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With Non-ST-Elevation Acute Coronary Syndromes

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https://www.readbyqxmd.com/read/28191713/tissue-characterization-and-phenotype-classification-in-patients-presenting-with-acute-myocardial-infarction-insights-from-the-iwonder-study
#1
Cristiano F Souza, Akiko Maehara, Gary S Mintz, Mitsuaki Matsumura, Claudia M R Alves, Antonio Carlos Carvalho, Adriano Caixeta
OBJECTIVES: We sought to assess a new modality of radiofrequency intravascular ultrasound (IVUS) called iMAP-IVUS (Boston Scientific, Santa Clara, California) during the evaluation of patients presenting with high-risk acute coronary syndromes. BACKGROUND: There are limited data on plaque tissue characterization and phenotype classification using iMAP-IVUS. METHODS: In the iWonder study patients presenting with ST-elevation myocardial infarction (STEMI) or non-STEMI underwent three-vessel grayscale IVUS and iMAP-IVUS tissue characterization prior to percutaneous intervention...
February 13, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28191514/anticoagulant-therapy-for-non-st-segment-elevation-acute-coronary-syndrome-in-china-a-multi-center-observational-study
#2
Xiao-Huan Gong, Jin-Ming Yu, Yong Mao, Da-Yi Hu
OBJECTIVE: To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. METHODS: A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI...
April 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28179617/relationship-between-serum-25-hydroxyvitamin-d-levels-and-the-syntax-score-in-patients-with-acute-coronary-syndrome
#3
Ahmet Oğuz Baktır, Yasemin Doğan, Bahadır Şarlı, Ömer Şahin, Erkan Demirci, Mahmut Akpek, Eyüp Özkan, Hüseyin Arınç, Hayrettin Sağlam
OBJECTIVE: The extent of severity and complexity of coronary artery disease (CAD) in patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and possible correlations between serum 25-hydroxyvitamin D (25(OH)D) have not yet been adequately studied. We evaluated the relationship between 25(OH)D levels and the burden of CAD as assessed by the SYNTAX score (SXscore) in patients with acute coronary syndrome (ACS) including STEMI and NSTEMI. METHODS: After exclusion, a total of 113 patients who were admitted to our hospital due to ACS and who were referred for undergoing coronary angiography were prospectively included...
February 1, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28164519/angiotensin-converting-enzyme-inhibitors-influence-on-antiplatelet-therapy-of-clopidogrel-in-acs
#4
Shuo Yang, Chanjuan Cui, Jie Zhang, Rui Qiao
BACKGROUND: Clopidogrel is a prodrug, the minority of which is converted to an active metabolite by hepatic cytochrome P450 (CYP2C19), however, most of it is metabolized to inactive substance by hepatic carboxylesterase1 (CES1). Meanwhile angiotensin-converting enzyme inhibitors (ACEIs) are mostly metabolized by CES1. We aimed to assess the impact of ACEIs on platelet inhibition by clopidogrel. METHODS: We genotyped variants CES1, CYP2C19*2 and *3 in 502 patients with acute coronary syndrome (ACS) receiving clopidogrel therapy, and analyzed the effects of ACEIs on responsiveness to clopidogrel by the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay and ADP-stimulated impedance whole blood platelet aggregation assay...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28150850/chewing-versus-swallowing-ticagrelor-to-accelerate-platelet-inhibitionin-acute-coronary-syndrome-the-cheers-study-for-the-platis-platelets-and-thrombosis-in-sheba-study-group
#5
Elad Asher, Shir Frydman, Moshe Katz, Ehud Regev, Avi Sabbag, Israel Mazin, Arsalan Abu-Much, Andrew Kukuy, Anna Mazo, Aharon Erez, Anat Berkovitch, Michael Narodistky, Israel Barbash, Amit Segev, Roy Beigel, Shlomi Matetzky
It was the study objective to evaluate whether chewing a 180 mg loading dose of ticagrelor versus an equal dose of traditional oral administration, enhances inhibition of platelet aggregation 1 hour (h) after administering a ticagrelor loading dose in non-ST elevation myocardial infarction (NSTEMI) patients. Dual anti-platelet therapy represents standard care for treating NSTEMI patients. Ticagrelor is a direct acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation...
