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risk evaluation in coronary syndrome

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https://www.readbyqxmd.com/read/28303685/impact-of-coronary-plaque-morphology-assessed-by-optical-coherence-tomography-on-cardiac-troponin-elevation-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome
#1
Tetsumin Lee, Tadashi Murai, Mitsuaki Isobe, Tsunekazu Kakuta
OBJECTIVES: This study aimed to use optical coherence tomography (OCT) to study the relationship between plaque morphology prior to percutaneous coronary intervention (PCI) and post-PCI cardiac troponin (cTn) elevations in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Furthermore, the relationship between these findings and the adverse cardiac events during follow-up was assessed. BACKGROUND: Association between post-PCI cTn elevations and OCT findings in NSTE-ACS patients is unclear...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302342/does-percutaneous-coronary-stent-implantation-increase-platelet-reactivity
#2
REVIEW
P W A Janssen, E A Mol, S M C Geene, E Barbato, J M Ten Berg
High platelet reactivity (PR) values on treatment with clopidogrel are associated with an increased rate of thrombotic events after a percutaneous coronary intervention (PCI). However, we do not know the optimal timing of the performance of the PR measurements. Platelets might be activated during a PCI, which means that the timing of PR measurements, before or after PCI, could influence the outcome. In turn, this could lead to misinterpretation of the patient's response to antiplatelet therapy and a less accurate prediction of the patient's risk of thrombotic events during follow-up...
March 8, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28286825/screening-characteristics-of-timi-score-in-predicting-acute-coronary-syndrome-outcome-a-diagnostic-accuracy-study
#3
Mostafa Alavi-Moghaddam, Saeed Safari, Hamideh Alavi-Moghaddam
INTRODUCTION: In cases with potential diagnosis of ischemic chest pain, screening high risk patients for adverse outcomes would be very helpful. The present study was designed aiming to determine the diagnostic accuracy of thrombolysis in myocardial infarction (TIMI) score in Patients with potential diagnosis of ischemic chest pain. METHOD: This diagnostic accuracy study was designed to evaluate the screening performance characteristics of TIMI score in predicting 30-day outcomes of mortality, myocardial infarction (MI), and need for revascularization in patients presenting to ED with complaint of typical chest pain and diagnosis of unstable angina or Non-ST elevation MI...
2017: Emergency (Tehran, Iran)
https://www.readbyqxmd.com/read/28284460/the-impact-of-prolonged-waiting-time-for-coronary-care-unit-admission-on-patients-with-non-st-elevation-acute-coronary-syndrome
#4
Chien-Chih Chen, I-Min Chiu, Fu-Jen Cheng, Kuan-Han Wu, Chao-Jui Li
BACKGROUND: The boarding of patients in the emergency department consumes nursing and physician resources, and may delay the evaluation of new patients. It may also contribute to poor cardiovascular outcomes in patients with acute coronary syndrome (ACS). This study analyzed the relationship between the delay in coronary care unit (CCU) admission and the clinical outcomes of patients with ACS with non-ST-segment elevation (NSTE-ACS). METHODS: Patients were divided into 2 groups according to the CCU waiting time (<12h and >12h)...
February 28, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28275590/protocol-for-evaluating-the-cardio-ankle-vascular-index-to-predict-cardiovascular-events-in-japan-a-prospective-multicenter-cohort-study
#5
REVIEW
Toru Miyoshi, Hiroshi Ito, Shigeo Horinaka, Kohji Shirai, Jitsuo Higaki, Hajime Orimio
INTRODUCTION: The cardio-ankle vascular index (CAVI) was developed in Japan and is a blood pressure-independent index of arterial stiffness from the origin of the aorta to the ankle. In recent years, it has been studied by many researchers worldwide, and it is strongly anticipated that it will play a role as a predictive factor for arteriosclerotic diseases. The objective of this study was to examine the benefits of using CAVI as a predictor of cardiovascular events in high-risk patients...
