Third universal definition of myocardial infarction

Thygesen, Kristian; Alpert, Joseph S.; Jaffe, Allan S.; Simoons, Maarten L.; Chaitman, Bernard R.; White, Harvey D.

doi:10.1038/nrcardio.2012.122

Cited by 3,529 publications

(1,906 citation statements)

References 107 publications

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“…Acute STEMI was diagnosed by electrocardiogram changes consistent with STEMI along with associated symptoms of ischemia, peri-PCI cardiac biomarkers, and coronary angioplasty findings as used in previous analyses and consistent with current guidelines [12,[19][20][21][22]. LVT on TTE was identified using at least 2 views, typically long and short-axis views with or without an echocardiographic contrast agent.…”

Section: Study Definitionsmentioning

confidence: 99%

Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction

Garber

Mentz

Al‐Khalidi

et al. 2015

J Thromb Thrombolysis

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We aimed to characterize the independent predictors of LVT following STEMI and the association with outcomes. The clinical predictors of left ventricular thrombus (LVT) formation after ST-segment elevation myocardial infarction (STEMI) are not well-defined in the contemporary era. We performed a retrospective analysis of STEMI patients at Duke from 2000 to 2011 who had a transthoracic echocardiogram within 90 days post-STEMI and compared patients with and without LVT (LVT+ vs. LVT-). Univariate Cox proportional hazards regression models of baseline characteristics were examined and significant variables were used in a multivariable model to assess adjusted relationships with LVT. A multivariable Cox PH survival model with covariate adjustments was used for assessment of LVT and long-term mortality. Of all eligible patients, 1734 patients met inclusion criteria and 4.3 % (N = 74) had a LVT. LVT+ patients tended to have a history of heart failure (HF) and higher initial troponin compared to LVT- patients. After adjustment, higher heart rate, non-white race, HF severity, and presence of left anterior descending artery (LAD) disease were independent predictors of LVT. There was a trend toward an association between LVT and increased all-cause mortality (HR 1.36; 95 % CI 0.84-2.21, P = 0.22), however this was not statistically significant. LVT was seen in over 4 % of this contemporary post-STEMI population. Several baseline characteristics were independently associated with LVT: Heart rate, HF severity, LAD disease, and non-white race. Prospective studies are warranted to determine whether anticoagulation in patients at increased risk for LVT improves outcomes.

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Section: Study Definitionsmentioning

confidence: 99%

Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction

Garber

Mentz

Al‐Khalidi

et al. 2015

J Thromb Thrombolysis

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“…The endpoint was a composite of the following major adverse cardiac events (MACE): all-cause mortality, non-fatal myocardial infarction and coronary revascularization with either percutaneous coronary intervention or coronary artery bypass grafting. Non-fatal myocardial infarction was defined based on the criteria of typical chest pain, elevated cardiac enzyme levels and typical changes on the ECG as defined by Thygesen et al [14]. The first event in each patient was used for the survival analysis.…”

Section: Clinical Follow-upmentioning

confidence: 99%

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Yokota

Mouden

Ottervanger

et al. 2015

Eur J Nucl Med Mol Imaging

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“…Beim ACS stellt die Kaskade mit PlaqueRuptur/Erosion, daraus resultierender Plättchenaktivierung und nachfolgender Bildung eines intraluminalen Thrombus die pathophysiologische Grundlage der Verminderung des intrakoronaren Blutflusses und somit der myokardialen Ischämie dar [7]. Daher empfehlen die Leitlinien, mit einer aggregationshemmenden Therapie so früh wie möglich nach Diagnosestellung zu beginnen [2,3,4,5].…”

Section: Antithrombozytäre Therapieunclassified

Plättchenhemmung und Antikoagulation beim akuten Koronarsyndrom

Waha

Thiele

Richardt

2014

Herz

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In recent years, the prognosis of patients with an acute coronary syndrome (ACS) has significantly improved. This can mainly be attributed to the implementation of primary percutaneous coronary intervention (PCI). Apart from mechanical reperfusion, an optimal medical strategy is of great importance. Antiplatelet and antithrombotic therapies in particular play a crucial role in the management of patients with ACS. New options in antiplatelet therapy are more potent P2Y12 inhibitors in addition to acetylsalicylic acid and clopidogrel. Furthermore, anticoagulant therapy before, during and after PCI can be performed by the use of unfractionated heparin, low molecular weight heparins, such as enoxaparin, the synthetic pentasaccharide fondaparinux and the direct thrombin inhibitor bivalirudin with or without additional administration of glycoprotein IIb/IIIa inhibitors. In this article, data on antiplatelet and anticoagulant therapy are presented and the current evidence is discussed.

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Third universal definition of myocardial infarction

Cited by 3,529 publications

References 107 publications

Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction

Clinical predictors and outcomes of patients with left ventricular thrombus following ST-segment elevation myocardial infarction

Prognostic value of normal stress-only myocardial perfusion imaging: a comparison between conventional and CZT-based SPECT

Plättchenhemmung und Antikoagulation beim akuten Koronarsyndrom

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