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Acute coronary syndromes

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https://www.readbyqxmd.com/read/29166703/in-hospital-outcomes-in-invasively-managed-acute-myocardial-infarction-patients-who-receive-morphine
#1
Cian P McCarthy, Vijeta Bhambhani, Eugene Pomerantsev, Jason H Wasfy
OBJECTIVE: We aimed to analyze the association between morphine and in-hospital outcomes in invasively managed ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS) patients. BACKGROUND: Morphine is commonly used for analgesia in the setting of acute coronary syndromes (ACS); however, recently its utility in ACS has come under closer scrutiny. METHODS: We identified all STEMI and NSTE-ACS patients undergoing coronary angiogram +/- percutaneous intervention between January 2009 and July 2016 in our center and recorded patient characteristics and inpatient outcomes...
November 22, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29166367/smoke-free-policies-in-the-world-s-50-busiest-airports-august-2017
#2
Michael A Tynan, Elizabeth Reimels, Jennifer Tucker, Brian A King
Exposure to secondhand smoke from burning tobacco products causes premature death and disease, including coronary heart disease, stroke, and lung cancer among nonsmoking adults and sudden infant death syndrome, acute respiratory infections, middle ear disease, exacerbated asthma, respiratory symptoms, and decreased lung function in children (1,2). The U.S. Surgeon General has concluded that there is no risk-free level of exposure to secondhand smoke (1). Previous CDC reports on airport smoke-free policies found that most large-hub airports in the United States prohibit smoking (3); however, the extent of smoke-free policies at airports globally has not been assessed...
November 24, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29165381/factors-associated-with-the-need-for-and-the-impact-of-extracorporeal-membrane-oxygenation-in-children-with-congenital-heart-disease-during-admissions-for-cardiac-surgery
#3
Salvatore Aiello, Rohit S Loomba
INTRODUCTION: This study aimed to determine factors associated with the need for extracorporeal membrane oxygenation (ECMO) in children with congenital heart disease (CHD) during admission for cardiac surgery (CS). A secondary aim was to determine how ECMO impacted length, cost, and mortality of the admission. METHODS: Data from the Kids' Inpatient Database (KIDS) were utilized. Admissions with CHD under 18 years of age with cardiac surgery were included. Need for ECMO in these admissions was then identified...
November 22, 2017: Children
https://www.readbyqxmd.com/read/29164902/secondary-prevention-programme-of-ischaemic-heart-disease-in-the-elderly-a-randomised-clinical-trial
#4
Elisenda Marcos-Forniol, José F Meco, Emili Corbella, Francesc Formiga, Xavier Pintó
Background Elderly patients have been underrepresented in secondary cardiovascular prevention programmes. This study aimed to ascertain the effects of a secondary coronary disease prevention programme in these patients. Design Open randomised intervention study with parallel groups. Methods One hundred and twenty-seven patients aged ≥70 years with a recent acute coronary syndrome were randomised to a protocolised clinical intervention plus usual care (intervention group, n = 64) or to usual care alone (control group, n = 63)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29164302/impact-of-initial-myocardial-perfusion-imaging-versus-invasive-coronary-angiography-on-outcomes-in-coronary-artery-disease-a-nationwide-cohort-study
#5
Guang-Uei Hung, Kuan-Yin Ko, Cheng-Li Lin, Ruoh-Fang Yen, Chia-Hung Kao
PURPOSE: In patients with stable coronary artery disease (CAD), two main options exist to guide management: initial invasive coronary angiography (CAG), or selective CAG after risk stratification using myocardial perfusion imaging (MPI). This study compared clinical outcomes between these two strategies in a large, real-world population. METHODS: The initial cohort comprised 1,000,000 randomly selected patients who had been entered in the National Health Insurance Research Database of Taiwan between 2000 and 2011...
