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https://www.readbyqxmd.com/read/29345690/clozapine-induced-myocarditis
#1
COMMENT
Tanuka Datta, Allen J Solomon
Approved in 1989 for the management of treatment-resistant schizophrenia, Clozapine is a last-line atypical antipsychotic drug used with increasing frequency. In addition to its well-known side effect of agranulocytosis, this drug also carries with it rare but serious adverse cardiovascular risk of myocarditis. We present a patient on Clozapine who was admitted to the cardiology service with chest pain, ST segment elevations and elevated troponin concerning for acute myocardial infarction. Evaluation with imaging revealed decreased left ventricular function, however, no coronary artery disease was present on catheterization; findings consistent with a diagnosis of myocarditis...
January 2018: Oxford Medical Case Reports
https://www.readbyqxmd.com/read/29345592/prolonging-ticagrelor-beyond-a-year-of-acute-coronary-syndrome-worth-or-harmful
#2
Daniel Aradi, Dome Dezsi, Gabor Veress, Bela Merkely
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12-inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#3
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345584/mechanical-support-in-cardiogenic-shock-complicating-acute-coronary-syndrome-ready-for-prime-time
#4
Guillaume Schurtz, Marc Laine, Clement Delmas, Francois Kerbaul, Etienne Puymirat, Gilles Lemesle, Laurent Bonello
Cardiogenic shock (CS) is a major challenge in current cardiology. Over the last decade, cardiogenic shock mortality has decreased somewhat, but it still remains high, particularly when associated with ischaemic heart disease. The challenges are numerous and include prevention, accurate diagnosis, prompt management and effective therapies to support a failing heart and prevent multi-organ failure. Despite improvements in the care of acute coronary syndrome (ACS), it remains the most common cause of CS. In addition to existing medical therapy, mechanical circulatory support has been proposed for the management of ventricular failure...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#5
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29345157/evaluation-of-serum-cysteine-rich-protein-61-levels-in-patients-with-coronary-artery-disease
#6
Jingang Deng, Xiaoxian Qian, Jianping Li, Yanghua Li, Yang Li, Yijun Luo
AIM: The aim is to evaluate serum cysteine-rich protein 61 (Cyr61) levels in patients with coronary artery disease (CAD). PATIENTS & METHODS: Serum Cyr61 levels were measured in 180 patients with CAD and 74 participants without CAD. RESULTS: Serum Cyr61 levels were significantly higher in CAD patients. Patients with acute coronary syndrome showed significantly higher Cyr61 than those with stable angina pectoris. Serum Cyr61 levels in complex lesion group were significantly higher...
January 18, 2018: Biomarkers in Medicine
https://www.readbyqxmd.com/read/29344840/design-and-rationale-for-comparison-between-ticagrelor-and-clopidogrel-on-microcirculation-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-pleio-trial
#7
Kyungil Park, Young-Rak Cho, Jong-Sung Park, Tae-Ho Park, Moo-Hyun Kim, Young-Dae Kim
It has been previously demonstrated that ticagrelor can reduce mortality compared to clopidogrel in acute coronary syndrome (ACS) patients. However, the mechanism for this mortality reduction remains uncertain. The objective of the present study is to assess the impact of chronic ticagrelor treatment on microvascular circulation. A total of 120 participants aged 20-85 years with clinical diagnosis of ACS will be randomized in a 1:1 fashion to the following two groups: ticagrelor 90 mg twice daily; clopidogrel 75 mg once daily...
January 17, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29344637/mir%C3%A2-186-a-serum-microrna-induces-endothelial-cell-apoptosis-by-targeting-smad6-in-kawasaki-disease
#8
Rongzhou Wu, Danping Shen, Hareshwaree Sohun, Donghui Ge, Xianda Chen, Xuliang Wang, Ruiyao Chen, Yuqing Wu, Jingjing Zeng, Xing Rong, Xiaoping Su, Maoping Chu
Kawasaki disease (KD) is an acute, self‑limited vasculitis that predominantly affects medium‑sized arteries, particularly the coronary arteries. Recent studies have indicated that microRNAs are involved in many diseases, including KD. However, the detailed mechanism remains unclear. The aim of the present study was to explore the role of miR‑186 in KD and potentially discover a new target for KD treatment. The results demonstrated that miR‑186 was upregulated in serum from patients with KD and KD serum could increase miR‑186 transcript levels in endothelial cells (HUVECs)...
