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ST Elevation Related to the Site of Coronary Occlusion

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Abstract

Coronary artery disease (CAD) is the most common cause of death in the whole world. Acute myocardial infarction with ST elevation (STEMI) is a clinical syndrome characterized by the typical symptoms of myocardial ischemia with electrocardiographic ST elevation (persistent for more than 20 min) and following release in cardiac biomarkers. Coronary atherosclerosis complicated by coronary thrombosis with totally occlusion of the coronary artery is the main cause of STEMI. So, mechanical or pharmacological reperfusion should be considered as soon as possible and dual antiplatelet therapy and anticoagulant drugs should be administered. Arrhythmias are very frequent in the acute phase of STEMI, and every kind of arrhythmia could be seen.

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References

  1. Steg PG, James SK, Atar D, Badano LP, Blömstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, Ducrocq G, Fernandez-Aviles F, Gershlick AH, Giannuzzi P, Halvorsen S, Huber K, Juni P, Kastrati A, Knuuti J, Lenzen MJ, Mahaffey KW, Valgimigli M, van’t Hof A, Widimsky P, Zahger D (2012) ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 33(20):2569–2619

    Article  CAS  PubMed  Google Scholar 

  2. O’Gara PT, Kushner FG, Ascheim DD, Casey DE, Chung MK, de Lemos JA, Ettinger SM, Fang JC, Fesmire FM, Franklin BA, Granger CB, Krumholz HM, Linderbaum JA, Morrow DA, Newby LK, Ornato JP, Radford MJ, Tamis-Holland JE, Tommaso CL, Tracy CM, Woo YJ, Zhao DX (2013) ACCF/AHA guideline for the management of ST-elevation myocardial infarction. J Am Coll Cardiol 61(4):e78–e140

    Article  PubMed  Google Scholar 

  3. WHO Fact sheet 310. Updated 2012, http://www.who.int/mediacentre/factsheets/fs310/en/index2.html

  4. Mehta RH, Parsons L, Rao SV et al (2012) Association of bleeding and in-hospital mortality in black and white patients with ST-segment elevation myocardial infarction receiving reperfusion. Circulation 125:1727–1734

    Article  PubMed  Google Scholar 

  5. Fox KAA, Steg PG, Eagle KA et al (2007) Decline in rates of death and heart failure in acute coronary syndromes, 1999–2006. JAMA 297:1892–1900

    Article  CAS  PubMed  Google Scholar 

  6. Yeh RW, Sidney S, Chandra M et al (2010) Population trends in the incidence and outcomes of acute myocardial infarction. N Engl J Med 362:2155–2165

    Article  CAS  PubMed  Google Scholar 

  7. Mandelzweig L, Battler A, Boyko V et al (2006) The second Euro Heart Survey on acute coronary syndromes: characteristics, treatment, and outcome of patients with ACS in Europe and the Mediterranean Basin in 2004. Eur Heart J 27:2285–2293

    Article  PubMed  Google Scholar 

  8. Widimsky P, Wijns W, Fajadet J, de Belder M, Knot J, Aaberge L, Andrikopoulos G, Baz JA, Betriu A, Claeys M, Danchin N, Djambazov S, Erne P, Hartikainen J, Huber K, Kala P, Klinceva M, Kristensen SD, Ludman P, Ferre JM, Merkely B, Milicic D, Morais J, Noc M, Opolski G, Ostojic M, Radovanovic D, De Servi S, Stenestrand U, Studencan M, Tubaro M, Vasiljevic Z, Weidinger F, Witkowski A, Zeymer U (2010) Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Eur Heart J 31:943–957

    Article  PubMed Central  PubMed  Google Scholar 

  9. Widimsky P, Zelizko M, Jansky P, Tousek F, Holm F, Aschermann M (2007) The incidence, treatment strategies, outcomes of acute coronary syndromes in the “reperfusion network” of different hospital types in the Czech Republic: results of the Czech evaluation of acute coronary syndromes in hospitalized patients (CZECH) registry. Int J Cardiol 119:212–219

    Article  PubMed  Google Scholar 

  10. McManus DD, Gore J, Yarzebski J, Spencer F, Lessard D, Goldberg RJ (2011) Recent trends in the incidence, treatment, and outcomes of patients with STEMI and NSTEMI. Am J Med 124:40–47

    Article  PubMed Central  PubMed  Google Scholar 

  11. Birkhead JS, Weston C, Lowe D (2006) Impact of specialty of admitting physician and type of hospital on care and outcome for myocardial infarction in England and Wales during 2004–5: observational study. BMJ 332:1306

