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https://www.readbyqxmd.com/read/29127948/association-of-high-sensitivity-cardiac-troponin-i-concentration-with-cardiac-outcomes-in-patients-with-suspected-acute-coronary-syndrome
#1
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
#2
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/29109595/the-role-of-hematological-indices-in-patients-with-acute-coronary-syndrome
#3
REVIEW
Jan Budzianowski, Konrad Pieszko, Paweł Burchardt, Janusz Rzeźniczak, Jarosław Hiczkiewicz
An increased systemic and local inflammation plays a key role in the pathophysiology of acute coronary syndrome (ACS). This review will discuss the role of hematological indices: white blood cells (WBC), neutrophil to lymphocyte ratio (NLR), red cell distribution width (RDW), and platelet indices, that is, platelet to lymphocyte ratio (PLR), mean platelet volume (MPV), and platelet distribution width (PDW) in the case of ACS. In recent years, a strong interest has been drawn to these indices, given that they may provide independent information on pathophysiology, risk stratification, and optimal management...
2017: Disease Markers
https://www.readbyqxmd.com/read/29081979/dual-antiplatelet-therapy-for-secondary-prevention-of-coronary-artery-disease
#4
REVIEW
Sophie Degrauwe, Thomas Pilgrim, Adel Aminian, Stephane Noble, Pascal Meier, Juan F Iglesias
Dual antiplatelet therapy (DAPT) combining aspirin and a P2Y12 receptor inhibitor has been consistently shown to reduce recurrent major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease (CAD) compared with aspirin monotherapy, but at the expense of an increased risk of major bleeding. Nevertheless, the optimal duration of DAPT for secondary prevention of CAD remains uncertain, owing to the conflicting results of several large randomised trials...
2017: Open Heart
https://www.readbyqxmd.com/read/29081000/association-between-medicare-s-mandatory-hospital-value-based-purchasing-program-and-cost-inefficiency
#5
Germán M Izón, Chelsea A Pardini
BACKGROUND: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency. OBJECTIVE AND METHOD: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs...
October 28, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29072961/reducing-smoking-in-the-us-federal-workforce-5-year-health-and-economic-impacts-from-improved-cardiovascular-disease-outcomes
#6
Garrett R Beeler Asay, David M Homa, Erin M Abramsohn, Xin Xu, Erin L O'Connor, Guijing Wang
OBJECTIVE: We estimated the reduction in number of hospitalizations for acute myocardial infarction and stroke as well as the associated health care costs resulting from reducing the number of smokers in the US federal workforce during a 5-year period. METHODS: We developed a 5-year spreadsheet-based cohort model with parameter values from past literature and analysis of national survey data. We obtained 2015 data on the federal workforce population from the US Office of Personnel Management and data on smoking prevalence among federal workers from the 2013-2015 National Health Interview Survey...
November 2017: Public Health Reports
https://www.readbyqxmd.com/read/29068166/meta-analysis-of-transfemoral-tavr-versus-surgical-aortic-valve-replacement
#7
Sameer Arora, Satyanarayana R Vaidya, Paula D Strassle, Jacob A Misenheimer, Jeremy A Rhodes, Cassandra J Ramm, Evan N Wheeler, Thomas G Caranasos, Matthew A Cavender, John P Vavalle
BACKGROUND: In the recently concluded PARTNER 2 trial, TF-TAVR cohort was shown to have lower risks of death or disabling strokes as compared to SAVR, whereas the outcomes with transthoracic TAVR were comparable with SAVR. METHODS: We searched PubMed, EMBASE, Web of Science, and Google Scholar for all comparison studies between TAVR and SAVR and mortality as an outcome, irrespective of surgical risk. Randomized controlled trials and propensity-score-matched cohort studies that used a transfemoral approach exclusively or stratified results by route of access and reported data for TF-TAVR patients were eligible for inclusion...
