Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.7
3.0
Journals
JCM
Special Issues
Clinical Treatment and Prognosis of Acute Myocardial Infarction
share announcement

Clinical Treatment and Prognosis of Acute Myocardial Infarction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Emergency Medicine".

Deadline for manuscript submissions: closed (28 February 2021) | Viewed by 5230

Special Issue Editor

Prof. MUDr. Zuzana Motovska

E-Mail Website
Guest Editor
1. Third Faculty of Medicine, Charles University, Prague, Czech Republic
2. University Hospital Kralovske Vinohrady, Prague, Czech Republic
Interests: acute coronary syndromes; cardiogenic shock; antithrombotic therapy; gender-related aspects of acute cardiac care

Special Issue Information

Dear Colleagues,

The prepared Special Issue will be devoted to all aspects of clinical treatment and prognosis of patients with acute myocardial infarction. Acute myocardial infarction (AMI) is a clinical entity, which is confronted by physicians regardless of their respective specialization.

In the prehospital phase, the network and organization of care enabling the earliest possible availability of coronary intervention have essential influence on the patient’s prognosis. The availability of reperfusion therapy in patients with AIM and STE elevations—primary percutaneous coronary intervention—is related not only to the system of care provided but also to the patient’s delay in making the decision to seek medical help. Despite media campaigns, a long patient time delay generally persists. The room for further research and its implications for practice therefore remains considerable. The still unanswered issue in patients with out-of-hospital cardiac arrest without significant changes on the ECG is the timing of diagnostic coronary angiography. Efforts to restore the earliest possible coronary artery flow have led to application of prehospital antithrombotic drugs and fibrinolytic therapy. Adjuvant pharmacotherapy of primary angioplasty is undergoing great developments. Multiple scientific projects have attempted to define the balance of the intense antithrombotic therapy effects while maintaining an acceptable risk of bleeding. The early period of hospitalization is challenging, especially in patients with circulatory instability. Patients with cardiogenic shock represent a population with persistently high in-hospital mortality, and thus a target population for new treatments that would improve their prognosis.

The risk of recurrent cardiovascular event grows with increase in time since the onset of the event. Secondary prevention after myocardial infarction must be sufficiently effective, especially in the most at-risk patients. Risk stratification after MI remains at the center of scientific attention, such as new approaches to secondary prevention. Apart from pharmacotherapy, the latter also comprises lifestyle adjustments, which in themselves present a highly effective approach to influencing the prognosis of patients after AIM.

Prof. MUDr. Zuzana Motovska
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Acute myocardial infarction
  • Patient time delay
  • Pre-hospital care
  • Reperfusion therapy
  • Primary angioplasty
  • Thrombolysis
  • Cardiogenic shock
  • Out-of hospital cardiac arrest
  • Risk stratification
  • Secondary prevention

Published Papers (2 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

11 pages, 1074 KiB  
Article
Predictive Value of Pro-BNP for Heart Failure Readmission after an Acute Coronary Syndrome
by Alberto Cordero, Elías Martínez Rey-Rañal, María J. Moreno, David Escribano, José Moreno-Arribas, Maria A. Quintanilla, Pilar Zuazola, Julio Núñez and Vicente Bertomeu-González
J. Clin. Med. 2021, 10(8), 1653; https://doi.org/10.3390/jcm10081653 - 13 Apr 2021
Cited by 7 | Viewed by 1859
Abstract
Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed [...] Read more.
Background: N-terminal pro-brain natural peptide (NT-pro-BNP) is a well-established biomarker of tissue congestion and has prognostic value in patients with heart failure (HF). Nonetheless, there is scarce evidence on its predictive capacity for HF re-admission after an acute coronary syndrome (ACS). We performed a prospective, single-center study in all patients discharged after an ACS. HF re-admission was analyzed by competing risk regression, taking all-cause mortality as a competing event. Results are presented as sub-hazard ratios (sHR). Recurrent hospitalizations were tested by negative binomial regression, and results are presented as incidence risk ratio (IRR). Results: Of the 2133 included patients, 528 (24.8%) had HF during the ACS hospitalization, and their pro-BNP levels were higher (3220 pg/mL vs. 684.2 pg/mL; p < 0.001). In-hospital mortality was 2.9%, and pro-BNP was similarly higher in these patients. Increased pro-BNP levels were correlated to increased risk of HF or death during the hospitalization. Over follow-up (median 38 months) 243 (11.7%) patients had at least one hospital readmission for HF and 151 (7.1%) had more than one. Complete revascularization had a preventive effect on HF readmission, whereas several other variables were associated with higher risk. Pro-BNP was independently associated with HF admission (sHR: 1.47) and readmission (IRR: 1.45) at any age. Significant interactions were found for the predictive value of pro-BNP in women, diabetes, renal dysfunction, STEMI and patients without troponin elevation. Conclusions: In-hospital determination of pro-BNP is an independent predictor of HF readmission after an ACS. Full article
(This article belongs to the Special Issue Clinical Treatment and Prognosis of Acute Myocardial Infarction)
►▼ Show Figures

