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NSTEMI GUIDELINES

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https://www.readbyqxmd.com/read/29073657/is-cardiomegaly-on-chest-radiograph-representative-of-true-cardiomegaly-a-cross-sectional-observational-study-comparing-cardiac-size-on-chest-radiograph-to-that-on-echocardiography
#1
COMPARATIVE STUDY
Jane L McKee, Katherine Ferrier
AIMS: To determine whether or not cardiomegaly identified on chest radiograph (CXR) is indicative of true cardiomegaly as determined using echocardiography (echo) as the gold standard tool, and therefore whether or not cardiomegaly on CXR should be investigated further. METHODS: CXR and echocardiogram reports were reviewed for the presence of cardiomegaly in a population following non-ST segment elevation myocardial infarction (NSTEMI). Data was evaluated to determine whether cardiomegaly reported on CXR did indeed represent true cardiomegaly...
October 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29072379/-early-rather-than-immediate-pci-in-nstemi-is-time-equal-to-muscle-once-again
#2
Shemy Carasso, Ali Nassar, Fabio Kuzniec, Yevgeni Hazanov, Nabeeh Salman, Yussra Halhla, Offer Amir, Diab Ghanem
BACKGROUND: Current guidelines advocate immediate vs. non-immediate percutaneous coronary intervention (PCI) strategy in ST elevation vs. non ST elevation myocardial infarction (STEMI, NSTEMI). There is however increasing concern that "next-day PCI" in NSTEMI may adversely affect LV systolic and/or diastolic function and a more urgent aggressive approach should be taken in NSTEMI, similar to that in STEMI. In the current study we compared echocardiographic data between patients with STEMI and NSTEMI who had either primary or early PCI respectively...
October 2017: Harefuah
https://www.readbyqxmd.com/read/29054840/contemporary-risk-stratification-after-myocardial-infarction-in-the-community-performance-of-scores-and-incremental-value-of-soluble-suppression-of-tumorigenicity-2
#3
Yariv Gerber, Susan A Weston, Maurice Enriquez-Sarano, Allan S Jaffe, Sheila M Manemann, Ruoxiang Jiang, Véronique L Roger
BACKGROUND: Current American Heart Association/American College of Cardiology guidelines recommend the GRACE (Global Registry of Acute Coronary Events) and TIMI (Thrombolysis in Myocardial Infarction) scores to assess myocardial infarction (MI) prognosis. Changes in the epidemiological characteristics of MI and the availability of new biomarkers warrant an assessment of the performance of these scores in contemporary practice. We assessed the following: (1) the performance of GRACE and TIMI to predict 1-year mortality in a cohort of patients stratified by ST-segment elevation MI (STEMI) and non-STEMI (NSTEMI) and (2) the incremental discriminatory power of soluble suppression of tumorigenicity-2, a myocardial fibrosis biomarker...
October 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29035427/differences-in-the-korea-acute-myocardial-infarction-registry-compared-with-western-registries
#4
REVIEW
Doo Sun Sim, Myung Ho Jeong
The Korea Acute Myocardial Infarction Registry (KAMIR) is the first nationwide registry that reflects current therapeutic approaches and acute myocardial infarction (AMI) management in Korea. The results of the KAMIR demonstrated different risk factors and responses to medical and interventional treatments. The results indicated that the incidence of ST-elevation myocardial infarction (STEMI) was relatively high, and that the prevalence of dyslipidemia was relatively low with higher triglyceride and lower high-density lipoprotein cholesterol levels...
September 18, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28958142/serum-25-hydroxy-vitamin-d-concentration-in-acute-coronary-syndrome
#5
E Anastasi, M Suppa, V Viggiani, S Tartaglione, A Angeloni, T Granato
Vitamin D may have prognostic value in cardiovascular disease (CVD) patients and, in addition to conventional biomarkers, could be a valuable tool for disease management. The aim of this study was to assess the association of vitamin D status in patients with acute coronary syndrome (ACS) and to evaluate its prognostic utility. The levels of 25(OH) vitamin D were correlated with troponin T hs. Forty-eight consecutive outpatients (40 Caucasian and 8 Asian) aged between 40 and 70 years (mean 61.5, range 43-77 years) were enrolled in the study...
