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ACS GUIDELINES

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https://www.readbyqxmd.com/read/28906404/ticagrelor-induced-life-threatening-bleeding-via-the-cyclosporine-mediated-drug-interaction-a-case-report
#1
Chi Zhang, Long Shen, Min Cui, Xiaoyan Liu, Zhichun Gu
RATIONALE: Ticagrelor has become one of the first-line antiplatelet agents in acute coronary syndrome (ACS) patients recommend by the guideline due to its more potent and predictable antiplatelet effect. However, bleeding is still a severe drug adverse reaction of ticagrelor therapy. We report a first case on ticagrelor-induced life-threatening bleeding via the cyclosporine-mediated drug interaction. PATIENT CONCERNS: A 58-year-old Chinese male who received cyclosporine 200 mg daily 5 years after renal transplantation...
September 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28892533/association-of-guideline-adherent-antibiotic-treatment-with-readmission-of-children-with-sickle-cell-disease-hospitalized-with-acute-chest-syndrome
#2
David G Bundy, Troy E Richardson, Matthew Hall, Jean L Raphael, David C Brousseau, Staci D Arnold, Ram V Kalpatthi, Angela M Ellison, Suzette O Oyeku, Samir S Shah
Importance: Acute chest syndrome (ACS) is a common, serious complication of sickle cell disease (SCD) and a leading cause of hospitalization and death in both children and adults with SCD. Little is known about the effectiveness of guideline-recommended antibiotic regimens for the care of children hospitalized with ACS. Objectives: To use a large, national database to describe patterns of antibiotic use for children with SCD hospitalized for ACS and to determine whether receipt of guideline-adherent antibiotics was associated with lower readmission rates...
September 11, 2017: JAMA Pediatrics
https://www.readbyqxmd.com/read/28886083/nurse-led-telephone-based-follow-up-of-secondary-prevention-after-acute-coronary-syndrome-one-year-results-from-the-randomized-controlled-nailed-acs-trial
#3
Daniel Huber, Robin Henriksson, Stina Jakobsson, Thomas Mooe
BACKGROUND: Secondary prevention after acute coronary syndrome (ACS) could reduce morbidity and mortality, but guideline targets are seldom reached. We hypothesized that nurse-led telephone-based intervention would increase adherence. METHODS: The NAILED ACS trial is a prospective, controlled, randomized trial. Patients admitted for ACS at Östersund hospital, Sweden, were randomized to usual follow-up by a general practitioner or a nurse-led intervention. The intervention comprised telephone follow-up after 1 month and then yearly with lifestyle counselling and titration of medications until reaching target values for LDL-C (<2...
2017: PloS One
https://www.readbyqxmd.com/read/28885816/new-acs-surgical-practice-guidelines-now-include-patient-education
#4
Sapna Dalal, Nancy Strand
No abstract text is available yet for this article.
June 2017: Bulletin of the American College of Surgeons
https://www.readbyqxmd.com/read/28874297/patients-with-non-st-segment-elevation-acute-coronary-syndromes-managed-without-coronary-revascularization-a-population-needing-treatment-improvement
#5
Alberto Menozzi, Stefano De Servi, 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, Zoran Olivari, Leonardo De Luca
NSTE-ACS patients are a heterogeneous population, with different clinical features and prognosis. A large proportion of them is medically managed, without any revascularization. In the EYSHOT and FAST-MI registries such patients were 40% and 35%, respectively. These patients are at higher risk of adverse cardiovascular events and have a worse prognosis compared with those receiving revascularization. Medically managed NSTE-ACS patients consist of different subgroups: those not undergoing coronary angiography, those without significant coronary artery disease, and those with coronary stenoses not referred to revascularization...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28868073/antithrombotic-treatment-tailoring-and-risk-score-evaluation-in-elderly-patients-diagnosed-with-an-acute-coronary-syndrome
#6
REVIEW
Alexandru Nicolae Mischie, Catalina Liliana Andrei, Crina Sinescu, Gani Bajraktari, Eugen Ivan, Georgios Nikolaos Chatziathanasiou, Michele Schiariti
Age is an important prognostic factor in the outcome of acute coronary syndromes (ACS). A substantial percentage of patients who experience ACS is more than 75 years old, and they represent the fastest-growing segment of the population treated in this setting. These patients present different patterns of responses to pharmacotherapy, namely, a higher ischemic and bleeding risk than do patients under 75 years of age. Our aim was to identify whether the currently available ACS ischemic and bleeding risk scores, which has been validated for the general population, may also apply to the elderly population...
