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https://www.readbyqxmd.com/read/28416248/contemporary-practice-and-outcomes-of-an-elderly-cohort-of-japanese-patients-with-non-st-elevation-acute-coronary-syndrome-in-the-era-of-routine-early-invasive-strategy
#1
Takuya Nagata, Yohei Hyakuna, Kenji Miyata, Masahiro Mohri
BACKGROUND: An early invasive strategy for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has been recommended. However, patients at greater risk including the elderly are more often managed conservatively. We aimed to elucidate contemporary practice and outcomes of patients with NSTE-ACS who were referred to our hospital located in Kitakyushu City, one of the most aging metropolises in Japan. METHODS: A total of 270 consecutive NSTE-ACS patients hospitalized between January 2012 and December 2014 were retrospectively studied...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28409008/two-year-outcome-after-early-or-late-intervention-in-non-st-elevation-acute-coronary-syndrome
#2
Erik A Badings, Wouter S Remkes, Salem H K The, Jan-Henk E Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R Timmer, Marloes L J van der Wielen, Dirk J A Lok, Renicus S Hermanides, Jan Van Wijngaarden, Harry Suryapranata, Arnoud W J van 't Hof
OBJECTIVE: To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate <12 hours) or a delayed invasive strategy (>48 hours after randomisation)...
2017: Open Heart
https://www.readbyqxmd.com/read/28408018/early-invasive-versus-selective-strategy-for%C3%A2-non-st-segment-elevation-acute%C3%A2-coronary-syndrome-the-ictus-trial
#3
Niels P G Hoedemaker, Peter Damman, Pier Woudstra, Alexander Hirsch, Fons Windhausen, Jan G P Tijssen, Robbert J de Winter
BACKGROUND: The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and an elevated cardiac troponin T. No long-term benefit of an early invasive strategy was found at 1 and 5 years. OBJECTIVES: The aim of this study was to determine the 10-year clinical outcomes of an early invasive strategy versus a selective invasive strategy in patients with NSTE-ACS and an elevated cardiac troponin T...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28391887/investigating-the-prevalence-predictors-and-prognosis-of-suboptimal-statin-use-early-after-a-non-st-elevation-acute-coronary-syndrome
#4
Richard M Turner, Peng Yin, Anita Hanson, Richard FitzGerald, Andrew P Morris, Rod H Stables, Andrea L Jorgensen, Munir Pirmohamed
BACKGROUND: High-potency statin therapy is recommended in the secondary prevention of cardiovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occur in practice. OBJECTIVES: To determine the prevalence and predictors of deviation from high-potency statin use early after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subsequent major adverse cardiovascular events (MACE) and all-cause mortality (ACM)...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28366473/correlation-of-corrected-qt-interval-with-quantitative-cardiac-troponin-i-levels-and-its-prognostic-role-in-non-st-elevation-myocardial-infarction
#5
Satyam Rajvanshi, Ranjit Nath, Manoj Kumar, Ankit Gupta, Neeraj Pandit
BACKGROUND: Non-ST-elevation Myocardial Infarction (NSTEMI) subgroup of ACS has wide variability in patient prognosis. Risk stratification in NSTE-ACS is essential for deciding about early management. Corrected QT interval estimation is one tool which has utility in bedside risk stratification. Whether it differentiates NSTEMI patients into different risk groups is the contention of this study. OBJECTIVE: To assess (1) correlation between maximum corrected QT interval (QTc) and cardiac Troponin I (cTnI) levels; (2) if prolonged corrected QT interval is an independent predictor of higher MACE in NSTEMI patients...
March 24, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28341306/high-frequency-qrs-analysis-in-the-evaluation-of-chest-pain-in-the-emergency-department
#6
Ori Galante, Guy Amit, Yair Granot, Linda R Davrath, Shimon Abboud, Doron Zahger
OBJECTIVES: High frequency QRS (HFQRS) analysis has been shown to be an accurate marker for myocardial ischemia. Our objective was to test the use of HFQRS in diagnosing ACS in the emergency department. METHODS: 324 patients presenting to the ED with chest pain were enrolled. Resting ECG was recorded and later analyzed by an HFQRS algorithm. Results were compared to the conventional ECG diagnosis by 3 independent interpretations: treating physician, expert cardiologist and an automated computer program...
