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risk evaluation in coronary syndrome

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https://www.readbyqxmd.com/read/28515106/direct-comparison-of-2-rule-out-strategies-for-acute-myocardial-infarction-2-h-accelerated-diagnostic-protocol-vs-2-h-algorithm
#1
Karin Wildi, Louise Cullen, Raphael Twerenbold, Jaimi H Greenslade, William Parsonage, Jasper Boeddinghaus, Thomas Nestelberger, Zaid Sabti, Maria Rubini-Giménez, Christian Puelacher, Janosch Cupa, Lukas Schumacher, Patrick Badertscher, Karin Grimm, Nikola Kozhuharov, Claudia Stelzig, Michael Freese, Katharina Rentsch, Jens Lohrmann, Wanda Kloos, Andreas Buser, Tobias Reichlin, John Pickering, Martin Than, Christian Mueller
BACKGROUND: We compared 2 high-sensitivity cardiac troponin (hs-cTn)-based 2-h strategies in patients presenting with suspected acute myocardial infarction (AMI) to the emergency department (ED): the 2-h accelerated diagnostic protocol (2h-ADP) combining hs-cTn, electrocardiogram, and a risk score, and the 2-h algorithm exclusively based on hs-cTn concentrations and their absolute changes. METHODS: Analyses were performed in 2 independent diagnostic cohorts [European Advantageous Predictors of Acute Coronary Syndrome Evaluation (APACE) study, Australian-New Zealand 2-h Accelerated Diagnostic Protocol to Assess patients with chest Pain symptoms using contemporary Troponins as the only biomarker (ADAPT) study] employing hs-cTnT (Elecsys) and hs-cTnI (Architect)...
May 17, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28511683/acute-coronary-syndrome-patients-admitted-to-a-cardiology-vs-non-cardiology-service-variations-in-treatment-outcome
#2
Deirdre E O'Neill, Danielle A Southern, Colleen M Norris, Blair J O'Neill, Helen J Curran, Michelle M Graham
BACKGROUND: Specialized cardiology services have contributed to reduced mortality in acute coronary syndromes (ACS).  We sought to evaluate the outcomes of ACS patients admitted to non-cardiology services in Southern Alberta. METHODS: Retrospective chart review performed on all troponin-positive patients in the Calgary Health Region identified those diagnosed with ACS by their attending team. Patients admitted to non-cardiology and cardiology services were compared, using linked data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry and the Strategic Clinical Network for Cardiovascular Health and Stroke...
May 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28511403/a-prospective-analysis-of-drug-interactions-in-patients-of-intensive-cardiac-care-unit
#3
Shipra Jain, Pushpawati Jain, Kopal Sharma, Pushpendra Saraswat
INTRODUCTION: Drug-Drug Interaction (DDI) is a serious concern in cardiac patients due to polypharmacy. AIM: The present study was aimed to identify the potential DDI among hospitalized cardiac patients and evaluate the mechanism and severity of such interactions. MATERIALS AND METHODS: A prospective observational study was conducted in intensive cardiac care unit of a tertiary care hospital for six months. Patients aged 18 years and above and taking two or more drugs were included in the study...
March 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28509704/effectiveness-of-2-hour-troponin-in-high-risk-patients-with-suspected-acute-coronary-syndrome
#4
Joseph Bove, Steven Hochman, Jacob Miller, Stephen Artim
BACKGROUND: Research has shown the safety and effectiveness of drawing a standard troponin level at presentation and again at 2 hours in only low-risk patients. Because high-sensitivity troponins are not currently approved in the United States, we studied the utility of a standard troponin that is presently in use. Our goal was to determine if 2-hour standard troponin would be safe and effective in the evaluation of a high-risk cohort of patients never studied previously. METHODS: We conducted a single-center prospective observational study of adult patients presenting to the emergency department with signs and symptoms suggestive of acute coronary syndrome...
June 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28506470/coronary-ct-angiography-in-the-emergency-department-utilizing-second-and-third-generation-dual-source-ct
#5
Nandini M Meyersohn, Balint Szilveszter, Pedro V Staziaki, Jan-Erik Scholtz, Richard A P Takx, Udo Hoffmann, Brian B Ghoshhajra
BACKGROUND: Coronary computed tomography angiography (coronary CTA) allows efficient triage of low to intermediate risk patients with suspected acute coronary syndrome (ACS) in the emergency department (ED). Techniques for coronary CTA acquisition in the ED continue to evolve with the establishment of standardized scan protocols and the introduction of newer generations of CT hardware. OBJECTIVES: To evaluate qualitative and quantitative image quality and radiation dose exposure of coronary CTA acquired on 2nd versus 3rd generation dual source CT (DSCT) scanners using a standardized institutional scan protocol designed for the ED...
