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ACS GUIDELINES

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https://www.readbyqxmd.com/read/29345591/should-antithrombotic-treatment-strategies-in-east-asians-differ-from-caucasians-focused-on-acs-or-pci-treated-patients
#1
Jae Seok Bae, Jong-Hwa Ahn, Udaya Tantry, Paul A Gurbel, Young-Hoon Jeong
With over 1.5 billion people, East Asians are the most populous race in the world. Health status in this population is an important global issue. In the contemporary trials of antithrombotic treatment, East Asian patients have a lower risk for atherothrombotic diseases (especially, coronary artery disease [CAD]) and a higher risk for bleeding (especially, gastrointestinal bleeding and hemorrhagic stroke). Despite these observations, antithrombotic treatment strategies in East Asian patients are mainly based on the American or European guidelines that are derived from randomized, controlled trials including mostly Caucasians...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29339844/the-risk-of-deep-vein-thrombosis-in-total-joint-patients-compared-to-orthopaedic-trauma-patients-need-for-new-prevention-guidelines
#2
Michelle Shen, Norele J Cutrera, Ashley C Dodd, Christopher Wallace, Frank R Avilucea, Craig Melbourne, Alex A Jahangir, Hassan H Mir, William T Obremskey, Manish K Sethi
Background: The development of Deep Vein Thrombosis (DVT) is a major concern following orthopaedic surgery. No study has yet to compare the rate and risk factors for DVT between total joint and orthopaedic trauma patients. To evaluate if DVT prophylaxis for trauma should differ from total joints, we explored the rate and risk factors for DVT between both cohorts. Methods: Using a CPT code search from 2005 to 2013 in the ACS-NSQIP database, 150,657 orthopaedic total joint patients and 44,594 orthopaedic trauma patients were identified...
November 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/29332134/breast-cancer-survivorship-state-of-the-science
#3
REVIEW
Kathy Pan, Arti Hurria, Rowan T Chlebowski
PURPOSE: Only recently has breast cancer survivorship earned formal recognition as a research discipline. Complicating survivorship research is the frequent overlap between aging and treatment sequelae. The ACS/ASCO 2016 Breast Cancer Survivorship Care Guideline (Guideline) reflects comprehensive literature review through April 2015, while the jointly sponsored, inaugural Cancer Survivorship Symposium in 2016 (Symposium) reflects ongoing research activity in the area. Together, these platforms provide an opportunity to examine the use of randomized trials and controlled studies in survivorship care research...
January 13, 2018: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/29329796/the-evolving-face-of-myocardial-reperfusion-in-acute-coronary-syndromes-a-primer-for-the-internist
#4
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/29300792/management-of-acute-coronary-syndromes-in-patients-with-diabetes
#5
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/29288404/paradoxical-impact-of-decreased-low-density-lipoprotein-cholesterol-level-at-baseline-on-the-long-term-prognosis-in-patients-with-acute-coronary-syndrome
#6
Takuya Nakahashi, Hayato Tada, Kenji Sakata, Yohei Yakuta, Yoshihiro Tanaka, Akihiro Nomura, Tadatsugu Gamou, Hidenobu Terai, Yuki Horita, Masatoshi Ikeda, Masanobu Namura, Masayuki Takamura, Kenshi Hayashi, Masakazu Yamagishi, Masa-Aki Kawashiri
Although statin therapy is beneficial in the setting of acute coronary syndrome (ACS), a substantial proportion of patients with ACS still do not receive the guideline-recommended lipid management in contemporary practice. We hypothesize that the low-density lipoprotein cholesterol (LDL-C) level at the time of admission might affect patient management and the subsequent outcome. Nine-hundred and forty-two consecutive patients with ACS who underwent percutaneous coronary intervention were analyzed retrospectively...
December 29, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/29283450/the-effect-of-fasting-status-on-lipids-lipoproteins-and-inflammatory-biomarkers-assessed-after-hospitalization-for-an-acute-coronary-syndrome-insights-from-prove-it-timi-22
#7
Dylan L Steen, Amarachi A Umez-Eronini, Jianping Guo, Naseer Khan, Christopher P Cannon
BACKGROUND: For decades, fasting for 8 to 12 hours has been recommended for measurement of lipid profiles. The effect of fasting on low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG) has been described in healthy cohorts and those with stable disease states. Recently, guidelines suggested that fasting may not be necessary due to its small effect on lipid measures. Little is known, however, regarding whether the impact of fasting is altered in the setting of an acute coronary syndrome (ACS)...
December 28, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/29281086/characteristics-of-patients-with-atrial-fibrillation-prescribed-antiplatelet-monotherapy-compared-with-those-on-anticoagulants-insights-from-the-garfield-af-registry
#8
Freek W A Verheugt, Haiyan Gao, Wael Al Mahmeed, Giuseppe Ambrosio, Pantep Angchaisuksiri, Dan Atar, Jean-Pierre Bassand, A John Camm, Frank Cools, John Eikelboom, Gloria Kayani, Toon Wei Lim, Frank Misselwitz, Karen S Pieper, Martin van Eickels, Ajay K Kakkar
Aims: Current atrial fibrillation (AF) guidelines discourage antiplatelet (AP) monotherapy as alternative to anticoagulants (ACs). Why AP only is still used is largely unknown. Methods and results: Factors associated with AP monotherapy prescription were analysed in GARFIELD-AF, a registry of patients with newly diagnosed (≤6 weeks) AF and ≥1 investigator-determined stroke risk factor. We analysed 51 270 patients from 35 countries enrolled into five sequential cohorts between 2010 and 2016...
