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https://www.readbyqxmd.com/read/28780509/rehospitalizations-following-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-results-from-a-multi-center-randomized-trial
#1
Ernest Spitzer, Martina Frei, Serge Zaugg, Susanne Hadorn, Henning Kelbaek, Miodrag Ostojic, Andreas Baumbach, David Tüller, Marco Roffi, Thomas Engstrom, Giovanni Pedrazzini, Vladan Vukcevic, Michael Magro, Ran Kornowski, Thomas F Lüscher, Clemens von Birgelen, Dik Heg, Stephan Windecker, Lorenz Räber
BACKGROUND: Rehospitalizations (RHs) after ST-elevation myocardial infarction carry a high economic burden and may deteriorate quality of life. Characterizing patients at higher risk may allow the design of preventive measures. We studied the frequency, reasons, and predictors for unplanned cardiac and noncardiac RHs in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. METHODS AND RESULTS: In this post-hoc analysis of the COMFORTABLE AMI (Comparison of Biolimus Eluted From an Erodible Stent Coating With Bare Metal Stents in Acute ST-Elevation Myocardial Infarction; NCT00962416) trial including 1137 patients, unplanned cardiac and noncardiac RHs occurred in 133 (11...
August 5, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28771550/gdf-15-predicts-cardiovascular-events-in-acute-chest-pain-patients
#2
Stergios Tzikas, Lars Palapies, Constantinos Bakogiannis, Tanja Zeller, Christoph Sinning, Stephan Baldus, Christoph Bickel, Vassilios Vassilikos, Karl J Lackner, Andreas Zeiher, Thomas Münzel, Stefan Blankenberg, Till Keller
BACKGROUND: Treatment of patients presenting with possible acute myocardial infarction (AMI) is based on timely diagnosis and proper risk stratification aided by biomarkers. We aimed at evaluating the predictive value of GDF-15 in patients presenting with symptoms suggestive of AMI. METHODS: Consecutive patients presenting with suspected AMI were enrolled in three study centers. Cardiovascular events were assessed during a follow-up period of 6 months with a combined endpoint of death or MI...
2017: PloS One
https://www.readbyqxmd.com/read/28761679/the-safety-efficacy-and-cost-effectiveness-of-stress-echocardiography-in-patients-with-high-pretest-probability-of-coronary-artery-disease
#3
Alexandros Papachristidis, Daniela Cassar Demarco, Damian Roper, Ioannis Tsironis, Michael Papitsas, Jonathan Byrne, Khaled Alfakih, Mark J Monaghan
OBJECTIVE: In this study, we assess the clinical and cost-effectiveness of stress echocardiography (SE), as well as the place of SE in patients with high pretest probability (PTP) of coronary artery disease (CAD). METHODS: We investigated 257 patients with no history of CAD, who underwent SE, and they had a PTP risk score >61% (high PTP). According to the National Institute for Health and Care Excellence guidance (NICE CG95, 2010), these patients should be investigated directly with an invasive coronary angiogram (ICA)...
2017: Open Heart
https://www.readbyqxmd.com/read/28742646/comparison-of-3-symptom-classification-methods-to-standardize-the-history-component-of-the-heart-score
#4
Michael R Marchick, Michael L Setteducato, Jesse J Revenis, Matthew A Robinson, Emily C Weeks, Thomas F Payton, David E Winchester, Brandon R Allen
OBJECTIVES: The History, Electrocardiography, Age, Risk factors, Troponin (HEART) score enables rapid risk stratification of emergency department patients presenting with chest pain. However, the subjectivity in scoring introduced by the history component has been criticized by some clinicians. We examined the association of 3 objective scoring models with the results of noninvasive cardiac testing. METHODS: Medical records for all patients evaluated in the chest pain center of an academic medical center during a 1-year period were reviewed retrospectively...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742306/identifying-emergency-department-patients-with-chest-pain-who-are-at-low-risk-for-acute-coronary-syndromes-digest
#5
David Markel, Jeremy Kim
Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes,identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing...
