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Myocardial infarction utilization

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https://www.readbyqxmd.com/read/28220472/renal-denervation-for-resistant-hypertension
#1
REVIEW
Giuseppe Coppolino, Anna Pisano, Laura Rivoli, Davide Bolignano
BACKGROUND: Resistant hypertension is highly prevalent among the general hypertensive population and the clinical management of this condition remains problematic. Different approaches, including a more intensified antihypertensive therapy, lifestyle modifications, or both, have largely failed to improve patients' outcomes and to reduce cardiovascular and renal risk. As renal sympathetic hyperactivity is a major driver of resistant hypertension, renal sympathetic ablation (renal denervation) has been recently proposed as a possible therapeutic alternative to treat this condition...
February 21, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28214795/pre-implantation-balloon-aortic-valvuloplasty-and-clinical-outcomes-following-transcatheter-aortic-valve-implantation-a-propensity-score-analysis-of-the-uk-registry
#2
Glen P Martin, Matthew Sperrin, Rodrigo Bagur, Mark A de Belder, Iain Buchan, Mark Gunning, Peter F Ludman, Mamas A Mamas
BACKGROUND: Aortic valve predilation with balloon aortic valvuloplasty (BAV) is recommended before transcatheter aortic valve implantation (TAVI), despite limited data around the requirement of this preprocedural step and the potential risks of embolization. This study aimed to investigate the trends in practice and associations of BAV on short-term outcomes in the UK TAVI registry. METHODS AND RESULTS: Eleven clinical endpoints were investigated, including 30-day mortality, myocardial infarction, aortic regurgitation, valve dysfunction, and composite early safety...
February 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28214504/frequency-of-troponin-testing-in-inpatient-versus-outpatient-settings
#3
Adam J Farber, Keith Suarez, Kipp Slicker, Chhaya D Patel, Brandon Pope, Robert Kowal, Jeffrey B Michel
Troponin elevation is required to diagnose acute myocardial infarction (AMI), yet elevated values are often encountered in noncardiac disease states. We evaluated inpatient (IP) and outpatient (OP) encounters at 14 hospitals in calendar year 2014 and found that troponin assays were performed during 12% of all OP visits and 29% of all IP visits: 82,853 encounters in all. We employed an expert panel to estimate the likelihood of AMI based on primary International Statistical Classification of Diseases and Related Health Problems, 9th edition diagnoses...
January 25, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28209729/edoxaban-for-the-prevention-of-thromboembolism-in-patients-with-atrialfibrillation-and-bioprosthetic-valves
#4
Anthony P Carnicelli, Raffaele De Caterina, Jonathan L Halperin, Giulia Renda, Christian T Ruff, Marco Trevisan, Francesco Nordio, Michele F Mercuri, Elliott Antman, Robert P Giugliano
Atrial fibrillation (AF) and valvular heart disease (VHD) frequently coexist and independently increase mortality1. Bioprosthetic valve implantation (surgical or transcatheter), is a common, increasingly utilized treatment for VHD2. Patients with AF and bioprosthetic valves require anticoagulation to prevent thromboembolic events. Non-vitamin K oral anticoagulants (NOACs) are safe and efficacious alternatives to vitamin K antagonists for anticoagulation in AF. However, guidelines recommend against NOACs in patients with bioprosthetic valves, citing a lack of supporting data...
