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https://www.readbyqxmd.com/read/29664030/do-practice-gaps-exist-in-evidence-based-medication-prescription-at-hospital-discharge-in-patients-undergoing-coronary-artery-bypass-surgery-coronary-angioplasty
#1
Pradeep Pereira, Aditya Kapoor, Archana Sinha, Surendra K Agarwal, Shantanu Pande, Roopali Khanna, Nilesh Srivastava, Sudeep Kumar, Naveen Garg, Satyendra Tewari, Pravin Goel
Background & objectives: Prescription patterns of guideline-directed medical therapy (GDMT) after coronary artery bypass surgery [coronary artery bypass graft (CABG)] and percutaneous coronary intervention (PCI) at hospital discharge are often not optimal. In view of scarce data from the developing world, a retrospective analysis of medication advice to patients following CABG and PCI was conducted. Methods: Records of 5948 patients (post-PCI: 5152, post-CABG: 796) who underwent revascularization from 2010 to 2014 at a single tertiary care centre in north India were analyzed...
December 2017: Indian Journal of Medical Research
https://www.readbyqxmd.com/read/29663506/new-classification-of-geometric-ventricular-patterns-in-severe-aortic-stenosis-could-it-be-clinically-useful
#2
Concetta Di Nora, Eugenio Cervesato, Iulian Cosei, Andreea Ravasel, Bogdan A Popescu, Concetta Zito, Scipione Carerj, Francesco Antonini-Canterin, Andreea C Popescu
BACKGROUND: In severe aortic stenosis, different left ventricle (LV) remodeling patterns as a response to pressure overload have distinct hemodynamic profiles, cardiac function, and outcomes. The most common classification considers LV relative wall thickness and LV mass index to create 4 different groups. A new classification including also end-diastolic volume index has been recently proposed. AIM: To describe the prevalence of the newly identified remodeling patterns in patients with severe aortic stenosis and to evaluate their clinical relevance according to symptoms...
April 16, 2018: Echocardiography
https://www.readbyqxmd.com/read/29652166/ambulance-use-distance-and-outcomes-in-patients-with-suspected-cardiovascular-disease-a-registry-based-geographic-information-system-study
#3
Nariman Sepehrvand, Wendimagegn Alemayehu, Padma Kaul, Rick Pelletier, Aminu K Bello, Robert C Welsh, Paul W Armstrong, Justin A Ezekowitz
BACKGROUND: Despite guideline recommendations, the majority of patients with symptoms suggestive of acute coronary syndrome do not use emergency medical services to reach the emergency department (ED). The aim of this study was to investigate the factors associated with EMS utilisation and subsequent patient outcomes. METHODS: Using administrative data, all patients who presented to an ED in the metropolitan areas of Edmonton and Calgary in the years of 2007-2013 with main ED diagnosis of acute coronary syndrome, stable angina or chest pain were included...
April 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29627899/influence-of-visual-functional-mismatch-on-coronary-flow-profiles-after-percutaneous-coronary-intervention-a-propensity-score-matched-analysis
#4
Masahiro Hoshino, Taishi Yonetsu, Tadashi Murai, Yoshihisa Kanaji, Eisuke Usui, Masahiro Hada, Rikuta Hamaya, Yoshinori Kanno, Tetsumin Lee, Tsunekazu Kakuta
The aims of this study are to clarify whether discrepancies between angiographic and fractional flow reserve (FFR) measurements (visual-functional mismatch) influence coronary flow profiles after percutaneous coronary intervention. While current guidelines FFR-guided revascularization, clinical practice most commonly relies on angiographic evaluation, which may under- or over-estimate the functional relevance of the lesion. Our retrospective analysis involved 274 vessels from 264 patients with stable angina pectoris who underwent FFR, index of microvascular resistance, and coronary flow reserve (CFR) measurements before and after PCI...
