• Title/Summary/Keyword: Acute Myocardial Infarction

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Clinical outcomes and characteristics of acute myocardial infarction patients with developing fever after percutaneous coronary intervention

  • Jae-Geun Lee;Yeekyoung Ko;Joon Hyouk Choi;Jeong Rae Yoo;Misun Kim;Ki Yung Boo;Jong Wook Beom;Song-Yi Kim;Seung-Jae Joo
    • Journal of Medicine and Life Science
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    • v.19 no.2
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    • pp.46-56
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    • 2022
  • The incidence of fever complicating percutaneous coronary intervention (PCI) is rare. However, little is known regarding the cause of fever after PCI. Therefore, this study aimed to determine the clinical characteristics of patients with acute myocardial infarction (AMI), with or without fever, after PCI. We enrolled a total of 926 AMI patients who underwent PCI. Body temperature (BT) was measured every 4 hours or 8 hours for 5 days after PCI. Patients were divided into two groups according to BT as follows: BT<37.7℃ (no-fever group) and BT ≥37.7℃ (fever group). The 2 years clinical outcomes were compared subsequently. Fever after PCI was associated with higher incidence of major adverse cardiac events (MACE) (hazard ratio [HR], 1.56; 95% confidence interval [CI], 1.07-2.28; P=0.021), all-cause death (HR, 2.32; 95% CI, 1.18-4.45; P=0.014), cardiac death (CD) (HR, 2.57; 95% CI, 1.02-6.76; P=0.049), and any revascularization (HR, 1.69; 95% CI, 1.02-2.81; P=0.044) than without fever. In women, prior chronic kidney disease, lower left ventricular (LV) ejection fraction, higher LV wall motion score index, white blood cell count, peak creatine kinase-myocardial band level, and longer PCI duration were associated with fever after PCI. Procedures such as an intra-aortic balloon pump, extracorporeal membrane oxygenation, continuous renal replacement therapy, central and arterial line insertion, and cardiopulmonary resuscitation were related to fever after PCI. Fever after PCI in patients with AMI was associated with a higher incidence of MACE, all-cause death, CD, and any revascularization at the 2 years mark than in those without fever.

LncRNA AC005332.7 Inhibited Ferroptosis to Alleviate Acute Myocardial Infarction Through Regulating miR-331-3p/CCND2 Axis

  • Rixin Dai;Xiheng Yang;Wujin He;Qiang Su;Xuexin Deng;Juanfen Li
    • Korean Circulation Journal
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    • v.53 no.3
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    • pp.151-167
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    • 2023
  • Background and Objectives: Acute myocardial infarction (AMI) often occurs suddenly and leads to fatal consequences. Ferroptosis is closely related to the progression of AMI. However, the specific mechanism of ferroptosis in AMI remains unclear. Methods: We constructed a cell model of AMI using AC16 cells under oxygen and glucose deprivation (OGD) conditions and a mice model of AMI using the left anterior descending (LAD) ligation. The 3-(4, 5-dimethylthiazol-2-yl)-2, 5 diphenyltetrazolium bromide was employed to determine cell viability. The levels of lactate dehydrogenase, creatine kinase, reactive oxygen species (ROS), glutathione (GSH), malondialdehyde (MDA), and iron were measured using corresponding kits. Dual luciferase reporter gene assay, RNA-binding protein immunoprecipitation, and RNA pull-down were performed to validate the correlations among AC005332.7, miR-331-3p, and cyclin D2 (CCND2). Hematoxylin and eosin staining was employed to evaluate myocardial damage. Results: AC005332.7 and CCND2 were lowly expressed, while miR-331-3p was highly expressed in vivo and in vitro models of AMI. AC005332.7 sufficiency reduced ROS, MDA, iron, and ACSL4 while boosting the GSH and GPX4, indicating that AC005332.7 sufficiency impeded ferroptosis to improve cardiomyocyte injury in AMI. Mechanistically, AC005332.7 interacted with miR-331-3p, and miR-331-3p targeted CCND2. Additionally, miR-331-3p overexpression or CCND2 depletion abolished the suppressive impact of AC005332.7 on ferroptosis in OGD-induced AC16 cells. Moreover, AC005332.7 overexpression suppressed ferroptosis in mice models of AMI. Conclusions: AC005332.7 suppressed ferroptosis in OGD-induced AC16 cells and LAD ligation-operated mice through modulating miR-331-3p/CCND2 axis, thereby mitigating the cardiomyocyte injury in AMI, which proposed novel targets for AMI treatment.

