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https://www.readbyqxmd.com/read/28087286/incidence-and-survival-outcome-according-to-heart-rhythm-during-resuscitation-attempt-in-out-of-hospital-cardiac-arrest-patients-with-presumed-cardiac-etiology
#1
Shahzleen Rajan, Fredrik Folke, Steen Møller Hansen, Carolina Malta Hansen, Kristian Kragholm, Thomas A Gerds, Freddy K Lippert, Lena Karlsson, Sidsel Møller, Lars Køber, Gunnar H Gislason, Christian Torp-Pedersen, Mads Wissenberg
BACKGROUND: Knowledge about heart rhythm conversion from non-shockable to shockable rhythm during resuscitation attempt after out-of-hospital cardiac arrest (OHCA) and following chance of survival is limited and inconsistent. METHODS: We studied 13,860 patients with presumed cardiac-caused OHCA not witnessed by the emergency medical services from the Danish Cardiac Arrest Register (2005-2012). Patients were stratified according to rhythm: shockable, converted shockable (based on receipt of subsequent defibrillation) and sustained non-shockable rhythm...
January 10, 2017: Resuscitation
https://www.readbyqxmd.com/read/28087181/challenging-the-99th-percentile-a-lower-troponin-cutoff-leads-to-low-mortality-of-chest-pain-patients
#2
Nils Arne Sörensen, Johannes Tobias Neumann, Francisco Ojeda, Tjark Schwemer, Thomas Renné, Renate B Schnabel, Tanja Zeller, Mahir Karakas, Stefan Blankenberg, Dirk Westermann
BACKGROUND: Rule-out of non-ST-elevation myocardial infarction is based on consecutive measurements of cardiac troponins using the 99th percentile of the respective assay as cutoff. The new ESC guidelines alternatively offer rapid 1h algorithms with lower cutoffs than the 99th percentile for rule-out of non-ST-elevation myocardial infarction. We aimed to compare a recently introduced 1h algorithm based on a high-sensitivity cardiac troponin I (hs-TnI) cutoff of 6ng/L at 0h and 1h to the current standard of care using the 99th percentile (27ng/L) as cutoff with reference to follow-up events in a large chest pain cohort...
December 27, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28087097/quick-epinephrine-administration-induces-favorable-neurological-outcomes-in-out-of-hospital-cardiac-arrest-patients
#3
H Ueta, H Tanaka, S Tanaka, R Sagisaka, H Takyu
OBJECTIVE: This research is to study if quick administration of adrenaline on OHCA prior to hospitalization has an effect on improving CPC1-2 at one month. METHODOLOGY: A total 13,326 cases were extracted from 2011 to 2014 Utstein data for this retrospective cohort study, also, EMT reached the patients within 16min after 119 called and adrenaline was then administered within 22min of after contact. PATIENTS DIVIDED INTO TWO GROUPS: Patients were contacted within 8min of the 119 call (n=6956), and were contacted between 8 and 16min after the call (n=6370)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28081310/a-simple-risk-score-in-acute-st-elevation-myocardial-infarction-modified-acef-age-creatinine-and-ejection-fraction-score
#4
Arzu Kalaycı, Vecih Oduncu, Çetin Geçmen, Selim Topcu, Can Yücel Karabay, İbrahim Akın İzgi, Cevat Kırma
BACKGROUND/AIM: The aim of this study was to evaluate if the modified ACEF (age, creatinine, and ejection fraction) score is a predictor of major adverse cardiac and cerebrovascular events during 1 year of follow-up in patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention (PCI). MATERIALS AND METHODS: We retrospectively enrolled 1632 consecutive patients who were admitted to our emergency department diagnosed with STEMI within 12 h of chest pain and treated with primary PCI...
December 20, 2016: Turkish Journal of Medical Sciences
https://www.readbyqxmd.com/read/28079732/oncology-emergency-series-when-cardiac-tamponade-puts-the-pressure-on
#5
Roberta Kaplow, Karen Iyere
No abstract text is available yet for this article.
