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acute coronary syndrome with normal coronary artery

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https://www.readbyqxmd.com/read/28805949/the-reversible-p2y12-antagonist-act-246475-causes-significantly-less-blood-loss-than-ticagrelor-at-equivalent-antithrombotic-efficacy-in-rat
#1
Markus Rey, Markus Kramberg, Patrick Hess, Keith Morrison, Roland Ernst, Franck Haag, Edgar Weber, Martine Clozel, Martine Baumann, Eva Caroff, Francis Hubler, Markus A Riederer, Beat Steiner
The P2Y12 receptor is a validated target for prevention of major adverse cardiovascular events in patients with acute coronary syndrome. The aim of this study was to compare two direct-acting, reversible P2Y12 antagonists, ACT-246475 and ticagrelor, in a rat thrombosis model by simultaneous quantification of their antithrombotic efficacy and surgery-induced blood loss. Blood flow velocity was assessed in the carotid artery after FeCl3 -induced thrombus formation using a Doppler flow probe. At the same time, blood loss after surgical wounding of the spleen was quantified...
October 2017: Pharmacology Research & Perspectives
https://www.readbyqxmd.com/read/28795637/do-angptl-4-and-galectin-3-reflect-the-severity-of-coronary-artery-disease
#2
Luxitaa Goenka, Melvin George, Vishakha Singh, Amrita Jena, Deepika Seshadri, Vasanth Karunakaran, Dhandapani Vellala Elumalai, Jamuna Rani, Ilango Kaliappan
BACKGROUND: Coronary artery disease (CAD) is one of the leading causes of mortality and morbidity worldwide. We thereby sought to investigate whether the biomarkers, angiopoietin-like 4 (ANGPTL-4) and galectin-3, reflect the severity of CAD. METHODS: Patients were screened based on inclusion/exclusion criteria and written informed consent was obtained from the patients. Serum ANGPTL-4 and galectin-3 was quantified using enzyme-linked immunosorbent assay (ELISA) and correlated with the Global Registry of Acute Coronary Events (GRACE) and GENSINI score using Spearman's rank correlation coefficient and multivariate analysis...
August 1, 2017: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/28780762/valve-sparing-aortic-root-replacement-for-extremely-localized-circumferential-aortic-dissection-associated-with-intimo-intimal-intussusception
#3
Yujiro Ito, Yoshitsugu Nakamura, Miho Kuroda, Yuki Endo, Yusuke Nakanishi, Takaki Hori
Circumferential dissection is a rare clinical condition of aortic dissection, which is also known as intimo-intimal intussusception. In patients with type A aortic dissection with intimo-intimal intussusception, disruption and prolapse of the intimal flap into the left ventricle may occur and cause severe aortic regurgitation or blockage of the coronary artery ostium. A 43-year-old man presented with sudden dyspnea. Echocardiography revealed severe aortic insufficiency. Acute coronary syndrome was also suspected, but coronary angiography showed normal coronary arteries...
August 5, 2017: General Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28764226/cisplatin-induced-acute-myocardial-infarction-and-dyslipidemia
#4
Lalith Prabhakar Hanchate, Shimpa Rakesh Sharma, Sadhana Madyalkar
Myocardial infarction commonly occurs due to rupture of atherosclerotic plaque in the coronary arteries and is manifested on coronary angiography. Myocardial infarction with angiographically normal coronary arteries can occur due to hypercoagulable state, coronary spasm, embolism, arteritis, congenital condition and drugs. Illicit drugs such as cocaine, amphetamines and marijuana are known to cause myocardial infarction. Of the many medications that are associated with cardiovascular toxicity, chemotherapeutic agents form a large group with both acute and delayed cardiotoxicity...
June 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28756888/-can-tako-tsubo-syndrome-be-integrated-into-post-pneumonectomy-syndrome
#5
S Rabiou, H Siradjidine, G Fofana, I Issoufou, M Lakranbi, A Elbouazzaoui, M Serraj, Y Ouadnouni, M Smahi
INTRODUCTION: Tako-tsubo syndrome, or "left ventricular transitory apical balloon syndrome", is an acute coronary syndrome with normal coronary arteries. OBSERVATION: We report the case of a 50-year-old patient operated for a post-tuberculous destroyed lung, for which she had a left pneumonectomy. Six months later, she presented with chest pain complicated by cardiorespiratory arrest. The Tako-tsubo syndrome was retained after eliminating the other causes. CONCLUSION: The diagnosis of Tako-tsubo syndrome should be considered before the sudden occurrence of an acute coronary syndrome in the aftermath of stress or emotional shock...