July 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28867028/corrigendum-to-national-heart-foundation-of-australia-cardiac-society-of-australia-and-new-zealand-australian-clinical-guidelines-for-the-management-of-acute-coronary-syndromes-2016-heart-lung-and-circulation-volume-25-2016-898-952
#7
Derek P Chew, Ian A Scott, Louise Cullen, John K French, Tom G Briffa, Philip A Tideman, Stephen Woodruffe, Alistair Kerr, Maree Branagan, Philip E G Aylward
No abstract text is available yet for this article.
October 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28859658/the-effect-of-socioeconomic-disadvantage-on-prescription-of-guideline-recommended-medications-for-patients-with-acute-coronary-syndrome-systematic-review-and-meta-analysis
#8
REVIEW
Karice K Hyun, David Brieger, Mark Woodward, Sarah Richtering, Julie Redfern
BACKGROUND: There are varying data on whether socioeconomic status (SES) affects the treatment in patients with acute coronary syndrome (ACS). Our aim was to obtain a reliable estimate of the effect of SES on discharge prescription of medications following an ACS through systematic review and meta-analysis. METHODS: Medline, EMBASE and Global Health were searched systematically on 6th April 2016. Studies were eligible if the participants had ACS and reported the rate/odds of guideline-recommended ACS medications prescription (aspirin, antiplatelet, beta blocker, angiotensin co-enzyme inhibitors (ACEi)/angiotensin receptor blockers (ARB) and statin) at discharge stratified by SES...
August 31, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28855078/guided-de-escalation-of-antiplatelet-treatment-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-tropical-acs-a-randomised-open-label-multicentre-trial
#9
Dirk Sibbing, Dániel Aradi, Claudius Jacobshagen, Lisa Gross, Dietmar Trenk, Tobias Geisler, Martin Orban, Martin Hadamitzky, Béla Merkely, Róbert Gábor Kiss, András Komócsi, Csaba A Dézsi, Lesca Holdt, Stephan B Felix, Radoslaw Parma, Mariusz Klopotowski, Robert H G Schwinger, Johannes Rieber, Kurt Huber, Franz-Josef Neumann, Lukasz Koltowski, Julinda Mehilli, Zenon Huczek, Steffen Massberg
BACKGROUND: Current guidelines recommend potent platelet inhibition with prasugrel or ticagrelor for 12 months after an acute coronary syndrome managed with percutaneous coronary intervention (PCI). However, the greatest anti-ischaemic benefit of potent antiplatelet drugs over the less potent clopidogrel occurs early, while most excess bleeding events arise during chronic treatment. Hence, a stage-adapted treatment with potent platelet inhibition in the acute phase and de-escalation to clopidogrel in the maintenance phase could be an alternative approach...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28822560/comparison-of-outcomes-of-acute-coronary-syndrome-in-patients-%C3%A2-80-years-versus-those-80-years-in-israel-from-2000-to-2013
#10
Michael Shechter, Roy Rubinstein, Ilan Goldenberg, Shlomi Matetzki
Although patients ≥80 years old constitute the fastest-growing segment of the population and have a high prevalence of coronary artery disease, few data exist regarding the outcome of octogenarians with acute coronary syndrome (ACS). In a retrospective study based on data of 13,432 ACS patients who were enrolled in the ACS Israel Survey, we first evaluated the clinical outcome of 1,731 ACS patients ≥80 years (13%) compared with 11,701 ACS patients <80 years (87%) hospitalized during 2000 to 2013. Second, we evaluated the clinical outcome of patients ≥80 years hospitalized during the 2000 to 2006 ("early") period (n = 1,037) compared with those of the same age group of patients hospitalized during the 2008 to 2013 ("late") period (n = 694)...
