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https://www.readbyqxmd.com/read/29131549/diagnosis-of-kawasaki-disease
#1
Surjit Singh, Ankur Kumar Jindal, Rakesh Kumar Pilania
Kawasaki disease (KD) is a medium vessel vasculitis with predilection for coronary arteries. Due to lack of a reliable confirmatory laboratory test, the diagnosis of KD is based on a constellation of clinical findings that appear in a typical temporal sequence. These diagnostic criteria have been modified from time to time and the most recent guidelines have been proposed by the American Heart Association (AHA) in 2017. However, several children may have incomplete or atypical forms of KD and the diagnosis can often be difficult, especially in infants and young children...
November 13, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/29131289/negative-predictors-of-treatment-success-in-outpatient-therapy-of-arterial-hypertension-in-poland-results-of-the-control-nt-observational-registry
#2
Krzysztof J Filipiak, Mariusz Tomaniak, Anna E Płatek, Filip M Szymański, Andrzej Tykarski
BACKGROUND: Identification of factors interfering with adequate control of arterial hypertension in the course of antihypertensive therapy is necessary to plan the strategy or reducing the incidence of cardiovascular disorders and optimize clinical practice guidelines. There have only been limited reliable studies describing the current status of hypertension treatment. AIM: The study objective was to conduct a screening assessment of the rate of uncontrolled hypertension among hypertensive patients coming to a routine follow-up visit, and to characterize patients with inadequate control of arterial hypertension in the aspect of their cardiovascular risk profile and therapeutic strategies used...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29129396/sex-difference-between-target-levels-of-cholesterol-related-parameters-and-post-pci-long-term-clinical-outcomes-from-the-fu-registry
#3
Yuta Matsuoka, Amane Ike, Masahiro Ogawa, Kouki Gondo, Kazuyuki Shirai, Makoto Sugihara, Daisuke Nose, Hiroaki Nishikawa, Atsushi Iwata, Akira Kawamura, Ken Mori, Bo Zhang, Shin'ichiro Yasunaga, Shin-Ichiro Miura, Keijiro Saku
BACKGROUND: Since single lipid parameters are too weak to predict the risk of coronary artery disease, we examined whether the allocation of patients into four groups based on achievement of the target levels set by the Japan Atherosclerosis Guidelines at the time of percutaneous coronary intervention (PCI) would reveal different long-term (5 years) clinical outcomes in males and females. METHODS: The results of a 5-year follow-up study are summarized as FU-Registry, Long-Term Clinical Outcome Results...
November 9, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/29129260/lipid-management-in-contemporary-community-practice-results-from-the-provider-assessment-of-lipid-management-palm-registry
#4
Ann Marie Navar, Tracy Y Wang, Shuang Li, Jennifer G Robinson, Anne C Goldberg, Salim Virani, Veronique L Roger, Peter W F Wilson, Joseph Elassal, L Veronica Lee, Eric D Peterson
BACKGROUND: The latest cholesterol guidelines have shifted focus from achieving low-density lipoprotein cholesterol (LDL-C) targets toward statin use and intensity guided by atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: Statin use and intensity were evaluated in 5,905 statin-eligible primary or secondary prevention patients from 138 PALM Registry practices. RESULTS: Overall, 74.7% of eligible adults were on statins; only 42...
November 2017: American Heart Journal
https://www.readbyqxmd.com/read/29108840/use-of-the-coronary-artery-calcium-score-in-discussion-of-initiation-of-statin-therapy-in-primary-prevention
#5
Erin D Michos, Michael J Blaha, Roger S Blumenthal
Clinical guidelines for instituting pharmacotherapy for the primary prevention of atherosclerotic cardiovascular disease (ASCVD), specifically lipid management and aspirin, have long been based on absolute risk. However, lipid management in the current era remains challenging to both patients and clinicians in the setting of somewhat discordant recommendations from various organizations. All guidelines endorse the use of statins for primary prevention for those at sufficient absolute risk, and treatment recommendations are generally "risk-based" rather than exclusively targeting specific low-density lipoprotein cholesterol levels...
