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https://www.readbyqxmd.com/read/27895344/peri-operative-determinants-of-prolonged-cicu-stay-after-coronary-artery-bypass-graft-surgery-in-elderly-at-a-private-tertiary-care-hospital-a-case-control-study
#1
Fazal Wahab Khan, Shiraz Hashmi, Syed Saeed Naeem, Benish Fatima, Hashim Hanif, Mubashir Zareen, Saulat Hasnain Fatimi
OBJECTIVE: To explore peri-operative risk factors associated with prolonged stay in cardiac intensive care unit among patients undergoing isolated coronary artery bypass grafting. Methods: This retrospective case control study was conducted at the Aga Khan University Hospital, Karachi, comprised medical records of patients who had undergone cardiothoracic revascularisation surgery from January 2006 to December 2013. The patients were grouped into cases and controls at a ratio of 1:2 on the basis of length of stay at cardiac intensive care unit, i...
October 2016: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/27891375/flow-mediated-dilatation-carotid-intima-media-thickness-ankle-brachial-pressure-index-and-pulse-pressure-in-young-male-post-myocardial-infarction-patients-in-india
#2
Nikhil Gupta, Subhash Giri, Vinita Rathi, Gajender Singh Ranga
INTRODUCTION: Due to increase in Coronary Artery Disease (CAD) at a younger age, we should try to diagnose atherosclerotic process and population at risk, at the earliest. Flow Mediated Dilatation (FMD), Carotid Intima-Media Thickness (CIMT) and Ankle-Brachial Pressure Index (ABI) are probable markers for early atherosclerosis and may be useful in coronary risk stratification. AIM: To compare and correlate the FMD, CIMT, ABI and Pulse Pressure (PP) in young male patients of Myocardial Infarction (MI) with age and sex matched healthy controls...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27885414/clinical-implementation-of-an-emergency-department-coronary-computed-tomographic-angiography-protocol-for-triage-of-patients-with-suspected-acute-coronary-syndrome
#3
Brian B Ghoshhajra, Richard A P Takx, Pedro V Staziaki, Harshna Vadvala, Phillip Kim, Tomas G Neilan, Nandini M Meyersohn, Daniel Bittner, Sumbal A Janjua, Thomas Mayrhofer, Jeffrey L Greenwald, Quyhn A Truong, Suhny Abbara, David F M Brown, James L Januzzi, Sanjeev Francis, John T Nagurney, Udo Hoffmann
OBJECTIVES: To evaluate the efficiency and safety of emergency department (ED) coronary computed tomography angiography (CTA) during a 3-year clinical experience. METHODS: Single-center registry of coronary CTA in consecutive ED patients with suspicion of acute coronary syndrome (ACS). The primary outcome was efficiency of coronary CTA defined as the length of hospitalization. Secondary endpoints of safety were defined as the rate of downstream testing, normalcy rates of invasive coronary angiography (ICA), absence of missed ACS, and major adverse cardiac events (MACE) during follow-up, and index radiation exposure...
November 24, 2016: European Radiology
https://www.readbyqxmd.com/read/27880845/central-sleep-apnoea-is-related-to-the-severity-and-short-term-prognosis-of-acute-coronary-syndrome
#4
Marina Florés, Jordi de Batlle, Alicia Sánchez-de-la-Torre, Manuel Sánchez-de-la-Torre, Albina Aldomá, Fernando Worner, Estefanía Galera, Asunción Seminario, Gerard Torres, Mireia Dalmases, Josep M Montserrat, Onintza Garmendia, Ferran Barbé
OBJECTIVE: To evaluate the relation of central sleep apnoea (CSA) to the severity and short-term prognosis of patients who experience acute coronary syndrome (ACS). METHODS: Observational study with cross-sectional and longitudinal analyses. Patients acutely admitted to participating hospitals because of ACS underwent respiratory polygraphy during the first 24 to 72 h. CSA was defined as an apnoea-hypopnoea index (AHI) >15 events•h-1 (>50% of central apnoeas)...
