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https://www.readbyqxmd.com/read/28874297/patients-with-non-st-segment-elevation-acute-coronary-syndromes-managed-without-coronary-revascularization-a-population-needing-treatment-improvement
#1
Alberto Menozzi, Stefano De Servi, Roberta Rossini, Marco Ferlini, Daniela Lina, Maurizio Giuseppe Abrignani, Piera Capranzano, Nazario Carrabba, Marcello Galvani, Alfredo Marchese, Gianfranco Mazzotta, Luciano Moretti, Nicola Signore, Massimo Uguccioni, Zoran Olivari, Leonardo De Luca
NSTE-ACS patients are a heterogeneous population, with different clinical features and prognosis. A large proportion of them is medically managed, without any revascularization. In the EYSHOT and FAST-MI registries such patients were 40% and 35%, respectively. These patients are at higher risk of adverse cardiovascular events and have a worse prognosis compared with those receiving revascularization. Medically managed NSTE-ACS patients consist of different subgroups: those not undergoing coronary angiography, those without significant coronary artery disease, and those with coronary stenoses not referred to revascularization...
October 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28840515/high-sensitivity-cardiac-troponin-for-the-diagnosis-of-patients-with-acute-coronary-syndromes
#2
REVIEW
Vlad C Vasile, Allan S Jaffe
PURPOSE OF REVIEW: High-sensitivity cardiac troponin (hscTn) assays are replacing the older-generation assays used to detect myocardial injury because they have improved analytical sensitivity and lead to a more rapid diagnosis of acute myocardial infarction (AMI) and enhanced risk stratification in patients with non-ST elevation acute coronary syndromes (NSTE-ACS). This review focuses on advantages and difficulties of using hscTn as diagnostic and prognostic tools in acute coronary syndromes (ACS)...
August 24, 2017: Current Cardiology Reports
https://www.readbyqxmd.com/read/28838475/comparison-of-ticagrelor-versus-prasugrel-for-inflammation-vascular-function-and-circulating-endothelial-progenitor-cells-in-diabetic-patients-with-non-st-segment-elevation-acute-coronary-syndrome-requiring-coronary-stenting-a-prospective-randomized-crossover
#3
Han Saem Jeong, Soon Jun Hong, Sang-A Cho, Jong-Ho Kim, Jae Young Cho, Seung Hun Lee, Hyung Joon Joo, Jae Hyoung Park, Cheol Woong Yu, Do-Sun Lim
OBJECTIVES: This study compared adenosine-associated pleiotropic effects of the 2 P2Y12 receptor antagonists on vascular function, systemic inflammation, and circulating endothelial progenitor cells (EPCs). BACKGROUND: Both ticagrelor and prasugrel have potent antiplatelet effects. However, only ticagrelor inhibits cellular uptake of adenosine. METHODS: Using a randomized, crossover design with 10-week follow-up ticagrelor or prasugrel was administered to type 2 diabetic patients with non-ST-segment elevation acute coronary syndrome requiring stent implantation...
August 28, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28830367/mir-941-as-a-promising-biomarker-for-acute-coronary-syndrome
#4
Ruina Bai, Qiaoning Yang, Ruixi Xi, Lizhi Li, Dazhuo Shi, Keji Chen
BACKGROUND: Circulating miRNAs can function as biomarkers for diagnosis, treatment, and prevention of diseases. However, it is unclear whether miRNAs can be used as biomarkers for acute coronary syndrome (ACS). To this end, we applied gene chip technology to analyze miRNA expression in patients with stable angina (SA), non-ST elevation ACS (NSTE-ACS), and ST-segment elevation myocardial infarction (STEMI). METHODS: We enrolled patients with chest pain who underwent diagnostic coronary angiography, including five patients each with SA, NSTE-ACS, or STEMI, and five controls without coronary artery disease (CAD) but with three or more risk factors...
August 22, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28822510/high-versus-low-dose-statin-therapy-in-indian-patients-with-acute-st-segment-elevation-myocardial-infarction-undergoing-thrombolysis
#5
K Priti, Anand Agrawal, Bhanwar L Ranwa
OBJECTIVES: This study sought to compare high dose versus low dose statin therapy in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. BACKGROUND: Randomized trials have demonstrated that statin treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, randomized studies of statin therapy in Indian patients with STEMI are scarce. METHODS: Of 1859 patients with acute STEMI, 1027 eligible patients were randomized to 80-mg (n=512) or 10-mg (n=515) atorvastatin...
