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https://www.readbyqxmd.com/read/29118947/in-hospital-and-long-term-results-of-primary-angioplasty-and-medical-therapy-in-nonagenarian-patients-with-acute-myocardial-infarction
#1
Muslum Sahin, Lutfi Ocal, Ali Kemal Kalkan, Alev Kilicgedik, Mehmet Emin Kalkan, Burak Teymen, Ugur Arslantas, Mehmet Muhsin Turkmen
Introduction: Although percutaneous coronary intervention is an accepted "first-line" therapy in acute ST elevation myocardial infarction (STEMI) in general population, few data are available on the short- and long-term outcomes of very old patients (age >90 years). Our aim is to evaluate and compare the short and long-term outcomes after primary percutaneous coronary intervention (PPCI) or medical therapy in nonagenarian patients with STEMI. Methods: We retrospectively identified patients older than 90 years old in our clinic, with acute STEMI who presented within 12 hours after symptoms onset, either underwent PPCI or medically treated...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29051816/eptifibatide-is-associated-with-significant-cost-savings-and-similar-clinical-outcomes-to-abciximab-when-used-during-primary-percutaneous-coronary-intervention-for-st-elevation-myocardial-infarction-an-observational-cohort-study-of-3863-patients
#2
K S Rathod, S Antoniou, P Avari, N Ding, P Wright, C Knight, A K Jain, A Mathur, E J Smith, R Weerackody, A Wragg, D A Jones
INTRODUCTION: Glycoprotein IIb/IIIa inhibitors are recommended by guidelines in patients with ST-segment elevation myocardial infarction treated with primary percutaneous coronary intervention. There are few studies directly comparing these agents. The aim of this study was to assess whether eptifibatide is a safe and cost-effective alternative to abciximab in the treatment of primary percutaneous coronary intervention for ST-segment elevation myocardial infarction. METHODS: This was an observational cohort study of 3863 patients who received a GPIIb/IIIa inhibitor whilst undergoing primary percutaneous coronary intervention from 2007 to 2014...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/29025684/ninety-day-readmission-and-long-term-mortality-in-medicare-patients-%C3%A2-65-years-treated-with-ticagrelor-versus-prasugrel-after-percutaneous-coronary-intervention-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium
#3
Chris Song, Devraj Sukul, Milan Seth, James M Dupree, Akshay Khandelwal, Simon R Dixon, David Wohns, Thomas LaLonde, Hitinder S Gurm
Ticagrelor and prasugrel were found to be superior to clopidogrel for the treatment of acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI); however, the comparative effectiveness of these 2 drugs remains unknown. We compared postdischarge outcomes among older patients treated with ticagrelor versus prasugrel after PCI for ACS. We linked clinical data from PCIs performed in older patients (age ≥65) for ACS at 47 Michigan hospitals to Medicare fee-for-service claims from January 1, 2013, to December 31, 2014, to ascertain rates of 90-day readmission and long-term mortality...
August 30, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29020314/improved-outcomes-in-patients-with-st-elevation-myocardial-infarction-during-the-last-20%C3%A2-years-are-related-to-implementation-of-evidence-based-treatments-experiences-from-the-swedeheart-registry-1995-2014
#4
Karolina Szummer, Lars Wallentin, Lars Lindhagen, Joakim Alfredsson, David Erlinge, Claes Held, Stefan James, Thomas Kellerth, Bertil Lindahl, Annica Ravn-Fischer, Erik Rydberg, Troels Yndigegn, Tomas Jernberg
Aims: Impact of changes of treatments on outcomes in ST-elevation myocardial infarction (STEMI) patients in real-life health care has not been documented. Methods and results: All STEMI cases (n = 105.674) registered in the nation-wide SWEDEHEART registry between 1995 and 2014 were included and followed for fatal and non-fatal outcomes for up to 20 years. Most changes in treatment and outcomes occurred from 1994 to 2008. Evidence-based treatments increased: reperfusion from 66...
November 1, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29018137/incidence-and-outcomes-of-myocardial-infarction-in-patients-admitted-with-acute-ischemic-stroke
#5
Fahad Alqahtani, Sami Aljohani, Abdul Tarabishy, Tatiana Busu, Amelia Adcock, Mohamad Alkhouli
BACKGROUND AND PURPOSE: Data on the incidence and outcomes of acute myocardial infarction (AMI) complicating acute ischemic stroke (AIS) are limited. We aim to evaluate the incidence, treatment patterns, and outcomes of AMI in patients with AIS using a nationwide database. METHODS: The National Inpatient Sample was used to identify patient with AIS between 2003 and 2014. Trends of incidence of AMI and its associated in-hospital mortality were evaluated. Univariate and multivariate logistic regressions were used to evaluate predictors of AMI...
