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Critical Pathways in Cardiology

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https://www.readbyqxmd.com/read/29768320/monocyte-chemoattractant-protein-1-as-a-predictor-of-coronary-atherosclerosis-in-patients-receiving-coronary-angiography
#1
Simon A Mahler, Thomas C Register, Robert F Riley, Ralph B D'Agostino, Jason P Stopyra, Chadwick D Miller
BACKGROUND: Animal studies suggest that monocyte chemoattractant protein-1 (MCP-1) is a promising biomarker for coronary artery atherosclerosis (CAA), but human studies have been inconclusive. OBJECTIVE: To determine potential relationships between plasma MCP-1 and CAA in patients with acute chest pain. METHODS: A secondary analysis of 150 patients enrolled in emergency department chest pain risk stratification clinical investigations was conducted...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768319/contrast-enhanced-stress-echocardiography-and-myocardial-perfusion-imaging-in-patients-hospitalized-with-chest-pain-a-randomized-study
#2
Gerald Salame, Whitney E Juselius, Marisha Burden, Carlin S Long, Tiffany Bendelow, Brenda Beaty, Frederick A Masoudi, Mori J Krantz
Ultrasound contrast-enhanced stress echocardiography improves endocardial visualization, but diagnostic test rates versus stress myocardial perfusion imaging (MPI) have not been studied. A prospective randomized trial was performed between April 2012 and October 2014 at a single-center, safety net hospital. Hospitalized patients referred for noninvasive stress imaging were randomized 1:1 to stress echocardiography or stress MPI. The primary outcome was diagnostic test rate defined as interpretable images and achievement of >85% of age-predicted maximal heart rate (for dobutamine and exercise)...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768318/angiographic-characteristics-of-st-elevation-myocardial-infarction-patients-with-infarct-related-coronary-artery-ectasia-undergoing-primary-percutaneous-coronary-intervention
#3
Babak Geraiely, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeh Hamideh Mortazavi
Coronary ectasia accounts for 0.3%-4.9% of patients undergoing coronary angiography. We conducted the present study to evaluate the angiographic characteristics of ST-elevation myocardial infarction (STEMI) patients with infarct-related coronary artery ectasia (IRAE) undergoing primary percutaneous coronary intervention. We evaluated 667 STEMI patients who were divided into 2 groups of IRAE (n = 81) and non-IRAE (n = 568). Preprocedural thrombolysis in myocardial infarction (TIMI) flow grade, postprocedural TIMI flow grade, thrombus burden grade, and TIMI frame count were then evaluated...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768317/heart-failure-episodes-of-missed-major-cardiac-events-when-applying-the-heart-pathway-to-an-observation-unit-population
#4
Alan Tesson, Rami Abdo, Aparna Kamath, Joanne Sutter, Rachel Cline, Sarah L Hale, Jonathan Bae, Lalit Verma
OBJECTIVE: The HEART Pathway risk prediction tool (HEART score plus serial troponin measures at 0 and 3 hours post-presentation) is used to identify low-risk patients with chest pain who may qualify for safe, early discharge. We calculated the percentage of patients in our observation unit that qualified as low risk using HEART Pathway, as well as their associated outcomes. METHODS: We retrospectively reviewed charts on 966 consecutive patients admitted to our observation unit for chest pain (January 2015 to February 2016); HEART Pathway scores were retrospectively calculated and serial cardiac troponin values logged...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768316/evaluation-of-compliance-with-a-weight-based-nurse-driven-heparin-nomogram-in-a-tertiary-academic-medical-center
