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With Non-ST-Elevation Acute Coronary Syndromes

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https://www.readbyqxmd.com/read/28437675/whole-blood-sequencing-reveals-circulating-microrna-associations-with-high-risk-traits-in-non-st-segment-elevation-acute-coronary-syndrome
#1
Alice Wang, Lydia Coulter Kwee, Elizabeth Grass, Megan L Neely, Simon G Gregory, Keith A A Fox, Paul W Armstrong, Harvey D White, E Magnus Ohman, Matthew T Roe, Svati H Shah, Mark Y Chan
BACKGROUND AND AIMS: Although circulating microRNA (miRNAs) have emerged as biomarkers predicting mortality in acute coronary syndrome (ACS), more data are needed to understand these mechanisms. Mapping miRNAs to high-risk traits may identify miRNAs involved in pathways conferring risk for poor outcome in ACS. We aim to investigate the relationship between circulating miRNAs and high-risk traits in non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: Whole-genome miRNA sequencing was performed on RNA extracted from whole blood of 199 patients with NSTE-ACS...
March 30, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28435280/high-adherence-to-therapy-and-low-cardiac-mortality-and-morbidity-in-patients-after-acute-coronary-syndrome-systematically-managed-by-office-based-cardiologists-in-germany-1-year-outcomes-of-the-proacor-study
#2
Franz Goss, Johannes Brachmann, Christian W Hamm, Winfried Haerer, Nicolaus Reifart, Benny Levenson
We aimed to assess patient acceptance and effectiveness of a 12-month structured management program in patients after an acute coronary syndrome (ACS) event who were treated in a special setting of office-based cardiologists. The program comprised patient documentation with a specific tool (Bundesverband Niedergelassener Kardiologen [German Federation of Office-Based Cardiologists] cardiac pass with visit scheduling) shared by the hospital physician and the office-based cardiologist, the definition of individual treatment targets, and the systematic information of patients in order to optimize adherence to therapy...
2017: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/28432157/effect-of-interleukin-6-inhibition-on-coronary-microvascular-and-endothelial-function-in-myocardial-infarction
#3
Espen Holte, Ola Kleveland, Thor Ueland, Gabor Kunszt, Marte Bratlie, Kaspar Broch, Annika E Michelsen, Bjørn Bendz, Brage H Amundsen, Svend Aakhus, Jan Kristian Damås, Lars Gullestad, Pål Aukrust, Rune Wiseth
OBJECTIVE: Interleukin-6 (IL-6) is a driver of inflammation and associated endothelial cell activation in acute coronary syndromes. We evaluated the effect of the IL-6 receptor antagonist tocilizumab on coronary microvascular function and endothelial dysfunction measured by coronary flow reserve (CFR) and markers of endothelial cell activation in patients with non-ST-elevation myocardial infarction (NSTEMI). METHODS: This substudy was part of a two-centre, double-blind, randomised, placebo-controlled trial evaluating the effect of a single dose of tocilizumab in NSTEMI...
April 21, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28427574/acute-noncardiovascular-illness-in-the-cardiac-intensive-care-unit
#4
Eric M Holland, Travis J Moss
BACKGROUND: Fifty years after the inception of the cardiac intensive care unit (CICU), noncardiovascular illnesses have become more prevalent and may contribute to morbidity and mortality. OBJECTIVES: The authors performed multivariate statistical analyses to determine the association of acute noncardiovascular illnesses with outcomes, including length of stay (LOS), mortality, and hospital readmission. METHODS: We studied 1,042 admissions between October 12, 2013 and November 28, 2014 to the CICU at the University of Virginia Health System, a tertiary-care academic medical center...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28425755/thrombus-aspiration-in-acute-coronary-syndromes-prevalence-procedural-success-change-in-serial-troponin-t-levels-and-clinical-outcomes-in-a-contemporary-swiss-cohort
#5
Soheila Aghlmandi, Nadine Schärer, Dik Heg, Lorenz Räber, Marcel Zwahlen, Baris Gencer, David Nanchen, David Carballo, Sebastian Carballo, Peter Jüni, Arnold von Eckardstein, Ulf Landmesser, Nicolas Rodondi, François Mach, Stephan Windecker, Christian M Matter, Thomas F Lüscher, Roland Klingenberg
