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https://www.readbyqxmd.com/read/28132542/-atypical-complaint-in-myocardial-ischaemia-belching
#1
Nóra Turi-Kováts, Hrisula Arabadzisz, András Zsoldos, János Tomcsányi
While educating non-medical personnel on acute coronary syndrome we often emphasize the importance of early recognition and urgent transfer to acute cardiac center of patients with acute myocardial infarction. Aside from typical symptoms of chest tightness and pain radiating to shoulder, arm and jaw, angina often presents with atypical, non-cardiac complaints. These symptoms, often suggesting gastrointestinal problems, can sometimes mislead even the most experienced physicians. We would like to present the case of an 83-year-old woman with several decades long history of ischaemic heart disease, who recently developed a new anginal symptom: lound, uncontrollable belching...
February 2017: Orvosi Hetilap
https://www.readbyqxmd.com/read/28129736/identification-of-new-biosignatures-for-clinical-outcomes-in-stable-coronary-artery-disease-the-study-protocol-and-initial-observations-of-a-prospective-follow-up-study-in-taiwan
#2
Hsin-Bang Leu, Wei-Hsian Yin, Wei-Kung Tseng, Yen-Wen Wu, Tsung-Hsien Lin, Hung-I Yeh, Kuan-Cheng Chang, Ji-Hung Wang, Chau-Chung Wu, Jaw-Wen Chen
BACKGROUND: Either classic or novel biomarkers have not been well investigated for clinical outcomes of coronary artery disease (CAD) in Asian people especially ethnic Chinese. We reported here a prospective national-based follow-up study that aims to elucidate the clinical profiles and to identify the new biosignatures (especially the non-lipid profile and inflammatory biomakers) for future clinical outcomes in a sizable cohort of stable CAD patients in Taiwan. METHODS: A total of 2500 CAD patients under stable condition after successful percutaneous coronary intervention will be enrolled for clinical data collection and blood/urine sampling in northern, southern, western, or eastern part of Taiwan between 2012 and 2017...
January 28, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27935738/the-coronary-sinus-reducer-clinical-evidence-and-technical-aspects
#3
REVIEW
Francesco Giannini, Andrea Aurelio, Richard J Jabbour, Luca Ferri, Antonio Colombo, Azeem Latib
Chronic refractory angina is often a disabling condition, predominantly due to severe obstructive coronary artery disease, that is inadequately controlled by optimal medical therapy and not amenable to further percutaneous or surgical revascularization. mortality rates associated with this condition are relatively low in clinically stable patients. however, it is associated with a high hospitalization rate and a reduction in both exercise capacity and quality of life. due to the paucity of available treatment options, there is an unmet need for new therapies for these patients and for a reduction in the associated economic healthcare burden...
January 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/27903568/effects-of-trans-endocardial-delivery-of-bone-marrow-derived-cd133-cells-on-left-ventricle-perfusion-and-function-in-patients-with-refractory-angina-final-results-of-randomized-double-blinded-placebo-controlled-regent-vsel-trial
#4
Wojciech Wojakowski, Tomasz Jadczyk, Aleksandra Michalewska-Wludarczyk, Zofia Parma, Miroslaw Markiewicz, Wojciech Rychlik, Magdalena Kostkiewicz, Katarzyna Gruszczynska, Anna Blach, Monika Dzierzak-Mietla, Wojciech Wanha, Joanna Ciosek, Beata Ochala, Lukasz Rzeszutko, Wieslaw Cybulski, Lukasz Partyka, Wojciech Zasada, Witold Wludarczyk, Sebastian Dworowy, Waclaw B Kuczmik, Grzegorz Smolka, Tomasz Z Pawlowski, Andrzej Ochala, Michal Tendera
RATIONALE: New therapies for refractory angina are needed. OBJECTIVE: Assessment of trans-endocardial delivery of bone marrow (BM) CD133(+)cells in patients with refractory angina. METHODS AND RESULTS: Randomized, double-blinded, placebo-controlled trial enrolled 31 patients with recurrent CCS II-IV angina despite optimal medical therapy, ≥ one myocardial segment with inducible ischemia in Tc-99m SPECT who underwent BM biopsy and were allocated to cells (n=16) or placebo (n=15)...
