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Acute coronary syndrome

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https://www.readbyqxmd.com/read/28345361/implant-of-permanent-pacemaker-during-acute-coronary-syndrome-mortality-and-associated-factors-in-the-ariam-registry
#1
María Dolores Pola-Gallego-de-Guzmán, Manuel Ruiz-Bailén, Maria-Angeles Martínez-Arcos, Artur Gómez-Blizniak, Ana-Maria Castillo Rivera, Jesus Cobo Molinos
BACKGROUND: Patients with acute coronary syndrome complicated with high degree atrioventricular block still have a high mortality. A low percentage of these patients need a permanent pacemaker (PPM) but mortality and associated factors with the PPM implant in acute coronary syndrome patients are not known. We assess whether PPM implant is an independent variable in the mortality of acute coronary syndrome patients. Also, we explored the variables that remain independently associated with PPM implantation...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28345355/coronary-spasm-secondary-to-cefuroxime-injection-complicated-with-cardiogenic-shock-a-manifestation-of-kounis-syndrome-case-report-and-literature-review
#2
Andreas Mitsis, Evi Christodoulou, Panayiota Georgiou
Kounis syndrome is defined as the coincidental occurrence of an acute coronary syndrome with hypersensitivity reactions following an allergic event. The three reported variants of Kounis syndrome are vasospastic allergic angina, allergic myocardial infarction and stent thrombosis with occluding thrombus. The syndrome is caused by various inflammatory mediators. The pathophysiological characteristics of Kounis syndrome involve coronary artery spasm and/or atheromatous plaque erosion or rupture during an allergic reaction...
March 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28344817/urinary-biomarkers-as-indicator-of-chronic-inflammation-and-endothelial-dysfunction-in-obese-adolescents
#3
Ruchi Singh, Arushi Verma, Salim Aljabari, Tetyana L Vasylyeva
BACKGROUND: Obesity is a pro-inflammatory state that may predispose patients to acute coronary syndrome characterized by chronic low grade inflammation resulting in endothelial dysfunction (ED). The aim of the study was to evaluate urinary biomarkers of inflammation and ED in adolescents with obesity. METHODS: Sixty three subjects were recruited for the study. Twenty healthy adolescents with normal body mass (NW), 14 overweight (OW), 29 obese (OA) subjects were selected...
2017: BMC Obesity
https://www.readbyqxmd.com/read/28344139/post-discharge-worsening-renal-function-in-patients-with-type-2-diabetes-and-recent-acute-coronary-syndrome-impact-on-long-term-outcome
#4
Nuccia Morici, Stefano Savonitto, Claudio Ponticelli, Ilse C Schrieks, Anna Nozza, Francesco Cosentino, Barbara Stäehli, Pasquale Perrone Filardi, Gregory G Schwartz, Linda Mellbin, A Michael Lincoff, Jean-Claude Tardif, Diederick E Grobbee
BACKGROUND: Worsening renal function during hospitalization for an acute coronary syndrome is strongly predictive of in-hospital and long-term outcome. However, the role of post-discharge worsening renal function has never been investigated in this setting. METHODS: We considered the placebo cohort of the AleCardio trial comparing aleglitazar to standard medical therapy among patients with type 2 diabetes mellitus and a recent acute coronary syndrome. Patients who had died or had been admitted to hospital for heart failure before the 6-month follow-up, as well as patients without complete renal function data were excluded, leaving 2776 patients for the analysis...
March 23, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28343766/prediction-of-high-on-treatment-platelet-reactivity-in-clopidogrel-treated-patients-with-acute-coronary-syndromes
#5
G M Podda, E Grossi, T Palmerini, M Buscema, E A Femia, D Della Riva, S de Servi, P Calabrò, F Piscione, D Maffeo, A Toso, C Palmieri, M De Carlo, D Capodanno, P Genereux, M Cattaneo
BACKGROUND: About 40% of clopidogrel-treated patients display high platelet reactivity (HPR). Alternative treatments of HPR patients, identified by platelet function tests, failed to improve their clinical outcomes in large randomized clinical trials. A more appealing alternative would be to identify HPR patients a priori, based on the presence/absence of demographic, clinical and genetic factors that affect PR. Due to the complexity and multiplicity of these factors, traditional statistical methods (TSMs) fail to identify a priori HPR patients accurately...
