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risk evaluation in coronary syndrome

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https://www.readbyqxmd.com/read/29164902/secondary-prevention-programme-of-ischaemic-heart-disease-in-the-elderly-a-randomised-clinical-trial
#1
Elisenda Marcos-Forniol, José F Meco, Emili Corbella, Francesc Formiga, Xavier Pintó
Background Elderly patients have been underrepresented in secondary cardiovascular prevention programmes. This study aimed to ascertain the effects of a secondary coronary disease prevention programme in these patients. Design Open randomised intervention study with parallel groups. Methods One hundred and twenty-seven patients aged ≥70 years with a recent acute coronary syndrome were randomised to a protocolised clinical intervention plus usual care (intervention group, n = 64) or to usual care alone (control group, n = 63)...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29160388/incremental-prognostic-value-of-the-incorporation-of-clinical-data-into-coronary-anatomy-data-in-acute-coronary-syndromes-syntax-grace-score
#2
Mateus Dos Santos Viana, Fernanda Lopes, Antonio Mauricio Dos Santos Cerqueira, Jessica Gonzalez Suerdieck, André Barcelos da Silva, Ana Clara Barcelos da Silva, Thiago Menezes Barbosa de Souza, Manuela Campelo Carvalhal, Marcia Maria Noya Rabelo, Luis Claudio Lemos Correia
BACKGROUND: When performing coronary angiography in patients with acute coronary syndrome (ACS), the anatomical extent of coronary disease usually prevails in the prognostic reasoning. It has not yet been proven if clinical data should be accounted for in risk stratification together with anatomical data. OBJECTIVE: To test the hypothesis that clinical data increment the prognostic value of anatomical data in patients with ACS. METHODS: Patients admitted with objective criteria for ACS and who underwent angiography during hospitalization were included...
November 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/29155984/cysteine-rich-angiogenic-inducer-61-cyr61-a-novel-soluble-biomarker-of-acute-myocardial-injury-improves-risk-stratification-after-acute-coronary-syndromes
#3
Roland Klingenberg, Soheila Aghlmandi, Christoph Liebetrau, Lorenz Räber, Baris Gencer, David Nanchen, David Carballo, Alexander Akhmedov, Fabrizio Montecucco, Stefan Zoller, Chad Brokopp, Dik Heg, Peter Jüni, Helena Marti Soler, Pedro-Manuel Marques-Vidal, Peter Vollenweider, Oliver Dörr, Nicolas Rodondi, François Mach, Stephan Windecker, Ulf Landmesser, Arnold von Eckardstein, Christian W Hamm, Christian M Matter, Thomas F Lüscher
Aims: We aimed to identify a novel biomarker involved in the early events leading to an acute coronary syndrome (ACS) and evaluate its role in diagnosis and risk stratification. Methods and results: Biomarker identification was based on gene expression profiling. In coronary thrombi of ACS patients, cysteine-rich angiogenic inducer 61 (Cyr61, CCN1) gene transcripts were highly up-regulated compared with peripheral mononuclear cells. In a murine ischaemia-reperfusion model (I/R), myocardial Cyr61 expression was markedly increased compared with the controls...
November 16, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29154691/optimal-screening-methods-to-detect-cardiac-disorders-in-athletes-an-evidence-based-review
#4
Zachary K Winkelmann, Ashley K Crossway
Reference/Citation:  Harmon KG, Zigman M, Drezner JA. The effectiveness of screening history, physical exam, and ECG to detect potentially lethal cardiac disorders in athletes: a systematic review/meta-analysis. J Electrocardiol. 2015;48(3):329-338. CLINICAL QUESTION:   Which screening method should be considered best practice to detect potentially lethal cardiac disorders during the preparticipation physical examination (PE) of athletes? DATA SOURCES:   The authors completed a comprehensive literature search of MEDLINE, CINAHL, Cochrane Library, Embase, Physiotherapy Evidence Database (PEDro), and SPORTDiscus from January 1996 to November 2014...
