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https://www.readbyqxmd.com/read/28199464/identification-of-patients-with-stable-chest-pain-deriving-minimal-value-from-noninvasive-testing-the-promise-minimal-risk-tool-a-secondary-analysis-of-a-randomized-clinical-trial
#1
Christopher B Fordyce, Pamela S Douglas, Rhonda S Roberts, Udo Hoffmann, Hussein R Al-Khalidi, Manesh R Patel, Christopher B Granger, John Kostis, Daniel B Mark, Kerry L Lee, James E Udelson
Importance: Guidelines recommend noninvasive testing for patients with stable chest pain, although many subsequently have normal test results and no adverse clinical events. Objective: To describe a risk tool developed to use only pretest clinical data to identify patients with chest pain with normal coronary arteries and no clinical events during follow-up (minimal-risk cohort). Design, Setting, and Participants: This secondary analysis of a randomized, pragmatic comparative effectiveness trial (Prospective Multicenter Imaging Study for Evaluation of Chest Pain [PROMISE]) includes stable, symptomatic outpatients without known coronary artery disease referred for noninvasive testing at 193 sites in North America...
February 15, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28186938/an-online-questionnaire-survey-of-uk-general-practitioners-knowledge-and-management-of-familial-hypercholesterolaemia
#2
See Kwok, Jing Pang, Safwaan Adam, Gerald F Watts, Handrean Soran
OBJECTIVE: Early diagnosis and treatment of heterozygous familial hypercholesterolaemia (HeFH) is known to be associated with reduced mortality from premature coronary artery disease, but HeFH remains underdiagnosed. This survey aims to determine knowledge and current management of HeFH in general practice. SETTING: An online questionnaire was administered to general practitioners' (GPs') in the North West of England to assess their knowledge and management of HeFH...
November 9, 2016: BMJ Open
https://www.readbyqxmd.com/read/28186444/the-diagnostic-accuracy-of-myocardial-perfusion-scintigraphy-in-athletes-with-abnormal-exercise-test-results
#3
Danny Ajp van de Sande, Ing Han Liem, Jan Hoogsteen, Hareld Mc Kemps
Background Previous studies revealed a relatively high prevalence of electrocardiographic findings indicative for myocardial ischemia in asymptomatic athletes undergoing pre-participation screening. Myocardial perfusion scintigraphy is generally considered a valuable diagnostic and prognostic modality and often used for further diagnostic evaluation in these subjects. However, data on the diagnostic accuracy of myocardial perfusion scintigraphy in athletes are scarce. Objectives The main purpose of this study was to investigate the positive predictive value of myocardial perfusion scintigraphy for detection of coronary artery disease in asymptomatic athletes with abnormal exercise testing results during pre-participation screening...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28181201/management-of-hypertension-in-the-elderly-and-frail-elderly
#4
REVIEW
Claudio Ferri, Livia Ferri, Giovambattista Desideri
An elevated systolic but not diastolic blood pressure level represents a common finding in elderly patients and is associated with an increased risk for developing coronary artery disease, cerebrovascular disease, peripheral artery disease, progressive cognitive decline and renal failure. Although less frequently, elderly patients manifest not only with systolic but also diastolic hypertension. Also in this case, the elderly patient will present an increased risk for developing hypertension-related abnormalities...
March 2017: High Blood Pressure & Cardiovascular Prevention: the Official Journal of the Italian Society of Hypertension
https://www.readbyqxmd.com/read/28169555/aspiration-thrombectomy-and-intracoronary-tirofiban-via-guideliner-%C3%A2-catheter-for-a-thrombosed-aneurysmal-vessel
#5
James Fry, Ali Naqvi, Amit Bahia, Arnold Seto
A 52-year-old Asian male with no traditional risk factors for coronary artery disease presented with acute coronary syndrome. Coronary angiography showed complete thrombotic occlusion of the left circumflex with a large thrombus burden in the setting of diffuse aneurysmal enlargement of the coronary arteries consistent with antecedent Kawasaki disease. Manual thrombectomy with adjunctive intracoronary tirofiban was performed utilizing the GuideLiner catheter. Stent implantation was deferred. Follow-up imaging 48 h later showed preserved coronary flow and decreased thrombus burden...
