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Non-ST-Elevation Acute Coronary Syndromes

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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
#1
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/28089498/anticoagulants-in-ischemia-guided-management-of-non-st-elevation-acute-coronary-syndromes
#2
REVIEW
Martin Mayer
BACKGROUND: The most recent joint guidelines from the American Heart Association (AHA) and American College of Cardiology (ACC) on the management of non-ST-elevation acute coronary syndromes (NSTE-ACS) are a result of a substantial and considered undertaking, and those involved deserve much recognition for their efforts. However, the handling of anticoagulants seems somewhat inadequate, and this is a highly-relevant matter when managing NSTE-ACS. OBJECTIVE OF THE REVIEW: Among areas of potential uncertainty, emergency medicine professionals might still be left wondering about the particulars of anticoagulant therapy when pursuing ischemia-guided management of NSTE-ACS (that is, managing NSTE-ACS without an intent for early invasive measures, such as coronary angiography and revascularization)...
January 3, 2017: American Journal of Emergency Medicine
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28042404/in-hospital-and-one-year-clinical-outcome-of-percutaneous-coronary-intervention-in-a-tertiary-hospital-in-oman-oman-pci-registry
#6
Prashanth Panduranga, Majdah Al-Rashidi, Fatma Al-Hajri
OBJECTIVES: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in a tertiary hospital in Oman. METHODS: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event (MACE), defined as death, any myocardial infarction (MI), cerebrovascular accident (CVA), and target vessel revascularization (TVR) with either repeat PCI or coronary artery bypass surgery (CABG)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28040835/novel-ecg-changes-in-acute-coronary-syndromes-would-improvement-in-the-recognition-of-stemi-equivalents-affect-time-until-reperfusion
#7
Joshua Wall, Leigh D White, Astin Lee
Current guidelines recommend that patients with non-ST elevation myocardial infarction (NSTEMI) are treated with medical management alone, or in combination with coronary angiography within 24 h. Recent research suggests that NSTEMIs show angiographic evidence of complete occlusion at rates comparable to STEMIs, suggesting a subgroup of NSTEMI patients who require urgent angiography. Novel ECG changes, termed 'STEMI-equivalents', have been described as a way of identifying this subgroup. The aim of this study was to determine whether patients with STEMI-equivalent ECG changes experience similar degrees of myocardial damage, and would thus benefit from urgent PCI...
December 31, 2016: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28040190/comparison-of-outcomes-of-women-versus-men-with-non-st-elevation-acute-coronary-syndromes-undergoing-percutaneous-coronary-intervention-from-the-japanese-nationwide-registry
#8
Yohei Numasawa, Taku Inohara, Hideki Ishii, Toshiki Kuno, Masaki Kodaira, Shun Kohsaka, Kenshi Fujii, Shiro Uemura, Tetsuya Amano, Kazushige Kadota, Masato Nakamura
Previous studies have reported that women have worse outcomes than men after percutaneous coronary intervention (PCI), especially in patients with ST-elevation myocardial infarction. However, gender-related differences in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) have not been thoroughly investigated. In the Japanese nationwide registry, a total of 43,239 patients with NSTE-ACS from 861 hospitals underwent PCI in 2014. Overall, 11,326 patients (26.2%) were women. The women were older (75...
December 18, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28039466/elevated-plasma-interleukin-37-playing-an-important-role-in-acute-coronary-syndrome-through-suppression-of-rock-activation
#9
Tengyu Yang, Fang Fang, Yawen Chen, Jing Ma, Zhaowen Xiao, Songfeng Zou, Na Zheng, Dewen Yan, Songyan Liao, Shaoyuan Chen, Hongchen Fang, Chekmen Yu, Jie Liu, Ming Dong
OBJECTIVE: The plasma level of interleukin-37 is elevated in patients with acute coronary syndrome, however, its function during the onset and progress of the disease remains unclear. This study aimed to investigate the clinical significance of IL-37 in acute coronary syndrome and its underlying mechanism. METHODS: 124 patients with acute coronary syndrome and 40 healthy controls were recruited in this study. Plasma interleukin-37 levels were measured in 41 patients with ST elevation myocardial infarction (STEMI), 41 patients with non-STEMI, 42 patients with unstable angina, and 40 controls...
