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risk evaluation in coronary syndrome

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https://www.readbyqxmd.com/read/28207573/genome-wide-analysis-of-clopidogrel-active-metabolite-levels-identifies-novel-variants-that-influence-antiplatelet-response
#1
Joshua D Backman, Jeffrey R O'Connell, Keith Tanner, Cody J Peer, William D Figg, Shawn D Spencer, Braxton D Mitchell, Alan R Shuldiner, Laura M Yerges-Armstrong, Richard B Horenstein, Joshua P Lewis
Clopidogrel is one of the most commonly used therapeutics for the secondary prevention of cardiovascular events in patients with acute coronary syndromes. However, considerable interindividual variation in clopidogrel response has been documented, resulting in suboptimal therapy and an increased risk of recurrent events for some patients. In this investigation, we carried out the first genome-wide association study of circulating clopidogrel active metabolite levels in 513 healthy participants to directly measure clopidogrel pharmacokinetics...
February 15, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28198635/impact-of-comorbidities-by-age-on-symptom-presentation-for-suspected-acute-coronary-syndromes-in-the-emergency-department
#2
Larisa A Burke, Anne G Rosenfeld, Mohamud R Daya, Karen M Vuckovic, Jessica K Zegre-Hemsey, Maria Felix Diaz, Josemare Tosta Daiube Santos, Sahereh Mirzaei, Holli A DeVon
BACKGROUND: It is estimated half of acute coronary syndrome (ACS) patients have one or more associated comorbid conditions. AIMS: Aims were to: 1) examine the prevalence of comorbid conditions in patients presenting to the emergency department with symptoms suggestive of ACS; 2) determine if comorbid conditions influence ACS symptoms; and 3) determine if comorbid conditions predict the likelihood of receiving an ACS diagnosis. METHODS: A total of 1064 patients admitted to five emergency departments were enrolled in this prospective study...
February 1, 2017: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/28195938/low-adverse-event-rates-but-high-emergency-department-utilization-in-chest-pain-patients-treated-in-an-emergency-department-observation-unit
#3
Anthony M Napoli, Janette Baird, Steven Tran, Jing Wang
OBJECTIVES: Nearly 40% of all previously admitted chest pain patients re-present to the emergency department (ED) within 1 year regardless of stress testing, and nearly 5% of patients return with a major adverse cardiac event (MACE). The primary objective of this study was to determine the prevalence of return visits to the ED among patients previously admitted to an ED chest pain observation unit (CPU). We also identified the patient characteristics and health risk factors associated with these return ED visits...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28191713/tissue-characterization-and-phenotype-classification-in-patients-presenting-with-acute-myocardial-infarction-insights-from-the-iwonder-study
#4
Cristiano F Souza, Akiko Maehara, Gary S Mintz, Mitsuaki Matsumura, Claudia M R Alves, Antonio Carlos Carvalho, Adriano Caixeta
OBJECTIVES: We sought to assess a new modality of radiofrequency intravascular ultrasound (IVUS) called iMAP-IVUS (Boston Scientific, Santa Clara, California) during the evaluation of patients presenting with high-risk acute coronary syndromes. BACKGROUND: There are limited data on plaque tissue characterization and phenotype classification using iMAP-IVUS. METHODS: In the iWonder study patients presenting with ST-elevation myocardial infarction (STEMI) or non-STEMI underwent three-vessel grayscale IVUS and iMAP-IVUS tissue characterization prior to percutaneous intervention...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28187174/hyperglycemia-effect-on-coronary-disease-in-patients-with-metabolic-syndrome-evaluated-by-intracoronary-ultrasonography
#5
Beatriz Dal Santo Francisco Bonamichi, Erika Bezerra Parente, Ana Carolina Noronha Campos, Adriano Namo Cury, João Eduardo Nunes Salles
INTRODUCTION: Metabolic syndrome (MS) is characterized by dyslipidemia, central obesity, hypertension and hyperglycemia. However, type 2 diabetes mellitus (T2DM) may or may not be present in metabolic syndrome. MS and T2DM are considered important cardiovascular risk factors, but the role of hyperglycemia in coronary disease is still contested in the literature. Therefore, we decided to evaluate the effect of hyperglycemia on the severity of coronary disease in MS patients, with or without T2DM, submitted to coronary angiography (CA) and intravascular ultrasonography (IVUS)...
