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A P Golikov, S A Berns, R I Stryuk, E A Shmidt, A A Golikova, O L Barbarash
AIM: To investigate factors that influence annual prognosis in patients with non-ST-segment elevation acute coronary syndrome ((NSTEACS) concurrent with type 2 diabetes mellitus (DM2). SUBJECTS AND METHODS: The registry of patients with NSTEACS (non-ST-segment elevation myocardial infarction (NSTEMI), unstable angina) included 415 patients, of them 335 had no carbohydrate metabolic disorders, 80 had DM2. The follow-up period, during which the prognosis was evaluated in the patients, was one year after hospital discharge following the index NSTEACS event...
2017: Terapevticheskiĭ Arkhiv
Héctor Bueno, Stuart Pocock, Jesús Medina, Nicolas Danchin, Lieven Annemans, Muriel Licour, John Gregson, Ana María Vega, Frans van de Werf
INTRODUCTION AND OBJECTIVES: A large proportion of patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) are initially selected for medical management (MM) and do not undergo coronary revascularization during or immediately after the index event. The aim of this study was to explore the clinical pathways leading to MM in NSTEACS patients and their influence on prognosis. METHODS: Patient characteristics, pathways leading to MM, and 2-year outcomes were recorded in a prospective cohort of 5591 NSTEACS patients enrolled in 555 hospitals in 20 countries across Europe and Latin America...
March 10, 2017: Revista Española de Cardiología
Hua Yu, Likun Ma, Kefu Feng, Hongwu Chen, Hao Hu
OBJECTIVE: This study aimed to evaluate the clinical significance and safety of optical coherence tomography (OCT) in patients with non-ST-elevation acute coronary syndrome (NSTEACS) combined with intermediate lesions. METHODS: Sixty-five NSTEACS patients with intermediate lesions confirmed with coronary angiography at our department were included in this study. Among them, 33 patients received only standardized drug treatment (drug group) and the other 32 patients received percutaneous coronary intervention (PCI) according to the OCT examination based on drug treatment (OCT group)...
February 28, 2017: Heart Surgery Forum
T Turan, A R Akyüz, S Sahin, S Kul, A S Yilmaz, F Kara, S O Mentese, A Ç Aykan, S Demir, S Celik, S C Karahan
OBJECTIVE: Ischemia-modified albumin (IMA), a novel biochemical marker, is known to reflect ischemia in early phases of acute coronary syndrome (ACS). In the present study, we evaluated the role of IMA on the prediction of coronary atherosclerotic plaque burden and ischemic burden in patients with non-ST-segment-elevation acute coronary syndromes (NSTEACS). PATIENTS AND METHODS: Ninety-six consecutive NSTEACS patients presented within the first three hours of symptom onset were prospectively enrolled in this study...
February 2017: European Review for Medical and Pharmacological Sciences
Kevin Liou, Nigel Jepson, Virag Kushwaha, Jenny Yu, Greg Cranney, Sze-Yuan Ooi
No abstract text is available yet for this article.
November 1, 2016: Journal of the American College of Cardiology
Ramez Nairooz, Marco Valgimigli, Yogita Rochlani, Naga Venkata Pothineni, Sameer Raina, Partha Sardar, Debabrata Mukherjee, Srihari S Naidu, David M Shavelle
BACKGROUND: It is unknown whether pretreatment with clopidogrel in acute coronary syndrome (ACS) managed invasively, is superior to a strategy of administering clopidogrel in the cardiac catheterization laboratory at the time of percutaneous coronary intervention (PCI). Current practice guidelines do not endorse one strategy over the other. METHODS: A comprehensive literature search was done to identify all relevant studies comparing pretreatment with clopidogrel to administration in the cardiac catheterization laboratory at the time of PCI (no pretreatment)...
February 15, 2017: International Journal of Cardiology
Tatsuya Nakachi, Masami Kosuge, Naoki Iinuma, Hidekuni Kirigaya, Shingo Kato, Kazuki Fukui, Kazuo Kimura
BACKGROUND: Several studies have shown higher early mortality for ST-segment elevation acute coronary syndrome (STEACS), but late mortality remains consistently higher for non-ST-segment elevation acute coronary syndrome (NSTEACS). We hypothesized that ST-segment category at acute presentation is associated with the time course of coronary artery disease progression (CP) of nonculprit lesions in patients with acute coronary syndrome (ACS). METHODS: A total of 226 patients (182 men, age 65 ± 10 years) with STEACS (n = 95) or NSTEACS (n = 131) who underwent percutaneous coronary intervention (PCI) during initial hospitalization were studied...
