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https://www.readbyqxmd.com/read/29353319/management-strategies-for-noncardiac-surgery-following-a-coronary-artery-event
#1
REVIEW
Thomas F Whayne, Sibu P Saha
PURPOSE OF REVIEW: Coronary artery event includes acute coronary syndrome (ACS), percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) surgery. Following such an event, risk of noncardiac surgery is increased. Of major concern is what can make this surgery safer? RECENT FINDINGS: High functional capacity improves cardiovascular (CV) risk; at least 4.0 metabolic equivalents (METs) on stress test are favorable. Risk scores can suggest need for further evaluation...
January 20, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29352692/ckd-epi-versus-cockcroft-gault-formula-for-predicting-contrast-induced-nephropathy-following-percutaneous-coronary-intervention-in-patients-without-significant-renal-impairment
#2
Mário B G Nunes, Antônio C Filho, Valéria R C Alvares, Rafael Moreno, Edgar Lamas, Vitor Loures, Daniel Chamié, Alexandre Abizaid
INTRODUCTION: Individuals with glomerular filtration rate (GFR) ≥60 ml/min/1.73 m2 estimated by the Cockcroft-Gault formula (CG) who undergo percutaneous coronary intervention (PCI) frequently develop contrast-induced nephropathy (CIN). This study aimed to assess whether individuals with significant renal impairment assessed by the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula, but not by CG, more often develop CIN following PCI than those without renal impairment by either formula...
January 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29352691/adopting-an-early-invasive-strategy-for-non-st-elevation-myocardial-infarction-analysis-of-the-portuguese-registry-on-acute-coronary-syndromes
#3
Gonçalo Morgado, Hélder Pereira, Daniel Caldeira
INTRODUCTION: In patients with non-ST-elevation myocardial infarction (NSTEMI), the best timing for coronary angiography is not definitely established, although it is recognized that in high-risk patients it should be performed within the first 24 hours. The aim of this work was to describe the evolution over time of the use of an invasive strategy in the treatment of NSTEMI and in-hospital mortality. METHODS: We performed a retrospective analysis of patients admitted with NSTEMI included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between 2002 and 2015...
January 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29352673/chest-pain-in-a-young-female
#4
Paul S Basel, Daniel Reschke, Michael D April
Acute Coronary Syndrome (ACS) is a common diagnosis in the emergency department (ED), the most severe manifestation of which is ST elevation on electrocardiogram (ECG). ST elevation reflects obstruction of flow through the coronary arteries, most commonly due to coronary atherosclerotic plaque rupture. However, alternative causes of coronary obstruction causing ST elevation are possible. Spontaneous coronary artery dissection (SCAD) is an unusual cause of ST elevation in ED patients which providers may encounter in patients without traditional atherosclerosis risk factors...
January 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29351794/metabolic-syndrome-severity-is-significantly-associated-with-future-coronary-heart-disease-in-type-2-diabetes
#5
Matthew J Gurka, Yi Guo, Stephanie L Filipp, Mark D DeBoer
BACKGROUND: The severity of the metabolic syndrome (MetS) is significantly associated with future coronary heart disease (CHD) among individuals without baseline Type 2 diabetes. However, the validity of assessing MetS severity among individuals with diabetes is unknown. OBJECTIVE: To assess for differences in MetS severity by timing of Type 2 diabetes diagnosis and to assess for associations between MetS severity and future CHD among individuals with diabetes. METHODS: We analyzed data from participants of the Atherosclerosis Risk in Communities study, including 1419 with- and 7241 without diabetes, followed during 4 visits and adjudicated CHD diagnoses over a 20-year period...
January 19, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29351086/active-phytoconstituents-for-diabetes-management-a-review
#6
Rajnish Gupta
Diabetes is a metabolic syndrome increasing rapidly due to occupational stress, lack of physical activity, sedentary lifestyle and increasing occurrence of obesity, associated with rapidly growing urbanization and industrialization. Due to erroneous carbohydrate metabolism, diabetics are more prone to chronic complications like nephropathy, neuropathy, retinopathy, coronary artery disease and peripheral arterial disease resulting in tissue damage. Current treatment protocols to these problems produce more serious adverse effects and are costly too...
January 19, 2018: Journal of Complementary & Integrative Medicine
https://www.readbyqxmd.com/read/29350674/takotsubo-cardiomyopathy-in-an-ultra-centenarian-woman
#7
Laura Bonfanti, Silvia Buratti, Luigi Vignali, Giuseppe Lippi, Franco Masini, Michele Bianconcini, Gianfranco Cervellin
A 101 years-old woman was admitted to our Emergency Department (ED) for acute dyspnea which onset nearly two hours before presentation. She had been on hydrochlorothyazyde-amiloride therapy due to mild hypertension. No other relevant features were present in the clinical history. The old lady had never been admitted to the hospital, and she was still living alone. A few days before hospital admission, one of the daughters became ill, so that a caregiver was paid for assisting her 12/24. This new circumstance was reluctantly accepted by the old lady...