November 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28939715/precatheterization-use-of-p2y12-inhibitors-in-non-st-elevation-myocardial-infarction-patients-undergoing-early-cardiac-catheterization-and-in-hospital-coronary-artery-bypass-grafting-insights-from-the-national-cardiovascular-data-registry-%C3%A2
#6
Marwan Badri, Amr Abdelbaky, Shuang Li, Karen Chiswell, Tracy Y Wang
BACKGROUND: Current guidelines recommend early P2Y12 inhibitor administration in non-ST-elevation myocardial infarction, but it is unclear if precatheterization use is associated with longer delays to coronary artery bypass grafting (CABG) or higher risk of post-CABG bleeding and transfusion. This study examines the patterns and outcomes of precatheterization P2Y12 inhibitor use in non-ST-elevation myocardial infarction patients who undergo CABG. METHODS AND RESULTS: Retrospective analysis was done of 20 304 non-ST-elevation myocardial infarction patients in the ACTION (Acute Coronary Treatment and Intervention Outcomes Network) Registry (2009-2014) who underwent catheterization within 24 hours of admission and CABG during the index hospitalization...
September 22, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28845876/-characteristics-and-outcomes-of-acute-coronary-syndrome-in-italian-born-patients-and-immigrants-a-population-based-observational-study-using-health-administrative-data-of-the-emilia-romagna-region
#7
Jacopo Lenzi, Maria Pia Fantini, Vera Maria Avaldi, Maria Giovanna Pallotti, Paola Rucci, Angelo Fioritti, Giuseppe Di Pasquale
BACKGROUND: The aim of this study was to analyze the characteristics and outcomes of patients with acute coronary syndrome (ACS) in relation to country of origin. METHODS: The study population included patients living in the Emilia-Romagna Region and discharged from 2012 to 2014 with a diagnosis of acute myocardial infarction (with [STEMI] and without ST-elevation). The study outcomes were: percutaneous coronary intervention (PCI) within 48 hours of admission for STEMI, 30-day all-cause mortality, 1-year all-cause mortality, 1-year major adverse cardiac and cerebrovascular events (MACCE), and adherence to post-infarction medications...
September 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28794118/utilization-characteristics-and-in-hospital-outcomes-of-coronary-artery-bypass-grafting-in-patients-with-st-segment-elevation-myocardial-infarction-results-from-the-national-cardiovascular-data-registry-acute-coronary-treatment-and-intervention-outcomes-network
#8
Yi Pi, Matthew T Roe, DaJuanicia N Holmes, Karen Chiswell, J Lee Garvey, Gregg C Fonarow, James A de Lemos, Kirk N Garratt, Ying Xian
BACKGROUND: There are limited data on the utilization and outcomes of coronary artery bypass grafting (CABG) among ST-segment-elevation myocardial infarction (STEMI) patients in contemporary practice. METHODS AND RESULTS: Using data from National Cardiovascular Data Registry Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines between 2007 and 2014, we analyzed trends in CABG utilization and hospital-level variation in CABG rates...
August 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#9
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28606999/invasive-management-strategies-and-antithrombotic-treatments-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-in-china-findings-from-the-improving-ccc-project-care-for-cardiovascular-disease-in-china
#10
Qing Yang, Ying Wang, Jing Liu, Jun Liu, Yongchen Hao, Sidney C Smith, Yong Huo, Gregg C Fonarow, Changsheng Ma, Junbo Ge, Kathryn A Taubert, Louise Morgan, Yang Guo, Wei Wang, Yujie Zhou, Dong Zhao
BACKGROUND: Early invasive strategies and antithrombotic treatments are key treatments of non-ST-segment-elevation acute coronary syndrome (NSTE-ACS). Few studies have examined the use of these strategies in patients with NSTE-ACS in China. This study aimed to assess the applications of invasive strategies and antithrombotic treatments in patients with NSTE-ACS and compare their outcomes. METHODS AND RESULTS: A nationwide registry study, Improving CCC (Care for Cardiovascular Disease in China) ACS project, was launched in 2014 as a collaborative study of the American Heart Association and Chinese Society of Cardiology (CSC), with 142 participating hospitals reporting details of clinical management and outcomes of patients with NSTE-ACS...
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28541601/the-approach-to-coronary-bifurcation-treatment-and-its-outcomes-in-poland-the-single-center-experience
#11
Adam Kern, Robert J Gil, Krystian Bojko, Bartłomiej Rzeszowski, Rakesh Jalali, Jerzy Górny, Jacek Bil
BACKGROUND: Coronary bifurcation lesions pose therapeutic problems during percutaneous coronary interventions. The aim of this study was to analyze the strategy of coronary bifurcation treatment and associated angiographic as well as clinical outcomes in a large hospital in Northern Poland. METHODS: Between January 2012 and January 2014 patients with stable coronary artery disease or non-ST-elevation acute coronary syndrome (NSTE-ACS) were treated with regular drug-eluting stents (rDES) or dedicated bifurcation stents (BiOSS Expert® or BiOSS LIM®)...
