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acute coronary syndrome with ST segment elevation

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https://www.readbyqxmd.com/read/28089149/fasting-glucose-nt-probnp-treatment-with-eptifibatide-and-outcomes-in-non-st-segment-elevation-acute-coronary-syndromes-an-analysis-from-early-acs
#1
Serdar Farhan, Robert M Clare, Rudolf Jarai, Robert P Giugliano, Yuliya Lokhnygina, Robert A Harrington, L Kristin Newby, Kurt Huber
BACKGROUND: Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels have been linked to a more favorable glucometabolic profile. Little is known about the interaction of NT-proBNP and fasting glucose in non-ST-segment elevation acute coronary syndrome (NSTE ACS). METHODS: Fasting glucose and NT-proBNP were measured in 2240 patients enrolled in the EARLY ACS trial. Multivariable Cox models were used to assess associations between fasting glucose and NT-proBNP and a 96-hour composite of death, myocardial infarction (MI), recurrent ischemia, or thrombotic bailout; 30-day death or MI; and 1-year mortality...
January 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28052578/ticagrelor-increased-adenosine-and-cyclic-adenosine-monophosphate-plasma-concentration-compared-with-clopidogrel-in-acute-coronary-syndromes-patients
#2
Xiao-Ye Li, Qi-Bing Wang, Ying Xue, Jia-Hui Chen, Qian-Zhou Lv
Ticagrelor produces a more potent antiplatelet effect than clopidogrel, and inhibits cellular uptake of adenosine, which is associated with several cardiovascular consequences. We aimed to explore the correlation between adenosine and cyclic adenosine monophosphate (cAMP) plasma concentration and antiplatelet effect by clopidogrel or ticagrelor in acute coronary syndrome (ACS) patients receiving dual antiplatelet therapy (DAPT). We conducted a prospective, observational and single-centre cohort study enrolling 68 patients with non-ST-segment elevation ACS from January 2016 to May 2016...
January 4, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28051221/contribution-of-cardiac-magnetic-resonance-imaging-in-the-diagnosis-of-acute-coronary-syndrome-with-normal-coronary-angiography
#3
Rana Dahmani, Rim Ben Said, Younes Arous, Houaida Mahfoudhi, Chedia Chourabi, Mehdi Ghommidh, Badii Jedaida, Nizar Ben Mansour, Abdeddayem Haggui, Nadhem Hajlaoui, Dhaker Lahidheb, Wafa Fehri, Habib Haouala
Background - Acute coronary syndrome with high level of troponin is a common pattern for emergency consultation. In 10% of cases, coronary angiography concluded that there were no significant coronary lesions. The contribution of cardiac magnetic resonance imaging (MRI) in the etiological investigation is increasing in these conditions. Aim - We analyzed the diagnostic value of cardiac MRI in case of acute coronary syndromes with elevated troponin and normal coronary angiography. Methods - It's a retrospective analytical study including 31 patients presenting with acute coronary syndrome with positive troponins and normal coronary angiography...
June 2016: La Tunisie Médicale
https://www.readbyqxmd.com/read/28040387/takotsubo-cardiomyopathy-associated-with-miller-fisher-syndrome
#4
Dalvir Gill, Kan Liu
51-year-old female who presented with progressive paresthesia, numbness of the lower extremities, double vision, and trouble walking. Physical exam was remarkable for areflexia, and ptosis. Her initial EKG showed nonspecific ST segment changes and her Troponin T was elevated to 0.41ng/mL which peaked at 0.66ng/mL. Echocardiogram showed a depressed left ventricular ejection fraction to 35% with severely hypokinetic anterior wall and left ventricular apex was severely hypokinetic. EMG nerve conduction study showed severely decreased conduction velocity and prolonged distal latency in all nerves consistent with demyelinating disease...
December 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28031086/respiratory-and-cardiac-characteristics-of-icu-patients-aged-90-years-and-older-a-report-of-12-cases
#5
Hong-Min Zhang, Da-Wei Liu, Xiao-Ting Wang, Yun Long, Quan-Hui Yang
Objective To investigate the respiratory and cardiac characteristics of elderly Intensive Care Unit (ICU) patients.Methods Twelve senior ICU patients aged 90 years and older were enrolled in this study. We retrospectively collected all patients' clinical data through medical record review. The basic demographics, primary cause for admission, the condition of respiratory and circulatory support, as well as prognosis were recorded. Shock patients and pneumonia patients were specifically analyzed in terms of clinical manifestations, laboratory variables, echocardiography, and lung ultrasound Results...
