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Myocardial infarction utilization

Mark Doyle, Gerald M Pohost, C Noel Bairey Merz, Leslee J Shaw, George Sopko, William J Rogers, Barry L Sharaf, Carl J Pepine, Diane V Thompson, Geetha Rayarao, Lindsey Tauxe, Sheryl F Kelsey, Robert W W Biederman
BACKGROUND: We introduce an algorithmic approach to optimize diagnostic and prognostic value of gated cardiac single photon emission computed tomography (SPECT) and magnetic resonance (MR) myocardial perfusion imaging (MPI) modalities in women with suspected myocardial ischemia. The novel approach: bio-informatics assessment schema (BIAS) forms a mathematical model utilizing MPI data and cardiac metrics generated by one modality to predict the MPI status of another modality. The model identifies cardiac features that either enhance or mask the image-based evidence of ischemia...
October 2016: Cardiovascular Diagnosis and Therapy
Jacob R Joseph, Brandon W Smith, Paul Park
OBJECTIVE: National databases are used with increasing frequency in spine surgery literature to evaluate patient outcomes. The differences between individual databases in relationship to outcomes of lumbar fusion are not known. We evaluated the variability in standard outcomes of posterior lumbar fusion between the University HealthSystem Consortium (UHC) database and the Healthcare Cost and Utilization Project National Inpatient Sample (NIS). METHODS: NIS and UHC databases were queried for all posterior lumbar fusions (ICD-9 81...
October 11, 2016: World Neurosurgery
M Fernanda Bellolio, Lindsey R Sangaralingham, Stephanie R Schilz, Claire M Noel-Miller, Keith D Lind, Pamela Morin, Peter A Noseworthy, Nilay D Shah, Erik P Hess
OBJECTIVES: To compare healthcare utilization including coronary angiography, percutaneous coronary intervention (PCI), rehospitalization, and rate of subsequent acute myocardial infarction (AMI) within 30-days, among patients presenting to the Emergency Department (ED) with chest pain admitted as short-term inpatient (≤2 days) versus observation (in ED observation units combined with in-hospital observation). METHODS: We identified adults diagnosed with acute chest pain in the ED from 2010-2014 using administrative claims from privately insured and Medicare Advantage...
October 14, 2016: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Sebastian Johannes Reinstadler, Hans-Josef Feistritzer, Martin Reindl, Gert Klug, Agnes Mayr, Johannes Mair, Werner Jaschke, Bernhard Metzler
OBJECTIVE: The utility of different biomarkers for the prediction of left ventricular remodelling (LVR) following ST-elevation myocardial infarction (STEMI) has been evaluated in several studies. However, very few data exist on the prognostic value of combined biomarkers. The aim of this study was to comprehensively investigate the prognostic value for LVR of routinely available biomarkers measured after reperfused STEMI. METHODS: Serial measurements of N-terminal pro-B-type natriuretic peptide (NT-proBNP), high-sensitivity cardiac troponin T (hs-cTnT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and high-sensitivity C reactive protein (hs-CRP) were performed in 123 patients with STEMI treated with primary percutaneous coronary intervention in this prospective observational study...
2016: Open Heart
Cory G Couch, Mariano E Menendez, C Lowry Barnes
BACKGROUND: Epilepsies is a spectrum of brain disorders ranging from severe, life threatening, and disabling to more benign, but little is known about its impact in the perioperative arthroplasty setting. We sought to determine whether epileptic patients undergoing elective total joint arthroplasty (TJA) would be at increased risk for in-hospital complications and death, prolonged stay, and nonroutine discharge. METHODS: Using discharge records from the Nationwide Inpatient Sample (2002-2001), we identified 6,054,344 patients undergoing elective primary TJA, of whom 31,865 (0...
August 20, 2016: Journal of Arthroplasty
Fernando Alfonso, Marcos García-Guimarães, Gonzalo Navarrete, Javier Cuesta, Teresa Bastante, Amparo Benedicto, Fernando Rivero, Bernardo Cortese
Drug-eluting balloons (DEB) may be considered as a "quiet revolution" in percutaneous coronary interventions. Early-generation DEB eluting paclitaxel proved to be very effective in animal models to reduce neointimal hyperplasia. Areas covered: Review of DEB efficacy in patients with coronary de novo lesions and in-stent restenosis (ISR). Expert opinion: Many randomized clinical trials and meta-analyses have demonstrated the value of DEB in patients with ISR. In this setting, DEB are safe and effective with clinical and angiographic results superior to plain balloon angioplasty and at least equivalent to first generation drug-eluting stents (DES)...
