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https://www.readbyqxmd.com/read/29236147/-platelet-inhibition-in-elderly-patients
#1
A Schäfer, J Bauersachs
Single antiplatelet therapy (SAPT) using predominantly acetylsalicylic acid (ASA) is the baseline anti-thrombotic therapy in primary as well as secondary prevention of atherosclerotic disease. Dual antiplatelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary interventions or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina pectoris). In the past the duration of DAPT in particular has been frequently discussed...
December 13, 2017: Herz
https://www.readbyqxmd.com/read/29234038/sodium-tanshinone-iia-sulfate-adjunct-therapy-reduces-high-sensitivity-c-reactive-protein-level-in-coronary-artery-disease-patients-a-randomized-controlled-trial
#2
Siming Li, Yang Jiao, Hanjay Wang, Qinghua Shang, Fang Lu, Li Huang, Jiangang Liu, Hao Xu, Keji Chen
High-sensitivity C-reactive protein (hs-CRP) is independently associated with cardiovascular events in coronary artery disease (CAD) patients and reducing the hs-CRP level may further benefit this population. We conduct this parallel design, randomized-controlled trial to assess the effectiveness of adjunct sodium tanshinone IIA sulfate (STS) therapy on circulating inflammation markers in CAD patients. Unstable angina or non-ST-elevation myocardial infarction patients with increased hs-CRP level were randomly assigned to atorvastatin-based standard medical therapy or standard therapy plus STS injection (80 mg, once daily for 14 consecutive days)...
December 12, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29230658/guidelines-in-review-comparison-of-the-2014-aha-acc-guideline-for-the-management-of-patients-with-non-st-elevation-acute-coronary-syndromes-and-the-2015-esc-guidelines-for-the-management-of-acute-coronary-syndromes-in-patients-presenting-without-persistent
#3
Shane P Prejean, Munaib Din, Eliana Reyes, Fadi G Hage
In this Guidelines in Review, we review side-by-side the recommendations provided by the 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. We review the recommendations for imaging in the evaluation of patients with possible ACS followed by the diagnostic evaluation of patients with proven NSTE-ACS, based on their risk for adverse clinical events...
December 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29230180/immediate-early-vs-delayed-invasive-strategy-for-patients-with-non-st-segment-elevation-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#4
REVIEW
Yanda Li, Zhenpeng Zhang, Xingjiang Xiong, William C Cho, Dan Hu, Yonghong Gao, Hongcai Shang, Yanwei Xing
Invasive coronary revascularization has been shown to improve prognoses in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of intervention remains unclear. This meta-analysis is to evaluate the outcomes in immediate (<2 h), early (<24 h), and delayed invasive group and find out which is the optimal timing of intervention in NSTE-ACS patients. Studies were identified through electronic literature search of Medline, PubMed Central, Embase, the Cochrane Library, and CNKI...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29229216/immediate-complete-revascularization-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-disease-treated-by-primary-percutaneous-coronary-intervention-insights-from-the-orbi-registry
#5
Anna Pimor, Vincent Auffret, Romain Didier, Régis Delaunay, Emmanuelle Filippi, Jean-Philippe Hacot, Djamel Saouli, Gilles Rouault, Philippe Druelles, Emilie Bot, Isabelle Coudert, Bertrand Boulanger, Marielle Le Guellec, Dominique Boulmier, Guillaume Leurent, Marc Bedossa, Martine Gilard, Hervé Le Breton
BACKGROUND: Recent studies demonstrated the superiority of complete revascularization (CR) in patients treated by primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI). AIM: To evaluate whether immediate CR improves in-hospital outcomes in patients with STEMI with multivessel disease. METHODS: Data from a prospective multicentre registry including 9365 patients with STEMI were analysed. Patients with multivessel disease and treated with pPCI (n=3412) were included and separated into two groups according to whether immediate CR was performed during the index procedure...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29228878/quality-assessment-in-belgian-st-elevation-myocardial-infarction-patients-results-from-the-belgian-stemi-database
#6
Marc J Claeys, Peter R Sinnaeve, Carl Convens, Philippe Dubois, Suzanne Pourbaix, Pascal Vranckx, Sofie Gevaert, Herbert De Raedt, Christophe Beauloye, Jean-Francois Argacha, Patrick Evrard, Patrick Coussement
The present report describes the quality of care, including in hospital mortality for more than 22.000 STEMI patients admitted in 60 Belgian hospitals for the period 2008-2016. We found a strong increase in the use of primary PCI over time, particularly for patients that were admitted first in a non-PCI capable hospital, reaching a penetration rate of >95%. The transition of thrombolysis to transfer for pPCI in the setting of a STEMI network was, however, associated with an increase of the proportion of patients with prolonged (>120 min) diagnosis-to-balloon time (from 16 to 22%), suggesting still suboptimal interhospital transfer...
