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https://www.readbyqxmd.com/read/29135622/troponin-limit-of-detection-plus-cardiac-risk-stratification-scores-to-rule-out-acute-myocardial-infarction-and-30-day-major-adverse-cardiac-events-in-ed-patients
#1
Mitchell D Datlow, Kelly M Gray, Adriel Watts, Deborah B Diercks, Bryn E Mumma
When screening for acute myocardial infarction (AMI), troponin levels below the 99th percentile, including those below the limit of detection (LOD), are considered normal. We hypothesized that a low-risk HEART score (0-3) or ACS Pretest Probability Assessment <2% plus a single troponin below the LOD would rule out both AMI and 30-day major adverse cardiac events (MACE). We studied all patients who presented to a single academic emergency department and received a troponin I (Siemens Ultra Troponin I) from September 1, 2013, to November 13, 2013 (n=888)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135620/safety-of-a-1-hour-rule-out-high-sensitive-troponin-t-protocol-in-patients-with-chest-pain-at-the-emergency-department
#2
E Röttger, S de Vries-Spithoven, J B Reitsma, A Limburg, C E E van Ofwegen-Hanekamp, A W Hoes, J M Poldervaart
BACKGROUND: The 1-hour rule-out high-sensitive cardiac troponin T protocol (hs-cTnT), in which a serial troponin measurement is performed 1 hour after the first to assess the possibility of acute coronary syndrome (ACS), has been implemented in the European guidelines in 2015. Our aim was to assess the safety of this protocol in low-risk patients in the Emergency Department (ED) when implemented in daily practice. METHODS: Patients with acute chest pain presenting to the ED of our hospital and younger than 75 years were included (May 2013 to October 2014, The Netherlands)...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29132152/diagnostic-accuracy-of-screening-tests-and-treatment-for-post-acute-coronary-syndrome-depression-a-systematic-review
#3
Jason A Nieuwsma, John W Williams, Natasha Namdari, Jeffrey B Washam, Giselle Raitz, James A Blumenthal, Wei Jiang, Roshini Yapa, Amanda J McBroom, Kathryn Lallinger, Robyn Schmidt, Andrzej S Kosinski, Gillian D Sanders
Background: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. Purpose: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29131477/a-risk-assessment-score-and-initial-high-sensitivity-troponin-combine-to-identify-low-risk-of-acute-myocardial-infarction-in-the-emergency-department
#4
John W Pickering, Dylan Flaws, Stephen W Smith, Jaimi Greenslade, Louise Cullen, William Parsonage, Edward Carlton, A Mark Richards, Richard Troughton, Christopher Pemberton, Peter M George, Martin P Than
OBJECTIVES: Early discharge of patients with presentations triggering assessment for possible acute coronary syndrome is safe when clinical assessment indicates low-risk, biomarkers are negative, and electrocardiograms (ECGs) are non-ischemic. We hypothesized that the Emergency Department Assessment of Chest Pain Score (EDACS) combined with a single measurement of high-sensitivity cardiac troponin (hs-cTn) could allow early discharge of a clinically meaningful proportion of patients. METHODS: We pooled data from 4 patient cohorts from New Zealand and Australia presenting to an ED with symptoms suggestive of ACS...
November 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29126112/risk-scoring-to-guide-anti-platelet-therapy-post-percutaneous-coronary-intervention-pci-for-acute-coronary-syndrome-acs-results-in-improved-clinical-outcomes
#5
S Antoniou, M Colicchia, O Guttmann, K Rathod, P Wright, S Fhadil, C Knight, A K Jain, E J Smith, A Mathur, R Weerackody, A Wragg, D A Jones
Objective: To use the GRACE and CRUSADE scores to risk stratify anti-platelet treatment post Acute Coronary Syndrome (ACS). Methods: This was a prospective registry of 3374 patients undergoing PCI for ACS between 2013-2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified to clopidogrel therapy otherwise ticagrelor was used. The primary end-point was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1...
