Secondary prevention MI

BACKGROUND: Myocardial infarction with non-obstructive coronary arteries (MINOCA) is a known clinical conundrum with limited investigation. Using a large population-based cohort, we examined the incidence, demographic profile, use of evidence-based medicines (EBM) and clinical outcomes of MINOCA patients. METHODS: Patients hospitalized with a primary diagnosis of MI who underwent coronary angiography between 01/04/2002 and 31/03/2014 in Alberta, Canada, were included in the study...

BACKGROUND: Patients admitted to our institution with a cerebrovascular accident (stroke) or transient ischemic attack (TIA) are referred to the pharmacist-run stroke prevention clinic (SPC) for medication and risk factor management. OBJECTIVE: The objective was to determine if patients receiving care from the SPC have better outcomes than patients who received usual care. METHODS: This was a retrospective chart review of patients referred to the SPC...

BACKGROUND AND AIMS: Risk stratification of patients with recent myocardial infarction (MI) for subsequent cardiovascular (CV) events helps identify patients most likely to benefit from secondary prevention therapies. This study externally validated a new risk score (TRS2˚P) for secondary events derived from the TRA2°P-TIMI 50 trial among post-MI patients from two large health care systems. METHODS: This retrospective cohort study included 9618 patients treated for acute MI at either the Cleveland Clinic (CC) or Geisinger Health System (GHS) between 2008 and 2013...

Objective: Post-myocardial infarction (MI) care is crucial to preventing recurrent major adverse cardiovascular events (MACE), but can be complicated to personalise. A tool is needed that effectively stratifies risk of cardiovascular (CV) events 1-3 years after MI but is also clinically usable. Methods: Patients surviving ≥1 year after an index MI with ≥1 risk factor for recurrent MI (ie, age ≥65 years, prior MI, multivessel coronary disease, diabetes, glomerular filtration rate <60 mL/min/1...

BACKGROUND: Secondary prevention guidelines after myocardial infarction (MI) are gender neutral, but underutilisation of treatment in women has been reported. DESIGN: We investigated the change in total and low-density lipoprotein (LDL) cholesterol levels and lipid-lowering drug (LLD) use after first-ever MI in a population-based study. METHODS: We followed 10,005 participants (54% women) attending the Tromsø Study 1994-1995 and 8483 participants (55% women) attending the Tromsø Study 2007-2008 for first-ever MI up to their participation in 2007-2008 and 2015-2016, respectively...

BACKGROUND: Preventive treatment goals for blood pressure and cholesterol levels continue to be unmet for many coronary patients. The effect of drug treatment depends on both its appropriateness and the patients' adherence to the treatment regimen. There is a need for adherence interventions that have a measurable effect on clinical outcomes. OBJECTIVE: This study aims to evaluate the effects on treatment goals of an intervention designed to improve patient adherence and treatment quality in secondary prevention of coronary heart disease...

BACKGROUND: The American Heart Association recommends focusing on 7 health factors (Life's Simple 7) for primordial prevention of cardiovascular health. However, whether greater adherence to Life's Simple 7 in midlife improves prognosis after myocardial infarction (MI) in later life is unknown. METHODS AND RESULTS: In 1277 participants who developed MI during the ARIC (Atherosclerosis Risk in Communities) Study follow-up, a 14-point score of Life's Simple 7 was constructed according to the status (2 points for ideal, 1 point for intermediate, and 0 points for poor) of each of 7 factors (smoking, adiposity, physical activity, diet, total cholesterol, blood pressure, and fasting glucose) at baseline (1987-1989)...

BACKGROUND: Patients with prior myocardial infarction (MI) and multivessel coronary disease (MVD) are at high risk for recurrent coronary events. OBJECTIVES: The authors investigated the efficacy and safety of ticagrelor versus placebo in patients with MVD in the PEGASUS-TIMI 54 (Prevention of Cardiovascular Events in Patients With Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin-Thrombolysis In Myocardial Infarction 54) trial. METHODS: Patients with a history of MI 1 to 3 years before inclusion in the PEGASUS-TIMI 54 trial were stratified in a pre-specified analysis based on the presence of MVD...

Objective To characterize patterns of secondary complications after inpatient head and neck surgery. Study Design Retrospective cohort study. Setting National Surgical Quality Improvement Program (2005-2015). Subjects and Methods We identified 18,584 patients who underwent inpatient otolaryngologic surgery. Four index complications were studied: pneumonia, bleeding or transfusion event (BTE), deep/organ space surgical site infection (SSI), and myocardial infarction (MI). Each patient with an index complication was matched to a control patient based on propensity for the index event and event-free days...

Background -Medication adherence is important to improve long-term outcomes after acute myocardial infarction (MI). We hypothesized that there is significant variation among United States (U.S.) hospitals in terms of post-MI medication adherence, and that patients treated at hospitals with higher post-MI medication adherence will have better long-term cardiovascular outcomes. Methods -We identified 19,704 Medicare patients discharged after acute MI from 347 U.S. hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) from 1/2/2007 to 10/1/2010...

