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https://www.readbyqxmd.com/read/28337485/safety-and-efficacy-of-minimal-biliary-sphincterotomy-with-papillary-balloon-dilation-m-ebs-epbd-in-patients-using-clopidogrel-or-anticoagulation
#1
Shaffer R S Mok, Murtaza Arif, David L Diehl, Harshit S Khara, Henry C Ho, Adam B Elfant
Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) with endoscopic biliary sphincterotomy (EBS) or endoscopic papillary balloon dilation (EPBD) are common techniques of biliary decompression. Potential risks include gastrointestinal hemorrhage, which can be increased by antiplatelet agents, anticoagulants (AC) and/or novel oral anticoagulants (NOACs) (ie. apixaban, dabigatran and rivaroxaban). The study aim is to evaluate the safety/efficacy of an alternative technique, minimal-EBS plus EPBD (m-EBS + EPBD), in individuals for whom clopidogrel, AC, and/or NOACs cannot be interrupted due to high cardiovascular or thromboembolic risk...
March 2017: Endoscopy International Open
https://www.readbyqxmd.com/read/28337347/myocardial-infarction-after-endoscopic-removal-of-foreign-body
#2
Carola Maraboto, Florentino Lupercio, Ileana L Piña
The development of cardiac complications during or after endoscopic procedures is rare. However, mortality from myocardial ischemia, particularly in the elderly population, is elevated. We illustrate the rare case of a 79-year-old man with multiple cardiovascular risk factors who developed a non-ST elevation myocardial infarction (NSTEMI) after endoscopic removal of a foreign body. This case report summarizes a rare complication of a low-risk procedure and highlights the importance of considering this potential adverse event, particularly in patients with significant cardiovascular risk factors, to promote early diagnosis and proper treatment...
2017: Case Reports in Cardiology
https://www.readbyqxmd.com/read/28334029/prognostic-power-of-global-2d-strain-according-to-left-ventricular-ejection-fraction-in-patients-with-st-elevation-myocardial-infarction
#3
Myung-Jin Cha, Hyun-Sook Kim, Seong Hwan Kim, Jae-Hyeong Park, Goo-Yeong Cho
BACKGROUNDS: We aimed to evaluate the predictive power of longitudinal and circumferential fibers according to left ventricular ejection fraction (LVEF) in successfully reperfused acute ST elevation myocardial infarction (STEMI) patients. METHODS: Total 691 patients (age 59±13, 20% female) underwent clinical evaluation and conventional and strain echocardiography (Global longitudinal strain (GLS), global circumferential strain (GCS)). The clinical outcome was defined as the composite of death, hospitalization for heart failure, non-fatal myocardial infarction, and ventricular arrhythmia...
2017: PloS One
https://www.readbyqxmd.com/read/28329389/radial-versus-femoral-access-in-patients-with-acute-coronary-syndromes-with-or-without-st-segment-elevation-a-pre-specified-analysis-from-the-randomized-minimizing-adverse-haemorrhagic-events-by-transradial-access-site-and-systemic-implementation-of-angiox
#4
Pascal Vranckx, Enrico Frigoli, Martina Rothenbühler, Francesco Tomassini, Stefano Garducci, Giuseppe Andò, Andrea Picchi, Paolo Sganzerla, Anita Paggi, Fabrizio Ugo, Arturo Ausiello, Gennaro Sardella, Nicoletta Franco, Marco Nazzaro, Nicoletta de Cesare, Paolo Tosi, Camillo Falcone, Carlo Vigna, Pietro Mazzarotto, Emilio Di Lorenzo, Claudio Moretti, Gianluca Campo, Carlo Penzo, Giampaolo Pasquetto, Dik Heg, Peter Jüni, Stephan Windecker, Marco Valgimigli
Aims: To assess whether radial compared with femoral access is associated with consistent outcomes in patients with ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation acute coronary syndrome (NSTE-ACS). Methods and results: In the Minimizing Adverse Haemorrhagic Events by TRansradial Access Site and Systemic Implementation of angioX (MATRIX) programme patients were randomized to radial or femoral access, stratified by STEMI (2001 radial, 2009 femoral) and NSTE-ACS (2196 radial, 2198 femoral)...