November 8, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29121808/the-prognostic-value-of-lipoprotein-associated-phospholipase-a2-in-the-long-term-care-of-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#6
Lijiao Yang, Hong Wang, Yida Zhang, Tingting Han, Wenfeng Wang
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an independent risk factor for cardiovascular disease. Accordingly, studies from many countries around the world have shown an association between Lp-PLA2 and cardiovascular events in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI), but this association has not been documented among the Chinese. The aim of this study was to assess the use of Lp-PLA2 as a useful marker for predicting the long-term prognosis of Chinese patients with ACS undergoing PCI...
January 1, 2017: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29121752/identification-of-coronary-artery-calcification-can-optimize-risk-stratification-in-patients-with-acute-chest-pain
#7
Daniel O Bittner, Richard A P Takx, Pedro V Staziaki, Sumbal Janjua, Tomas G Neilan, Nandini M Meyersohn, Michael T Lu, Anand M Prabhakar, John T Nagurney, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: The number of patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) is substantial. We tested whether identification of coronary artery calcium (CAC) can improve the negative predictive value (NPV) of clinical risk assessment for ACS in patients with acute chest pain. METHODS AND RESULTS: We included 826 consecutive patients (mean age: 53±11years; 42% female) without known coronary artery disease (CAD) or initially elevated serum biomarkers, whom underwent non-contrast CT, to assess the CAC score, and CT angiography (CTA), to detect coronary stenosis...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29121725/real-world-study-of-low-density-lipoprotein-cholesterol-levels-and-cardiovascular-outcomes-in-chinese-a-retrospective-cohort-study-in-post-percutaneous-coronary-intervention-acute-coronary-syndrome-patients
#8
Yun Wang, Bryan P Yan, Michael B Nichol, Brian Tomlinson, Vivian W Y Lee
BACKGROUND: This study aimed to assess the effect of low-density lipoprotein cholesterol (LDL-C) goal attainments (of <2.6mmol/L and <1.8mmol/L) on first major adverse cardiovascular events (MACEs) for acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). METHODS: A retrospective cohort study was conducted using case reviews of post-PCI ACS patients at an acute public hospital in Hong Kong between January 2009 and August 2015...
December 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29118879/prevalence-and-risk-factors-for-acute-coronary-syndrome-among-sudanese-individuals-with-diabetes-a-population-based-study
#9
Mohamed H Ahmed, Heitham Awadalla, Wadie M Elmadhoun, Mugtaba Osman, Sufian K Noor, Ahmed O Almobarak
Background: Acute coronary syndrome (ACS) is common with diabetes. The aim of this study was to establish prevalence and risk factors for ACS among Sudanese individuals with diabetes mellitus (DM). Methods: A descriptive cross-sectional study was conducted in Khartoum State and Atabra (North of Sudan). The data collection was performed through pretested questionnaire, in addition to measurement of lipid profile and HbA1c. Results: Among the 496 respondents, 234 (48...
October 2017: Cardiology Research
https://www.readbyqxmd.com/read/29109595/the-role-of-hematological-indices-in-patients-with-acute-coronary-syndrome
#10
REVIEW
Jan Budzianowski, Konrad Pieszko, Paweł Burchardt, Janusz Rzeźniczak, Jarosław Hiczkiewicz
An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management...
