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Non-ST-Elevation Acute Coronary Syndromes

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https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#1
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29343534/effect-of-acute-coronary-syndrome-probability-on-diagnostic-and-prognostic-performance-of-high-sensitivity-cardiac-troponin
#2
Patrick Badertscher, Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, Karin Wildi, Zaid Sabti, Christian Puelacher, Maria Rubini Giménez, Julian Pfäffli, Dayana Flores, Jeanne du Fay de Lavallaz, Òscar Miró, F Javier Martin-Sanchez, Beata Morawiec, Jens Lohrmann, Andreas Buser, Dagmar I Keller, Nicolas Geigy, Tobias Reichlin, Christian Mueller
BACKGROUND: There is concern that high-sensitivity cardiac troponin (hs-cTn) may have low diagnostic accuracy in patients with low acute coronary syndrome (ACS) probability. METHODS: We prospectively stratified patients presenting with acute chest discomfort to the emergency department (ED) into 3 groups according to their probability for ACS as assessed by the treating ED physician using a visual analog scale-≤10%, 11% to 79%, and ≥80%-reviewing all information available at 90 min...
January 17, 2018: Clinical Chemistry
https://www.readbyqxmd.com/read/29336914/switching-from-clopidogrel-to-prasugrel-to-protect-early-invasive-treatment-in-acute-coronary-syndromes-results-of-the-switch-over-trial
#3
Filippo Ottani, Eti Alessandra Femia, Marco Cattaneo, Luciano Caravita, Chiara Attanasio, Marcello Galvani
BACKGROUND: Clopidogrel is used to pretreat patients with non-ST elevation acute coronary syndromes (NSTE-ACS), but prasugrel provides better platelet inhibition with improved outcome. However, switching from clopidogrel at the time of percutaneous coronary intervention (PCI) remains incompletely defined. Our aim was to compare the pharmacodynamic (PD) effects of 3 prasugrel loading doses (LDs; G1:10mg, G2: 30mg, and G3: 60mg) before PCI. A fourth group, continuing clopidogrel, served as control (G4)...
December 27, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/29317116/giant-coronary-aneurysm-culprit-of-an-acute-coronary-syndrome
#4
Iván J Núñez-Gil, Pedro Marcos Alberca, Nieves Gonzalo, Luis Nombela-Franco, Pablo Salinas, Antonio Fernández-Ortiz
A 66-year-old male ex-smoker with hypertension, type 2 diabetes mellitus and dyslipidaemia was admitted due to a non-ST segment elevation myocardial infarction. The catheterisation depicted an extensive and calcified disease: chronic total obstruction of the right coronary and severe disease with a giant aneurysm at the first marginal branch as the culprit vessel. After discussion, the right coronary was treated before the circumflex-giant aneurysm was closed with a stent graft and its multiple severe stenosis solved with two drug-eluting stents...
January 6, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29313559/the-long-term-prognosis-following-acute-coronary-syndromes-a-prospective-observational-study-of-unselected-group-treated-in-the-24-7-cardiac-catheterization-laboratory-at-university-hospital
#5
Marcin Grabowski, Krzysztof J Filipiak, Grzegorz Opolski, Renata Główczyńska, Monika Gawałko, Paweł Balsam, Andrzej Cacko, Zenon Huczek, Grzegorz Karpiński, Robert Kowalik, Franciszek Majstrak, Janusz Kochman
BACKGROUND: The risk stratification in acute coronary syndrome (ACS) is usually based on the clinical data obtained during hospitalization. To date, there is a limited number of prospective observational studies assessing long-term prognosis of patients discharged from the hospital after ACS. AIM: This study is to investigate long-term follow-up of unselected ACS patients treated at the 24 hours/7 days (24/7) cardiac catheterization laboratory and discharged from referral, university hospital...
January 9, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29306481/effect-of-calcifediol-treatment-on-cardiovascular-outcomes-in-patients-with-acute-coronary-syndrome-and-percutaneous-revascularization
#6
Cristina Navarro-Valverde, Jose M Quesada-Gómez, Ramón Pérez-Cano, Ana Fernández-Palacín, Luis F Pastor-Torres
BACKGROUND AND OBJECTIVES: Vitamin D deficiency has been consistently linked with cardiovascular diseases. However, results of intervention studies are contradictory. The aim of this study was to evaluate the effect of treatment with calcifediol (25(OH)D3) on the cardiovascular system of patients with non-ST-elevation acute coronary syndrome after percutaneous coronary intervention. PATIENTS AND METHODS: A prospective study assessing≥60-year-old patients with non-ST-elevation acute coronary syndrome, coronary artery disease and percutaneous revascularisation...
