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https://www.readbyqxmd.com/read/28098068/the-differential-diagnosis-of-dyspnea
#1
Dominik Berliner, Nils Schneider, Tobias Welte, Johann Bauersachs
BACKGROUND: Dyspnea is a common symptom affecting as many as 25% of patients seen in the ambulatory setting. It can arise from many different underlying conditions and is sometimes a manifestation of a life-threatening disease. METHODS: This review is based on pertinent articles retrieved by a selective search in PubMed, and on pertinent guidelines. RESULTS: The term dyspnea refers to a wide variety of subjective perceptions, some of which can be influenced by the patient's emotional state...
December 9, 2016: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28097904/estimated-burden-of-cardiovascular-disease-and-value-based-price-range-for-evolocumab-in-a-high-risk-secondary-prevention-population-in-the-us-payer-context
#2
Peter P Toth, Mark Danese, Guillermo Villa, Yi Qian, Anne Beaubrun, Armando Lira, Jeroen P Jansen
AIM: To estimate real-world cardiovascular disease (CVD) burden and value-based price range of evolocumab for a US-context, high-risk, secondary-prevention population. MATERIALS AND METHODS: Burden of CVD was assessed using the UK-based Clinical Practice Research Datalink (CPRD) in order to capture complete CV burden including CV mortality. Patients on standard of care (SOC; high-intensity statins) in CPRD were selected based on eligibility criteria of FOURIER, a phase 3 CV outcomes trial of evolocumab, and categorized into 4 cohorts: high-risk prevalent atherosclerotic CVD (ASCVD) cohort (N = 1448), acute coronary syndrome (ACS) (N = 602), ischemic stroke (IS) (N = 151), and heart failure (HF) (N = 291) incident cohorts...
January 18, 2017: Journal of Medical Economics
https://www.readbyqxmd.com/read/28097639/risk-of-bleeding-and-repeated-bleeding-events-in-prasugrel-treated-patients-a-review-of-data-from-the-japanese-prasfit-studies
#3
REVIEW
Masakatsu Nishikawa, Takaaki Isshiki, Takeshi Kimura, Hisao Ogawa, Hiroyoshi Yokoi, Shunichi Miyazaki, Yasuo Ikeda, Masato Nakamura, Yuko Tanaka, Shigeru Saito
Prasugrel is a third-generation thienopyridine that achieves potent platelet inhibition with less pharmacological variability than other thienopyridines. However, clinical experience suggests that prasugrel may be associated with a higher risk of de novo and recurrent bleeding events compared with clopidogrel in Japanese patients undergoing percutaneous coronary intervention (PCI). In this review, we evaluate the risk of bleeding in Japanese patients treated with prasugrel at the doses (loading/maintenance doses: 20/3...
January 17, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28096844/influence-of-an-extended-education-program-on-the-knowledge-of-cardiovascular-risk-factors-among-subjects-undergoing-rehabilitation-following-acute-coronary-syndrome
#4
Wojciech S Kapko, Łukasz J Krzych
INTRODUCTION: Health education is a component of complex cardiac rehabilitation (CCR). AIM: To evaluate the influence of an authorial extended educational program on the knowledge of cardiovascular risk factors among subjects undergoing early in-hospital rehabilitation following acute coronary syndrome treated with percutaneous intervention. MATERIAL AND METHODS: This prospective study covered 205 consecutive subjects (153 men and 52 women, aged 62 ±9 years) undergoing CCR...
December 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
https://www.readbyqxmd.com/read/28094128/lessons-from-contemporary-trials-of-cardiovascular-prevention-and-rehabilitation-a-systematic-review-and-meta-analysis
#5
Gijs van Halewijn, Jaap Deckers, Hung Yong Tay, Ron van Domburg, Kornelia Kotseva, David Wood
BACKGROUND: Meta-analyses of cardiac rehabilitation trials up to 2010 showed a significant reduction in all-cause mortality but many of these trials were conducted before the modern management of acute coronary syndromes. METHODS: We undertook a meta-analysis of contemporary randomised controlled trials published in the period 2010 to 2015, including patients with other forms of atherosclerotic cardiovascular disease, to investigate the impact of cardiovascular prevention and rehabilitation on hard outcomes including survival...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28093987/the-prognostic-value-of-heart-type-fatty-acid-binding-protein-in-patients-with-suspected-acute-coronary-syndrome-a-systematic-review
#6
Julia D Jones, Pei Gee Chew, Rebecca Dobson, Andrew Wootton, Reza Ashrafi, Aleem Khand
BACKGROUND: Heart type fatty acid protein(HFABP) is a cytosolic protein released early after acute coronary syndrome(ACS) even in the absence of myocardial necrosis. OBJECTIVES: The purpose of this systematic review was to determine whether HFABP levels in patients with suspected, or confirmed ACS, improves risk stratification when added to established means of risk assessment. METHODS: We searched Medline, Pubmed and Embase databases from inception to July 2015 to identify prospective studies with suspected or confirmed ACS, who had HFABP measured during the index admission with at least 1 month follow up data...
