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acute coronary syndrome with ST segment elevation

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https://www.readbyqxmd.com/read/28197284/st-segment-elevation-myocardial-infarction-door-to-balloon-time-improvement-project
#1
Saad Al Bugami, Jamilah Alrahimi, Abdullah Almalki, Farqad Alamger, Ahmed Krimly, Wail Al Kashkari
BACKGROUND: The purpose of this quality improvement project was to evaluate prospectively the causes of delay for patients with acute ST-segment elevation myocardial infarction (STEMI) requiring primary percutaneous coronary intervention (PCI) upon arrival at the emergency department (ED) and implement recommendations to reduce delays and analyze the impact of recommendations to reduce the door-to-balloon (D2B) time in a newly established cardiac center (King Faisal Cardiac Center (KFCC))...
August 2016: Cardiology Research
https://www.readbyqxmd.com/read/28193678/aspirin-desensitization-in-patients-with-coronary-artery-disease-results-of-the-multicenter-adapted-registry-aspirin-desensitization-in-patients-with-coronary-artery-disease
#2
Roberta Rossini, Annamaria Iorio, Roberto Pozzi, Matteo Bianco, Giuseppe Musumeci, Sergio Leonardi, Corrado Lettieri, Irene Bossi, Paola Colombo, Stefano Rigattieri, Cinzia Dossena, Angelo Anzuini, Davide Capodanno, Michele Senni, Dominick J Angiolillo
BACKGROUND: There are limited data on aspirin (ASA) desensitization for patients with coronary artery disease. The aim of the present study was to assess the safety and efficacy of a standard rapid desensitization protocol in patients with ASA sensitivity undergoing coronary angiography. METHODS AND RESULTS: This is a prospective, multicenter, observational study including 7 Italian centers including patients with a history of ASA sensitivity undergoing coronary angiography with intent to undergo percutaneous coronary intervention...
February 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28191514/anticoagulant-therapy-for-non-st-segment-elevation-acute-coronary-syndrome-in-china-a-multi-center-observational-study
#3
Xiao-Huan Gong, Jin-Ming Yu, Yong Mao, Da-Yi Hu
OBJECTIVE: To assess the anticoagulant therapy for non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in China and to offer the rationale for establishing reasonable strategies to improve the prognosis of NSTE-ACS. METHODS: A total of 1,502 patients with NSTE-ACS were recruited from 28 third-grade hospitals distributed in 14 provinces and cities in China from December 2009 to December 2011. The strategies for diagnosis and treatment, decided by each hospital respectively, were used for further analysis and comparison of medication, percutaneous coronary intervention (PCI), and end points for efficacy and safety assessment at 9 and 30 days following PCI...
April 1, 2016: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28179617/relationship-between-serum-25-hydroxyvitamin-d-levels-and-the-syntax-score-in-patients-with-acute-coronary-syndrome
#4
Ahmet Oğuz Baktır, Yasemin Doğan, Bahadır Şarlı, Ömer Şahin, Erkan Demirci, Mahmut Akpek, Eyüp Özkan, Hüseyin Arınç, Hayrettin Sağlam
OBJECTIVE: The extent of severity and complexity of coronary artery disease (CAD) in patients presenting with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) and possible correlations between serum 25-hydroxyvitamin D (25(OH)D) have not yet been adequately studied. We evaluated the relationship between 25(OH)D levels and the burden of CAD as assessed by the SYNTAX score (SXscore) in patients with acute coronary syndrome (ACS) including STEMI and NSTEMI. METHODS: After exclusion, a total of 113 patients who were admitted to our hospital due to ACS and who were referred for undergoing coronary angiography were prospectively included...
February 1, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28179614/genotyping-of-six-clopidogrel-metabolizing-enzyme-polymorphisms-has-a-minor-role-in-the-assessment-of-platelet-reactivity-in-patients-with-acute-coronary-syndrome
#5
María Henar García-Lagunar, Luciano Consuegra-Sánchez, Pablo Conesa-Zamora, Javier Ruiz-Cosano, Federico Soria-Arcos, Luis García de Guadiana, Pedro Cano Vivar, Juan Antonio Castillo-Moreno, Antonio Melgarejo-Moreno
OBJECTIVE: To evaluate the contribution of six polymorphisms to the platelet reactivity in patients with acute coronary syndrome (ACS) treated with clopidogrel. METHODS: Cross-sectional study of 278 consecutive patients with ACS. Detailed clinical information for each patient was collected and genotypes (CYP2C9*2, CYP2C9*3, CYP2C19*2, CYP2C19*17, CYP3A4*1B, and PON1-Q192R) were evaluated with TaqMan® and KASPar® assays. Platelet reactivity was measured with VerifyNow®...