July 21, 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28732653/sestrins-increase-in-patients-with-coronary-artery-disease-and-associate-with-the-severity-of-coronary-stenosis
#6
Jing Ye, Menglong Wang, Yao Xu, Jianfang Liu, Huimin Jiang, Zhen Wang, Yingzhong Lin, Jun Wan
BACKGROUND: Sestrins (Sesns) family, which including three members Sesn1, Sesn2 and Sesn3, is known as stress-inducible proteins and participate in multiple diseases via regulating oxidative stress, inflammatory response and cell apoptosis. The present study aimed to investigate the plasma levels and the clinical significance of Sesns in patients with coronary artery disease (CAD). METHODS: In the case-control study, 119 CAD patients, including stable angina pectoris (SAP, n=44), unstable angina pectoris (UAP, n=41) and acute myocardial infarction (AMI, n=29) were included...
July 18, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28712683/-stratification-of-thoracic-pain-with-modified-heart-score-and-its-relationship-to-short-term-cardiovascular-events
#7
Manuel Chacón-Diaz, Jorge Salinas, Rafael Doig
OBJECTIVE: Chest pain is a major reason for emergency room care worldwide. The relationship between the Modified Heart Score and the presence of major cardiac events at 30 days after emergency admission was evaluated. METHODS: Retrospective, observational study in a single center. In patients older than 18 years old, who were treated for chest pain, in whom the Modified HEART Score was applied at admission and related to the presence of major cardiac events (myocardial infarction, death, hospitalization due to cardiac causes and percutaneous coronary revascularization Or surgical) at 30 days of follow-up...
July 13, 2017: Archivos de Cardiología de México
https://www.readbyqxmd.com/read/28708954/pneumococcal-and-influenza-vaccination-status-of-hospitalized-adults-with-community-acquired-pneumonia-and-the-effects-of-vaccination-on-clinical-presentation
#8
Ezgi Demirdogen Cetinoglu, Esra Uzaslan, Abdullah Sayıner, Aykut Cilli, Oguz Kılınc, Aysın Sakar Coskun, Armağan Hazar, Nurdan Kokturk, Ayten Filiz, Mehmet Polatli
BACKGROUND: Previous reports have shown that vaccination rates of adult at-risk populations are low in Turkey. There are differing reports with regards to the effectiveness of the influenza and the pneumococcal polysaccharide vaccine (PPSV23) on the clinical outcomes of community acquired pneumonia (CAP). The purpose of this study was to analyze the influenza (FV) and pneumococcal vaccination (PV) status, the factors that influence the receipt of influenza/pneumococcal vaccine and the effects of prior vaccination on the clinical outcomes in adults hospitalized with CAP...
July 14, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28667815/pulmonary-thromboembolism-in-an-emergency-hospital-are-our-patients-different
#9
Ana Maria Balahura, Andrada Guţă, Vlad Mihalcea, Emma Weiss, Maria Dorobanţu, Daniela Bartoş, Elisabeta Bădilă, Gheorghe Andrei Dan
INTRODUCTION: Pulmonary embolism (PTE) represents a medical emergency and is the third most common cause of mortality after myocardial infarction and stroke. The purpose of this study was to describe the characteristics and management of patients with PTE admitted in a referral emergency hospital in Romania. MATERIAL AND METHODS: We retrospectively reviewed all cases of PTE diagnosed in one of the largest emergency hospitals in Bucharest during a 2-year period (January 2014 - December 2016)...
June 27, 2017: Romanian Journal of Internal Medicine, Revue Roumaine de Médecine Interne
https://www.readbyqxmd.com/read/28666458/risk-score-to-predict-false-positive-st-segment-elevation-myocardial-infarction-in-the-emergency-department-a-retrospective-analysis
#10
Ji Hoon Kim, Yun Ho Roh, Yoo Seok Park, Joon Min Park, Bo Young Joung, In Cheol Park, Sung Phil Chung, Min Joung Kim
BACKGROUND: The best treatment approach for ST-segment elevation myocardial infarction (STEMI) is prompt primary percutaneous coronary intervention (PCI). However, some patients show ST elevation on electrocardiography (ECG), but do not have myocardial infarction. We sought to identify the frequency of and to develop a prediction model for false-positive STEMI. METHODS: This study was conducted in the emergency departments (EDs) of two hospitals using the same critical pathway (CP) protocol to treat STEMI patients with primary PCI...