BACKGROUND: Randomised controlled trials have provided conflicting results regarding procedural and clinical outcomes of thrombus aspiration combined with percutaneous coronary intervention, when compared with primary percutaneous coronary intervention alone in patients with acute coronary syndromes. METHODS: Acute coronary syndrome patients referred for coronary angiography to four Swiss university hospitals between 2009 and 2012 were enrolled in the SPUM-ACS cohort...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28420804/contemporary-trends-and-outcomes-associated-with-the-preprocedural-use-of-oral-p2y12-inhibitors-in-patients-undergoing-percutaneous-coronary-intervention-insights-from-the-blue-cross-blue-shield-of-michigan-cardiovascular-consortium-bmc2
#6
Devraj Sukul, Milan Seth, Simon R Dixon, Akshay Khandelwal, Thomas A LaLonde, Hitinder S Gurm
OBJECTIVES: We sought to describe trends in the use of preprocedural P2Y12 inhibitors and their clinical impact in patients undergoing percutaneous coronary intervention (PCI). BACKGROUND: Oral P2Y12 inhibitors are ubiquitously used medications; however, the specific timing of initial P2Y12 inhibitor administration remains intensely debated. METHODS: Our study population comprised 74,053 consecutive patients undergoing PCI at 47 hospitals in Michigan from January 2013 through June 2015...
April 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28416248/contemporary-practice-and-outcomes-of-an-elderly-cohort-of-japanese-patients-with-non-st-elevation-acute-coronary-syndrome-in-the-era-of-routine-early-invasive-strategy
#7
Takuya Nagata, Yohei Hyakuna, Kenji Miyata, Masahiro Mohri
BACKGROUND: An early invasive strategy for patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) has been recommended. However, patients at greater risk including the elderly are more often managed conservatively. We aimed to elucidate contemporary practice and outcomes of patients with NSTE-ACS who were referred to our hospital located in Kitakyushu City, one of the most aging metropolises in Japan. METHODS: A total of 270 consecutive NSTE-ACS patients hospitalized between January 2012 and December 2014 were retrospectively studied...
March 30, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28416165/influence-of-cardiovascular-risk-in-the-prediction-and-timing-of-cardiac-events-after-exercise-echocardiogram-testing-without-ischemia
#8
Sonia Velasco Del Castillo, Ane Antón Ladislao, Verónica Gómez Sánchez, José Juan Onaindia Gandarias, Ángela Cacicedo Fernández de Bobadilla, Ibon Rodríguez Sánchez, Eva Laraudogoitia Zaldumbide
INTRODUCTION AND OBJECTIVES: There have been no analyses of the influence of cardiovascular risk as a predictor of events in patients with exercise echocardiography (EE) without ischemia. Our objective was to determine the predictors of cardiac events, paying special attention to cardiovascular risk. METHODS: This study included 1640 patients with EE without ischemia. Of these, there were 1206 with no previously known coronary artery disease (CAD), whose risk of a fatal cardiovascular disease event was estimated according to the European SCORE (Systematic COronary Risk Evaluation) risk assessment system, and 434 with known CAD...
April 13, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/28409008/two-year-outcome-after-early-or-late-intervention-in-non-st-elevation-acute-coronary-syndrome
#9
Erik A Badings, Wouter S Remkes, Salem H K The, Jan-Henk E Dambrink, Geert Tjeerdsma, Saman Rasoul, Jorik R Timmer, Marloes L J van der Wielen, Dirk J A Lok, Renicus S Hermanides, Jan Van Wijngaarden, Harry Suryapranata, Arnoud W J van 't Hof
OBJECTIVE: To compare long-term outcome of an early to a delayed invasive strategy in high-risk patients with non-ST elevation acute coronary syndrome (NSTE-ACS). METHODS: This prospective, multicentre trial included patients with NSTE-ACS and at least two out of three of the following high-risk criteria: (1) evidence of extensive myocardial ischaemia on ECG, (2) elevated biomarkers for myocardial necrosis and (3) age above 65 years. Patients were randomised to either an early (angiography and revascularisation if appropriate <12 hours) or a delayed invasive strategy (>48 hours after randomisation)...