February 1, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28164519/angiotensin-converting-enzyme-inhibitors-influence-on-antiplatelet-therapy-of-clopidogrel-in-acs
#6
Shuo Yang, Chanjuan Cui, Jie Zhang, Rui Qiao
BACKGROUND: Clopidogrel is a prodrug, the minority of which is converted to an active metabolite by hepatic cytochrome P450 (CYP2C19), however, most of it is metabolized to inactive substance by hepatic carboxylesterase1 (CES1). Meanwhile angiotensin-converting enzyme inhibitors (ACEIs) are mostly metabolized by CES1. We aimed to assess the impact of ACEIs on platelet inhibition by clopidogrel. METHODS: We genotyped variants CES1, CYP2C19*2 and *3 in 502 patients with acute coronary syndrome (ACS) receiving clopidogrel therapy, and analyzed the effects of ACEIs on responsiveness to clopidogrel by the vasodilator-stimulated phosphoprotein (VASP) phosphorylation assay and ADP-stimulated impedance whole blood platelet aggregation assay...
October 1, 2016: Clinical Laboratory
https://www.readbyqxmd.com/read/28153630/proacs-risk-score-an-early-and-simple-score-for-risk-stratification-of-patients-with-acute-coronary-syndromes
#7
Ana Teresa Timóteo, Sílvia Aguiar Rosa, Marta Afonso Nogueira, Adriana Belo, Rui Cruz Ferreira
INTRODUCTION: There are barriers to proper implementation of risk stratification scores in patients with acute coronary syndromes (ACS), including their complexity. Our objective was to develop a simple score for risk stratification of all-cause in-hospital mortality in a population of patients with ACS. METHODS: The score was developed from a nationwide ACS registry. The development and internal validation cohorts were obtained from the first 31829 patients, randomly separated (60% and 40%, respectively)...
February 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28150284/renal-function-on-admission-affects-both-treatment-strategy-and-long-term-outcomes-of-patients-with-myocardial-infarction-from-polish-registry-of-acute-coronary-syndromes
#8
MIchal Hawranek, Marek Gierlotka, Mariusz Gąsior, Bartosz Hudzik, Piotr Desperak, Aneta Ciślak, Mateusz Tajstra, Tadeusz Osadnik, Piotr Rozentryt, Lech Poloński
BACKGROUND: Impairment of renal function (IRF) is an independent risk factor of myocardial infarction (MI). AIM: The aims of study was to determine if the presence of IRF affects the choice of treatment strategy in patients with MI, and if long-term mortality rates are influenced by the use of invasive strategy in patients with MI according to the grade of IRF. METHODS: Data from the PL-ACS Registry of 22,431 patients hospitalized for MI during 2007-2008 with an available estimated glomerular filtration rate (eGFR) with 2009 Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) formula were included...
February 2, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28145667/acute-coronary-syndrome-diagnostic-evaluation
#9
Craig Barstow, Matthew Rice, Jonathan D McDivitt
Myocardial infarction (MI), a subset of acute coronary syndrome, is damage to the cardiac muscle as evidenced by elevated cardiac troponin levels in the setting of acute ischemia. Coronary artery disease is the leading cause of mortality in the United States. Chest pain is a common presentation in patients with MI; however, there are multiple noncardiac causes of chest pain, and the diagnosis cannot always be made based on initial presentation. The assessment of a possible MI includes evaluation of risk factors and presenting signs and symptoms, rapid electrocardiography, and serum cardiac troponin measurements...
February 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28144818/practice-of-st-segment-elevation-myocardial-infarction-care-in-the-netherlands-during-four-snapshot-weeks-with-the-national-cardiovascular-database-registry-for-acute-coronary-syndrome
#10
N P G Hoedemaker, M E Ten Haaf, J C Maas, P Damman, Y Appelman, J G P Tijssen, R J de Winter, A W J van 't Hof
BACKGROUND: Clinical registries provide information on the process of care and patient outcomes, with the potential to improve the quality of patient care. A large Dutch national acute coronary syndrome (ACS) registry is currently lacking. Recently, we initiated the National Cardiovascular Database Registry (NCDR) for ACS in the Netherlands. The purpose of this study was to assess the NCDR ACS registry on feasibility and data completeness during a pilot phase of four snapshot weeks...
