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risk evaluation in coronary syndrome

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https://www.readbyqxmd.com/read/29352673/chest-pain-in-a-young-female
#1
Paul S Basel, Daniel Reschke, Michael D April
Acute Coronary Syndrome (ACS) is a common diagnosis in the emergency department (ED), the most severe manifestation of which is ST elevation on electrocardiogram (ECG). ST elevation reflects obstruction of flow through the coronary arteries, most commonly due to coronary atherosclerotic plaque rupture. However, alternative causes of coronary obstruction causing ST elevation are possible. Spontaneous coronary artery dissection (SCAD) is an unusual cause of ST elevation in ED patients which providers may encounter in patients without traditional atherosclerosis risk factors...
January 11, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29350392/diagnostic-and-prognostic-micro-rnas-in-ischemic-stroke-due-to-carotid-artery-stenosis-and-in-acute-coronary-syndrome-the-4-year-prospective-study
#2
Jacek Gacoń, Rafał Badacz, Ewa Stępień, Izabela Karch, Francisco J Enguita, Krzysztof Żmudka, Tadeusz Przewłocki, Anna Kabłak-Ziembicka
BACKGROUND: Circulating microRNAs (miRs) levels are potentially important diagnostic and prognostic biomarkers in acute coronary syndrome (ACS) or cerebral ischemic event (CIE) resulting from internal carotid artery stenosis (ICAS). AIM: This 4-year prospective study aimed to compare the levels of circulating miRs in ACS vs CIE patients, and investigate miRs potentially associated with risk of recurrent cardiovascular event. METHODS: The circulating miRs levels (miR-1-3p, miR-16-5p, miR-34a-5p, mir-122-5p, miR-124-3p, miR-133a-3p, miR-133b, miR-134-5p, miR-208b-3p, miR-375 and miR-499-5p) were compared in 43 (34M, 57...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350382/risk-factors-for-adverse-outcomes-of-acute-coronary-syndrome-patients-single-center-experience-in-long-term-follow-up-of-treated-patients
#3
Marcin Grabowski, Krzysztof J Filipiak, Grzegorz Opolski, Renata Główczyńska, Monika Gawałko, Paweł Balsam, Andrzej Cacko, Zenon Huczek, Grzegorz Karpiński, Robert Kowalik, Franciszek Majstrak, Janusz Kochman
BACKGROUND: For patients experiencing an acute coronary syndrome (ACS), a crucial time to assess their prognosis and future management is at discharge from hospital. AIM: To identify patients' risk factors of mortality during post-discharge period following an ACS hospitalization. METHODS: We studied 672 consecutive ACS patients hospitalized and discharged alive between 2002 and 2004. The analysis was done in respect of the type of ACS, i...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29339686/clinical-characteristics-and-outcomes-of-acute-coronary-syndrome-patients-with-intra-aortic-balloon-pump-inserted-in-intensive-cardiac-care-unit-of-a-tertiary-clinic
#4
Mert İlker Hayıroğlu, Yiğit Çanga, Özlem Yıldırımtürk, Emrah Bozbeyoğlu, Ayça Gümüşdağ, Ahmet Okan Uzun, Koray Kalenderoğlu, Muhammed Keskin, Göksel Çinier, Murat Acarel, Seçkin Pehlivanoğlu
OBJECTIVE: An intra-aortic balloon pump (IABP) is a mechanical support device that is used in addition to pharmacological treatment of the failing heart in intensive cardiac care unit (ICCU) patients. In the literature, there are limited data regarding the clinical characteristics and in-hospital outcomes of acute coronary syndrome patients in Turkey who had an IABP inserted during their ICCU stay. This study is an analysis of the clinical characteristics and outcomes of these acute coronary syndrome patients...
January 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/29339356/kidney-biomarkers-and-decline-in-egfr-in-patients-with-type-2-diabetes
#5
Katherine G Garlo, William B White, George L Bakris, Faiez Zannad, Craig A Wilson, Stuart Kupfer, Muthiah Vaduganathan, David A Morrow, Christopher P Cannon, David M Charytan
BACKGROUND AND OBJECTIVES: Biomarkers may improve identification of individuals at risk of eGFR decline who may benefit from intervention or dialysis planning. However, available biomarkers remain incompletely validated for risk stratification and prediction modeling. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We examined serum cystatin C, urinary kidney injury molecule-1 (uKIM-1), and urinary neutrophil gelatinase-associated lipocalin (UNGAL) in 5367 individuals with type 2 diabetes mellitus and recent acute coronary syndromes enrolled in the Examination of Cardiovascular Outcomes with Alogliptin versus Standard of Care (EXAMINE) trial...
