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https://www.readbyqxmd.com/read/29906667/the-high-cost-of-critical-care-unit-over-utilization-for-patients-with-nste-acs
#1
Sean van Diepen, Dat T Tran, Justin A Ezekowitz, David A Zygun, Jason N Katz, Renato D Lopes, L Kristin Newby, Finlay A McAlister, Padma Kaul
BACKGROUND: There is substantial variability among hospitals in critical care unit (CCU) utilization for patients admitted with non-ST-Segment Elevation Acute Coronary Syndromes (NSTE ACS). We estimated the potential cost saving if all hospitals adopted low CCU utilization practices for patients with NSTE ACS. METHODS: National hospital claims data were used to identify all patients with a primary diagnosis of NSTE ACS initially admitted to an acute care hospital between 2007 and 2013...
May 19, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29895599/activated-clotting-time-to-guide-heparin-dosing-in-non-st-segment-elevation-acute-coronary-syndrome-patients-undergoing-percutaneous-coronary-intervention-and-treated-with-iib-iiia-inhibitors-impact-on-ischemic-and-bleeding-outcomes-insights-from-the-tao-trial
#2
Jean-Guillaume Dillinger, Gregory Ducrocq, Yedid Elbez, Marc Cohen, Christoph Bode, Charles Pollack, José C Nicolau, Patrick Henry, Sasko Kedev, Stephen D Wiviott, Marc S Sabatine, Shamir R Mehta, Philippe Gabriel Steg
BACKGROUND: Monitoring anticoagulation with activated clotting time (ACT) has been proposed to reduce ischemic or bleeding events. However, the value of using ACT to improve outcomes is uncertain. This study sought to determine the relationship between ACT and outcomes during percutaneous coronary intervention in patients with non-ST-segment-elevation acute coronary syndrome (NSTE-ACS) treated by unfractionated heparin with GPIs (glycoprotein IIb/IIIa inhibitors). METHODS AND RESULTS: From the randomized TAO trial (Treatment of Acute Coronary Syndromes With Otamixaban), we analyzed the value of ACT to predict ischemic and bleeding outcomes in the 3275 patients receiving unfractionated heparin plus eptifibatide...
June 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29878290/acute-coronary-syndrome-without-persistent-st-segment-elevation-in-the-emergency-department-epidemiology-clinical-features-and-prognosis
#3
Hanen Ghazali, Mouna Gammoudi, Anware Yahmadi, Aymen Zoubli, Ahlem Azouzi, Sami Souissi
BACKGROUND: Acute coronary syndrome without persistent ST segment elevation (NSTE-ACS) is a major public health problem. It has been the subject of numerous studies but little has been published from the emergency department (ED). OBJECTIVE: Describe the epidemiology, clinical features, management and prognosis of patients with NSTE-ACS presenting to ED. METHODS: Prospective, observational, over four years study (2011-2015). INCLUSION CRITERIA: patients (> 18 years of age) presenting consecutively to ED with the diagnosis of NSTE-ACS...
December 2017: La Tunisie Médicale
https://www.readbyqxmd.com/read/29848920/admission-glycemic-variability-correlates-with-in-hospital-outcomes-in-diabetic-patients-with-non-st-segment-elevation-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#4
Gong Su, Tao Zhang, Hongxia Yang, Wenlong Dai, Lei Tian, Hong Tao, Tao Wang, Shuhua Mi
OBJECTIVE: The aim of this study is to evaluate the effects of admission glycemic variability (AGV) on in-hospital outcomes in diabetic patients with non-ST segment elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary intervention (PCI). METHODS: We studied 759 diabetic patients with NSTE-ACS undergoing PCI. AGV was accessed based on the mean amplitude of glycemic excursions (MAGEs) in the first 24 hours after admission. Primary outcome was a composite of in-hospital events, all-cause mortality, new-onset myocardial infarction, acute heart failure, and stroke...
June 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29846808/-acute-coronary-syndrome-in-older-people
#5
D Eckner, S Popp, S Wicklein, M Pauschinger
The acute coronary syndrome (ACS) is subdivided into ST segment elevation myocardial infarction (STEMI), non-ST segment elevation acute coronary syndrome (NSTE-ACS) and unstable angina pectoris. It poses a particular challenge in terms of diagnostics and treatment, especially in the elderly. Starting with the possibly difficult anamnesis, through the laboratory chemical findings up to special features in the electrocardiogram (ECG), echocardiography and angiography, these patients should be considered in some ways different to the younger population...
