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https://www.readbyqxmd.com/read/28079915/intravenous-immunoglobulin-for-the-treatment-of-kawasaki-disease
#1
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
#2
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
#3
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
#4
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
#5
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
https://www.readbyqxmd.com/read/28055992/-practicality-of-cardiovascular-risk-functions
#6
Jaume Marrugat, Roberto Elosua, Gloria Icaza, Alberto Morales-Salinas, Irene R Dégano
Cardiovascular diseases prevention strategies require refinement because their incidence decreases very slowly. Risk functions were developed by including classical cardiovascular risk factors (age, sex, smoking, diabetes, blood pressure, and basic lipid profile) in cohorts followed more than 10 years. They are reasonably precise for population screening of, principally, coronary artery disease risk, required in all cardiovascular primary prevention clinical guidelines. Coronary artery disease risk functions classify patients in risk strata to concentrate the maximum therapeutic and life style effort in the highest risk groups, in which the number needed to treat and cost-effectiveness are optimal...
December 13, 2016: Medwave
https://www.readbyqxmd.com/read/28042727/new-evidence-for-cardiac-benefit-of-postmenopausal-hormone-therapy
#7
T S Mikkola, H Savolainen-Peltonen, M Venetkoski, O Ylikorkala
Coronary artery disease (CAD) is still the most common killer of western women. Coronary arteries, expressing estrogen receptors, are a target for estrogen action. Prior to the Women's Health Initiative (WHI) study, postmenopausal hormone therapy (HT) was widely advocated for primary prevention of CAD, but such use was criticized after the WHI publication. However, new data accumulated in the USA and in Europe indicate that the use of estradiol-based HT regimens does not endanger the heart, but rather, it significantly reduces the incidence of CAD events and mortality...
January 2, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/28026916/antianginal-medications-and-long-term-outcomes-after-elective-catheterization-in-patients-with-coronary-artery-disease
#8
Lan Shen, John P Vavalle, Samuel Broderick, Linda K Shaw, Pamela S Douglas
BACKGROUND: Antianginal medications are a class I recommendation by the American College of Cardiology/American Heart Association guidelines for stable ischemic heart disease. We sought to better understand guidance in drug selection and real-life outcomes of antianginal medication use. HYPOTHESIS: In patients with stable ischemic heart disease, antianginal medications lower mortality. METHODS: We evaluated 5608 patients with obstructive coronary artery disease (CAD) on elective cardiac catheterization with follow-up through self-administered questionnaires...
December 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/28025191/fractional-flow-reserve-to-guide-and-to-assess-coronary-artery-bypass-grafting
#9
REVIEW
Mariano Pellicano, Bernard De Bruyne, Gabor G Toth, Filip Casselman, William Wijns, Emanuele Barbato
The aim of this review is to highlight the role of invasive functional evaluation in patients in whom coronary artery bypass graft (CABG) is indicated, and to examine the clinical evidence available in favour of fractional flow reserve (FFR) adoption in these patients, outline appropriate use, as well as point out potential pitfalls. FFR after CABG will also be reviewed, highlighting its correct interpretation and adoption when applied to both native coronary arteries and bypass grafts. Practice European guidelines support the use of FFR to complement coronary angiography with the highest degree of recommendation (Class IA) for the assessment of coronary stenosis before undertaking myocardial revascularization when previous non-invasive functional evaluation is unavailable or not conclusive...
December 23, 2016: European Heart Journal
https://www.readbyqxmd.com/read/28007240/the-society-of-thoracic-surgeons-2017-clinical-practice-guidelines-for-the-surgical-treatment-of-atrial-fibrillation
#10
Vinay Badhwar, J Scott Rankin, Ralph J Damiano, A Marc Gillinov, Faisal G Bakaeen, James R Edgerton, Jonathan M Philpott, Patrick M McCarthy, Steven F Bolling, Harold G Roberts, Vinod H Thourani, Rakesh M Suri, Richard J Shemin, Scott Firestone, Niv Ad
Surgical ablation for atrial fibrillation (AF) can be performed without additional risk of operative mortality or major morbidity, and is recommended at the time of concomitant mitral operations to restore sinus rhythm. (Class I, Level A) Surgical ablation for AF can be performed without additional operative risk of mortality or major morbidity, and is recommended at the time of concomitant isolated aortic valve replacement, isolated coronary artery bypass graft surgery, and aortic valve replacement plus coronary artery bypass graft operations to restore sinus rhythm...
