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https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#1
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into 4 cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (N = 1448), acute coronary syndrome (ACS) (N = 602), ischemic stroke (IS) (N = 151), and heart failure (HF) (N = 291) incident cohorts...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28093987/the-prognostic-value-of-heart-type-fatty-acid-binding-protein-in-patients-with-suspected-acute-coronary-syndrome-a-systematic-review
#2
Julia D Jones, Pei Gee Chew, Rebecca Dobson, Andrew Wootton, Reza Ashrafi, Aleem Khand
BACKGROUND: Heart type fatty acid protein(HFABP) is a cytosolic protein released early after acute coronary syndrome(ACS) even in the absence of myocardial necrosis. OBJECTIVES: The purpose of this systematic review was to determine whether HFABP levels in patients with suspected, or confirmed ACS, improves risk stratification when added to established means of risk assessment. METHODS: We searched Medline, Pubmed and Embase databases from inception to July 2015 to identify prospective studies with suspected or confirmed ACS, who had HFABP measured during the index admission with at least 1 month follow up data...
January 16, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28068529/impact-of-high-dose-statins-on-vitamin-d-levels-and-platelet-function-in-patients-with-coronary-artery-disease
#3
Monica Verdoia, Patrizia Pergolini, Roberta Rolla, Matteo Nardin, Alon Schaffer, Lucia Barbieri, Veronica Daffara, Paolo Marino, Giorgio Bellomo, Harry Suryapranata, Giuseppe De Luca
BACKGROUND: Statins represent a pivotal treatment in coronary artery disease, offering a reduction in cardiovascular risk even beyond their lipid-lowering action. However, the mechanism of these "pleiotropic" benefits of statins is poorly understood. Vitamin D has been suggested as a potential mediator of the anti-inflammatory, anti-thrombotic and vascular protecting effects of statins. Aim of present study was to assess the impact of a high-intensity statin therapy on vitamin D levels and platelet function in patients with coronary artery disease...
December 28, 2016: Thrombosis Research
https://www.readbyqxmd.com/read/28062612/cardiac-troponin-assays-guide-to-understanding-analytical-characteristics-and-their-impact-on-clinical-care
#4
REVIEW
Fred S Apple, Yader Sandoval, Allan S Jaffe, Jordi Ordonez-Llanos
BACKGROUND: Cardiac troponin I (cTnI) and cardiac troponin T (cTnT) determinations are fixtures in clinical practice and research. Cardiac troponin testing has been the standard of practice for the diagnosis of acute myocardial infarction (AMI), early rule-out, risk stratification, and outcomes assessment in patients presenting with acute coronary syndrome (ACS) and non-ACS myocardial injury. We recognize from reading the literature over the past several years how poorly understood the analytical characteristics are for cTnI and cTnT assays by laboratorians, clinicians, and scientists who use these assays...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28059679/perioperative-outcomes-for-pediatric-neurosurgical-procedures-analysis-of-the-national-surgical-quality-improvement-program-pediatrics
#5
Benjamin J Kuo, Joao Ricardo N Vissoci, Joseph R Egger, Emily R Smith, Gerald A Grant, Michael M Haglund, Henry E Rice
OBJECTIVE Existing studies have shown a high overall rate of adverse events (AEs) following pediatric neurosurgical procedures. However, little is known regarding the morbidity of specific procedures or the association with risk factors to help guide quality improvement (QI) initiatives. The goal of this study was to describe the 30-day mortality and AE rates for pediatric neurosurgical procedures by using the American College of Surgeons (ACS) National Surgical Quality Improvement Program-Pediatrics (NSQIP-Peds) database platform...
January 6, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28042404/in-hospital-and-one-year-clinical-outcome-of-percutaneous-coronary-intervention-in-a-tertiary-hospital-in-oman-oman-pci-registry
#6
Prashanth Panduranga, Majdah Al-Rashidi, Fatma Al-Hajri
OBJECTIVES: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in a tertiary hospital in Oman. METHODS: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event (MACE), defined as death, any myocardial infarction (MI), cerebrovascular accident (CVA), and target vessel revascularization (TVR) with either repeat PCI or coronary artery bypass surgery (CABG)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28027187/analysis-of-morbidity-readmission-and-reoperation-after-craniosynostosis-repair-in-children
#7
Kevin T Jubbal, Nikhil Agrawal, Larry H Hollier
The impact of specific patient comorbidities on outcomes in craniosynostosis surgical repair is not well defined. The aim of this retrospective review was to evaluate the short-term 30-day reoperation rate, unplanned readmission rate, and overall morbidity of craniosynostosis surgical repair using the 2012 through 2014 American College of Surgeons National Surgical Quality Improvement Program-Pediatrics (ACS NSQIP-Pediatric) database. Overall morbidity included pneumonia, wound occurrence, shock/sepsis, venous thromboembolism, cardiac complication, renal and urinary complications, or nerve injury...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27998631/emergency-department-cardiopulmonary-evaluation-of-low-risk-chest-pain-patients-with-self-reported-stress-and-anxiety
#8
Paul I Musey, Jeffrey A Kline
BACKGROUND: Chest pain is a high-risk emergency department (ED) chief complaint; the majority of clinical resources are directed toward detecting and treating cardiopulmonary emergencies. However, at follow-up, 80%-95% of these patients have only a symptom-based diagnosis; a large number have undiagnosed anxiety disorders. OBJECTIVE: Our aim was to measure the frequency of self-identified stress or anxiety among chest pain patients, and compare their pretest probabilities, care processes, and outcomes...
