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https://www.readbyqxmd.com/read/28623740/detection-of-atherosclerotic-cardiovascular-disease-influences-the-perceived-need-for-aggressive-lipid-management
#1
G B John Mancini, Milan Gupta, Michelle Tsigoulis, Christopher P Cannon, Jacques Genest, Kausik K Ray, Raul D Santos, Gerald F Watts, Paolo Raggi
BACKGROUND AND AIMS: Overt atherosclerotic cardiovascular disease (ASCVD) warrants aggressive lipid lowering. Imaging for ambiguous symptoms suggesting ischemia or for clarification of CV risk in asymptomatic individuals often uncovers previously unknown ASCVD. Guidelines do not provide clear recommendations for aggressive lipid lowering in such cases. We explored physicians' perception, as influenced by tests that detect ASCVD, regarding appropriateness of getting to lipid goals and for theoretically accessing proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i)...
June 3, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28617044/translation-and-validation-of-the-norwegian-version-of-the-coronary-revascularisation-outcome-questionnaire
#2
Siw A Lillevik, Sara Schroter, Tove A Hanssen
BACKGROUND: Health-related quality of life (HRQOL) questionnaires are increasingly used as outcome measures in research and clinical practice to assess treatment effectiveness in coronary heart disease (CHD) alongside traditional outcome measures. The Coronary Revascularisation Outcome Questionnaire (CROQ) is a patient-reported outcome measure (PROM) to evaluate health outcomes and HRQOL before and after coronary artery bypass grafting surgery (CABG) and percutaneous coronary intervention (PCI)...
June 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28596449/noninvasive-ventilatory-correction-in-patients-with-acute-ischemic-stroke-a-systematic-review-and-meta-analysis
#3
Georgios Tsivgoulis, Andrei V Alexandrov, Aristeidis H Katsanos, Kristian Barlinn, Robert Mikulik, Vaia Lambadiari, Anastasios Bonakis, Anne W Alexandrov
BACKGROUND AND PURPOSE: Even though current guidelines suggest that noninvasive ventilatory correction (NIVC) could be considered for acute ischemic stroke patients with obstructive sleep apnea, available evidence is conflicting, with no adequately powered randomized clinical trial being available to date. METHODS: We conducted a systematic review and meta-analysis of all available literature data evaluating the effect of NIVC on neurological improvement (based on decrease in National Institutes of Health Stroke Scale score), vascular events (recurrent stroke, transient ischemic attack, myocardial infarction and unstable angina), and mortality during the follow-up period...
June 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28596132/crusade-score-is-superior-to-platelet-function-testing-for-prediction-of-bleeding-in-patients-following-coronary-interventions
#4
Junghee Bang, Sun Young Choi, Moo Hyun Kim, Victor Serebruany
Hypothetically, diminished platelet reactivity (PR) during dual antiplatelet therapy (DAPT) should cause extra major bleeding events (MBE), although definite evidence is lacking. Multiple scores have been proposed to stratify bleeding risk, but their predictive value during DAPT is unclear. We compared the performance of the Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guidelines (CRUSADE) with PR testing to predict MBE in Korean patients with acute coronary syndrome...
June 1, 2017: EBioMedicine
https://www.readbyqxmd.com/read/28539572/malondialdehyde-modified-low-density-lipoprotein-as-oxidative-stress-marker-in-vasospastic-angina-patients
#5
Tetsuo Oumi, Toshihiro Nozato, Atsushi Sakakibara, Hidetsugu Nomoto, Masakazu Ohno, Yoshihide Takahashi, Takashi Ashikaga, Yasuhiro Satoh, Mitsuaki Isobe
Vasospastic angina (VSA) is caused by endothelial dysfunction and hypercontraction of vascular smooth muscle cells. Although oxidative-stress can induce endothelial dysfunction, the relationship of VSA and the oxidative-stress marker malondialdehyde-modified low density lipoprotein (MDA-LDL) remains unclear. PURPOSE: Serum MDA-LDL was evaluated in candidate VSA patients.The subjects were 84 patients admitted to our hospital because of chest pain at rest. We stratified the patients into 3 groups; definite VSA, suspected VSA, and unlikely VSA according to a Japanese Circulation Society (JCS) guideline...