February 28, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28329274/trichinella-nativa-outbreak-with-rare-thrombotic-complications-associated-with-meat-from-a-black-bear-hunted-in-northern-ontario
#5
Daniel Dalcin, Dante S Zarlenga, Nicholas C Larter, Eric Hoberg, Daniel A Boucher, Samuel Merrifield, Rachel Lau, Filip Ralevski, Karamjit Cheema, Kevin L Schwartz, Andrea K Boggild
Background: Although trichinellosis is known to cause thrombotic disease, serious thrombotic events are rare and have not been previously associated with Trichinella nativa infection. Methods: Patient interviews and medical chart reviews were conducted on 10 men who became ill following consumption of a common source of black bear meat. Trichinella serology on patient sera as well as PCR and larval identification of the meat samples was conducted. Results: All 10 exposed individuals developed an acute illness clinically compatible with trichinellosis, characterized by fever, abdominal pain, and diarrhea, along with eosinophilia ranging from 0...
February 22, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28329196/diabetic-patients-with-acute-coronary-syndromes-in-contemporary-european-registries-characteristics-and-outcomes
#6
Maddalena Lettino, Pontus Andell, Uwe Zeymer, Petr Widimsky, Nicolas Danchin, Alfredo Bardaji, Jose A Barrabes, Angel Cequier, Marc J Claeys, Leonardo De Luca, Jakob Dörler, David Erlinge, Paul Erne, Patrick Goldstein, Sasha M Koul, Gilles Lemesle, Thomas F Lüscher, Christian M Matter, Gilles Montalescot, Dragana Radovanovic, Jose Lopez Sendón, Petr Tousek, Franz Weidinger, Clive F M Weston, Azfar Zaman, Jin Li, J Wouter Jukema
Aims: Among patients with acute coronary syndromes (ACS), those with diabetes mellitus (DM) are at particularly high risk of recurrent cardiovascular events and premature death. We aimed to provide a descriptive overview of unadjusted analyses of patient characteristics, ACS management, and outcomes up to 1 year after hospital admission for an ACS/index-ACS event, in patients with DM in contemporary registries in Europe. Methods and results: A total of 10 registries provided data in a systematic manner on ACS patients with DM (total n =28 899), and without DM (total n= 97 505)...
March 10, 2017: European Heart Journal. Cardiovascular Pharmacotherapy
https://www.readbyqxmd.com/read/28325638/clinically-significant-bleeding-with-low-dose-rivaroxaban-versus-aspirin-in-addition-to-p2y12-inhibition-in-acute-coronary-syndromes-gemini-acs-1-a-double-blind-multicentre-randomised-trial
#7
E Magnus Ohman, Matthew T Roe, P Gabriel Steg, Stefan K James, Thomas J Povsic, Jennifer White, Frank Rockhold, Alexei Plotnikov, Hardi Mundl, John Strony, Xiang Sun, Steen Husted, Michal Tendera, Gilles Montalescot, M Cecilia Bahit, Diego Ardissino, Héctor Bueno, Marc J Claeys, Jose C Nicolau, Jan H Cornel, Shinya Goto, Róbert Gábor Kiss, Ümit Güray, Duk-Woo Park, Christoph Bode, Robert C Welsh, C Michael Gibson
BACKGROUND: Dual antiplatelet therapy (DAPT), aspirin plus a P2Y12 inhibitor, is the standard antithrombotic treatment following acute coronary syndromes. The factor Xa inhibitor rivaroxaban reduced mortality and ischaemic events when added to DAPT, but caused increased bleeding. The safety of a dual pathway antithrombotic therapy approach combining low-dose rivaroxaban (in place of aspirin) with a P2Y12 inhibitor has not been assesssed in acute coronary syndromes. We aimed to assess rivaroxaban 2·5 mg twice daily versus aspirin 100 mg daily, in addition to clopidogrel or ticagrelor (chosen at investigator discretion before randomisation), for patients with acute coronary syndromes started within 10 days after presentation and continued for 6-12 months...
March 17, 2017: Lancet
https://www.readbyqxmd.com/read/28320999/long-term-outcomes-of-non-st-elevation-myocardial-infarction-without-creatine-kinase-elevation%C3%A3-the-j-minuet-study
#8
Masaharu Ishihara, Koichi Nakao, Yukio Ozaki, Kazuo Kimura, Junya Ako, Teruo Noguchi, Masashi Fujino, Satoshi Yasuda, Satoru Suwa, Kazuteru Fujimoto, Yasuharu Nakama, Takashi Morita, Wataru Shimizu, Yoshihiko Saito, Atsushi Hirohata, Yasuhiro Morita, Teruo Inoue, Atsunori Okamura, Masaaki Uematsu, Kazuhito Hirata, Kengo Tanabe, Yoshisato Shibata, Mafumi Owa, Kenichi Tsujita, Hiroshi Funayama, Nobuaki Kokubu, Ken Kozuma, Tetsuya Tobaru, Shigeru Oshima, Michikazu Nakai, Kunihiro Nishimura, Yoshihiro Miyamoto, Hisao Ogawa
BACKGROUND: According to troponin-based criteria of myocardial infarction (MI), patients without elevation of creatine kinase (CK), formerly classified as unstable angina (UA), are now diagnosed as non-ST-elevation MI (NSTEMI), but little is known about their outcomes.Methods and Results:Between July 2012 and March 2014, 3,283 consecutive patients with MI were enrolled. Clinical follow-up data were obtained up to 3 years. The primary endpoint was a composite of all-cause death, non-fatal MI, non-fatal stroke, cardiac failure and urgent revascularization for UA...
