabetes mellitus. Late presenters with an identifiable culprit lesion were less likely to be revascularized with PCI (96%, 96%, 95%, and 92%; p for trend = 0.004) and had a longer median door‐to‐balloon time (82, 109, 107, and 117 min; p for trend < 0.001). In‐hospital and 1‐year death risks were comparable between late and earlier presenters. Conclusion Despite the unfavorable risk profile and longer door‐to‐balloon time, clinical outcomes of late presenters were similar to those presenting within 12 h of symptom onset.

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Section: Methodssupporting

confidence: 87%

Section: Discussionmentioning

confidence: 74%

Frequency and outcomes of STEMI patients presenting between 12 and 24 h after symptom onset: Late‐presenting STEMI

Griffin

Yıldız

Bradley

et al. 2022

Cathet Cardio Intervent

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“…A STEMI is the most severe heart attack because it obstructs one or more coronary arteries, and blocks blood flow to the heart. STEMI can result in more long‐term heart disease and increase the risk of death in patients in the short term 5,6 …”

Section: Introductionmentioning

confidence: 99%

“…STEMI can result in more long-term heart disease and increase the risk of death in patients in the short term. 5,6 Low-and middle-income nations account for at least threequarters of CVD deaths worldwide. People in low-and middleincome nations have less access to primary health care for the early detection and treatment of CVDs.…”

Section: Introductionmentioning

confidence: 99%

Clinical and epidemiological profile of ST‐segment elevation myocardial infarction patients in a megacity of west of Iran

Janjani,

Motevaseli,

Salimi

et al. 2023

Health Science Reports

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Background and Aims: Low-and middle-income nations account for at least three-quarters of cardiovascular disease deaths worldwide. This study aimed to obtain real knowledge about ST segment elevation myocardial infarction (STEMI) patients and provide the context for developing a principles for care quality improvement.Method: This cross-sectional study was conducted from July 2018 through December 2019. The study sample consisted of1169 eligible patients based on inclusion criteria. The data were collected using the standard EROP and three specialized, trained questionnaires. The collected data were checked by the quality control officer and analyzed using Stata Version 14.Results: Patient baseline characteristics showed that body mass index, low-density lipoprotein, high-density lipoprotein, total cholesterol, and triglyceride levels were higher in women. Also, females recorded a considerable history of diabetes mellitus, hypertension, and hypercholesterolemia compared to men. The results also showed that most men were smokers (46.80%). Aspirin (94.27%), statins (91.48%), and clopidogrel (90.68%) were the common medications used at hospital discharge for patients. Conclusion:The present study suggests that identifying and managing modifiable risk factors can improve cardiovascular disease outcomes. Also, considering the early identification of STEMI patients with new therapies can effectively decrease the rate of cardiovascular disease and its attributed health outcomes.

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“…ST-segment elevation myocardial infarction (STEMI) is the most severe type of heart attack [ 1 ]. It remains the most common cause of death in adults globally [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

Association between Platelet to Neutrophil Ratio (PNR) and Clinical Outcomes in STEMI Patients after Successful pPCI: A Secondary Analysis Based on a Cohort Study

Wang

Qing

Wang

et al. 2022

Cardiovascular Therapeutics

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Purpose. This study was aimed at investigating whether the platelet-to-neutrophil ratio (PNR) is independently related to the prognosis of patients with ST-elevation myocardial infarction (STEMI) after successful primary percutaneous coronary intervention (pPCI). Methods. This was a secondary analysis of data retrieved from the DATADRYAD database, which was a prospective cohort study. A total of 464 STEMI patients who underwent successful pPCI were recruited between January 2010 and October 2014. The target-independent variable, PNR, was measured at the baseline. The dependent variable in the current study was the occurrence of major adverse cardiovascular events (MACEs) during the 30-month follow-up. Results. Two patients were excluded from the final analysis because their platelet counts were unavailable. The average age of the 462 participants was 63 ± 11.92 years, and approximately 76.6% were male. After adjusting for age, sex, anterior wall myocardial infarction (MI), history of MI, apelin-12, apelin-12 change rate, left ventricular end-diastolic diameter, peak cardiac troponin I, pathological Q wave, Killip classification grade, fasting blood glucose, albumin, GENSINI score, and estimated glomerular filtration rate, a nonlinear relationship was found between the PNR and MACEs in the included cohort. The threshold value of the PNR for MACEs was 23.1. Over this cutoff value, the incidence rate of MACEs increased by 43% per 10-unit change in PNR (95% CI: 1.16–1.75, p = 0.0006 ). Conclusion. There was a threshold relationship between PNR and MACEs in patients with STEMI who underwent successful pPCI. The incidence of MACEs was positively associated with the PNR when the PNR exceeded 23.1.

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STEMI care 2021: Addressing the knowledge gaps

Cited by 8 publications

References 68 publications

Frequency and outcomes of STEMI patients presenting between 12 and 24 h after symptom onset: Late‐presenting STEMI

Frequency and outcomes of STEMI patients presenting between 12 and 24 h after symptom onset: Late‐presenting STEMI

Clinical and epidemiological profile of ST‐segment elevation myocardial infarction patients in a megacity of west of Iran

Association between Platelet to Neutrophil Ratio (PNR) and Clinical Outcomes in STEMI Patients after Successful pPCI: A Secondary Analysis Based on a Cohort Study

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