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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
#1
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
#2
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
https://www.readbyqxmd.com/read/28885386/a-delta-neutrophil-index-for-the-prediction-of-contrast-induced-nephropathy-in-patients-with-st-elevation-myocardial-infarction-followed-by-percutaneous-coronary-intervention
#3
Taeyoung Kong, Yoo Seok Park, Hye Sun Lee, Sinae Kim, Sehee Han, Claire H Eun, Jong Wook Lee, Je Sung You, Hyun Soo Chung, Incheol Park, Sung Phil Chung
PURPOSE: We assessed the usefulness of the delta neutrophil index (DNI), reflecting immature granulocytes, to stratify risk for developing contrast-induced nephropathy (CIN) in patients with ST-elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI) in a clinical setting. METHODS: This study retrospectively analyzed prospective data of eligible adult patients admitted to the ED with STEMI followed by PCI. We determined DNI at multiple time points and analyzed the development of CIN and in-hospital mortality according to CIN incidence...
September 6, 2017: Shock
https://www.readbyqxmd.com/read/28871571/acute-aortic-dissection-pathogenesis-risk-factors-and-diagnosis
#4
Joanna Gawinecka, Felix Schönrath, Arnold von Eckardstein
Acute aortic dissection is a rare but life-threatening condition with a lethality rate of 1 to 2% per hour after onset of symptoms in untreated patients. Therefore, its prompt and proper diagnosis is vital to increase a patient's chance of survival and to prevent grievous complications. Typical symptoms of acute aortic dissection include severe chest pain, hypotension or syncope and, hence, mimic acute myocardial infarction or pulmonary embolism. Advanced age, male gender, long-term history of arterial hypertension and the presence of aortic aneurysm confer the greatest population attributable risk...
September 5, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28865892/comparison-of-readmission-rates-after-acute-myocardial-infarction-in-3-patient-age-groups-18-to-44-45-to-64-and-%C3%A2-65-years-in-the-united-states
#5
Rohan Khera, Snigdha Jain, Ambarish Pandey, Vijay Agusala, Dharam J Kumbhani, Sandeep R Das, Jarett D Berry, James A de Lemos, Saket Girotra
Postacute myocardial infarction (AMI) readmissions are common among Medicare beneficiaries (≥65 years) and are associated with significant resource utilization. However, patterns of AMI readmissions for younger age groups in the United States are not known. In the Nationwide Readmissions Database, a nationally representative all-payer database of inpatient hospitalizations, we identified 212,171 index AMI hospitalizations in January to November 2013, weighted to represent 478,247 hospitalizations nationally (mean age 66...
August 4, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28862479/cost-effectiveness-analysis-of-dabigatran-versus-rivaroxaban-for-stroke-prevention-in-patients-with-non-valvular-atrial-fibrillation-using-real-world-evidence-in-elderly-us-medicare-beneficiaries
#6
Siyang Peng, Kristen A Deger, Anastasia Ustyugova, Pranav Gandhi, Nan Qiao, Cheng Wang, Anuraag R Kansal
OBJECTIVE: Dabigatran and rivaroxaban have been approved by the US FDA to reduce the risk of stroke and systemic embolism in non-valvular atrial fibrillation (NVAF) patients. Newly published real-world evidence based on the US population found that elderly Medicare patients with NVAF treated with rivaroxaban experienced statistically significant increases in intracranial hemorrhage (ICH) and major extracranial bleeding, and statistically nonsignificant decreases in thromboembolic stroke and acute myocardial infarction (AMI) compared with dabigatran...
September 1, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28860018/comparison-of-in-hospital-outcomes-of-transcatheter-aortic-valve-implantation-versus-surgical-aortic-valve-replacement-in-obese-body-mass-index%C3%A2-%C3%A2-%C3%A2-30%C3%A2-kg-m2-patients
#7
Tomo Ando, Emmanuel Akintoye, Naveen Trehan, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Luis Afonso
The comparative outcomes of transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR) in obese (body mass index ≥ 30 kg/m(2)) patients are underexplored. Nationwide Inpatient Sample database was queried from 2011 to 2014, and those who underwent TAVI or SAVR with obesity were identified. A complete case analysis with multivariate analysis was performed to adjust for the difference in underlying co-morbidities. We identified a total of 12,525 patients (989 TAVI and 11,536 SAVR)...
August 7, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28858942/colonoscopy-in-patients-with-postmyocardial-infarction-gastrointestinal-bleeding-a-nationwide-analysis
#8
Rohan M Modi, Feng Li, Khalid Mumtaz, Alice Hinton, Scott M Lilly, Hisham Hussan, Edward Levine, Cheng Zhang, Darwin L Conwell, Somashekar G Krishna, Peter P Stanich
GOALS: The goal of this study was to evaluate outcomes of colonoscopy in the setting of post myocardial infarction (MI) gastrointestinal bleeding (GIB) in a large population-based data set. BACKGROUND: The literature to substantiate the proposed safety of colonoscopy following an acute MI is limited. STUDY: The Nationwide Inpatient Sample (2007 to 2013) was utilized to identify all adult patients (age, 18 y or above) hospitalized with a primary diagnosis of ST-elevation MI and receiving left heart catheterization (STEMI-C)...
