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https://www.readbyqxmd.com/read/28288007/clinical-utility-of-the-heart-score-in-patients-admitted-with-chest-pain-to-an-inner-city-hospital-in-the-usa
#1
Soumya Patnaik, Mahek Shah, Yaser Alhamshari, Pradhum Ram, Ritika Puri, Marvin Lu, Percy Balderia, John B Imms, Obiora Maludum, Vincent M Figueredo
BACKGROUND: Chest pain is one of the most common presentations to a hospital, and appropriate triaging of these patients can be challenging. The HEART score has been used for such purposes in some countries and only a few validation studies from the USA are available. We aim to determine the utility of the HEART score in patients presenting with chest pain to an inner-city hospital in the USA. PATIENTS AND METHODS: We retrospectively screened 417 consecutive patients admitted with chest pain to the observation/telemetry units at Einstein Medical Center Philadelphia...
March 10, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28280901/does-training-of-general-practitioners-for-intensive-treatment-of-people-with-screen-detected-diabetes-have-a-spillover-effect-on-mortality-and-cardiovascular-morbidity-in-at-risk-individuals-with-normoglycaemia-results-from-the-addition-denmark-cluster-randomised
#2
Rebecca K Simmons, Niels H Bruun, Daniel R Witte, Knut Borch-Johnsen, Marit E Jørgensen, Annelli Sandbæk, Torsten Lauritzen
AIMS/HYPOTHESIS: Within a trial of intensive treatment of people with screen-detected diabetes, we aimed to assess a potential spillover effect of the trial intervention on incident cardiovascular disease (CVD) and all-cause mortality among people who screened positive on a diabetes risk questionnaire but who were normoglycaemic. METHODS: In the Anglo-Danish-Dutch Study of Intensive Treatment In People with Screen-Detected Diabetes in Primary Care (ADDITION)-Denmark trial, 175 general practices were cluster-randomised into: (1) screening plus routine care of individuals with screen-detected diabetes (control group); or (2) screening plus training and support in intensive multifactorial treatment of individuals with screen-detected diabetes (intervention group)...
March 9, 2017: Diabetologia
https://www.readbyqxmd.com/read/28167641/prognostic-utility-of-a-modified-heart-score-in-chest-pain-patients-in-the-emergency-department
#3
James McCord, Rafael Cabrera, Bertil Lindahl, Evangelos Giannitsis, Kaleigh Evans, Richard Nowak, Tiberio Frisoli, Richard Body, Michael Christ, Christopher R deFilippi, Robert H Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller
BACKGROUND: The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial. METHODS AND RESULTS: Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28140637/radiographic-assessment-of-the-cardiac-silhouette-in-clinically-normal-large-and-small-breed-dogs
#4
Ayman A Mostafa, Clifford R Berry
OBJECTIVE To determine manubrium heart scores (MHSs) from measurements of cardiac short-axis length (cSAL) and long-axis length (cLAL) relative to the corresponding manubrium length (ML) on thoracic radiographic views of dogs and assess correlation of MHSs with vertebral heart scores (VHSs). ANIMALS 120 clinically normal large-breed dogs (LBDs) and small-breed dogs (SBDs). PROCEDURES On right lateral views (RLVs) and ventrodorsal views (VDVs) for each dog, cSAL and cLAL were measured and expressed as a ratio; the cSAL:ML ratio (short-MHS), cLAL:ML ratio (long-MHS), and cSAL-and-cLAL:ML ratio (overall-MHS) were also calculated...
February 2017: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/28080897/radiographic-cardiac-silhouette-measurement-in-captive-livingstone-s-fruit-bats-pteropus-livingstonii
#5
Katherine V R Dickson, Ceri W Twiston Davies, Andrew Routh, Rowena Killick, Alberto R Barbon
Cardiomyopathies have been increasingly noted in the captive population of Livingstone's fruit bat ( Pteropus livingstonii ). The aim of this study was to produce a set of repeatable quantitative reference measurements that could be used to assess the cardiac size during radiographic examination of this species. Ventro-dorsal and lateral radiographs (n = 129) from a total of 42 individual Livingstone's fruit bats were examined. The control group radiographs (n = 102) consisted of 34 healthy individuals. Radiographic measurements were taken of structures within the thorax and then converted into ratios...