January 10, 2017: Nursing
https://www.readbyqxmd.com/read/28078997/lipoprotein-a-and-cardiovascular-risk-the-show-must-go-on
#6
Niki Katsiki, Khalid Al-Rasadi, Dimitri P Mikhailidis
Lipoprotein (a) [Lp(a)] is an independent but moderate, predictor for coronary heart disease (CHD) prevalence and severity. Several established and emerging cardiovascular (CV) risk factors including age, gender, ethnicity, smoking, dyslipidemia, hypertension, obesity, type 2 diabetes mellitus, alcohol consumption, arterial stiffness and hyperuricemia have been linked to Lp(a) metabolism. Apart from CHD, Lp(a) has been also associated with non-cardiac vascular diseases and diseases associated with increased CV risk such as chronic kidney disease, metabolic syndrome, non-alcoholic fatty liver disease, erectile dysfunction, obstructive sleep apnea syndrome, inflammatory bowel diseases and human immunodeficiency virus infection...
January 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28077467/gut-microbiota-dependent-trimethylamine-n-oxide-in-acute-coronary-syndromes-a-prognostic-marker-for-incident-cardiovascular-events-beyond-traditional-risk-factors
#7
Xinmin S Li, Slayman Obeid, Roland Klingenberg, Baris Gencer, François Mach, Lorenz Räber, Stephan Windecker, Nicolas Rodondi, David Nanchen, Olivier Muller, Melroy X Miranda, Christian M Matter, Yuping Wu, Lin Li, Zeneng Wang, Hassan S Alamri, Valentin Gogonea, Yoon-Mi Chung, W H Wilson Tang, Stanley L Hazen, Thomas F Lüscher
AIMS: Systemic levels of trimethylamine N-oxide (TMAO), a pro-atherogenic and pro-thrombotic metabolite produced from gut microbiota metabolism of dietary trimethylamine (TMA)-containing nutrients such as choline or carnitine, predict incident cardiovascular event risks in stable primary and secondary prevention subjects. However, the prognostic value of TMAO in the setting of acute coronary syndromes (ACS) remains unknown. METHODS AND RESULTS: We investigated the relationship of TMAO levels with incident cardiovascular risks among sequential patients presenting with ACS in two independent cohorts...
January 11, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28076676/use-of-metformin-for-cardiometabolic-risks-in-psychiatric-practice-need-to-know-safety-issues
#8
Chittaranjan Andrade
Metformin, a biguanide drug, is emerging as an important treatment option for the prevention or treatment of weight gain, type 2 diabetes mellitus, and the metabolic syndrome in psychiatric patients, especially those who require or receive antipsychotic drugs. Metformin treatment is commonly associated with gastrointestinal adverse effects; the risk of these is reduced by gradual dose uptitration, administration of the drug with meals, and use of a time-release formulation. Lactic acidosis, a potentially fatal complication of biguanide therapy, is very rare with metformin; the risk can be reduced by avoidance of its prescription in patients with impaired renal function, impaired liver function, cardiac failure, and certain other conditions...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28074817/extracorporeal-membrane-oxygenation-for-refractory-cardiac-arrest
#9
REVIEW
Steven A Conrad, Peter T Rycus
Extracorporeal cardiopulmonary resuscitation (ECPR) is the use of rapid deployment venoarterial (VA) extracorporeal membrane oxygenation to support systemic circulation and vital organ perfusion in patients in refractory cardiac arrest not responding to conventional cardiopulmonary resuscitation (CPR). Although prospective controlled studies are lacking, observational studies suggest improved outcomes compared with conventional CPR when ECPR is instituted within 30-60 min following cardiac arrest. Adult and pediatric patients with witnessed in-hospital and out-of-hospital cardiac arrest and good quality CPR, failure of at least 15 min of conventional resuscitation, and a potentially reversible cause for arrest are candidates...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074798/proseal-laryngeal-mask-airway-as-an-alternative-to-standard-endotracheal-tube-in-securing-upper-airway-in-the-patients-undergoing-beating-heart-coronary-artery-bypass-grafting
#10
Kalpana Shah
BACKGROUND: ProSeal laryngeal mask airways (PLMAs) are routinely used after failed tracheal intubation as airway rescue, facilitating tracheal intubation by acting as a conduit and to secure airway during emergencies. In long duration surgeries, use of endotracheal tube (ETT) is associated with various hemodynamic complications, which are minimally affected during PLMA use. However, except for few studies, there are no significant data available that promote the use of laryngeal mask during cardiac surgery...