August 30, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28854143/biases-in-individualized-cost-effectiveness-analysis-influence-of-choices-in-modeling-short-term-trial-based-mortality-risk-reduction-and-post-trial-life-expectancy
#9
David van Klaveren, John B Wong, David M Kent, Ewout W Steyerberg
BACKGROUND: The benefits and costs of a treatment are typically heterogeneous across individual patients. Randomized clinical trials permit the examination of individualized treatment benefits over the trial horizon but extrapolation to lifetime horizon usually involves combining trial-based individualized estimates of short-term risk reduction with less detailed (less granular) population life tables. However, the underlying assumption of equal post-trial life expectancy for low- and high-risk patients of the same sex and age is unrealistic...
October 2017: Medical Decision Making: An International Journal of the Society for Medical Decision Making
https://www.readbyqxmd.com/read/28844989/acute-myocardial-infarction-changes-in-patient-characteristics-management-and-6-month-outcomes-over-a-period-of-20-years-in-the-fast-mi-program-french-registry-of-acute-st-elevation-or-non-st-elevation-myocardial-infarction-1995-to-2015
#10
Etienne Puymirat, Tabassome Simon, Guillaume Cayla, Yves Cottin, Meyer Elbaz, Pierre Coste, Gilles Lemesle, Pascal Motreff, Batric Popovic, Khalife Khalife, Jean Noel Labeque, Thibault Perret, Christophe Le Ray, Laurent Orion, Bernard Jouve, Didier Blanchard, Patrick Peycher, Johanne Silvain, P Gabriel Steg, Patrick Goldstein, Pascal J Gueret, Loic Belle, Nadia Aissaoui, Jean Ferrières, Francois Schiele, Nicolas Danchin
Background -ST-segment-elevation myocardial infarction (STEMI) and non-ST-segment-elevation myocardial infarction (NSTEMI) management has evolved considerably over the past 2 decades. Little information on mortality trends in the most recent years is available. We assessed trends in characteristics, treatments, and outcomes for acute myocardial infarction in France between 1995 and 2015. Methods - We used data from 5 one-month registries, conducted 5 years apart, from 1995 to 2015, including 14 423 patients with acute myocardial infarction (59% STEMI) admitted to cardiac intensive care units in metropolitan France...
August 27, 2017: Circulation
https://www.readbyqxmd.com/read/28841230/rationale-and-design-of-the-drug-eluting-stents-vs-bare-metal-stents-in-saphenous-vein-graft-angioplasty-diva-trial
#11
Emmanouil S Brilakis, Subhash Banerjee, Robert Edson, Kendrick Shunk, Steven Goldman, David R Holmes, Deepak L Bhatt, Sunil V Rao, Mark W Smith, Mike Sather, Cindy Colling, Biswajit Kar, Lori Nielsen, Todd Conner, Todd Wagner, Bavana V Rangan, Beverly Ventura, Ying Lu, Mark Holodniy, Mei-Chiung Shih
VA Cooperative Studies Program #571 (DIVA) was designed to evaluate the efficacy of drug-eluting stents (DES) for reducing aortocoronary saphenous vein bypass graft (SVG) failure when compared with bare-metal stents (BMS) in participants undergoing stenting of de novo SVG lesions. Participants undergoing clinically indicated stenting of de novo SVG lesions were randomized in a 1:1 ratio to DES or BMS. Randomization was stratified by presence/absence of diabetes mellitus and the number of target SVG lesions (1 vs ≥2) within each participating site...
August 25, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28840515/high-sensitivity-cardiac-troponin-for-the-diagnosis-of-patients-with-acute-coronary-syndromes
#12
REVIEW
Vlad C Vasile, Allan S Jaffe
PURPOSE OF REVIEW: High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS)...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28840032/the-missed-diagnosis-of-aortic-dissection-in-patients-with-acute-myocardial-infarction-a-disastrous-event
#13
Di Wang, Li-Li Zhang, Zhi-Yan Wang, Zhen-Yu Zhang, Yi Wang
We present a case of aortic dissection (AD) accompanied by acute myocardial infarction (AMI). For patients with AMI, the missed diagnosis of AD could be catastrophic. Therefore, we strongly recommend that portable echocardiography should be routinely available in the ambulance. Moreover, multicenter studies concerning the cost-benefit ratio of portable echocardiography routinely available in the ambulance should urgently be considered.
July 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28833489/coronary-revascularization-for-acute-myocardial-infarction-in-the-hiv-population
#14
Vikas Singh, Rodrigo Mendirichaga, Ghanshyambhai T Savani, Alexis P Rodriguez, Nitika Dabas, Anish Munagala, Carlos E Alfonso, Mauricio G Cohen, Sammy Elmariah, Igor F Palacios
OBJECTIVE: To analyze trends in management and outcomes of patients infected with the human immunodeficiency virus (HIV) undergoing percutaneous coronary intervention (PCI) for an acute myocardial infarction (AMI) in the United States. BACKGROUND: Infection with HIV is an independent risk factor for accelerated atherosclerosis associated with higher rates of AMI. Current trends and outcomes of HIV-infected individuals presenting with AMI in the United States remain unknown...
