An episode of MYOCARDIAL ISCHEMIA that generally lasts longer than a transient anginal episode that ultimately may lead to MYOCARDIAL INFARCTION.
A characteristic symptom complex.
Precordial pain at rest, which may precede a MYOCARDIAL INFARCTION.
Radiography of the vascular system of the heart muscle after injection of a contrast medium.
NECROSIS of the MYOCARDIUM caused by an obstruction of the blood supply to the heart (CORONARY CIRCULATION).
The veins and arteries of the HEART.
Pathological processes of CORONARY ARTERIES that may derive from a congenital abnormality, atherosclerotic, or non-atherosclerotic cause.
Drugs or agents which antagonize or impair any mechanism leading to blood platelet aggregation, whether during the phases of activation and shape change or following the dense-granule release reaction and stimulation of the prostaglandin-thromboxane system.
Dilation of an occluded coronary artery (or arteries) by means of a balloon catheter to restore myocardial blood supply.
An imbalance between myocardial functional requirements and the capacity of the CORONARY VESSELS to supply sufficient blood flow. It is a form of MYOCARDIAL ISCHEMIA (insufficient blood supply to the heart muscle) caused by a decreased capacity of the coronary vessels.
Disease having a short and relatively severe course.
An effective inhibitor of platelet aggregation commonly used in the placement of STENTS in CORONARY ARTERIES.
Coagulation of blood in any of the CORONARY VESSELS. The presence of a blood clot (THROMBUS) often leads to MYOCARDIAL INFARCTION.
Pressure, burning, or numbness in the chest.
The circulation of blood through the CORONARY VESSELS of the HEART.
Measurable and quantifiable biological parameters (e.g., specific enzyme concentration, specific hormone concentration, specific gene phenotype distribution in a population, presence of biological substances) which serve as indices for health- and physiology-related assessments, such as disease risk, psychiatric disorders, environmental exposure and its effects, disease diagnosis, metabolic processes, substance abuse, pregnancy, cell line development, epidemiologic studies, etc.
Bleeding or escape of blood from a vessel.
Recording of the moment-to-moment electromotive forces of the HEART as projected onto various sites on the body's surface, delineated as a scalar function of time. The recording is monitored by a tracing on slow moving chart paper or by observing it on a cardioscope, which is a CATHODE RAY TUBE DISPLAY.
An aspect of personal behavior or lifestyle, environmental exposure, or inborn or inherited characteristic, which, on the basis of epidemiologic evidence, is known to be associated with a health-related condition considered important to prevent.
Evaluation undertaken to assess the results or consequences of management and procedures used in combating disease in order to determine the efficacy, effectiveness, safety, and practicability of these interventions in individual cases or series.
Platelet membrane glycoprotein complex important for platelet adhesion and aggregation. It is an integrin complex containing INTEGRIN ALPHAIIB and INTEGRIN BETA3 which recognizes the arginine-glycine-aspartic acid (RGD) sequence present on several adhesive proteins. As such, it is a receptor for FIBRINOGEN; VON WILLEBRAND FACTOR; FIBRONECTIN; VITRONECTIN; and THROMBOSPONDINS. A deficiency of GPIIb-IIIa results in GLANZMANN THROMBASTHENIA.
Narrowing or constriction of a coronary artery.
One of the three polypeptide chains that make up the TROPONIN complex. It is a cardiac-specific protein that binds to TROPOMYOSIN. It is released from damaged or injured heart muscle cells (MYOCYTES, CARDIAC). Defects in the gene encoding troponin T result in FAMILIAL HYPERTROPHIC CARDIOMYOPATHY.
Surgical therapy of ischemic coronary artery disease achieved by grafting a section of saphenous vein, internal mammary artery, or other substitute between the aorta and the obstructed coronary artery distal to the obstructive lesion.
Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group.
The symptom of paroxysmal pain consequent to MYOCARDIAL ISCHEMIA usually of distinctive character, location and radiation. It is thought to be provoked by a transient stressful situation during which the oxygen requirements of the MYOCARDIUM exceed that supplied by the CORONARY CIRCULATION.
A family of percutaneous techniques that are used to manage CORONARY OCCLUSION, including standard balloon angioplasty (PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOPLASTY), the placement of intracoronary STENTS, and atheroablative technologies (e.g., ATHERECTOMY; ENDARTERECTOMY; THROMBECTOMY; PERCUTANEOUS TRANSLUMINAL LASER ANGIOPLASTY). PTCA was the dominant form of PCI, before the widespread use of stenting.
The restoration of blood supply to the myocardium. (From Dorland, 28th ed)
One of the three polypeptide chains that make up the TROPONIN complex. It inhibits F-actin-myosin interactions.
The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
A disorder of cardiac function caused by insufficient blood flow to the muscle tissue of the heart. The decreased blood flow may be due to narrowing of the coronary arteries (CORONARY ARTERY DISEASE), to obstruction by a thrombus (CORONARY THROMBOSIS), or less commonly, to diffuse narrowing of arterioles and other small vessels within the heart. Severe interruption of the blood supply to the myocardial tissue may result in necrosis of cardiac muscle (MYOCARDIAL INFARCTION).
In screening and diagnostic tests, the probability that a person with a positive test is a true positive (i.e., has the disease), is referred to as the predictive value of a positive test; whereas, the predictive value of a negative test is the probability that the person with a negative test does not have the disease. Predictive value is related to the sensitivity and specificity of the test.
Elements of limited time intervals, contributing to particular results or situations.
Compounds that bind to and block the stimulation of PURINERGIC P2Y RECEPTORS. Included under this heading are antagonists for specific P2Y receptor subtypes.
A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.
The prototypical analgesic used in the treatment of mild to moderate pain. It has anti-inflammatory and antipyretic properties and acts as an inhibitor of cyclooxygenase which results in the inhibition of the biosynthesis of prostaglandins. Aspirin also inhibits platelet aggregation and is used in the prevention of arterial and venous thrombosis. (From Martindale, The Extra Pharmacopoeia, 30th ed, p5)
Lesions formed within the walls of ARTERIES.
Low-molecular-weight fragment of heparin, having a 4-enopyranosuronate sodium structure at the non-reducing end of the chain. It is prepared by depolymerization of the benzylic ester of porcine mucosal heparin. Therapeutically, it is used as an antithrombotic agent. (From Merck Index, 11th ed)
An isoenzyme of creatine kinase found in the CARDIAC MUSCLE.
Studies in which individuals or populations are followed to assess the outcome of exposures, procedures, or effects of a characteristic, e.g., occurrence of disease.
The hospital unit in which patients with acute cardiac disorders receive intensive care.
Agents that prevent clotting.
The use of ultrasound to guide minimally invasive surgical procedures such as needle ASPIRATION BIOPSY; DRAINAGE; etc. Its widest application is intravascular ultrasound imaging but it is useful also in urology and intra-abdominal conditions.
A plasma protein that circulates in increased amounts during inflammation and after tissue damage.
Spasm of the large- or medium-sized coronary arteries.
7-carbon saturated monocarboxylic acids.
One of the minor protein components of skeletal muscle. Its function is to serve as the calcium-binding component in the troponin-tropomyosin B-actin-myosin complex by conferring calcium sensitivity to the cross-linked actin and myosin filaments.
Devices that provide support for tubular structures that are being anastomosed or for body cavities during skin grafting.
Fibrinolysin or agents that convert plasminogen to FIBRINOLYSIN.
Persistent and reproducible chest discomfort usually precipitated by a physical exertion that dissipates upon cessation of such an activity. The symptoms are manifestations of MYOCARDIAL ISCHEMIA.
Compounds that inhibit HMG-CoA reductases. They have been shown to directly lower cholesterol synthesis.
The confinement of a patient in a hospital.
The return of a sign, symptom, or disease after a remission.
Agents that affect the rate or intensity of cardiac contraction, blood vessel diameter, or blood volume.
Tear or break of an organ, vessel or other soft part of the body, occurring in the absence of external force.
Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons.
The systems and processes involved in the establishment, support, management, and operation of registers, e.g., disease registers.
Single-chain polypeptides of about 65 amino acids (7 kDa) from LEECHES that have a neutral hydrophobic N terminus, an acidic hydrophilic C terminus, and a compact, hydrophobic core region. Recombinant hirudins lack tyr-63 sulfation and are referred to as 'desulfato-hirudins'. They form a stable non-covalent complex with ALPHA-THROMBIN, thereby abolishing its ability to cleave FIBRINOGEN.
Compounds based on N-phenylacetamide, that are similar in structure to 2-PHENYLACETAMIDES. They are precursors of many other compounds. They were formerly used as ANALGESICS and ANTIPYRETICS, but often caused lethal METHEMOGLOBINEMIA.
Abnormal balloon- or sac-like dilatation in the wall of CORONARY VESSELS. Most coronary aneurysms are due to CORONARY ATHEROSCLEROSIS, and the rest are due to inflammatory diseases, such as KAWASAKI DISEASE.
Azoles of one NITROGEN and two double bonds that have aromatic chemical properties.
A vital statistic measuring or recording the rate of death from any cause in hospitalized populations.
A highly acidic mucopolysaccharide formed of equal parts of sulfated D-glucosamine and D-glucuronic acid with sulfaminic bridges. The molecular weight ranges from six to twenty thousand. Heparin occurs in and is obtained from liver, lung, mast cells, etc., of vertebrates. Its function is unknown, but it is used to prevent blood clotting in vivo and vitro, in the form of many different salts.
Recurrent narrowing or constriction of a coronary artery following surgical procedures performed to alleviate a prior obstruction.
Formation and development of a thrombus or blood clot in the blood vessel.
Works about clinical trials that involve at least one test treatment and one control treatment, concurrent enrollment and follow-up of the test- and control-treated groups, and in which the treatments to be administered are selected by a random process, such as the use of a random-numbers table.
A nonparametric method of compiling LIFE TABLES or survival tables. It combines calculated probabilities of survival and estimates to allow for observations occurring beyond a measurement threshold, which are assumed to occur randomly. Time intervals are defined as ending each time an event occurs and are therefore unequal. (From Last, A Dictionary of Epidemiology, 1995)
Levels within a diagnostic group which are established by various measurement criteria applied to the seriousness of a patient's disorder.
A set of techniques used when variation in several variables has to be studied simultaneously. In statistics, multivariate analysis is interpreted as any analytic method that allows simultaneous study of two or more dependent variables.
Endoscopic examination, therapy or surgery performed on the interior of blood vessels.
Complete blockage of blood flow through one of the CORONARY ARTERIES, usually from CORONARY ATHEROSCLEROSIS.
The sorting out and classification of patients or casualties to determine priority of need and proper place of treatment.
Use of HIRUDINS as an anticoagulant in the treatment of cardiological and hematological disorders.
Therapy with two or more separate preparations given for a combined effect.
Procedures in which placement of CARDIAC CATHETERS is performed for therapeutic or diagnostic procedures.
A method of studying a drug or procedure in which both the subjects and investigators are kept unaware of who is actually getting which specific treatment.
A distribution in which a variable is distributed like the sum of the squares of any given independent random variable, each of which has a normal distribution with mean of zero and variance of one. The chi-square test is a statistical test based on comparison of a test statistic to a chi-square distribution. The oldest of these tests are used to detect whether two or more population distributions differ from one another.