January 31, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28139897/oral-antiplatelet-agents-for-the-management-of-acute-coronary-syndromes-a-review-for-nurses-and-allied-healthcare-professionals
#11
REVIEW
Tania Gesheff, Cescelle Barbour
PURPOSE: We review the use of oral antiplatelet (OAP) therapies in acute coronary syndrome (ACS) management for nurse practitioners (NPs), focusing on current guideline recommendations. DATA SOURCES: Treatment guidelines and clinical articles from PubMed. CONCLUSIONS: Guidelines recommend that dual antiplatelet therapy with a P2Y12 inhibitor and aspirin be initiated for ACS management. The P2Y12 inhibitor clopidogrel has established efficacy, but is associated with suboptimal and delayed platelet inhibition and variability in response...
January 31, 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28135823/canada-acute-coronary-syndrome-score
#12
Yuan-Hui Liu, Lei Jiang, Chong-Yang Duan, Peng-Cheng He, Yong Liu, Ning Tan, Ji-Yan Chen
In patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention, contrast-induced nephropathy (CIN) is a serious complication associated with poor outcomes. We assessed the predictive value of the Canada Acute Coronary Syndrome (C-ACS) score for CIN in these patients. A total of 394 consecutive patients with STEMI were enrolled and divided into 3 groups according to their C-ACS scores-group 1, score 0; group 2, score 1; and group 3, score ≥2. The clinical outcomes were CIN and major adverse clinical events (MACEs) during hospital and follow-up; 8...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28128312/preprocedural-c-reactive-protein-predicts-outcomes-after-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-myocardial-infarction-a-systematic-meta-analysis
#13
Raluca-Ileana Mincu, Rolf Alexander Jánosi, Dragos Vinereanu, Tienush Rassaf, Matthias Totzeck
Risk assessment in patients with acute coronary syndromes (ACS) is critical in order to provide adequate treatment. We performed a systematic meta-analysis to assess the predictive role of serum C-reactive protein (CRP) in patients with ST-segment elevation myocardial infarction (STEMI), treated with primary percutaneous coronary intervention (PPCI). We included 7 studies, out of 1,033 studies, with a total of 6,993 patients with STEMI undergoing PPCI, which were divided in the high or low CRP group, according to the validated cut-off values provided by the corresponding CRP assay...
January 27, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28123475/clinical-effect-of-preoperative-high-dose-atorvastatin-against-no-reflow-after-pci
#14
Wenbo Liu, Zhipeng Zou, Haipeng Jiang, Qiang Li, Fangming Guo, Zhen Wang, Hongguang Zhu
The aim of the present study was to evaluate the use of preoperative high-dose atorvastatin to prevent the no-reflow phenomenon after percutaneous coronary intervention (PCI). A total of 138 patients with ST-segment elevation myocardial infarction, admitted from March 2014 to January 2015, were enrolled and randomly divided into 3 groups of 46 individuals each. The groups included a control group in which patients were not treated with atorvastatin before PCI; a conventional-dose atorvastatin treatment group in which patients received a single dose of 20 mg at bedtime one day prior to PCI; and a high-dose atorvastatin treatment group in which patients were treated with 40 mg divided in two doses the day before PCI...
January 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28122793/real-world-insights-on-the-initiation-and-treatment-duration-of-oral-antiplatelets-in-acute-coronary-syndromes-a-retrospective-cohort-study
#15
Marc J Claeys, Christophe Beauloye, Suzanne Pourbaix, Peter R Sinnaeve
AIMS: This study is a real world, observational study evaluating the treatment persistence of oral antiplatelet (OAP) therapy during a one-year follow-up in patients after an acute coronary syndrome (ACS). METHODS AND RESULTS: Data on diagnosis, comorbidities, follow-up, OAP treatment, reasons, and decision maker for treatment discontinuation in patients who were discharged from a hospital in Belgium after an ACS between 1 July 2012 and 1 June 2013 were collected by cardiologists from 18 centres, up to 360 days from discharge...
