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ACS GUIDELINES

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https://www.readbyqxmd.com/read/28104706/selecting-patients-with-non-st-elevation-acute-coronary-syndrome-for-coronary-angiography-a-nationwide-clinical-vignette-study-in-the-netherlands
#1
Josien Engel, Judith M Poldervaart, Ineke van der Wulp, Johannes B Reitsma, Martine C de Bruijne, Jeroen J H Bunge, Maarten J Cramer, Wouter J Tietge, Ruben Uijlings, Cordula Wagner
OBJECTIVE: Cardiac guidelines recommend that the decision to perform coronary angiography (CA) in patients with Non-ST-Elevation Acute Coronary Syndrome (NST-ACS) is based on multiple factors. It is, however, unknown how cardiologists weigh these factors in their decision-making. The aim was to investigate the importance of different clinical characteristics, including information derived from risk scores, in the decision-making of Dutch cardiologists regarding performing CA in patients with suspected NST-ACS...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28103494/factors-associated-with-meeting-physical-activity-guidelines-by-adults-with-intellectual-and-developmental-disabilities
#2
Roger J Stancliffe, Lynda L Anderson
BACKGROUND: Many individuals with intellectual and developmental disabilities (IDD) have sedentary lifestyles. AIMS: (a) compare adults with IDD with the general adult population on adherence to U.S. physical activity (PA) guidelines, and (b) determine what factors predict adherence to PA guidelines by adults with IDD. METHODS: We compared adults with IDD from the 2011-2012 National Core Indicators Adult Consumer Survey (NCI-ACS) with the general U...
January 16, 2017: Research in Developmental Disabilities
https://www.readbyqxmd.com/read/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#3
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28089153/temporal-trends-in-management-and-outcomes-of-patients-with-acute-coronary-syndrome-according-to-renal-function
#4
Mony Shuvy, Shmuel Chen, Dina Vorobeichik, Eilon Krashin, Nir Shlomo, Ilan Goldenberg, David Pereg
INTRODUCTION: Recent new therapeutic options have improved outcomes of acute coronary syndrome (ACS) patients. However, data regarding the incremental effect of the improved treatment on patients with renal dysfunction are limited. We sought to evaluate temporal trends in management and outcome of ACS patients according to renal function. METHODS: The study population consisted of all ACS patients enrolled in the Acute Coronary Syndromes Israeli Survey (ACSIS) during 2002-2013...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28067454/concomitant-use-of-calcium-channel-blockers-with-dual-antiplatelet-therapy-and-re-hospitalization-for-acute-coronary-syndrome
#5
Chen-Yu Wang, Zhen-Fang Lin, Chii-Ming Lee, Yi-Wen Tsai, Ting-Ying Huang, Li-Jiuan Shen, Fei-Yuan Hsiao
BACKGROUND: Existing studies suggested that concomitant use of calcium channel blockers (CCBs) may interfere with the antiplatelet effect of clopidogrel. The objective of this study was to examine the effect of concomitant use of CCBs and clopidogrel on risks of acute coronary syndrome (ACS) re-hospitalization in patients receiving percutaneous coronary intervention. METHODS: Using the Taiwan National Health Insurance Research Database, we identified 51 925 patients who were admitted for newly diagnosed ACS, received percutaneous coronary intervention, and used clopidogrel within 1 year after discharge...
January 9, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#6
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28058865/impact-of-pharmacist-intervention-to-increase-compliance-with-guideline-directed-statin-therapy-during-an-acute-coronary-syndrome-hospitalization
#7
Robert K Tunney, Daniel C Johnson, Li Wang, Zachary L Cox
BACKGROUND: Despite evidence on poor adherence to guideline-directed statin therapy (GDST) following an acute coronary syndrome (ACS), little information has been published on pharmacist-led statin pilot programs for secondary prevention. OBJECTIVE: We sought to evaluate the impact of a pharmacist intervention (PI) on GDST during an ACS hospitalization. METHODS: A historical control (HC) group consisting of 125 ACS hospitalizations was retrospectively identified, with prospective data of 113 patients captured over 6 months in the PI group...
January 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28054150/ki-67-labeling-index-of-neuroendocrine-tumors-of-the-lung-has-a-high-level-of-correspondence-between-biopsy-samples-and-surgical-specimens-when-strict-counting-guidelines-are-applied
#8
Alessandra Fabbri, Mara Cossa, Angelica Sonzogni, Mauro Papotti, Luisella Righi, Gaia Gatti, Patrick Maisonneuve, Barbara Valeri, Ugo Pastorino, Giuseppe Pelosi
Optimal histopathological analysis of biopsies from metastases of neuroendocrine tumor (NET) of the lung requires more than morphology only. Additional parameters such as Ki-67 labeling index are required for adequate diagnosis, but few studies have compared reproducibility of different counting protocols and modalities of reporting on biopsies of lung NET. We compared the results of four different manual counting techniques to establish Ki-67 LI. On 47 paired biopsies and surgical specimens from 22 typical carcinoids (TCs), 14 atypical carcinoids (ACs), six large cell neuroendocrine carcinomas (LCNECs), and five small cell carcinomas (SCCs) immunohistochemical staining of Ki-67 antigen was performed...
