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https://www.readbyqxmd.com/read/28813741/a-case-of-an-acute-myocardial-infarction-post-thrombolytic-treatment-of-ischemic-stroke-a-management-dilemma
#1
Kalyan Wagle, Jimmy Yee, Vishesh Kumar, Amornpol Anuwatworn, Tomasz Stys, Adam Stys, Christopher Stanton
Acute ischemic stroke and myocardial infarction are emergency clinical events that require prompt intervention. Concurrent occurrence of both events magnifies the complexity of the clinical management. We present a case of a patient who presented with acute ischemic stroke, complicated by acute myocardial infarction shortly after thrombolytic was administered. This case highlights the importance of individualization of management especially in complex cases where there are no clear specific guidelines to follow...
August 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813636/using-systems-science-to-inform-population-health-strategies-in-local-health-departments-a-case-study-in-san-antonio-texas
#2
Yan Li, Norma A Padrón, Anil T Mangla, Pamela G Russo, Thomas Schlenker, José A Pagán
OBJECTIVES: Because of state and federal health care reform, local health departments play an increasingly prominent role leading and coordinating disease prevention programs in the United States. This case study shows how a local health department working in chronic disease prevention and management can use systems science and evidence-based decision making to inform program selection, implementation, and assessment; enhance engagement with local health systems and organizations; and possibly optimize health care delivery and population health...
January 1, 2017: Public Health Reports
https://www.readbyqxmd.com/read/28813123/pharmacotherapy-for-hypertension-in-adults-aged-18-to-59-years
#3
REVIEW
Vijaya M Musini, Francois Gueyffier, Lorri Puil, Douglas M Salzwedel, James M Wright
BACKGROUND: Hypertension is an important risk factor for adverse cardiovascular events including stroke, myocardial infarction, heart failure and renal failure. The main goal of treatment is to reduce these events. Systematic reviews have shown proven benefit of antihypertensive drug therapy in reducing cardiovascular morbidity and mortality but most of the evidence is in people 60 years of age and older. We wanted to know what the effects of therapy are in people 18 to 59 years of age...
August 16, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28811382/an-engineered-s1p-chaperone-attenuates-hypertension-and-ischemic-injury
#4
Steven L Swendeman, Yuquan Xiong, Anna Cantalupo, Hui Yuan, Nathalie Burg, Yu Hisano, Andreane Cartier, Catherine H Liu, Eric Engelbrecht, Victoria Blaho, Yi Zhang, Keisuke Yanagida, Sylvain Galvani, Hideru Obinata, Jane E Salmon, Teresa Sanchez, Annarita Di Lorenzo, Timothy Hla
Endothelial dysfunction, a hallmark of vascular disease, is restored by plasma high-density lipoprotein (HDL). However, a generalized increase in HDL abundance is not beneficial, suggesting that specific HDL species mediate protective effects. Apolipoprotein M-containing HDL (ApoM(+)HDL), which carries the bioactive lipid sphingosine 1-phosphate (S1P), promotes endothelial function by activating G protein-coupled S1P receptors. Moreover, HDL-bound S1P is limiting in several inflammatory, metabolic, and vascular diseases...
August 15, 2017: Science Signaling
https://www.readbyqxmd.com/read/28810873/six-month-adherence-to-statin-use-and-subsequent-risk-of-major-adverse-cardiovascular-events-mace-in-patients-discharged-with-acute-coronary-syndromes
#5
Gaoqiang Xie, Yihong Sun, Phyo Kyaw Myint, Anushka Patel, Xingzi Yang, Min Li, Xian Li, Tao Wu, Shenshen Li, Runlin Gao, Yangfeng Wu
BACKGROUND: The evidence of adherence to statin decreasing risk of major adverse cardiovascular events (MACEs) is still lack among patients discharged with acute coronary syndrome (ACS). Our objective is to determine the relationship between six-month adherence to statins and subsequent risk of MACEs in patients discharged with ACS. METHODS: Using two prospective registry cohorts (CPACS-1 and -2), we analyzed data from 12,516 consecutive patients with ACS who were prescribed statin at hospital discharge and survived beyond 6 months without recurrent myocardial infarction (MI) or stroke...