July 24, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28814233/statins-in-acute-coronary-syndromes
#11
Manolis Vavuranakis, Maria Kariori, Gerasimos Siasos, Konstantinos Kalogeras, Dimitris Tousoulis
BACKGROUND: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. OBJECTIVE: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits...
August 15, 2017: Current Pharmaceutical Design
https://www.readbyqxmd.com/read/28789568/temporal-trends-in-the-use-of-antiplatelet-therapy-in-patients-with-acute-coronary-syndromes
#12
María Asunción Esteve-Pastor, Juan Miguel Ruíz-Nodar, Esteban Orenes-Piñero, José Miguel Rivera-Caravaca, Miriam Quintana-Giner, Andrea Véliz-Martínez, Antonio Tello-Montoliu, Vicente PerniasEscrig, Miriam Sandín Rollán, Nuria Vicente-Ibarra, Manuel Jesús MacíasVillanego, Elena Candela Sánchez, Luna Carrillo Alemán, Teresa Lozano, Mariano Valdés, Francisco Marín
BACKGROUND: Current clinical guidelines of acute coronary syndromes (ACS) recommend the use of potent antiplatelet therapy, prasugrel or ticagrelor, because both drugs consistently reduce cardiovascular events. PURPOSE: The aim of this study was to examine temporal changes in the use of optimal antiplatelet therapy in patients with ACS. METHODS: A total of 1717 consecutive patients admitted for ACS in 3 tertiary hospitals from February 2014 to December 2015 were enrolled...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28780622/outcomes-after-bariatric-surgery-according-to-large-databases-a-systematic-review
#13
Andrea Balla, Gabriela Batista Rodríguez, Santiago Corradetti, Carmen Balagué, Sonia Fernández-Ananín, Eduard M Targarona
PURPOSE: The rapid development of technological tools to record data allows storage of enormous datasets, often termed "big data". In the USA, three large databases have been developed to store data regarding surgical outcomes: the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP), the Healthcare Cost and Utilization Project (HCUP) National Inpatient Sample (NIS) and the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP)...
August 5, 2017: Langenbeck's Archives of Surgery
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#14
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28761680/nurse-coordinated-care-improves-the-achievement-of-ldl-cholesterol-targets-through-more-intensive-medication-titration
#15
Marjolein Snaterse, Harald T Jorstad, Marlies Heiligenberg, Gerben Ter Riet, S Matthijs Boekholdt, Wilma Scholte Op Reimer, Ron J Peters
BACKGROUND: Nurse-coordinated care (NCC) improves the achievement of low-density lipoprotein-cholesterol (LDL-C) targets after an acute coronary syndrome (ACS). We hypothesised that NCC improves achievement of LDL-C targets through more intensive medication titration. METHODS: We used data from Randomised Evaluation of Secondary Prevention by Outpatient Nurse Specialists (RESPONSE), a multicentre randomised trial on the efficacy of NCC in 754 ACS patients. Follow-up data were collected at 6 and 12 months...
2017: Open Heart
https://www.readbyqxmd.com/read/28760210/a-randomized-trial-of-a-1-hour-troponin-t-protocol-in-suspected-acute-coronary-syndromes-design-of-the-rapid-assessment-of-possible-acs-in-the-emergency-department-with-high-sensitivity-troponin-t-rapid-tnt-study
#16
RANDOMIZED CONTROLLED TRIAL
Cynthia Papendick, Andrew Blyth, Anil Seshadri, Michael J R Edmonds, Tom Briffa, Louise Cullen, Stephen Quinn, Jon Karnon, Anthony Chuang, Adam J Nelson, Matthew Horsfall, Erin Morton, Derek P Chew
BACKGROUND: Protocols incorporating high-sensitivity troponin to guide decision making in the disposition of patients with suspected acute coronary syndromes (ACS) in the emergency department have received a lot of attention. Traditionally, patients with chest pain have required long periods of observation in emergency department before being deemed safe for discharge. In an era of limited health service resources, a protocol that could discharge patients safely within an hour of presentation is extremely attractive...