November 8, 2016: Heart and Vessels
Pilar Calmarza, Carlos Lapresta, Sandra García-Castañón, Carlos López-Perales, Ainhoa Pérez-Guerrero, Ana Portolés
OBJECTIVES: This study was conducted in order to evaluate the usefulness of copeptin (a stable fragment of the precursor of arginine vasopressin) in the differential diagnosis of acute chest pain of probable coronary origin. MATERIAL AND METHODS: The study includes 82 patients who were initially evaluated according to the protocol of a patient with suspected acute coronary syndrome (ACS) in our Emergency Department, including the determination of troponin and copeptin with specimens taken on admission (time 0) and at 6h...
September 2016: Clínica e Investigación en Arteriosclerosis
Lucy McGrath-Cadell, Pamela McKenzie, Sam Emmanuel, David W M Muller, Robert M Graham, Cameron J Holloway
BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an uncommon but serious condition presenting as an acute coronary syndrome (ACS) or cardiac arrest. The pathophysiology and outcomes are poorly understood. We investigated the characteristics and outcomes of patients presenting with SCAD. METHODS: In a retrospective study of a large cohort of patients with SCAD, data were collected regarding clinical presentation, patient characteristics, vascular screening, coronary artery involvement and clinical outcomes...
2016: Open Heart
Elena Conti, Maria B Musumeci, Jasmine P Desideri, Martina Ventura, Danilo Fusco, Luigi Zezza, Marco De Giusti, Andrea Berni, Pietro Francia, Massimo Volpe, Camillo Autore
BACKGROUND: As benefits of revascularization in non-ST elevation acute coronary syndromes (NSTEACSs) in the elderly are still unproven, we sought to assess the association between invasive or conservative management of NSTEACS and short-, mid- and long-term mortality or composite outcome of all-cause mortality and myocardial infarction in a cohort of consecutive elderly patients. METHODS AND RESULTS: Consecutive NSTEACS patients older than 75 years discharged between 2006 and 2010 from a single intensive cardiac care unit, and managed with invasive or conservative strategy according to available guidelines were retrospectively surveyed...
October 2016: Journal of Cardiovascular Medicine
Abdulhalim Jamal Kinsara, Jamilah Saad Alrahimi, Oyindamola B Yusuf
OBJECTIVES: To compare the clinical features, management, and in-hospital outcomes of patients with ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTEACS), in the Western Region of Saudi Arabia. METHODS: A total of 71 patients were enrolled in a longitudinal study at a tertiary hospital without cardiac catheterization facility. These data were collected from Saudi Project for Assessment of Coronary Events registry. RESULTS: Twenty-three patients with STEMI were compared to 48 patients with NSTEACS...
July 2016: Indian Heart Journal
Ming Cui, Chen Chen Tu, Er Zhen Chen, Xiao Li Wang, Seng Chuen Tan, Can Chen
INTRODUCTION: There are a number of economic evaluation studies of clopidogrel for patients with non-ST-segment elevation acute coronary syndrome (NSTEACS) published from the perspective of multiple countries in recent years. However, relevant research is quite limited in China. We aimed to estimate the long-term cost effectiveness for up to 1-year treatment with clopidogrel plus acetylsalicylic acid (ASA) versus ASA alone for NSTEACS from the public payer perspective in China. METHODS: This analysis used a Markov model to simulate a cohort of patients for quality-adjusted life years (QALYs) gained and incremental cost for lifetime horizon...
September 2016: Advances in Therapy
S Koganti, N Patel, A Seraphim, T Kotecha, M Whitbread, R D Rakhit
OBJECTIVE: To assess whether a novel 'direct access pathway' (DAP) for the management of high-risk non-ST-elevation acute coronary syndromes (NSTEACS) is safe, results in 'shorter time to intervention and shorter admission times'. This pathway was developed locally to enable London Ambulance Service to rapidly transfer suspected high-risk NSTEACS from the community to our regional heart attack centre for consideration of early angiography. METHODS: This is a retrospective case-control analysis of 289 patients comparing patients with high-risk NSTEACS admitted via DAP with age-matched controls from the standard pan-London high-risk ACS pathway (PLP) and the conventional pathway (CP)...
2016: BMJ Open
Levent Cerit
BACKGROUND: ST-segment elevation in lead aVR (STEaVR) anticipates left main and/or three-vessel disease (LM/3VD) in patients with acute coronary syndromes. STEaVR is generally reciprocal to and accompanied by ST-segment depression (STD) in the precordial leads. SYNTAX score (SS) is an angiographic scoring system and is widely used to evaluate the severity and complexity of coronary artery disease. The purpose of our study was to assess the relationship between STEaVR and SS. METHODS: We performed a retrospective analysis of 117 patients with non-ST-segment elevation acute coronary syndrome (NSTEACS)...
