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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
#1
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
#2
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
#3
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...
October 18, 2016: 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
#4
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...
October 30, 2016: 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
#5
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...
September 28, 2016: 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
#6
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...
September 27, 2016: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27691948/radiographic-thoracic-anatomy-of-the-red-panda-ailurus-fulgens
#7
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
#8
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...
September 14, 2016: 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
#9
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
#10
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
#11
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
#12
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
#13
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
https://www.readbyqxmd.com/read/27183254/prognostic-factors-in-chest-pain-patients-a-quantitative-analysis-of-the-heart-score
#14
Barbra E Backus, A Jacob Six, Pieter A Doevendans, Johannes C Kelder, Ewout W Steyerberg, Yvonne Vergouwe
OBJECTIVES: Risk stratification for chest pain patients at the emergency department is recommended in several guidelines. The history, ECG, age, risk factors, and troponin (HEART) score is based on medical literature and expert opinion to estimate the risk of a major adverse cardiac event. We aimed to assess the predictive effects of the 5 HEART components and to compare performances of the original HEART score and a model based on regression analysis. METHODS: We analyzed prospectively collected data from 2388 patients, of whom 407 (17%) had a major adverse cardiac event within 6 weeks (acute myocardial infarction, percutaneous coronary intervention, coronary artery bypass graft, significant stenosis with conservative treatment and death due to any cause)...
June 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27183252/short-and-long-term-prognostic-utility-of-the-heart-score-in-patients-evaluated-in-the-emergency-department-for-possible-acute-coronary-syndrome
#15
Tarun Jain, Richard Nowak, Michael Hudson, Tiberio Frisoli, Gordon Jacobsen, James McCord
INTRODUCTION: The HEART score is a risk-stratification tool that was developed and validated for patients evaluated for possible acute coronary syndrome (ACS) in the emergency department (ED). We sought to determine the short-term and long-term prognostic utility of the HEART score. METHODS: A retrospective single-center analysis of 947 patients evaluated for possible ACS in the ED in 1999 was conducted. Patients were followed for major adverse cardiac events (MACEs) at 30 days: death, acute myocardial infarction, or revascularization procedure...
June 2016: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/27182132/vertebral-scale-system-to-measure-heart-size-in-thoracic-radiographs-of-indian-spitz-labrador-retriever-and-mongrel-dogs
#16
Deepti Bodh, Mozammel Hoque, Abhishek Chandra Saxena, Mudasir Bashir Gugjoo, Deepika Bist, J K Chaudhary
AIM: To establish reference values of vertebral heart score (VHS) in Indian Spitz, Labrador retriever, and Mongrel dogs; to assess applicability of VHS in these three dog breeds; to determine if breed, recumbency side, gender, body weight, and thoracic depth (TD) to thoracic width (TW) ratio has an influence on the VHS measurement in these dog breeds. MATERIALS AND METHODS: A total of 60, client owned, clinically healthy Indian Spitz (n=20, mean age = 4.25±2.15 years, body weight = 11...
April 2016: Veterinary World
https://www.readbyqxmd.com/read/27178708/the-heart-score-with-high-sensitive-troponin-t-at-presentation-ruling-out-patients-with-chest-pain-in-the-emergency-room
#17
Luca Santi, Gabriele Farina, Annagiulia Gramenzi, Franco Trevisani, Margherita Baccini, Mauro Bernardi, Mario Cavazza
The HEART score is a simple scoring system, ranging from 0 to 10, specifically developed for risk stratification of patients with undifferentiated chest pain. It has been validated for the conventional troponin, but not for high-sensitive troponin. We assess a modified version of the HEART score using a single high-sensitivity troponin T dosage at presentation, regardless of symptom duration, and with different ECG criteria to evaluate if the patients with a low HEART score could be safely discharged early...
May 13, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/27175173/investigation-of-mmp-2-and-mmp-9-activities-in-canine-sera-with-dilated-cardiomyopathy
#18
S Chegeni, Z Khaki, D Shirani, A Vajhi, M Taheri, Y Tamrchi, A Rostami
Dilated cardiomyopathy (DCM) is accompanied by myocytes and connective tissue changes. Matrix metalloproteinases (MMPs) play important roles in cardiac remodeling. It seems that the gelatinases (MMP-2 and MMP-9) are effective enzymes in cardiomyopathy. Dilated cardiomyopathy was confirmed in 22 dogs (patient group) including 11 female and 11 male by clinical examination, auscultation, thoracic radiography and echocardiography. 17 healthy dogs (control group) with similar weight and breed to patients were also selected from referred cases to Small Animal Hospital of the Veterinary Faculty of Tehran University and the same diagnostic procedures were performed on them...
2015: Iranian journal of veterinary research
https://www.readbyqxmd.com/read/27155957/vegetarianism-and-cardiometabolic-disease-risk-factors-differences-between-south-asian-and-us-adults
#19
Lindsay M Jaacks, Deksha Kapoor, Kalpana Singh, K M Venkat Narayan, Mohammed K Ali, M Masood Kadir, Viswanathan Mohan, Nikhil Tandon, Dorairaj Prabhakaran
OBJECTIVES: Cardiometabolic diseases are increasing disproportionately in South Asia compared with other regions of the world despite high levels of vegetarianism. This unexpected discordance may be explained by differences in the healthfulness of vegetarian and non-vegetarian diets in South Asia compared with the United States. The aim of this study was to compare the food group intake of vegetarians with non-vegetarians in South Asia and the United States and to evaluate associations between vegetarianism and cardiometabolic disease risk factors (overweight/obesity, central obesity, diabetes, hypertension, high triacylglycerols, high low-density lipoprotein, low high-density lipoprotein, and high Framingham Heart Score)...
September 2016: Nutrition
https://www.readbyqxmd.com/read/27147894/clinical-decision-aids-for-chest-pain-in-the-emergency-department-identifying-low-risk-patients
#20
REVIEW
William Alley, Simon A Mahler
Chest pain is one of the most common presenting complaints in the emergency department, though only a small minority of patients are subsequently diagnosed with acute coronary syndrome (ACS). However, missing the diagnosis has potential for significant morbidity and mortality. ACS presentations can be atypical, and their workups are often prolonged and costly. In order to risk-stratify patients and better direct the workup and care given, many decision aids have been developed. While each may have merit in certain clinical settings, the most useful aid in the emergency department is one that finds all cases of ACS while also identifying a substantial subset of patients at low risk who can be discharged without stress testing or coronary angiography...
2015: Open Access Emergency Medicine: OAEM
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