January 3, 2018: Medicina Clínica
https://www.readbyqxmd.com/read/29298651/is-atherothromboaspiration-a-possible-solution-for-the-prevention-of-no-reflow-phenomenon-in-acute-coronary-syndromes-single-centre-experience-and-review-of-the-literature
#7
Antonis S Manolis
BACKGROUND: Intracoronary thrombus in acute myocardial infarction (MI) confers higher rates of no-reflow with attendant adverse consequences. Earlier randomized-controlled-trials (RCTs) of routine thromboaspiration during percutaneous coronary intervention (PCI) indicated a clinical benefit, but more recent RCTs were negative. However, data of selective use of this adjunctive approach remain scarce. OBJECTIVE: The aim of this single-centre prospective study was to report the results of selective thromboaspiration during PCI in patients with intracoronary thrombi, and also to provide an extensive literature review on current status of thromboaspiration...
January 1, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29297906/-treatment-of-acute-myocardial-infarction-in-2017
#8
Giovanni Cimmino, Davide D'Andrea, Ciro Mauro, Carmine Morisco, Plinio Cirillo
Acute myocardial infarction is a clinical cardiac emergency associated with potential and substantial morbidity and mortality. This disorder is triggered by an acute coronary syndrome caused by episodes of plaque ulceration, fissuration, or rupture with subsequent production of thrombogenic material and intravascular thrombus formation. The presence or absence of ST-segment elevation on the ECG defines the two main clinical spectrum of ST-segment elevation or non-ST-segment elevation myocardial infarction. In the last three decades, pharmacological and interventional management as well as in-hospital care have dramatically improved...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29278387/indoleamine-2-3-dioxygenase-ido-enzyme-links-innate-immunity-and-altered-t-cell-differentiation-in-non-st-segment-elevation-acute-coronary-syndrome
#9
Chiara Zara, Anna Severino, Davide Flego, Aureliano Ruggio, Daniela Pedicino, Ada Francesca Giglio, Francesco Trotta, Claudia Lucci, Domenico D'Amario, Ramona Vinci, Eugenia Pisano, Giulio La Rosa, Luigi Marzio Biasucci, Filippo Crea, Giovanna Liuzzo
Atherosclerosis is a chronic inflammatory disease characterized by a complex interplay between innate and adaptive immunity. Dendritic cells (DCs) play a key role in T-cell activation and regulation by promoting a tolerogenic environment through the expression of the immunosuppressive enzyme indoleamine 2,3-dioxygenase (IDO), an intracellular enzyme involved in tryptophan catabolism. IDO expression and activity was analyzed in monocytes derived DCs (MDDCs) from non-ST segment elevation myocardial infarction (NSTEMI) patients, stable angina (SA) patients and healthy controls (HC) by real-time quantitative polymerase chain reaction (RT-qPCR) before and after in vitro maturation with lipopolysaccharide (LPS)...
December 26, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29276924/-myocardial-hypoenhancement-on-multidetector-computed-tomography-in-patients-with-non-st-elevation-acute-coronary-syndrome
#10
M Y Ruda, N A Barysheva, I N Merkulova, M S Shabanova, M A Shariya, S A Gaman, T S Sukhinina, T N Veselova
The purpose of our study was analysis of myocardial hypoenhancement areas (MHAs) found by multidetector computed tomography (MDCT) in patients with non-ST elevation acute coronary syndrome (NSTEACS) and comparison of these findings with results of standard methods of diagnostics of myocardial infarction and ischemia [electrocardiography (ECG) and echocardiography (ECHO)]. METHODS: MHAs were found in 18 of 21 patients with non-ST segment elevation myocardial infarction (NSTEMI) (85.7%) and only in 3 of 22 patients with unstable angina (UA) (13...
