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Common Mistakes and Evidence-based Approaches in Goals-of-Care Conversations for Seriously Ill Older Adults in Cardiac Care Unit Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-04-08 Katharine A Manning, Jason Bowman, Shunichi Nakagawa, Kei Ouchi
For older adults with serious, life-limiting illnesses near the end of life, clinicians frequently face difficult decisions about the medical care they provide because of clinical uncertainty. This difficulty is further complicated by unique challenges and medical advancements for patients with advanced heart diseases. In this article, we describe common mistakes encountered by clinicians when having
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Frailty in the Cardiac Intensive Care Unit: Assessment and Impact Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-03-25 Mohamad B Moumneh, Yasser Jamil, Kriti Kalra, Naila Ijaz, Greta Campbell, Ajar Kochar, Michael G Nanna, Sean van Diepen, Abdulla A Damluji
Frailty, a clinical syndrome of increased vulnerability, due to diminished cognitive, physical, and physiological reserves is a growing concern in the cardiac intensive care unit (CICU). It contributes to morbidity, mortality, and complications and often exerts a bidirectional association with cardiovascular disease. Althought it predominately affects older adults, frailty can also be observed in younger
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European practices on antithrombotic management during percutaneous mechanical circulatory support in adults: A survey of the Association for Acute CardioVascular Care (ACVC) of the ESC and the European branch of the Extracorporeal Life Support Organization (EuroELSO) Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-03-25 Charlotte J Van Edom, Justyna Swol, Thomas Castelein, Mario Gramegna, Kurt Huber, Sergio Leonardi, Thomas Mueller, Federico Pappalardo, Susanna Price, Hannah Schaubroeck, Benedikt Schrage, Guido Tavazzi, Leen Vercaemst, Pascal Vranckx, Christophe Vandenbriele
Background Bleeding and thrombotic complications compromise outcomes in patients undergoing percutaneous mechanical circulatory support (pMCS) with veno-arterial extracorporeal membrane oxygenation (V-A ECMO) and/or microaxial flow pumps like the Impella™. Antithrombotic practices are an important determinant of the coagulopathic risk, but standardization in the antithrombotic management during pMCS
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Development and external validation of a dynamic risk score for early prediction of cardiogenic shock in cardiac intensive care units using machine learning Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-03-22 Yuxuan Hu, Albert Lui, Mark Goldstein, Mukund Sudarshan, Andrea Tinsay, Cindy Tsui, Samuel D Maidman, John Medamana, Neil Jethani, Aahlad Puli, Vuthy Nguy, Yindalon Aphinyanaphongs, Nicholas Kiefer, Nathaniel R Smilowitz, James Horowitz, Tania Ahuja, Glenn I Fishman, Judith Hochman, Stuart Katz, Samuel Bernard, Rajesh Ranganath
Background Myocardial infarction and heart failure are major cardiovascular diseases that affect millions of people in the US with the morbidity and mortality being highest among patients who develop cardiogenic shock. Early recognition of cardiogenic shock allows prompt implementation of treatment measures. Our objective is to develop a new dynamic risk score, called CShock, to improve early detection
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Early vs. Delayed Mechanical Circulatory Support in Patients with Acute Myocardial Infarction and Cardiogenic Shock Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-03-19 Kevin G Buda, Katarzyna Hryniewicz, Peter M Eckman, Mir B Basir, Jennifer A Cowger, Khaldoon Alaswad, Srini Mukundan, Yader Sandoval, Andrea Elliott, Emmanouil S Brilakis, Michael S Megaly
Background Despite increased temporary mechanical circulatory support (tMCS) utilization for acute myocardial infarction complicated by cardiogenic shock (AMI-CS), data regarding efficacy and optimal timing for tMCS support are limited. This study aimed to describe outcomes based on tMCS timing in AMI-CS and to identify predictors of 30-day mortality and readmission. Methods Patients with AMI-CS identified
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Relationship Between the Mixed Venous-to-Arterial Carbon Dioxide Gradient and Cardiac Index in Acute Pulmonary Embolism Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-03-08 Eugene Yuriditsky, Robert S Zhang, Jan Bakker, James M Horowitz, Peter Zhang, Samuel Bernard, Allison A Greco, Radu Postelnicu, Vikramjit Mukherjee, Kerry Hena, Lindsay Elbaum, Carlos L Alviar, Norma M Keller, Sripal Bangalore
Background Among patients with acute pulmonary embolism (PE) undergoing mechanical thrombectomy, the cardiac index (CI) is frequently reduced even among those without clinically apparent shock. The purpose of this study was to describe the mixed venous-to-arterial carbon dioxide gradient (CO2 gap), a surrogate of perfusion adequacy, among patients with acute PE undergoing mechanical thrombectomy. Methods
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In-hospital Prognosis of Acute ST-Elevation Myocardial Infarction in Patients with Recent Recreational Drug use Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-21 Arthur Clement, Jean-Guillaume Dillinger, Arthur Ramonatxo, Vincent Roule, Fabien Picard, Eugenie Thevenet, Federico Swedzky, Marie Hauguel-Moreau, David Sulman, Mathilde Stevenard, Nabil Amri, David Martinez, Laura Maitre-Ballesteros, Thomas Landemaine, Alexandre Coppens, Nabil Bouali, Paul Guiraud-Chaumeil, Emmanuel Gall, Antoine Lequipar, Patrick Henry, Theo Pezel
BACKGROUND Although recreational drug use may induce ST-elevated myocardial infarction (STEMI), its prevalence in patients hospitalized in intensive cardiac care units (ICCUs), as well as its short-term cardiovascular consequences, remain unknown. We aimed to assess the in-hospital prognosis of STEMI in patients with recreational drug use from the ADDICT-ICCU study. METHODS From April 7 to 22, 2021