2017: PloS One
https://www.readbyqxmd.com/read/28181202/long-term-outcome-of-acute-coronary-syndromes-in-young-patients
#6
Giacomo Tini, Giulia Proietti, Matteo Casenghi, Marzia Colopi, Katia Bontempi, Camillo Autore, Massimo Volpe, Beatrice Musumeci
INTRODUCTION: Acute coronary syndromes (ACS) in young patients are uncommon and their influence on morbidity and mortality in this population is still debated. AIM: We investigated clinical and angiographic characteristics, risk factors and outcome in young patients diagnosed with ACS, compared with those of older patients, evaluating survival free from death and/or nonfatal myocardial infarction (MI) and/or coronary revascularization (primary endpoint), and then with respect to each component of the primary endpoint...
February 8, 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28179614/genotyping-of-six-clopidogrel-metabolizing-enzyme-polymorphisms-has-a-minor-role-in-the-assessment-of-platelet-reactivity-in-patients-with-acute-coronary-syndrome
#7
María Henar García-Lagunar, Luciano Consuegra-Sánchez, Pablo Conesa-Zamora, Javier Ruiz-Cosano, Federico Soria-Arcos, Luis García de Guadiana, Pedro Cano Vivar, Juan Antonio Castillo-Moreno, Antonio Melgarejo-Moreno
OBJECTIVE: To evaluate the contribution of six polymorphisms to the platelet reactivity in patients with acute coronary syndrome (ACS) treated with clopidogrel. METHODS: Cross-sectional study of 278 consecutive patients with ACS. Detailed clinical information for each patient was collected and genotypes (CYP2C9*2, CYP2C9*3, CYP2C19*2, CYP2C19*17, CYP3A4*1B, and PON1-Q192R) were evaluated with TaqMan® and KASPar® assays. Platelet reactivity was measured with VerifyNow®...
February 1, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28174174/discordance-between-circulating-atherogenic-cholesterol-mass-and-lipoprotein-particle-concentration-in-relation-to-future-coronary-events-in-women
#8
Patrick R Lawler, Akintunde O Akinkuolie, Paul M Ridker, Allan D Sniderman, Julie E Buring, Robert J Glynn, Daniel I Chasman, Samia Mora
BACKGROUND: It is uncertain whether measurement of circulating total atherogenic lipoprotein particle cholesterol mass (non-HDL cholesterol [nonHDLc]) or particle concentration (apolipoprotein B[apo B] and LDL particle concentration [LDLp]) more accurately reflects risk of incident coronary heart disease (CHD). We evaluated CHD risk among women in whom these markers where discordant. METHODS: Among 27533 initially healthy women in the Women's Health Study (NCT00000479), using residuals from linear regression models, we compared risk among women with higher or lower observed particle concentration relative to nonHDLc (highest and lowest residual quartiles, respectively) to individuals with agreement between markers (middle quartiles) using Cox proportional hazards models...
February 7, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28153000/effectiveness-of-the-cardiac-diabetes-transcare-program-protocol-for-a-randomised-controlled-trial
#9
Chiung-Jung Jo Wu, John J Atherton, Richard J MacIsaac, Mary Courtney, Anne M Chang, David R Thompson, Karam Kostner, Andrew I MacIsaac, Michael d'Emden, Nick Graves, Steven M McPhail
BACKGROUND: This paper presents a protocol for a randomised controlled trial of the Cardiac-Diabetes Transcare program which is a transitional care, multi-modal self-management program for patients with acute coronary syndrome comorbid with type 2 diabetes. Prior research has indicated people hospitalised with dual cardiac and diabetes diagnoses are at an elevated risk of hospital readmissions, morbidity and mortality. The primary aim of this study is to evaluate the effectiveness (and cost-effectiveness) of a Cardiac-Diabetes Transcare intervention program on 6-month readmission rate in comparison to usual care...
