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angina unstable

Alexandre de Matos Soeiro, Victor Arrais Araújo, Júlia Pitombo Vella, Aline Siqueira Bossa, Bruno Biselli, Tatiana de Carvalho Andreucci Torres Leal, Maria Carolina Feres de Almeida Soeiro, Carlos V Serrano, Christian Mueller, Mucio Tavares de Oliveira Junior
BACKGROUND: Some small studies have related higher levels of thyrotropin (TSH) to potentially worse prognosis in acute coronary syndromes. However, this relationship remains uncertain. OBJECTIVE: To analyze the outcomes of patients with acute coronary syndromes in relation to the value of TSH at admission. METHODS: Observational and retrospective study with 505 patients (446 in group I [TSH ≤ 4 mIU/L] and 59 in group II [TSH > 4 mIU/L]) with acute coronary syndromes between May 2010 and May 2014...
February 2018: Arquivos Brasileiros de Cardiologia
Fengwen Yang, Jiahan Zou, Xuemei Li, Long Ge, Jinhui Tian, Myeong Soo Lee, Junhua Zhang
BACKGROUND: Chinese herbal injections (CHIs) have been commonly used in the treatment of unstable angina pectoris (UAP) in China. However, there is no consensus or evidence on how to select CHIs for patients with UAP. The choice often depends on the personal experience or preference of clinician. This study aims to compare the effect of different CHIs for UAP using Bayesian network meta-analysis (NMA). METHODS: A systematic search will be conducted in PubMed, the Cochrane Central Register of Controlled Trials, Embase, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Data from inception to February 2018...
March 2018: Medicine (Baltimore)
Rhys D Pockett, Phil McEwan, Joshua Ray, Irwin Tran, Simon Shutler, Steven Martin, Zaheer Yousef, Ameet Bakhai
OBJECTIVES: The effects of acute coronary syndrome (ACS) events on health-related quality of life (HRQoL) and the time dependency of these effects are unknown. This study aimed to characterise health utilities in ACS patients to aid development of future economic models estimating the cost per quality-adjusted life-year impact of ACS events and potential treatments. METHODS: Multicentre, non-interventional, longitudinal evaluation of health utility in patients experiencing ACS or stroke events...
March 20, 2018: Journal of Medical Economics
M Snaterse, J W Deckers, M J Lenzen, H T Jorstad, D De Bacquer, R J G Peters, C Jennings, K Kotseva, W J M Scholte Op Reimer
OBJECTIVE: We investigated smoking cessation rates in coronary heart disease (CHD) patients throughout Europe; current and as compared to earlier EUROASPIRE surveys, and we studied characteristics of successful quitters. METHODS: Analyses were done on 7998 patients from the EUROASPIRE-IV survey admitted for myocardial infarction, unstable angina and coronary revascularisation. Self-reported smoking status was validated by measuring carbon monoxide in exhaled air...
May 1, 2018: International Journal of Cardiology
Joo-Yong Hahn, Young Bin Song, Ju-Hyeon Oh, Deok-Kyu Cho, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jin-Ok Jeong, Jang-Ho Bae, Byung-Ok Kim, Jang Hyun Cho, Il-Woo Suh, Doo-Il Kim, Hoon-Ki Park, Jong-Seon Park, Woong Gil Choi, Wang Soo Lee, Jihoon Kim, Ki Hong Choi, Taek Kyu Park, Joo Myung Lee, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuk Choi, Hyeon-Cheol Gwon
BACKGROUND: Current guidelines recommend dual antiplatelet therapy (DAPT) of aspirin plus a P2Y12 inhibitor for at least 12 months after implantation of drug-eluting stents (DES) in patients with acute coronary syndrome. However, available data about the optimal duration of DAPT in patients with acute coronary syndrome undergoing percutaneous coronary intervention are scant. We aimed to investigate whether a 6-month duration of DAPT would be non-inferior to the conventional 12-month or longer duration of DAPT in this population...