November 22, 2017: European Journal of Nuclear Medicine and Molecular Imaging
https://www.readbyqxmd.com/read/29162403/cope-s-sign-and-complete-heart-block-in-a-78-year-old-patient-with-biliary-colic
#6
Panteleimon E Papakonstantinou, Natalia I Asimakopoulou, Emmanuel Kanoupakis, Spyridon Maragkoudakis, Simeon Panagiotakis, Achilleas Gikas
INTRODUCTION: Acute cholecystitis and biliary colic may have signs and symptoms similar to those of Acute Coronary Syndrome(ACS) along with ischemic ECG changes. Cholecystitis and/or biliary colic have been both reported as trigger factors for bradyarrhythmia in the literature. CASE REPORT: A 78-year-old male patient was admitted to our Emergency Department (ED) due to acute abdominal pain. The ECG on admission showed sinus bradycardia with a rate of 40 beats per minute (bpm) without signs of acute ischemia and a brief period (7 s) of complete atrioventricular (AV) block...
November 18, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/29160388/incremental-prognostic-value-of-the-incorporation-of-clinical-data-into-coronary-anatomy-data-in-acute-coronary-syndromes-syntax-grace-score
#7
Mateus Dos Santos Viana, Fernanda Lopes, Antonio Mauricio Dos Santos Cerqueira, Jessica Gonzalez Suerdieck, André Barcelos da Silva, Ana Clara Barcelos da Silva, Thiago Menezes Barbosa de Souza, Manuela Campelo Carvalhal, Marcia Maria Noya Rabelo, Luis Claudio Lemos Correia
BACKGROUND: When performing coronary angiography in patients with acute coronary syndrome (ACS), the anatomical extent of coronary disease usually prevails in the prognostic reasoning. It has not yet been proven if clinical data should be accounted for in risk stratification together with anatomical data. OBJECTIVE: To test the hypothesis that clinical data increment the prognostic value of anatomical data in patients with ACS. METHODS: Patients admitted with objective criteria for ACS and who underwent angiography during hospitalization were included...
November 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29157245/low-1-5-anhydroglucitol-levels-are-associated-with-long-term-cardiac-mortality-in-acute-coronary-syndrome-patients-with-hemoglobin-a1c-levels-less-than-7-0
#8
Shohei Ouchi, Kazunori Shimada, Tetsuro Miyazaki, Shuhei Takahashi, Yurina Sugita, Megumi Shimizu, Azusa Murata, Tomoyasu Kadoguchi, Takao Kato, Tatsuro Aikawa, Shoko Suda, Eiryu Sai, Masaru Hiki, Hiroshi Iwata, Takatoshi Kasai, Katsumi Miyauchi, Hiroyuki Daida
BACKGROUND: Diabetes mellitus is considered an important risk factor for cardiovascular diseases. High hemoglobin A1c (HbA1c) levels, which indicate poor glycemic control, have been associated with occurrence of cardiovascular diseases. There are few parameters which can predict cardiovascular risk in patients with well-controlled diabetes. Low 1,5-anhydroglucitol (1,5-AG) levels are considered a clinical marker of postprandial hyperglycemia. We hypothesized that low 1,5-AG levels could predict long-term mortality in acute coronary syndrome (ACS) patients with relatively low HbA1c levels...
November 21, 2017: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29155984/cysteine-rich-angiogenic-inducer-61-cyr61-a-novel-soluble-biomarker-of-acute-myocardial-injury-improves-risk-stratification-after-acute-coronary-syndromes
#9
Roland Klingenberg, Soheila Aghlmandi, Christoph Liebetrau, Lorenz Räber, Baris Gencer, David Nanchen, David Carballo, Alexander Akhmedov, Fabrizio Montecucco, Stefan Zoller, Chad Brokopp, Dik Heg, Peter Jüni, Helena Marti Soler, Pedro-Manuel Marques-Vidal, Peter Vollenweider, Oliver Dörr, Nicolas Rodondi, François Mach, Stephan Windecker, Ulf Landmesser, Arnold von Eckardstein, Christian W Hamm, Christian M Matter, Thomas F Lüscher
Aims: We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Methods and results: Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls...