October 25, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29034393/centrifugal-micropipette-tip-with-pressure-signal-readout-for-portable-quantitative-detection-of-myoglobin
#8
Yanling Song, Yuan An, Weizhi Liu, Wanfu Hou, Xingrui Li, Bingqian Lin, Zhi Zhu, Shengxiang Ge, Huang-Hao Yang, Chaoyong Yang
This paper describes a centrifugal micropipette-tip method for ELISA sample processing combined with a pressure meter for portable quantitative detection of acute myocardial infarction (AMI) biomarker myoglobin (Myo). The method enables sensitive and reliable quantification of Myo in 35 minutes. With the advantages of simplicity, speed, user friendliness, low cost, and small sample consumption, centrifugal micropipette-tip ELISA shows great potential for quantitative POC diagnostics for AMI.
August 22, 2017: Chemical Communications: Chem Comm
https://www.readbyqxmd.com/read/29018137/incidence-and-outcomes-of-myocardial-infarction-in-patients-admitted-with-acute-ischemic-stroke
#9
Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli
BACKGROUND AND PURPOSE: Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. METHODS: The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28991122/peripheral-nerve-blocks-for-hip-fractures-a-cochrane-review
#10
Joanne Guay, Martyn J Parker, Richard Griffiths, Sandra L Kopp
BACKGROUND: This review focuses on the use of peripheral nerve blocks as preoperative analgesia, as postoperative analgesia, or as a supplement to general anesthesia for hip fracture surgery and tries to determine if they offer any benefit in terms of pain on movement at 30 minutes after block placement, acute confusional state, myocardial infarction/ischemia, pneumonia, mortality, time to first mobilization, and cost of analgesic. METHODS: Trials were identified by computerized searches of Cochrane Central Register of Controlled Trials (2016, Issue 8), MEDLINE (Ovid SP, 1966 to 2016 August week 1), Embase (Ovid SP, 1988 to 2016 August week 1), and the Cumulative Index to Nursing and Allied Health Literature (EBSCO, 1982 to 2016 August week 1), trials registers, and reference lists of relevant articles...
October 4, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28990736/hospital-outcomes-of-transcatheter-versus-surgical-aortic-valve-replacement-in-female-in-the-united-states
#11
Tomo Ando, Emmanuel Akintoye, Tesfaye Telila, Alexandros Briasouolis, Hisato Takagi, Theodore Schreiber, Luis Afonso, Cindy L Grines
OBJECTIVES: To assess the in-hospital mortality and complications in female between transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR). BACKGROUND: Female is one of the risk factors for increased adverse events in cardiac surgery. METHODS AND RESULTS: Nationwide Inpatient Sample database was queried from 2011 to 2014 for patients who underwent TAVR or SAVR in female patients. The primary endpoint was in-hospital all-cause mortality and second endpoints were perioperative complications...
October 9, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28973289/early-postoperative-complications-for-elderly-patients-undergoing-single-level-decompression-for-lumbar-disc-herniation-ligamentous-hypertrophy-or-neuroforaminal-stenosis
#12
Arpan V Prabhu, Bryan A Lieber, Jenson K Henry, Nitin Agarwal, Monir Tabbosha, David O Okonkwo
BACKGROUND: Lumbar decompression for disc herniation is frequently performed on elderly patients, and this trend will continue as the population ages. Clinical reports on the complications of lumbar discectomy show good results and cost effectiveness in young or middle-aged patients. OBJECTIVE: To assess and compare the morbidity of single-level lumbar disc surgery for radicular pain in a cohort of patients greater than 80 yr of age to that of a middle-aged cohort...