December 20, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29278630/predictive-value-of-high-sensitive-troponin-i-assay-in-acute-coronary-syndrome-compared-to-classic-biochemical-markers
#9
Tomislav Čolak, Ivanka Mikulić, Kristina Landeka, Ana Sesar, Marija Vranješ, Ivanka Mikulić
The aims of this study were to compare predictive values of hsTroponin I assay with contemporary assays and its usefulness in diagnosis of acute coronary syndrome (ACS). We also aimed to determine reference values of the assay and the possibility of fast ACS diagnosis using hsTnI. The study included 26 patients with ongoing chest pains and suspected ACS. ACS diagnosis was determined using electrocardiographic changes and international guidelines. Biochemical parameters were measured using standard tests which included Troponin I, hsTroponin I, CK, CK-MB and CRP...
December 2017: Psychiatria Danubina
https://www.readbyqxmd.com/read/29251702/safety-and-efficacy-of-brain-injury-guidelines-at-a-level-iii-trauma-center
#10
Grace E Martin, Christopher P Carroll, Zach J Plummer, D A Millar, Timothy A Pritts, Amy T Makley, Bellal A Joseph, Laura B Ngwenya, Michael D Goodman
BACKGROUND: Patients with mild-to-moderate traumatic brain injury (TBI) are often primarily managed by emergency medicine and trauma/acute care physicians. The Brain Injury Guidelines (BIG) were developed at an ACS-accredited level 1 trauma center to triage mild-to-moderate TBI patients and help identify patients who warrant neurosurgical consultation. The BIG have not been validated at a level III trauma center. We hypothesized that BIG criteria can be safely adapted to an ACS-accredited level III trauma center to guide transfers to a higher echelon of care...
December 14, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29243497/preventing-recurrent-events-in-survivors-of-acute-coronary-syndromes-in-australia-consensus-recommendations-using-the-delphi-process
#11
Christopher J Hammett, John Amerena, David Brieger, Andrew Sindone, Peter L Thompson, Matthew I Worthley, Philip E Aylward
OBJECTIVE: There remain substantial gaps in implementation of evidence-based care in patients with acute coronary syndromes (ACS) in Australia, which contribute to high recurrent event rates. Improved translation of evidence into effective action is a key health-care priority. We engaged cardiovascular experts from across Australia to develop straightforward, easily actionable recommendations on key medications to use following ACS. METHODS: An eight-person steering committee (SC) reviewed the published evidence and developed an initial set of statements to be developed into consensus recommendations using a modified Delphi technique...
December 15, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29230658/guidelines-in-review-comparison-of-the-2014-aha-acc-guideline-for-the-management-of-patients-with-non-st-elevation-acute-coronary-syndromes-and-the-2015-esc-guidelines-for-the-management-of-acute-coronary-syndromes-in-patients-presenting-without-persistent
#12
Shane P Prejean, Munaib Din, Eliana Reyes, Fadi G Hage
In this Guidelines in Review, we review side-by-side the recommendations provided by the 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. We review the recommendations for imaging in the evaluation of patients with possible ACS followed by the diagnostic evaluation of patients with proven NSTE-ACS, based on their risk for adverse clinical events...
December 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29217152/advanced-cardiopulmonary-resuscitation-cpr-in-the-catheterization-laboratory-consensus-document-of-the-working-groups-of-1-cardiopulmonary-resuscitation-acute-cardiac-care-and-2-hemodynamic-and-interventional-cardiology-hellenic-cardiological-society
#13
George Latsios, George Mpompotis, Kostas Tsioufis, Kostas Toutouzas, Emmanouil Skalidis, Andreas Synetos, Dimosthenis Avramidis, Dimitris Tousoulis
The incidence of Cardiac (Cardio-Pulmonary) Arrest (CA) in the Catheterization Laboratory is not common. However, not only does it happen occasionally but its frequency tends to increase due to the increase in the overall number and complexity of interventions performed by interventional cardiologists. Therefore, certified knowledge and application of the ALS (Advanced Life Support) protocols by trained Catheterization Laboratory staff is imperative in many countries, by local Hospital standards and also by Law...
December 4, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29197254/utilization-of-lipid-modifying-therapy-and-low-density-lipoprotein-cholesterol-goal-attainment-in-patients-at-high-and-very-high-cardiovascular-risk-real-world-evidence-from-germany
#14
Winfried März, Franz-Werner Dippel, Karlheinz Theobald, Katherine Gorcyca, Şerban R Iorga, David Ansell
BACKGROUND AND AIMS: Elevated low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for cardiovascular (CV) events. European guidelines recommend reducing LDL-C as the primary lipid target to reduce CV risk, using lifestyle modifications and lipid-lowering therapy (LLT). Many European patients do not achieve guideline-recommended LDL-C levels. The present database analysis aimed to assess LLT treatment patterns and LDL-C threshold attainment in Germany in a large, real-world cohort of patients...
