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https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#1
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29150850/comparison-of-pharmacodynamic-effects-of-ticagrelor-vs-prasugrel-in-type-2-diabetes-mellitus-patients-with-coronary-heart-disease
#2
L-L Shang, D-D Guo, H-Y Zhao, A-J Quan, P-G Cao
WHAT IS KNOWN AND OBJECTIVE: Patients with type 2 diabetes mellitus (T2DM) are at higher risk of thrombotic complications. Studies have indicated that patients with T2DM have impaired clopidogrel-induced antiplatelet effect. Ticagrelor and prasugrel are two latest generation P2Y12 inhibitors with advantageous platelet inhibitory profiles. However, the pharmacodynamic differences between the two drugs in patients with T2DM remain poorly explored. METHODS: This study, involving 140 patients with T2DM following percutaneous coronary intervention (PCI), evaluated the efficacy of aspirin upon concomitant use of prasugrel (10 mg/d) or ticagrelor (90 mg/d)...
November 17, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/29150751/comparison-of-esc-and-acc-aha-guidelines-for-the-diagnosis-and-management-of-patients-with-stable-coronary-heart-disease-are-the-differences-clinically-relevant-an-american-perspective
#3
EDITORIAL
Raymond J Gibbons
No abstract text is available yet for this article.
November 17, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29150536/availability-sales-and-affordability-of-tobacco-cessation-medicines-in-kerala-india
#4
Smitha Sarma, Sivadasanpillai Harikrishnan, Abigail S Baldridge, Raji Devarajan, Aashna Mehta, Sakhtivel Selvaraj, Mohammed K Ali, Padinhare P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
BACKGROUND: India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization. METHODS AND RESULTS: From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29150530/declining-rates-of-hospitalization-for-selected-cardiovascular-disease-conditions-among-adults-aged-%C3%A2-35-years-with-diagnosed-diabetes-u-s-1998-2014
#5
Nilka Ríos Burrows, YanFeng Li, Edward W Gregg, Linda S Geiss
OBJECTIVE: Reductions in heart attack and stroke hospitalizations are well documented in the U.S. population with diabetes. We extended trend analyses to other cardiovascular disease (CVD) conditions, including stroke by type, and used four additional years of data. RESEARCH DESIGN AND METHODS: Using 1998-2014 National (Nationwide) Inpatient Sample data, we estimated the number of discharges having acute coronary syndrome (ACS) (ICD-9 codes 410-411), cardiac dysrhythmia (427), heart failure (428), hemorrhagic stroke (430-432), or ischemic stroke (433...
November 17, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29150493/very-late-pathological-responses-to-cobalt-chromium-everolimus-eluting-stainless-steel-sirolimus-eluting-and-cobalt-chromium-bare-metal-stents-in-humans
#6
Hiroyoshi Mori, Dheeraj R Atmakuri, Sho Torii, Ryan Braumann, Samantha Smith, Hiroyuki Jinnouchi, Anuj Gupta, Emanuel Harari, Melsi Shkullaku, Robert Kutys, David Fowler, Maria Romero, Renu Virmani, Aloke V Finn
BACKGROUND: The "very late" clinical outcomes for durable polymer drug-eluting stents and bare metal stents (BMSs) have been shown to be dissimilar in clinical studies. Conceptually, the long-term vascular compatibility of BMSs is still regarded to be superior to drug-eluting stents; however, no pathologic study to date has specifically addressed this issue. We evaluated the very late (≥1 year) pathologic responses to durable polymer drug-eluting stents (cobalt-chromium [CoCr] everolimus-eluting stents [EESs] and stainless steel sirolimus-eluting stents [SS-SESs]) versus BMSs (CoCr-BMSs)...
