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acute coronary syndrome with normal coronary artery

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https://www.readbyqxmd.com/read/28626545/case-of-acute-st-segment-elevation-myocardial-infarction-in-infective-endocarditis-management-with-intra-coronary-stenting
#1
Ghulam Murtaza, Zia Ur Rahman, Puja Sitwala, Vatsal Ladia, Bhavesh Barad, Kais Albalbissi, Timir K Paul, Vijay Ramu
Embolic events from infective endocarditis can cause acute coronary syndrome. Mortality rate is high and optimal management might be different from those chosen in setting of classic atherosclerotic coronary artery disease. We present a case of 56-year-old male who had received 5 weeks of antibiotics for aortic valve endocarditis and developed acute ST segment elevation myocardial infarction in hospital settings. Interestingly, patient had recent left heart catheterization that was normal. This was recognized as embolic event from sterile vegetation...
June 7, 2017: Clinics and Practice
https://www.readbyqxmd.com/read/28606950/pathophysiology-of-takotsubo-syndrome
#2
REVIEW
Francesco Pelliccia, Juan Carlos Kaski, Filippo Crea, Paolo G Camici
Originally described by Japanese authors in the 1990s, Takotsubo syndrome (TTS) generally presents as an acute myocardial infarction characterized by severe left ventricular dysfunction. TTS, however, differs from an acute coronary syndrome because patients have generally a normal coronary angiogram and left ventricular dysfunction, which extends beyond the territory subtended by a single coronary artery and recovers within days or weeks. The prognosis was initially thought to be benign, but subsequent studies have demonstrated that both short-term mortality and long-term mortality are higher than previously recognized...
June 13, 2017: Circulation
https://www.readbyqxmd.com/read/28605143/enhanced-serum-levels-of-matrix-gla-protein-and-bone-morphogenetic-protein-in-acute-coronary-syndrome-patients
#3
Zafer Buyukterzi, Ummugulsum Can, Sertac Alpaydin, Asuman Guzelant, Sukru Karaarslan, Mehmet Mustu, Duygu Kocyigit, Kadri Murat Gurses
BACKGROUND: Vascular calcification has been found to be associated with increased risk of cardiovascular (CV) morbidity and mortality. Various bone-associated proteins have been suggested to be related with this process. In this study, we aimed to evaluate whether serum levels of bone morphogenic protein-4 (BMP-4) and matrix Gla protein (MGP) differed in patients who were found to have normal epicardial coronary arteries or a culprit lesion in the coronary angiography leading to acute coronary syndrome (ACS)...
June 12, 2017: Journal of Clinical Laboratory Analysis
https://www.readbyqxmd.com/read/28529306/normalization-of-diffuse-st-depression-with-avr-elevation-after-rehydration-in-a-patient-with-severe-aortic-stenosis
#4
Sachin R Patel, Vikas J Patel, Brittany Clark, George Rust
BACKGROUND Isolated ST elevation in lead aVR in combination with global ST depression with normalization after rehydration is a unique electrocardiographic pattern that is associated with a broad range of diagnoses. Its association with left main coronary artery disease and other acute coronary syndromes suggest the need for early and aggressive cardiac evaluation. CASE REPORT A 53-year-old man presented with altered mental status and loss of consciousness. He was unresponsive, hypotensive, tachycardiac, and diaphoretic...
May 22, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28515825/late-presentation-of-aortic-aneurysm-and-dissection-following-cardiac-catheterization
#5
Abimbola Shofu, G Mustafa Awan, Bassam Omar, Ghazanfar Qureshi
We report a 63-year-old female with hypertension, hyperlipidemia, and prior pacemaker insertion for atrial fibrillation with symptomatic bradycardia, who was admitted with substernal chest pressure and diaphoresis. Her electrocardiogram revealed atrial fibrillation with demand ventricular pacing and her cardiac biomarkers were negative for acute coronary syndrome. Echocardiogram revealed normal left ventricular systolic function and normal aortic root diameter. Coronary angiography revealed 60-70% obtuse marginal lesion, otherwise mild disease...