2017: Disease Markers
https://www.readbyqxmd.com/read/29082019/antenatal-corticosteroids-for-women-at-risk-of-imminent-preterm-birth-in-low-resource-countries-the-case-for-equipoise-and-the-need-for-efficacy-trials
#11
REVIEW
Joshua P Vogel, Olufemi T Oladapo, Cynthia Pileggi-Castro, Ebunoluwa A Adejuyigbe, Fernando Althabe, Shabina Ariff, Adejumoke Idowu Ayede, Abdullah H Baqui, Anthony Costello, Davy M Chikamata, Caroline Crowther, Bukola Fawole, Luz Gibbons, Alan H Jobe, Monica Lulu Kapasa, John Kinuthia, Alka Kriplani, Oluwafemi Kuti, James Neilson, Janna Patterson, Gilda Piaggio, Rahat Qureshi, Zahida Qureshi, Mari Jeeva Sankar, Jeffrey S A Stringer, Marleen Temmerman, Khalid Yunis, Rajiv Bahl, A Metin Gülmezoglu
The scientific basis for antenatal corticosteroids (ACS) for women at risk of preterm birth has rapidly changed in recent years. Two landmark trials-the Antenatal Corticosteroid Trial and the Antenatal Late Preterm Steroids Trial-have challenged the long-held assumptions on the comparative health benefits and harms regarding the use of ACS for preterm birth across all levels of care and contexts, including resource-limited settings. Researchers, clinicians, programme managers, policymakers and donors working in low-income and middle-income countries now face challenging questions of whether, where and how ACS can be used to optimise outcomes for both women and preterm newborns...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29079376/validation-of-the-troponin-only-manchester-acute-coronary-syndromes-decision-aid-with-a-contemporary-cardiac-troponin-i-assay
#12
Patricia Va Den Berg, Gillian Burrows, Philip Lewis, Simon Carley, Richard Body
OBJECTIVES: The Manchester Acute Coronary Syndromes (MACS) decision aid can 'rules in' and 'rule out' acute coronary syndromes (ACS) by combining a patient's symptoms with the results of a single blood test taken at the time of arrival in the Emergency Department (ED). The original model (MACS) included two biomarkers: high sensitivity cardiac troponin T (hs-cTnT) and heart-type fatty acid binding protein (h-FABP). A refined model without h-FABP was found to have comparable sensitivity but greater specificity...
September 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29075133/do-cyp2c19-and-abcb1-gene-polymorphisms-and-low-cyp3a4-isoenzyme-activity-have-an-impact-on-stent-implantation-complications-in-acute-coronary-syndrome-patients
#13
Eric Rytkin, Karin B Mirzaev, Elena A Grishina, Valeriy V Smirnov, Kristina A Ryzhikova, Zhannet A Sozaeva, Michael Iu Giliarov, Denis A Andreev, Dmitriy A Sychev
AIM: The aim of this study was to determine the impact of CYP2C19 and ABCB1 gene polymorphisms and CYP3A4 isoenzyme activity on stent implantation complications among patients with an acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). PATIENTS AND METHODS: Seventy-six patients (median age 63, range 37-91 years) with an ACS who underwent PCI were screened for CYP2C19 and ABCB1 gene polymorphisms with real-time polymerase chain reaction: CYP2C19*2, CYP2C19*17, and ABCB1 3435...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/29059255/prevalence-and-predictors-of-dual-antiplatelet-therapy-prolongation-beyond-one-year-in-patients-with-acute-coronary-syndrome
#14
Giuseppe Patti, Ilaria Cavallari, Emilia Antonucci, Paolo Calabrò, Plinio Cirillo, Paolo Gresele, Gualtiero Palareti, Vittorio Pengo, Pasquale Pignatelli, Elisabetta Ricottini, Rossella Marcucci
There are limited real-world data on prevalence and predictors of dual antiplatelet therapy (DAPT) prolongation beyond one year after acute coronary syndrome (ACS). We have explored such issue in the START ANTIPLATELET Registry, which is a prospective, observational, multicenter, Italian registry performed in seven Italian cardiology institutions including patients admitted for ACS and followed up to one year. Out of a total population of 840 ACS patients, 596 patients had completed 12-month follow-up being on DAPT...
2017: PloS One
https://www.readbyqxmd.com/read/29058074/acute-coronary-syndrome-in-immigrants-and-non-immigrants-results-of-an-austrian-prospective-pilot-study
#15
Duygu Gündüz, Anita Lesjak, Angela Wiedemann, Marion Avanzini, Walther-Benedikt Winkler, Hadice Ucar-Altenberger, Claudia Stöllberger, Franz Weidinger
BACKGROUND: There are indications that immigrant patients with acute coronary syndrome (ACS) differ in demographic characteristics and clinical presentation from non-immigrant patients. The aim of this prospective pilot study was to gather clinical and sociodemographic data from patients with ACS and to compare immigrants with non-immigrants. METHODS: Included were consecutive patients who underwent acute coronary angiography in one cardiological department for ACS from September 2011 to September 2013...