February 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28150284/renal-function-on-admission-affects-both-treatment-strategy-and-long-term-outcomes-of-patients-with-myocardial-infarction-from-polish-registry-of-acute-coronary-syndromes
#6
MIchal Hawranek, Marek Gierlotka, Mariusz Gąsior, Bartosz Hudzik, Piotr Desperak, Aneta Ciślak, Mateusz Tajstra, Tadeusz Osadnik, Piotr Rozentryt, Lech Poloński
BACKGROUND: Impairment of renal function (IRF) is an independent risk factor of myocardial infarction (MI). AIM: The aims of study was to determine if the presence of IRF affects the choice of treatment strategy in patients with MI, and if long-term mortality rates are influenced by the use of invasive strategy in patients with MI according to the grade of IRF. METHODS: Data from the PL-ACS Registry of 22,431 patients hospitalized for MI during 2007-2008 with an available estimated glomerular filtration rate (eGFR) with 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula were included...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28145667/acute-coronary-syndrome-diagnostic-evaluation
#7
Craig Barstow, Matthew Rice, Jonathan D McDivitt
Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common presentation in patients with MI; however, there are multiple noncardiac causes of chest pain, and the diagnosis cannot always be made based on initial presentation. The assessment of a possible MI includes evaluation of risk factors and presenting signs and symptoms, rapid electrocardiography, and serum cardiac troponin measurements...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28144818/practice-of-st-segment-elevation-myocardial-infarction-care-in-the-netherlands-during-four-snapshot-weeks-with-the-national-cardiovascular-database-registry-for-acute-coronary-syndrome
#8
N P G Hoedemaker, M E Ten Haaf, J C Maas, P Damman, Y Appelman, J G P Tijssen, R J de Winter, A W J van 't Hof
BACKGROUND: Clinical registries provide information on the process of care and patient outcomes, with the potential to improve the quality of patient care. A large Dutch national acute coronary syndrome (ACS) registry is currently lacking. Recently, we initiated the National Cardiovascular Database Registry (NCDR) for ACS in the Netherlands. The purpose of this study was to assess the NCDR ACS registry on feasibility and data completeness during a pilot phase of four snapshot weeks...
January 31, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28139897/oral-antiplatelet-agents-for-the-management-of-acute-coronary-syndromes-a-review-for-nurses-and-allied-healthcare-professionals
#9
REVIEW
Tania Gesheff, Cescelle Barbour
PURPOSE: We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES: Treatment guidelines and clinical articles from PubMed. CONCLUSIONS: Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response...
January 31, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28139353/suspected-acs-patients-presenting-with-myocardial-damage-or-a-type-2-myocardial-infarction-have-a-similar-late-mortality-to-patients-with-a-type-1-myocardial-infarction-a-report-from-the-australian-and-new-zealand-2012-snapshot-acs-study
#10
Aisha Etaher, Derek Chew, Julie Redfern, Tom Briffa, Chris Ellis, Christopher Hammett, Jeffrey Lefkovits, John Elliott, Louise Cullen, David Brieger, John K French
BACKGROUND: Cardiac troponin (T and I) are considered the standard markers for detection of myocardial damage and the diagnosis of acute coronary syndrome (ACS) among patients who present to an emergency department with chest pain. However, these markers can be released in other situations and may be associated with short- and long-term clinical outcomes. In this study, we examine late mortality rates among patients presenting with a suspected ACS due to an unstable coronary plaque and those patients having a non-ACS...