April 7, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29592946/new-nice-guidelines-for-the-management-of-stable-angina
#5
Luke Dancy, Kevin O'Gallagher, Peter Milton, Dan Sado
No abstract text is available yet for this article.
April 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29579580/cost-effectiveness-of-a-management-strategy-based-on-exercise-echocardiography-versus-exercise-electrocardiography-in-patients-presenting-with-suspected-angina-during-long-term-follow-up-a-randomized-study
#6
Sothinathan Gurunathan, Kostas Zacharias, Mohammed Akhtar, Asrar Ahmed, Vishal Mehta, Nikos Karogiannis, Anastasia Vamvakidou, Raj Khattar, Roxy Senior
INTRODUCTION: Exercise ECG (Ex-ECG) is advocated by guidelines for patients with low - intermediate probability of coronary artery disease (CAD). However, there are no randomized studies comparing Ex-ECG with exercise stress echocardiography (ESE) evaluating long term cost-effectiveness of each management strategy. METHODS: Accordingly, 385 patients with no prior CAD and low-intermediate probability of CAD (mean pre-test probability 34%), were randomized to undergo either Ex-ECG (194 patients) or ESE (191 patients)...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29561418/chinese-herbal-injections-for-unstable-angina-pectoris-a-protocol-for-systematic-review-and-network-meta-analyses
#7
Fengwen Yang, Jiahan Zou, Xuemei Li, Long Ge, Jinhui Tian, Myeong Soo Lee, Junhua Zhang
BACKGROUND: Chinese herbal injections (CHIs) have been commonly used in the treatment of unstable angina pectoris (UAP) in China. However, there is no consensus or evidence on how to select CHIs for patients with UAP. The choice often depends on the personal experience or preference of clinician. This study aims to compare the effect of different CHIs for UAP using Bayesian network meta-analysis (NMA). METHODS: A systematic search will be conducted in PubMed, the Cochrane Central Register of Controlled Trials, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data from inception to February 2018...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29544699/6-month-versus-12-month-or-longer-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndrome-smart-date-a-randomised-open-label-non-inferiority-trial
#8
Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-Il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients with acute coronary syndrome. However, available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. We aimed to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population...
March 31, 2018: Lancet
https://www.readbyqxmd.com/read/29543035/guideline-adherence-regarding-critical-time-intervals-in-the-german-chest-pain-unit-registry
#9
Mehrshad Vafaie, Matthias Hochadel, Thomas Münzel, Birgit Hailer, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Michael Haude, Sebastian Barth, Claus Schmitt, Harald Darius, Lars S Maier, Hugo A Katus, Jochen Senges, Evangelos Giannitsis
BACKGROUND: Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units. METHODS: From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/29526417/comparison-of-crusade-and-acuity-horizons-bleeding-risk-scores-in-patients-with-acute-coronary-syndromes
#10
Diego Castini, Marco Centola, Giulia Ferrante, Sara Cazzaniga, Simone Persampieri, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: Compare the discriminative performance of two validated bleeding risk models for in-hospital bleeding events in a non-selected cohort of acute coronary syndrome (ACS) patients. METHODS: CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) and ACUITY-HORIZONS (Acute Catheterization and Urgent Intervention Triage strategY-Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) scores were calculated in 501 consecutive patients (median age 68 years (IQR 57-77), 31% female) admitted for ACS to the coronary care unit (CCU) of San Paolo Hospital in Milan (Italy)...
March 2, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29520510/variant-angina-and-aborted-sudden-cardiac-death
#11
REVIEW
Amartya Kundu, Aditya Vaze, Partha Sardar, Ahmed Nagy, Wilbert S Aronow, Naomi F Botkin
PURPOSE OF REVIEW: Variant angina, which is characterized by recurrent chest pain and transient ECG changes along with angiographic evidence of coronary artery spasm, generally has a favorable prognosis. However, episodes of ischemia caused by vasospasm may lead to potentially life-threatening ventricular arrhythmias and cardiac arrest, even in patients with no history of prior cardiac disease. This review describes the epidemiology, pathogenesis, clinical spectrum, and management of variant angina, as well as outcomes in patients who present with aborted sudden cardiac death (ASCD)...
