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https://www.readbyqxmd.com/read/29232768/modification-of-the-thrombolysis-in-myocardial-infarction-risk-score-for-patients-presenting-with-chest-pain-to-the-emergency-department
#1
Jaimi H Greenslade, Kimberly Chung, William A Parsonage, Tracey Hawkins, Martin Than, John W Pickering, Louise Cullen
OBJECTIVE: To develop a modified Thrombolysis in Myocardial Infarction (TIMI) score to effectively risk stratify patients presenting to the ED with chest pain. METHODS: A prospective observational study was conducted at two metropolitan EDs. Data were obtained during patient interview. The primary outcome was major adverse cardiovascular events (MACE) within 30 days of presentation. Two separate modifications of the TIMI score were developed. These scores were compared to the original TIMI in terms of the area under the receiver operating characteristic curve and diagnostic accuracy statistics (sensitivity, specificity, positive and negative predictive values)...
December 12, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/29232563/immunologic-burden-links-periodontitis-to-acute-coronary-syndrome
#2
John M Liljestrand, Susanna Paju, Milla Pietiäinen, Kåre Buhlin, G Rutger Persson, Markku S Nieminen, Juha Sinisalo, Päivi Mäntylä, Pirkko J Pussinen
BACKGROUND AND AIMS: Periodontitis, a common polymicrobial inflammatory disease in the tooth supporting tissues, is a risk factor for coronary artery disease. One of the proposed underlying mechanisms is the systemic immune response to periodontal infection. We studied how serum antibodies against seven periodontal pathogens and their subgingival levels associate with each other, periodontitis, and coronary artery disease. METHODS: The Parogene cohort included 505 Finnish patients (mean age 63 y) who underwent coronary angiography, and clinical and radiographic oral examinations...
December 6, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29232296/morbid-obesity-does-not-increase-morbidity-or-mortality-in-robotic-cardiac-surgery
#3
Hiroto Kitahara, Brooke Patel, Mackenzie McCrorey, Sarah Nisivaco, Husam H Balkhy
OBJECTIVE: Morbid obesity (body mass index ≥ 35 kg/m) usually confers a higher perioperative risk in cardiac surgery. Robotic cardiac surgery may have many advantages for these high-risk patients. METHODS: We retrospectively reviewed patients undergoing robotic cardiac surgery from July 2013 to April 2017 at our institution. We compared the outcomes of morbidly obese patients versus nonobese patients. RESULTS: A total of 486 patients underwent robotic cardiac surgery (322 men, median age = 65 years)...
December 7, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/29231917/stable-coronary-artery-disease-medical-treatment
#4
REVIEW
Rafał Dąbrowski, Marcin Dobrowolski
The crucial issues in optimal medical therapy to improve prognosis and reduce angina symptoms are secondary prevention, effective control of concomitant diseases, risk factors and medical treatment. In spite of successful percutaneous coronary interventions (PCI) and medical treatment with beta-blockers, ACE-inhibitors or angiotensin receptor blockers, statins and antiplatelet drugs, some patients are still symptomatic. In the era of PCI not sufficient attention is paid to other drugs reducing the incidence of angina episodes: calcium antagonists, long-acting nitrates, metabolic agents and novel antianginal drugs...
November 23, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/29230658/guidelines-in-review-comparison-of-the-2014-aha-acc-guideline-for-the-management-of-patients-with-non-st-elevation-acute-coronary-syndromes-and-the-2015-esc-guidelines-for-the-management-of-acute-coronary-syndromes-in-patients-presenting-without-persistent
#5
Shane P Prejean, Munaib Din, Eliana Reyes, Fadi G Hage
In this Guidelines in Review, we review side-by-side the recommendations provided by the 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. We review the recommendations for imaging in the evaluation of patients with possible ACS followed by the diagnostic evaluation of patients with proven NSTE-ACS, based on their risk for adverse clinical events...