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The association of the Sequential Organ Failure Assessment score at intensive care unit discharge with intensive care unit readmission in the cardiac intensive care unit Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-21 Yonghoon Shin, Ji Hoon Jang, Ryoung-Eun Ko, Soo Jin Na, Chi Ryang Chung, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang
Aims Unplanned intensive care unit (ICU) readmissions contribute to increased morbidity, mortality, and healthcare costs. The severity of patient illness at ICU discharge may predict early ICU readmission. Thus, in this study, we investigated the association of cardiac ICU (CICU) discharge Sequential Organ Failure Assessment (SOFA) score with unplanned CICU readmission in patients admitted to the CICU
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The outcomes of patients with septic shock treated with propafenone compared to amiodarone for supraventricular arrhythmias are related to end-systolic left atrial volume Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-19 P Waldauf, M Porizka, J Horejsek, M Otahal, E Svobodova, I Jurisinova, M Maly, T Brozek, J Rulisek, P Trachta, T Tencer, A Krajcova, F Duska, M Balik
Background A recently published trial has shown no differences in outcomes between patients with new-onset supraventricular arrhythmia (SVA) in septic shock treated with either propafenone or amiodarone. However, these outcome data have not been evaluated in relation to the presence or absence of a dilated left atrium (LA). Methods Patients with SVA and a left ventricular ejection fraction ≥35% were
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Rate of cardiovascular events up to 8 years after uncomplicated myocarditis: A nationwide cohort study Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-16 Andreas Schelldorfer, Claudia Gregoriano, Stephanie Hauser, Tobias A Fuchs, Beat Mueller, Philipp Schuetz, Alexander Kutz
Background While prognosis of acute myocarditis with uncomplicated presentation is perceived as benign, data on long-term outcomes is scarce. We evaluated rates of myocarditis-associated cardiovascular events after a first-time hospitalization with uncomplicated acute myocarditis in patients without known heart disease. Methods In this retrospective nationwide population-based cohort study from 2013
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Current Spectrum and Outcomes of Infarct-Related Cardiogenic Shock: Insights from the CULPRIT-SHOCK Registry and RCT Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-12 Uwe Zeymer, Tobias Heer, Taoufik Ouarrak, Ibrahim Akin, Marko Noc, Janina Stepinska, Keith Oldroyd, Pranas Serpytis, Giles Montalescot, Kurt Huber, Stephan Windecker, Stefano Savonitto, Christiaan Vrints, Steffen Schneider, Steffen Desch, Holger Thiele
Background We analysed consecutive patients with acute myocardial infarction complicated by cardiogenic shock (CS) who were enrolled into the CULPRIT-SHOCK randomized controlled trial (RCT) and those with exclusion criteria who were included into the accompanying registry. Methods In total, 1,075 patients with infarct-related CS were screened for CULPRIT-SHOCK in 83 specialised centres in Europe; 369
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Modelling Costs of Interventional Pulmonary Embolism Treatment: Implications of US Trends for a European Healthcare System Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-12 Katharina Mohr, Brent Keeling, Klaus Kaier, Thomas Neusius, Rachel P Rosovsky, John M Moriarty, Kenneth Rosenfield, Christina Abele, Ioannis T Farmakis, Karsten Keller, Stefano Barco, Richard N Channick, Jay S Giri, Robert A Lookstein, Thomas M Todoran, Konstantinos C Christodoulou, Lukas Hobohm, Michelle Lanno, Jamie Reed, Harald Binder, Stavros V Konstantinides, Luca Valerio, Eric A Secemsky
Background Catheter-directed treatment (CDT) of acute pulmonary embolism (PE) is entering a growth phase in Europe following a steady increase in the United States (US) in the past decade, but the potential economic impact on European healthcare systems remains unknown. Methods and Results We built two statistical models for the monthly trend of proportion of CDT among patients with severe (intermediate-
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Nutritional support in the Cardiac Intensive Care Unit Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-09 P Frederiks, M Peetermans, A Wilmer
Optimal care of critically ill patients in the cardiac intensive care unit (CICU) includes adequate nutritional support. This review highlights the high prevalence of malnutrition in acute heart failure, acute coronary syndrome, cardiogenic shock and post-cardiac arrest, and its adverse impact on prognosis. There is a lack of robust evidence regarding appropriate nutritional support in this patient
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Periprocedural Myocardial Infarction and Injury Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-06 Marco Spagnolo, Giovanni Occhipinti, Claudio Laudani, Antonio Greco, Davide Capodanno
Periprocedural myocardial infarction (PMI) and injury, pertinent to both cardiac and non-cardiac procedures, have gained increasing recognition in clinical practice. Over time, diverse definitions for diagnosing PMI have been developed and validated among patient populations undergoing coronary revascularization. However, this variety in definitions presents considerable challenges in clinical settings
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The Association of Off-Hour vs. On-Hour ICU Admission Time with Mortality in Patients with Cardiogenic Shock - a Retrospective Multicenter Analysis Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-02-01 Dominik Naumann, Julius Fischer, Jonas Gmeiner, Enzo Lüsebrink, Benedikt N Beer, Maximilian Grieger, Atakan Giousouf, Benedikt Schrage, Christopher Stremmel, Steffen Massberg, Martin Orban, Clemens Scherer
Background Studies have shown a so-called off-hour effect for many different diseases, but data are scarce concerning cardiogenic shock. We therefore assessed the association of off-hour vs. on-hour intensive care unit (ICU) admission with 30-day mortality in patients with cardiogenic shock. Methods In total, 1720 cardiogenic shock patients (666 admitted during off-hours) from two large university