March 9, 2018: Lancet
Mehrshad Vafaie, Matthias Hochadel, Thomas Münzel, Birgit Hailer, Burghard Schumacher, Gerd Heusch, Thomas Voigtländer, Harald Mudra, Michael Haude, Sebastian Barth, Claus Schmitt, Harald Darius, Lars S Maier, Hugo A Katus, Jochen Senges, Evangelos Giannitsis
BACKGROUND: Since 2008, the German Cardiac Society certified 256 Chest Pain Units (CPUs). Little is known about adherence to recommended performance measures in patients with suspected acute coronary syndrome (ACS) presenting to CPUs. We investigated guideline-adherence regarding critical time intervals and selected performance measures in German Chest Pain Units. METHODS: From 2008 to 2014, 23,804 consecutive patients with suspected ACS were prospectively enrolled in the Chest Pain Unit registry of the German Cardiac Society...
March 1, 2018: European Heart Journal. Acute Cardiovascular Care
Taysir S Garadah, Khalid Bin Thani, Leena Sulibech, Ahmed A Jaradat, Mohamed E Al Alawi, Haytham Amin
Background: Risk factors and short-term mortality in patients presented with Acute Coronary Syndrome (ACS) in Bahrain has not been evaluated before. Aim: In this prospective observational study, we aim to determine the clinical risk profiles of patients with ACS in Bahrain and describe the incidence, pattern of presentation and predictors of in-hospital clinical outcomes after admission. Methods: Patients with ACS were prospectively enrolled over a 12 month period...
2018: Open Cardiovascular Medicine Journal
Jun Shiraishi, Nariko Koshi, Yuki Matsubara, Tetsuro Nishimura, Akira Shikuma, Keisuke Shoji, Daisuke Ito, Masayoshi Kimura, Eigo Kishita, Yusuke Nakagawa, Masayuki Hyogo, Takahisa Sawada
BACKGROUND: Experiences of rotational atherectomy (RA) followed by drug-coated balloon (DCB) dilation alone (RA/DCB) for de novo coronary artery lesion have been limited. CASE SERIES: Case 1 (65 year-old male) with silent myocardial ischemia and hemodialysis had old anterior myocardial infarction and intact LM/LCx, and underwent RA/DCB against a diffuse calcified lesion in the proximal LAD and a tandem lesion in the proximal RCA. Case 2 (88 year-old female) with post-infarction unstable angina had severe thrombocytopenia and anemia due to myelodysplastic syndrome (platelet 6000/μL, hemoglobin 8...
February 12, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Erin A Bohula, Robert P Giugliano, Lawrence A Leiter, Subodh Verma, Jeong-Gun Park, Peter S Sever, Armando Lira Pineda, Narimon Honarpour, Huei Wang, Sabina A Murphy, Anthony Keech, Terje R Pedersen, Marc S Sabatine
BACKGROUND : In the FOURIER trial (Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Patients With Elevated Risk), the PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor evolocumab reduced low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk. It is not known whether the efficacy of evolocumab is modified by baseline inflammatory risk. We explored the efficacy of evolocumab stratified by baseline high-sensitivity C-reactive protein (hsCRP). We also assessed the importance of inflammatory and residual cholesterol risk across the range of on-treatment LDL-C concentrations...
March 12, 2018: Circulation
William B White, Kenneth G Saag, Michael A Becker, Jeffrey S Borer, Philip B Gorelick, Andrew Whelton, Barbara Hunt, Majin Castillo, Lhanoo Gunawardhana
Background Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. Methods We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function...
March 12, 2018: New England Journal of Medicine
Nizar Andria, Ali Nassar, Fabio Kusniec, Diab Ghanim, Dahud Qarawani, Erez Kachel, Khaled Taha, Offer Amir, Shemy Carasso
BACKGROUND: Coronary artery disease (CAD) has known risk factors. Individual risks related to specific ethnicities are complex and depend on genetic predisposition and lifestyle. OBJECTIVES: To compare the nature and prevalence of risk factors in Arab and non-Arab ethnic patients with symptomatic obstructive CAD referred for coronary angiography. METHODS: CAD, defined as coronary angiography with a ≥ 50% narrowing in ≥ 1 vessel, was diagnosed in 1029 patients admitted to a medical center between April 2014 and October 2015...