March 22, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28504219/one-year-clinical-results-of-the-italian-diffuse-multivessel-disease-absorb-prospective-registry-it-disappears
#6
Luca Testa, Marco De Carlo, Alessandro Petrolini, Claudio Rapetto, Ferdinando Varbella, Bernardo Cortese, Gabriele Gabrielli, Salvatore Geraci, Bruno Loi, Giacomo Boccuzzi, Giuseppe Tarantini, Daniela Fischetti, Paolo Calabria, Fabrizio Tomai, Flavio Ribichini, Corrado Tamburino, Ciro Indolfi, Antonio L Bartorelli, Anna Sonia Petronio, Francesco Bedogni
AIMS: The present multicentre prospective study, IT-DISAPPEARS, was designed with the aim of evaluating early and long-term clinical outcomes of the Absorb BVS in patients with long coronary lesions and/or multivessel coronary artery disease. The aim of this article is to present the one-year clinical results of this study. METHODS AND RESULTS: Between November 2014 and January 2016, we enrolled 1,002 patients undergoing BVS implantation (long lesion [≥ 24 mm] of a single vessel in 80...
May 16, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28491083/comparison-of-the-performance-of-the-crusade-acuity-horizons-and-action-bleeding-scores-in-acs-patients-undergoing-pci-insights-from-a-cohort-of-4939-patients-in-china
#7
Ran Liu, Shu-Zheng Lyu, Guan-Qi Zhao, Wen Zheng, Xiao Wang, Xue-Dong Zhao, Sheng-Hui Zhou, Lei Zhen, Shao-Ping Nie
BACKGROUND: The CRUSADE, ACTION and ACUITY-HORIZONS scores are commonly used for predicting in-hospital major bleeding events in patients with acute coronary syndrome (ACS), but the homogeneous nature of these models' population limits simple extrapolation to other local population. We aimed to compare the performance of the three risk models in Chinese patients. METHODS: We evaluated the performance of the three predicting scores for predicting in-hospital major bleeding events defined by thrombolysis in myocardial infarction (TIMI) serious (major and minor) episodes, in a cohort of Chinese ACS patients with either non-ST-elevation ACS (NSTE-ACS) or ST-elevation myocardial infarction (STEMI)...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28489635/trends-in-sex-differences-in-clinical-characteristics-treatment-strategies-and-mortality-in-patients-with-st-elevation-myocardial-infarction-in-poland-from-2005-to-2011
#8
Lukasz Zandecki, Marcin Sadowski, Marianna Janion, Marek Gierlotka, Mariusz Gasior, Lech Polonski
INTRODUCTION: During the last decade, there has been an increased awareness of sex differences in the clinical characteristics, management, and mortality in myocardial infarction. Many previous studies have found that women with ST-elevation myocardial infarction (STEMI) have a poorer baseline risk profile, are less intensively treated, and have worse outcomes. OBJECTIVE: To evaluate whether sex disparities in STEMI have changed in recent years. METHODS: This is a retrospective analysis of data on 111 148 STEMI patients enrolled in the Polish Registry of Acute Coronary Syndromes between 2005 and 2011...
May 5, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28487137/clinical-risk-factors-alone-are-inadequate-for-predicting-significant-coronary-artery-disease
#9
Frederick K Korley, Constantine Gatsonis, Bradley S Snyder, Richard T George, Thura Abd, Stefan L Zimmerman, Harold I Litt, Judd E Hollander
OBJECTIVE: We sought to derive and validate a model for identifying suspected ACS patients harboring undiagnosed significant coronary artery disease (CAD). METHODS: This was a secondary analysis of data from a randomized control trial (RCT). Patients randomized to the CTA arm of an RCT examining a CTA-based strategy for ruling-out acute coronary syndrome (ACS) constitute the derivation cohort, which was randomly divided into a training dataset (2/3, used for model derivation) and a test dataset (1/3, used for internal validation (IV))...
April 27, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28483589/takotsubo-cardiomyopathy-after-microwave-ablation-for-metastatic-liver-lesions
#10
Mostafa Afennas, Hans Bonnier, Danny Schoors
Takotsubo cardiomyopathy (TCMP) is characterized by transient and reversible left ventricular regional wall motion abnormalities triggered by acute and intense emotional or physical stress. We present a case of a 79 year old woman with a hypertensive crisis after microwave ablation (MWA) for metastatic liver lesions. Initial evaluation suggested an acute coronary syndrome with an ST segment elevation and with elevated serum troponin T. No associated chest pain or dyspnea was present. Further evaluation with ECG, echocardiography, coronarography with left ventricle angiogram and MRI was consistent with an apical ballooning syndrome...