February 7, 2017: Future Cardiology
https://www.readbyqxmd.com/read/28154958/combination-of-high-sensitivity-troponin-i-and-n-terminal-pro-b-type-natriuretic-peptide-predicts-future-hospital-admission-for-heart-failure-in-high-risk-hypertensive-patients-with-preserved-left-ventricular-ejection-fraction
#6
Ryunosuke Okuyama, Junnichi Ishii, Hiroshi Takahashi, Hideki Kawai, Takashi Muramatsu, Masahide Harada, Akira Yamada, Sadako Motoyama, Shigeru Matsui, Hiroyuki Naruse, Masayoshi Sarai, Midori Hasegawa, Eiichi Watanabe, Atsushi Suzuki, Mutsuharu Hayashi, Hideo Izawa, Yukio Yuzawa, Yukio Ozaki
Additional risk stratification may provide more aggressive and focalized preventive treatment to high-risk hypertensive patients according to the Japanese hypertension guidelines. We prospectively investigated the predictive value of high-sensitivity troponin I (hsTnI), both independently and in combination with N-terminal pro-B-type natriuretic peptide (NT-proBNP), for incident heart failure (HF) in high-risk hypertensive patients with preserved left ventricular ejection fraction (LVEF). Baseline hsTnI and NT-proBNP levels and echocardiography data were obtained for 493 Japanese hypertensive outpatients (mean age, 68...
February 2, 2017: Heart and Vessels
https://www.readbyqxmd.com/read/28137546/burr-hole-drainage-for-chronic-subdural-hematoma-under-low-dose-acetylsalicylic-acid-a-comparative-risk-analysis-study
#7
Maria Kamenova, Edin Nevzati, Katharina Lutz, Armando Dolp, Javier Fandino, Luigi Mariani, Jehuda Soleman
BACKGROUND: Chronic subdural hematoma (cSDH) is one of the most common neurosurgical diseases typically affecting elderly people. Many of these patients present with coronary artery disease (CAD) and receive antiplatelet therapy, usually Acetylsalicylic acid (ASA). Despite growing clinical relevance, there is still a lack of data focusing on the perioperative management of such patients. OBJECTIVE: The aim of this study is to compare the peri- and postoperative bleeding and cardiovascular complication rates of patients undergoing burr-hole drainage for cSDH with and without discontinuation of low-dose ASA...
January 27, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28133467/application-of-drug-coated-balloon-in-coronary-artery-intervention-challenges-and-opportunities
#8
REVIEW
Lei Gao, Yun-Dai Chen
In recent decades, the outcomes of coronary heart disease (CHD) have markedly improved, which can be partly attributed to the use of novel drugs (especially statins and antiplatelet drugs) and partly to the evolution of percutaneous coronary intervention (PCI). From percutaneous transluminal coronary angioplasty to bare-metal stent and then to drug-eluting stent, every step of PCI is attractive to interventional cardiologist, great progress has been made for patients with CHD. In the past few years, some successor devices for treating CHD have emerged...
November 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28132982/impact-of-mitral-annular-displacement-on-left-ventricular-diastolic-function-improvement-after-transcatheter-aortic-valve-implantation
#9
Hiroto Utsunomiya, Hirotsugu Mihara, Yuji Itabashi, Robert J Siegel, Tarun Chakravarty, Hasan Jilaihawi, Raj R Makkar, Takahiro Shiota
BACKGROUND: The clinical significance of left ventricular (LV) diastolic function (DF) improvement after transcatheter aortic valve implantation (TAVI) is not fully elucidated. We sought to investigate the long-term clinical and hemodynamic effects of post-TAVI DF improvement and to identify its determinants.Methods and Results:Clinical and serial echocardiographic data before and after TAVI were retrospectively reviewed together with measurement of mitral annular displacement (MAD) representing longitudinal myocardial function in 98 patients with severe aortic stenosis and ejection fraction >55%...
January 27, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28130653/addressing-knowledge-gaps-in-the-2013-acc-aha-guideline-on-the-assessment-of-cardiovascular-risk-a-review-of-recent-coronary-artery-calcium-literature
#10
REVIEW
Vasanth Sathiyakumar, Roger S Blumenthal, Khurram Nasir, Seth S Martin
PURPOSE OF REVIEW: Coronary artery calcium (CAC) has been proposed as an integrator of information from traditionally measured, non-traditionally measured, and unmeasured risk factors for coronary atherosclerosis. The 2013 American College of Cardiology/American Heart Association Guideline on the Assessment of Cardiovascular Risk identified several knowledge gaps regarding CAC, including radiation risks, cost-effectiveness, and improving discrimination and reclassification of estimated risk over the Pooled Cohort Equations in the ACC/AHA Atherosclerotic Cardiovascular Disease Estimator...