December 17, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27993878/relationship-between-glutathione-peroxidase-platelet-reactivity-and-reactive-oxygen-species-in-an-acute-coronary-syndrome-population
#9
Ana S Holley, John H Miller, Peter D Larsen, Scott A Harding
Low activity levels of the antioxidant enzyme, glutathione peroxidase (GPx), have been implicated in adverse clinical outcomes in coronary artery disease. A potential mechanistic link for this relationship is that low GPx activity predisposes patients to thrombotic complications due to impaired reactive oxygen species (ROS) metabolism. GPx potentially regulates the bioavailability of nitric oxide (NO) - a potent platelet inhibitor - therefore indirectly affecting platelet activation. This study examined the relationship between levels of GPx activity, ROS, and platelet activation in 51 acute coronary syndrome (ACS) patients...
December 2016: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/27992823/the-effect-of-renal-dysfunction-on-short-term-outcomes-after-lumbar-fusion
#10
Taylor E Purvis, Remi A Kessler, Christine Boone, Benjamin D Elder, C Rory Goodwin, Daniel M Sciubba
OBJECTIVE: To compare post-lumbar decompression and fusion complication rates and mortality for patients without preoperative hemodialysis (HD) use with and without renal dysfunction as estimated by glomerular filtration rate (GFR) and creatinine levels. PATIENTS AND METHODS: Baseline and outcome data were obtained from the 2005-2014 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database for patients over the age of 18 who underwent non-emergent lumbar fusion surgery...
December 6, 2016: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/27974385/simulation-models-of-misclassification-error-for-single-thresholds-of-high-sensitivity-cardiac-troponin-i-due-to-assay-bias-and-imprecision
#11
Andrew W Lyon, Peter A Kavsak, Oliver A S Lyon, Andrew Worster, Martha E Lyon
BACKGROUND: Clinical outcome studies for cardiac troponins (cTn) are expensive and difficult to design owing to variation in patients, in the assays, and in the incidence of different types of myocardial infarction (MI). To overcome these difficulties, simulation models were used to estimate the rate of misclassification error for MI and risk prediction resulting from assay bias and imprecision. METHODS: Finite mixture analysis of Abbott high-sensitivity cTnI (hs-cTnI) results at time 0 h in patients presenting early with acute coronary syndrome (ACS) symptoms to the emergency department (ED) [n = 145, Reducing the Time Interval for Identifying New Guideline (RING) study] allowed derivation of a simulation data set (n = 10000)...
December 14, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27965279/sex-differences-in-prodromal-symptoms-in-acute-coronary-syndrome-in-patients-aged-55%C3%A2-years-or-younger
#12
Nadia A Khan, Stella S Daskalopoulou, Igor Karp, Mark J Eisenberg, Roxanne Pelletier, Meytal Avgil Tsadok, Kaberi Dasgupta, Colleen M Norris, Louise Pilote
BACKGROUND: Studies suggest that young women are at highest risk for failing to recognise early symptoms of acute coronary syndrome (ACS). OBJECTIVES: To examine sex differences in prodromal symptoms occurring days and weeks prior to the acute presentation of ACS. We also examined health-seeking behaviours and prehospital management in young patients. METHODS: Prospective cross-sectional analysis of 1145 patients (368 women) hospitalised for ACS, aged ≤55 years, from the GENdEr and Sex DetermInantS of Cardiovascular Disease: From Bench to Beyond Premature Acute Coronary SYndrome cohort study (January 2009-April 2013)...
December 13, 2016: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/27958691/triple-rule-out-cardiac-ct-is-it-finally-a-reality
#13
Regina DE LA Mora Cervantes, Carole Dennie
Acute coronary syndrome (ACS), pulmonary embolism and acute aortic syndrome are the most common causes of life threatening chest pain. The triple rule-out CT (TRO CT) has emerged as a technology that can simultaneously visualize the coronary arteries, aorta and pulmonary arteries as well as other intrathoracic structures. It has been proposed as a one-stop imaging modality in patients who present to the emergency department with low to intermediate risk of ACS in whom pulmonary embolism and/or acute aortic syndrome are also considered...
