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acute coronary syndrom

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https://www.readbyqxmd.com/read/27925308/impact-of-calcified-target-lesions-on-the-outcome-of-percutaneous-coronary-intervention-for-acute-coronary-syndrome-insights-from-the-base-acs-trial
#1
Pasi P Karjalainen, Wail Nammas, Kari Kervinen, Adam de Belder, Fernando Rivero-Crespo, Antti Ylitalo, Juhani K E Airaksinen
OBJECTIVES: We performed a post hoc analysis of outcome in patients with, versus those without, calcified target lesions from the BASE ACS trial. BACKGROUND: The outcome of contemporary stent implantation in patients with calcified lesions presenting with acute coronary syndrome is unknown. METHODS: The BASE ACS trial randomized 827 patients (1:1) presenting with acute coronary syndrome to receive either titanium-nitride-oxide-coated stents or everolimus-eluting stents...
December 7, 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27925053/risk-factor-paradox-in-the-occurrence-of-cardiac-arrest-in-acute-coronary-syndrome-patients
#2
Silvia Aguiar Rosa, Ana Teresa Timóteo, Marta Afonso Nogueira, Adriana Belo, Rui Cruz Ferreira
Objective: To compare patients without previously diagnosed cardiovascular risk factors) and patients with one or more risk factors admitted with acute coronary syndrome. Methods: This was a retrospective analysis of patients admitted with first episode of acute coronary syndrome without previous heart disease, who were included in a national acute coronary syndrome registry. The patients were divided according to the number of risk factors, as follows: 0 risk factor (G0), 1 or 2 risk factors (G1 - 2) and 3 or more risk factors (G ≥ 3)...
December 1, 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#3
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
December 7, 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27923390/the-rapid-ctca-trial-rapid-assessment-of-potential-ischaemic-heart-disease-with-ctca-a-multicentre-parallel-group-randomised-trial-to-compare-early-computerised-tomography-coronary-angiography-versus-standard-care-in-patients-presenting-with-suspected-or-confirmed
#4
Alasdair J Gray, Carl Roobottom, Jason E Smith, Steve Goodacre, Katherine Oatey, Rachel O'Brien, Robert F Storey, Lumine Na, Steff C Lewis, Praveen Thokala, David E Newby
BACKGROUND: Emergency department attendances with chest pain requiring assessment for acute coronary syndrome (ACS) are a major global health issue. Standard assessment includes history, examination, electrocardiogram (ECG) and serial troponin testing. Computerised tomography coronary angiography (CTCA) enables additional anatomical assessment of patients for coronary artery disease (CAD) but has only been studied in very low-risk patients. This trial aims to investigate the effect of early CTCA upon interventions, event rates and health care costs in patients with suspected/confirmed ACS who are at intermediate risk...
December 7, 2016: Trials
https://www.readbyqxmd.com/read/27923348/comparison-of-different-statistical-approaches-for-urinary-peptide-biomarker-detection-in-the-context-of-coronary-artery-disease
#5
Eleanor Stanley, Eleni Ioanna Delatola, Esther Nkuipou-Kenfack, William Spooner, Walter Kolch, Joost P Schanstra, Harald Mischak, Thomas Koeck
BACKGROUND: When combined with a clinical outcome variable, the size, complexity and nature of mass-spectrometry proteomics data impose great statistical challenges in the discovery of potential disease-associated biomarkers. The purpose of this study was thus to evaluate the effectiveness of different statistical methods applied for urinary proteomic biomarker discovery and different methods of classifier modelling in respect of the diagnosis of coronary artery disease in 197 study subjects and the prognostication of acute coronary syndromes in 368 study subjects...