October 2017: Kardiologiia
https://www.readbyqxmd.com/read/29258913/evaluation-of-dyslipidaemia-and-the-impact-of-hypolipidemic-therapy-on-prognosis-in-high-and-very-high-risk-patients-through-the-hyperlipidaemia-therapy-in-tertiary-cardiological-center-tercet-registry
#11
Krzysztof Dyrbuś, Tadeusz Osadnik, Piotr Desperak, Aneta Desperak, Mariusz Gąsior, Maciej Banach
The use of statins in the treatment of hyperlipidaemia leads to a significant decrease in cardiovascular (CV) endpoints, and therapy effects are proportional to the reduction of cholesterol levels. In Poland, information about the effects of statin therapy is scarcely available. The information gathered in the Hyperlipidaemia Therapy in the tERtiary Cardiological cEnTer (TERCET) Registry on high-risk and very high-risk patients might improve our knowledge on this issue and help to introduce suitable activities...
December 16, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/29247157/a-case-of-subacute-bioresorbable-vascular-scaffold-thrombosis-what-was-wrong
#12
Seraj A Abualnaja, Hanan M Alrammah, Bayan A Alsaif, Malak O Almulla, Bayan A Alzahrani
BACKGROUND The introduction of bioresorbable vascular scaffolds (BVS) into the field of percutaneous coronary intervention (PCI) was thought to be a promising step in solving the issues raised with the use of early bare metal stents (BMS) and drug eluting stents (DES); however, studies have raised concerns regarding thrombosis risk associated with the use of these stents. CASE REPORT A 42-year-old male presented with acute coronary syndrome (ACS), on diagnostic coronary angiography he had 75% and 70% stenosis in mid and distal left anterior descending artery (LAD) respectively, PCI with BVS implantation was done...
December 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/29240961/anomalous-origin-of-culprit-coronary-arteries-in-acute-coronary-syndromes
#13
Paweł Tyczyński, Krzysztof Kukuła, Arkadiusz Pietrasik, Tomasz Bochenek, Artur Dębski, Anna Oleksiak, Miłosz Marona, Michał Lelek, Janina Stępińska, Adam Witkowski
BACKGROUND: To describe a series of acute coronary syndrome (ACS) patients in whom anomalous origin of culprit coronary artery (AOCCA) was diagnosed. Percutaneous coronary interventions (PCI) in AOCCA are performed very infrequently. METHODS: Electronic databases from three high-volume tertiary cardiac centers were retrospectively searched for the presence of AOCCA in ACS. RESULTS: Different types of AOCCA in ACS were identified in 20 patients...
December 14, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/29236147/-platelet-inhibition-in-elderly-patients
#14
A Schäfer, J Bauersachs
Single antiplatelet therapy (SAPT) using predominantly acetylsalicylic acid (ASA) is the baseline anti-thrombotic therapy in primary as well as secondary prevention of atherosclerotic disease. Dual antiplatelet therapy (DAPT) is the cornerstone of maintenance medication following elective percutaneous coronary interventions or acute coronary syndromes (ST elevation myocardial infarction, non-ST elevation myocardial infarction and unstable angina pectoris). In the past the duration of DAPT in particular has been frequently discussed...
December 13, 2017: Herz
https://www.readbyqxmd.com/read/29230658/guidelines-in-review-comparison-of-the-2014-aha-acc-guideline-for-the-management-of-patients-with-non-st-elevation-acute-coronary-syndromes-and-the-2015-esc-guidelines-for-the-management-of-acute-coronary-syndromes-in-patients-presenting-without-persistent
#15
Shane P Prejean, Munaib Din, Eliana Reyes, Fadi G Hage
In this Guidelines in Review, we review side-by-side the recommendations provided by the 2014 AHA/ACC Guideline for the management of patients with non-ST-elevation acute coronary syndromes and the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. We review the recommendations for imaging in the evaluation of patients with possible ACS followed by the diagnostic evaluation of patients with proven NSTE-ACS, based on their risk for adverse clinical events...