April 29, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28482277/serum-polyunsaturated-fatty-acids-and-risk-of-psychiatric-disorder-after-acute-coronary-syndrome-a-prospective-cohort-study
#11
Akihiro Yamashita, Hiroko Noguchi, Kei Hamazaki, Yasuhiro Sato, Tomomi Narisawa, Yuzuru Kawashima, Masato Usuki, Daisuke Nishi, Haruo Yoshimasu, Naoshi Horikawa, Yutaka J Matsuoka
BACKGROUND: Around 20% of patients with acute coronary syndrome (ACS) develop depression. Furthermore, some observational studies revealed baseline polyunsaturated fatty acids (PUFAs) may affect the prognosis of depression after ACS. This prospective cohort study examined the association between psychiatric disorder and PUFAs after ACS. METHODS: Subjects were ACS patients admitted to a Tokyo teaching hospital. Psychiatric morbidity as a primary endpoint was measured using structured interview 3 months after admission...
May 3, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28472362/association-of-diabetic-macular-edema-and-proliferative-diabetic-retinopathy-with-cardiovascular-disease-a-systematic-review-and-meta-analysis
#12
Jing Xie, M Kamran Ikram, Mary Frances Cotch, Barbara Klein, Rohit Varma, Jonathan E Shaw, Ronald Klein, Paul Mitchell, Ecosse L Lamoureux, Tien Yin Wong
Importance: Previous studies on the relationship between diabetic retinopathy (DR) and cardiovascular disease (CVD) focused on the early stages of DR. Understanding whether patients with type 2 diabetes and severe stages of DR (diabetic macular edema [DME] and proliferative diabetic retinopathy [PDR]) have a higher risk of CVD will allow physicians to more effectively counsel patients. Objective: To examine the association of severe stages of DR (DME and PDR) with incident CVD in patients with type 2 diabetes...
May 4, 2017: JAMA Ophthalmology
https://www.readbyqxmd.com/read/28460769/premature-coronary-artery-disease-in-india-coronary-artery-disease-in-the-young-cady-registry
#13
S S Iyengar, Rajiv Gupta, Sandhya Ravi, Saral Thangam, Thomas Alexander, C N Manjunath, R Keshava, C B Patil, Annie Sheela, J P S Sawhney
BACKGROUND: Coronary artery disease (CAD) occurs at younger age in India but only a limited number of studies have evaluated risk factors and management status. This is a multisite observational registry to assess risk factors and treatment patterns in young patients presenting with acute coronary syndrome (ACS) and stable ischemic heart disease (IHD). METHODS: We recruited 997 young patients (men <55, women <65y) presenting with ACS or stable IHD successively at 22 centers across India...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28456882/the-nlrp3-and-casp1-gene-polymorphisms-are-associated-with-developing-of-acute-coronary-syndrome-a-case-control-study
#14
Hector Gonzalez-Pacheco, Gilberto Vargas-Alarcon, Javier Angeles-Martinez, Carlos Martinez-Sanchez, Oscar Perez-Mendez, Gabriel Herrera-Maya, Marco Antonio Martinez-Rios, Marco Antonio Peña-Duque, Carlos Posadas-Romero, Jose Manuel Fragoso
The protein products of NLRP3 and CASP1 genes are involved in the cleavage of pro-IL-1B and pro-IL-18 leading to the active cytokines, which play an important role in the development of the acute coronary syndrome (ACS). The aim of the present study was to evaluate whether NLRP3 and CASP1 gene polymorphisms are biomarkers of ACS susceptibility in Mexican population. Two polymorphisms of the CASP1 gene [G+7/in6A (rs501192) and A10370-G Exon-6 (rs580253)] and one of the NLRP3 gene [UTR'3 G37562-C (rs10754558)] were genotyped by 5' exonuclease TaqMan assays in a group of 617 patients with ACS and 609 control individuals...
April 30, 2017: Immunologic Research
https://www.readbyqxmd.com/read/28454837/balancing-the-risk-of-spontaneous-ischemic-and-major-bleeding-events-in-acute-coronary-syndromes
#15
Gregory Ducrocq, Phillip J Schulte, Andrzej Budaj, Jan H Cornel, Claes Held, Anders Himmelmann, Steen Husted, Robert F Storey, Christopher P Cannon, Richard C Becker, Stefan K James, Hugo A Katus, Renato D Lopes, Emmanuel Sorbets, Lars Wallentin, Philippe Gabriel Steg
Evaluation of antithrombotic treatments for acute coronary syndromes (ACS) requires balancing ischemic and bleeding risks to assess net benefit. We sought to compare the relative effects of ischemic and bleeding events on mortality. METHODS: In the PLATelet inhibition and patient Outcomes (PLATO) trial, we compared spontaneous ischemic events (myocardial infarction or stroke) with spontaneous major bleeding events (PLATO major, Thrombolysis In Myocardial Infarction [TIMI] major, Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries [GUSTO] severe) with respect to risk of mortality using time-dependent Cox proportional hazards models...