March 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
https://www.readbyqxmd.com/read/28029055/improved-risk-stratification-of-patients-with-acute-coronary-syndromes-using-a-combination-of-hstnt-nt-probnp-and-hscrp-with-the-grace-score
#6
Roland Klingenberg, Soheila Aghlmandi, Lorenz Räber, Baris Gencer, David Nanchen, Dik Heg, Sebastian Carballo, Nicolas Rodondi, François Mach, Stephan Windecker, Peter Jüni, Arnold von Eckardstein, Christian M Matter, Thomas F Lüscher
BACKGROUND: Clinical scores and biomarkers improve risk stratification of patients with acute coronary syndromes. However, little is known about their value in patients referred for coronary angiography. METHODS: Consecutive patients admitted at four Swiss university hospitals with a diagnosis of acute coronary syndrome were enrolled into the SPUM-ACS Biomarker Cohort between 2009 and 2012. Patients were followed at 30 days and 1 year with assessment of adjudicated events including all-cause mortality and the composite of all-cause mortality or non-fatal recurrent myocardial infarction...
December 1, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28025925/contemporary-trends-in-oral-antiplatelet-agent-use-in-patients-treated-with-percutaneous-coronary-intervention-for-acute-coronary-syndrome
#7
Kibum Kim, Todd A Lee, Daniel R Touchette, Robert J DiDomenico, Amer K Ardati, Surrey M Walton
BACKGROUND: Recent trials demonstrated the efficacy of prasugrel and ticagrelor compared with clopidogrel in the reduction of cardiovascular complications in patients with acute coronary syndrome (ACS). However, it is unclear how use of the 3 antiplatelet medications has changed in commercially insured patients since the advent of the new agents. OBJECTIVES: To (a) describe the adoption of prasugrel and ticagrelor in patients who received percutaneous coronary intervention (PCI) for the onset of ACS and (b) explore patient factors associated with the selection of the drug to provide insight into utilization patterns of these antiplatelet agents...
January 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28018669/effects-of-omeprazole-or-pantoprazole-on-platelet-function-in-non-st-segment-elevation-acute-coronary-syndrome-patients-receiving-clopidogrel
#8
Ruo-Xi Gu, Xiao-Zeng Wang, Jing Li, Jie Deng, Xing-Xing Li, Jiao Wang
BACKGROUND: This study evaluated the effect of omeprazole or pantoprazole on platelet reactivity in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients receiving clopidogrel. METHODS: Consecutive patients with NSTE-ACS (n = 620) from general hospital of Shenyang Military Command were randomized to the omeprazole or pantoprazole (20 mg/d) group (1:1), and received routine dual antiplatelet treatment. Patients' reversion rate of adenosine diphosphate-induced platelet aggregation (ADP-PA) was assessed at baseline, 12 to 24 h after administration of medication, and after 72 h of percutaneous coronary intervention (PCI)...
2016: Military Medical Research
https://www.readbyqxmd.com/read/28013562/deciphering-acute-coronary-syndrome-biomarkers-high-resolution-proteomics-in-platelets-thrombi-and-microparticles
#9
Diana Navas-Carrillo, Francisco Marín, Mariano Valdés, Esteban Orenes-Piñero
Acute coronary syndromes (ACS) encompass unstable angina, non-ST segment elevation myocardial infarction, ST-segment elevation myocardial infarction and sudden cardiac death. They are commonly associated with the presence of vulnerable plaques in the coronary arteries and occur when a thrombus formed from a ruptured atheromatous plaque causes a prolonged occlusion of a coronary artery. The erosion of the vulnerable plaques results in the formation of luminal thrombi secondary to platelet activation and the release of thrombogenic elements within the atherosclerotic lesions...
