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infarct myocardial

Ahmad A Abdul-Aziz, Rodney A Hayward, Keith D Aaronson, Scott L Hummel
Importance: US hospitals receive financial penalties for excess risk-standardized 30-day readmissions and mortality in Medicare patients. Under current policy, readmission prevention is incentivized over 10-fold more than mortality reduction. Objective: To determine how penalties for US hospitals would change if policy equally weighted 30-day readmissions and mortality. Design, Setting, and Participants: Publicly available hospital-level data for fiscal year 2014 was obtained, including excess readmission ratio (ERR; risk-standardized predicted over expected 30-day readmissions) and 30-day mortality rates for heart failure, pneumonia, and acute myocardial infarction, as well as readmission penalties (as percent of Medicare Diagnosis Group payments)...
October 26, 2016: JAMA Cardiology
Chiara Lazzeri, Serafina Valente, Marco Chiostri, Claudio Picariello, Gian Franco Gensini
No abstract text is available yet for this article.
October 25, 2016: Internal and Emergency Medicine
Katarina Novak, Davorka Vrdoljak, Igor Jelaska, Josip Anđelo Borovac
BACKGROUND: The goal of this observational cohort study was to examine gender-specific differences in the incidence of acute coronary syndrome (ACS), in-hospital complications and mortality. METHODS: A cohort of 1550 patients with the primary diagnosis of ACS were enrolled in the study over a period of 4 years. The in-hospital mortality and complications were analyzed as the main outcome measures. RESULTS: Women were significantly older compared to men (71 ± 11 years vs...
October 25, 2016: Wiener Klinische Wochenschrift
Koray Akkan, Erhan Ilgit, Baran Onal, Emetullah Cindil, Evsen Polattas Solak, Fatih Oncu, Dilan Ece Geylan
BACKGROUND: The treatment strategy and the correct incidence of near occlusion (NO) of the internal carotid artery (ICA) is still controversial. In routine radiological imaging NO can easily be misdiagnosed as complete occlusion and there is no consensus on the standard treatment strategy. PURPOSE: To present our perioperative and long-term follow-up results of ICA NO patients treated with carotid artery stenting (CAS). MATERIAL AND METHODS: Between 2004-2014 a total of 182 patients with ICA NO were evaluated for CAS...
October 25, 2016: Clinical Neuroradiology
Tomohiro Mizuno, Koso Egi, Kenji Sakai, Keiji Oi, Tsuyoshi Hachimaru, Tohru Makita, Kiyotoshi Oishi, Hirokuni Arai
Off-pump coronary artery bypass grafting (OPCAB) in patients with acute myocardial infarction (AMI) is difficult because of circulatory deterioration during displacement of the heart. At our institution, we performed minimally circulatory-assisted on-pump beating coronary artery bypass grafting (MICAB) in these patients. During MICAB, support flow was controlled at a minimal level to maintain a systemic blood pressure of approximately 100 mm Hg and a pulmonary arterial systolic pressure of <30 mm Hg, providing optimal pulsatile circulation for end-organ perfusion and prevention of heart congestion...
October 26, 2016: Artificial Organs
Wei-Chieh Lee, Shu-Kai Hsueh, Chih-Yuan Fang, Chiung-Jen Wu, Chi-Ling Hang, Hsiu-Yu Fang
BACKGROUND: This study aimed to evaluate short- and long-term outcomes of polytetrafluoroethylene covered stent for patients with coronary artery perforation. METHODS: During April 2004 and February 2016, a total 48 patients underwent implantation using polytetrafluoroethylene-covered JOSTENT GraftMaster stents (Abbott Vascular, Santa Clara, CA) in the native coronary arteries implantation for coronary artery perforation. Clinical outcomes such as target lesion revascularization (TLR), myocardial infarction (MI), definite or possible stent thrombosis, cardiovascular mortality, and all-cause mortality were analyzed...
October 25, 2016: Journal of Interventional Cardiology
Jincheng Guo, Wenming Chen, Guozhong Wang, Zijing Liu, Minghui Hao, Min Xu, Fuli Zhu
BACKGROUND: There are limited data on the impact of using a single dedicated radial guiding catheter in primary percutaneous coronary intervention (PCI) via radial access. OBJECTIVES: To investigate the effect of using a single guiding catheter (MAC 3.5) for left and right coronary angiography and intervention on catheterization laboratory door to balloon (C2B) time in patients with ST elevation myocardial infarction (STEMI). METHODS: Three hundred and sixty patients were randomized (1:1) to using a single MAC3...
