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acute coronary syndrome angiography

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https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#1
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)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28089453/serum-uromodulin-is-a-predictive-biomarker-for-cardiovascular-events-and-overall-mortality-in-coronary-patients
#2
Andreas Leiherer, Axel Muendlein, Christoph H Saely, Janine Ebner, Eva M Brandtner, Peter Fraunberger, Heinz Drexel
BACKGROUND: Uromodulin is a protein produced exclusively by the kidneys and present in urine and blood. In contrast to weak and in part contradictory study data on uromodulin in urine samples, the analysis of serum samples recently proved uromodulin's value as superior biomarker for ongoing kidney disease. Whether serum uromodulin is associated with cardiovascular event risk and whether it has predictive power for overall mortality is still unknown and has been evaluated in the present study...
December 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28077820/acute-coronary-syndrome-demonstrating-plaque-rupture-in-calcified-lesions-visualized-by-optical-frequency-domain-imaging
#3
Yutaka Goryo, Teruyoshi Kume, Yusuke Kobayashi, Hiroshi Okamoto, Ai Kawamura, Kenzo Fukuhara, Terumasa Koyama, Ryotaro Yamada, Koichiro Imai, Yoji Neishi, Shiro Uemura
A 68-year-old female with acute coronary syndrome was transferred to our hospital. Emergency coronary angiography showed 90% stenosis with severe calcification in the proximal right coronary artery (RCA). Intravascular ultrasound (IVUS) images were obtained and showed circumferential heavy calcification without any evidence of plaque rupture. Optical frequency domain imaging (OFDI) images were obtained in the RCA lesion 3 days after the initial coronary angiography. A cavity of plaque rupture in the calcified plaque by using OFDI was observed in the lesion, which could not be recognized by IVUS...
January 11, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28077467/gut-microbiota-dependent-trimethylamine-n-oxide-in-acute-coronary-syndromes-a-prognostic-marker-for-incident-cardiovascular-events-beyond-traditional-risk-factors
#4
Xinmin S Li, Slayman Obeid, Roland Klingenberg, Baris Gencer, François Mach, Lorenz Räber, Stephan Windecker, Nicolas Rodondi, David Nanchen, Olivier Muller, Melroy X Miranda, Christian M Matter, Yuping Wu, Lin Li, Zeneng Wang, Hassan S Alamri, Valentin Gogonea, Yoon-Mi Chung, W H Wilson Tang, Stanley L Hazen, Thomas F Lüscher
AIMS: Systemic levels of trimethylamine N-oxide (TMAO), a pro-atherogenic and pro-thrombotic metabolite produced from gut microbiota metabolism of dietary trimethylamine (TMA)-containing nutrients such as choline or carnitine, predict incident cardiovascular event risks in stable primary and secondary prevention subjects. However, the prognostic value of TMAO in the setting of acute coronary syndromes (ACS) remains unknown. METHODS AND RESULTS: We investigated the relationship of TMAO levels with incident cardiovascular risks among sequential patients presenting with ACS in two independent cohorts...
January 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063812/left-main-occlusion-secondary-to-infective-endocarditis-vegetation-the-unusual-suspect
#5
Marco Pavani, Federico Conrotto, Fabrizio D'Ascenzo, Maurizio D'Amico, Paolo Centofanti, Fiorenzo Gaita
Treatment of acute coronary syndrome secondary to septic coronary embolism during valvular endocarditis is controversial. Urgent coronary angiography and stent implantation or surgical intervention have been proposed. We present the case of a patient presented at the emergency department with chest pain and cardiogenic shock. The coronary angiography showed a large filling defect in the left main due to a septic coronary embolism.
November 30, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28052578/ticagrelor-increased-adenosine-and-cyclic-adenosine-monophosphate-plasma-concentration-compared-with-clopidogrel-in-acute-coronary-syndromes-patients
#6
Xiao-Ye Li, Qi-Bing Wang, Ying Xue, Jia-Hui Chen, Qian-Zhou Lv
Ticagrelor produces a more potent antiplatelet effect than clopidogrel, and inhibits cellular uptake of adenosine, which is associated with several cardiovascular consequences. We aimed to explore the correlation between adenosine and cyclic adenosine monophosphate (cAMP) plasma concentration and antiplatelet effect by clopidogrel or ticagrelor in acute coronary syndrome (ACS) patients receiving dual antiplatelet therapy (DAPT). We conducted a prospective, observational and single-centre cohort study enrolling 68 patients with non-ST-segment elevation ACS from January 2016 to May 2016...