November 20, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/29151439/clopidogrel-or-ticagrelor-in-acute-coronary-syndrome-patients-treated-with-newer-generation-drug-eluting-stents-change-dapt
#5
Paolo Zocca, Liefke C van der Heijden, Marlies M Kok, Marije M Löwik, Marc Hartmann, Martin G Stoel, J W Louwerenburg, Frits H A F de Man, Gerard C M Linssen, Iris L Knottnerus, Carine J M Doggen, K Gert van Houwelingen, Clemens von Birgelen
AIMS: Acute coronary syndrome (ACS) guidelines have been changed, favouring more potent antiplatelet drugs. We aimed to evaluate the safety and efficacy of a ticagrelor- instead of a clopidogrel-based primary dual antiplatelet (DAPT) regimen in ACS patients treated with newer-generation drug-eluting stents (DES). METHODS AND RESULTS: CHANGE DAPT (clinicaltrials.gov: NCT03197298) assessed 2,062 consecutive real-world ACS patients, treated by percutaneous coronary intervention (PCI), the primary composite endpoint being net adverse clinical and cerebral events (NACCE: all-cause death, any myocardial infarction, stroke or major bleeding)...
November 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/29150207/carotid-and-femoral-atherosclerosis-in-antiphospholipid-syndrome-equivalent-risk-with-diabetes-mellitus-in-a-case-control-study
#6
Evrydiki Kravvariti, George Konstantonis, Nikolas Tentolouris, Petros P Sfikakis, Maria G Tektonidou
BACKGROUND: Antiphospholipid syndrome (APS) may carry a worse prognosis for vascular complications when co-existing with subclinical atherosclerosis; however, the association between the two conditions remains ambiguous. METHODS: We evaluated ultrasonographic markers of subclinical atherosclerosis in carotid and femoral arteries of 86 patients with thrombotic APS [43 primary APS (PAPS), 43 systemic lupus erythematosus-associated APS (SLE/APS)], 86 patients with diabetes mellitus (DM) and 86 healthy controls, individually matched for age and gender, and investigated their associations with traditional and disease-related factors in APS...
October 23, 2017: Seminars in Arthritis and Rheumatism
https://www.readbyqxmd.com/read/29141503/association-of-the-genetic-and-traditional-risk-factors-of-ischaemic-heart-disease-with-stemi-and-nstemi-development
#7
Diana Žaliaduonytė-Pekšienė, Vaiva Lesauskaitė, Rasa Liutkevičienė, Vytenis Tamakauskas, Vilius Kviesulaitis, Giedrė Šinkūnaitė-Maršalkienė, Sandrita Šimonytė, Simonita Mačiulskytė, Eglė Tamulevičiūtė-Prascienė, Olivija Gustienė, Abdonas Tamošiūnas, Remigijus Žaliūnas
INTRODUCTION: To evaluate the influence of traditional risk factors of ischaemic heart disease and genetic factors to predict different types of acute coronary syndromes. MATERIALS AND METHODS: Five hundred and twenty-three patients with acute coronary syndromes (393 with ST elevation myocardial infarction (STEMI) and 130 with non-ST elevation myocardial infarction (NSTEMI)) comprised the study group. The control group consisted of 645 subjects free from symptoms of ischaemic heart disease and stroke...
