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https://www.readbyqxmd.com/read/28330794/radiation-exposure-and-vascular-access-in-acute-coronary-syndromes-the-radmatrix-trial
#1
Alessandro Sciahbasi, Enrico Frigoli, Alessandro Sarandrea, Martina Rothenbühler, Paolo Calabrò, Alessandro Lupi, Francesco Tomassini, Bernardo Cortese, Stefano Rigattieri, Enrico Cerrato, Dennis Zavalloni, Antonio Zingarelli, Paolo Calabria, Paolo Rubartelli, Gennaro Sardella, Matteo Tebaldi, Stephan Windecker, Peter Jüni, Dik Heg, Marco Valgimigli
BACKGROUND: It remains unclear whether radial increases the risk of operator or patient radiation exposure when performed by expert operators OBJECTIVES: To determine whether radial access increases radiation exposure METHODS: We randomly assigned 8404 patients, with or without ST-segment elevation acute coronary syndrome, to radial or femoral access for coronary angiography and percutaneous intervention, and collected fluoroscopy time and dose area product (DAP). In the radiation sub-study (RAD-MATRIX), we anticipated that 13 or more operators, each wearing a thorax (primary endpoint), wrist and head (secondary endpoints) lithium fluoride thermo luminescent dosimeter and randomizing at least 13 patients per access site were needed to establish non-inferiority of radial versus femoral access...
March 15, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#2
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329196/diabetic-patients-with-acute-coronary-syndromes-in-contemporary-european-registries-characteristics-and-outcomes
#3
Maddalena Lettino, Pontus Andell, Uwe Zeymer, Petr Widimsky, Nicolas Danchin, Alfredo Bardaji, Jose A Barrabes, Angel Cequier, Marc J Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M Koul, Gilles Lemesle, Thomas F Lüscher, Christian M Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez Sendón, Petr Tousek, Franz Weidinger, Clive F M Weston, Azfar Zaman, Jin Li, J Wouter Jukema
Aims: Among patients with acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at particularly high risk of recurrent cardiovascular events and premature death. We aimed to provide a descriptive overview of unadjusted analyses of patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in contemporary registries in Europe. Methods and results: A total of 10 registries provided data in a systematic manner on ACS patients with DM (total n =28 899), and without DM (total n= 97 505)...
March 10, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28329036/predictive-value-of-plaque-morphology-assessed-by-frequency-domain-optical-coherence-tomography-for-impaired-microvascular-perfusion-after-elective-stent-implantation-the-intracoronary-electrocardiogram-study
#4
Hiroki Ikenaga, Satoshi Kurisu, Tsukasa Nakao, Shingo Kono, Yoji Sumimoto, Noriaki Watanabe, Takashi Shimonaga, Tadanao Higaki, Toshitaka Iwasaki, Naoya Mitsuba, Ken Ishibashi, Yoshihiro Dohi, Yukihiro Fukuda, Yasuki Kihara
Aims: This study was undertaken to assess the association between plaque features at culprit lesions assessed by frequency-domain optical coherence tomography (FD-OCT) and impaired microvascular perfusion estimated by intracoronary electrocardiogram (IcECG) after elective percutaneous coronary intervention (PCI). Furthermore, we investigated whether IcECG could predict future cardiac events. Methods and results: This study consisted of 84 patients who underwent both FD-OCT and IcECG during PCI...
March 7, 2017: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/28326201/hyperkalemia-induced-brugada-phenocopy-a-rare-ecg-manifestation
#5
Muhammad Ameen, Ghulam Akbar, Naeem Abbas, Ghazi Mirrani
Brugada syndrome (BrS) is an inherited disorder of cardiac ion channels characterized by peculiar ECG findings predisposing individuals to ventricular arrhythmias, syncope, and sudden cardiac death (SCD). Various electrolyte disturbances and ion channels blocking drugs could also provoke BrS ECG findings without genetic BrS. Clinical differentiation and recognition are essential for guiding the legitimate action. Hyperkalemia is well known to cause a wide variety of ECG manifestations. Severe hyperkalemia can even cause life threatening ventricular arrhythmias and cardiac conduction abnormalities...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#6
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28325070/methotrexate-therapy-in-st-segment-elevation-myocardial-infarctions
#7
Daniel Medeiros Moreira, Maria Emilia Lueneberg, Roberto Leo da Silva, Tammuz Fattah, Carlos Antonio Mascia Gottschall
PURPOSE: Methotrexate is an anti-inflammatory drug that has been shown to have anti-ischemic effects. Our aim was to evaluate if methotrexate could reduce infarct size in patients with ST-segment elevation myocardial infarction (STEMI). METHODS: We randomly assigned patients with STEMI to receive either methotrexate or placebo. Primary outcome was infarct size determined by calculating the area under the curve (AUC) for creatine kinase (CK) release. Secondary outcomes were AUC of CK MB (CK-MB) and AUC of troponin I; peak CK, peak CK-MB, and troponin I; B-type natriuretic peptide (BNP) level, high-sensitivity C-reactive protein (hsCRP) result, and erythrocyte sedimentation rate (ESR); left ventricular ejection fraction (LVEF); thrombolysis in myocardial infarction (TIMI) frame count; Killip score; mortality and reinfarction incidence; and incidence of adverse reactions...
