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risk evaluation in coronary syndrome

Markus Zutt, Hagen Rudolph, Kjell Matthias Kaune, Werner Wosniok, Ulrich Gärtner, Rainer Linke
BACKGROUND: In recent years, cardiac comorbidities in psoriasis patients have increasingly moved into the focus of clinical research. The objective of the present study was to evaluate myocardial scintigraphy as a screening method in patients with psoriasis. PATIENTS AND METHODS: Assessment of various comorbidities in 50 psoriasis patients without clinical symptoms of cardiac disease. Myocardial scintigraphy was employed to detect cardiac risk/exercise-induced ischemia...
October 2016: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
Debjani S Goswami, Tanuja P Manohar
INTRODUCTION: Cardiovascular diseases are becoming the major cause of morbidity and mortality in most of the developing countries including India. Cardiometabolic risk factors play a vital role in causation of coronary artery disease. Present study was carried out to investigate the role of various risk factors in the occurrence of coronary artery disease (CAD) in population from Central India. SETTING AND DESIGN: This was a hospital-based age and sex matched case-control study, carried out at Lata Mangeshkar Hospital, Nagpur...
October 2016: Journal of the Association of Physicians of India
Marina Pieri, Alessandro Belletti, Fabrizio Monaco, Antonio Pisano, Mario Musu, Veronica Dalessandro, Giacomo Monti, Gabriele Finco, Alberto Zangrillo, Giovanni Landoni
BACKGROUND: In patients undergoing cardiac surgery, a reduced preoperative left ventricular ejection fraction (LVEF) is common and is associated with a worse outcome. Available outcome data for these patients address specific surgical procedures, mainly coronary artery bypass graft (CABG). Aim of our study was to investigate perioperative outcome of surgery on patients with low pre-operative LVEF undergoing a broad range of cardiac surgical procedures. METHODS: Data from patients with pre-operative LVEF ≤40 % undergoing cardiac surgery at a university hospital were reviewed and analyzed...
October 18, 2016: BMC Anesthesiology
Chan Joo Lee, Jaewon Oh, Sang-Hak Lee, Seok-Min Kang, Donghoon Choi, Hyeon-Chang Kim, Sungha Park
OBJECTIVE: In most cases, the 5 first line drugs are recommended for management of hypertension without preference for one or the other. However, it is unclear whether different classes of anti-hypertensive agents have different effect on survival in low risk, uncomplicated hypertension. The aim of this study was to evaluate effects of 4 classes of first line anti-hypertensive agents on improving survival in patients with low risk, uncomplicated hypertension. DESIGN AND METHOD: Adult hypertensive patients without chronic kidney disease, end stage renal disease, diabetes mellitus, acute coronary syndrome, and heart failure in 2002 were selected from Korean National Health Insurance sample cohort consisting of one million subjects...
September 2016: Journal of Hypertension
Soo-Kyeong Song, Sang-Rok Lee, Lae-Young Jung, Yi-Shik Kim, Sun-Hwa Lee, Kyoung-Suk Rhee, Jei-Keon Chae, Won-Ho Kim, Jae-Ki Ko
OBJECTIVE: Wall shear stress contributes to atherosclerosis progression and plaque rupture. There were limited studies for hypertension as influence factor on whole blood viscosity (WBV) in acute coronary syndrome (ACS) patients. We evaluated the relations between WBV and hypertension in patients who visited to the emergency room by acute chest pain. DESIGN AND METHOD: From April 2013 through June 2015, we prospectively enrolled 471 acute chest pain patients who visited emergency room...
September 2016: Journal of Hypertension
William R Fox, Deborah B Diercks
Troponins are proteins commonly found in cardiac tissue that are released during myocardial ischemia or necrosis. These troponins can be detected by assays that can then be used to guide clinical decision-making and disposition, especially if the suspected insult is related to acute coronary syndrome. Timing of troponin measurement can be important as elevations may not be detectible immediately after an insult. New assays have been designed to detect troponin con-centrations previously too low to be detected by conventional assays...
March 2016: Clin Exp Emerg Med
Axel C Mühlbacher, Susanne Bethge, Anika Kaczynski
BACKGROUND: Cardiovascular disease is one of the most common causes of death worldwide, with many individuals having experienced acute coronary syndrome (ACS). How patients with a history of ACS value aspects of their medical treatment have been evaluated rarely. The aim of this study was to determine patient priorities for long-term drug therapy after experiencing ACS. METHODS: To identify patient-relevant treatment characteristics, a systematic literature review and qualitative patient interviews were conducted...
