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ACS GUIDELINES

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https://www.readbyqxmd.com/read/27896677/results-of-database-studies-in-spine-surgery-can-be-influenced-by-missing-data
#1
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
https://www.readbyqxmd.com/read/27887802/meta-analysis-of-clopidogrel-pretreatment-in-acute-coronary-syndrome-patients-undergoing-invasive-strategy
#2
Ramez Nairooz, Marco Valgimigli, Yogita Rochlani, Naga Venkata Pothineni, Sameer Raina, Partha Sardar, Debabrata Mukherjee, Srihari S Naidu, David M Shavelle
BACKGROUND: It is unknown whether pretreatment with clopidogrel in acute coronary syndrome (ACS) managed invasively, is superior to a strategy of administering clopidogrel in the cardiac catheterization laboratory at the time of percutaneous coronary intervention (PCI). Current practice guidelines do not endorse one strategy over the other. METHODS: A comprehensive literature search was done to identify all relevant studies comparing pretreatment with clopidogrel to administration in the cardiac catheterization laboratory at the time of PCI (no pretreatment)...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27884453/a-call-for-a-standardized-definition-of-perforated-appendicitis
#3
Andrew P Rogers, Tiffany J Zens, Charles M Leys, Peter F Nichol, Daniel J Ostlie
BACKGROUND: Abscess rates have been reported to be as low as 1% and as high as 50% following perforated appendicitis (PA). This range may be because of lack of universal definition for PA. An evidence-based definition (EBD) is crucial for accurate wound classification, risk-stratification, and subsequent process optimization. ACS NSQIP-Pediatric guidelines do not specify a definition of PA. We hypothesize that reported postoperative abscess rates underrepresent true incidence, as they may include low-risk cases in final calculations...
October 27, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27881527/clinical-factors-associated-with-initiation-of-and-persistence-with-adp-receptor-inhibiting-oral-antiplatelet-treatment-after-acute-coronary-syndrome-a-nationwide-cohort-study-from-finland
#4
Tuire Prami, Houssem Khanfir, Anna Deleskog, Pål Hasvold, Ville Kytö, Eeva Reissell, Juhani Airaksinen
OBJECTIVES: To study patient selection for and persistence with ADP receptor-inhibiting oral antiplatelet (OAP) treatment after acute coronary syndrome (ACS). DESIGN: Observational, retrospective, cohort study linking real-life patient-level register data. SETTING: Nationwide drug usage study using data of patients with ACS discharged from hospitals in Finland. PARTICIPANTS: The study population consisted of 54 416 patients (aged ≥18 years) following hospital admission for unstable angina pectoris or myocardial infarction during 2009-2013...
November 22, 2016: BMJ Open
https://www.readbyqxmd.com/read/27869899/-patients-with-non-st-elevation-acute-coronary-syndrome-managed-without-coronary-revascularization-an-undertreated-population
#5
Alberto Menozzi, Leonardo De Luca, Zoran Olivari, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Stefano De Servi
Non-ST-elevation acute coronary syndromes (NSTE-ACS) represent one of the most common clinical presentations of ischemic heart disease. Patients with NSTE-ACS are a heterogeneous population, with different clinical features and prognosis. A significant proportion of this population is medically managed, without any revascularization. In the Italian EYESHOT and French FAST-MI registries, patients managed with a conservative strategy were 40% and 35%, respectively. NSTE-ACS patients not undergoing coronary revascularization are at higher risk of adverse cardiovascular events and have a worse prognosis, including short- and long-term mortality, compared with those receiving revascularization...