June 30, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28665964/therapy-options-in-deep-sternal-wound-infection-sternal-plating-versus-muscle-flap
#11
Martin Grapow, Martin Haug, Chistopher Tschung, Bernhard Winkler, Prerana Banerjee, Paul Philipp Heinisch, Jens Fassl, Oliver Reuthebuch, Friedrich Eckstein
BACKGROUND: Management of deep sternal wound infection (DSWI) in cardiac surgical patients still remains challenging. A variety of treatment strategies has been described. Aim of this cohort study was to analyse two different treatment strategies for DSWI: titanium sternal plating system (TSFS) and muscle flap coverage (MFC). METHODS: Between January 2007 and December 2011, from 3122 patients undergoing cardiac surgery 42 were identified with DSWI and treated with one of the above mentioned strategies...
2017: PloS One
https://www.readbyqxmd.com/read/28665102/identifying-emergency-department-patients-with-chest-pain-who-are-at-low-risk-for-acute-coronary-syndromes
#12
David Markel
Though a minority of patients presenting to the emergency department with chest pain have acute coronary syndromes, identifying the patients who may be safely discharged and determining whether further testing is needed remains challenging. From the prehospital care setting to disposition and follow-up, this systematic review addresses the fundamentals of the emergency department evaluation of patients determined to be at low risk for acute coronary syndromes or adverse outcomes. Clinical risk scores are discussed, as well as the evidence and indications for confirmatory testing...
July 2017: Emergency Medicine Practice
https://www.readbyqxmd.com/read/28657113/high-burden-of-coronary-atherosclerosis-in-patients-with-cirrhosis
#13
Konstantin Kazankov, Kim Munk, Kristian Altern Øvrehus, Jesper Møller Jensen, Cecilie Brøckner Siggaard, Henning Grønbaek, Bjarne Linde Nørgaard, Hendrik Vilstrup
BACKGROUND: Population studies report increased cardiovascular mortality in patients with cirrhosis. Coronary artery disease may be a trait of end-stage liver disease, but whether it is frequent or extensive in cirrhosis in general is unknown. Thus, we aimed to assess the prevalence and extent of coronary artery disease in unselected cirrhosis patients. MATERIALS AND METHODS: Using coronary computed tomography angiography, we investigated 52 patients from all Child-Pugh classes and aetiologies of cirrhosis without known cardiac disease for presence and severity of coronary artery disease in a cross-sectional design...
June 28, 2017: European Journal of Clinical Investigation
https://www.readbyqxmd.com/read/28647935/evaluation-of-patients-with-acute-chest-pain-using-spect-myocardial-perfusion-imaging-prognostic-implications-of-mildly-abnormal-scans
#14
Ronen Goldkorn, Alexey Naimushin, Roy Beigel, Ekaterina Naimushin, Michael Narodetski, Shlomi Matetzky
BACKGROUND: While patients presenting to emergency departments (ER) with chest pain are increasingly managed in chest pain units (CPU) that utilize accelerated diagnostic protocols for risk stratification, such as single-photon emission computed tomography (SPECT) myocardial perfusion imaging (MPI), data are lacking regarding the prognostic implications of mildly abnormal scans in this population. OBJECTIVES: To evaluate the prognostic implications of mildly abnormal SPECT MPI results in patients with acute chest pain...