May 25, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28457096/long-term-outcomes-of-mguard-stent-deployment-in-saphenous-vein-grafts-and-native-coronary-arteries-a-single-center-experience
#12
Hana Vaknin-Assa, Abid Assali, Eli I Lev, Gabriel Greenberg, Katia Orvin, Orna Valzer, Gideon Paul, Amos Levi, Ran Kornowski
BACKGROUND: The MGuard™ stent (InspireMD, Tel Aviv, Israel) is a bare metal mesh-covered stent, developed to prevent no-reflow phenomenon during percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) and acute myocardial infarction (MI), both associated with significant atherothrombotic lesions. OBJECTIVES: To report on local experience with patients treated with the MGuard stent until follow-up at 1 year. METHODS: We followed 163 consecutive patients who underwent MGuard stent deployment during the period 2009 to 2014 in a large tertiary cardiac center in central Israel...
March 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28174052/a-randomised-trial-of-expedited-transfer-to-a-cardiac-arrest-centre-for-non-st-elevation-ventricular-fibrillation-out-of-hospital-cardiac-arrest-the-arrest-pilot-randomised-trial
#13
Tiffany Patterson, Gavin D Perkins, Jubin Joseph, Karen Wilson, Laura Van Dyck, Steven Robertson, Hanna Nguyen, Hannah McConkey, Mark Whitbread, Rachael Fothergill, Joanne Nevett, Miles Dalby, Roby Rakhit, Philip MacCarthy, Divaka Perera, Jerry P Nolan, Simon R Redwood
BACKGROUND: Wide variation exists in inter-hospital survival from out-of-hospital cardiac arrest (OHCA). Regionalisation of care into cardiac arrest centres (CAC) may improve this. We report a pilot randomised trial of expedited transfer to a CAC following OHCA without ST-elevation. The objective was to assess the feasibility of performing a large-scale randomised controlled trial. METHODS: Adult witnessed ventricular fibrillation OHCA of presumed cardiac cause were randomised 1:1 to either: (1) treatment: comprising expedited transfer to a CAC for goal-directed therapy including access to immediate reperfusion, or (2) control: comprising current standard of care involving delivery to the geographically closest hospital...
February 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/27606119/a-combination-of-drug-eluting-stents-and-bioresorbable-vascular-scaffolds-in-the-treatment-of-multivessel-coronary-artery-disease
#14
Ahmed Al-Mamary, Filippo Zilio, Massimo Napodano
Optimal management of multivessel coronary artery disease can be complex. We report a 67-year-old male patient who was admitted to the Padua University Hospital, Padua, Italy, in 2014 with a non-ST-elevation myocardial infarction. Coronary angiography showed diffuse multiple sub-occlusive lesions of the proximal and distal left coronary vessels involving a long segment of the vessel. On intravascular ultrasonography (IVUS), the left main artery was moderately diseased with critically stenotic and calcified branch ostia...
August 2016: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/27585757/early-invasive-versus-non-invasive-treatment-in-patients-with-non-st-elevation-acute-coronary-syndrome-frisc-ii-15-year-follow-up-of-a-prospective-randomised-multicentre-study
#15
RANDOMIZED CONTROLLED TRIAL
Lars Wallentin, Lars Lindhagen, Elisabet Ärnström, Steen Husted, Magnus Janzon, Søren Paaske Johnsen, Frederic Kontny, Tibor Kempf, Lars-Åke Levin, Bertil Lindahl, Mats Stridsberg, Elisabeth Ståhle, Per Venge, Kai C Wollert, Eva Swahn, Bo Lagerqvist
BACKGROUND: The FRISC-II trial was the first randomised trial to show a reduction in death or myocardial infarction with an early invasive versus a non-invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome. Here we provide a remaining lifetime perspective on the effects on all cardiovascular events during 15 years' follow-up. METHODS: The FRISC-II prospective, randomised, multicentre trial was done at 58 Scandinavian centres in Sweden, Denmark, and Norway...