Graphical abstract

12 pages, 1196 KiB  
Article
The Effect of Diabetes on Prognosis Following Myocardial Infarction Treated with Primary Angioplasty and Potent Antiplatelet Therapy
by Stanislav Simek, Zuzana Motovska, Ota Hlinomaz, Petr Kala, Milan Hromadka, Jiri Knot, Ivo Varvarovsky, Jaroslav Dusek, Richard Rokyta, Frantisek Tousek, Michal Svoboda, Alexandra Vodzinska, Jan Mrozek and Jiri Jarkovsky
J. Clin. Med. 2020, 9(8), 2555; https://doi.org/10.3390/jcm9082555 - 6 Aug 2020
Cited by 5 | Viewed by 2981
Abstract
Purpose: To investigate the prognostic significance of diabetes mellitus (DM) in patients with high risk acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) in the era of potent antithrombotics. Methods: Data from 1230 ST-segment elevation myocardial infarction (STEMI) patients enrolled [...] Read more.
Purpose: To investigate the prognostic significance of diabetes mellitus (DM) in patients with high risk acute myocardial infarction (AMI) treated with primary percutaneous coronary intervention (pPCI) in the era of potent antithrombotics. Methods: Data from 1230 ST-segment elevation myocardial infarction (STEMI) patients enrolled in the PRAGUE-18 (prasugrel vs. ticagrelor in pPCI) study were analyzed. Ischemic and bleeding event rates were calculated for patients with and without diabetes. The independent impact of diabetes on outcomes was evaluated after adjustment for outcome predictors. Results: The prevalence of DM was 20% (N = 250). Diabetics were older and more often female. They were more likely to have hypertension, hyperlipoproteinemia, multivessel coronary disease and left main disease, and be obese. The primary net-clinical endpoint (EP) containing death, spontaneous nonfatal MI, stroke, severe bleeding, and revascularization at day 7 occurred in 6.1% of patients with, and in 3.5% of patients without DM (HR 1.8; 95% CI 0.978–3.315; P = 0.055). At one year, the key secondary endpoint defined as cardiovascular death, spontaneous MI, or stroke occurred in 8.8% with, and 5.5% without DM (HR 1.621; 95% CI 0.987–2.661; P = 0.054). In those with DM the risk of total one-year mortality (6.8% vs. 3.9% (HR 1.773; 95% CI 1.001–3.141; P = 0.047)) and the risk of nonfatal reinfarction (4.8% vs. 2.2% (HR 2.177; 95% CI 1.077–4.398; P = 0.026)) were significantly higher compared to in those without DM. There was no risk of major bleeding associated with DM (HR 0.861; 95% CI 0.554–1.339; P = 0.506). In the multivariate analysis, diabetes was independently associated with the one-year risk of reinfarction (HR 2.176; 95% Confidence Interval, 1.055–4.489; p = 0.035). Conclusion: Despite best practices STEMI treatment, diabetes is still associated with significantly worse prognoses, which highlights the importance of further improvements in the management of this high-risk population. Full article
(This article belongs to the Special Issue Clinical Treatment and Prognosis of Acute Myocardial Infarction)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-2
Back to TopTop