April 2017: Cardiology Research
https://www.readbyqxmd.com/read/28473221/cyp2c19-activity-and-cardiovascular-risk-factors-in-patients-with-an-acute-coronary-syndrome
#6
Efrén Martínez-Quintana, Fayna Rodríguez-González, José María Medina-Gil, Paloma Garay-Sánchez, Antonio Tugores
INTRODUCTION: CYP2C19 is a major isoform of cytochrome P450 that metabolizes a number of drugs and is involved in the glucocorticoids synthesis. CYP2C19 polymorphisms have been associated with the genetic risk for type 2 diabetes. METHODS: Five hundred and three patients with an acute coronary event were studied to assess the association between the CYP2C19 activity (CYP2C19*2, CYP2C19*3 and CYP2C19*17 variants) and the type of acute coronary syndrome, cardiovascular risk factors (arterial systemic hypertension, diabetes mellitus, dyslipidemia and smoking), analytical parameters and the extent and severity of coronary atherosclerosis...
May 1, 2017: Medicina Clínica
https://www.readbyqxmd.com/read/28464182/why-is-reverse-takotsubo-reverse
#7
Daniela Rosu, Sameh Askandar, Rami N Khouzam
OBJECTIVES: Takotsubo cardiomyopathy (TTC) is an acute cardiac syndrome simulating myocardial infarction that is characterized by transient wall motion abnormalities in the absence of coronary artery obstruction. Reverse TTC (rTTC) is a recently described variant of TTC. This review defines and compares both forms of TTC, stating their resemblances and differences. METHODS: We conducted a search of the MEDLINE database. Forty-one cases of rTTC met our eligibility criteria and were summarized in a synthesis of the demographic features, clinical characteristics, and laboratory studies...
May 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28403620/altered-mental-status-predicts-mortality-in-cardiogenic-shock-results-from-the-cardshock-study
#8
Anu Kataja, Tuukka Tarvasmäki, Johan Lassus, Lars Køber, Alessandro Sionis, Jindrich Spinar, John Parissis, Valentina Carubelli, Jose Cardoso, Marek Banaszewski, Rossella Marino, Markku S Nieminen, Alexandre Mebazaa, Veli-Pekka Harjola
BACKGROUND: Altered mental status is among the signs of hypoperfusion in cardiogenic shock, the most severe form of acute heart failure. The aim of this study was to investigate the prevalence of altered mental status, to identify factors associating with it, and to assess the prognostic significance of altered mental status in cardiogenic shock. METHODS: Mental status was assessed at presentation of shock in 215 adult cardiogenic shock patients in a multinational, prospective, observational study...
April 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28386054/acute-myocardial-infarction-due-to-coronary-artery-embolism-in-a-22-year-old-woman-with-mitral-stenosis-with-atrial-fibrillation-under-warfarinization-successful-management-with-anticoagulation
#9
Santosh Kumar Sinha, Mukesh Jitendra Jha, Mahmadula Razi, Vikash Chaturvedi, Yatish Besthenahalli Erappa, Shravan Singh, Vikas Mishra, Dibbendhu Khanra, Karandeep Singh
BACKGROUND Coronary artery embolization is an exceedingly rare cause of myocardial infarction, but a few cases in association with prosthetic mechanical valves have been reported. We report a case of embolic myocardial infarction caused by a thrombus in the left atrium with deranged coagulation profile in a patient with critical mitral stenosis under warfarinization. CASE REPORT A 22-year-old woman was taken to the catheterization lab for early coronary intervention in lieu of non-ST elevation myocardial infarction...
April 7, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28379039/elevated-serum-il-39-in-patients-with-st-segment-elevation-myocardial-infarction-was-related-with-left-ventricular-systolic-dysfunction
#10
Yu Luo, Feng Liu, Huadong Liu, Hongdan Chen, Wenfei Cheng, Shaohong Dong, Wei Xiong
AIM: To investigate the changes and significance of circulating IL-39 in patients with acute coronary syndrome (ACS). PATIENTS & METHODS: Serum IL-39 levels in ACS patients and normal coronary arteries were measured. The correlations of IL-39 with high-sensitivity CRP, cTnI, N-terminal of the prohormone brain natriuretic peptide (NTproBNP) and left ventricular ejection fraction were investigated. RESULTS: The serum levels of IL-39 in ACS patients were significantly increased...
April 5, 2017: Biomarkers in Medicine
https://www.readbyqxmd.com/read/28378733/-prognostic-factors-in-patients-with-non-st-segment-elevation-acute-coronary-syndrome-concurrent-with-type-2-diabetes-mellitus-according-to-the-results-of-the-registry
#11
A P Golikov, S A Berns, R I Stryuk, E A Shmidt, A A Golikova, O L Barbarash
AIM: To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). SUBJECTS AND METHODS: The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event...