December 6, 2016: BMC Bioinformatics
https://www.readbyqxmd.com/read/27922911/meta-analysis-of-comparison-of-the-newer-p2y12-inhibitors-oral-preparation-or-intravenous-to-clopidogrel-in-patients-with-acute-coronary-syndrome
#6
Lu Zhang, Jun Lu, Weihua Dong, Huiping Tian, Weiyi Feng, Haisheng You, Hairong He, Jing Ma, Yalin Dong
AIMS: New P2Y12 adenosine diphosphate receptor antagonist that has been used in the treatment of acute coronary syndrome (ACS) with mixed results. This systematic review analyzed and compared the evidence from large, clinical trials regarding the efficacy of clopidogrel relative to that of cangrelor, prasugrel, and ticagrelor in reducing the incidence of cardiovascular events in patients with ACS. METHODS AND RESULTS: This analysis of the findings for comparing newer P2Y12 inhibitors with clopidogrel of 13 clinical trials involving a total of 87,985 patients with ACS ...
November 29, 2016: Journal of Cardiovascular Pharmacology
https://www.readbyqxmd.com/read/27920592/left-main-coronary-ostial-stenosis-after-aortic-valve-replacement-a-case-report
#7
Munish Sharma, Daniel Mascarenhas
Coronary ostial stenosis is a rare but potentially life-threatening complication of aortic valve replacement (AVR). It can present potential complications such as acute coronary syndrome, left ventricular failure, ventricular arrhythmias, or sudden death. Exact pathogenetic mechanism is not known, but a few hypotheses have been proposed. We present a case of left main coronary stenosis 11 months after AVR was done for symptomatic critical aortic stenosis. High index of clinical suspicion and timely coronary angiography helped to determine the exact etiology...
2016: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/27920547/predictive-value-of-nt-probnp-for-30-day-mortality-in-patients-with-non-st-elevation-acute-coronary-syndromes-a-comparison-with-the-grace-and-timi-risk-scores
#8
Dirk Aam Schellings, Ahmet Adiyaman, Jan-Henk E Dambrink, At Marcel Gosselink, Elvin Kedhi, Vincent Roolvink, Jan Paul Ottervanger, Arnoud Wj Van't Hof
BACKGROUND: The biomarker N-terminal pro-brain natriuretic peptide (NT-proBNP) predicts outcome in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). Whether NT-proBNP has incremental prognostic value beyond established risk strategies is still questionable. PURPOSE: To evaluate the predictive value of NT-proBNP for 30-day mortality over and beyond the Global Registry of Acute Coronary Events (GRACE) and Thrombolysis In Myocardial Infarction (TIMI) risk scores in patients with NSTE-ACS...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27920074/a-critical-appraisal-of-aspirin-in-secondary-prevention-is-less-more
#9
Giuseppe Gargiulo, Stephan Windecker, Pascal Vranckx, Charles Michael Gibson, Roxana Mehran, Marco Valgimigli
Aspirin represents the sine qua non for antiplatelet pharmacotherapy in patients with cardiovascular diseases because of its well-established role in secondary prevention and its widespread availability and affordability. Historical studies, conducted in an era that bears little resemblance to contemporary clinical practice, demonstrated large reductions in thrombotic risk when aspirin was compared with placebo, thus forming the evidence base promulgated in practice guidelines and recommendations. P2Y12 inhibitors have mostly been studied in addition to aspirin; dual-antiplatelet therapy proved superiority compared with aspirin monotherapy for the prevention of ischemic events, despite increased bleeding risks...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27919865/shared-decision-making-in-patients-with-low-risk-chest-pain-prospective-randomized-pragmatic-trial
#10
Erik P Hess, Judd E Hollander, Jason T Schaffer, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Nilay D Shah, Jonathan Inselman, Jeph Herrin, Ana Castaneda-Guarderas, Victor M Montori
OBJECTIVE:  To compare the effectiveness of shared decision making with usual care in choice of admission for observation and further cardiac testing or for referral for outpatient evaluation in patients with possible acute coronary syndrome. DESIGN:  Multicenter pragmatic parallel randomized controlled trial. SETTING:  Six emergency departments in the United States. PARTICIPANTS:  898 adults (aged >17 years) with a primary complaint of chest pain who were being considered for admission to an observation unit for cardiac testing (451 were allocated to the decision aid and 447 to usual care), and 361 emergency clinicians (emergency physicians, nurse practitioners, and physician assistants) caring for patients with chest pain...