A transferase that catalyzes formation of PHOSPHOCREATINE from ATP + CREATINE. The reaction stores ATP energy as phosphocreatine. Three cytoplasmic ISOENZYMES have been identified in human tissues: the MM type from SKELETAL MUSCLE, the MB type from myocardial tissue and the BB type from nervous tissue as well as a mitochondrial isoenzyme. Macro-creatine kinase refers to creatine kinase complexed with other serum proteins.
Use of infusions of FIBRINOLYTIC AGENTS to destroy or dissolve thrombi in blood vessels or bypass grafts.
Statistical models used in survival analysis that assert that the effect of the study factors on the hazard rate in the study population is multiplicative and does not change over time.
An antilipemic fungal metabolite isolated from cultures of Nocardia autotrophica. It acts as a competitive inhibitor of HMG CoA reductase (HYDROXYMETHYLGLUTARYL COA REDUCTASES).
A series of progressive, overlapping events, triggered by exposure of the PLATELETS to subendothelial tissue. These events include shape change, adhesiveness, aggregation, and release reactions. When carried through to completion, these events lead to the formation of a stable hemostatic plug.
Binary classification measures to assess test results. Sensitivity or recall rate is the proportion of true positives. Specificity is the probability of correctly determining the absence of a condition. (From Last, Dictionary of Epidemiology, 2d ed)
A cluster of metabolic risk factors for CARDIOVASCULAR DISEASES and TYPE 2 DIABETES MELLITUS. The major components of metabolic syndrome X include excess ABDOMINAL FAT; atherogenic DYSLIPIDEMIA; HYPERTENSION; HYPERGLYCEMIA; INSULIN RESISTANCE; a proinflammatory state; and a prothrombotic (THROMBOSIS) state. (from AHA/NHLBI/ADA Conference Proceedings, Circulation 2004; 109:551-556)
A PEPTIDE that is secreted by the BRAIN and the HEART ATRIA, stored mainly in cardiac ventricular MYOCARDIUM. It can cause NATRIURESIS; DIURESIS; VASODILATION; and inhibits secretion of RENIN and ALDOSTERONE. It improves heart function. It contains 32 AMINO ACIDS.
The prevention of recurrences or exacerbations of a disease or complications of its therapy.
Studies in which subsets of a defined population are identified. These groups may or may not be exposed to factors hypothesized to influence the probability of the occurrence of a particular disease or other outcome. Cohorts are defined populations which, as a whole, are followed in an attempt to determine distinguishing subgroup characteristics.
The number of new cases of a given disease during a given period in a specified population. It also is used for the rate at which new events occur in a defined population. It is differentiated from PREVALENCE, which refers to all cases, new or old, in the population at a given time.
Statistical models which describe the relationship between a qualitative dependent variable (that is, one which can take only certain discrete values, such as the presence or absence of a disease) and an independent variable. A common application is in epidemiology for estimating an individual's risk (probability of a disease) as a function of a given risk factor.
Deposition of calcium into the blood vessel structures. Excessive calcification of the vessels are associated with ATHEROSCLEROTIC PLAQUES formation particularly after MYOCARDIAL INFARCTION (see MONCKEBERG MEDIAL CALCIFIC SCLEROSIS) and chronic kidney diseases which in turn increase VASCULAR STIFFNESS.
A graphic means for assessing the ability of a screening test to discriminate between healthy and diseased persons; may also be used in other studies, e.g., distinguishing stimuli responses as to a faint stimuli or nonstimuli.
Studies which start with the identification of persons with a disease of interest and a control (comparison, referent) group without the disease. The relationship of an attribute to the disease is examined by comparing diseased and non-diseased persons with regard to the frequency or levels of the attribute in each group.
Univalent antigen-binding fragments composed of one entire IMMUNOGLOBULIN LIGHT CHAIN and the amino terminal end of one of the IMMUNOGLOBULIN HEAVY CHAINS from the hinge region, linked to each other by disulfide bonds. Fab contains the IMMUNOGLOBULIN VARIABLE REGIONS, which are part of the antigen-binding site, and the first IMMUNOGLOBULIN CONSTANT REGIONS. This fragment can be obtained by digestion of immunoglobulins with the proteolytic enzyme PAPAIN.
Markedly reduced or absent REPERFUSION in an infarct zone following the removal of an obstruction or constriction of an artery.
Services specifically designed, staffed, and equipped for the emergency care of patients.
A class of statistical procedures for estimating the survival function (function of time, starting with a population 100% well at a given time and providing the percentage of the population still well at later times). The survival analysis is then used for making inferences about the effects of treatments, prognostic factors, exposures, and other covariates on the function.
A nucleoside that is composed of ADENINE and D-RIBOSE. Adenosine or adenosine derivatives play many important biological roles in addition to being components of DNA and RNA. Adenosine itself is a neurotransmitter.
Laboratory examination used to monitor and evaluate platelet function in a patient's blood.
A group of pathological conditions characterized by sudden, non-convulsive loss of neurological function due to BRAIN ISCHEMIA or INTRACRANIAL HEMORRHAGES. Stroke is classified by the type of tissue NECROSIS, such as the anatomic location, vasculature involved, etiology, age of the affected individual, and hemorrhagic vs. non-hemorrhagic nature. (From Adams et al., Principles of Neurology, 6th ed, pp777-810)
Age as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or the effect of a circumstance. It is used with human or animal concepts but should be differentiated from AGING, a physiological process, and TIME FACTORS which refers only to the passage of time.
The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
Drugs that bind to but do not activate beta-adrenergic receptors thereby blocking the actions of beta-adrenergic agonists. Adrenergic beta-antagonists are used for treatment of hypertension, cardiac arrhythmias, angina pectoris, glaucoma, migraine headaches, and anxiety.
Research techniques that focus on study designs and data gathering methods in human and animal populations.
Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)
Heparin fractions with a molecular weight usually between 4000 and 6000 kD. These low-molecular-weight fractions are effective antithrombotic agents. Their administration reduces the risk of hemorrhage, they have a longer half-life, and their platelet interactions are reduced in comparison to unfractionated heparin. They also provide an effective prophylaxis against postoperative major pulmonary embolism.
Pathologic deposition of calcium salts in tissues.
A low-molecular-weight fragment of heparin, prepared by nitrous acid depolymerization of porcine mucosal heparin. The mean molecular weight is 4000-6000 daltons. It is used therapeutically as an antithrombotic agent. (From Merck Index, 11th ed)
Tomography using x-ray transmission and a computer algorithm to reconstruct the image.
Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.
A product of the PLACENTA, and DECIDUA, secreted into the maternal circulation during PREGNANCY. It has been identified as an IGF binding protein (IGFBP)-4 protease that proteolyzes IGFBP-4 and thus increases IGF bioavailability. It is found also in human FIBROBLASTS, ovarian FOLLICULAR FLUID, and GRANULOSA CELLS. The enzyme is a heterotetramer of about 500-kDa.
Generally, restoration of blood supply to heart tissue which is ischemic due to decrease in normal blood supply. The decrease may result from any source including atherosclerotic obstruction, narrowing of the artery, or surgical clamping. Reperfusion can be induced to treat ischemia. Methods include chemical dissolution of an occluding thrombus, administration of vasodilator drugs, angioplasty, catheterization, and artery bypass graft surgery. However, it is thought that reperfusion can itself further damage the ischemic tissue, causing MYOCARDIAL REPERFUSION INJURY.
A subclass of purinergic P2Y receptors that have a preference for ADP binding and are coupled to GTP-BINDING PROTEIN ALPHA SUBUNIT, GI. The P2Y12 purinergic receptors are found in PLATELETS where they play an important role regulating PLATELET ACTIVATION.
Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.
Hospital department responsible for the administration and provision of immediate medical or surgical care to the emergency patient.
Cholesterol which is contained in or bound to low density lipoproteins (LDL), including CHOLESTEROL ESTERS and free cholesterol.
The attachment of PLATELETS to one another. This clumping together can be induced by a number of agents (e.g., THROMBIN; COLLAGEN) and is part of the mechanism leading to the formation of a THROMBUS.
A chromosome disorder associated either with an extra chromosome 21 or an effective trisomy for chromosome 21. Clinical manifestations include hypotonia, short stature, brachycephaly, upslanting palpebral fissures, epicanthus, Brushfield spots on the iris, protruding tongue, small ears, short, broad hands, fifth finger clinodactyly, Simian crease, and moderate to severe INTELLECTUAL DISABILITY. Cardiac and gastrointestinal malformations, a marked increase in the incidence of LEUKEMIA, and the early onset of ALZHEIMER DISEASE are also associated with this condition. Pathologic features include the development of NEUROFIBRILLARY TANGLES in neurons and the deposition of AMYLOID BETA-PROTEIN, similar to the pathology of ALZHEIMER DISEASE. (Menkes, Textbook of Child Neurology, 5th ed, p213)
The hospital department responsible for the administration and provision of diagnostic and therapeutic services for the cardiac patient.
Substances used to lower plasma CHOLESTEROL levels.
A subcategory of phospholipases A2 that are secreted from cells. They are 14 kDa proteins containing multiple disulfide-bonds and access their substrate via an interfacial binding site that interacts with phospholipid membranes. In addition specific PHOSPHOLIPASE A2 RECEPTORS can bind to and internalize the enzymes.
Maleness or femaleness as a constituent element or influence contributing to the production of a result. It may be applicable to the cause or effect of a circumstance. It is used with human or animal concepts but should be differentiated from SEX CHARACTERISTICS, anatomical or physiological manifestations of sex, and from SEX DISTRIBUTION, the number of males and females in given circumstances.
Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable.
The presence of co-existing or additional diseases with reference to an initial diagnosis or with reference to the index condition that is the subject of study. Comorbidity may affect the ability of affected individuals to function and also their survival; it may be used as a prognostic indicator for length of hospital stay, cost factors, and outcome or survival.
A transient left ventricular apical dysfunction or ballooning accompanied by electrocardiographic (ECG) T wave inversions. This abnormality is associated with high levels of CATECHOLAMINES, either administered or endogenously secreted from a tumor or during extreme stress.
Visualization of the heart structure and cardiac blood flow for diagnostic evaluation or to guide cardiac procedures via techniques including ENDOSCOPY (cardiac endoscopy, sometimes refered to as cardioscopy), RADIONUCLIDE IMAGING; MAGNETIC RESONANCE IMAGING; TOMOGRAPHY; or ULTRASONOGRAPHY.
The probability that an event will occur. It encompasses a variety of measures of the probability of a generally unfavorable outcome.
Endogenous factors and drugs that directly inhibit the action of THROMBIN, usually by blocking its enzymatic activity. They are distinguished from INDIRECT THROMBIN INHIBITORS, such as HEPARIN, which act by enhancing the inhibitory effects of antithrombins.
VASCULAR DISEASES that are associated with DIABETES MELLITUS.
Non-nucleated disk-shaped cells formed in the megakaryocyte and found in the blood of all mammals. They are mainly involved in blood coagulation.
