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acute coronary syndrome angiography

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https://www.readbyqxmd.com/read/28818351/recent-trends-in-management-and-outcome-of-patients-with-acute-coronary-syndromes-and-atrial-fibrillation
#1
Leonardo De Luca, Gianni Casella, Andrea Rubboli, Lucio Gonzini, Donata Lucci, Alessandro Boccanelli, Francesco Chiarella, Antonio Di Chiara, Stefano De Servi, Andrea Di Lenarda, Giuseppe Di Pasquale, Stefano Savonitto
AIMS: To describe the clinical characteristics, contemporary trends of in-hospital management and outcome of patients admitted for an acute coronary syndrome (ACS) with associated atrial fibrillation (AF). METHODS: We analyzed data from four Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive ACS patients. RESULTS: Out of 16,803 ACS patients, 1019 (6.1%) presented with concomitant AF: 668 with non-ST elevation (NSTE)-ACS and 351 with ST-elevation myocardial infarction (STEMI)...
August 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28814587/a-case-of-cardiopulmonary-arrest-due-to-spontaneous-coronary-artery-dissection-in-a-pregnant-woman
#2
Emiko Ejima, Yoshinobu Murasato
We present the case of a young pregnant woman with cardiopulmonary arrest due to acute coronary syndrome. Emergent coronary angiography (CAG) and intravascular ultrasound (IVUS) showed extensive coronary artery dissection in the left anterior descending artery, which was treated with primary percutaneous coronary intervention. After managing the heart failure and disseminated intravascular coagulation, a dead fetus was delivered via caesarean section 4 days after admission to the hospital. Follow-up CAG and IVUS at 18 months showed persistent dissection in the non-stented site; hence, another stent was implanted...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28812321/prognostic-impact-of-intensive-statin-therapy-on-n-terminal-pro-bnp-level-in-non-st-segment-elevation-acute-myocardial-infarction-patients
#3
Mohamed Shehata, Ayman Samir, May Dardiri
OBJECTIVE: This study explored the impact of intensive daily dosing of atorvastatin on in-hospital N-terminal pro-B-type natriuretic peptide level, left ventricular systolic function and incidence of major adverse cardiac events in non-ST-segment elevation myocardial infarction patients. BACKGROUND: Several studies showed that early initiation of statin therapy in acute coronary syndrome patients has a favorable prognostic impact. METHODS: Hundred statin naive patients were prospectively enrolled...
August 15, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28804682/effects-of-intensive-pitavastatin-therapy-on-glucose-control-in-patients-with-non-st-elevation-acute-coronary-syndrome
#4
Yan-Bo Wang, Xiang-Hua Fu, Xin-Shun Gu, Wei-Ze Fan, Yun-Fa Jiang, Guo-Zhen Hao, Qing Miao, Jie Cao, Bing Fu, Yi Li
Objective: This study aimed to investigate the effects of intensive pitavastatin therapy on glucose control in patients with non-ST elevation acute coronary syndrome (ACS). Methods: Patients who had ACS with significant stenosis on initial coronary angiography and received successful percutaneous coronary intervention (PCI) in the Second Hospital of Hebei Medical University, Shijiazhuang, China from August 2015 to January 2016 were enrolled in this study. The patients were randomized to receive pitavastatin (4 mg daily) or atorvastatin (20 mg daily)...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/28804589/spontaneous-coronary-artery-dissection-an-under-recognized-cause-of-acute-coronary-syndromes
#5
Hanan Al Naabi, Hatim Al Lawati
Spontaneous coronary artery dissection (SCAD) is a rare condition that is often underdiagnosed given limitations of conventional cineangiography. In addition to the diagnostic challenge, the condition poses a major therapeutic dilemma given paucity of literature to guide management. We report the case of a 55-year-old woman, who presented with acute coronary syndrome. Coronary angiography at the time of the index hospitalization revealed type 2 SCAD. She was managed conservatively. Repeat coronary angiography three months later showed complete resolution of the previously noted dissection...
