European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Dec 2018
Multicenter StudyLong-term clinical outcomes in patients with ST-segment elevation acute myocardial infarction complicated by cardiogenic shock due to acute pump failure.
Cardiogenic shock remained the leading cause of death in ST-segment elevation acute myocardial infarction (STEMI) patients even in the primary percutaneous coronary intervention era. ⋯ The long-term mortality of STEMI patients complicated by cardiogenic shock due to acute pump failure remains high even in the current clinical practice. In this high-risk category of patients, shorter onset-to-balloon and door-to-balloon time were associated with significantly lower long-term risk for mortality.
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Eur Heart J Acute Cardiovasc Care · Dec 2018
ReviewEditor's Choice- What do small serum creatinine changes tell us about outcomes after acute myocardial infarction?
Acute kidney injury (AKI), mostly defined as a rise in serum creatinine concentration of more than 0.5 mg/dl, is a common, serious, and potentially preventable complication of percutaneous coronary intervention and is associated with adverse outcomes including an increased risk of inhospital mortality. Recent data from the National Cardiovascular Data Registry/Cath-PCI registry including 985,737 consecutive patients undergoing percutaneous coronary intervention suggest that approximately 7% experienced AKI with a reported incidence of 3-19%. In patients undergoing primary percutaneous coronary intervention for acute myocardial infarction (AMI), AKI occurs more frequently with rates up to 20% depending on patient and procedural characteristics. ⋯ In patients undergoing primary PCI for acute myocardial infarction (AMI), AKI occurs up to 20% of such individuals. Varying definitions of AKI limit comparisons of AKI rates across different studies. Additionally, even small increases in serum creatinine beyond lavels meeting AKI definitions may be associated with adverse outcomes including increased hospital length of stay.
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Eur Heart J Acute Cardiovasc Care · Dec 2018
Predictors of survival and ability to wean from short-term mechanical circulatory support device following acute myocardial infarction complicated by cardiogenic shock.
Cardiogenic shock following acute myocardial infarction (AMI-CS) portends a poor prognosis. Short-term mechanical circulatory support devices (MCSDs) provide hemodynamic support for patients with cardiogenic shock but predictors of survival and the ability to wean from short-term MCSDs remain largely unknown. ⋯ Among AMI-CS patients requiring short-term MCSDs, age and cardiac index predict survival to discharge. Angiographic result and cardiac index predict ventricular recovery but 50% of those optimally revascularized still required heart replacement therapy.
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Eur Heart J Acute Cardiovasc Care · Dec 2018
Case ReportsAn intriguing case of acute myocardial ischaemia in a patient with severe respiratory failure with veno-venous extracorporeal support.
We describe a case of a young woman requiring veno-venous extracorporeal support for severe secondary respiratory failure who developed a myocardial ischaemia due to an intermittent obstruction of the right coronary sinus by a fluttering thrombus. She was medically treated with full anticoagulation regimen, needed for the veno-venous extracorporeal membrane oxygenation support, without any other ischaemic or embolic event.