June 2018: Zeitschrift Für Gerontologie und Geriatrie
https://www.readbyqxmd.com/read/29799975/amyloid-%C3%AE-1-40-and-mortality-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-a-cohort-study
#6
Kimon Stamatelopoulos, Matthias Mueller-Hennessen, Georgios Georgiopoulos, Marco Sachse, Jasper Boeddinghaus, Kateryna Sopova, Aikaterini Gatsiou, Carolin Amrhein, Moritz Biener, Mehrshad Vafaie, Fani Athanasouli, Dimitrios Stakos, Konstantinos Pateras, Raphael Twerenbold, Patrick Badertscher, Thomas Nestelberger, Stefanie Dimmeler, Hugo A Katus, Andreas M Zeiher, Christian Mueller, Evangelos Giannitsis, Konstantinos Stellos
Background: Amyloid-β (1-40) (Aβ40) is implicated in mechanisms related to plaque destabilization and correlates with adverse outcomes in stable coronary artery disease. Objective: To determine the prognostic and reclassification value of baseline circulating levels of Aβ40 after adjustment for the Global Registry of Acute Coronary Events (GRACE) score, which is widely recommended for risk stratification in non-ST-segment elevation acute coronary syndrome (NSTE-ACS)...
June 19, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29761721/association-between-serum-s100a1-level-and-global-registry-of-acute-coronary-events-score-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#7
Yuanmin Li, Chenjun Han, Peng Zhang, Wangfu Zang, Rong Guo
Objective Acute coronary syndrome (ACS) is associated with several clinical syndromes, one of which is acute non-ST-segment ACS (NSTE-ACS). S100A1 is a calcium-dependent regulator of heart contraction and relaxation. We investigated the association between the serum S100A1 level and the Global Registry of Acute Coronary Events (GRACE) risk score in patients with NSTE-ACS and the potential of using the serum S100A1 level to predict the 30-day prognosis of NSTE-ACS. Methods The clinical characteristics of 162 patients with NSTE-ACS were analyzed to determine the GRACE score...
January 1, 2018: Journal of International Medical Research
https://www.readbyqxmd.com/read/29753418/-percutaneous-coronary-intervention-in-the-management-of-acute-coronary-syndromes-in-ivory-coast-challenges-and-outcomes
#8
R N'Guetta, A Ekou, H Yao, J B Anzouan-Kacou, B Gérardin, R Pillière, A M Adoh, R Seka
AIM: Assess the challenges and outcomes of percutaneous coronary intervention (PCI) in the management of ACS at Abidjan Heart Institute. PATIENTS AND METHODS: Prospective survey carried out from April, 1st, 2010 to April, 29th, 2016. Whole patients aged 18-year-old, admitted at Abidjan Heart Institute for ACS, and who underwent PCI were included in the Registre prospectif des actes de cardiologie interventionnelle de l'institut de cardiologie d'Abidjan (REPACI)...
May 9, 2018: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29747324/-prognostic-value-of-myeloperoxidase-concentration-in-patients-with-acute-coronary-syndrome
#9
S C Liu, T C Yi, H Y Weng, L Zhang, Y X Li, Momin Mohetaboer, Y Zhang, J Jiang, J P Li, Y Huo
Objective: To evaluate the difference of plasma myeloperoxidase (MPO) level in different types of acute coronary syndrome (ACS) patients, and the value of baseline MPO level in predicting short-term and long-term outcomes in patients with ACS. Methods: The study cohort was derived from "the 12th Five-Year" National Science and Technology Support Program Project "Study on Comprehensive Intervention and Prognosis of Acute Coronary Syndrome" . We enrolled all hospitalized ACS patients who were enrolled in "the 12th Five-Year" cohort from January 1, 2011 to December 31, 2013...
April 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29743902/early-and-long-term-outcomes-of-complete-revascularization-with-percutaneous-coronary-intervention-in-patients-with-multivessel-coronary-artery-disease-presenting-with-non-st-segment-elevation-acute-coronary-syndromes
#10
Michał Hawranek, Piotr Desperak, Paweł Gąsior, Aneta Desperak, Andrzej Lekston, Mariusz Gąsior
Introduction: The clinical significance of complete revascularization with percutaneous coronary intervention (CR-PCI) in patients with non-ST-segment acute coronary syndrome (NSTE-ACS) remains uncertain. Aim: To evaluate the impact of CR-PCI during index hospitalization on short and long-term incidence of death and composite endpoint among patients with multivessel coronary artery disease (CAD) presenting with NSTE-ACS. Material and methods: We analyzed consecutive data of 1,592 patients with multivessel CAD from 2006 to 2014...