June 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/28637780/sex-based-differences-in-the-performance-of-the-heart-score-in-patients-presenting-to-the-emergency-department-with-acute-chest-pain
#15
Ingrid E M Bank, Vince C de Hoog, Dominique P V de Kleijn, Gerard Pasterkamp, Pieter A Doevendans, Hester M den Ruijter, Geertje Dalmeijer, Thierry X Wildbergh, Arend Mosterd, Leo Timmers
BACKGROUND: Sex-based differences in clinical presentation, pathophysiology, and outcomes of patients with acute chest pain are increasingly being recognized, but are not implemented in guidelines and clinical prediction tools. We evaluated the performance of the HEART score in women versus men, because sex-based differences may exist among the algorithm's components: history, electrocardiogram, age, risk factors, and admission troponin level. METHODS AND RESULTS: The HEART score was retrospectively assessed in 831 women and 1084 men presenting to the emergency department with acute chest pain, assigning patients to the low-, intermediate-, or high-risk category for the occurrence of major adverse cardiac events (MACE) within 6 weeks...
June 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#16
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623174/sex-differences-in-the-management-and-5-year-outcome-of-young-patients-55-years-with-acute-coronary-syndromes
#17
Avi Sabbag, Shlomi Matetzky, Avital Porter, Zaza Iakobishvili, Mady Moriel, Donna Zwas, Paul Fefer, Elad Asher, Roy Beigel, Shmuel Gottlieb, Ilan Goldenberg, Amit Segev
BACKGROUND: Young women are usually protected against coronary artery disease due to hormonal and risk-factor profile. Previous studies have suggested poorer outcome in women hospitalized with acute coronary syndrome as compared with men. However, when adjusted for age and other risk factors, this difference does not remain significant. We compared the risk profile and outcome between young (≤55 years) women and men admitted with acute coronary syndrome. METHODS: We analyzed clinical characteristics, management strategies, and outcomes of men and women ≤55 years of age enrolled in the biennial Acute Coronary Syndrome Israeli Surveys between 2000 and 2013...
June 13, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28616559/gender-differences-in-the-prevalence-of-coronary-artery-tortuosity-and-its-association-with-coronary-artery-disease
#18
Joseph Chiha, Paul Mitchell, Bamini Gopinath, George Burlutsky, Pramesh Kovoor, Aravinda Thiagalingam
BACKGROUND: Little is known about the significance of severe coronary tortuosity (SCT) despite it being a relatively common finding on coronary angiography. We examined whether the presence of tortuosity was influenced by gender or cardiac risk factors. METHODS AND RESULTS: We examined 870 patients (Men = 589, Women = 281) who presented to Westmead Hospital, Sydney, Australia for invasive coronary angiography for the assessment of chest pain due to suspected CAD...
March 2017: IJC Heart & Vasculature
https://www.readbyqxmd.com/read/28575245/peroral-endoscopic-myotomy-versus-surgical-myotomy-for-primary-achalasia-single-center-retrospective-analysis-of-74-patients
#19
S de Pascale, A Repici, F Puccetti, E Carlani, R Rosati, U Fumagalli
Achalasia is a neurodegenerative motility disorder of the esophagus; dysphagia, weight loss, chest pain, and regurgitation are its main symptoms. Surgical myotomy (HM) is considered the gold standard treatment. However, peroral endoscopic myotomy (POEM) seems to be a safe and effective alternative option. The aim of this study is to compare the safety and efficacy of these techniques. From March 2012 to June 2015, 74 patients with symptomatic primary achalasia underwent myotomy. The two groups were compared in terms of intraoperative and postoperative outcomes and Eckardt score at last follow-up...
August 1, 2017: Diseases of the Esophagus: Official Journal of the International Society for Diseases of the Esophagus
https://www.readbyqxmd.com/read/28572221/the-2016-update-to-nice-cg95-guideline-for-the-investigation-of-new-onset-stable-chest-pain-more-innovation-but-at-a-cost
#20
Khaled Alfakih, John P Greenwood, Sven Plein
The National Institute for Health and Care Excellence (NICE) published an update on its guideline on chest pain of recent onset in 2016. The new guideline makes three key changes to the 2010 version. NICE recommend that the previously proposed pre-test probability risk score should no longer be used. They also recommend that a calcium score of zero should no longer be used to rule out coronary artery disease in patients with low pre-test probability. However, the most radical change is that NICE now recommend that all patients with new onset chest pain should be investigated with a computerised tomography coronary angiogram as a first-ine investigation...
June 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
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