November 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29150476/predictive-value-of-apelin-12-in-patients-with-st-elevation-myocardial-infarction-with-different-renal-function-a-prospective-observational-study
#7
Lingchang Yang, Ting Zheng, Haopeng Wu, Wenwei Xin, Xiongneng Mou, Hui Lin, Yide Chen, Xiaoyu Wu
OBJECTIVES: To investigate factors predicting the onset of major adverse cardiovascular events (MACEs) after primary percutaneous coronary intervention (pPCI) for patients with ST-segment elevation myocardial infarction (STEMI) . BACKGROUND: Apelin-12 plays an essential role in cardiovascular homoeostasis. However, current knowledge of its predictive prognostic value is limited. METHODS: 464 patients with STEMI (63.0±11.9 years, 355 men) who underwent successful pPCI were enrolled and followed for 2...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150426/long-term-outcomes-in-patients-with-type-2-myocardial-infarction-and-myocardial-injury
#8
Andrew R Chapman, Anoop S V Shah, Kuan Ken Lee, Atul Anand, Oliver Francis, Philip Adamson, David A McAllister, Fiona Strachan, David E Newby, Nicholas L Mills
Background -Type 2 myocardial infarction and myocardial injury are common in clinical practice, but long-term consequences are uncertain. We aimed to define long-term outcomes and explore risk stratification in patients with type 2 myocardial infarction and myocardial injury. Methods -We identified consecutive patients (n=2,122) with elevated cardiac troponin I concentrations (≥0.05 μg/L) at a tertiary cardiac center. All diagnoses were adjudicated as per the Universal Definition of Myocardial Infarction...
November 17, 2017: Circulation
https://www.readbyqxmd.com/read/29150363/development-of-a-3-french-dual-frequency-intravascular-ultrasound-catheter
#9
Chelsea E Munding, Emmanuel Chérin, Isaac Jourard, Jill J Weyers, David E Goertz, Brian K Courtney, F Stuart Foster
Coronary plaque morphology, including plaque size and fibrous cap thickness, is thought to contribute to the risk of plaque rupture and future cardiac events. Dual-frequency intravascular ultrasound has been proposed as a possible technique to visualize both large-scale features and superficial detail of coronary plaque; however, it has not been found to be feasible within the constraints of a clinically functional intravascular ultrasound catheter. In this study, we describe the design and fabrication of a dual-frequency catheter using a bidirectional transducer stack with center frequencies of approximately 30 and 80 MHz...
November 14, 2017: Ultrasound in Medicine & Biology
https://www.readbyqxmd.com/read/29150290/premature-atherosclerosis-in-premenopausal-women-does-cytokine-balance-play-a-role
#10
Jo-Ann Eastwood, Doris A Taylor, B Delia Johnson, Micheline Resende, Barry L Sharaf, Bina Ahmed, Margo Minissian, Chrisandra Shufelt, Noel Bairey Merz
Contributory risk factors to premature coronary artery disease (CAD) in premenopausal women are poorly understood and data on this subset of women is lacking. There is growing evidence that the process of inflammation is a part of the atherosclerotic process. Mechanistic insights from animal work suggest that the profile of circulating cytokines reflects both endothelial integrity and the presence of immune and progenitor cells. Significant differences in pro- and anti-inflammatory cytokine concentrations between patients with and without CAD exist...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29150207/carotid-and-femoral-atherosclerosis-in-antiphospholipid-syndrome-equivalent-risk-with-diabetes-mellitus-in-a-case-control-study
#11
Evrydiki Kravvariti, George Konstantonis, Nikolas Tentolouris, Petros P Sfikakis, Maria G Tektonidou
BACKGROUND: Antiphospholipid syndrome (APS) may carry a worse prognosis for vascular complications when co-existing with subclinical atherosclerosis; however, the association between the two conditions remains ambiguous. METHODS: We evaluated ultrasonographic markers of subclinical atherosclerosis in carotid and femoral arteries of 86 patients with thrombotic APS [43 primary APS (PAPS), 43 systemic lupus erythematosus-associated APS (SLE/APS)], 86 patients with diabetes mellitus (DM) and 86 healthy controls, individually matched for age and gender, and investigated their associations with traditional and disease-related factors in APS...