2017: Open Heart
https://www.readbyqxmd.com/read/28408018/early-invasive-versus-selective-strategy-for%C3%A2-non-st-segment-elevation-acute%C3%A2-coronary-syndrome-the-ictus-trial
#10
Niels P G Hoedemaker, Peter Damman, Pier Woudstra, Alexander Hirsch, Fons Windhausen, Jan G P Tijssen, Robbert J de Winter
BACKGROUND: The ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes) trial compared early invasive strategy with a selective invasive strategy in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and an elevated cardiac troponin T. No long-term benefit of an early invasive strategy was found at 1 and 5 years. OBJECTIVES: The aim of this study was to determine the 10-year clinical outcomes of an early invasive strategy versus a selective invasive strategy in patients with NSTE-ACS and an elevated cardiac troponin T...
April 18, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28400368/relationship-between-peak-troponin-values-and-long-term-ischemic-events-among-medically-managed-patients-with-acute-coronary-syndromes
#11
Sarah A Goldstein, L Kristin Newby, Derek D Cyr, Megan Neely, Thomas F Lüscher, Eileen B Brown, Harvey D White, E Magnus Ohman, Matthew T Roe, Christian W Hamm
BACKGROUND: The relationship between troponin level and outcomes among patients with non-ST-segment elevation ACS is established, but the relationship of troponin level with long-term outcomes among medically managed non-ST-segment elevation ACS patients receiving contemporary antiplatelet therapy is inadequately defined. METHODS AND RESULTS: In 6763 medically managed non-ST-segment elevation ACS patients randomized in TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) (prasugrel versus clopidogrel), we examined relationships between categories of peak troponin/upper limit of normal (ULN) ratio within 48 hours of the index ACS event (≈4...
April 11, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28398396/-bioresorbable-vascular-scaffolds-clinical-experience-of-the-emilia-romagna-region-italy
#12
Alberto Menozzi, Gianluca Calogero Campo, Vincenzo Guiducci, Gianni Dall'Ara, Andrea Santarelli, Paolo Sbarzaglia, Marco Balducelli, Paolo Magnavacchi, Fabio Sgura, Luciano Losi, Luigi Vignali, Gianni Casella, Luigi Steffanon, Fabio Tarantino, Francesco Saia
BACKGROUND: The bioresorbable vascular scaffold (BRS) technology constitutes the new revolution of the coronary artery disease interventional treatment. Currently, three distinct types of BRSs are available but only one, the Absorb BVS, was on the market in 2013 when the Regional Commission for Medical Devices and the Cardiology and Cardiac Surgery Commission of the Emilia-Romagna Region drew up a technical and scientific essay to provide guidance for the introduction of BRS in public and affiliated health facilities...
February 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/28396570/optimal-timing-of-complete-revascularization-in-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#13
REVIEW
Rouan Gaffar, Bettina Habib, Kristian B Filion, Pauline Reynier, Mark J Eisenberg
BACKGROUND: Studies have suggested that complete revascularization is superior to culprit-only revascularization for the treatment of enzyme-positive acute coronary syndrome. However, the optimal timing of complete revascularization remains unclear. We conducted a systematic review and meta-analysis of randomized controlled trials comparing single-stage complete revascularization with multistage percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction or non-ST-segment elevation myocardial infarction with multivessel disease...
April 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28391887/investigating-the-prevalence-predictors-and-prognosis-of-suboptimal-statin-use-early-after-a-non-st-elevation-acute-coronary-syndrome
#14
Richard M Turner, Peng Yin, Anita Hanson, Richard FitzGerald, Andrew P Morris, Rod H Stables, Andrea L Jorgensen, Munir Pirmohamed
BACKGROUND: High-potency statin therapy is recommended in the secondary prevention of cardiovascular disease but discontinuation, dose reduction, statin switching, and/or nonadherence occur in practice. OBJECTIVES: To determine the prevalence and predictors of deviation from high-potency statin use early after a non-ST elevation acute coronary syndrome (NSTE-ACS) and its association with subsequent major adverse cardiovascular events (MACE) and all-cause mortality (ACM)...