December 5, 2016: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/27919473/kounis-syndrome-and-ziprasidone
#11
Leonard Hamera, Basem F Khishfe
Kounis syndrome (KS), described by Kounis and Zavras in 1991, is the manifestation of an allergic reaction preceding and leading to an acute coronary syndrome (ACS). There are three variants of Kounis Syndrome. Here we describe a novel case report of a type 1 variant secondary to Ziprasidone.
November 30, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27918068/temporal-trends-and-outcomes-associated-with-atrial-fibrillation-observed-during-acute-coronary-syndrome-real-world-data-from-the-acute-coronary-syndrome-israeli-survey-acsis-2000-2013
#12
Aharon Erez, Ilan Goldenberg, Avi Sabbag, Eyal Nof, Doron Zahger, Shaul Atar, Arthur Pollak, Idit Dobrecky-Merye, Roy Beigel, Shlomi Matetzky, Michael Glikson, Roy Beinart
BACKGROUND: The past decade has brought major advances in therapy of patients presenting with acute coronary syndromes (ACS). HYPOTHESIS: The outcomes of ACS patients with atrial fibrillation (AF) has improved over the years. METHODS: We evaluated time-dependent changes in clinical characteristics, management strategies, and outcomes associated with AF observed during ACS hospitalization in patients enrolled in the biannual ACS Israeli Surveys (ACSIS) between 2000 and 2013...
December 5, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27917298/lambl-s-excrescences-a-case-report-and-review-of-the-literature
#13
Haroon Kamran, Nirav Patel, Gagandeep Singh, Venu Pasricha, Moro Salifu, Samy I McFarlane
Lambl's excrescences are filamentous extensions of cardiac valves, mostly asymptomatic but rarely associated with catastrophic thromboembolic events such as acute ischemic stroke and acute coronary syndromes. Numerous case reports cited in the literature have addressed various spectrum of presentation of these syndromes and their outcomes based on therapies used. We encountered such a patient from our own experience who presented with an acute ischemic stroke with no other identifiable cause other than the Lambl's excrescences...
2016: Clinical Case Reports and Reviews
https://www.readbyqxmd.com/read/27916744/does-acute-coronary-syndrome-impact-on-the-incidence-of-thrombosis-after-the-implantation-of-absorb-bioresorbable-vascular-scaffold
#14
Yohei Sotomi, Yosuke Miyazaki, Carlos Colet, Taku Asano, Pannipa Suwannasom, Jan Tijssen, Robbert J de Winter, Ron Waksman, Michael J Lipinski, Yoshinobu Onuma, Patrick W Serruys
AIMS: In the drug eluting stent (DES) era, patients with acute coronary syndrome (ACS) had a higher risk of early stent thrombosis compared with stable patients. The present study evaluated whether the same is true for the bioresorbable vascular scaffold (BVS: Abbott Vascular, Santa Clara CA). METHODS AND RESULTS: We assessed the relationship between the incidence of definite/probable scaffold thrombosis (ScT) (overall ScT and early ScT) and ACS percentage with the latest publications including the most recent large randomized controlled trials...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916295/association-of-biomarkers-with-serious-cardiac-adverse-events-during-abiraterone-acetate-treatment-in-castration-resistant-prostate-cancer
#15
REVIEW
Sara Campora, Eleonora Campazzi, Silvia Zanardi, Matteo Puntoni, Marco Piccininno, Arnoldo Piccardo, Mehrdad Shoushtari Zadeh Naseri, Carlotta Defferrari, Nicoletta Provinciali, Marilena Petrera, Domenico Marra, Ennio Biscaldi, Gian Carlo Antonucci, Damiano Ricci, Matteo Clavarezza, Alessandra Gennari, Alberto Gozza, Mauro D'Amico, Marco Mori, Andrea DeCensi
BACKGROUND: Abiraterone acetate is an effective drug for castration-resistant prostate cancer, but cardiac serious adverse events (SAEs) may occur. We studied their association with N-terminal pro-brain natriuretic peptide (NT-proBNP) and troponin T (TnT) during abiraterone therapy. PATIENTS AND METHODS: In a single institution, 17 patients were treated with abiraterone acetate 1 g daily with concomitant prednisone and then switched to dexametasone plus canrenone...
