Background: To evaluate whether the administration of eplerenone 24 hours after an acute myocardial infarction (AMI) in patients without heart failure reduces mortality and cardiovascular morbidity. Methods and results: The study randomized 612 patients to evaluate the safety and efficacy of early treatment with eplerenone in patients with AMI. The primary end point was a...
We evaluated 41,537 patients admitted with myocardial infarction without ST elevation on the SCAAR register and who had not received IIBIIIB glycoprotein inhibitors and divided them into two groups: 31,351 patients who received heparin versus 10,186 who received bivalirudin. We adjusted baseline characteristics of the two groups using the Propensity score with the exception of...
This study evaluated the administration of prasugrel at the time of diagnosis of non-ST segment acute coronary syndrome vs administration at the time of the coronary angiography without indication of angioplasty. 4033 enrolled patients with non-ST segment acute coronary syndrome and positive troponin levels were randomized and who would undergo the angiography between 2 and...
The acute chest pain is responsible for more than 11 % of queries to an emergency service . Only 10% of these patients really have an acute myocardial infarction. The standard protocol for managing these patients includes serial electrocardiogram, dosage of biomarkers and an observation time of 6-12 hours. This overloads the emergency services and...
Original title: Long-Term Use of Ticagrelor in Patients with Prior Myocardial Infarction. PEGASUS-TIMI 54. Referencia: Marc P. Bonaca et al. N Engl J Med. 2015 Mar 14. Patients with acute myocardial infarction (AMI) have an increased risk of recurrent events suggesting that this population could benefit from intensive secondary prevention. Current guidelines recommend adding to aspirin an...
Original title: Long-Term Benefict of Early Pre-Reperfusion Metoprolol Administraction in Patients With Acute Myocardial Infaction. From the METOCARD-CNIC Trial. Reference: Gonzalo Pizarro et, al. J Am Coll Cardiol 20141;63:2356-62 The anterior infarction with ST- segment elevation has a high morbidity and mortality, both in the acute phase as well as after the presence of heart failure, arrhythmias...
Original title: Intracoronary stem cell infusion after acute myocardial infarction: a meta-analysis and update on clinical trials. Reference: de Jong R, Houtgraaf JH, Samiei S, et al. Circ Cardiovasc Interv. 2014;Epub ahead of print. This meta-analysis included 30 randomized studies conducted between July 2002 and September 2013, totalling 2037 patients with acute myocardial infarction. Of the total, 1218...
Original title: Acute multivessel revascularization improves 1 year outcomes in ST-elevation myocardial infarction. A nationwide study from AMIS plus registry. Reference: Raban Jeger, et al. International journal of Cardiology 2014;172:76-81 The presence of multiple vessel lesions is present in about 50% of patients referred for primary angioplasty. The accepted strategy is to treat the culprit artery even...
Original title: Complete Versus Culprit-Only Revascularization for Patients with Multi-Vessel Disease Undergoing Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction: A Systematic Review and Meta-analysis. Reference: Kevin R et al. American Heart Journal, article in press. Primary angioplasty is the preferred reperfusion strategy in patients experiencing a STEMI as it has proven superior to fibrinolysis in reducing...
Original title: Randomized Trial of Preventive Angioplasty in Myocardial Infarction (PRAMI trial). Referencia: David S. Wald et al. N Engl J Med 2013.DOI: 10.1056/NEJMoa1305520. Patients developing ST segment elevation myocardial infarction are effectively treated with primary angioplasty to responsible artery . It is unclear whether revascularized other significant lesions in other non culprit vessels will prevent future events...