Browsing by Subject "Myocardial Infarction"
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Item Acute myocardial infarction in women: does a gender gap persist?(2018-03-16) Collins, Laura J.Item Adjuncts to reperfusion in treatment of acute myocardial infarction(1996-02-22) Hillis, L. DavidItem Anticoagulant therapy in coronary heart disease(1964-01-16) Bashour, Fouad A.Item Arm squeeze, ischemic preconditioning and more on the horizon(2023-10-13) Olafiranye, OladipupoItem Cardiac arrhythmias in acute myocardial infarction: the prophylactic use of dilantin (diphenylhydantoin)(1965-10-28) Bashour, Fouad A.Item Cardiogenic shock today: will better cardiac rest be the difference?(2013-12-06) Addo, Tayo A.Item Diabetes mellitus: a cardiologist's perspective(1998-04-02) Radford, Nina ButwellItem Drug therapy of acute myocardial infarction(1994-09-29) Rutherford, John D.Item Early phases of cardiac rehabilitation following myocardial infarction(1976-11-11) Mullins, C. B. (Charles B.)Item Evolving concepts in the treatment of acute myocardial infarction, 1988(1988-03-17) Hillis, L. DavidItem Factors That Alter the Relationship Between Peak Postoperative CKMB and Troponin T After CABG(2019-04-02) Mehta, Kinjal Mukesh; Jessen, Michael; Pruszynski, Jessica; Huffman, LynnBACKGROUND: Peak postoperative creatine kinase MB fraction (CKMB) and Troponin T (TnT) levels have been measured after cardiac surgery to assess perioperative myocardial damage, evaluate myocardial protective strategies and predict adverse events. However, the relationship between peak levels of both enzymes has not been fully established in this setting. We compared peak levels of CKMB and TnT in patients after CABG to test the hypothesis that patient and operative characteristics influence the correlation between the values of these biomarkers. OBJECTIVE: To examine the relationship between peak levels of cTnT and CKMB following CABG in defined subsets of patients with pre-defined comorbidities to test the hypothesis that patient and operative characteristics influence the correlation between the values of these biomarkers. METHODS: Data were prospectively collected from 885 consecutive patients undergoing on-pump CABG at a single institution between July 2011 and June 2017. Peak values were selected from all serum levels of CKMB and TnT collected during the hospital stay following surgery. Clinical variables were collected based on definitions in the STS Adult Cardiac Surgery Database version 2.181. Analysis of covariance (ANCOVA) and linear regression models were used to statistically compare the slope of the linear relationship between peak postoperative CKMB and TnT for the patient cohort. Models were created to compare the slopes by pre-defined clinical variables including (1) age, (2) sex, (3) race, (4) current smoking status (5) hypertension, (6) dyslipidemia, (7) ejection fraction (EF), (8) diabetes, (9) renal dysfunction (GFR<60), (10) recent MI, preoperative use of (11) ACE-inhibitors, (12) beta-blockers, and (13) anticoagulants; and operative variables including (1) cross clamp time (< or > 70 min), (2) CPB time (< or > 100 min), and (3) intra-operative blood products transfusion. RESULTS: Overall, the correlation between peak postoperative CKMB and TnT was robust in patients undergoing CABG. However, the slope of the relationship was significantly lower in males, diabetics, patients with dyslipidemia, patients with hypertension, patients with lower EF, patients who received red blood cell transfusions, and patients receiving beta-blockers. The slope was significantly greater in patients with renal dysfunction, current smokers, patients with a recent MI, patients with longer cross clamp times, patients with longer CPB time, and patients receiving ACE inhibitors. CONCLUSION: The relationship between CKMB and TnT following CABG appears to be influenced by patient and operative characteristics. These data do not assess which enzyme more accurately reflects myocardial injury, but does suggest conclusions about myocardial damage may be affected by the biomarker selected in the presence of certain variables. Further study to assess the association between these biomarkers and patient outcomes is warranted.Item Frontier strategies for protection after acute myocardial infarction(1992-12-10) Benjamin, Ivor J.Item Increasingly sensitive assays for cardiac troponins: one step back and two steps forward?(2012-09-21) De Lemos, JamesItem Long-Term Outcomes with First vs Second Generation Drug-Eluting Stents in Saphenous Vein Graft Lesions(2014-02-04) Pokala, Nagendra; Menon, Rohan V.; Patel, Siddharth M.; Christopoulos, George; Kotsia, Anna P.; Rangan, Bavana V.; Roesle, Michele; Abdullah, Shuaib; Grodin, Jerrold; Kumbhani, Dharam J.; Hastings, Jeffrey; Banerjee, Subhash; Brilakis, EmmanouilBACKGROUND: Compared to bare metal stents, first-generation drug-eluting stents (DES) significantly improved post-procedural outcomes in aortocoronary saphenous vein graft (SVG) lesions, but there is limited information on outcomes after use of second-generation DES. METHODS: We compared the outcomes of patients who received first-generation DES (n=82) with those who received second-generation DES (n=166) in SVG lesions at our institution between 2006 and 2013. Major adverse cardiac events (MACE) were defined as the composite of all-cause death, myocardial infarction, and target vessel revascularization. RESULTS: Mean age was 66.0 years and 97.6% of the patients were men. Mean SVG age was 11.1 ± 0.4 years. First-generation DES were sirolimus-eluting (n=17) and paclitaxel-eluting (n=65) stents. Second-generation DES were everolimus-eluting (n=115) and zotarolimus-eluting (n=51) stents. Median follow-up was 41 months. At 2 years post-procedure, patients with first- and second-generation DES had similar rates of death (20.00% vs. 20.91%, p=0.881), target lesion revascularization (16.13% vs. 20.00%, p=0.541), target vessel revascularization (20.63% vs. 23.16%, p=0.709), myocardial infarction (25.76% vs. 23.00%, p=0.684), and MACE (40.04% vs. 40.87%, p=0.764), respectively. CONCLUSIONS: Outcomes with first and second generation DES in SVGs are similar. Novel stent designs are needed to further improve the clinical outcomes in this challenging lesion subgroup.Item Myocardial infarction 1990 what is routine therapy?(1990-07-19) Smitherman, Thomas C.Item Myocardial infarction II: posthospital discharge management(1981-10-22) Cohen, Lawrence S.Item Myocardial infarction: complications and current management(1968-10-10) UnknownItem [News](1982-06-04) Harrell, AnnItem [News](1977-11-08) Land, Chris
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