March 17, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#9
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
March 21, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28320749/sex-differences-in-percutaneous-coronary-intervention-insights-from-the-coronary-angiography-and-pci-registry-of-the-german-society-of-cardiology
#10
Tobias Heer, Matthias Hochadel, Karin Schmidt, Julinda Mehilli, Ralf Zahn, Karl-Heinz Kuck, Christian Hamm, Michael Böhm, Georg Ertl, Hans Martin Hoffmeister, Stefan Sack, Jochen Senges, Steffen Massberg, Anselm K Gitt, Uwe Zeymer
BACKGROUND: Several studies have suggested sex-related differences in diagnostic and invasive therapeutic coronary procedures. METHODS AND RESULTS: Data from consecutive patients who were enrolled in the Coronary Angiography and PCI Registry of the German Society of Cardiology were analyzed. We aimed to compare sex-related differences in in-hospital outcomes of patients undergoing percutaneous coronary intervention (PCI) for stable coronary artery disease, non-ST elevation acute coronary syndromes, ST elevation myocardial infarction, and cardiogenic shock...
March 20, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28319533/-perfscore-a-multidimensional-score-a-simple-way-to-predict-the-success-of-cardiac-rehabilitation
#11
Patrizia Maras, Sara Doimo, Alessando Altinier, Alessio Della Mattia, Luigia Scudeller, Gianfranco Sinagra, Catherine Klersy
BACKGROUND: We propose a simple and reliable score, performance score ('PERFSCORE'), that allows cardiologists to assess the achievement of therapeutic goals. METHODS: We identified six indicators of cardiac rehabilitation performance: heart rate (HR) less than 70 beats/min; blood pressure (BP) less than 140/90 mmHg; smoking cessation or non-smokers; left ventricular ejection fraction (LVEF) more than 40%; LDLc less than 100 mg/dl or more than 70 mg/dl if diabetic; and on treatment at least with three drugs among angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blocker (ARBs), β-blockers, statins, and ASA...
March 17, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28317428/fractional-flow-reserve-guided-multivessel-angioplasty-in-myocardial-infarction
#12
Pieter C Smits, Mohamed Abdel-Wahab, Franz-Josef Neumann, Bianca M Boxma-de Klerk, Ketil Lunde, Carl E Schotborgh, Zsolt Piroth, David Horak, Adrian Wlodarczak, Paul J Ong, Rainer Hambrecht, Oskar Angerås, Gert Richardt, Elmir Omerovic
Background In patients with ST-segment elevation myocardial infarction (STEMI), the use of percutaneous coronary intervention (PCI) to restore blood flow in an infarct-related coronary artery improves outcomes. The use of PCI in non-infarct-related coronary arteries remains controversial. Methods We randomly assigned 885 patients with STEMI and multivessel disease who had undergone primary PCI of an infarct-related coronary artery in a 1:2 ratio to undergo complete revascularization of non-infarct-related coronary arteries guided by fractional flow reserve (FFR) (295 patients) or to undergo no revascularization of non-infarct-related coronary arteries (590 patients)...
March 18, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28315826/early-invasive-strategy-and-in-hospital-survival-among-diabetics-with-non-st-elevation-acute-coronary-syndromes-a-contemporary-national-insight
#13
Ahmed N Mahmoud, Islam Y Elgendy, Hend Mansoor, Xuerong Wen, Mohammad K Mojadidi, Anthony A Bavry, R David Anderson
BACKGROUND: There are limited data on the merits of an early invasive strategy in diabetics with non-ST-elevation acute coronary syndrome, with unclear influence of this strategy on survival. The aim of this study was to evaluate the in-hospital survival of diabetics with non-ST-elevation acute coronary syndrome treated with an early invasive strategy compared with an initial conservative strategy. METHODS AND RESULTS: The National Inpatient Sample database, years 2012-2013, was queried for diabetics with a primary diagnosis of non-ST-elevation acute coronary syndrome defined as either non-ST-elevation myocardial infarction or unstable angina (unstable angina)...