    Article  PubMed Central  PubMed  Google Scholar 

  12. Cheitlin MD, McAllister HA, de Castro CM (1975) Myocardial infarction without atherosclerosis. JAMA 231:951

    Article  CAS  PubMed  Google Scholar 

  13. Achenbach S (2008) Can CT detect the vulnerable coronary plaque? Int J Cardiovasc Imaging 24:311

    Article  PubMed  Google Scholar 

  14. Fox JJ, Strauss HW (2009) One step closer to imaging vulnerable plaque in the coronary arteries. J Nucl Med 50:497

    Article  PubMed  Google Scholar 

  15. Manfredini R, Boari B, Salmi R et al (2005) Circadian rhythms and reperfusion in patients with acute ST-segment elevation myocardial infarction. JAMA 294:2846

    CAS  PubMed  Google Scholar 

  16. Schoen FJ (2010) The heart. In: Kumar V, Abbas AK, Fausto N (eds) Robbins & Cotran pathologic basis of disease, 8th edn. WB Saunders, Philadelphia, pp 529–587

    Chapter  Google Scholar 

  17. Hamon M, Agostini D, Le Page O, Riddell JW (2008) Prognostic impact of right ventricular involvement in patients with acute myocardial infarction: meta-analysis. Crit Care Med 36:2023

    Article  PubMed  Google Scholar 

  18. Popescu BA, Antonini-Canterin F, Temporelli PL et al (2005) Right ventricular functional recovery after acute myocardial infarction: relation with left ventricular function and interventricular septum motion. GISSI-3 echo substudy. Heart 91:484

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  19. Funaro S, La Torre G, Madonna M et al (2009) Incidence, determinants, and prognostic value of reverse left ventricular remodelling after primary percutaneous coronary intervention: results of the Acute Myocardial Infarction Contrast Imaging (AMICI) multicenter study. Eur Heart J 30:566

    Article  PubMed Central  PubMed  Google Scholar 

  20. Konstam MA (2008) Patterns of ventricular remodeling after myocardial infarction: clues toward linkage between mechanism and morbidity. JACC Cardiovasc Imaging 1:592

    Article  PubMed  Google Scholar 

  21. Dorfman TA, Aqel R (2009) Regional pericarditis: a review of the pericardial manifestations of acute myocardial infarction. Clin Cardiol 32:115

    Article  PubMed  Google Scholar 

  22. Lopes RD, Siha H, Fu Y, Mehta RH, Patel MR, Armstrong PW, Granger CB (2011) Diagnosing acute myocardial infarction in patients with left bundle branch block. Am J Cardiol 108:782–788

    Article  PubMed  Google Scholar 

  23. Sgarbossa EB, Pinski SL, Barbagelata A, Underwood DA, Gates KB, Topol EJ, Califf RM, Wagner GS (1996) Electrocardiographic diagnosis of evolving acute myocardial infarction in the presence of left bundle-branch block. GUSTO-1 (Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries) investigators. N Engl J Med 334:481–487

    Article  CAS  PubMed  Google Scholar 

  24. Kornowski R, Mehran R, Dangas G, Nikolsky E, Assali A, Claessen BE, Gersh BJ, Wong SC, Witzenbichler B, Guagliumi G, Dudek D, Fahy M, Lansky AJ, Stone GW (2011) Prognostic impact of staged vs. “one-time” multivessel percutaneous intervention in acute myocardial infarction: analysis from the HORIZONS-AMI (Harmonizing Outcomes with RevascularIZatiON and stents in Acute Myocardial Infarction) trial. J Am Coll Cardiol 58:704–711

    Article  PubMed  Google Scholar 

  25. Hussain F, Philipp RK, Ducas RA, Elliott J, Dzavik V, Jassal DS, Tam JW, Roberts D, Garber PJ, Ducas J (2011) The ability to achieve complete revascularization is associated with improved in-hospital survival in cardiogenic shock due to myocardial infarction: Manitoba cardiogenic SHOCK Registry investigators. Catheter Cardiovasc Interv 78:540–548

    Article  PubMed  Google Scholar 

  26. Mylotte D, Morice MC, Eltchaninoff H, Garot J, Louvard Y, Lefèvre T, Garot P (2013) Primary percutaneous coronary intervention in patients with acute myocardial infarction, resuscitated cardiac arrest, and cardiogenic shock: the role of primary multivessel revascularization. JACC Cardiovasc Interv 6(2):115–125

    Article  PubMed  Google Scholar 

  27. Bainey KR, Mehta SR, Lai T, Welsh RC (2014) Complete vs culprit-only revascularization for patients with multivessel disease undergoing primary percutaneous coronary intervention for ST-segment elevation myocardial infarction: a systematic review and meta-analysis. Am Heart J 167(1):1–14