October 25, 2016: Journal of Interventional Cardiology
Jun-Xian Song, Li Zhu, Chong-You Lee, Hui Ren, Cheng-Fu Cao, Hong Chen
OBJECTIVE: To investigate whether admission time was associated with the delay of reperfusion therapy and in-hospital death in patients with ST-elevation myocardial infarction (STEMI). METHODS: All patients with STEMI who were admitted to the emergency department and underwent primary percutaneous coronary intervention at Peking University People's Hospital between April 2012 and March 2015 were included. We examined differences in clinical characteristics, total ischemic time, and in-hospital death between patients admitted during off-hours and those admitted during regular hours...
August 2016: Journal of Geriatric Cardiology: JGC
Yi-Fan Li, Wei-Hong Li, Zhao-Ping Li, Xin-Heng Feng, Wei-Xian Xu, Shao-Min Chen, Wei Gao
BACKGROUND: The left atrial size has been considered as a useful marker of adverse cardiovascular outcomes. However, it is not well known whether left atrial area index (LAAI) has predictive value for prognosis in patients with unstable angina pectoris (UAP). This study was aimed to assess the association between LAAI and outcomes in UAP patients. METHODS: We enrolled a total of 391 in-hospital patients diagnosed as UAP. Clinical and echocardiographic data at baseline were collected...
August 2016: Journal of Geriatric Cardiology: JGC
Tareq Kass-Hout, Melanie Winningham, Omar Kass-Hout, Laura Henriquez, Frank Tong, Jacques Dion, Michael Cawley, Samir Belagaje, Michael Frankel, Aaron Anderson, Fadi Nahab
BACKGROUND AND PURPOSE: There are limited data on the optimal duration of dual antiplatelet therapy for secondary stroke prevention in patients with symptomatic intracranial atherosclerotic disease. METHODS: Consecutive patients presenting with high-grade (70-99%) symptomatic intracranial stenosis from January 1, 2011, to December 31, 2013, and evaluated within 30 days of the index event were eligible for this analysis. All patients underwent treatment with aspirin plus clopidogrel for a target duration of 12 months along with aggressive medical management based on the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) protocol; all patients were given gastrointestinal prophylaxis for the duration of their aspirin and clopidogrel treatment...
September 2016: Interventional Neurology
Supriya Shore, Kim G Smolderen, Kevin F Kennedy, Philip G Jones, Suzanne V Arnold, David J Cohen, Joshua M Stolker, Zhenxiang Zhao, Tracy Y Wang, P Michael Ho, John A Spertus
BACKGROUND: Rehospitalizations after acute myocardial infarction for unplanned coronary revascularization and unstable angina (UA) are common. However, despite the inclusion of these events in composite end points of many clinical trials, their association with health status has not been studied. METHODS AND RESULTS: We included 3283 patients with acute myocardial infarction enrolled in a prospective, 24-center US study who had rehospitalizations independently classified by experienced cardiologists...
October 25, 2016: Circulation. Cardiovascular Quality and Outcomes
Mario Santos, Dalane W Kitzman, Kunihiro Matsushita, Laura Loehr, Carla A Sueta, Amil M Shah
BACKGROUND: The relationship between dyspnea and incident heart failure (HF) and myocardial infarction (MI) among patients without previously diagnosed cardiopulmonary disease is unclear. We studied the prognostic relevance of self-reported dyspnea for cardiovascular outcomes and all-cause mortality in persons without previously diagnosed cardiopulmonary disease. METHODS AND RESULTS: We studied 10 881 community-dwelling participants (mean age 57±6, 56% women, 25% black) who were free of prevalent cardiopulmonary disease from Atherosclerosis Risk in Communities Study...
2016: PloS One
Cheng-Wei Liu, Pen-Chih Liao, Kuo-Chin Chen, Yu-Wei Chiu, Yuan-Hung Liu, Shin-Rong Ke, Yen-Wen Wu
BACKGROUND: There is conflicting information regarding the association between hyperuricemia and survival in STEMI patients. Our study examined the interaction between hyperuricemia and Killip class on mortality of STEMI patients. METHODS: We analyzed 951 consecutive STEMI patients between February 2006 and September 2012. Hyperuricemia was defined as SUA of at least 7mg/dL in males and 6mg/dL in females. Killip class I patients were divided into hyperuricemia and normouricemia groups...
October 11, 2016: International Journal of Cardiology
Yintang Wang, Yang Wang, Shijie You, Hongjian Wang, Dong Yin, Kefei Dou, Weihua Song
BACKGROUND: Despite its severity, coronary artery ectasia (CAE) is still poorly understood. High-sensitivity C-reactive protein (hs-CRP) has been recognized as a prognostic factor in some cardiovascular diseases but not assessed in CAE. The aim of this observational study was to investigate the prognostic value of hs-CRP in CAE. METHODS: Our analysis evaluated the effect of the baseline hs-CRP on cardiovascular events (CVs) (cardiac death and nonfetal myocardial infarction) in consecutively enrolled stable CAE patients...
