Search Results
Results 351 - 400 of 728
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Virk S J - - 1997
We describe the setting up of a 'heart emergency centre' linked to a pre-existing coronary care unit. The 'heart emergency centre' offers a new and efficient way of providing a fast and effective system for the assessment and management of patients with cardiac emergencies. This set-up can result in significant ...
Danchin N - - 1997
OBJECTIVES: This survey sought to determine actual practices in the management of acute myocardial infarction on a nationwide scale. BACKGROUND: Few data are available regarding the adoption of clinical trial results of treatment of myocardial infarction into "real-world" clinical practice. METHODS: Of 501 intensive care units in France, 373 (74%) ...
Ishihara M - - 1997
This study was undertaken to assess whether reperfusion in smokers could be achieved spontaneously or therapeutically and to assess whether favorable outcome in smokers could be sustained for years after infarction. We studied 260 patients with anterior myocardial infarction who underwent coronary angiography and thrombolysis within 24 hours after the ...
Faxon D P - - 1997
The best technique for reestablishing blood flow after myocardial infarction has been the subject of heated debate for more than a decade. An the answer is still elusive. Which option is the safest? Which salvages the most heart tissue? Dr Faxon explains the pros and cons of both thrombolysis and ...
Millar-Craig M W - - 1997
OBJECTIVES: To establish the feasibility of training paramedics of diagnose acute myocardial infarction by ECG before hospital admission and whether direct paramedic coronary care admission, arranged by very high frequency (VHF) radio communication with the coronary care unit (CCU), would reduce delay of thrombolysis treatment. DESIGN: Prospective controlled study. SETTING: ...
Spinler S A - - 1997
OBJECTIVE: To evaluate the feasibility, safety, and efficacy of prehospital-initiated thrombolysis in decreasing the mortality rate due to acute myocardial infarction. DATA SOURCES: English-language clinical studies, abstracts, and review articles identified from MEDLINE searches and bibliographies of identified articles. Epidemiologic data were extracted from the Internet. STUDY SELECTION: Eight randomized ...
Daida H H Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, - - 1997
To determine whether changes in coronary-care unit therapy for elderly patients with acute myocardial infarction have been associated with improved survival. We conducted a retrospective cohort analysis of all patients 70 years of age or older from Olmsted County, Minnesota, who were hospitalized in a coronary-care unit in this county ...
Selker H P - - 1997
BACKGROUND: Thrombolytic therapy can be life-saving in patients with acute myocardial infarction. However, if given too late or insufficiently selectively, it may provide little benefit but still cause serious complications and incur substantial costs. OBJECTIVE: To develop a thrombolytic predictive instrument for real-time use in emergency medical service settings that ...
Crouch M A - - 1997
Percutaneous transluminal coronary angioplasty is complicated by abrupt closure in 4.4-9.5% of procedures. Although the etiology of closure is difficult to determine, arterial dissection and thrombus formation are often involved. When abrupt closure occurs, repeat balloon dilation of the affected vessel is the mainstay of treatment and results in a ...
Christenson R H - - 1997
BACKGROUND: Several biochemical markers have been investigated for the noninvasive assessment of reperfusion after myocardial infarction. Because myoglobin is released very soon after myocardial injury and clears rapidly after reperfusion, it may prove to be an excellent marker of occlusion and reperfusion. METHODS AND RESULTS: We examined the relation between ...
Cannon C P - - 1997
Although the use of composite end points in clinical trials has increased in recent years, few data are available on the validity of such an approach. In the Thrombolysis In Myocardial Infarction (TIMI) 4 and 5 trials, we set out to validate prospectively the nonfatal components of the "unsatisfactory outcome" ...
Webber M D - - 1997
Acute myocardial infarction has an incidence in pregnancy of 1 in 10,000, with a mortality ranging from 37-50%. Mortality is increased if the infarct occurs in the third trimester, if the patient is under age 35 yr, if she delivers within 2 wk of her infarct, and if she has ...
Storey R F - - 1997
OBJECTIVE: To assess the skills and opinions of different grades of doctors and cardiac-trained nurses in interpreting electrocardiographic changes when deciding upon administration of thrombolysis to patients with chest pain. DESIGN: A questionnaire was distributed to staff in several local hospitals. SUBJECTS AND METHODS: Participants were asked to assess 30 ...