Defect of $^{18}F-FDG$ Uptake Observed in Infarcted Myocardium Showing Reverse Redistribution on Rest / 24-Hour Delayed $^{201}Tl$ Myocardial SPEG after Acute Myocardial Infarction (급성 심근경색 후 휴식 / 24시간 지연 $^{201}Tl$ 심근 SPECT 상 역재분포를 보인 경색심근에서 관찰된 $^{18}F-FDG$ 섭취 결손)

  • Lee, Ho-Young;Paeng, Jin-Chul;Oh, So-Won;Kim, Ji-Yeong;Chung, Woo-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.6
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    • pp.478-481
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    • 2008
  • Reverse redistribution is frequently observed after revascularization in acute myocardial infarction, and usually regarded as a predictor of viable myocardium on stress/rest and 2- to 4-hour redistribution $^{201}Tl$ SPECT. However, there is not enough report of reverse redistribution in case of 24-hour delayed SPECT, which is commonly used for viability assessment. In this report, a case of reverse redistribution on rest and 24-hour delayed $^{201}Tl$ SPECT is reported with use of automatic segmental quantitative analysis. The myocardium of reverse redistribution was dysfunctional on gated SPECT, and diagnosed as non-viable on $^{18}F-FDG$ PET.

Convergence Study in Development of Severity Adjustment Method for Death with Acute Myocardial Infarction Patients using Machine Learning (머신러닝을 이용한 급성심근경색증 환자의 퇴원 시 사망 중증도 보정 방법 개발에 대한 융복합 연구)

  • Baek, Seol-Kyung;Park, Hye-Jin;Kang, Sung-Hong;Choi, Joon-Young;Park, Jong-Ho
    • Journal of Digital Convergence
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    • v.17 no.2
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    • pp.217-230
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    • 2019
  • This study was conducted to develop a customized severity-adjustment method and to evaluate their validity for acute myocardial infarction(AMI) patients to complement the limitations of the existing severity-adjustment method for comorbidities. For this purpose, the subjects of KCD-7 code I20.0 ~ I20.9, which is the main diagnosis of acute myocardial infarction were extracted using the Korean National Hospital Discharge In-depth Injury survey data from 2006 to 2015. Three tools were used for severity-adjustment method of comorbidities : CCI (charlson comorbidity index), ECI (Elixhauser comorbidity index) and the newly proposed CCS (Clinical Classification Software). The results showed that CCS was the best tool for the severity correction, and that support vector machine model was the most predictable. Therefore, we propose the use of the customized method of severity correction and machine learning techniques from this study for the future research on severity adjustment such as assessment of results of medical service.

A case of Guillain-Barr$\acute{e}$ Syndrome Complicated with Reversible Cardiomyopathy (길랑-바레 증후군에 합병된 가역적 심근병증 1예)

  • Kim, Sung-Hyouk;Kim, Su-Hyun;Lee, Yeong-Bae
    • Annals of Clinical Neurophysiology
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    • v.12 no.2
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    • pp.66-69
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    • 2010
  • A 73-year-old man with progressive quadriparesis was diagnosed as Guillain-Barr$\acute{e}$ syndrome. On the 6th hospital day, the patient complained of sudden chest discomfort. The blood test and echocardiography suggested myocardial injury, and acute myocardial infarction was considered. However, coronary angiography displayed no vascular lesion, and the electrocardiography and echocardiogram showed marked improvement 14 days later. We concluded the patient had a reversible cardiomyopathy which is a rare complication of Guillain-Barr$\acute{e}$ syndrome.

Assessment of Myocardial Viability Using PET (PET을 이용한 심근생존능의 평가)

  • Yoon, Seok-Nam
    • The Korean Journal of Nuclear Medicine
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    • v.39 no.2
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    • pp.133-140
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    • 2005
  • The potential for recovery of left ventricular dysfunction after myocardial revascularization represents a practical clinical definition for myocardial viability. The evaluation of viable myocardium in patients with severe global left ventricular dysfunction due to coronary artery disease and with regional dysfunction after acute myocardial infarction is an important issue whether left ventricular dysfunction may be reversible or irreversible after therapy. If the dysfunction is due to stunning or hibernation, functional improvement is observed. but stunned myocardium may recover of dysfunction with no revascularization. Hibernation is chronic process due to chronic reduction in the resting myocardial blood flow. There are two types of myocardial hibernation: "functional hibernation" with preserved contractile reserve and "structural hibernation" without contractile reserve in segments with preserved glucose metabolism. This review focus on the application of F-18 FDG and other radionuclides to evaluate myocardial viability. In addition the factors influencing predictive value of FDG imaging for evaluating viability and the different criteria for viability are also reviewed.