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Antithrombotic Therapy in Patients with Acute Coronary Syndrome: Similarities and Differences between a European Expert Consensus Document and the 2023 European Society of Cardiology Guidelines Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2024-01-03 Antonio Landi, Victor Aboyans, Dominick J Angiolillo, Dan Atar, Davide Capodanno, Keith A A Fox, Sigrun Halvorsen, Stefan James, Peter Jüni, Sergio Leonardi, Roxana Mehran, Gilles Montalescot, Eliano Pio Navarese, Josef Niebauer, Angelo Oliva, Raffaele Piccolo, Susanna Price, Robert F Storey, Heinz Völler, Pascal Vranckx, Stephan Windecker, Marco Valgimigli
Antithrombotic therapy represents the cornerstone of the pharmacological treatment in patients with acute coronary syndrome (ACS). The optimal combination and duration of antithrombotic therapy is still matter of debate requiring a critical assessment of patient comorbidities, clinical presentation, revascularization modality and/or optimization of medical treatment. The 2023 European Society of Cardiology
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Diagnosis and treatment of right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale). A Clinical Consensus Statement of the Association for Acute CardioVascular Care (ACVC) of the ESC Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-12-23 Mattia Arrigo, Susanna Price, Veli-Pekka Harjola, Lars C Huber, Hannah A I Schaubroeck, Antoine Vieillard-Baron, Josep Masip, Alexandre Mebazaa
Purpose and Aim Acute right ventricular failure secondary to acutely increased right ventricular afterload (acute cor pulmonale) is a life-threatening condition that may arise in different clinical settings. Patients at risk of developing or with manifest acute cor pulmonale usually present with an acute pulmonary disease (e.g., pulmonary embolism, pneumonia, ARDS) and are managed initially in emergency
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Sex differences in outcomes after acute coronary syndrome vary with age: A New Zealand national study Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-12-12 N J Earle, R N Doughty, G Devlin, H White, C Riddell, Y Choi, A J Kerr, K K Poppe
Aim This study investigated age-specific sex differences in short and long-term clinical outcomes following hospitalisation for a first-time acute coronary syndrome (ACS) in New Zealand (NZ). Methods Using linked national health datasets, people admitted to hospital for a first-time ACS between January 2010-December 2016 were included. Analyses were stratified by sex and 10-year age groups. Logistic
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Impella device in Fulminant Myocarditis: Japanese Registry for Percutaneous Ventricular Assist Device (J-PVAD) registry analysis on outcomes and adverse events Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-12-04 Takahito Nasu, Ryo Ninomiya, Yorihiko Koeda, Yoshihiro Morino
Aims Given that fulminant myocarditis, characterized by unstable hemodynamics, is a significant clinical challenge and that traditional pharmacological treatments have limitations, evaluating alternatives such as the Impella device is a crucial focus of this study. Further, this study presents pioneering large-scale registry data on its use in managing fulminant myocarditis. Methods Data from the Japanese
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Agreement between high-sensitivity cardiac troponin assays and non-invasive testing, clinical-, quality of care outcomes based on the 2020 ESC guidelines Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-11-25 Júlia Karády, Thomas Mayrhofer, James L Januzzi, James E Udelson, Jerome L Fleg, Bela Merkely, Michael T Lu, W Frank Peacock, John T Nagurney, Wolfgang Koenig, Maros Ferencik, Udo Hoffmann
Background Quality-of-care and safety of patients with suspected acute coronary syndrome (ACS) would benefit if management was independent of which high-sensitivity cardiac troponin (hs-cTn) assay was used for risk stratification. We aimed to determine concordance of hs-cTn assays to risk stratify patients with suspected ACS according to the European Society of Cardiology (ESC) 2020 Guidelines. Methods
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Beta blocker and calcium channel blocker toxicity: Current evidence on evaluation and management Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-11-16 Charlotte E Goldfine, Andrew Troger, Timothy B Erickson, Peter R Chai
Beta blocker and calcium channel blocker overdoses are associated with severe morbidity and mortality; therefore, it is important to recognize and appropriately treat individuals with toxicity. The most common clinical findings in toxicity are bradycardia and hypotension. In addition to supportive care and cardiac monitoring, specific treatment includes administration of calcium salts, vasopressors
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Early Predictors of Clinical Deterioration in Intermediate – High-Risk Pulmonary Embolism: Clinical Needs, Research Imperatives, and Pathways Forward Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-11-15 Marco Zuin, Cecilia Becattini, Gregory Piazza
A subset of intermediate-high-risk pulmonary embolism (PE) patients will suffer clinical deterioration in the early hours following the acute event. Current evidence-based guidelines for the management of acute PE have provided limited direction for identification of which intermediate-high-risk PE patients will go on to develop hemodynamic decompensation. Furthermore, a paucity of data further hampers
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Prognostic impact of acute decompensated heart failure in patients with heart failure and mildly reduced ejection fraction Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-11-11 Alexander Schmitt, Tobias Schupp, Marielen Reinhardt, Noah Abel, Felix Lau, Jan Forner, Mohamed Ayoub, Kambis Mashayekhi, Christel Weiß, Ibrahim Akin, Michael Behnes
