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ESC Heart Failure Feb 2021The aim of the present paper was to provide an up-to-date view on epidemiology and risk factors of heart failure (HF) development after myocardial infarction. (Review)
Review
AIMS
The aim of the present paper was to provide an up-to-date view on epidemiology and risk factors of heart failure (HF) development after myocardial infarction.
METHODS AND RESULTS
Based on literature review, several clinical risk factors and biochemical, genetic, and imaging biomarkers were identified to predict the risk of HF development after myocardial infarction.
CONCLUSIONS
Heart failure is still a frequent complication of myocardial infarction. Timely identification of subjects at risk for HF development using a multimodality approach, and early initiation of guideline-directed HF therapy in these patients, can decrease the HF burden.
Topics: Biomarkers; Heart Failure; Humans; Incidence; Myocardial Infarction; Risk Factors
PubMed: 33319509
DOI: 10.1002/ehf2.13144 -
F1000Research 2018Over the last 40 years, our understanding of the pathogenesis of myocardial infarction has evolved and allowed new treatment strategies that have greatly improved... (Review)
Review
Over the last 40 years, our understanding of the pathogenesis of myocardial infarction has evolved and allowed new treatment strategies that have greatly improved survival. Over the years, there has been a radical shift in therapy from passive healing of the infarction through weeks of bed rest to early discharge usually within 2 to 3 days as a result of immediate reperfusion strategies and other guideline-directed medical therapies. Nevertheless, challenges remain. Patients who develop cardiogenic shock still face a high 30-day mortality of at least 40%. Perhaps even more important is how do we identify and prevent patients from developing myocardial infarction in the first place? This article discusses these milestones of therapy and considers important issues for progress in the future.
Topics: Humans; Myocardial Infarction; Shock, Cardiogenic
PubMed: 30228871
DOI: 10.12688/f1000research.15096.1 -
The Yale Journal of Biology and Medicine Mar 2023The incidence of arrhythmia after myocardial infarction has declined since the introduction of reperfusion techniques. Nevertheless, ischemic arrhythmias are often... (Review)
Review
The incidence of arrhythmia after myocardial infarction has declined since the introduction of reperfusion techniques. Nevertheless, ischemic arrhythmias are often associated with increased morbidity and mortality particularly in the first 48 hours after hospital admission. This paper presents a comprehensive review of the epidemiology, characteristics, and management of ischemic tachy- and brady-arrhythmias focusing on the period shortly after myocardial infarction (MI) in patients with both ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI).
Topics: Humans; Myocardial Infarction; ST Elevation Myocardial Infarction; Non-ST Elevated Myocardial Infarction; Arrhythmias, Cardiac; Risk Factors; Treatment Outcome
PubMed: 37009192
DOI: 10.59249/LSWK8578 -
Current Cardiology Reviews 2021Understanding the similarities and differences between myocardial infarction with or without ST-segment elevation is an essential step for proper patients' management in... (Review)
Review
Understanding the similarities and differences between myocardial infarction with or without ST-segment elevation is an essential step for proper patients' management in current practice. Both syndromes are caused by critical stenosis or total occlusion of coronary arteries (mostly due to thrombosis on atherosclerotic plaque), and manifest with a similar clinical presentation. Recent epidemiologic studies show that the relative incidence of ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) moves in an opposite fashion (decreasing and increasing respectively), with a prognosis that is worse at short-term follow-up for STEMI but comparable at long-term. Current management differs, as for STEMIs, immediate reperfusion is recommended, while for NSTEMIs, risk stratification is mandatory in order to stratify patients' risk, and then decide the timing for coronary angiography. Periprocedural and technical aspects of the interventional management, as well as antithrombotic medications, are for the most similarly implemented in the two types of MI, with routine radial access, DES implant, and novel P2Y12 inhibitors representing the standard of care in both cases. The following review article aims to compare the two types of MI, with and without persistent STsegment elevation. The main purpose is to explore their similarities and differences and address areas of uncertainty with regards to clinical presentation, therapeutic management, and prognosis. The identification of high-risk NSTEMI patients is important as they may require an individualised approach that can substantially overlap with current STEMI recommendations, and their mortality remains high if their management is delayed.
Topics: Coronary Angiography; Humans; Myocardial Infarction; Non-ST Elevated Myocardial Infarction; Prognosis; Risk Factors; ST Elevation Myocardial Infarction
PubMed: 33305709
DOI: 10.2174/1573403X16999201210195702 -
Reviews in Cardiovascular Medicine Dec 2021Right ventricular myocardial infarction (RVMI) and right ventricular (RV) failure are complications from an acute occlusion of a dominant right coronary artery (RCA) or... (Review)
Review
Right ventricular myocardial infarction (RVMI) and right ventricular (RV) failure are complications from an acute occlusion of a dominant right coronary artery (RCA) or left anterior descending (LAD) artery. Although some patients have good long-term RV recovery, RVMI is associated with high rates of in-hospital morbidity and mortality driven by hemodynamic compromise, cardiogenic shock, and electrical complications. As such, it is important to identify specific clinical signs and symptoms, initiate resuscitation and commence reperfusion therapy with fibrinolytic therapy or percutaneous coronary intervention. This review will discuss RVMI pathophysiology, describe the current diagnostic measures, highlight current therapies, and explore future management options.
