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Acute cardiovascular care

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https://www.readbyqxmd.com/read/28527642/depressive-symptoms-and-perceptions-of-ed-care-in-patients-evaluated-for-acute-coronary-syndrome
#1
Tara St Onge, Donald Edmondson, Emily Cea, Syed Husain, Bernard P Chang
INTRODUCTION: Posttraumatic stress disorder (PTSD) develops in 1 out of 8 survivors of acute coronary syndrome (ACS) events, and these persons have a doubling of risk for recurrent ACS and mortality. Overcrowding in the emergency department during ACS evaluation has been associated with increased risk for PTSD, and depressed patients have been found to be particularly vulnerable. Little is known about the mechanisms by which overcrowding increases PTSD risk in depressed patients. Our aim was to evaluate one possible mechanism, patient perception of crowding and care, in depressed and nondepressed ED patients evaluated for ACS...
May 17, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28523440/assessing-and-modifying-coronary-artery-disease-risk-in-women
#2
REVIEW
Amy Sarma, Nandita S Scott
Despite continued advances in the field, cardiovascular disease remains the leading cause of death in women in the USA with an annual mortality rate that has remained higher for women as compared to men. The factors leading to this sex difference remain incompletely understood. Likely contributors include atypical symptoms at presentation and lack of recognition of cardiovascular risk by women and their providers alike. In addition, women have a higher burden of comorbidities at the time of disease diagnosis and can have differential pathophysiological mechanisms of their acute events...
July 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28522758/regulation-of-erythropoiesis-after-normoxic-return-from-chronic-sustained-and-intermittent-hypoxia
#3
Jihyun Song, Krishna Sundar, Radhika Gangaraju, Josef T Prchal
Hypoxia increases erythropoiesis mediated by hypoxia-inducible transcription factors (HIF) which regulate erythropoietin (EPO) transcription. Neocytolysis is a physiological mechanism that corrects polycythemia from chronic sustained hypoxemia (CSH) by transient, preferential destruction of young RBCs after normoxia is restored. We showed that neocytolysis is caused by excessive mitochondrial-derived reactive oxygen species (ROS) in reticulocytes mediated by down-regulation of HIF-controlled BNIP3L regulated mitophagy and a decrease in RBC antioxidant catalase (CAT) in hypoxia-produced erythrocytes...
May 18, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28514784/effects-of-intensive-statin-therapy-on-left-ventricular-function-in-patients-with-myocardial-infarction-and-abnormal-glucose-tolerance
#4
Søren Auscher, Brian Bridal Løgstrup, Jacob Eifer Møller, Kristina Hoeg Vinther, Jess Lambrechtsen, Kenneth Egstrup
OBJECTIVES: Abnormal glucose tolerance in patients with acute myocardial infarction (AMI) is associated with greater mortality and adverse cardiovascular effects. As statins possess a range of beneficial pleiotropic effects on the cardiovascular system, we sought to assess the cardioprotective effects of statins on left ventricular function in patients with AMI in relation to glycometabolic state. METHODS: In a prospective, randomized trial, 140 patients with AMI were randomized to intensive statin therapy receiving statin loading with 80 mg of rosuvastatin followed by 40 mg daily or standard statin therapy...
May 18, 2017: Cardiology
https://www.readbyqxmd.com/read/28511683/acute-coronary-syndrome-patients-admitted-to-a-cardiology-vs-non-cardiology-service-variations-in-treatment-outcome
#5
Deirdre E O'Neill, Danielle A Southern, Colleen M Norris, Blair J O'Neill, Helen J Curran, Michelle M Graham
BACKGROUND: Specialized cardiology services have contributed to reduced mortality in acute coronary syndromes (ACS).  We sought to evaluate the outcomes of ACS patients admitted to non-cardiology services in Southern Alberta. METHODS: Retrospective chart review performed on all troponin-positive patients in the Calgary Health Region identified those diagnosed with ACS by their attending team. Patients admitted to non-cardiology and cardiology services were compared, using linked data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) registry and the Strategic Clinical Network for Cardiovascular Health and Stroke...