November 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29154109/development-and-validation-of-a-sensitive-and-rapid-uhplc-ms-ms-method-for-the-simultaneous-quantification-of-the-common-active-and-inactive-metabolites-of-vicagrel-and-clopidogrel-in-human-plasma
#10
Cai Liu, Youming Lu, Hongbin Sun, Jin Yang, Yongqiang Liu, Xiaojuan Lai, Yanchun Gong, Xuefang Liu, Yongguo Li, Yifan Zhang, Xiaoyan Chen, Dafang Zhong
Vicagrel, an analog of clopidogrel, is a novel thienopyridine P2Y12 antagonist in clinical development in China for the treatment of acute coronary syndromes. Vicagrel and clopidogrel are prodrugs requiring metabolic activation to produce a pharmacologically active thiol metabolite (H4) in vivo. The formation of H4 from vicagrel in humans is promising more efficient and consistent than that from clopidogrel. After oral dosing of vicagrel or clopidogrel to humans, the active thiol metabolite H4 and two inactive metabolites closely related to H4 formation (the thiol metabolite H3 and the S-methylated metabolite SM3) were observed in plasma; SM3 was the most abundant drug-related component of vicagrel in circulation...
November 6, 2017: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29153753/an-easy-assessment-of-frailty-at-baseline-independently-predicts-prognosis-in-very-elderly-patients-with-acute-coronary-syndromes
#11
Oriol Alegre, Francesc Formiga, Ramón López-Palop, Francisco Marín, María T Vidán, Manuel Martínez-Sellés, Antoni Carol, Alessandro Sionis, Pablo Díez-Villanueva, Jaime Aboal, Anna Palau-Vendrel, Héctor Bueno, Angel Perez Rivera, Juan Sanchís, Emad Abu-Assi, Miguel Corbí, Juan C Castillo, Jordi Bañeras, Violeta González-Salvado, Àngel Cequier, Albert Ariza-Solé
BACKGROUND: Information about the impact of frailty in patients with acute coronary syndromes (ACS) is scarce. No study has assessed the prognostic impact of frailty as measured by the FRAIL scale in very elderly patients with ACS. METHODS: The prospective multicenter LONGEVO-SCA registry included unselected patients with ACS aged 80 years or older. A comprehensive geriatric assessment was performed during hospitalization, including frailty assessment by the FRAIL scale...
November 16, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29153201/troponin-in-heart-failure
#12
REVIEW
Kevin S Shah, Alan S Maisel, Gregg C Fonarow
Cardiac troponin is an integral biomarker in the evaluation and management of patients with acute coronary syndrome. Troponin is also established as a valuable prognostic marker in patients with acute or chronic heart failure (HF). As the sensitivity of troponin assays transition to high sensitive troponin, more patients with HF will have detectable troponin. In this review, the authors discuss the current literature on the value of troponin in the management of patients with HF. Furthermore, the authors highlight the potential for future strategies to use troponin as a potential target for therapy in patients with HF...
January 2018: Heart Failure Clinics
https://www.readbyqxmd.com/read/29153072/smoking-abstinence-twelve-months-after-an-acute-coronary-syndrome
#13
Vânia Rocha, Marina P Guerra, Marina S Lemos, Júlia Maciel, Geoffrey C Williams
Studies on the cognitive working mechanism of smoking cessation in high-risk populations are few and much needed, and identifying long-term psychosocial factors to smoking cessation are relevant to improve intervention for cardiac patient groups. This longitudinal study followed patients who smoked and suffered an acute coronary syndrome from hospitalization to 12 months after clinical discharge. Questionnaires were administered to assess nicotine dependence, behavioral dependence, autonomous self-regulation, perceived competence, social support, anxiety, depressive symptoms and meaning in life at baseline, six months and twelve months after clinical discharge...
November 20, 2017: Spanish Journal of Psychology
https://www.readbyqxmd.com/read/29151439/clopidogrel-or-ticagrelor-in-acute-coronary-syndrome-patients-treated-with-newer-generation-drug-eluting-stents-change-dapt
#14
Paolo Zocca, Liefke C van der Heijden, Marlies M Kok, Marije M Löwik, Marc Hartmann, Martin G Stoel, J W Louwerenburg, Frits H A F de Man, Gerard C M Linssen, Iris L Knottnerus, Carine J M Doggen, K Gert van Houwelingen, Clemens von Birgelen
AIMS: Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). METHODS AND RESULTS: CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive real-world ACS patients, treated by percutaneous coronary intervention (PCI), the primary composite endpoint being net adverse clinical and cerebral events (NACCE: all-cause death, any myocardial infarction, stroke or major bleeding)...