January 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/27999513/choosing-non-vitamin-k-antagonist-oral-anticoagulants-practical-considerations-we-need-to-know
#11
REVIEW
Alpesh Amin
BACKGROUND: Warfarin is a well-established agent for use in the prevention of stroke or systemic embolic event (SEE) in patients with nonvalvular atrial fibrillation (NVAF) and for the treatment of venous thromboembolism (VTE). However, management of patients requiring oral anticoagulation with warfarin can be complicated by the need for frequent monitoring, drug-drug and drug-food interactions, and a variable response based on genetic polymorphisms. The non-vitamin K antagonist oral anticoagulants (NOACs) were developed as alternatives to warfarin; they do not require routine monitoring and have predictable pharmacokinetics, fewer drug-drug interactions, and limited drug-food interactions...
2016: Ochsner Journal
https://www.readbyqxmd.com/read/27988074/the-acetylcholine-administration-time-plays-the-key-role-for-provoked-spasm-in-the-spasm-provocation-test
#12
Shozo Sueda, Hiroaki Kohno
BACKGROUND: Acetylcholine (ACh) was administered for 3min in the ENCORE study, while the Japanese Circulation Society guidelines recommended the 20s ACh injection as an ACh test. OBJECTIVES: We compared the ischemic findings between ACh administration for 3min and ACh injection for 20s in the same patients and in the same ACh doses without administration of nitrates in the left coronary artery. METHODS: We investigated 30 patients with ischemic heart disease (25 men, 67±10 years, ACh 50μg: 3, ACh 100μg: 9, ACh 200μg: 18) by the above two ACh injection procedures...
December 14, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27964699/a-review-of-hypertension-management-in-atrial-fibrillation
#13
Sidakpal S Panaich, Nilay Patel, Shilpkumar Arora, Kanishk Agnihotri, Nileshkumar J Patel, Samir V Patel, Rajesh Sonani, Achint Patel, Sopan Lahewala, Vikas Singh, Badal Thakkar, Parth Bhatt, Abhishek Deshmukh, Apurva O Badheka
Atrial fibrillation (AF) is one of the commonest arrhythmias in clinical practice and has major healthcare and economic implications. It is a growing epidemic with prevalence all set to double to 12 million by 2050. After adjusting for other associated conditions, hypertension confers a 1.5- and 1.4-fold risk of developing AF, for men and women respectively. Furthermore, in patients with AF, the presence of hypertension has a cumulative effect on the risk of stroke. Growing evidence suggests reversal or attenuation of various structural and functional changes predisposing to AF with the use of anti-hypertensive medications...
December 13, 2016: Current Hypertension Reviews
https://www.readbyqxmd.com/read/27957818/optimal-pharmacological-treatment-and-adherence-to-medication-in-secondary-prevention-of-cardiovascular-events-in-spain-results-from-the-caps-study
#14
Alberto Cordero, Luis Rodriguez Padial, Alberto Batalla, Luis López Barreiro, Francisco Torres Calvo, Jose M Castellano, Emilio Ruiz, Vicente Bertomeu-Martínez
INTRODUCTION: Despite the large amount of evidence supporting the use of antiplatelet agents, beta-blockers, angiotensin antagonists, and lipid-lowering statins in patients with stable coronary artery disease, several studies have documented underprescription of optimal medical treatment (OMT) in Spain. AIMS: The present study aims to describe the current trend of pharmacological prescription in secondary prevention treatment for cardiovascular diseases (CVD) in a Spanish cohort...