August 15, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#6
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28808855/incidence-of-myocardial-infarction-and-stroke-in-acromegaly-patients-results-from-the-german-acromegaly-registry
#7
Christof Schöfl, David Petroff, Anke Tönjes, Martin Grussendorf, Michael Droste, Günter Stalla, Cornelia Jaursch-Hancke, Sylvère Störmann, Jochen Schopohl
PURPOSE: Acromegaly is a rare disease generally brought about by a benign tumour in the pituitary and characterized by growth hormone (GH) and insulin-like growth factor 1 (IGF-1) excess. Increased mortality has been related to cardiovascular events that could be linked to these hormones and patients suffer from high rates of diabetes and hypertension. In this study, we examine if the incidence of myocardial infarction (MI) and stroke differ from that of the general population. METHODS: Data from the German Acromegaly Registry in seven specialized endocrine centres were analysed (n = 479, 56% female, 46 years old at diagnosis, 5549 person-years from diagnosis)...
August 14, 2017: Pituitary
https://www.readbyqxmd.com/read/28808297/secretory-phospholipase-a2-modified-hdl-rapidly-and-potently-suppresses-platelet-activation
#8
Sanja Curcic, Michael Holzer, Lisa Pasterk, Eva Knuplez, Thomas O Eichmann, Saša Frank, Robert Zimmermann, Rudolf Schicho, Akos Heinemann, Gunther Marsche
Levels of secretory phospholipases A2 (sPLA2) highly increase under acute and chronic inflammatory conditions. sPLA2 is mainly associated with high-density lipoproteins (HDL) and generates bioactive lysophospholipids implicated in acute and chronic inflammatory processes. Unexpectedly, pharmacological inhibition of sPLA2 in patients with acute coronary syndrome was associated with an increased risk of myocardial infarction and stroke. Given that platelets are key players in thrombosis and inflammation, we hypothesized that sPLA2-induced hydrolysis of HDL-associated phospholipids (sPLA2-HDL) generates modified HDL particles that affect platelet function...
August 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28807582/comparative-efficacy-of-angiotensin-ii-antagonists-in-essential-hypertension-systematic-review-and-network-meta-analysis-of-randomised-controlled-trials
#9
Bernice Tsoi, Leo E Akioyamen, Ashley Bonner, Claudia Frankfurter, Mitchell Levine, Eleanor Pullenayegum, Ron Goeree, Daria O'Reilly
BACKGROUND: Evidence on the long-term clinical benefits of individual members of angiotensin II receptor blockers is limited given the lack of head-to-head studies. We conducted a network meta-analysis to determine the comparative efficacy of different members within this drug class with respect to outcomes of (i) blood pressure reduction (at 24 and 52 weeks) and (ii) prevention of cardiovascular disease (>104 weeks). METHODS: A systematic literature review was conducted - Protocol registration: (PROSPERO - CRD42014007067) - to identify relevant literature from the following databases: Cochrane Library, PubMed, MEDLINE and Embase; searched from inception to July 2016...
July 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28807045/a-randomized-multi-center-prospective-study-comparing-best-medical-treatment-versus-best-medical-treatment-plus-renal-artery-stenting-in-patients-with-hemodynamically-relevant-atherosclerotic-renal-artery-stenosis-radar-one-year-results-of-a-pre-maturely-terminated
#10
Thomas Zeller, Hans Krankenberg, Andrejs Erglis, Erwin Blessing, Torsten Fuss, Dierk Scheinert, Ralf Weser, Beatrix B Doerr, Wilfrid D Yollo, Joerg Radermacher
BACKGROUND: The indications for conservative "best medical treatment" (BMT) versus additional renal artery stenting are a matter of ongoing debate. The RADAR study aimed to evaluate the impact of percutaneous renal artery stenting on the impaired renal function in patients with hemodynamically significant atherosclerotic renal artery stenosis (RAS). METHODS: RADAR is an international, prospective, randomized (1:1) controlled study comparing BMT alone versus BMT plus renal artery stenting in patients with duplex sonographic hemodynamically relevant RAS...
