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acute coronary syndrome angiography

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https://www.readbyqxmd.com/read/28330794/radiation-exposure-and-vascular-access-in-acute-coronary-syndromes-the-radmatrix-trial
#1
Alessandro Sciahbasi, Enrico Frigoli, Alessandro Sarandrea, Martina Rothenbühler, Paolo Calabrò, Alessandro Lupi, Francesco Tomassini, Bernardo Cortese, Stefano Rigattieri, Enrico Cerrato, Dennis Zavalloni, Antonio Zingarelli, Paolo Calabria, Paolo Rubartelli, Gennaro Sardella, Matteo Tebaldi, Stephan Windecker, Peter Jüni, Dik Heg, Marco Valgimigli
BACKGROUND: It remains unclear whether radial increases the risk of operator or patient radiation exposure when performed by expert operators OBJECTIVES: To determine whether radial access increases radiation exposure METHODS: We randomly assigned 8404 patients, with or without ST-segment elevation acute coronary syndrome, to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose area product (DAP). In the radiation sub-study (RAD-MATRIX), we anticipated that 13 or more operators, each wearing a thorax (primary endpoint), wrist and head (secondary endpoints) lithium fluoride thermo luminescent dosimeter and randomizing at least 13 patients per access site were needed to establish non-inferiority of radial versus femoral access...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#2
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28325613/head-to-head-comparison-of-the-diagnostic-performance-of-coronary-computed-tomography-angiography-and-dobutamine-stress-echocardiography-in-the-evaluation-of-acute-chest-pain-with-normal-ecg-findings-and-negative-troponin-tests-a-prospective-multicenter-study
#3
Eric Durand, Fabrice Bauer, Nicolas Mansencal, Arshid Azarine, Benoit Diebold, Albert Hagege, Ludivine Perdrix, Martine Gilard, Yannick Jobic, Hélène Eltchaninoff, Mourad Bensalah, Benjamin Dubourg, Jérôme Caudron, Ralph Niarra, Gilles Chatellier, Jean-Nicolas Dacher, Elie Mousseaux
OBJECTIVE: To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. METHODS: Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up...
March 2, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28321018/coronary-artery-disease-in-premenopausal-and-postmenopausal-women
#4
Lu Yihua, Jiang Yun, Zhao Dongshen
The purpose was to determine the differences between premenopausal and postmenopausal coronary artery disease (CAD) risk factors, clinical manifestation, cardiovascular features, rates of recurrence, and influencing factors.Premenopausal (n = 57) and postmenopausal (n = 178) CAD women hospitalized during the same period were enrolled. All patients were followed-up, and the combined recurrence of major adverse cardiovascular events was recorded as the clinical outcome. Differences were compared between the 2 groups...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#5
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320749/sex-differences-in-percutaneous-coronary-intervention-insights-from-the-coronary-angiography-and-pci-registry-of-the-german-society-of-cardiology
#6
Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Hans Martin Hoffmeister, Stefan Sack, Jochen Senges, Steffen Massberg, Anselm K Gitt, Uwe Zeymer
BACKGROUND: Several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures. METHODS AND RESULTS: Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease, non-ST elevation acute coronary syndromes, ST elevation myocardial infarction, and cardiogenic shock...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28317438/instantaneous-wave-free-ratio-versus-fractional-flow-reserve-to-guide-pci
#7
Matthias Götberg, Evald H Christiansen, Ingibjörg J Gudmundsdottir, Lennart Sandhall, Mikael Danielewicz, Lars Jakobsen, Sven-Erik Olsson, Patrik Öhagen, Hans Olsson, Elmir Omerovic, Fredrik Calais, Pontus Lindroos, Michael Maeng, Tim Tödt, Dimitrios Venetsanos, Stefan K James, Amra Kåregren, Margareta Nilsson, Jörg Carlsson, Dario Hauer, Jens Jensen, Ann-Charlotte Karlsson, Georgios Panayi, David Erlinge, Ole Fröbert