October 2017: Journal of the Renin-angiotensin-aldosterone System: JRAAS
https://www.readbyqxmd.com/read/29138293/icare-acs-improving-care-processes-for-patients-with-suspected-acute-coronary-syndrome-a-study-of-cross-system-implementation-of-a-national-clinical-pathway
#8
Martin P Than, John W Pickering, Jeremy M Dryden, Sally J Lord, S Andrew Aitken, Sally J Aldous, Kate E Allan, Michael W Ardagh, John W N Bonning, Rosie Callender, Laura R E Chapman, Jonathan P Christiansen, Andre P J Cromhout, Louise Cullen, Joanne M Deely, Gerard P Devlin, Katherine A Ferrier, Christopher M Florkowski, Christopher M A Frampton, Peter M George, Gregory J Hamilton, Allan S Jaffe, Andrew J Kerr, G Luke Larkin, Richard M Makower, Timothy J E Matthews, William A Parsonage, W Frank Peacock, Bradley F Peckler, Nicholaas C van Pelt, Louise Poynton, A Mark Richards, Anthony G Scott, Mark B Simmonds, David Smyth, Oliver P Thomas, Andrew C Y To, Stephen A Du Toit, Richard W Troughton, Kim M Yates
BACKGROUND : Efforts to safely reduce length of stay for emergency department patients with symptoms suggestive of acute coronary syndrome (ACS) have had mixed success. Few system-wide efforts affecting multiple hospital emergency departments have ever been evaluated. We evaluated the effectiveness of a nationwide implementation of clinical pathways for potential ACS in disparate hospitals. METHODS : This was a multicenter pragmatic stepped-wedge before-and-after trial in 7 New Zealand acute care hospitals with 31 332 patients investigated for suspected ACS with serial troponin measurements...
November 14, 2017: Circulation
https://www.readbyqxmd.com/read/29135625/impact-of-sex-on-long-term-clinical-outcomes-after-percutaneous-coronary-intervention
#9
Seyed-Mohammad Ghoreyshi-Hefzabad, Seyed-Ebrahim Kassaian, Shahrbanoo Kheirkhah-Sabetghadam, Arash Jalali, Hamidreza Poorhosseini, Mohammad Reza Movahed, Ebrahim Nematipour, Mojtaba Salarifar, Mohammad Alidoosti, Seyedeharezoo Ghoreyshi-Hefzabad, Farshid Alaeddini, Saeed Sadeghian, Masoumeh Lotfi-Tokaldany
AIMS: To evaluate the impact of sex on long-term clinical outcomes after percutaneous coronary intervention (PCI). METHODS: In a large prospective cohort, 5664 patients (1716 women and 3948 men) who underwent PCI in a tertiary cardiac center between March 2007 and March 2010 were enrolled. Patients were followed up for median of 74.3 months. We compared the occurrence of long-term mortality, myocardial infarction (MI), and repeated revascularization between 2 sexes...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29135621/efficacy-of-implementation-of-a-chest-pain-center-at-a-community-hospital
#10
Alexandra Davis, Jason Chiu, Stanley K Lau, Yih Jen Kok, Jonathan Y H Wu
INTRODUCTION: Chest pain is the second leading cause for emergency department (ED) visits in the United States; however, <20% of the patients have acute coronary syndrome that require immediate attention. The HEART score is designed for rapid risk stratification of ED chest pain patients using the following criteria: history, electrocardiogram, age, risk factors, and troponin. It has been shown to be superior in identifying patients with low (HEART score 0-3) and high (7-10) risk of major adverse cardiac events, who can then be rapidly discharged or admitted for intervention...
December 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/29134853/real-world-clopidogrel-utilization-in-acute-coronary-syndromes-patients-selection-and-outcomes-in-a-single-center-experience
#11
Diego Castini, Simone Persampieri, Sara Cazzaniga, Giulia Ferrante, Marco Centola, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: With this study, we sought to identify patient characteristics associated with clopidogrel prescription and its relationship with in-hospital adverse events in an unselected cohort of ACSs patients. MATERIALS AND METHODS: We studied all consecutive patients admitted at our institution for ACSs from 2012 to 2014. Patients were divided into two groups based on clopidogrel or novel P2Y12 inhibitors (prasugrel or ticagrelor) prescription and the relationship between clopidogrel use and patient clinical characteristics and in-hospital adverse events was evaluated using logistic regression analysis...