December 25, 2016: Oncotarget
https://www.readbyqxmd.com/read/28032431/degree-of-dyspnoea-in-patients-with-non-st-elevation-acute-coronary-syndrome-a-report-from-japanese-multicenter-registry
#10
Yasuyuki Shiraishi, Shun Kohsaka, Ikuko Ueda, Taku Inohara, Mitsuaki Sawano, Yohei Numasawa, Kentaro Hayashida, Yuichiro Maekawa, Yukihiko Momiyama, Keiichi Fukuda
BACKGROUND: Degree of dyspnoea is almost universally evaluated in the patients presenting with acute coronary syndrome (ACS), but its clinical implications has not been thoroughly investigated. We aimed to describe the relationship between the severity of dyspnoea and in-hospital outcomes in patients with non-ST elevation ACS (NSTE-ACS) complicated with acute heart failure (AHF). METHODS: Between 2009 and 2014, 3287 consecutive patients with NSTE-ACS were enrolled in the Japanese prospective multicenter PCI registry...
December 2016: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28029055/improved-risk-stratification-of-patients-with-acute-coronary-syndromes-using-a-combination-of-hstnt-nt-probnp-and-hscrp-with-the-grace-score
#11
Roland Klingenberg, Soheila Aghlmandi, Lorenz Räber, Baris Gencer, David Nanchen, Dik Heg, Sebastian Carballo, Nicolas Rodondi, François Mach, Stephan Windecker, Peter Jüni, Arnold von Eckardstein, Christian M Matter, Thomas F Lüscher
BACKGROUND: Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. METHODS: Consecutive patients admitted at four Swiss university hospitals with a diagnosis of acute coronary syndrome were enrolled into the SPUM-ACS Biomarker Cohort between 2009 and 2012. Patients were followed at 30 days and 1 year with assessment of adjudicated events including all-cause mortality and the composite of all-cause mortality or non-fatal recurrent myocardial infarction...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28029000/comparison-between-soluble-st2-and-high-sensitivity-troponin-i-in-predicting-short-term-mortality-for-patients-presenting-to-the-emergency-department-with-chest-pain
#12
Rossella Marino, Laura Magrini, Francesca Orsini, Veronica Russo, Patrizia Cardelli, Gerardo Salerno, Mina Hur, Salvatore Di Somma
BACKGROUND: High-sensitivity cardiac troponin I (hs-cTnI) and the soluble isoform of suppression of tumorigenicity 2 (sST2) are useful prognostic biomarkers in acute coronary syndrome (ACS). The aim of this study was to test the short term prognostic value of sST2 compared with hs-cTnI in patients with chest pain. METHODS: Assays for hs-cTnI and sST2 were performed in 157 patients admitted to the Emergency Department (ED) for chest pain at arrival. In-hospital and 30-day follow-up mortalities were assessed...
March 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28018669/effects-of-omeprazole-or-pantoprazole-on-platelet-function-in-non-st-segment-elevation-acute-coronary-syndrome-patients-receiving-clopidogrel
#13
Ruo-Xi Gu, Xiao-Zeng Wang, Jing Li, Jie Deng, Xing-Xing Li, Jiao Wang
BACKGROUND: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients receiving clopidogrel. METHODS: Consecutive patients with NSTE-ACS (n = 620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole (20 mg/d) group (1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation (ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention (PCI)...
2016: Military Medical Research
https://www.readbyqxmd.com/read/28013562/deciphering-acute-coronary-syndrome-biomarkers-high-resolution-proteomics-in-platelets-thrombi-and-microparticles
#14
Diana Navas-Carrillo, Francisco Marín, Mariano Valdés, Esteban Orenes-Piñero
Acute coronary syndromes (ACS) encompass unstable angina, non-ST segment elevation myocardial infarction, ST-segment elevation myocardial infarction and sudden cardiac death. They are commonly associated with the presence of vulnerable plaques in the coronary arteries and occur when a thrombus formed from a ruptured atheromatous plaque causes a prolonged occlusion of a coronary artery. The erosion of the vulnerable plaques results in the formation of luminal thrombi secondary to platelet activation and the release of thrombogenic elements within the atherosclerotic lesions...
December 26, 2016: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28011810/cohort-profile-of-biomarcs-the-biomarker-study-to-identify-the-acute-risk-of-a-coronary-syndrome-a-prospective-multicentre-biomarker-study-conducted-in-the-netherlands
#15
Rohit M Oemrawsingh, K Martijn Akkerhuis, Victor A Umans, Bas Kietselaer, Carl Schotborgh, Eelko Ronner, Timo Lenderink, Anho Liem, David Haitsma, Pim van der Harst, Folkert W Asselbergs, Arthur Maas, Anton J Oude Ophuis, Ben Ilmer, Rene Dijkgraaf, Robbert-Jan de Winter, S Hong Kie The, Alexander J Wardeh, Walter Hermans, Etienne Cramer, Ron H van Schaik, Imo E Hoefer, Pieter A Doevendans, Maarten L Simoons, Eric Boersma
PURPOSE: Progression of stable coronary artery disease (CAD) towards acute coronary syndrome (ACS) is a dynamic and heterogeneous process with many intertwined constituents, in which a plaque destabilising sequence could lead to ACS within short time frames. Current CAD risk assessment models, however, are not designed to identify increased vulnerability for the occurrence of coronary events within a precise, short time frame at the individual patient level. The BIOMarker study to identify the Acute risk of a Coronary Syndrome (BIOMArCS) was designed to evaluate whether repeated measurements of multiple biomarkers can predict such 'vulnerable periods'...
