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Acute cardiovascular care

Natalia Sanchez-Aguadero, Luis Garcia-Ortiz, Maria C Patino-Alonso, Sara Mora-Simon, Manuel A Gomez-Marcos, Rosario Alonso-Dominguez, Benigna Sanchez-Salgado, Jose I Recio-Rodriguez
BACKGROUND: Postprandial glycaemic response affects cognitive and vascular function. The acute effect of breakfast glycaemic index on vascular parameters is not sufficiently known. Also, the influence of breakfasts with different glycaemic index on cognitive performance has been mostly studied in children and adolescents with varying results. Therefore, the purpose of this study is to analyse the postprandial effect of high and low glycaemic index breakfasts on vascular function and cognitive performance and their relationship with postprandial glycaemic response in healthy young adults...
October 24, 2016: Trials
Cunlin Wang, Robert Kane, Mark Levenson, Jeffrey Kelman, Michael Wernecke, Joo-Yeon Lee, Steven Kozlowski, Carmen Dekmezian, Zhiwei Zhang, Aliza Thompson, Kimberly Smith, Yu-Te Wu, Yuqin Wei, Yoganand Chillarige, Qin Ryan, Chris Worrall, Thomas E MaCurdy, David J Graham
Importance: In 2011, the US Centers for Medicare & Medicaid Services (CMS) changed its reimbursement policy for hemodialysis to a bundled comprehensive payment system that included the cost of erythrocyte-stimulating agents (ESAs). Also in 2011, the US Food and Drug Administration revised the drug label for ESAs, recommending more conservative dosing in patients with chronic kidney disease. In response to concerns that these measures could have adverse effects on patient care and outcomes, the CMS and the FDA initiated a collaboration to assess the effect...
October 24, 2016: JAMA Internal Medicine
Jennifer C Cook, Richard H Tran, J Herbert Patterson, Jo E Rodgers
PURPOSE: The pharmacology, clinical efficacy, and safety profiles of evolving therapies for the management of chronic heart failure (HF) and acute decompensated heart failure (ADHF) are described. SUMMARY: HF confers a significant financial burden despite the widespread use of traditional guideline-directed medical therapies such as angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, β-blockers, and aldosterone receptor antagonists, and the rates of HF-related mortality and hospitalization have remained unacceptably high...
November 1, 2016: American Journal of Health-system Pharmacy: AJHP
April Robinson, Delilah McCarty, Janine Douglas
Acute coronary syndrome (ACS) is a cardiovascular condition with a multifactorial pathophysiology that includes atherosclerotic plaques, platelet activation and thrombin production, among others. Thrombin production and the prothrombotic state of ACS patients have provided a role for anticoagulants to treat patients during the acute event and has led to subsequent research for the post-acute state. Warfarin has an indication for ACS, however, it is restricted to specific patients and many factors limit its use...
October 7, 2016: Therapeutic Advances in Cardiovascular Disease
Nan Liu, Wei Zhang, Weiguo Ma, Wei Shang, Jun Zheng, Lizhong Sun
OBJECTIVES: To identify the risk factors for hypoxaemia following surgical repair of acute type A aortic dissection. METHODS: This was a retrospective study of patients treated between October 2013 and December 2014 at the Department of Cardiovascular Surgery, Anzhen Hospital, China. Univariable and multivariable analyses were performed on the clinical data of 160 patients with acute type A dissection and who underwent ascending aortic and arch replacement under deep hypothermic circulatory arrest...
October 17, 2016: Interactive Cardiovascular and Thoracic Surgery
Craig Anderson, Doug McEvoy, Jiguang Wang
OBJECTIVE: There is uncertainty over whether treatment of obstructive sleep apnea (OSA) can prevent serious cardiovascular (CV) events. DESIGN AND METHOD: SAVE (NCT00738179; ACTRN12608000409370) was designed to determine whether treatment of OSA with CPAP reduces the risk of serious CV events in patients with established CV disease. Participants were centrally randomised to CPAP treatment or usual care between 2008 and 2013,with follow-up completed late 2015 and the results will be announced in August 2016...
September 2016: Journal of Hypertension
Kyung Sik Kang, Hyung Il Kim, Oh Hyun Kim, Kyoung Chul Cha, Hyun Kim, Kang Hyun Lee, Sung Oh Hwang, Yong Sung Cha
OBJECTIVE: Adverse cardiovascular events (ACVEs) account for a large proportion of the morbidities and mortalities associated with drug overdose emergencies. However, there are no published reports regarding outcomes of ACVEs associated with acute dapsone poisoning. Here, the authors retrospectively analyzed ACVEs reported within 48 hours of treatment in patients with acute dapsone poisoning and assessed the significance of ACVEs as early predictors of mortality. METHODS: Sixty-one consecutive cases of acute dapsone poisoning that were diagnosed and treated at a regional emergency center between 2006 and 2014 were included in the study...