January 2017: Pulse (Basel, Switzerland)
https://www.readbyqxmd.com/read/28268082/discrimination-of-stress-takotsubo-cardiomyopathy-from-acute-coronary-syndrome-with-clinical-risk-factors-and-coronary-evaluation-in-real-world-clinical-practice
#6
So-Ryoung Lee, Sang Eun Lee, Tae-Min Rhee, Jin Joo Park, Hyunjai Cho, Hae-Young Lee, Dong-Ju Choi, Byung-Hee Oh
BACKGROUND: Diagnosing stress cardiomyopathy (SCMP) apart from acute coronary syndrome (ACS) is challenging since coronary evaluation is not always feasible in real-world clinical practice. We explored the current practice pattern of coronary evaluation in patients suspected to have SCMP and divulged the distinguishable features of SCMP from ACS. METHODS AND RESULTS: From 2010 to 2015, only 219 out of 691 (32%) hospitalized patients suspected to have SCMP have received coronary evaluation in two tertiary hospitals...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28267472/intravascular-ultrasound-guided-vs-angiography-guided-drug-eluting-stent-implantation-in-complex-coronary-lesions-meta-analysis-of-randomized-trials
#7
Chirag Bavishi, Partha Sardar, Saurav Chatterjee, Abdur Rahman Khan, Arpit Shah, Sameer Ather, Pedro A Lemos, Pedro Moreno, Gregg W Stone
The relative outcomes of intravascular ultrasound (IVUS)-guided percutaneous coronary intervention (PCI) compared with angiography-guided PCI with drug-eluting stent (DES) in complex lesions have not been established. We sought to compare the efficacy and safety of IVUS-guided PCI with angiography-guided PCI in patients with complex coronary lesions treated with DES. METHODS: Electronic databases were searched to identify all randomized trials comparing IVUS-guided vs angiography-guided DES implantation...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28267384/comparison-of-p2y12-inhibitors-for-mortality-and-stent-thrombosis-in-patients-with-acute-coronary-syndromes-single-center-study-of-10-793-consecutive-real-world-patients
#8
Rebecca Gosling, Momina Yazdani, Yasir Parviz, Ian R Hall, Ever D Grech, Julian P Gunn, Robert F Storey, Javaid Iqbal
Three oral platelet P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are available for reducing the risk of cardiovascular death and stent thrombosis in patients with acute coronary syndromes (ACS). We sought to compare the efficacy of these antiplatelet drugs in contemporary practice. Data were collected for 10 793 consecutive ACS patients undergoing coronary angiography at Sheffield, UK (2009-2015). Since prasugrel use was mostly restricted to the STEMI subgroup, clopidogrel and ticagrelor were compared for all ACS patients, and all three agents were compared in the STEMI subgroup...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#9
Maame Yaa A B Maya Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome guidelines directing the clinical practice implementation of ED screening and diagnosis, there is variable screening and diagnostic clinical practice across ED facilities. This practice diversity may be warranted. Understanding the variability may identify opportunities for more consistent practice. METHODS: This is a cross-sectional clinical practice epidemiology study with the emergency department (ED) as the unit of analysis characterizing variability in the acute coronary syndrome (ACS) evaluation across 62 diverse EDs...
March 6, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28261502/does-i-t744c-p2y12-polymorphism-modulate-clopidogrel-response-among-moroccan-acute-coronary-syndromes-patients
#10
Hind Hassani Idrissi, Wiam Hmimech, Nada El Khorb, Hafid Akoudad, Rachida Habbal, Sellama Nadifi
Background. An interindividual variability in response to Clopidogrel has been widely described in patients with acute coronary syndromes (ACS). The contribution of genetics on modulating this response was widely discussed. The objective of our study was to investigate the potential effect of i-T744C P2Y12 polymorphism on Clopidogrel response in a sample of Moroccan ACS patients. We tried also to determine the frequency of this polymorphism among Moroccan ACS compared to healthy subjects. Methods and Results...
2017: Genetics Research International
https://www.readbyqxmd.com/read/28260288/-usefulness-of-the-residual-syntax-score-to-predict-long-term-outcome-in-acute-coronary-syndrome-patients-underwent-percutaneous-coronary-intervention
#11
Y Song, J J Xu, X F Tang, Y L Ma, Y Yao, C He, H H Wang, R Liu, N Xu, P Jiang, L Jiang, X Y Zhao, Z Gao, R L Gao, S B Qiao, Y J Yang, B Xu, J Q Yuan
Objective: To quantify the extent and complexity of residual coronary stenosis following PCI by the residual SYNTAX score, and to evaluate its impact on adverse ischemic outcomes in acute coronary syndrome(ACS) patients. Methods: From January 2013 to December 2013, a total of 1 414 consecutive moderate- and high-risk ACS patients who underwent any PCI with multi-vessel coronary artery disease were evaluated.Patients were stratified by rSS quartiles and their outcomes were compared. Results: The rSS was 4.8±6...