#5
James W Schurr, Craig A Stevens, Anne Bane, Sarah E Culbreth, Amy Leigh Miller, Jean M Connors, Katelyn W Sylvester
BACKGROUND: Recently, our institution adopted a weight-based nurse-driven heparin titration protocol that relies on nurses ordering laboratories, adjusting doses, and initiating boluses. Numerous institutions have implemented similar protocols with reported success. METHODS: A single-center retrospective analysis was conducted at the Brigham and Women's Hospital in Boston, Massachusetts that included all patients who were initiated on the weight-based nurse-driven heparin nomogram during a 30-day period...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768315/angiography-guided-multivessel-percutaneous-coronary-intervention-versus-ischemia-guided-percutaneous-coronary-intervention-versus-medical-therapy-in-the-management-of-significant-disease-in-non-infarct-related-arteries-in-st-elevation-myocardial-infarction
#6
Dhanuka Perera, Tom Crake, Victor Lee
BACKGROUND: In ST-elevation myocardial infarction (STEMI) patients with multivessel (MV) disease, after primary percutaneous coronary intervention (PCI), emerging evidence suggests that significant disease in non-infarct-related coronary arteries (IRAs) should be routinely stented. Whether this procedure should be guided by angiography alone or ischemia testing is unclear. METHODS: All STEMI patients treated with primary PCI between January 1, 2005, and December 31, 2012, at a tertiary cardiology center were reviewed retrospectively...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768314/medication-administration-delays-in-non-st-elevation-myocardial-infarction-analysis-of-1002-patients-admitted-to-an-academic-medical-center
#7
LeAnn N Denlinger, Ellen C Keeley
Our goal was to assess adherence to American College of Cardiology/American Heart Association guideline-based medical therapy in patients admitted with type I non-ST elevation myocardial infarction (NSTEMI) and to determine factors associated with medication administration delay. We performed a retrospective analysis using data from the Acute Coronary Treatment and Intervention Outcomes Network (ACTION) Registry. Baseline patient demographics, 12-lead electrocardiogram (ECG) findings, laboratory values, medications administered and the time they were administered, and in-hospital clinical outcomes were collected...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768313/the-incidence-of-myocardial-injury-after-loading-doses-of-clopidogrel-versus-prasugrel-in-the-candidates-for-percutaneous-coronary-intervention-a-randomized-controlled-trial
#8
Reza Rahmani, Laya Jiriaee, Zahra Jiriaee, Akbar Shafiee, Amir Farhang Zand Parsa
INTRODUCTION: Prevention of myocardial injury is an essential issue in percutaneous coronary intervention (PCI). We compared the incidence of myocardial injury after loading doses of clopidogrel versus prasugrel in the candidates for PCI. METHODS: In this randomized-controlled clinical trial, we enrolled 88 stable angina patients, candidate for PCI. Patients received either prasugrel (60 mg orally) (n = 42) or clopidogrel (600 mg orally) (n = 46). Serum levels of creatine phosphokinase muscle-brain type, cardiac troponin I, and high sensitive C-reactive protein were measured at baseline and 6 and 12 hours postprocedural...
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29768312/advances-in-the-treatment-of-stable-coronary-artery-disease-and-peripheral-artery-disease
#9
W Brian Gibler
No abstract text is available yet for this article.