December 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/28057898/a-retrospective-study-of-degenerative-mitral-valve-disease-in-small-breed-dogs-survival-and-prognostic-variables
#6
Hyun-Tae Kim, Sei-Myoung Han, Woo-Jin Song, Boeun Kim, Mincheol Choi, Junghee Yoon, Hwa-Young Youn
Small-breed (n= 168 dogs; weight < 15 kg) diagnosed with MMVD based on a routine clinical examination, radiology, an electrocardiogram, and echocardiography at the Seoul National University Veterinary Medical Teaching Hospital were included. The survival periods were ascertained and a significant difference was observed in the survival rates between the International Small Animal Cardiac Health Council classes. The mean follow-up period was 14.3 ± 12.1 months. Univariate analysis revealed that dyspnea, pulmonary edema, and vertebral heart score were significantly associated with the survival times (P < 0...
January 4, 2017: Journal of Veterinary Science
https://www.readbyqxmd.com/read/28033243/prognostic-values-of-4-risk-scores-in-chinese-patients-with-chest-pain-prospective-2-centre-cohort-study
#7
MULTICENTER STUDY
Xiao-Hui Chen, Hui-Lin Jiang, Yun-Mei Li, Cangel Pui Yee Chan, Jun-Rong Mo, Chao-Wei Tian, Pei-Yi Lin, Colin A Graham, Timothy H Rainer
Four risk scores for stratifying patients with chest pain presenting to emergency departments (EDs) (namely Thrombolysis in myocardial infarction [TIMI], Global registry for acute coronary events [GRACE], Banach and HEART) have been developed in Western settings but have never been compared and validated in Chinese patients. We aimed to find out to the number of MACE within 7 days, 30 days, and 6 months after initial ED presentation, and also to compare the prognostic performance of these scores in Chinese patients with suspected cardiac chest pain (CCP) to predict 7-day, 30-day, and 6-month major adverse cardiac events (MACE)...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27846006/chest-pain-risk-scores-can-reduce-emergent-cardiac-imaging-test-needs-with-low-major-adverse-cardiac-events-occurrence-in-an-emergency-department-observation-unit
#8
Hao Wang, Katherine Watson, Richard D Robinson, Kristina H Domanski, Johnbosco Umejiego, Layton Hamblin, Sterling E Overstreet, Amanda M Akin, Steven Hoang, Meena Shrivastav, Michael Collyer, Ryan N Krech, Chet D Schrader, Nestor R Zenarosa
OBJECTIVE: To compare and evaluate the performance of the HEART, Global Registry of Acute Coronary Events (GRACE), and Thrombolysis in Myocardial Infarction (TIMI) scores to predict major adverse cardiac event (MACE) rates after index placement in an emergency department observation unit (EDOU) and to determine the need for observation unit initiation of emergent cardiac imaging tests, that is, noninvasive cardiac stress tests and invasive coronary angiography. METHODS: A prospective observational single center study was conducted from January 2014 through June 2015...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27846004/implementation-of-a-risk-stratification-and-management-pathway-for-acute-chest-pain-in-the-emergency-department
#9
Christopher W Baugh, Jeffrey O Greenberg, Simon A Mahler, Joshua M Kosowsky, Jeremiah D Schuur, Siddharth Parmar, George R Ciociolo, Christina W Carr, Roya Ghazinouri, Benjamin M Scirica
OBJECTIVES: Chest pain is a common complaint in the emergency department, and a small but important minority represents an acute coronary syndrome (ACS). Variation in diagnostic workup, risk stratification, and management may result in underuse, misuse, and/or overuse of resources. METHODS: From July to October 2014, we conducted a prospective cohort study in an academic medical center by implementing a Standardized Clinical Assessment and Management Plan (SCAMP) for chest pain based on the HEART score...
