 |
|
Two treatment innovations improve heart function after heart attack
September 16, 2009Supersaturated oxygen (SSO2) administered during catheter-based treatments for heart attack can significantly reduce heart muscle damage, according to a new study reported in Circulation: Cardiovascular Interventions, a journal of the American Heart Association.
In another study from the same issue, a different group of researchers found that manually removing a blood clot provided greater recovery of heart function after a heart attack.
"The greatest benefits were seen in the patients most at risk," said Gregg W. Stone, M.D., lead author of the SSO2 study, and professor of medicine at Columbia University Medical Center in New York, N.Y. "The larger the heart attack, the more heart muscle salvaged."
SSO2 - highly concentrated oxygen mixed in blood and delivered to the area of heart muscle dying after a heart attack - showed promise in animal studies and a previous human trial (AMIHOT-I). So Stone and his colleagues conducted AMIHOT-II with a similar protocol, focusing on patients with anterior ST-segment elevation myocardial infarctions (STEMIs) who were treated within six hours of heart attack symptoms.
"STEMIs are the large attacks," Stone said. "They have a really bad early prognosis because there is so much heart muscle lost." When a large area of the heart is damaged, heart failure is more likely.
Of the 733,000 Americans who suffer acute coronary syndromes (i.e. heart attack or chest pain) each year, 361,000 (almost half) have a STEMI. Catheter-based percutaneous coronary intervention (PCI) is a procedure that can effectively open blocked arteries in STEMI patients.
The AMIHOT-II researchers studied 301 STEMI patients who arrived within six hours after the onset of symptoms at 20 sites in four countries. The researchers randomized 222 to receive PCI plus SSO2 - infused for 90 minutes during treatment -- and 79 to PCI only. Some of their analyses also included data pooled from 101 patients from the AMIHOT-I.
Major study findings included:
* In AMIHOT-II patients, heart damage 14 days after treatment averaged 26.5 percent of the left ventricle for PCI-only patients and 20 percent for the PCI plus SS02 group. Pooled data from both AMIHOT studies showed 25 percent damage in PCI-only patients and 18.5 percent in the SSO2 group.
* Among 154 patients whose left ventricle ejected less than 40 percent of the blood with each contraction prior to treatment, the PCI-only group had 33.5 percent damage versus 23.5 percent in the SSO2 patients. "For patients with large heart attacks, this is the first therapy shown to be beneficial in an adequately powered, multicenter trial," Stone said.
* In those with more than 40 percent blood ejection, muscle damage was 16.5 percent in PCI-only patients and 12.5 percent in the SSO2 group, which is a similar relative reduction in heart attack size as in patients with larger attacks, but a smaller absolute reduction.
* Researchers found no significant differences between the two groups of AMIHOT-II patients in the levels of blood markers that indicate a heart attack, or in the percentage of heart muscle at risk of dying, which was measured three hours after treatment.
* At 30 days post-op, the pooled data showed the two groups had similar percentages of major adverse events - death, another heart attack, reopening the same heart artery and stroke: 4.7 percent for the SSO2 patients and 5.1 percent for PCI-only group.
"Some scientists have questioned the safety of SSO2 in heart patients, but only a few major and minor problems occurred in AMIHOT-II, and the study met all of its pre-defined safety endpoints," Stone said.
In the same issue of Circulation: Cardiovascular Interventions, Francesco Liistro, M.D., and colleagues at San Donato Hospital in Arezzo, Italy, reported that manually removing a blood clot during PCI provides STEMI patients greater heart muscle perfusion and recovery of left ventricle function.
In their single-center study, researchers randomized 55 patients to clot aspiration and 56 to standard PCI. In PCI, a physician typically inflates a balloon on a catheter tip to flatten a clot against the vessel wall, and then inserts a metal-mesh stent to prop the vessel open.
Instead of using a balloon, which leaves clot debris in the blood, the team pushed a special catheter into the blockage and sucked the clot into the tube to remove it from the body before stenting.
Major study findings included:
* The ST-segment of an electrocardiogram returned to normal in 39 (71 percent) of the clot-aspiration group versus 22 (39 percent) of those getting standard PCI.
* Ninety-six percent of aspiration patients reached TIMI grade 3, the desired blood flow through the opened artery, compared to 82 percent for the standard PCI group.