January 16, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29330938/predictive-value-of-neutrophil-to-lymphocyte-ratio-in-long-term-outcomes-of-left-main-and-or-three-vessel-disease-in-patients-with-acute-myocardial-infarction
#6
Na Xu, Xiao-Fang Tang, Yi Yao, Xueyan- Zhao, Jue- Chen, Zhan- Gao, Yuejin- Yang, Run-Lin Gao, Bo Xu, Jin-Qing Yuan
OBJECTIVES: We sought to evaluate the independent predictive value of left main disease (LMD) and/or three-vessel disease (LMD/3VD) in acute myocardial infarction (AMI) patients. BACKGROUND: Patients with acute coronary syndrome resulting from LMD and/or three-vessel disease (LMD/3VD) are at the highest risk of adverse cardiovascular events. Neutrophil to lymphocyte ratio (NLR) has been proposed as a marker of cardiovascular risk, but the prognostic value of NLR in patients with LMD/3VD who underwent percutaneous coronary intervention (PCI) is not clearly defined...
January 13, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#7
REVIEW
R Jay Widmer, Peter M Pollak, Malcolm R Bell, Bernard J Gersh, Nandan S Anavekar
Acute coronary syndromes (ACSs) account for a large proportion of disease burden in the United States and worldwide, and our understanding of ACS management continues to evolve. In this review we take a practical approach to evaluating and treating a patient with ACS, focusing on the optimal timing and methods of coronary reperfusion. Beginning with initial assessment and risk stratification, a provider managing the patient with ACS must be able to expeditiously decide on and implement the correct guideline-directed pathway to optimize outcomes...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29322612/validation-of-contemporary-risk-scores-in-predicting-coronary-thrombotic-events-and-major-bleeding-in-patients-with-acute-coronary-syndrome-after-drug-eluting-stent-implantations
#8
Li Song, Changdong Guan, Hongbing Yan, Shubin Qiao, Yongjian Wu, Jinqing Yuan, Kefei Dou, Yuejin Yang, George D Dangas, Bo Xu
OBJECTIVES: We aimed to assess the prognostic ability of the ST score, DAPT score, and PARIS score in a Chinese population. BACKGROUND: Recently, several risk scores predicting the long-term risk of coronary thrombotic events [CTE, defined as the composite of definite or probable stent thrombosis (ST) and myocardial infarction] and bleeding have been developed and initially validated in Western populations. METHODS: A total of 6,088 consecutive patients with acute coronary syndrome (mean age 58...
January 11, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29321798/impact-of-triple-antithrombotic-therapy-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-real-world-practice
#9
Yan Yan, Xiao Wang, Jing-Yao Fan, Shao-Ping Nie, Sergio Raposeiras-Roubín, Emad Abu-Assi, Jose P Simao Henriques, Fabrizio D'Ascenzo, Jorge Saucedo, José R González-Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xian-Tao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Claudio Moretti, Zenon Huczek, Toshiharu Fujii, Luis Cl Correia, Masa-Aki Kawashiri, Sasko Kedev
Objective: The optimal antithrombotic regimen for patients on oral anticoagulation (OAC) after acute coronary syndrome (ACS) and percutaneous coronary intervention (PCI) remains debated. This study sought to evaluate the efficacy and safety of OAC plus clopidogrel with or without aspirin in a real-world setting. Methods: We retrospectively analyzed data from an international, multi-center registry between 2003 and 2014 (n = 15,401). Patients with ACS and receiving OAC after PCI were screened...
November 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29319245/cardiometabolic-risk-factors-in-acute-coronary-syndrome-with-special-reference-to-non-hdl-cholesterol
#10
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. Settings and Design: This was a hospital-based age and sex matched case-control study, carried out at Lata Mangeshkar Hospital, Nagpur...