November 20, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/29195738/a-perioperative-care-map-improves-outcomes-in-patients-with-morbid-obesity-undergoing-major-surgery
#15
Benjamin D Boodaie, Anthony H Bui, David L Feldman, Michael Brodman, Peter Shamamian, Ronald Kaleya, Meg Rosenblatt, Donna Somerville, Patricia Kischak, I Michael Leitman
BACKGROUND: The surgical management of patients with morbid obesity (body mass index ≥ 40) is notable for a relatively high risk of complications. To address this problem, a perioperative care map was developed using precautions and best practices commonly employed in bariatric surgery. It requires additional medical assessments, sleep apnea surveillance, more stringent guidelines for anesthetic management, and readily available bariatric operating room equipment, among other items...
November 28, 2017: Surgery
https://www.readbyqxmd.com/read/29188358/anticoagulation-strategies-in-patients-with-atrial-fibrillation-after-pci-or-with-acs-the-end-of-triple-therapy
#16
N Fluschnik, P M Becher, R Schnabel, S Blankenberg, D Westermann
Clinicians struggle daily with the optimal regimen for patients with an indication for antiplatelet therapy after stenting and in patients needing oral anticoagulation treatment for atrial fibrillation (AF). This is not only difficult in patients with acute coronary syndrome (ACS) but also in the large number of patients with AF undergoing elective percutaneous coronary intervention (PCI). The challenge is to strike a balance between the increasing risk of bleeding events and ischemic or thrombotic events. Until recently, guidelines were based on expert consensus and a few small, many of them retrospective, trials...
November 29, 2017: Herz
https://www.readbyqxmd.com/read/29180189/impact-of-triage-guidelines-on-prehospital-triage-comparison-of-guidelines-with-a-statistical-model
#17
COMPARATIVE STUDY
Priti P Parikh, Pratik Parikh, Bradley Guthrie, Logan Mamer, Melissa Whitmill, Timothy Erskine, Randy Woods, Jonathan Saxe
BACKGROUND: The American College of Surgeons developed the National Field Triage Decision Scheme (NFTDS) that has been adapted by many trauma centers in the nation, but quantitative evidence of its efficacy is unclear. We compare the NFTDS and state of Ohio guidelines to the "observed" rates and with rates derived using a statistical model. METHODS: We used 4757 trauma records from 2008-2012 available from the state and calculated undertriage (UT) and overtriage (OT) rates...
December 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29171001/modern-imaging-techniques-in-intra-abdominal-hypertension-and-abdominal-compartment-syndrome-a-bench-to-bedside-overview
#18
Gavin Sugrue, Manu L N G Malbrain, Bruno Pereira, Robert Wise, Michael Sugrue
Intra-abdominal hypertension (IAH) is common in critically ill patients. Diagnosis is based on measurement of intra-abdominal pressure, most commonly via the bladder. Modern imaging techniques with plain radiographs, computed tomography and magnetic resonance can help establish the diagnosis and also guide treatment. In 2013 the Abdominal Compartment Society (WSACS) published updated consensus definitions and recommendations for management of IAH and abdominal compartment syndrome (ACS). This review will give a concise overview of the important role radiographic imaging plays within these management guidelines...
November 24, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29170312/15%C3%A2-a-clinical-decision-tool-for-prescribing-anti-platelet-medication-for-patients-with-suspected-acute-coronary-syndrome-pam
#19
Charles Reynard, Rick Body
BACKGROUND: The benefit of antiplatelet medication in confirmed acute coronary syndrome (ACS) is well established. In the Emergency Department (ED) diagnostic uncertainty may lead to over-treatment, with consequent risks (e.g., bleeding), or under-treatment, compromising clinical outcomes. Clinicians must subjectively balance the anticipated risks and benefits with their perceived probability of ACS in order to decide whether to prescribe these medications. We aimed to construct a clinical model to optimise and personalise recommendations for anti-platelet prescription in this context...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29168689/in-hospital-prescriptions-of-secondary-prevention-medications-for-post-acute-coronary-syndrome-patients-in-south-korea%C3%A2
#20
Han-Bin Kang, Minwook Choi, Sang Gyeong Yoon, Young Seuk Cho, Nam Kyung Je
BACKGROUND: Optimal medical therapy and the management of cardiac risk factors are crucial for the secondary prevention of acute coronary syndrome (ACS). However, there have been reports on the underutilization of secondary-prevention medications for ACS. This study aimed to investigate adherence of in-hospital prescriptions to clinical practice guidelines for the secondary prevention of ACS using real-world data. MATERIALS AND METHODS: We collected information on ACS patients from national insurance claims data...
January 2018: International Journal of Clinical Pharmacology and Therapeutics
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