* Aspiration patients showed a higher rate of artery perfusion, as measured by ultrasound, than those getting standard PCI, 85 percent versus 64 percent.
Co-authors with Stone are: Jack L. Martin, M.D.; Menko-Jan de Boer, M.D.; Massimo Margheri, M.D.; Ezio Bramucci, M.D.; James C. Blankenship, M.D.; D. Christopher Metzger, M.D.; Raymond J. Gibbons, M.D.; Barbara S. Lindsay, R.N.; Bonnie H. Weiner, M.D.; Alexandra J. Lansky, M.D.; Mitchell W. Krucoff, M.D.; Martin Fahy, M.Sc.; and W. John Boscardin, Ph.D.
TherOx, Inc. funded the AMIHOT-II study.
Co-authors with Liistro are: Simone Grotti, M.D.; Paolo Angioli, M.D.; Giovanni Falsini, M.D.; Kenneth Ducci, M.D.; Silvia Baldassarre, M.D.; Alessandra Sabini, M.D.; Rossella Brandini, M.D.; Eugenia Capati, M.D.; and Leonardo Bolognese, M.D.
Author disclosures are on the manuscripts.
American Heart Association
SSO2 - highly concentrated oxygen mixed in blood and delivered to the area of heart muscle dying after a heart attack - showed promise in animal studies and a previous human trial (AMIHOT-I). So Stone and his colleagues conducted AMIHOT-II with a similar protocol, focusing on patients with anterior ST-segment elevation myocardial infarctions (STEMIs) who were treated within six hours of heart attack symptoms.
"STEMIs are the large attacks," Stone said. "They have a really bad early prognosis because there is so much heart muscle lost." When a large area of the heart is damaged, heart failure is more likely.
Of the 733,000 Americans who suffer acute coronary syndromes (i.e. heart attack or chest pain) each year, 361,000 (almost half) have a STEMI. Catheter-based percutaneous coronary intervention (PCI) is a procedure that can effectively open blocked arteries in STEMI patients.
The AMIHOT-II researchers studied 301 STEMI patients who arrived within six hours after the onset of symptoms at 20 sites in four countries. The researchers randomized 222 to receive PCI plus SSO2 - infused for 90 minutes during treatment -- and 79 to PCI only. Some of their analyses also included data pooled from 101 patients from the AMIHOT-I.
Major study findings included:
* In AMIHOT-II patients, heart damage 14 days after treatment averaged 26.5 percent of the left ventricle for PCI-only patients and 20 percent for the PCI plus SS02 group. Pooled data from both AMIHOT studies showed 25 percent damage in PCI-only patients and 18.5 percent in the SSO2 group.
* Among 154 patients whose left ventricle ejected less than 40 percent of the blood with each contraction prior to treatment, the PCI-only group had 33.5 percent damage versus 23.5 percent in the SSO2 patients. "For patients with large heart attacks, this is the first therapy shown to be beneficial in an adequately powered, multicenter trial," Stone said.
* In those with more than 40 percent blood ejection, muscle damage was 16.5 percent in PCI-only patients and 12.5 percent in the SSO2 group, which is a similar relative reduction in heart attack size as in patients with larger attacks, but a smaller absolute reduction.
* Researchers found no significant differences between the two groups of AMIHOT-II patients in the levels of blood markers that indicate a heart attack, or in the percentage of heart muscle at risk of dying, which was measured three hours after treatment.
* At 30 days post-op, the pooled data showed the two groups had similar percentages of major adverse events - death, another heart attack, reopening the same heart artery and stroke: 4.7 percent for the SSO2 patients and 5.1 percent for PCI-only group.
"Some scientists have questioned the safety of SSO2 in heart patients, but only a few major and minor problems occurred in AMIHOT-II, and the study met all of its pre-defined safety endpoints," Stone said.
In the same issue of Circulation: Cardiovascular Interventions, Francesco Liistro, M.D., and colleagues at San Donato Hospital in Arezzo, Italy, reported that manually removing a blood clot during PCI provides STEMI patients greater heart muscle perfusion and recovery of left ventricle function.
In their single-center study, researchers randomized 55 patients to clot aspiration and 56 to standard PCI. In PCI, a physician typically inflates a balloon on a catheter tip to flatten a clot against the vessel wall, and then inserts a metal-mesh stent to prop the vessel open.