February 16, 2017: Circulation
https://www.readbyqxmd.com/read/28197294/diagnostic-approach-to-myocarditis-mimicking-myocardial-infarction-at-initial-presentation
#5
Craig Basman, Pratik R Agrawal, Chad McRee, Louis Saravolatz, Carol Chen-Scarabelli, Tiziano M Scarabelli
We present a case of a 35-year-old male patient with a 12-hour history of sudden-onset, crushing chest pain and associated complaints of profuse diaphoresis, nausea and vomiting. The patient was transferred to our institution from an outside hospital for evaluation and possible emergent catheterization. Left heart catheterization was conclusive for normal coronary arteries and a ventriculogram revealed a left ventricular ejection fraction of approximately 45%. Due to a suspicion of myocarditis based on clinical history, pertinent serology tests were ordered, which were found to be negative...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28194628/association-between-ck-mb-area-under-the-curve-and-tranexamic-acid-utilization-in-patients-undergoing-coronary-artery-bypass-surgery
#6
Sean van Diepen, Peter D Merrill, Michel Carrier, Jean-Claude Tardif, Mihai Podgoreanu, John H Alexander, Renato D Lopes
Myonecrosis after coronary artery bypass graft (CABG) surgery is associated with excess mortality. Tranexamic acid (TA), an anti-fibrinolytic agent, has been shown to reduce peri-operative blood loss without increasing the risk of myocardial infarction (MI); however, no large study has examined the association between TA treatment and post-CABG myonecrosis. In the MC-1 to Eliminate Necrosis and Damage in Coronary Artery Bypass Graft Surgery II trial, inverse probability weighting of the propensity to receive TA was used to test for differences among the 656 patients receiving and 770 patients not receiving TA...
February 14, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28191743/manual-thrombectomy-efficiency-in-relationship-to-the-area-at-risk-in-patients-with-myocardial-infarction-with-timi-0-1-coronary-flow-insights-from-an-all-comers-registry
#7
André Luz, Inês Silveira, Bruno Brochado, Patrícia Rodrigues, Maria João Sousa, Raquel Santos, Maria Trêpa, Mário Santos, João Silveira, Severo Torres, Adelino F Leite-Moreira, Henrique Carvalho
OBJECTIVES: To review the effectiveness of manual thrombectomy (MT) in a series of patients with ST-elevation myocardial infarction (STEMI) exclusively presenting with TIMI 0-1 flow undergoing percutaneous coronary intervention (PCI), in accordance to the angiographically estimated area at risk (AAR). Second, to assess major in-hospital clinical events, emphasizing neurological outcomes. BACKGROUND: The routine utilization of MT in STEMI is not recommended. However, in recent trials, a significant proportion of patients had neither large thrombus burden nor a totally occluded coronary segment, neutralizing the expected benefits of MT...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28183991/cardiac-and-respiratory-motion-correction-for-simultaneous-cardiac-pet-mr
#8
Christoph Kolbitsch, Mark A Ahlman, Cynthia Davies-Venn, Robert Evers, Michael Hansen, Devis Peressutti, Paul Marsden, Peter Kellman, David A Bluemke, Tobias Schaeffter
Cardiac Positron Emission Tomography (PET) is a versatile imaging technique providing important diagnostic information about ischemic heart diseases. Respiratory and cardiac motion of the heart can strongly impair image quality and therefore diagnostic accuracy of cardiac PET scans. The aim of this study is to investigate a new cardiac PET-Magnetic Resonance (MR) approach providing respiratory and cardiac motion-compensated MR and PET images in less than five minutes. Methods: Free-breathing 3D MR data was acquired and retrospectively binned into multiple respiratory and cardiac motion states...
February 9, 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
https://www.readbyqxmd.com/read/28178979/managed-care-and-inpatient-mortality-in-adults-effect-of-primary-payer
#9
Anika L Hines, Susan O Raetzman, Marguerite L Barrett, Ernest Moy, Roxanne M Andrews
BACKGROUND: Because managed care is increasingly prevalent in health care finance and delivery, it is important to ascertain its effects on health care quality relative to that of fee-for-service plans. Some stakeholders are concerned that basing gatekeeping, provider selection, and utilization management on cost may lower quality of care. To date, research on this topic has been inconclusive, largely because of variation in research methods and covariates. Patient age has been the only consistently evaluated outcome predictor...
