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Acute coronary syndromes

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https://www.readbyqxmd.com/read/28817542/safety-of-transesophageal-echocardiography%C3%A2-guided-electrical-cardioversion-in-patients-with-atrial-fibrillation-and-inadequate-anticoagulation
#1
Joanna Zaprutko, Artur Baszko, Michał Michalak, Karol Kochman, Radosław Szymański, Jan Kłopocki, Anna Nowicka, Rafał Dankowski, Marek Michalski, Piotr Kałmucki, Andrzej Szyszka
INTRODUCTION    Restoring sinus rhythm in patients with atrial fibrillation (AF)/atrial flutter (AFl) requires adequate oral anticoagulation prior to direct current cardioversion (DCC). Some patients eligible for DCC are not properly anticoagulated. OBJECTIVES    The aim of the study was to assess risk factors for thrombus and spontaneous echo contrast (SEC) in the left atrium (LA) as well as the safety profile of transesophageal echocardiography (TEE)-guided DCC in patients with inadequate anticoagulation...
August 9, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28815384/association-between-discordance-of-ldl-c-and-non-hdl-c-and-clinical-outcomes-in-patients-with-stent-implantation-from-the-fu-registry
#2
Michiyo Shiiba, Bo Zhang, Shin-Ichiro Miura, Amane Ike, Daisuke Nose, Takashi Kuwano, Satoshi Imaizumi, Makoto Sugihara, Atushi Iwata, Hiroaki Nishikawa, Akira Kawamura, Kazuyuki Shirai, Shin'ichiro Yasunaga, Keijiro Saku
It is not yet clear whether the discordance of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) predicts the follow-up clinical outcome (major adverse cardiovascular events: MACEs) in patients with coronary stent implantation. Among 2015 patients with coronary stent implantation (Fukuoka University [FU]-Registry), excluding those with acute coronary syndrome or hemodialysis, we selected 801 patients who had undergone successful stent implantation with a follow-up until 18 months, and classified them into 3 groups according to baseline LDL-C and non-HDL-C levels [percentile(P)non-HDL-C more than (P)LDL-C, (P)non-HDL-C equal to (P)LDL-C, and (P)non-HDL-C less than (P) LDL-C]...
August 16, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28815187/a-rare-presentation-of-fibromuscular-dysplasia-postpartum-vascular-catastrophe-and-brief-literature-review
#3
Fatima Khan, Ali Raza Ghani, Larami Mackenzie, Ashwin Matthew, Usman Sarwar, Bruce Klugherz
Spontaneous coronary artery dissection is a very rare cause of acute coronary syndromes and can be life threatening given the rarity of the condition. It should be part of differentials in young females presenting with acute coronary syndromes without routine risk factors for coronary artery disease, especially before, during, and after pregnancy. It is closely associated with fibromuscular dysplasia and management can be very challenging at times. We present a case of spontaneous coronary artery dissection presenting with recurrent ST segment elevation myocardial infarction in association with fibromuscular dysplasia...
July 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28814587/a-case-of-cardiopulmonary-arrest-due-to-spontaneous-coronary-artery-dissection-in-a-pregnant-woman
#4
Emiko Ejima, Yoshinobu Murasato
We present the case of a young pregnant woman with cardiopulmonary arrest due to acute coronary syndrome. Emergent coronary angiography (CAG) and intravascular ultrasound (IVUS) showed extensive coronary artery dissection in the left anterior descending artery, which was treated with primary percutaneous coronary intervention. After managing the heart failure and disseminated intravascular coagulation, a dead fetus was delivered via caesarean section 4 days after admission to the hospital. Follow-up CAG and IVUS at 18 months showed persistent dissection in the non-stented site; hence, another stent was implanted...
