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https://www.readbyqxmd.com/read/28528430/risk-classification-of-highly-sensitive-troponin-i-predict-presence-of-vulnerable-plaque-assessed-by-dual-source-coronary-computed-tomography-angiography
#1
Ting Liu, Guan Wang, Peiling Li, Xu Dai
Patients presenting to the emergency department with acute chest pain, negative conventional troponin and electrocardiogram require serial testing to rule out acute coronary syndrome (ACS). We studied the association of highly sensitive troponin (hsTn) I with vulnerable plaque features as detected by coronary dual source computed tomography angiography (DSCTA) and determined whether hsTn I at the time of presentation combined with early DSCTA could improve classification of patients as high-risk or low risk for ACS...
May 20, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28516316/venous-thromboembolism-after-nephrectomy-incidence-timing-and-associated-risk-factors-from-a-national-multi-institutional-database
#2
Brian J Jordan, Richard S Matulewicz, Brian Trihn, Shilajit Kundu
PURPOSE: To evaluate the rate of venous thromboembolism (VTE) after nephrectomy with specific focus on event timing and location (before or after hospital discharge) in order to identify modifiable risk factors and establish benchmarks for preventive interventions. METHODS: Using the ACS-NSQIP database, we identified patients undergoing nephrectomy from 2006 to 2012. Patients were analyzed in two cohorts: collectively and by surgical approach [open vs. lap/robotic (MIS)]...
May 17, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28511683/acute-coronary-syndrome-patients-admitted-to-a-cardiology-vs-non-cardiology-service-variations-in-treatment-outcome
#3
Deirdre E O'Neill, Danielle A Southern, Colleen M Norris, Blair J O'Neill, Helen J Curran, Michelle M Graham
BACKGROUND: Specialized cardiology services have contributed to reduced mortality in acute coronary syndromes (ACS).  We sought to evaluate the outcomes of ACS patients admitted to non-cardiology services in Southern Alberta. METHODS: Retrospective chart review performed on all troponin-positive patients in the Calgary Health Region identified those diagnosed with ACS by their attending team. Patients admitted to non-cardiology and cardiology services were compared, using linked data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry and the Strategic Clinical Network for Cardiovascular Health and Stroke...
May 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28509568/low-body-weight-and-clinical-outcomes-in-acute-coronary-syndrome-patients-results-of-the-achilles-registry
#4
José Miguel Rivera-Caravaca, Juan M Ruiz-Nodar, Antonio Tello-Montoliu, María Asunción Esteve-Pastor, Andrea Veliz-Martínez, Esteban Orenes-Piñero, Mariano Valdés, Vicente Pernias-Escrig, Miriam Sandin-Rollán, Nuria Vicente-Ibarra, Manuel J Macías-Villanego, Elena Candela-Sánchez, Teresa Lozano, Luna Carrillo-Alemán, Francisco Marín
BACKGROUND: Being overweight increases the risk of cardiovascular diseases and mortality. However, among high-body-weight patients with established acute coronary syndrome (ACS) this evidence is not clear. In this scenario, a low body weight (LBW) has been proposed to confer higher prognostic risk and higher bleeding risk with new P2Y12 inhibitors. AIMS: We aimed to examine differences in mortality, catheterizations/revascularizations, antiplatelet therapy and ischemic/bleeding adverse events between ACS patients with LBW...
May 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28506470/coronary-ct-angiography-in-the-emergency-department-utilizing-second-and-third-generation-dual-source-ct
#5
Nandini M Meyersohn, Balint Szilveszter, Pedro V Staziaki, Jan-Erik Scholtz, Richard A P Takx, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: Coronary computed tomography angiography (coronary CTA) allows efficient triage of low to intermediate risk patients with suspected acute coronary syndrome (ACS) in the emergency department (ED). Techniques for coronary CTA acquisition in the ED continue to evolve with the establishment of standardized scan protocols and the introduction of newer generations of CT hardware. OBJECTIVES: To evaluate qualitative and quantitative image quality and radiation dose exposure of coronary CTA acquired on 2nd versus 3rd generation dual source CT (DSCT) scanners using a standardized institutional scan protocol designed for the ED...