Objective This study sought to determine the prognostic impact of acute decompensated heart failure (ADHF) in patients with heart failure with mildly reduced ejection fraction (HFmrEF). Background ADHF is a major complication in patients with heart failure (HF), however, the prognostic impact of ADHF in patients with HFmrEF has not yet been clarified. Methods Consecutive patients hospitalized with
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Sex-specific presentation, care, and clinical events in individuals admitted with NSTEMI: the ACVC-EAPCI EORP NSTEMI Registry of the European Society of Cardiology Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-11-06 Ramesh Nadarajah, Peter Ludman, Cécile Laroche, Yolande Appelman, Salvatore Brugaletta, Andrzej Budaj, Hector Bueno, Kurt Huber, Vijay Kunadian, Sergio Leonardi, Maddalena Lettino, Dejan Milasinovic, Chris P Gale
Background Women have historically been disadvantaged in terms of care and outcomes for NSTEMI. We describe patterns of presentation, care, and outcomes for NSTEMI by sex in a contemporary and geographically diverse cohort. Methods Prospective cohort study including 2947 patients (907 women, 2040 men) with Type I NSTEMI from 287 centres in 59 countries, stratified by sex. Quality of care was evaluated
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Diagnostic and prognostic value of the sex-specific 99th percentile of four high-sensitivity cardiac troponin assays in patients with suspected myocardial infarction Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-25 Jonas Lehmacher, Nils Arne Sörensen, Raphael Twerenbold, Alina Goßling, Paul Michael Haller, Tau Sarra Hartikainen, Alina Schock, Betül Toprak, Tanja Zeller, Dirk Westermann, Johannes Tobias Neumann
Background High-sensitivity cardiac troponin (hs-cTn) assays are used for detection of myocardial infarction (MI). 99th percentiles show wide inter-assay variation. Use of sex-specific cutoffs is recommended as definitory cutoff for MI. We compared diagnostic performance and prognostic value of sex-specific 99th percentiles of four hs-cTn assays in patients with suspected MI. Methods Concentrations
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Organ perfusion pressure at admission and clinical outcomes in patients hospitalized for acute heart failure Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-25 Pier Paolo Bocchino, Marco Cingolani, Simone Frea, Filippo Angelini, Guglielmo Gallone, Laura Garatti, Alice Sacco, Claudia Raineri, Stefano Pidello, Nuccia Morici, Gaetano Maria De Ferrari
Background Hypoperfusion portends adverse outcomes in acute heart failure (AHF). The gradient between end-organ inflow and outflow pressures may more closely reflect hypoperfusion than mean arterial pressure (MAP) alone. The aim of this study was to investigate organ perfusion pressure (OPP), calculated as MAP minus central venous pressure (CVP), as a prognostic marker in AHF. Methods The SNIP-AHF
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Complications in patients with cardiogenic shock on veno-arterial extracorporeal membrane oxygenation therapy: distribution and relevance. Results from an international, multicentre cohort study. Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-24 Benedikt N Beer, Caroline Kellner, Alina Goßling, Jonas Sundermeyer, Lisa Besch, Angela Dettling, Paulus Kirchhof, Stefan Blankenberg, Alexander M Bernhardt, Stefan Brunner, Pascal Colson, Dennis Eckner, Derk Frank, Ingo Eitel, Norbert Frey, Matthias Eden, Tobias Graf, Danny Kupka, Ulf Landmesser, Nicolas Majunke, Octavian Maniuc, Sven Möbius-Winkler, David A Morrow, Marc Mourad, Curt Noel, Peter Nordbeck
Background VA-ECMO restores circulation and tissue oxygenation in cardiogenic shock (CS) patients, but can also lead to complications. Objectives To quantify VA-ECMO complications and analyse their association with overall survival as well as favourable neurological outcome (CPC 1 + 2). Methods All-comer patients with CS treated with VA-ECMO were retrospectively enrolled from 16 centres in 4 countries
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Absence of visible infarction on cardiac magnetic resonance imaging despite the established diagnosis of myocardial infarction by 4th UDMI definition Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-24 Janek Salatzki, Evangelos Giannitsis, Anastasia Hegenbarth, Matthias Mueller-Hennessen, Florian André, Norbert Frey, Moritz Biener
Background Myocardial scarring due to acute myocardial infarction (AMI) can be visualized by Late Gadolinium Enhancement (LGE) on cardiac magnetic resonance imaging (CMR). However, a recent study revealed a group of type 1 AMI patients with undetectable myocardial injury on LGE. This study aims to describe these cases in detail and explore possible explanations for this new phenomenon. Methods 137
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A Bayesian re-analysis of the INCEPTION-trial Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-24 Samuel Heuts, Anina F van de Koolwijk, Andrea Gabrio, Johannes F H Ubben, Iwan C C van der Horst, Thijs S R Delnoij, Martje M Suverein, Jos G Maessen, Roberto Lorusso, Marcel C G van de Poll
Background Previously, we performed the multicenter INCEPTION-trial, randomizing patients with refractory out-of-hospital cardiac arrest to extracorporeal CPR (ECPR) or conventional CPR (CCPR). Frequentist analysis showed no statistically significant treatment effect for the primary outcome; 30-day survival with favorable neurologic outcome (Cerebral Performance Category score 1-2). To facilitate a
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Quality Control to improve low-density lipoprotein cholesterol management in patients with acute coronary syndromes based on the ACS EuroPath IV project. Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-12 François Schiele, Alberico L Catapano, Raffaele De Caterina, Ulrich Laufs, J Wouter Jukema, Azfar Zaman, Alessandro Sionis
Background We performed quality control of lipid-lowering therapy (LLT) in patients with acute coronary syndrome, with a view to proposing corrective actions. Methods Using a Define-Measure-Analysis-Improve-Control (DMAIC) approach applied to data from the ACS EuroPath IV survey, we measured attainment of two Quality Indicators (QIs) related to lipid lowering treatment: (1) prescription of high intensity