December 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29230597/presence-of-post-systolic-shortening-is-an-independent-predictor-of-heart-failure-in-patients-following-st-segment-elevation-myocardial-infarction
#6
Philip Brainin, Sune Haahr-Pedersen, Morten Sengeløv, Flemming Javier Olsen, Thomas Fritz-Hansen, Jan Skov Jensen, Tor Biering-Sørensen
Following an ischemic event post systolic shortening (PSS) may occur. We investigated the association between PSS in patients with ST-segment elevation myocardial infarction (STEMI) following primary percutaneous coronary intervention (pPCI) and occurrence of cardiovascular events at follow-up. A total of 373 patients admitted with STEMI and treated with pPCI were prospectively included in the study cohort. All patients were examined by echocardiography a median of 2 days after admission (interquartile range, 1-3 days)...
December 11, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29230180/immediate-early-vs-delayed-invasive-strategy-for-patients-with-non-st-segment-elevation-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#7
REVIEW
Yanda Li, Zhenpeng Zhang, Xingjiang Xiong, William C Cho, Dan Hu, Yonghong Gao, Hongcai Shang, Yanwei Xing
Invasive coronary revascularization has been shown to improve prognoses in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of intervention remains unclear. This meta-analysis is to evaluate the outcomes in immediate (<2 h), early (<24 h), and delayed invasive group and find out which is the optimal timing of intervention in NSTE-ACS patients. Studies were identified through electronic literature search of Medline, PubMed Central, Embase, the Cochrane Library, and CNKI...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29230004/prognostic-impact-of-baseline-urinary-albumin-excretion-rate-in-patients-with-resistant-hypertension-a-prospective-cohort-study
#8
Paula Moreira da Costa, Arthur Fernandes Cortez, Fabio de Souza, Gabriel de Souza Mares, Bruno Dussoni Moreira Dos Santos, Elizabeth Silaid Muxfeldt
Moderately increased albuminuria, defined as urinary albumin excretion rate (UAER) between 30 and 300-mg/24-h is a well-known cardiovascular risk factor, especially in diabetic and hypertensive patients. This study aim to analyze the prognostic value of baseline UAER in a still understudied group, patients with resistant hypertension (RHT). This is a prospective observational study, which had enrolled 1048 outpatients with RHT, who were submitted to a clinical-laboratory assessment and ambulatory blood pressure monitoring (ABPM) during the follow-up...
December 11, 2017: Journal of Human Hypertension
https://www.readbyqxmd.com/read/29229890/q192r-polymorphism-in-the-pon1-gene-and-familial-hypercholesterolemia-in-a-saudi-population
#9
Khalid Khalaf Alharbi, May Salem Alnbaheen, Fawiziah Khalaf Alharbi, Rana M Hasanato, Imran Ali Khan
BACKGROUND: Familial hypercholesterolemia (FH) is an autosomal dominant condition characterized by abnormal levels of low-density lipoprotein (LDL) in the blood. FH is a risk factor for atherosclerosis and cardiovascular disease. The relationship between the paraoxonase 1 (PON1) gene, atherosclerosis and coronary artery disease has not been studied in Saudi patients. OBJECTIVE: To investigate the genetic associations of the Q192R polymorphism in the PON1 gene with FH in Saudi patients...
November 2017: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/29229303/pretransplant-coronary-artery-disease-is-a-predictor-for-myocardial-infarction-and-cardiac-death-after-liver-transplantation
#10
F Darstein, M Hoppe-Lotichius, J Vollmar, V Weyer-Elberich, A Zimmermann, J Mittler, G Otto, H Lang, P R Galle, T Zimmermann
BACKGROUND: Cardiovascular disease is a serious problem of liver transplant (LT) recipients because of increased cardiovascular risk due to immunosuppressive therapy, higher age, intraoperative risk and comorbidities (such as diabetes and nicotine abuse). Reported frequency of cardiovascular events after LT shows a high variability between different LT cohorts. Our aim was to analyze a cohort of LT recipients from a single center in Germany to evaluate frequency of the cardiovascular endpoints (CVE) myocardial infarction and/or cardiac death after LT and to investigate correlations of CVE post LT with pretransplant patient characteristics...
December 8, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29229271/using-metabolic-equivalents-in-clinical-practice
#11
REVIEW
Barry A Franklin, Jenna Brinks, Kathy Berra, Carl J Lavie, Neil F Gordon, Laurence S Sperling
Metabolic equivalents, or METs, are routinely employed as a guide to exercise training and activity prescription and to categorize cardiorespiratory fitness (CRF). There are, however, inherent limitations to the concept, as well as common misapplications. CRF and the patient's capacity for physical activity are often overestimated and underestimated, respectively. Moreover, frequently cited fitness thresholds associated with the highest and lowest mortality rates may be misleading, as these are influenced by several factors, including age and gender...