A heterogeneous condition in which the heart is unable to pump out sufficient blood to meet the metabolic need of the body. Heart failure can be caused by structural defects, functional abnormalities (VENTRICULAR DYSFUNCTION), or a sudden overload beyond its capacity. Chronic heart failure is more common than acute heart failure which results from sudden insult to cardiac function, such as MYOCARDIAL INFARCTION.
Stents that are covered with materials that are embedded with chemicals that are gradually released into the surrounding milieu.
Ultrasonic recording of the size, motion, and composition of the heart and surrounding tissues. The standard approach is transthoracic.
The muscle tissue of the HEART. It is composed of striated, involuntary muscle cells (MYOCYTES, CARDIAC) connected to form the contractile pump to generate blood flow.
Establishment of the level of a quantifiable effect indicative of a biologic process. The evaluation is frequently to detect the degree of toxic or therapeutic effect.
A thickening and loss of elasticity of the walls of ARTERIES that occurs with formation of ATHEROSCLEROTIC PLAQUES within the ARTERIAL INTIMA.
An isoenzyme of GLYCOGEN PHOSPHORYLASE that catalyzes the degradation of GLYCOGEN in brain tissue.
Laboratory and other services provided to patients at the bedside. These include diagnostic and laboratory testing using automated information entry.
Conditions or pathological processes associated with the disease of diabetes mellitus. Due to the impaired control of BLOOD GLUCOSE level in diabetic patients, pathological processes develop in numerous tissues and organs including the EYE, the KIDNEY, the BLOOD VESSELS, and the NERVE TISSUE.
Hemorrhage following any surgical procedure. It may be immediate or delayed and is not restricted to the surgical wound.
Coronary artery bypass surgery on a beating HEART without a CARDIOPULMONARY BYPASS (diverting the flow of blood from the heart and lungs through an oxygenator).
The proportion of survivors in a group, e.g., of patients, studied and followed over a period, or the proportion of persons in a specified group alive at the beginning of a time interval who survive to the end of the interval. It is often studied using life table methods.
Types of spiral computed tomography technology in which multiple slices of data are acquired simultaneously improving the resolution over single slice acquisition technology.
Partial proteins formed by partial hydrolysis of complete proteins or generated through PROTEIN ENGINEERING techniques.
First aid or other immediate intervention for accidents or medical conditions requiring immediate care and treatment before definitive medical and surgical management can be procured.
A growth differentiation factor that is secreted in response to cell stress and in response to MACROPHAGE ACTIVATION. In addition growth differentiation factor 15 demonstrates a diverse array of biological properties including the induction of cartilage formation, the inhibition of hematopoietic progenitor proliferation, and the induction of neuronal migration.
The study of the heart, its physiology, and its functions.
Compounds that bind to and block the stimulation of PURINERGIC P2 RECEPTORS.
The pathological process occurring in cells that are dying from irreparable injuries. It is caused by the progressive, uncontrolled action of degradative ENZYMES, leading to MITOCHONDRIAL SWELLING, nuclear flocculation, and cell lysis. It is distinct it from APOPTOSIS, which is a normal, regulated cellular process.
The region of southwest Asia and northeastern Africa usually considered as extending from Libya on the west to Afghanistan on the east. (From Webster's New Geographical Dictionary, 1988)
The total number of cases of a given disease in a specified population at a designated time. It is differentiated from INCIDENCE, which refers to the number of new cases in the population at a given time.
A pathological process characterized by injury or destruction of tissues caused by a variety of cytologic and chemical reactions. It is usually manifested by typical signs of pain, heat, redness, swelling, and loss of function.
The process of accepting patients. The concept includes patients accepted for medical and nursing care in a hospital or other health care institution.
Subsequent admissions of a patient to a hospital or other health care institution for treatment.
Percutaneous transluminal procedure for removing atheromatous plaque from the coronary arteries. Both directional (for removing focal atheromas) and rotational (for removing concentric atheromatous plaque) atherectomy devices have been used.
The administrative process of discharging the patient, alive or dead, from hospitals or other health facilities.
Works about controlled studies which are planned and carried out by several cooperating institutions to assess certain variables and outcomes in specific patient populations, for example, a multicenter study of congenital anomalies in children.
Single pavement layer of cells which line the luminal surface of the entire vascular system and regulate the transport of macromolecules and blood components.
A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable.
A heterogeneous group of disorders characterized by HYPERGLYCEMIA and GLUCOSE INTOLERANCE.
Shock resulting from diminution of cardiac output in heart disease.
The direct continuation of the brachial trunk, originating at the bifurcation of the brachial artery opposite the neck of the radius. Its branches may be divided into three groups corresponding to the three regions in which the vessel is situated, the forearm, wrist, and hand.
A pteridine derivative present in body fluids; elevated levels result from immune system activation, malignant disease, allograft rejection, and viral infections. (From Stedman, 26th ed) Neopterin also serves as a precursor in the biosynthesis of biopterin.
Cell adhesion molecule and CD antigen that mediates the adhesion of neutrophils and monocytes to activated platelets and endothelial cells.
Conditional probability of exposure to a treatment given observed covariates.
Pathological conditions involving the HEART including its structural and functional abnormalities.
The creation and display of functional images showing where the blood is flowing into the MYOCARDIUM by following over time the distribution of tracers injected into the blood stream.
Criteria and standards used for the determination of the appropriateness of the inclusion of patients with specific conditions in proposed treatment plans and the criteria used for the inclusion of subjects in various clinical trials and other research protocols.
The time required for the appearance of FIBRIN strands following the mixing of PLASMA with phospholipid platelet substitute (e.g., crude cephalins, soybean phosphatides). It is a test of the intrinsic pathway (factors VIII, IX, XI, and XII) and the common pathway (fibrinogen, prothrombin, factors V and X) of BLOOD COAGULATION. It is used as a screening test and to monitor HEPARIN therapy.
A class of drugs whose main indications are the treatment of hypertension and heart failure. They exert their hemodynamic effect mainly by inhibiting the renin-angiotensin system. They also modulate sympathetic nervous system activity and increase prostaglandin synthesis. They cause mainly vasodilation and mild natriuresis without affecting heart rate and contractility.
An approach of practicing medicine with the goal to improve and evaluate patient care. It requires the judicious integration of best research evidence with the patient's values to make decisions about medical care. This method is to help physicians make proper diagnosis, devise best testing plan, choose best treatment and methods of disease prevention, as well as develop guidelines for large groups of patients with the same disease. (from JAMA 296 (9), 2006)
Drugs used to cause dilation of the blood vessels.
The period of confinement of a patient to a hospital or other health facility.
A class of statistical methods applicable to a large set of probability distributions used to test for correlation, location, independence, etc. In most nonparametric statistical tests, the original scores or observations are replaced by another variable containing less information. An important class of nonparametric tests employs the ordinal properties of the data. Another class of tests uses information about whether an observation is above or below some fixed value such as the median, and a third class is based on the frequency of the occurrence of runs in the data. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed, p1284; Corsini, Concise Encyclopedia of Psychology, 1987, p764-5)
Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.
The amount of BLOOD pumped out of the HEART per beat, not to be confused with cardiac output (volume/time). It is calculated as the difference between the end-diastolic volume and the end-systolic volume.
Substances that lower the levels of certain LIPIDS in the BLOOD. They are used to treat HYPERLIPIDEMIAS.
The statistical reproducibility of measurements (often in a clinical context), including the testing of instrumentation or techniques to obtain reproducible results. The concept includes reproducibility of physiological measurements, which may be used to develop rules to assess probability or prognosis, or response to a stimulus; reproducibility of occurrence of a condition; and reproducibility of experimental results.
A membrane glycoprotein and differentiation antigen expressed on the surface of T-cells that binds to CD40 ANTIGENS on B-LYMPHOCYTES and induces their proliferation. Mutation of the gene for CD40 ligand is a cause of HYPER-IGM IMMUNODEFICIENCY SYNDROME, TYPE 1.
Constituent composed of protein and phospholipid that is widely distributed in many tissues. It serves as a cofactor with factor VIIa to activate factor X in the extrinsic pathway of blood coagulation.
Surgical removal of an obstructing clot or foreign material from a blood vessel at the point of its formation. Removal of a clot arising from a distant site is called EMBOLECTOMY.
Conformity in fulfilling or following official, recognized, or institutional requirements, guidelines, recommendations, protocols, pathways, or other standards.
Maintenance of blood flow to an organ despite obstruction of a principal vessel. Blood flow is maintained through small vessels.
The domestic dog, Canis familiaris, comprising about 400 breeds, of the carnivore family CANIDAE. They are worldwide in distribution and live in association with people. (Walker's Mammals of the World, 5th ed, p1065)
The range or frequency distribution of a measurement in a population (of organisms, organs or things) that has not been selected for the presence of disease or abnormality.
The relationship between the dose of an administered drug and the response of the organism to the drug.
Controlled physical activity which is performed in order to allow assessment of physiological functions, particularly cardiovascular and pulmonary, but also aerobic capacity. Maximal (most intense) exercise is usually required but submaximal exercise is also used.
Irreversible cessation of all bodily functions, manifested by absence of spontaneous breathing and total loss of cardiovascular and cerebral functions.
The movement and the forces involved in the movement of the blood through the CARDIOVASCULAR SYSTEM.
A condition characterized by severe PROTEINURIA, greater than 3.5 g/day in an average adult. The substantial loss of protein in the urine results in complications such as HYPOPROTEINEMIA; generalized EDEMA; HYPERTENSION; and HYPERLIPIDEMIAS. Diseases associated with nephrotic syndrome generally cause chronic kidney dysfunction.
A plant genus of the family CELASTRACEAE. The leafy stems of khat are chewed by some individuals for stimulating effect. Members contain ((+)-norpseudoephedrine), cathionine, cathedulin, cathinine & cathidine.
A generic term for fats and lipoids, the alcohol-ether-soluble constituents of protoplasm, which are insoluble in water. They comprise the fats, fatty oils, essential oils, waxes, phospholipids, glycolipids, sulfolipids, aminolipids, chromolipids (lipochromes), and fatty acids. (Grant & Hackh's Chemical Dictionary, 5th ed)
A heparin fraction with a mean molecular weight of 4500 daltons. It is isolated from porcine mucosal heparin and used as an antithrombotic agent. (From Merck Index, 11th ed)
Any disturbances of the normal rhythmic beating of the heart or MYOCARDIAL CONTRACTION. Cardiac arrhythmias can be classified by the abnormalities in HEART RATE, disorders of electrical impulse generation, or impulse conduction.

