The Experts below are selected from a list of 56001 Experts worldwide ranked by ideXlab platform
D. Tchetche - One of the best experts on this subject based on the ideXlab platform.
-
Periodontopathogens antibodies and major adverse events following an acute myocardial infarction: results from the French RegiSTry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI)
Journal of Epidemiology and Community Health, 2016Co-Authors: A. Boillot, H. Range, N. Danchin, S. Kotti, G. Cosler, S. Czernichow, Olivier Meilhac, E. Puymirat, M. Zeller, D. TchetcheAbstract:Background Periodontopathogens antibodies have been shown to be associated with primary myocardial events, but little is known regarding their impact on major adverse events after a prior acute myocardial infarction (AMI). The present prospective STudy evaluates the association between antibody levels of 4 periodontopathogens and the risk of all-cause death or non-fatal myocardial infarction (MI) at 1 year in 975 patients admitted for acute ST segment or non-ST segment Elevation MI in French RegiSTry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI), a nationwide French survey. Methods Multiserotype ELISAs were performed to assess levels of IgG and IgA againST Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia. Results AdjuSTed HRs indicate the lack of association between IgG-anti-Po. gingivalis levels (0.96 (0.78 to 1.18)), IgA-anti-Po. gingivalis levels (1.13 (0.90 to 1.42)) and the risk of all-cause death or non-fatal MI at 1 year. Additionally, no significant association was found between the occurence of an event at 1 year and immunoglobulins levels againST the others periodontopathogens. Conclusions The present data indicate that circulating levels of periodontopathogens antibodies are not associated with an increased risk of major adverse events in patients with a prior AMI. STudies dealing with bacterial and clinical data are needed to assess the role of oral health in comprehensive cardiac rehabilitation programmes.
Yochai Birnbaum - One of the best experts on this subject based on the ideXlab platform.
-
Pseudo–ST-Elevation acute myocardial infarction
Journal of Electrocardiology, 2020Co-Authors: Yochai Birnbaum, Galen S. WagnerAbstract:The current guidelines recommend that patients with suggeSTive symptoms of myocardial ischemia within the preceding 12 hours (even if symptoms are resolved) and have ST Elevation in 2 or more anatomically adjacent electrocardiographic (ECG) leads (N0.2 mV in leads V1-V3 and N0.1 mV in all other leads, measured at the J point) should receive immediate reperfusion therapy, preferentially by primary percut aneous coronar y intervent ion. 1,2 There is a tremendous effort to shorten the time to reperfusion. The current guidelines suggeST that a decision should be made within 10 minutes of arrival to the emergency department. However, nonischemic ST Elevation is common, especially in the African-American and Asian populations. Many patients with baseline ST Elevation due to bearly repolarizationQ or secondary to left ventricular hypertrophy and/or cardiomyopathy may present to the emergency department with cheST pain. Some of them may have true ST-Elevation myocardial infarction (STEMI) (ST changes that are different from their baseline ECG with further evolution, such as subsequent decrease in ST Elevation, T-wave inversion, and development of new Q waves), some will have positive cardiac markers, such as troponin, without further ECG changes (non-STEMI with baseline ST Elevation, or bpseudo-STEMIQ), whereas in others, cardiac markers will remain negative (with or without resolution of ST Elevation-no MI) (Fig. 1). Although it is well known that there are many nonischemic causes of transient ST Elevation, many times, it is difficult to diSTinguish nonischemic from ischemic ST changes. The American Heart Association/American College of Cardiology 2004 guidelines suggeST that initial errors in ECG interpretation can result in up to 12% of patients being categorized inappropriately, demonSTrating a potential benefit of accurate computer-interpreted electrocardiography and wireless transmission to an expert. It is suggeSTed that it is less likely that STEMI is present if the upwarddirected ST segment changes are concave rather than
-
PR depression with multi‑lead ST Elevation and ST depression in aVR: Is it always acute pericarditis?
Journal of Electrocardiology, 2019Co-Authors: Yochai Birnbaum, Andrés Ricardo Pérez Riera, Kjell NikusAbstract:AbSTract The classic electrocardiographic (ECG) manifeSTation of STage I of acute pericarditis is diffuse ST Elevation and PR depression with ST depression in lead aVR. One of the moST common conditions, that is often confused with acute pericarditis, is the benign diffuse ST Elevation, termed “early repolarization with ST Elevation” (ERSTE). ERSTE often presents with diffuse ST Elevation in the inferior and anterolateral leads, with or without terminal QRS notching or slurring. As ERSTE often presents with ST Elevation in leads I and II, frequently there is concomitant ST depression in lead aVR, similar to the acute pericarditis ECG pattern. Moreover, PR depression in the inferior leads and/or PR Elevation in lead aVR is often seen. Here we describe four patients with ERSTE, all had ST Elevation in II with either ST Elevation or isoelectric ST in lead I and concomitant ST depression in aVR. Two also had PR depression in the inferior leads. None of the patients had clinical symptoms or signs of acute pericarditis. In conclusion, diffuse ST Elevation in the inferolateral leads associated with ST depression in aVR and even with PR segment depression is commonly found in ERSTE and should not be considered as pathognomonic of only acute pericarditis.
