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https://www.readbyqxmd.com/read/29353233/cardiovascular-safety-long-term-noncardiovascular-safety-and-efficacy-of-sodium-glucose-cotransporter-2-inhibitors-in-patients-with-type-2-diabetes-mellitus-a-systemic-review-and-meta-analysis-with-trial-sequential-analysis
#1
REVIEW
Xin-Lin Zhang, Qing-Qing Zhu, Yu-Han Chen, Xue-Ling Li, Fu Chen, Jian-An Huang, Biao Xu
BACKGROUND: The cardiovascular and long-term noncardiovascular safety and efficacy of SGLT2 (sodium-glucose cotransporter 2) inhibitors have not been well documented. METHODS AND RESULTS: For cardiovascular outcomes, we performed a meta-analysis with trial sequential analysis of randomized controlled trials and adjusted observational studies, each with a minimum of 26 weeks and 2000 patient-years of follow-up. For long-term noncardiovascular safety and efficacy outcome analyses, we included only randomized controlled trials with at least 2 years and 1000 patient-years of follow-up...
January 20, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29352691/adopting-an-early-invasive-strategy-for-non-st-elevation-myocardial-infarction-analysis-of-the-portuguese-registry-on-acute-coronary-syndromes
#2
Gonçalo Morgado, Hélder Pereira, Daniel Caldeira
INTRODUCTION: In patients with non-ST-elevation myocardial infarction (NSTEMI), the best timing for coronary angiography is not definitely established, although it is recognized that in high-risk patients it should be performed within the first 24 hours. The aim of this work was to describe the evolution over time of the use of an invasive strategy in the treatment of NSTEMI and in-hospital mortality. METHODS: We performed a retrospective analysis of patients admitted with NSTEMI included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between 2002 and 2015...
January 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29352061/what-to-do-about-fibrin-rich-tough-clots-comparing-the-solitaire-stent-retriever-with-a-novel-geometric-clot-extractor-in-an-in-vitro-stroke-model
#3
Vernard S Fennell, Swetadri Vasan Setlur Nagesh, Karen M Meess, Liza Gutierrez, Rhys H James, Michael E Springer, Adnan H Siddiqui
BACKGROUND: Despite advances in revascularization tools for large vessel occlusion presenting as acute ischemic stroke, a significant subset of clots remain recalcitrant to current strategies. We assessed the effectiveness of a novel thrombectomy device that was specifically designed to retrieve resistant fibrin rich clots, the geometric clot extractor (GCE; Neuravi, Galway, Ireland), in an in vitro cerebrovascular occlusion stroke model. METHODS: After introducing fibrin rich clot analogues into the middle cerebral artery of the model, we compared the rates of recanalization between GCE and Solitaire flow restoration stent retriever (SR; Medtronic, Minneapolis, Minnesota, USA; control group) cases...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29352054/increased-blood-brain-barrier-permeability-in-contralateral-hemisphere-predicts-worse-outcome-in-acute-ischemic-stroke-after-reperfusion-therapy
#4
Chang Liu, Shenqiang Yan, Ruiting Zhang, Zhicai Chen, Feina Shi, Ying Zhou, Meixia Zhang, Min Lou
AIMS: We sought to investigate the risk factors of blood-brain barrier (BBB) disruption, and its potential impact on 90-day clinical outcome in acute ischemic stroke (AIS) patients after reperfusion therapy. METHODS: Consecutive acute anterior circulation AIS patients imaged with computed tomographic perfusion (CTP) before reperfusion therapy were included. Tmax >6 s was used for the volumetric measurement of the hypoperfusion area. BBB permeability (BBBP) was calculated as the average relative permeability-surface area product (rPS) within the hypoperfusion region (rPShypo-i) and its contralateral mirror region (rPShypo-c) on CTP-derived PS color maps...
January 19, 2018: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/29351744/risk-factors-for-first-time-acute-myocardial-infarction-patients-in-trinidad
#5
M Bahall, T Seemungal, G Legall
BACKGROUND: The relative importance of coronary artery disease (CAD) risk varies globally. The aim of this study was to determine CAD risk factors for acute myocardial infarction (AMI) among patients in public health care institutions in Trinidad using a case-control type study design. METHODS: The sample comprised 251 AMI patients hospitalized between March 1, 2011 and April 30, 2012 and 464 age- and sex-matched non-AMI patients with no terminal or life-threatening illness and who did not undergo treatment for CAD...