May 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28504565/early-intensive-statin-treatment-reduces-hard-cardiovascular-outcomes-after-acute-coronary-syndrome
#6
Gregory G Schwartz, Rana Fayyad, Michael Szarek, David DeMicco, Anders G Olsson
Background Early, intensive statin treatment is the standard of care after acute coronary syndrome (ACS). However, the benefit of this approach to prevent major adverse cardiovascular events has been demonstrated in only one randomised, placebo controlled trial. The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial demonstrated that atorvastatin 80 mg daily, compared with placebo, reduced time to first occurrence of death, non-fatal myocardial infarction, resuscitated cardiac arrest, or hospitalisation for unstable angina (stroke not included) during the 16 week period following ACS...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28502983/alkaline-phosphatase-a-novel-treatment-target-for-cardiovascular-disease-in-ckd
#7
REVIEW
Mathias Haarhaus, Vincent Brandenburg, Kamyar Kalantar-Zadeh, Peter Stenvinkel, Per Magnusson
Cardiovascular disease is the main cause of early death in the settings of chronic kidney disease (CKD), type 2 diabetes mellitus (T2DM), and ageing. Cardiovascular events can be caused by an imbalance between promoters and inhibitors of mineralization, which leads to vascular calcification. This process is akin to skeletal mineralization, which is carefully regulated and in which isozymes of alkaline phosphatase (ALP) have a crucial role. Four genes encode ALP isozymes in humans. Intestinal, placental and germ cell ALPs are tissue-specific, whereas the tissue-nonspecific isozyme of ALP (TNALP) is present in several tissues, including bone, liver and kidney...
May 15, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28502847/the-role-for-cardiologists-in-stroke-intervention
#8
REVIEW
Richard R Heuser
Even though cardiovascular disease (CVD) is still the leading cause of death in the United States, stroke is the second leading of global cause of death behind CVD . In the 21st Century, less than 40% of overall stroke patients are discharged to home and almost 25% of Medicare beneficiaries do not survive 90days. In spite of the fact that tissue plasminogen activator (TPA) has been approved for stroke care for 20years, only .75% of annual strokes are actually treated with intravenous (IV) TPA. Similar to how interventional cardiologists evolved from IV to catheter mechanical treatment for acute myocardial infarctions (AMI) over 30years ago, over the last few years, neurointerventionists now perform endovascular stroke therapy in many of these patients using stent retrievers...
May 11, 2017: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/28498219/premarathon-evaluations-is-there-a-role-for-runner-prerace-medical-screening-and-education-to-reduce-the-risk-of-medical-complications
#9
Martin Peter Schwellnus
There is irrefutable evidence that regular participation in physical activity has substantial health benefits, and as such participation in mass community-based sports events should be supported. However, with the promotion of physical activity comes the potential risk of medical complications during an acute exercise session, with this risk varying according to the risk factor profile of an individual and the nature of the event. The demographics of marathon race entrants changed over the past two to three decades, and currently about 50% of runners are older than 40 yr...
May 2017: Current Sports Medicine Reports
https://www.readbyqxmd.com/read/28496365/prevalence-and-prognosis-of-stress-disorders-a-review-of-the-epidemiologic-literature
#10
REVIEW
Jaimie L Gradus
Given the ubiquity of traumatic events, it is not surprising that posttraumatic stress disorder (PTSD) - a common diagnosis following one of these experiences - is characterized as conferring a large burden for individuals and society. Although there is recognition of the importance of PTSD diagnoses throughout psychiatry, the literature on other diagnoses one may receive following a stressful or traumatic event is scant. This review summarizes the literature on stress disorders (classified according to the International Classification of Diseases, 10th Edition [ICD-10]), including acute stress reaction, PTSD, adjustment disorder and unspecified stress reactions...