July 18, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28971637/an-intervention-to-reduce-the-time-interval-between-hospital-entry-and-emergency-coronary-angiography-in-patients-with-st-elevation-myocardial-infarction
#13
Basheer Karkabi, Ronen Jaffe, David A Halon, Amnon Merdler, Nader Khader, Ronen Rubinshtein, Jacob Goldstein, Barak Zafrir, Keren Zissman, Nissan Ben-Dov, Michael Gabrielly, Alex Fuks, Avinoam Shiran, Salim Adawi, Yaron Hellman, Johny Shahla, Salim Halabi, Moshe Y Flugelman, Shai Cohen, Irina Bergman, Sameer Kassem, Chen Shapira
BACKGROUND: Outcomes of patients with acute ST-elevation myocardial infarction (STEMI) are strongly correlated to the time interval from hospital entry to primary percutaneous coronary intervention (PPCI). Current guidelines recommend a door to balloon time of < 90 minutes. OBJECTIVES: To reduce the time from hospital admission to PPCI and to increase the proportion of patients treated within 90 minutes. METHODS: In March 2013 the authors launched a seven-component intervention program:  Direct patient evacuation by out-of-hospital emergency medical services to the coronary intensive care unit or catheterization laboratory Education program for the emergency department staff Dissemination of information regarding the urgency of the PPCI decision Activation of the catheterization team by a single phone call Reimbursement for transportation costs to on-call staff who use their own cars Improvement in the quality of medical records Investigation of failed cases and feedback...
September 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28956743/transradial-versus-transfemoral-approach-for-percutaneous-coronary-intervention-in-elderly-patients-in-china-a-retrospective-analysis
#14
Chen Jin, Yi Xu, Shu-Bin Qiao, Xin-Ran Tang, Yong-Jian Wu, Hong-Bing Yan, Ke-Fei Dou, Bo Xu, Jin-Gang Yang, Yue-Jin Yang
Objective To compare hospital costs and clinical outcomes between transradial intervention (TRI) and transfemoral intervention (TFI) in elderly patients aged over 65 years. Methods We identified 1229 patients aged over 65 years who underwent percutaneous coronary intervention (PCI) in Fuwai Hospital, Beijing, China, between January 1 and December 31, 2010. Total hospital costs and in-hospital outcomes were compared between TRI and TFI. An inverse probability weighting (IPW) model was introduced to control potential biases...
September 27, 2017: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28954802/henry-ford-heart-score-randomized-trial-rapid-discharge-of-patients-evaluated-for-possible-myocardial-infarction
#15
Tiberio M Frisoli, Richard Nowak, Kaleigh L Evans, Michael Harrison, Maath Alani, Saira Varghese, Mehnaz Rahman, Samantha Noll, Katherine R Flannery, Alex Michaels, Mishel Tabaku, Gordon Jacobsen, James McCord
BACKGROUND: Hospital evaluation of patients with chest pain is common and costly. The HEART score risk stratification tool that merges troponin testing into a clinical risk model for evaluation emergency department patients with possible acute myocardial infarction (AMI) has been shown to effectively identify a substantial low-risk subset of patients possibly safe for early discharge without stress testing, a strategy that could have tremendous healthcare savings implications. METHOD AND RESULTS: A total of 105 patients evaluated for AMI in the emergency departments of 2 teaching hospitals in the Henry Ford Health System (Detroit and West Bloomfield, MI), between February 2014 and May 2015, with a modified HEART score ≤3 (which includes cardiac troponin I <0...
October 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28953006/cardiac-auscultation-for-noncardiologists-application-in-cardiac-rehabilitation-programs-part-i-patients-after-acute-coronary-syndromes-and-heart-failure
#16
Leonida Compostella, Caterina Compostella, Nicola Russo, Tiziana Setzu, Sabino Iliceto, Fabio Bellotto
During outpatient cardiac rehabilitation after an acute coronary syndrome or after an episode of congestive heart failure, a careful, periodic evaluation of patients' clinical and hemodynamic status is essential. Simple and traditional cardiac auscultation could play a role in providing useful prognostic information.Reduced intensity of the first heart sound (S1), especially when associated with prolonged apical impulse and the appearance of added sounds, may help identify left ventricular (LV) dysfunction or conduction disturbances, sometimes associated with transient myocardial ischemia...