May 23, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28500753/a-0h-1h-protocol-for-safe-early-discharge-of-chest-pain-patients
#6
Arash Mokhtari, Bertil Lindahl, Alexandru Schiopu, Troels Yndigegn, Ardavan Khoshnood, Patrik Gilje, Ulf Ekelund
OBJECTIVES: Guidelines recommend a 0h/1h high-sensitivity cardiac troponin T (hs-cTnT) diagnostic strategy in acute chest pain patients. There is however little data on the performance of this strategy when combined with clinical risk stratification. We aimed to evaluate the diagnostic accuracy of an accelerated diagnostic protocol (ADP) using the 0h/1h hs-cTnT strategy together with an adapted Thrombolysis In Myocardial Infarction (TIMI) score and ECG for ruling out major adverse cardiac events (MACE) within 30 days...
May 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28476519/the-underutilisation-of-dual-antiplatelet-therapy-in-acute-coronary-syndrome
#7
Malcolm Anastasius, Jerrett K Lau, Karice Hyun, Mario D'Souza, Anushka Patel, Jamie Rankin, Darren Walters, Craig Juergens, Bernadette Aliprandi-Costa, Andrew T Yan, Shaun G Goodman, Derek Chew, David Brieger
BACKGROUND: Despite guideline recommendation of dual antiplatelet therapy (DAPT) in treating ACS, DAPT is underutilized. Our objective was to determine independent predictors of DAPT non-prescription in ACS and describe pattern of DAPT prescription over time. METHODS: Patients presenting to 41 Australian hospitals with an ACS diagnosis between 2009 and 2016 were stratified according to discharge prescription with DAPT and single antiplatelet therapy (SAPT) or no antiplatelet therapy...
April 25, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28473096/acr-appropriateness-criteria-%C3%A2-chronic-chest-pain-high-probability-of-coronary-artery-disease
#8
Scott R Akers, Vandan Panchal, Vincent B Ho, Garth M Beache, Richard K J Brown, Brian B Ghoshhajra, S Bruce Greenberg, Joe Y Hsu, Gregory A Kicska, James K Min, Arthur E Stillman, Jadranka Stojanovska, Suhny Abbara, Jill E Jacobs
In patients with chronic chest pain in the setting of high probability of coronary artery disease (CAD), imaging has major and diverse roles. First, imaging is valuable in determining and documenting the presence, extent, and severity of myocardial ischemia, hibernation, scarring, and/or the presence, site, and severity of obstructive coronary lesions. Second, imaging findings are important in determining the course of management of patients with suspected chronic myocardial ischemia and better defining those patients best suited for medical therapy, angioplasty/stenting, or surgery...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28454832/rationale-and-design-of-the-coronary-computed-tomographic-angiography-for-selective-cardiac-catheterization-relation-to-cardiovascular-outcomes-cost-effectiveness-and-quality-of-life-conserve-trial
#9
Sang-Eun Lee, Fay Y Lin, Yao Lu, Hyuk-Jae Chang, James K Min
Although coronary computed tomography angiography (CCTA) has shown promise as a "gatekeeper" to invasive coronary angiography (ICA) in longitudinal cohort studies, it remains unknown whether the strategy of selective ICA by initial performance of CCTA is either safe or effective when compared with a direct ICA strategy in patients with an American Heart Association (AHA)/American College of Cardiology (ACC) guideline-directed indication for ICA. OBJECTIVES: The CONSERVE trial is a prospective randomized multicenter trial to determine the clinical effectiveness of "selective catheterization" vs "direct catheterization" strategies for stable patients with suspected but without known coronary artery disease, who meet AHA/ACC guideline indication for ICA...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28450654/left-circumflexus-coronary-artery-total-occlusion-with-clinical-presentation-as-nstemi-and-acute-pulmonary-oedema
#10
Budi Yuli Setianto, Nahar Taufiq, Heri Hernawan
Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the electrocardiogram to divide patients into ST-elevation acute myocardial infarction (STEMI) or non-ST-elevation acute myocardial infarction (NSTEMI)/unstable angina (UA). Patients with STEMI in the earliest time will receive reperfusion therapy to destruct occlusive thrombus. An ST segment elevation is the 'sine qua non' for diagnosing acute total coronary occlusion causing transmural myocardial infarction. Left circumflex coronary artery (LCx) occlusion is often categorized as NSTEMI because of the absence of significant ST-elevation on the 12 lead standard electrocardiogram...
