International journal of cardiology
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ESC guidelines recommend a shorter (90 min) delay for the use of primary percutaneous intervention (pPCI) in patients presenting within the first 2h of pain onset. Using registry data on STEMI patients in the Greater Paris Area, we assessed changes between 2003 and 2008 in the rates of pPCI, pre-hospital fibrinolytic therapy (PHF) and time delays in patients presenting within 2h of STEMI pain onset. ⋯ In areas with a low density of pPCI centers, efforts should be made to improve the timeliness of pPCI. Otherwise, PHF followed by an immediate transfer to a pPCI capable hospital may be considered.
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Observational Study
Left circumflex artery-related myocardial infarction: does ST elevation matter? Results from the Euro Heart Survey PCI registry.
Little is known about angiographic and clinical differences in patients presenting with left circumflex artery (LCX)-related ST elevation myocardial infarction (STEMI) and non ST elevation myocardial infarction (NSTEMI). We sought to determine the clinical significance of ST elevations in patients with LCX-related myocardial infarction. ⋯ Over 50% of the patients with LCX-related myocardial infarction treated with PCI had ST elevations in the initial electrocardiogram. STEMIs were more often associated with total vessel occlusions or haemodynamic instability. In-hospital mortality was significantly higher in patients with LCX-related STEMI.
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Comparative Study
Six-minute walk test distance and resting oxygen saturations but not functional class predict outcome in adult patients with Eisenmenger syndrome.
Eisenmenger syndrome (ES) represents the extreme manifestation of pulmonary arterial hypertension in patients with congenital heart disease, associated with significant exercise intolerance and mortality. Even though of six-minute-walk-test (6MWT) is routinely used in these patients, little is known about its prognostic value in comparison to functional class. ⋯ The 6MWD and resting SO2, but not functional class were predictive of outcome in this contemporary cohort of Eisenmenger patients and should be incorporated in both risk stratification and management algorithms for these patients.
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Multicenter Study
Rheumatoid arthritis and risk of acute myocardial infarction--a nationwide retrospective cohort study.
Rheumatoid arthritis (RA) imposes substantial social costs, including an increased risk of work-related disability and accelerated cardiovascular diseases. The aim of the study is to determine the risk of acute myocardial infarction (AMI) associated with RA in a nationwide retrospective cohort study. ⋯ This nationwide retrospective cohort study indicates that AMI risk increased by 38% in RA patients compared to the general population. Comorbidities increase the AMI risk independently.