August 16, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28814233/statins-in-acute-coronary-syndromes
#5
Manolis Vavuranakis, Maria Kariori, Gerasimos Siasos, Konstantinos Kalogeras, Dimitris Tousoulis
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28813699/t1-and-t2-mapping-in-cardiology-mapping-the-obscure-object-of-desire
#6
Sophie Mavrogeni, Dimitris Apostolou, Panayiotis Argyriou, Stella Velitsista, Lilika Papa, Stelios Efentakis, Evangelos Vernardos, Mikela Kanoupaki, George Kanoupakis, Athanassios Manginas
The increasing use of cardiovascular magnetic resonance (CMR) is based on its capability to perform biventricular function assessment and tissue characterization without radiation and with high reproducibility. The use of late gadolinium enhancement (LGE) gave the potential of non-invasive biopsy for fibrosis quantification. However, LGE is unable to detect diffuse myocardial disease. Native T1 mapping and extracellular volume fraction (ECV) provide knowledge about pathologies affecting both the myocardium and interstitium that is otherwise difficult to identify...
August 17, 2017: Cardiology
https://www.readbyqxmd.com/read/28812321/prognostic-impact-of-intensive-statin-therapy-on-n-terminal-pro-bnp-level-in-non-st-segment-elevation-acute-myocardial-infarction-patients
#7
Mohamed Shehata, Ayman Samir, May Dardiri
OBJECTIVE: This study explored the impact of intensive daily dosing of atorvastatin on in-hospital N-terminal pro-B-type natriuretic peptide level, left ventricular systolic function and incidence of major adverse cardiac events in non-ST-segment elevation myocardial infarction patients. BACKGROUND: Several studies showed that early initiation of statin therapy in acute coronary syndrome patients has a favorable prognostic impact. METHODS: Hundred statin naive patients were prospectively enrolled...
August 15, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28810873/six-month-adherence-to-statin-use-and-subsequent-risk-of-major-adverse-cardiovascular-events-mace-in-patients-discharged-with-acute-coronary-syndromes
#8
Gaoqiang Xie, Yihong Sun, Phyo Kyaw Myint, Anushka Patel, Xingzi Yang, Min Li, Xian Li, Tao Wu, Shenshen Li, Runlin Gao, Yangfeng Wu
BACKGROUND: The evidence of adherence to statin decreasing risk of major adverse cardiovascular events (MACEs) is still lack among patients discharged with acute coronary syndrome (ACS). Our objective is to determine the relationship between six-month adherence to statins and subsequent risk of MACEs in patients discharged with ACS. METHODS: Using two prospective registry cohorts (CPACS-1 and -2), we analyzed data from 12,516 consecutive patients with ACS who were prescribed statin at hospital discharge and survived beyond 6 months without recurrent myocardial infarction (MI) or stroke...
August 15, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28810445/enduring-somatic-threat-perceptions-and-post-traumatic-stress-disorder-symptoms-in-survivors-of-cardiac-events
#9
Laura Meli, Carmela Alcántara, Jennifer A Sumner, Brendan Swan, Bernard P Chang, Donald Edmondson
Post-traumatic stress disorder due to acute cardiovascular events may be uniquely defined by enduring perceptions of somatic threat. We tested whether post-traumatic stress disorder at 1 month post-acute coronary syndrome indeed required both high peritraumatic threat during the acute coronary syndrome and ongoing cardiac threat perceptions. We assessed peritraumatic threat during emergency department enrollment of 284 patients with a provisional acute coronary syndrome diagnosis and cardiac threat perceptions and post-traumatic stress disorder symptoms 1 month post-discharge...
April 1, 2017: Journal of Health Psychology
https://www.readbyqxmd.com/read/28810280/-dual-antiplatelet-therapy-in-the-perioperative-period-to%C3%A2-continue-or-discontinue-treatment
#10
Jürgen Koscielny, Christian von Heymann, Uwe Zeymer, Jochen Cremer, Michael Spannagl, Joachim Labenz, Evangelos Giannitsis, Franz Goss
Background For secondary prevention of acute coronary syndrome, guidelines recommend dual antiplatelet therapy (DAPT) with acetylsalicylic acid and a P2Y12 receptor antagonist such as clopidogrel, prasugrel or ticagrelor for a period of 12 months. Often, uncertainty exists with respect to surgical or diagnostic procedures in these high-risk patients: can the DAPT be continued without interruption? If not, what is the recommended withdrawal strategy? What should be considered for the perioperative management? Methods An interdisciplinary group of experienced experts in the fields of cardiology, cardiac surgery, gastroenterology, anaesthesiology, intensive care and haemostaseology developed recommendations relevant to daily clinical practice based on the current scientific evidence...
