2013 and Myocardial Infarction - Cardiovascular Update

Factors related to cardiac rupture after acute myocardial infarction

Frontiers in Cardiovascular Medicine

OCTOBER 7, 2024

BackgroundCardiac rupture (CR) after acute myocardial infarction (AMI) is a fatal mechanical complication. The purpose of our study was to discover relevant risk factors for CR after AMI and in-hospital mortality from CR.MethodsIn this study, we enrolled 1,699 AMI cases from October 2013 to May 2020.

Myocardial Infarction

Myocardial Infarction Risk Factors Hospital

Long-term outcomes among stable post-acute myocardial infarction patients living in rural versus urban areas: insights from the prospective, observational TIGRIS registry

Open Heart

AUGUST 21, 2023

Background Insights on the differences in clinical outcomes, quality of life (QoL) and health resource utilisation (HRU) with different levels of care available to post-acute myocardial infarction (AMI) populations in rural and urban settings are limited.

Myocardial Infarction

Myocardial Infarction Angina Outcomes Coronary Artery Disease

Comparative Analysis of Anticoagulation Versus Combination Anticoagulation and Antiplatelet Therapy in Atrial Fibrillation Patients Presenting With Gastrointestinal Bleeding

Journal of Cardiovascular Pharmacology

OCTOBER 9, 2024

This study compares outcomes in AF patients with GIB on AC alone to those on combination AP and AC therapy, as part of a larger prospective study from 2013 to 2023. Patients in the combination AP +AC therapy group had a higher prevalence of CAD, myocardial infarction, and coronary/vascular stent placement compared to the AC monotherapy group.

Atrial Fibrillation

Atrial Fibrillation Myocardial Infarction Kidney Disease Stent

Association Between Cardiovascular Event Type and Smoking Cessation Rates Among Outpatients With Atherosclerotic Cardiovascular Disease: Insights From the NCDR PINNACLE Registry

Circulation: Cardiovascular Quality & Outcomes

FEBRUARY 6, 2024

Self-reported smoking status was assessed at each consecutive visit and used to determine smoking cessation after each interim ASCVD event (myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, stroke/transient ischemic attack, peripheral artery disease).

Coronary Artery Bypass Graft

Coronary Artery Bypass Graft Outpatient Peripheral Arterial Disease Cardiovascular Disease

Safe Deferral of Coronary Computed Tomography Angiography for Patients With a Low Pretest Probability of Coronary Artery Disease in 2019 European Society of Cardiology Guidelines

Journal of the American Heart Association

DECEMBER 1, 2023

PTP was calculated according to the 2013 and 2019 ESC guidelines. The overall mortality, cardiac deaths, myocardial infarctions, and hospitalizations for unstable angina were acquired from national registry data for 1 to 10 years of follow‐up (median, 4 years).

Coronary Artery Disease

Coronary Artery Disease Myocardial Infarction Angina Hospital

A man in his 70s with acute chest pain and paced rhythm.

Dr. Smith's ECG Blog

MAY 8, 2023

Diagnosis of Acute Myocardial Infarction in the Presence of Left Bundle Branch Block using the ST Elevation to S-Wave Ratio in a Modified Sgarbossa Rule. Electrocardiographic Diagnosis of Acute Coronary Occlusion Myocardial Infarction in Ventricular Paced Rhythm Using the Modified Sgarbossa Criteria.

Chest Pain

Chest Pain Myocardial Infarction STEMI Pacemaker

Abstract TP237: Acute Risk Factors Associated With Health Service Use Within 90 Days Before Stroke: A Systematic Review and Meta-Analysis

Stroke Journal

FEBRUARY 1, 2024

We performed a systematic review to understand the acute risk factors having health service contact within 90 days before incident strokes.Methods:PubMed, Embase and Scopus were searched for studies within last 10 years (2013- September 2022). Studies selected using PRISMA guidelines underwent quality assessment with Newcastle Ottawa scale.