July 2017: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/28942868/gender-differences-in-the-management-of-acute-coronary-syndrome-patients-one-year-results-from-hpiar-hp-india-acs-registry
#6
Kunal Mahajan, Prakash Chand Negi, Rajeev Merwaha, Nitin Mahajan, Vivek Chauhan, Sanjeev Asotra
INTRODUCTION: Data from high-income countries suggest that women receive less intensive diagnostic and therapeutic management than men for acute coronary syndrome (ACS). There is a paucity of such data in the Indian population, which is 69% rural and prior studies focused mostly on urban populations. The objective of the present study was to identify the gender based differences in ACS management, if any, in a predominantly rural population. METHODS: Data from 35 hospitals across Himachal Pradesh covering >90% of state population were collected for one year (July 2015-June 2016)...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28893843/timing-of-angiography-and-outcomes-in-high-risk-patients-with-non-st-segment-elevation-myocardial-infarction-managed-invasively-insights-from-the-tao-trial
#7
Pierre Deharo, Gregory Ducrocq, Christoph Bode, Marc Cohen, Thomas Cuisset, Shamir Mehta, Charles V Pollack, Stephen D Wiviott, Yedid Elbez, Marc Sabatine, P Gabriel Steg
Background -In patients with non ST-elevation myocardial infarction (NSTEMI) and Global Registry of Acute Coronary Events (GRACE) score >140, coronary angiography (CAG) is recommended by European and American guidelines within 24h. We sought to study the association of a "very early" (i.e. ≤12h), early (12-24h) and delayed (>24h) CAG in NSTEMI with GRACE score >140 with ischemic outcomes. Methods -The Treatment of Acute coronary syndrome with Otamixaban (TAO) trial randomized patients with NSTEMI and CAG scheduled within 72h to heparin plus eptifibatide versus otamixaban...
September 11, 2017: Circulation
https://www.readbyqxmd.com/read/28868075/determinants-of-invasive-strategy-in-elderly-patients-with-non-st-elevation-myocardial-infarction
#8
Antonin Negers, Jacques Boddaert, Lucie Mora, Jean-Louis Golmard, Laura Moïsi, Ariel Cohen, Jean-Philippe Collet, Alice Breining
BACKGROUND: Knowledge gaps across literature prevent current guidelines from providing the profile of elderly patients most likely to derive benefit from invasive strategy (IS) in non ST-elevation myocardial infarction (NSTEMI). Furthermore, the benefit of IS in a real-world elderly population with NSTEMI remains unclear. The aims of this study were to determine factors that lead the cardiologist to opt for an IS in elderly patients with NSTEMI, and to assess the impact of IS on the 6-month all-cause mortality...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28660806/antiplatelet-therapy-for-non-st-segment-elevation-myocardial-infarction-in-complex-real-clinical-scenarios-a-consensus-document-of-the-campania-nstemi-study-group
#9
Marino Scherillo, Plinio Cirillo, Dario Formigli, Giulio Bonzani, Paolo Calabrò, Paolo Capogrosso, Rosario Farina, Tonino Lanzillo, Franco Mascia, Ciro Mauro, Bernardino Tuccillo, Alessandro Bellis, Renato Bianchi, Giovanni Cimmino, Orlando Piro, Amelia Ravera, Fortunato Scotto di Uccio, Paolo Tammaro, Alfredo Vetrano, Bruno Trimarco
The incidence of ST-segment elevation myocardial infarction (STEMI) has significantly decreased. Conversely, the rate of non-STEMI (NSTEMI) has increased. Patients with NSTEMI have lower short-term mortality compared to patients with STEMI, whereas at long-term follow-up, the mortality becomes comparable. This might be due to the differences in baseline characteristics, including older age and a greater prevalence of comorbidities in the NSTEMI population. Although antithrombotic strategies used in patients with NSTEMI have been well studied in clinical trials and updated guidelines are available, patterns of use and outcomes in clinical practice are less well described...
August 2017: Angiology
https://www.readbyqxmd.com/read/28625385/seasonal-and-circadian-variations-of-acute-myocardial-infarction-findings-from-the-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#10
MULTICENTER STUDY
Vijaiganesh Nagarajan, Gregg C Fonarow, Christine Ju, Michael Pencina, Warren K Laskey, Thomas M Maddox, Adrian Hernandez, Deepak L Bhatt
BACKGROUND: Seasonal variation with winter preponderance of myocardial infarction incidence has been described decades ago, but only a few small studies have classified myocardial infarction based on ST-segment elevation. It is unclear whether seasonal and circadian variations are equally present in warmer and colder regions. We investigated whether seasonal and circadian variations in acute myocardial infarction (AMI) are more prominent in colder northern states compared with warmer southern states...