November 3, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29098634/pre-and-postoperative-anemia-acute-kidney-injury-and-mortality-after-coronary-artery-bypass-grafting-surgery-a-retrospective-observational-study
#6
Adriana D Oprea, J Mauricio Del Rio, Mary Cooter, Cynthia L Green, Jörn A Karhausen, Patrick Nailer, Nicole R Guinn, Mihai V Podgoreanu, Mark Stafford-Smith, Jacob N Schroder, Manuel L Fontes, Miklos D Kertai
BACKGROUND: Preoperative and postoperative anemia have been identified individually as potential risk factors for postoperative complications after coronary artery bypass grafting (CABG) surgery. Their interrelationship with acute kidney injury (AKI) and long-term mortality, however, has not been clearly defined and was the purpose of this study. METHODS: We retrospectively evaluated 6,130 adult patients undergoing CABG surgery performed at a single large academic medical center...
November 2, 2017: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29097746/quality-of-medical-therapy-in-heart-failure-patients-undergoing-elective-revascularisation-a-protective-effect-of-disease-modifying-therapy-at-discharge
#7
Raphael Wurm, Martin Huelsmann, Marius Hienert, Veronika Seidl, Dominik Wiedemann, Guenther Laufer, Alfred Kocher, Christopher Adlbrecht, Martin Andreas
The STICH(-ES) trial showed that coronary artery bypass grafting was superior to medical therapy alone in treating ischemic heart failure. However, dosages of disease modifying drugs were not reported. We included 128 (84% male, mean age 66 ± 11 years) consecutive patients with ischemic heart failure and an ejection fraction ≤35% undergoing isolated elective coronary artery bypass grafting. We defined optimal medical therapy (OMT) as prescription of ≥50% dosages of guideline recommended medications (i...
November 2, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29094875/heart-failure-with-preserved-ejection-fraction-diagnosis-and-management
#8
John D Gazewood, Patrick L Turner
Heart failure with preserved ejection fraction, also referred to as diastolic heart failure, causes almost one-half of the 5 million cases of heart failure in the United States. It is more common among older patients and women, and results from abnormalities of active ventricular relaxation and passive ventricular compliance, leading to a decline in stroke volume and cardiac output. Heart failure with preserved ejection fraction should be suspected in patients with typical symptoms (e.g., fatigue, weakness, dyspnea, orthopnea, paroxysmal nocturnal dyspnea, edema) and signs (S3 heart sound, displaced apical pulse, and jugular venous distension) of chronic heart failure...
November 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/29092917/the-ageing-heart-the-systemic-and-coronary-circulation
#9
REVIEW
Shane Nanayakkara, Thomas H Marwick, David M Kaye
Most cardiovascular disease (CVD) occurs in patients over the age of 60. However, most evidence-based current cardiovascular guidelines lack evidence in an older population, due to the under-representation of older patients in randomised trials. Blood pressure rises with age due to increasing arterial stiffness, and stricter control results in improved outcomes. Myocardial ischaemia is also more common with increasing age, due to a combination of coronary artery disease and myocardial changes. However, despite higher rates of adverse outcomes, older patients are offered guideline-based therapy less frequently...
November 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29089819/2017-multimodality-appropriate-use-criteria-for-noninvasive-cardiac-imaging-expert-consensus-of-the-asian-society-of-cardiovascular-imaging
#10
REVIEW
Kyongmin Sarah Beck, Jeong A Kim, Yeon Hyeon Choe, Sim Kui Hian, John Hoe, Yoo Jin Hong, Sung Mok Kim, Tae Hoon Kim, Young Jin Kim, Yun Hyeon Kim, Sachio Kuribayashi, Jongmin Lee, Lilian Leong, Tae-Hwan Lim, Bin Lu, Jae Hyung Park, Hajime Sakuma, Dong Hyun Yang, Tan Swee Yaw, Yung-Liang Wan, Zhaoqi Zhang, Shihua Zhao, Hwan Seok Yong
In 2010, the Asian Society of Cardiovascular Imaging (ASCI) provided recommendations for cardiac CT and MRI, and this document reflects an update of the 2010 ASCI appropriate use criteria (AUC). In 2016, the ASCI formed a new working group for revision of AUC for noninvasive cardiac imaging. A major change that we made in this document is the rating of various noninvasive tests (exercise electrocardiogram, echocardiography, positron emission tomography, single-photon emission computed tomography, radionuclide imaging, cardiac magnetic resonance, and cardiac computed tomography/angiography), compared side by side for their applications in various clinical scenarios...