Prendergast B D - - 1997
We conducted a postal survey amongst members of the British Cardiac Society to determine current strategies for the detection and management of failed thrombolysis for acute myocardial infarction. The response rate was 290/387 (75%). On-site cardiac catheterisation facilities are available to 162 (60%), 112 (41%) of which are prepared for ...
Fath-Ordoubadi F - - 1997
Thrombolysis in Myocardial Infarction (TIMI) flow scores were originally devised as semiquantitative angiographic measures of coronary artery perfusion. Several studies have indicated an important relation between different TIMI flow grades at 90 minutes after thrombolysis and clinical outcome. To further evaluate this relation we conducted a metaanalysis of all angiographic, ...
Juliard J M - - 1997
OBJECTIVES: This study sought to assess the maximal rate of acute Thrombolysis in Myocardial Infarction (TIMI) grade 3 patency that can be achieved in unselected patients. BACKGROUND: Early and complete (TIMI grade 3 flow) reperfusion is an important therapeutic goal during acute myocardial infarction. However, thrombolysis, although widely used, is ...
Nesković A N - - 1997
BACKGROUND AND HYPOTHESIS: It has been reported that high-dose dipyridamole echocardiography test (DET) can be successfully used for the detection of critical residual stenosis of the infarct-related artery (IRA). However, we have recently noticed low sensitivity of DET for the detection of residual IRA stenosis in patients with single-vessel disease. ...
Giannitsis E - - 1997
OBJECTIVE: To assess the efficacy of early accelerated dose tissue plasminogen activator on in-hospital patency of the infarct related artery in patients with inferior myocardial infarction with and without right ventricular involvement. DESIGN: Single centre prospective assessment before discharge of infarct related vessel patency after early thrombolysis. SETTING: Tertiary cardiac ...
Gotsman M S - - 1997
Acute myocardial infarction occurs when a ruptured coronary artery plaque causes sudden thrombotic occlusion of a coronary artery and cessation of coronary artery blood flow. This paper reviews the underlying coronary pathology in progressive coronary atherosclerosis, mechanisms of plaque rupture and arterial occlusion and the time relationship between coronary occlusion ...
Kawalsky D L DL Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic Rochester, Minnesota 55905, - - 1997
To assess the effect of patency of the infarct-related artery and the presence of late potentials on late cardiac mortality after myocardial infarction. We studied the influence of the infarct-related artery patency and the presence of late potentials during signal-averaged electrocardiography on late mortality in 124 survivors of acute myocardial ...
van Ommen V G - - 1997
This study evaluates the feasibility and safety of a 6Fr hydrodynamic thrombectomy catheter, the Hydrolyser, in native coronary arteries and aortocoronary bypass grafts. With use of a conventional contrast injector, saline solution is injected into the narrow lumen of the catheter which makes a 180 degrees bend at the tip. ...
Pandey A S - - 1997
Two patients with pulmonary emboli and right heart masses detected on echocardiography are described. One patient underwent successful surgical embolectomy and the other was successfully treated with intravenous thrombolysis. Both were alive and well at six months' follow-up. The presence of a right heart clot in the setting of pulmonary ...
Rosenschein U - - 1997
BACKGROUND: It has been demonstrated that therapeutic ultrasound effects ultrasound thrombolysis by selectively disrupting the fibrin matrix of the thrombus. This study was conducted to evaluate the clinical feasibility of percutaneous transluminal coronary ultrasound thrombolysis in acute myocardial infarction (AMI). METHODS AND RESULTS: Consecutive patients (n = 15) with evidence ...
Bär F W - - 1997
Four hundred seventy-three patients with acute myocardial infarction (AMI) were treated with either saruplase (80 mg/hour, n = 236) or alteplase (100 mg every 3 hours, n = 237). Comedication included heparin and acetylsalicylic acid. Angiography was performed at 45 and 60 minutes after the start of thrombolytic therapy. When ...
Gorfinkel HJ - - 1997
OBJECTIVES: To determine the success and survival rate of patients undergoing rescue angioplasty in failed thrombolysis in acute myocardial infarction, in the private practice setting of a tertiary care community hospital. METHODS: Between January 1990, and March 1995 we treated 125 patients with rescue angioplasty after failed thrombolysis for acute ...