November 30, 2016: Circulation Research
https://www.readbyqxmd.com/read/27860148/a-review-of-rapid-access-cardiology-services-can-these-reduce-the-burden-of-acute-chest-pain-on-australian-and-new-zealand-health-services
#5
REVIEW
Harry Klimis, Aravinda Thiagalingam, Mikhail Altman, Emily Atkins, Gemma Figtree, Harry Lowe, N Wah Cheung, Pramesh Kovoor, A Robert Denniss, Clara K Chow
Chest pain is common and places a significant burden on hospital resources. Many patients with undifferentiated low to intermediate risk chest pain are admitted to hospital. Rapid Access Cardiology (RAC) services are hospital co-located cardiologist-led outpatient clinics that provide rapid assessment and immediate management but not long term management. This service model is described as part of chest pain management and the National Service Framework for coronary heart disease in the United Kingdom (UK)...
November 16, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27729662/-coronary-sinus-reducer-implantation-a-new-treatment-for-chronic-refractory-angina
#6
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27686005/emerging-drugs-for-the-treatment-of-angina-pectoris
#7
Cher-Rin Chong, Gao J Ong, John D Horowitz
Angina pectoris, or symptomatic myocardial ischaemia, reflects an impairment of coronary blood flow, and usually a deficiency of available myocardial energetics. Treatment options vary with the precise cause, which may vary with regards to the roles of increased myocardial oxygen demand versus reduced supply. Traditionally, organic nitrates, β-adrenoceptor antagonists, and non-dihydropyridine calcium antagonists were the only commonly used prophylactic anti-anginal agents. However, many patients failed to respond adequately to such therapy, and/or were unsuitable for their use...
December 2016: Expert Opinion on Emerging Drugs
https://www.readbyqxmd.com/read/27612144/use-of-selective-serotonin-reuptake-inhibitors-and-risks-of-stroke-in-patients-with-obsessive-compulsive-disorder-a-population-based-study
#8
Che-Sheng Chu, Po-Han Chou, Ching-Heng Lin, Chin Cheng, Chia-Jui Tsai, Tsuo-Hung Lan, Min-Wei Huang, Gerald Nestadt
BACKGROUND: Previous research has suggested a link between antidepressants use and the development of cerebrovascular events, but there has never been any study investigating the risk of stroke in obsessive-compulsive disorder (OCD) patients treated with a selective serotonin reuptake inhibitor (SSRI). METHODS: A retrospective observational cohort study was conducted using data from the National Health Insurance Database of Taiwan between the year of 2001 and 2009...
2016: PloS One
https://www.readbyqxmd.com/read/27595692/rationale-and-design-of-a-randomized-trial-of-automated-hovering-for-post-myocardial-infarction-patients-the-heartstrong-program
#9
Andrea B Troxel, David A Asch, Shivan J Mehta, Laurie Norton, Devon Taylor, Tirza A Calderon, Raymond Lim, Jingsan Zhu, Daniel M Kolansky, Brian M Drachman, Kevin G Volpp
BACKGROUND: Coronary artery disease is the single leading cause of death in the United States, and medications can significantly reduce the rate of repeat cardiovascular events and treatment procedures. Adherence to these medications, however, is very low. METHODS: HeartStrong is a national randomized trial offering 3 innovations. First, the intervention is built on concepts from behavioral economics that we expect to enhance its effectiveness. Second, the implementation of the trial takes advantage of new technology, including wireless pill bottles and remote feedback, to substantially automate procedures...
September 2016: American Heart Journal
https://www.readbyqxmd.com/read/27574412/chest-pain-after-percutaneous-coronary-intervention-in-patients-with-stable-angina
#10
Chao-Chien Chang, Yueh-Chung Chen, Eng-Thiam Ong, Wei-Cheng Chen, Chia-Hsiu Chang, Kuan-Jen Chen, Cheng-Wen Chiang
BACKGROUND: Percutaneous coronary intervention (PCI) has been widely used to treat acute coronary syndrome but is only recommended as an additional treatment to medical therapy and risk modification in patients with refractory or progressing angina. The number of PCI in this patient population is still increasing. Post-PCI chest pain (PPCP) is one of the common problems of PCI. Its presentation and causes in patients with stable angina are poorly understood. PATIENTS AND METHODS: This study retrospectively collected clinical information of 167 patients who had stable angina and underwent elective PCI, including 70 patients with PPCP 24 hours after procedure and 97 patients without PPCP...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27574382/ranolazine-therapy-reduces-non-st-segment-elevation-myocardial-infarction-and-unstable-angina-in-coronary-disease-patients-with-angina
#11
Gary L Murray, Joseph Colombo
High sympathetic tone and cardiac autonomic neuropathy (CAN) are associated with major adverse cardiac events (MACE). We have shown ranolazine (RAN) improves autonomic function. RAN was introduced to 51 successive anginal CD patients (RANCD). A control group of 54 successive nonanginal CD patients (NORANCD) continued baseline therapy. Mean study duration was 6.1 years, which included semi-annual autonomic function measures (ANX 3.0, ANSAR Medical Technologies, Inc., Philadelphia, PA) and yearly myocardial perfusion SPECT studies (MPI)...