October 23, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29150157/all-cause-mortality-following-an-acute-coronary-syndrome-12-year-follow-up-of-the-comprehensive-2002-new-zealand-acute-coronary-syndrome-audit
#12
Chris J Ellis, Greg D Gamble, Michael J A Williams, Phil Matsis, John M Elliott, Gerry Devlin, Stewart Mann, John K French, Harvey D White
BACKGROUND: To describe the long-term mortality of a complete national cohort of acute coronary syndrome (ACS) patients enrolled in 2002, to compare this with a national age, sex and Māori ethnicity matched population, and to assess the influence of baseline factors on the 12-year mortality. METHODS: We reviewed 721 patients with a discharge diagnosis of an ACS who were enrolled in the first New Zealand ACS audit group cohort over 14days in May 2002. We matched the cohort to the national mortality database using each patient's unique national identity number...
November 7, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29149967/early-prediction-of-cardiovascular-disease-in-kidney-transplant-recipients
#13
G Bilancio, M Celano, V Cozza, F Zingone, G Palladino, M Cirillo
Cardiovascular disease (CVD) is frequent after kidney transplantation (KT). This study investigated CVD prediction in KT by information available before KT or within 6 months after KT. The study cohort consisted of 629 patients with KT in 2005-10 and with adult age at KT. The end point was incidence up to 2015 of CVD (coronary heart disease, cerebrovascular disease, peripheral artery disease). Graft failure, non-CVD death with functioning graft, and loss to follow-up were considered competing events. CVD prediction was investigated for 34 variables by means of competing-risks regression...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149953/myocardial-perfusion-scans-and-mortality-in-asymptomatic-patients-awaiting-renal-transplantation
#14
A Jauhal, S Harenberg, J J Crawford, I Bare, B Prasad, L Zahorski, G Ollenberger, V Trivedi, V Chopra, A Shoker, A Lavoie, P Dehghani
Cardiac risk assessment for asymptomatic patients awaiting renal transplantation is controversial. Patients awaiting renal transplantation in Southern Saskatchewan from 2005 to 2015 were retrospectively reviewed. Patients underwent cardiac risk stratification with stress myocardial perfusion scan. Baseline clinical characteristics, nuclear scan results, all-cause mortality, and cardiovascular events were analyzed. Abnormal scans were defined as studies with reversible defects, wall motion abnormalities, lung uptake, or transient ischemic dilation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149718/coronary-risk-assessment-at-x-ray-dose-equivalent-ungated-chest-ct-results-of-a-multi-reader-study
#15
Michael Messerli, Lukas Hechelhammer, Sebastian Leschka, René Warschkow, Simon Wildermuth, Ralf W Bauer
OBJECTIVES: To determine the value of ultra-low dose chest CT with tin filtration for ordinal coronary artery calcium (CAC) risk scoring. METHODS: 50 patients were prospectively included and underwent clinical standard dose chest CT (1.8±0.7mSv) and ultra-low dose CT (0.13±0.01mSv). Four radiologists estimated presence and extent of CAC. RESULTS: Weighted kappa values for CAC were 0.76-0.97 in standard dose and 0.75-0.95 in ultra-low dose CT (p<0...
October 25, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/29149707/over-expression-of-cyclooxygenase-2-in-increased-reticulated-platelets-leads-to-aspirin-resistance-after-elective-off-pump-coronary-artery-bypass-surgery
#16
Xiaoxuan Gong, Xuezhong Wang, Zhuowen Xu, Tiantian Zhu, Qiu Zhang, Jinying Zhang, Xiaowei Wang, Chunjian Li
INTRODUCTION: Aspirin resistance (AR) has been reported to present after coronary artery bypass graft causing saphenous vein graft failure. We aimed to investigate the factors that affect the anti-platelet effect of aspirin after off-pump coronary artery bypass surgery (OPCAB). MATERIALS AND METHODS: Thirty OPCAB candidates were successively recruited. Platelet count, platelet aggregation, reticulated platelet (RP), platelets' cyclooxygenase (COX)-1 and COX-2 expressions were determined during the peri-operative period...