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Coronary Calcification In Patients Presenting With Acute Coronary Syndromes: Insights From The Matrix Trial Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-09 Jorge Sanz Sánchez, Hector M Garcia-Garcia, Mattia Branca, E Frigoli, S Leonardi, A Gagnor, P Calabrò, S Garducci, P Rubartelli, C Briguori, G Andò, A Repetto, U Limbruno, R Garbo, P Sganzerla, F Russo, A Lupi, B Cortese, A Ausiello, S Ierna, G Esposito, A Santarelli, G Sardella, F Varbella, S Tresoldi, N de Cesare, S Rigattieri, A Zingarelli, P Tosi, A van ‘t Hof, G Boccuzzi, E Omerovic, M Sabaté
Objective The role of coronary calcification on clinical outcomes among different revascularization strategies in patients presenting with acute coronary syndromes (ACS) has been rarely investigated. The aim of this investigation is to evaluate the role of coronary calcification, detected by coronary angiography, in the whole spectrum of patients presenting with acute ACS. Methods The present study
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Discovery of plasma proteins associated with ventricular fibrillation during first ST-elevation myocardial infarction via proteomics Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-10-09 Niels Kjær Stampe, Maud Eline Ottenheijm, Lylia Drici, Nicolai J Wewer Albrechtsen, Annelaura Bach Nielsen, Christina Christoffersen, Peder Emil Warming, Thomas Engstrøm, Bo Gregers Winkel, Reza Jabbari, Jacob Tfelt-Hansen, Charlotte Glinge
Background and aims The underlying biological mechanisms of ventricular fibrillation (VF) during acute myocardial infarction are largely unknown. To our knowledge, this is the first proteomic study for this trait, with the aim to identify and characterize proteins that are associated with VF during first ST-elevation myocardial infarction (STEMI). Methods We included 230 participants from a Danish
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Percutaneous Coronary Intervention for ST-elevation Myocardial Infarction Complicated by Cardiogenic Shock in a Super-aging Society Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-09-18 Kensaku Nishihira, Satoshi Honda, Misa Takegami, Sunao Kojima, Jun Takahashi, Tomonori Itoh, Tetsu Watanabe, Jun Yamashita, Mike Saji, Kenichi Tsujita, Morimasa Takayama, Tetsuya Sumiyoshi, Kazuo Kimura, Satoshi Yasuda
Aims ST-segment elevation myocardial infarction complicated by cardiogenic shock (STEMICS) is associated with substantial mortality. As life expectancy increases, percutaneous coronary intervention (PCI) is being performed more frequently, even in elderly patients with acute myocardial infarction (AMI). This study sought to investigate the characteristics and impact of PCI on in-hospital mortality
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Incidence, management, and prognostic impact of arrhythmias in patients with Takotsubo syndrome: a nationwide retrospective cohort study Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-09-13 Toshiaki Isogai, Hiroki Matsui, Hiroyuki Tanaka, Kanako Makito, Kiyohide Fushimi, Hideo Yasunaga
Background Arrhythmia is a major complication of Takotsubo syndrome (TTS). However, its incidence, management, and prognostic impact remain to be elucidated in a large cohort. Methods We retrospectively identified 16713 patients hospitalized for TTS between July 2010 and March 2021 from the Japanese Diagnosis Procedure Combination database. Serious arrhythmias were defined as ventricular tachycardia/fibrillation
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Air Pollution and out-of-hospital cardiac arrest risk Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-09-11 L Moderato, D Aschieri, D Lazzeroni, L Rossi, A Biagi, S M Binno, A Monello, V Pelizzoni, C Sticozzi, A Zanni, A Capucci, S Nani, D Ardissino, F Nicolini, G Niccoli
Background Globally nearly 20% of cardiovascular disease deaths were attributable to air pollution. Out-of-hospital cardiac arrest (OHCA) represents a major public health problem, therefore, the identification of novel OHCA triggers is of crucial relevance. The aim of the study was to evaluate the association between air pollution (short-, mid- and long-term exposure) and out-of-hospital cardiac arrest
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First Myocardial Infarction in Patients with Premature Coronary Artery Disease: Insights into Patient Characteristics and Outcome after Treatment with Contemporary Stents Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-22 Tineke H Pinxterhuis, Eline H Ploumen, Carine J M Doggen, Marc Hartmann, Carl E Schotborgh, Rutger L Anthonio, Ariel Roguin, Peter W Danse, Edouard Benit, Adel Aminian, Gerard C M Linssen, Clemens von Birgelen
Background Patients with premature coronary artery disease (CAD) have a higher incidence of myocardial infarction (MI) than patients with non-premature CAD. Yet, it is unknown whether these patient groups differ in clinical outcome after a first acute MI, percutaneously treated with new-generation drug-eluting stents. Methods We pooled and analyzed the characteristics and clinical outcome of all patients
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Short-Term Percutaneous Mechanical Circulatory Support: No Promise Without Positioning! Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-22 Tim Balthazar, Nicolas M Van Mieghem, Matthias Raes, Ines Van Loo, Frederik H Verbrugge
Short-term percutaneous mechanical circulatory support by a micro-axial flow pump is increasingly used to support the left ventricle in cardiogenic shock. After a correct indication and placement, appropriate device management in the cardiac intensive care unit is vital to ensure optimal pump function and adequate hemodynamic support. A key element hereby is a correct percutaneous ventricular assist
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Acute Cardiovascular Complications of Immune-Mediated Systemic Inflammatory Diseases Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-21 Brittany N Weber, Micheal Garshick, Antonio Abbate, Taryn Youngstein, Garrick Stewart, Erin Bohula, Sven Plein, Monica Mukherjee