December 23, 2016: BMJ Open
https://www.readbyqxmd.com/read/28011706/profiling-and-validation-of-circulating-micrornas-for-cardiovascular-events-in-patients-presenting-with-st-segment-elevation-myocardial-infarction
#16
Philipp Jakob, Tim Kacprowski, Sylvie Briand-Schumacher, Dik Heg, Roland Klingenberg, Barbara E Stähli, Milosz Jaguszewski, Nicolas Rodondi, David Nanchen, Lorenz Räber, Pierre Vogt, Francois Mach, Stephan Windecker, Uwe Völker, Christian M Matter, Thomas F Lüscher, Ulf Landmesser
AIMS: MicroRNAs (miRNA) are important non-coding modulators controlling patterns of gene expression. However, profiling and validation of circulating miRNA levels related to adverse cardiovascular outcome has not been performed in patients with an acute coronary syndrome (ACS). METHODS AND RESULTS: In a multicentre, prospective ACS cohort, 1002 out of 2168 patients presented with ST-segment elevation myocardial infarction (STEMI). Sixty-three STEMI patients experienced an adjudicated major cardiovascular event (MACE, defined as cardiac death or recurrent myocardial infarction) within 1 year of follow-up...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28005944/ventricular-dysfunction-in-patients-with-acute-coronary-syndrome-undergoing-coronary-surgical-revascularization-prognostic-impact-on-long-term-outcomes
#17
Batric Popovic, Nelly Agrinier, Damien Voilliot, Mazen Elfarra, Jean Pierre Villemot, Pablo Maureira
BACKGROUND: Patients with non-ST elevation acute coronary syndrome complicated by left ventricular dysfunction (LVEF) are a poor prognosis group. The aim of our study was to assess the short and long term LEVF prognostic value in a cohort of NSTE-ACS patients undergoing surgical revascularization. METHODS: We performed elective and isolated CABG on a cohort of 206 consecutive patients with LVEF≤0.40 complicating acute coronary syndrome. The case cohort was compared with a cohort of controls (LVEF>0...
2016: PloS One
https://www.readbyqxmd.com/read/27998837/rotational-atherectomy-in-acute-coronary-syndrome-early-and-midterm-outcomes-from-a-multicentre-registry
#18
Mario Iannaccone, Fabio Piazza, Giacomo G Boccuzzi, Fabrizio D'Ascenzo, Azeem Latib, Mauro Pennacchi, Marco Luciano Rossi, Fabrizio Ugo, Emanuele Meliga, Hiroyoshi Kawamoto, Claudio Moretti, Alfonso Ielasi, Roberto Garbo, Antonio H Frangieh, David Hildick-Smith, Christian Templin, Antonio Colombo, Gennaro Sardella
AIMS: The safety and efficacy of rotational atherectomy (RA) in patients presenting with non-ST-elevation myocardial infarction (NSTE-ACS) remain to be defined. The aim of our study was to assess the safety and efficacy of RA in NSTE-ACS patients with reference to both short- and long-term follow-up. METHODS AND RESULTS: This was an observational retrospective registry which enrolled all consecutive patients undergoing RA, comparing patients with stable angina (SA) and NSTE-ACS...
December 20, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27988230/spontaneous-coronary-artery-dissection-still-a-lot-to-learn
#19
David Neves, Ângela Bento, Renato Fernandes, Lino Patrício, José Aguiar
Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is an uncommon but probably underdetected pathological substrate for acute coronary syndrome. Clinical associations have been noted, like female gender and young age, but its pathophysiology is not yet fully understood. In this report we describe the case of a 50-year-old woman, without cardiovascular risk factors presenting with non-ST segment elevation myocardial infarction, in whom SCAD was diagnosed. Treatment was initially conservative but due to aggravation of the dissection she eventually underwent a complex percutaneous coronary intervention, requiring implantation of multiple stents, but with a good clinical outcome...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27981367/-cardiac-causes-of-chest-pain
#20
C Wächter, B Markus, B Schieffer
Because of the life-threatening character and a high prevalence in emergency rooms, cardiac causes are important differential diagnoses of acute chest pain with the need for rapid clarification. In this context the working diagnosis "acute coronary syndrome" (ACS) plays a major role. In a synopsis of the clinical presentation, medical history, electrocardiogram and analysis of cardiac biomarkers, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris can be specified as entities of ACS...
January 2017: Der Internist
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