March 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28479165/validation-of-the-cha2ds2-vasc-score-in-predicting-coronary-atherosclerotic-burden-and-in-hospital-mortality-in-patients-with-acute-coronary-syndrome
#6
Alparslan Kurtul, Sadik Kadri Acikgoz
Although the CHA2DS2-VASc score has been initially recommended for the assessment of the risk of thromboembolic event in patients with atrial fibrillation, in recent years, it is used to predict adverse outcomes in various cardiovascular diseases. However, little is known about its predictive value for coronary atherosclerotic burden in patients with acute coronary syndrome (ACS). The aim of the present study is to investigate whether the CHA2DS2-VASc score could predict higher coronary atherosclerotic burden assessed by SYNTAX score (SS) in ACS...
April 12, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28471148/clinical-imaging-in-patients-experiencing-chest-pain
#7
Angelo Silverio, Rodolfo Citro
Non-invasive imaging modalities integrate the clinical and laboratory diagnostic work-up of patients admitted in emergency department for chest pain. Transthoracic echocardiography is the first-line imaging tool because it is rapidly and widely available, bedside feasible and cost-effective. Even when a comprensive exam is not feasible, a fast focused ultrasound exam should be performed. Contrast enhanced computed tomography is an easily accessible tool with specific application in patients suspected for pulmonary embolism (PE) and acute coronary syndrome (ACS) according to the pre-test risk assessment and to the clinical status...
May 3, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28470562/outcomes-are-local-patient-disease-and-procedure-specific-risk-factors-for-colorectal-surgical-site-infections-from-a-single-institution
#8
Robert R Cima, John R Bergquist, Kristine T Hanson, Cornelius A Thiels, Elizabeth B Habermann
BACKGROUND: Colorectal surgical site infections (SSIs) contribute to postoperative morbidity, mortality, and resource utilization. Risk factors associated with colorectal SSI are well-documented. However, quality improvement efforts are informed by national data, which may not identify institution-specific risk factors. METHOD: Retrospective cohort study of colorectal surgery patients uses institutional ACS-NSQIP data from 2006 through 2014. ACS-NSQIP data were enhanced with additional variables from medical records...
May 3, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28466882/asia-pacific-consensus-statement-on-the-optimal-use-of-high-sensitivity-troponin-assays-in-acute-coronary-syndromes-diagnosis-focus-on-hs-tni
#9
COMMENT
Jack Wei Chieh Tan, Carolyn S P Lam, Sazzli Shahlan Kasim, Tar Choon Aw, Joel M Abanilla, Wei-Ting Chang, Van Phuoc Dang, Maria Iboleon-Dy, Sari Sri Mumpuni, Arintaya Phommintikul, Manh Cuong Ta, Punkiat Topipat, Kai Hang Yiu, Louise Cullen
OBJECTIVE: High-sensitivity troponin (hs-Tn) assays need to be applied appropriately to improve diagnosis and patient outcomes in acute coronary syndromes (ACS). METHODS: Experts from Asia Pacific convened in 2015 to provide data-driven consensus-based, region-specific recommendations and develop an algorithm for the appropriate incorporation of this assay into the ACS assessment and treatment pathway. RESULTS: Nine recommendations were developed by the expert panel: (1) troponin is the preferred cardiac biomarker for diagnostic assessment of ACS and is indicated for patients with symptoms of possible ACS; (2) hs-Tn assays are recommended; (3) serial testing is required for all patients; (4) testing should be performed at presentation and 3 hours later; (5) gender-specific cut-off values should be used for hs-Tn I assays; (6) hs-Tn I level >10 times the upper limit of normal should be considered to 'rule in' a diagnosis of ACS; (7) dynamic change >50% in hs-Tn I level from presentation to 3-hour retest identifies patients at high risk for ACS; (8) where only point-of-care testing is available, patients with elevated readings should be considered at high risk, while patients with low/undetectable readings should be retested after 6 hours or sent for laboratory testing and (9) regular education on the appropriate use of troponin tests is essential...