March 2018: Israel Medical Association Journal: IMAJ
Benoît Merat, Matthias Waliszewski, Guillaume Dillinger, Patrick Henry, Georgios Sideris
OBJECTIVES: The objective of this study was to assess the 12-month clinical outcomes in patients with drug-eluting stent in-stent restenosis (DES-ISR) who were either pre-dilated with non-compliant balloons (NCBA) and with additional scoring balloons (NCBA + SBA) prior to drug coated balloon (DCB) angioplasty. METHODS: This monocentric, retrospective study included patients with DES-ISR who were routinely treated over a 2-year time span. Patients with stable angina and documented ischemia or selected forms of unstable angina due to a culprit DES-ISR lesion were analyzed...
March 11, 2018: Journal of Interventional Cardiology
Diego Castini, Marco Centola, Giulia Ferrante, Sara Cazzaniga, Simone Persampieri, Stefano Lucreziotti, Diego Salerno-Uriarte, Carlo Sponzilli, Stefano Carugo
BACKGROUND: Compare the discriminative performance of two validated bleeding risk models for in-hospital bleeding events in a non-selected cohort of acute coronary syndrome (ACS) patients. METHODS: CRUSADE (Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes with Early implementation of the ACC/AHA Guidelines) and ACUITY-HORIZONS (Acute Catheterization and Urgent Intervention Triage strategY-Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction) scores were calculated in 501 consecutive patients (median age 68 years (IQR 57-77), 31% female) admitted for ACS to the coronary care unit (CCU) of San Paolo Hospital in Milan (Italy)...
March 2, 2018: Heart, Lung & Circulation
Steven E Nissen, Sreekumar G Pillai, Stephen J Nicholls, Kathy Wolski, Jeffrey S Riesmeyer, Govinda J Weerakkody, Wendra M Foster, Ellen McErlean, Lin Li, Pallav Bhatnagar, Giacomo Ruotolo, A Michael Lincoff
Importance: A pharmacogenetic analysis of dalcetrapib, a cholesteryl ester transfer protein inhibitor, reported an association between a single-nucleotide polymorphism (SNP) in the ADCY9 gene (rs1967309) and reduction in major adverse cardiovascular events despite a neutral result for the overall trial. Objective: To determine whether the association between the SNP in the ADCY9 gene and a reduction in major adverse cardiovascular events could be replicated for another cholesteryl ester transfer protein inhibitor, evacetrapib, in patients with high-risk vascular disease...
March 11, 2018: JAMA Cardiology
Heesun Lee, Yeonyee E Yoon, Wonjae Lee, Hong-Mi Choi, Jun-Bean Park, Hack-Lyoung Kim, Hyo Eun Park, Seung-Pyo Lee, Hyung-Kwan Kim, Su-Yeon Choi, Yong-Jin Kim, Goo-Yeong Cho, Joo-Hee Zo, Dae-Won Sohn
BACKGROUND: While coronary computed tomography angiography (CCTA) provides comprehensive anatomic evaluation of coronary artery disease (CAD) with prognostic implications, clinically, the focus is usually placed on presence or absence of functionally significant CAD. Herein, we aimed to suggest a new risk stratification strategy using CCTA in patients with anatomic CAD but without myocardial ischemia on single-photon emission computed tomography (SPECT). METHODS: Consecutive patients (n=798) with CAD on CCTA who underwent SPECT for evaluation of myocardial ischemia were retrospectively evaluated...
March 7, 2018: Journal of Cardiology
William King, Arron Lacey, James White, Daniel Farewell, Frank Dunstan, David Fone
BACKGROUND: Coronary heart disease (CHD) mortality in England fell by 36% between 2000 and 2007 and it is estimated that approximately 50% of the fall was due to improved treatment uptake. Marked socio-economic inequalities in CHD mortality in the United Kingdom (UK) remain, with higher age-adjusted rates in more deprived groups. Inequalities in the persistence of medication for primary and secondary prevention of CHD may contribute to the observed social gradient and we investigated this possibility in the population of Wales (UK)...