October 8, 2016: Expert Opinion on Drug Delivery
Muhammad Muzaffar Mahmood, David Austin
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ankit Sakhuja, R Scott Wright, Jesse D Schold, James T McCarthy, Amy W Williams, Hatem Amer, Robert C Albright
BACKGROUND: Though cardiovascular disease is an important cause of mortality in patients with end-stage renal disease, epidemiology of ST-elevation myocardial infarction (STEMI) is less well described in this population. METHODS: This study included STEMI hospitalizations in patients aged ≥20 using Nationwide Inpatient Sample Database from 2006 to 2010. Primary outcomes were incidence and trends of STEMI hospitalizations based on renal function status. We also looked at utilization of revascularization procedures, all-cause-hospital mortality and predictors of mortality...
October 6, 2016: American Journal of Nephrology
Selma Kenar Tiryakioglu, Hakan Ozkan, Hasan Ari, Kıvanc Yalin, Senol Coskun, Osman Tiryakioglu
Background. The aim of this study is to show whether the septal E/(E' × S') ratio assessed by tissue Doppler echocardiography can predict left ventricular remodeling after first ST segment elevation myocardial infarction treated successfully with primary percutaneous intervention. Methods. Consecutive patients (n = 111) presenting with acute anterior myocardial infarction for the first time in their life were enrolled. All patients underwent successful primary percutaneous coronary intervention. Standard and tissue Doppler echocardiography were performed in the first 24-36 hours of admission...
2016: BioMed Research International
Xiuqing Tian, Qing Wang, Rui Guo, Lingling Xu, Qin M Chen, Yinglong Hou
BACKGROUND: Paroxetine is a selective serotonin reuptake inhibitor utilized in the treatment of depression and anxiety disorders. Recent studies have identified paroxetine as a G protein-coupled receptor kinase-2 (GRK2) inhibitor capable of reversing cardiac dysfunction and remodeling in experimental models of acute myocardial infarction (AMI). We determine the clinical importance of paroxetine on cardiac functions in patients having AMI with depression (AMID) in comparison with fluoxetine, an unrelated selective serotonin reuptake inhibitor that does not inhibit GRK2...
2016: Neuropsychiatric Disease and Treatment
Linda Jayne Nichols, Seana Gall, Christine Stirling
An aneurysmal subarachnoid hemorrhage (aSAH) carries a high disability burden. The true impact of rurality as a predictor of outcome severity is unknown. Our aim is to clarify the relationship between the proposed explanations of regional and rural health disparities linked to severity of outcome following an aSAH. An initial literature search identified limited data directly linking geographical location, rurality, rural vulnerability, and aSAH. A further search noting parallels with ischemic stroke and acute myocardial infarct literature presented a number of diverse and interrelated predictors...
October 2016: Journal of Neurosciences in Rural Practice
Wei-Ting Wang, Shih-Hsien Sung, Cheng-Hsueh Wu, Shao-Sung Huang, Wan-Leong Chen, Shing-Jong Lin, Tse-Min Lu
BACKGROUND: Among patients with very small vessel disease and chronic kidney disease (CKD), the comparative efficacy of bare metal stents (BMSs) versus drug-eluting stents (DESs) is not frequently addressed. This study aimed to evaluate the long-term outcomes of patients with very small vessel disease managed with percutaneous coronary intervention. METHODS: Our study included 158 consecutive patients undergoing percutaneous coronary intervention from January 2003 to December 2013...
September 28, 2016: Journal of the Chinese Medical Association: JCMA
S Pinar Bilir, Qiufei Ma, Zhongyun Zhao, Elizabeth Wehler, Julie Munakata, Beth Barber
BACKGROUND: Little has been reported on the costs of managing the adverse events (AEs) associated with current therapies for patients with regional or distant metastatic melanoma. OBJECTIVES: To identify treatment-related AEs in patients with metastatic melanoma and to estimate the associated costs of treating these AEs in the United States. METHODS: A cost-estimation study for AEs associated with treatment of metastatic melanoma was conducted from 2012 to 2013 by identifying grades 3 and 4 AEs through the use of a comprehensive search of drug labels and English-language, published phase 2/3 studies in PubMed, conference abstracts, and the National Comprehensive Cancer Network guidelines...
June 2016: American Health & Drug Benefits
Wenduo Gu, Xuechong Hong, Claire Potter, Aijuan Qu, Qingbo Xu
In recent years mesenchymal stem cells (MSCs) have emerged as a promising therapeutic cell type in regenerative medicine. They hold great promise for treating cardiovascular diseases, such as myocardial infarction and limb ischemia. MSCs may be utilized in both cell-based therapy and vascular graft engineering to restore vascular function, thereby providing therapeutic benefits to patients. The efficacy of MSCs lies in their multipotent differentiation ability towards vascular smooth muscle cells, endothelial cells and other cell types, as well as their capacity to secrete various trophic factors, which are potent in promoting angiogenesis, inhibiting apoptosis and modulating immunoreaction...