August 4, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28943533/incidence-and-significance-of-spontaneous-st-segment-re-elevation-after-reperfused-anterior-acute-myocardial-infarction%C3%A3-relationship-with-infarct-size-adverse-remodeling-and-events-at-1-year
#17
Léo Cuenin, Sophie Lamoureux, Mathieu Schaaf, Thomas Bochaton, Jean-Pierre Monassier, Marc J Claeys, Gilles Rioufol, Gérard Finet, David Garcia-Dorado, Denis Angoulvant, Meyer Elbaz, Nicolas Delarche, Pierre Coste, Marc Metge, Thibault Perret, Pascal Motreff, Eric Bonnefoy-Cudraz, Gérald Vanzetto, Olivier Morel, Inesse Boussaha, Michel Ovize, Nathan Mewton
BACKGROUND: Up to 25% of patients with ST elevation myocardial infarction (STEMI) have ST segment re-elevation after initial regression post-reperfusion and there are few data regarding its prognostic significance.Methods and Results:A standard 12-lead electrocardiogram (ECG) was recorded in 662 patients with anterior STEMI referred for primary percutaneous coronary intervention (PPCI). ECGs were recorded 60-90 min after PPCI and at discharge. ST segment re-elevation was defined as a ≥0...
September 23, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28939546/using-smart-technology-to-improve-outcomes-in-myocardial-infarction-patients-rationale-and-design-of-a-protocol-for-a-randomized-controlled-trial-the-box
#18
Roderick Willem Treskes, Louise Anna van Winden, Nicole van Keulen, Douwe Ekke Atsma, Enno Tjeerd van der Velde, Elske van den Akker-van Marle, Bart Mertens, Martin Jan Schalij
BACKGROUND: Recent evidence suggests that frequent monitoring using smartphone-compatible wearable technologies might improve clinical effectiveness and patient satisfaction of care. OBJECTIVE: The aim of this study is to investigate the clinical effectiveness and patient satisfaction of a smart technology intervention in patients admitted with a ST elevation myocardial infarction (STEMI) or non-ST acute coronary syndrome (NST-ACS). METHODS: In this single center, open, randomized controlled trial patients who suffered from STEMI or NST-ACS will be randomized 1:1 to an intervention group or control group...
September 22, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28923845/high-sensitivity-cardiac-troponin-i-as-a-gatekeeper-for-coronary-computed-tomography-angiography-and-stress-testing-in-patients-with-acute-chest-pain
#19
Maros Ferencik, Thomas Mayrhofer, Michael T Lu, Pamela K Woodard, Quynh A Truong, W Frank Peacock, Fabian Bamberg, Benjamin C Sun, Jerome L Fleg, John T Nagurney, James E Udelson, Wolfgang Koenig, James L Januzzi, Udo Hoffmann
BACKGROUND: Most patients presenting to the emergency department (ED) with suspected acute coronary syndrome (ACS) undergo noninvasive cardiac testing with a low diagnostic yield. We determined whether a combination of high-sensitivity cardiac troponin I (hs-cTnI) and cardiovascular risk factors might improve selection of patients for cardiac testing. METHODS: We included patients from the Rule Out Myocardial Infarction/Ischemia Using Computer Assisted Tomography (ROMICAT) I and II trials who presented to the ED with acute chest pain and were referred for cardiac testing...
September 18, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28902880/cost-and-cost-effectiveness-of-a-school-based-education-program-to-reduce-salt-intake-in-children-and-their-families-in-china
#20
RANDOMIZED CONTROLLED TRIAL
Xian Li, Stephen Jan, Lijing L Yan, Alison Hayes, Yunbo Chu, Haijun Wang, Xiangxian Feng, Wenyi Niu, Feng J He, Jun Ma, Yanbo Han, Graham A MacGregor, Yangfeng Wu
OBJECTIVE: The School-based Education Program to Reduce Salt Intake in Children and Their Families study was a cluster randomized control trial among grade five students in 28 primary schools and their families in Changzhi, China. It achieved a significant effect in lowering systolic blood pressure (SBP) in all family adults by 2.3 mmHg and in elderlies (aged > = 60 years) by 9.5 mmHg. The aim of this study was to assess the cost-effectiveness of this salt reduction program. METHODS: Costs of the intervention were assessed using an ingredients approach to identify resource use...
2017: PloS One
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