Risk Factors

Risk Factors Stroke Strokes Myocardial Infarction

How cardiogenic shock in NSTEMI is different from STEMI?

Dr. S. Venkatesan MD

DECEMBER 29, 2023

Anderson ML, Peterson ED, Peng SA, Differences in the profile, treatment, and prognosis of patients with cardiogenic shock by myocardial infarction classification: A report from NCDR. 2013 Nov;6(6):708-15. Epub 2013 Nov 12. PMID: 35743628; PMCID: PMC9224589. Circ Cardiovasc Qual Outcomes. doi: 10.1161/CIRCOUTCOMES.113.000262.

Cardiogenic Shock

Cardiogenic Shock STEMI Myocardial Infarction Outcomes

How does Acute Total Left Main Coronary occlusion present on the ECG?

Dr. Smith's ECG Blog

AUGUST 9, 2019

At the bottom of the post, I have re-printed the section on aVR in my article on the ECG in ACS from the Canadian Journal of Cardiology: New Insights Into the Use of the 12-Lead Electrocardiogram for Diagnosing Acute Myocardial Infarction in the Emergency Department Case 1. Widimsky P et al. O'Gara PT, Kushner FG, Ascheim DD, et al.

Myocardial Infarction

Myocardial Infarction Ischemia STEMI Cardiogenic Shock

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Dr. Smith's ECG Blog

NOVEMBER 15, 2023

associated typical Myocardial Infarction therapies such as statins and ACE inhibitors with significantly decreased 1 year mortality in MINOCA patients, which suggests that they do indeed have a similar pathophysiology to MI patients with obstructive coronary disease. MINOCA I do not have the bandwidth here to write a review of MINOCA.

Coronary Angiogram

Coronary Angiogram Plaque Thrombosis STEMI

Oral PCSK9 Inhibitor Demonstrated Significant LDL-C Reduction on Top of Statin in Phase I Trial Presented at EAS Congress

DAIC

MAY 29, 2024

Low-density lipoprotein-cholesterol target attainment according to the 2011 and 2016 ESC/EAS dyslipidaemia guidelines in patients with a recent myocardial infarction: nationwide cohort study, 2013-17. 2016;76(12):1175-90. 7 Allahyari A, et al. Eur Heart J Qual Care Clin Outcomes. 2021;7(1):59-67. J Am Coll Cardiol.

Cholesterol

Cholesterol Cardiovascular Disease Atherosclerosis Myocardial Infarction

Right precordial ST depression in a patient with chest pain

Dr. Smith's ECG Blog

AUGUST 3, 2017

Electrocardiographic Manifestations: Acute posterior wall myocardial infarction. Posterior myocardial infarction: the dark side of the moon. New electrocardiographic criteria for posterior wall myocardial ischemia validated by percutaneous transluminal coronary angioplasty model of acute myocardial infarction.

Chest Pain

Chest Pain Myocardial Infarction STEMI Ischemia

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

DAIC

JANUARY 23, 2024

3 Patients with ASCVD are at a higher risk for major adverse cardiovascular events (MACE) including heart attack or myocardial infarction (MI), stroke, and cardiovascular (CV) death.4 2013;368(21):2004-2013. Published 2013 Apr 4. Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction.

Cardiovascular Disease

Cardiovascular Disease Heart attacks Heart Attack Coronary Artery Disease

Time trends in adherence to guideline recommendations for anticoagulation therapy in patients with atrial fibrillation and myocardial infarction

Open Heart

APRIL 6, 2022

Background Poor adherence to guideline recommendations for anticoagulation in patients with acute myocardial infarction (MI) and atrial fibrillation (AF) is previously reported. of 78369) patients registered in the NORMI from 2013 through 2019. Results AF was observed in 8565 (10.9% 95% CI 0.7 95% CI 0.7 p<0.001).