March 8, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29516497/platelet-transfusion-is-not-associated-with-increased-mortality-or-morbidity-in-patients-undergoing-cardiac-surgery
#12
Slavisa Ninkovic, Zoe McQuilten, Robert Gotmaker, Andrew E Newcomb, Merrole F Cole-Sinclair
BACKGROUND: Transfusion of platelets is common in cardiac surgery, and while there are guidelines for their use, there are concerns about potential risks. We aimed to assess the impact of platelet transfusion on mortality, thrombosis, and infection in this patient group. STUDY DESIGN AND METHODS: A retrospective cohort study of all patients at St Vincent's Hospital Melbourne who underwent a first cardiac surgery procedure from June 2001 to June 2014 was conducted...
March 7, 2018: Transfusion
https://www.readbyqxmd.com/read/29514584/unstable-angina-in-the-era-of-high-sensitivity-troponin-testing-a-genuine-entity-and-a-cautionary-tale
#13
Thomas Krysztofiak, John Byrne
High-sensitivity cardiac troponin assays have emerged as a powerful tool in the management of patients presenting acutely to hospital with suspected cardiac chest pain. Recent guidelines emphasize the reassurance offered by low troponin concentrations early after admission. We describe a patient with known coronary artery disease, who presented with a classical history of recurrent myocardial ischaemia. High-sensitivity cardiac Troponin-I concentrations remained in the low-normal sex-specific reference range, despite serial testing on the day of admission, and despite recurrent pain with dynamic ECG changes...
January 1, 2018: Scottish Medical Journal
https://www.readbyqxmd.com/read/29508153/efficacy-of-ivabradine-in-combination-with-beta-blockers-versus-uptitration-of-beta-blockers-in-patients-with-stable-angina-control-2-study
#14
Maria Glezer, Yuri Vasyuk, Yuri Karpov
INTRODUCTION: Heart rate (HR) reduction is an integral part of antianginal therapy, but many patients do not reach the guideline-recommended target of less than 60 bpm despite high use of beta-blockers (BB). Failure to uptitrate BB doses may be partly to blame. To explore other options for lowering HR and improving angina control, CONTROL-2 was initiated to compare the efficacy and tolerability of the combination of BBs with ivabradine versus uptitration of BBs to maximal tolerated dose, in patients with stable angina...
March 5, 2018: Advances in Therapy
https://www.readbyqxmd.com/read/29502999/outcomes-and-management-costs-of-peripheral-artery-disease-in-france
#15
Alessandra Bura Riviere, Stéphane Bouée, Caroline Laurendeau, Elodie Torreton, Julie Gourmelen, Florence Thomas-Delecourt
BACKGROUND: Little is known about the characteristics and prognosis of patients with peripheral arterial disease (PAD) and related real-life health costs in France. METHODS: A cohort of patients diagnosed with PAD between 2007 and 2011 was extracted from the French Echantillon Généraliste des Bénéficiaires (EGB) claims database. The patients were followed up from the date of PAD diagnosis. Their characteristics, incidence of death and other events, treatments, and costs were analyzed by comparison with age- and gender-matched PAD-free controls...
March 1, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29479390/acute-stent-loss-and-its-retrieval-of-a-long-tapering-morph-stent-in-a-tortuous-calcified-lesion
#16
Santosh Kumar Sinha, Anupam Mahrotra, Nishant Kumar Abhishekh, Mahmodula Razi, Puneet Aggarwal, Sunil Tripathi, Lokendra Rekwaal, Anupam Singh
A 72-year-old male with diabetes and smoking as coronary risk factors was evaluated for chronic stable angina - Canadian Cardiovascular Society III - despite guideline directed medical treatment which revealed a diffuse, tortuous, calcified narrowing (90% stenosis) in left circumflex (LCx) coronary artery. After predilatation, a 3.0 - 2.5 × 60 mm BioMime Morph stent - long tapering stent (Sirolimus eluting stent, Meril life Sciences, India) - was tracked which failed and dislodged to right deep femoral artery during its pullback...
