| 1. |
|
|
| 2. |
|
|
| 3. |
|
|
| 4. |
|
|
| 5. |
|
|
| 6. |
- Collste, O., et al.
(author)
-
Myocardial infarction with normal coronary arteries is common and associated with normal findings on cardiovascular magnetic resonance imaging: results from the Stockholm Myocardial Infarction with Normal Coronaries study
- 2013
-
In: Journal of Internal Medicine. - : Wiley. - 1365-2796 .- 0954-6820. ; 273:2, s. 189-196
-
Journal article (peer-reviewed)abstract
- Collste O, Sorensson P, Frick M, Agewall S, Daniel M, Henareh L, Ekenback C, Eurenius L, Guiron C, Jernberg T, Hofman-Bang C, Malmqvist K, Nagy E, Arheden H, Tornvall P (Sodersjukhuset, Stockholm; Karolinska Hospital, Karolinska Institutet, Stockholm, Sweden; University of Oslo, Oslo, Norway; Sankt Goran Hospital Capio, Karolinska Institutet, Stockholm; Huddinge, Stockholm; Danderyd Hospital, Karolinska Institutet, Stockholm; and Skane University Hospital, Lund University, Lund, Sweden). Myocardial infarction with normal coronary arteries is common and associated with normal findings on cardiovascular magnetic resonance imaging: results from the Stockholm Myocardial Infarction with Normal Coronaries study. J Intern Med 2013; 273: 189-196. Objectives Myocardial infarction with angiographically normal coronary arteries (MINCA) is an important subtype of myocardial infarction; however, the prevalence, underlying pathophysiology, prognosis and optimal management of this condition are still largely unknown. Cardiovascular magnetic resonance (CMR) imaging has the potential to clarify the underlying pathology in patients with MINCA. The objective of this study was to investigate the diagnostic value of CMR imaging in this group of patients. Design The prospective, multicentre, observational Stockholm Myocardial Infarction with Normal Coronaries (SMINC) study. Setting Coronary care units in the Stockholm metropolitan area. Subjects Patients between 35 and 70 years of age with MINCA were consecutively included in the screening phase of the SMINC study. All patients had a typical clinical presentation, fulfilling the universal definition of myocardial infarction and had normal coronary angiography finding. Patients with known structural or coronary heart disease or other known causes of elevated troponin levels were excluded. Results In total, 176 patients with MINCA were screened from 2007 to 2011. Of these, 152 underwent CMR imaging. The investigation was performed a median of 12 (interquartile range 628) days after hospital admission; 67% of the findings were normal, whereas 19% of patients had signs of myocardial necrosis and 7% had signs of myocarditis. The remaining patients (7%) had either unrecognized hypertrophic cardiomyopathy or could not be classified. Conclusion In this consecutive series of patients with MINCA, CMR imaging may help to differentiate between those with myocarditis, myocardial necrosis and normal myocardium. The incidence of MINCA was higher than previously reported. After excluding cases of myocarditis, MINCA consists of a large group of patients with normal CMR imaging results and a smaller group with myocardial necrosis. The aetiologies of these different imaging findings need to be explored.
|
|
| 7. |
|
|
| 8. |
- Jakobsson, Stina, et al.
(author)
-
The risk of ischemic stroke after an acute myocardial infarction in diabetic subjects
- 2013
-
In: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 34:Supplement: 1, s. 647-647
-
Journal article (other academic/artistic)abstract
- Purpose: The incidence, any trend over time and predictors ofischemic stroke after an Acute Myocardial Infarction (AMI) inpatients with diabetes mellitus are unknown.Methods: Data for 173233 unselected AMI patients, including 33503diabetic subjects, was taken from the Swedish Register of Informationand Knowledge about Swedish Heart Intensive Care Admissions (RIKS-HIA) registry during 1998-2008. Ischemic stroke events were recorded during one year of follow-up.Results: Diabetic subjects more often had a history of cardiovascular disease, received less reperfusion therapy and were treated with Acetylsalicylic Acid (ASA), P2Y12-inhibitors and statins to a lesser extent than nondiabetic subjects. However, the use of evidence basedtherapies increased markedly in both groups during the study period.The incidence of ischemic stroke during the first year after the AMI decreased from 7.1 to 4.7% and from 4.2 to 3.7% in diabetic and nondiabetic subjects, respectively. The risk reduction was significantly larger in the diabetic subgroup. Reperfusion therapy, ASA, P2Y12-inhibitors and statins were independently associated with the reduced stroke risk.Conclusion: Ischemic stroke is not an uncommon complication afteran AMI in diabetic subjects but the risk of stroke has markedly decreased during recent years. The increased use of evidence basedtherapies importantly contributes to this risk reduction, particularly indiabetic subjects, but there is still room for improvement.
|
|
| 9. |
|
|
| 10. |
|
|
