Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Nov 2020
Multicenter StudyImpact of COVID-19 Pandemic on Mechanical Reperfusion for Patients With STEMI.
The fear of contagion during the coronavirus disease-2019 (COVID-19) pandemic may have potentially refrained patients with ST-segment elevation myocardial infarction (STEMI) from accessing the emergency system, with subsequent impact on mortality. ⋯ The COVID-19 pandemic had significant impact on the treatment of patients with STEMI, with a 19% reduction in PPCI procedures, especially among patients suffering from hypertension, and a longer delay to treatment, which may have contributed to the increased mortality during the pandemic. (Primary Angioplasty for STEMI During COVID-19 Pandemic [ISACS-STEMI COVID-19] Registry; NCT04412655).
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J. Am. Coll. Cardiol. · Nov 2020
Multicenter StudyCharacterization of Myocardial Injury in Patients With COVID-19.
Myocardial injury is frequent among patients hospitalized with coronavirus disease-2019 (COVID-19) and is associated with a poor prognosis. However, the mechanisms of myocardial injury remain unclear and prior studies have not reported cardiovascular imaging data. ⋯ Among patients with COVID-19 who underwent TTE, cardiac structural abnormalities were present in nearly two-thirds of patients with myocardial injury. Myocardial injury was associated with increased in-hospital mortality particularly if echocardiographic abnormalities were present.
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J. Am. Coll. Cardiol. · Oct 2020
Multicenter StudyPrognostic Utility of Right Ventricular Remodeling Over Conventional Risk Stratification in Patients With COVID-19.
Coronavirus disease 2019 (COVID-19) is a growing pandemic that confers augmented risk for right ventricular (RV) dysfunction and dilation; the prognostic utility of adverse RV remodeling in COVID-19 patients is uncertain. ⋯ Adverse RV remodeling predicts mortality in COVID-19 independent of standard clinical and biomarker-based assessment.
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J. Am. Coll. Cardiol. · Oct 2020
Comparative StudyClinical and Angiographic Features of Patients With Out-of-Hospital Cardiac Arrest and Acute Myocardial Infarction.
Sudden cardiac arrest is a serious complication of acute myocardial infarction (MI). Although in-hospital mortality from MI has decreased, the mortality of MI patients complicated with out-of-hospital cardiac arrest (OHCA) remains high. However, the features of acute MI patients with OHCA have not been well known. ⋯ Younger age, no use of calcium-channel antagonists, worse renal function, larger infarct size, culprit lesion in the left main coronary artery, and having chronic total occlusion were associated with OHCA.
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J. Am. Coll. Cardiol. · Oct 2020
Multicenter StudyIncidence, Characteristics, Predictors, and Outcomes of Surgical Explantation After Transcatheter Aortic Valve Replacement.
Currently, there is a paucity of information on surgical explantation after transcatheter aortic valve replacement (TAVR). ⋯ The present study provides updated evidence on the incidence, timing, and outcomes of surgical explantation of a TAVR prosthesis. Although the overall incidence was low, short-term mortality was high. These findings stress the importance of future mechanistic studies on TAVR explantation and may have implications on lifetime management of aortic stenosis, particularly in younger patients.