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Myocardial infarction utilization

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https://www.readbyqxmd.com/read/29139601/utility-of-the-acc-aha-lesion-classification-as-a-predictor-of-procedural-30-day-and-12-month-outcomes-in-the-contemporary-percutaneous-coronary-intervention-era
#1
James Theuerle, Matias B Yudi, Omar Farouque, Nick Andrianopoulos, Peter Scott, Andrew E Ajani, Angela Brennan, Stephen J Duffy, Christopher M Reid, David J Clark
BACKGROUND: Correlations between the ACC/AHA coronary lesion classification and clinical outcomes in the contemporary percutaneous coronary intervention (PCI) era are not well established. METHODS: We analyzed clinical characteristics and outcomes according to ACC/AHA lesion classification (A, B1, B2, C) in 13,701 consecutive patients from the Melbourne Interventional Group (MIG) registry. Patients presenting with STEMI, cardiogenic shock and out-of-hospital cardiac arrest were excluded...
November 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29133337/identification-of-myocardial-infarction-type-from-electronic-hospital-data-in-england-and-australia-a-comparative-data-linkage-study
#2
Lee Nedkoff, Derrick Lopez, Michael Goldacre, Frank Sanfilippo, Michael Hobbs, F Lucy Wright
OBJECTIVE: To determine the utility of International Classification of Diseases (ICD) codes in investigating trends in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) using person-linked electronic hospitalisation data in England and Western Australia (WA). METHODS: All hospital admissions with myocardial infarction (MI) as the principal diagnosis were identified from 2000 to 2013 from both jurisdictions...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#3
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29132090/the-potential-use-of-transdermal-drug-delivery-for-the-prophylaxis-and-management-of-stroke-and-coronary-artery-disease
#4
REVIEW
Kevin Ita
In 2013, cardiovascular disease was responsible for 30.8% (800,937) of all 2,596,993 deaths, or approximately 1 of every 3 deaths while stroke caused about 1 of every 20 deaths in the United States [1]. To put it in context, about 795,000 people continue to have a new or recurrent stroke (ischemic or hemorrhagic) [1] in the USA. Mechanical vascular recanalization and thrombolysis with tissue plasminogen activator are the only clinically useful approaches available now for the management of ischemic stroke [2]...
June 4, 2017: Pharmacological Reports: PR
https://www.readbyqxmd.com/read/29129253/rationale-of-a-novel-study-design-for-the-bioflow-v-study-a-prospective-randomized-multicenter-study-to-assess-the-safety-and-efficacy-of-the-orsiro-sirolimus-eluting-coronary-stent-system-using-a-bayesian-approach
#5
Gheorghe Doros, Joseph M Massaro, David E Kandzari, Ron Waksman, Jacques J Koolen, Donald E Cutlip, Laura Mauri
BACKGROUND: Traditional study design submitted to the Food and Drug Administration to test newer drug-eluting stents (DES) for marketing approval is the prospective randomized controlled trial. However, several DES have extensive clinical data from trials conducted outside the United States that have led to utilization of a novel design using the Bayesian approach. This design was proposed for testing DES with bioresorbable polymer compared with DES most commonly in use today that use durable polymers for drug elution...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29128156/utility-of-a-power-aspiration-based-extraction-technique-as-an-initial-and-secondary-approach-in-the-treatment-of-peripheral-arterial-thromboembolism-results-of-the-multicenter-prism-trial
#6
Richard R Saxon, James F Benenati, Corey Teigen, George L Adams, Luke E Sewall
PURPOSE: To investigate the safety and initial efficacy of XTRACT, a power aspiration-based extraction technique for treatment of peripheral arterial thromboembolism with the use of the Penumbra/Indigo system. MATERIALS AND METHODS: A total of 79 patients were enrolled: 39 (49.4%) underwent XTRACT as the initial therapy and 40 (50.6%) underwent XTRACT after failed catheter-directed thrombolysis or other mechanical intervention or for removal of distal emboli that occurred during an intervention...