    Article  PubMed  Google Scholar 

  28. Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, Horrow J, Husted S, James S, Katus H, Mahaffey KW, Scirica BM, Skene A, Steg PG, Storey RF, Harrington RA, Freij A, Thorsen M (2009) Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 361:1045–1057

    Article  CAS  PubMed  Google Scholar 

  29. Wiviott SD, Braunwald E, McCabe CH, Montalescot G, Ruzyllo W, Gottlieb S, Neumann FJ, Ardissino D, De Servi S, Murphy SA, Riesmeyer J, Weerakkody G, Gibson CM, Antman EM (2007) Prasugrel versus clopidogrel in patients with acute coronary syndromes. N Engl J Med 357:2001–2015

    Article  CAS  PubMed  Google Scholar 

  30. Yusuf S, Zhao F, Mehta SR, Chrolavicius S, Tognoni G, Fox KK, Clopidogrel in Unstable Angina to Prevent Recurrent Events Trial Investigators (2001) Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 345(7):494–502

    Article  CAS  PubMed  Google Scholar 

  31. Mehta SR, Yusuf S, Peters RJ, Bertrand ME, Lewis BS, Natarajan MK, Malmberg K, Rupprecht H, Zhao F, Chrolavicius S, Copland I, Fox KA (2001) Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 358:527–533

    Article  CAS  PubMed  Google Scholar 

  32. Mehran R, Lansky AJ, Witzenbichler B, Guagliumi G, Peruga JZ, Brodie BR, Dudek D, Kornowski R, Hartmann F, Gersh BJ, Pocock SJ, Wong SC, Nikolsky E, Gambone L, Vandertie L, Parise H, Dangas GD, Stone GW (2009) Bivalirudin in patients undergoing primary angioplasty for acute myocardial infarction (HORIZONS-AMI): 1-year results of a randomised controlled trial. Lancet 374:1149–1159

    Article  PubMed  Google Scholar 

  33. Morrison LJ, Verbeek PR, McDonald AC, Sawadsky BV, Cook DJ (2000) Mortality and pre-hospital thrombolysis for acute myocardial infarction: a meta-analysis. JAMA 283:2686–2692

    Article  CAS  PubMed  Google Scholar 

  34. Schmitt J, Duray G, Gersh BJ, Hohnloser SH (2009) Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J 30:1038–1045

    Article  PubMed  Google Scholar 

  35. Newby KH, Thompson T, Stebbins A, Topol EJ, Califf RM, Natale A (1998) Sustained ventricular arrhythmias in patients receiving thrombolytic therapy: incidence and outcomes. The GUSTO investigators. Circulation 98(23):2567

    Article  CAS  PubMed  Google Scholar 

  36. Mehta RH, Starr AZ, Lopes RD, Hochman JS, Widimsky P, Pieper KS, Armstrong PW, Granger CB, APEX AMI Investigators (2009) Incidence of and outcomes associated with ventricular tachycardia and fibrillation in patients undergoing primary percutaneous coronary intervention. JAMA 301(17):1779

    Article  CAS  PubMed  Google Scholar 

  37. Neumar RW, Otto CW, Link MS, Kronick SL, Shuster M, Callaway CW, Kudenchuk PJ, Ornato JP, McNAlly B, Silvers EP, Passman RS, White RD, Hess EP, Tang W, Davis D, Sinz E, Morrison LJ (2010) Part 8: adult advanced cardiovascular life support: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation 122(18 Suppl 3):S729

    Article  PubMed  Google Scholar 

  38. Lawler PR, Filion KB, Eisenberg MJ (2011) Efficacy of exercise-based cardiac rehabilitation post-myocardial infarction: a systematic review and meta-analysis of randomized controlled trials. Am Heart J 162(4):571–584 e572

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Dipartimento di cardiologia, Clinica di Cardiologia e Aritmologia, Università Politecnica delle Marche, Via Conca, 71, Ancona, 60126, Italy

    Maria Vittoria Matassini & Matilda Shkoza

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  1. Maria Vittoria Matassini
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  2. Matilda Shkoza
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Correspondence to Maria Vittoria Matassini .

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  1. Cardiology Clinic, Università Politecnica delle Marche Ospedali Riuniti Ancona, Ancona, Italy

    Alessandro Capucci

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Matassini, M.V., Shkoza, M. (2015). ST Elevation Related to the Site of Coronary Occlusion. In: Capucci, A. (eds) Clinical Cases in Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-19926-9_1

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  • DOI: https://doi.org/10.1007/978-3-319-19926-9_1

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-19925-2

  • Online ISBN: 978-3-319-19926-9

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