October 18, 2016: International Journal of Technology Assessment in Health Care
S A Yuca, E A Cimbek, Y Şen, O Güvenç, H Vatansev, F Buğrul, F Gün, B Oran
Objective: Childhood obesity which is a predictor of adulthood obesity is associated with type 2 diabetes, metabolic syndrome, dyslipidemia, coronary artery diseases and subclinical inflammation. Growth differentiation factor-15, also known as macrophage inhibitory cytokine-1 (MIC-1/GDF15) is a member of the transforming growth factor- β super family and increases during inflammatory states. Adults with obesity have increased serum concentrations of MIC-1/GDF15. MIC-1/GDF15 is associated with cardio metabolic risk in adults...
October 17, 2016: Experimental and Clinical Endocrinology & Diabetes
Rashmi Kerr, Cinosh Mathew, Ram Gopal Shahi, Rajneesh Calton
OBJECTIVE: To assess the clinical and angiographic profile of patients with coronary artery ectasias (CAE) and assess their outcomes. METHODS: One year retrospective and one year prospective study was carried out in the Department of Cardiology in CMC, Ludhiana from January 2011 to December 2012 on all patients undergoing coronary angiographies and each patient was followed up for 1 year. Their outcomes were noted and statistical analysis carried out. RESULTS: There were a total of 327 males (66...
June 2016: Journal of the Association of Physicians of India
Jeffrey L Carson, Gordon Guyatt, Nancy M Heddle, Brenda J Grossman, Claudia S Cohn, Mark K Fung, Terry Gernsheimer, John B Holcomb, Lewis J Kaplan, Louis M Katz, Nikki Peterson, Glenn Ramsey, Sunil V Rao, John D Roback, Aryeh Shander, Aaron A R Tobian
Importance: More than 100 million units of blood are collected worldwide each year, yet the indication for red blood cell (RBC) transfusion and the optimal length of RBC storage prior to transfusion are uncertain. Objective: To provide recommendations for the target hemoglobin level for RBC transfusion among hospitalized adult patients who are hemodynamically stable and the length of time RBCs should be stored prior to transfusion. Evidence Review: Reference librarians conducted a literature search for randomized clinical trials (RCTs) evaluating hemoglobin thresholds for RBC transfusion (1950-May 2016) and RBC storage duration (1948-May 2016) without language restrictions...
October 12, 2016: JAMA: the Journal of the American Medical Association
Izabella Uchmanowicz, Beata Jankowska-Polanska, Mariusz Chabowski, Bartosz Uchmanowicz, Andrzej M Fal
COPD is one of the most debilitating diseases. Frailty syndrome and advanced age may decrease the acceptance of illness, quality of life, and worsen health conditions in these patients, as well as lead to an increase in health care expenses. The aim of the study was to assess how the level of frailty affects the acceptance of illness in elderly patients with COPD. We also aimed to evaluate the associations between sociodemographic and clinical factors and the level of acceptance of illness, anxiety, and frailty in this group of patients...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Giovanni Teruzzi, Giuseppe Calligaris, Paolo Ravagnani, Daniela Trabattoni, Luca Grancini, Giovanni Monizzi, Alessandro Lualdi, Antonio L Bartorelli
Spontaneous coronary artery dissection (SCAD) accounts approximately for 0.2% of cases of acute coronary syndrome. It is defined "spontaneous" in absence of any coronary wall damage. This disease affects primarily young women in good health, with no risk factors for coronary artery disease, especially during the postpartum period. Since the clinical presentation varies widely from no symptoms to typical angina and sudden cardiac death, SCAD incidence is underestimated.A 40-year-old woman, in the 8th week after delivery, was admitted to our emergency department because of acute chest pain, and a diagnosis of inferior and posterior non-ST-elevation myocardial infarction was made...