November 9, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29127948/association-of-high-sensitivity-cardiac-troponin-i-concentration-with-cardiac-outcomes-in-patients-with-suspected-acute-coronary-syndrome
#7
Andrew R Chapman, Kuan Ken Lee, David A McAllister, Louise Cullen, Jaimi H Greenslade, William Parsonage, Andrew Worster, Peter A Kavsak, Stefan Blankenberg, Johannes Neumann, Nils A Söerensen, Dirk Westermann, Madelon M Buijs, Gerard J E Verdel, John W Pickering, Martin P Than, Raphael Twerenbold, Patrick Badertscher, Zaid Sabti, Christian Mueller, Atul Anand, Philip Adamson, Fiona E Strachan, Amy Ferry, Dennis Sandeman, Alasdair Gray, Richard Body, Brian Keevil, Edward Carlton, Kim Greaves, Frederick K Korley, Thomas S Metkus, Yader Sandoval, Fred S Apple, David E Newby, Anoop S V Shah, Nicholas L Mills
Importance: High-sensitivity cardiac troponin I testing is widely used to evaluate patients with suspected acute coronary syndrome. A cardiac troponin concentration of less than 5 ng/L identifies patients at presentation as low risk, but the optimal threshold is uncertain. Objective: To evaluate the performance of a cardiac troponin I threshold of 5 ng/L at presentation as a risk stratification tool in patients with suspected acute coronary syndrome. Data Sources: Systematic search of MEDLINE, EMBASE, Cochrane, and Web of Science databases from January 1, 2006, to March 18, 2017...
November 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29121105/economic-evaluation-of-the-one-hour-rule-out-and-rule-in-algorithm-for-acute-myocardial-infarction-using-the-high-sensitivity-cardiac-troponin-t-assay-in-the-emergency-department
#8
Apoorva Ambavane, Bertil Lindahl, Evangelos Giannitis, Julie Roiz, Joan Mendivil, Lutz Frankenstein, Richard Body, Michael Christ, Roland Bingisser, Aitor Alquezar, Christian Mueller
BACKGROUND: The 1-hour (h) algorithm triages patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED) towards "rule-out," "rule-in," or "observation," depending on baseline and 1-h levels of high-sensitivity cardiac troponin (hs-cTn). The economic consequences of applying the accelerated 1-h algorithm are unknown. METHODS AND FINDINGS: We performed a post-hoc economic analysis in a large, diagnostic, multicenter study of hs-cTnT using central adjudication of the final diagnosis by two independent cardiologists...
2017: PloS One
https://www.readbyqxmd.com/read/29118378/the-association-between-galectin-3-and-hs-crp-and-the-clinical-outcome-after-non-st-elevation-myocardial-infarction-with-preexisting-atrial-fibrillation
#9
Milan Pavlović, Svetlana Apostolović, Dragana Stokanović, Stefan Momčilović, Tatjana Jevtović-Stoimenov, Snezana Ćirić Zdravković, Sonja Šalinger Martinović, Nebojsa Krstić, Goran Koraćević, Danijela Djordjevic, Vladan Ćosić, Valentina N Nikolic
Increased galectin-3 plasma concentration has been linked to an unfavorable outcome in patients with heart failure or atrial fibrillation (AF). There are no published data about the prognostic utility of galectin-3 and high-sensitivity C-reactive protein (hs-CRP) for long-term clinical outcome in the Non-ST elevation acute myocardial infarction (NSTEMI) patients with preexisting AF. Thirty-two patients with the first acute NSTEMI and preexisting AF and 22 patients without preexisting AF, were prospectively followed for fifteen months...
November 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29113999/index-of-microcirculatory-resistance-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-early-cardiac-complications-insights-from-the-oxami-oxford-study-in-acute-myocardial-infarction-cohort
#10
Gregor Fahrni, Mathias Wolfrum, Giovanni Luigi De Maria, Florim Cuculi, Sam Dawkins, Mohammad Alkhalil, Niket Patel, John C Forfar, Bernard D Prendergast, Robin P Choudhury, Keith M Channon, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND: Early risk stratification after primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction is currently challenging. Identification of a low-risk group may improve triage of patients to alternative clinical pathways and support early hospital discharge. Our aim was to assess whether the index of microcirculatory resistance (IMR) at the time of PPCI can identify patients at low risk of early major cardiac complications and to compare its performance against guideline-recommended risk scores...