September 28, 2016: Microcirculation: the Official Journal of the Microcirculatory Society, Inc
Glenn H Engelman, Patrick M Carry, Kyle M Kubes, Michael J Gleason
OBJECTIVES: Patients presenting with ST-elevation myocardial infarction (STEMI) benefit from rapid cardiac reperfusion therapy. Emergency medical service (EMS) agencies can improve patient outcomes by calling STEMI alerts to the receiving facility. The aim of this study was to evaluate the use of pre-hospital activation systems for suspected ST-elevation myocardial infarctions (STEMI) throughout Colorado. METHODS: A cross sectional, survey design was utilized to collect all data from EMS agencies in Colorado...
October 6, 2016: Postgraduate Medicine
Hasanat Sharif, Hamza Zaheer Ansari, Awais Ashfaq, Wasiq Faraz Rawasia, Gulshan Bano, Shiraz Hashmi
OBJECTIVE: To build a clinical predictive model to determine the need for transfusing blood and its products in coronary artery bypass grafting (CABG) procedures in South East Asian population. STUDY DESIGN: Analytical study. PLACE AND DURATION OF STUDY: Section of Cardiothoracic Surgery, Aga Khan University Hospital, Karachi, from January 2006 to October 2014. METHODOLOGY: Information on pre-, intra- and postoperative variables were collected for all adult patients who underwent on-pump CABG...
September 2016: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
X Y Liu, Y Zhang, M W Li, X P Wang, D D Qi, P Y Hao, H Zhang, Q Q Cheng, L S Zhao, C Y Gao, D Y Hu
Objective: To evaluate the efficacy and safety of intravenous thrombolytic therapy using reteplase in patients with acute ST-segment elevation myocardial infarction (STEMI). Method: A total of 73 hospitals from Henan province took part in this clinical trials during October 2012 to October 2014, 1 226 cases (1 014 male (82.7%), mean age 59.0 (51.0, 66.0) years) with acute STEMI received reteplase as thrombolytic agent.Reperfusion rate was judged according to the clinical symptoms, electrocardiogram, myocardial enzymes and heart rhythm, and the rate of cardiovascular events and bleeding events during hospitalization was also observed...
September 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
John F O Sullivan, Antoinette Neylon, Catherine McGorrian, Gavin J Blake
BACKGROUND: MicroRNAs (miRNAs), small non-coding RNAs, have been implicated as regulators of all mediators of atherosclerosis, and some reports have suggested increased levels in coronary artery disease (CAD) and acute myocardial infarction (AMI). However, the potential of miRNAs as biomarkers or predictors of disease remains to be established. METHODS: We designed a study comprising 150 patients (50 Control, 50 Stable CAD, and 50 ST Elevation Myocardial Infarction (STEMI)), and measured plasma miRNAs in each...
September 13, 2016: International Journal of Cardiology
Amit N Vora, Eric D Peterson, Lisa A McCoy, Mark B Effron, Kevin J Anstrom, Douglas E Faries, Marjorie E Zettler, Gregg C Fonarow, Brian A Baker, Gregg W Stone, Tracy Y Wang
BACKGROUND: Few studies have examined how antiplatelet therapies are selected during the routine care of acute myocardial infarction patients, particularly relative to the patient's estimated mortality and bleeding risks. METHODS AND RESULTS: We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE-ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection...
2016: Journal of the American Heart Association
Jérémie Abtan, P Gabriel Steg, Gregg W Stone, Kenneth W Mahaffey, C Michael Gibson, Christian W Hamm, Matthew J Price, Freddy Abnousi, Jayne Prats, Efthymios N Deliargyris, Harvey D White, Robert A Harrington, Deepak L Bhatt
OBJECTIVES: The purpose of this study was to examine the safety and efficacy of cangrelor in patients with stable angina (SA) or acute coronary syndrome (ACS). BACKGROUND: The CHAMPION PHOENIX (A Clinical Trial Comparing Cangrelor to Clopidogrel Standard Therapy in Subjects Who Require Percutaneous Coronary Intervention) trial demonstrated that cangrelor significantly reduced periprocedural ischemic events in all-comer percutaneous coronary intervention with a modest increase in mild and moderate bleeding...
September 26, 2016: JACC. Cardiovascular Interventions
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