Abstract:
STUDY OBJECTIVE:We seek to examine the efficacy and safety of prereperfusion emergency medical services (EMS)-administered intravenous metoprolol in anterior ST-segment elevation myocardial infarction patients undergoing eventual primary angioplasty. METHODS:This is a prespecified subgroup analysis of the Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction trial population, who all eventually received oral metoprolol within 12 to 24 hours. We studied patients receiving intravenous metoprolol by EMS and compared them with others treated by EMS but not receiving intravenous metoprolol. Outcomes included infarct size and left ventricular ejection fraction on cardiac magnetic resonance imaging at 1 week, and safety by measuring the incidence of the predefined combined endpoint (composite of death, malignant ventricular arrhythmias, advanced atrioventricular block, cardiogenic shock, or reinfarction) within the first 24 hours. RESULTS:From the total population of the trial (N=270), 147 patients (54%) were recruited during out-of-hospital assistance and transferred to the primary angioplasty center (74 intravenous metoprolol and 73 controls). Infarct size was smaller in patients receiving intravenous metoprolol compared with controls (23.4 [SD 15.0] versus 34.0 [SD 23.7] g; adjusted difference -11.4; 95% confidence interval [CI] -18.6 to -4.3). Left ventricular ejection fraction was higher in the intravenous metoprolol group (48.1% [SD 8.4%] versus 43.1% [SD 10.2%]; adjusted difference 5.0; 95% CI 1.6 to 8.4). Metoprolol administration did not increase the incidence of the prespecified safety combined endpoint: 6.8% versus 17.8% in controls (risk difference -11.1; 95% CI -21.5 to -0.6). CONCLUSION:Out-of-hospital administration of intravenous metoprolol by EMS within 4.5 hours of symptom onset in our subjects reduced infarct size and improved left ventricular ejection fraction with no excess of adverse events during the first 24 hours.
journal_name
Ann Emerg Medjournal_title
Annals of emergency medicineauthors
Mateos A,García-Lunar I,García-Ruiz JM,Pizarro G,Fernández-Jiménez R,Huertas P,García-Álvarez A,Fernández-Friera L,Bravo J,Flores-Arias J,Barreiro MV,Chayán-Zas L,Corral E,Fuster V,Sánchez-Brunete V,Ibáñez B,METOCARD-CNICdoi
10.1016/j.annemergmed.2014.07.010subject
Has Abstractpub_date
2015-03-01 00:00:00pages
318-24issue
3eissn
0196-0644issn
1097-6760pii
S0196-0644(14)00617-9journal_volume
65pub_type
杂志文章,多中心研究,随机对照试验abstract::The use of electronic control devices has expanded worldwide during the last few years, the most widely used model being the Taser. However, the scientific knowledge about electronic control devices remains limited. We reviewed the medical literature to examine the potential implications of electronic devices in terms...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
doi:10.1016/j.annemergmed.2011.01.023
更新日期:2011-08-01 00:00:00
abstract::The World Health Assembly 2007 Resolution 60.22 tasked the global health community to address the lack of emergency care in low- and middle-income countries. Little progress has yet been made in integrating emergency care into most low- and middle-income-country health systems. At a rural Ugandan district hospital, ho...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.01.035
更新日期:2014-11-01 00:00:00
abstract:STUDY OBJECTIVE:Buffered lidocaine was compared with plain lidocaine as a local anesthetic for simple lacerations. DESIGN:Randomized, double-blind, prospective clinical trial. SETTING:Urban emergency department. TYPE OF PARTICIPANTS:Ninety-one adult patients with simple linear lacerations were enrolled. Patients wit...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0196-0644(05)82603-4
更新日期:1990-12-01 00:00:00
abstract:STUDY OBJECTIVE:We determine whether children with immediate posttraumatic seizures require hospitalization for observation of possible neurologic complications. METHODS:This was a prospective observational cohort study of children younger than 18 years with blunt head trauma resulting in immediate posttraumatic seizu...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/S0196064403012071
更新日期:2004-06-01 00:00:00
abstract:STUDY OBJECTIVE:Annually, 38 million people are evaluated for trauma, the leading cause of death in persons younger than 45 years. The primary objective is to assess whether using a protocol inclusive of point-of-care, limited ultrasonography (PLUS), compared to usual care (control), among patients presenting to the em...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.annemergmed.2006.01.008
更新日期:2006-09-01 00:00:00
abstract:STUDY OBJECTIVE:The Centers for Medicare & Medicaid Services (CMS) recently published emergency department (ED) timeliness measures. These data show substantial variation in hospital performance and suggest the need for process improvement initiatives. However, the CMS measures are not risk adjusted and may provide mis...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2015.05.029
更新日期:2016-04-01 00:00:00
abstract::Since September 11, 2001, concern about potential terrorist attacks has increased in the United States. To reduce morbidity and mortality from outbreaks of illness from the intentional release of chemical agents, we examine data from the Toxic Exposure Surveillance System (TESS). TESS, a national system for timely col...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2005.09.016
更新日期:2006-02-01 00:00:00
abstract::To simulate the effect of sublingual injections on pediatric patients, open-chested kid goats were injected sublingually or peripherally with Cardio-Green while being supported by internal cardiac massage. Our study demonstrates that there is statistically a ten-fold lower central blood level after sublingual injectio...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(84)80005-0
更新日期:1984-06-01 00:00:00
abstract::Recent animal and clinical data require a reevaluation of the traditional approach to the patient exposed to carbon monoxide. Unfortunately, these new data are inconclusive and generate controversies regarding the indications and value of neuropsychologic testing, cause of carbon monoxide toxicity, and indications (if...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:1994-08-01 00:00:00