March 2016: Clin Exp Emerg Med
Tetsurou Satoh, Osamu Isozaki, Atsushi Suzuki, Shu Wakino, Tadao Iburi, Kumiko Tsuboi, Naotetsu Kanamoto, Hajime Otani, Yasushi Furukawa, Satoshi Teramukai, Takashi Akamizu
Thyroid storm is an endocrine emergency which is characterized by multiple organ failure due to severe thyrotoxicosis, often associated with triggering illnesses. Early suspicion, prompt diagnosis and intensive treatment will improve survival in thyroid storm patients. Because of its rarity and high mortality, prospective intervention studies for the treatment of thyroid storm are difficult to carry out. We, the Japan Thyroid Association and Japan Endocrine Society taskforce committee, previously developed new diagnostic criteria and conducted nationwide surveys for thyroid storm in Japan...
October 15, 2016: Endocrine Journal
Ita Muharram Sari, Lyna Soertidewi, Chiaki Yokota, Muneaki Kikuno, Masatoshi Koga, Kazunori Toyoda
BACKGROUND: Pneumonia is one of the most common medical complications after stroke. Incidence and risk factor analyses of stroke-associated pneumonia (SAP) in stroke care units (SCUs) are limited. SAP incidence comparisons across countries can identify the most effective treatment to reduce this incidence. METHODS: This was a retrospective study including consecutive patients with acute stroke in SCUs in 2 hospitals: 105 patients (mean age 78.2 ± 5.8) from the National Cerebral and Cardiovascular Center (NCVC) in Osaka, Japan (from July to August 2015), and 105 patients (mean age 60 ± 5...
October 13, 2016: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
S K Zyryanov, D Yu Belousov, E V Afanas'eva, E V Dumchenko
AIM: Clinical and economic examinations were made to study whether it is appropriate to use antiplatelet therapy (APT) with ticagrelor in combination with acetylsalicylic acid (ASA) versus a combination of clopidogrel and ASA in patients with acute coronary syndrome (ACS) following coronary artery bypass surgery (CABS). MATERIAL AND METHODS: A budget impact analysis was used. Data on the efficiency and safety of APT were taken from a relevant analysis in the subgroups of the randomized controlled trial PLATO...
2016: Terapevticheskiĭ Arkhiv
Jaskaran S Kang, Maria C Bennell, Feng Qiu, Merril L Knudtson, Peter C Austin, Dennis T Ko, Harindra C Wijeysundera
BACKGROUND: Cardiovascular disease is costly, and annual expenditures are projected to increase. Our objective was to examine the variation in patient-level costs and identify drivers of cost in patients with stable coronary artery disease. METHODS: In this retrospective cohort study using administrative databases in Ontario, Canada, we identified all patients with stable coronary artery disease after index angiography between Oct. 1, 2008, and Sept. 30, 2011. We excluded patients with a myocardial infarction within 90 days before the index, with normal coronaries, or with mild coronary disease...
July 2016: CMAJ Open
Satoshi Yasuda, Kazuhiro Nakao, Kunihiro Nishimura, Yoshihiro Miyamoto, Yoko Sumita, Toshiaki Shishido, Toshihisa Anzai, Hiroyuki Tsutsui, Hiroshi Ito, Issei Komuro, Yoshihiko Saito, Hisao Ogawa
BACKGROUND: Since cardiovascular disease accounts for one-quarter of deaths in the Japanese population, we developed a nationwide database using the administrative case-mix Diagnostic Procedure Combination (DPC) system (ie, theJapaneseRegistryOfAll cardiac and vascularDiseases (JROAD)-DPC) to reveal the current status of cardiovascular medicine in Japan.Methods and Results:The JROAD-DPC database included 704,593 health records' data of 2012 from 610 certificated hospitals of the Japanese Circulation Society...
October 5, 2016: Circulation Journal: Official Journal of the Japanese Circulation Society
Samuel M Brown, Jeffrey Sorensen, Michael J Lanspa, Matthew T Rondina, Colin K Grissom, Sajid Shahul, V J Mathews
BACKGROUND: Septic shock is a common and often devastating syndrome marked by severe cardiovascular dysfunction commonly managed with vasopressors. Whether markers of heart rate complexity before vasopressor up-titration could be used to predict success of the up-titration is not known. METHODS: We studied patients with septic shock requiring vasopressor, newly admitted to the intensive care unit. We measured the complexity of heart rate variability (using the ratio of fractal exponents from detrended fluctuation analysis) in the 5 min before all vasopressor up-titrations in the first 24 h of an intensive care unit (ICU) admission...
October 10, 2016: BMC Infectious Diseases
Milo Engoren, Michael D Maile, Michael Heung, Elizabeth S Jewell, Christie Vahabzadeh, Jonathan W Haft, Sachin Kheterpal
BACKGROUND: Acute kidney injury can be defined by a fall in urine output, and urine output criteria may be more sensitive in identifying acute kidney injury than traditional serum creatinine criteria. However, as pointed out in the Kidney Disease Improving Global Outcome guidelines, the association of urine output with subsequent creatinine elevations and death is poorly characterized. The purpose of this study was to determine what degrees of reduced urine output are associated with subsequent creatinine elevation and death...