February 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28124965/-bacteremia-caused-by-ciprofloxacin-resistant-salmonella-serotype-kentucky-a-case-report-and-the-review-of-literature
#11
Tuba Müderris, Fatma Yekta Ürkmez, Şeref Alp Küçüker, Muhammet Fethi Sağlam, Gül Ruhsar Yılmaz, Rahmet Güner, Revasiye Güleşen, Ziya Cibali Açıkgöz
Salmonella infections can be seen in four clinical types, namely gastroenteritis, bacteremia/sepsis, enteric fever and carriage. These infections can result in uncomplicated diarrhea in most cases, but can lead to invasive disease requiring antimicrobial therapy and can be life-threatening in elderly or immunocomprimised patients. Broad-spectrum cephalosporins and fluoroquinolones are crucial options in the treatment of the invasive infections. Ciprofloxacin resistance is rarely seen in non-typhoid Salmonella enterica isolates, and only in S...
October 2016: Mikrobiyoloji Bülteni
https://www.readbyqxmd.com/read/28120185/drug-therapy-for-stable-angina-pectoris
#12
Talla A Rousan, Sunil T Mathew, Udho Thadani
Chronic stable angina pectoris refers to the predictable, reproducible occurrence of pressure or a choking sensation in the chest or adjacent areas caused by myocardial ischemia in association with physical or emotional stress, and cessation of exertion and or sublingual nitroglycerin invariably relieves the discomfort. It is a common presenting symptom of severe narrowing of one or more coronary arteries, non-obstructive coronary arteries, or even when the coronary arteries are angiographically normal. Patients often avoid activities which precipitate symptoms and have impaired quality of life...
January 24, 2017: Drugs
https://www.readbyqxmd.com/read/28111055/oral-anticoagulant-use-in-octogenarian-european-patients-with-atrial-fibrillation-a-subanalysis-of-prefer-in-af
#13
Olivier Hanon, Jean-Sébastien Vidal, Jean-Yves Le Heuzey, Paulus Kirchhof, Raffaele De Caterina, Josef Schmitt, Petra Laeis, Pier Mannuccio Mannucci, Maura Marcucci
BACKGROUND: Few studies describe oral anticoagulant (OAC) prescription practices in very elderly patients with atrial fibrillation (AF). METHODS: In this sub-analysis of the PREFER in AF study, performed in 2012, patients were stratified according to age (<80 [n=5565] and ≥80years [n=1660]) and OAC treatment. Factors associated with OAC prescription were analyzed in a multivariate logistic regression model with backward elimination of variables least associated with OAC use...
January 7, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28104706/selecting-patients-with-non-st-elevation-acute-coronary-syndrome-for-coronary-angiography-a-nationwide-clinical-vignette-study-in-the-netherlands
#14
Josien Engel, Judith M Poldervaart, Ineke van der Wulp, Johannes B Reitsma, Martine C de Bruijne, Jeroen J H Bunge, Maarten J Cramer, Wouter J Tietge, Ruben Uijlings, Cordula Wagner
OBJECTIVE: Cardiac guidelines recommend that the decision to perform coronary angiography (CA) in patients with Non-ST-Elevation Acute Coronary Syndrome (NST-ACS) is based on multiple factors. It is, however, unknown how cardiologists weigh these factors in their decision-making. The aim was to investigate the importance of different clinical characteristics, including information derived from risk scores, in the decision-making of Dutch cardiologists regarding performing CA in patients with suspected NST-ACS...
January 19, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100277/stress-echo-2020-the-international-stress-echo-study-in-ischemic-and-non-ischemic-heart-disease
#15
Eugenio Picano, Quirino Ciampi, Rodolfo Citro, Antonello D'Andrea, Maria Chiara Scali, Lauro Cortigiani, Iacopo Olivotto, Fabio Mori, Maurizio Galderisi, Marco Fabio Costantino, Lorenza Pratali, Giovanni Di Salvo, Eduardo Bossone, Francesco Ferrara, Luna Gargani, Fausto Rigo, Nicola Gaibazzi, Giuseppe Limongelli, Giuseppe Pacileo, Maria Grazia Andreassi, Bruno Pinamonti, Laura Massa, Marco A R Torres, Marcelo H Miglioranza, Clarissa Borguezan Daros, José Luis de Castro E Silva Pretto, Branko Beleslin, Ana Djordjevic-Dikic, Albert Varga, Attila Palinkas, Gergely Agoston, Dario Gregori, Paolo Trambaiolo, Sergio Severino, Ayana Arystan, Marco Paterni, Clara Carpeggiani, Paolo Colonna
BACKGROUND: Stress echocardiography (SE) has an established role in evidence-based guidelines, but recently its breadth and variety of applications have extended well beyond coronary artery disease (CAD). We lack a prospective research study of SE applications, in and beyond CAD, also considering a variety of signs in addition to regional wall motion abnormalities. METHODS: In a prospective, multicenter, international, observational study design, > 100 certified high-volume SE labs (initially from Italy, Brazil, Hungary, and Serbia) will be networked with an organized system of clinical, laboratory and imaging data collection at the time of physical or pharmacological SE, with structured follow-up information...