January 19, 2018: BMC Public Health
https://www.readbyqxmd.com/read/29351624/takotsubo-cardiomyopathy-associated-with-work-place-bullying
#6
Halla Malik, Nadarajah Kangaharan, Ian Agahari
Background: Takotsubo cardiomyopathy (TC) is a condition of transient left ventricular dysfunction precipitated by acute physical or emotional stress. The pathogenesis of TC is not well understood, but it is known to predominantly affect postmenopausal women in the context of physical or emotional triggers. Aims: To describe a case of TC with an association to a never previously described work place stressor of bullying. Case Report: A 48-year-old female lawyer developed acute chest pain after experiencing significant emotional distress at a workplace meeting...
January 17, 2018: Occupational Medicine
https://www.readbyqxmd.com/read/29351557/effects-of-night-time-and-weekend-admissions-on-in-hospital-mortality-in-acute-myocardial-infarction-patients-in-japan
#7
Seiko Mizuno, Susumu Kunisawa, Noriko Sasaki, Kiyohide Fushimi, Yuichi Imanaka
BACKGROUND: Patients admitted to hospital during off-hours may experience poorer quality of care and clinical outcomes. However, few studies have examined the variations in clinical processes and outcomes across admission times and days of the week in acute myocardial infarction (AMI) patients. This study aimed to comparatively analyze the effect of weekend and weekday admissions stratified by admission time on in-hospital mortality in AMI patients. METHODS AND RESULTS: Using a large nationwide administrative database, we analyzed 103,908 AMI patients admitted to 639 Japanese acute care hospitals between April 2011 and March 2015...
2018: PloS One
https://www.readbyqxmd.com/read/29350803/thrombectomy-outcomes-for-acute-stroke-patients-with-anterior-circulation-tandem-lesions-a-clinical-registry-and-an-update-of-systematic-review-with-meta-analysis
#8
Udi Sadeh-Gonik, Noam Tau, Tal Friehmann, Serge Bracard, René Anxionnat, Anne-Laure Derelle, Romain Tonnelet, Liang Lia, Sébastien Richard, Xavier Armoiry, Benjamin Gory
BACKGROUND AND PURPOSE: Although mechanical thrombectomy (MT) appears to be superior in stroke patients with extracranial carotid disease (ECD) compared to thrombolysis alone, the impact of emergent carotid stenting during MT remains unclear. We assessed the MT outcomes in anterior stroke patients with ECD, especially when combined with carotid stenting. METHODS: We performed a retrospective analysis of our registry and conducted an update of a systematic review and meta-analysis of MT studies with or without stenting for anterior circulation stroke with ECD published between November 2010 and April 2017...
January 19, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29350392/diagnostic-and-prognostic-micro-rnas-in-ischemic-stroke-due-to-carotid-artery-stenosis-and-in-acute-coronary-syndrome-the-4-year-prospective-study
#9
Jacek Gacoń, Rafał Badacz, Ewa Stępień, Izabela Karch, Francisco J Enguita, Krzysztof Żmudka, Tadeusz Przewłocki, Anna Kabłak-Ziembicka
BACKGROUND: Circulating microRNAs (miRs) levels are potentially important diagnostic and prognostic biomarkers in acute coronary syndrome (ACS) or cerebral ischemic event (CIE) resulting from internal carotid artery stenosis (ICAS). AIM: This 4-year prospective study aimed to compare the levels of circulating miRs in ACS vs CIE patients, and investigate miRs potentially associated with risk of recurrent cardiovascular event. METHODS: The circulating miRs levels (miR-1-3p, miR-16-5p, miR-34a-5p, mir-122-5p, miR-124-3p, miR-133a-3p, miR-133b, miR-134-5p, miR-208b-3p, miR-375 and miR-499-5p) were compared in 43 (34M, 57...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350388/chronic-statin-treatment-is-a-predictor-of-pre-interventional-infarct-related-artery-patency-in-patients-with-st-elevation-myocardial-infarction-treated-with-percutaneous-coronary-intervention
#10
Süleyman Özbiçer, Mustafa Gür, Gülhan Kalkan, Betül Özaltun, Murat Çaylı