January 16, 2017: Current Cardiology Reviews
https://www.readbyqxmd.com/read/28093874/management-of-coronary-artery-disease-and-acute-coronary-syndrome-in-the-chronic-kidney-disease-population-a-review-of-the-current-literature
#7
REVIEW
Justin M Lingel, Mukta C Srivastava, Anuj Gupta
Coronary Artery Disease (CAD) is a large contributor to morbidity and mortality in the chronic kidney disease (CKD) and end-stage renal disease (ESRD) population. Due to the fact that many large-scale trials evaluating management for acute coronary syndromes (ACS) and CAD have excluded patients with CKD, there is a paucity of data investigating medical management of CAD and revascularization strategies of these patients. Further, while there have been many advances in the treatment for ACS and CAD, both medically and technologically, few studies have focused on the CKD population and many predate these advancements in management...
January 17, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/28093243/clinical-study-on-efficacy-of-allopurinol-in-patients-with-acute-coronary-syndrome-and-its-functional-mechanism
#8
Ying Huang, Chunya Zhang, Zhiqing Xu, Jinghua Shen, Xiaogang Zhang, Huanhua Du, Kanjian Zhang, Daifu Zhang
OBJECTIVE: To investigate the therapeutic effect of allopurinol treatment on acute coronary syndrome and to elucidate its possible mechanism. METHODS: Patients with acute coronary syndrome (n=100) were recruited as research subjects in our hospital. The patients were randomly divided into two groups (allopurinol group, n = 50) and control group, n= 50). These two groups were treated with conventional antiplatelet, anticoagulation and anti-ischemic therapy, while allopurinol was added to allopurinol group based on conventional treatment...
January 13, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28092990/in-hospital-statin-underutilization-among-high-risk-patients-delayed-uptake-of-the-2013-cholesterol-guidelines-in-a-u-s-cohort
#9
Subeer K Wadia, Mark Belkin, Kelsey Chow, Jonathan Nattiv, Andrew Appis, Steven B Feinstein, Kim Allan Williams
OBJECTIVES: Clinician utilization of the 2013 cholesterol lowering guidelines remains variable and unknown. We sought to examine statin prescribing patterns and compare rates among specialists who treat high-risk cardiovascular patients admitted to the hospital. METHODS: We retrospectively (via chart review) examined four specialty groups: (i) Cardiology, (ii) Cardiovascular or Vascular (CV) Surgery, (iii) Neurology, and (iv) Internal Medicine. Adult patients were included based on a discharge diagnosis of acute coronary syndrome, coronary artery bypass graft surgery, carotid endarterectomy, acute ischemic stroke, transient ischemic attack, or high-risk chest pain...
January 17, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/28091972/-secondary-prevention-with-antiplatelet-therapy-in-cardiac-rehabilitation
#10
Maria M Wanitschek, Hannes F Alber
The long-term increased cardiovascular risk of patients with an acute coronary syndrome (ACS) is a challenging and common clinical problem. Recent evidence demonstrated an ischemic benefit for a prolonged dual antiplatelet therapy beyond the initial 12 months at the cost of an increased bleeding risk. Individual, careful and repeated risk-benefit analyses are essential for an optimized patient management in which cardiovascular rehabilitation providers may play a central role.
January 13, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28090403/a-review-of-the-relationship-of-atrial-fibrillation-and-acute-coronary-syndrome
#11
Bory Kea, Tahroma Alligood, Vincent Manning, Merritt Raitt
Atrial fibrillation (AF) is the most common arrhythmia encountered by clinicians. Clinical decision-making focuses on reducing ischemic stroke risk in AF patients; however, AF is also associated with an increased risk of acute coronary syndromes (ACS). Patients with ACS and concurrent AF are less likely to receive appropriate therapies and more likely to experience adverse outcomes than ACS patients in sinus rhythm (SR). Clinicians may be able to stratify ACS patients at increased risk of AF development based on clinical characteristics...
September 2016: Current Emergency and Hospital Medicine Reports
https://www.readbyqxmd.com/read/28090071/impact-of-morning-onset-on-the-incidence-of-recurrent-acute-coronary-syndrome-and-progression-of-coronary-atherosclerosis-in-acute-myocardial-infarction
#12
Hiroshi Nakashima, Yuka Mashimo, Masaya Kurobe, Shigenori Muto, Shinnosuke Furudono, Koji Maemura
BACKGROUND: The relationship between time of onset of acute myocardial infarction (MI) and long-term clinical outcome has not been completely understood. We hypothesized that morning onset acute MI may be associated with adverse cardiac events.Methods and Results:This study involved 663 patients who underwent primary percutaneous coronary intervention (PCI). The main outcome measures were cardiac death, recurrent acute coronary syndrome (ACS), and re-hospitalization for heart failure...