2017: Clinical Epidemiology
https://www.readbyqxmd.com/read/28495247/hospital-variation-in-treatment-and-outcomes-in-acute-coronary-syndromes-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#11
Kevin R Bainey, Padma Kaul, Paul W Armstrong, Anamaria Savu, Cynthia M Westerhout, Colleen M Norris, Neil Brass, Dean Traboulsi, Blair O'Neill, Jayan Nagendran, Imtiaz Ali, Merril Knudtson, Robert C Welsh
BACKGROUND: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. METHODS: Patients hospitalized in 106 hospitals in Alberta, Canada with a primary diagnosis of ACS were included (July 1, 2010-March 31, 2013) with comparisons made across the three cardiac catheterization-capable hospitals (Sites A-C). Cox proportional-hazard regression models were used to examine the multivariable-adjusted association between site and 1-year death or repeat cardiovascular (CV) hospitalization (primary endpoint)...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28492297/recent-anti-seizure-medications-in-the-intensive-care-unit
#12
Cindy Orinx, Benjamin Legros, Nicolas Gaspard
BACKGROUND: Seizures and status epilepticus (SE), both clinical and subclinical, are frequent in critically ill patients. The list of available anti-seizure medications (ASMs) is expanding and now includes older and widely used drugs as well as more recent medications with a better safety and pharmacokinetics profile. METHODS: We review a selection of recent publications about the indications and administration of ASMs in critical care for the prophylaxis and treatment of seizures and SE, focusing on recent ASMs available as intravenous formulation and emphasizing pharmacokinetics and safety issues in relation to several aspects of critical illness...
May 11, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28490423/declining-trends-of-cardiovascular-renal-complications-and-mortality-in-type-2-diabetes-the-hong-kong-diabetes-database
#13
Andrea O Y Luk, Eric M T Hui, Ming-Chuen Sin, Chun-Yip Yeung, Wing-Sun Chow, Andrew Y Y Ho, Hin-Fai Hung, Eva Kan, Chiu-Ming Ng, Wing-Yee So, Chi-Kin Yeung, Kin-Sang Chan, Kin-Wah Chan, Pang-Fai Chan, Shing-Chung Siu, Sau-Cheung Tiu, Vincent T F Yeung, Juliana C N Chan, Frank W K Chan, Clement Cheung, Ngai-Tseung Cheung, Siu-Tung Ho, Karen S L Lam, Linda W L Yu, David Chao, Ip-Tim Lau
OBJECTIVE: Nationwide studies on secular trends of diabetes complications are not available in Asia. We examined changes in risk factor control and incidence of complications from diabetes and death in a large longitudinal cohort of Chinese adults with type 2 diabetes in Hong Kong. RESEARCH DESIGN AND METHODS: Between 1 January 2000 and 31 December 2012, 338,908 Chinese adults with type 2 diabetes underwent metabolic and complication assessment in 16 diabetes centers operated by Hong Kong Hospital Authority that provided care to a large majority of diagnosed patients...
May 10, 2017: Diabetes Care
https://www.readbyqxmd.com/read/28484929/functional-mri-for-assessment-of-the-default-mode-network-in-acute-brain-injury
#14
Daniel Kondziella, Patrick M Fisher, Vibeke Andrée Larsen, John Hauerberg, Martin Fabricius, Kirsten Møller, Gitte Moos Knudsen
BACKGROUND: Assessment of the default mode network (DMN) using resting-state functional magnetic resonance imaging (fMRI) may improve assessment of the level of consciousness in chronic brain injury, and therefore, fMRI may also have prognostic value in acute brain injury. However, fMRI is much more challenging in critically ill patients because of cardiovascular vulnerability, intravenous sedation, and artificial ventilation. METHODS: Using resting-state fMRI, we investigated the DMN in a convenience sample of patients with acute brain injury admitted to the intensive care unit...
May 8, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28477328/can-chronic-disease-be-managed-through-integrated-care-cost-effectively-evidence-from-a-systematic-review
#15
J Cronin, A Murphy, E Savage
BACKGROUND: The increase in demand for integrated care models to manage chronic disease is a challenge for the Irish health system, which is traditionally organised around the acute hospital services. Implementing integrated care programmes requires significant investment, and thus, their economic impact requires consideration. AIMS: This paper updates the previous evidence on the cost-effectiveness of integrated care programmes to support the development of a cost-effective integrated care programme for chronic disease management...