February 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28167641/prognostic-utility-of-a-modified-heart-score-in-chest-pain-patients-in-the-emergency-department
#10
James McCord, Rafael Cabrera, Bertil Lindahl, Evangelos Giannitsis, Kaleigh Evans, Richard Nowak, Tiberio Frisoli, Richard Body, Michael Christ, Christopher R deFilippi, Robert H Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller
BACKGROUND: The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial. METHODS AND RESULTS: Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28159815/validation-of-the-prognostic-utility-of-the-electrocardiogram-for-acute-drug-overdose
#11
Alex F Manini, Ajith P Nair, Rajesh Vedanthan, David Vlahov, Robert S Hoffman
BACKGROUND: While it is certain that some emergency department patients with acute drug overdose suffer adverse cardiovascular events (ACVE), predicting ACVE is difficult. The prognostic utility of the ECG for heterogeneous drug overdose patients remains to be proven. This study was undertaken to validate previously derived features of the initial ECG associated with ACVE in this population. METHODS AND RESULTS: We performed a prospective validation cohort study to evaluate adult emergency department patients with acute drug overdose at 2 urban university hospitals over 5 years in whom an emergency department admission ECG was performed...
February 3, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28150313/improved-outcomes-and-reduced-costs-associated-with-a-health-system-wide-patient-blood-management-program-a-retrospective-observational-study-in-four-major-adult-tertiary-care-hospitals
#12
Michael F Leahy, Axel Hofmann, Simon Towler, Kevin M Trentino, Sally A Burrows, Stuart G Swain, Jeffrey Hamdorf, Trudi Gallagher, Audrey Koay, Gary C Geelhoed, Shannon L Farmer
BACKGROUND: Patient blood management (PBM) programs are associated with improved patient outcomes, reduced transfusions and costs. In 2008, the Western Australia Department of Health initiated a comprehensive health-system-wide PBM program. This study assesses program outcomes. STUDY DESIGN AND METHODS: This was a retrospective study of 605,046 patients admitted to four major adult tertiary-care hospitals between July 2008 and June 2014. Outcome measures were red blood cell (RBC), fresh-frozen plasma (FFP), and platelet units transfused; single-unit RBC transfusions; pretransfusion hemoglobin levels; elective surgery patients anemic at admission; product and activity-based costs of transfusion; in-hospital mortality; length of stay; 28-day all-cause emergency readmissions; and hospital-acquired complications...
February 2, 2017: Transfusion
https://www.readbyqxmd.com/read/28149853/clinical-utility-of-novel-biomarkers-in-acute-myocardial-infarction
#13
EDITORIAL
Thomas Stiermaier, Holger Thiele, Ingo Eitel
No abstract text is available yet for this article.
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28145874/comparative-matched-outcome-of-evolut-r-vs-corevalve-transcatheter-aortic-valve-implantation
#14
Uri Landes, Tamir Bental, Alon Barsheshet, Abid Assali, Hana Vaknin Assa, Amos Levi, Katia Orvin, Ran Kornowski
OBJECTIVES: The Evolut-R (Medtronic, Inc) is a transcatheter aortic valve implantation (TAVI) system that was built on the well-established foundation of Medtronic's CoreValve device platform. Although already in extensive clinical utilization, it is unknown if the Evolut-R improves TAVI outcomes. Herein, we compared TAVI outcomes of the Evolut-R and CoreValve devices. METHODS: A propensity score 1:1 matching was conducted on 358 Evolut-R patients (n = 75) and CoreValve patients (n = 283)...
February 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28145489/improving-the-diagnostic-accuracy-of-acute-myocardial-infarction-with-the-use-of-high-sensitive-cardiac-troponin-t-in-different-chronic-kidney-disease-stages
#15
Hongliu Yang, Jing Liu, Han Luo, Xiaoxi Zeng, Xi Tang, Liang Ma, Hongxia Mai, Shenju Gou, Fang Liu, Ping Fu
High-sensitive cardiac troponin T (hs-TnT) is a critical biomarker in diagnosis of acute myocardial infarction (AMI). However, CKD individuals usually have elevated hs-TnT even in the absence of AMI. Our study aimed to explore the optimal cutoff-value of hs-TnT and further to improve diagnostic accuracy of AMI in CKD patients. Clinical data of 489 patients were collected from the maintained database between September 2010 and June 2014. CKD patients with AMI were assigned to CKD+AMI group and CKD patients without AMI were assigned to CKD group...