December 26, 2016: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/28011706/profiling-and-validation-of-circulating-micrornas-for-cardiovascular-events-in-patients-presenting-with-st-segment-elevation-myocardial-infarction
#10
Philipp Jakob, Tim Kacprowski, Sylvie Briand-Schumacher, Dik Heg, Roland Klingenberg, Barbara E Stähli, Milosz Jaguszewski, Nicolas Rodondi, David Nanchen, Lorenz Räber, Pierre Vogt, Francois Mach, Stephan Windecker, Uwe Völker, Christian M Matter, Thomas F Lüscher, Ulf Landmesser
AIMS: MicroRNAs (miRNA) are important non-coding modulators controlling patterns of gene expression. However, profiling and validation of circulating miRNA levels related to adverse cardiovascular outcome has not been performed in patients with an acute coronary syndrome (ACS). METHODS AND RESULTS: In a multicentre, prospective ACS cohort, 1002 out of 2168 patients presented with ST-segment elevation myocardial infarction (STEMI). Sixty-three STEMI patients experienced an adjudicated major cardiovascular event (MACE, defined as cardiac death or recurrent myocardial infarction) within 1 year of follow-up...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/27999129/ascending-aortic-dissection-presented-as-inferior-myocardial-infarction-a-clinical-and-diagnostic-mimicry
#11
Ali A Alsaad, Olufunso W Odunukan, John Norman Patton
Acute ST segment elevation myocardial infarction (STEMI) is typically associated with acute coronary thrombosis or plaque rupture. Rarely, STEMI can be associated with ascending aortic dissection, which represents the majority of acute aortic syndrome aetiologies and carries dreadful outcomes. Routine cardiac intervention with emergent cardiac catheterisation may lead to a higher mortality rate in this group of patients. We present a case of painless inferior STEMI in the setting of ascending aortic dissection...
December 20, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27988230/spontaneous-coronary-artery-dissection-still-a-lot-to-learn
#12
David Neves, Ângela Bento, Renato Fernandes, Lino Patrício, José Aguiar
Non-atherosclerotic spontaneous coronary artery dissection (SCAD) is an uncommon but probably underdetected pathological substrate for acute coronary syndrome. Clinical associations have been noted, like female gender and young age, but its pathophysiology is not yet fully understood. In this report we describe the case of a 50-year-old woman, without cardiovascular risk factors presenting with non-ST segment elevation myocardial infarction, in whom SCAD was diagnosed. Treatment was initially conservative but due to aggravation of the dissection she eventually underwent a complex percutaneous coronary intervention, requiring implantation of multiple stents, but with a good clinical outcome...
January 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/27981367/-cardiac-causes-of-chest-pain
#13
C Wächter, B Markus, B Schieffer
Because of the life-threatening character and a high prevalence in emergency rooms, cardiac causes are important differential diagnoses of acute chest pain with the need for rapid clarification. In this context the working diagnosis "acute coronary syndrome" (ACS) plays a major role. In a synopsis of the clinical presentation, medical history, electrocardiogram and analysis of cardiac biomarkers, ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina pectoris can be specified as entities of ACS...
January 2017: Der Internist
https://www.readbyqxmd.com/read/27978944/bleeding-events-before-coronary-angiography-in-patients-with-non-st-segment-elevation-acute%C3%A2-coronary-syndrome
#14
Björn Redfors, Ajay J Kirtane, Stuart J Pocock, Girma Minalu Ayele, Efthymios N Deliargyris, Roxana Mehran, Gregg W Stone, Philippe Généreux
BACKGROUND: Upstream administration of antithrombotic drugs to patients with non-ST-segment elevation acute coronary syndromes before coronary angiography is a common practice despite an incomplete understanding of the risks and benefits. OBJECTIVES: The authors analyzed the incidence of bleeding and ischemic events occurring before angiography and assessed their association with antithrombotic drugs and mortality risk. METHODS: All patients from the ACUITY (Acute Catheterization and Urgent Intervention Triage Strategy) trial with planned angiography after enrollment were included...
December 20, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27974670/the-syntax-score-does-not-predict-risk-of-adverse-events-in-patients-with-non-st-elevation-acute-coronary-syndrome-who-undergo-coronary-artery-bypass-graft-surgery
#15
Björn Redfors, Chun-Hui He, Tullio Palmerini, Adriano Caixeta, Gennaro Giustino, Girma Minalu Ayele, Ajay J Kirtane, Roxana Mehran, Gregg W Stone, Philippe Généreux
OBJECTIVES: We tested the ability of the SYNTAX score (SS) to predict 1-year adverse outcomes for patients with non-ST segment elevation acute coronary syndromes (NSTE-ACS) who undergo coronary artery bypass graft (CABG) surgery. BACKGROUND: The SS effectively risk stratifies patients who undergo percutaneous coronary intervention, but not patients with stable coronary disease who undergo CABG. METHODS: We calculated the SS for 457 patients with NSTE-ACS in the angiographic substudy of the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) trial who underwent CABG...