Coronary care medicine: it's not your father's CCU anymore. (1/1612)

The management of ST-elevation MI (STEMI) has gone through four phases: 1. The "clinical observation phase"; 2. the "coronary care unit phase"; 3. the "high-technology phase"; and 4. the "evidence-based coronary care phase". A significant advance in the care of patients with acute myocardial infarction that arose as an outgrowth of the evidence-based era was introduction of a lexicon that more accurately reflected contemporary concepts of the pathophysiology underlying myocardial ischemia and infarction. Although considerable improvement has occurred in the process of care for patient with STEMI, room for improvement exists. Despite strong evidence in the literature that prompt use of reperfusion therapy improves survival of STEMI patients such treatment is underutilized and often not administered in an expeditious timeframe relative to the onset of symptom. Even in the reperfusion era, left ventricular dysfunction remains the single most important predictor of mortality following STEMI. After administration of aspirin, initiating reperfusion strategies and, where appropriate, beta blockade all STEMI patients should be considered for inhibition of the renin-angiotensin-aldosterone system. Several adjunctive pharmacotherapies have been investigated to prevent inflammatory damage in the infarct zone. Contrary to earlier beliefs that the heart is a terminally differentiated organ without the capacity to regenerate, evidence now exists that human cardiac myocytes divide after STEMI and stem cells can promote regeneration of cardiac tissue. These observations open up the possibility of myocardial replacement therapy after STEMI.  (+info)