October 31, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29229216/immediate-complete-revascularization-in-patients-with-st-segment-elevation-myocardial-infarction-and-multivessel-disease-treated-by-primary-percutaneous-coronary-intervention-insights-from-the-orbi-registry
#12
Anna Pimor, Vincent Auffret, Romain Didier, Régis Delaunay, Emmanuelle Filippi, Jean-Philippe Hacot, Djamel Saouli, Gilles Rouault, Philippe Druelles, Emilie Bot, Isabelle Coudert, Bertrand Boulanger, Marielle Le Guellec, Dominique Boulmier, Guillaume Leurent, Marc Bedossa, Martine Gilard, Hervé Le Breton
BACKGROUND: Recent studies demonstrated the superiority of complete revascularization (CR) in patients treated by primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI). AIM: To evaluate whether immediate CR improves in-hospital outcomes in patients with STEMI with multivessel disease. METHODS: Data from a prospective multicentre registry including 9365 patients with STEMI were analysed. Patients with multivessel disease and treated with pPCI (n=3412) were included and separated into two groups according to whether immediate CR was performed during the index procedure...
December 8, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29228817/cangrelor-in-percutaneous-coronary-intervention-current-status-and-perspectives
#13
Dimitrios Alexopoulos, Christos Pappas, Danai Sfantou, John Lekakis
Cangrelor is an intravenously administered P2Y12 receptor antagonist with very fast, potent, and quickly reversible action. In the CHAMPION PHOENIX trial, cangrelor provided an improved anti-ischemic protection compared with clopidogrel, without increasing the risk of severe bleeding. Cangrelor is currently approved by drug regulating authorities for patients undergoing percutaneous coronary intervention (PCI) without prior treatment with a P2Y12 receptor antagonist and not receiving a glycoprotein IIb/IIIa inhibitor, while its use is endorsed with a class IIb recommendation by the European Society of Cardiology guidelines...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/29228313/transfusion-of-red-blood-cells-in-coronary-surgery-is-there-an-effect-on-long-term-mortality-when-adjusting-for-risk-factors-and-postoperative-complications
#14
Long Tran, Guri Greiff, Hilde Pleym, Alexander Wahba, Roar Stenseth, Vibeke Videm
OBJECTIVES: The aim of this study was to compare long-term mortality in patients undergoing primary isolated coronary artery bypass grafting who received ≥1 units of red blood cells (RBCs) or no RBCs. We hypothesized that a possible difference in long-term mortality was due to preoperative morbidity and/or postoperative morbidity. METHODS: This prospective cohort study, part of the Cardiac Surgery Outcome Study (CaSOS) at St. Olavs University Hospital, Trondheim, Norway, included patients operated on from 2000 through 2014 (n = 4014) and excluded those with large intra- or postoperative blood loss or 30-day mortality...
December 8, 2017: European Journal of Cardio-thoracic Surgery
https://www.readbyqxmd.com/read/29228159/patients-with-acute-myocardial-infarction-and-non-obstructive-coronary-arteries-safety-and-prognostic-relevance-of-invasive-coronary-provocative-tests
#15
Rocco A Montone, Giampaolo Niccoli, Francesco Fracassi, Michele Russo, Filippo Gurgoglione, Giulia Cammà, Gaetano A Lanza, Filippo Crea
Aims: Functional alterations of epicardial coronary arteries or coronary microcirculation represent a frequent cause of myocardial infarction and non-obstructive coronary arteries (MINOCA). We aimed at assessing the prognostic value of intracoronary provocative tests in patients presenting with MINOCA and in which other causes of MINOCA have been excluded. Methods and results: We prospectively evaluated patients with a diagnosis of MINOCA, excluding patients with aetiologies other than suspected coronary vasomotor abnormalities...