October 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/29316169/elevated-blood-pressure-during-emergency-departments-visit-is-associated-with-increased-rate-of-hospitalization-for-heart-failure-a-retrospective-cohort-study
#11
Irit Ayalon-Dangur, Yaron Rudman, Tzippy Shochat, Shachaf Shiber, Alon Grossman
There is a limited literature discussing the long-term outcome of patients admitted to the emergency department with elevated blood pressure. The aim of the present study was to evaluate outcomes of patients with hypertension who attended an emergency department. All patients with hypertension who attended an emergency department without target organ damage were evaluated. A composite end point at 18 months, which included all-cause mortality, acute coronary syndrome, cerebrovascular accident, or hospitalization for heart failure, were compared between patients with hypertension and those with normotension...
January 5, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29306481/effect-of-calcifediol-treatment-on-cardiovascular-outcomes-in-patients-with-acute-coronary-syndrome-and-percutaneous-revascularization
#12
Cristina Navarro-Valverde, Jose M Quesada-Gómez, Ramón Pérez-Cano, Ana Fernández-Palacín, Luis F Pastor-Torres
BACKGROUND AND OBJECTIVES: Vitamin D deficiency has been consistently linked with cardiovascular diseases. However, results of intervention studies are contradictory. The aim of this study was to evaluate the effect of treatment with calcifediol (25(OH)D3) on the cardiovascular system of patients with non-ST-elevation acute coronary syndrome after percutaneous coronary intervention. PATIENTS AND METHODS: A prospective study assessing≥60-year-old patients with non-ST-elevation acute coronary syndrome, coronary artery disease and percutaneous revascularisation...
January 3, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29306269/sealone-safety-and-efficacy-of-coronary-computed-tomography-angiography-with-low-dose-in-patients-visiting-emergency-room-trial-study-protocol-for-a-randomized-controlled-trial
#13
Joonghee Kim, Joon-Won Kang, Kyuseok Kim, Sang Il Choi, Eun Ju Chun, Yeo Goon Kim, Won Young Kim, Dong Woo Seo, Jonghwan Shin, Huijai Lee, Kwang-Nam Jin, Soyeon Ahn, Seung Sik Hwang, Kwang Pyo Kim, Ru-Bi Jeong, Sang Ook Ha, Byungho Choi, Chang-Hwan Yoon, Jung-Won Suh, Hack-Lyoung Kim, Ju Kyoung Kim, Sujin Jang, Ji Seon Seo
OBJECTIVE: Chest pain is one of the most common complaints in the emergency department (ED). Cardiac computed tomography angiography (CCTA) is a frequently used tool for the early triage of patients with low- to intermediate-risk acute chest pain. We present a study protocol for a multicenter prospective randomized controlled clinical trial testing the hypothesis that a low-dose CCTA protocol using prospective electrocardiogram (ECG)-triggering and limited-scan range can provide sufficient diagnostic safety for early triage of patients with acute chest pain...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29301579/linagliptin-and-cardiovascular-outcomes-in-type-2-diabetes-after-acute-coronary-syndrome-or-acute-ischemic-stroke
#14
Yan-Rong Li, Sung-Sheng Tsai, Dong-Yi Chen, Szu-Tah Chen, Jui-Hung Sun, Hung-Yu Chang, Miaw-Jene Liou, Tien-Hsing Chen
BACKGROUND: The cardiovascular safety and efficacy of linagliptin, a dipeptidyl peptidase-4 inhibitor, in patients with type 2 diabetes mellitus (T2DM) after acute coronary syndrome (ACS) or acute ischemic stroke (AIS) are unclear. The aim of our real-world cohort study was to evaluate the cardiovascular outcomes of linagliptin in patients with T2DM after ACS or AIS. METHODS: An open observational noncrossover retrospective cohort study was conducted between June 1, 2012 and December 31, 2013 utilizing Taiwan National Health Insurance Research Database...
January 4, 2018: Cardiovascular Diabetology
https://www.readbyqxmd.com/read/29300792/management-of-acute-coronary-syndromes-in-patients-with-diabetes
#15
Peter P Toth
Given the heightened risk for adverse cardiovascular outcomes in patients with diabetes mellitus, it is important that primary care clinicians be comfortable with the routine management of acute coronary syndromes (ACS) in this patient population. Notably, patients with diabetes are more likely to present atypically during an ACS. To improve health outcomes, patients with a history of diabetes and ACS should be evaluated for peripheral arterial disease and encouraged to pursue cardiac rehabilitation. Clinicians should also be cognizant of the high rate of polypharmacy in patients with diabetes and the potential glycemic and cardioprotective impact of medications they prescribe for these patients...