February 21, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28259226/prevalence-and-prognosis-of-nonobstructive-coronary-artery-disease-in-patients-undergoing-coronary-angiography-or-coronary-computed-tomography-angiography-a-meta-analysis
#12
Zhi Jian Wang, Lin Lin Zhang, Sammy Elmariah, Hong Ya Han, Yu Jie Zhou
OBJECTIVE: To evaluate the prevalence, clinical characteristics, and risk of cardiac events in patients with nonobstructive coronary artery disease (CAD). PATIENTS AND METHODS: We searched PubMed, EMBASE, and the Cochrane Library from January 1, 1990, to November 31, 2015. Studies were included if they reported prevalence or prognosis of patients with nonobstructive CAD (≤50% stenosis) among patients with known or suspected CAD. Patients with nonobstructive CAD were further grouped as those with no angiographic CAD (0% or ≤20%) and those with mild CAD (>0% or >20% to ≤50%)...
March 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28246236/serial-measurement-of-high-sensitivity-troponin-i-and-cardiovascular-outcomes-in-patients-with-type-2-diabetes-mellitus-in-the-examine-trial
#13
Matthew A Cavender, William B White, Petr Jarolim, George L Bakris, William C Cushman, Stuart Kupfer, Qi Gao, Cyrus R Mehta, Faiez Zannad, Christopher P Cannon, David A Morrow
Background -We sought to describe the relationship between changes in high-sensitivity cardiac troponin I (hsTnI) and cardiovascular (CV) outcomes. Methods -The Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) was a phase IIIb clinical outcomes trial designed to evaluate the CV safety of alogliptin, a non-selective dipeptidyl peptidase 4 (DPP-4) inhibitor. Patients with type 2 diabetes mellitus (T2DM), glycated hemoglobin between 6.5%-11% (or 7%-11% if they were on insulin), and a recent acute coronary syndrome (between 15-90 days prior to randomization) were eligible for the trial...
February 28, 2017: Circulation
https://www.readbyqxmd.com/read/28240341/factors-influencing-cardiometabolic-risk-profile-in-patients-with-psoriasis
#14
Neus Curcó, Nuria Barriendos, Maria José Barahona, Carmen Arteaga, Mercedes García, Stanislav Yordanov, Olimpia De La Barrera, Carolina Prat, Pere Vives, Nuria Giménez
BACKGROUND: Psoriasis has been associated with metabolic syndrome and with an increased cardiovascular risk especially in patients with severe disease. The goal of this study was to estimate the prevalence of metabolic syndrome and other cardiovascular risk factors and its association with the psoriasis severity, sex and age. METHODS: Consecutive patients with psoriasis were enrolled in a prospective study over a 1-year period. Blood samples were collected. Psoriasis area and severity index (PASI) and body surface area scores and two dermatology quality of life (DQOL) questionnaires were used to evaluate psoriasis severity and the impact of the disease...
February 27, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28230811/basigin-rs8259-polymorphism-confers-decreased-risk-of-chronic-heart-failure-in-a-chinese-population
#15
Mu-Peng Li, Xiao-Lei Hu, Yong-Long Yang, Yan-Jiao Zhang, Ji-Peng Zhou, Li-Ming Peng, Jie Tang, Xiao-Ping Chen
Left ventricular remodeling is an essential risk factor contributing to the pathogenesis of chronic heart failure (CHF). Basigin (BSG) promotes cardiovascular inflammation and myocardial remodeling processes by induction of extracellular matrix metalloproteinases and inflammatory cytokines. BSG rs8259 polymorphism was associated with BSG expression and risk of acute coronary syndrome. Therefore, we investigated whether rs8259 polymorphism contributes to risk and prognosis of CHF in Chinese patients. In total 922 adult patients with CHF and 1107 matched healthy controls were enrolled...
February 21, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28228148/the-effect-of-melatonin-on-depressive-symptoms-anxiety-circadian-and-sleep-disturbances-in-patients-after-acute-coronary-syndrome-medacis-study-protocol-for-a-randomized-controlled-trial
#16
Michael Tvilling Madsen, Anders Isbrand, Ulla Overgaard Andersen, Lars Juel Andersen, Mustafa Taskiran, Erik Simonsen, Ismail Gögenur
BACKGROUND: Depression following acute coronary syndrome (ACS) constitutes a serious and debilitating problem. Approximately one in five patients will develop significant depression following ACS and less severe depressive symptoms are even more frequent. Furthermore, anxiety symptoms and sleep-wake disturbances are frequent. The objective of the MEDACIS trial is to investigate whether prophylactic treatment with melatonin has a preventive effect on depression, depressive and anxiety symptoms, sleep, and circadian disturbances following ACS...
February 23, 2017: Trials
https://www.readbyqxmd.com/read/28207573/genome-wide-analysis-of-clopidogrel-active-metabolite-levels-identifies-novel-variants-that-influence-antiplatelet-response
#17
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...
April 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
#18
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
#19
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
#20
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
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