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Acute coronary disease

Xiuqing Tian, Rui Guo, Yujiao Zhang, Lingling Xu, Xianbing Liu, Yinglong Hou
OBJECTIVE: To observe the effects of sympathetic overactivity on the immune system involved in the imbalance of T helper (Th) lymphocytes, we investigated the correlation between autonomic dysregulation and the generation of regulatory T (Treg) and Th1 chemokines in patients with acute coronary syndrome (ACS). METHODS: Blood samples obtained from patients with coronary artery disease and controls were analyzed for levels of Th1 and Treg cells and their associated cytokines by flow cytometry...
October 21, 2016: Neuroimmunomodulation
Gerard Pasterkamp, Hester M den Ruijter, Peter Libby
The concept of the 'vulnerable plaque' originated from pathological observations in patients who died from acute coronary syndrome. This recognition spawned a generation of research that led to greater understanding of how complicated atherosclerotic plaques form and precipitate thrombotic events. In current practice, an increasing number of patients who survive their first event present with non-ST-segment elevation myocardial infarction (NSTEMI) rather than myocardial infarction (MI) with ST-segment elevation (STEMI)...
October 20, 2016: Nature Reviews. Cardiology
Elaheh Malakan Rad, Iran Malekzadeh, Vahid Ziaee, Raheleh Rajabi, Zohreh Shahabi
BACKGROUND: Kawasaki disease (KD) is the most common cause of acquired myocardial infarction in children. Coronary artery involvement is the most serious feature of this vasculitis syndrome. Timely diagnosis of coronary artery involvement is of utmost importance since it can prevent long-term morbidity and mortality. The current methods for the diagnosis of coronary artery dilation in KD are inconsistent and are also not capable of detecting all the abnormal coronary arteries or the so-called occult dilations present...
August 2016: Iranian Journal of Pediatrics
Christopher Semsarian, Jodie Ingles
Sudden cardiac death (SCD) is a rare but devastating complication of a number of underlying cardiovascular diseases. While coronary artery disease and acute myocardial infarction are the most common causes of SCD in older populations, inherited cardiac disorders comprise a substantial proportion of SCD cases aged less than 40 years. Inherited cardiac disorders include primary inherited arrhythmogenic disorders such as familial long QT syndrome (LQTS), Brugada syndrome (BrS), catecholaminergic polymorphic ventricular tachycardia (CPVT), and inherited cardiomyopathies, most commonly hypertrophic cardiomyopathy (HCM)...
October 2016: Journal of Arrhythmia
Shotaro Sakka, Koji Kawai, Ippei Tsujimoto, Masahiro Kurobe, Daishi Ichioka, Shuya Kantori, Takahiro Kojima, Takahiro Suetomi, Akira Jouraku, Jun Miyazaki, Tomoya Hoshi, Hiroyuki Nishiyama
A 37-year-old man presented at our hospital. Pathological examination of a right orchiectomy specimen, radiographic examination, and tumor marker profile resulted in a diagnosis of retroperitoneal nonseminomatous germ cell tumor (intermediate risk according to IGCC classification). Laboratory testing revealed mild elevation of low density lipoprotein cholesterol. Induction chemotherapy with bleomycin, etoposide and cisplatin (BEP) was started, but he complained of chest pain on day 10 of the second cycle of BEP...
September 2016: Hinyokika Kiyo. Acta Urologica Japonica
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
Ravi S Hira, Larry S Dean
Provisional use of rotational atherectomy (RA) is indicated for procedural success in heavily calcified lesions. In the current study, RA use at three high volume percutaneous coronary intervention (PCI) centers between 2005 and 2013 was 1.4%. MACE rate was 17.8% at median follow-up of 22 months. Peripheral vascular disease (PVD), diabetes mellitus (DM), acute coronary syndrome (ACS), and SYNTAX > 23 were found to be independently associated with MACE. With increasing complexity of disease and SYNTAX score, there is usually an increase in severity of calcification and need for atherectomy...