2017: Heart Asia
https://www.readbyqxmd.com/read/28457177/high-sensitivity-cardiac-troponin-assays-from-improved-analytical-performance-to-enhanced-risk-stratification
#10
Marek Kozinski, Magdalena Krintus, Jacek Kubica, Grazyna Sypniewska
Implementation of cardiac troponin (cTn) assays has revolutionized the diagnosis, risk stratification, triage and management of patients with suspected myocardial infarction (MI). The Universal Definition of MI brought about a shift in the diagnostics of MI, from an approach primarily based on electrocardiography (ECG) to one primarily based on biomarkers. Currently, detection of a rise and/or fall in concentration or activity of myocardial necrosis biomarkers, preferentially cTns, with at least one value above the 99th percentile upper reference limit (URL), is the essential component for the diagnosis of MI...
May 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#11
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28432661/lipid-biomarkers-for-risk-assessment-in-acute-coronary-syndromes
#12
REVIEW
Jeffrey W Meeusen, Leslie J Donato, Allan S Jaffe
PURPOSE OF REVIEW: The objective of this review was to summarize evidence gathered for the prognostic value of routine and novel blood lipids and lipoproteins measured in patients with acute coronary syndromes (ACS). RECENT FINDINGS: Data supports clear association with risk and actionable value for non-high-density lipoprotein (Non-HDL) cholesterol and plasma ceramides in a setting of ACS. The prognostic value and clinical actionability of apolipoprotein B (apoB) and lipoprotein(a) [Lp(a)] in ACS have not been thoroughly tested, while the data for omega-3 fatty acids and oxidized low-density lipoprotein (Ox-LDL) are either untested or more varied...
June 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28430910/low-density-lipoprotein-cholesterol-targeting-with-pitavastatin-ezetimibe-for-patients-with-acute-coronary-syndrome-and-dyslipidaemia-the-hij-proper-study-a-prospective-open-label-randomized-trial
#13
Nobuhisa Hagiwara, Erisa Kawada-Watanabe, Ryo Koyanagi, Hiroyuki Arashi, Junichi Yamaguchi, Koichi Nakao, Tetsuya Tobaru, Hiroyuki Tanaka, Toshiaki Oka, Yasuhiro Endoh, Katsumi Saito, Tatsuro Uchida, Kunihiko Matsui, Hiroshi Ogawa
Aims: To elucidate the effects of intensive LDL-C lowering treatment with a standard dose of statin and ezetimibe in patients with dyslipidaemia and high risk of coronary events, targeting LDL-C less than 70 mg/dL (1.8 mmol/L), compared with standard LDL-C lowering lipid monotherapy targeting less than 100 mg/dL (2.6 mmol/L). Methods and Results: The HIJ-PROPER study is a prospective, randomized, open-label trial to assess whether intensive LDL-C lowering with standard-dose pitavastatin plus ezetimibe reduces cardiovascular events more than standard LDL-C lowering with pitavastatin monotherapy in patients with acute coronary syndrome (ACS) and dyslipidaemia...
April 18, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28430052/predicting-complication-risk-in-spine-surgery-a-prospective-analysis-of-a-novel-risk-assessment-tool
#14
Anand Veeravagu, Amy Li, Christian Swinney, Lu Tian, Adrienne Moraff, Tej D Azad, Ivan Cheng, Todd Alamin, Serena S Hu, Robert L Anderson, Lawrence Shuer, Atman Desai, Jon Park, Richard A Olshen, John K Ratliff
OBJECTIVE The ability to assess the risk of adverse events based on known patient factors and comorbidities would provide more effective preoperative risk stratification. Present risk assessment in spine surgery is limited. An adverse event prediction tool was developed to predict the risk of complications after spine surgery and tested on a prospective patient cohort. METHODS The spinal Risk Assessment Tool (RAT), a novel instrument for the assessment of risk for patients undergoing spine surgery that was developed based on an administrative claims database, was prospectively applied to 246 patients undergoing 257 spinal procedures over a 3-month period...