September 2016: International Journal of Angiology: Official Publication of the International College of Angiology, Inc
https://www.readbyqxmd.com/read/27571048/cpap-for-prevention-of-cardiovascular-events-in-obstructive-sleep-apnea
#12
RANDOMIZED CONTROLLED TRIAL
R Doug McEvoy, Nick A Antic, Emma Heeley, Yuanming Luo, Qiong Ou, Xilong Zhang, Olga Mediano, Rui Chen, Luciano F Drager, Zhihong Liu, Guofang Chen, Baoliang Du, Nigel McArdle, Sutapa Mukherjee, Manjari Tripathi, Laurent Billot, Qiang Li, Geraldo Lorenzi-Filho, Ferran Barbe, Susan Redline, Jiguang Wang, Hisatomi Arima, Bruce Neal, David P White, Ron R Grunstein, Nanshan Zhong, Craig S Anderson
BACKGROUND: Obstructive sleep apnea is associated with an increased risk of cardiovascular events; whether treatment with continuous positive airway pressure (CPAP) prevents major cardiovascular events is uncertain. METHODS: After a 1-week run-in period during which the participants used sham CPAP, we randomly assigned 2717 eligible adults between 45 and 75 years of age who had moderate-to-severe obstructive sleep apnea and coronary or cerebrovascular disease to receive CPAP treatment plus usual care (CPAP group) or usual care alone (usual-care group)...
September 8, 2016: New England Journal of Medicine
https://www.readbyqxmd.com/read/27558904/is-the-incidence-of-heart-attack-still-decreasing-in-australia-developing-reliable-methods-for-monitoring-trends-in-myocardial-infarction-and-coronary-heart-disease-aus-mocha-a-study-protocol
#13
Lee Nedkoff, Matthew Knuiman, Michael S T Hobbs, Joseph Hung, Sushma Mathur, John Beilby, Anna Reynolds, Tom G Briffa, Derrick Lopez, Frank M Sanfilippo
INTRODUCTION: Accurate monitoring of acute coronary heart disease (CHD) is essential for understanding the effects of primary and secondary prevention and for planning of healthcare services. The ability to reliably monitor acute CHD has been affected by new diagnostic tests for myocardial infarction (MI) and changing clinical classifications and management of CHD. Our study will develop new and reliable methods for monitoring population trends in incidence, outcomes and health service usage for acute CHD and chest pain...
August 24, 2016: BMJ Open
https://www.readbyqxmd.com/read/27497930/pharmacological-agents-targeting-myocardial-metabolism-for-the-management-of-chronic-stable-angina-an-update
#14
Giacinta Guarini, Alda Huqi, Doralisa Morrone, Mario Marzilli
Despite continuous advances in myocardial revascularization procedures and intracoronary devices, patients with ischemic heart disease (IHD) still experience worse prognosis and poor quality of life (QoL). Indeed, chronic stable angina (CSA) is a common disease with a large burden on healthcare costs. Traditionally, CSA is interpreted as episodes of reversible myocardial ischemia related to the presence of stable coronary artery plaque causing myocardial demand/supply mismatch when myocardial oxygen consumption increases...
August 2016: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27430315/long-term-prognosis-of-unrecognized-myocardial-infarction-detected-with-cardiovascular-magnetic-resonance-in-an-elderly-population
#15
Charlotte Ebeling Barbier, Raquel Themudo, Tomas Bjerner, Lars Johansson, Lars Lind, Håkan Ahlström
BACKGROUND: Individuals with unrecognized myocardial infarctions (UMIs) detected with cardiovascular magnetic resonance (CMR) constitute a recently defined group whose prognosis has not been fully evaluated. However, increasing evidence indicate that these individuals may be at considerable cardiovascular risk. The aim of the present study was to investigate the prognostic impact of CMR detected UMIs for major adverse cardiac events (MACE) in community living elderly individuals. METHODS: Late gadolinium enhancement CMR was performed in 248 randomly chosen 70-year-olds...