January 2017: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/28074556/qt-interval-shortening-with-isavuconazole-in-vitro-and-in-vivo-effects-on-cardiac-repolarization
#11
J Keirns, A Desai, D Kowalski, C Lademacher, S Mujais, B Parker, M J Schneidkraut, R Townsend, T Wojtkowski, T Yamazaki, M Yen, P R Kowey
Effects of isavuconazole (active moiety of isavuconazonium sulfate) on cardiac ion channels in vitro and cardiac repolarization clinically were assessed in a Phase 1, randomized, double-blind study in healthy individuals who received isavuconazole (after 2-day loading dose), at therapeutic or supratherapeutic doses daily for 11 days, moxifloxacin (400 mg QD), or placebo. A post-hoc analysis of the Phase 3 SECURE trial assessed effects on cardiac safety. L-type Ca(2+) channels were most sensitive to inhibition by isavuconazole...
January 11, 2017: Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28072687/the-negative-chronotropic-effect-during-lumbar-spine-surgery-a-systemic-review-and-aggregation-of-an-emerging-model-of-spinal-cardiac-reflex
#12
Tumul Chowdhury, Bernhard Schaller
BACKGROUND: Hemodynamic perturbations in spine surgeries are predominantly reported in cervical and thoracic level procedures. The literature related to negative cardiovascular changes (decrease of heart rate and blood pressure) in lumbar spine procedures is still scarce and only highlighted in few case reports/letters until now. METHODS: With the help of a systematic literature review with predefined criteria, we, therefore, examined and synthesized here the probable underlying common cause of these hemodynamic disturbances in lumbar spine surgeries...
January 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28072628/clinical-recommendations-of-cardiac-magnetic-resonance-part-i-ischemic-and-valvular-heart-disease-a-position-paper-of-the-working-group-applicazioni-della-risonanza-magnetica-of-the-italian-society-of-cardiology
#13
Giovanni Donato Aquaro, Gianluca Di Bella, Silvia Castelletti, Viviana Maestrini, Pierluigi Festa, Lamia Ait-Ali, Pier Giorgio Masci, Lorenzo Monti, Gabriella di Giovine, Manuel De Lazzari, Alberto Cipriani, Andrea I Guaricci, Santo Dellegrottaglie, Alessia Pepe, Martina Perazzolo Marra, Gianluca Pontone
Cardiac magnetic resonance (CMR) has emerged as a reliable and accurate diagnostic tool for the evaluation of patients with cardiac disease in several clinical settings and with proven additional diagnostic and prognostic value compared with other imaging modalities. This document has been developed by the working group on the 'application of CMR' of the Italian Society of Cardiology to provide a perspective on the current state of technical advances and clinical applications of CMR and to inform cardiologists on how to implement their clinical and diagnostic pathways with the inclusion of this technique in clinical practice...
January 7, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28070239/cardiac-biomarkers-in-pediatric-heart-disease-a-state-of-art-review
#14
REVIEW
Benedict A Fernandes, Kevin O Maher, Shriprasad R Deshpande
Every year there are more than 11000 hospitalizations related to heart failure in children resulting in significant morbidity and mortality. Over the last two decades, our understanding, diagnosis and management of pediatric heart failure is evolving but our ability to prognosticate outcomes in pediatric heart acute heart failure is extremely limited due to lack of data. In adult heart failure patients, the role of cardiac biomarkers has exponentially increased over the last two decades. Current guidelines for management of heart failure emphasize the role of cardiac biomarkers in diagnosis, management and prognostication of heart failure...
December 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/28069573/relations-between-aortic-stiffness-and-left-ventricular-mechanical-function-in-the-community
#15
Vanessa Bell, Elizabeth L McCabe, Martin G Larson, Jian Rong, Allison A Merz, Ewa Osypiuk, Birgitta T Lehman, Plamen Stantchev, Jayashri Aragam, Emelia J Benjamin, Naomi M Hamburg, Ramachandran S Vasan, Gary F Mitchell, Susan Cheng
BACKGROUND: Aortic stiffness impairs optimal ventricular-vascular coupling and left ventricular systolic function, particularly in the long axis. Left ventricular global longitudinal strain (GLS) has recently emerged as a sensitive measure of early cardiac dysfunction. In this study, we investigated the relation between aortic stiffness and GLS in a large community-based sample. METHODS AND RESULTS: In 2495 participants (age 39-90 years, 57% women) of the Framingham Offspring and Omni cohorts, free of cardiovascular disease, we performed tonometry to measure arterial hemodynamics and echocardiography to assess cardiac function...