April 21, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28429111/impact-of-serum-albumin-levels-on-long-term-outcomes-in-patients-undergoing-percutaneous-coronary-intervention
#15
Hideki Wada, Tomotaka Dohi, Katsumi Miyauchi, Jun Shitara, Hirohisa Endo, Shinichiro Doi, Ryo Naito, Hirokazu Konishi, Shuta Tsuboi, Manabu Ogita, Takatoshi Kasai, Shinya Okazaki, Kikuo Isoda, Satoru Suwa, Hiroyuki Daida
Epidemiological studies have demonstrated an association between low serum albumin levels and both coronary artery disease (CAD) and mortality. However, the long-term clinical impact of low serum albumin level in patients with CAD undergoing percutaneous coronary intervention (PCI) has not yet been fully investigated. We studied 2860 all-comer patients with CAD who underwent their first PCI and had data available for pre-procedural serum albumin between 2000 and 2011. Patients were assigned to tertiles based on pre-procedural albumin levels...
April 20, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28408093/myocardial-infarction-without-obstructive-coronary-artery-disease-is-not-a-benign-condition-anzacs-qi-10
#16
Peter R Barr, Wil Harrison, David Smyth, Charmaine Flynn, Mildred Lee, Andrew J Kerr
BACKGROUND: Non-obstructive coronary artery disease (CAD) on coronary angiography after myocardial infarction (MI) is associated with a lower risk of adverse outcomes, but the prognosis may not be benign. Our aim was to assess outcomes in MI with and without obstructive CAD, and in an age and sex matched comparison cohort without known cardiovascular disease. METHODS: We performed a single centre analysis of consecutive patients undergoing coronary angiography for MI between 2007 and 2012...
March 30, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28400189/predicting-complications-following-robot-assisted-partial-nephrectomy-with-the-acs-nsqip-universal-surgical-risk-calculator
#17
Jared S Winoker, David J Paulucci, Harry Anastos, Nikhil Waingankar, Ronney Abaza, Daniel D Eun, Akshay Bhandari, Ashok K Hemal, John P Sfakianos, Ketan K Badani
PURPOSE: We evaluated the predictive value of the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) surgical risk calculator in a tertiary referral cohort of patients undergoing robot-assisted partial nephrectomy (RAPN). MATERIALS AND METHODS: We queried our prospectively maintained multi-institutional database of RAPN patients and input the preoperative details of 300 randomly selected patients into the calculator. Accuracy of the calculator was assessed by receiver-operator area under the curve (AUC) and also by Brier score (BS)...
April 8, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28394006/prognostic-value-of-platelet-to-lymphocyte-ratio-in-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#18
Hui Li, Yun Zhou, Yan Ma, Su Xia Han, Lian Suo Zhou
BACKGROUND: The aim of this study was to investigate whether the platelet-to-lymphocyte ratio (PLR) is an independent predictor of all-cause mortality and cardiovascular events in patients with acute coronary syndrome (ACS). METHODS: PubMed, Embase, and the Cochrane Library were searched for relevant cohort studies regarding the association between PLR and outcomes of patients with ACS. Either a random- or a fixed-effect model was used for pooling data. RESULTS: Eight studies involving 6627 patients with ACS were included...
April 10, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28391913/clinical-and-economic-consequences-of-statin-intolerance-in-the-united-states-results-from-an-integrated-health-system
#19
Jove H Graham, Robert J Sanchez, Joseph J Saseen, Usha G Mallya, Mary P Panaccio, Michael A Evans
BACKGROUND: Although statins are considered safe and effective, they have been associated with statin intolerance (SI) in clinical and observational studies. OBJECTIVE: The objective of this study was to describe the clinical and economic consequences of SI through comparison of an SI cohort of patients with matched controls. METHODS: This study used data extracted from an integrated health system's electronic health records from 2008 to 2014...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28389125/use-of-cardiovascular-prevention-treatments-after-acute-coronary-syndrome-in-china-and-associated-factors
#20
Emily R Atkins, Xin Du, Yangfeng Wu, Runlin Gao, Anushka Patel, Clara K Chow
BACKGROUND: Prevention of repeat cardiovascular events is an important means of addressing the increasing burden of coronary heart disease in China, however there is minimal information about the use of cardiovascular prevention treatment following acute coronary syndrome (ACS) in China. METHODS: We analysed data from baseline and 6, 12, 18, and 24-month follow-up surveys of 15,140 consecutive ACS patients recruited in 70 hospitals from 17 provinces of China. We describe the use of indicated cardiovascular prevention medicines, risk factor control, change over time and factors associated with continued prevention...
March 27, 2017: International Journal of Cardiology
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