2018: PloS One
Ji Hyun Lee, Donghee Han, Bríain Ó Hartaigh, Heidi Gransar, Yao Lu, Asim Rizvi, Mahn Won Park, Hadi Mirhedayati Roudsari, Wijnand J Stuijfzand, Daniel S Berman, Tracy Q Callister, Augustin DeLago, Martin Hadamitzky, Joerg Hausleiter, Mouaz H Al-Mallah, Matthew J Budoff, Philipp A Kaufmann, Gilbert Raff, Kavitha Chinnaiyan, Filippo Cademartiri, Erica Maffei, Todd C Villines, Yong-Jin Kim, Jonathon Leipsic, Gudrun Feuchtner, Gianluca Pontone, Daniele Andreini, Hugo Marques, Ronen Rubinshtein, Stephan Achenbach, Leslee J Shaw, Hyuk-Jae Chang, Jeroen Bax, Benjamin Chow, Ricardo C Cury, Millie Gomez, Erica C Jones, Fay Y Lin, James K Min, Jessica M Peña
OBJECTIVE: To assess the prognostic value of symptom typicality in patients without obstructive coronary artery disease (CAD), determined by coronary computed tomographic angiography (CCTA). METHODS: 4,215 patients without prior history of CAD and without obstructive CAD (<50% CCTA stenosis) were identified. CAD severity was categorized as non-obstructive (1%-49%) and none (0%). Based upon the Diamond-Forrester criteria for angina pectoris, symptom typicality was classified as: asymptomatic, non-anginal, atypical, and typical...
March 9, 2018: Clinical Cardiology
Amartya Kundu, Aditya Vaze, Partha Sardar, Ahmed Nagy, Wilbert S Aronow, Naomi F Botkin
PURPOSE OF REVIEW: Variant angina, which is characterized by recurrent chest pain and transient ECG changes along with angiographic evidence of coronary artery spasm, generally has a favorable prognosis. However, episodes of ischemia caused by vasospasm may lead to potentially life-threatening ventricular arrhythmias and cardiac arrest, even in patients with no history of prior cardiac disease. This review describes the epidemiology, pathogenesis, clinical spectrum, and management of variant angina, as well as outcomes in patients who present with aborted sudden cardiac death (ASCD)...
March 8, 2018: Current Cardiology Reports
Slavisa Ninkovic, Zoe McQuilten, Robert Gotmaker, Andrew E Newcomb, Merrole F Cole-Sinclair
BACKGROUND: Transfusion of platelets is common in cardiac surgery, and while there are guidelines for their use, there are concerns about potential risks. We aimed to assess the impact of platelet transfusion on mortality, thrombosis, and infection in this patient group. STUDY DESIGN AND METHODS: A retrospective cohort study of all patients at St Vincent's Hospital Melbourne who underwent a first cardiac surgery procedure from June 2001 to June 2014 was conducted...
March 7, 2018: Transfusion
Ayman S Samman Tahhan, Muhammad Hammadah, Mohamad Raad, Zakaria Almuwaqqat, Ayman Alkhoder, Pratik B Sandesara, Heval Kelli, Salim S Hayek, Jeong H Kim, Wesley T O'Neal, Matthew L Topel, Aubrey J Grant, Nabil Sabbak, Robert E Heinl, Mohamad M Gafeer, Malik Obideen, Belal Kaseer, Naser Abdelhadi, Yi-An Ko, Chang Liu, Iraj Ghaini, Ernestine A Mahar, Viola Vaccarino, Edmund K Waller, Arshed A Quyyumi
<u>Rationale:</u> Circulating progenitor cells (CPCs) mobilize in response to ischemic injury, but their predictive value remains unknown in acute coronary syndrome (ACS). <u>Objective:</u> We aimed to investigate the number of CPCs in ACS compared to those with stable coronary artery disease (CAD), relationship between bone marrow PCs and CPCs, and whether CPC counts predict mortality in patients with ACS. <u>Methods and Results:</u> In 2028 patients, 346 had unstable angina, 183 had an acute myocardial infarction (AMI) and the remaining 1499 patients had stable CAD...
March 7, 2018: Circulation Research
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