April 2017: American Heart Journal
https://www.readbyqxmd.com/read/28454808/an-examination-of-the-relationship-between-serum-uric-acid-level-a-clinical-history-of-gout-and-cardiovascular-outcomes-among-patients-with-acute-coronary-syndrome
#16
Neha J Pagidipati, Connie N Hess, Robert M Clare, Axel Akerblom, Pierluigi Tricoci, Daniel Wojdyla, Robert T Keenan, Stefan James, Claes Held, Kenneth W Mahaffey, Alyssa B Klein, Lars Wallentin, Matthew T Roe
BACKGROUND: Studies have suggested a relationship between higher baseline serum uric acid (sUA) levels and an elevated risk of subsequent ischemic cardiovascular outcomes among acute coronary syndrome (ACS) patients; this relationship may be modified by a clinical history of gout and has not been studied in large patient cohorts. We sought to understand the effect of sUA and gout on ACS outcomes. METHODS: Using PLATO and TRACER data on 27,959 ACS patients, we evaluated baseline sUA levels in relation to a composite of cardiovascular death, myocardial infarction (MI), or stroke...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28449559/effects-of-escitalopram-on-anxiety-in-patients-with-acute-coronary-syndrome-a-randomized-controlled-trial
#17
Hee-Ju Kang, Kyung-Yeol Bae, Sung-Wan Kim, Il-Seon Shin, Young Joon Hong, Youngkeun Ahn, Myung Ho Jeong, Jin-Sang Yoon, Jae-Min Kim
Objective: There are no evidence-based practices for treating anxiety in patients with acute coronary syndrome (ACS). Thus, we investigated the effects of escitalopram on anxiety in this population. Methods: We enrolled 217 patients with ACS who met Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria for depressive disorders into a randomized double-blind placebo-controlled study. Patients received either escitalopram or placebo over a 24-week period...
May 31, 2017: Clinical Psychopharmacology and Neuroscience: the Official Scientific Journal of the Korean College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28437620/american-association-of-clinical-endocrinologists-and-american-college-of-endocrinology-guidelines-for-management-of-dyslipidemia-and-prevention-of-cardiovascular-disease
#18
Paul S Jellinger, Yehuda Handelsman, Paul D Rosenblit, Zachary T Bloomgarden, Vivian A Fonseca, Alan J Garber, George Grunberger, Chris K Guerin, David S H Bell, Jeffrey I Mechanick, Rachel Pessah-Pollack, Kathleen Wyne, Donald Smith, Eliot A Brinton, Sergio Fazio, Michael Davidson
OBJECTIVE: The development of these guidelines is mandated by the American Association of Clinical Endocrinologists (AACE) Board of Directors and American College of Endocrinology (ACE) Board of Trustees and adheres with published AACE protocols for the standardized production of clinical practice guidelines (CPGs). METHODS: Recommendations are based on diligent reviews of the clinical evidence with transparent incorporation of subjective factors, according to established AACE/ACE guidelines for guidelines protocols...
April 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28434483/what-imaging-techniques-should-be-used-in-primary-versus-secondary-prevention-for-further-risk-stratification
#19
François Schiele, Eliano Pio Navarese, Adriana Visoná, Kausik Ray
BACKGROUND AND AIMS: An accurate assessment of the cardiovascular (CV) risk of an individual is key for guiding the appropriate treatment strategy for cardiovascular disease (CVD). Although conventional risk factors for CVD are well established, there can be substantial variation in the extent of atherosclerosis between patients. The use of a variety of imaging modalities can be beneficial in the primary prevention stage and in the classification of an individual's CV risk. Therefore, appropriate implementation of these imaging techniques for risk assessment purposes, in line with clinical guidelines, can influence the outcomes of CVD prevention...
April 2017: Atherosclerosis. Supplements
https://www.readbyqxmd.com/read/28430594/the-prognostic-significance-of-preoperative-left-ventricular-diastolic-dysfunction-and-left-atrial-enlargement-on-acute-coronary-syndrome-in-kidney-transplantation
#20
Jin Ho Hwang, Jun-Bean Park, Yong-Jin Kim, Jung Nam An, Jaeseok Yang, Curie Ahn, In Mok Jung, Chun Soo Lim, Yon Su Kim, Young Hoon Kim, Jung Pyo Lee
Echocardiography is commonly performed as a screening test to evaluate perioperative risks before kidney transplantation. However, only limited data are available on echocardiographic parameters of left ventricular diastolic dysfunction (LVDD) and left atrial enlargement (LAE) on acute coronary syndrome and mortality in kidney transplant recipients. We reviewed 2779 adult recipients who underwent pretransplant echocardiography from 1997 to 2012. We divided the patients into two and four groups by two categories: LVDD grades 0-1 vs...
April 5, 2017: Oncotarget
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