July 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28818351/recent-trends-in-management-and-outcome-of-patients-with-acute-coronary-syndromes-and-atrial-fibrillation
#6
Leonardo De Luca, Gianni Casella, Andrea Rubboli, Lucio Gonzini, Donata Lucci, Alessandro Boccanelli, Francesco Chiarella, Antonio Di Chiara, Stefano De Servi, Andrea Di Lenarda, Giuseppe Di Pasquale, Stefano Savonitto
AIMS: To describe the clinical characteristics, contemporary trends of in-hospital management and outcome of patients admitted for an acute coronary syndrome (ACS) with associated atrial fibrillation (AF). METHODS: We analyzed data from four Italian nationwide prospective registries, conducted between 2001 and 2014, including consecutive ACS patients. RESULTS: Out of 16,803 ACS patients, 1019 (6.1%) presented with concomitant AF: 668 with non-ST elevation (NSTE)-ACS and 351 with ST-elevation myocardial infarction (STEMI)...
August 10, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28802810/early-invasive-versus-initially-conservative-strategy-in-elderly-patients-older-than-75-years-with-non-st-elevation-acute-coronary-syndrome-a-meta-analysis
#7
Wenfang Ma, Yan Liang, Jun Zhu
BACKGROUND: Fear of complications related to the procedure and unclear benefits in elderly patients are common reasons for invasive angiography being withheld. METHODS: We searched PubMed and Embase from inception until February 2016 for studies that enrolled individuals older than 75 years with non-ST-elevation acute coronary syndrome (NSTE-ACS) and allocated patients to either an invasive or conservative strategy. RESULTS: Thirteen studies (four randomised controlled trials (RCTs) and nine observational studies) enrolling 832,007 elderly NSTE-ACS patients were analysed...
July 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28764841/non-st-elevation-acute-coronary-syndromes-a-comprehensive-review
#8
Tamunoinemi Bob-Manuel, Ikechuckwu Ifedili, Guy Reed, Uzoma N Ibebuogu, Rami N Khouzam
Non-ST elevation-acute coronary syndrome (NSTE-ACS) includes NSTE myocardial infarction and unstable angina. This patient population forms approximately two-thirds of all hospital admissions for ACS in the United States each year and is associated with an in-hospital mortality of 5%. NSTE-ACS is primarily due to an acute change in the supply and demand balance of coronary perfusion and myocardial oxygen consumption, because of the significant coronary artery obstruction presenting as plaque rupture or erosion...
September 2017: Current Problems in Cardiology
https://www.readbyqxmd.com/read/28747021/characteristics-and-outcomes-of-medically-managed-patients-with-non-st-segment-elevation-acute-coronary-syndromes-insights-from-the-multinational-epicor-asia-study
#9
Chee Tang Chin, Tiong K Ong, Rungroj Krittayaphong, Stephen W-L Lee, Jitendra P S Sawhney, Hyo-Soo Kim, Angeles Alonso Garcia, Héctor Bueno, Stuart J Pocock, Vo T Nhan, Ana Vega, Nobuya Hayashi, Yong Huo
BACKGROUND: Many patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) are medically managed without coronary revascularization. The reasons vary and may impact prognosis. METHODS: EPICOR Asia (NCT01361386) is a prospective study of hospital survivors post-ACS enrolled in 218 hospitals from 8 countries/regions in Asia (06/2011-05/2012). All medically managed NSTE-ACS patients were classified into 3 groups: 1) no coronary angiography (CAG-); 2) non-significant coronary artery disease (CAD) on angiogram (CAG+ CAD-); and 3) significant CAD (CAG+ CAD+)...
September 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28715070/evaluation-of-the-relationship-between-renal-resistive-index-and-extensivity-and-complexity-of-coronary-artery-disease-in-patients-with-acute-coronary-syndrome
#10
Alaa Quisi, Ibrahim Halil Kurt, Durmuş Yıldıray Şahin, Onur Kaypaklı, Gökhan Söker, Ömer Kaya, Samir Allahverdiyev, Ömer Genç, Gökhan Alıcı, Mevlüt Koç
BACKGROUND: Despite the advances in cardiovascular medicine, acute coronary syndrome (ACS) is still a major cause of morbidity and mortality worldwide. Synergy between PCI ™ with TAXUS and Cardiac Surgery (SYNTAX) score is used to determine the extensivity and complexity of coronary artery disease (CAD). Renal resistive index (RRI), a renal Doppler ultrasound parameter, is used to detect renal hemodynamics. Although some risk factors for CAD, including hypertension and diabetes mellitus were demonstrated to have an association with RRI, direct relationship between the presence...