2016: PloS One
https://www.readbyqxmd.com/read/27871588/novel-resuscitation-devices-facilitate-complete-neurologic-recovery-after-prolonged-cardiac-arrest-in-postanesthesia-care-unit
#5
Elif C Cingi, Luke A McMahon, Richard C Prielipp
Cardiac arrest in the perioperative period is associated with significant morbidity and mortality. Novel resuscitation devices may afford patients improved survival and limit neurologic injury. We report a case of cardiac arrest in the postanesthesia care unit that required an extensive period of cardiopulmonary resuscitation assisted by the ResQPOD impedance threshold device to optimize coronary perfusion and a LUCAS chest compression system to maintain optimal cardiopulmonary resuscitation while transporting the patient to the cardiac catheterization laboratory...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27871542/severe-respiratory-depression-and-bradycardia-before-induction-of-anesthesia-and-onset-of-takotsubo-cardiomyopathy-after-cardiopulmonary-resuscitation
#6
Yuko Furuichi, Ayaka Hamada, Keiko Nakazato, Katsuya Kobayashi, Atsuhiro Sakamoto
A 69-year-old woman undergoing treatment for hypertension and epilepsy was scheduled to undergo cataract surgery. All preoperative examination results were within normal limits. Despite being tense, she walked to the operating room. Approximately 2 minutes after an intravenous line was established by an anesthesia resident, severe hypoxia and bradycardia developed, and she lost consciousness. Cardiopulmonary resuscitation was initiated immediately, and after 1 minute, she regained consciousness, and her breathing and circulation recovered...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27869900/-transient-left-ventricular-apical-ballooning-with-dynamic-outflow-tract-obstruction-complicated-by-persistent-hypotension
#7
Rodolfo Pino, Faro Manzella, Danilo Puccio, Giuseppa Sciortino, Giovanni Polizzi
The pathogenesis of tako-tsubo syndrome remains, nowadays, unclear: it is likely that the relevance of the different proposed mechanisms differs among specific clinical contexts. In this paper, we describe the case of a 61-year-old woman admitted to the intensive cardiac care unit for pre-syncope and persistent hypotension. Clinical and echocardiographic data were suggestive of tako-tsubo syndrome with severe dynamic left ventricular outflow tract (LVOT) obstruction and severe mitral regurgitation. Coronary angiography was normal...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27865197/efficacy-and-safety-of-ticagrelor-versus-clopidogrel-with-different-dosage-in-high-risk-patients-with-acute-coronary-syndrome
#8
Yan-Guo Xin, Hai-Shan Zhang, Yu-Ze Li, Qi-Gang Guan, Liang Guo, Yuan Gao, Hai-Jie Yu, Xin-Gang Zhang, Feng Xu, Yue-Lan Zhang, Da-Lin Jia, Ying-Xian Sun, Guo-Xian Qi, Wen Tian
BACKGROUND: Dual antiplatelet therapy is recommended as a standard antiplatelet strategy in acute coronary syndrome. For those with reduced pharmacologic response to clopidogrel, strengthening antiplatelet therapy (clopidogrel 150mg daily) may reduce adverse clinical events. Ticagrelor is a direct-acting inhibitor of the adenosine diphosphate receptor P2Y12 that has a more rapid onset and offset than clopidogrel. METHODS: In this retrospective study, we compared ticagrelor (180mg loading dose 90mg twice daily thereafter), clopidogrel (300mg loading dose, 75mg or 150mg daily thereafter) for the prevention of cardiovascular events in 273 high-risk patients admitted to coronary care unit with acute coronary syndrome...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27860148/a-review-of-rapid-access-cardiology-services-can-these-reduce-the-burden-of-acute-chest-pain-on-australian-and-new-zealand-health-services
#9
REVIEW
Harry Klimis, Aravinda Thiagalingam, Mikhail Altman, Emily Atkins, Gemma Figtree, Harry Lowe, N Wah Cheung, Pramesh Kovoor, A Robert Denniss, Clara K Chow
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27855433/type-a-personality-stress-anxiety-and-health-locus-of-control-in-patients-with-acute-myocardial-infarction
#10
Davor Miličić, Lovorka Brajković, Jana Ljubas Maček, Adriana Andrić, Žarko Ardalić, Tina Buratović, Darko Marčinko
BACKGROUND: The aim of this study was to define the level of patient exposure to stress in the previous 5 years before acute myocardial infarction (AMI), personality type A assessment, ways of coping with stressful situations, health locus of control and the grade of anxiety (as state and personality trait). SUBJECTS AND METHODS: 118 patients who were consecutively hospitalized during 8 months in our Coronary care unit due to AMI, took part in the study. As controls we examined 103 healthy male volunteers (mean age 60...