January 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28446943/the-updated-nice-guidelines-cardiac-ct-as-the-first-line-test-for-coronary-artery-disease
#11
REVIEW
Alastair J Moss, Michelle C Williams, David E Newby, Edward D Nicol
PURPOSE OF REVIEW: Cost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography...
2017: Current Cardiovascular Imaging Reports
https://www.readbyqxmd.com/read/28446550/national-institute-for-health-and-care-excellence-updates-the-stable-chest-pain-guideline-with-radical-changes-to-the-diagnostic-paradigm
#12
REVIEW
Adam Timmis, Carl A Roobottom
In the 2016 update of the stable chest pain guideline, the National Institute for Health and Care Excellence (NICE) has made radical changes to the diagnostic paradigm that it-like other international guidelines-had previously placed at the centre of its recommendations. No longer are quantitative assessments of the disease probability considered necessary to determine the need for diagnostic testing and the choice of test. Instead, the recommendation is for no diagnostic testing if chest pain is judged to be 'non-anginal' and CT coronary angiography (CTCA) in patients with 'typical' or 'atypical' chest pain with additional perfusion imaging only if there is uncertainty about the functional significance of coronary lesions...
July 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28420281/long-term-follow-up-of-antithrombotic-management-patterns-in-patients-with-acute-coronary-syndrome-in-russia-an-observational-study-epicor-rus-study
#13
Mikhail Ya Ruda, Oleg V Averkov, Yunona V Khomitskaya
OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28375096/evaluation-on-curative-effect-and-safety-of-interventional-treatment-for-patients-with-acute-myocardial-infarction
#14
Yinchuan Zhu, Jianmin Tang, Feifei Pei
To evaluate the effectiveness and recent safety of emergency and selective percutaneous coronary intervention (PCI) in elderly patients (>80 years old) with acute myocardial infarction (AMI). 120 elderly patients with coronary heart disease (CHD) were divided into AMI group (with 55 cases) and non-myocardial infarction group (control group with 65 cases). Among the AMI group, there were 18 cases underwent emergency PCI within 12 hours after the onset, (AMI emergency PCI group), the rest 37 cases were AMI selective PCI group...
November 2016: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28361599/antianginal-therapy-for-stable-ischemic-heart-disease
#15
Santosh K Padala, Michael P Lavelle, Mandeep S Sidhu, Katherine P Cabral, Doralisa Morrone, William E Boden, Peter P Toth
Chronic angina pectoris is associated with considerable morbidity and mortality, especially if treated suboptimally. For many patients, aggressive pharmacologic intervention is necessary in order to alleviate anginal symptoms. The optimal treatment of stable ischemic heart disease (SIHD) should be the prevention of angina and ischemia, with the goal of maximizing both quality and quantity of life. In addition to effective risk factor modification with lifestyle changes, intensive pharmacologic secondary prevention is the therapeutic cornerstone in managing patients with SIHD...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28331015/association-between-clinically-recorded-alcohol-consumption-and-initial-presentation-of-12-cardiovascular-diseases-population-based-cohort-study-using-linked-health-records
#16
Steven Bell, Marina Daskalopoulou, Eleni Rapsomaniki, Julie George, Annie Britton, Martin Bobak, Juan P Casas, Caroline E Dale, Spiros Denaxas, Anoop D Shah, Harry Hemingway
Objectives To investigate the association between alcohol consumption and cardiovascular disease at higher resolution by examining the initial lifetime presentation of 12 cardiac, cerebrovascular, abdominal, or peripheral vascular diseases among five categories of consumption.Design Population based cohort study of linked electronic health records covering primary care, hospital admissions, and mortality in 1997-2010 (median follow-up six years).Setting CALIBER (ClinicAl research using LInked Bespoke studies and Electronic health Records)...