December 11, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/29230180/immediate-early-vs-delayed-invasive-strategy-for-patients-with-non-st-segment-elevation-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#16
REVIEW
Yanda Li, Zhenpeng Zhang, Xingjiang Xiong, William C Cho, Dan Hu, Yonghong Gao, Hongcai Shang, Yanwei Xing
Invasive coronary revascularization has been shown to improve prognoses in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), but the optimal timing of intervention remains unclear. This meta-analysis is to evaluate the outcomes in immediate (<2 h), early (<24 h), and delayed invasive group and find out which is the optimal timing of intervention in NSTE-ACS patients. Studies were identified through electronic literature search of Medline, PubMed Central, Embase, the Cochrane Library, and CNKI...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/29222628/one-year-clinical-effectiveness-comparison-of-prasugrel-with-ticagrelor-results-from-a-retrospective-observational-study-using-an-integrated-claims-database
#17
Mark B Effron, Kavita V Nair, Cliff Molife, Stuart Y Keller, Robert L Page, Jason C Simeone, Brian Murphy, Beth L Nordstrom, Yajun Zhu, Patrick L McCollam, George W Vetrovec
BACKGROUND: No direct comparisons of ticagrelor and prasugrel with 1-year clinical follow-up have been reported. OBJECTIVES: Our objective was to compare 1-year clinical outcomes among patients with acute coronary syndrome (ACS) managed with percutaneous coronary intervention (PCI) and treated with either ticagrelor or prasugrel in a real-world setting. METHODS: This retrospective study included patients from a payer database who were aged ≥18 years and had ACS managed with PCI with no history of transient ischemic attack (TIA)/stroke...
December 8, 2017: American Journal of Cardiovascular Drugs: Drugs, Devices, and Other Interventions
https://www.readbyqxmd.com/read/29211854/matrix-metalloproteinase-9-might-affect-adaptive-immunity-in-non-st-segment-elevation-acute-coronary-syndromes-by-increasing-cd31-cleavage-on-cd4-t-cells
#18
Giulia Angelini, Davide Flego, Ramona Vinci, Daniela Pedicino, Francesco Trotta, Aureliano Ruggio, Giuseppe P Piemontese, Domenico Galante, Myriana Ponzo, Luigi M Biasucci, Giovanna Liuzzo, Filippo Crea
Aims: In patients with acute coronary syndrome (ACS), the higher activity of effector T-cells suggests that mechanisms involving adaptive immunity dysregulation might play a role in coronary instability. The shedding of the functional CD31 domain 1-5 leads to uncontrolled lymphocyte activation. In experimental models, matrix metalloproteinase-9 (MMP-9) has been implicated in endothelial CD31 cleavage. Interestingly, higher serum levels of MMP-9 have been observed in ACS. We aim to investigate the mechanisms underlying CD31 dysregulation in ACS...
December 2, 2017: European Heart Journal
https://www.readbyqxmd.com/read/29208858/correlation-of-troponin-i-level-with-left-ventricular-ejection-fraction-and-in-hospital-outcomes-after-first-attack-of-non-st-segment-elevation-myocardial-infarction
#19
M H Khan, M N Islam, G P Aditya, M Z Islam, A S Bhuiyan, B Saha, K Bhowmick, M Hassan, P K Paul, S Chowdhury, R Rahman
Coronary heart disease (CHD) is the most common cause of heart disease and is the single most important cause of premature death in developed world. Recognizing a patient with ACS is important because the diagnosis triggers both triage and management. cTnI is 100% tissue-specific for the myocardium and it has been shown to be a very sensitive and specific marker for acute myocardial infarction (AMI). Ventricular function is the best predictor of death after an acute coronary syndrome. It serves as a marker of myocardial damage, provides information on systolic function as well as diagnosis and prognosis...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29206072/cigarette-smoking-reduces-platelet-reactivity-independently-of-clopidogrel-treatment-in-patients-with-non-st-elevation-acute-coronary-syndromes
#20
Gabriele Crimi, Alberto Somaschini, Marco Cattaneo, Dominick J Angiolillo, Federico Piscione, Tullio Palmerini, Stefano De Servi
Smokers receiving clopidogrel show a lower residual platelet reactivity than non-smokers, a phenomenon generally ascribed to smoking-induced increased production of clopidogrel active metabolite, but also associated with the high hemoglobin levels of smokers, which decreases platelet reactivity in tests that measure platelet function in whole blood. We evaluated the impact of cigarette smoking and of hemoglobin levels on platelet reactivity index (PRI) measured by the vasodilator-stimulated phosphoprotein phosphorylation (VASP-P) assay in whole blood samples from patients with non-ST elevation acute coronary syndrome (NSTE-ACS) undergoing percutaneous coronary interventions, both before and after clopidogrel administration...
December 5, 2017: Platelets
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