January 4, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28051221/contribution-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-acute-coronary-syndrome-with-normal-coronary-angiography
#7
Rana Dahmani, Rim Ben Said, Younes Arous, Houaida Mahfoudhi, Chedia Chourabi, Mehdi Ghommidh, Badii Jedaida, Nizar Ben Mansour, Abdeddayem Haggui, Nadhem Hajlaoui, Dhaker Lahidheb, Wafa Fehri, Habib Haouala
Background - Acute coronary syndrome with high level of troponin is a common pattern for emergency consultation. In 10% of cases, coronary angiography concluded that there were no significant coronary lesions. The contribution of cardiac magnetic resonance imaging (MRI) in the etiological investigation is increasing in these conditions. Aim - We analyzed the diagnostic value of cardiac MRI in case of acute coronary syndromes with elevated troponin and normal coronary angiography. Methods - It's a retrospective analytical study including 31 patients presenting with acute coronary syndrome with positive troponins and normal coronary angiography...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#8
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28040445/the-react-trial-randomized-evaluation-of-routine-follow-up-coronary%C3%A2-angiography-after%C3%A2-percutaneous-coronary-intervention%C3%A2-trial
#9
Hiroki Shiomi, Takeshi Morimoto, Shoji Kitaguchi, Yoshihisa Nakagawa, Katsuhisa Ishii, Yoshisumi Haruna, Itaru Takamisawa, Makoto Motooka, Kazuhiro Nakao, Shintaro Matsuda, Satoru Mimoto, Yutaka Aoyama, Teruki Takeda, Koichiro Murata, Masaharu Akao, Tsukasa Inada, Hiroshi Eizawa, Eiji Hyakuna, Kojiro Awano, Manabu Shirotani, Yutaka Furukawa, Kazushige Kadota, Katsumi Miyauchi, Masaru Tanaka, Yuichi Noguchi, Sunao Nakamura, Satoshi Yasuda, Shunichi Miyazaki, Hiroyuki Daida, Kazuo Kimura, Yuji Ikari, Haruo Hirayama, Tetsuya Sumiyoshi, Takeshi Kimura
OBJECTIVES: The purpose of this study was to evaluate long-term clinical impact of routine follow-up coronary angiography (FUCAG) after percutaneous coronary intervention (PCI) in daily clinical practice in Japan. BACKGROUND: The long-term clinical impact of routine FUCAG after PCI in real-world clinical practice has not been evaluated adequately. METHODS: In this prospective, multicenter, open-label, randomized trial, patients who underwent successful PCI were randomly assigned to routine angiographic follow-up (AF) group, in which patients were to receive FUCAG at 8 to 12 months after PCI, or clinical follow-up alone (CF) group...
December 19, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28031683/left-main-coronary-spasm-an-extremely-rare-entity-with-possible-life-threatening-complications
#10
A Al Emam, N Sricharoen
Coronary artery spasm is a known cause of acute coronary syndrome. However, left main coronary spasm is an extremely rare entity and can present in different ways depending on the duration and severity of the spasm. We present a 44-year-old female patient who presented with transient ST elevation in the lead aVR and ST depression in the lateral and inferior leads. Coronary angiography showed mid left main and ostial right coronary artery spasm that significantly improved after intracoronary nitroglycerine administration...