January 9, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28069483/epinephrine-use-in-older-patients-with-anaphylaxis-clinical-outcomes-and-cardiovascular-complications
#16
Takahisa Kawano, Frank Xavier Scheuermeyer, Robert Stenstrom, Brian H Rowe, Eric Grafstein, Brian Grunau
BACKGROUND: There is little data describing the differences in epinephrine (epi) administration and cardiac complications among older and younger patients with anaphylaxis. METHODS: This retrospective cohort study was conducted at two urban emergency departments (ED) over a 5 year-period, and included adults who met a pre-specified criteria for anaphylaxis. Patients≥50years of age were defined as "older". Univariate logistic regression was performed to compare the difference in frequency of epi administration between the "older" and "younger" groups...
January 6, 2017: Resuscitation
https://www.readbyqxmd.com/read/28064149/emerging-roles-for-rna-binding-proteins-as-effectors-and-regulators-of-cardiovascular-disease
#17
REVIEW
Ruben G de Bruin, Ton J Rabelink, Anton Jan van Zonneveld, Eric P van der Veer
The cardiovascular system comprises multiple cell types that possess the capacity to modulate their phenotype in response to acute or chronic injury. Transcriptional and post-transcriptional mechanisms play a key role in the regulation of remodelling and regenerative responses to damaged cardiovascular tissues. Simultaneously, insufficient regulation of cellular phenotype is tightly coupled with the persistence and exacerbation of cardiovascular disease. Recently, RNA-binding proteins such as Quaking, HuR, Muscleblind, and SRSF1 have emerged as pivotal regulators of these functional adaptations in the cardiovascular system by guiding a wide-ranging number of post-transcriptional events that dramatically impact RNA fate, including alternative splicing, stability, localization and translation...
January 6, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28063723/early-illness-experiences-related-to-unexpected-heart-surgery-a-qualitative-descriptive-study
#18
Yu-Ling Chang, Yun-Fang Tsai
BACKGROUND: Most studies on patients' experiences following emergency cardiac surgery focus on evaluation of patients after their discharge. Few studies have evaluated patients' experiences after being transferred from intensive care and before being discharged. OBJECTIVE: This study aimed to describe patients' experiences in the early stages of recovery following emergency heart surgery. METHODS: For this exploratory qualitative descriptive study, 13 patients were recruited from a medical centre in northern Taiwan...
January 4, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/28062801/wire-escalation-in-emergent-revascularization-procedures-of-internal-carotid-artery-occlusions-the-use-of-high-tip-stiffness-microguidewires
#19
José E Cohen, Ronen R Leker, John M Gomori, Eyal Itshayek
OBJECTIVE: We examined the usefulness and safety of high tip stiffness cardiac microguidewires in the endovascular revascularization of selected cases of internal carotid artery (ICA) occlusion. METHODS: Files of patients with acute ischemic symptoms due to ICA occlusions managed from August 2010 to August 2016 by urgent endovascular revascularization were retrospectively reviewed with a waiver of informed consent. Cases where there was escalation to stiff tipped cardiovascular microguidewires after at least two failed attempts to cross the carotid occlusion with standard neuro-microguidewires were included...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28062631/rule-in-and-rule-out-of-myocardial-infarction-using-cardiac-troponin-and-glycemic-biomarkers-in-patients-with-symptoms-suggestive-of-acute-coronary-syndrome
#20
Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Richard Whitlock, Guillaume Pare, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster, Peter A Kavsak
BACKGROUND: Early rule-in/rule-out of myocardial infarction (MI) in patients presenting to the emergency department (ED) is important for patient care and resource allocation. Given that dysglycemia is a strong risk factor for MI, we sought to explore and compare different combinations of cardiac troponin (cTn) cutoffs with glycemic markers for the early rule-in/rule-out of MI. METHODS: We included ED patients (n = 1137) with symptoms suggestive of acute coronary syndrome (ACS) who had cTnI, high-sensitivity cTnI (hs-cTnI), hs-cTnT, glucose, and hemoglobin A1c (Hb A1c) measurements...
January 2017: Clinical Chemistry
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