December 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29132766/neutrophil-to-lymphocyte-ratio-predict-mortality-and-major-adverse-cardiac-events-in-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#12
Chao-Hui Dong, Zhang-Min Wang, Si-Yu Chen
OBJECTIVES: Neutrophil to lymphocyte ratio (NLR) might be associated with the mortality or major adverse cardiac events (MACEs) in acute coronary syndrome (ACS) patients. We performed a meta-analysis to evaluate the correlation between NLR and mortality/MACEs in ACS. METHODS: We assessed clinical trials through Pubmed, EMBASE, the Cochrane Library and Web of science in investigating the association between NLR and mortality/MACEs in ACS patients up to August 15, 2017...
November 10, 2017: Clinical Biochemistry
https://www.readbyqxmd.com/read/29132152/diagnostic-accuracy-of-screening-tests-and-treatment-for-post-acute-coronary-syndrome-depression-a-systematic-review
#13
Jason A Nieuwsma, John W Williams, Natasha Namdari, Jeffrey B Washam, Giselle Raitz, James A Blumenthal, Wei Jiang, Roshini Yapa, Amanda J McBroom, Kathryn Lallinger, Robyn Schmidt, Andrzej S Kosinski, Gillian D Sanders
Background: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. Purpose: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29131477/a-risk-assessment-score-and-initial-high-sensitivity-troponin-combine-to-identify-low-risk-of-acute-myocardial-infarction-in-the-emergency-department
#14
John W Pickering, Dylan Flaws, Stephen W Smith, Jaimi Greenslade, Louise Cullen, William Parsonage, Edward Carlton, A Mark Richards, Richard Troughton, Christopher Pemberton, Peter M George, Martin P Than
OBJECTIVES: Early discharge of patients with presentations triggering assessment for possible acute coronary syndrome is safe when clinical assessment indicates low-risk, biomarkers are negative, and electrocardiograms (ECGs) are non-ischemic. We hypothesized that the Emergency Department Assessment of Chest Pain Score (EDACS) combined with a single measurement of high-sensitivity cardiac troponin (hs-cTn) could allow early discharge of a clinically meaningful proportion of patients. METHODS: We pooled data from 4 patient cohorts from New Zealand and Australia presenting to an ED with symptoms suggestive of ACS...
November 13, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29131293/dynamic-thiol-disulfide-homeostasis-and-its-prognostic-value-in-patients-with-non-st-elevation-acute-coronary-syndromes
#15
Serkan Sivri, Hacı Ahmet Kasapkara, Melike Polat, Yakup Alsancak, Tahir Durmaz, Özcan Erel, Engin Bozkurt
BACKGROUND: Cardiovascular diseases are still one of the leading causes of death in industrialized countries, and oxidative stress plays an important role in the pathogenesis of acute coronary syndromes (ACS). The dynamic thiol/disulfide homeostasis has an important role in maintaining the oxidant-antioxidant balance. AIM: We aimed to demonstrate the relationship between dynamic thiol/disulfide homeostasis parameters and non-ST elevation ACS (NSTE-ACS). METHODS: The patients with NSTE-ACS (n:210) and a control group (n:185) were included in the study...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29129350/evaluation-of-ecg-algorithms-designed-to-improve-detect-of-transient-myocardial-ischemia-to-minimize-false-alarms-in-patients-with-suspected-acute-coronary-syndrome
#16
Michele M Pelter, Yuan Xu, Richard Fidler, Ran Xiao, David W Mortara, Hu Xiao
BACKGROUND: Patients hospitalized for suspected acute coronary syndrome (ACS) are at risk for transient myocardial ischemia. During the "rule-out" phase, continuous ECG ST-segment monitoring can identify transient myocardial ischemia, even when asymptomatic. However, current ST-segment monitoring software is vastly underutilized due to false positive alarms, with resultant alarm fatigue. Current ST algorithms may contribute to alarm fatigue because; (1) they are not designed with a delay (minutes), rather alarm to brief spikes (i...