May 5, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28475274/remote-ischaemic-preconditioning-for-coronary-artery-bypass-grafting-with-or-without-valve-surgery
#16
REVIEW
Carina Benstoem, Christian Stoppe, Oliver J Liakopoulos, Julia Ney, Dirk Hasenclever, Patrick Meybohm, Andreas Goetzenich
BACKGROUND: Despite substantial improvements in myocardial preservation strategies, coronary artery bypass grafting (CABG) is still associated with severe complications. It has been reported that remote ischaemic preconditioning (RIPC) reduces reperfusion injury in people undergoing cardiac surgery and improves clinical outcome. However, there is a lack of synthesised information and a need to review the current evidence from randomised controlled trials (RCTs). OBJECTIVES: To assess the benefits and harms of remote ischaemic preconditioning in people undergoing coronary artery bypass grafting, with or without valve surgery...
May 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28475215/effect-of-inpatient-dobutamine-vs-milrinone-on-out-of-hospital-mortality-in-patients-with-acute-decompensated-heart-failure
#17
Jordan B King, Rashmee U Shah, Amy Sainski-Nguyen, Joseph Biskupiak, Mark A Munger, Adam P Bress
STUDY OBJECTIVE: To determine the effect of dobutamine versus milrinone on out-of-hospital mortality in treatment of patients with acute decompensated heart failure (ADHF). DESIGN: Propensity score weighted, retrospective cohort study with mortality as primary outcome. SETTING: An academic health-care system. PATIENTS: 500 adult patients with a prior history of heart failure, who survived a hospitalization for ADHF that included treatment with dobutamine or milrinone between January 1, 2006 and April 30, 2014...
May 5, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28469499/a-case-of-statin-associated-autoimmune-myopathy
#18
Alexander J Sweidan, Anthony Leung, Cassandra J Kaiser, Sarah J Strube, Andrei N Dokukin, Stephen Romansky, Sassan Farjami
A 70-year-old previously independent man developed progressive proximal leg weakness resulting in a fall at home suffering traumatic brain injury. He was prescribed a statin medication two years prior, but this was discontinued on admission to the hospital due to concern for statin myopathy. His weakness continued to progress while in acute rehabilitation, along with the development of dysphagia requiring placement of gastrostomy tube and respiratory failure requiring tracheostomy. Corticosteroids and intravenous immunoglobulin were administered without response...
2017: Clinical Medicine Insights. Case Reports
https://www.readbyqxmd.com/read/28465771/clinical-characteristics-and-unmet-need-among-patients-with-atherosclerotic-cardiovascular-disease-stratified-by-statin-use
#19
Qing Huang, Michael Grabner, Robert J Sanchez, Vincent J Willey, Mark J Cziraky, Swetha R Palli, Thomas P Power
BACKGROUND: The American College of Cardiology (ACC)/American Heart Association (AHA) 2013 guidelines for blood cholesterol treatment recommend high-intensity statins for adults with atherosclerotic cardiovascular disease (ASCVD). Currently, little is known about the real-world patient characteristics of ASCVD, as well as the clinical and economic consequences of different treatment options for this disease. OBJECTIVES: To compare the demographic, clinical, and economic characteristics of patients with clinical ASCVD who started therapy with high-intensity statins, low-/moderate-intensity statins, or no statins in usual-care settings based on data primarily before the release of the ACC/AHA 2013 guidelines...
November 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28462739/improving-early-exclusion-of-acute-coronary-syndrome-in-primary-care-the-added-value-of-point-of-care-troponin-as-stated-by-general-practitioners
#20
Michelle M A Kip, Amber M Noltes, Hendrik Koffijberg, Maarten J IJzerman, Ron Kusters
Aim To investigate general practitioners' (GPs') desire and perceived added value of point-of-care (POC) troponin, its effect on referral decisions, and test requirements. BACKGROUND: Excluding acute coronary syndrome (ACS) in primary care remains a diagnostic challenges for GPs. Consequently, referral rates of chest pain patients are high, while the incidence of a cardiovascular problem is only 8-15%. Previous studies have shown that GPs are interested in a POC troponin test. This test could enhance rapid exclusion of ACS, thereby preventing unnecessary patient distress, without compromising safety and while reducing costs...
May 2, 2017: Primary Health Care Research & Development
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