January 4, 2017: Virchows Archiv: An International Journal of Pathology
https://www.readbyqxmd.com/read/28052158/factors-associated-with-nontransfer-in-trauma-patients-meeting-american-college-of-surgeons-criteria-for-transfer-at-nontertiary-centers
#9
Quanhong Zhou, Matthew R Rosengart, Timothy R Billiar, Andrew B Peitzman, Jason L Sperry, Joshua B Brown
Importance: Secondary triage from nontertiary centers is vital to trauma system success. It remains unclear what factors are associated with nontransfer among patients who should be considered for transfer to facilities providing higher-level care. Objective: To identify factors associated with nontransfer among patients meeting American College of Surgeons (ACS) guideline criteria for transfer from nontertiary centers. Design, Setting, and Participants: A retrospective cohort study was performed using multilevel logistic regression to ascertain factors associated with nontransfer from nontertiary centers, including demographics, injury characteristics, and center resources...
January 4, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#10
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28017673/outcome-after-surgery-for-acute-aortic-dissection-influence-of-preoperative-antiplatelet-therapy-on-prognosis
#11
Raphaelle Avigael Chemtob, Hasse Moeller-Soerensen, Lene Holmvang, Peter Skov Olsen, Hanne Berg Ravn
OBJECTIVES: Outcome in patients with acute coronary syndrome (ACS) is improved with dual antiplatelet therapy (DAPT). Patients with acute aortic dissection type A (AAD) often present with similar symptoms and may therefore be prescribed DAPT before diagnosis. The aim of this study was to evaluate the use of antiplatelet therapy (APT) prior to AAD surgery and patient outcome, including indications according to the European Society of Cardiology's (ESC) recent guidelines. DESIGN: A retrospective, observational study...
October 11, 2016: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/28007934/should-the-1h-algorithm-for-rule-in-and-rule-out-of-acute-myocardial-infarction-be-used-universally
#12
Filippo Crea, Allan S Jaffe, Paul O Collinson, Christian W Hamm, Bertil Lindahl, Nicholas L Mills, Kristian Thygesen, Christian Mueller, Carlo Patrono, Marco Roffi
No abstract text is available yet for this article.
November 21, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27974385/simulation-models-of-misclassification-error-for-single-thresholds-of-high-sensitivity-cardiac-troponin-i-due-to-assay-bias-and-imprecision
#13
Andrew W Lyon, Peter A Kavsak, Oliver A S Lyon, Andrew Worster, Martha E Lyon
BACKGROUND: Clinical outcome studies for cardiac troponins (cTn) are expensive and difficult to design owing to variation in patients, in the assays, and in the incidence of different types of myocardial infarction (MI). To overcome these difficulties, simulation models were used to estimate the rate of misclassification error for MI and risk prediction resulting from assay bias and imprecision. METHODS: Finite mixture analysis of Abbott high-sensitivity cTnI (hs-cTnI) results at time 0 h in patients presenting early with acute coronary syndrome (ACS) symptoms to the emergency department (ED) [n = 145, Reducing the Time Interval for Identifying New Guideline (RING) study] allowed derivation of a simulation data set (n = 10000)...
December 14, 2016: Clinical Chemistry
https://www.readbyqxmd.com/read/27966184/2015-esc-guidelines-for-the-management-of-acute-coronary-syndromes-in-patients-presenting-without-persistent-st-segment-elevation-comments-from-the-dutch-acs-working-group
#14
P Damman, A W van 't Hof, J M Ten Berg, J W Jukema, Y Appelman, A H Liem, R J de Winter
On behalf of the Dutch ACS working group, we discuss multiple recommendations which have been implemented in the 2015 ESC guidelines for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation.