Instead of using a balloon, which leaves clot debris in the blood, the team pushed a special catheter into the blockage and sucked the clot into the tube to remove it from the body before stenting.
Major study findings included:
* The ST-segment of an electrocardiogram returned to normal in 39 (71 percent) of the clot-aspiration group versus 22 (39 percent) of those getting standard PCI.
* Ninety-six percent of aspiration patients reached TIMI grade 3, the desired blood flow through the opened artery, compared to 82 percent for the standard PCI group.
* Aspiration patients showed a higher rate of artery perfusion, as measured by ultrasound, than those getting standard PCI, 85 percent versus 64 percent.
Co-authors with Stone are: Jack L. Martin, M.D.; Menko-Jan de Boer, M.D.; Massimo Margheri, M.D.; Ezio Bramucci, M.D.; James C. Blankenship, M.D.; D. Christopher Metzger, M.D.; Raymond J. Gibbons, M.D.; Barbara S. Lindsay, R.N.; Bonnie H. Weiner, M.D.; Alexandra J. Lansky, M.D.; Mitchell W. Krucoff, M.D.; Martin Fahy, M.Sc.; and W. John Boscardin, Ph.D.
TherOx, Inc. funded the AMIHOT-II study.
Co-authors with Liistro are: Simone Grotti, M.D.; Paolo Angioli, M.D.; Giovanni Falsini, M.D.; Kenneth Ducci, M.D.; Silvia Baldassarre, M.D.; Alessandra Sabini, M.D.; Rossella Brandini, M.D.; Eugenia Capati, M.D.; and Leonardo Bolognese, M.D.
Author disclosures are on the manuscripts.
American Heart Association
Heart Attack Current Events and Heart Attack News RSSInhibition of GRK2 is protective against acute cardiac stress injuries
Inhibition of a protein known to contribute to heart failure also appears to be protective of the heart in more acute cardiac stress injury, namely ischemia reperfusion.
Vitamin B niacin offers no extra benefit to statin therapy in seniors already diagnosed with CAD
The routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease, a new vascular imaging study from Johns Hopkins experts shows.
Heart and bone damage from low vitamin D tied to declines in sex hormones
Researchers at Johns Hopkins are reporting what is believed to be the first conclusive evidence in men that the long-term ill effects of vitamin D deficiency are amplified by lower levels of the key sex hormone estrogen, but not testosterone.
Elevated biomarkers lead to diminished quality of life in heart attack patients post-discharge
Many heart attack patients have high levels of cardiac biomarkers in the blood for several months after leaving the hospital, with more shortness of breath and chest pain, according to a Henry Ford Hospital study.
Tiny particles can deliver antioxidant enzyme to injured heart cells
Researchers at Emory University and the Georgia Institute of Technology have developed microscopic polymer beads that can deliver an antioxidant enzyme made naturally by the body into the heart.
Early end to key study on benefits of niacin, a B vitamin, in keeping arteries open was premature
Heart experts at Johns Hopkins are calling premature the early halt of a study by researchers at Walter Reed Army Medical Center and Washington Hospital Center on the benefits of combining extended-release niacin, a B vitamin, with cholesterol-lowering statin medications to prevent blood vessel narrowing.
oo much selenium can increase your cholesterol
A new study from the University of Warwick has discovered taking too much of the essential mineral selenium in your diet can increase your cholesterol by almost 10%.
Higher carotid arterial stenting rates associated with poorer clinical outcomes
Among eligible Medicare beneficiaries, increased use of carotid arterial stenting (CAS) procedures to treat carotid stenosis-the narrowing of the carotid artery-is associated with higher rates of mortality and adverse clinical outcomes, including heart attack and stroke, according to researchers from the University of Pennsylvania School of Medicine.
Study suggests dentists can identify patients at risk for fatal cardiovascular event
A new study indicates dentists can play a potentially life-saving role in health care by identifying patients at risk of fatal heart attacks and referring them to physicians for further evaluation.
Common Pain Relievers May Dilute Power of Flu Shots
With flu vaccination season in full swing, research from the University of Rochester Medical Center cautions that use of many common pain killers - Advil, Tylenol, aspirin - at the time of injection may blunt the effect of the shot and have a negative effect on the immune system.