BACKGROUND: Beyond lipid-lowering effects, early statin treatment has beneficial effects on prognosis after acute coronary syndrome. Infarct related artery patency before percutaneous coronary intervention is known to be a strong predictor of improved clinical outcome. AIM: We aimed to investigate the effects of chronic statin treatment before admission on the infarct related artery patency after infarction. METHODS: In this study, 938 ST elevation myocardial infarction patients admitted to the hospital within the first 12 hours of symptom onset were prospectively enrolled (682 male, 256 female; mean age 58...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350382/risk-factors-for-adverse-outcomes-of-acute-coronary-syndrome-patients-single-center-experience-in-long-term-follow-up-of-treated-patients
#11
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: For patients experiencing an acute coronary syndrome (ACS), a crucial time to assess their prognosis and future management is at discharge from hospital. AIM: To identify patients' risk factors of mortality during post-discharge period following an ACS hospitalization. METHODS: We studied 672 consecutive ACS patients hospitalized and discharged alive between 2002 and 2004. The analysis was done in respect of the type of ACS, i...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomized-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#12
Stefan Grajek, Michał Michlak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: To compare the impact of bivalirudin- and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: Total of 18 randomised clinical trials involving 41752 subjects were included. The endpoints comprised: net adverse clinical event (NACE: death, myocardial infarction [MI], unscheduled revascularisation, major bleeding [MB]), major adverse cardiovascular event (MACE: death, MI or stroke), acute/subacute stent thrombosis (ST)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350253/direct-transfer-of-stemi-patients-to-cardiac-catheterization-laboratory-prognostic-relevance-for-in-hospital-mortality
#13
M Ali, S A Lange, T Wittlinger, G Lehnert, S Behrend, B Ziadeh, K Ali, S Sakellaropoulos, G Ganchev, A G Rigopoulos, M Noutsias
BACKGROUND: Although the incidence of acute myocardial infarction and in-hospital mortality after ST-elevation myocardial infarction (STEMI) has declined substantially in countries that have established primary percutaneous coronary interventions (pPCI) over the past two decades, coronary artery disease remains a major cause of morbidity and mortality worldwide. We aimed to examine whether the direct transfer of STEMI patients to the cardiac catheterization laboratory (CCL) had a prognostic effect on in-hospital mortality in patients who underwent pPCI after STEMI...
January 19, 2018: Herz
https://www.readbyqxmd.com/read/29350061/the-adverse-effects-of-environmental-noise-exposure-on-oxidative-stress-and-cardiovascular-risk
#14
Thomas Münzel, Mette Sørensen, Frank P Schmidt, Erwin Schmidt, Sebastian Steven, Swenja Kröller-Schön, Andreas Daiber
Epidemiological studies have provided evidence that traffic noise exposure is linked to cardiovascular diseases such as arterial hypertension, myocardial infarction and stroke. Noise is a non-specific stressor that activates the autonomous nervous system and endocrine signaling. According to the noise reaction model introduced by Babisch and colleagues, chronic low levels of noise can cause so called non-auditory effects, such as disturbances of activity, sleep and communication, which can trigger a number of emotional responses, including annoyance and subsequent stress...
January 19, 2018: Antioxidants & Redox Signaling
https://www.readbyqxmd.com/read/29349645/the-incidence-and-the-prognostic-impact-of-acute-kidney-injury-in-acute-myocardial-infarction-patients-current-preventive-strategies
#15
Evangelos Kaltsas, George Chalikias, Dimitrios Tziakas
Acute kidney injury (AKI) is one of the most common complications during hospitalization in various clinical settings. The goal of this review was to assess the incidence of AKI in acute myocardial infarction patients (AMI), how this incidence is affected by the diverse definitions, and if there is variability in the reported rates over recent years. Additionally, we sought to appraise the impact of AKI on short- and long-term prognosis of these patients. Finally, we report on the current preventive measures as they are suggested in the current guidelines of various societies, we comment on the evidence that support them, and we review the literature for other proposed therapeutic strategies, which either failed to prove their efficacy or they are not adequately confirmed yet...