October 2016: Catheterization and Cardiovascular Interventions
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Masatsune Ogura, Hisashi Makino, Chizuko Kamiya, Jun Yoshimatsu, Handrean Soran, Ruth Eatough, Giuseppina Perrone, Mariko Harada-Shiba, Claudia Stefanutti
BACKGROUND AND AIMS: For patients with homozygous familial hypercholesterolemia (HoFH), atherogenic lipoprotein changes and increased stress on cardiovascular system during pregnancy may pose substantial risk for both the mother and her fetus. Although lipoprotein apheresis (LA) is reported as the most effective therapy to control LDL-C levels during pregnancy in HoFH patients, only case reports have been published, and there is no guidance for management. METHODS: We report twelve pregnancies and ten deliveries in seven patients with HoFH, and compare the clinical outcomes between patients who received LA during pregnancy and those who did not...
October 8, 2016: Atherosclerosis
Shirley J Ingram, Gabrielle McKee, Mary B Quirke, Niamh Kelly, Ashling Moloney
BACKGROUND: Chest pain is a common presentation to emergency departments (EDs). Pathways for patients with non-acute coronary syndrome (ACS) chest pain are not optimal. An advanced cardiology nurse-led chest pain service was commenced to address this. The aim of the study was to assess the outcomes of non-ACS patients discharged from ED to an advanced cardiology nurse-led chest pain clinic and compare by referral type (nurse or ED physician). METHODS: The service consisted of advanced cardiology nurse or ED physician consultation in the ED and discharge to advanced nurse-led chest pain clinic review less than 72 hours after discharge...
October 14, 2016: Journal of Cardiovascular Nursing
Sergio E Masnaghetti, Simona Sarzi Braga, Raffaella Vaninetti, Paola Baiardi, Roberto F E Pedretti
BACKGROUND AND AIMS: Hospitalized patients after acute cardiovascular events have poorer prognosis if glucose regulation is diagnosed as abnormal. We compared the short and long-term outcome of patients with newly diagnosed altered fasting glycemia (AFG) to that of known diabetic patients and patients with normal glucose regulation (NGR) after admission to cardiac rehabilitation. METHODS: We retrospectively analyzed 2490 consecutive patients. Three groups were identified: known diabetes mellitus (n = 540, 22%), fasting glycemia above 110 mg/dl (AFG, n = 269, 11%), and fasting glycemia 110 mg/dl or less (NGR, n = 1681, 67%)...
October 15, 2016: Journal of Cardiovascular Medicine
Nermina Buljubasic, K Martijn Akkerhuis, Jin M Cheng, Rohit M Oemrawsingh, Hector M Garcia-Garcia, Sanneke P M de Boer, Evelyn Regar, Robert-Jan M van Geuns, Patrick W J C Serruys, Eric Boersma, Isabella Kardys
OBJECTIVE: The aim of this study was to provide additional insight into the role of fibrinogen in coronary artery disease by investigating the associations between plasma fibrinogen with both degree and composition of coronary atherosclerosis as determined by virtual histology-intravascular ultrasound. PATIENTS AND METHODS: In 581 patients undergoing coronary angiography for acute coronary syndrome (ACS) or stable angina pectoris, preprocedural blood samples were drawn for fibrinogen, C-reactive protein (CRP), interleukin-6, and plasminogen activator inhibitor-1 measurements, and virtual histology-intravascular ultrasound of a nonculprit coronary artery was performed...
October 14, 2016: Coronary Artery Disease
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
Paul Whelton
BACKGROUND: Choice of the optimal target for blood pressure (BP) reduction during treatment of patients with hypertension, including those with underlying co-morbid conditions, is an important challenge in clinical practice. The Systolic Blood Pressure Intervention Trial (SPRINT) was designed to provide guidance in selection of a Systolic BP target during treatment of hypertension. METHODS: Adults ≥50 years old with hypertension and at least one additional risk factor for cardiovascular disease (CVD), but excluding persons with diabetes mellitus, prior stroke, or advanced chronic kidney disease (CKD) were randomly assigned to intensive therapy (intensive), targeting a systolic BP (SBP) <120 mmHg, or standard therapy (standard), targeting a SBP <140 mmHg...