June 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432377/two-year-follow-up-of-patients-with-unstable-angina-non-st-segment-elevation-myocardial-infarction-undergoing-early-invasive-strategy-predictors-of-normal-or-near-normal-coronary-angiography-and-mortality
#10
Yaser Jenab, Ebrahim Kassaian, Hamid Reza Pourhosseini, Mojtaba Salarifar, Arash Jalali, Azita Hajhossein Talasaz
BACKGROUND: Predictors of normal or near-normal coronary angiography (NONCAG) in patients with unstable angina/non-ST-elevation myocardial infarction (UA/NSTEMI) and their importance regarding the prognosis are not understood. Accordingly, we determined these predictors as well as mortality risk factors at 2-year follow-up of UA/NSTEMI patients managed by the early invasive strategy. METHODS: We prospectively studied consecutive patients with UA/NSTEMI managed with the early invasive strategy at Tehran Heart Center, in 1-year period...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432376/complementary-diagnostic-value-of-heart-type-fatty-acid-binding-protein-in-early-detection-of-acute-myocardial-infarction
#11
Maryam Sotoudeh Anvari, Mahsa Karimi, Akbar Shafiee, Mohammadali Boroumand, Ali Bozorgi, Reza Sedaghat, Arash Jalali
BACKGROUND: Heart-type fatty acid-binding protein (H-FABP) is a novel biomarker for myocardial injury. We compared the use of H-FABP with serum levels of cardiac troponin-T (cTnT) and creatine kinase-MB (CK-MB) in the diagnosis of patients suspicious to acute myocardial infarction (AMI). METHODS: From October 2013 to December 2014, 182 consecutive patients suspicious to acute coronary syndrome were enrolled in this study, who presented within the past 6 hours from the onset of symptoms...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432375/positive-predictive-value-of-noninvasive-stress-testing-is-poor-in-the-real-world
#12
Geetanjali Dang, Muhammad Shahreyar, Ahmet Afşin Oktay, Samian Sulaiman, Husein Husein, Ana Inashvili, Nadia Elhangouche, Preethi Subramanian, Mohammad Waqas Bashir, Aradhna Pathak, Shu B Chan, Shahriar Dadkhah
Abnormal noninvasive stress test (NIST) findings do not always correlate with angiographically significant (luminal obstruction ≥50%) coronary artery disease. Positive predictive value (PPV) of NIST in the real clinical practice is not well known. The goal of this retrospective study was to determine the PPV of NIST and assess the factors affecting PPV in a US community hospital. This study included all consecutive patients (n = 355) who underwent invasive coronary angiography after a positive NIST within ~1-year duration at our institution...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432374/development-of-an-outpatient-guideline-for-optimal-anticoagulation-bridging-in-patients-with-durable-mechanical-circulatory-support
#13
Amy A Levesque, Jessica M Rimsans, Katelyn W Sylvester, Erin N Lyons, Katie A Frankel, Lara L Coakley, Maryclare Hickey, Krystin A Montoya, Mandeep R Mehra, Michael M Givertz, Garrick C Stewart, Jean M Connors
Patients with durable mechanical circulatory support are at increased risk of thromboembolic and bleeding complications. Current guidelines recommend that these patients receive chronic anticoagulation with warfarin to maintain a target international normalized ratio (INR) as specified by device manufacturers. Limited data exist regarding management of subtherapeutic INRs in this setting. To standardize clinical practice at our institution, we assembled a multidisciplinary task force including members from various specialties to develop a guideline for managing subtherapeutic INRs that incorporates published data and expert opinion...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432373/contrast-induced-nephropathy-in-stemi-patients-with-and-without-chronic-kidney-disease
#14
Tarun Jain, Sunay Shah, Jainil Shah, Gordon Jacobsen, Akshay Khandelwal
INTRODUCTION: Contrast-induced nephropathy (CIN) following percutaneous coronary intervention (PCI) is associated with adverse outcomes; however, there are scarce data comparing clinical outcomes of post-PCI CIN in ST elevation myocardial infarction (STEMI) patients with and without chronic kidney disease (CKD). We sought to assess the incidence, clinical predictors, and short-term and long-term clinical outcomes of post-PCI CIN in STEMI patients with and without CKD. METHODS: We performed a retrospective observational cohort study involving 554 patients who underwent PCI for STEMI from February 2010 to November 2013...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432372/ecg-to-decision-time-impact-on-30-day-mortality-and-reperfusion-times-for-stemi-care
#15
Richard Mullvain, Daniel M Saman, Ashlee Rostvedt, Pauline Landgren