December 13, 2016: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/27957249/physiology-of-in-situ-arterial-revascularization-in-coronary-artery-bypass-grafting-preoperative-intraoperative-and-postoperative-factors-and-influences
#15
REVIEW
T Bruce Ferguson
Surgical revascularization with coronary artery bypass grafting (CABG) has become established as the most effective interventional therapy for patients with moderately severe and severe stable ischemic heart disease (SIHD). This recommendation is based on traditional 5-year outcomes of mortality and avoidance of myocardial infarction leading to reintervention and/or cardiac death. However, these results are confounded in that they challenge the traditional CABG surgical tenets of completeness of anatomic revascularization, the impact of arterial revascularization on late survival, and the lesser impact of secondary prevention following CABG on late outcomes...
November 26, 2016: World Journal of Cardiology
https://www.readbyqxmd.com/read/27937054/efficacy-of-aspirin-325-mg-omeprazole-40-mg-in-treating-coronary-artery-disease
#16
Tushar Sharma, Kevin Bliden, Rahul Chaudhary, Udaya Tantry, Paul A Gurbel
Aspirin is indicated for primary and secondary prevention of cardiovascular diseases (CVD) by major guidelines. However, its use may be associated with gastrointestinal (GI) toxicities, including, but not limited to, GI bleeding. This may lead to increased morbidity and mortality, as well as diminished compliance, which again leads to increased risk of major cardiovascular events. Modified formulations of aspirin often have comparable risks of GI toxicity despite their dose or formulation and have had limited success to prevent GI toxicities...
January 2017: Expert Opinion on Pharmacotherapy
https://www.readbyqxmd.com/read/27931592/the-rationale-for-performance-of-coronary%C3%A2-angiography-and-stenting-before-transcatheter-aortic-valve-replacement-from-the-interventional-section-leadership-council-of-the-american-college-of-cardiology
#17
REVIEW
Stephen Ramee, Saif Anwaruddin, Gautam Kumar, Robert N Piana, Vasilis Babaliaros, Tanveer Rab, Lloyd W Klein
Transcatheter aortic valve replacement (TAVR) is an effective, nonsurgical treatment option for patients with severe aortic stenosis. The optimal treatment strategy for treating concomitant coronary artery disease (CAD) has not been tested prospectively in a randomized clinical trial. Nevertheless, it is standard practice in the United States to perform coronary angiography and percutaneous coronary intervention for significant CAD at least 1 month before TAVR. All existing clinical trials were designed using this strategy...
December 12, 2016: JACC. Cardiovascular Interventions
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
#18
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
https://www.readbyqxmd.com/read/27928449/severe-asymptomatic-coronary-obstruction-in-chronic-hemodialysed-patient-a-case-report
#19
Voiculeț C, Zara O, Văcăroiu I, Bogeanu C, Tiron T, Turcu F, Aron G, Ciocâlteu A
Introduction. Arterial stiffness and vascular calcifications are independent predictors of cardiovascular morbidity and mortality in the chronic kidney disease (CKD) stage 5D population. According to the guidelines, patients on renal replacement therapy represent a very high cardiovascular risk class. Case report. We report the case of a 67-year-old hypertensive male patient, known with CKD stage 5D on hemodialysis (three times per week), secondary bone mineral disease, admitted for progressive right leg pain...
October 2016: Journal of Medicine and Life
https://www.readbyqxmd.com/read/27927939/have-clinicians-adopted-the-use-of-brain-mri-for-patients-with-tia-and-minor-stroke
#20
Seemant Chaturvedi, Susan Ofner, Fitsum Baye, Laura J Myers, Mike Phipps, Jason J Sico, Teresa Damush, Edward Miech, Mat Reeves, Jason Johanning, Linda S Williams, Greg Arling, Eric Cheng, Zhangsheng Yu, Dawn Bravata
BACKGROUND: Use of MRI with diffusion-weighted imaging (DWI) can identify infarcts in 30%-50% of patients with TIA. Previous guidelines have indicated that MRI-DWI is the preferred imaging modality for patients with TIA. We assessed the frequency of MRI utilization and predictors of MRI performance. METHODS: A review of TIA and minor stroke patients evaluated at Veterans Affairs hospitals was conducted with regard to medical history, use of diagnostic imaging within 2 days of presentation, and in-hospital care variables...
December 7, 2016: Neurology
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