December 31, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28122793/real-world-insights-on-the-initiation-and-treatment-duration-of-oral-antiplatelets-in-acute-coronary-syndromes-a-retrospective-cohort-study
#11
Marc J Claeys, Christophe Beauloye, Suzanne Pourbaix, Peter R Sinnaeve
AIMS: This study is a real world, observational study evaluating the treatment persistence of oral antiplatelet (OAP) therapy during a one-year follow-up in patients after an acute coronary syndrome (ACS). METHODS AND RESULTS: Data on diagnosis, comorbidities, follow-up, OAP treatment, reasons, and decision maker for treatment discontinuation in patients who were discharged from a hospital in Belgium after an ACS between 1 July 2012 and 1 June 2013 were collected by cardiologists from 18 centres, up to 360 days from discharge...
January 24, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28114618/five-year-outcome-after-implantation-of-zotarolimus-and-everolimus-eluting-stents-in-randomized-trial-participants-and-nonenrolled-eligible-patients-a-secondary-analysis-of-a-randomized-clinical-trial
#12
Clemens von Birgelen, Liefke C van der Heijden, Mounir W Z Basalus, Marlies M Kok, Hanim Sen, Hans W Louwerenburg, K Gert van Houwelingen, Martin G Stoel, Frits H A F de Man, Gerard C M Linssen, Kenneth Tandjung, Carine J M Doggen, Job van der Palen, Marije M Löwik
Importance: Long-term follow-up after a clinical trial of 2 often-used, newer-generation drug-eluting stents (DESs) in a broad patient population is of interest. Comprehensive long-term outcome of eligible nonenrolled patients has never been reported. Objective: To assess 5-year safety and efficacy of 2 newer-generation DESs in randomized participants with non-ST-elevation acute coronary syndromes or stable angina and to evaluate long-term outcomes of nonenrolled eligible patients treated with the same DESs...
January 18, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28108465/outcomes-of-women-and-men-with-acute-coronary-syndrome-treated-with-and-without-percutaneous-coronary-revascularization
#13
Jacob A Udell, Maria Koh, Feng Qiu, Peter C Austin, Harindra C Wijeysundera, Akshay Bagai, Andrew T Yan, Shaun G Goodman, Jack V Tu, Dennis T Ko
BACKGROUND: Women hospitalized with a non-ST segment elevation acute coronary syndrome (ACS) have worse clinical outcomes compared with men. An early invasive strategy with prompt coronary revascularization may mitigate sex differences in outcomes. However, few contemporary studies have evaluated whether clinical outcomes differ between women and men presenting with ACS treated with an early invasive strategy. METHODS AND RESULTS: A population-based cohort of hospitalized ACS patients who received prompt cardiac catheterization from 2008 to 2011 in Ontario, Canada and followed for up to 2 years was studied...
January 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28107026/impact-of-mobile-intensive-care-unit-use-on-total-ischemic-time-and-clinical-outcomes-in-st-elevation-myocardial-infarction-patients-real-world-data-from-the-acute-coronary-syndrome-israeli-survey
#14
Edward Koifman, Roy Beigel, Zaza Iakobishvili, Nir Shlomo, Yitschak Biton, Avi Sabbag, Elad Asher, Shaul Atar, Shmuel Gottlieb, Ronny Alcalai, Doron Zahger, Amit Segev, Ilan Goldenberg, Rafael Strugo, Shlomi Matetzky
BACKGROUND: Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. METHODS: Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. RESULTS: The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units...
January 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28105138/clinical-and-angiographic-correlation-of-high-sensitivity-c-reactive-protein-with-acute-st-elevation-myocardial-infarction
#15
Syed Tanveer, Shaheena Banu, Nasimudeen Rehumathbeevi Jabir, Mohd Shahnawaz Khan, Ghulam Md Ashraf, Nanjappa Cholenahally Manjunath, Shams Tabrez
Vascular inflammation and associated ongoing inflammatory responses are considered as the critical culprits in the pathogenesis of acute atherothrombotic events such as acute coronary syndrome (ACS) and myocardial infarction (MI). ST segment elevation myocardial infarction (STEMI) is considered as one of the prominent clinical forms of ACS. Moreover, C-reactive protein (CRP) is an important acute phase prsotein, which may be estimated using high-sensitivity methods (hs-CRP), and its elevated level in body fluids reflects chronic inflammatory status...