October 2016: Giornale Italiano di Cardiologia
Shuhei Takahashi, Kazunori Shimada, Katsumi Miyauchi, Tetsuro Miyazaki, Eiryu Sai, Manabu Ogita, Shuta Tsuboi, Hiroshi Tamura, Shinya Okazaki, Tomoyuki Shiozawa, Shohei Ouchi, Tatsuro Aikawa, Tomoyasu Kadoguchi, Hamad Al Shahi, Takuma Yoshihara, Makoto Hiki, Kikuo Isoda, Hiroyuki Daida
BACKGROUND: Postprandial hyperglycemia plays an important role in the pathogenesis of coronary artery disease and cardiovascular events. Serum 1,5-anhydroglucitol (1,5-AG) levels are known to be a clinical marker of postprandial hyperglycemia. However, the impact of 1,5-AG level on cardiovascular events has not been fully investigated. METHODS: We enrolled 240 consecutive patients who had undergone first-time elective percutaneous coronary intervention (PCI) with follow-up angiography within 1 year...
October 11, 2016: Cardiovascular Diabetology
Manuel Monti, Giovanni Maria Vincentelli, Giuseppe Murdolo, Giuliano Bertazzoni, Francesco Rocco Pugliese, Francesco Borgognoni, Maria Pia Ruggieri, Raffaele Landolfi
INTRODUCTION: Venous thromboembolism (VTE) is the third most common cardiovascular illness after acute coronary syndrome and stroke and and the most common preventable cause of hospital-related death. Several studies have demonstrated a significant reduction of fatal pulmonary embolism attributed to the introduction of thromboprophylactic measures and changes in hospital practices. However, the influence of some demographical variables, especially age, has largely been under appreciated...
September 2016: Recenti Progressi in Medicina
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
October 7, 2016: Expert Opinion on Drug Metabolism & Toxicology
Michał Kowara, Kajetan Grodecki, Zenon Huczek, Dominika Puchta, Katarzyna Paczwa, Bartosz Rymuza, Karol Zbroński, Krzysztof J Filipiak, Grzegorz Opolski
BACKGROUND: Platelets' role in pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be valuable predicting factor in cardiac patients. However platelet distribution width (PDW) is reported to be more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is up-to-date subject of research...
October 7, 2016: Kardiologia Polska
Hack-Lyoung Kim, Myung-A Kim, Sohee Oh, Mina Kim, Seong Mi Park, Hyun Ju Yoon, Mi Seung Shin, Kyung-Soon Hong, Gil Ja Shin, Wan-Joo Shim
BACKGROUND: Sex-related differences in the influence of metabolic syndrome (MetS) on various cardiovascular diseases have been suggested. The aim of this study was to investigate the effect of sex on the association between MetS and left ventricular (LV) diastolic dysfunction in patients with suspected coronary artery disease (CAD). METHODS: Two hundred ten patients (105 men and age-matched 105 women; mean age: 56.5 ± 10.9 years) undergoing elective coronary angiography for the evaluation of CAD were studied...
October 6, 2016: Metabolic Syndrome and related Disorders
Mohamed F Lutfi
Previous studies assessing effect of ischemia on ventricular repolarization are mostly directed toward patients with coronary artery disease (CAD); however, similar reports on cardiac syndrome X (CSX) are scarce. Whether microvascular dysfunction of CSX and ischemia induced by CAD produce comparable effect on ventricular repolarization is unclear and deserve further studies. In the present study, ECG measures of ventricular repolarization were compared between CAD and CSX patients (40 subjects in each group)...
2016: Frontiers in Physiology
Yun Liu, Benjamin M Scirica, Collin M Stultz, John V Guttag
Frequency domain measures of heart rate variability (HRV) are associated with adverse events after a myocardial infarction. However, patterns in the traditional frequency domain (measured in Hz, or cycles per second) may capture different cardiac phenomena at different heart rates. An alternative is to consider frequency with respect to heartbeats, or beatquency. We compared the use of frequency and beatquency domains to predict patient risk after an acute coronary syndrome. We then determined whether machine learning could further improve the predictive performance...
October 6, 2016: Scientific Reports
Miguel Manzur, Sukgu M Han, Joie Dunn, Ramsey S Elsayed, Fernando Fleischman, Yolee Casagrande, Fred A Weaver
OBJECTIVE: The objective of this study was to describe the outcomes of patients with acute aortic syndrome (AAS) during and after transfer to a regional aortic center by a rapid transport system. METHODS: Review of patients with AAS who were transferred by a rapid transport system to a regional aortic center was performed. Data regarding demographics, diagnosis, comorbidities, transportation, and hospital course were acquired. Severity of existing comorbidities was determined by the Society for Vascular Surgery Comorbidity Severity Score (SVSCSS)...
October 1, 2016: Journal of Vascular Surgery
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