Search for Articles:
Title / Keyword
Author / Affiliation / Email
Journal
Article Type
 
 
Advanced Search
 
Section
Special Issue
Volume
Issue
Number
Page
 
5.4
3.9
Journals
JCM
Special Issues
Enhancing the Diagnosis of Acute Myocardial Infarction
share announcement

Enhancing the Diagnosis of Acute Myocardial Infarction

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Cardiology".

Deadline for manuscript submissions: closed (15 May 2021) | Viewed by 4442

Special Issue Editor

Dr. Thomas Nestelberger

E-Mail Website
Guest Editor
1. Division of Cardiology, Vancouver General Hospital , Vancouver, BC, Canada
2. Cardiovascular Research Institute Basel, University Hospital Basel, Basel, Switzerland
Interests: heart failure; clinical cardiology; cardiovascular medicine; interventional cardiology; structural cardiology; acute myocardial infarction; Biomarkers; electrocardiography; myocardial reperfusion; syncope

Special Issue Information

Dear Colleagues,

It is my great pleasure and honor to announce this Special Issue on “Enhancing the Diagnosis of Acute Myocardial Infarction.” Over the last decade, intense collaboration between academic investigators and the diagnostic industry have allowed the integration of high sensitivity cardiac troponin (hs-cTn) assays into clinical practice worldwide. Hs-cTn assays, with their increased diagnostic accuracy for acute myocardial infarction (AMI), have facilitated the maturation of early rule-out strategies.

Although it is mandatory to use hs-cTnT/I algorithms, in conjunction with full clinical assessment and the 12-lead ECG, it is unknown how to best combine these diagnostic variables and how possible combinations would affect its performance characteristics.

The use of hs-cTnT/I assays has enabled the detection of slightly elevated concentrations around the 99th percentile. The differentiation between type 1 myocardial infarction due to an acute plaque rupture/erosion, type 2 myocardial infarction due to an oxygen supply/demand mismatch (e.g., tachyarrhythmias or anemia) and acute or chronic myocardial injury due to several other conditions (e.g., heart failure, myocarditis) is still very challenging in patients with mildly elevated troponin concentrations. Based on this lack of knowledge, specific pathways for diagnostic work-up, treatment strategies and prognosis are lacking.

With this Special Issue, we aim to enhance and update current diagnostic strategies for the early diagnosis of acute myocardial infarction in patients presenting with acute chest pain. Therefore, we would like to invite the submission of original research, state-of-the-art reviews, and viewpoints. In particular, we are eager to receive papers covering the use of hs-cTnT/I, other cardiovascular biomarkers, clinical characteristics and the ECG.

Dr. Thomas Nestelberger
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Acute myocardial infarction
  • NSTE-ACS
  • Electrocardiography
  • Biomarkers
  • Diagnostic Algorithms

Published Papers (2 papers)

Download All Papers
Order results
Result details
Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:

Research

15 pages, 11918 KiB  
Article
External Validation and Extension of a Clinical Score for the Discrimination of Type 2 Myocardial Infarction
by Thomas Nestelberger, Pedro Lopez-Ayala, Jasper Boeddinghaus, Ivo Strebel, Maria Rubini Gimenez, Iris Huber, Karin Wildi, Desiree Wussler, Luca Koechlin, Alexandra Prepoudis, Danielle M. Gualandro, Christian Puelacher, Noemi Glarner, Philip Haaf, Simon Frey, Adam Bakula, Rupprecht Wick, Òscar Miró, F. Javier Martin-Sanchez, Damian Kawecki, Dagmar Keller, Raphael Twerenbold and Christian Muelleradd Show full author list remove Hide full author list
J. Clin. Med. 2021, 10(6), 1264; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10061264 - 18 Mar 2021
Cited by 3 | Viewed by 2084
Abstract
Background: The early non-invasive discrimination of Type 2 versus Type 1 Myocardial Infarction (T2MI, T1MI) is a major unmet clinical need. We aimed to externally validate a recently derived clinical score (Neumann) combing female sex, no radiating chest pain, and high-sensitivity cardiac troponin [...] Read more.
Background: The early non-invasive discrimination of Type 2 versus Type 1 Myocardial Infarction (T2MI, T1MI) is a major unmet clinical need. We aimed to externally validate a recently derived clinical score (Neumann) combing female sex, no radiating chest pain, and high-sensitivity cardiac troponin I (hs-cTnI) concentration ≤40.8 ng/L. Methods: Patients presenting with acute chest discomfort to the emergency department were prospectively enrolled into an international multicenter diagnostic study. The final diagnoses of T2MI and T1MI were centrally adjudicated by two independent cardiologists using all information including cardiac imaging and serial measurements of hs-cTnT/I according to the fourth universal definition of MI. Model performance for T2MI diagnosis was assessed by formal tests and graphical means of discrimination and calibration. Results: Among 6684 enrolled patients, MI was the adjudicated final diagnosis in 1079 (19%) patients, of which 242 (22%) had T2MI. External validation of the Neumann Score showed a moderate discrimination (C-statistic 0.67 (95%CI 0.64–0.71)). Model calibration showed underestimation of the predicted probabilities of having T2MI for low point scores. Model extension by adding the binary variable heart rate >120/min significantly improved model performance (C-statistic 0.73 (95% CI 0.70–0.76, p < 0.001) and had good calibration. Patients with the highest score values of 3 (Neumann Score, 9.9%) and 5 (Extended Neumann Score, 3.3%) had a 53% and 91% predicted probability of T2MI, respectively. Conclusion: The Neumann Score provided moderate discrimination and suboptimal calibration. Extending the Neumann Score by adding heart rate >120/min improved the model’s performance. Full article
(This article belongs to the Special Issue Enhancing the Diagnosis of Acute Myocardial Infarction)
►▼ Show Figures

Figure 1

14 pages, 3426 KiB  
Article
Comparison of First- and Second-Generation Drug-Eluting Stents in Patients with ST-Segment Elevation Myocardial Infarction Based on Pre-Percutaneous Coronary Intervention Thrombolysis in Myocardial Infarction Flow Grade
by Yong Hoon Kim, Ae-Young Her, Myung Ho Jeong, Byeong-Keuk Kim, Sung-Jin Hong, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong and Yangsoo Jang
J. Clin. Med. 2021, 10(2), 367; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10020367 - 19 Jan 2021
Cited by 1 | Viewed by 1913
Abstract
This study aims to investigate the two-year clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DES) based on pre-percutaneous coronary intervention (PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) in patients with ST-segment elevation myocardial infarction (STEMI). Overall, 17,891 STEMI [...] Read more.
This study aims to investigate the two-year clinical outcomes between first-generation (1G) and second-generation (2G) drug-eluting stents (DES) based on pre-percutaneous coronary intervention (PCI) thrombolysis in myocardial infarction (TIMI) flow grade (pre-TIMI) in patients with ST-segment elevation myocardial infarction (STEMI). Overall, 17,891 STEMI patients were classified into two groups: pre-TIMI 0/1 group (n = 12,862; 1G-DES (n = 4318), 2G-DES (n = 8544)) and pre-TIMI 2/3 group (n = 5029; 1G-DES (n = 2046), 2G-DES (n = 2983)). During a two-year follow-up period, major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (re-MI), or any repeat revascularization and stent thrombosis (ST) were considered as the primary and the secondary outcomes. In the pre-TIMI 0/1 and 2/3 groups, the cumulative incidences of MACEs (adjusted hazard ratio (aHR): 1.348, p < 0.001, and aHR: 1.415, p = 0.02, respectively) and any repeat revascularization (aHR: 1.938, p < 0.001, and aHR: 1.674, p = 0.001, respectively) were significantly higher in the 1G-DES than in the 2G-DES. However, sirolimus-eluting stent showed similar cumulative incidence of any repeat revascularization compared with zotarolimus-eluting stent and biolimus-eluting stent in both pre-TIMI 0/1 and 2/3 groups. The cumulative incidences of all-cause death, re-MI, and ST were similar between the 1G-DES and 2G-DES groups. In this study, 2G-DES showed better clinical outcomes than 1G-DES concerning MACEs and any repeat revascularization regardless of pre-TIMI. However, more research is needed to support these results. Full article
(This article belongs to the Special Issue Enhancing the Diagnosis of Acute Myocardial Infarction)
►▼ Show Figures

Figure 1

Show export options expand_more Show export options expand_less
Select all
Export citation of selected articles as:
 
Displaying articles 1-2
Back to TopTop