October 4, 2016: Annals of Thoracic Surgery
Mandeep Singh, Deepak L Bhatt, Gregg W Stone, Charanjit S Rihal, Bernard J Gersh, Ryan J Lennon, Jagat Narula, Valentin Fuster
It is estimated that in the United States, each year, approximately 620,000 persons will experience an acute coronary syndrome and approximately 70% of these will have non-ST-elevation acute coronary syndrome. Cardiovascular disease still accounts for 1 of every 3 deaths in the United States, and there is an urgent need to improve the prognosis of patients presenting with acute coronary syndrome. Cardiovascular mortality and ischemic complications are common after acute coronary syndrome, and the advent of newer antithrombotic therapies has reduced ischemic complications, but at the expense of greater bleeding...
October 2016: Mayo Clinic Proceedings
Hadi A R Khafaji, Kadhim Sulaiman, Rajvir Singh, Khalid F Alhabib, Nidal Asaad, Alawi Alsheikh-Ali, Mohammed Al-Jarallah, Bassam Bulbanat, Wael Almahmeed, Mustafa Ridha, Nooshin Bazargani, Haitham Amin, Ahmed Al-Motarreb, Husam Al Faleh, Abdelfatah Elasfar, Prashanth Panduranga, Jassim Al Suwaidi
BACKGROUND: The purpose of this study was to report the prevalence, clinical characteristics, contributing factors, management and outcome of patients with chronic obstructive pulmonary disease (COPD) among patients hospitalized with heart failure (HF). METHODS: Data were derived from Gulf Care (Gulf acute heart failure registry), a prospective multicenter study of 5005 consecutive patients hospitalized with acute heart failure during February to November 2012 in seven Middle Eastern countries...
December 2015: Acute Cardiac Care
Thomas M MacDonald, Chris J Hawkey, Ian Ford, John J V McMurray, James M Scheiman, Jesper Hallas, Evelyn Findlay, Diederick E Grobbee, F D Richard Hobbs, Stuart H Ralston, David M Reid, Matthew R Walters, John Webster, Frank Ruschitzka, Lewis D Ritchie, Susana Perez-Gutthann, Eugene Connolly, Nicola Greenlaw, Adam Wilson, Li Wei, Isla S Mackenzie
BACKGROUND: Selective cyclooxygenase-2 inhibitors and conventional non-selective non-steroidal anti-inflammatory drugs (nsNSAIDs) have been associated with adverse cardiovascular (CV) effects. We compared the CV safety of switching to celecoxib vs. continuing nsNSAID therapy in a European setting. METHOD: Patients aged 60 years and over with osteoarthritis or rheumatoid arthritis, free from established CV disease and taking chronic prescribed nsNSAIDs, were randomized to switch to celecoxib or to continue their previous nsNSAID...
October 4, 2016: European Heart Journal
Gina Nicholson, Shravanthi R Gandra, Ronald J Halbert, Akshara Richhariya, Robert J Nordyke
OBJECTIVE: Robust cost estimates of cardiovascular (CV) events are required for assessing health care interventions aimed at reducing the economic burden of major adverse CV events. This review synthesizes international cost estimates of CV events. METHODS: MEDLINE database was searched electronically for English language studies published during 2007-2012, with cost estimates for CV events of interest - unstable angina, myocardial infarction, heart failure, stroke, and CV revascularization...
2016: ClinicoEconomics and Outcomes Research: CEOR
Rachel J Le, Michael W Cullen, Brian D Lahr, R Scott Wright, Stephen L Kopecky
BACKGROUND: Patients hospitalized for first acute coronary syndrome (ACS) are frequently discharged on multiple new medications. The short-term tolerability of these medications is unknown. METHODS: This single-center cohort study assessed 30-day health-care utilization and how it may be impacted by medication prescribing trends. We included Olmsted County patients presenting with ACS and previously undiagnosed coronary artery disease in 2008 to 2009. All health-care contacts were reviewed 30 days after index hospital discharge for potential adverse medication effects including documented hypotension or bradycardia, or symptoms likely attributed to the medications...
October 2, 2016: Journal of Cardiovascular Pharmacology and Therapeutics
Alina M Allen, W Ray Kim, James P Moriarty, Nilay D Shah, Joseph J Larson, Patrick S Kamath
: Acute on chronic liver failure (ACLF) is associated with multi-system organ failure and poor prognosis in hospitalized patients with cirrhosis. We aimed to determine time trends in the epidemiology, economic burden and mortality of ACLF in the United States. The National Inpatient Sample database was queried between 2001 and 2011. ACLF was defined as 2 or more extrahepatic organ failures in patients with cirrhosis. The primary outcomes were trends in hospitalizations, hospital costs and inpatient mortality in ACLF...
October 3, 2016: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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