December 11, 2017: Acta Cardiologica
https://www.readbyqxmd.com/read/29223602/prognostic-significance-of-shockable-and-non-shockable-cardiac-arrest-in-st-segment-elevation-myocardial-infarction-patients-undergoing-primary-angioplasty
#7
Nevio Taglieri, Francesco Saia, Maria Letizia Bacchi Reggiani, Gabriele Ghetti, Antonio Giulio Bruno, Claudia Rosetti, Matteo Bruno, Anna Corsini, Paola Battistini, Gianluca Lanati, Maria Teresa Di Dio, Diego Della Riva, Miriam Compagnone, Cinzia Marrozzini, Claudio Rapezzi
OBJECTIVE: To determine, in patients with ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI), the prognostic weight of cardiac arrest (CA) according to the type of rhythm (shockable vs. non-shockable). METHODS: We prospectively enrolled 3278 consecutive STEMI patients undergoing PPCI. Multivariable Cox regression was used to establish the relation to 1-year cardiac mortality of both type of CA. In patients suffering from CA we identified predictors of both poor neurological outcome (cerebral performance categories 3-5) and cardiac mortality at 1year...
December 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/29223437/outcomes-in-elderly-and-young-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-with-bivalirudin-versus-heparin-pooled-analysis-from-the-euromax-and-horizons-ami-trials
#8
Khalid Qaderdan, Gerrit-Jan A Vos, Thomas McAndrew, Philippe Gabriel Steg, Christian W Hamm, Arnoud Van't Hof, Roxana Mehran, Efthymios N Deliargyris, Debra Bernstein, Gregg W Stone, Jurriën M Ten Berg
BACKGROUND: Since older age is a strong predictor of not only bleeding but also of ischemic events, understanding the risk:benefit profile of bivalirudin in the elderly undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation (STEMI) is important. For this, we aim to compare elderly with young patients, who all underwent pPCI for STEMI and randomly received either bivalirudin or heparin. METHODS: We performed a patient-level pooled analysis (n=5800) of two large randomized trials...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29223429/predicting-risk-of-cardiac-events-among-st-segment-elevation-myocardial-infarction-patients-with-conservatively-managed-non-infarct-related-artery-coronary-artery-disease-an-analysis-of-the-duke-databank-for-cardiovascular-disease
#9
Sameer A Hirji, Susanna R Stevens, Linda K Shaw, Erin C Campbell, Christopher B Granger, Manesh R Patel, Michael H Sketch, Tracy Y Wang, E Magnus Ohman, Eric D Peterson, J Matthew Brennan
BACKGROUND: Recent randomized evidence has demonstrated benefit with complete revascularization during the index hospitalization for multivessel coronary artery disease ST-segment elevation myocardial infarction (STEMI) patients; however, this benefit likely depends on the risk of future major adverse cardiovascular events (MACE). METHODS: Using data from Duke University Medical Center (2003-2012), we identified those at high risk for 1-year MACE among 664 STEMI patients with conservatively managed non-infarct-related artery (non-IRA) lesions...
December 2017: American Heart Journal
https://www.readbyqxmd.com/read/29222628/one-year-clinical-effectiveness-comparison-of-prasugrel-with-ticagrelor-results-from-a-retrospective-observational-study-using-an-integrated-claims-database
#10
Mark B Effron, Kavita V Nair, Cliff Molife, Stuart Y Keller, Robert L Page, Jason C Simeone, Brian Murphy, Beth L Nordstrom, Yajun Zhu, Patrick L McCollam, George W Vetrovec
BACKGROUND: No direct comparisons of ticagrelor and prasugrel with 1-year clinical follow-up have been reported. OBJECTIVES: Our objective was to compare 1-year clinical outcomes among patients with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI) and treated with either ticagrelor or prasugrel in a real-world setting. METHODS: This retrospective study included patients from a payer database who were aged ≥18 years and had ACS managed with PCI with no history of transient ischemic attack (TIA)/stroke...