July 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28802810/early-invasive-versus-initially-conservative-strategy-in-elderly-patients-older-than-75-years-with-non-st-elevation-acute-coronary-syndrome-a-meta-analysis
#6
Wenfang Ma, Yan Liang, Jun Zhu
BACKGROUND: Fear of complications related to the procedure and unclear benefits in elderly patients are common reasons for invasive angiography being withheld. METHODS: We searched PubMed and Embase from inception until February 2016 for studies that enrolled individuals older than 75 years with non-ST-elevation acute coronary syndrome (NSTE-ACS) and allocated patients to either an invasive or conservative strategy. RESULTS: Thirteen studies (four randomised controlled trials (RCTs) and nine observational studies) enrolling 832,007 elderly NSTE-ACS patients were analysed...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28799447/a-higher-volume-of-fibrotic-tissue-on-virtual-histology-prior-to-coronary-stent-implantation-predisposes-to-more-pronounced-neointima-proliferation
#7
Steven Haine, Kristien Wouters, Hielko Miljoen, Tom Vandendriessche, Marc Claeys, Johan Bosmans, Christiaan Vrints
BACKGROUND: Since neointima smooth muscle cells (SMC) mainly originate from the vessel wall, we investigated whether atherosclerotic plaque composition influences subsequent in-stent neointima proliferation and restenosis. METHODS: We performed intravascular ultrasound (IVUS) with virtual histology in 98 patients prior to elective bare-metal stent (BMS) implantation in de novo coronary artery lesions. Virtual histology variables pre-percutaneous coronary intervention (PCI) were related to in-stent neointima proliferation six months after implantation assessed as late luminal loss of 0...
August 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/28798192/coronary-angiography-in-worsening-heart-failure-determinants-findings-and-prognostic-implications
#8
João Pedro Ferreira, Patrick Rossignol, Biniyam Demissei, Abhinav Sharma, Nicolas Girerd, Stefan D Anker, John G Cleland, Kenneth Dickstein, Gerasimos Filippatos, Hans L Hillege, Chim C Lang, Marco Metra, Leong L Ng, Piotr Ponikowski, Nilesh J Samani, Dirk J van Veldhuisen, Aeilko H Zwinderman, Adriaan Voors, Faiez Zannad
OBJECTIVES: Coronary angiography is regularly performed in patients with worsening signs and/or symptoms of heart failure (HF). However, little is known on the determinants, findings and associated clinical outcomes of coronary angiography performed in patients with worsening HF. METHODS: The BIOSTAT-CHF (a systems BIOlogy Study to TAilored Treatment in Chronic Heart Failure) programme enrolled 2516 patients with worsening symptoms and/or signs of HF, either hospitalised or in the outpatient setting...
August 10, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28797471/preinfarct-health-status-and-the-use-of-early-invasive-versus-ischemia-guided-management-in-non-st-elevation-acute-coronary-syndrome
#9
Mohammed Qintar, Kim G Smolderen, Paul S Chan, Kensey L Gosch, Philip G Jones, Donna M Buchanan, Saket Girotra, John A Spertus
Early invasive management improves outcomes in non-ST-elevation myocardial infarction (NSTEMI). The association between preinfarct health status and the selecting patients for early invasive management is unknown. The Prospective Registry Evaluating outcomes after Myocardial Infarctions: Events and Recovery and Translational Research Investigating Underlying disparities in acute Myocardial infarction Patients' Health status are consecutive US multicenter registries, in which the associations between preinfarct angina frequency and quality of life (both assessed by the Seattle Angina Questionnaire on admission) and the Global Registry of Acute Coronary Events (GRACE) risk score and referral to early invasive management (coronary angiography within 48 hours) were evaluated using Poisson regression, after adjusting for site, demographics, and clinical and psychosocial variables...