January 18, 2018: International Journal of Molecular Medicine
https://www.readbyqxmd.com/read/29344402/young-asian-men-with-diabetes-have-the-highest-risk-for-acute-coronary-events-retrospective-cohort-analyses
#9
Ansu Basu, Nithya Sukumar, Robert Ej Ryder
Objective: To understand the ethnic differences in coronary heart disease risk among inpatients with diabetes following acute coronary syndrome. Design: Single-centre retrospective cohort-analysis of patients with type II diabetes over a six-year period receiving standard care. Setting: Birmingham, UK. Participants: One thousand and one hundred and five patients with type II diabetes from a multi-ethnic background. Main outcome measures: Odds ratios of coronary heart disease events among three ethnic groups...
January 2018: JRSM Open
https://www.readbyqxmd.com/read/29344380/sex-stratified-analysis-of-national-trends-and-outcomes-in-isolated-tricuspid-valve-surgery
#10
Pranav Chandrashekar, Erin Amanda Fender, Chad J Zack, Yogesh N V Reddy, Courtney E Bennett, Megha Prasad, Mohammed A Al-Hijji, John M Stulak, Virginia M Miller
Objective: Female sex is a known risk factor for cardiac surgery, and tricuspid valve (TV) disease is more common in women. There are few data on sex-stratified surgical outcomes for isolated TV surgery. An administrative database was used to compare acute in-hospital outcomes between men and women undergoing isolated TV surgery. Methods: Patients aged >18 who underwent TV repair or replacement from 2004 to 2013 were identified using the National Inpatient Sample...
2018: Open Heart
https://www.readbyqxmd.com/read/29344374/cardioprotection-by-an-anti-masp-2-antibody-in-a-murine-model-of-myocardial-infarction
#11
James E Clark, Thomas Dudler, Michael S Marber, Wilhelm Schwaeble
Background: Myocardial ischaemia-reperfusion injury is a major cause of mortality and morbidity in the developed world. Many approaches have been investigated to counteract the pathological consequences associated with acute myocardial infarction (AMI) and cardiac remodelling. It is accepted that inflammation, and therefore activation of the complement pathway, is a crucial step in the pathogenesis of this injury, and many attempts have been made to ameliorate the infarction and consequent dysfunction using anticomplement therapy, with mixed success...
2018: Open Heart
https://www.readbyqxmd.com/read/29343815/microrna-145-5p-and-microrna-320a-encapsulated-in-endothelial-microparticles-contribute-to-the-progression-of-vasculitis-in-acute-kawasaki-disease
#12
Hideyuki Nakaoka, Keiichi Hirono, Seiji Yamamoto, Ichiro Takasaki, Kei Takahashi, Koshi Kinoshita, Asami Takasaki, Naonori Nishida, Mako Okabe, Wang Ce, Nariaki Miyao, Kazuyoshi Saito, Keijiro Ibuki, Sayaka Ozawa, Yuichi Adachi, Fukiko Ichida
Kawasaki Disease (KD) is an acute inflammatory disease that takes the form of systemic vasculitis. Endothelial microparticles (EMPs) have been recognized as an important transcellular delivery system. We hypothesized whether EMPs are involved in vasculitis in acute KD. Fifty patients with acute KD were enrolled, divided into two subgroups: those with coronary artery lesions (CAL) (n = 5) and those without CAL (NCAL) (n = 45). EMPs were measured using flow cytometry, and microRNA (miR) expression profiling was performed by microRNA array...
January 17, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29343534/effect-of-acute-coronary-syndrome-probability-on-diagnostic-and-prognostic-performance-of-high-sensitivity-cardiac-troponin
#13
Patrick Badertscher, Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Julian Pfäffli, Dayana Flores, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Nicolas Geigy, Tobias Reichlin, Christian Mueller
BACKGROUND: There is concern that high-sensitivity cardiac troponin (hs-cTn) may have low diagnostic accuracy in patients with low acute coronary syndrome (ACS) probability. METHODS: We prospectively stratified patients presenting with acute chest discomfort to the emergency department (ED) into 3 groups according to their probability for ACS as assessed by the treating ED physician using a visual analog scale-≤10%, 11% to 79%, and ≥80%-reviewing all information available at 90 min...