July 27, 2017: Revue de Pneumologie Clinique
https://www.readbyqxmd.com/read/28742643/sensitive-troponin-i-and-stress-testing-in-the-emergency-department-for-the-early-management-of-chest-pain-using-2-hour-protocol
#6
Shahriar Dadkhah, Zakaria Almuwaqqat, Samian Sulaiman, Husein Husein, Quang Nguyen, Saad Ali, Tuncay Taskesen
BACKGROUND: Despite improvements in identifying high-risk patients with non-ST segment ACS (acute coronary syndrome), low risk patients presenting with atypical chest pain and non-diagnostic Electrocardiogram (ECG) continued to undergo unnecessary admissions and testing. Since 1992, our chest pain protocol included using 4-hour serial biomarkers from ED admission in combination with stress testing to evaluate these patients. Our study aimed at determining whether a new accelerated diagnostic protocol using sensitive cardiac troponin I (cTnI) 2 hours after admission to the ED followed by stress testing is safe and effective in emergency settings, allowing for appropriate triage, earlier discharge and reducing costs...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28726653/retrospective-study-of-evaluation-of-patients-with-st-elevation-myocardial-infarction-and-intact-coronary-arteries-evaluation-of-treatment-approaches-outcome-and-prognosis
#7
E Tsetskhladze, I Khintibidze
Myocardial infarction with normal coronary arteries is a well known pathology. It may or may not be associated with left ventricle wall motion abnormalities. Data was reviewed retrospectively for patients with ST elevation myocardial infarction who underwent cardiac catheterization. From the total number of patients evaluated 10.3% (17) patients had Myocardial Infarction with normal coronary arteries. Females were more likely to present with MINCA then males. Coronary flow was normal in 11 from 17 patients with MINCA...
June 2017: Georgian Medical News
https://www.readbyqxmd.com/read/28718877/takotsubo-syndrome-in-hemodynamically-unstable-patients-admitted-to-the-intensive-care-unit-a-retrospective-study
#8
J Oras, J Lundgren, B Redfors, D Brandin, E Omerovic, H Seeman-Lodding, S-E Ricksten
INTRODUCTION: Takotsubo syndrome (TS) is an acute cardiac condition that is often triggered by critical illness but that has rarely been studied in the intensive care unit (ICU) setting. The aim of this study was to (i) estimate the incidence of TS in a hemodynamically unstable ICU-population; (ii) identify predictors of TS in this population; (iii) study the impact of TS on prognosis and course of hospitalization. METHODS: Medical records from all patients admitted to our general ICU from 2012 to 2015 were analyzed...
September 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28717414/cardiac-magnetic-resonance-in-patients-with-acute-cardiac-injury-and-unobstructed-coronary-arteries
#9
Giovanni Salvatore Camastra, Stefano Sbarbati, Massimiliano Danti, Luca Cacciotti, Raffaella Semeraro, Sabino Walter Della Sala, Gerardo Ansalone
AIM: To define the role of cardiac magnetic resonance (CMR) by analyzing a particular group of patients with suspected acute coronary syndrome (ACS) and normal coronary angiogram. METHODS: From January 2009 to December 2015, we examined 220 patients with clinical suspicion of ACS, Troponin elevation [the threshold used to define a positive Troponin T test (TnT) was 0.1 ng/mL] and no significant coronary disease at angiography (the patients were considered to have significant angiographic disease only a 50% stenosis was detected in any of their coronary arteries)...
June 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28696852/imaging-of-pregnancy-related-vascular-complications
#10
R Scooter Plowman, Cylen Javidan-Nejad, Constantine A Raptis, Douglas S Katz, Vincent M Mellnick, Sanjeev Bhalla, Patricia Cornejo, Christine O Menias
Pregnancy results in substantial hemodynamic and prothrombotic changes that form the foundation for downstream vascular complications, both during pregnancy and in the postpartum period. In addition, several important risk factors, including older patient age, diabetes, and smoking, can increase the risk for vascular-related pregnancy complications. Because radiologists often play an important role in evaluation of the pregnant patient, understanding the pathophysiology of vascular-related complications in pregnancy and their imaging appearances is essential for diagnostic accuracy...
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28667812/utility-of-3d-oct-imaging-with-angiographic-co-registration-in-acute-coronary-syndrome-with-normal-or-near-normal-coronary-arteries
#11
Santiago Jesús Camacho Freire, Javier León Jiménez, Antonio Enrique Gómez Menchero, Jessica Roa Garrido, Rosa Cardenal Piris, José Francisco Díaz Fernández
The OPTIS integrated system (St. Jude Medical) is a new technology allowing the online co-registration of optical coherence tomography (OCT) images with the angiogram in the catheterization laboratory. Additionally, 3D navigation can be performed. This integration of OCT information on an angiographic roadmap could find broad application in the characterization of substrates causing acute coronary syndromes with normal or near-normal coronary arteries. The utility of OCT with co-registration for the guidance of percutaneous coronary intervention could be considerable in the management of patients with acute coronary syndromes...
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28655300/dynamic-high-sensitivity-troponin-elevations-in-atrial-fibrillation-patients-might-not-be-associated-with-significant-coronary-artery-disease
#12
Johan Thelin, Olle Melander
BACKGROUND: Since the introduction of high-sensitivity troponin assays a greater proportion of atrial fibrillation (AF) patients present with dynamic troponin elevations. We hypothesize that significant coronary artery disease (CAD) causes relative ischemia in the setting of a rapid heart rate resulting in dynamic troponin elevation. The aim of this study was to examine if patients without known CAD who present with AF, tachycardia and dynamic high-sensitivity troponin T (hsTnT) change have an increased risk of cardiac events...
June 27, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28626545/case-of-acute-st-segment-elevation-myocardial-infarction-in-infective-endocarditis-management-with-intra-coronary-stenting
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
REVIEW
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
#20
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
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