January 13, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28090045/a-pitfall-in-the-diagnosis-of-eosinophilic-myocarditis-in-a-patient-who-received-steroid-therapy
#13
Yusuke Watanabe, Hiroshi Wada, Kenichi Sakakura, Hideo Fujita, Shin-Ichi Momomura
Eosinophilic myocarditis is a rare form of myocardial inflammation that is characterized by the infiltration of eosinophilic cells into the myocardium. The clinical symptoms of eosinophilic myocarditis are similar to those of acute coronary syndrome, and eosinophilic myocarditis sometimes occurs in combination with bronchial asthma. We herein present a case of eosinophilic myocarditis in which additional time was required to make a definitive diagnosis because the patient received steroid therapy. The diagnosis of eosinophilic myocarditis is challenging, especially when a patient has other inflammatory diseases, such as bronchial asthma...
2017: Internal Medicine
https://www.readbyqxmd.com/read/28090005/unstable-angina-pectoris-in-a-22-year-old-female-patient
#14
Hanae Yoshimura, Toyoharu Oba, Takanobu Nagata, Eita Kumagai, Naoki Itaya, Naohiro Yoshikawa, Daiki Akagaki, Hideki Ohshima, Michihide Nishihara, Takafumi Ueno, Yoshihiro Fukumoto
Because of the protective effect of estrogen for atherosclerosis, the prevalence of acute coronary syndrome in women before menopause is low. We report a rare case of unstable angina in a young Japanese female who had a history of cigarette smoking and contraceptive use. Her coronary stenosis was successfully treated by percutaneous coronary intervention.
January 16, 2017: Kurume Medical Journal
https://www.readbyqxmd.com/read/28089789/differing-clinical-characteristics-between-young-and-older-patients-presenting-with-myocardial-infarction
#15
Kyriakos Matsis, Ana Holley, Ali Al-Sinan, Phillip Matsis, Peter D Larsen, Scott A Harding
BACKGROUND: To date, there has been no detailed study of the risk factors and clinical characteristics of patients presenting with myocardial infarction (MI) at a young age in our region. The purpose of this study was to assess the rate and clinical profile of those presenting with young MI in New Zealand. METHODS: We identified a cohort of 1199 patients presenting with acute MI between January 2012 and November 2015 from the Wellington Acute Coronary Syndrome Registry...
November 11, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#16
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28089453/serum-uromodulin-is-a-predictive-biomarker-for-cardiovascular-events-and-overall-mortality-in-coronary-patients
#17
Andreas Leiherer, Axel Muendlein, Christoph H Saely, Janine Ebner, Eva M Brandtner, Peter Fraunberger, Heinz Drexel
BACKGROUND: Uromodulin is a protein produced exclusively by the kidneys and present in urine and blood. In contrast to weak and in part contradictory study data on uromodulin in urine samples, the analysis of serum samples recently proved uromodulin's value as superior biomarker for ongoing kidney disease. Whether serum uromodulin is associated with cardiovascular event risk and whether it has predictive power for overall mortality is still unknown and has been evaluated in the present study...
December 29, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28089153/temporal-trends-in-management-and-outcomes-of-patients-with-acute-coronary-syndrome-according-to-renal-function
#18
Mony Shuvy, Shmuel Chen, Dina Vorobeichik, Eilon Krashin, Nir Shlomo, Ilan Goldenberg, David Pereg
INTRODUCTION: Recent new therapeutic options have improved outcomes of acute coronary syndrome (ACS) patients. However, data regarding the incremental effect of the improved treatment on patients with renal dysfunction are limited. We sought to evaluate temporal trends in management and outcome of ACS patients according to renal function. METHODS: The study population consisted of all ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) during 2002-2013...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28089149/fasting-glucose-nt-probnp-treatment-with-eptifibatide-and-outcomes-in-non-st-segment-elevation-acute-coronary-syndromes-an-analysis-from-early-acs
#19
Serdar Farhan, Robert M Clare, Rudolf Jarai, Robert P Giugliano, Yuliya Lokhnygina, Robert A Harrington, L Kristin Newby, Kurt Huber
BACKGROUND: Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS). METHODS: Fasting glucose and NT-proBNP were measured in 2240 patients enrolled in the EARLY ACS trial. Multivariable Cox models were used to assess associations between fasting glucose and NT-proBNP and a 96-hour composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-day death or MI; and 1-year mortality...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28089137/a-comparison-of-cangrelor-prasugrel-ticagrelor-and-clopidogrel-in-patients-undergoing-percutaneous-coronary-intervention-a-network-meta-analysis
#20
Peter C Westman, Michael J Lipinski, Rebecca Torguson, Ron Waksman
BACKGROUND: Newer P2Y12 inhibitors have more rapid onset of platelet inhibition compared with clopidogrel, especially the intravenous P2Y12 inhibitor cangrelor. Direct comparisons between cangrelor and oral P2Y12 inhibitors ticagrelor and prasugrel do not exist. Thus, we performed a network meta-analysis to directly and indirectly compare different P2Y12 inhibitors in patients undergoing percutaneous coronary intervention (PCI). METHODS: MEDLINE/PubMed and ClinicalTrials...
October 21, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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