February 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28127121/interpretation-of-positive-troponin-results-among-patients-with-and-without-myocardial-infarction
#16
Kristen M Tecson, William Arnold, Tyler Barrett, Robert Birkhahn, Lori B Daniels, Christopher DeFilippi, Gary Headden, W Frank Peacock, Michael Reed, Adam J Singer, Jeffrey M Schussler, Stephen Smith, Martin P Than, Peter A McCullough
Measuring cardiac troponins is integral to diagnosing acute myocardial infarction (AMI); however, troponins may be elevated without AMI, and the use of multiple different assays confounds comparisons. We considered characteristics and serial troponin values in emergency department chest pain patients with and without AMI to interpret troponin excursions. We compared serial troponin in 124 AMI and non-AMI patients from the observational Performance of Triage Cardiac Markers in the Clinical Setting (PEARL) study who presented with chest pain and had at least one troponin value exceeding the 99th percentile of normal...
January 2017: Proceedings of the Baylor University Medical Center
https://www.readbyqxmd.com/read/28120282/treatment-of-atrial-fibrillation-with-warfarin-among-older-adults-with-end-stage-renal-disease
#17
Jingwen Tan, Sunjae Bae, Jodi B Segal, Junya Zhu, Dorry L Segev, G Caleb Alexander, Mara McAdams-DeMarco
BACKGROUND: There is increasing evidence questioning the use of warfarin for atrial fibrillation (AF) among older adults with end stage renal disease (ESRD). We assessed the patterns and determinants of warfarin utilization among these patients in the US. METHODS: We assembled a cohort of older adults (age ≥65) undergoing dialysis with incident AF from July 2007 to November 2011 from the US Renal Data System (USRDS). We used descriptive statistics to characterize warfarin utilization within 30 days of AF discharge, and logistic regression to quantify patient characteristics associated with warfarin initiation...
January 24, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28119150/vascular-katp-channels-mitigate-severe-muscle-o2-delivery-utilization-mismatch-during-contractions-in-chronic-heart-failure-rats
#18
Clark T Holdsworth, Scott K Ferguson, Trenton D Colburn, Alexander J Fees, Jesse C Craig, Daniel M Hirai, David C Poole, Timothy I Musch
The vascular ATP-sensitive K(+) (KATP) channel is a mediator of skeletal muscle microvascular oxygenation (PO2mv) during contractions in health. We tested the hypothesis that KATP channel function is preserved in chronic heart failure (CHF) and therefore its inhibition would reduce PO2mv and exacerbate the time taken to reach the PO2mv steady-state during contractions of the spinotrapezius muscle. Moreover, we hypothesized that subsequent KATP channel activation would oppose the effects of this inhibition. Muscle PO2mv (phosphorescence quenching) was measured during 180s of 1-Hz twitch contractions (∼6V) under control, glibenclamide (GLI, KATP channel antagonist; 5mg/kg) and pinacidil (PIN, KATP channel agonist; 5mg/kg) conditions in 16 male Sprague-Dawley rats with CHF induced via myocardial infarction (coronary artery ligation, left ventricular end-diastolic pressure: 18±1mmHg)...
January 22, 2017: Respiratory Physiology & Neurobiology
https://www.readbyqxmd.com/read/28115328/myocardial-infarction-in-the-wisconsin-longitudinal-study-the-interaction-among-environmental-health-social-behavioural-and-genetic-factors
#19
Tina K Gonzales, James A Yonker, Vicky Chang, Carol L Roan, Pamela Herd, Craig S Atwood
OBJECTIVES: This study examined how environmental, health, social, behavioural and genetic factors interact to contribute to myocardial infarction (MI) risk. DESIGN: Survey data collected by Wisconsin Longitudinal Study (WLS), USA, from 1957 to 2011, including 235 environmental, health, social and behavioural factors, and 77 single- nucleotide polymorphisms were analysed for association with MI. To identify associations with MI we utilized recursive partitioning and random forest prior to logistic regression and chi-squared analyses...
January 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#20
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
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