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Biomarkers in acs

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https://www.readbyqxmd.com/read/28419383/cell-death-biomarkers-and-obstructive-sleep-apnea-implications-in-the-acute-coronary-syndrome
#1
Josep Miquel Bauça, Aina Yañez, Laura Fueyo, Mónica de la Peña, Javier Pierola, Alicia Sánchez-de-la-Torre, Olga Mediano, Valentín Cabriada-Nuño, María José Masdeu, Joaquin Teran-Santos, Joaquin Duran-Cantolla, Juan Fernando Masa, Jorge Abad, Manuel Sanchez-de-la-Torre, Ferran Barbé, Antònia Barceló
Background: Nucleosomes and cell-free DNA (dsDNA) have been suggested as promising biomarkers in cell death-related diseases, such as acute coronary syndrome (ACS). Currently, the impact of obstructive sleep apnea (OSA) in patients with ACS is unclear. Our aim was to evaluate the relationship between OSA, dsDNA and nucleosomes, and to assess their potential implication in the development of ACS. Methods: Up to 549 patients were included in the study and divided into 4 groups (145 ACS; 290 ACS+OSA; 62 OSA; 52 controls)...
April 17, 2017: Sleep
https://www.readbyqxmd.com/read/28409008/two-year-outcome-after-early-or-late-intervention-in-non-st-elevation-acute-coronary-syndrome
#2
Erik A Badings, Wouter S Remkes, Salem H K The, Jan-Henk E Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R Timmer, Marloes L J van der Wielen, Dirk J A Lok, Renicus S Hermanides, Jan Van Wijngaarden, Harry Suryapranata, Arnoud W J van 't Hof
OBJECTIVE: To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate <12 hours) or a delayed invasive strategy (>48 hours after randomisation)...
2017: Open Heart
https://www.readbyqxmd.com/read/28403119/combined-measurement-of-soluble-st2-and-amino-terminal-pro-b-type-natriuretic-peptide-provides-early-assessment-of-severity-in-cardiogenic-shock-complicating-acute-coronary-syndrome
#3
Heli Tolppanen, Mercedes Rivas-Lasarte, Johan Lassus, Malha Sadoune, Etienne Gayat, Kari Pulkki, Mattia Arrigo, Evguenia Krastinova, Alessandro Sionis, John Parissis, Jindrich Spinar, James Januzzi, Veli-Pekka Harjola, Alexandre Mebazaa
OBJECTIVES: Mortality in cardiogenic shock complicating acute coronary syndrome is high, and objective risk stratification is needed for rational use of advanced therapies such as mechanical circulatory support. Traditionally, clinical variables have been used to judge risk in cardiogenic shock. The aim of this study was to assess the added value of serial measurement of soluble ST2 and amino-terminal pro-B-type natriuretic peptide to clinical parameters for risk stratification in cardiogenic shock...
April 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28391559/cardiac-biomarkers-and-the-diagnosis-of-myocardial-infarction-in-women
#4
REVIEW
Anoop S V Shah, Amy V Ferry, Nicholas L Mills
PURPOSE OF REVIEW: Women with suspected acute coronary syndrome are less likely to undergo investigation or receive treatment than men, and women consistently have poorer outcomes. This review summarises how the latest development in cardiac biomarkers could improve both diagnosis and outcomes in women. RECENT FINDINGS: Novel high-sensitivity cardiac troponin assays have identified differences in the reference range and therefore diagnostic threshold for myocardial infarction in men and women...
May 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28378340/long-term-prognostic-value-of-peak-exercise-echocardiogram-in-patients-hospitalized-with-acute-chest-pain
#5
German Merchan Ortega, Juan Carlos Bonaque Gonzalez, Alejandro Dionisio Sanchez Espino, Maria Jose Aguado Martin, Francisco Navarro Garcia, Fuensanta Ruiz Lopez, Francisco Ramos Perales, Jose Luis Zamorano Gomez
INTRODUCTION: Peak exercise echocardiogram (EEcho) has shown reasonable sensitivity and specificity in detecting significant coronary artery disease (CAD). The objective was to evaluate the prognostic value of EEcho in patients hospitalized for acute chest pain (CP) and its additional prognostic information regarding exercise electrocardiogram test (EECG). METHODS: Prospective observational study performed between May 2011 and September 2013, including 250 patients consecutively admitted for acute CP with normal cardiac biomarkers and nondiagnostic electrocardiogram...
April 5, 2017: Echocardiography
https://www.readbyqxmd.com/read/28377429/circulating-micrornas-potential-markers-of-cardiotoxicity-in-children-and-young-adults-treated-with-anthracycline-chemotherapy
#6
Kasey J Leger, David Leonard, Danelle Nielson, James A de Lemos, Pradeep P A Mammen, Naomi J Winick
BACKGROUND: Biomarkers for early detection of anthracycline (AC)-induced cardiotoxicity may allow cardioprotective intervention before irreversible damage. Circulating microRNAs (miRNAs) are promising biomarkers of cardiovascular disease, however, have not been studied in the setting of AC-induced cardiotoxicity. This study aimed to identify AC-induced alterations in plasma miRNA expression in children and correlate expression with markers of cardiac injury. METHODS AND RESULTS: Candidate plasma profiling of 24 miRNAs was performed in 33 children before and after a cycle of AC (n=24) or noncardiotoxic chemotherapy (n=9)...