Gender differences in management and outcome in non-ST-elevation acute coronary syndrome. (2/1612)

OBJECTIVE: To study gender differences in management and outcome in patients with non-ST-elevation acute coronary syndrome. DESIGN, SETTING AND PATIENTS: Cohort study of 53 781 consecutive patients (37% women) from the Register of Information and Knowledge about Swedish Heart Intensive care Admissions (RIKS-HIA), with a diagnosis of either unstable angina pectoris or non-ST-elevation myocardial infarction. All patients were admitted to intensive coronary care units in Sweden, between 1998 and 2002, and followed for 1 year. MAIN OUTCOME MEASURES: Treatment intensity and in-hospital, 30-day and 1-year mortality. RESULTS: Women were older (73 vs 69 years, p<0.001) and more likely to have a history of hypertension and diabetes, but less likely to have a history of myocardial infarction or revascularisation. After adjustment, there were no major differences in acute pharmacological treatment or prophylactic medication at discharge. Revascularisation was, however, even after adjustment, performed more often in men (OR 1.15; 95% CI, 1.09 to 1.21). After adjustment, there was no significant difference in in-hospital (OR 1.03; 95% CI, 0.94 to 1.13) or 30-days (OR 1.07; 95% CI, 0.99 to 1.15) mortality, but at 1 year being male was associated with higher mortality (OR 1.12; 95% CI, 1.06 to 1.19). CONCLUSION: Although women are somewhat less intensively treated, especially regarding invasive procedures, after adjustment for differences in background characteristics, they have better long-term outcomes than men.  (+info)

