AIMS Serial forecasts of final myocardial infarct (MI) size during fibrinolytic treatment (Rx) of ST-elevation MI would allow the identification of high-risk patients with a predicted major loss of viable myocardium, at a point when treatment may still be modified. We investigated a model for such forecasting, using time and the ECG. METHODS AND RESULTS We collected 234 patients with ST-eleva...

It is rare to observe ST-segment elevation in only the anterior leads and not the inferior leads during right coronary artery occlusion. We describe a case with acute myocardial infarction (MI) by right coronary artery occlusion who developed ST-segment elevation only in the precordial leads V1 to V3.

Antagonists of the platelet fibrinogen receptor glycoprotein IIb/IIIa are potent inhibitors of platelet function and provide marked protection from ischemic events in patients undergoing PCI. These agents are also of benefit in patients with unstable angina or non-ST segment elevation myocardial infarction (MI) and provide a 9% reduction in the combined endpoint of 30-day death or MI. This bene...

Patients The development set comprised data from 13 253 patients who had ST elevation MI and were enrolled within 6 hours of symptom onset, and who did not have a history of cerebrovascular disease, systolic blood pressure (SBP) > 180 mm Hg, diastolic blood pressure (DBP) > 110 mm Hg, cardiogenic shock, or increased risk of severe bleeding. The validation set comprised data from 3659 patients w...

BACKGROUND Although the prognostic value of admission ST changes in patients with non-ST elevation acute coronary syndrome (ACS) is established, the utility of the discharge ECG is unknown. Accordingly, using the PARAGON-B Troponin substudy, we assessed the prevalence of ST depression on both admission and discharge ECG, the likelihood of developing new Q-waves at discharge and the additional p...

Although thrombolytic therapy has been a major advance in the treatment of acute ST-segment elevation myocardial infarction (MI), new thrombolytic agents have been unable to improve early reperfusion. Because aspirin has been shown to be a very effective adjunctive agent in patients with acute MI, it has been hypothesized that the use of platelet glycoprotein (GP) IIb/IIIa receptor inhibitors c...

OBJECTIVES Several publications have demonstrated increased 30-day mortality in patients admitted on Saturdays or Sundays compared with weekdays. We sought to determine whether this was true for two different cohorts of patients admitted with acute myocardial infarction (MI). METHODS AND RESULTS Thirty-day mortality data were obtained for 3757 patients who had been admitted to the Belfast Hea...

We aimed to define factors predicting mortality in patients having ST elevation myocardial infarction (STEMI) who had Primary Percutaneous Coronary Intervention (PCI) in our setting.This is a prospective study on patients presenting to the emergency department with STEMI who underwent PCI during a 12-month period. Physiological parameters were calculated using the vital signs and age of patient...

The electrocardiogram (ECG) is a fairly accurate test in the diagnosis of myocardial infarction (MI). However, given more sensitive technologies, such as cardiac biomarker testing, its primary role should be as an important adjunct in the evaluation and detection of MI (strength of recommendation [SOR]: A). The sensitivity of ECG for detection of MI is directly related to what is defined as pos...