April 4, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28377153/clinical-performance-of-cardiac-troponin-i-a-comparison-between-the-poct-aqt90-flex-and-the-dimension-vista-analyzer-in-an-emergency-setting
#7
Monica Maria Mion, Giada Bragato, Alessandra Casarotti, Chiara Cosma, Stefania Vigolo, Gianna Vettore, Franco Tosato, Martina Zaninotto, Mario Plebani
BACKGROUND: Cardiac troponin [cTn (I or T)] is the preferred biomarker for the diagnosis of myocardial infarction (MI). AIM: We studied the analytical performance of the POCT AQT90 FLEX cTnI assay and its diagnostic accuracy, in comparison to the Dimension Vista cTnI method, in patients presenting to the Emergency Department (ED) with suspect of acute coronary syndrome (ACS). METHODS: 786 consecutive patients were enrolled. cTnI was measured at admission to the ED and about 3 and 6 hours later...
April 1, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/28376710/electrocardiographic-changes-mimicking-acute-coronary-syndrome-in-a-large-intracranial-tumour-a-diagnostic-dilemma
#8
Nilukshana Yogendranathan, H M M T B Herath, S P Pahalagamage, Aruna Kulatunga
BACKGROUND: ST elevation Myocardial infarction is a medical emergency. A variety of noncardiac conditions had been known to mimic the ECG changes that are seen in acute coronary syndrome. Although the common ECG changes that are documented with raised intracranial pressure are T inversions, prolongation of QT interval and sinus bradycardia, ST elevation or depression, arrhythmias and prominent U waves have also been recognized. However, ST elevations in association with primary intracranial tumours are rarely reported...
April 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28348007/genome-wide-analysis-of-dna-methylation-and-acute-coronary-syndrome
#9
Jun Li, Xiaoyan Zhu, Kuai Yu, Haijing Jiang, Yizhi Zhang, Siyun Deng, Longxian Cheng, Xuezhen Liu, Jia Zhong, Xiaomin Zhang, Mei'an He, Weihong Chen, Jing Yuan, Ming Gao, Yansen Bai, Xu Han, Bing Liu, Xiaoting Luo, Wenhua Mei, Xiaosheng He, Shunchang Sun, Liyun Zhang, Hesong Zeng, Huizhen Sun, Chuanyao Liu, Yanjun Guo, Bing Zhang, Zhihong Zhang, Jinyan Huang, An Pan, Yu Yuan, Francesca Angileri, Bingxia Ming, Fang Zheng, Qiutang Zeng, Xiaobo Mao, Yudong Peng, Yi Mao, Ping Ye, Qing K Wang, Lu Qi, Frank B Hu, Liming Liang, Tangchun Wu
Rationale: Acute coronary syndrome (ACS) is a leading cause of death worldwide. Immune functions play a vital role in ACS development, however, whether epigenetic modulation contributes to the regulation of blood immune cells in this disease has not been investigated. Objective: We conducted an epigenome-wide analysis with circulating immune cells to identify differentially methylated genes in ACS. Methods and Results: We examined genome-wide methylation of whole blood in 102 ACS patients and 101 controls using HumanMethylation450 array, and externally replicated significant discoveries in 100 patients and 102 controls...
March 27, 2017: Circulation Research
https://www.readbyqxmd.com/read/28344817/urinary-biomarkers-as-indicator-of-chronic-inflammation-and-endothelial-dysfunction-in-obese-adolescents
#10
Ruchi Singh, Arushi Verma, Salim Aljabari, Tetyana L Vasylyeva
BACKGROUND: Obesity is a pro-inflammatory state that may predispose patients to acute coronary syndrome characterized by chronic low grade inflammation resulting in endothelial dysfunction (ED). The aim of the study was to evaluate urinary biomarkers of inflammation and ED in adolescents with obesity. METHODS: Sixty three subjects were recruited for the study. Twenty healthy adolescents with normal body mass (NW), 14 overweight (OW), 29 obese (OA) subjects were selected...
2017: BMC Obesity
https://www.readbyqxmd.com/read/28340038/coincidental-coronary-artery-disease-impairs-outcome-in-patients-with-takotsubo-cardiomyopathy
#11
V Bill, I El-Battrawy, K Schramm, U Ansari, U Hoffmann, D Haghi, J Kuschyk, M Borggrefe, I Akin
Background and aim: Takotsubo cardiomyopathy (TC) is an important differential diagnosis of coronary artery disease (CAD), mimicking acute coronary syndrome in clinical symptoms, biomarker profiles and ST-elevation in ECG. Absence of occlusive coronary disease is an essential criterion distinguishing both diseases. The aim of the study was to explore the influence of co-existing incidental CAD on poorer clinical outcomes and all-cause mortality in TC. Design, methods and results: Our mono-centric study cohort constituted 114 consecutive patients diagnosed with TC between 2003 and 2015...
