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Peix A, Jimenez-Heffernan A, Devasenapathy N, Sobic-Saranovic D, Vitola J, Giubbini R, Rodella C, Haque SU, Alexanderson Rosas E, Ozkan E, Keng YJF, Dondi M, Paez D, Karthikeyan G. Correlates of markers of dyssynchrony in patients with STEMI and multivessel disease: an analysis from the IAEA SPECT STEMI trial. Nucl Med Commun 2024:00006231-990000000-00298. [PMID: 38745501 DOI: 10.1097/mnm.0000000000001860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
BACKGROUND In this substudy of the Value of Gated-SPECT MPI for Ischemia- Guided PCI of non-culprit vessels in STEMI Patients with Multi vessel Disease after primary PCI trial on the value of myocardial perfusion imaging (MPI) for ischemia-guided percutaneous coronary intervention (PCI) of nonculprit vessels in patients with ST-segment-elevation myocardial infarction (STEMI) and multivessel disease after primary PCI we aim to assess if infarct size affects conventional measures of dyssynchrony at rest. Additionally, we explore if there is an independent correlation of stress-inducible ischemia with dyssynchrony at rest. METHODS The 48 patients with imaging at randomization were analyzed. Gated-single-photon emission computed tomography (SPECT) MPI with vasodilator stress and technetium-99m-labeled tracers was performed. The phase histogram bandwidth (HBW), phase SD, and entropy were obtained with the QGS software. Correlation between dyssynchrony at rest and infarct size and inducible ischemia was performed using the Spearman test. RESULTS According to normal database limits dyssynchrony parameters at rest were abnormal for men. In women only HBW was abnormal. Correlation between the summed rest score with dyssynchrony was significant only for entropy (P = 0.035). No correlation was observed for dyssynchrony and stress-induced ischemia. CONCLUSION Entropy, as a measure of dyssynchrony, has potential in the assessment of patients with STEMI and multivessel disease after primary PCI. Smaller residual myocardial scars in PCI-reperfused patients with STEMI may contribute to the lack of correlation between dyssynchrony at rest and infarct size and stress-induced ischemia, respectively.
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Affiliation(s)
- Amalia Peix
- Department of Nuclear Medicine, Cardiology and Cardiovascular Surgery Institute, Havana, Cuba
| | | | | | | | - Joao Vitola
- Quanta Diagnóstico por Imagem, Curitiba, Brazil
| | - Raffaele Giubbini
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Carlo Rodella
- Nuclear Medicine, University of Brescia and Spedali Civili Brescia, Brescia, Italy
| | - Saif-Ul Haque
- Nuclear Medicine, Oncology and Radiotherapy Institute, Islamabad, Pakistan
| | | | - Elgin Ozkan
- Department of Nuclear Medicine, Medical School, Ankara University, Ankara, Turkey
| | - Yung Jih Felix Keng
- Center for Nuclear Medicine, University Clinical Centre of Serbia, Belgrade, Serbia
- Quanta Diagnóstico por Imagem, Curitiba, Brazil
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore
| | - Maurizio Dondi
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Diana Paez
- George Institute for Global Health, New Delhi, India
- Nuclear Medicine and Diagnostic Imaging Section, Division of Human Health, Department of Nuclear Sciences and Applications, International Atomic Energy Agency, Vienna, Austria
| | - Ganesan Karthikeyan
- George Institute for Global Health, New Delhi, India
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
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Solangi AR, Wahab A, Ansari AR, Tahseen M, Zaidi SHM, Muqtadir J. Mean Activated Clotting Time of Patients Receiving Intravenous Heparin and Undergoing Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction. Cureus 2024; 16:e56867. [PMID: 38659548 PMCID: PMC11040425 DOI: 10.7759/cureus.56867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/25/2024] [Indexed: 04/26/2024] Open
Abstract
Introduction The most prevalent cause of death is acute myocardial infarction (AMI). Primary percutaneous coronary intervention (PPCI) has replaced thrombolysis as the recommended therapeutic option for individuals with ST-segment elevation myocardial infarction (STEMI). However, more effective anticoagulation regimes are required for PCI due to the limitations of unfractionated heparin. Objective This study aimed to ascertain the connection between the mean activated clotting time and the risk of bleeding and infarcts in individuals receiving intravenous heparin during PPCI for STEMI. Methods This was a one-year prospective observational study carried out at the National Institute of Cardiovascular Diseases (NICVD), Karachi, Pakistan. Results The majority (70.15%) were male, with a mean age of 56.08 ± 8.92 years. Following PPCI, the average active clotting time (ACT) was 350.56 ± 39.62 seconds (range 255 to 453), compared to the pre-PPCI mean of 504.15 ± 38.98 seconds. ACT was considerably higher in female patients, smokers, and overweight patients. The mean ACT was not significantly higher in patients with hypertension (HTN) and dyslipidemia (DLD). Conclusion The ACT range in this investigation was 255 to 453 seconds, and there was no discernible relationship between ACT readings and problems related to bleeding and ischemia. To determine who is more at risk, bleeding risk models should be used and improved further before catheterization.
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Affiliation(s)
- Abdul R Solangi
- Cardiology, National Institute of Cardiovascular Diseases, Karachi, PAK
| | | | | | | | | | - Jamil Muqtadir
- Infectious Diseases, Ziauddin University, Karachi, PAK
- Infectious Diseases, Dr. Ziauddin Hospital, Karachi, PAK
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Clinical values of left ventricular mechanical dyssynchrony assessment by gated myocardial perfusion SPECT in patients with acute myocardial infarction and multivessel disease. Eur J Nucl Med Mol Imaging 2016; 44:259-266. [DOI: 10.1007/s00259-016-3542-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 09/29/2016] [Indexed: 10/20/2022]
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WITHDRAWN: Clinical outcomes of complete versus lesion only primary percutaneous coronary revascularization for multivessel disease and ST-segment elevation myocardial infarction. Indian Heart J 2016. [DOI: 10.1016/j.ihj.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Lee SH, Yang JH, Choi SH, Song YB, Hahn JY, Choi JH, Kim WS, Lee YT, Gwon HC. Long-Term Clinical Outcomes of Medical Therapy for Coronary Chronic Total Occlusions in Elderly Patients (≥75 Years). Circ J 2015; 79:1780-6. [DOI: 10.1253/circj.cj-15-0041] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Seung Hwa Lee
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Jeong Hoon Yang
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Seung-Hyuk Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Young Bin Song
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Joo-Yong Hahn
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Jin-Ho Choi
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Wook Sung Kim
- Department of Thoracic and Cardiovascular Surgery, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Young Tak Lee
- Department of Thoracic and Cardiovascular Surgery, Cardiac and Vascular Center, Samsung Medical Center, Sungkyunkwan University School of Medicine
| | - Hyeon-Cheol Gwon
- Division of Cardiology, Department of Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine
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