January 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/28386054/acute-myocardial-infarction-due-to-coronary-artery-embolism-in-a-22-year-old-woman-with-mitral-stenosis-with-atrial-fibrillation-under-warfarinization-successful-management-with-anticoagulation
#15
Santosh Kumar Sinha, Mukesh Jitendra Jha, Mahmadula Razi, Vikash Chaturvedi, Yatish Besthenahalli Erappa, Shravan Singh, Vikas Mishra, Dibbendhu Khanra, Karandeep Singh
BACKGROUND Coronary artery embolization is an exceedingly rare cause of myocardial infarction, but a few cases in association with prosthetic mechanical valves have been reported. We report a case of embolic myocardial infarction caused by a thrombus in the left atrium with deranged coagulation profile in a patient with critical mitral stenosis under warfarinization. CASE REPORT A 22-year-old woman was taken to the catheterization lab for early coronary intervention in lieu of non-ST elevation myocardial infarction...
April 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28381584/predicting-the-risk-of-bleeding-during-dual-antiplatelet-therapy-after-acute-coronary-syndromes
#16
Joakim Alfredsson, Benjamin Neely, Megan L Neely, Deepak L Bhatt, Shaun G Goodman, Pierluigi Tricoci, Kenneth W Mahaffey, Jan H Cornel, Harvey D White, Keith Aa Fox, Dorairaj Prabhakaran, Kenneth J Winters, Paul W Armstrong, E Magnus Ohman, Matthew T Roe
OBJECTIVES: Dual antiplatelet therapy (DAPT) with aspirin + a P2Y12 inhibitor is recommended for at least 12 months for patients with acute coronary syndrome (ACS), with shorter durations considered for patients with increased bleeding risk. However, there are no decision support tools available to predict an individual patient's bleeding risk during DAPT treatment in the post-ACS setting. METHODS: To develop a longitudinal bleeding risk prediction model, we analysed 9240 patients with unstable angina/non-ST segment elevation myocardial infarction (NSTEMI) from the Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes (TRILOGY ACS) trial, who were managed without revascularisation and treated with DAPT for a median of 14...
April 5, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28378733/-prognostic-factors-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-concurrent-with-type-2-diabetes-mellitus-according-to-the-results-of-the-registry
#17
A P Golikov, S A Berns, R I Stryuk, E A Shmidt, A A Golikova, O L Barbarash
AIM: To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). SUBJECTS AND METHODS: The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28368850/not-all-that-blurs-is-clot-an-unusual-but-not-infrequent-cause-of-acute-coronary-syndrome
#18
Etelberto Hernández Hernández, Víctor Alfonso Jiménez Díaz, José Antonio Baz Alonso, Saleta Fernández Barbeira, Jorge Alberto Vitela Rodríguez, Jorge Andrade Pacheco, Alberto Ortiz Sáez, Guillermo Bastos Fernández, Antonio Alejandro De Miguel Castro, Andrés Iñiguez Romo
A 73-year-old man was admitted for non-ST segment elevation acute myocardial infarction. Coronary angiography suggested intrastent thrombosis as the etiology, but optical coherence tomography revealed a non-expanded stent, which was successfuly crushed and covered with a new stent.
April 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28363222/trade-off-of-myocardial-infarction-vs-bleeding-types-on-mortality-after-acute-coronary-syndrome-lessons-from-the-thrombin-receptor-antagonist-for-clinical-event-reduction-in-acute-coronary-syndrome-tracer-randomized-trial
#19
Marco Valgimigli, Francesco Costa, Yuliya Lokhnygina, Robert M Clare, Lars Wallentin, David J Moliterno, Paul W Armstrong, Harvey D White, Claes Held, Philip E Aylward, Frans Van de Werf, Robert A Harrington, Kenneth W Mahaffey, Pierluigi Tricoci
Aims: Dual antiplatelet therapy reduces non-fatal ischaemic events after acute coronary syndrome (ACS) but increases bleeding to a similar extent. We sought to determine the prognostic impact of myocardial infarction (MI) vs. bleeding during an extended follow-up period to gain insight into the trade-off between efficacy and safety among patients after ACS. Methods and results: In 12 944 patients with non-ST-segment elevation ACS from the Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome (TRACER) trial, we investigated the relative impact of MI and bleeding occurring >30 days post-ACS and subsequent all-cause mortality...
March 14, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28356318/early-invasive-strategy-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-delays-death-or-mi-by-18-months
#20
Robert Henderson
No abstract text is available yet for this article.
March 29, 2017: Evidence-based Medicine
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