Immune-mediated systemic inflammatory conditions (IMIDs) are associated with an increased risk of atherosclerosis and adverse cardiovascular (CV) events secondary to pathogenic inflammation and derangements in the innate and adaptive immune responses inherent to the underlying rheumatic diseases. As the intersection of cardio-rheumatology continues to expand, a multidisciplinary approach must be considered
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Sex differences in symptoms of anxiety, depression, post-traumatic stress disorder and cognitive function among survivors of Out-of-Hospital Cardiac Arrest Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-08 Johannes Grand, Cecilie Fuglsbjerg, Britt Borregaard, Mette Kirstine Wagner, Astrid Rolin Kragh, Ditte Bekker-Jensen, Astrid Duus Mikkelsen, Jacob Eifer Møller, Heidi Glud, Christian Hassager, Selina Kikkenborg, Jesper Kjaergaard
Background Anxiety, depression, and post-traumatic stress disorder (PTSD) among out-of-hospital cardiac arrest (OHCA) survivors may impact long-term recovery. Coping and perception of symptoms may vary between sexes. The aim was to explore sex-differences in psychological consequences following OHCA. Methods Prospective observational study of OHCA survivors that attended structured three-month follow-up
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Temporal Trends in the Utilization of Advanced Therapies Among Patients with Acute Pulmonary Embolism: Insights from a National Database Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-04 Abdelrhman Abumoawad, Islam Shatla, Leili Behrooz, Robert T Eberhardt, Naomi Hamburg, Rami Sedhom, Islam Y Elgendy, Dharam J Kumbhani, Scott J Cameron, Ayman Elbadawi
There is a paucity of data regarding the contemporary temporal trends in the adoption of advanced pulmonary embolism (PE) therapies in the Western World as well as the parallel trends in outcomes of patients with acute PE. Therefore, we queried the Nationwide Readmissions Database (years 2016-2020) to report the temporal trends in utilization of advanced PE therapies. Our final analysis included 920
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Derivation and External Validation of Machine-Learning- Models for Risk Stratification in Chest Pain with Normal Troponin Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-08-02 Agustín Fernández-Cisnal, Pedro Lopez-Ayala, Ernesto Valero, Luca Koechlin, Arturo Catarralá, Jasper Boeddinghaus, José Noceda, Thomas Nestelberger, Òscar Miró Andreu, Julio Núñez, Christian Mueller, Juan Sanchis
Background Risk stratification of patients with chest pain and a high-sensitivity cardiac troponin T (hs-cTnT) concentration
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Temperature Management after Cardiac Arrest: What is next after the TTM-2 and BOX trials? Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-25 Fabio Silvio Taccone, Filippo Annoni
This commentary aims to summarize the main findings of the TTM-2 and BOX trials, to highlight pending questions regarding targeted temperature management after cardiac arrest and to explore how to improve the quality of future trials on this topic.
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Diagnosis and management of seizures and myoclonus after cardiac arrest Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-24 J Horn, M M Admiraal, J Hofmeijer
Cardiac arrest may lead to postanoxic brain injury. In approximately one third of the patients who remain in coma, myoclonus or status myoclonus is seen. Clinically manifest or electrographic epileptic seizures or status epilepticus are less common. Both status myoclonus and electrographic seizures indicate severe brain injury. Electroencephalography can contribute to discrimination between epileptic
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Sedation and Shivering Management After Cardiac Arrest Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-22 Bram J Geller, Carolina B Maciel, Teresa L May, Jacob C Jentzer
Management of sedation and shivering during targeted temperature management (TTM) after cardiac arrest is limited by a dearth of high-quality evidence to guide clinicians. Data from general intensive care unit (ICU) populations can likely be extrapolated to post cardiac arrest patients, but clinicians should be mindful of key differences that exist between these populations. Most importantly, the goals
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ECPR for refractory OHCA – lessons from 3 randomized controlled trials. The trialists´view Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-21 Johannes F H Ubben, Samuel Heuts, Thijs S R Delnoij, Martje M Suverein, Anina F van de Koolwijk, Iwan C C van der Horst, Jos G Maessen, Jason Bartos, Petra Kavalkova, Daniel Rob, Demetris Yannopoulos, Jan Bělohlávek, Roberto Lorusso, Marcel C G van de Poll
Extracorporeal cardiopulmonary resuscitation is a promising treatment for refractory out-of-hospital cardiac arrest. Three recent randomized trials (ARREST-trial, Prague OHCA study, and INCEPTION-trial) that addressed the clinical benefit of ECPR in out-of-hospital cardiac arrest, yielded seemingly diverging results. The evidence for extracorporeal cardiopulmonary resuscitation in out-of-hospital cardiac
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Hemodynamic, Oxygenation, and Ventilation Targets after Cardiac Arrest: the current ABC of post cardiac arrest intensive care Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-17 Jesper Kjaergaard, Jacob Eifer Møller
Post cardiac arrest care has been significantly improved over the past two decades following the publication of the two trials in therapeutic hypothermia, later renamed to targeted temperature management (TTM). While the initial research and treatment guidelines focussed in lowering core temperature, guidelines recommend more treatment goals, some of which are based in very limited evidence. The review