August 14, 2017: Trials
https://www.readbyqxmd.com/read/28806210/risk-stratification-for-major-postoperative-complications-in-patients-undergoing-intra-abdominal-general-surgery-using-latent-class-analysis
#11
Minjae Kim, Melanie M Wall, Guohua Li
BACKGROUND: Preoperative risk stratification is a critical element in assessing the risks and benefits of surgery. Prior work has demonstrated that intra-abdominal general surgery patients can be classified based on their comorbidities and risk factors using latent class analysis (LCA), a model-based clustering technique designed to find groups of patients that are similar with respect to characteristics entered into the model. Moreover, the latent risk classes were predictive of 30-day mortality...
August 10, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28805102/favourable-long-term-outcome-after-coronary-artery-bypass-grafting-in-a-nationwide-cohort
#12
Hera Johannesdottir, Linda O Arnadottir, Jonas A Adalsteinsson, Tomas A Axelsson, Martin I Sigurdsson, Solveig Helgadottir, Dadi Helgason, Helga R Gardarsdottir, Steinthor A Marteinsson, Arnar Geirsson, Gudmundur Thorgeirsson, Tomas Gudbjartsson
OBJECTIVES: In a nationwide cohort, we analyzed long-term outcome following coronary artery bypass grafting, using the combined strategy of left internal mammary artery to the left anterior descending artery and saphenous vein as secondary graft to other coronary targets. METHODS: 1,507 consecutive patients that underwent myocardial revascularization during 2001-2012 in Iceland. Mean follow-up was 6.8 years. Major adverse cardiac and cerebrovascular events were depicted using the Kaplan-Meier method...
August 13, 2017: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/28804959/head-to-head-comparison-of-prasugrel-versus-ticagrelor-in-patients-undergoing-percutaneous-coronary-intervention-a-meta-analysis-of-randomized-controlled-trials
#13
Ryota Sakurai, Ivana Burazor, Heidi N Bonneau, Hideaki Kaneda
OBJECTIVES: We sought to compare the efficacy and safety of prasugrel and ticagrelor in patients with coronary artery disease undergoing percutaneous coronary intervention (PCI). BACKGROUND: Evidence from randomized head-to-head comparison between prasugrel and ticagrelor is rare regarding clinical endpoints. METHODS: PubMed, the Cochrane Library, and Web of Science were queried with the terms "prasugrel," "ticagrelor," and "randomized." Relevant randomized controlled trials (RCTs) or the same terms were also surveyed using clinicaltrials...
August 13, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28804899/coronary-artery-disease-and-risk-of-adverse-cardiac-events-and-stroke
#14
Kevin Kris Warnakula Olesen, Morten Madsen, Gregory Lip, Gro Egholm, Troels Thim, Lisette Okkels Jensen, Bent Raungaard, Jens Cosedis Nielsen, Hans Erik, Henrik Toft Sørensen, Michael Maeng
BACKGROUND: Patients with acute myocardial infarction are at increased risk of ischemic stroke. Previous myocardial infarction is an important part of risk assessment for ischemic stroke. However, there is a lack of information regarding the association between the severity and extent of coronary artery disease and long-term risk of ischemic stroke. MATERIALS AND METHODS: A cohort study of coronary angiographies performed in Western Denmark from January 1, 2003 to December 31, 2012...
August 14, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28803840/development-and-validation-of-risk-equations-for-complications-of-type-2-diabetes-recode-using-individual-participant-data-from-randomised-trials
#15
Sanjay Basu, Jeremy B Sussman, Seth A Berkowitz, Rodney A Hayward, John S Yudkin
BACKGROUND: In view of substantial mis-estimation of risks of diabetes complications using existing equations, we sought to develop updated Risk Equations for Complications Of type 2 Diabetes (RECODe). METHODS: To develop and validate these risk equations, we used data from the Action to Control Cardiovascular Risk in Diabetes study (ACCORD, n=9635; 2001-09) and validated the equations for microvascular events using data from the Diabetes Prevention Program Outcomes Study (DPPOS, n=1018; 1996-2001), and for cardiovascular events using data from the Action for Health in Diabetes (Look AHEAD, n=4760; 2001-12)...