December 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29216725/decreased-circulatory-microrna-4478-as-a-specific-biomarker-for-diagnosing-non-st-segment-elevation-myocardial-infarction-nstemi-and-its-association-with-soluble-leptin-receptor
#11
R Gholikhani-Darbroud, F Khaki-Khatibi, F Mansouri, M Hajahmadipoorrafsanjani, M Ghojazadeh
OBJECTIVE: This study aimed to assess the usefulness of circulatory microRNA-4478 (miR-4478) and soluble leptin receptor (sLEPR) in prognosis and diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) and to introduce miR-4478 as a new biomarker for NSTEMI disease. This study aimed also to examine correlation between miR-4478 and soluble leptin receptor and effects of miR-4478 on leptin receptor concentration. BACKGROUND: MicroRNAs could be used as predictive biomarkers for diseases...
2017: Bratislavské Lekárske Listy
https://www.readbyqxmd.com/read/29211854/matrix-metalloproteinase-9-might-affect-adaptive-immunity-in-non-st-segment-elevation-acute-coronary-syndromes-by-increasing-cd31-cleavage-on-cd4-t-cells
#12
Giulia Angelini, Davide Flego, Ramona Vinci, Daniela Pedicino, Francesco Trotta, Aureliano Ruggio, Giuseppe P Piemontese, Domenico Galante, Myriana Ponzo, Luigi M Biasucci, Giovanna Liuzzo, Filippo Crea
Aims: In patients with acute coronary syndrome (ACS), the higher activity of effector T-cells suggests that mechanisms involving adaptive immunity dysregulation might play a role in coronary instability. The shedding of the functional CD31 domain 1-5 leads to uncontrolled lymphocyte activation. In experimental models, matrix metalloproteinase-9 (MMP-9) has been implicated in endothelial CD31 cleavage. Interestingly, higher serum levels of MMP-9 have been observed in ACS. We aim to investigate the mechanisms underlying CD31 dysregulation in ACS...
December 2, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29208858/correlation-of-troponin-i-level-with-left-ventricular-ejection-fraction-and-in-hospital-outcomes-after-first-attack-of-non-st-segment-elevation-myocardial-infarction
#13
M H Khan, M N Islam, G P Aditya, M Z Islam, A S Bhuiyan, B Saha, K Bhowmick, M Hassan, P K Paul, S Chowdhury, R Rahman
Coronary heart disease (CHD) is the most common cause of heart disease and is the single most important cause of premature death in developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has been shown to be a very sensitive and specific marker for acute myocardial infarction (AMI). Ventricular function is the best predictor of death after an acute coronary syndrome. It serves as a marker of myocardial damage, provides information on systolic function as well as diagnosis and prognosis...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29206072/cigarette-smoking-reduces-platelet-reactivity-independently-of-clopidogrel-treatment-in-patients-with-non-st-elevation-acute-coronary-syndromes
#14
Gabriele Crimi, Alberto Somaschini, Marco Cattaneo, Dominick J Angiolillo, Federico Piscione, Tullio Palmerini, Stefano De Servi
Smokers receiving clopidogrel show a lower residual platelet reactivity than non-smokers, a phenomenon generally ascribed to smoking-induced increased production of clopidogrel active metabolite, but also associated with the high hemoglobin levels of smokers, which decreases platelet reactivity in tests that measure platelet function in whole blood. We evaluated the impact of cigarette smoking and of hemoglobin levels on platelet reactivity index (PRI) measured by the vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) assay in whole blood samples from patients with non-ST elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary interventions, both before and after clopidogrel administration...
December 5, 2017: Platelets
https://www.readbyqxmd.com/read/29205743/rotational-atherectomy-and-new-generation-drug-eluting-stent-implantation
#15
Daisuke Hachinohe, Yoshifumi Kashima, Daitaro Kanno, Ken Kobayashi, Takuro Sugie, Umihiko Kaneko, Yutaka Tadano, Tomohiko Watanabe, Hidemasa Shitan, Tsutomu Fujita
OBJECTIVES: The aim of this study was to evaluate the clinical outcomes of rotational atherectomy (RA) followed by new-generation drug-eluting stent (DES) implantation in patients with an extensive amount of calcified and fibrotic plaque. BACKGROUND: RA followed by new-generation DES implantation for complex lesions has not been thoroughly evaluated. METHODS: A total of 744 consecutive patients (770 lesions) treated with new-generation DES implantation following RA for de novo lesions between January 2013 and November 2015 were retrospectively identified using our institutional database...