August 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28810251/a-prospective-randomized-open-label-blinded-endpoint-study-exploring-platelet-response-to-half-dose-prasugrel-and-ticagrelor-in-patients-with-the-acute-coronary-syndrome-hope-tailor-study
#11
Cai De Jin, Moo Hyun Kim, Junghee Bang, Victor Serebruany
BACKGROUND: The optimal dosing of novel oral P2Y12 receptor platelet inhibitors such as prasugrel or ticagrelor is unclear and especially challenging in East Asians. We hypothesize that half-dose prasugrel and ticagrelor may be sufficient for long-term maintenance management in Korean patients with the acute coronary syndrome (ACS) compared with conventional dosages. DESIGN: HOPE-TAILOR (Half Dose of Prasugrel and Ticagrelor in Platelet Response after Acute Coronary Syndromes) is a prospective, randomized, open-label, blinded, endpoint (PROBE) single-center, clinical trial...
August 16, 2017: Cardiology
https://www.readbyqxmd.com/read/28809046/platelet-transfusion-to-reverse-antiplatelet-therapy-before-decompressive-surgery-in-patients-with-intracranial-haemorrhage
#12
M Baschin, S Selleng, J-P Zeden, A Westphal, T Kohlmann, H W Schroeder, A Greinacher, T Thiele
BACKGROUND: Platelet concentrates (PC) are transfused to improve primary haemostasis before urgent neurosurgery in patients with intracranial haemorrhage (ICH) receiving antiplatelet therapy (APT). It is unresolved, whether PCs increase the risk for major cardio- and cerebrovascular adverse events. We evaluated a standardized transfusion regimen to reverse APT in patients with ICH who required decompressive neurosurgery. METHODS: Analysed were consecutive patients between 2012 and 2014...
August 14, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28808989/can-we-reliably-predict-the-level-of-anticoagulation-after-enoxaparin-injection-in-elderly-patients-with-renal-failure
#13
Luca Pellizzari, Roberto Facchinetti, Luigi Corrà, Anna Sepe, Francesco Fantin, Giorgia Fontana, Mauro Zamboni, Vincenzo Di Francesco
OBJECTIVES: The aim of this study was to evaluate the activity of anti-activated factor X (anti-Xa) in patients with different degrees of chronic renal failure (CRF), treated with therapeutic doses of low molecular weight heparin. DESIGN: This prospective study evaluated the effect of age, renal function, BMI, gender, in determining the efficacy and safety of treatment with enoxaparin, evaluated by assessing the anti-Xa. The therapeutic anticoagulant range was set between 0...
August 14, 2017: Aging Clinical and Experimental Research
https://www.readbyqxmd.com/read/28808297/secretory-phospholipase-a2-modified-hdl-rapidly-and-potently-suppresses-platelet-activation
#14
Sanja Curcic, Michael Holzer, Lisa Pasterk, Eva Knuplez, Thomas O Eichmann, Saša Frank, Robert Zimmermann, Rudolf Schicho, Akos Heinemann, Gunther Marsche
Levels of secretory phospholipases A2 (sPLA2) highly increase under acute and chronic inflammatory conditions. sPLA2 is mainly associated with high-density lipoproteins (HDL) and generates bioactive lysophospholipids implicated in acute and chronic inflammatory processes. Unexpectedly, pharmacological inhibition of sPLA2 in patients with acute coronary syndrome was associated with an increased risk of myocardial infarction and stroke. Given that platelets are key players in thrombosis and inflammation, we hypothesized that sPLA2-induced hydrolysis of HDL-associated phospholipids (sPLA2-HDL) generates modified HDL particles that affect platelet function...
August 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28808149/acute-coronary-syndrome-what-is-the-affected-artery-where-is-the-occlusion-located-and-how-important-is-the-myocardial-mass-involved
#15
Miguel Fiol-Sala, Antonio Bayés de Luna
No abstract text is available yet for this article.