December 2016: Psychiatria Danubina
https://www.readbyqxmd.com/read/27851838/trends-and-outcomes-of-pulmonary-arterial-hypertension-related-hospitalizations-in-the-united-states-analysis-of-the-nationwide-inpatient-sample-database-from-2001-through-2012
#11
Vidhu Anand, Samit S Roy, Stephen L Archer, E Kenneth Weir, Sushil Kumar Garg, Sue Duval, Thenappan Thenappan
Importance: Recent trends and outcomes of pulmonary arterial hypertension (PAH)-related hospitalization in adults in the United States are unknown. Objective: To examine the characteristics of PAH-related hospitalizations. Design, Setting, and Participants: We analyzed the National Inpatient Sample database for all adult patients (≥18 years old) with PAH as the principal discharge diagnosis from January 1, 2001, through December 31, 2012...
November 16, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27849262/time-to-treatment-of-acute-coronary-syndrome-and-unit-of-first-contact-in-the-erico-study
#12
Rafael Caire de Oliveira Dos Santos, Alessandra Carvalho Goulart, Alan Loureiro Xavier Kisukuri, Rodrigo Martins Brandão, Debora Sitnik, Henrique Lane Staniak, Marcio Sommer Bittencourt, Paulo Andrade Lotufo, Isabela Martins Bensenor, Itamar de Souza Santos
BACKGROUND: To the best of our knowledge, there are no studies evaluating the influence of the unit of the first contact on the frequency and time of pharmacological treatment during an acute coronary syndrome (ACS) event. OBJECTIVES: The main objective was to investigate if the unit of first contact influenced the frequency and time of aspirin treatment in the Strategy of Registry of Acute Coronary Syndrome (ERICO) study. METHODS: We analyzed the pharmacological treatment time in 830 ERICO participants - 700 individuals for whom the hospital was the unit of first contact and 130 who initially sought primary care units...
October 2016: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/27827275/cost-comparison-of-pressure-ulcer-preventive-dressings-hydrocolloid-dressing-versus-transparent-polyurethane-film
#13
R A A Dutra, G M Salomé, L M F Leal, M G Alves, J P Moura, A T Silva, V O S Pereira, M J A de Brito, L M Ferreira
OBJECTIVE: To evaluate and compare the costs of using a transparent polyurethane film (PF) and hydrocolloid dressing (HD) in the prevention of pressure ulcers (PUs). METHOD: This descriptive, observational, longitudinal, comparative study was conducted in the intensive care units, coronary care unit and medical clinic of a charity hospital in Brazil. Data were collected during a 30-day study period, consisting of physical examination, assessment of risk factors for PU development and application of the Braden scale, which were performed at inclusion in the study and once daily during hospitalisation...
November 2, 2016: Journal of Wound Care
https://www.readbyqxmd.com/read/27826337/the-relationship-between-angiotensin-ii-type-1-receptor-gene-polymorphism-and-repolarization-parameters-after-a-first-anterior-acute-myocardial-infarction
#14
Onder Ozturk, Unal Ozturk, Sebnem Nergiz, M Zulkif Karahan
BACKGROUND AND OBJECTIVES: Genetic influence on T-wave peak to End (Tpe) time in patients with a first anterior acute myocardial infarction (AMI) is uncertain. A polymorphism in the angiotensin-II type 1 receptor (AT1R) gene was discovered recently. The polymorphism consists of an A or C variant, given three different possible genotypes: AA, AC, CC. The purpose of this study was to determine the effects of polymorphism of the AT1R gene polymorphism on Tpe after a first anterior AMI. SUBJECTS AND METHODS: The subjects were 142 patients (110 men, 32 women, 58±13 years) with a first anterior AMI; ten patients were excluded from this study...
November 2016: Korean Circulation Journal
https://www.readbyqxmd.com/read/27820669/marijuana-use-in-acute-coronary-syndromes
#15
Eman I Draz, Mervat M Oreby, Eman A Elsheikh, Lamia A Khedr, Salwa A Atlam
BACKGROUND: Cannabis is one of the most widely used illicit substances worldwide, and it has the highest prevalence among drugs used in Egypt. OBJECTIVES: The aims were to evaluate whether the use of cannabis is a risk factor of acute coronary heart disease in low-risk, young males and to compare the cardiac pathological changes between cannabis exposed and non-exposed ischemic patients. METHODS: This was a cross-sectional study that was performed on 138 male patients, aged ≤ 40 years, with acute myocardial infarction who were admitted to the Cardiac Care Unit at the University Hospital...
