Accès ouvert déclaré
2025
article
A Diagnostic Paradigm Shift in Acute Myocardial Infarction
Emre K Aslanger, Burcu Aggül, Özlem Yıldırımtürk, Can Yücel Karabay, H. Pendell Meyers, Stephen W. Smith, Muzaffer Deǧertekin, Belma Kalaycı, A N Erdem, Havva Tuğba Gürsoy, Ahmet Akdi, Sinan Cemgil Özbek, V O Tanık, Arzu Neslihan Akgün, Ertan Ekici, Gürbey Söğüt, Tolgahan Efe, Ayşenur Özkaya İbiş, Çağatay Tunca, Y Oz, İbrahim Halil UYGUN, Buse Çuvalcıoğlu, Muhammed Aydın, Ezgi Polat Ocaklı, Tuğba Kayhan Altuner, Dursun Akaslan, Murat Esin, Burcu Ozyazgan, Aydin Ih, Ali Oğuzhan Karal, Esra Dönmez, Sevgi Özcan, O Ince, Muhammed Furkan Deni̇z, Irfan Sahin, Abuzer Coşkun, Mustafa Rauf Karayumak, Ersin İbişoğlu, Uğur Ozan Demirhan, Aslan Erdoğan, Eyüp Özkan, İlyas Çetin, Yusuf İnci, S S Kalkan, Ufuk Yıldız, Said Kural, Tuba Danacı, Burcu Kırbıyık, Merve Işık, Utku ULUKÖKSAL, Furkan Fatih Yücedağ, Elif Ozoguz, Oktay Seker, Barış Yaylak, Ufuk Sadık Ceylan, Gönül Zeren, Mustafa Azmi Sungur, Mehmet Fatih Yılmaz, Tolga Onuk, Oğuzhan Birdal, Sidar Şiyar Aydın, E TEKIN, Emrah İlkay Varınca, Ezgi Çamlı Babayiğit, Halit Emre Yalvaç, E Sener, Hazal Tiraş, Barış Özden, Ayberk Beral, Kadir Uğur Mert, Gurbet Özge Mert, Cihat Çalışkan, Azmican Kaya, Metehan Kibar, Mustafa Furkan Kılıçarslan, Emre Kipritçi, Seyma Zeynep Atici, Simay Erdal, Sedat Kalkan, Çetin Geçmen, Muzaffer Kahyaoğlu, Mehmet Aytürk, Mevlüt Demir, Taner Şen, Halil İbrahim Durmuş, Emrah Kaya, Fatih Kahraman, Celal Kılıt, M A Astarcioglu, Veysel Elitas, Yakup Han Yilmaz, Uğur Güven, Zekeriya Doğan, Eren Uysaler, Ahmet Cem Nizam, Tansu ÇELİK, Ebrunur Türkmen, B Çavuş, Fevzi Sünbül, Sena Nasif, Melih Gözünke, Ahmet Anıl Şahin, Ayhan Kol, Doğancan Çeneli, Sinan Karacabey, Serhat Bulut, Ayşe Zeynep İnan, Mustafa Aytemiz, Emre Kudu, Mehmet Birkan Korgan, Altun Ml, Mehmet Oğuzhan Narlı, Elif Yaren Yurtman, Mehmet Ertürk, Ümit Bulut, Dama Hatice Kübra, Utku Yartaşı, S T Huseynova, Gizemnur Coşkun, M C Gundogdu, Dilara Pay, Özcan Başaran, Bülent Özlek, I Altun, Süleyman Barutçu, Zahit Arda Tok, Tolga Terdöken, Serhat Kesriklioğlu, Muhammed Fatih Kaleli, Mehmet Akif Düzenli, Sümeyye Toprak, Ferit Recepoğlu, Leyla Feyzullayeva, Mertcan Gezer, Emirhan Feyzullahoglu, Nuraiym Moloshova, Gur S, A Salvarci, Mücahit Kılavuz, Mustafa Çelık, Yakup Alsancak, Ahmet Seyfeddin Gürbüz, Sefa Tatar, Barış Güven, Mehmet Emin Gökçe, Çağrı Zorlu, Sefa Erdi Ömür, Ahmet Şimşek, Yağmur Demirezen, Ömer Kümet, Görkem Ayhan, Medeni Karaduman, Ertuğ Günsoy, Veysi Can, Remzi Sarıkaya, Yemlihan Ceylan, Y S Kaya, Mehmet Şirin Türkan, Emre K. Aslanger, Can Yücel Karabay, M Degertekin, Gamze Acar, Şeyma Acaroğlu, Hüseyin Akgün, Orkun Canbolat, Fatma Ekici, Muhammed Mert Göksu, Ufuk Sali Halil, Emel Hamkan, Furkan Karaca, Şevval Kılıç, Cansu Göksenin Özdoğan, Furkan Sarıkafa, Melek Topçu, Ömer Türkmen, Emrah Bozbeyoğlu, Funda Özlem Pamuk, Mustafa Emin Çanakçı, Ramazan Güven
10Citations signalées, ce qui n’est pas une note de qualité
7Institutions déclarées
5Pays d’affiliation déclarés
Rattachement africain : tr, ag, fi, kh, us.
Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
BACKGROUND: The current ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) paradigm have long been the cornerstone of myocardial infarction (MI) care but fail to identify many patients with acute coronary occlusion (ACO), delaying treatment and worsening outcomes. OBJECTIVES: The new occlusive MI (OMI) and nonocclusive MI (NOMI) paradigm addresses these limitations by shifting from rigid electrocardiography (ECG)-driven thresholds to a pathophysiology-based strategy. It integrates clinical judgment, ECG subtleties, supportive artificial intelligence, biomarkers, and imaging when needed to actively detect ACO. The current trial investigates whether this approach improves outcomes. METHODS: The DIFOCCULT-3 (Time for a DIagnostic paradigm shift from ST-elevation/non-ST-elevation to OCClUsion/non-occLusion myocardial infarcTion? trial is a multicenter, modified cluster-randomized, open-label study designed to compare the OMI/NOMI paradigm with the STEMI/NSTEMI approach in 6,000 participants presenting with suspected MI. The OMI/NOMI approach integrates clinical gestalt, artificial intelligence-supported ECG analysis, and adjunctive diagnostic tools to actively identify ACO. The primary endpoint is the composite of all-cause mortality and all-cause rehospitalization at 1-year follow-up. Secondary endpoints include infarct size, left ventricular ejection fraction, wall motion score index, and accurate diagnosis of ACO. RESULTS: Enrollment and follow-up are ongoing; acute outcomes such as earlier identification of ACO and infarct size will be reported after enrollment, and late outcomes including mortality and rehospitalization will be available after 1-year follow-up. CONCLUSIONS: The DIFOCCULT-3 study aims to determine whether the OMI/NOMI paradigm represents a significant advancement in MI care by improving outcomes through earlier and more accurate identification of ACO than the STEMI/NSTEMI framework (Time for a Diagnostic Paradigm Shift From STEMI/NSTEMI to OMI/NOMI [DIFOCCULT-3]; NCT06570759).
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- A Diagnostic Paradigm Shift in Acute Myocardial Infarction
- Date Crossref
- 01/11/2025
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Les institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Les sujets associés
Acute Myocardial Infarction ResearchCoronary Interventions and DiagnosticsCardiac Imaging and Diagnostics