February 2018: Cardiology Research
https://www.readbyqxmd.com/read/29478020/chinese-observational-prospective-study-of-ageing-population-with-chronic-kidney-disease-c-option-a-study-protocol
#17
Shuang Liang, Wen-Ling Wang, Fang-Lei Zhu, Shu-Wei Duan, Xue-Feng Sun, Xiang-Mei Chen, Guang-Yan Cai
INTRODUCTION: The proportion of elderly people is steadily rising worldwide, especially in low-income and middle-income countries, including China. Chronic kidney disease (CKD) is a common disorder in older people. However, little is known about the epidemiology of CKD and its consequences among the elderly. Improvements on clinical guidelines and healthcare policies for this population are required. This study aims to examine the risk factors for progression of CKD among the elderly and develop models to identify subgroups who are at high risk...
February 24, 2018: BMJ Open
https://www.readbyqxmd.com/read/29431470/economic-evaluation-of-safflower-yellow-injection-for-the-treatment-of-patients-with-stable-angina-pectoris-in-china-a-cost-effectiveness-analysis
#18
Jianwei Xuan, Min Huang, Yongji Lu, Libo Tao
OBJECTIVE: The purpose of this study was to evaluate the cost-effectiveness of Safflower Yellow Injection (SYI) plus conventional treatment (SYI group) versus conventional treatment only (conventional group) for the treatment of stable angina pectoris (SAP) patients in China. METHODS: A decision-tree model was constructed and the treatment impact was estimated for up to 1 year. The data, including treatment effectiveness, episodes of angina pectoris (AP)-associated hospitalization and its in-hospital mortality, mortality rate of heart diseases, and cost of hospitalization, were obtained from literature...
February 12, 2018: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/29429843/invasive-in-the-cath-lab-assessment-of-myocardial-ischemia-in-patients-with-coronary-artery-disease-when-does-the-gold-standard-not-apply
#19
REVIEW
Stefano Benenati, Giovanni Luigi De Maria, Roberto Scarsini, Italo Porto, Adrian P Banning
International guidelines recommend that revascularization for coronary artery disease (CAD) should be guided by evidence of myocardial ischemia. Fractional flow reserve (FFR) and instantaneous free wave ratio (iFR) are the main invasive indices for assessing the ischemic potential of angiographically intermediate coronary stenosis as a large body of evidence supports their routine application. Both indices have been tested and validated in patients with isolated stable CAD, but notably their application outside this specific context is a matter of debate and investigation...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29421014/use-of-echocardiography-in-outpatients-with-chest-pain-and-normal-resting-electrocardiograms-referred-to-mayo-clinic-rochester
#20
Raymond J Gibbons, Damita Carryer, Hongfang Liu, Peter A Brady, John Wells Askew, David Hodge, Naser Ammash, Jon O Ebbert, Veronique L Roger
OBJECTIVES: To determine how often unnecessary resting echocardiograms that are "not recommended" by clinical practice guidelines are performed in patients with stable chest pain and normal resting electrocardiograms (ECGs). BACKGROUND: There are scant data to indicate how often Class III recommendations are ignored in clinical practice. PATIENTS AND METHODS: We searched electronically all medical records of referral outpatients seen at Mayo Clinic Rochester from January 1, 2010, through December 31, 2013, to identify patients with stable chest pain and known or suspected coronary artery disease who underwent resting echocardiography and had normal resting ECGs and no other indication for echocardiography...
February 2018: American Heart Journal
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