Myocardial Infarction

Myocardial Infarction Atrial Fibrillation Heart Failure Stroke

Occlusion/reperfusion through 6 ‘normal’ ECGs

Dr. Smith's ECG Blog

FEBRUARY 10, 2022

In the STEMI/NSTEMI dichotomy, NSTEMI is supposed to mean non-occlusive myocardial infarction, but this patient had transient Occlusion MI that was at risk for re-occlusion (like ‘transient STEMI’). Arch Cardiovasc Dis 2013 Khan AR et al. JAHA 2022 Grosmaitre P et al. Eur Heart J 2017 Driver BE, Shroff GR, Smith SW.

STEMI

STEMI Myocardial Infarction Chest Pain Angina

A Tough ECG, But Learn From It!

Dr. Smith's ECG Blog

JUNE 18, 2013

Acute Myocardial Infarction Due to Left Circumflex Artery Occlusion and Significance of ST-Segment Elevation. Incidence Incidence, angiographic features and outcomes of patients presenting with subtle ST-elevation myocardial infarction. Figure-1: I've labeled the initial ECG from this June 18, 2013 post.

STEMI

STEMI Chest Pain Myocardial Infarction Webinar

Is There a Delayed Activation Wave???

Dr. Smith's ECG Blog

MAY 6, 2018

One of our fine interns, Daniel Lee, who is also an ECG whiz, found this paper from 2013 and brought it to my attention: The delayed activation wave in non-ST-elevation myocardial infarction.

STEMI

STEMI Chest Pain Myocardial Infarction Stent

Chest pain, a ‘normal’ ECG, a 'normal trop', and low HEART and EDACS scores: Discharge home? Stress test? Many errors here.

Dr. Smith's ECG Blog

APRIL 22, 2022

Int J Cardiol 2013 2. ST-elevation myocardial infarction after pharmacologic persantine stress test in a patient with Wellens’ syndrome. Single High-Sensitivity Cardiac Troponin I to Rule Out Acute Myocardial Infarction. Backus BE, Six AJ, Kelder JC, et al. Shin YS, Ahn S, Kim YJ. Am J Emerg Med 2020 3.

Chest Pain

Chest Pain Ischemia Myocardial Infarction Angina

A Middle-Aged male with Chest Pain and an Unusual ECG

Dr. Smith's ECG Blog

MAY 6, 2019

Only 5-18% of ED patients with chest pain have a myocardial infarction of any kind. This definition was changed following an expert consensus panel in 2013 — so that at the present time, all that is needed to diagnose Brugada Syndrome is a spontaneous or induced Brugada-1 ECG pattern, without need for additional criteria.

Chest Pain

Chest Pain STEMI Ischemia Myocardial Infarction

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Dr. Smith's ECG Blog

NOVEMBER 4, 2022

New insights into the use of the 12-lead electrocardiogram for diagnosing acute myocardial infarction in the emergency department. Here is the abstract: Background Identification of ST elevation myocardial infarction (STEMI) is critical because early reperfusion can save myocardium and increase survival.

Ischemia

Ischemia STEMI Stenosis Chest Pain

Target Acquired

EMS 12-Lead

APRIL 2, 2022

He was found diaphoretic and uncomfortable, and verbalizing a prior history of myocardial infarction and that, furthermore, the acute symptoms were identical to that which had been associated with RCA stent placement 4 years prior. Terminal QRS distortion is present in anterior myocardial infarction but absent in early repolarization.

Myocardial Infarction

Myocardial Infarction Stent Stents STEMI

Why do we NOT name Occlusion MI (OMI) after an EKG finding? (In contrast to STEMI, which is named after ST Elevation)

Dr. Smith's ECG Blog

JUNE 1, 2022

They recorded a third ECG before intervention: No significant difference Angiogram : Impression and Recommendations: Culprit for the patient's non-ST elevation myocardial infarction is a thrombotic occlusion of the mid circumflex Formal Echo Normal left ventricular cavity size, normal wall thickness and normal LV systolic function.