July 14, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28797410/prevalence-predictors-and-clinical-presentation-of-a-calcified-nodule-as-assessed-by-optical-coherence-tomography
#10
Tetsumin Lee, Gary S Mintz, Mitsuaki Matsumura, Wenbin Zhang, Yang Cao, Eisuke Usui, Yoshihisa Kanaji, Tadashi Murai, Taishi Yonetsu, Tsunekazu Kakuta, Akiko Maehara
OBJECTIVES: This study sought to determine the anatomic characteristics and clinical presentation associated with a calcified nodule (CN) as assessed by optical coherence tomography. BACKGROUND: CN is an unusual but demonstrable cause of acute coronary syndromes (ACS). METHODS: We studied 889 de novo culprit lesions in 889 patients (48% ACS) who underwent optical coherence tomography before intervention. CN was defined as an eruptive accumulation of nodular calcification (small fractured calcifications)...
August 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#11
Yujiro Ito, Yoshitsugu Nakamura, Miho Kuroda, Yuki Endo, Yusuke Nakanishi, Takaki Hori
Circumferential dissection is a rare clinical condition of aortic dissection, which is also known as intimo-intimal intussusception. In patients with type A aortic dissection with intimo-intimal intussusception, disruption and prolapse of the intimal flap into the left ventricle may occur and cause severe aortic regurgitation or blockage of the coronary artery ostium. A 43-year-old man presented with sudden dyspnea. Echocardiography revealed severe aortic insufficiency. Acute coronary syndrome was also suspected, but coronary angiography showed normal coronary arteries...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28774187/mean-platelet-volume-to-lymphocyte-ratio-as-a-novel-marker-for-severity-and-complexity-of-coronary-atherosclerosis-in-patients-with-acute-coronary-syndrome
#12
Alparslan Kilic, Alparslan Kurtul
The thromboinflammatory process plays an important role in the pathophysiology of acute coronary syndrome (ACS). Recently, the mean platelet volume-to-lymphocyte ratio (MPVLR) has been suggested as a prognostic marker in patients with ACS. We assessed the association of MPVLR with the severity and complexity of coronary atherosclerosis in patients with ACS. A total of 1782 patients undergoing urgent coronary angiography were enrolled. The SYNTAX score (SXscore) was calculated for each patient. Patients were divided into 2 groups: low SXscore (<23) and intermediate-to-high SXscore (≥23)...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28765791/coronary-artery-disease-presenting-with-left-upper-quadrant-pain-in-a-patient-with-chronic-cervical-tetraplegia
#13
Lianne Michelle Nier, Peter S Hansen
INTRODUCTION: This single-subject case report aims to describe and discuss a case of a patient with established C5 tetraplegia with acute coronary syndrome presenting with left upper quadrant pain and tenderness. CASE PRESENTATION: A 65-year-old male with chronic C5 American Spinal Injury Association Impairment Scale (AIS) A tetraplegia presented to the emergency department with severe left upper quadrant pain radiating across the chest to the right upper limb with associated dyspnoea and diaphoresis...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28765182/a-vulnerable-plaque-identified-on-ct-coronary-angiography-when-should-we-act-in-stable-coronary-artery-disease
#14
Sarah R Blake, Thomas D Heseltine, Scott Murray, Balazs Ruzsics
CT coronary angiography (CTCA) is increasingly being used to diagnose coronary artery disease (CAD). Recent technological advancements, including dual energy CT and improved gantry times, have led to the ability to image coronary arteries with excellent spatial resolution at low radiation doses. Atheromatous plaques can be identified using CTCA and assessed to establish the risk of acute coronary syndrome from each individual plaque. If CTCA identifies CAD, it should then be used in conjunction with functional testing or invasive angiography with physiological assessment to establish the significance of coronary disease in an individual patient...