December 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27842923/mean-heart-scores-for-hospitalized-chest-pain-patients-are-higher-in-more-experienced-providers
#10
Jeff Dubin, Eric Kiechle, Matt Wilson, Christian Timbol, Rahul Bhat, Dave Milzman
BACKGROUND: The HEART score has been validated as a predictor of major adverse cardiac events (MACEs) in emergency department patients complaining of chest pain. Our objective was to determine the extent of physician variation in the HEART score of admitted patients stratified by years of experience. METHODS: We performed a retrospective medical record review at an academic tertiary care emergency department to determine HEART score, outcome of hospitalization, and 30-day MACE...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27810290/comparison-of-the-grace-heart-and-timi-score-to-predict-major-adverse-cardiac-events-in-chest-pain-patients-at-the-emergency-department
#11
J M Poldervaart, M Langedijk, B E Backus, I M C Dekker, A J Six, P A Doevendans, A W Hoes, J B Reitsma
BACKGROUND: The performance of the GRACE, HEART and TIMI scores were compared in predicting the probability of major adverse cardiac events (MACE) in chest pain patients presenting at the emergency department (ED), in particular their ability to identify patients at low risk. METHODS: Chest pain patients presenting at the ED in nine Dutch hospitals were included. The primary outcome was MACE within 6weeks. The HEART score was determined by the treating physician at the ED...
January 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/27745728/documentation-of-heart-score-discordance-between-emergency-physician-and-cardiologist-evaluations-of-ed-patients-with-chest-pain
#12
W Kelly Wu, Maame Yaa A B Yiadom, Sean P Collins, Wesley H Self, Ken Monahan
INTRODUCTION: A triage cardiology program, in which cardiologists provide consultation to the Emergency Department (ED), may safely reduce admissions. For patients with chest pain, the HEART Pathway may obviate the need for cardiology involvement, unless there is a difference between ED and cardiology assessments. Therefore, in a cohort concurrently evaluated by both specialties, we analyzed discordance between ED and cardiology HEART scores. METHODS: We performed a single-center, cross-sectional, retrospective study of adults presenting to the ED with chest pain who had a documented bedside evaluation by a triage cardiologist...
January 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27692651/best-clinical-practice-current-controversies-in-the-evaluation-of%C3%A2-low-risk-chest-pain-with-risk-stratification-aids-part-2
#13
Brit Long, Alex Koyfman
BACKGROUND: Chest pain accounts for 10% of emergency department (ED) visits annually, and many of these patients are admitted because of potentially life-threatening conditions. A substantial percentage of patients with chest pain are at low risk for a major cardiac adverse event (MACE). OBJECTIVE: We investigated controversies in the evaluation of patients with low-risk chest pain, including clinical scores, decision pathways, and shared decision-making. DISCUSSION: ED patients with chest pain who have negative biomarker results and nonischemic electrocardiograms are at low risk for MACE...
January 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27691948/radiographic-thoracic-anatomy-of-the-red-panda-ailurus-fulgens
#14
Modesta Makungu, Wencke M du Plessis, Michelle Barrows, Hermanus B Groenewald, Katja N Koeppel
The red panda ( Ailurus fulgens ) is classified as an endangered species by the International Union for Conservation of Nature and Natural Resources. The natural distribution of the red panda is in the Himalayas and southern China. Thoracic diseases such as dirofilariasis, hypertrophic cardiomyopathy, tracheal obstruction, lung worm infestation, and pneumonia have been reported in the red panda. The aim of this study was to describe the normal radiographic thoracic anatomy of captive red pandas as a species-specific reference for routine health examinations and clinical cases...
September 2016: Journal of Zoo and Wildlife Medicine: Official Publication of the American Association of Zoo Veterinarians
https://www.readbyqxmd.com/read/27633454/heart-score-estimation-by-specialized-nurses-in-a-greek-urban-population
#15
Evaggelia Papadopoulou, Maria Meidani, Maria Boutsikou, Pinelopi Papaspiropoulou, Theodosia Kelaiditou, Afedia Koukouzli, Anastasia Tapola, Ioanna Voudoufianaki, Sophie Mavrogeni, Niki Katsiki, Genovefa Kolovou, Ioannis Lekakis
AIMS: Specialized nurses estimated the HeartScore in an urban Greek population by recognizing cardiovascular disease (CVD) risk factors in the setting of the Onassis Cardiovascular Prevention Program (OCPP). They also provided nursing consultation and assessed the clinical and biochemical characteristics of the studied population. METHODS AND RESULTS: Individuals were recruited through TV announcements and via the website of the Onassis Cardiac Surgery Centre. All participants visited the Onassis Cardiac Centre from 20 September to 30 October 2011...