August 15, 2017: Circulation
https://www.readbyqxmd.com/read/28806965/decreased-circulating-dihomo-gamma-linolenic-acid-levels-are-associated-with-total-mortality-in-patients-with-acute-cardiovascular-disease-and-acute-decompensated-heart-failure
#16
Shohei Ouchi, Tetsuro Miyazaki, Kazunori Shimada, Yurina Sugita, Megumi Shimizu, Azusa Murata, Takao Kato, Tatsuro Aikawa, Shoko Suda, Tomoyuki Shiozawa, Masaru Hiki, Shuhei Takahashi, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Polyunsaturated fatty acids (PUFAs) have important roles in the pathogenesis of cardiovascular diseases. However, the clinical significance of omega-6 PUFAs in acute cardiovascular disease remains unknown. METHODS: We enrolled 417 consecutive patients with acute cardiovascular disease admitted to the cardiac intensive care unit at Juntendo University Hospital between April 2012 and October 2013. We investigated the association between serum PUFA levels and long-term mortality...
August 14, 2017: Lipids in Health and Disease
https://www.readbyqxmd.com/read/28806444/eliminating-creatine-kinase-myocardial-band-testing-in-suspected-acute-coronary-syndrome-a-value-based-quality-improvement
#17
Matthew D Alvin, Allan S Jaffe, Roy C Ziegelstein, Jeffrey C Trost
Cardiac biomarker testing is estimated to occur in nearly 30 million emergency department visits nationwide each year in the United States. The American College of Cardiology/European Society of Cardiology indicate that cardiac troponin is the biomarker of choice owing to its nearly absolute myocardial tissue specificity and high clinical sensitivity for myocardial injury. Multiple academic medical centers have implemented interventions to eliminate the routine ordering of creatine kinase-myocardial band tests, with published patient safety outcomes data; however, creatine kinase-myocardial band testing is still ordered in many hospitals and emergency departments...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28805949/the-reversible-p2y12-antagonist-act-246475-causes-significantly-less-blood-loss-than-ticagrelor-at-equivalent-antithrombotic-efficacy-in-rat
#18
Markus Rey, Markus Kramberg, Patrick Hess, Keith Morrison, Roland Ernst, Franck Haag, Edgar Weber, Martine Clozel, Martine Baumann, Eva Caroff, Francis Hubler, Markus A Riederer, Beat Steiner
The P2Y12 receptor is a validated target for prevention of major adverse cardiovascular events in patients with acute coronary syndrome. The aim of this study was to compare two direct-acting, reversible P2Y12 antagonists, ACT-246475 and ticagrelor, in a rat thrombosis model by simultaneous quantification of their antithrombotic efficacy and surgery-induced blood loss. Blood flow velocity was assessed in the carotid artery after FeCl3 -induced thrombus formation using a Doppler flow probe. At the same time, blood loss after surgical wounding of the spleen was quantified...
October 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28804682/effects-of-intensive-pitavastatin-therapy-on-glucose-control-in-patients-with-non-st-elevation-acute-coronary-syndrome
#19
Yan-Bo Wang, Xiang-Hua Fu, Xin-Shun Gu, Wei-Ze Fan, Yun-Fa Jiang, Guo-Zhen Hao, Qing Miao, Jie Cao, Bing Fu, Yi Li
Objective: This study aimed to investigate the effects of intensive pitavastatin therapy on glucose control in patients with non-ST elevation acute coronary syndrome (ACS). Methods: Patients who had ACS with significant stenosis on initial coronary angiography and received successful percutaneous coronary intervention (PCI) in the Second Hospital of Hebei Medical University, Shijiazhuang, China from August 2015 to January 2016 were enrolled in this study. The patients were randomized to receive pitavastatin (4 mg daily) or atorvastatin (20 mg daily)...
2017: American Journal of Cardiovascular Disease
https://www.readbyqxmd.com/read/28804589/spontaneous-coronary-artery-dissection-an-under-recognized-cause-of-acute-coronary-syndromes
#20
Hanan Al Naabi, Hatim Al Lawati
Spontaneous coronary artery dissection (SCAD) is a rare condition that is often underdiagnosed given limitations of conventional cineangiography. In addition to the diagnostic challenge, the condition poses a major therapeutic dilemma given paucity of literature to guide management. We report the case of a 55-year-old woman, who presented with acute coronary syndrome. Coronary angiography at the time of the index hospitalization revealed type 2 SCAD. She was managed conservatively. Repeat coronary angiography three months later showed complete resolution of the previously noted dissection...
July 2017: Oman Medical Journal
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