November 2017: Korean Journal of Radiology: Official Journal of the Korean Radiological Society
https://www.readbyqxmd.com/read/29073655/deceased-donor-kidney-transplantation-in-new-zealand-use-and-audit-of-a-survival-prediction-tool
#11
Frances Dowen, Nicholas Cross, Philip Clayton, Helen Pilmore
AIMS: New Zealand follows the guideline that only patients with projected five-year survival of 80% are listed for deceased donor kidney transplantation. An algorithm derived from US data estimates survival after transplantation, however, this may not be as applicable to the New Zealand population. We review use of the US derived algorithm in New Zealand. We assessed accuracy of scores calculated by referring units and audited whether the system is applied in New Zealand. METHODS: Data on 422 patients assessed for transplantation was entered into the algorithm to calculate a projected survival score...
October 27, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/29071290/data-from-a-multidisciplinary-poll-of-178-expert-physicians-on-the-usage-of-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-venous-thromboembolism
#12
Paolo Colonna, Felicita Andreotti, Walter Ageno, Vittorio Pengo, Niccolò Marchionni
This data article contains data from a multidisciplinary questionnaires filled in by 178 expert physicians on the usage of non-vitamin K Oral Anticoagulants in patients with atrial fibrillation (AF) and for the treatment of patients with venous thromboembolism (VTE). The questionnaire consists of 9 statements of clinical complex AF and VTE cases and informative campaign on antithrombotic therapy for stroke prevention in AF. The data are potentially valuable for the scientific community, showing the doubts of different specialists (Internists, Pneumologists, Geriatricians, Cardiologists and Neurologists) with a large experience in prescribing oral anticoagulation in difficult AF and VTE cases (see full list of participants provided)...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/29069037/dopamine-versus-norepinephrine-in-the-treatment-of-cardiogenic-shock-a-prisma-compliant-meta-analysis
#13
COMPARATIVE STUDY
Qing Rui, Yufeng Jiang, Min Chen, Nannan Zhang, Huajia Yang, Yafeng Zhou
BACKGROUND: Guidelines recommend that norepinephrine (NA) should be used to reach the target mean arterial pressure (MAP) during cardiogenic shock (CS), rather than epinephrine and dopamine (DA). However, there has actually been few studies on comparing norepinephrine with dopamine and their results conflicts. These studies raise a heat discussion. This study aimed to validate the effectiveness of norepinephrine for treating CS in comparison with dopamine. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) to assess pooled estimates of risk ratio (RR) and 95% confidence interval (CI) for 28-day mortality, incidence of arrhythmic events, gastrointestinal reaction, and some indexes after treatment...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29064286/spontaneous-coronary-artery-dissection-challenges-of-diagnosis-and-management
#14
Mohamed A Ahmed, Mardi Hamra, Mohamed Ali, Abdullah S Abdullah, Samer Arnous, Thomas J Kiernan
Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome in young patients. No clear factors exist to predict the natural history of the disease and the prognosis of the condition. Furthermore, current management practice of SCAD is based mainly on retrospective data and case series and clear management guidelines are lacking. In this article, we present a series of cases of patients with SCAD and we will discuss the different clinical presentations, the diagnostic approaches and the options of management of this cohort of patients...
October 24, 2017: Future Cardiology
https://www.readbyqxmd.com/read/29050797/25-year-physical-activity-trajectories-and-development-of-subclinical-coronary-artery-disease-as-measured-by-coronary-artery-calcium-the-coronary-artery-risk-development-in-young-adults-cardia-study
#15
Deepika R Laddu, Jamal S Rana, Rosenda Murillo, Michael E Sorel, Charles P Quesenberry, Norrina B Allen, Kelley P Gabriel, Mercedes R Carnethon, Kiang Liu, Jared P Reis, Donald Lloyd-Jones, J Jeffrey Carr, Stephen Sidney
OBJECTIVE: To evaluate 25-year physical activity (PA) trajectories from young to middle age and assess associations with the prevalence of coronary artery calcification (CAC). PATIENTS AND METHODS: This study includes 3175 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who self-reported PA by questionnaire at 8 follow-up examinations over 25 years (from March 1985-June 1986 through June 2010-May 2011). The presence of CAC (CAC>0) at year 25 was measured using computed tomography...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29046758/coronary-artery-ectasia-presenting-with-acute-inferior-wall-myocardial-infarction-in-a-young-adult
#16
Htun Latt, Sammy Aung, Kyaw Kyaw, Richard Seher
Coronary artery ectasia (CAE), a variant of coronary artery anomalies, is a rare clinical entity. Although atherosclerotic coronary artery disease (CAD) is the most common cause of acute coronary syndrome (ACS), CAE also conveys a relatively high risk for potentially life-threatening cardiac events. We report a case of a 35-year-old male with two-vessel CAE, who presented with acute inferior wall ST election myocardial infarction (STEMI). After initiating medical therapy including bivalirudin, emergent percutaneous coronary intervention (PCI) with stenting of postero-lateral branch of right coronary artery (RCA) was performed...
