86,640 research outputs found
Parenteral antithrombotic therapy during primary percutaneous coronary intervention
No full textAcute myocardial infarction (AMI) is a major cause of morbidity, mortality and disability worldwide. ST-segment elevation myocardial infarction (STEMI) accounts for 25-40% of AMI presentations. Arterial thrombosis due to atherosclerotic plaque rupture with formation of an occlusive thrombus is the main cause of STEMI. Platelets and coagulation factors are the two principal elements involved in this process. The main goal of STEMI treatment is the early reperfusion. Prompt primary percutaneous coronary intervention (pPCI) together with an appropriate antithrombotic therapy are the treatment of choice in this setting. In this chapter, we provide an overview of currently available parenteral antithrombotic therapies used in patients with STEMI undergoing pPCI
Don't stop now: The imperative to maintain SGLT2 inhibitors in older patients with heart failure
No full textAnomalous origin of the left coronary artery from the pulmonary artery in a 72-year-old patient
No full textAcute myocardial infarction complicated by cardiogenic shock in a patient with a single coronary artery
No full textHemodynamic Assessment in the Cardiac Intensive Care Unit: May Echocardiography Solve the Conundrum?
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Left atrioventricular coupling index in hypertrophic cardiomyopathy and risk of new-onset atrial fibrillation
No full textBackgrounds: This study aimed to investigate the association between left atrioventricular coupling index (LACI) and the occurrence of atrial fibrillation (AF) in patients with hypertrophic cardiomyopathy (HCM).
Methods: A total of 373 patients with HCM and no history of AF were evaluated by transthoracic echocardiography. LACI was defined by the ratio of left atrial (LA) end-diastolic volume divided by left ventricular (LV) end-diastolic volume. The cut-off value for LACI (≥40%) to identify LA-LV uncoupling was chosen based on the risk excess of new-onset AF described with a spline curve analysis.
Results: The median LACI was 37.5% (IQR: 24.4-56.7) and LA-LV uncoupling (LACI ≥40%) was observed in 171 (45.8%) patients. During a median follow-up of 11 (IQR 7-15) years, 118 (31.6%) subjects developed new-onset AF. The cumulative event-free survival at 10 years was 53% for patients with LA-LV uncoupling versus 94% for patients without LA-LV uncoupling (p < 0.001). Multivariable Cox regression analyses performed separately for each LA parameter showed an independent association between new-onset AF and LACI (hazard ratio [HR], 1.021; 95% CI, 1.017-1.026), LA maximum volume indexed (HR, 1.028; 95% CI, 1.017-1.039), LA minimum volume indexed (HR, 1.047; 95% CI, 1.037-1.060) and LA emptying fraction (HR, 0.967; 95% CI, 0.959-0.977, all p < 0.001). The inclusion of LACI in the multivariate model provided a larger improvement in the risk stratification for new-onset AF, as compared to conventional LA parameters.
Conclusion: In patients with HCM, LACI was more predictive of the occurrence of new-onset AF than conventional LA parameters
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