2018: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/29741487/regular-drug-eluting-stents-versus-dedicated-bifurcation-drug-eluting-bioss%C3%A2-stents-for-coronary-bifurcation-treatment-four-year-results-of-randomized-polbos-i-and-polbos-ii-clinical-trials
#11
Robert J Gil, Jacek Bil, Adam Kern, Luis A Ingio Garcia, Radoslaw Formuszewicz, Slawomir Dobrzycki, Dobrin Vassilev, Agnieszka Segiet
AIMS: The aim of this study was to analyze 4-year follow-up data of two clinical trials POLBOS I & II to compare regular DES (rDES) and dedicated bifurcation stents BiOSS®. METHODS AND RESULTS: In POLBOS trials BiOSS® stents were compared with rDES in patients with stable CAD or NSTE-ACS (POLBOS I: paclitaxel eluting BiOSS® Expert vs rDES; POLBOS II: sirolimus eluting BiOSS® LIM vs rDES). 445 patients with 222 patients in BiOSS group and 223 patients in rDES group were analyzed...
May 8, 2018: EuroIntervention
https://www.readbyqxmd.com/read/29713990/optimal-treatment-of-patients-with-nste-acs-in-the-dutch-health-care-system
#12
REVIEW
J P van Kuijk, J M Ten Berg
In the current daily practice of acute coronary syndromes, patients experiencing non-ST-elevation acute coronary syndrome (NSTE-ACS) represent the majority of this population. In these patients it is of utmost importance to estimate both ischaemic and bleeding risk, with subsequent, and preferably tailored pharmacological and, if indicated, invasive treatment. In this paper we describe the several risk scores and evaluate which are most applicable to the Dutch health-care system. Furthermore, we provide an overview of the recommended pharmacological treatment in keeping with the European Society of Cardiology guidelines...
June 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29663124/regional-variations-in-hospital-management-and-post-discharge-mortality-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#13
Héctor Bueno, Xavier Rossello, Stuart Pocock, Frans Van de Werf, Chee Tang Chin, Nicolas Danchin, Stephen W-L Lee, Jesús Medina, Ana Vega, Yong Huo
BACKGROUND: Therapeutic variability not explained by patient clinical characteristics is a potential source of avoidable morbidity and mortality. We aimed to explore regional variability in the management and mortality of patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). METHODS AND RESULTS: 11,931 NSTE-ACS hospital survivors enrolled in two prospective registries: EPICOR [5625 patients, 555 hospitals, 20 countries in Europe (E) and Latin America (LA), September 2010-March 2011] and EPICOR Asia (6306 patients, 218 hospitals, 8 countries, June 2011-May 2012) were compared among eight pre-defined regions: Northern E (NE), Southern E (SE), Eastern E (EE); Latin America (LA); China (CN), India (IN), South-East Asia (SA), and South Korea, Hong Kong and Singapore (KS)...
April 16, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29622974/pre-hospital-and-hospital-delay-in-patients-with-non-st-elevation-acute-coronary-syndromes-in-tertiary-care
#14
G S Youssef, H H Kassem, O A Ameen, H S Al Taaban, H H Rizk
Background: Early presentation is desirable in all cases of acute prolonged chest pain. Causes of delayed presentation vary widely across geographic regions because of different patients' profile and different healthcare capabilities. Objectives: To detect causes of delay of Non-ST elevation acute coronary syndrome (NSTE-ACS) patients in our country. Methods: Patients admitted with NSTE-ACS were included. We recorded the time delay between the onsets of acute severe symptoms till their arrival to the hospital (Pre-hospital delay)...
September 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29606324/comparison-of-outcomes-and-intervention-among-patients-with-non-st-segment-elevation-acute-myocardial-infarction-of-those-with-a-left-circumflex-versus-those-with-a-non-left-circumflex-related-coronary-artery-from-the-elisa-3-trial
#15
Erik A Badings, Renicus S Hermanides, Salem H K The, Jan-Henk E Dambrink, Saman Rasoul, Jan Van Wijngaarden, Esther Van 't Riet, Evelien Kolkman, Wouter S Remkes, Geert Tjeerdsma, Marloes L J Van Der Wielen, Dirk J A Lok, Harry Suryapranata, Arnoud W J Van 't Hof
Previous studies found that patients with an acute coronary syndrome (ACS) due to occlusion of the left circumflex (LC) coronary artery often present without ST-elevation, leading to a delay in diagnosis and revascularization, a larger infarct size, and a worse prognosis. In this subgroup analysis of the ELISA-3 study (early or late intervention in high-risk non-ST-segment elevation acute coronary syndromes [NSTE-ACS]) incidence, characteristics and prognosis of LC-related NSTE-ACS was investigated, and the outcome of early versus late invasive strategy was compared...