December 2017: Journal of Family Practice
https://www.readbyqxmd.com/read/29297191/angiographic-advancement-of-the-coronary-disease-and-the-cardiovascular-risk-at-the-acute-coronary-syndrome-in-patients-with-the-metabolic-syndrome
#16
Katarzyna Widecka-Ostrowska, Krzysztof Safranow, Maciej Lewandowski, Krzysztof Przybycień, Jarosław Gorący, Zdzisława Kornacewicz-Jach
BACKGROUND: Extent of angiographic lesions, size of infarct and in-hospital and distant prognosis in patients with the metabolic syndrome have been not clearly determined. Detailed knowledge of markers both for ACS occurrence as well as those affecting early and further prognosis will have key significance at taking correct preventive and therapeutic decisions. AIM: Comparing in patients with first ACS treated with coronary angioplasty the advancement of coronary disease and the cardiovascular risk evaluated using GRACE 2...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29279531/dual-antiplatelet-therapy-guided-by-cyp2c19-polymorphisms-after-implantation-of-second-generation-drug-eluting-stents-for-management-of-acute-coronary-syndrome
#17
Takuya Ozawa, Masayoshi Suda, Ryutaro Ikegami, Toshiki Takano, Takayuki Wakasugi, Takao Yanagawa, Komei Tanaka, Kazuyuki Ozaki, Satoru Hirono, Tohru Minamino
Prasugrel, a novel P2Y12 receptor inhibitor, is administered to patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI), but it can increase the risk of bleeding. The Japanese exhibit weaker responses to clopidogrel than other races because of CYP2C19 polymorphisms; thus, it is unclear whether these patients should continue dual antiplatelet therapy (DAPT) using prasugrel or switch to clopidogrel in the chronic phase. Here we evaluated the clinical outcomes of DAPT guided by CYP2C19 polymorphisms after implantation of second-generation drug-eluting stents (DESs) for ACS management...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29275928/spontaneous-coronary-artery-dissection-scad-the-underdiagnosed-cardiac-condition-that-plagues-women
#18
REVIEW
Sandrine Lebrun, Rachel M Bond
Coronary heart disease (CHD) continues to be understudied, underdiagnosed, and undertreated in women. Gender and age bias complicate the evaluation of women with acute coronary syndrome (ACS). As a result, conditions like spontaneous coronary artery dissection (SCAD) are often missed. SCAD is an infrequent yet important cause of myocardial infarction (MI) with a predilection for young to middle aged women. The condition is thought to be under-reported, likely a result of both low index of suspicion as well as an unfamiliarity with SCAD's angiographic variants...
December 11, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29274849/predictors-of-carotid-plaque-progression-over-a-4-year-follow-up-in-the-reykjavik-refine-study
#19
Ran Sturlaugsdottir, Thor Aspelund, Gudlaug Bjornsdottir, Sigurdur Sigurdsson, Bolli Thorsson, Gudny Eiriksdottir, Vilmundur Gudnason
BACKGROUND AND AIMS: Carotid plaque is an arterial marker suggested as a surrogate end point for cardiovascular disease. The aim of this study was to examine the association of risk factors at visit 1 with plaque formation and progression of total plaque area (TPA) during follow-up. METHODS: We examined 1894 participants (50-69 years of age) in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. RESULTS: Among those with no plaque at baseline, plaque formation was associated with low density lipoprotein, sex, waist, former smoker and physical activity...
December 6, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29274198/dabigatran-versus-vitamin-k-antagonist-an-observational-across-cohort-comparison-in-acute-coronary-syndrome-patients-with-atrial-fibrillation
#20
Mélanie Gaubert, Noémie Resseguier, Marc Laine, Laurent Bonello, Laurence Camoin-Jau, Franck Paganelli
BACKGROUND: Dual antithrombotic therapy comprising a vitamin K antagonist (VKA) plus clopidogrel reduces the incidence of major bleeding compared with triple therapy (VKA+clopidogrel+aspirin) in acute coronary syndrome (ACS) patients with atrial fibrillation (AF), with a similar thrombotic risk. The oral thrombin inhibitor dabigatran (150 mg twice a day) showed superiority over VKA in non-valvular AF, but data supporting its use in AF patients presenting with ACS are limited. OBJECTIVE: We sought to evaluate the efficacy of dabigatran versus VKA in the management of AF patients undergoing percutaneous coronary intervention for an ACS...
December 23, 2017: Journal of Thrombosis and Haemostasis: JTH
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