2017: Terapevticheskiĭ Arkhiv
https://www.readbyqxmd.com/read/28378340/long-term-prognostic-value-of-peak-exercise-echocardiogram-in-patients-hospitalized-with-acute-chest-pain
#12
German Merchan Ortega, Juan Carlos Bonaque Gonzalez, Alejandro Dionisio Sanchez Espino, Maria Jose Aguado Martin, Francisco Navarro Garcia, Fuensanta Ruiz Lopez, Francisco Ramos Perales, Jose Luis Zamorano Gomez
INTRODUCTION: Peak exercise echocardiogram (EEcho) has shown reasonable sensitivity and specificity in detecting significant coronary artery disease (CAD). The objective was to evaluate the prognostic value of EEcho in patients hospitalized for acute chest pain (CP) and its additional prognostic information regarding exercise electrocardiogram test (EECG). METHODS: Prospective observational study performed between May 2011 and September 2013, including 250 patients consecutively admitted for acute CP with normal cardiac biomarkers and nondiagnostic electrocardiogram...
April 5, 2017: Echocardiography
https://www.readbyqxmd.com/read/28329022/annexin-a1-in-blood-mononuclear-cells-from-patients-with-coronary-artery-disease-its-association-with-inflammatory-status-and-glucocorticoid-sensitivity
#13
Ida Bergström, Anna K Lundberg, Simon Jönsson, Eva Särndahl, Jan Ernerudh, Lena Jonasson
Annexin A1 (AnxA1) is a key player in resolution of inflammation and a mediator of glucocorticoid actions. In atherosclerotic tissue, increased expression of AnxA1 has been associated with protective plaque-stabilizing effects. Here, we investigated the expression of AnxA1 in peripheral blood mononuclear cells (PBMCs) from patients with coronary artery disease (CAD). Blood was collected from 57 patients with stable CAD (SCAD) and 41 healthy controls. We also included a minor group (n = 10) with acute coronary syndrome (ACS)...
2017: PloS One
https://www.readbyqxmd.com/read/28325613/head-to-head-comparison-of-the-diagnostic-performance-of-coronary-computed-tomography-angiography-and-dobutamine-stress-echocardiography-in-the-evaluation-of-acute-chest-pain-with-normal-ecg-findings-and-negative-troponin-tests-a-prospective-multicenter-study
#14
Eric Durand, Fabrice Bauer, Nicolas Mansencal, Arshid Azarine, Benoit Diebold, Albert Hagege, Ludivine Perdrix, Martine Gilard, Yannick Jobic, Hélène Eltchaninoff, Mourad Bensalah, Benjamin Dubourg, Jérôme Caudron, Ralph Niarra, Gilles Chatellier, Jean-Nicolas Dacher, Elie Mousseaux
OBJECTIVE: To perform a head-to-head comparison of coronary CT angiography (CCTA) and dobutamine-stress echocardiography (DSE) in patients presenting recent chest pain when troponin and ECG are negative. METHODS: Two hundred seventeen patients with recent chest pain, normal ECG findings, and negative troponin were prospectively included in this multicenter study and were scheduled for CCTA and DSE. Invasive coronary angiography (ICA), was performed in patients when either DSE or CCTA was considered positive or when both were non-contributive or in case of recurrent chest pain during 6month follow-up...
August 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28321011/vehicle-dependent-effects-of-sphingosine-1-phosphate-on-plasminogen-activator-inhibitor-1-expression
#15
Chiharu Takahashi, Makoto Kurano, Masako Nishikawa, Kuniyuki Kano, Tomotaka Dohi, Katsumi Miyauchi, Hiroyuki Daida, Tomo Shimizu, Junken Aoki, Yutaka Yatomi
AIM: Sphingosine 1-phosphate (S1P) has been suggested to be a positive regulator of plasminogen activator inhibitor 1 (PAI-1) in adipocytes, while some studies are not consistent with this prothrombotic property of S1P. Since S1P is bound to apolipoprotein M (apoM) on HDL or to albumin in plasma, we compared the properties of these two forms on the PAI-1 induction. METHODS: We investigated the associations of S1P, apoM, and PAI-1 concentrations in the plasma of normal coronary artery (NCA), stable angina pectoris (SAP), and acute coronary syndrome (ACS) subjects (n=32, 71, and 38, respectively)...