December 13, 2016: Netherlands Heart Journal
https://www.readbyqxmd.com/read/27931543/efficacy-and-safety-of-the-intensive-dose-of-rosuvastatin-40mg-day-in-patients-with-acute-coronary-syndrome-and-at-high-risk-of-cardiovascular-disease-rosuvees-2
#15
Chetan P Shah, Bhaskar P Shah, Sameer I Dani, B B Channa, S S Lakshmanan, N C Krishnamani, Ashwani Mehta, P Moorthy
BACKGROUND: Randomized clinical trials have established the benefits of statin therapy in acute coronary syndromes (ACS) via their pleiotropic effects. AIM OF THE STUDY: This was a 12-week, open-label, multicenter, postmarketing observational study evaluating the efficacy and safety of rosuvastatin 40 mg/day in very high-risk or high-risk Indian patients according to NCEP ATP III guidelines. METHODOLOGY: One hundred and sixty two patients (age: 30 to 69 years) with evidence of coronary artery disease, hospitalized with chest pain with/without electrocardiogram changes and with non-ST segment elevation ACS and ST segment elevation ACS who received optimal reperfusion therapy were enrolled...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27914991/antiplatelet-therapy-in-patients-with-glucose-6-phosphate-dehydrogenases-deficiency-after-percutaneous-coronary-intervention-a-reappraisal-for-clinical-and-interventional-cardiologists
#16
REVIEW
Marco Zuin, Gianluca Rigatelli, Mauro Carraro, Maria Paola Galasso, Fabio Dell'Avvocata, Rossella Paolini, Giovanni Zuliani, Loris Roncon
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents one of the most common erythrocyte enzymopathy. In the era of drug-eluting stents (DESs), the use of prolonged dual antiplatelet therapy (DAPT) with aspirin (ASA) and thienopyridine (clopidogrel or ticlopidine) has become mandatory in the treatment of patients with acute coronary syndromes (ACS) and/or after percutaneous coronary intervention (PCI). However, the use of ASA, and more in general of antiplatelet drugs in patients with G6PD deficiency remains controversial, also for the absence of specific guidelines and scientific evidences...
November 28, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27914488/safety-of-6-month-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-rationale-and-design-of-the-smart-angioplasty-research-team-safety-of-6-month-duration-of-dual-antiplatelet-therapy-after
#17
Joo Myung Lee, Deok-Kyu Cho, Joo-Yong Hahn, Young Bin Song, Taek Kyu Park, Ju-Hyeon Oh, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) is a fundamental treatment that optimizes clinical outcomes after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). Although current international guidelines recommend DAPT for at least 12 months after implantation of a drug-eluting stent in patients with ACS, these recommendations are not based on randomized controlled trials dedicated to ACS population. STUDY DESIGN: The SMART-DATE trial is a prospective, multicenter, randomized, and open-label study to demonstrate the noninferiority of 6-month DAPT compared with 12 months or longer DAPT in patients with ACS undergoing percutaneous coronary intervention...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27908843/treatment-of-acute-coronary-syndrome-by-telemedically-supported-paramedics-compared-with-physician-based-treatment-a-prospective-interventional-multicenter-trial
#18
Jörg C Brokmann, Clemens Conrad, Rolf Rossaint, Sebastian Bergrath, Stefan K Beckers, Miriam Tamm, Michael Czaplik, Frederik Hirsch
BACKGROUND: Prehospital treatment of acute coronary syndrome (ACS) in German emergency medical services (EMSs) is reserved for EMS physicians due to legal issues. OBJECTIVE: The objective of this prospective, interventional, multicenter trial was to evaluate the quality of telemedically-delegated therapy and the possible complications in patients with ACS. METHODS: After approval by the ethics committee and trial registration, a one-year study phase was started in August 2012 with 5 ambulances, telemedically equipped and staffed with paramedics, in 4 German EMS districts...
December 1, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27906920/the-electronic-tracking-of-referral-and-attendance-at-cardiac-rehabilitation-in-counties-manukau-health-a-potential-model-for-new-zealand
#19
Andy McLachlan, Fiona Doolan-Noble, Mildred Lee, Katherine McLean, Andrew J Kerr
AIM: Cardiac rehabilitation (CR) programmes for patients surviving an acute coronary syndrome (ACS) event are important and recommended by clinical guidelines. Referral and attendance, however, remain suboptimal and tracking both of these aspects to inform quality improvement has been difficult. The aim of this study was to describe the use of an electronic registry to capture referral and attendance at CR in CMH and to report the characteristics of the initial cohort. METHOD: We developed and implemented an electronic tracking tool, designed to be compatible with ANZAC-QI to monitor referral and attendance in a cohort of patients with confirmed ACS between 1 January 2013 and 1 January 2015...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#20
Bryce A Basques, Ryan P McLynn, Michael P Fice, Andre M Samuel, Adam M Lukasiewicz, Daniel D Bohl, Junyoung Ahn, Kern Singh, Jonathan N Grauer
BACKGROUND: National databases are increasingly being used for research in spine surgery; however, one limitation of such databases that has received sparse mention is the frequency of missing data. Studies using these databases often do not emphasize the percentage of missing data for each variable used and do not specify how patients with missing data are incorporated into analyses. This study uses the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database to examine whether different treatments of missing data can influence the results of spine studies...
November 28, 2016: Clinical Orthopaedics and related Research
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