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29151434/dual-antiplatelet-therapy-after-acute-coronary-syndromes-no-time-for-a-change
#15
Davide Capodanno
No abstract text is available yet for this article.
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29151034/efficacy-and-safety-of-adding-ezetimibe-to-statin-therapy-among-women-and-men-insight-from-improve-it-improved-reduction-of-outcomes-vytorin-efficacy-international-trial
#16
Eri Toda Kato, Christopher P Cannon, Michael A Blazing, Erin Bohula, Sema Guneri, Jennifer A White, Sabina A Murphy, Jeong-Gun Park, Eugene Braunwald, Robert P Giugliano
BACKGROUND: IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) showed that adding the nonstatin ezetimibe to statin therapy further reduced cardiovascular events in patients after an acute coronary syndrome. In a prespecified analysis, we explore results stratified by sex. METHODS AND RESULTS: In IMPROVE-IT, patients with acute coronary syndrome and low-density lipoprotein cholesterol of 50 to 125 mg/dL were randomized to placebo/simvastatin 40 mg or ezetimibe/simvastatin 10/40 mg...
November 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29151032/elevated-baseline-serum-fibrinogen-effect-on-2-year-major-adverse-cardiovascular-events-following-percutaneous-coronary-intervention
#17
Lawrence Ang, Omid Behnamfar, Samhita Palakodeti, Felice Lin, Ali Pourdjabbar, Mitul P Patel, Ryan R Reeves, Ehtisham Mahmud
BACKGROUND: Elevated fibrinogen is associated with short-term major adverse cardiovascular events (MACE) after percutaneous coronary intervention, but the relation with late MACE is unknown. METHODS AND RESULTS: Baseline demographics and 2-year MACE were recorded among subjects undergoing nonemergent percutaneous coronary intervention. A total of 332 subjects (66.6±19.5 years, 69.9% male, 25.3% acute coronary syndrome) were enrolled. Two-year MACE (periprocedural myocardial infarction 9...
November 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#18
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29150536/availability-sales-and-affordability-of-tobacco-cessation-medicines-in-kerala-india
#19
Smitha Sarma, Sivadasanpillai Harikrishnan, Abigail S Baldridge, Raji Devarajan, Aashna Mehta, Sakhtivel Selvaraj, Mohammed K Ali, Padinhare P Mohanan, Dorairaj Prabhakaran, Mark D Huffman
BACKGROUND: India is the world's second largest consumer of tobacco, but tobacco cessation remains uncommon due, at least in part, to underutilization of cessation pharmacotherapy. We evaluated the availability, sales, and affordability of nicotine replacement therapy, bupropion, and varenicline in the South Indian state of Kerala to understand potential reasons for underutilization. METHODS AND RESULTS: From November 2016 to April 2017, we collected data on availability, inventory, and pricing of cessation medication through a cross-sectional survey of 199 public, semiprivate (Karunya), and private pharmacies across 5 districts in Kerala using World Health Organization/Health Action International methodology...
November 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29150530/declining-rates-of-hospitalization-for-selected-cardiovascular-disease-conditions-among-adults-aged-%C3%A2-35-years-with-diagnosed-diabetes-u-s-1998-2014
#20
Nilka Ríos Burrows, YanFeng Li, Edward W Gregg, Linda S Geiss
OBJECTIVE: Reductions in heart attack and stroke hospitalizations are well documented in the U.S. population with diabetes. We extended trend analyses to other cardiovascular disease (CVD) conditions, including stroke by type, and used four additional years of data. RESEARCH DESIGN AND METHODS: Using 1998-2014 National (Nationwide) Inpatient Sample data, we estimated the number of discharges having acute coronary syndrome (ACS) (ICD-9 codes 410-411), cardiac dysrhythmia (427), heart failure (428), hemorrhagic stroke (430-432), or ischemic stroke (433...
November 17, 2017: Diabetes Care
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