November 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29103584/selective-aortic-arch-and-root-replacement-in-repair-of-acute-type-a-aortic-dissection
#11
Fernando Fleischman, Ramsey S Elsayed, Robbin G Cohen, James M Tatum, S Ram Kumar, Kayvan Kazerouni, Wendy J Mack, Mark L Barr, Mark J Cunningham, Amy E Hackmann, Craig J Baker, Vaughn A Starnes, Michael E Bowdish
BACKGROUND: Controversy exists regarding the optimal extent of repair for type A aortic dissection. Our approach is to replace the ascending aorta, and only replace the aortic root or arch when intimal tears are present in those areas. We examined intermediate outcomes with this approach to acute type A aortic dissection repair. METHODS: Between March 2005 and October 2016, 195 patients underwent repair of acute type A aortic dissection. Repair was categorized by site of proximal and distal anastomosis and extent of repair...
November 3, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29102582/variation-in-the-adoption-of-transradial%C3%A2-access-for-st-segment-elevation-myocardial-infarction-insights-from-the-ncdr-cathpci-registry
#12
Javier A Valle, Lisa A Kaltenbach, Steven M Bradley, Robert W Yeh, Sunil V Rao, Hitinder S Gurm, Ehrin J Armstrong, John C Messenger, Stephen W Waldo
OBJECTIVES: The study sought to define patient, operator, and institutional factors associated with transradial access (TRA) in ST-segment elevation myocardial infarction (STEMI) percutaneous coronary intervention (PCI), the variation in use across operators and institutions, and the relationship with mortality and bleeding. BACKGROUND: TRA for PCI in STEMI is underutilized. Factors associated with TRA are not well described, nor is there variation across operators and institutions or their relationship with outcomes...
October 25, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29097450/clinical-outcomes-and-cost-effectiveness-of-fractional-flow-reserve-guided-percutaneous-coronary-intervention-in-patients-with-stable-coronary-artery-disease-three-year-follow-up-of-the-fame-2-trial-fractional-flow-reserve-versus-angiography-for-multivessel
#13
William F Fearon, Takeshi Nishi, Bernard De Bruyne, Derek B Boothroyd, Emanuele Barbato, Pim Tonino, Peter Jüni, Nico H J Pijls, Mark A Hlatky
BACKGROUND : Previous studies found that percutaneous coronary intervention (PCI) does not improve outcome compared with medical therapy (MT) in patients with stable coronary artery disease, but PCI was guided by angiography alone. FAME 2 trial (Fractional Flow Reserve Versus Angiography for Multivessel Evaluation) compared PCI guided by fractional flow reserve with best MT in patients with stable coronary artery disease to assess clinical outcomes and cost-effectiveness. METHODS : A total of 888 patients with stable single-vessel or multivessel coronary artery disease with reduced fractional flow reserve were randomly assigned to PCI plus MT (n=447) or MT alone (n=441)...
November 2, 2017: Circulation
https://www.readbyqxmd.com/read/29096864/care-high-cascade-screening-and-registry-for-high-cholesterol-in-germany
#14
Nina Schmidt, Tanja Grammer, Ioanna Gouni-Berthold, Ulrich Julius, Ursula Kassner, Gerald Klose, Christel König, Ulrich Laufs, Britta Otte, Elisabeth Steinhagen-Thiessen, Christoph Wanner, Winfried März
INTRODUCTION: Familial hypercholesterolemia (FH) is an inherited disorder of the LDL metabolism, leading to cardiovascular disease, even at young age. This risk can be significantly lowered by early diagnosis and treatment. About 270,000 patients affected in Germany are not diagnosed correctly and only a small number is treated properly. To improve FH diagnosis in the general population a cascade screening and registry data is warranted, yet missing in Germany. This project aims to fill this gap...
November 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/29088950/neurosurgical-applications-of-viscoelastic-hemostatic-assays
#15
Svetlana Kvint, James Schuster, Monisha A Kumar
Patients taking antithrombotic agents are very common in neurosurgical practice. The perioperative management of these patients can be extremely challenging especially as newer agents, with poorly defined laboratory monitoring and reversal strategies, become more prevalent. This is especially true with emergent cases in which rapid reversal of anticoagulation is required and the patient's exact medical history is not available. With an aging patient population and the associated increase in diseases such as atrial fibrillation, it is expected that the use of these agents will continue to rise in coming years...