September 2016: Journal of Hypertension
Guido Grassi
The Systolic Blood Pressure Intervention Trial (SPRINT), sponsored by the National Heart, Lung and Blood Institute in the USA, allocated 9361 hypertensive patients (mean age 68 years) to two systolic blood pressure treatment targets (either < 120mmHg or < 140mmHg). Although SPRINT intended to enrol hypertensive patients at high cardiovascular risk, it specifically excluded patients with diabetes mellitus or prior stroke. SPRINT was stopped earlier than planned, after a mean follow-up of 3.26 years, on the recommendation of its data and safety monitoring board, and data were published on 9 November 2015...
September 2016: Journal of Hypertension
Nuccia Morici, Laura Farioli, Laura Michelina Losappio, Giulia Colombo, Michele Nichelatti, Donatella Preziosi, Gianluigi Micarelli, Fabrizio Oliva, Cristina Giannattasio, Silvio Klugmann, Elide Anna Pastorello
OBJECTIVE: To assess the relationship between serum tryptase and the occurrence of major cardiovascular and cerebrovascular events (MACCE) at 2-year follow-up in patients admitted with acute coronary syndrome (ACS). To compare serum tryptase to other validated prognostic markers (maximum high-sensitivity troponin (hs-Tn), C reactive protein (CRP) levels at admission, Synergy between percutaneous coronary intervention with Taxus and Cardiac Surgery (SYNTAX) score). METHODS: We measured serum tryptase at admission in 140 consecutive patients with ACS and in 50 healthy controls...
2016: Open Heart
Martin Möckel, Julia Searle, Henning Thomas Baberg, Peter Dirschedl, Benny Levenson, Jürgen Malzahn, Thomas Mansky, Christian Günster, Elke Jeschke
OBJECTIVES: We aimed to analyse the short-term and long-term outcome of patients with end-stage renal disease (ESRD) undergoing percutaneous intervention (PCI) as compared to coronary artery bypass surgery (CABG) to evaluate the optimal coronary revascularisation strategy. DESIGN: Retrospective analysis of routine statutory health insurance data between 2010 and 2012. MAIN OUTCOME MEASURES: Primary outcome was adjusted all-cause mortality after 30 days and major adverse cardiovascular and cerebrovascular events at 1 year...
2016: Open Heart
Sunil Kr Verma
A 62-year-old male was undergoing treatment of NHL with bone marrow involvement with thrombocytopenia. After 15min of starting of IV infusion of rituximab, he started having severe retrosternal chest pain, diagnosed as acute ST elevation inferior wall MI. Patient was pre-loaded with dual anti platelets. Coronary angiogram showed 100% occlusion of proximal RCA. Thrombosuction of this culprit RCA revealed underlying 90% stenosis. After that, PCI with balloon angioplasty of RCA was done. The procedure was terminated in the view of successful balloon angioplasty with good TIMI flow...
September 2016: Indian Heart Journal
Axel C Mühlbacher, Susanne Bethge, Anika Kaczynski
BACKGROUND: Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. METHODS: To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted...
October 18, 2016: International Journal of Technology Assessment in Health Care
Qianqian Chen, Xingchen Shang, Meng Yuan, Lining Liang, Xia Zhong
OBJECTIVE: An association between coronary artery disease (CAD) and serum omentin-1 was recently identified. The aim of the present study was to investigate the effect of atorvastatin on serum levels of omentin-1 in patients with CAD. METHODS: One-hundred and ninety-eight patients with CAD were divided into two groups: those with acute coronary syndrome (ACS) and those with stable angina pectoris (SAP). All patients were randomized to receive atorvastatin therapy at a dose of either 20 or 40 mg/day for 12 weeks...
October 4, 2016: Coronary Artery Disease
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