January 17, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29343532/clinical-laboratory-practice-recommendations-for-the-use-of-cardiac-troponin-in-acute-coronary-syndrome-expert-opinion-from-the-academy-of-the-american-association-for-clinical-chemistry-and-the-task-force-on-clinical-applications-of-cardiac-bio-markers-of
#14
Alan H B Wu, Robert H Christenson, Dina N Greene, Allan S Jaffe, Peter A Kavsak, Jordi Ordonez-Llanos, Fred S Apple
This document is an essential companion to the third iteration of the National Academy of Clinical Biochemistry [NACB,8 now the American Association for Clinical Chemistry (AACC) Academy] Laboratory Medicine Practice Guidelines (LMPG) on cardiac markers. The expert consensus recommendations were drafted in collaboration with the International Federation of Clinical Chemistry and Laboratory Medicine Task Force on Clinical Applications of Bio-Markers (IFCC TF-CB). We determined that there is sufficient clinical guidance on the use of cardiac troponin (cTn) testing from clinical practice groups...
January 17, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#15
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29343466/long-term-cardiovascular-prognosis-after-transient-ischemic-attack-associated-predictors
#16
Angel Ois, Ana Zabalza, Antia Moreira, Elisa Cuadrado-Godia, Jordi Jimenez-Conde, Eva Giralt-Steinhauer, Ana Rodríguez-Campello, Carolina Soriano-Tarraga, Jaume Roquer
OBJECTIVE: To determine long-term cardiovascular risk after TIA and to identify the factors associated with increased risk. METHODS: This was a prospective observational registry of TIA patients admitted to the emergency room of our tertiary stroke center from June 2006 to January 2016. New vascular events (NVEs) were recorded from 3 months after TIA onset until June 2017, including both stroke and nonstroke events (coronary and peripheral disease). We registered TIA etiology, age, sex, vascular risk factors, radiologic data, and clinical TIA features and analyzed these variables in relation to NVE long-term risk...
January 17, 2018: Neurology
https://www.readbyqxmd.com/read/29343076/high-loading-dose-of-atorvastatin-for-the-prevention-of-serum-creatinine-and-cystatin-c-based-contrast-induced-nephropathy-following-percutaneous-coronary-intervention
#17
Naikuan Fu, Min Liang, Shicheng Yang
The aim of this study is to assess the efficacy of high-dose atorvastatin on the prevention of contrast-induced nephropathy (CIN) in patients with acute coronary syndrome (ACS) undergoing percutaneous intervention and observe the incidence of cystatin C (CyC)-based CIN. A total of 496 patients with ACS were randomly assigned to either the control group (247 patients receiving conventional dose atorvastatin 10 mg daily from 1 day before to 3 days after contrast administration) or the high-dose atorvastatin group (249 patients receiving atorvastatin 40 mg daily for the same perioperative period)...
January 1, 2018: Angiology
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#18
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341058/-takotsubo-cardiomyopathy-and-catatonia-in-a-patient-with-psychotic-depression
#19
W Kerkhof, K Abrahams, J Vandenberghe
Takotsubo cardiomyopathy (tcmp) is an acute, reversible disruption of the left ventricular systolic function. In many respects the clinical presentation closely resembles acute coronary syndromes (myocardial infarction). tcmp is a syndrome with a pathophysiology that is not fully understood and which seems to be closely associated with psychiatric disorders or psychological problems. We present a case in which a patient with several risk factors developed a tcmp and a depression with psychotic features, followed by catatonia...
2018: Tijdschrift Voor Psychiatrie
https://www.readbyqxmd.com/read/29340768/the-comparison-of-clinical-outcomes-in-patients-with-acute-myocardial-infarction-and-advanced-chronic-kidney-disease-on-chronic-hemodialysis-versus-off-hemodialysis
#20
Naoyuki Akashi, Kenichi Sakakura, Yusuke Watanabe, Masamitsu Noguchi, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Acute myocardial infarction (AMI) is more frequently observed in patients with chronic kidney disease (CKD) than in patients without CKD. Initial treatment strategy for AMI includes primary percutaneous coronary intervention (PCI), which requires substantial amount of contrast media. We hypothesized that the clinical outcomes are comparable or worse in patients with AMI and advanced CKD off chronic hemodialysis as compared to patients with AMI and advanced CKD on chronic hemodialysis. The purpose of this study was to compare the clinical outcomes of patients with AMI and advanced CKD on hemodialysis versus off hemodialysis...
January 16, 2018: Heart and Vessels
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