May 15, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29579602/high-on-treatment-platelet-reactivity-and-outcome-in-elderly-with-non-st-segment-elevation-acute-coronary-syndrome-insight-from-the-gepress-study
#16
Roberta De Rosa, Tullio Palmerini, Stefano De Servi, Marta Belmonte, Gabriele Crimi, Stefano Cornara, Paolo Calabrò, Marco Cattaneo, Diego Maffeo, Anna Toso, Antonio Bartorelli, Cataldo Palmieri, Marco De Carlo, Davide Capodanno, Philippe Genereux, Dominick Angiolillo, Federico Piscione, Gennaro Galasso
BACKGROUND: Elderly treated with dual antiplatelet therapy after percutaneous coronary intervention (PCI) represent a challenging population because of increased risk of both ischemic and bleeding events. We aimed to investigate the association between high on-treatment platelet reactivity (HPR) and long-term outcome in elderly with non-ST-elevated acute coronary syndromes (NSTE-ACS) undergoing PCI. METHODS: Platelet reactivity was measured by vasodilator-stimulated phosphoprotein (VASP) assay at three time-points (baseline, discharge, 1 month after PCI) in 1053 NSTE-ACS patients (311 elderly) treated with clopidogrel...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29531382/-temporal-evolution-of-antithrombotic-therapy-use-in-patients-with-acute-coronary-syndromes-undergoing-percutaneous-coronary-intervention-in-italy-comparison-between-the-eyeshot-and-scope-registries
#17
Leonardo De Luca, Mauro Pennacchi, Giuseppe Musumeci, Fabrizio D'Ascenzo, Pamela Gallo, Stefano Rigattieri, Antonino Granatelli, Sergio Berti, Michele Massimo Gulizia, Stefano De Servi, Leonardo Bolognese
BACKGROUND: Few data exist on temporal evolution of antithrombotic agent use in patients with acute coronary syndromes (ACS) undergoing percutaneous coronary intervention (PCI) in Italy. We sought to compare data from the most recent prospective, multicenter, nationwide registries conducted in Italy, namely EYESHOT and SCOPE. METHODS: EYESHOT enrolled 2585 consecutive ACS patients, both ST-segment elevation myocardial infarction (STEMI) and non-ST elevation ACS (NSTE-ACS), admitted to 203 Italian coronary care units over a 3-week period (2-22 Dec 2013 and 27 Jan-16 Feb 2014)...
February 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29486987/multivessel-vs-culprit-only-revascularization-in-patients-with-non-st-elevation-acute-coronary-syndromes-and-multivessel-coronary-disease
#18
César Correia, Carlos Galvão Braga, Juliana Martins, Carina Arantes, Glória Abreu, Catarina Quina, Alberto Salgado, Miguel Álvares Pereira, João Costa, Jorge Marques
INTRODUCTION: There have been no prospective randomized trials that enable the best strategy and timing to be determined for revascularization in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and multivessel coronary artery disease (CAD). OBJECTIVES: To compare short- and long-term adverse events following multivessel vs. culprit-only revascularization in patients with NSTE-ACS and multivessel CAD. METHODS: This was a retrospective observational study that included all patients diagnosed with NSTE-ACS and multivessel CAD who underwent percutaneous coronary intervention (PCI) between January 2010 and June 2013 (n=232)...
February 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29447786/high-sensitivity-cardiac-troponin-t-left-ventricular-function-and-outcome-in-non-st-elevation-acute-coronary-syndrome
#19
K M Eggers, T Jernberg, B Lindahl
BACKGROUND: Cardiac troponin (cTn) levels reflect infarct size and depressed left ventricular ejection fraction (LVEF) in patients with non-ST elevation acute coronary syndrome (NSTE-ACS). However, there is very limited information on whether cTn measured with a high-sensitivity (hs) assay would provide incremental prognostic information to the LVEF in NSTE-ACS patients. METHODS: This was a registry-based study (SWEDEHEART registry) investigating 20,652 NSTE-ACS patients with available information on hs-cTnT (highest level recorded during the hospitalization) and the LVEF estimated using echocardiography...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29446567/prognostic-value-of-the-index-of-microcirculatory-resistance-after-percutaneous-coronary-intervention-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#20
Tadashi Murai, Taishi Yonetsu, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hoshino, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
BACKGROUND: The prognostic value of physiological indices in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients undergoing percutaneous coronary intervention (PCI) is unknown. We investigated the prognostic efficacy of physiological indices obtained after PCI in patients with NSTE-ACS. METHODS: Eighty-three patients (men: n = 70, age: 63.7 ± 9.7 years) undergoing PCI for NSTE-ACS within 48 hr postadmission were investigated. Fractional flow reserve (FFR), coronary flow reserve (CFR), and the index of microcirculatory resistance (IMR) of the culprit vessels were measured after the completion of PCI...
February 15, 2018: Catheterization and Cardiovascular Interventions
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