Association between plasma adiponectin levels and unstable coronary syndromes. (3/1612)

AIMS: Obesity is a risk factor for an acute coronary syndrome (ACS). The association between elevated body mass index (BMI) and ACS is independent of most traditional risk factors, suggesting a possible contribution of other body fat-related mediators. This study evaluated the association between adiponectin and ACS. METHODS AND RESULTS: Four hundred and ninety-nine patients undergoing coronary angiography were divided into a subgroup without (n = 331) and with ACS (n = 168). In multiple regression analysis, higher adiponectin levels were independently associated with a lower risk of ACS [odds ratio (OR) = 0.61; 95% CIs: 0.46-0.81; P < 0.001]. In contrast, a higher BMI, a history of myocardial infarction, C-reactive protein, and angiographic coronary artery disease severity were all associated with a higher risk. The greatest increase in risk for ACS was seen at adiponectin levels < or = 5.5 microg/mL. CONCLUSION: Higher plasma adiponectin levels are independently associated with a lower risk of ACS.  (+info)

Pregnancy-associated plasma protein A and proform eosinophilic major basic protein in the detection of different types of coronary artery disease. (4/1612)

Kryptor system was proven to be a rapid, standard method for pregnancy-associated plasma protein A and proform eosinophilic major basic protein (PAPP-A/proMBP) complex detection in coronary artery disease (CAD). No age and/or gender differences in 51 controls and 110 stable coronary artery disease (SCAD) patients were found. SCAD patients did not differ from controls and no difference in PAPP-A/proMBP levels with regards to the number of affected vessels was found. In 21 unstable angina pectoris (UAP), in 35 without and 66 with ST elevation acute myocardial infarctions (NSTEMI, STEMI respectively) patients PAPP-A/proMBP levels were increased (P=0.004 and P<0.0005, respectively). PAPP-A/proMBP levels did not correlate with cardiac troponin I (cTnI) in STEMI and NSTEMI patients. PAPP-A/ proMBP increase was more frequent than cTnI (P=0.036) within the early phase of STEMI. In NSTEMI patients PAPP-A/proMBP positivity was present in 50% of cTnI negative cases. Receiver operating characteristic (ROC) analysis revealed the highest diagnostic accuracy of PAPP-A/proMBP (0.919) in STEMI cTnI positive cases. The highest specificity/sensitivity PAPP-A/proMBP levels for particular acute coronary syndrome (ACS) types were 10.65-14.75 mIU/l. Combination of PAPP-A/proMBP with cTnI increases their diagnostic efficacy within the early phase of ACS. Our results suggest that PAPP-A/proMBP complex is involved in processes preceding vulnerable plaque development in ACS.  (+info)

Effects of revascularization within 14 days of hospital admission due to acute coronary syndrome on 1-year mortality in patients with previous coronary artery bypass graft surgery. (5/1612)

AIMS: To determine whether revascularization within 14 days reduces 1-year mortality in patients with a previous CABG admitted for non-ST-elevation ACS. Current guidelines for patients with acute coronary syndrome (ACS) include early revascularization. The evidence is derived from studies, in which patients with previous coronary artery by-pass graft (CABG) surgery often were excluded and thus insufficient to support a similar strategy in these high-risk patients in whom coronary interventions are associated with lower success and higher complication rates. METHODS AND RESULTS: A cohort of 10 469 patients < 80 years old from a national registry, admitted to coronary care units in Sweden, was studied. We obtained 1-year mortality data from the Swedish National Cause of Death Registry. Relative risk (RR) in patients undergoing revascularization within 14 days (n = 4269) of admission compared to those who did not (n = 6200) was calculated by using multivariable logistic regression analyses and propensity scores for the likelihood of early revascularization. At 1-year, unadjusted mortality was 5.4% in the revascularized group and 13.1% in the conservatively treated group. In multiple regression analyses, revascularization was associated with a reduction of 1-year mortality (RR 0.67; 95% CI, 0.56-0.81; P < 0.001). CONCLUSION: In patients with a previous CABG admitted for ACS, revascularization within 14 days of hospital admission was associated with a marked reduction in 1-year mortality, supporting an early invasive approach also in this subset of patients.  (+info)

Clinical use of clopidogrel in acute coronary syndrome. (6/1612)

Several therapeutic approaches have been developed to improve the outcome among patients with acute coronary syndrome (ACS). However, treatment with antithrombotic therapies such as oral glycoprotein IIb/IIIa inhibitors has been limited by the lack of efficacy and excess bleeding complications. As the publication of the landmark study Clopidogrel in Unstable Angina to Prevent Recurrent Events (CURE), the clinical benefit of early and intermediate-term use of combined antiplatelet agents--clopidogrel plus aspirin--in non-ST-segment elevation myocardial infarction (NSTEMI) patients became evident. Pretreatment and intermediate-term therapy with clopidogrel in NSTEMI ACS patients undergoing percutaneous coronary intervention (PCI) was further supported by the PCI-CURE trial. Recently, the results of two major trials Clopidogrel as Adjunctive Reperfusion Therapy-Thrombolysis in Myocardial Infarction 28, Clopidogrel and Metoprolol in Myocardial Infarction Trial established the pivotal role of clopidogrel in the other spectrum of ACS-STEMI. Coupled with the results from previous multicentre trials, these two studies provide a guide for the early and long-term use of clopidogrel in the whole spectrum of ACS. A review summarising the results of the recent clinical trials and a discussion on its implications for the clinical management of ACS is presented.  (+info)

64-Slice CT coronary angiography in patients with non-ST elevation acute coronary syndrome. (7/1612)

BACKGROUND: A high diagnostic accuracy of 64-slice CT coronary angiography (CTCA) has been reported in selected patients with stable angina pectoris, but only scant information is available in patients with non-ST elevation acute coronary syndrome (ACS). OBJECTIVES: To study the diagnostic performance of 64-slice CTCA in patients with non-ST elevation ACS. PATIENTS AND METHODS: 64-slice CTCA was performed in 104 patients (mean (SD) age 59 (9) years) with non-ST elevation ACS. Two independent, blinded observers assessed all coronary arteries for stenosis, using conventional quantitative angiography as a reference. Coronary lesions with >or=50% luminal narrowing were classified as significant. RESULTS: Conventional coronary angiography demonstrated the absence of significant disease in 15% (16/104) of patients, and the presence of single-vessel disease in 40% (42/104) and multivessel disease in 44% (46/104) of patients. Sensitivity for detecting significant coronary stenoses on a patient-by-patient analysis was 100% (88/88; 95% CI 95 to 100), specificity 75% (12/16; 95% CI 47 to 92), and positive and negative predictive values were 96% (88/92; 95% CI 89 to 99) and 100% (12/12; 95% CI 70 to 100), respectively. CONCLUSION: 64-slice CTCA has a high sensitivity to detect significant coronary stenoses, and is reliable to exclude the presence of significant coronary artery disease in patients who present with a non-ST elevation ACS.  (+info)

Relationship between circulating endothelial cells and the predicted risk of cardiovascular events in acute coronary syndromes. (8/1612)

AIMS: The quantification of circulating endothelial cells (CECs) in whole blood is a novel marker of direct endothelial injury and shows promise as a potential biomarker of cardiovascular (CV) risk. The inter-relationship(s) between CECs and predicted CV risk has not been explored in large cohort of 'high-risk' patients. We hypothesized that there would be a significant relationship between increasing CEC counts and predicted CV risk in a broad spectrum of patients presenting with acute coronary syndrome (ACS). METHODS AND RESULTS: We studied 197 patients (aged 40-80 years) admitted with a confirmed diagnosis of unstable angina (UA), non-ST-elevation myocardial infarction (MI, NSTEMI), or ST-elevation MI (STEMI). CEC counts were performed on venous whole blood using the immunobead technique. Four well-validated ACS risk scores [(PURSUIT and TIMI for NSTEMI/UA) TIMI (STEMI) and GRACE (all ACS)] were calculated from the initial clinical history and electrocardiogram, as well as from values of laboratory parameters collected within 12 h of admission. We included a healthy control (HC) group of 50 matched patients in order to quantify the accuracy of CEC counts for the diagnosis of ACS and to compare disease vs. HC counts. CEC counts were significantly higher in the disease group when compared with the HC group. CEC counts significantly increased with increasing severity of disease (that is, UA vs. NSTEMI vs. STEMI; P = 0.002). CEC counts were higher among patients with clinical evidence of heart failure (Killip Class II-IV) when compared with those without (Killip Class I) on admission (P < 0.0001). There was a significant correlation between CEC counts and predicted CV risk for each of the four ACS risk scoring schemes (all P < 0.05). The area under the receiver-operating characteristic (ROC) curve (AUC) for the entire ACS cohort was 0.82 (95% CI: 0.76-0.88; P < 0.0001). A CEC count of >or=7/mL provided a positive predictive value of 90.6% (95% CI: 85.6-95.7%) and a negative predictive value of 53.5% (41.9-65.1%) for the diagnosis of MI (NSTEMI/STEMI) in the presence of an appropriate clinical presentation. CONCLUSION: There is a significant and positive correlation between increasing CECs and increasing CV risk in ACS. The diagnostic accuracy of CECs in this setting is only 'moderate'. Whilst it is good at confirming the presence of MI, a CEC value of <7.0/mL is less reliable at confidently excluding patients without disease.  (+info)