October 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27865674/does-anemia-affect-the-predictive-ability-of-bleeding-risk-scores-in-patients-with-acute-coronary-syndromes
#6
Alberto Garay, Albert Ariza-Solé, Francesc Formiga, Victoria Lorente, José C Sánchez-Salado, Joel Salazar-Mendiguchía, Gerard Roura, Guillem Muntané, Oriol Alegre, Lara Fuentes, Joan A Gómez-Hospital, Angel Cequier
INTRODUCTION AND OBJECTIVE: Anemia is a common comorbidity in patients with acute coronary syndromes (ACS), and is associated with higher risk for both bleeding and ischemic complications. We aimed to assess the predictive ability of bleeding risk scores (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines [CRUSADE], Mehran and Acute Coronary Treatment and Intervention Outcomes Network [ACTION]) in ACS patients with anemia...
November 16, 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27863363/exercise-based-cardiac-rehabilitation-in-twelve-european-countries-results-of-the-european-cardiac-rehabilitation-registry
#7
Werner Benzer, Bernhard Rauch, Jean-Paul Schmid, Ann Dorthe Zwisler, Paul Dendale, Constantinos H Davos, Evangelia Koudi, Attila Simon, Ana Abreu, Nana Pogosova, Dan Gaita, Bojan Miletic, Gerd Bönner, Taoufik Ouarrak, Hannah McGee
AIM: Results from EuroCaReD study should serve as a benchmark to improve guideline adherence and treatment quality of cardiac rehabilitation (CR) in Europe. METHODS AND RESULTS: Data from 2.054 CR patients in 12 European countries were derived from 69 centres. 76% were male. Indication for CR differed between countries being predominantly ACS in Switzerland (79%), Portugal (62%) and Germany (61%), elective PCI in Greece (37%), Austria (36%) and Spain (32%), and CABG in Croatia and Russia (36%)...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27861707/investigating-antenatal-corticosteroid-clinical-guideline-practice-at-an-organisational-level
#8
Emma L McGoldrick, Julie A Brown, Katie M Groom, Caroline A Crowther
BACKGROUND: High-quality, evidence-based guidelines can improve the quality of health care and facilitate standardisation of practice within and across healthcare organisations. Limited information is known regarding existing antenatal corticosteroid (ACS) guideline practices within organisations across Australia and New Zealand. AIMS: To assess existing ACS clinical practice guidelines (CPG). To describe current organisational practice related to the production, implementation and renewal of CPG...
November 15, 2016: Australian & New Zealand Journal of Obstetrics & Gynaecology
https://www.readbyqxmd.com/read/27856518/a-consensus-statement-on-lipid-management-after-acute-coronary-syndrome
#9
François Schiele, Michel Farnier, Michel Krempf, Eric Bruckert, Jean Ferrières
In patients admitted for acute coronary syndrome (ACS), the guidelines of the European Society of Cardiology give a Class I, Level A recommendation for the prescription of high-intensity statins to be initiated as early as possible, regardless of the low-density lipoprotein cholesterol (LDL-C) level. Although statins are widely prescribed after ACS, the intensity of therapy and the proportion of patients achieving target LDL-C values are often not in line with recommendations due to a lack of compliance with guidelines by the physicians, a lack of compliance with treatment or poor tolerance by patients, and poor dose adaptation...
November 17, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27852195/clinical-care-standards-appropriate-care-everywhere-acute-coronary-syndromes-as-an-example
#10
Derek P Chew, Robert Herkes, Meredith A Page
Audit data show that despite clinical practice guidelines, some patients miss out on evidence-based care, which is not explained by individual needs or preferences. Clinical care standards are small sets of concise recommendations that focus on known gaps in evidence-based care for a particular clinical condition. They aim to ensure that all patients with the same clinical condition are offered appropriate care, regardless of their location. Clinical care standards are nationally agreed standards and are developed to maximise engagement of consumers, clinicians, health services, and state and territory health departments and agencies...