March 18, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28343173/fast-track-protocols-using-highly-sensitive-troponin-assays-for-ruling-out-and-ruling-in-non-st-elevation-acute-coronary-syndrome
#6
Simona Ferraro, Alberto Dolci, Mauro Panteghini
The introduction of "highly sensitive" cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision...
March 27, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28342713/a-laboratory-score-at-presentation-to-rule-out-serious-cardiac-outcomes-or-death-in-patients-presenting-with-symptoms-suggestive-of-acute-coronary-syndrome
#7
Peter A Kavsak, Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster
BACKGROUND: We evaluated whether a low high-sensitivity cardiac troponin (hs-cTn) cutoff combined with glucose, red cell distribution width (RDW), and the estimated glomerular filtration rate (eGFR) can be used to rule-out a serious cardiac outcome or death in patients presenting with symptoms suggestive of acute coronary syndrome (ACS). METHODS: This was a prospective observational emergency department (ED) study enrolling consecutive patients presenting with symptoms suggestive of ACS (ClinicalTrials...
March 23, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28341793/bet-1-in-patients-with-suspected-acute-coronary-syndrome-does-wellens-sign-on-the-electrocardiograph-identify-critical-left-anterior-descending-artery-stenosis
#8
Niall Morris, Laura Howard
Wellens' syndrome consists of a history suggestive of an acute coronary syndrome and biphasic or deeply inverted T waves in ECG leads V2-V3. A shortcut review was carried out to establish whether this ECG pattern identifies patients with a critical left anterior descending artery stenosis. Six relevant papers were found. The clinical bottom line is that biphasic T-wave inversion in lead V2-V3 should alert the clinician to a probable critical stenosis of the left anterior descending artery.
April 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28341359/prognostic-value-of-the-clinical-syntax-score-on-2-year-outcomes-in-patients-with-acute-coronary-syndrome-who-underwent-percutaneous-coronary-intervention
#9
Chen He, Ying Song, Chuang-Shi Wang, Yi Yao, Xiao-Fang Tang, Xue-Yan Zhao, Run-Lin Gao, Yue-Jin Yang, Bo Xu, Jin-Qing Yuan
This prospective, single-center, observational study evaluated prognostic value of clinical SYNTAX score (CSS) on 2-year outcomes in patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI). The SYNTAX score (SS) is a scoring system based on the complexity and severity of coronary lesions and is thought to be a prognostic tool to predict long-term outcomes. However, SS was a sole angiographic grading tool only with no consideration for clinical factors. There are few studies investigating the prognostic value of CSS in patients with ACS who underwent PCI...
March 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28340038/coincidental-coronary-artery-disease-impairs-outcome-in-patients-with-takotsubo-cardiomyopathy
#10
V Bill, I El-Battrawy, K Schramm, U Ansari, U Hoffmann, D Haghi, J Kuschyk, M Borggrefe, I Akin
Background and aim: Takotsubo cardiomyopathy (TC) is an important differential diagnosis of coronary artery disease (CAD), mimicking acute coronary syndrome in clinical symptoms, biomarker profiles and ST-elevation in ECG. Absence of occlusive coronary disease is an essential criterion distinguishing both diseases. The aim of the study was to explore the influence of co-existing incidental CAD on poorer clinical outcomes and all-cause mortality in TC. Design, methods and results: Our mono-centric study cohort constituted 114 consecutive patients diagnosed with TC between 2003 and 2015...