Background The instantaneous wave-free ratio (iFR) is an index used to assess the severity of coronary-artery stenosis. The index has been tested against fractional flow reserve (FFR) in small trials, and the two measures have been found to have similar diagnostic accuracy. However, studies of clinical outcomes associated with the use of iFR are lacking. We aimed to evaluate whether iFR is noninferior to FFR with respect to the rate of subsequent major adverse cardiac events. Methods We conducted a multicenter, randomized, controlled, open-label clinical trial using the Swedish Coronary Angiography and Angioplasty Registry for enrollment...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28315826/early-invasive-strategy-and-in-hospital-survival-among-diabetics-with-non-st-elevation-acute-coronary-syndromes-a-contemporary-national-insight
#8
Ahmed N Mahmoud, Islam Y Elgendy, Hend Mansoor, Xuerong Wen, Mohammad K Mojadidi, Anthony A Bavry, R David Anderson
BACKGROUND: There are limited data on the merits of an early invasive strategy in diabetics with non-ST-elevation acute coronary syndrome, with unclear influence of this strategy on survival. The aim of this study was to evaluate the in-hospital survival of diabetics with non-ST-elevation acute coronary syndrome treated with an early invasive strategy compared with an initial conservative strategy. METHODS AND RESULTS: The National Inpatient Sample database, years 2012-2013, was queried for diabetics with a primary diagnosis of non-ST-elevation acute coronary syndrome defined as either non-ST-elevation myocardial infarction or unstable angina (unstable angina)...
March 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#9
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28294854/-registry-of-acute-coronary-syndromes-record-3-characteristics-of-patients-and-treatment-during-initial-hospitalization
#10
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
https://www.readbyqxmd.com/read/28292380/correlation-of-c-reactive-protein-and-cardiac-enzymes-with-angiographic-severity-of-coronary-artery-disease-in-pakistani-patients-with-acute-coronary-syndrome
#11
Ayesha Saleem, Azmat Ali
OBJECTIVE: To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). STUDY DESIGN: Prospective, descriptive study...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28291730/association-between-clinical-pathways-leading-to-medical-management-and-prognosis-in-patients-with-nsteacs
#12
Héctor Bueno, Stuart Pocock, Jesús Medina, Nicolas Danchin, Lieven Annemans, Muriel Licour, John Gregson, Ana María Vega, Frans van de Werf
INTRODUCTION AND OBJECTIVES: A large proportion of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) are initially selected for medical management (MM) and do not undergo coronary revascularization during or immediately after the index event. The aim of this study was to explore the clinical pathways leading to MM in NSTEACS patients and their influence on prognosis. METHODS: Patient characteristics, pathways leading to MM, and 2-year outcomes were recorded in a prospective cohort of 5591 NSTEACS patients enrolled in 555 hospitals in 20 countries across Europe and Latin America...
March 10, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28290859/-prognostic-significance-of-erythropoietin-in-patients-with-acute-coronary-syndrome
#13
M V Menzorov, A M Shutov, N V Larionova, A A Strakhov, D V Serova
AIM: to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS: Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290841/-novel-scale-for-long-term-prognostication-of-risk-of-death-and-nonfatal-cardiovascular-complications-in-patients-from-the-prognosis-ihd-registry
#14
S N Tolpygina, S Yu Martsevich, E A Gofman, A D Deev
PURPOSE: To elaborate a risk score for prognostication of long-term survival of patients with chronic ischemic heart disease (CIHD) using data of the PROGNOSIS-IHD Registry. MATERIAL AND METHODS: Participants of the PROGNOSIS-IHD Registry (n=641, 500 men, 141 women) were inhabitants of Moscow region consecutively admitted for planned hospitalization with diagnosis of IHD to the clinic of the Center of Preventive Medicine from 01.01.2004 to 31.12.2007. During hospitalization all patients underwent coronary angiography...