November 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/29079508/early-coronary-angiography-in-patients-resuscitated-from-out-of-hospital-cardiac-arrest-without-st-segment-elevation-a-systematic-review-and-meta-analysis
#16
Muhammad Shahzeb Khan, Sayed Mustafa Mahmood Shah, Ayesha Mubashir, Abdur Rahman Khan, Kaneez Fatima, Aldo L Schenone, Faisal Khosa, Habib Samady, Venu Menon
OBJECTIVE: A meta-analysis of published studies was performed to determine the impact of performing early versus delayed or no coronary angiography in patients without ST-segment elevation myocardial infarction following out of hospital cardiac arrest. METHODS: A structured search was conducted using Medline, Embase and Ovid by two independent investigators using a variety of keywords. The primary outcome was short term (at discharge) and long term (at 6-14 months follow-up) mortality whereas the secondary end-point was good neurological outcome (defined as a Cerebral Performance Category Score of 1 or 2), at discharge and follow up...
October 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/29078880/impact-of-complications-on-length-of-stay-in-elective-laparoscopic-colectomies
#17
Mary Megan Mrdutt, Claire L Isbell, J Scott Thomas, Courtney N Shaver, Rahila Essani, Rajalakshmi Warrier, Harry Troy Papaconstantinou
BACKGROUND: Length of hospital stay (LOS) is an indirect measure of surgical quality and a surrogate for cost. The impact of postoperative complications on LOS following elective colorectal surgery is not well defined. The purpose of this study is to determine the contribution of specific complications towards LOS in elective laparoscopic colectomy patients. MATERIALS AND METHODS: American College of Surgeon's National Surgical Quality Improvement Program database (2011-2014) was queried for patients undergoing elective laparoscopic partial colectomy with primary anastomosis...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29068691/myocardial-injury-is-distinguished-from-stable-angina-by-a-set-of-candidate-plasma-biomarkers-identified-using-itraq-mrm-based-approach
#18
Esther Sok Hwee Cheow, Woo Chin Cheng, Terence Yap, Bamaprasad Dutta, Chuen Neng Lee, Dominique Pv de Kleijn, Vitaly Sorokin, Siu Kwan Sze
The lack of precise biomarkers that discriminates patient at risk for myocardial injury and stable angina, contributed to the delayed administration of optimal therapy. Hence, the search for noninvasive biomarkers that could accurately stratify patients with impending heart attack, from patients with stable coronary artery disease (CAD) are urgently needed in the clinic. Herein, we performed comparative quantitative proteomics on whole plasma sampled from patients with stable angina (NMI), acute myocardial infarction (MI), and healthy control subjects (Ctrl)...
October 25, 2017: Journal of Proteome Research
https://www.readbyqxmd.com/read/29064626/high-sensitivity-c-reactive-protein-low-density-lipoprotein-cholesterol-and-cardiovascular-outcomes-in-patients-with-type-2-diabetes-in-the-examine-examination-of-cardiovascular-outcomes-with-alogliptin-versus-standard-of-care-trial
#19
You-Cheol Hwang, David A Morrow, Christopher P Cannon, Yuyin Liu, Richard Bergenstal, Simon Heller, Cyrus Mehta, William Cushman, George L Bakris, Faiez Zannad, William B White
OBJECTIVE: We sought to assess the risk of major adverse cardiovascular events (MACE) by utilizing high-sensitivity C-reactive protein (hsCRP) level and low-density lipoprotein cholesterol (LDL-C) in patients with type 2 diabetes and recent acute coronary syndrome. RESEARCH DESIGN AND METHODS: Study participants enrolled in the EXAMINE trial, were stratified by baseline hsCRP levels (<1, 1-3, and >3 mg/l) and were also sub-divided into 4 groups according to baseline hsCRP (≤3 or >3 mg/l) and achieved LDL-C (<70 or ≥70 mg/dl) levels...
October 24, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/29062745/review-of-minimal-access-versus-transcatheter-aortic-valve-replacement-for-patients-with-severe-aortic-stenosis
#20
Carson T Hoffmann, Jacob A Heiner, Tom C Nguyen
Transcatheter aortic valve replacement (TAVR) and minimally invasive aortic valve replacement (miniAVR) have become alternatives to surgical aortic valve replacement via median sternotomy (SAVR) to treat severe aortic stenosis (AS). Despite increased interest and utilization, few studies have directly compared TAVR and miniAVR. A review of the current literature shows TAVR to be an indispensable tool for inoperable, high-risk, and perhaps intermediate-risk patients with severe AS. However, it is associated with a number of deleterious perioperative outcomes, such as valvular regurgitation and vascular complications...
September 2017: Annals of Cardiothoracic Surgery
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