November 21, 2016: Medical Journal of Australia
https://www.readbyqxmd.com/read/27843565/systematic-reviews-causes-of-non-adherence-to-p2y12-inhibitors-in-acute-coronary-syndromes-and-response-to-intervention
#11
Nina Johnston, John Weinman, Lucy Ashworth, Peter Smethurst, Jad El Khoury, Clare Moloney
To understand the factors associated with non-adherence to oral antiplatelet (OAP) therapy in acute coronary syndromes (ACS), and where interventions have modified these factors. Linked systematic reviews were undertaken in accordance with the Preferred Reporting Items for Systematic reviews and Meta-analysis guidelines, using CINAHL Plus, MEDLINE, PsycINFO and PubMed databases. The searches were limited to studies available in English and published from 2000 onwards; last run in June 2015. Review 1: factors...
2016: Open Heart
https://www.readbyqxmd.com/read/27834012/postoperative-complications-of-laparoscopic-cholecystectomy-for-acute-cholecystitis-a-comparison-to-the-acs-nsqip-risk-calculator-and-the-tokyo-guidelines
#12
Roxanne L Massoumi, Colleen M Trevino, Travis P Webb
BACKGROUND: We compared observed postoperative outcomes from laparoscopic cholecystectomy performed for acute cholecystitis (AC) to outcomes predicted by the ACS-NSQIP risk calculator.We also noted and compared any differences in observed outcomes across the different Tokyo Guidelines (TG) levels of AC severity.We hypothesized that ACS-NSQIP would accurately predict complications and length of stay (LOS) and that increased TG severity levels would correlate with more complications, increased conversion to open surgery, and longer LOS...
November 10, 2016: World Journal of Surgery
https://www.readbyqxmd.com/read/27829379/evidence-based-interventions-in-primary-care-following-acute-coronary-syndrome-in-australia-and-new-zealand-a-systematic-scoping-review
#13
Manavi M Bhagwat, John A Woods, Mithilesh Dronavalli, Sandra J Hamilton, Sandra C Thompson
BACKGROUND: Coronary artery disease has a significant disease burden, but there are many known barriers to management of acute coronary syndrome (ACS). General practitioners (GPs) bear considerable responsibility for post-discharge management of ACS in Australia and New Zealand (NZ), but knowledge about the extent and efficacy of such management is limited. This systematic review summarises published evidence from Australia and New Zealand regarding management in primary care after discharge following ACS...
November 9, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27823684/impact-of-the-2013-american-college-of-cardiology-american-heart-association-cholesterol-guidelines-on-the-prescription-of-high-intensity-statins-in-patients-hospitalized-for-acute-coronary-syndrome-or-stroke
#14
Michael Valentino, Jad Al Danaf, Andrew Panakos, Loheetha Ragupathi, Danielle Duffy, David Whellan
BACKGROUND: The 2013 American College of Cardiology/American Heart Association cholesterol management guidelines represented a paradigm shift from the National Cholesterol Education Program Adult Treatment Panel III guidelines, replacing low-density lipoprotein cholesterol targets with a risk assessment model to guide statin therapy. Our objectives are to compare provider prescription of high-intensity statin therapy in patients hospitalized with acute coronary syndrome (ACS) or cerebrovascular accident (CVA) before and after the publication of the 2013 cholesterol guidelines, determine potential predictors of high-intensity statin utilization, and identify targets for improvement in cardiovascular risk reduction among these high-risk populations...
November 2016: American Heart Journal
https://www.readbyqxmd.com/read/27821064/the-prognostic-utility-of-grace-risk-score-in-predictive-cardiovascular-event-rate-in-stemi-patients-with-successful-fibrinolysis-and-delay-intervention-in-non-pci-capable-hospital-a-retrospective-cohort-study
#15
Yotsawee Chotechuang, Arintaya Phrommintikul, Roungtiva Muenpa, Jayanton Patumanond, Tuanchai Chaichuen, Srun Kuanprasert, Noparat Thanachikun, Thanawat Benjanuwatra, Apichard Sukonthasarn
BACKGROUND: Fibrinolytic therapy is the main reperfusion therapy for most STEMI patients in several countries. Current practice guidelines recommended routine early pharmacoinvasive (within 3-24 h after successful fibrinolysis, however it cannot be performed in timely fashion due to limitation of PCI-capable hospitals. This study aimed to evaluate the prognostic utility of the GRACE score in patients receiving delayed intervention after successful fibrinolysis in non PCI-capable hospital...