October 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29046004/-coronary-computed-tomography-angiography-in-patients-with-stable-coronary-artery-disease
#17
Helen Ullrich, Tommaso Gori
The guidelines on the management of stable coronary artery disease (SCAD) recommend the use of coronary computed tomography angiography (CTA) in the process of diagnosing coronary artery disease in patients with low intermediate pre-test probability for SCAD. Particularly in cases where stress electrocardiogram or stress imaging provides unclear results, a computed tomographic examination can be considered as a reliable alternative to invasive coronary angiography. Due to its high negative predictive value, coronary CTA can provide accurate information on the presence of coronary artery stenosis and thus coronary artery disease can be reliably excluded without the risks associated with invasive procedures...
October 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29033611/stable-ischemic-heart-disease-in-women-current-perspectives
#18
REVIEW
Fatima Samad, Anushree Agarwal, Zainab Samad
Cardiovascular disease is the leading cause of death in women accounting for 1 in every 4 female deaths. Pathophysiology of ischemic heart disease in women includes epicardial coronary artery, endothelial dysfunction, coronary vasospasm, plaque erosion and spontaneous coronary artery dissection. Angina is the most common presentation of stable ischemic heart disease (SIHD) in women. Risk factors for SIHD include traditional risks such as older age, obesity (body mass index [BMI] >25 kg/m(2)), smoking, hypertension, dyslipidemia, cerebrovascular and peripheral vascular disease, sedentary lifestyle, family history of premature coronary artery disease, metabolic syndrome and diabetes mellitus, and nontraditional risk factors, such as gestational diabetes, insulin resistance/polycystic ovarian disease, pregnancy-induced hypertension, pre-eclampsia, eclampsia, menopause, mental stress and autoimmune diseases...
2017: International Journal of Women's Health
https://www.readbyqxmd.com/read/29031580/prevalence-and-characteristics-of-coronary-artery-disease-in-heart-failure-with-preserved-and-mid-range-ejection-fractions-a-systematic-angiography-approach
#19
Lory Trevisan, Jennifer Cautela, Noemie Resseguier, Marc Laine, Stephane Arques, Johan Pinto, Morgane Orabona, Jeremie Barraud, Michael Peyrol, Franck Paganelli, Laurent Bonello, Franck Thuny
BACKGROUND: Guidelines recommend careful screening and treatment of coronary artery disease (CAD) in heart failure with preserved or mid-range ejection fraction (HFpEF/HFmEF). AIM: We aimed to determine the prevalence and characteristics of CAD using a prospective systematic coronary angiography approach. METHODS: A systematic coronary angiography protocol was applied in consecutive patients admitted for HFpEF/HFmEF during a 6-month period in a single centre...
October 11, 2017: Archives of Cardiovascular Diseases
https://www.readbyqxmd.com/read/29027093/long-term-prognostic-value-of-coronary-computed-tomography-angiography
#20
REVIEW
Takor B Arrey-Mbi, Seth M Klusewitz, Todd C Villines
Coronary CT angiography (CTA) is a highly accurate test for the diagnosis of coronary artery disease (CAD), with its use guided by numerous contemporary appropriate use criteria and clinical guidelines. Unique among non-invasive tests for CAD, coronary CTA provides direct visualization of coronary atherosclerosis for the assessment of angiographic stenosis, as well as validated measures of plaque vulnerability. Long-term studies now clearly demonstrate that the absence of CAD on coronary CTA identifies a patient that is at very low risk for future cardiovascular events...
October 12, 2017: Current Treatment Options in Cardiovascular Medicine
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