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Thrombotic Risk in Patients with Acute Coronary Syndromes Discharged on Prasugrel or Clopidogrel: Results From the PROMETHEUS Study Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-14 Mauro Chiarito, Davide Cao, Samantha Sartori, Zhongjie Zhang, Birgit Vogel, Alessandro Spirito, Kenneth F Smith, William Weintraub, Craig Strauss, Catalin Toma, Anthony DeFranco, Mark B Effron, Giulio Stefanini, Stuart Keller, Samir Kapadia, Sunil V Rao, Timothy D Henry, Stuart Pocock, Samin Sharma, George Dangas, Annapoorna Kini, Usman Baber, Roxana Mehran
Background Based on recent clinical data, the 2020 ESC guidelines on non-ST elevation acute coronary syndrome (NSTE-ACS) suggest to tailor antithrombotic strategy on individual thrombotic risk. Nonetheless, prevalence and prognostic impact of the high thrombotic risk (HTR) criteria proposed are yet to be described. Methods and results PROMETHEUS was a multicenter prospective study comparing prasugrel
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Potential performance of a 0/1-hour algorithm and a single cut-off measure of high-sensitivity troponin T in a diverse population: Main results of the IN-HOPE study Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-14 Pedro G M de Barros e Silva, Ana Amaral Ferreira, Felipe Malafaia, Antonielle Figueiredo Macedo Tavares Reis, Henry Sznejder, Augusto Celso De Araujo Lopes Junior, Camila Anacleto Agostinho, Luiz Henrique de Oliveira Fonseca, Débora Vieira Donini Okitoi, Celso Musa Correa, Eduardo Zincone, Marcelo Paiva Cury, Gustavo Augusto Lopes Rosa, Henrique Barbosa Ribeiro, Alexandre de Matos Soeiro, Carlos Alexandre
Background Chest pain is a major cause of medical evaluation at emergency department (ED) and demands observation to exclude the diagnosis of acute myocardial infarction (AMI). High-sensitivity cardiac troponin assays used as isolated measure and by 0 h and 1 h algorithms are accepted as a rule-in/rule-out strategy but there is a lack of validation in specific populations. Methods The IN-HOspital Program
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Time-based reperfusion in hemodynamically unstable pulmonary embolism patients: Does early reperfusion therapy improve survival? Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-08 Marco Zuin, Gregory Piazza, Stefano Barco, Behnood Bikdeli, Lukas Hobohm, George Giannakoulas, Stavros Konstantinides
High-risk pulmonary embolism (PE) is associated with significant morbidity and mortality. Systemic thrombolysis (ST) remains the most evidenced-based treatment for hemodynamically unstable PE but, in daily clinical practice, it remains largely underused. In addition, unlike acute myocardial infarction or stroke, a clear time window for reperfusion therapy, including fibrinolysis, for high-risk PE has
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Incidence of Hypoxic Hepatitis in Patients with Cardiogenic Shock and Association with Mortality Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-06 Benedikt N Beer, Lisa Besch, Jessica Weimann, Kishore Surendra, Kevin Roedl, Jörn Grensemann, Jonas Sundermeyer, Angela Dettling, Stefan Kluge, Paulus Kirchhof, Stefan Blankenberg, Clemens Scherer, Benedikt Schrage
Background Shock of any cause leads to end organ damage due to ischaemia, especially in perfusion-sensitive organs such as the liver. In septic shock, hypoxic hepatitis (S-HH) is defined as the 20-fold increase of the upper normal limit of ASAT and ALAT and is associated with a mortality of up to 60%. However, as pathophysiology, dynamics and treatment differ between septic and cardiogenic shock, the
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Characteristics, management and outcomes of active cancer patients with cardiogenic shock Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-06 Hamid Merdji, Justine Gantzer, Laurent Bonello, Nicolas Lamblin, François Roubille, Bruno Levy, Sebastien Champion, Pascal Lim, Francis Schneider, Alain Cariou, Hadi Khachab, Jeremy Bourenne, Marie-France Seronde, Guillaume Schurtz, Brahim Harbaoui, Gerald Vanzetto, Charlotte Quentin, Anais Curtiaud, Jean-Emmanuel Kurtz, Nicolas Combaret, Benjamin Marchandot, Benoit Lattuca, Caroline Biendel, Guillaume
Aims Characteristics, management, and outcomes of patients with active cancer admitted for cardiogenic shock remain largely unknown. This study aimed to address this issue and identify the determinants of 30-day and 1-year mortality in a large cardiogenic shock cohort of all etiologies. Methods and results FRENSHOCK is a prospective multicenter observational registry conducted in French critical care
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Intrarenal Venous Doppler as a novel marker for optimal decongestion, management and prognosis in acute heart failure patients Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-07-05 Fabrizio Turrini, Matteo Galassi, Sacchi Andrea, Beatrice Ricco’, Johanna Chester, Elena Famiglietti, Roberto Messora, Marco Bertolotti, Giovanni Pinelli
Aims An increase in right atrial pressure is a common feature of acute decompensated heart failure (ADHF). Such increased pressure leads to persistent kidney congestion. A marker to guide optimal diuretic therapy is missing. We aim to correlate intrarenal Doppler ultrasound (IRD) in ADHF patients with clinical outcomes to assess whether renal hemodynamic parameter changes are useful for monitoring
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Spontaneous coronary artery dissection in women with acute myocardial infarction: is there a new role for autoimmunity? Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-30 Giovanni Civieri, Marta Vadori, Giulia Masiero, Laura Iop, Donatella Tansella, Valeria Pergola, Emanuele Cozzi, Sabino Iliceto, Francesco Tona
Aims spontaneous coronary artery dissection (SCAD) is an uncommon cause of acute myocardial infarction in women and has an unclear pathophysiology. Autoantibodies (AAs) targeting angiotensin-II receptor type 1 (AT1R) and endothelin-1 receptor type A (ETAR) have known detrimental effects on endothelial function. We investigated the prevalence of these autoantibodies in SCAD-affected female patients
