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Myocardial Infarction Outcomes STEMI 
Frontiers in Cardiovascular Medicine
MARCH 30, 2025
This narrative review aims to evaluate strategies for reducing door-to-balloon (D2B) time in ST-elevation myocardial infarction (STEMI) patients, focusing on pre-hospital, in-hospital, and technological innovations, as well as addressing challenges to ensure sustainability.
Frontiers in Cardiovascular Medicine
MARCH 28, 2025
ST-elevation myocardial infarction (STEMI) is a critical cardiovascular emergency characterized by acute coronary artery occlusion and subsequent myocardial injury. However, despite successful revascularization, microvascular obstruction (MVO) remains a major challenge, contributing to adverse clinical outcomes.
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Dr. Smith's ECG Blog
DECEMBER 11, 2023
Occlusion myocardial infarction is a clinical diagnosis Written by Willy Frick (@Willyhfrick). Recall from this post referencing this study that "reciprocal STD in aVL is highly sensitive for inferior OMI (far better than STEMI criteria) and excludes pericarditis, but is not specific for OMI." The case continues. Worrall, C.,
American College of Cardiology
NOVEMBER 7, 2024
What is the impact of complete revascularization versus culprit-only revascularization on outcomes in older patients with ST-segment elevation myocardial infarction (STEMI) and non–ST-segment elevation myocardial infarction (NSTEMI)?
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Frontiers in Cardiovascular Medicine
MARCH 10, 2024
Background Hyperglycemia, characterized by elevated blood glucose levels, is frequently observed in patients with acute coronary syndrome, including ST-elevation myocardial infarction (STEMI). There are conflicting sources regarding the relationship between hyperglycemia and outcomes in STEMI patients.
American College of Cardiology
OCTOBER 9, 2024
What are the outcomes of bivalirudin vs. heparin anticoagulation during percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI)?
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Frontiers in Cardiovascular Medicine
OCTOBER 9, 2024
We developed a user-friendly web application for real-world use, yielding risk scores as a percentage.ConclusionsThe STEMI-ML score effectively predicts in-hospital outcomes in STEMI patients and may assist with risk stratification and individualising patient management.
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Med Page Today
APRIL 10, 2024
(MedPage Today) -- ATLANTA -- Fractional flow reserve (FFR)-guided complete revascularization in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary artery disease did not result in better outcomes compared.
Dr. Smith's ECG Blog
MAY 31, 2023
Cath lab declined as it is not a STEMI." And now this finding is even formally endorsed as a "STEMI equivalent" in the 2022 ACC guidelines!!! Another myocardial wall is sacrificed at the altar of the STEMI/NonSTEMI mindset. Opiates are associated with worse outcomes in Myocardial Infarction.
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Frontiers in Cardiovascular Medicine
JANUARY 13, 2025
BackgroundThe pharmacoinvasive (PhI) strategy is the standard-of-care for ST-elevation myocardial infarction (STEMI) patients when primary percutaneous coronary intervention (pPCI) is unfeasible. Multivariable logistic regression models were used to assess the association between lysis-PCI timing and outcomes.
Heart BMJ
JULY 10, 2024
Background Despite restoration of epicardial blood flow in acute ST-elevation myocardial infarction (STEMI), inadequate microcirculatory perfusion is common and portends a poor prognosis. The primary outcome was major adverse cardiac events (MACE). to 3.28; I 2 =0%; p=0.67; minor bleeding, RR=1.47; 95% CI 0.90
Dr. Smith's ECG Blog
SEPTEMBER 26, 2023
See these 2 articles Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study Author links open overlay panel [link] 1 Background We sought to determine if an association exists between prehospital chest pain severity and markers of myocardial injury.
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All About Cardiovascular System and Disorders
MAY 26, 2024
It is now well known that even if a coronary artery is opened well after a myocardial infarction, with good flow in the epicardial coronary arteries, there could be impaired myocardial perfusion. Immediate Microvascular Physiology After Mechanical Coronary Reperfusion of STEMI. J Am Coll Cardiol. van Leeuwen, Stephen P.
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Open Heart
JANUARY 29, 2024
Objectives This study aimed to perform a meta-analysis of the short-term impact of ischaemic postconditioning (IPoC) on myocardial injury in ST elevation myocardial infarction (STEMI) using surrogate cardiac biomarkers. Few studies used troponin as an outcome, thus, a subanalysis of troponin dynamics was not performed.
Open Heart
JUNE 21, 2022
Background Several studies have demonstrated that complete revascularisation improves clinical outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel coronary disease. However, the optimal timing of non-culprit lesion revascularisation remains controversial.