October 15, 2016: Lancet
https://www.readbyqxmd.com/read/27519655/high-risk-coronary-plaque-invasive-coronary-procedures-and-cardiac-events-among-hiv-positive-individuals-and-matched-controls
#16
James Nadel, Eoin O'Dwyer, Sam Emmanuel, Justyn Huang, Sarat Cheruvu, Neville Sammel, Bruce Brew, James Otton, Cameron J Holloway
BACKGROUND: Human immunodeficiency virus (HIV) infection is considered a chronic, treatable disease, although treatment is associated with increased rates of coronary artery disease (CAD). We analyzed the utility of coronary CTA in the assessment of CAD among HIV patients and explored whether HIV patients are at greater risk of associated morbidity and mortality compared to HIV-negative controls. METHODS: In a retrospective, single center cohort study 97 males without history of previous coronary artery disease who had undergone coronary CTA between 2011 and 2014 was analyzed, including 32 HIV positive patients and 65 matched HIV negative controls...
September 2016: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/27438315/diagnosis-of-myocardial-infarction-using-a-high-sensitivity-troponin-i-1-hour-algorithm
#17
Johannes Tobias Neumann, Nils Arne Sörensen, Tjark Schwemer, Francisco Ojeda, Rafael Bourry, Vanessa Sciacca, Sarina Schaefer, Christoph Waldeyer, Christoph Sinning, Thomas Renné, Martin Than, William Parsonage, Karin Wildi, Nataliya Makarova, Renate B Schnabel, Ulf Landmesser, Christian Mueller, Louise Cullen, Jaimi Greenslade, Tanja Zeller, Stefan Blankenberg, Mahir Karakas, Dirk Westermann
IMPORTANCE: Rapid and accurate diagnosis of acute myocardial infarction (AMI) currently constitutes an unmet need. OBJECTIVE: To test a 1-hour diagnostic algorithm to diagnose AMI using a high-sensitivity troponin I assay with a new cutoff level of 6 ng/L. DESIGN, SETTING, AND PARTICIPANTS: The Biomarkers in Acute Cardiac Care study is a prospective study that investigated the application of the troponin I assay for the diagnosis of AMI in 1040 patients presenting to the emergency department with acute chest pain from July 19, 2013, to December 31, 2014...
July 1, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27423981/randomized-comparison-between-the-invasive-and-conservative-strategies-in-comorbid-elderly-patients-with-non-st-elevation-myocardial-infarction
#18
RANDOMIZED CONTROLLED TRIAL
Juan Sanchis, Eduardo Núñez, José Antonio Barrabés, Francisco Marín, Luciano Consuegra-Sánchez, Silvia Ventura, Ernesto Valero, Mercè Roqué, Antoni Bayés-Genís, Bruno García Del Blanco, Irene Dégano, Julio Núñez
BACKGROUND: Comorbid elderly patients with non-ST-elevation myocardial infarction (non-STEMI) are underrepresented in randomized trials and undergo fewer cardiac catheterizations according to registries. Our aim was to compare the conservative and invasive strategies in these patients. METHODS: Randomized multicenter study, including 106 patients (January 2012-March 2014) with non-STEMI, over 70years and with comorbidities defined by at least two of the following: peripheral artery disease, cerebral vascular disease, dementia, chronic pulmonary disease, chronic renal failure or anemia...
November 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27418612/predictors-of-initial-revascularization-versus-medical-therapy-alone-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-undergoing-an-invasive-strategy
#19
Harindra C Wijeysundera, Mandeep S Sidhu, Maria C Bennell, Feng Qiu, Dennis T Ko, Merril L Knudtson, Jack V Tu, William E Boden
BACKGROUND: Although an invasive strategy is a class I clinical practice guideline for non-ST-segment-elevation acute coronary syndromes, there is wide variation in the proportion of patients who undergo revascularization despite early angiography. We sought to identify the predictors of early revascularization versus medical therapy alone in patients with non-ST-segment-elevation acute coronary syndrome undergoing an invasive strategy and to assess their clinical outcomes. METHODS AND RESULTS: We assessed revascularization status by percutaneous coronary intervention or coronary artery bypass grafting within 7 days of the index angiogram in all patients with non-ST-segment-elevation acute coronary syndrome who underwent an invasive strategy in Ontario, Canada, from October 1, 2008, to October 31, 2013, with follow-up through December 31, 2014...
July 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27417010/management-of-patients-with-nste-acs-a-comparison-of-the-recent-aha-acc-and-esc-guidelines
#20
REVIEW
Fatima Rodriguez, Kenneth W Mahaffey
Non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are the leading cause of morbidity and mortality from cardiovascular disease worldwide. The American Heart Association/American College of Cardiology and the European Society of Cardiology periodically release practice guidelines to guide clinicians in the management of NSTE-ACS, most recently in in 2014 and 2015, respectively. The present review compares and contrasts the 2 guidelines, with a focus on the strength of recommendation and level of evidence in the approach to initial presentation and diagnosis of NSTE-ACS, risk assessment, treatments, and systems of care...
July 19, 2016: Journal of the American College of Cardiology
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