March 18, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28315181/update-on-the-management-of-chronic-total-occlusions-in-coronary-artery-disease
#14
REVIEW
Kathleen Kearney, Ravi S Hira, Robert F Riley, Arun Kalyanasundaram, William L Lombardi
PURPOSE OF THE REVIEW: Chronic total occlusions (CTOs) are found in about a third of patients with coronary artery disease (CAD) and can pose a significant challenge during percutaneous revascularization. However, advances in CTO percutaneous coronary intervention (PCI) strategies, devices, and algorithms have led to significant improvements in successful treatment of CTOs. This review summarizes current management of CTOs in the context of modern PCI techniques and current evidence. RECENT FINDINGS: The hybrid algorithm now provides a standardized, teachable approach to CTO PCI, and success rates are approximately 90% in experienced hands...
April 2017: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/28296641/root-cause-analysis-of-deaths-in-st-segment-elevation-myocardial-infarctions-treated-with-primary-pci-what-can-we-do-better
#15
Fredy El Sakr, Mohamad Kenaan, Daniel Menees, Milan Seth, Hitinder S Gurm
OBJECTIVE: Recent data demonstrate that mortality of patients with ST-elevation myocardial infarction (STEMI) has not changed despite dramatic reduction in door-to-balloon times. Identifying potential areas in care that can be further optimized to decrease mortality remains a priority. METHODS: We performed a root cause analysis of all patients who died following primary percutaneous coronary intervention (PCI) during index hospitalization from 2008 to 2013 at the University of Michigan...
March 15, 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28294020/acute-coronary-syndrome-assessment-and-management
#16
Cormac Norton
Acute coronary syndrome is a serious condition that requires urgent assessment and management. This article outlines the nature of the condition, and discusses its underlying pathophysiology. It discusses three types of acute coronary syndrome: unstable angina, ST elevation myocardial infarction and non-ST elevation myocardial infarction. Research and guidelines are used to guide the reader through approaches to initial nursing assessment and the immediate management of patients with suspected acute coronary syndrome...
March 15, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28292380/correlation-of-c-reactive-protein-and-cardiac-enzymes-with-angiographic-severity-of-coronary-artery-disease-in-pakistani-patients-with-acute-coronary-syndrome
#17
Ayesha Saleem, Azmat Ali
OBJECTIVE: To determine the correlation of C-reactive protein (CRP) levels with the severity of coronary stenosis on angiography and the association of cardiac enzymes with the degree of stenosis in acute coronary syndrome (ACS) patients. Secondly, to compare association of angiographic severity of vascular stenosis with CRP in patients with ST segment elevation myocardial infarction (STEMI) and non-STEMI / Unstable angina (UA). STUDY DESIGN: Prospective, descriptive study...
February 2017: Journal of the College of Physicians and Surgeons—Pakistan: JCPSP
https://www.readbyqxmd.com/read/28290859/-prognostic-significance-of-erythropoietin-in-patients-with-acute-coronary-syndrome
#18
M V Menzorov, A M Shutov, N V Larionova, A A Strakhov, D V Serova
AIM: to investigate the prognostic role of erythropoietin (EPO) in patients with acute coronary syndrome (ACS). MATERIAL AND METHODS: Eighty-four patients (46 men, 38 women, mean age 63+/-11 years) with ACS were studied. Twenty-one patients had ST-elevation myocardial infarction (STEMI), 12 - non-ST-elevation myocardial infarction, 51 - unstable angina (UA). Ten patients with STEMI received thrombolytic therapy. Coronary angiography during hospitalization was criterion for exclusion from the study...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28290631/acute-coronary-syndrome-current-treatment
#19
Timothy L Switaj, Scott R Christensen, Dean M Brewer
Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation...
February 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28281731/current-patterns-of-antithrombotic-and-revascularization-therapy-in-patients-hospitalised-for-acute-coronary-syndromes-data-from-the-polish-subset-of-the-epicor-study
#20
Izabela Wojtkowska, Janina Stępińska, Małgorzata Stępień-Wojno, Mateusz Sobota, Jerzy Kopaczewski, Zygfryd Reszka, Michał Kurzelewski, Jesus Medina
BACKGROUND: Cardiovascular disease is the leading cause of mortality and morbidity in developed countries, including Poland. Antithrombotic drugs play a crucial role in the management of acute coronary syndromes (ACS). Recent clinical trials have demonstrated the efficacy and safety profiles of new antiplatelet and anticoagulant agents, which may be used as add-on therapy or replacements for older drugs. The EPICOR: (long-t E: rm follow-u P: of antithrombotic management patterns I: n acute COR: onary syndrome patients) is a prospective international observational study (NCT01171404) designed to describe the use of antithrombotic management strategies for the treatment of ACS during the acute phase and over a follow-up period of up to 2 years from the index event...
March 10, 2017: Kardiologia Polska
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