Chest Pain

Chest Pain STEMI Myocardial Infarction Bradycardia

Temporal trends in concordance between ICD-coded and cardiac biomarker-classified hospitalisation rates for acute coronary syndromes: a linked hospital and biomarker data study

Open Heart

OCTOBER 23, 2024

Background Since 2000, the definition of myocardial infarction (MI) has evolved with reliance on cardiac troponin (cTn) tests. male), and 96% of cases had linked biomarker data, predominantly conventional cTn at the start and high-sensitive cTn from late 2013. Results There were 37 272 ACS admissions in 30 683 patients (64.2%

Biomarkers

Biomarkers Hospital STEMI Myocardial Infarction

A man in his early 40s with chest pain a "normal ECG" by computer algorithm. Should we avoid interrupting a physician to interpret his ECG?

Dr. Smith's ECG Blog

MAY 23, 2023

Available from: [link] Excerpt: "To illustrate the limitations imposed by sample size, recent data from our institution reveal that we identify approximately 225 type I myocardial infarctions (MI) in a typical year.

Chest Pain

Chest Pain STEMI Blog Stent

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

Dr. Smith's ECG Blog

NOVEMBER 19, 2016

myocardial infarction), arrhythmias, valvular pathology, shunts, or outflow obstructions. N Engl J Med 2003; 348:1756-1763, 5/1/2013. This patient’s severe aortic stenosis (AS) and associated severe cardiogenic shock likely created the ECG pattern, resulting in a very difficult challenge for our inpatient team. Khot, MD; et al.

Ischemia

Ischemia Cardiogenic Shock Aortic Stenosis

Factors related to cardiac rupture after acute myocardial infarction

Long-term outcomes among stable post-acute myocardial infarction patients living in rural versus urban areas: insights from the prospective, observational TIGRIS registry

Comparative Analysis of Anticoagulation Versus Combination Anticoagulation and Antiplatelet Therapy in Atrial Fibrillation Patients Presenting With Gastrointestinal Bleeding

Association Between Cardiovascular Event Type and Smoking Cessation Rates Among Outpatients With Atherosclerotic Cardiovascular Disease: Insights From the NCDR PINNACLE Registry

Safe Deferral of Coronary Computed Tomography Angiography for Patients With a Low Pretest Probability of Coronary Artery Disease in 2019 European Society of Cardiology Guidelines

A man in his 70s with acute chest pain and paced rhythm.

Abstract TP237: Acute Risk Factors Associated With Health Service Use Within 90 Days Before Stroke: A Systematic Review and Meta-Analysis

How cardiogenic shock in NSTEMI is different from STEMI?

How does Acute Total Left Main Coronary occlusion present on the ECG?

What does the angiogram show? The Echo? The CT coronary angiogram? How do you explain this?

Oral PCSK9 Inhibitor Demonstrated Significant LDL-C Reduction on Top of Statin in Phase I Trial Presented at EAS Congress

Right precordial ST depression in a patient with chest pain

Lowering Atherosclerotic Cardiovascular Disease Events by Treating Residual Inflammatory Risk

Time trends in adherence to guideline recommendations for anticoagulation therapy in patients with atrial fibrillation and myocardial infarction

Occlusion/reperfusion through 6 ‘normal’ ECGs

A Tough ECG, But Learn From It!

Is There a Delayed Activation Wave???

Chest pain, a ‘normal’ ECG, a 'normal trop', and low HEART and EDACS scores: Discharge home? Stress test? Many errors here.

A Middle-Aged male with Chest Pain and an Unusual ECG

90 year old with acute chest and epigastric pain, and diffuse ST depression with reciprocal STE in aVR: activate the cath lab?

Target Acquired

Why do we NOT name Occlusion MI (OMI) after an EKG finding? (In contrast to STEMI, which is named after ST Elevation)

Temporal trends in concordance between ICD-coded and cardiac biomarker-classified hospitalisation rates for acute coronary syndromes: a linked hospital and biomarker data study

A man in his early 40s with chest pain a "normal ECG" by computer algorithm. Should we avoid interrupting a physician to interpret his ECG?

Diffuse Subendocardial Ischemia on the ECG. Left main? 3-vessel disease? No!

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