December 15, 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/27969939/tct-55-risk-benefit-analysis-of-upstream-antithrombotic-therapy-in-patients-with-non-st-segment-elevation-acute-coronary-syndromes-prior-to-coronary-angiography
#16
Bjorn Redfors, Philippe Généreux, Ajay Kirtane, Stuart Pocock, Girma Ayele, Makis Deliargyris, Roxana Mehran, Gregg Stone
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/27956004/incidence-and-prognostic-impact-of-respiratory-support-in-patients-with-st-segment-elevation-myocardial-infarction
#17
Thomas S Metkus, Aiham Albaeni, Nisha Chandra-Strobos, Shaker M Eid
Data addressing the use of respiratory support in acute coronary syndromes are lacking. To address this evidence gap, we characterized prognostic impact and trends in utilization of invasive mechanical ventilation (IMV) and noninvasive ventilation (NIV) in patients hospitalized with ST-segment elevation myocardial infarction (STEMI) from 2002 through 2013 using the National Inpatient Sample. Multivariate logistic regression was performed to identify patient, hospital, and clinical characteristics associated with requiring IMV or NIV within 24 hours of hospitalization...
January 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/27951539/wellens-syndrome-with-syncope-but-not-chest-pain
#18
Omar Z Yasin, Alberto Rubio-Tapia, Maurice E Sarano
We report the case of a woman in her 70s presenting to the emergency department with syncope, troponemia, and an electrocardiogram with deep symmetric T-wave inversions in V2 and V3 and prolonged QTc. Her presentation was concerning for acute coronary syndrome, Wellens syndrome in particular, given the elevated troponin levels, lack of ST segment changes, and characteristic T-wave findings. The diagnosis was confirmed with angiography that showed a critical left anterior descending (LAD) artery occlusion. Since myocardial infarction does not typically present with syncope, we explored the differential diagnoses for T-wave inversions, which include electrolyte abnormalities, medications, intracranial hemorrhage, pulmonary embolism, and other cardiac diseases that were ruled out in our patient...
December 13, 2016: Cardiology
https://www.readbyqxmd.com/read/27931558/time-to-shift-from-contemporary-to-high-sensitivity-cardiac-troponin-in-diagnosis-of-acute-coronary-syndromes
#19
REVIEW
Jamshed J Dalal, C K Ponde, Brian Pinto, C N Srinivas, Joy Thomas, Sunil Kumar Modi, Sanjay Mehta, Suvin Shetty, Manimarane, Bhupen Desai
Early rule-in and rule-out of non-ST-segment elevation myocardial infarction (NSTEMI) is a challenge. In patients with inconclusive findings on ECG, cardiac biomarkers play a crucial role in the diagnosis. The introduction of the new high-sensitive cardiac troponin test (hs-TnI assay) has changed the landscape of NSTEMI diagnosis. The new hs-TnI assay can detect troponin values at a lower level compared with a contemporary cardiac troponin (cTn) assay. The hs-cTnI assay has a coefficient of variation of ≤10%, well below the 99th percentile value...
November 2016: Indian Heart Journal
https://www.readbyqxmd.com/read/27931543/efficacy-and-safety-of-the-intensive-dose-of-rosuvastatin-40mg-day-in-patients-with-acute-coronary-syndrome-and-at-high-risk-of-cardiovascular-disease-rosuvees-2
#20
Chetan P Shah, Bhaskar P Shah, Sameer I Dani, B B Channa, S S Lakshmanan, N C Krishnamani, Ashwani Mehta, P Moorthy
BACKGROUND: Randomized clinical trials have established the benefits of statin therapy in acute coronary syndromes (ACS) via their pleiotropic effects. AIM OF THE STUDY: This was a 12-week, open-label, multicenter, postmarketing observational study evaluating the efficacy and safety of rosuvastatin 40 mg/day in very high-risk or high-risk Indian patients according to NCEP ATP III guidelines. METHODOLOGY: One hundred and sixty two patients (age: 30 to 69 years) with evidence of coronary artery disease, hospitalized with chest pain with/without electrocardiogram changes and with non-ST segment elevation ACS and ST segment elevation ACS who received optimal reperfusion therapy were enrolled...
November 2016: Indian Heart Journal
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