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Improved Detection of Echocardiographically Occult Left Ventricular Thrombi Following ST-elevation Myocardial Infarction Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-24 Martin Reindl, Ivan Lechner, Magdalena Holzknecht, Christina Tiller, Priscilla Fink, Fritz Oberhollenzer, Agnes Mayr, Felix Troger, Mathias Pamminger, Benjamin Henninger, Markus Theurl, Gert Klug, Christoph Brenner, Axel Bauer, Bernhard Metzler, Sebastian J Reinstadler
Objectives The aim of this study was to investigate predictors of TTE-occult LV thrombi and to propose a clinical model for improved detection of TTE-occult LV thrombi post ST-elevation myocardial infarction (STEMI). Background Patients with acute STEMI are at significant risk for developing left ventricular (LV) thrombi. However, this complication often (up to 65%) remains undetected by using transthoracic
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State of the Art Post-Cardiac Arrest Care: Evolution and future of post cardiac arrest care Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-17 Johannes Grand, Christian Hassager
Out-of-hospital cardiac arrest is a leading cause of mortality. In the prehospital setting, bystander response with cardiopulmonary resuscitation and use of publicly available automated external defibrillators have been associated with improved survival. Early in-hospital treatment still focuses on emergency coronary angiography for selected patients. For patients remaining comatose, temperature control
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Heart transplantation as a rescue strategy for patients with refractory electrical storm Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-15 Raphael P Martins, Mathilde Hamel-Bougault, Francis Bessière, Matteo Pozzi, Fabrice Extramiana, Zohra Brouk, Charles Guenancia, Audrey Sagnard, Sandro Ninni, Céline Goemine, Pascal Defaye, Aude Boignard, Baptiste Maille, Vlad Gariboldi, Pierre Baudinaud, Anne-Céline Martin, Laure Champ-Rigot, Katrien Blanchart, Jean-Marc Sellal, Christian De Chillou, Katia Dyrda, Laurence Jesel-Morel, Michel Kindo
BACKGROUND Heart transplantation (HT) can be proposed as a therapeutic strategy for patients with severe refractory electrical storm (ES). Data in the literature are scarce and based on case reports. We aimed at determining the characteristics and survival of patients transplanted for refractory ES. METHODS Patients registered on HT waiting list during the following days after ES and eventually transplanted
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Catheter-directed mechanical aspiration thrombectomy in a real-world pulmonary embolism population - a multicenter registry Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-15 Sylwia Sławek-Szmyt, Jakub Stępniewski, Marcin Kurzyna, Wiktor Kuliczkowski, Stanisław Jankiewicz, Grzegorz Kopeć, Szymon Darocha, Ewa Mroczek, Arkadiusz Pietrasik, Marek Grygier, Maciej Lesiak, Aleksander Araszkiewicz
Background High- (HR) and intermediate-high risk (IHR) pulmonary embolisms (PEs) are related to high early mortality and long-term sequelae. We aimed to describe clinical outcomes and adverse events in IHR and HR PE treated with catheter-directed mechanical thrombectomy (CDMT) in a real-world population. Methods This study is a multicenter, prospective registry enrolling 110 PE patients treated with
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Impact of annual volume of cases and Intensive Cardiac Care Unit availability on mortality of patients with acute myocardial infarction- related cardiogenic shock treated at revascularization capable centers Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-08 M Isabel Barrionuevo-Sánchez, Ana Viana-Tejedor, Albert Ariza-Solé, Náyade del Prado, Nicolás Rosillo, José Carlos Sánchez-Salado, Victòria Lorente, Pablo Jorge-Pérez, Francisco Javier Noriega, Carlos Ferrera, Oriol Alegre, Isaac Llaó, José Luis Bernal, Laura Triguero, Cristina Fernández-Pérez, José González-Costello, Marta Marcos, Francisco de la Cuerda, Jesús Carmona, Angel Cequier, Antonio Fernández-Ortiz
Background Cardiogenic shock (CS) is associated with high mortality. The purpose of this study was to assess the impact of Hospital structure-related variables on mortality in patients with CS treated at percutaneous and surgical revascularization capable centers (psRCC) from a large nationwide registry. Methods Retrospective observational study including consecutive patients with main or secondary
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Somatosensory Evoked Potential for Post-Arrest Neuroprognostication Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-07 Julie Kromm, Caralyn Bencsik, Andrea Soo, Craig Ainsworth, Martin Savard, Sean van Diepen, Andreas Kramer
Several guidelines recommend utilizing SSEPs, when available, as part of a multimodal approach to neuroprognostication in patients who remain comatose post-arrest. The evidence suggests somatosensory evoked potentials are an accurate and precise test for predicting a poor neurologic prognosis following cardiac arrest. Bilaterally absent cortical N20 potentials 24-48 hours post return of spontaneous
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Sex and age-related differences in outcomes of patients with acute myocardial infarction: MINOCA versus MIOCA Eur. Heart J. Acute Cardiovasc. Care (IF 4.1) Pub Date : 2023-06-01 Lisa Canton, Damiano Fedele, Luca Bergamaschi, Alberto Foà, Ornella Di Iuorio, Francesco Pio Tattilo, Andrea Rinaldi, Francesco Angeli, Matteo Armillotta, Angelo Sansonetti, Andrea Stefanizzi, Sara Amicone, Andrea Impellizzeri, Nicole Suma, Francesca Bodega, Daniele Cavallo, Davide Bertolini, Khrystyna Ryabenko, Marcello Casuso, Marta Belmonte, Emanuele Gallinoro, Gianni Casella, Nazzareno Galiè, Pasquale
Background To evaluate the impact of sex on acute myocardial infarction (AMI) patients’ clinical presentation and outcomes, comparing those with non-obstructive and obstructive coronary arteries (MINOCA vs MIOCA). Methods We enrolled 2455 patients with AMI undergoing coronary angiography from January 2017 to September 2021. Patients were divided according to the type of AMI and sex: male (n=1593) and