December 2016: Experimental and Therapeutic Medicine
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
#16
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/28100879/association-between-prior-aspirin-use-and-morphological-features-of-culprit-lesions-at-first-presentation-of-acute-coronary-syndrome-assessed-by-optical-coherence-tomography
#17
Taishi Yonetsu, Tetsumin Lee, Tadashi Murai, Yoshinori Kanno, Rikuta Hamaya, Sadamitsu Ichijo, Takayuki Niida, Masahiro Hada, Makoto Araki, Junji Matsuda, Eisuke Usui, Masahiro Hoshino, Yoshihisa Kanaji, Tsunekazu Kakuta
BACKGROUND: The effect of prior use of aspirin (ASA) on the onset of acute coronary syndrome (ACS) has not been clarified. This study used optical coherence tomography (OCT) to investigate the morphological features of culprit lesions of ACS in patients with prior ASA use.Methods and Results:In total, 442 patients with their first ACS episode undergoing OCT for the culprit lesions were investigated. Clinical characteristics, OCT findings, and adverse events at 30 days were compared between patients with prior ASA use and ASA-naïve patients (non-ASA)...
January 19, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28089149/fasting-glucose-nt-probnp-treatment-with-eptifibatide-and-outcomes-in-non-st-segment-elevation-acute-coronary-syndromes-an-analysis-from-early-acs
#18
Serdar Farhan, Robert M Clare, Rudolf Jarai, Robert P Giugliano, Yuliya Lokhnygina, Robert A Harrington, L Kristin Newby, Kurt Huber
BACKGROUND: Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS). METHODS: Fasting glucose and NT-proBNP were measured in 2240 patients enrolled in the EARLY ACS trial. Multivariable Cox models were used to assess associations between fasting glucose and NT-proBNP and a 96-hour composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-day death or MI; and 1-year mortality...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28062617/growth-differentiation-factor-15-as-a-biomarker-in-cardiovascular-disease
#19
REVIEW
Kai C Wollert, Tibor Kempf, Lars Wallentin
BACKGROUND: Growth differentiation factor 15 (GDF-15) is expressed and secreted in response to inflammation, oxidative stress, hypoxia, telomere erosion, and oncogene activation. Cardiovascular (CV) disease is a major driver of GDF-15 production. GDF-15 has favorable preanalytic characteristics and can be measured in serum and plasma by immunoassay. CONTENT: In community-dwelling individuals higher concentrations of GDF-15 are associated with increased risks of developing CV disease, chronic kidney disease, and cancer, independent of traditional CV risk factors, renal function, and other biomarkers (C-reactive protein, B-type natriuretic peptide, cardiac troponin)...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28052578/ticagrelor-increased-adenosine-and-cyclic-adenosine-monophosphate-plasma-concentration-compared-with-clopidogrel-in-acute-coronary-syndromes-patients
#20
Xiao-Ye Li, Qi-Bing Wang, Ying Xue, Jia-Hui Chen, Qian-Zhou Lv
Ticagrelor produces a more potent antiplatelet effect than clopidogrel, and inhibits cellular uptake of adenosine, which is associated with several cardiovascular consequences. We aimed to explore the correlation between adenosine and cyclic adenosine monophosphate (cAMP) plasma concentration and antiplatelet effect by clopidogrel or ticagrelor in acute coronary syndrome (ACS) patients receiving dual antiplatelet therapy (DAPT). We conducted a prospective, observational and single-centre cohort study enrolling 68 patients with non-ST-segment elevation ACS from January 2016 to May 2016...
January 4, 2017: Basic & Clinical Pharmacology & Toxicology
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