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Current outcomes and outcome measures in acute coronary syndrome
Published in K Sarat Chandra, AJ Swamy, Acute Coronary Syndromes, 2020
Dinkar Bhasin, Shaheer Ahmed, Nitish Naik
Reinfarction within 30 days of STEMI after successful primary PCI is seen in 1.8% of cases according to HORIZON AMI trial data and 2.1% in the PAMI trial [19,20]. After successful thrombolysis, 4.3% of patients experience re-occlusion [21,22]. Killip Class 2 or more, thrombocytosis, current smoking, stent length, final stenosis more than 30% and coronary dissection and left ventricular dysfunction are found to be independent predictors of reinfarction [19,20]. Reinfarction is an independent predictor of mortality after STEMI.
Social Support, Social Networks, Social Cohesion and Health
Published in Gary Rosenberg, Andrew Weissman, Behavioral Social Work in Health Care Settings, 2016
In order to look at many conditions simultaneously, we conducted a multiple logistic regression analysis, a multivariate analysis, putting in all the conditions that showed significant effects in bivariate analyses. We found that when we controlled for covariates, the relationship between emotional support and mortality grew stronger. Table 1 shows the results of these analyses. We included age, killip class, comorbidity, ejection fraction, ventricular tachycardia, reinfarction and functional disability. In these analyses we found that people were almost three times as likely to die in the six-month follow up period if they had no emotional support compared to people who had a lot of emotional support (OR 2.9 CI 1.2-6.9). The risks can be seen in in-hospital mortality as well as throughout the first year post-MI. Overall, we concluded that older men and women who report no sources of emotional support were almost three times as likely to die in the six-month period following hospitalization for MI as their contemporaries with one or more sources of support.
Effects of RAAS blocker use on AKI in elderly hypertensive STEMI patients with propensity score weighed method
Published in Clinical and Experimental Hypertension, 2022
Gönül Zeren, İlhan İlker Avcı, Mustafa Azmi Sungur, Barış Şimşek, Aylin Sungur, Fatma Can, Mehmet Fatih Yılmaz, Ufuk Gürkan, Sedat Kalkan, Ali Karagöz, İbrahim Halil Tanboğa, Can Yücel Karabay
Defined as given below (25):Killip class I: patients without any clinical sign of heart failureKillip class II: patients with crackles or rales in the lungs, elevated jugular venous pressure, and an S3 gallopKillip class III: patients with evident acute pulmonary edemaKillip class IV: patients with cardiogenic shock or hypotension (systolic blood pressure < 90 mmHg) and features of low cardiac output (oliguria, cyanosis, or impaired mental status).
Clinical characteristics and outcomes of infective endocarditis: impact of haemodialysis status, especially vascular access infection on short-term mortality
Published in Infectious Diseases, 2021
Seong Soon Kwon, Se Yoon Park, Duk Won Bang, Min-Ho Lee, Min-Su Hyon, Seong Soo Lee, Sangchul Yun, Dan Song, Byoung-Won Park
Complications were divided into three categories of (1) cardiac complications (conduction disturbance, and heart failure), (2) embolic complications (cerebral emboli, splenic infarct or abscess, septic lung and other peripheral embolisms) and (3) shock. Conduction abnormality complications of IE were defined as any new-onset abnormality in impulse generation or conduction such as atrioventricular blocks that required temporary pacing. Heart failure was defined as Killip class II and III. The shock state referred to systolic blood pressure below 90 mmHg for 30 min or inotrope use to maintain systolic blood pressure above 90 mmHg at the initial clinical assessment [14]. Due to the low sensitivity of echocardiography for perivascular complications such as abscess formation [15], it has not been described in detail. The major clinical outcome was 60-day mortality.
Key interventions and quality indicators for quality improvement of STEMI care: a RAND Delphi survey
Published in Acta Cardiologica, 2018
Daan Aeyels, Peter R. Sinnaeve, Marc J. Claeys, Sofie Gevaert, Danny Schoors, Walter Sermeus, Massimiliano Panella, Ellen Coeckelberghs, Luk Bruyneel, Kris Vanhaecht
An overview of content validity indices is given for key interventions (Table 2) and quality indicators (Table 3). In round one, the I-CVI for key interventions varied between 41 (assessment of HbA1c) and 100% (assessment and interpretation of a 12 lead electrocardiogram (ECG)). Eleven key interventions obtained an I-CVI higher than 90%. Six key interventions (22%) obtained an I-CVI below 75%: estimated glomerular filtration rate (eGFR;59%), creatine kinase-MB (CK-MB;53%), hemoglobin A1c (HbA1c;41%), complete blood formula (47%), peri-procedural admission of morphine or alike (44%) and assessment of Killip class (65%). All key interventions with an I-CVI higher than 75% were validated in the consensus meeting. In the meeting, the panellists grouped eGFR, CK-MB, HbA1c and complete blood formula blood testing as one intervention. Panellist stated that the results of these blood test may alter the follow-up care process. The assessment of Killip Class was retained as it is needed to calculate STEMI Thrombolysis in Myocardial Infarction (TIMI) score. The peri-procedural admission of morphine or alike was added to inform the recent discussion on influence of morphine administration on medication uptake [23]. Three suggested key interventions were validated in the consensus meeting: assessment of cardiovascular antecedents, STEMI TIMI score and reperfusion type. The former two allow for risk stratification of quality indicators. The latter was added to differentiate reperfusion delay goals and clinical follow- up of substitute treatment options.