July 17, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28647999/-relationship-between-the-ratio-of-neutrophil-lymphocyte-and-risk-stratification-prognosis-in-patients-with-non-st-elevation-acute-coronary-syndrome
#11
Y Wang, S J Jia, Z Chi
Objective: To investigate the value of neutrophil to lymphocyte ratio (NLR) in predicting risk stratification and prognosis in patients with non-ST-elevation acute coronary syndrome (NSTE-ACS). Methods: A total of 227 NSTE-ACS patients after percutaneous coronary intervention (PCI) were collected from September 2012 to September 2014 in Beijing Anzhen Hospital.Groups: (1)According to NLR, the patients were divided into 3 groups: NLR<2.20 group; 2.2≤NLR<3.33 group; NLR≥3.33 group.(2)According to the global registry of acute coronary events (GRACE) score, the patients were divided into 3 groups: Low-risk group, Medium-risk group and High-risk group...
June 20, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647406/unstable-angina-in-the-era-of-cardiac-troponin-assays-with-improved-sensitivity-a-clinical-dilemma
#12
K M Eggers, T Jernberg, B Lindahl
INTRODUCTION: There is an expectation that with the adoption of more sensitive cardiac troponin (cTn) assays, unstable angina would become a rarity. However, recent data from the SWEDEHEART registry demonstrated that 15% of patients admitted with non ST-elevation acute coronary syndrome (NSTE-ACS) still were regarded having unstable angina. We aimed to further investigate the clinical characteristics and outcome of these patients. METHODS: Retrospective registry-based analysis (SWEDEHEART) including 3204 unstable patients, 18,194 non ST-elevation myocardial infarction (NSTEMI) patients and 977 controls without acute cardiovascular disease...
June 21, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28645803/grace-risk-score-sex-based-validity-of-in-hospital-mortality-prediction-in-canadian-patients-with-acute-coronary-syndrome
#13
Inna Y Gong, Shaun G Goodman, David Brieger, Chris P Gale, Derek P Chew, Robert C Welsh, Thao Huynh, J Paul DeYoung, Carolyn Baer, Gabor T Gyenes, Jacob A Udell, Keith A A Fox, Andrew T Yan
BACKGROUND: Although there are sex differences in management and outcome of acute coronary syndromes (ACS), sex is not a component of Global Registry of Acute Coronary Events (GRACE) risk score (RS) for in-hospital mortality prediction. We sought to determine the prognostic utility of GRACE RS in men and women, and whether its predictive accuracy would be augmented through sex-based modification of its components. METHODS: Canadian men and women enrolled in GRACE and Canadian Registry of Acute Coronary Events were stratified as ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation ACS (NSTE-ACS)...
June 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#14
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28625240/-dynamic-changes-of-complement-level-in-patients-with-acute-coronary-syndrome-and-its-relationships-with-myocardial-injury
#15
Aihong Shao, Xin Qi, Qi Li, Wenjun Jia, Liping Wei, Wenguang Hou, Yanfang Qi, Yue Liu
OBJECTIVE: To study relationships between myocardial injury and the levels of serum complement C3, C4 and C5b-9 in patients with acute coronary syndrome (ACS). METHODS: A retrospectively analysis was conducted. 170 ACS patients [including 110 cases of ST-segment elevation myocardial infarction (STEMI) and 60 cases of non-ST-segment elevation acute coronary syndrome (NSTE-ACS)] with ischemic chest pain or chest discomfort onset within the prior 12 hours admitted to the cardiology department of Tianjin Union Medicine Center from January 2014 to July 2016 were enrolled...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28608310/platelet-inhibition-after-loading-dose-of-prasugrel-in-patients-with-st-elevation-and-non-st-elevation-acute-coronary-syndrome
#16
Shinichi Wakabayashi, Hideki Kitahara, Takeshi Nishi, Kazumasa Sugimoto, Takashi Nakayama, Yoshihide Fujimoto, Noritaka Ariyoshi, Yoshio Kobayashi
The PRASFIT-ACS study showed the antiplatelet effect 2-4 h after prasugrel loading. However, there is little information about the antiplatelet effect <2 h after prasugrel loading dose, especially in patients with acute coronary syndrome (ACS). There had not been any comparison between ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation ACS (NSTE-ACS). Fifty patients with ACS (15 with STEMI and 35 with NSTE-ACS) were enrolled. They received a 20-mg prasugrel loading dose followed by a maintenance dose of 3...