August 10, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28803595/vitamin-d-intake-and-risk-of-cvd-and-all-cause-mortality-evidence-from-the-caerphilly-prospective-cohort-study
#16
Jing Guo, John R Cockcroft, Peter C Elwood, Janet E Pickering, Julie A Lovegrove, David I Givens
OBJECTIVE: Prospective data on the associations between vitamin D intake and risk of CVD and all-cause mortality are limited and inconclusive. The aim of the present study was to investigate the associations between vitamin D intake and CVD risk and all-cause mortality in the Caerphilly Prospective Cohort Study. DESIGN: The associations of vitamin D intake with CVD risk markers were examined cross-sectionally at baseline and longitudinally at 5-year, 10-year and >20-year follow-ups...
August 14, 2017: Public Health Nutrition
https://www.readbyqxmd.com/read/28803513/mechanisms-of-unexpected-death-and-autopsy-findings-in-friedreich-ataxia
#17
Roger W Byard, John D Gilbert
A 36-year-old woman with a clinical history of Friedreich ataxia and hypertrophic cardiomyopathy was found unexpectedly dead at her home. The heart showed asymmetric left ventricular hypertrophy, with an interventricular septal thickness of 20-25 mm (the remainder of the left ventricular wall measured 15 mm). Histologically, both ventricles had irregular areas of marked myocyte hypertrophy with associated interstitial fibrosis and focal myofibre disarray. There was neuronal loss within the dentate nucleus of the cerebellum, with vacuolation and axonal loss in the dorsal columns and spinocerebellar tracts of the upper cervical spinal cord...
January 1, 2017: Medicine, Science, and the Law
https://www.readbyqxmd.com/read/28802735/incidence-of-cardiovascular-events-and-vascular-interventions-in-patients-with-type-2-diabetes
#18
Suzanne E Engelen, Yolanda van der Graaf, Manon C Stam-Slob, Diederick E Grobbee, Maarten J Cramer, L Jaap Kappelle, Gert J de Borst, Frank L J Visseren, Jan Westerink
OBJECTIVE: Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort of 9...
July 23, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28801528/epidemiology-and-natural-history-of-the-cardiorenal-syndromes-in-a-cohort-with-echocardiography
#19
Thomas A Mavrakanas, Aisha Khattak, Karandeep Singh, David M Charytan
BACKGROUND AND OBJECTIVES: It is unknown whether echocardiographic parameters are independently associated with the cardiorenal syndrome. No direct comparison of the natural history of various cardiorenal syndrome types has been conducted. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study enrolled adult patients with at least one transthoracic echocardiography between 2004 and 2014 at a single health care system. Information on comorbidities was extracted using condition-specific diagnostic codes...
August 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28801210/the-longitudinal-relationship-between-hand-hip-and-knee-osteoarthritis-and-cardiovascular-events-a-population-based-cohort-study
#20
Tetyana Kendzerska, Peter Jüni, Lauren K King, Ruth Croxford, Ian Stanaitis, Gillian A Hawker
OBJECTIVE: In this population-based cohort study, we examined the association between the presence of symptomatic osteoarthritis (OA) and risk for cardiovascular (CV) events. METHOD: A cohort aged ≥55 years recruited from 1996-98 was followed through provincial health administrative data to 2014. Demographics, joint complaints and functional limitations were collected. Hip, knee and hand OA were defined using a validated definition. Using Cox-regressions, the relationship between OA and a composite CV outcome (myocardial infarction, stroke, angina, heart failure, revascularization) was assessed controlling for age, BMI, sex, pre-existing metabolic factors, comorbidities, income status, primary care exposure and functional limitations...
August 8, 2017: Osteoarthritis and Cartilage
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