August 22, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28822510/high-versus-low-dose-statin-therapy-in-indian-patients-with-acute-st-segment-elevation-myocardial-infarction-undergoing-thrombolysis
#15
K Priti, Anand Agrawal, Bhanwar L Ranwa
OBJECTIVES: This study sought to compare high dose versus low dose statin therapy in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. BACKGROUND: Randomized trials have demonstrated that statin treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, randomized studies of statin therapy in Indian patients with STEMI are scarce. METHODS: Of 1859 patients with acute STEMI, 1027 eligible patients were randomized to 80-mg (n=512) or 10-mg (n=515) atorvastatin...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28821512/protocol-for-an-economic-evaluation-of-the-randomised-controlled-trial-of-culprit-lesion-only-pci-versus-immediate-multivessel-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-culprit-shock-trial
#16
Zahidul Quayyum, Andrew Briggs, Jose Robles-Zurita, Keith Oldroyd, Uwe Zeymer, Steffen Desch, Suzanne de Waha, Holger Thiele
INTRODUCTION: Emergency percutaneous coronary intervention (PCI) of the culprit lesion for patients with acute myocardial infarctions is an accepted practice. A majority of patients present with multivessel disease with additional relevant stenoses apart from the culprit lesion. In haemodynamically stable patients, there is increasing evidence from randomised trials to support the practice of immediate complete revascularisation. However, in the presence of cardiogenic shock, the optimal management strategy for additional non-culprit lesions is unknown...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28807713/opioid-drug-use-and-acute-cardiac-events-among-pregnant-women-in-the-united-states
#17
Hamisu M Salihu, Jason L Salemi, Anjali Aggarwal, Beverly F Steele, Ross C Pepper, Mulubrhan F Mogos, Muktar H Aliyu
BACKGROUND: Cardiovascular disease remains a leading cause of pregnancy-associated deaths in the United States (US). The extent to which increasing opioid use among pregnant women contributes to fatal cardiovascular events is unknown. We examine trends in opioid use among pregnant women over the previous decade, and the association between changes in temporal trends in opioid drug use and the incidence of acute cardiac events among mothers. METHODS: In this retrospective analysis of the Healthcare and Cost Utilization Project (HCUP), we utilized a two-stage stratified cluster sampling of all inpatient hospital discharges from non-federal hospitals between 01/01/2002 through 12/31/2014...
August 11, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28781023/comparison-of-30-day-readmission-rates-after-hospitalization-for-acute-myocardial-infarction-in-men-versus-women
#18
MULTICENTER STUDY
Cashel O'Brien, Linda Valsdottir, Jason H Wasfy, Jordan B Strom, Eric A Secemsky, Yun Wang, Robert W Yeh
Readmission after hospitalization for acute myocardial infarction (AMI) significantly contributes to preventable morbidity and health-care costs. Outcomes after AMI vary by sex but the relationship of sex to readmissions warrants further exploration. Using the 2013 Nationwide Readmissions Database, we identified patients with a principal discharge diagnosis of AMI and stratified all-cause 30-day readmissions by sex and age. Of 214,824 patients, 44% were 18 to 64 years of age, 56% were ≥65 years, and 28% and 45%, respectively, were female...
October 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28767576/association-between-costs-and-quality-of-acute-myocardial-infarction-care-hospitals-under-the-korea-national-health-insurance-program
#19
Hee-Chung Kang, Jae-Seok Hong
If cost reductions produce a cost-quality trade-off, healthcare policy makers need to be more circumspect about the use of cost-effective initiatives. Additional empirical evidence about the relationship between cost and quality is needed to design a value-based payment system. We examined the association between cost and quality performances for acute myocardial infarction (AMI) care at the hospital level.In 2008, this cross-sectional study examined 69 hospitals with 6599 patients hospitalized under the Korea National Health Insurance (KNHI) program...
August 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28763308/revascularization-strategies-and-in-hospital-management-in-acute-coronary-syndromes-complicated-by-hemophilia-a-or-hemophilia-b
#20
Matthew J Reilley, Anne Blair, William H Matthai, Rolando Vega, Meghan Buckley, Phyllis A Gimotty, Patrick F Fogarty
: Among adult patients with hemophilia A and hemophilia B the emergent management of acute coronary syndromes (ACSs) is challenging, and exposure to antithrombotic agents and/or revascularization procedures may confer an enhanced risk of bleeding. We sought to identify clinical characteristics and in-hospital outcomes among ACS patients with hemophilia A/hemophilia B, compared with matched noncoagulopathic ACS controls. Case discharges from the Nationwide Inpatient Sample, Healthcare Cost and Utilization Project, Agency for Healthcare Research and Quality (1998-2011) had International Classification of Diseases, 9th Revision codes for hemophilia A/hemophilia B and ACS...
July 29, 2017: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
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