January 24, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28122463/inflammatory-bowel-disease
#16
Grigorios Tsigkas, Periklis Davlouros, Stefanos Despotopoulos, Stelios Assimakopoulos, Georgios Theocharis, George Hahalis
Patients with inflammatory bowel disease (IBD) have a higher incidence of coronary artery disease (CAD) compared with the general population. Left main coronary artery (LMCA) thrombosis constitutes a very rare but catastrophic manifestation of acute coronary syndrome. Case reports describing young patients with IBD and LMCA thrombosis are scarce. Most importantly, patients with a positive family history of thrombotic events and those with significant genetic or acquired risk factors such as the antiphospholipid antibody syndrome, advanced age, immobilization, pregnancy, oral contraceptive use, obesity, diabetes, and cigarette smoking may have a higher risk of thrombosis among those with active IBD...
January 1, 2017: Angiology
https://www.readbyqxmd.com/read/28115812/ivus-guided-implantation-of-bioresorbable-vascular-scaffolds-for-very-late-paclitaxel-stent-thrombosis
#17
Zhe-Zhong Lin, Wei-Ting Chang, Chun-Yen Chiang, Zhih-Cherng Chen, Po-Ming Ku
Bioresorbable vascular scaffold (BVS) implantation has been shown to be safe in patients with stable coronary disease, and effective against the thrombotic lesion and the in-stent restenosis (ISR) of the drug-eluting stent (DES). BVSs have the advantages of a snow racket concept, positive vessel remodeling, and better conformability compared with DES in acute coronary syndrome (ACS). We report on a young patient with ST-elevation myocardial infarction (STEMI) who presented to our emergency department arising from very late stent thrombosis (VLST) of a 2...
January 2017: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/28108465/outcomes-of-women-and-men-with-acute-coronary-syndrome-treated-with-and-without-percutaneous-coronary-revascularization
#18
Jacob A Udell, Maria Koh, Feng Qiu, Peter C Austin, Harindra C Wijeysundera, Akshay Bagai, Andrew T Yan, Shaun G Goodman, Jack V Tu, Dennis T Ko
BACKGROUND: Women hospitalized with a non-ST segment elevation acute coronary syndrome (ACS) have worse clinical outcomes compared with men. An early invasive strategy with prompt coronary revascularization may mitigate sex differences in outcomes. However, few contemporary studies have evaluated whether clinical outcomes differ between women and men presenting with ACS treated with an early invasive strategy. METHODS AND RESULTS: A population-based cohort of hospitalized ACS patients who received prompt cardiac catheterization from 2008 to 2011 in Ontario, Canada and followed for up to 2 years was studied...
January 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28106470/grace-score-validation-in-predicting-hospital-mortality-analysis-of-the-role-of-sex
#19
Eva de-Miguel-Balsa, Jaime Latour-Pérez, Anna Baeza-Román, Cristina Amorós-Verdú, Juan Antonio Fernández-Lozano
BACKGROUND: The GRACE (Global Registry of Acute Coronary Events) risk score is recommended for risk stratification in acute coronary syndrome (ACS). It does not include sex, a variable strongly associated with ACS prognosis. The aim of this study was to examine if sex adds prognostic information to the GRACE score in a contemporary population. MATERIALS AND METHODS: Analysis of discrimination and calibration of GRACE score in the validation population, derived from the ARIAM-SEMICYUC registry (2012-2015)...
January 20, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28105138/clinical-and-angiographic-correlation-of-high-sensitivity-c-reactive-protein-with-acute-st-elevation-myocardial-infarction
#20
Syed Tanveer, Shaheena Banu, Nasimudeen Rehumathbeevi Jabir, Mohd Shahnawaz Khan, Ghulam Md Ashraf, Nanjappa Cholenahally Manjunath, Shams Tabrez
Vascular inflammation and associated ongoing inflammatory responses are considered as the critical culprits in the pathogenesis of acute atherothrombotic events such as acute coronary syndrome (ACS) and myocardial infarction (MI). ST segment elevation myocardial infarction (STEMI) is considered as one of the prominent clinical forms of ACS. Moreover, C-reactive protein (CRP) is an important acute phase prsotein, which may be estimated using high-sensitivity methods (hs-CRP), and its elevated level in body fluids reflects chronic inflammatory status...
December 2016: Experimental and Therapeutic Medicine
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