-
ST-segment Elevation: DiSTinguishing ST Elevation myocardial infarction from ST Elevation secondary to nonischemic etiologies
World Journal of Cardiology, 2014Co-Authors: Alok Deshpande, Yochai BirnbaumAbstract:The benefits of early perfusion in ST Elevation myocardial infarctions (STEMI) are eSTablished; however, early perfusion of non-ST Elevation myocardial infarctions has not been shown to be beneficial. In addition, ST Elevation (STE) caused by conditions other than acute ischemia is common. Non-ischemic STE may be confused as STEMI, but can also mask STEMI on electrocardiogram (ECG). As a result, activating the primary percutaneous coronary intervention (pPCI) protocol often depends on determining which ST Elevation patterns reflect transmural infarction due to acute coronary artery thrombosis. Coordination of interpreting the ECG in its clinical context and appropriately activating the pPCI protocol has proved a difficult task in borderline cases. But its importance cannot be ignored, as reflected in the 2013 American College of Cardiology Foundation/American Heart Association guidelines concerning the treatment of ST Elevation myocardial infarction. Multiples STrategies have been teSTed and STudied, and are currently being further perfected. No matter the STrategy, at the heart of delivering the beST care lies rapid and accurate interpretation of the ECG. Here, we present the different patterns of non-ischemic STE and methods of diSTinguishing between them. In writing this paper, we hope for quicker and better STratification of patients with STE on ECG, which will lead to be better outcomes.
-
ST Elevation: Telling Pathology from the Benign Patterns
Global Journal of Health Science, 2012Co-Authors: Waleed T. Kayani, Henry D. Huang, Salman Bandeali, Salim S. Virani, James M. Wilson, Yochai BirnbaumAbstract:Benefits of early reperfusion in patients presenting with acute ST Elevation myocardial infarction (STEMI) are well known. The American College of Cardiology / American Heart Association guidelines recommend triage decisions are made within 10 minutes of performing initial electrocardiogram (ECG). Since many patients presenting with ischemic symptoms may have ST Elevation (STE) at baseline, not all STE signify transmural ischemia. Benign patterns can be easy to find in some cases. However, patients with benign STE at baseline (left ventricular hypertrophy, early repolarization pattern) may have ongoing ischemia and present with Non-ST Elevation myocardial infarction (NSTEMI) or even STEMI superimposed on the benign pattern. The ability of clinicians to diSTinguish between ischemic and non ischemic STE varies widely and is affected by prevalence of such changes in patient population. More STudies need to be done to delineate the criteria to clearly diSTinguish between ischemic and non ischemic ST Elevation.
-
Electrocardiographic diagnosis of ST-Elevation myocardial infarction.
Cardiology Clinics, 2006Co-Authors: Shaul Atar, Alejandro Barbagelata, Yochai BirnbaumAbstract:The ECG is an essential part of the initial evaluation of patients who have cheST pain, especially in the immediate decision-making process in patients who have ST-Elevation myocardial infarction. This article reviews and summarizes the current information that can be obtained from the admission ECG in patients who have ST-Elevation acute myocardial infarction, with an emphasis on: (1) prediction of final infarct size, (2) eSTimation of prognosis, and (3) the correlations between various ECG patterns and the localization of the infarct and the underlying coronary anatomy.
Walter Markiewicz - One of the best experts on this subject based on the ideXlab platform.
-
hyponatremia and long term mortality in survivors of acute ST Elevation myocardial infarction
JAMA Internal Medicine, 2006Co-Authors: Alexander Goldberg, Haim Hammerman, Sirouch Petcherski, Alexander Zdorovyak, Sergey Yalonetsky, Michael Kapeliovich, Yoram Agmon, Mithal Nassar, Rafael Beyar, Walter MarkiewiczAbstract:Background Hyponatremia, a marker of neurohormonal activation, is a common electrolyte disorder among patients with acute ST-Elevation myocardial infarction. The long-term prognoSTic value of hyponatremia during the acute phase of infarction is not known. Methods We STudied 978 patients with acute ST-Elevation myocardial infarction and without a hiSTory of heart failure who survived the index event. During the hospital STay, sodium levels were obtained on admission and at 24, 48, and 72 hours. The median duration of follow-up after hospital discharge was 31 months (range, 9-61 months). Results Hyponatremia, defined as a mean serum sodium level less than 136 mEq/L, was present during admission in 108 patients (11.0%). In a multivariable Cox proportional hazards model adjuSTing for other potential clinical predictors of mortality and for left ventricular ejection fraction, hyponatremia during admission remained an independent predictor of poSTdischarge death (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.3-3.2;P = .002). Hyponatremia during admission was also independently associated with poSTdischarge readmission for heart failure (HR, 1.6; 95% CI, 1.1-2.6;P = .04). When serum sodium level was used as a continuous variable, the adjuSTed HR for death or heart failure was 1.12 for every 1-mEq/L decrease (95% CI, 1.07-1.18;P Conclusion Hyponatremia in the early phase of ST-Elevation myocardial infarction is a predictor of long-term mortality and admission for heart failure after hospital discharge, independent of other clinical predictors of adverse outcome and left ventricular ejection fraction.