January 16, 2018: Acta Bio-medica: Atenei Parmensis
https://www.readbyqxmd.com/read/29350536/diagnostic-accuracy-of-functional-imaging-and-biochemical-tests-for-patients-presenting-with-chest-pain-to-the-emergency-department-a-systematic-review-and-meta-analysis
#8
Mario Iannaccone, Sebastiano Gili, Ovidio De Filippo, Salvatore D'Amico, Marco Gagliardi, Maurizio Bertaina, Silvia Mazzilli, Sara Rettegno, Federica Bongiovanni, Paolo Gatti, Fabrizio Ugo, Giacomo G Boccuzzi, Salvatore Colangelo, Silvia Prato, Claudio Moretti, Maurizio D'Amico, Patrizia Noussan, Roberto Garbo, David Hildick-Smith, Fiorenzo Gaita, Fabrizio D'Ascenzo
BACKGROUND: Non-invasive ischaemia tests and biomarkers are widely adopted to rule out acute coronary syndrome in the emergency department. Their diagnostic accuracy has yet to be precisely defined. METHODS: Medline, Cochrane Library CENTRAL, EMBASE and Biomed Central were systematically screened (start date 1 September 2016, end date 1 December 2016). Prospective studies (observational or randomised controlled trial) comparing functional/imaging or biochemical tests for patients presenting with chest pain to the emergency department were included...
January 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29350392/diagnostic-and-prognostic-micro-rnas-in-ischemic-stroke-due-to-carotid-artery-stenosis-and-in-acute-coronary-syndrome-the-4-year-prospective-study
#9
Jacek Gacoń, Rafał Badacz, Ewa Stępień, Izabela Karch, Francisco J Enguita, Krzysztof Żmudka, Tadeusz Przewłocki, Anna Kabłak-Ziembicka
BACKGROUND: Circulating microRNAs (miRs) levels are potentially important diagnostic and prognostic biomarkers in acute coronary syndrome (ACS) or cerebral ischemic event (CIE) resulting from internal carotid artery stenosis (ICAS). AIM: This 4-year prospective study aimed to compare the levels of circulating miRs in ACS vs CIE patients, and investigate miRs potentially associated with risk of recurrent cardiovascular event. METHODS: The circulating miRs levels (miR-1-3p, miR-16-5p, miR-34a-5p, mir-122-5p, miR-124-3p, miR-133a-3p, miR-133b, miR-134-5p, miR-208b-3p, miR-375 and miR-499-5p) were compared in 43 (34M, 57...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350388/chronic-statin-treatment-is-a-predictor-of-pre-interventional-infarct-related-artery-patency-in-patients-with-st-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention
#10
Süleyman Özbiçer, Mustafa Gür, Gülhan Kalkan, Betül Özaltun, Murat Çaylı
BACKGROUND: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct related artery patency before percutaneous coronary intervention is known to be a strong predictor of improved clinical outcome. AIM: We aimed to investigate the effects of chronic statin treatment before admission on the infarct related artery patency after infarction. METHODS: In this study, 938 ST elevation myocardial infarction patients admitted to the hospital within the first 12 hours of symptom onset were prospectively enrolled (682 male, 256 female; mean age 58...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350382/risk-factors-for-adverse-outcomes-of-acute-coronary-syndrome-patients-single-center-experience-in-long-term-follow-up-of-treated-patients
#11
Marcin Grabowski, Krzysztof J Filipiak, Grzegorz Opolski, Renata Główczyńska, Monika Gawałko, Paweł Balsam, Andrzej Cacko, Zenon Huczek, Grzegorz Karpiński, Robert Kowalik, Franciszek Majstrak, Janusz Kochman
BACKGROUND: For patients experiencing an acute coronary syndrome (ACS), a crucial time to assess their prognosis and future management is at discharge from hospital. AIM: To identify patients' risk factors of mortality during post-discharge period following an ACS hospitalization. METHODS: We studied 672 consecutive ACS patients hospitalized and discharged alive between 2002 and 2004. The analysis was done in respect of the type of ACS, i...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29349668/serum-mmp-9-diagnostics-prognostics-and-activation-in-acute-coronary-syndrome-and-its-recurrence
#12
Laura Lahdentausta, Jaakko Leskelä, Alina Winkelmann, Taina Tervahartiala, Timo Sorsa, Erkki Pesonen, Pirkko J Pussinen
Matrix metalloproteinase (MMP)-9 is crucial in atherosclerotic plaque rupture and tissue remodeling after a cardiac event. The balance between MMP-9 and endogenous inhibitor, tissue inhibitors of matrix metalloproteinase 1 (TIMP-1), is important in acute coronary syndrome (ACS). This is an age- and gender-matched case-control study of ACS (N = 669). Patients (45.7%) were resampled after recovery, and all were followed up for 6 years. The molecular forms of MMP-9 were investigated by gelatin zymography...