2016: Chinese Medical Journal
Robert K Andrews, Elizabeth E Gardiner
Proteolytic shedding of the extracellular ectodomain of platelet receptors provides a key mechanism for irreversible loss of ligand-binding capacity, and for regulating platelet function in health and disease. Platelets derived from megakaryocytes are small anucleate cells in peripheral blood, with the ability to rapidly adhere, become activated, and secrete an array of procoagulant and proinflammatory factors at sites of vascular injury or disease, and to form a platelet aggregate (thrombus) which is not only critical in normal hemostasis and wound healing, but in atherothrombotic diseases including myocardial infarction and ischemic stroke...
October 25, 2016: Platelets
Aaron E Brice, Gabriel A Hernandez, Mariluz Sanchez, Marshall Haynick, Cesar E Mendoza
Dual antiplatelet therapy with aspirin and a P2Y12 receptor blocker has been proven to reduce subsequent cardiovascular events and in-stent thrombosis in patients undergoing percutaneous coronary intervention. Newer P2Y12 antagonists with faster onset and greater inhibition of platelet activity have improved cardiovascular outcomes but have created uncertainty with the appropriate dosing when switching between agents. Currently, there are no evidence-based guidelines to aid clinicians when switching between P2Y12 receptor blockers...
October 25, 2016: Platelets
Pei-Li Wang, Lei Zhang, Shao-Li Wang, Qiao-Ning Yang, Zhu-Ye Gao, Jian-Peng Du, Da-Wu Zhang, Chang-Geng Fu, Feng Gu, Hao Xu, Li-Zhi Li, Cheng-Long Wang, Da-Zhuo Shi
OBJECTIVE: To evaluate the prognosis effect of Chinese herbal medicines (CHMs) for benefifiting qi and activating blood circulation adjunctive to conventional treatment in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI). METHODS: A total of 702 patients with ACS who underwent PCI were enrolled and randomly assigned to receive conventional treatment plus CHMs for benefifiting qi and activating blood circulation (treatment group, 351 cases) or conventional treatment alone (control group, 351 cases) for 6 months...
October 24, 2016: Chinese Journal of Integrative Medicine
Mohammad Ali Ostovan, Mahdi Sajedi Khanian, Sahand Hamidi, Mostafa Fattahi, Pooyan Dehghani
Spontaneous coronary artery vasospasm is one of the important causes of acute chest pain syndromes. The diagnosis of diffuse multifocal spasm can be quite challenging and it could be easily mistaken for diffuse coronary artery disease. The use of intracoronary nitroglycerin can relieve spasm and reveal the real extent of coronary artery disease. Herein we present a case presenting with acute myocardial infarction due to severe coronary artery spasm that had even received fibrinolytic therapy. Multiple narrowing was shown during coronary angiography and the patient was scheduled for percutaneous coronary intervention (PCI)...
2016: Journal of Cardiovascular and Thoracic Research
Hassanali Lotfollahi, Mustafa Mohammadi, Samad Ghaffari, Reza Badalzadeh, Bahram Sohrabi, Naser Aslanabadi, Ahmad Separham, Ali Golmohammadi, Ali Abbasnejad, Mehri Roshani
Introduction: This study designed to use remote ischemic post conditioning (RIPC) as a protective strategy during percutaneous coronary intervention (PCI) in patients with ST segment elevation myocardial infarction (STEMI) to reduce myocardial cells damage due to reperfusion injury. Methods: Sixty-one patients were divided into test group (32 patients) receiving RIPC and control group (29 patients). Patients were included with first MI who had 20-80 years old. The RIPC protocol was applied on patients arm in three successive episodes during the opening of infarct-related artery (IRA)...
2016: Journal of Cardiovascular and Thoracic Research
Deepa Prasad, James P Strainic, Khyati Pandya, Peter C Kouretas, Ravi C Ashwath
We report a rare causal association between obstructed supracardiac totally anomalous pulmonary venous drainage and coronary sinus ostial atresia. Our 12-week-old patient developed venous myocardial infarction secondary to coronary venous hypertension because her sole route of coronary venous drainage was obstructed. She recovered after the obstruction was relieved by balloon dilation. Surgical repair then included anastomosis of the pulmonary venous confluence to the left atrium, ligation of the vertical vein, and unroofing of the coronary sinus...
October 2016: Texas Heart Institute Journal
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