March 17, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28298620/refractory-cardiogenic-shock-from-right-ventricular-infarction-successfully-managed-with-inhaled-epoprostenol
#16
Natalie Held, Nathaniel Little, Mori J Krantz, Brian L Stauffer
BACKGROUND Recognition and appropriate management of right ventricular (RV) infarction is essential, as RV injury increases mortality and substantially alters management during acute coronary syndrome. We report a case of RV infarction presenting with new right bundle branch block (RBBB), and therapeutic use of inhaled epoprostenol to reduce RV afterload and augment cardiac output during refractory cardiogenic shock. CASE REPORT A 53-year-old male presented to our institution in ventricular fibrillation with subsequent development of RBBB in the setting of proximal right coronary artery occlusion...
March 16, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28268083/epicardial-adipose-tissue-microbial-colonization-and-inflammasome-activation-in-acute-coronary-syndrome
#17
Daniela Pedicino, Anna Severino, Sara Ucci, Francesca Bugli, Davide Flego, Ada F Giglio, Francesco Trotta, Aureliano Ruggio, Claudia Lucci, Antonio Iaconelli, Francesco Paroni Sterbini, Luigi M Biasucci, Maurizio Sanguinetti, Franco Glieca, Nicola Luciani, Massimo Massetti, Filippo Crea, Giovanna Liuzzo
BACKGROUND: Epicardial adipose tissue (EAT) has a close functional and anatomic relationship with epicardial coronary arteries. Accumulating evidence suggests that host microbiome alterations may play a role in several inflammatory/immune disorders, triggering a robust proinflammatory response also involving interleukin-1β (IL-1β) and the NALP3 inflammasome. In the current study, we explore the hypothesis that in patients with non-ST elevation acute coronary syndrome (ACS), EAT contains potentially pro-atherosclerotic bacteria that might elicit inflammasome activation...
February 16, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28258851/longitudinal-2d-strain-can-help-diagnose-coronary-artery-disease-in-patients-with-suspected-non-st-elevation-acute-coronary-syndrome-but-apparent-normal-global-and-segmental-systolic-function
#18
Thibault Caspar, Hafida Samet, Mickaël Ohana, Philippe Germain, Soraya El Ghannudi, Samy Talha, Olivier Morel, Patrick Ohlmann
BACKGROUND: The clinical work-up of patients presenting with chest pain is a diagnostic challenge. We investigated the diagnostic performance of global (GLS) and territorial (TLS) longitudinal strain to predict coronary artery disease (CAD) in patients presenting with suspected non-ST-segment elevation acute coronary syndrome (NSTE-ACS) but apparent normal global and regional systolic function. METHODS: 150 consecutive suspected NSTE-ACS patients were initially screened for inclusion ; 58 patients with normal LVEF (≥55%) and WMSI (=1) were prospectively enrolled...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28246237/cardiac-outcomes-after-ischemic-stroke-or-transient-ischemic-attack-effects-of-pioglitazone-in-patients-with-insulin-resistance-without-diabetes-mellitus
#19
Lawrence H Young, Catherine M Viscoli, Jeptha P Curtis, Silvio E Inzucchi, Gregory G Schwartz, Anne M Lovejoy, Karen L Furie, Mark J Gorman, Robin Conwit, J Dawn Abbott, Daniel L Jacoby, Daniel M Kolansky, Steven E Pfau, Frederick S Ling, Walter N Kernan
BACKGROUND: Insulin resistance is highly prevalent among patients with atherosclerosis and is associated with an increased risk for myocardial infarction (MI) and stroke. The IRIS trial (Insulin Resistance Intervention after Stroke) demonstrated that pioglitazone decreased the composite risk for fatal or nonfatal stroke and MI in patients with insulin resistance without diabetes mellitus, after a recent ischemic stroke or transient ischemic attack. The type and severity of cardiac events in this population and the impact of pioglitazone on these events have not been described...
May 16, 2017: Circulation
https://www.readbyqxmd.com/read/28237549/il-37-increased-in-patients-with-acute-coronary-syndrome-and-associated-with-a-worse-clinical-outcome-after-st-segment-elevation-acute-myocardial-infarction
#20
Kun Liu, Qiang Tang, Xinyuan Zhu, Xinchun Yang
BACKGROUND: IL-37 emerges as a natural suppressor of inflammatory responses. The potential role of IL-37 in the pathology of atherosclerosis is unclear. The purpose of this study was to assess IL-37 profile in acute coronary syndrome (ACS) and the prognostic role of this cytokine in patients with ST-segment elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI). METHODS: In a case-control study, we prospectively enrolled 216 patients undergoing the first coronary angiography, which consisted of 5 groups: normal (n=57), stable angina (SAP, n=36), unstable angina (UAP, n=42), non-STEMI (n=36), STEMI (n=45)...
February 24, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
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