Ward S R - - 1997
The Thrombolysis and Angioplasty in Acute Myocardial Infarction phase 5 (TAMI-5) trial randomized patients to 1 of 3 thrombolytic regimens (alteplase, urokinase, or both), then further randomized them to acute or deferred catheterization. The group of patients randomized to acute catheterization had improved infarct zone but not global left ventricular ...
- - 1997
OBJECTIVE: To study the effects of patency of infarct-related coronary artery on acute outcome in cases of acute myocardial infarction undergoing urokinase therapy. METHODS: One thousand one hundred and thirty-eight cases of acute myocardial infarction admitted in 37 collaborative hospitals were given urokinase intravenously with a standard program. Patency of ...
Shaukat N - - 1997
OBJECTIVE: To compare long term outcome after first myocardial infarction among British patients originating from the Indian subcontinent and from Europe. DESIGN: Matched pairs study. SETTING: Coronary care unit in central Leicester. SUBJECTS: 238 pairs of patients admitted during 1987-93 matched for age (within 2 years), sex, date of admission ...
Kontoyannis D A - - 1997
The objective was to predict the patency grade of an infarct-related artery by identifying the time course of the changes of the late potential parameters before, during, and shortly after thrombolysis. The study population consisted of 51 patients with acute myocardial infarction (AMI) who received thrombolytic therapy within 3.2 +/- ...
Zahn R - - 1997
This study investigates the hypothesis if primary angioplasty is superior to intravenous thrombolysis in the treatment of acute myocardial infarction (AMI). Small prospective randomized studies did not demonstrate a significant benefit regarding total mortality. A total of 14,980 patients with AMI were registered by "The 60-Minutes Myocardial Infarction Project," a ...
Nijland F - - 1997
BACKGROUND: Successful thrombolysis can prevent left ventricular dilatation after acute myocardial infarction. However, in almost 30% of patients, reocclusion occurs. The aim of this study was to assess the long-term implications of reocclusion on left ventricular size and function. METHODS AND RESULTS: Fifty-six patients were studied with two-dimensional echocardiography at ...
Chan A W - - 1997
A 42-year-old man presented with acute anterior myocardial infarction and hemoglobin of 248 g/L. Laboratory studies suggested the diagnosis of polycythemia rubra vera (PRV). Management of this condition with acetylsalisylic acid, heparin, warfarin and phlebotomy constitutes a therapeutic dilemma. This case also brings up the question of the appropriateness of ...
Haugh CJ - - 1997
Prompt opening of the infarct-related artery reduces mortality and subsequent morbid events. Not all benefit of timely thrombolysis or angioplasty appears to be accounted for by myocardial preservation. A favorable modification of the electrophysiologic postinfarction milieu by a patent infarct-related artery has been proposed to help explain this improved outcome. ...
- - 1997
OBJECTIVE: To investigate the influence of different starting time of intravenous urokinase after onset of acute myocardial infarction on the efficacy of thrombolysis. METHODS: One thousand one hundred and thirty eight cases of acute myocardial infarction admitted in 37 collaborative hospitals were given intravenous urokinase with a standard program. Patency ...
Steg And Patrick Seknadji - - 1997
Primary PTCA is at least as effective as intravenous thrombolysis for the management of acute myocardial infarction. When the capability for primary PTCA exists, it is also a very cost-effective treatment, allowing earlier hospital discharge, reduced readmissions and reduced risks of recurrent ischemia and infarction. Finally, many patients with acute ...
Nee P A - - 1997
Appropriate use of a thrombolytic agent may save 20 to 30 lives per 1000 treatments. Thrombolysis should be considered in all patients presenting with cardiac chest pain lasting more than 30 minutes for up to 12 hours after symptom onset. ECG criteria include ST elevation of at least 1 mm ...
Woodfield S L - - 1996
OBJECTIVES: This study sought to determine whether diabetes mellitus, in the setting of thrombolysis for acute myocardial infarction, affects 1) early infarct-related artery patency and reocclusion rates; and 2) global and regional ventricular function indexes. We also sought to assess whether angiographic or baseline clinical variables, or both, can account ...