February 2, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28146212/impact-of-high-risk-for-obstructive-sleep-apnea-on-survival-after-acute-coronary-syndrome-insights-from-the-erico-registry
#10
Flavia C Maia, Alessandra C Goulart, Luciano F Drager, Henrique L Staniak, Itamar de Souza Santos, Paulo Andrade Lotufo, Isabela M Bensenor
BACKGROUND: Obstructive sleep apnea (OSA) is a very often clinical condition that can be associated with high mortality risk, particularly in coronary heart disease (CHD). The diagnosis of OSA is not always accessible via the gold-standard method polysomnography. OBJECTIVE: To evaluate long-term influence of the high risk for OSA on fatal and non-fatal outcomes after acute coronary syndrome (ACS) in the Acute Coronary Syndrome Registry Strategy (ERICO) Study using the Berlin questionnaire as a surrogate...
January 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28145667/acute-coronary-syndrome-diagnostic-evaluation
#11
Craig Barstow, Matthew Rice, Jonathan D McDivitt
Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common presentation in patients with MI; however, there are multiple noncardiac causes of chest pain, and the diagnosis cannot always be made based on initial presentation. The assessment of a possible MI includes evaluation of risk factors and presenting signs and symptoms, rapid electrocardiography, and serum cardiac troponin measurements...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28145609/evaluation-of-clinical-outcomes-after-combo-stent-treatment-in-patients-presenting-with-acute-coronary-syndrome
#12
Deborah N Kalkman, Pier Woudstra, Huangling Lu, Ian B A Menown, Peter den Heijer, Harry Suryapranata, Andrés Iñiguez, Karin E Arkenbout, Arnoud W J Van't Hof, Philippe Muller, Andrejs Erglis, Jan G Tijssen, Marcel A M Beijk, Robbert J de Winter
BACKGROUND: Patients presenting with acute coronary syndrome (ACS) are at increased risk of complications after percutaneous coronary intervention with stent placement compared to patients with stable angina (SA) treated in an elective setting. The novel pro-healing COMBO stent is a bio-engineered drug eluting stent designed to promote vessel healing. Therefore, the stent may reduce this difference in clinical outcomes between elective and ACS-patients and prevent late stent thrombosis...
February 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28140321/systematic-review-of-the-association-between-dairy-product-consumption-and-risk-of-cardiovascular-related-clinical-outcomes
#13
REVIEW
Jean-Philippe Drouin-Chartier, Didier Brassard, Maude Tessier-Grenier, Julie Anne Côté, Marie-Ève Labonté, Sophie Desroches, Patrick Couture, Benoît Lamarche
The objective of this systematic review was to determine if dairy product consumption is detrimental, neutral, or beneficial to cardiovascular health and if the recommendation to consume reduced-fat as opposed to regular-fat dairy is evidence-based. A systematic review of meta-analyses of prospective population studies associating dairy consumption with cardiovascular disease (CVD), coronary artery disease (CAD), stroke, hypertension, metabolic syndrome (MetS), and type 2 diabetes (T2D) was conducted on the basis of the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement...
November 2016: Advances in Nutrition
https://www.readbyqxmd.com/read/28139221/long-term-prognostic-value-of-lipoprotein-a-in-symptomatic-patients-with-nonobstructive-coronary-artery-disease
#14
Hao Xie, Liming Chen, Hang Liu, Yuqi Cui, Zhun Zhang, Lianqun Cui
Our study aimed to evaluate the association of lipoprotein(a) [Lp(a)] and prognosis in patients with nonobstructive coronary artery disease (CAD). A total of 4,254 symptomatic patients with suspected CAD referred for coronary angiography were analyzed and 451 patients (250 women, average age 58 ± 9 years) with nonobstructive CAD (defined as no angiographic stenosis ≥50% in any major epicardial artery) were finally included in our cohort. Subjects were categorized into tertile groups according to Lp(a) levels on admission...