More Heart Attack Current Events and Heart Attack News Articles
 |
The Cardiac Recovery Handbook: The Complete Guide to Life After Heart Attack or Heart Surgery, Second Edition by Paul Kligfield (Author) Maybe a suspicious angiogram has the doctor suggesting bypass surgery. Maybe a major heart attack has you confined to the ICU. After a heart attack or heart surgery, you have a hundred questions and your family has more. How long will I be in the hospital? What are the side effects of that medication? Why do I feel so depressed? What can I eat? Can I exercise? One of the nation's most respected cardiologists answers all your questions in The Cardiac Recovery Handbook. In clear, everyday language, the book covers all aspects of cardiac recovery—from the initial diagnosis of heart disease to medications and surgical options, from hospitalization to rehabilitation, from diet and exercise to keeping your spirits up. No question is left unanswered. Filled with a wealth of vital... |
 |
Heart Attack Low vs Diamond (Primary Contributor) |
 |
The Last War 1980-84 by Heart Attack |
 |
Heart Attack (A Cleveland Clinic Guide) (Cleveland Clinic Guides) by Curtis Rimmerman (Author) Heart Attack: A Cleveland Clinic Guide There is no other medical center more qualified to write a book on this subject.The Cleveland Clinic Heart Center has been selected as the best Heart Center in America, according to U.S. News & World Report’s annual survey for the past 11 years. Our doctors are leaders in cardiology, cardiac surgery, cardiothoracic anesthesia, and research into the heart and its diseases. No heart program has more experience, more knowledge and better access to technology. As medical pioneers, The Clinic developed cardiac angiography and the coronary artery bypass. One great lesson is that heart disease is a tremendously frustrating condition. It progresses silently and makes its presence known—if at all—only well after it is established in the... |
 |
Zippo Lighter Heart Attack Emblem, Candy Apple Red by Zippo Manufacturing The World Famous Zippo® Guarantee Any Zippo metal product, when returned to our factory will be put in first class condition free of charge, for we have yet to charge a cent for the repair of a Zippo metal product, regardless of age or condition. The finish, however, is not guaranteed. This guarantee gives you specific legal rights and you may also have other rights which vary from state to state. "It works or we fix it for free"? |
 |
Sweet Dee Has A Heart Attack Also With: FOX (Producer) |
 |
Heart Attack,Candy Apple Red by pachi paradice Purchase this top quality zippo lighter. Makes a great gift. Original zippo. Sure to be loved by anyone |
|
Heart Attack Starring: Marcus Allen Cooper Rachel Darden Bennett Directed By: David Harris Also With: David Harris (Producer), David Harris (Writer) A short, romantic comedy from a student filmmaker, "Heart Attack" has been called "romantic and charming" by director of Juno Jason Reitman and honored at such festivals as the Santa Cruz Film Festival and Phoenix Film Festival, among others. Leslie stands in front of a white wall, smiling. She's a pretty girl, happily gazing at us. A narration ensues. This gentle voice describes Leslie's kind attributes and her most basic, yet great, goal: to find her true love. The narrator introduces us to Leslie's boyfriend. We are now in a park, and the narrator describes the scene: Leslie's boyfriend becomes Leslie's ex-boyfriend. Unfortunately, we next look at a moping, tearful Leslie blowing her nose, reading relationship books, and eating ice cream in her bed. She sobs profusely as the... | |
 |
HEART HEALTHY TIPS by The U.S. Heart Healthy Company Not sure where to start when it comes to improving your heart health? Take some time and create a plan that you can stick to. Include specific goals to eat healthier, exercise more regularly and have a medical physical if it’s been more than a year. |
 |
The Widow-Maker Heart Attack At Age 48: Written By A Heart Attack Survivor For A Heart Attack Survivor And Their Loved Ones by Patrick J. Fox (Author) The Widow-Maker Heart attack at age 48 was written by a "miracle" survivor of a massive heart attack. He provides hope and a pathway to recovery for other heart attack patients and their loved ones facing the same daunting life changing, unexpected experience. His entire first year of life after suffering his heart attack; actually dying six times, is chronicled in this book combined with his ever changing physical and psychological feelings. In writing this book it was the author's goal to help other families and loved ones facing the same devastating unfamiliar territory as his family faced on March 31, 2008. His goal was to provide timeless support for the loved ones of the heart attack victim so that they might better be able to understand what the patient is going through and what... |
| © 2009 BrightSurf.com |