January 18, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29348285/vancomycin-induced-coronary-artery-spasm-a-case-of-kounis-syndrome
#13
Eric Martinez, Sonu Sahni, Muhammad Ai Cheema, Asma Iftikhar
Kounis syndrome defined as the appearance of acute coronary syndrome in the context of an allergic reaction is a relatively rare phenomenon. There are three variants of this syndrome in which the patient presents with symptoms of an acute chest. Herein, we describe a case of an 83-year-old woman who demonstrated type I variant of Kounis syndrome in response to vancomycin administration. After initialisation of vancomycin, she became unresponsive and an ECG demonstrated ST changes consistent with inferior-lateral myocardial infarction...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348279/-clinically-suspected-myocarditis-with-pseudoinfarct-presentation-complicated-with-left-ventricular-aneurysm
#14
Annick Haouzi, Ahmed Ahmed
A 51-year-old man presented with chest pain, high troponin level, inflammatory syndrome and ST-segment elevation in the anterior leads. While the transthoracic echocardiogram (TTE) showed anteroseptal hypokinesis and apical akinesis, the coronary angiogram was normal. Cardiac MR demonstrated a typical aspect of myocarditis (multiple areas of mid-myocardial late gadolinium enhancement, sparing the subendocardial layer, along with oedema). The initial diagnosis was clinically suspected myocarditis with pseudoinfarct presentation...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348027/implications-of-underlying-mechanisms-for%C3%A2-the-recognition-and-management-of-diabetic-cardiomyopathy
#15
REVIEW
Thomas H Marwick, Rebecca Ritchie, Jonathan E Shaw, David Kaye
Heart failure is a complex clinical syndrome, the incidence and prevalence of which is increased in diabetes mellitus, pre-diabetes, and obesity. Although this may arise from underlying coronary artery disease, it often occurs in the absence of significant major epicardial coronary disease, and most commonly manifests as heart failure with preserved ejection fraction. Despite epidemiological evidence linking diabetes to heart failure incidence and outcome, the presence of a distinct primary "diabetic" cardiomyopathy has been difficult to prove, because the link between diabetes and heart failure is confounded by hypertension, microvascular dysfunction, and autonomic neuropathy...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29348012/coronary-embolus-an-underappreciated-cause-of-acute-coronary-syndromes
#16
REVIEW
Claire E Raphael, John A Heit, Guy S Reeder, Melanie C Bois, Joseph J Maleszewski, R Thomas Tilbury, David R Holmes
Coronary embolism is the underlying cause of 3% of acute coronary syndromes but is often not considered in the differential of acute coronary syndromes. It should be suspected in the case of high thrombus burden despite a relatively normal underlying vessel or recurrent coronary thrombus. Coronary embolism may be direct (from the aortic valve or left atrial appendage), paroxysmal (from the venous circulation through a patent foramen ovale), or iatrogenic (following cardiac intervention). Investigations include transesophageal echocardiography to assess the left atrial appendage and atrial septum and continuous electrocardiographic monitoring to assess for paroxysmal atrial fibrillation...
January 22, 2018: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29347970/a-synergic-effect-between-cyp2c19-2-cyp2c19-3-loss-of-function-and-cyp2c19-17-gain-of-function-alleles-is-associated-with-clopidogrel-resistance-among-moroccan-acute-coronary-syndromes-patients
#17
Hind Hassani Idrissi, Wiam Hmimech, Nada El Khorb, Hafid Akoudad, Rachida Habbal, Sellama Nadifi
OBJECTIVE: The main objective of our study was to investigate the association of CYP2C19*2 and CYP2C19*3 loss-of-function and CYP2C19*17 gain-of-function variants of CYP2C19 gene with Clopidogrel resistance in a sample of Moroccan Acute Coronary Syndromes patients. RESULTS: Our results showed the existence of a synergic effect between the three alleles, statistically very significant, on Clopidogrel resistance among the treated patients (P = 0.0033). For the three variants of the CYP2C19 gene, the heterozygous and homozygous mutant genotypes were the most frequent among ACS patients (CYP2C19*2: 82...
January 18, 2018: BMC Research Notes
https://www.readbyqxmd.com/read/29345592/prolonging-ticagrelor-beyond-a-year-of-acute-coronary-syndrome-worth-or-harmful
#18
Daniel Aradi, Dome Dezsi, Gabor Veress, Bela Merkely
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12-inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#19
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345587/is-there-a-role-for-oral-triple-therapy-in-patients-with-acute-coronary-syndromes-without-atrial-fibrillation
#20
Nikolaos Spinthakis, Mohamed Farag, Zaki Akhtar, Diana Adrienne Gorog
BACKGROUND: Acute coronary syndrome (ACS) patients, despite treatment with dual antiplatelet therapy (DAPT), have up to 10% risk of recurrent major adverse cardiac events (MACE) in the short term. METHODS: Here we review studies using more potent antithrombotic agent combinations to reduce this risk, namely triple therapy (TT) with the addition of an oral anticoagulant, PAR-1 antagonist, or cilostazol to DAPT (mainly aspirin and clopidogrel), and discuss the limitations of trials to date...
January 16, 2018: Current Vascular Pharmacology
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