January 19, 2018: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/29349392/ovarian-hyperstimulation-syndrome-as-a-rare-cause-of-acute-bilateral-limb-and-renal-ischemia
#16
Anita Quintas, Maria Emilia Ferreira, Frederico Bastos Gonçalves, José Aragão de Morais, Joao Albuquerque E Castro, Luís Mota Capitao
Ovarian hyperstimulation syndrome (OHS) is a rare and potentially fatal condition, particularly when it is associated with arterial thromboembolic events. We present a case of acute ischemia of both lower limbs and left kidney due to OHS. The clinical presentation included voluminous ascites, pleural effusion, and significant ovarian enlargement. Subsequently, bilateral severe acute limb ischemia and left kidney segmental infarction were established. Surgical thromboembolectomy and muscle débridement of the lower limbs were necessary, and the patient recovered with partial limitations...
June 2017: Journal of Vascular Surgery Cases and Innovative Techniques
https://www.readbyqxmd.com/read/29348441/sdf1-gradient-associates-with-the-distribution-of-c-kit-cardiac-cells-in-the-heart
#17
Outi Renko, Anna-Maria Tolonen, Jaana Rysä, Johanna Magga, Erja Mustonen, Heikki Ruskoaho, Raisa Serpi
Identification of the adult cardiac stem cells (CSCs) has offered new therapeutic possibilities for treating ischemic myocardium. CSCs positive for the cell surface antigen c-Kit are known as the primary source for cardiac regeneration. Accumulating evidence shows that chemokines play important roles in stem cell homing. Here we investigated molecular targets to be utilized in modulating the mobility of endogenous CSCs. In a four week follow-up after experimental acute myocardial infarction (AMI) with ligation of the left anterior descending (LAD) coronary artery of Sprague-Dawley rats c-Kit+ CSCs redistributed in the heart...
January 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29348285/vancomycin-induced-coronary-artery-spasm-a-case-of-kounis-syndrome
#18
Eric Martinez, Sonu Sahni, Muhammad Ai Cheema, Asma Iftikhar
Kounis syndrome defined as the appearance of acute coronary syndrome in the context of an allergic reaction is a relatively rare phenomenon. There are three variants of this syndrome in which the patient presents with symptoms of an acute chest. Herein, we describe a case of an 83-year-old woman who demonstrated type I variant of Kounis syndrome in response to vancomycin administration. After initialisation of vancomycin, she became unresponsive and an ECG demonstrated ST changes consistent with inferior-lateral myocardial infarction...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29348018/myocardial-inflammation-predicts-remodeling-and-neuroinflammation-after-myocardial-infarction
#19
James T Thackeray, Henri C Hupe, Yong Wang, Jens P Bankstahl, Georg Berding, Tobias L Ross, Johann Bauersachs, Kai C Wollert, Frank M Bengel
BACKGROUND: The local inflammatory tissue response after acute myocardial infarction (MI) determines subsequent healing. Systemic interaction may induce neuroinflammation as a precursor to neurodegeneration. OBJECTIVES: This study sought to assess the influence of MI on cardiac and brain inflammation using noninvasive positron emission tomography (PET) of the heart-brain axis. METHODS: After coronary artery ligation or sham surgery, mice (n = 49) underwent serial whole-body PET imaging of the mitochondrial translocator protein (TSPO) as a marker of activated macrophages and microglia...
January 23, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29348013/dose-dependent-cardioprotection-of-moderate-32%C3%A2-c-versus-mild-35%C3%A2-c-therapeutic-hypothermia-in-porcine-acute%C3%A2-myocardial-infarction
#20
Rajesh Dash, Yoshiaki Mitsutake, Wook Bum Pyun, Fady Dawoud, Jennifer Lyons, Atsushi Tachibana, Kazuyuki Yahagi, Yuka Matsuura, Frank D Kolodgie, Renu Virmani, Michael V McConnell, Uday Illindala, Fumiaki Ikeno, Alan Yeung
OBJECTIVES: The study investigated whether a dose response exists between myocardial salvage and the depth of therapeutic hypothermia. BACKGROUND: Cardiac protection from mild hypothermia during acute myocardial infarction (AMI) has yielded equivocal clinical trial results. Rapid, deeper hypothermia may improve myocardial salvage. METHODS: Swine (n = 24) undergoing AMI were assigned to 3 reperfusion groups: normothermia (38°C) and mild (35°C) and moderate (32°C) hypothermia...
January 22, 2018: JACC. Cardiovascular Interventions
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