December 13, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27931543/efficacy-and-safety-of-the-intensive-dose-of-rosuvastatin-40mg-day-in-patients-with-acute-coronary-syndrome-and-at-high-risk-of-cardiovascular-disease-rosuvees-2
#14
Chetan P Shah, Bhaskar P Shah, Sameer I Dani, B B Channa, S S Lakshmanan, N C Krishnamani, Ashwani Mehta, P Moorthy
BACKGROUND: Randomized clinical trials have established the benefits of statin therapy in acute coronary syndromes (ACS) via their pleiotropic effects. AIM OF THE STUDY: This was a 12-week, open-label, multicenter, postmarketing observational study evaluating the efficacy and safety of rosuvastatin 40 mg/day in very high-risk or high-risk Indian patients according to NCEP ATP III guidelines. METHODOLOGY: One hundred and sixty two patients (age: 30 to 69 years) with evidence of coronary artery disease, hospitalized with chest pain with/without electrocardiogram changes and with non-ST segment elevation ACS and ST segment elevation ACS who received optimal reperfusion therapy were enrolled...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#15
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27914806/interprovincial-differences-in-canadian-coronary-care-unit-resource-use-and-outcomes
#16
Sean van Diepen, Meng Lin, Justin A Ezekowitz, Finlay A McAlister, Douglas S Lee, Shaun G Goodman, Paul W Armstrong, Padma Kaul
International registries have reported a wide variation in coronary care unit (CCU) admission rates for patients hospitalized with acute coronary syndrome (ACS) or heart failure (HF). Little is known about variation in Canadian interprovincial use and outcomes. Canadian Institute of Health Information data were used to identify hospitalized patients admitted to a CCU with a primary diagnosis of ACS or HF between April 1, 2007 and March 31, 2013. We examined interprovincial differences in CCU admission rates, use of CCU restricted therapies in the first 2 days of admission, and the association between CCU admission rate and risk-adjusted in-hospital mortality at the provincial level...
January 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27914504/on-treatment-analysis-of-the-improved-reduction-of-outcomes-vytorin-efficacy-international-trial-improve-it
#17
Michael A Blazing, Robert P Giugliano, James A de Lemos, Christopher P Cannon, Andrew Tonkin, Christie M Ballantyne, Basil S Lewis, Thomas A Musliner, Andrew M Tershakovec, Yuliya Lokhnygina, Jennifer A White, Craig Reist, Amy McCagg, Eugene Braunwald
BACKGROUND: We aimed to determine the efficacy and safety of adding ezetimibe (Ez) to simvastatin (S) in a post-acute coronary syndrome (ACS) population in a prespecified on-treatment analysis. METHODS: We evaluated 17,706 post-ACS patients from the IMPROVE-IT trial who had low-density lipoprotein cholesterol values between 50 and 125 mg/dL and who received Ez 10 mg/d with S 40 mg/d (Ez/S) or placebo with simvastatin 40 mg/d (P/S). The primary composite end point was cardiovascular death, myocardial infarction, unstable angina, coronary revascularization ≥30 days postrandomization, or stroke...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27892884/%C3%AE-blocker-dosage-and-outcomes-after-acute-coronary-syndrome
#18
Jason E Allen, Stacey Knight, Raymond O McCubrey, Tami Bair, Joseph Brent Muhlestein, Jeffrey J Goldberger, Jeffrey L Anderson
BACKGROUND: Although β-blockers increase survival in acute coronary syndrome (ACS) patients, the doses used in trials were higher than doses used in practice, and recent data do not support an advantage of higher doses. We hypothesized that rates of major adverse cardiac events (MACE), all-cause death, myocardial infarction, and stroke are equivalent for patients on low-dose and high-dose β-blocker. METHODS: Patients admitted to Intermountain Healthcare with ACS and diagnosed with ≥70% coronary stenosis between 1994 and 2013 were studied (N = 7,834)...
October 22, 2016: American Heart Journal
https://www.readbyqxmd.com/read/27885830/extended-dual-antiplatelet-therapy-after-acute-coronary-syndrome-in-spain-results-from-the-epicor-study
#19
Alfredo Bardají, Manuel Leal, Vicente Arrarte, Xavier Garcia-Moll, Leopoldo Pérez de Isla, Héctor Bueno
INTRODUCTION: Real-world, country-specific studies of dual antiplatelet therapy (DAPT) duration among survivors of acute coronary syndrome (ACS) are important for improving long-term prognosis. AIMS: To investigate DAPT duration after hospital discharge for ACS in Spain. RESULTS: Data from patients enrolled in the Spanish cohort of the EPICOR (long-tErm follow-up of antithrombotic management Patterns In acute CORonary syndrome patients) study (NCT01171404) were analyzed for changes to antithrombotic medication up to 2 years post-discharge according to index event diagnosis and patient characteristics...
November 25, 2016: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27884453/a-call-for-a-standardized-definition-of-perforated-appendicitis
#20
Andrew P Rogers, Tiffany J Zens, Charles M Leys, Peter F Nichol, Daniel J Ostlie
BACKGROUND: Abscess rates have been reported to be as low as 1% and as high as 50% following perforated appendicitis (PA). This range may be because of lack of universal definition for PA. An evidence-based definition (EBD) is crucial for accurate wound classification, risk-stratification, and subsequent process optimization. ACS NSQIP-Pediatric guidelines do not specify a definition of PA. We hypothesize that reported postoperative abscess rates underrepresent true incidence, as they may include low-risk cases in final calculations...
October 27, 2016: Journal of Pediatric Surgery
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