February 20, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#7
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28306587/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-non-st-segment-elevation-acute-coronary-syndromes
#8
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
March 16, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28303685/impact-of-coronary-plaque-morphology-assessed-by-optical-coherence-tomography-on-cardiac-troponin-elevation-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#9
Tetsumin Lee, Tadashi Murai, Mitsuaki Isobe, Tsunekazu Kakuta
OBJECTIVES: This study aimed to use optical coherence tomography (OCT) to study the relationship between plaque morphology prior to percutaneous coronary intervention (PCI) and post-PCI cardiac troponin (cTn) elevations in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Furthermore, the relationship between these findings and the adverse cardiac events during follow-up was assessed. BACKGROUND: Association between post-PCI cTn elevations and OCT findings in NSTE-ACS patients is unclear...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28291622/a-randomized-controlled-comparison-of-different-intensive-lipid-lowering-therapies-in-chinese-patients-with-non-st-elevation-acute-coronary-syndrome-nste-acs-ezetimibe-and-rosuvastatin-versus-high-dose-rosuvastatin
#10
Dan Ran, Hui-Juan Nie, Yu-Lin Gao, Song-Bai Deng, Jian-Lin Du, Ya-Jie Liu, Xiao-Dong Jing, Qiang She
BACKGROUND: Statin combined with ezetimibe demonstrates significant benefit in lowering low density lipid cholesterol (LDL-C) and cardiovascular events abroad, but whether intermediate intensity statins combined with ezetimibe is superior to high-intensity statin monotherapy in Chinese people is unknown. METHODS: A total of 125 patients were randomly assigned to a intermediate intensity rosuvastatin group (rosuvastatin 10mg/d, n=42), high-dose rosuvastatin group (rosuvastatin 20mg/d, n=41) or combination therapy group (ezetimibe 10mg/d and rosuvastatin 10mg/d, n=42) with a 12-week follow-up...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28284460/the-impact-of-prolonged-waiting-time-for-coronary-care-unit-admission-on-patients-with-non-st-elevation-acute-coronary-syndrome
#11
Chien-Chih Chen, I-Min Chiu, Fu-Jen Cheng, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). METHODS: Patients were divided into 2 groups according to the CCU waiting time (<12h and >12h)...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28258851/longitudinal-2d-strain-can-help-diagnose-coronary-artery-disease-in-patients-with-suspected-non-st-elevation-acute-coronary-syndrome-but-apparent-normal-global-and-segmental-systolic-function
#12
Thibault Caspar, Hafida Samet, Mickaël Ohana, Philippe Germain, Soraya El Ghannudi, Samy Talha, Olivier Morel, Patrick Ohlmann
BACKGROUND: The clinical work-up of patients presenting with chest pain is a diagnostic challenge. We investigated the diagnostic performance of global (GLS) and territorial (TLS) longitudinal strain to predict coronary artery disease (CAD) in patients presenting with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) but apparent normal global and regional systolic function. METHODS: 150 consecutive suspected NSTE-ACS patients were initially screened for inclusion ; 58 patients with normal LVEF (≥55%) and WMSI (=1) were prospectively enrolled...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28236456/outcomes-after-percutaneous-coronary-intervention-of-acute-coronary-syndrome-complicated-with-cardiopulmonary-arrest-from-a-japanese-multicenter-registry
#13
Yohei Numasawa, Mitsuaki Sawano, Hiroaki Miyata, Ikuko Ueda, Shigetaka Noma, Masahiro Suzuki, Toshiki Kuno, Masaki Kodaira, Yuichiro Maekawa, Keiichi Fukuda, Shun Kohsaka
Details on the characteristics and outcomes in patients with acute coronary syndrome (ACS) complicated with cardiopulmonary arrest (CPA) have been limited. We evaluated inhospital outcomes after percutaneous coronary intervention in these patients. From 2008 to 2014, 5,943 patients with ACS including 2,973 patients with ST-elevation myocardial infarction (STEMI) and 2,970 patients with non-STEMI or unstable angina (NSTE-ACS) were registered. In total, 264 patients experienced CPA within 24 hours of admission...