July 2017: American Heart Journal
https://www.readbyqxmd.com/read/28498644/early-versus-late-percutaneous-revascularization-in-patients-hospitalized-with-non-st-segment-elevation-myocardial-infarction-the-atherosclerosis-risk-in-communities-surveillance-study
#11
Sameer Arora, Kunihiro Matsushita, Arman Qamar, R Brandon Stacey, Melissa C Caughey
BACKGROUND: Current guidelines recommend early invasive intervention (<24 hr) for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI). A delayed invasive strategy (24-72 hr) is considered reasonable for low risk patients. The real-world effectiveness of this strategy is unknown. METHODS: The ARIC Study has conducted hospital surveillance of acute myocardial infarction (MI) since 1987. NSTEMI was classified using a validated algorithm...
May 12, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28454811/compliance-with-guideline-directed-therapy-in-diabetic-patients-admitted-with-acute-coronary-syndrome-findings-from-the-american-heart-association-s-get-with-the-guidelines-coronary-artery-disease-gwtg-cad-program
#12
Prakash Deedwania, Tushar Acharya, Kamal Kotak, Gregg C Fonarow, Christopher P Cannon, Warren K Laskey, W Frank Peacock, Wenqin Pan, Deepak L Bhatt
BACKGROUND: To evaluate and compare baseline characteristics, outcomes and compliance with guideline based therapy at discharge among diabetic and non-diabetic patients admitted with acute coronary syndromes (ACS). METHODS AND RESULTS: Study population consisted of 151,270 patients admitted with ACS from 2002 through 2008 at 411 sites participating in the American Heart Association's Get with the Guidelines (GWTG) program. Demographic variables, physical exam findings, laboratory data, left ventricular ejection fraction, length of stay, in-hospital mortality and discharge medications were compared between diabetic and non-diabetic patients...
May 2017: American Heart Journal
https://www.readbyqxmd.com/read/28450654/left-circumflexus-coronary-artery-total-occlusion-with-clinical-presentation-as-nstemi-and-acute-pulmonary-oedema
#13
Budi Yuli Setianto, Nahar Taufiq, Heri Hernawan
Current guidelines for the management of patients with acute coronary syndromes (ACSs) focus on the electrocardiogram to divide patients into ST-elevation acute myocardial infarction (STEMI) or non-ST-elevation acute myocardial infarction (NSTEMI)/unstable angina (UA). Patients with STEMI in the earliest time will receive reperfusion therapy to destruct occlusive thrombus. An ST segment elevation is the 'sine qua non' for diagnosing acute total coronary occlusion causing transmural myocardial infarction. Left circumflex coronary artery (LCx) occlusion is often categorized as NSTEMI because of the absence of significant ST-elevation on the 12 lead standard electrocardiogram...
January 2017: Acta Medica Indonesiana
https://www.readbyqxmd.com/read/28420281/long-term-follow-up-of-antithrombotic-management-patterns-in-patients-with-acute-coronary-syndrome-in-russia-an-observational-study-epicor-rus-study
#14
Mikhail Ya Ruda, Oleg V Averkov, Yunona V Khomitskaya
OBJECTIVE: This study sought to describe the short- and long-term (up to 2 years) antithrombotic management patterns in a real-life setting for patients hospitalized for an acute coronary syndrome (ACS) event, and to document clinical outcomes. RESEARCH DESIGN AND METHODS: EPICOR-RUS was a multicenter (34 centers), prospective, observational, longitudinal cohort study conducted across Russia on antithrombotic management in hospitalized (within 24 hours of symptom onset) ACS patients with 2 year follow-up...
April 19, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28343173/fast-track-protocols-using-highly-sensitive-troponin-assays-for-ruling-out-and-ruling-in-non-st-elevation-acute-coronary-syndrome
#15
Simona Ferraro, Alberto Dolci, Mauro Panteghini
The introduction of "highly sensitive" cardiac troponin assays (hsTn) has reinforced the evidence that only serial testing incorporated in running algorithms allows a more accurate diagnosis of acute myocardial infarction. In this report, we consider the available evidence supporting the use of fast track protocols for ruling out and ruling in non-ST elevation myocardial infarction (NSTEMI) and compare it with the content of recently released guideline by the European Society of Cardiology, noting some uncomfortable aspects that need urgent clarification and/or revision...