December 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/28029210/impact-of-an-optical-coherence-tomography-guided-approach-in-acute-coronary-syndromes-a-propensity-matched-analysis-from-the-international-formidable-cardiogroup-iv-and-usz-registry
#11
Mario Iannaccone, Fabrizio D'Ascenzo, Antonio H Frangieh, Giampaolo Niccoli, Fabrizio Ugo, Giacomo Boccuzzi, Maurizio Bertaina, Massimo Mancone, Antonio Montefusco, Nicolas Amabile, Gennaro Sardella, Pascal Motreff, Konstantinos Toutouzas, Francesco Colombo, Roberto Garbo, Giuseppe Biondi-Zoccai, Corrado Tamburino, Pierluigi Omedè, Claudio Moretti, Maurizio D'amico, Geraud Souteyrand, Pascal Meieir, Thomas F Lüscher, Fiorenzo Gaita, Christian Templin
AIM: To determine the potential clinical impact of OCT (Optical Coherence Tomography) during primary percutaneous coronary intervention in patients presenting with ACS (Acute Coronary Syndrome). METHODS AND RESULTS: FORMIDABLE is a multicentre retrospective registry enrolling all patients presenting with ACS and treated with an OCT-guided approach, while the USZ registry enrolled patients treated with a standard angiography guided approach. Multivariate adjustment was performed via a propensity score matching...
December 28, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28029055/improved-risk-stratification-of-patients-with-acute-coronary-syndromes-using-a-combination-of-hstnt-nt-probnp-and-hscrp-with-the-grace-score
#12
Roland Klingenberg, Soheila Aghlmandi, Lorenz Räber, Baris Gencer, David Nanchen, Dik Heg, Sebastian Carballo, Nicolas Rodondi, François Mach, Stephan Windecker, Peter Jüni, Arnold von Eckardstein, Christian M Matter, Thomas F Lüscher
BACKGROUND: Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. METHODS: Consecutive patients admitted at four Swiss university hospitals with a diagnosis of acute coronary syndrome were enrolled into the SPUM-ACS Biomarker Cohort between 2009 and 2012. Patients were followed at 30 days and 1 year with assessment of adjudicated events including all-cause mortality and the composite of all-cause mortality or non-fatal recurrent myocardial infarction...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28028722/relationship-between-two-blood-stasis-syndromes-and-inflammatory-factors-in-patients-with-acute-coronary-syndrome
#13
Cai-Yun Ma, Jing-Hua Liu, Jian-Xun Liu, Da-Zhuo Shi, Zhen-Ye Xu, Shao-Ping Wang, Min Jia, Fu-Hai Zhao, Yue-Rong Jiang, Qin Ma, Hong-Yu Peng, Yuan Lu, Ze Zheng, Feng-Xue Ren
OBJECTIVE: To investigate the relationship between inflammatory factors and two Chinese medicine (CM) syndrome types of qi stagnation and blood stasis (QSBS) and qi deficiency and blood stasis (QDBS) in patients with acute coronary syndrome (ACS). METHODS: Sixty subjects with ACS, whose pathogenesis changes belongs to qi disturbance blood stasis syndrome, were divided into 2 groups: 30 in the QSBS group and 30 in the QDBS group. The comparative analysis on them was carried out through comparing general information, coronary angiography and inflammatory factors including intracellular adhesion molecule-1 (ICAM-1), chitinase-3-like protein 1 (YKL-40) and lipoprotein-associated phospholipase A2 (Lp-PLA2)...
December 27, 2016: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28025065/trends-in-u-s-cardiovascular-care-2016-report-from-4-acc-national-cardiovascular-data-registries
#14
REVIEW
Frederick A Masoudi, Angelo Ponirakis, James A de Lemos, James G Jollis, Mark Kremers, John C Messenger, John W M Moore, Issam Moussa, William J Oetgen, Paul D Varosy, Robert N Vincent, Jessica Wei, Jeptha P Curtis, Matthew T Roe, John A Spertus
Cardiovascular disease (CVD) is a leading cause of death and disability in the United States. National quality programs such as the National Cardiovascular Data Registry (NCDR®) permit assessments of the quality of care and outcomes for broad populations of patients with CVD. This report provides data from 2014 from four NCDR® hospital quality programs: 1) CathPCI® for coronary angiography and percutaneous coronary intervention (667,424 procedures performed in 1,612 hospitals) ICD™ for implantable cardioverter defibrillators (158,649 procedures performed in 1,715 hospitals); 3) ACTION®-GWTG™ for acute coronary syndromes (182,903 patients admitted to 907 hospitals); and 4) IMPACT® for cardiac catheterization and intervention for pediatric and adult congenital heart disease (20,169 procedures in 76 hospitals)...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28024654/coronary-computed-tomography-angiography-derived-plaque-quantification-in-patients-with-acute-coronary%C3%A2-syndrome
#15
Christian Tesche, Damiano Caruso, Carlo N De Cecco, Darby C Shuler, Jess D Rames, Moritz H Albrecht, Taylor M Duguay, Akos Varga-Szemes, David Jochheim, Moritz Baquet, Richard R Bayer, Ullrich Ebersberger, Sheldon E Litwin, Salvatore A Chiaramida, Ellen Hoffmann, U Joseph Schoepf
This study investigated the discriminatory value of quantitative atherosclerotic plaque markers derived from coronary computed tomography angiography (cCTA) in patients with first acute coronary syndrome (ACS) compared with patients with stable coronary artery disease (CAD). Forty patients (56.9 ± 9.3 years, 55% men) admitted with their first ACS and Framingham risk score-matched controls with stable CAD were retrospectively analyzed. All patients had undergone cCTA followed by invasive coronary angiography...