OBJECTIVES: Little data are published on the unique care performance metric of electrocardiogram-to-decision time (E2Decide) for primary percutaneous coronary intervention (PCI) treatment of ST-elevation myocardial infarction (STEMI). The objective of this study is to evaluate E2Decide time on mortality and delayed reperfusion. METHODS: This was a retrospective study of STEMI activations treated with primary PCI at 2 PCI-capable hospitals located in Duluth, Minnesota, and Fargo, North Dakota, originating in 3 different settings: (1) primary PCI-capable hospital emergency departments, (2) non-PCI facilities, and (3) in the field by emergency medical services...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432371/clinical-outcomes-of-transferred-versus-onsite-primary-percutaneous-coronary-intervention-for-patients-with-stemi-time-to-look-beyond-door-to-balloon-time
#16
Jaya Mallidi, Paul Visintainer, Indupriya Pallekonda, Daniel Fisher, Kurt Barringhaus, Aaron Kugelmass, Amir Lotfi
BACKGROUND: It is currently unknown if the delay due to practical aspects associated with transfer of patients from a non-percutaneous coronary intervention (PCI) facility to a primary PCI facility is associated with adverse outcomes. METHODS: We conducted a retrospective cohort study of all patients who presented with ST-segment elevation myocardial infarction (STEMI) and underwent primary PCI in 2 large regional STEMI centers in Massachusetts between January 2005 and June 2009...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432370/experiences-of-a-one-hour-algorithm-in-chest-pain-patients-with-a-nonelevated-troponin-t-at-presentation
#17
Anna Pettersson, Lina Ljung, Caroline Johansson, Umut Heilborn, Tomas Jernberg, Mats Frick, Kai M Eggers, Bertil Lindahl, Rikard Linder, Arne Martinsson, Per Svensson
BACKGROUND: We aimed to evaluate the use of a 1-hour measurement of high-sensitivity cardiac troponin T (hs-cTnT) in an emergency department (ED) population of chest pain patients with a nonelevated baseline hs-cTnT and to examine the prevalence of early dynamic changes in hs-cTnT and the association with admission rate, diagnosis, and outcome. METHODS: All patients with a chief complaint of chest pain presenting to the ED of Karolinska University Hospital, Solna, Sweden, from December 2014 to September 2015 who had a baseline hs-cTnT of ≤14 ng/L and a second value obtained within >30 to ≤90 minutes were followed for 30 days regarding admission, readmission, myocardial infarction (MI), and death...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29432369/implementation-of-an-early-discharge-protocol-and-chest-pain-clinic-for-low-risk-chest-pain-in-the-emergency-department
#18
Mohammad Amin Kashef, Jane Garb, Aaron Kugelmass, Amir Lotfi
BACKGROUND: Most of the patients presenting to emergency department with chest pain are at low risk of adverse events. Identifying high-risk patients can be challenging and resource intensive. METHODS: We created a protocol to assist early discharge of low-risk adults with chest pain from emergency department. Also a chest pain clinic (CPC) was started for cardiology follow-up within 72 hours. In a retrospective cohort study, primary outcome of major adverse cardiac events (MACEs) of death, myocardial infarction, or revascularization was compared between CPC patients and those hospitalized for observation...
March 2018: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135626/community-outreach-in-terms-of-early-heart-attack-care-as-a-new-way-of-thinking-in-chest-pain-center-unit-care-giving-commentary-on-the-german-chest-pain-unit-network
#19
Raymond Bahr, Tienush Rassaf, Frank Breuckmann
No abstract text is available yet for this article.
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135625/impact-of-sex-on-long-term-clinical-outcomes-after-percutaneous-coronary-intervention
#20
Seyed-Mohammad Ghoreyshi-Hefzabad, Seyed-Ebrahim Kassaian, Shahrbanoo Kheirkhah-Sabetghadam, Arash Jalali, Hamidreza Poorhosseini, Mohammad Reza Movahed, Ebrahim Nematipour, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeharezoo Ghoreyshi-Hefzabad, Farshid Alaeddini, Saeed Sadeghian, Masoumeh Lotfi-Tokaldany
AIMS: To evaluate the impact of sex on long-term clinical outcomes after percutaneous coronary intervention (PCI). METHODS: In a large prospective cohort, 5664 patients (1716 women and 3948 men) who underwent PCI in a tertiary cardiac center between March 2007 and March 2010 were enrolled. Patients were followed up for median of 74.3 months. We compared the occurrence of long-term mortality, myocardial infarction (MI), and repeated revascularization between 2 sexes...
December 2017: Critical Pathways in Cardiology
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