97 research outputs found
Prevalence and prognostic implications of non-sustained ventricular tachycardia in ST-segment elevation myocardial infarction after revascularization with either fibrinolysis or primary angioplasty
Clinical characteristics and lipid lowering treatment of patients initiated on proprotein convertase subtilisin-kexin type 9 inhibitors:a nationwide cohort study
Left ventricular hypertrophy is associated with increased infarct size and decreased myocardial salvage in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention
Unreported exclusion and sampling bias in interpretation of randomized controlled trials in patients with STEMI
Aims: To assess the impact of sampling bias due to reported as well as unreported exclusion of the target population in a multi-center randomized controlled trial (RCT)of ST-elevation myocardial infarction (STEMI). Methods and Results: We compared clinical characteristics and mortality between participants in the DANAMI-3 trial to contemporary non-participants with STEMI using unselected registries. A total of 179 DANAMI-3 participants (8%)and 617 contemporary non-participants (22%)had died (Log-Rank: P < 0.001)after a median follow-up of 1333 days (range: 1–2021 days). In an unadjusted Cox regression model all groups of non-participants had a higher hazard ratio to predict mortality compared to participants: eligible excluded (n = 144)(hazard ratio: 3.41 (95% CI: (2.69–4.32)), ineligible excluded (n = 472)(hazard ratio: 3.42 (95% CI: (2.44–4.80), eligible non-screened (n = 154)(hazard ratio: 3.37 (95% CI: (2.36–4.82)), ineligible non-screened (n = 154)(hazard ratio: 6.48 (95% CI: (4.77–8.80). Conclusion: Sampling bias had occurred due to both reported and unreported exclusion of eligible patients and the difference in mortality between participants and non-participants could not be explained only by the trial exclusion criteria. Thus, screening logs may not be suited to address the risks of sampling bias
MR-proADM as a Prognostic Marker in Patients With ST-Segment-Elevation Myocardial Infarction - DANAMI-3 (a Danish Study of Optimal Acute Treatment of Patients With STEMI) Substudy
Background
Midregional proadrenomedullin (
MR
‐pro
ADM
) has demonstrated prognostic potential after myocardial infarction (
MI
). Yet, the prognostic value of
MR
‐pro
ADM
at admission has not been examined in patients with ST‐segment–elevation
MI
(
STEMI
).
Methods and Results
The aim of this substudy, DANAMI‐3 (The Danish Study of Optimal Acute Treatment of Patients with
ST
‐segment–elevation myocardial infarction), was to examine the associations of admission concentrations of
MR
‐pro
ADM
with short‐ and long‐term mortality and hospital admission for heart failure in patients with
ST
‐segment–elevation myocardial infarction. Outcomes were assessed using Cox proportional hazard models and area under the curve using receiver operating characteristics. In total, 1122 patients were included. The median concentration of
MR
‐pro
ADM
was 0.64 nmol/L (25th–75th percentiles, 0.53–0.79). Within 30 days 23 patients (2.0%) died and during a 3‐year follow‐up 80 (7.1%) died and 38 (3.4%) were admitted for heart failure. A doubling of
MR
‐pro
ADM
was, in adjusted models, associated with an increased risk of 30‐day mortality (hazard ratio, 2.67; 95% confidence interval, 1.01–7.11;
P
=0.049), long‐term mortality (hazard ratio, 3.23; 95% confidence interval, 1.97–5.29;
P
<0.0001), and heart failure (hazard ratio, 2.71; 95% confidence interval, 1.32–5.58;
P
=0.007). For 30‐day and 3‐year mortality, the area under the curve for
MR
‐pro
ADM
was 0.77 and 0.78, respectively. For 3‐year mortality, area under the curve (0.84) of the adjusted model marginally changed (0.85;
P
=0.02) after addition of
MR
‐pro
ADM
.
Conclusions
Elevation of admission
MR
‐pro
ADM
was associated with long‐term mortality and heart failure, whereas the association with short‐term mortality was borderline significant.
MR
‐pro
ADM
may be a marker of prognosis after ST‐segment–elevation myocardial infarction but does not seem to add substantial prognostic information to established clinical models.
Clinical Trial Registration
URL
:
http:/www.ClinicalTrials.gov
/. Unique identifiers:
NCT
01435408 and
NCT
01960933.
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GLP-1 analogues for neuroprotection after out-of-hospital cardiac arrest: study protocol for a randomized controlled trial
Prevalence and prognostic implications of ST-segment deviations from ambulatory Holter monitoring after ST-segment elevation myocardial infarction treated with either fibrinolysis or primary percutaneous coronary intervention (a Danish Trial in Acute Myocardial Infarction-2 Substudy)
Abnormal glucose metabolism in acute myocardial infarction: influence on left ventricular function and prognosis
Is It Safe to Mobilize Patients Very Early After Transfemoral Coronary Procedures? (SAMOVAR): A Randomized Clinical Trial
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