October 24, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/29128412/association-between-gestational-diabetes-and-incident-maternal-ckd-the-coronary-artery-risk-development-in-young-adults-cardia-study
#17
Elizabeth W Dehmer, Milind A Phadnis, Erica P Gunderson, Cora E Lewis, Kirsten Bibbins-Domingo, Stephanie M Engel, Michele Jonsson Funk, Holly Kramer, Abhijit V Kshirsagar, Gerardo Heiss
BACKGROUND: Gestational diabetes mellitus (GDM) is associated with increased risk for diabetes mellitus, metabolic syndrome, and cardiovascular disease. We evaluated whether GDM is associated with incident chronic kidney disease (CKD), controlling for prepregnancy risk factors for both conditions. STUDY DESIGN: Prospective cohort. SETTING & PARTICIPANTS: Of 2,747 women (aged 18-30 years) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) Study in 1985 to 86, we studied 820 who were nulliparous at enrollment, delivered at least 1 pregnancy longer than 20 weeks' gestation, and had kidney function measurements during 25 years of follow-up...
November 8, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29127948/association-of-high-sensitivity-cardiac-troponin-i-concentration-with-cardiac-outcomes-in-patients-with-suspected-acute-coronary-syndrome
#18
Andrew R Chapman, Kuan Ken Lee, David A McAllister, Louise Cullen, Jaimi H Greenslade, William Parsonage, Andrew Worster, Peter A Kavsak, Stefan Blankenberg, Johannes Neumann, Nils A Söerensen, Dirk Westermann, Madelon M Buijs, Gerard J E Verdel, John W Pickering, Martin P Than, Raphael Twerenbold, Patrick Badertscher, Zaid Sabti, Christian Mueller, Atul Anand, Philip Adamson, Fiona E Strachan, Amy Ferry, Dennis Sandeman, Alasdair Gray, Richard Body, Brian Keevil, Edward Carlton, Kim Greaves, Frederick K Korley, Thomas S Metkus, Yader Sandoval, Fred S Apple, David E Newby, Anoop S V Shah, Nicholas L Mills
Importance: High-sensitivity cardiac troponin I testing is widely used to evaluate patients with suspected acute coronary syndrome. A cardiac troponin concentration of less than 5 ng/L identifies patients at presentation as low risk, but the optimal threshold is uncertain. Objective: To evaluate the performance of a cardiac troponin I threshold of 5 ng/L at presentation as a risk stratification tool in patients with suspected acute coronary syndrome. Data Sources: Systematic search of MEDLINE, EMBASE, Cochrane, and Web of Science databases from January 1, 2006, to March 18, 2017...
November 11, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29122277/influence-of-body-mass-index-on-long-term-survival-after-cardiac-catheterization
#19
Barak Zafrir, Ronen Jaffe, Ronen Rubinshtein, Basheer Karkabi, Moshe Y Flugelman, David A Halon
We examined 18,654 patients who underwent cardiac catheterization in a single center to clarify the association between catheterization indication, body mass index (BMI), and long-term survival over a mean follow-up of 81 months. Patients were grouped by indication for catheterization: (a) acute coronary syndromes (ACS), 7,426 patients; (b) coronary artery disease (CAD) evaluation in stable clinical presentation, 6,911 patients; and (c) primarily non-CAD cardiac evaluations, 4,317 patients. Compared with normal weight, overweight and obesity (but not morbid obesity) was associated with lower risk of long-term mortality...
October 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/29121725/real-world-study-of-low-density-lipoprotein-cholesterol-levels-and-cardiovascular-outcomes-in-chinese-a-retrospective-cohort-study-in-post-percutaneous-coronary-intervention-acute-coronary-syndrome-patients
#20
Yun Wang, Bryan P Yan, Michael B Nichol, Brian Tomlinson, Vivian W Y Lee
BACKGROUND: This study aimed to assess the effect of low-density lipoprotein cholesterol (LDL-C) goal attainments (of <2.6mmol/L and <1.8mmol/L) on first major adverse cardiovascular events (MACEs) for acute coronary syndrome (ACS) patients who underwent percutaneous coronary intervention (PCI). METHODS: A retrospective cohort study was conducted using case reviews of post-PCI ACS patients at an acute public hospital in Hong Kong between January 2009 and August 2015...
December 15, 2017: International Journal of Cardiology
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