November 7, 2016: American Journal of Drug and Alcohol Abuse
https://www.readbyqxmd.com/read/27818120/efficacy-and-safety-of-prehospital-administration-of-unfractionated-heparin-enoxaparin-or-bivalirudin-in-patients-undergoing-primary-percutaneous-coronary-intervention-for-st-segment-elevation-myocardial-infarction-insights-from-the-orbi-registry
#16
Vincent Auffret, Guillaume Leurent, Dominique Boulmier, Marc Bedossa, Amer Zabalawi, Jean-Philippe Hacot, Isabelle Coudert, Emmanuelle Filippi, Philippe Castellant, Antoine Rialan, Gilles Rouault, Philippe Druelles, Bertrand Boulanger, Josiane Treuil, Bertrand Avez, Marielle Le Guellec, Martine Gilard, Hervé Le Breton
BACKGROUND: Despite numerous studies in recent years, the best anticoagulant option for primary percutaneous coronary intervention (PCI) remains a matter of debate. AIMS: To compare in-hospital outcomes after prehospital administration of low-dose unfractionated heparin (UFH)±glycoprotein IIb/IIIa inhibitors (GPIs), enoxaparin±GPIs, or bivalirudin in patients undergoing primary PCI for ST-segment elevation myocardial infarction (STEMI). METHODS: A total of 1720 patients (median age 62...
November 3, 2016: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/27816119/gender-differences-in-outcomes-and-predictors-of-all-cause-mortality-after-percutaneous-coronary-intervention-data-from-united-kingdom-and-sweden
#17
Vijay Kunadian, Weiliang Qiu, Bo Lagerqvist, Nina Johnston, Hannah Sinclair, Ying Tan, Peter Ludman, Stefan James, Giovanna Sarno
To determine gender differences and predictors of all-cause mortality (30 days and 1 year) after percutaneous coronary intervention (PCI) in patients with stable angina pectoris and acute coronary syndrome (non-ST-elevation myocardial infarction/unstable angina pectoris and ST-elevation myocardial infarction) in the British Cardiovascular Intervention Society (BCIS) and Swedish Coronary Angiography and Angioplasty Registry (SCAAR) data sets, an analysis of prospectively collected data from 2007 to 2011 was performed...
October 7, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27806938/meta-analysis-of-ascorbic-acid-for-prevention-of-postoperative-atrial-fibrillation-after-cardiac-surgery
#18
William L Baker, Craig I Coleman
PURPOSE: Results of a systematic review and meta-analysis of published data on use of ascorbic acid to prevent postoperative atrial fibrillation (POAF) after cardiac surgery are presented. METHODS: MEDLINE and other sources were searched for reports on trials evaluating the effects of preoperative and/or postoperative use of ascorbic acid in patients undergoing cardiac surgery. For each study selected for meta-analysis, an assessment for risks of methodological bias was performed...
November 2, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27806171/intensive-care-unit-utilization-and-mortality-among-medicare-patients-hospitalized-with-non-st-segment-elevation-myocardial-infarction
#19
Alexander C Fanaroff, Eric D Peterson, Anita Y Chen, Laine Thomas, Jacob A Doll, Christopher B Fordyce, L Kristin Newby, Ezra A Amsterdam, Mikhail N Kosiborod, James A de Lemos, Tracy Y Wang
Importance: Intensive care unit (ICU) utilization may have important implications for the care and outcomes of patients with non-ST-segment elevation myocardial infarction (NSTEMI). Objectives: To examine interhospital variation in ICU utilization in the United States for older adults with hemodynamically stable NSTEMI and outcomes associated with ICU utilization among patients with low, moderate, or high mortality risk. Design, Setting, and Participants: This study was a retrospective analysis of 28 018 Medicare patients 65 years or older admitted with NSTEMI to 346 hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network (ACTION)-Get With the Guidelines from April 1, 2011, through December 31, 2012...
November 2, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27803362/toward-optimal-decision-making-among-vulnerable-patients-referred-for-cardiac-surgery-a-qualitative-analysis-of-patient-and-provider-perspectives
#20
Ryan A Gainer, Janet Curran, Karen J Buth, Jennie G David, Jean-Francois Légaré, Gregory M Hirsch
OBJECTIVES: Comprehension of risks, benefits, and alternative treatment options has been shown to be poor among patients referred for cardiac interventions. Patients' values and preferences are rarely explicitly sought. An increasing proportion of frail and older patients are undergoing complex cardiac surgical procedures with increased risk of both mortality and prolonged institutional care. We sought input from patients and caregivers to determine the optimal approach to decision making in this vulnerable patient population...
November 1, 2016: Medical Decision Making: An International Journal of the Society for Medical Decision Making
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