January 1, 2017: Journal of Cardiovascular Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28321340/right-ventricular-compression-mimicking-brugada-like-electrocardiogram-in-a-patient-with-recurrent-pectus-excavatum
#8
Jinhee Ahn, Jong-Il Choi, Jaemin Shim, Sung Ho Lee, Young-Hoon Kim
Pectus excavatum (PE), the most common skeletal anomaly of chest wall, sometimes requires a surgical correction but recurrent PE is not uncommon. PE usually has a benign course; however, this chest deformity may be associated with symptomatic tachyarrhythmias due to mechanical compression. We report a case of a patient with recurrent PE after surgical correction presenting with palpitation and electrocardiogram (ECG) showing ST-segment elevation on the right precordial leads, which could be mistaken for a Brugada syndrome (BrS)...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28321022/administration-of-ticagrelor-and-double-dose-clopidogrel-based-on-platelet-reactivity-determined-by-verifynow-p2y12-for-chinese-subjects-after-elective-pci
#9
Xi Wu, Gang Liu, Jie Lu, Xin-Xin Zheng, Jin-Gang Cui, Xue-Yan Zhao, Xiao-Hong Huang
Previous studies have identified high on treatment platelet reactivity (HTPR) as a potent factor predicting ischemic events for patients with coronary heart disease. We assessed the efficacy and safety of ticagrelor (90 mg twice-daily) and double-dose of clopidogrel (150 mg once-daily) among Chinese patients for elective percutaneous coronary intervention. We enrolled 40 patients with HTPR from among 317 patients with non-ST-segment elevation acute coronary syndromes after a successful elective percutaneous coronary intervention (PCI)...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28321019/myocardial-infarction-in-a-young-man-with-nephrotic-syndrome
#10
Zhenliang Chu, Hang Zhu, Bin Zhang, Liqin Jiang
A 26-year-old man diagnosed with nephrotic syndrome (NS) 2 years previously presented with chest pain. An electrocardiogram (ECG) performed at a local hospital showed ST-elevation in chest leads. Cardiac troponin-I was significantly positive. Echocardiography revealed mild regional wall-motion abnormalities in the heart apex. Seven days later, angiography (CAG) revealed a thrombus in the left anterior descending branch (LAD). Tirofiban was injected into the LAD for thromboclasis. ECG after CAG showed the ST-segment was much lower than before...
March 17, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320751/sex-and-outcomes-after-percutaneous-coronary-intervention-a-cause-for-concern-for-young-women-and-those-with-st-segment-elevation-myocardial-infarction
#11
EDITORIAL
Jacqueline E Tamis-Holland
No abstract text is available yet for this article.
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28320707/total-center-percutaneous-coronary-intervention-volume-and-30-day-mortality-a-contemporary-national-cohort-study-of-427%C3%A2-467-elective-urgent-and-emergency-cases
#12
Darragh O'Neill, Owen Nicholas, Chris P Gale, Peter Ludman, Mark A de Belder, Adam Timmis, Keith A A Fox, Iain A Simpson, Simon Redwood, Simon G Ray
BACKGROUND: The relationship between procedural volume and prognosis after percutaneous coronary intervention (PCI) remains uncertain, with some studies finding in favor of an inverse association and some against. This UK study provides a contemporary reassessment in one of the few countries in the world with a nationally representative PCI registry. METHODS AND RESULTS: A nationwide cohort study was performed using the national British Cardiovascular Intervention Society registry...
March 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28319321/unrecognized-coronary-vasospasm-in-patients-referred-for-percutaneous-coronary-intervention-intracoronary-nitroglycerin-the-forgotten-stepchild-of-cardiovascular-guidelines
#13
Alec Vishnevsky, Howard M Julien, David L Fischman, Paul Walinsky, J David Ogilby, Nicholas J Ruggiero, Babu Jasti, Michael P Savage
OBJECTIVE: The goal of this study was to demonstrate the importance of intracoronary nitroglycerin (IC NTG) administration during diagnostic coronary angiography and prior to percutaneous coronary intervention (PCI). BACKGROUND: PCI has been a mainstay treatment for patients with symptomatic coronary artery disease. While current guidelines emphasize the importance of periprocedural antithrombotic medications, they fail to mention the use of nitroglycerin prior to PCI...