December 3, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28017258/long-term-follow-up-after-near-infrared-spectroscopy-coronary-imaging-insights-from-the-lipid-core-plaque-association-with-clinical-events-oracle-nirs-registry
#16
Barbara Anna Danek, Aris Karatasakis, Judit Karacsonyi, Aya Alame, Erica Resendes, Pratik Kalsaria, Phuong-Khanh J Nguyen-Trong, Bavana V Rangan, Michele Roesle, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. METHODS: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up...
December 15, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28012615/acc-aats-aha-ase-asnc-scai-scct-sts-2016-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-acute-coronary-syndromes-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery
#17
https://www.readbyqxmd.com/read/28005450/the-ecg-in-the-differential-diagnosis-between-takotsubo-cardiomyopathy-and-acute-coronary-syndrome
#18
Federico Guerra, Irene Giannini, Alessandro Capucci
Takotsubo cardiomyopathy (TC) is an acquired cardiomyopathy affecting mostly postmenopausal women mimicking an acute coronary syndrome (ACS). TC clinical presentation involves chest pain, elevated cardiac enzymes, wall motion abnormalities and electrocardiographic changes, all of which share striking similarities to ACS. Areas covered: Differential diagnosis between TC and ACS can be complex since there are no reliable and widely-accepted electrocardiographic criteria and, at the moment, only coronary angiography can rule out one of the two diagnoses with good certainty...
December 29, 2016: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27999237/resting-and-activated-natural-tregs-decrease-in-the-peripheral-blood-of-patients-with-atherosclerosis
#19
Mohammadreza Yazdani, Shahdad Khosropanah, Ahmad Hosseini, Mehrnoosh Doroudchi
BACKGROUND: Atherosclerosis is a chronic inflammatory disease affecting large and medium arteries. CD4+ T cells are known to play a role in the progression of the disease. CD4+CD25+Foxp3+ natural Treg (nTreg) cells seem to have a protective role in the disease and their reduction in acute coronary syndrome is recently shown. OBJECTIVE: To investigate the frequency of nTreg subsets in the peripheral blood of patients with atherosclerosis. METHODS: Confirmation of atherosclerosis was done by angiography and 15 ml heparinized blood was obtained from each of the 13 non-diabetic patients and 13 non-diabetic, non-smoker individuals with normal/insignificant coronary artery disease confirmed by angiography...
December 2016: Iranian Journal of Immunology: IJI
https://www.readbyqxmd.com/read/27988230/spontaneous-coronary-artery-dissection-still-a-lot-to-learn
#20
David Neves, Ângela Bento, Renato Fernandes, Lino Patrício, José Aguiar
Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is an uncommon but probably underdetected pathological substrate for acute coronary syndrome. Clinical associations have been noted, like female gender and young age, but its pathophysiology is not yet fully understood. In this report we describe the case of a 50-year-old woman, without cardiovascular risk factors presenting with non-ST segment elevation myocardial infarction, in whom SCAD was diagnosed. Treatment was initially conservative but due to aggravation of the dissection she eventually underwent a complex percutaneous coronary intervention, requiring implantation of multiple stents, but with a good clinical outcome...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
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