April 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28191514/anticoagulant-therapy-for-non-st-segment-elevation-acute-coronary-syndrome-in-china-a-multi-center-observational-study
#14
Xiao-Huan Gong, Jin-Ming Yu, Yong Mao, Da-Yi Hu
OBJECTIVE: To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. METHODS: A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI...
April 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28139897/oral-antiplatelet-agents-for-the-management-of-acute-coronary-syndromes-a-review-for-nurses-and-allied-healthcare-professionals
#15
REVIEW
Tania Gesheff, Cescelle Barbour
PURPOSE: We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES: Treatment guidelines and clinical articles from PubMed. CONCLUSIONS: Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response...
February 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#16
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
March 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28089149/fasting-glucose-nt-probnp-treatment-with-eptifibatide-and-outcomes-in-non-st-segment-elevation-acute-coronary-syndromes-an-analysis-from-early-acs
#17
Serdar Farhan, Robert M Clare, Rudolf Jarai, Robert P Giugliano, Yuliya Lokhnygina, Robert A Harrington, L Kristin Newby, Kurt Huber
BACKGROUND: Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS). METHODS: Fasting glucose and NT-proBNP were measured in 2240 patients enrolled in the EARLY ACS trial. Multivariable Cox models were used to assess associations between fasting glucose and NT-proBNP and a 96-hour composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-day death or MI; and 1-year mortality...
April 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28040190/comparison-of-outcomes-of-women-versus-men-with-non-st-elevation-acute-coronary-syndromes-undergoing-percutaneous-coronary-intervention-from-the-japanese-nationwide-registry
#18
Yohei Numasawa, Taku Inohara, Hideki Ishii, Toshiki Kuno, Masaki Kodaira, Shun Kohsaka, Kenshi Fujii, Shiro Uemura, Tetsuya Amano, Kazushige Kadota, Masato Nakamura
Previous studies have reported that women have worse outcomes than men after percutaneous coronary intervention (PCI), especially in patients with ST-elevation myocardial infarction. However, gender-related differences in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) have not been thoroughly investigated. In the Japanese nationwide registry, a total of 43,239 patients with NSTE-ACS from 861 hospitals underwent PCI in 2014. Overall, 11,326 patients (26.2%) were women. The women were older (75...
March 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28032431/degree-of-dyspnoea-in-patients-with-non-st-elevation-acute-coronary-syndrome-a-report-from-japanese-multicenter-registry
#19
Yasuyuki Shiraishi, Shun Kohsaka, Ikuko Ueda, Taku Inohara, Mitsuaki Sawano, Yohei Numasawa, Kentaro Hayashida, Yuichiro Maekawa, Yukihiko Momiyama, Keiichi Fukuda
BACKGROUND: Degree of dyspnoea is almost universally evaluated in the patients presenting with acute coronary syndrome (ACS), but its clinical implications has not been thoroughly investigated. We aimed to describe the relationship between the severity of dyspnoea and in-hospital outcomes in patients with non-ST elevation ACS (NSTE-ACS) complicated with acute heart failure (AHF). METHODS: Between 2009 and 2014, 3287 consecutive patients with NSTE-ACS were enrolled in the Japanese prospective multicenter PCI registry...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28018669/effects-of-omeprazole-or-pantoprazole-on-platelet-function-in-non-st-segment-elevation-acute-coronary-syndrome-patients-receiving-clopidogrel
#20
Ruo-Xi Gu, Xiao-Zeng Wang, Jing Li, Jie Deng, Xing-Xing Li, Jiao Wang
BACKGROUND: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients receiving clopidogrel. METHODS: Consecutive patients with NSTE-ACS (n = 620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole (20 mg/d) group (1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation (ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention (PCI)...
2016: Military Medical Research
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