November 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27807732/acute-coronary-syndromes-differences-in-men-and-women
#16
REVIEW
Kris R Kawamoto, Melinda B Davis, Claire S Duvernoy
PURPOSE OF REVIEW: Increased awareness of cardiovascular disease in women has prompted studies to investigate gender-related disparities in acute coronary syndromes (ACSs). In this review, we discuss findings from current literature on the clinical presentation, pathophysiology, diagnosis, and management of ACS in women as compared to men. RECENT FINDINGS: Emerging data show that cardiovascular disease (CVD) continues to be the leading cause of death in women and the annual mortality rate from CVD remains higher in women compared to men...
December 2016: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/27789517/early-cessation-of-adenosine-diphosphate-receptor-inhibitors-among-acute-myocardial-infarction-patients-treated-with-percutaneous-coronary-intervention-insights-from-the-translate-acs-study-treatment-with-adenosine-diphosphate-receptor-inhibitors-longitudinal
#17
Emil L Fosbøl, Christine Ju, Kevin J Anstrom, Marjorie E Zettler, John C Messenger, Ron Waksman, Mark B Effron, Brian A Baker, David J Cohen, Eric D Peterson, Tracy Y Wang
BACKGROUND: Guidelines recommend the use of adenosine diphosphate receptor inhibitor (ADPri) therapy for 1 year postacute myocardial infarction; yet, early cessation of therapy occurs frequently in clinical practice. METHODS AND RESULTS: We examined 11 858 acute myocardial infarction patients treated with percutaneous coronary intervention discharged alive on ADPri therapy from 233 United States TRANSLATE-ACS study (Treatment With Adenosine Diphosphate Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome) participating hospitals to determine the prevalence of early ADPri cessation (within 1 year), patient-reported reasons for cessation, and associated risk of major adverse cardiovascular events at 1 year...
November 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27715344/pharmacokinetics-and-pharmacodynamics-of-ticagrelor-in-the-treatment-of-cardiac-ischemia
#18
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
December 2016: Expert Opinion on Drug Metabolism & Toxicology
https://www.readbyqxmd.com/read/27707608/cha2ds2-vasc-score-and-clinical-outcomes-of-patients-with-acute-coronary-syndrome
#19
Zach Rozenbaum, Avishay Elis, Mony Shuvy, Dina Vorobeichik, Nir Shlomo, Meital Shlezinger, Ilan Goldenberg, Oded Kimhi, David Pereg
BACKGROUND: The CHA2DS2-VASc score has been recommended for the assessment of thromboembolic risk in patients with atrial fibrillation. HYPOTHESIS: The CHA2DS2-VASc score may be associated with adverse outcomes in patients with ACS. METHODS: Included were patients with ACS enrolled in the Acute Coronary Syndrome Israeli biennial Surveys (ACSIS) during 2000-2013. Patients were divided into 4 groups according to their CHA2DS2-VASc score (0 or 1, 2 or 3, 4 or 5, and >5)...
October 1, 2016: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/27664899/multidisciplinary-approach-to-decrease-pediatric-trauma-undertriage
#20
Benjamin Eithun, Ankush Gosain
BACKGROUND: Trauma activation and/or leveling criteria are designed to balance the potential harm to individual patients from undertriage (UT) of severe injuries versus overutilization of resources from overtriage (OT) of lesser injuries. The American College of Surgeons (ACS) recommends an acceptable UT rate ≤5% and OT 25%-50%. To improve UT or OT, an intervention was performed to (1) improve accuracy in following established leveling criteria and (2) modify activation criteria in an evidence-based manner to better identify severely injured children...
October 2016: Journal of Surgical Research
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