December 8, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29228000/an-in-vivo-assessment-of-the-cholesterol-lowering-efficacy-of-lactobacillus-plantarum-ecgc-13110402-in-normal-to-mildly-hypercholesterolaemic-adults
#16
Adele Costabile, Ivan Buttarazzi, Sofia Kolida, Sara Quercia, Jessica Baldini, Jonathan R Swann, Patrizia Brigidi, Glenn R Gibson
Coronary heart disease (CHD) is one of the major causes of death and disability in industrialised countries, with elevated blood cholesterol an established risk factor. Total plasma cholesterol reduction in populations suffering from primary hypercholesterolemia may lower CHD incidence. This study investigated the cholesterol reducing capacity of Lactobacillus plantarum ECGC 13110402, a strain selected for its high bile salt hydrolase activity, in 49 normal to mildly hypercholesterolaemic adults. Primary efficacy outcomes included effect on blood lipids (total cholesterol (TC), low density lipoproteins (LDL-C), high density lipoproteins (HDL-C) and triacylgycerides (TAG), inflammatory biomarkers and occurrence/severity of gastrointestinal side effects to establish safety and tolerance of the intervention...
2017: PloS One
https://www.readbyqxmd.com/read/29227977/red-blood-cell-distribution-width-is-an-independent-predictor-of-aki-and-mortality-in-patients-in-the-coronary-care-unit
#17
Yugang Hu, Huilan Liu, Shuai Fu, Jing Wan, Xiaoning Li
BACKGROUND/AIMS: We investigated the hypothesis that RDW is an independent predictor of acute kidney injury (AKI) and mortality in patients in the coronary care unit (CCU). METHODS: In this prospective, observational study, we screened 412 adults admitted to the CCU at Zhongnan Hospital of Wuhan University from January 1, 2014 to June 1, 2015. AKI was defined based on the KDIGO-AKI criteria. The survivors were followed up for up to 2 years after hospital discharge...
December 8, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29227870/impact-of-alcohol-drinking-on-acetylcholine-induced-coronary-artery-spasm-in-korean-populations
#18
Sung Min Sohn, Byoung Geol Choi, Se Yeon Choi, Jae Kyeong Byun, Ahmed Mashaly, Yoonjee Park, Won Young Jang, Woohyeun Kim, Jah Yeon Choi, Eun Jin Park, Jin Oh Na, Cheol Ung Choi, Hong Euy Lim, Eung Ju Kim, Chang Gyu Park, Hong Seog Seo, Dong Joo Oh, Seung-Woon Rha
BACKGROUND AND AIMS: Generally, immoderate alcohol consumption is associated with variant angina and accepted as one of the risk factors for coronary artery spasm (CAS), but evidence is lacking in this regard. The aim of this study is to evaluate the impact of alcohol consumption and drinking pattern on CAS by acetylcholine (ACH) provocation test and long-term clinical outcomes. METHODS: A total of 5491 patients with typical or atypical chest pain, without significant coronary artery disease, who underwent intracoronary ACH provocation test, were enrolled prospectively, and retrospectively analyzed in this study...
December 8, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29227414/the-diagnostic-process-of-stable-angina-still-many-doubts-since-heberden-s-first-description-250-years-ago
#19
Irene Raso, Ilaria Passarelli, Gioacchino Valenti, Gabriele Crimi, Stefano de Servi
: Since Heberden's first description, stable angina has represented a challenge for the clinicians. Even the most recent guidelines seem ineffective to correctly identify patients who should be sent to cath labs. Still too many patients who undergo coronary angiography are found not to have significant lesions; moreover, its extensive use as the first diagnostic test leads to revascularizations with uncertain appropriateness and prognostic significance. These considerations underline the importance of noninvasive testing before sending patients to invasive coronary angiography...
December 8, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29227300/exercise-testing-in-heart-failure-a-contemporary-discussion-in-an-era-of-novel-diagnostic-techniques-and-biomarkers
#20
Kegan J Moneghetti, Jeffrey W Christle, Jonathan Myers, Francois Haddad
PURPOSE OF REVIEW: The purpose of this review is to highlight recent advances in the field of exercise testing for patients with heart failure. RECENT FINDINGS: The importance of assessment of cardiorespiratory fitness (CRF) and exercise testing in heart failure is highlighted in the consensus recommendation of the American Heart Association. Contemporary studies have validated the independent and incremental strength of CRF metrics in patients with heart failure and coronary artery disease...
December 8, 2017: Current Opinion in Cardiology
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