March 14, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#12
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28316143/endothelial-microparticles-act-as-novel-diagnostic-and-therapeutic-biomarkers-of-circulatory-hypoxia-related-diseases-a-literature-review
#13
REVIEW
Fan Deng, Shuang Wang, Liangqing Zhang
Circulatory hypoxia-related diseases (CHRDs), including acute coronary syndromes, stroke and organ transplantation, attract increased attention due to high morbidity and mortality. Mounting evidence shows that hypoxia-induced oxidative stress, coagulation, inflammation and angiogenesis play extremely important roles in the physiological and pathological processes of CHRD-related vascular endothelial injury. Interestingly, hypoxia, even hypoxia-induced oxidative stress, coagulation and inflammation can all induce release of endothelial microparticles (EMPs)...
March 18, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28315120/prognostic-biomarkers-in-acute-coronary-syndromes-risk-stratification-beyond-cardiac-troponins
#14
REVIEW
K M Eggers, B Lindahl
PURPOSE OF REVIEW: Cardiac troponin (cTn) plays an essential role for assessment of outcome in acute coronary syndrome (ACS). However, the prognostic value of cTn is not absolute. In this mini-review, we summarize the evidence on the utility of established biomarkers of left-ventricular dysfunction, hemodynamic stress, inflammation, and renal dysfunction for risk prediction beyond cTn in ACS. RECENT FINDINGS: Only few biomarkers consistently demonstrate additive prognostic value to cTn levels...
April 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28302644/what-is-an-roc-curve
#15
EDITORIAL
Zhe Hui Hoo, Jane Candlish, Dawn Teare
The paper by Body et al is concerned with the evaluation of decision aids, which can be used to identify potential acute coronary syndromes (ACS) in the ED. The authors previously developed the Manchester Acute Coronary Syndromes model (MACS) decision aid, which uses several clinical variables and two biomarkers to 'rule in' and 'rule out' ACS. However, one of the two biomarkers (heart-type fatty acid bindingprotein, H-FABP) is not widely used so a revised decision aid has been developed (Troponin-only Manchester Acute Coronary Syndromes, T-MACS), which include a single biomarker hs-cTnT...
March 16, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28290859/-prognostic-significance-of-erythropoietin-in-patients-with-acute-coronary-syndrome
#16
M V Menzorov, A M Shutov, N V Larionova, A A Strakhov, D V Serova
AIM: to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS: Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290631/acute-coronary-syndrome-current-treatment
#17
Timothy L Switaj, Scott R Christensen, Dean M Brewer
Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation...
February 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28289073/sympathetic-nervous-activity-in-patients-with-acute-coronary-syndrome-a-comparative-study-of-inflammatory-biomarkers
#18
Humberto G Moreira, Rony L Lage, Daniel G Martinez, Larissa Ferreira-Santos, Maria U P B Rondon, Carlos E Negrão, José C Nicolau
Previous studies have shown that both sympathetic hyperactivity and enhanced inflammatory responses are associated with poor outcomes in patients with acute coronary syndrome (ACS). Whether there is a correlation between these two characteristics remains unclear. Thirty-four patients with uncomplicated ACS were evaluated; their mean age was 51.7±7.0 years, 79.4% were male, and 94.1% had myocardial infarction (MI). On the fourth day of hospitalization, they underwent muscle sympathetic nerve activity (MSNA) analysis (microneurography), as well as ultrasensitive C-reactive protein (usCRP), interleukin-6 (IL-6), and lipoprotein-associated phospholipase A2 (Lp-PLA2) activity measurements...
May 1, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/28286818/validation-of-the-north-american-chest-pain-rule-in-prediction-of-very-low-risk-chest-pain-a-diagnostic-accuracy-study
#19
Somayeh Valadkhani, Mohammad Jalili, Elham Hesari, Hadi Mirfazaelian
INTRODUCTION: Acute coronary syndrome accounts for more than 15% of the chest pains. Recently, Hess et al. developed North American Chest Pain Rule (NACPR) to identify very low-risk patients who can be safely discharged from emergency department (ED). The present study aimed to validate this rule in EDs of two academic hospitals. METHODS: A prospective diagnostic accuracy study was conducted on consecutive patients 24 years of age and older presenting to the ED with the chief complaint of acute chest pain, during March 2013 to June 2013...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28279382/trials-of-imaging-use-in-the-emergency-department-for-acute-chest-pain
#20
REVIEW
Gilbert L Raff, Udo Hoffmann, James E Udelson
Over 8 million patients seek emergency department care for acute chest pain annually in the United States alone, and <5% have an acute coronary syndrome. In the absence of overt electrocardiographic or biomarker evidence, expensive and time-consuming diagnostic strategies are frequently required. Beginning in 2000, radionuclide myocardial perfusion, stress echocardiography, cardiac magnetic resonance imaging, and coronary computed tomographic angiography have become increasingly common in evaluating these patients...
March 2017: JACC. Cardiovascular Imaging
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