January 5, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28139136/spontaneous-coronary-artery-dissection-challenges-of-coronary-computed-tomography-angiography
#15
Mackram F Eleid, Marysia S Tweet, Phillip M Young, Eric Williamson, Sharonne N Hayes, Rajiv Gulati
BACKGROUND: There is limited understanding of the role of cardiac computed tomography angiography (CCTA) for assessment of patients with spontaneous coronary artery dissection (SCAD). METHODS: In this report we describe the diagnostic utility of CCTA in three young women presenting with signs and symptoms of myocardial ischemia who were eventually diagnosed with SCAD. RESULTS: None of the women had traditional atherosclerotic risk factors...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28135897/pharmacokinetic-drug-evaluation-of-vorapaxar-for-secondary-prevention-after-acute-coronary-syndrome
#16
Jose-Angel Perez-Rivera, Jairo Monedero-Campo, Clara Cieza-Borrella, Pablo Ruiz-Perez
Vorapaxar is the first protease-activated receptor-1 inhibitor approved for clinical use. Its main indication is the reduction in thrombotic cardiovascular events in patients with previous myocardial infarction or symptomatic peripheral artery disease. Areas covered: This article reviews the pharmacokinetics of vorapaxar and its potential use in secondary prevention after an acute coronary syndrome. Expert opinion: Vorapaxar inhibits platelet aggregation mediated by thrombin. This effect is carried out without affecting to coagulation parameters and bleeding times...
March 2017: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/28131423/angiotensin-receptor-blockade-improves-cardiac-surgical-outcomes-in-patients-with-metabolic-syndrome
#17
Michael W Manning, Mary Cooter, Joseph Mathew, John Alexander, Eric Peterson, T Bruce Ferguson, Renato Lopes, Mihai Podgoreanu
BACKGROUND: Perioperative use of angiotensin receptor blockers (ARBs) and angiotensin-converting enzyme inhibitors (ACEis) in patients undergoing cardiac operations remains controversial. The current practice of discontinuing renin-angiotensin-system inhibitors preoperatively may negate their beneficial effects in vulnerable populations, including patients with metabolic syndrome, who exhibit elevated renin-angiotensin system activity. We hypothesized that preoperative ARB use is associated with reduced incidence of postoperative complications, compared with ACEi or no drug, in patients with metabolic syndrome undergoing coronary artery bypass grafting...
January 25, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28129459/corticosteroids-for-the-treatment-of-kawasaki-disease-in-children
#18
REVIEW
Andrew J Wardle, Georgia M Connolly, Matthew J Seager, Robert Mr Tulloh
BACKGROUND: Kawasaki disease (KD), or mucocutaneous syndrome, is the leading cause of childhood-acquired heart disease in the developed world. There is much controversy on how best to treat children with KD and in particular who may benefit from additional treatment beyond the standard intravenous immunoglobulin (IVIG) and aspirin, such as the addition of corticosteroids. OBJECTIVES: To assess the impact of corticosteroid use on the incidence of coronary artery abnormalities in KD as either first-line or second-line treatment...
January 27, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28125968/the-ratio-of-serum-n-3-to-n-6-polyunsaturated-fatty-acids-is-associated-with-diabetes-mellitus-in-patients-with-prior-myocardial-infarction-a-multicenter-cross-sectional-study
#19
Masao Takahashi, Jiro Ando, Kazunori Shimada, Yuji Nishizaki, Shigemasa Tani, Takayuki Ogawa, Masato Yamamoto, Ken Nagao, Atsushi Hirayama, Michihiro Yoshimura, Hiroyuki Daida, Ryozo Nagai, Issei Komuro
BACKGROUND: In prior myocardial infarction (PMI) patients, diabetes mellitus (DM), dyslipidemia, and hypertension increase the risk of secondary cardiovascular events. Although a decreased ratio of serum eicosapentaenoic acid (EPA) to arachidonic acid (AA; EPA/AA) has been shown to significantly correlate with the onset of acute coronary syndrome, the associations between polyunsaturated fatty acid (PUFA) levels and coronary risk factors in PMI patients have not been evaluated thoroughly...
January 26, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28122793/real-world-insights-on-the-initiation-and-treatment-duration-of-oral-antiplatelets-in-acute-coronary-syndromes-a-retrospective-cohort-study
#20
Marc J Claeys, Christophe Beauloye, Suzanne Pourbaix, Peter R Sinnaeve
AIMS: This study is a real world, observational study evaluating the treatment persistence of oral antiplatelet (OAP) therapy during a one-year follow-up in patients after an acute coronary syndrome (ACS). METHODS AND RESULTS: Data on diagnosis, comorbidities, follow-up, OAP treatment, reasons, and decision maker for treatment discontinuation in patients who were discharged from a hospital in Belgium after an ACS between 1 July 2012 and 1 June 2013 were collected by cardiologists from 18 centres, up to 360 days from discharge...
January 24, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
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