December 5, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29204335/temporal-trends-in-lipid-testing-among-children-and-adolescents-a-population-based-study
#16
Swetha Sriram, Jennifer L St Sauver, Debra J Jacobson, Chun Fan, Brian A Lynch, Valeria Cristiani, Iftikhar J Kullo, Aida N Lteif, Seema Kumar
Unfavorable lipid levels during childhood are associated with subsequent development of atherosclerotic cardiovascular disease. The American Academy of Pediatrics and National Heart, Lung and Blood Institute in 2011 recommended universal lipid screening for children between ages 9-11 years and between ages 17-21 years. The objective of the study was to determine temporal trends in lipid testing among children and young adults in a mid-western population. The Rochester Epidemiology Project database was used to identify lipid testing in ages 2-21 years (n = 51,176) in the Olmsted County population from January 1, 2008 through December 31, 2014...
December 2017: Preventive Medicine Reports
https://www.readbyqxmd.com/read/29200825/efficacy-and-safety-of-quadruple-therapy-including-tirofiban-in-the-treatment-of-chinese-nste-acs-patients-failing-to-receive-timely-percutaneous-coronary-intervention
#17
Lan Li, Zhenrong Ge, Dengke Zhang, Jun Kuang, Xiang Ma, Shubin Jiang
Background: Although it has been shown to be superior to simple antithrombotic drug therapy, most patients are unable to receive timely percutaneous coronary intervention (PCI) and are treated with conventional triple antithrombotic therapy (aspirin, clopidogrel, low-molecular-weight heparin). Here, we evaluate the efficacy and safety of adding low-dose tirofiban to this regimen. Methods: A total of 1,783 patient records (unable to receive PCI) indicating non-ST-segment elevation acute coronary syndrome (NSTE-ACS) were included...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29199084/ethnicity-influences-cardiovascular-outcomes-and-complications-in-patients-with-type-2-diabetes
#18
S Kou, J Y Cao, S Yeo, D J Holmes-Walker, S L Lau, J E Gunton
AIM: To determine whether cardiovascular outcomes in type 2 diabetes (T2D) differ according to ethnicity, and whether ethnicity influences the effect of gender on these outcomes in Caucasians, East-Southeast-Asians, Middle-Easterners, South-Asians and Pacific-Islanders. METHODS: We compared demographics, HbA1c, lipid profile, renal function markers, and prevalence of macrovascular and microvascular complications between ethnic groups. Cross-sectional data was prospectively collected from 204 consecutive patients at Westmead Hospital's T2D clinic from April-October 2015...
November 6, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/29198105/sources-of-methylmercury-to-snowpacks-of-the-alberta-oil-sands-region-a-study-of-in-situ-methylation-and-particulates
#19
Chelsea E Willis, Jane L Kirk, Vincent L St Louis, Igor Lehnherr, Parisa A Ariya, Rodrigo Benjamin Rangel-Alvarado
Snowpacks in the Alberta Oil Sands Region (AOSR) of Canada contain elevated loadings of methylmercury (MeHg; a neurotoxin that biomagnifies through foodwebs) due to oil sands related activities. At sites ranging from 0-134 km from the major AOSR upgrading facilities, we examined sources of MeHg by quantifying potential rates of MeHg production in snowpacks and melted snow using mercury stable isotope tracer experiments, as well as quantifying concentrations of MeHg on particles in snowpacks (pMeHg). At four sites, methylation rate constants were low in snowpacks (km=0...
December 3, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/29191630/efficacy-and-safety-of-bivalirudin-in-coronary-artery-disease-patients-with-mild-to-moderate-chronic-kidney-disease-meta-analysis
#20
Xiaofang Zeng, A Michael Lincoff, Stefanie Schulz-Schüpke, Philippe Gabriel Steg, Yedid Elbez, Roxana Mehran, Gregg W Stone, Thomas McAndrew, Jianhui Lin, Xindan Zhang, Wenhai Shi, Han Lei, Zhicheng Jing, Wei Huang
BACKGROUND: Patients with chronic kidney disease (CKD) have elevated bleeding and ischemic outcomes. We aim to assess the short- and long-term efficacy and safety of bivalirudin compared to heparin plus glycoprotein IIb/IIIa inhibitors (GPIs) in coronary artery disease (CAD) patients with CKD. METHODS: Randomized trials were searched in PubMed, Cochrane, and Embase databases up to January 2017. Among the trials retrieved, efficacy endpoints were defined as mortality, myocardial infarction (MI), repeat revascularization, stent thrombosis, and major adverse cardiac events (MACEs)...
November 27, 2017: Journal of Cardiology
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