A Study on the prediction dyspnea-induced attributes of linear regression-based Article

  • Lee, Kwang-Keun;Jeon, Gyu-Hyeon
    • Korean Journal of Artificial Intelligence
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    • v.6 no.2
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    • pp.17-22
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    • 2018
  • According to the World Health Organization, the top 10 causes of death worldwide include heart disease. Heart diseases include coronary disease, which induces acute myocardial infarction. Ticagrelor drugs are being used to treat acute alliances, but it has become difficult to breathe due to the drugs. In a related study, Tobias predicted that uric acid causes acute respiratory distress independently of other factors, including BNP. And in the Ahmad study, serum uric acid numbers were related to the left ventricle depending on the level of uric acid. Experimental data are data used after 155 patients who received coronary intervention took ticagrelor. The research methods were leveraged by gradient decent algorithm and linear regression. In order to avoid overfitting in the experiment, training data and test data were separated into 70 and 30 percent respectively. The experimental results lacked the predictability of other attributes except DT in the correlation coefficient and crystal coefficient. However, all attributes related to dyspnea other than DT are determined to be related to causing relaxation of the heart in the left ventricle. Therefore, the attribute causing dyspnea is determined to be an attribute causing relaxation of the heart of the DT and left ventricle.

Case reports : Proximal aortic dissection with STEMI-equivalent ECG findings (STEMI equivalent 심전도 소견을 동반한 근위부 대동맥박리 1예)

  • Kim, Ji-Won;Kang, Min Seong
    • The Korean Journal of Emergency Medical Services
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    • v.24 no.3
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    • pp.141-145
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    • 2020
  • The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.

Treatment-seeking Behavior among those with Signs and Symptoms of Acute Myocardial Infarction (심근경색증 환자의 증상발현과 치료추구행위에 관한 연구)

  • 김조자;김기연
    • Journal of Korean Academy of Nursing
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    • v.29 no.3
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    • pp.605-613
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    • 1999
  • The main purposes of this study were to determine the time interval between the onset of symptoms of myocardial infarction and treatment-seeking time and to identify the factors related to the interval time. This study used a retrospective design. The sample consisted of 45 patients aged over 30 who were diagnosed with an acute myocardial infarction at two large university affiliated medical center from September 1, 1997 to June 30, 1998. Data was collected by using questionnaries, which included demographic data, permonitory clinical signs and symtoms of myocardial infarction, and a measure of the severity of the signs and symptoms. Also semi-structured interviews and chart reviews were used to obtain information related to treatment-seeking time. The results of this study are summarized as follows ; 1. The most frequent premonitory clinical symptom was chest pain(92.9%), the second, was perspiration(81.0%), and the next were nausea(40.5%) and dyspnea(38.1%). Thirty two patients reported having more than four premonitory signs and symtoms. Patients described the characteristics of chest pain as “somethings very heavy pressing down”(26.2%), “felt like my chest would burst”(24.4%), or “sharp pain”(16.7%), Over 95% of the sample reported having chest pain. 2. Twenty two (52.4%) patients reported to have “very severe” premonitory pain. 3. The mean time interval between the onset of signs and symptoms and the arrival at the medical center was 6.39$\pm$10.80 hours in 42 samples, the mean time from the onset to arrival at a local hospital was 3.27$\pm$5.39 hours and for transfer from a local hospital to the medical center was 4.75$\pm$9.87 hours in patients who had arrived at medical center via local hospital. 4. The severity of premonitory signs and symptoms did not differ significantly according to existence of premonitory signs and symptoms. 5. There was no significant relationship between treatment-seeking time and age, gender, marital status, economic status, occupation, or residence. But education had significant relationship(r=-0.51, p=0.01). Analysis of difference of the time interval according to the premonitory signs and symptoms showed that the time was shorter in patients who experienced nausea or dyspnea(U=115.50, p=0.01, U=132.00, p=0.04), however the severity of premonitory signs and symptoms did not have statistical significance.

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The Health Behavioral Experience of Patients with Myocardial Infarction during the Recovery Period (회복기 심근경색 환자의 건강행위 경험)

  • Kang, Kyung Ja;Kim, Moon Jeong
    • Korean Journal of Adult Nursing
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    • v.26 no.2
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    • pp.203-213
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    • 2014
  • Purpose: The purpose of this study was to understand and describe the every day life experience of patients with acute myocardial infarction (AMI) during the recovery period after Percutaneous Coronary Intervention (PCI) using a qualitative approach. Methods: Twelve patients with AMI participated in this study. Their age ranged from 42 to 75. The data were collected by individual in-depth interviews and all interviews were audio-taped and transcribed verbatim. The transcribed data were analyzed using traditional qualitative content analysis. Results: Six sub-themes emerged from the data as follows: Getting to know about illness, getting motivated for health behavior, putting an effort into health behavioral change, having difficulties maintaining health behavior, setting up coping strategies for health behavior and having a need for a tailored education. The results of this study showed how the health behaviors of patients with AMI are related to their every day life experiences. Conclusion: The results of this study could help health professionals to better understand patients with AMI and design effective educational interventions to improve their health behaviors.