August 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#15
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28764226/cisplatin-induced-acute-myocardial-infarction-and-dyslipidemia
#16
Lalith Prabhakar Hanchate, Shimpa Rakesh Sharma, Sadhana Madyalkar
Myocardial infarction commonly occurs due to rupture of atherosclerotic plaque in the coronary arteries and is manifested on coronary angiography. Myocardial infarction with angiographically normal coronary arteries can occur due to hypercoagulable state, coronary spasm, embolism, arteritis, congenital condition and drugs. Illicit drugs such as cocaine, amphetamines and marijuana are known to cause myocardial infarction. Of the many medications that are associated with cardiovascular toxicity, chemotherapeutic agents form a large group with both acute and delayed cardiotoxicity...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28762926/-giant-aneurisms-of-coronary-arteries-in-the-kawasaki-syndrome
#17
G A Lyskina, O L Bokeriya, O G Shirinskaya, N V Gagarina, A S Satyukova, A V Torbyak, Yu O Kostina
BACKGROUND: Kawasaki disease is an acute systemic vasculitis of childhood with possible coronary artery involvement which can cause acute coronary syndrome in children and young adults. PURPOSE: to study clinical and demographic characteristics of patients with Kawasaki disease with giant coronary aneurysms, to assess long-term prognosis in these patients. MATERIAL AND METHODS: In 2003-2015 262 children with Kawasaki disease were examined in the University Children Hospital of the I...
May 2017: Kardiologiia
https://www.readbyqxmd.com/read/28761455/unusual-presentation-of-extensive-spontaneous-coronary-dissection-case-report-and-literature-review
#18
Júlio César Queiroz França, Márcio Antonio Santos, Moacir Fernandes Godoy
BACKGROUND: The etiology of spontaneous dissection of coronary artery (SDCA) is not well understood yet. Different studies have linked this entity to pregnancy, physical stress, collagen diseases and vasculitis. In general, patients do not exhibit the classic risk factors for coronary artery disease, which mandates the suspicion of this condition, especially in young adults with acute coronary syndrome. CASE REPORT: In this article, we report the case of a 63-year old male patient, asymptomatic, who came for periodic evaluation and after evaluation by exercise and myocardial scintigraphy had high suspicion for severe coronary artery disease and underwent coronary angiography, which showed spontaneous dissection of the left and right branches of the coronary arteries...
January 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28761388/coronary-stents-and-vascular-response-to-implantation-literature-review
#19
REVIEW
Marta Francesca Brancati, Francesco Burzotta, Carlo Trani, Ornella Leonzi, Claudio Cuccia, Filippo Crea
Drug-eluting stents (DESs) have minimized the limitations of bare-metal stents (BMSs) after percutaneous coronary interventions. Nevertheless, serious concerns remain about possible late complications of stenting, such as stent thrombosis (ST) and in-stent restenosis (ISR), although the introduction of second-generation DESs seems to have softened the phenomenon, compared to the first-generation ones. ST is a potentially catastrophic event, which has been markedly reduced by optimization of stent implantation, novel stent designs, and dual antiplatelet therapy...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28751841/consensus-document-of-the-italian-association-of-hospital-cardiologists-anmco-italian-society-of-cardiology-sic-italian-association-of-interventional-cardiology-sici-gise-and-italian-society-of-cardiac-surgery-sicch-clinical-approach-to-pharmacologic-pre-treatment
#20
Roberto Caporale, Giovanna Geraci, Michele Massimo Gulizia, Mauro Borzi, Furio Colivicchi, A Menozzi, Giuseppe Musumeci, Marino Scherillo, Antonietta Ledda, Giuseppe Tarantini, Piersilvio Gerometta, Giancarlo Casolo, Dario Formigli, Francesco Romeo, Roberto Di Bartolomeo
The wide availability of effective drugs in reducing cardiovascular events together with the use of myocardial revascularization has greatly improved the prognosis of patients with coronary artery disease. The combination of antithrombotic drugs to be administered before the knowledge of the coronary anatomy and before the consequent therapeutic strategies, can allow to anticipate optimal treatment, but can also expose the patients at risk of bleeding that, especially in acute coronary syndromes, can significantly weigh on their prognosis, even more than the expected theoretical benefit...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
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