-
PrognoSTic Importance of Hyponatremia in Acute ST-Elevation Myocardial Infarction
The American Journal of Medicine, 2004Co-Authors: Alexander Goldberg, Haim Hammerman, Sirouch Petcherski, Alexander Zdorovyak, Sergey Yalonetsky, Michael Kapeliovich, Yoram Agmon, Walter Markiewicz, Doron AronsonAbstract:Purpose To determine the prevalence and prognoSTic implications of hyponatremia in the setting of acute ST-Elevation myocardial infarction. Methods The STudy sample consiSTed of 1047 consecutive patients presenting with acute ST-Elevation myocardial infarction. Plasma sodium concentrations were obtained on admission and at 24, 48, and 72 hours thereafter. Infarct size was determined by echocardiographic examination that was performed on day 2 or 3 of hospitalization. Results Hyponatremia, defined as a plasma sodium level P = 0.04) was similar to that of hyponatremia developing after admission (OR = 2.4; 95% CI: 1.5 to 4.2; P = 0.002). The risk of 30-day mortality increased with the severity of hyponatremia, with an odds ratio of 2.1 in patients with sodium levels between 130 and 134 mmol/L (95% CI: 1.2 to 3.5; P = 0.007) and 3.4 in those with levels P = 0.002). Conclusion Hyponatremia on admission or early development of hyponatremia in patients with acute ST-Elevation myocardial infarction is an independent predictor of 30-day mortality, and prognosis worsens with the severity of hyponatremia. Further STudies are required to determine if plasma sodium levels may serve as a simple marker to identify patients at high risk.
Maarten L Simoons - One of the best experts on this subject based on the ideXlab platform.
-
prognoSTic value of growth differentiation factor 15 in patients with non ST Elevation acute coronary syndrome
Circulation, 2007Co-Authors: Kai C Wollert, Tibor Kempf, Timo Peter, Sylvia Olofsson, Stefan James, Nina Johnston, Bertil Lindahl, Rudiger Hornwichmann, G Brabant, Maarten L SimoonsAbstract:Background— Growth-differentiation factor-15 (GDF-15) is a member of the transforming growth factor-β cytokine superfamily that is induced in the heart after ischemia-and-reperfusion injury. Circulating levels of GDF-15 may provide prognoSTic information in patients with non–ST-Elevation acute coronary syndrome. Methods and Results— Blood samples were obtained on admission from 2081 patients with acute cheST pain and either ST-segment depression or troponin Elevation who were included in the Global Utilization of STrategies to Open Occluded Arteries (GUSTO)-IV Non–ST-Elevation Acute Coronary Syndrome trial and from a matching cohort of 429 apparently healthy individuals. GDF-15 levels were determined by immunoradiometric assay. Approximately two thirds of patients presented with GDF-15 levels above the upper limit of normal in healthy controls (1200 ng/L); one third presented with levels >1800 ng/L. Increasing tertiles of GDF-15 were associated with an enhanced risk of death at 1 year (1.5%, 5.0%, and 14....
A. Boillot - One of the best experts on this subject based on the ideXlab platform.
-
Periodontopathogens antibodies and major adverse events following an acute myocardial infarction: results from the French RegiSTry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI)
Journal of Epidemiology and Community Health, 2016Co-Authors: A. Boillot, H. Range, N. Danchin, S. Kotti, G. Cosler, S. Czernichow, Olivier Meilhac, E. Puymirat, M. Zeller, D. TchetcheAbstract:Background Periodontopathogens antibodies have been shown to be associated with primary myocardial events, but little is known regarding their impact on major adverse events after a prior acute myocardial infarction (AMI). The present prospective STudy evaluates the association between antibody levels of 4 periodontopathogens and the risk of all-cause death or non-fatal myocardial infarction (MI) at 1 year in 975 patients admitted for acute ST segment or non-ST segment Elevation MI in French RegiSTry of Acute ST-Elevation and Non-ST-Elevation Myocardial Infarction (FAST-MI), a nationwide French survey. Methods Multiserotype ELISAs were performed to assess levels of IgG and IgA againST Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Prevotella intermedia and Tannerella forsythia. Results AdjuSTed HRs indicate the lack of association between IgG-anti-Po. gingivalis levels (0.96 (0.78 to 1.18)), IgA-anti-Po. gingivalis levels (1.13 (0.90 to 1.42)) and the risk of all-cause death or non-fatal MI at 1 year. Additionally, no significant association was found between the occurence of an event at 1 year and immunoglobulins levels againST the others periodontopathogens. Conclusions The present data indicate that circulating levels of periodontopathogens antibodies are not associated with an increased risk of major adverse events in patients with a prior AMI. STudies dealing with bacterial and clinical data are needed to assess the role of oral health in comprehensive cardiac rehabilitation programmes.