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. Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. Fibrinolysis is not recommended in patients with non-ST elevation acute coronary syndrome;
BACKGROUND: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease.. OBJECTIVES: The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS.. METHODS: The VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial (NCT02061891) evaluated the outcome of patients with confirmed NSTEACS randomized 1:1 to very early (within 12 h) or standard (48 to 72 h) invasive coronary angiography (ICA). As an observational component of the trial, a clinically blinded coronary CTA was conducted prior to ICA in both groups. The primary endpoint was the ability of coronary CTA to rule out coronary artery stenosis (≥50% stenosis) in the entire population, expressed as the negative predictive value (NPV), using ICA as ...
BACKGROUND: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease.. OBJECTIVES: The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS.. METHODS: The VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial (NCT02061891) evaluated the outcome of patients with confirmed NSTEACS randomized 1:1 to very early (within 12 h) or standard (48 to 72 h) invasive coronary angiography (ICA). As an observational component of the trial, a clinically blinded coronary CTA was conducted prior to ICA in both groups. The primary endpoint was the ability of coronary CTA to rule out coronary artery stenosis (≥50% stenosis) in the entire population, expressed as the negative predictive value (NPV), using ICA as ...
Although inflammation is involved in the pathogenesis of acute coronary syndromes, the extent of inflammation is not routinely assessed, and its prognostic implications in patients with non-ST-segment elevation acute coronary syndrome have not been investigated in depth. We analyzed the prognostic i …
Ticagrelor is an alternative to clopidogrel for secondary prevention of cardiovascular death in patients with acute coronary syndrome. In an international study it was found to be more effective, but patients in the United States did not experience superior outcomes.
The aim of this international study is to describe the short- and long-term (i.e. up to 2 years following the index event) antithrombotic management patterns (AMPs) in patients hospitalized for acute coronary syndromes (ST segment elevation myocardial infarction (STEMI), Non-ST-Segment Elevation Acute Coronary Syndrome (NSTE-ACS)), and to document the impact of AMPs in clinical outcomes, economic variables and quality of life in a real-life setting and to compare these between sites, countries and regions ...
BACKGROUND: Data are limited on whether clinical trials have randomized higher-risk patients over time and how trends in risk profiles and evidence-based pharmacotherapies have influenced trial outcomes. We quantified changes in baseline risk, treatment, and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) randomized in 9 phase 3 clinical trials of antithrombotic therapy over 15years. METHODS: We studied 58,771 patients in GUSTO IIb, PURSUIT, PARAGON-A, PARAGON-B, PRISM, PRISM-PLUS, GUSTO IV-ACS, SYNERGY, and EARLY ACS. Patient-level data were mapped to 3 pre-specified 5-year randomization periods. Temporal trends in GRACE score-predicted mortality were compared with trends in observed mortality. RESULTS: Over time, in-hospital and discharge use of thienopyridines (p=0.001), statins (p,0.0001), and angiotensin-converting enzyme inhibitors (p,0.0001) increased, and hospital length-of-stay decreased (p=0.024). Blood transfusion use increased (8.3% [1994-98], ...
AIMS: Stroke is an uncommon but serious complication after non-ST-segment elevation acute coronary syndrome (NSTE-ACS). We aimed to identify predictors of stroke within 30 days in patients who suffered NSTE-ACS. METHODS AND RESULTS: We pooled data from six trials (n=31 402) that randomized NSTE-ACS patients either to platelet glycoprotein (GP) IIb/IIIa receptor blockers or to placebo/control therapy. Potential predictors of stroke included treatment, demographic, and clinical characteristics. We identified predictors using univariable and multivariable logistic models, and their performance was evaluated with calibration (Hosmer-Lemeshow test) and discrimination (c-statistic). We found 228 (0.7%) all-cause strokes: 155 (0.5%) non-haemorrhagic, 20 (0.06%) haemorrhagic, and 53 without computed tomography (CT) confirmation. Patients with any type of stroke had a 30-day mortality of 25%. Randomization to GP IIb/IIIa receptor blockers was not significantly associated with all-cause stroke [OR (95% ...
Abstract Background In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pa | Jesper J. Linde, Henning Kelbæk, Thomas F. Hansen, | Journal of the American College of Cardiology |
BACKGROUND: Several countries affected by the COVID-19 pandemic have reported a substantial drop in the number of patients attending the emergency department with acute coronary syndromes and a reduced number of cardiac procedures. We aimed to understand the scale, nature, and duration of changes to admissions for different types of acute coronary syndrome in England and to evaluate whether in-hospital management of patients has been affected as a result of the COVID-19 pandemic. METHODS: We analysed data on hospital admissions in England for types of acute coronary syndrome from Jan 1, 2019, to May 24, 2020, that were recorded in the Secondary Uses Service Admitted Patient Care database. Admissions were classified as ST-elevation myocardial infarction (STEMI), non-STEMI (NSTEMI), myocardial infarction of unknown type, or other acute coronary syndromes (including unstable angina). We identified revascularisation procedures undertaken during these admissions (ie, coronary angiography without percutaneous
TY - JOUR. T1 - Racial Differences Among High-Risk Patients Presenting With Non-ST-Segment Elevation Acute Coronary Syndromes (Results from the SYNERGY Trial)††Disclosure. T2 - Drs. Mahaffey, Cohen, Newby, Ferguson, and Califf have received honoria for speaking from sanofi-aventis. Drs. Mahaffey, Ferguson, and Califf have acted as consultants for sanofi-aventis. Drs. Echols, Velazquez, Santos.. AU - Echols, Melvin R.. AU - Mahaffey, Kenneth W.. AU - Banerjee, Anindita. AU - Pieper, Karen S.. AU - Stebbins, Amanda. AU - Lansky, Alexandra. AU - Cohen, Mauricio G.. AU - Velazquez, Eric. AU - Santos, Renato. AU - Newby, L. Kristin. AU - Gurfinkel, Enrique P.. AU - Biasucci, Luigi. AU - Ferguson, James J.. AU - Califf, Robert M.. N1 - Funding Information: The SYNERGY trial was funded by Aventis Pharmaceuticals, Inc., Bridgewater, New Jersey, a member of the sanofi-aventis Group. Drs. Mahaffey, Lansky, Biasucci, Ferguson, and Califf were supported by sanofi-aventis. Ms. Banerjee, Ms. Pieper, and ...
ODYSSEY Outcomes will determine whether the addition of the PCSK9 antibody alirocumab to intensive statin therapy reduces cardiovascular morbidity and mortality after ACS.
The purpose of this study is to determine if testing patients for endothelial dysfunction will help identify which patients are more likely at risk to have another heart attack in the future. Study participants will undergo mental stress testing while at the same time being connected to a device that measures endothelial function via the Endopat device. These same participants will also undergo a sleep study via the Watchpat device ...
Immediate versus deferred coronary angioplasty in non-ST-segment elevation acute coronary syndromes. Riezebos, R K; Ronner, E; ter Bals, E; Slagboom, T; Smits, P C; ten Berg, J M; Kiemeneij, F; Amoroso, G; Patterson, M S; Suttorp, M J; Tijssen, J G P; Laarman, G J // Heart;May2009, Vol. 95 Issue 10, p807 Background: The field of acute coronary syndromes is characterised by an increasing tendency towards early invasive catheter-based diagnostics and therapeuticsâ€a practice based on observational and retrospective data. Objective: To compare immediate versus deferred angioplasty in patients... ...
The number of patients living with co-existing diseases is growing. This study aimed to assess the extent of multimorbidity, medication use, and drug- and gene-based interactions in patients following a non-ST elevation acute coronary syndrome (NSTE-ACS). In 1456 patients discharged from hospital for a NSTE-ACS, comorbidities and multimorbidity (≥ 2 chronic conditions) were assessed. Of these, 698 had complete drug use recorded at discharge, and 652 (the interaction cohort) had drug use and actionable genotypes available for CYP2B6, CYP2C9, CYP2C19, CYP2D6, CYP3A5, DPYD, F5, SLCO1B1, TPMT, UGT1A1, and VKORC1. The following drug interactions were investigated: pharmacokinetic drug-drug (DDIs) involving CYPs (CYPs above, plus CYP1A2, CYP2C8, CYP3A4), SLCO1B1, and P-glycoprotein; drug-gene (DGIs); drug-drug-gene (DDGIs); and drug-gene-gene (DGGIs). Interactions predicted to be substantial were defined as follows: DDIs due to strong inhibitors/inducers, DGIs due to variant homozygous/compound
TY - JOUR. T1 - Vorapaxar in acute coronary syndrome patients undergoing coronary artery bypass graft surgery. T2 - Subgroup analysis from the TRACER trial (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome). AU - Whellan, David J.. AU - Tricoci, Pierluigi. AU - Chen, Edmond. AU - Huang, Zhen. AU - Leibowitz, David. AU - Vranckx, Pascal. AU - Marhefka, Gregary D.. AU - Held, Claes. AU - Nicolau, Jose C.. AU - Storey, Robert F.. AU - Ruzyllo, Witold. AU - Huber, Kurt. AU - Sinnaeve, Peter. AU - Weiss, A. Teddy. AU - Dery, Jean Pierre. AU - Moliterno, David J.. AU - Van De Werf, Frans. AU - Aylward, Philip E.. AU - White, Harvey D.. AU - Armstrong, Paul W.. AU - Wallentin, Lars. AU - Strony, John. AU - Harrington, Robert A.. AU - Mahaffey, Kenneth W.. N1 - Funding Information: The TRACER trial was funded by Merck & Co., Inc . Dr. Whellan has received consultant honoraria from Novartis, POZEN, Terumo, and Medtronic; and he has received a research grant from Merck ...
Background. Evaluating the number of medical or interventional treatments of a registry cohort allows the inclusion of women without obstructive CAD, potentially confounding the results toward an apparent sex bias against women.. Aim. The aim of this study was to ascertain whether effective evidence based treatments for acute coronary syndromes (ACS) are underutilized among women with documented coronary disease in various geographic areas compared with men.. Methods. We collected data from 3 registries: the Finnish TACOS (Tampere Acute COronary Syndrome), the British EMMACE 2 (Evaluation of Methods and Management of Acute Coronary Events), and the Argentine PACS-ITALSIA (Prognosis in Acute Coronary Syndromes and the ITALian hospital Sindrome Isquemico Agudo). The gold standard test to which effective discharge treatments were compared was required to be angiographic evidence of obstructive coronary disease (more than 50% lumen diameter stenosis).. Results. The Finnish TACOS, the British EMMACE ...
Objective: To determine the differences in the inflammatory status between diabetic and non-diabetic patients and to evaluate the usefulness of C reactive protein, fibrinogen, and leucocyte count as predictors of death in diabetic patients with unstable coronary disease.. Design: Nested case-control comparisons of the inflammatory status between diabetic and non-diabetic patients. Prospective cohort analysis of C reactive protein concentration, fibrinogen concentration, and leucocyte count as predictors of cardiovascular death in diabetic patients.. Setting: Coronary care unit in Spain.. Participants: 83 diabetic patients with non-ST elevation acute coronary syndrome and 83 sex and aged matched patients selected from 361 non-diabetic patients with non-ST elevation acute coronary syndrome.. Main outcome measures: Plasma concentrations of C reactive protein and fibrinogen, and leucocyte count. Investigators contacted patients to assess clinical events.. Results: Concentrations of C reactive ...
Objective: To analyse intensity of treatment of high-risk patients with non-ST elevation acute coronary syndromes (NSTEACS) included in the DESCARTES (Descripción del Estado de los Sindromes Coronarios Agudos en un Registro Temporal Español) registry.. Patients and setting: Patients with NSTEACS (n = 1877) admitted to 45 randomly selected Spanish hospitals in April and May 2002 were studied.. Design: Patients with ST segment depression and troponin rise were considered high risk (n = 478) and were compared with non-high risk patients (n = 1399).. Results: 46.9% of high-risk patients versus 39.5% of non-high-risk patients underwent angiography (p = 0.005), 23.2% versus 18.8% (p = 0.038) underwent percutaneous revascularisation, and 24.9% versus 7.4% (p , 0.001) were given glycoprotein IIb/IIIa inhibitor. In-hospital and six-month mortality were 7.5% versus 1.1% and 17% versus 4.6% (p , 0.001), respectively. A treatment score (⩾ 4, 2-3 and , 2) was defined according to the number of class I ...