January 18, 2017: Cardiovascular Ultrasound
https://www.readbyqxmd.com/read/28079915/intravenous-immunoglobulin-for-the-treatment-of-kawasaki-disease
#16
Stanford T Shulman
Standard first-line therapy for Kawasaki disease (KD) consists of intravenous immunoglobulin (IVIG) and aspirin. Current guidelines recommend 2 g/kg of IVIG and 80 to 100 mg/kg of aspirin administered within the first 10 days of illness. This regimen has marked efficacy in preventing the development of coronary artery aneurysms. Approximately 15% to 20% of treated patients require a second dose of IVIG to control the inflammatory process. The role of adjunctive corticosteroid therapy with IVIG and aspirin is evolving, with Japanese studies showing a clear benefit in those patients at highest risk for development of coronary disease...
January 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28078997/lipoprotein-a-and-cardiovascular-risk-the-show-must-go-on
#17
Niki Katsiki, Khalid Al-Rasadi, Dimitri P Mikhailidis
Lipoprotein (a) [Lp(a)] is an independent but moderate, predictor for coronary heart disease (CHD) prevalence and severity. Several established and emerging cardiovascular (CV) risk factors including age, gender, ethnicity, smoking, dyslipidemia, hypertension, obesity, type 2 diabetes mellitus, alcohol consumption, arterial stiffness and hyperuricemia have been linked to Lp(a) metabolism. Apart from CHD, Lp(a) has been also associated with non-cardiac vascular diseases and diseases associated with increased CV risk such as chronic kidney disease, metabolic syndrome, non-alcoholic fatty liver disease, erectile dysfunction, obstructive sleep apnea syndrome, inflammatory bowel diseases and human immunodeficiency virus infection...
January 12, 2017: Current Medicinal Chemistry
https://www.readbyqxmd.com/read/28065766/changes-in-one-year-mortality-in-elderly-patients-admitted-with-acute-myocardial-infarction-in-relation-with-early-management
#18
Etienne Puymirat, Nadia Aissaoui, Guillaume Cayla, Alexandre Lafont, Elisabeth Riant, Marco Mennuni, Olivier Saint-Jean, Didier Blanchard, Patrick Jourdain, Meyer Elbaz, Patrick Henry, Vincent Bataille, Elodie Drouet, Geneviève Mulak, François Schiele, Jean Ferrières, Tabassome Simon, Nicolas Danchin
BACKGROUND: Elderly patients are underrepresented in acute myocardial infarction trials. Our aim was to determine whether, in elderly patients, changes in management in the past 15 years is associated with improved one-year mortality after hospital admission for myocardial infarction. METHODS: We used data from 4 one-month French registries, conducted 5 years apart from 1995 to 2010, including 3,389 elderly patients (≥75 years). RESULTS: From 1995 to 2010, mean age remained stable (82...
January 5, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28062620/application-of-cardiac-troponin-in-cardiovascular-diseases-other-than-acute-coronary-syndrome
#19
REVIEW
Kai M Eggers, Bertil Lindahl
BACKGROUND: Increased cardiac troponin concentrations in acute coronary syndrome (ACS) identify patients with ongoing cardiomyocyte necrosis who are at increased risk. However, with the use of more precise assays, cardiac troponin increases are commonly noted in other cardiovascular conditions as well. This has generated interest in the use of cardiac troponin for prognostic assessment and clinical management of these patients. In this review, we have summarized the data from studies investigating the implications of cardiac troponin concentrations in various acute and chronic conditions beyond ACS, i...
January 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28062171/-lipid-control-in-patients-with-coronary-artery-disease-in-a-healthcare-area-in-c%C3%A3-ceres-spain-lipiceres-study
#20
José J Gómez-Barrado, Carolina Ortiz, Marta Gómez-Turégano, Paula Gómez-Turégano, Francisco J Garcipérez-de-Vargas, Pablo Sánchez-Calderón
INTRODUCTION AND OBJECTIVES: Current guidelines recommend a low-density lipoprotein cholesterol (LDLc) target of <70mg/dl for patients with coronary artery disease. Despite the well-established benefits of strict lipid control, the most recent studies show that control rate of lipid targets are alarmingly low. An analysis was performed on the lipid targets attained according to current guidelines for the prevention of cardiovascular disease in coronary patients in a Caceres healthcare area...
January 3, 2017: Clínica e Investigación en Arteriosclerosis
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