March 22, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28319269/withdrawn-trimetazidine-for-stable-angina
#17
REVIEW
Agustín Ciapponi, Rudolf Pizarro, Jeff Harrison
BACKGROUND: Patients with stable angina not controlled by monotherapy with nitrates, beta blockers, or calcium channel blockers are often treated with combinations of these drugs. There may be adverse effects from, or contraindications to, the use of combinations. In low risk groups, medical treatment appears to be as good an option as percutaneous transluminal coronary angioplasty in terms of averting myocardial infarction, death, or subsequent revascularization. Revascularization procedures are too costly or inaccessible for many patients in developing countries therefore effective and safe medical treatment is needed...
March 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28294020/acute-coronary-syndrome-assessment-and-management
#18
Cormac Norton
Acute coronary syndrome is a serious condition that requires urgent assessment and management. This article outlines the nature of the condition, and discusses its underlying pathophysiology. It discusses three types of acute coronary syndrome: unstable angina, ST elevation myocardial infarction and non-ST elevation myocardial infarction. Research and guidelines are used to guide the reader through approaches to initial nursing assessment and the immediate management of patients with suspected acute coronary syndrome...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28274580/effect-of-part-time-cardiac-catheterization-facilities-in-patients-with-acute-myocardial-infarction
#19
Luciano Consuegra-Sánchez, Leticia Jaulent-Huertas, Marta Vicente-Gilabert, Ángela Díaz-Pastor, Germán Escudero-García, Nuria Alonso-Fernández, Francisco Javier Gil-Sánchez, Juan Martínez-Hernández, Juan Sanchis-Forés, José Galcerá-Tomás, Antonio Melgarejo-Moreno
BACKGROUND: Although the easy availability of invasive cardiac care facilities is associated with an increase in their use, their influence on outcomes is not clear. We sought to investigate whether a newly available cardiac catheterization laboratory (CCL) performing percutaneous coronary intervention (PCI) on a part-time (PT) basis might improve outcomes in patients with acute myocardial infarction (AMI). METHODS: This was an observational cohort study that included all consecutive patients with AMI admitted to a secondary-level hospital in Spain before and after the PT-CCL opened in January 2006: during 1998-2005 and 2006-2014, respectively...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28265967/acc-aats-aha-ase-asnc-scai-scct-sts-2016-appropriate-use-criteria-for-coronary-revascularization-in-patients-with-acute-coronary-syndromes-a-report-of-the-american-college-of-cardiology-appropriate-use-criteria-task-force-american-association-for-thoracic-surgery
#20
Manesh R Patel, John H Calhoon, Gregory J Dehmer, James Aaron Grantham, Thomas M Maddox, David J Maron, Peter K Smith
The American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, and American Association for Thoracic Surgery, along with key specialty and subspecialty societies, have completed a 2-part revision of the appropriate use criteria (AUC) for coronary revascularization. In prior coronary revascularization AUC documents, indications for revascularization in acute coronary syndromes (ACS) and stable ischemic heart disease were combined into 1 document. To address the expanding clinical indications for coronary revascularization, and in an effort to align the subject matter with the most current American College of Cardiology/American Heart Association guidelines, the new AUC for coronary artery revascularization were separated into 2 documents addressing ACS and stable ischemic heart disease individually...
April 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
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