2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/27526383/red-blood-cell-distribution-width-at-emergency-department-admission-increases-the-accuracy-of-the-heart-score-for-predicting-death-in-patients-with-chest-pain
#16
EDITORIAL
Gianni Turcato, Valentina Serafini, Alice Dilda, Beatrice Caruso, Massimo Zannoni, Giorgio Ricci, Giuseppe Lippi
No abstract text is available yet for this article.
November 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27428317/comparing-heart-timi-and-grace-scores-for-prediction-of-30-day-major-adverse-cardiac-events-in-high-acuity-chest-pain-patients-in-the-emergency-department
#17
Jeffrey Tadashi Sakamoto, Nan Liu, Zhi Xiong Koh, Nicholas Xue Jin Fung, Micah Liam Arthur Heldeweg, Janson Cheng Ji Ng, Marcus Eng Hock Ong
BACKGROUND: The HEART, TIMI, and GRACE scores have been applied in the Emergency Department (ED) to risk stratify patients with undifferentiated chest pain. This study aims to compare the accuracy of HEART, TIMI, and GRACE for the prediction of major adverse cardiac events (MACE) in high acuity chest pain patients. METHODS: Adult patients who presented with chest pain suggestive of cardiac origin in the most acute triage category at an academic ED from September 2010 to October 2015 were included...
October 15, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27390945/add-on-tests-for-improving-risk-stratification-in-emergency-department-patients-with-chest-pain-who-are-at-low-to-moderate-risk-of-30-day-major-adverse-cardiac-events
#18
T H Rainer, Y K Leung, A Lee, P Y Chan, N M Cheng, J K Wong, B P Yan, A T Ahuja, C A Graham
BACKGROUND: Chest pain patients commonly present to emergency departments (ED), and require either hospital admission and/or lengthy diagnostic protocols to rule-out myocardial infarction. We aimed to identify the best combination of add-on tests to high-sensitivity cardiac troponin (hs-cTnT) for predicting 30-day major adverse cardiac events (MACE) in adult chest pain patients presenting to an ED with suspected acute coronary syndrome. METHODS: This prospective observational study was conducted in the ED of a tertiary university hospital in Hong Kong, recruiting adult patients with chest pain of less than 24h duration, suspected with acute coronary syndrome (ACS), and had no history of coronary artery bypass grafting or stent insertion...
October 1, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27311905/medical-consumption-compared-for-timi-and-heart-score-in-chest-pain-patients-at-the-emergency-department-a-retrospective-cost-analysis
#19
A Nieuwets, J M Poldervaart, J B Reitsma, S Buitendijk, A J Six, B E Backus, A W Hoes, P A Doevendans
OBJECTIVE: To investigate which risk score (TIMI score or HEART score) identifies the largest population of low-risk patients at the emergency department (ED). Furthermore, we retrospectively calculated the corresponding expected decrease in medical consumption if these patients would have been discharged from the ED. METHODS: We performed analyses in two hospitals of the multicentre prospective validation study of the HEART score, executed in 2008 and 2009. Patients with chest pain presenting to the ED were included and information was collected on major adverse cardiac events (MACEs) and on hospital admissions and diagnostic procedures within 6 weeks...
2016: BMJ Open
https://www.readbyqxmd.com/read/27183256/association-of-early-stress-testing-with-outcomes-for-emergency-department-evaluation-of-suspected-acute-coronary-syndrome
#20
Benjamin C Sun, Amber Laurie, Rongwei Fu, Maros Ferencik, Michael Shapiro, Christopher J Lindsell, Deborah Diercks, James W Hoekstra, Judd E Hollander, J Douglas Kirk, W Frank Peacock, W Brian Gibler, Venkataraman Anantharaman, Charles V Pollack
BACKGROUND: Professional society guidelines suggest early stress testing (within 72 hours) after an emergency department (ED) evaluation for suspected acute coronary syndrome (ACS). However, there is increasing concern that current practice results in over-testing without evidence of benefit. We test the hypothesis that early stress testing improves outcomes. METHODS: We analyzed prospectively collected data from 9 EDs on patients with suspected ACS, 1999-2001. We excluded patients with an ED diagnosis of ACS...
June 2016: Critical Pathways in Cardiology
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