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Related Concept Videos

Electrocardiogram01:29

Electrocardiogram

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An electrocardiogram (ECG or EKG) is a critical diagnostic tool that records the electrical signals produced by the heart during each heartbeat. This recording is achieved through electrodes placed strategically on the arms, legs, and chest. The electrocardiograph amplifies these signals and produces 12 distinct tracings, offering a comprehensive understanding of the heart's electrical activity.
Three major waveforms are present in a typical ECG recording: the P wave, the QRS complex, and...
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Blood Studies for Cardiovascular System I: Cardiac Biomarkers01:20

Blood Studies for Cardiovascular System I: Cardiac Biomarkers

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Cardiac biomarkers are enzymes, proteins, and hormones released into the blood when cardiac cells are injured. They are powerful tools for triaging.
The essential diagnostic tools for detecting myocardial necrosis and monitoring individuals suspected of having acute coronary syndrome (ACS) include:
Troponins
Troponins, particularly cardiac troponins I and T, are the most precise and sensitive markers of myocardial injury. They are detectable within 4-6 hours of myocardial injury and remain...
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Left Anterior Descending Coronary Artery Ligation for Ischemia-Reperfusion Research: Model Improvement via Technical Modifications and Quality Control
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Shorter Door-to-ECG Time Is Associated with Improved Mortality in STEMI Patients.

Maame Yaa A B Yiadom1, Wu Gong2, Sean M Bloos3

  • 1Department of Emergency Medicine, Stanford University, 900 Welch Road, Ste 350, Palo Alto, CA 94304, USA.

Journal of Clinical Medicine
|May 11, 2024
PubMed
Summary

Timely electrocardiograms (ECG) within 10 minutes for ST-segment elevation myocardial infarction (STEMI) patients significantly reduce mortality. Consistent left ventricular ejection fraction (LVEF) assessment is crucial for evaluating STEMI care effectiveness.

Keywords:
STEMIdoor-to-ECGelectrocardiogrampercutaneous coronary intervention

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Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Outcomes Research

Background:

  • Delayed intervention in ST-segment elevation myocardial infarction (STEMI) correlates with increased mortality.
  • The impact of door-to-ECG (D2E) timing on clinical outcomes in contemporary US STEMI populations remains under-explored.

Purpose of the Study:

  • To investigate the association between timely (<10 min) versus untimely (>10 min) diagnostic ECG in the emergency department (ED) and mortality in STEMI patients.
  • To explore left ventricular ejection fraction (LVEF) dysfunction and recovery among STEMI survivors.

Main Methods:

  • A retrospective cohort study involving 10 centers over three years.
  • Comparison of mortality rates between STEMI patients receiving timely vs. untimely diagnostic ECGs.
  • Analysis of LVEF dysfunction during STEMI and post-discharge follow-up.

Main Results:

  • One-week mortality was significantly lower in the timely ECG group (5%) compared to the untimely ECG group (10.2%; p=0.016).
  • In-hospital mortality was also lower for timely ECGs (6.0%) versus untimely ECGs (10.9%; p=0.028).
  • LVEF data were inconsistently available, limiting comprehensive analysis of dysfunction and recovery.

Conclusions:

  • Achieving a D2E of under 10 minutes may halve mortality in ED STEMI patients.
  • LVEF dysfunction is a key morbidity in STEMI survivors, yet its assessment was infrequent, hindering evaluation of survival-improving therapies.
  • Standardized LVEF assessment is vital for future STEMI care intervention impact studies.