JOHN PAUL HIBBS

Senior Clinical Consultant for Abiomed with special interests in process improvement, hemodynamics and physiology, and complex coronary cases. Background in cardiac research, including coordinator for a large STEMI database and facilitated protocol changes in 30+ hospitals throughout the state. Forever looking to learn and grow.

CLINICAL CHARACTERISTICS AND OUTCOMES OF LEFT MAIN ST-ELEVATION MYOCARDIAL INFARCTIONCLINICAL CHARACTERISTICS AND OUTCOMES OF LEFT MAIN ST-ELEVATION MYOCARDIAL INFARCTION

Journal of the American College of cardiology · Mar 10, 2018

- This study addresses the scarcity of reported outcomes and clinical characteristics associated with ST-elevation myocardial infarction (STEMI) attributed to a left main (LM) culprit artery, a potentially catastrophic event. Utilizing comprehensive, prospective STEMI program databases from three leading institutions, namely the Minneapolis Heart Institute, Cedars Sinai Heart Institute, and Prairie Heart Institute, the study evaluates the clinical profiles and outcomes of STEMI patients with LM culprit arteries in comparison to those with non-LM culprit arteries. Among the 8,277 consecutive STEMI patients across the three centers, 84 (1%) were identified as having an LM artery culprit. These patients exhibited distinct characteristics, including advanced age, lower ejection fractions, and higher incidences of cardiac arrest and cardiogenic shock upon presentation compared to patients with non-LM culprit arteries. Importantly, individuals with LM culprit arteries experienced a significantly higher in-hospital mortality rate. The study identifies four distinct clinical scenarios associated with LM culprit artery involvement, ranging from unprotected LM total occlusion (highest risk) to spontaneous LM dissection. These findings underscore the high-risk nature of patients with STEMI due to LM culprit arteries.

OUTCOME AND CHARACTERISTICS OF SHOCKABLE VERSUS NON-SHOCKABLE CARDIAC ARREST IN ST ELEVATION MYOCARDIAL INFARCTION AT A REGIONAL TRANSFER CENTEROUTCOME AND CHARACTERISTICS OF SHOCKABLE VERSUS NON-SHOCKABLE CARDIAC ARREST IN ST ELEVATION MYOCARDIAL INFARCTION AT A REGIONAL TRANSFER CENTER

Journal of the American College of Cardiology · Mar 21, 2017

- This study investigates the impact of age and arrest type (shockable vs. non-shockable) on outcomes among patients presenting with cardiac arrest in the context of ST elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). Utilizing data from a prospective STEMI database spanning from March 2003 to December 2014, the analysis included 499 patients with cardiac arrest prior to PCI. Of these patients, 88% exhibited a shockable rhythm (ventricular tachycardia/ventricular fibrillation), while 12% displayed a non-shockable rhythm (asystole/pulseless electrical activity). The study revealed distinct baseline characteristics and outcomes associated with age and arrest type. Notably, younger patients (< 60 years old) experiencing cardiac arrest exhibited a higher prevalence of cigarette smoking, regardless of arrest type. Diabetes was more prevalent among older patients with a shockable rhythm. Moreover, no significant correlation was observed between cardiac arrest type and the location of coronary occlusion. The findings underscore the importance of considering age and arrest type in the management and prognosis of STEMI patients undergoing PCI.

INFLUENCE OF CARDIAC ARREST AND CARDIOGENIC SHOCK ON OUTCOMES AMONG 4,500 CONSECUTIVE ST ELEVATION MYOCARDIAL INFARCTION PATIENTSINFLUENCE OF CARDIAC ARREST AND CARDIOGENIC SHOCK ON OUTCOMES AMONG 4,500 CONSECUTIVE ST ELEVATION MYOCARDIAL INFARCTION PATIENTS

Journal of the American College of cardiology · Mar 21, 2017

- This study explores the influence of cardiac arrest and cariogenic shock on the outcomes of patients with ST-elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI) in the contemporary era. Analyzing data from a regional STEMI network spanning from March 2003 to December 2014, the study aimed to elucidate the incidence, characteristics, and prognosis of STEMI patients complicated by cardiac arrest with and without cardiogenic shock. Cardiac arrest episodes were categorized as shockable (ventricular tachycardia/ventricular fibrillation) or non-shockable (asystole/pulseless electrical activity). Among the 4,511 consecutive patients enrolled, 11% experienced cardiac arrest prior to PCI, with 88% exhibiting a shockable rhythm and 12% displaying a non-shockable rhythm. The findings revealed notable insights, including the absence of a history of myocardial infarction or revascularization in the majority of patients with cardiac arrest. Furthermore, cardiogenic shock significantly influenced hospital mortality only in individuals with a shockable rhythm. Interestingly, approximately one-third of patients with both shockable and non-shockable cardiac arrest had a non-proximal coronary culprit, with no significant difference in culprit coronary anatomy observed between those with and without cardiogenic shock. Survival outcomes varied based on arrest type, with a higher proportion of patients with shockable arrest surviving to discharge compared to those with non-shockable arrest. These results underscore the complex interplay between cardiac arrest, cardiogenic shock, and coronary anatomy in shaping outcomes among STEMI patients undergoing PCI, emphasizing the need for tailored therapeutic strategies and risk assessment approaches.

Giant J-Waves and ST-Segment Elevation Associated with Acute Gastric DistentionGiant J-Waves and ST-Segment Elevation Associated with Acute Gastric Distention

Circulation · Feb 1, 2016

- Lead author of a unique case discussing a young woman who experienced progressive and dramatic electrocardiographic changes mimicking an acute ST-segment myocardial infarction, but with associated giant J-waves, in the setting of gastric distention stemming from acute ileus. This case further expands the conditions associated with ST-segment elevation in the absence of acute myocardial infarction.

Left Main Intervention in Patients with ST-Elevation Myocardial InfarctionLeft Main Intervention in Patients with ST-Elevation Myocardial Infarction

American College of Cardiology · Mar 16, 2015

- Using a comprehensive prospective regional STEMI program database, we evaluated the demographics, clinical characteristics, and outcomes of STEMI patients with a LMCA culprit artery stratified by patients receiving coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).