November 9, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/29149097/acute-coronary-disease-prognosis-and-prevalence-of-risk-factors-in-young-adults
#17
REVIEW
Alvaro Gudiño Gomezjurado, Bianca Pujol Freitas, Flavia Contreira Longatto, Juliana Negrisoli, Gustavo Aguiar Sousa
Acute coronary disease is a rare entity in young people and is mostly related to atherosclerotic disease. However, other causes such as myocardial bridges, coronary artery dissection and antiphospholipid syndrome may be present. The prognosis of the disease in this group of patients is favorable; although women may have a higher morbidity because diagnosis and treatment can be delayed. The goal of this review is to update the knowledge about risk factors and prognosis of young patients with an acute coronary event compared to the older population...
November 9, 2017: Medwave
https://www.readbyqxmd.com/read/29148642/rare-co-existence-of-coronary-anomalies-anomaly-of-origin-and-distribution-together-with-anomaly-of-intrinsic-coronary-artery-anomaly
#18
Abraha Hailu, Diana Chin, Carmine Musto, Rosario Fiorilli, Roberto Violini
We describe a 63 year old Romanian female patient admitted to our institution with complaints of typical angina and a diagnosis of non ST-elevation myocardial infarction. Coronary arteriography unveiled anomalous origin of a left circumflex coronary artery from the right coronary sinus of Valsalva near the right coronary ostium and a hyperdominant left anterior descending coronary artery giving off a posterior descending coronary artery with small distal-posterolateral left ventricular branch. The co-existence of a left circumflex coronary artery originating ectopically from the right sinus of Valsalva together with a posterior descending coronary artery originating from the distal end of the anterior descending artery is important to keep in mind especially by those doing coronary angiography in the cardiac catheterization laboratory...
January 2017: Ethiopian Medical Journal
https://www.readbyqxmd.com/read/29148628/clinical-significance-of-st-depression-at-exercise-stress-testing-in-competitive-athletes-usefulness-of-coronary-ct-during-screening
#19
Fabio Sperandii, Emanuele Guerra, Eliana Tranchita, Carlo Minganti, Chiara Lanzillo, Antonia Nigro, Federico Quaranta, Attilio Parisi, Mauro DI Roma, Luciano Maresca, Federica Fagnani, Leonardo Calò
BACKGROUND: Congenital coronary anomalies (CCAs) and coronary artery disease (CAD) arouse intense scientific and clinical interest in sports medicine and sports cardiology medical communities because of their potential to trigger sudden cardiac death (SCD) in athletes. Exercise stress testing represent the first instrumental assessment to evaluate electrocardiographic changes during effort. Coronary computed tomography angiography (CCTA) is an advanced accurate noninvasive imaging modality for excluding CAD and abnormalities of origin and course of coronary vessels...
November 17, 2017: Journal of Sports Medicine and Physical Fitness
https://www.readbyqxmd.com/read/29148291/effectiveness-and-safety-of-anti-ischemic-trimetazidine-in-patients-with-stable-angina-pectoris-and-type-2-diabetes
#20
Zsófia Meiszterics, Attila Kónyi, Gábor Hild, Zsolt Sárszegi, Balázs Gaszner
Aim & methods: This 6-month prospective, observational, noninterventional, open-label clinical study assessed the effectiveness/safety of trimetazidine in 737 patients with stable angina pectoris and Type 2 diabetes mellitus (OGYI/51534-1/2014). RESULTS: Trimetazidine-based therapy was effective in stable coronary artery disease, with significant improvements from baseline (p < 0.05) in: number of angina attacks/week (2.9 ± 2.4 vs 1.1 ± 1.6), angina severity (Canadian Cardiovascular Society Classification 1...
November 17, 2017: Journal of Comparative Effectiveness Research
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