Frontiers in Cardiovascular Medicine
APRIL 2, 2025
However, its prognostic role following percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI) remains unclear. Echocardiography was performed upon admission and at 6 months post-myocardial infarction (MI). vs. 6.231.91, P 8.13
Cardiovascular Diabetology
DECEMBER 5, 2023
Stress hyperglycemia ratio (SHR), associated with adverse outcomes in patients with ST-segment elevation myocardial infarction (STEMI), has several definitions. This study aims to assess the prognostic value o.
Coronary Artery Disease Journal
JUNE 10, 2024
Background Despite improvements in outcomes of ST elevation myocardial infarction (STEMI), ventricular septal rupture (VSR) remains a known complication, carrying high mortality. The contemporary incidence, mortality, and management of post-STEMI VSR remains unclear.
Open Heart
DECEMBER 7, 2023
Introduction Cardiogenic shock (CS) complicates 5%–15% of cases of acute myocardial infarction (AMI) with inpatient mortality greater than 40%. The implementation of standardised protocols may improve clinical outcomes in patients with AMI-CS.
Frontiers in Cardiovascular Medicine
DECEMBER 11, 2024
Background and objectivesThe optimal timing for complete revascularization (CR) in patients with acute myocardial infarction (AMI) and multivessel disease (MVD) remain uncertain.MethodsThis post-hoc analysis of the FRAME-AMI trial included AMI patients with MVD (n=549). Other secondary endpoints were also not significantly different.
Frontiers in Cardiovascular Medicine
JANUARY 15, 2024
This systematic review of the literature aims to explore outcomes in the patients treated with conservative management vs. invasive strategy. of the patients were diagnosed with non-ST elevated myocardial infarction (NSTEMI), 36.8% Approximately 48.5%
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Dr. S. Venkatesan MD
DECEMBER 29, 2023
Cardiogenic shock (CS)is the most feared event following STEMI. We tend to perceive CS as an exclusive complication of STEMI. The incidence is half of that of STEMI, i.e., 2.5-5%. might show little elevation with considerable overlap of left main STEMI vs NSTEMI ) 2.Onset ACS pathophysiology is not that simple.
Dr. Smith's ECG Blog
NOVEMBER 1, 2018
European Heart Journal , ehy651, [link] Published: 26 October 2018 [link] Timing of revascularization in patients with transient ST-segment elevation myocardial infarction: a randomized clinical trial. This might extend to Wellens' syndrome, which is really and transient STEMI in which the ST Elevation is not recorded.
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Coronary Artery Disease Journal
OCTOBER 31, 2023
Background It is unclear how COVID-19 pandemic affected care and outcomes among patients who are diagnosed with ST-elevation myocardial infarction (STEMI) in the USA. Results There were 1 050 905 hospitalizations with STEMI, and there was an 8.2% reduction in admissions in 2020. reduction in admissions in 2020.
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Dr. Smith's ECG Blog
JULY 7, 2013
Thus, this is both an anterior and inferior STEMI. How old is this antero-inferior STEMI? Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. Could it be acute (vs. subacute or days old)?
52 
The American Journal of Cardiology
APRIL 1, 2025
Publication date: Available online 1 April 2025 Source: The American Journal of Cardiology Author(s): Yosuke Kakimoto, Ko Yamamoto, Masahiro Natsuaki, Goro Yoshioka, Yuhei Goriki, Kohei Kamishita, Kensuke Yokoi, Atsushi Kawaguchi, Mitsuhiro Shimomura, Keiki Yoshida, Shinjo Sonoda, Koichi Node, SAGA-ACS registry investigators
Dr. Smith's ECG Blog
MARCH 10, 2017
The cath lab was activated, as it should be with transient STEMI. See this case of transient STEMI: Spontaneous Reperfusion and Re-occlusion - My Bad Thinking Contributes to a Death. Been discharged to home with potential disastrous outcome. Undergone stress test with uncertain results. Learning Points 1.
52 
Dr. Smith's ECG Blog
MARCH 13, 2013
You can see how V1, V2, aVR, and V4R would have ST elevation in either a right ventricular STEMI or with a septal STEMI, and how lateral leads, and even posterior leads, would have reciprocal ST depression. of patients with anterior STEMI, ST elevation of greater than or equal to 3.0 STE in V4R is confirmatory evidence.
52 
Circulation
NOVEMBER 11, 2024
This study investigates the relationship between baseline 5-HTP levels and the incidence of major adverse cardiovascular events (MACE) in patients who have experienced ST-elevation myocardial infarction (STEMI).Objective:Our years, 53 women) followed for up to 15 years.
Dr. Smith's ECG Blog
JULY 18, 2014
Thus, this is BOTH an anterior and inferior STEMI in the setting of RBBB. How old is this antero-inferior STEMI? Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. Although acute anterior STEMI frequently has narrow QR-waves within one hour of onset (1. Could it be acute (vs.