PURPOSE OF REVIEW: Non-adherence to medications for the secondary prevention of myocardial infarction (MI) is a major contributor to morbidity and mortality in these patients. This review describes recent advances in promoting adherence to therapies for coronary artery disease (CAD). RECENT FINDINGS: Two large randomized controlled trials to "incentivize" adherence were somewhat disappointing; neither financial incentives nor "peer pressure" successfully increased rates of adherence in the post-MI population...

The National Institute for Health and Care Excellence (NICE) invited AstraZeneca, the manufacturer of ticagrelor (Brilique® ), to submit evidence on the clinical and cost effectiveness of ticagrelor 60 mg twice daily (BID) in combination with low-dose aspirin [acetylsalicylic acid (ASA)] compared with ASA only for secondary prevention of atherothrombotic events in patients with a history of myocardial infarction (MI) and who are at increased risk of atherothrombotic events. Kleijnen Systematic Reviews Ltd (KSR), in collaboration with Maastricht University Medical Centre+, was commissioned as the evidence review group (ERG)...

Background: Recurrent cardiovascular events after myocardial infarction (MI) are frequent, and gender differences in blood pressure treatment have been reported. Despite increased focus on secondary prevention, recent reports indicate that treatment targets are not achieved. There is a need for gender-specific analyses of post-MI blood pressure treatment target achievement and antihypertensive medication adherence. Design: We investigated the change in systolic and diastolic blood pressure and antihypertensive drug use after first-ever MI over two time periods in a Norwegian population-based study...

In Iran, cardiovascular diseases are the most common causes of death. We aimed to perform a systematic review on the prevalence of acute myocardial infarction (AMI) in Iran based on Persian and English papers had been published from 1985 to 2015. Among 267 initially found articles, 142 were excluded; finally, a total number of 40 articles were found relevant which were reduced to 18. Smoking, hypertension, diabetes mellitus, and hypercholesterolemia were the most common risk factors for AMI. Premature MI prevalence was high in men, and smoking was the most common risk factor among young people...

BACKGROUND: Allergic rhinitis is a common respiratory disease. Acupuncture is used to treat it in traditional Chinese medicine, and generally, the L120, ST2 and ST36 acupoints are selected in clinical practice. We report a new method of acupuncture at the sphenopalatine acupoint (SPA) for treatment of persistent allergic rhinitis (PAR). The effect of this treatment was investigated using two different needling depths. The efficacy of this treatment was associated with accurate stimulation of the sphenopalatine ganglion (SPG)...

BACKGROUND: The increasing popularity of wearable technology necessitates the evaluation of their accuracy to differentiate physical activity (PA) intensities. These devices may play an integral role in customizing PA interventions for primary prevention and secondary management of chronic diseases. For example, in persons with type 1 diabetes (T1D), PA greatly affects glucose concentrations depending on the intensity, mode (ie, aerobic, anaerobic, mixed), and duration. This variability in glucose responses underscores the importance of implementing dependable wearable technology in emerging avenues such as artificial pancreas systems...

BACKGROUND:  In recent decades, guideline-based therapy of myocardial infarction has led to a considerable reduction in myocardial infarction mortality. However, there are relevant differences in acute care and the extent of infarction mortality. The objective of this survey was to analyze the current care situation of patients with acute myocardial infarction in the region of northeast Germany (Berlin, Brandenburg and Mecklenburg-Vorpommern). METHODS:  Based on pseudonymized data from a statutory health insurance of 1 387 084 persons, a total of 6733 patients with inpatient admission at MI were filtered using the ICD10 code I21 and I22 for 2012...

Background: Lipid abnormalities are prevalent in tacrolimus-treated patients. The aim of the study was to evaluate the preventive effects of statin therapy on major adverse cardiovascular events (MACE) in patients treated with tacrolimus-based immunosuppression after kidney transplantation (KT), and to identify the risk factors. Methods: This observational cohort study included adult patients who underwent KT and were treated with tacrolimus. Patients who received any lipid-lowering agents except statins, or had a history of immunosuppressant use before transplantation were excluded...

OBJECTIVE: Improved risk assessment for patients with type 2 diabetes and elevated cardiovascular (CV) risk is needed. The Thrombolysis in Myocardial Infarction (TIMI) Risk Score for Secondary Prevention (TRS 2°P) predicts a gradient of risk in patients with prior myocardial infarction (MI) but has not been evaluated in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: CV event rates were compared by baseline TRS 2°P in 16,488 patients enrolled in SAVOR-TIMI 53 (Saxagliptin Assessment of Vascular Outcomes Recorded in Patients with Diabetes Mellitus-Thrombolysis in Myocardial Infarction 53) with type 2 diabetes and high CV risk or established CV disease...

BACKGROUND: The association of left ventricular remodeling (LVR) after myocardial infarction (MI) with the subsequent risk of heart failure (HF) and death has not been studied in patients receiving optimal secondary prevention. METHODS AND RESULTS: We performed a long-term clinical follow-up of patients included in 2 prospective multicentric studies on LVR after first anterior MI. At 1-year echocardiography, LVR (≥20% increase in end-diastolic volume from baseline to 1 year) occurred in 67/215 (31%) patients in cohort 1 and in 87/226 (38%) patients in cohort 2...