March 14, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28338281/cardiovascular-safety-of-vildagliptin-in-patients-with-type-2-diabetes-a-european-multi-database-non-interventional-post-authorization-safety-study
#11
R Williams, F de Vries, W Kothny, C Serban, S Lopez-Leon, C Chu, R Schlienger
This non-interventional, multi-database, analytical cohort study assessed the cardiovascular (CV) safety of vildagliptin vs. other non-insulin antidiabetic drugs (NIADs) using real-world data from five European electronic healthcare databases. Patients with type 2 diabetes aged ≥18 years on NIAD treatment were enrolled. Adjusted incidence rate ratios (IRRs) and 95% confidence intervals (95% CIs) for the outcomes of interest (myocardial infarction [MI], acute coronary syndrome [ACS], stroke, congestive heart failure [CHF], individually and as a composite) were estimated using negative binomial regression...
March 24, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28337385/comparison-of-ticagrelor-and-high-dose-clopidogrel-on-the-platelet-functions-in-patients-with-inadequate-response-to-clopidogrel
#12
Xinshun Gu, Xianghua Fu, Yanbo Wang, Wenhui Zhang, Weize Fan, Yunfa Jiang, Guozhen Hao, Qing Miao, Yi Li, Wei Zhi
OBJECTIVE: To evaluate the effects of ticagrelor and high-dose clopidogrel on the platelet functions in patients with inadequate response to clopidogrel. METHODS: In this prospective, randomized and controlled study, patients who had been diagnosed as acute coronary syndrome (ACS) with inadequate response to clopidogrel in the Second Hospital of Hebei Medical University from July 2015 to June 2016 were enrolled. Inadequate response to clopidogrel was defined as absolute reduction of platelet aggregation rate (PAR) <30% or PAR >70%...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/28335895/coronary-collaterals-function-and-clinical-outcome-between-patients-with-acute-and-chronic-total-occlusion
#13
Jang Hoon Lee, Chang-Yeon Kim, Namkyun Kim, Se Yong Jang, Myung Hwan Bae, Dong Heon Yang, Yongkeun Cho, Shung Chull Chae, Hun Sik Park
OBJECTIVES: This study sought to demonstrate how changes in the collateral function and its clinical significance before and after percutaneous coronary interventions (PCIs) are compared between patients with acute coronary syndrome and total or nearly total occlusions (ATOs) and chronic total occlusions (CTOs). BACKGROUND: The functional relevance of the collateral circulation in patients with ATOs and CTOs has not been fully investigated. METHODS: The pressure-derived collateral pressure index (CPI), myocardial fractional flow reserve (FFRmyo), and coronary fractional flow reserve (FFRcor) at maximum hyperemia induced by intravenous adenosine were evaluated in occluded vessels at baseline, after the PCI, and at 1 year in 23 ATO and 74 CTO patients...
March 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28335793/thrombus-leukocytes-exhibit-more-endothelial-cell-specific-angiogenic-markers-than-peripheral-blood-leukocytes-do-in-acute-coronary-syndrome-patients-suggesting-a-possibility-of-trans-differentiation-a-comprehensive-database-mining-study
#14
Hangfei Fu, Nish Vadalia, Eric R Xue, Candice Johnson, Luqiao Wang, William Y Yang, Claudette Sanchez, Jun Nelson, Qian Chen, Eric T Choi, Jian-Xing Ma, Jun Yu, Hong Wang, Xiaofeng Yang
BACKGROUND: Current angiogenic therapies for cancers and cardiovascular diseases have not yet achieved expected benefits, which reflects the need for improved understanding of angiogenesis. In this study, we focused on solving the problem of whether tissues have different angiogenic potentials (APs) in physiological conditions and how angiogenesis is regulated in various disease conditions. METHODS: In healthy and diseased human and mouse tissues, we profiled the expression of 163 angiogenic genes, including transcription regulators (TRs), growth factors and receptors (GF/Rs), cytokines and chemokines (C/Cs), and proteases and inhibitors (P/Is)...