August 2017: American Heart Journal
https://www.readbyqxmd.com/read/28751835/anmco-scientific-statement-clinical-management-of-hypercholesterolaemia-in-patients-with-acute-coronary-syndromes
#17
Furio Colivicchi, Michele Massimo Gulizia, Marcello Arca, Maurizio Giuseppe Abrignani, Gian Piero Perna, Gian Francesco Mureddu, Federico Nardi, Carmine Riccio
LDL cholesterol (LDL-C) reduction after Acute Coronary Syndromes (ACS) is associated with a significant decrease in subsequent atherosclerotic cardiovascular events. Accordingly, international guidelines recommend a reduction of LDL-C below 70 mg/dL in ACS patients. Such a result can be effectively accomplished in most cases by using high intensity statins. In selected cases, the association with ezetimibe may be necessary in order to achieve recommended LDL-C targets. This document outlines management strategies that can be consistently implemented in clinical practice in order to achieve and maintain guidelines recommended therapeutic goals...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28747270/predictive-power-of-the-grace-score-in-population-with-diabetes
#18
Anna Baeza-Román, Eva de Miguel-Balsa, Jaime Latour-Pérez, Andrés Carrillo-López
INTRODUCTION: Current clinical practice guidelines recommend risk stratification in patients with acute coronary syndrome (ACS) upon admission to hospital. Diabetes mellitus (DM) is widely recognized as an independent predictor of mortality in these patients, although it is not included in the GRACE risk score. OBJECTIVES: The objective of this study is to validate the GRACE risk score in a contemporary population and particularly in the subgroup of patients with diabetes, and to test the effects of including the DM variable in the model...
June 21, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28736558/evaluation-of-the-crusade-risk-score-for-predicting-major-bleeding-in-patients-with-concomitant-kidney-dysfunction-and-acute-coronary-syndromes
#19
Marianela Sánchez-Martínez, Pedro J Flores-Blanco, Ángel A López-Cuenca, María J Sánchez-Galián, Miriam Gómez-Molina, Francisco Cambronero-Sánchez, Esther Guerrero-Pérez, Mariano Valdés, James L Januzzi, Sergio Manzano-Fernández
BACKGROUND: Kidney dysfunction (KD) has been associated with increased risk for major bleeding (MB) in patients with acute coronary syndromes (ACS) and may be in part related to an underuse of evidence-based therapies. Our aim was to assess the predictive ability of the Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA guidelines (CRUSADE) risk score in patients with concomitant ACS and chronic kidney disease. METHODS: We conducted a retrospective analysis of a prospective registry including 1,587 ACS patients...
June 2017: Cardiorenal Medicine
https://www.readbyqxmd.com/read/28736557/the-effect-of-admission-renal-function-on-the-treatment-and-outcome-of-patients-with-acute-coronary-syndrome
#20
Zach Rozenbaum, Sydney Benchetrit, Saar Minha, Yoram Neuman, Meital Shlezinger, Ilan Goldenberg, Morris Mosseri, David Pereg
BACKGROUND: Chronic kidney disease is a frequent comorbidity among patients with acute coronary syndrome (ACS). We aimed to evaluate treatment characteristics in ACS patients according to their renal function and to assess the effect of differences in therapy on clinical outcomes. METHODS: Included were patients with ACS enrolled in the biennial Acute Coronary Syndrome Israeli Surveys (ACSIS) during 2000-2013. Excluded were patients with cardiogenic shock at presentation...
June 2017: Cardiorenal Medicine
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