June 8, 2016: Cardiovascular Journal of Africa
Phillip Freeman, James Berrill, John Green, Richard Anderson
This review outlines the priorities from cardiology and gastroenterology perspectives, resolves some of the misconceptions, and uses the evidence available to suggest strategies for optimizing management of these patients. The dual presentation of acute active gastrointestinal (GI) blood loss together with an acute coronary syndrome (NSTEACS or STEMI) is outside the remit of this review but has been previously reviewed by our group. The review covers NSTEACS together with chronic or sub-acute anemia, anemia that cannot be accounted for by chronic kidney disease, heart failure, or inflammatory disorders...
September 2016: Current Medical Research and Opinion
András Komócsi, Mihály Simon, Béla Merkely, Tibor Szűk, Róbert G Kiss, Dániel Aradi, Zoltán Ruzsa, Péter Andrássy, Lajos Nagy, Géza Lupkovics, Zsolt Kőszegi, Péter Ofner, András Jánosi
BACKGROUND: Data are limited on the real-life use of coronary intervention (PCI) and on its long-term efficacy and safety in elderly patients with acute myocardial infarction (AMI). METHODS: Data from a nation-wide registry of patients treated due to an AMI event in centers of invasive cardiology were analyzed for the potential interaction of age on the utilization of invasive therapy and outcome. Follow-up data of consecutive patients between March 1, 2013, and March 1, 2014 were analyzed...
July 1, 2016: International Journal of Cardiology
Matias B Yudi, Andrew E Ajani, Nick Andrianopoulos, Stephen J Duffy, Omar Farouque, Jay Ramchand, Ronen Gurvitch, Jeffrey Lefkovits, Melanie Freeman, Angela Brennan, David J Clark, Christopher Reid, David Eccleston
BACKGROUND: The optimal timing of angiography and percutaneous coronary intervention (PCI) in patients with non-ST elevation acute coronary syndromes (NSTEACS) remains uncertain. We sought to assess clinical characteristics and outcomes of patients in real-world contemporary practice who have early versus delayed PCI for NSTEACS. METHODS: We analyzed baseline clinical and procedural characteristics of 4307 patients with NSTEACS who underwent PCI from the Melbourne Interventional Group registry...
August 2016: Coronary Artery Disease
Shamir R Mehta, John W Eikelboom, Purnima Rao-Melacini, Jeffrey I Weitz, Sonia S Anand, Guillaume Pare, Andrezj Budaj, Janice Pogue, Keith A A Fox, Salim Yusuf
BACKGROUND: Several biomarkers have been shown to improve risk stratification in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS); however, they have not been integrated into risk prediction tools. METHODS: C-reactive-protein, N-terminal-pro-brain natriuretic peptide (NT-proBNP), and haemoglobin A1C were measured in 6447 patients with NSTEACS who were enrolled in the Clopidogrel in Unstable Angina to Prevent Recurrent Events trial. A risk score to predict cardiovascular (CV) death, myocardial infarction (MI), or stroke at 1 year was developed by incorporating biomarkers that were independently predictive of events with traditional variables, electrocardiogram, and troponin-T...
February 2, 2016: Canadian Journal of Cardiology
O A Alabas, R A Brogan, M Hall, S Almudarra, M J Rutherford, T B Dondo, R Feltbower, N Curzen, M de Belder, P Ludman, C P Gale
OBJECTIVE: For percutaneous coronary intervention (PCI) to the unprotected left main stem (UPLMS), there are limited long-term outcome data. We evaluated 5-year survival for UPLMS PCI cases taking into account background population mortality. METHODS: A population-based registry of 10 682 cases of chronic stable angina (CSA), non-ST-segment elevation acute coronary syndrome (NSTEACS), ST-segment elevation myocardial infarction with (STEMI+CS) and without cardiogenic shock (STEMI-CS) who received UPLMS PCI from 2005 to 2014 were matched by age, sex, year of procedure and country to death data for the UK populace of 56...
August 15, 2016: Heart: Official Journal of the British Cardiac Society
Alberto Dominguez-Rodriguez, Pedro Abreu-Gonzalez, Pablo Avanzas, Luciano Consuegra-Sanchez
Growth differentiation factor-15 (GDF-15) is produced by cardiomyocytes and atherosclerotic lesions under stress conditions, but little is known about its relation with severity and complexity of coronary lesions. The aim of this study was to investigate the association between GDF-15 and the syntax score for risk prediction of major adverse cardiovascular events (MACE) at 2-year follow-up in patients with non-ST-segment elevation acute coronary syndrome (NSTEACS). This is a prospective cohort study of 502 patients with NSTEACS...
May 15, 2016: American Journal of Cardiology
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