October 26, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28274580/effect-of-part-time-cardiac-catheterization-facilities-in-patients-with-acute-myocardial-infarction
#16
Luciano Consuegra-Sánchez, Leticia Jaulent-Huertas, Marta Vicente-Gilabert, Ángela Díaz-Pastor, Germán Escudero-García, Nuria Alonso-Fernández, Francisco Javier Gil-Sánchez, Juan Martínez-Hernández, Juan Sanchis-Forés, José Galcerá-Tomás, Antonio Melgarejo-Moreno
BACKGROUND: Although the easy availability of invasive cardiac care facilities is associated with an increase in their use, their influence on outcomes is not clear. We sought to investigate whether a newly available cardiac catheterization laboratory (CCL) performing percutaneous coronary intervention (PCI) on a part-time (PT) basis might improve outcomes in patients with acute myocardial infarction (AMI). METHODS: This was an observational cohort study that included all consecutive patients with AMI admitted to a secondary-level hospital in Spain before and after the PT-CCL opened in January 2006: during 1998-2005 and 2006-2014, respectively...
March 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28261908/acute-coronary-syndrome-screening-and-diagnostic-practice-variation
#17
MULTICENTER STUDY
Maame Yaa A B Yiadom, Xulei Liu, Conor M McWade, Dandan Liu, Alan B Storrow
BACKGROUND: In the absence of the existing acute coronary syndrome (ACS) guidelines directing the clinical practice implementation of emergency department (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 ED as the unit of analysis characterizing variability in the ACS evaluation across 62 diverse EDs...
June 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28238691/early-invasive-versus-initial-conservative-strategies-for-women-with-non-st-elevation-acute-coronary-syndromes-a-nationwide-analysis
#18
COMPARATIVE STUDY
Islam Y Elgendy, Ahmed N Mahmoud, Hend Mansoor, Anthony A Bavry
BACKGROUND: Studies conducted largely in men have shown improved outcomes with an early invasive strategy with non-ST-elevation acute coronary syndrome. In contrast, data have been less conclusive in women, with some trials demonstrating potential harm. This study aims to assess whether an early invasive strategy in women is associated with better outcomes in real-world data. METHODS: Women admitted with a primary diagnosis of non-ST-elevation myocardial infarction or unstable angina were identified from the National Inpatient Sample years 2012 and 2013...
September 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28220768/arterial-structure-and-function-in-subjects-with-acute-coronary-syndrome-after-one-year-of-treatment
#19
Agata Schneider, Joanna Gawęcka, Andrzej Minczykowski, Tomasz Krauze, Przemysław Guzik, Jarosław Piskorski, James Heathers, Andrzej Wykrętowicz
INTRODUCTION    It is controversial whether the modification of arterial stiffness and intima-media thickness (IMT) is plausible in patients with clinically significant atherosclerosis.  OBJECTIVES    We evaluated the effects of the one-year pharmacological therapy on the arterial stiffness and IMT in survivors of non-ST elevation myocardial infarction (NSTEMI) who were treated according to the clinical guidelines.  PATIENTS AND METHODS    For this study 298 NSTEMI patients (median age 64 years; 85 females) were enrolled...
February 15, 2017: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/28207887/platelet-monocyte-derived-and-tissue-factor-carrying-circulating-microparticles-are-related-to-acute-myocardial-infarction-severity
#20
Gemma Chiva-Blanch, Kristian Laake, Peder Myhre, Vibeke Bratseth, Harald Arnesen, Svein Solheim, Lina Badimon, Ingebjørg Seljeflot
OBJECTIVE: Circulating microparticles (cMPs) are phospholipid-rich vesicles released from cells when activated or injured, and contribute to the formation of intracoronary thrombi. Tissue factor (TF, CD142) is the main trigger of fibrin formation and TF-carrying cMPs are considered one of the most procoagulant cMPs. Similar types of atherosclerotic lesions may lead to different types of AMI, although the mechanisms behind are unresolved. Therefore, we aimed to investigate the phenotype of cMPs found in plasma of ACS patients and its relation to AMI severity and thrombotic burden...
2017: PloS One
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