Tighe M - - 1996
The purpose of the study was to compare observed mortality of a rural hospital coronary care unit with mortality rates estimated by two predictive instruments of mortality. The mortality rates of 86 consecutive patients with confirmed acute myocardial infarction were compared with those predicted by the presence or absence of ...
O'Keefe J H - - 1996
Poloxamer-188 is a surfactant polymer with antithrombotic and hemorheologic properties that make it potentially useful as an adjunct to acute reperfusion strategies. Animal studies and early human studies have documented poloxamer-188 to be effective at improving myocardial salvage when used as an adjunct to intravenous thrombolytic therapy for acute myocardial ...
Malcolm A D - - 1996
BACKGROUND: The goal of thrombolytic treatment in acute myocardial infarction is reperfusion of the infarct-related coronary artery. Duteplase is a double-chain recombinant tissue-type plasminogen activator. Its efficacy and safety were evaluated in patients with acute myocardial infarction treated within 4 h of onset of chest pain in this multicentre, open, ...
Vogt A - - 1996
In concept, mechanical interventions are attractive options for treating acute myocardial infarction with or without preceding thrombolysis: rapid reperfusion of the infarct-related artery can be achieved in the vast majority of cases, and the underlying coronary lesion is treated at the same time. Various strategies have been extensively investigated. When ...
Pasceri V - - 1996
Although a number of markers of successful coronary thrombolysis have been proposed, only a few of these have the two necessary features of a clinically useful marker: (1) widespread early availability and (2) good predictive value. The reduction in ST-segment elevation on the standard 12 lead electrocardiogram 1-4 h after ...
Gavagan T - - 1996
Myocardial infarction is the most common cause of death in the United States. Rapid postinfarction intervention in the first 24 hours decreases mortality. Treatment modalities are rapidly evolving as new data from basic science research and clinical trials become available. Rapid thrombolysis, accurate criteria for diagnosis and administration of effective ...
Brophy J M - - 1996
Thrombolysis in patients with acute myocardial infarction has been established to improve hospital survival. Less information is available about the long term evolution of unselected patients seen in community hospitals. Consequently, consecutive patients treated with thrombolysis for acute myocardial infarction and surviving until hospital discharge (n = 129) were followed ...
Lesnefsky E J - - 1996
OBJECTIVE: This study sought to determine whether the recovery of regional and global left ventricular function is reduced in elderly patients despite successful thrombolytic therapy for acute myocardial infarction. Comparisons were made between elderly (> or = 75 years old, n = 47) and adult (< 75 years old, n ...
Heisel A - - 1996
Patients with early reperfusion after thrombolysis for acute myocardial infarction revealed a significantly reduced incidence of ventricular late potentials in the signal-averaged electrocardiogram obtained in the chronic post-infarction period in comparison to patients who did not meet the criteria for early successful thrombolysis (14 vs. 39%; P < 0.05). This ...
van Gilst W H - - 1996
OBJECTIVES: In this study we sought to investigate the effect of intervention with captopril within 6 h of the onset of myocardial infarction on left ventricular volume and clinical symptoms of heart failure in relation to infarct size during a 1-year follow-up period. BACKGROUND: Remodeling of the heart starts in ...
Anderson J L - - 1996
Coronary patency has been used as a measure of thrombolysis success after acute myocardial infarction (AMI). The Thrombolysis in Myocardial Infarction (TIMI) study grading scale for coronary perfusion has gained wide acceptance, but the significance of individual grades on clinical outcome has not been adequately tested. We hypothesized that optimal ...
Barthel W - - 1996
The worldwide increase in the expenses of the National Health Services compels the legislation of some countries to take economizing regulatory measures. In Germany the existent and planned activities are an essential part of the German Structural Health Act of 1993. In the last years methods have been developed to ...
Peels K H - - 1996
To recognize patients prone to subsequent left ventricular dilation after the acute phase of a myocardial infarction treated with thrombolysis, we studied 233 patients with a first anterior infarction, treated with thrombolysis, with 2-dimensional echocardiography within 12 hours after admission and 3 months later. A wall motion score index (WMSI) ...
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