2016: Journal of Cardiovascular Magnetic Resonance
https://www.readbyqxmd.com/read/27234869/current-and-future-developments-in-the-field-of-central-sleep-apnoea
#16
REVIEW
Tarek Bekfani, William T Abraham
Central sleep apnoea (CSA) occurs in ∼30-50% of patients with heart failure (HF) with reduced left ventricular ejection fraction (LVEF) and in as much as in 18-30% of patients with preserved LVEF. In HF patients, it is characterized by periodic breathing also known as the Cheyne-Stokes respiration followed by pauses of breathing. Central sleep apnoea remains often unrecognized due to its chronic and insidious incidences. Patients may report excessive daytime somnolence, poor sleep quality, nocturnal angina, recurrent arrhythmias, refractory HF symptoms, or demonstrate abnormal respiratory pattern or apnoeas...
August 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27231794/comparative-assessment-of-medical-resource-use-and-costs-associated-with-patients-with-symptomatic-peripheral-artery-disease-in-the-united-states
#17
Monica Reed Chase, Howard S Friedman, Prakash Navaratnam, Kim Heithoff, Ross J Simpson
BACKGROUND: There is growing concern about appropriate disease management for peripheral artery disease (PAD) because of the rapidly expanding population at risk for PAD and the high burden of illness associated with symptomatic PAD. A better understanding of the potential economic impact of symptomatic PAD relative to a matched control population may help improve care management for these patients. OBJECTIVE: To compare the medical resource utilization, costs, and medication use for patients with symptomatic PAD relative to a matched control population...
June 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27226069/routine-invasive-strategies-versus-selective-invasive-strategies-for-unstable-angina-and-non-st-elevation-myocardial-infarction-in-the-stent-era
#18
REVIEW
Jonathon P Fanning, Jonathan Nyong, Ian A Scott, Constantine N Aroney, Darren L Walters
BACKGROUND: People with unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI) are managed with a combination of medical therapy, invasive angiography and revascularisation. Specifically, two approaches have evolved: either a 'routine invasive' strategy whereby all patients undergo coronary angiography shortly after admission and, if indicated, coronary revascularisation; or a 'selective invasive' (also referred to as 'conservative') strategy in which medical therapy alone is used initially, with a selection of patients for angiography based upon evidence of persistent myocardial ischaemia...
May 26, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27151378/autologous-cd34-sup-sup-cell-therapy-for-refractory-angina-2-year-outcomes-from-the-act34-cmi-study
#19
Timothy D Henry, Gary L Schaer, Jay H Traverse, Thomas J Povisc, Charles Davidson, Joon Sup Lee, Marco A Costa, Theodore Bass, Farrell Mendelsohn, F David Fortuin, Carl J Pepine, Amit N Patel, Norbert Riedel, Candice Junge, Andrea Hunt, Dean J Kereiakes, Christopher White, Robert A Harrington, Richard A Schatz, Douglas W Losordo, The Act34-Cmi Investigators
An increasing number of patients have refractory angina despite optimal medical therapy and are without further revascularization options. Pre-clinical studies indicate that human CD34(+) stem cells can stimulate new blood vessel formation in ischemic myocardium, improving perfusion and function. In ACT34-CMI (n=167), patients treated with autologous CD34(+) stem cells had improvements in angina and exercise time at 6 and 12 months compared to placebo; however, the longer-term effects of this treatment are unknown...
May 4, 2016: Cell Transplantation
https://www.readbyqxmd.com/read/27145835/a-survey-on-socioeconomic-determinants-of-diabetes-mellitus-management-in-a-lower-middle-income-setting
#20
Ambepitiyawaduge Pubudu De Silva, Sudirikku Hennadige Padmal De Silva, Rashan Haniffa, Isurujith Kongala Liyanage, Kosala Saroj Amarasiri Jayasinghe, Prasad Katulanda, Chandrika Neelakanthi Wijeratne, Sumedha Wijeratne, Lalini Chandika Rajapakse
BACKGROUND: Information on socioeconomic determinants in the management of diabetes mellitus is scarce in lower middle income countries. The aim of this study is to describe the socioeconomic determinants of management and complications of diabetes mellitus in a lower middle income setting. METHODS: Cross sectional descriptive study on a stratified random sample of 1300 individuals was conducted by an interviewer administered questionnaire, clinical examinations and blood investigations...
May 4, 2016: International Journal for Equity in Health
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