June 12, 2017: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/28606999/invasive-management-strategies-and-antithrombotic-treatments-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-in-china-findings-from-the-improving-ccc-project-care-for-cardiovascular-disease-in-china
#17
Qing Yang, Ying Wang, Jing Liu, Jun Liu, Yongchen Hao, Sidney C Smith, Yong Huo, Gregg C Fonarow, Changsheng Ma, Junbo Ge, Kathryn A Taubert, Louise Morgan, Yang Guo, Wei Wang, Yujie Zhou, Dong Zhao
BACKGROUND: Early invasive strategies and antithrombotic treatments are key treatments of non-ST-segment-elevation acute coronary syndrome (NSTE-ACS). Few studies have examined the use of these strategies in patients with NSTE-ACS in China. This study aimed to assess the applications of invasive strategies and antithrombotic treatments in patients with NSTE-ACS and compare their outcomes. METHODS AND RESULTS: A nationwide registry study, Improving CCC (Care for Cardiovascular Disease in China) ACS project, was launched in 2014 as a collaborative study of the American Heart Association and Chinese Society of Cardiology (CSC), with 142 participating hospitals reporting details of clinical management and outcomes of patients with NSTE-ACS...
June 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28605473/effects-of-statins-on-plaque-rupture-assessed-by-optical-coherence-tomography-in-patients-presenting-with-acute-coronary-syndromes-insights-from-the-optical-coherence-tomography-oct-formidable-registry
#18
Sebastiano Gili, Mario Iannaccone, Francesco Colombo, Antonio Montefusco, Nicolas Amabile, Simone Calcagno, Davide Capodanno, Giancarla Scalone, Andrea Rognoni, Pierluigi Omedè, Fabrizio Ugo, Erika Cavallo, Massimo Mancone, Andrea Mangiameli, Giacomo Boccuzzi, Joshua Hiansen, Pascal Motreff, Konstantinos Toutouzas, Roberto Garbo, Gennaro Sardella, Corrado Tamburino, Maurizio D'Amico, Claudio Moretti, Christian Templin, Fiorenzo Gaita, Geraud Souteyrand, Giampaolo Niccoli, Fabrizio D'Ascenzo
Aims: Chronic pre-treatment with statins may reduce mortality and morbidity in patients experiencing acute coronary syndromes (ACS), but mechanisms accounting for these findings are not completely understood. Methods and results: The optical coherence tomography (OCT)-Formidable registry retrospectively enrolled 285 consecutive patients with ACS undergoing OCT in 9 European centres. Mean age was 60.4 ± 12.8 years, 148 (51.9%) patients had hyperlipemia, 45 (15...
June 10, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28598510/relative-efficacy-and-safety-of-ticagelor-vs-clopidogrel-as-a-function-of-time-to-invasive-management-in-non-st-segment-elevation-acute-coronary-syndrome-in-the-plato-trial
#19
Charles V Pollack, Farideh Davoudi, Deborah B Diercks, Richard C Becker, Stefan K James, Soo Teik Lim, Phillip J Schulte, Jindrich Spinar, Philippe Gabriel Steg, Robert F Storey, Anders Himmelmann, Lars Wallentin, Christopher P Cannon
BACKGROUND: Guidelines suggest that "upstream" P2Y12 receptor antagonists should be considered in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS). HYPOTHESIS: Early use of ticagrelor in patients managed with an invasive strategy would be more effective than clopidogrel because of its more rapid onset of action and greater potency. METHODS: In the PLATO trial, 6792 NSTE-ACS patients were randomized to ticagrelor or clopidogrel (started prior to angiography) and underwent angiography within 72 hours of randomization...
June 9, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28595861/comparison-of-outcome-of-coronary-artery-bypass-grafting-versus-drug-eluting-stent-implantation-for-non-st-elevation-acute-coronary-syndrome
#20
RANDOMIZED CONTROLLED TRIAL
Mineok Chang, Cheol Whan Lee, Jung-Min Ahn, Rafael Cavalcante, Yohei Sotomi, Yoshinobu Onuma, Minkyu Han, Duk-Woo Park, Soo-Jin Kang, Seung-Whan Lee, Young-Hak Kim, Seong-Wook Park, Patrick W Serruys, Seung-Jung Park
There is limited data comparing effectiveness of coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) with drug-eluting stents in patients with non-ST-elevation acute coronary syndromes (NSTE-ACS). We compared the long-term outcomes of the 2 revascularization strategies in 1,246 patients presented with NSTE-ACS for left main or multivessel coronary artery disease. Data were pooled from the Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus-Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease (BEST) trial, the Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease (PRECOMBAT) trial, and the Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial...
August 1, 2017: American Journal of Cardiology
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