March 23, 2017: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/28335787/risk-factors-of-atherosclerotic-tissue-types-in-single-vessel-and-intermediate-coronary-lesions-a-cross-sectional-study
#15
Xianjin Wang, Qun Chen, Yu Xu, Yanqing Wang, Yang Yang, Ming Gu, Haihua Xu, Yanfang Zhao
BACKGROUND: Few data exist that correlate lesion-related risk factors such as conventional cardiovascular risks or lipoprotein-associated phospholipase A2 (Lp-PLA2) with tissue types within atherosclerotic plaques in patients with single-vessel and intermediate coronary lesions. METHODS: One hundred and ninety-two patients with single-vessel and intermediate coronary lesions were enrolled in a cross-sectional study and divided into two groups: stable angina pectoris (SAP) and acute coronary syndrome (ACS) groups...
March 23, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28335443/pharmacokinetic-and-pharmacodynamic-responses-to-clopidogrel-evidences-and-perspectives
#16
REVIEW
Yan-Jiao Zhang, Mu-Peng Li, Jie Tang, Xiao-Ping Chen
Clopidogrel has significantly reduced the incidence of recurrent atherothrombotic events in patients with acute coronary syndrome (ACS) and in those undergoing percutaneous coronary intervention (PCI). However, recurrence events still remain, which may be partly due to inadequate platelet inhibition by standard clopidogrel therapy. Genetic polymorphisms involved in clopidogrel's absorption, metabolism, and the P2Y12 receptor may interfere with its antiplatelet activity. Recent evidence indicated that epigenetic modification may also affect clopidogrel response...
March 14, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28333905/-the-inflammatory-processes-in-atherogenesis
#17
Natalia Cichoń, Dominika Lach, Angela Dziedzic, Michał Bijak, Joanna Saluk
Atherogenesis is the process of atherosclerotic plaque formation, leading to coronary artery heart disease. This process involves immune cells, mainly T and B cells, monocytes and macrophages. The process of atherogenesis is induced by inflammatory damage of endothelial cells. The characteristic construction features of the atherosclerotic plaque is a predisposing factor for acute coronary syndromes. The accumulation of inflammatory cells in the artery inner membrane enhances the local inflammatory process due to the secretion of reactive oxygen species, inflammatory cytokines and metalloproteinases, which accelerate the development of atherosclerotic lesions in the arteries...
March 21, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28333140/metabolic-and-molecular-insights-into-an-essential-role-of-nicotinamide-phosphoribosyltransferase
#18
Li Q Zhang, Leon Van Haandel, Min Xiong, Peixin Huang, Daniel P Heruth, Charlie Bi, Roger Gaedigk, Xun Jiang, Ding-You Li, Gerald Wyckoff, Dmitry N Grigoryev, Li Gao, Linheng Li, Min Wu, J Steven Leeder, Shui Qing Ye
Nicotinamide phosphoribosyltransferase (NAMPT) is a pleiotropic protein implicated in the pathogenesis of acute respiratory distress syndrome, aging, cancer, coronary heart diseases, diabetes, nonalcoholic fatty liver disease, obesity, rheumatoid arthritis, and sepsis. However, the underlying molecular mechanisms of NAMPT in these physiological and pathological processes are not fully understood. Here, we provide experimental evidence that a Nampt gene homozygous knockout (Nampt(-/-)) resulted in lethality at an early stage of mouse embryonic development and death within 5-10 days in adult mice accompanied by a 25...
March 23, 2017: Cell Death & Disease
https://www.readbyqxmd.com/read/28331988/point-of-care-testing-of-cardiac-autonomic-function-for-risk-assessment-in-patients-with-suspected-acute-coronary-syndromes
#19
C Eick, M Duckheim, P Groga-Bada, N Klumpp, S Mannes, C S Zuern, M Gawaz, K D Rizas, Axel Bauer
BACKGROUND: Impaired cardiac autonomic function has been linked to adverse outcomes in patients with acute coronary syndromes (ACS) but is not included in clinical risk models. This is the first study to investigate whether point-of-care testing of cardiac autonomic function by means of short-term deceleration capacity (DC) of heart rate improves risk assessment in patients with suspected ACS. METHODS: 1821 patients with suspected ACS were prospectively enrolled if they were older than 17 years and in sinus rhythm...
March 22, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28330794/radiation-exposure-and-vascular-access-in-acute-coronary-syndromes-the-radmatrix-trial
#20
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
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