June 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290832/-computed-tomography-in-the-evaluation-of-coronary-atherosclerotic-plaques-comparison-with-intravascular-ultrasound
#15
T N Veselova, M S Shabanova, V M Mironov, I N Merkulova, S K Ternovoy
PURPOSE: Determination of computed tomography angiography (CTA) informativeness in assessment of state of atherosclerotic coronary plaque (ACP) and identification of signs of its instability compared with intravascular ultrasound (IVUS). MATERIALS AND METHODS: Coronary CTA was carried out in 52 patients with clinical presentation of non-ST elevation (NSTE) acute coronary syndrome on the first day of hospitalization. ACPs were identified in 32 of 52 patients (61...
January 2017: Kardiologiia
https://www.readbyqxmd.com/read/28285408/essential-thrombocythemia-presenting-as-acute-coronary-syndrome-case-reports-and-literature-review
#16
Nanqing Xiong, Wen Gao, Junjie Pan, Xinping Luo, Haiming Shi, Jian Li
For the patients with essential thrombocythemia (ET), systemic thrombosis presents as one of the most dangerous complications. It's been widely accepted that acute coronary syndrome (ACS) is a kind of thrombotic diseases. However, there are very few case reports about ET first presenting as ACS. For some patients diagnosed as ACS, but without markedly elevated platelet, underlying ET was missed. And there are some controversies in the principles and target of treatment in those patients. We reported three cases of ACS, in which the patients who did not have common risk factors for coronary artery diseases and presented only mild atherosclerotic stenosis during coronary angiography, one of which had recurrent coronary artery thrombosis...
March 11, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28279382/trials-of-imaging-use-in-the-emergency-department-for-acute-chest-pain
#17
REVIEW
Gilbert L Raff, Udo Hoffmann, James E Udelson
Over 8 million patients seek emergency department care for acute chest pain annually in the United States alone, and <5% have an acute coronary syndrome. In the absence of overt electrocardiographic or biomarker evidence, expensive and time-consuming diagnostic strategies are frequently required. Beginning in 2000, radionuclide myocardial perfusion, stress echocardiography, cardiac magnetic resonance imaging, and coronary computed tomographic angiography have become increasingly common in evaluating these patients...
March 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/28275618/extracorporeal-life-support-for-refractory-ventricular-tachycardia
#18
REVIEW
Sujatha P Bhandary, Nicholas Joseph, James P Hofmann, Theodosios Saranteas, Thomas J Papadimos
Extracorporeal life support (ECLS) is a very effective bridging therapy in patients with refractory ventricular tachycardia (VT) associated with cardiogenic shock. A moribund patient in extremis, is not amenable to optimization by standard ACC/AHA guidelines. New approaches and novel salvage techniques are necessary to improve outcomes in patients with refractory clinical settings such as malignant ventricular arrhythmias, cardiac arrest, cardiogenic shock and/or pulmonary failure until further management options are explored...
February 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28275421/treating-a-structural-heart-disease-using-a-non-structural-approach-role-of-cardiac-pacing-in-hypertrophic-cardiomyopathy
#19
Bernard Benjamin P Albano, Erdie C Fadreguilan, Jeffrey M Chua, James Ho, Ana Beatriz Medrano
Hypertrophic cardiomyopathy (HCM) is the most common genetic cardiovascular disease characterized by a thickened non-dilated ventricle in the absence of another cardiac or systemic condition. Its most important hemodynamic consequence is left ventricular outflow tract (LVOT) obstruction. The primary management strategy of this condition is surgical septal myectomy, but an acceptable alternative treatment in patients who are not suitable for (or who refuse) surgery is alcohol septal ablation (ASA). However, in patients with unfavorable coronary anatomy which precludes ASA (i...
February 2017: Cardiology Research
https://www.readbyqxmd.com/read/28273300/one-year-follow-up-of-the-european-ambulance-acute-coronary-syndrome-angiography-trial
#20
Ajay J Kirtane, Robert A Harrington
No abstract text is available yet for this article.
March 8, 2017: JAMA Cardiology
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