abstract::One vital aspect of emergency medicine management is communication after episodes of care to improve future performance through group reflection on the shared experience. This reflective activity in teams is known as debriefing, and despite supportive evidence highlighting its benefits, many practitioners experience b...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2014.10.019
更新日期:2015-06-01 00:00:00
abstract::The last 3 to 5 years have witnessed a tremendous change in direction for the academic health center. The major trends in this regard are increased importance of managed care, cost consciousness, development of a clinical system, pressure to downsize graduate medical education, and increased competition. ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(97)70045-3
更新日期:1997-12-01 00:00:00
abstract:STUDY OBJECTIVES:To determine the sensitivity and specificity of the urine ketone dip test as a screening test for ketonemia in hyperglycemic patients and to compare the performance of the urine ketone dip test with the anion gap and serum bicarbonate level. METHODS:This was a prospective study conducted in an urban, ...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(99)70128-9
更新日期:1999-09-01 00:00:00
abstract::Breath alcohol analyzers are used to detect ethanol in motorists and others suspected of public intoxication. One concern is their ability to detect interfering substances that may falsely increase the ethanol reading. A 47-year-old-man was found in a public park, acting intoxicated. A breath analyzer test (Intoxilyze...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2009.07.021
更新日期:2010-02-01 00:00:00
abstract:STUDY OBJECTIVE:Transgender, transsexual, or transitioned (trans) people have reported avoiding medical care because of negative experiences or fear of such experiences. The extent of trans-specific negative emergency department (ED) experiences, and of ED avoidance, has not been documented. METHODS:The Trans PULSE Pr...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/j.annemergmed.2013.09.027
更新日期:2014-06-01 00:00:00
abstract::Colchicine overdose is an uncommon but serious problem that may be missed or ignored unless the physician is aware of the significant potential for, and the various stages of, toxicity. We report two fatal cases in which the potential for lethal complications was not initially realized. Both patients developed multipl...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
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abstract:STUDY OBJECTIVE:To determine the effect of the institution of out-of-hospital albuterol treatments for acute asthma on out-of-hospital time intervals emergency department (ED) morbidity. DESIGN:Retrospective chart and ambulance run report review. PARTICIPANTS:All patients who presented with a diagnosis of asthma on t...
journal_title:Annals of emergency medicine
pub_type: 临床试验,杂志文章
doi:10.1016/s0196-0644(94)70205-5
更新日期:1994-11-01 00:00:00
abstract::A retrospective review of all patients admitted to an urban teaching hospital emergency department with the complaint of overdose, poisoning, or ingestion during a 10-month period was conducted. Analysis of these 82 episodes involving 69 individuals revealed: 1) a preponderance of women in the 20- to 40-year old range...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80453-2
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abstract::Incarcerated rectal prolapse is a potential surgical emergency. We report a case in which a simple but effective technique involving the desiccating effect of granulated sugar (sucrose) was used to aid the manual reduction of prolapsed but viable rectal tissue. ...
journal_title:Annals of emergency medicine
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doi:10.1016/s0196-0644(97)70174-4
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abstract::There are many infectious causes of fatigue, sore throat, and fever, including mononucleosis and toxoplasmosis. Toxoplasma antibody testing is rarely performed in most emergency departments; as a result, toxoplasmosis is diagnosed infrequently. We obtained Toxoplasma IgG IFA titers on ED patients who had mononucleosis...
journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
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journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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journal_title:Annals of emergency medicine
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abstract::Latex allergy, an IgE-mediated reaction to proteins retained in finished natural rubber latex products, has become one of the most pervasive problems in medicine. Latex allergy has resulted in death, progressive asthma, severe food allergy from cross-reactivity, and disability of health care professionals with the acc...
journal_title:Annals of emergency medicine
pub_type: 杂志文章,评审
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更新日期:1998-12-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(86)80388-2
更新日期:1986-07-01 00:00:00
abstract:STUDY OBJECTIVE:To evaluate clinical and cellular changes of bone through the rapid growth phase of development after intraosseous infusion of hypertonic or isotonic solutions at slow or fast infusion rates in a pig model. METHODS:This was a prospective, randomized, partially blinded, comparative study using a porcine...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(96)70010-0
更新日期:1996-10-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
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abstract::Recent interest in civilian trauma as a public health problem dates from the National Academy of Sciences white paper in 1966. Civilian trauma patterns vary depending on locale--blunt trauma predominates in rural and smaller urban areas (65% to 80% of hospital admissions); penetrating trauma in larger urban areas outw...
journal_title:Annals of emergency medicine
pub_type: 杂志文章
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journal_title:Annals of emergency medicine
pub_type: 杂志文章
doi:10.1016/s0196-0644(81)80458-1
更新日期:1981-01-01 00:00:00
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journal_title:Annals of emergency medicine
pub_type: 杂志文章,随机对照试验
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