52 
Dr. Smith's ECG Blog
MARCH 19, 2024
The Queen of Hearts agrees: Here the Queen explains why: However, it was not interpreted correctly by the providers: ED interpretation of ECG: "paced rhythm, LBBB but no STEMI pattern." Smith: This is an enormous myocardial infarction. Most large STEMI have peak troponin I in the 20.0 Next trop in AM. Peak trop 257.97
111 
Dr. Smith's ECG Blog
FEBRUARY 9, 2024
Posterior leads are unnecessary if anterior leads are diagnostic According to the STEMI paradigm an ECG has to have ST elevation to diagnose acute coronary occlusion, and if there’s no ST elevation on anterior leads you can look for it on posterior leads. Do you need posterior leads? If so, how will they change management?
114 
Open Heart
JANUARY 30, 2024
Background Patients who experience in-hospital ST-segment elevation myocardial infarction (iSTEMI) represent a uniquely high-risk cohort owing to delays in diagnosis, prolonged time to reperfusion and increased mortality. Key metrics and clinical outcomes were compared before and after CSP implementation.
52 
Coronary Artery Disease Journal
MAY 29, 2024
Background Despite advances in percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI), in-hospital mortality remains a concern, highlighting the need for the identification of additional risk factors such as serum iron levels. μmol/L) and a control group (Fe ≥7.8 μmol/L).
Coronary Artery Disease Journal
NOVEMBER 26, 2023
Aim Acute injury and subsequent remodelling responses to ST-segment elevation myocardial infarction (STEMI) are major determinants of clinical outcome. Current imaging and plasma biomarkers provide delayed readouts of myocardial injury and recovery.
Circulation
NOVEMBER 11, 2024
A meta-analysis was performed on primary outcomes of major adverse cardiac events (MACE) and all-cause mortality. A meta-analysis was performed on primary outcomes of major adverse cardiac events (MACE) and all-cause mortality. Heterogeneity was examined with I2statistics. vs 6.0%), stroke (RR=1.02; 95% CI [0.38, 2.75]; p =0.97; 2.0%
Dr. Smith's ECG Blog
APRIL 8, 2016
Here is his ED ECG: There is obvious infero-posterior STEMI. What are you worried about in addition to his STEMI? The patient stabilized and had a good outcome. to greatly decrease risk (although in STEMI, the optimal level is about 4.0-4.5 The corrected QT interval is extremely long, about 500 ms. If the patient is at 1.8,
52 
Dr. Smith's ECG Blog
OCTOBER 26, 2011
Echo on the day after admission showed EF of 30-35% and antero-apical wall akinesis with an LV thrombus [these frequently form in complete or near complete (no early reperfusion) anterior STEMI because of akinesis/stasis] 2 more days later, this was recorded: ST elevation is still present. Zwolle Myocardial Infarction Study Group.
52 
Coronary Artery Disease Journal
NOVEMBER 20, 2023
Background: Gender-specific outcomes after percutaneous coronary interventions were studied by a number of research groups with different endpoints and cohorts of different ethnic extractions. In the unmatched STEMI subgroup, all-cause mortality was significantly higher in females driven by older age (P < 0.001). vs. 3.9%; P = 0.020).
52 
Circulation
NOVEMBER 11, 2024
Introduction:Elevated LDL cholesterol is linked to microvascular injury and adverse cardiac events in STEMI patients. This study examines the impact of prior statin use on LDL levels at the time of MI, focusing on NSTEMI and STEMI patients. For STEMI, the treated group had an average LDL level of 87.8 ± 42 mg/dL versus 103 ± 41.2
40 
Dr. Smith's ECG Blog
JUNE 27, 2021
Angiogram: "ACS - Non ST Elevation Myocardial Infarction. Meyers note: notice in their documentation many of the classic mistakes of the STEMI generation: "Non ST Elevation MI" as their reasoning for why the patient did not merit emergent reperfusion, while simultaneously calling it "emergently" (after 8 hours!!!)
Dr. Smith's ECG Blog
APRIL 22, 2024
Patient still not having chest pain however this is more concerning for OMI/STEMI. Wellens' syndrome is a syndrome of Transient OMI (old terminology would be transient STEMI). A comparison of electrocardiographic changes during reperfusion of acute myocardial infarction by thrombolysis or percutaneous transluminal coronary angioplasty.
117 
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.
Dr. Smith's ECG Blog
AUGUST 9, 2024
The receiving emergency physician consulted with interventional cardiology who stated there was no STEMI. AIVR is not always the result of significant pathology, but is classically associated with the reperfusion phase of acute myocardial infarction. Is there STEMI? The patient continued having chest pain. Moffat, M.
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