Topics: Coronary Vessels; Heart Ventricles; Humans; Myocardial Infarction; Percutaneous Coronary Intervention; Shock, Cardiogenic
PubMed: 34957766
DOI: 10.31083/j.rcm2204131 -
Acute myocardial infarction in the diabetic patient: pathophysiology, clinical course and prognosis.Journal of the American College of... Sep 1992Although there have been significant advances in the care of many of the extrapancreatic manifestations of diabetes, acute myocardial infarction continues to be a major... (Review)
Review
Although there have been significant advances in the care of many of the extrapancreatic manifestations of diabetes, acute myocardial infarction continues to be a major cause of morbidity and mortality in diabetic patients. Factors unique to diabetes increase atherosclerotic plaque formation and thrombosis, thereby contributing to myocardial infarction. Autonomic neuropathy may predispose to infarction and result in atypical presenting symptoms in the diabetic patient, making diagnosis difficult and delaying treatment. The clinical course of myocardial infarction is frequently complicated and carries a higher mortality rate in the diabetic than in the nondiabetic patient. Although the course and pathophysiology of myocardial infarction differ to some degree in diabetic patients from those in patients without diabetes, much more remains to be known to formulate more effective treatment strategies in this high risk subgroup.
Topics: Adult; Diabetes Complications; Diabetes Mellitus; Female; Humans; Incidence; Male; Myocardial Infarction; Prognosis; Risk Factors
PubMed: 1512357
DOI: 10.1016/0735-1097(92)90033-j -
Methodist DeBakey Cardiovascular Journal 2020Cardiogenic shock in the setting of acute myocardial infarction remains a major cause of morbidity and mortality. In fact, acute myocardial infarction accounts for 81%... (Review)
Review
Cardiogenic shock in the setting of acute myocardial infarction remains a major cause of morbidity and mortality. In fact, acute myocardial infarction accounts for 81% of patients in cardiogenic shock. Despite advances in pharmacologic and device-based approaches to support patients with cardiogenic shock, no significant improvement in mortality has been observed over the past 20 years, although multiple registries are providing new insight into this complex syndrome. Key elements for optimal treatment include integration of hemodynamic and metabolic data for diagnosis and risk stratification, early evaluation and appropriate initiation of acute mechanical circulatory support devices, and an organized algorithmic approach to decision making.
Topics: Algorithms; Clinical Decision-Making; Decision Support Techniques; Hemodynamics; Humans; Myocardial Infarction; Predictive Value of Tests; Recovery of Function; Risk Factors; Shock, Cardiogenic; Treatment Outcome; Ventricular Function
PubMed: 32280413
DOI: 10.14797/mdcj-16-1-16 -
Journal of the American College of... Apr 2019Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a... (Review)
Review
Acute myocardial infarction (MI) can occur from increased myocardial oxygen demand and/or reduced supply in the absence of acute atherothrombotic plaque disruption; a condition called type 2 myocardial infarction (T2MI). As with any MI subtype, there must be clinical evidence of myocardial ischemia to make the diagnosis. This condition is increasingly diagnosed due to the increasing sensitivity of cardiac troponin assays and is associated with adverse short-term and long-term prognoses. Limited data exist defining optimal management strategies because T2MI is a heterogeneous entity with varying etiologies and triggers. Thus, these patients require individualized care. A major barrier is the absence of a uniform definition that can be operationalized with high reproducibility. This document provides a synthesis of the data about T2MI to assist clinicians' understanding of its pathobiology, when to deploy the diagnosis, and its associated treatments. It also clarifies prognosis, identifies gaps in knowledge, and provides recommendations for moving forward.
Topics: Diagnosis, Differential; Humans; Myocardial Infarction; Myocardium; Oxygen Consumption; Patient Care Management; Troponin
PubMed: 30975302
DOI: 10.1016/j.jacc.2019.02.018 -
Journal of the American College of... Nov 2007
Topics: Biomarkers; Echocardiography; Electrocardiography; Humans; Magnetic Resonance Imaging; Myocardial Infarction; Myocardial Revascularization; Tomography, X-Ray Computed
PubMed: 18036459
DOI: 10.1016/j.jacc.2007.09.011 -
EBioMedicine Apr 2022Myocardial infarction is lethal to patients because of insufficient blood perfusion to vital organs. Several attempts have been made to improve its prognosis, among... (Review)
Review
Myocardial infarction is lethal to patients because of insufficient blood perfusion to vital organs. Several attempts have been made to improve its prognosis, among which nanomaterial research offers an opportunity to address this problem at the molecular level and has the potential to improve disease prevention, diagnosis, and treatment significantly. Up to now, nanomaterial-based technology has played a crucial role in broad novel diagnostic and therapeutic strategies for cardiac repair. This review summarizes various nanomaterial applications in myocardial infarction from multiple aspects, including high precision detection, pro-angiogenesis, regulating immune homeostasis, and miRNA and stem cell delivery vehicles. We also propose promising research hotspots that have not been reported much yet, such as conjugating pro-angiogenetic elements with nanoparticles to construct drug carriers, developing nanodrugs targeting other immune cells except for macrophages in the infarcted myocardium or the remote region. Though most of those strategies are preclinical and lack clinical trials, there is tremendous potential for their further applications in the future.
Topics: Drug Carriers; Humans; Myocardial Infarction; Myocardium; Nanoparticles; Stem Cells
PubMed: 35367772
DOI: 10.1016/j.ebiom.2022.103968