March 20, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28318811/st-elevation-myocardial-infarction-after-penetrating-thoracic-trauma
#14
Kiran Faryar, Michael P Flaherty, Martin Huecker
BACKGROUND: ST-segment elevation myocardial infarction (STEMI) may complicate penetrating thoracic trauma. CASE REPORT: This report describes a 42-year-old man who sustained a self-inflicted gunshot wound to the left chest. Electrocardiogram showed ST elevation in the inferior leads. Emergent catheterization was not recommended and conservative management was initiated. Cardiac catheterization 4 days later showed no perturbation of the coronary arteries, neither atherosclerotic nor traumatic...
March 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28318509/chest-pain-and-st-segment-elevation-in-an-18-year-old-man
#15
Mazen M Kawji, David Luke Glancy
An 18-year-old man came to the hospital because of 1 day of chest pain typical of pericarditis. He had had an upper respiratory infection 10 days earlier. His electrocardiograms indicated evolving pericarditis. His echocardiogram showed mild, diffuse left ventricular hypokinesia, and his troponin I level peaked at 47.5 ng/ml. Thus, he had myopericarditis.
February 28, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28317428/fractional-flow-reserve-guided-multivessel-angioplasty-in-myocardial-infarction
#16
Pieter C Smits, Mohamed Abdel-Wahab, Franz-Josef Neumann, Bianca M Boxma-de Klerk, Ketil Lunde, Carl E Schotborgh, Zsolt Piroth, David Horak, Adrian Wlodarczak, Paul J Ong, Rainer Hambrecht, Oskar Angerås, Gert Richardt, Elmir Omerovic
Background In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial. Methods We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients)...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28314876/effect-of-remote-ischemic-postconditioning-during-thrombolysis-in-stemi
#17
S Ghaffari, L Pourafkari, S Manzouri, N D Nader
BACKGROUND: Remote ischemic postconditioning (RIPC) is suggested to protect the myocardium against ischemia in various settings. However, the effect of RIPC in patients with acute ST-elevation myocardial infarction (STEMI) who undergo thrombolysis has yet to be examined. PATIENTS AND METHODS: In this single-center, randomized controlled trial, we examined the effect of RIPC on the resolution of ST-segment elevation (STR) in response to thrombolysis. Patients in the RIPC group had three cycles of 5‑min cuff inflation followed by 5‑min deflation to the upper arm...
March 17, 2017: Herz
https://www.readbyqxmd.com/read/28314798/insulin-like-growth-factor-binding-protein-4-fragments-provide-incremental-prognostic-information-on-cardiovascular-events-in-patients-with-st-segment-elevation-myocardial-infarction
#18
Rikke Hjortebjerg, Søren Lindberg, Sune Pedersen, Rasmus Mogelvang, Jan S Jensen, Claus Oxvig, Jan Frystyk, Mette Bjerre
BACKGROUND: Fragments of insulin-like growth factor binding protein 4 (IGFBP-4) are potential new biomarkers for cardiac risk assessment. The fragments are generated on specific cleavage by pregnancy-associated plasma protein-A, which exerts proatherogenic activity. This study investigated the prognostic value of IGFBP-4 fragments in patients with ST-segment elevation myocardial infarction. METHODS AND RESULTS: We prospectively included 656 patients with ST-segment elevation myocardial infarction treated with percutaneous coronary intervention from September 2006 to December 2008...
March 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#19
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28306587/comparison-of-the-american-college-of-cardiology-american-heart-association-and-the-european-society-of-cardiology-guidelines-for-the-management-of-patients-with-non-st-segment-elevation-acute-coronary-syndromes
#20
Aya J Alame, Aris Karatasakis, Judit Karacsonyi, Barbara A Danek, Erica Resendes, Jose R Martinez Parachini, Pratik Kalsaria, Michele Roesle, Bavana V Rangan, Paul Sorajja, Hani Jneid, Subhash Banerjee, Emmanouil S Brilakis
INTRODUCTION: The American College of Cardiology (ACC), the American Heart Association (AHA), and the European Society of Cardiology (ESC) have been developing guidelines to assist clinicians in making evidence-based decisions. MATERIALS AND METHODS: The current ACC/AHA and ESC guidelines for non-ST-segment elevation acute coronary syndromes (NSTE-ACS) that were updated in 2014 and 2015, respectively, were compared to assess the number of recommendations on the basis of class of recommendation and level of evidence (LOE), the sources cited, and the content...
March 16, 2017: Coronary Artery Disease
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