October 20, 2017: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29056118/validity-of-grace-risk-score-as-a-prognostic-marker-of-in-hospital-mortality-after-acute-coronary-syndrome
#16
Samar Firdous, Muhammad Amir Mehmood, Uzma Malik
OBJECTIVE: To determine validity of GRACE risk score as a determinant of immediate death during hospitalization for Acute Coronary Syndrome (ACS) and analyze the percentage of cardiac deaths among high, intermediate and low risk groups. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Coronary Care Unit of Mayo Hospital, Lahore, from April to July 2015. METHODOLOGY: Patients with acute chest pain were selected according to inclusion and exclusion criteria...
October 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/29051926/examining-multi-level-correlates-of-suicide-by-merging-nvdrs-and-acs-data
#17
David A Boulifard, Bernice A Pescosolido
This paper describes a novel database and an associated suicide event prediction model that surmount longstanding barriers in suicide risk factor research. The database comingles person-level records from the National Violent Death Reporting System (NVDRS) and the American Community Survey (ACS) to establish a case-control study sample that includes all identified suicide cases, while faithfully reflecting general population sociodemographics, in sixteen USA states during the years 2005-2011. It supports a statistical model of individual suicide risk that accommodates person-level factors and the moderation of these factors by their community rates...
2017: US Census Bur Cent Econ Stud Res Pap Ser
https://www.readbyqxmd.com/read/29044298/the-performance-of-crusade-and-acuity-bleeding-risk-scores-in-ticagrelor-treated-acs-patients-who-underwent-pci
#18
Shaozhi Xi, Shanshan Zhou, Xuyun Wang, Jia Liu, Liuan Qin, Jun Liu, Tong Yin, Yundai Chen
The performance of the CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines) and ACUITY (Acute Catheterization and Urgent Intervention Triage strategy) risk scores for the prediction of major bleeding in ticagrelor-treated acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI) is unknown. The aim of the present study is to validate the performance of both scores in a contemporary Chinese cohort of ACS patients hospitalized for PCI and administrated with ticagrelor...
October 10, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29043405/-focused-update-on-dual-antiplatelet-treatment-esc-guidelines-2017
#19
A Schäfer, J Bauersachs
Dual antiplatelet treatment (DAPT) is a cornerstone of maintenance medication of patients following elective percutaneous coronary interventions or an acute coronary syndrome (ACS), e. g. ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina. In recent years the inclusion of P2Y12 inhibition in addition to low-dose acetylsalicylic acid has been intensively debated. Following the introduction of the modern generation of drug-eluting stents for elective coronary interventions, the duration of the necessary DAPT has been clearly reduced...
October 17, 2017: Herz
https://www.readbyqxmd.com/read/29038044/readmission-rates-following-same-day-discharge-compared-to-postoperative-day-one-discharge-after-benign-laparoscopic-hysterectomy
#20
David Sheyn, Sherif El-Nashar, Megan Billow, Sangeeta Mahajan, Mary Duarte, Robert Pollard
STUDY OBJECTIVE: To determine if there is a difference in readmission rates after same day discharge compared to postoperative day one (POD#1) discharges following laparoscopic hysterectomy. DESIGN: Retrospective cohort study with 1:2 propensity score matching (Canadian Task Force Classification II-2). SETTING: American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. PATIENTS: Women undergoing benign laparoscopic total or supra-cervical hysterectomy or laparoscopic assisted vaginal hysterectomy with or without adnexal surgery, between the years 2010 to 2015...
October 13, 2017: Journal of Minimally Invasive Gynecology
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