December 2016: Translational Oncology
https://www.readbyqxmd.com/read/27914991/antiplatelet-therapy-in-patients-with-glucose-6-phosphate-dehydrogenases-deficiency-after-percutaneous-coronary-intervention-a-reappraisal-for-clinical-and-interventional-cardiologists
#16
REVIEW
Marco Zuin, Gianluca Rigatelli, Mauro Carraro, Maria Paola Galasso, Fabio Dell'Avvocata, Rossella Paolini, Giovanni Zuliani, Loris Roncon
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents one of the most common erythrocyte enzymopathy. In the era of drug-eluting stents (DESs), the use of prolonged dual antiplatelet therapy (DAPT) with aspirin (ASA) and thienopyridine (clopidogrel or ticlopidine) has become mandatory in the treatment of patients with acute coronary syndromes (ACS) and/or after percutaneous coronary intervention (PCI). However, the use of ASA, and more in general of antiplatelet drugs in patients with G6PD deficiency remains controversial, also for the absence of specific guidelines and scientific evidences...
November 28, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27914836/perioperative-retinal-artery-occlusion-risk-factors-in-cardiac-surgery-from-the-united-states-national-inpatient-sample-1998-2013
#17
Tyler Calway, Daniel S Rubin, Heather E Moss, Charlotte E Joslin, Katharina Beckmann, Steven Roth
PURPOSE: To study the incidence and risk factors for retinal artery occlusion (RAO) in cardiac surgery. DESIGN: Retrospective study using the National Inpatient Sample (NIS). METHODS: The NIS was searched for cardiac surgery. Retinal artery occlusion was identified by International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes. Postulated risk factors based on literature review were included in multivariate logistic models...
November 30, 2016: Ophthalmology
https://www.readbyqxmd.com/read/27914806/interprovincial-differences-in-canadian-coronary-care-unit-resource-use-and-outcomes
#18
Sean van Diepen, Meng Lin, Justin A Ezekowitz, Finlay A McAlister, Douglas S Lee, Shaun G Goodman, Paul W Armstrong, Padma Kaul
International registries have reported a wide variation in coronary care unit (CCU) admission rates for patients hospitalized with acute coronary syndrome (ACS) or heart failure (HF). Little is known about variation in Canadian interprovincial use and outcomes. Canadian Institute of Health Information data were used to identify hospitalized patients admitted to a CCU with a primary diagnosis of ACS or HF between April 1, 2007 and March 31, 2013. We examined interprovincial differences in CCU admission rates, use of CCU restricted therapies in the first 2 days of admission, and the association between CCU admission rate and risk-adjusted in-hospital mortality at the provincial level...
October 19, 2016: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/27914667/high-sensitivity-troponin-t-and-the-risk-of-recurrent-readmissions-after-hospitalisation-for-acute-heart-failure
#19
D Escribano, E Santas, G Miñana, A Mollar, S García-Blas, E Valero, A Payá, F J Chorro, J Sanchis, J Núñez
OBJECTIVES: High-sensitivity troponin is a biomarker of myocardial damage and is associated with a greater risk of mortality and disease progression in patients with acute heart failure (AHF). However, its relationship with the risk of future readmissions is less known. The aim of this study was to assess the association between ultrasensitive troponin T (TnT-us) values in patients with AHF and the risk of recurrent readmissions in the follow-up. METHODS: We prospectively included a cohort of 621 consecutive patients with AHF, excluding those patients with acute coronary syndrome...
November 30, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27914634/position-of-st-deviation-measurements-relative-to-the-j-point-impact-for-ischemia-detection
#20
Sumche Man, C Cato Ter Haar, Marjolein C de Jongh, Arie C Maan, Martin J Schalij, Cees A Swenne
BACKGROUND: There is no consensus about the time instant relative to the J point where ST deviation has to be measured for detection of acute ischemia in the ECG. METHODS: We analyzed 53 ECGs, recorded preceding emergency catheterization of acute coronary syndrome patients with a completely occluded culprit artery (cases), and 88 control ECGs recorded in the cardiology outpatient clinic. ECG-amplitude measurements were made every 10 ms, between 20 ms before till 80 ms after the J point...
October 28, 2016: Journal of Electrocardiology
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