References. 1 Vedanthan R, Seligman B, Fuster V. Global perspective on acute coronary syndrome: a burden on the young and poor. Circ Res. 2014;114(12):1959-75. [ Links ] 2 Ministério da Saúde. Datasus. [internet]. Sistema de informações de mortalidade. Óbitos por residência por ano do óbito segundo capítulo CID-10. Dados preliminares de mortalidade 2011. [Acesso em 2016 nov 22]. Disponível em: http://www.datasus.gov.br [ Links ] 3 Piegas LS, Avezum A, Guimarães HP, Muniz AJ, Reis HJ, Santos ES, et al. Acute coronary syndrome behavior: results of a Brazilian registry. Arq Bras Cardiol. 2013;100(6):502-10. [ Links ] 4 Wiviott SD, Steg PG. Clinical evidence for oral antiplatelet therapy in acute coronary syndromes. Lancet. 2015;386(9990):292-302. [ Links ] 5 Fuster V, Sweeny JM. Aspirin: a historical and contemporary therapeutic overview. Circulation. 2011;123(7):768-78. [ Links ] 6 Eikelboom JW, Mehta SR, Anand SS, Xie C, Fox KA, Yusuf S. Adverse impact of bleeding on prognosis in ...
Doctor answers on Symptoms, Diagnosis, Treatment, and More: Dr. Trettin on acute coronary syndrome: Both are a result of inadequate blood supply to the heart muscle. Acute coronary syndrome means that the imbalance is sufficient to cause symptoms that prompt aggressive intervention, but may not result in permanent heart damage; a myocardial infarction implies that overt heart damage has occurred, hence positive markers of tissue damage. for topic: Acute Coronary Syndrome
Background-Ventricular arrhythmias remain a lethal complication of acute coronary syndromes (ACS). However, the incidence and prognosis of sustained ventricular tachycardia/ventricular fibrillation (VT/VF) in contemporary non-ST-segment elevation (NSTE) ACS populations are not well described. Methods and Results-We examined the incidence of VT/VF and subsequent survival among 9211 patients enrolled in the Early Glycoprotein IIb/IIIa Inhibition in NSTE ACS (EARLY ACS) trial. The cumulative incidence of VT/VF was 1.5% (n=141); 0.6% (n=55) had VT/VF ≤48 hours after enrollment, and 0.9% (n=86) had VT/VF ,48 hours after enrollment. Patients with VT/VF more frequently had prior heart failure, an ejection fraction ,30%, and triple-vessel coronary artery disease. Predictors of sustained VT/VF were similar regardless of the timing of VT/VF (≤48 vs. ,48 hours). Patients with VT/VF ≤48 hours after enrollment had higher 30-day mortality than those who did not have VT/VF ≤48 hours (13.0 vs. 2.2%; ...
Background: Non ST-elevation Acute Coronary Syndromes are the most frequent manifestations of acute ischemic heart disease. Gender differences in treatment intensity, including differences in level of care, have been reported. Also differences in benefit from certain treatments, especially invasive treatment, have been discussed. Finally, difference in outcome between men and women, have been proposed. Results have been inconsistent, partly depending on if and how adjustment for differences in background characteristics has been made. The aims of the studies in this thesis were to assess differences between the genders in baseline characteristics, level of care, medical treatment and non-invasive and invasive cardiac procedures. The aims were also to determine gender differences in short and long-term mortality, including impact of level of care, and to determine differences between the genders in benefit from an invasive strategy, with special reference to benefit in women.. Method: We used ...
Objectives: This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. Background The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate.. Methods: Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk ...
The paradoxical use of cardiac catheterization in patients with non-ST-elevation acute coronary syndromes: lessons from the Can Rapid Stratification of Unstable Angina Patients Suppress Adverse Outcomes With Early Implementation of the ACC /AHA Guidelines (CRUSADE) Quality Improvement Initiative.
Thrombosis Canada is pleased to share two new clinical guides, as well as an educational slide deck on Acute Coronary Syndrome In Hospital Antiplatelet Management. The two new clinical guides can now be accessed through our website and focus on ST Elevation and Non-ST Elevation Acute Coronary Syndrome: Hospital Antiplatelet Management. In addition, a new educational slide desk on the same topic can be viewed or downloaded, in English and French, under the Resources tab of the Thrombosis Canada website.. ...
TY - JOUR. T1 - High-sensitivity cardiac troponin I at presentation in patients with suspected acute coronary syndrome: a cohort study. AU - High-STEACS investigators. AU - Shah, Anoop S V. AU - Anand, Atul. AU - Sandoval, Yader. AU - Lee, Kuan Ken. AU - Smith, Stephen W. AU - Adamson, Philip D. AU - Chapman, Andrew R.. AU - Langdon, Timothy. AU - Sandeman, Dennis. AU - Vaswani, Amar. AU - Strachan, Fiona E.. AU - Ferry, Amy. AU - Stirzaker, Alexandra G. AU - Reid, Alan. AU - Gray, Alasdair J. AU - Collinson, Paul O. AU - McAllister, David A. AU - Apple, Fred S. AU - Newby, David E. AU - Mills, Nicholas L. N1 - Date of Acceptance: 15/09/2015. PY - 2015/12/19. Y1 - 2015/12/19. N2 - Background: Suspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits.Methods: We did a prospective cohort study of 6304 consecutively ...
Objectives: The objectives of this study are to use CART (Classification and regression tree) and step-wise regression to 1) define the predictors of quality of life in ACS (acute coronary syndrome) patients, using demographics, ACS symptoms, and anxiety as independent variables; and 2) discuss and compare the results of these two statistical approaches. Back- ground: In outcome studies of ACS, CART is a good alternative approach to linear regression; however, CART is rarely used. Methods: A descriptive survey design was used with 100 samples recruited. Result and Conclusions: Anxiety is the most significant predictor and also a stronger predictor than symptoms of ACS for the quality of life. The anxiety level patients experienced at the time heart attack occurred can be used to predict quality of life a month later. Furthermore, the majority of ACS patients experienced a moderate to high level of anxiety during a heart attack.
Master thesis, Programme in Medicine TITLE: Predictors of long-term outcome of percutaneous coronary intervention in elderly patients with acute coronary syndrome - a retrospective analysis AUTHOR, YEAR: Maria Lindh, 2012 INSTITUTION, CITY, COUNTRY: Section of Cardiology, Department of Medicine, Sahlgrenska University Hospital/Östra Hospital, Gothenburg, Sweden BACKGROUND: Elderly patients constitute the majority of patients with acute coronary syndrome. Nevertheless, due to a paucity of data, decision-making on the use of percutaneous coronary intervention in this patient group is mainly empirical. Old age is associated with higher risk of adverse outcome of PCI. It is however not well-known what other factors than age that are of prognostic significance. Likely, considering the heterogeneity of the patient group, there is a subgroup of elderly patients for which the prospects of gaining from intervention are greater than for others. By studying and evaluating factors that may be of prognostic
TY - JOUR. T1 - Duration of eptifibatide infusion after percutaneous coronary intervention and outcomes among high-risk patients with non-ST-segment elevation acute coronary syndrome. T2 - Insights from EARLY ACS. AU - Hess, Connie N.. AU - Schulte, Phillip J.. AU - Newby, L. Kristin. AU - Steg, Philippe Gabriel. AU - Dalby, Anthony J.. AU - Schweiger, Marc J.. AU - Lewis, Basil S.. AU - Armstrong, Paul W.. AU - Califf, Robert M.. AU - van de Werf, Frans. AU - Harrington, Robert A.. PY - 2013/1/1. Y1 - 2013/1/1. N2 - Background and Objectives: Eptifibatide is indicated during percutaneous coronary intervention (PCI) with continuation for 18-24 hours post procedure but is associated with bleeding. We examined the efficacy and safety of shorter post-PCI eptifibatide infusions in high-risk non-ST-segment elevation acute coronary syndrome (NSTE ACS) patients. Methods: EARLY ACS patients treated with PCI and eptifibatide were grouped by post-procedure infusion duration: ,10, 10-13, 13-17, and 17-25 ...
Acute Coronary Syndrome covers the spectrum of clinical conditions ranging from unstable angina to non-ST elevation myocardial infarction and ST elevation myocardial infarction. These life-threatening disorders are a major cause of emergency medical care, hospitalization and mortality. Management of Acute Coronary Syndromes is designed to provide busy clinicians with a comprehensive guide to the investigation, diagnosis and treatment of these syndromes. It encompasses the latest technologies, including the use of biomarkers and non-invasive imaging procedures ...
TY - JOUR. T1 - Surgical Versus Percutaneous Coronary Revascularization in Patients With Diabetes and Acute Coronary Syndromes. AU - Ramanathan, Krishnan. AU - Abel, James G.. AU - Park, Julie E.. AU - Fung, Anthony. AU - Mathew, Verghese. AU - Taylor, Carolyn M.. AU - Mancini, G. B.John. AU - Gao, Min. AU - Ding, Lillian. AU - Verma, Subodh. AU - Humphries, Karin H.. AU - Farkouh, Michael E.. PY - 2017/12/19. Y1 - 2017/12/19. N2 - Background Randomized trial data support the superiority of coronary artery bypass grafting (CABG) surgery over percutaneous coronary intervention (PCI) in diabetic patients with multivessel coronary artery disease (MV-CAD). However, whether this benefit is seen in a real-world population among subjects with stable ischemic heart disease (SIHD) and acute coronary syndromes (ACS) is unknown. Objectives The main objective of this study was to assess the generalizability of the FREEDOM (Future REvascularization Evaluation in Patients with Diabetes Mellitus: Optimal ...
Another name for Acute Coronary Syndrome is Acute Coronary Syndrome. An electrocardiogram or ECG can be an effective tool in the evaluation of acute coronary ...
Platelet aggregation plays a central role in the development of the occlusive thrombus responsible for acute coronary occlusion in people with ACS. People with diabetes have a pro-thrombotic state due to dysfunctional and hyperactive platelets, endothelial dysfunction, elevated coagulation factors and decreased fibrinolysis (32). Increased platelet activity is due to multiple metabolic and cellular factors associated with diabetes that include endothelial dysfunction, the impact of hyperglycemia and deficient insulin action (32).. Diabetes is associated with an increased incidence of recurrent atherothrombotic events (33), including stent thrombosis (34). Anti-platelet therapy has been shown to reduce atherothrombotic events in people with ACS, both during the acute phase and in the longer term. The beneficial effect of ASA has been shown in multiple clinical trials in patients with non-ST-segment elevation acute coronary syndrome (NSTE ACS) and ST-segment elevation MI (STEMI). The ...
Acute coronary syndrome (ACS) is a leading cause of mortality and morbidity in the Arabian Gulf. In this study, the in‐hospital mortality amongst patients admitted with ACS to Arabian Gulf hospitals is predicted using a comprehensive modelling framework that combines powerful machine‐learning methods such as support‐vector machine (SVM), Naïve Bayes (NB), artificial neural networks (NN), and decision trees (DT). The performance of the machine‐learning methods is compared with that of the performance of a commonly used statistical method, namely, logistic regression (LR). The study follows the current practise of computing mortality risk using risk scores such as the Global Registry of Acute Coronary Events (GRACE) score, which has not been validated for Arabian Gulf patients. Cardiac registry data of 7,000 patients from 65 hospitals located in Arabian Gulf countries are used for the study. This study is unique as it uses a contemporary data analytics framework. A k‐fold (k = 10) ...
TY - JOUR. T1 - Current evidence for monitoring platelet reactivity in acute coronary syndrome. T2 - A plea for individualized antiplatelet treatment. AU - Aradi, D.. AU - Sibbing, Dirk. AU - Bonello, Laurent. PY - 2013/9/1. Y1 - 2013/9/1. N2 - Although clopidogrel is more effective in preventing thrombotic complications than aspirin alone in a broad spectrum of patients with ischemic heart disease, many of its limitations were recently brought to light including a delayed onset of action and highly unpredictable P2Y12-receptor inhibition. New-generation ADP-receptor antagonists, such as prasugrel and ticagrelor, were designed and developed to overcome these limitations, providing a more rapid, more reliable and more potent P2Y12-receptor inhibition. These pharmacodynamic benefits of new-generation antiplatelet agents were translated into significant clinical advantage among patients with acute coronary syndrome (ACS), especially in preventing stent thrombosis. However, the downsides of the ...
TY - JOUR. T1 - Current evidence for monitoring platelet reactivity in acute coronary syndrome. T2 - A plea for individualized antiplatelet treatment. AU - Aradi, D.. AU - Sibbing, Dirk. AU - Bonello, Laurent. PY - 2013/9/1. Y1 - 2013/9/1. N2 - Although clopidogrel is more effective in preventing thrombotic complications than aspirin alone in a broad spectrum of patients with ischemic heart disease, many of its limitations were recently brought to light including a delayed onset of action and highly unpredictable P2Y12-receptor inhibition. New-generation ADP-receptor antagonists, such as prasugrel and ticagrelor, were designed and developed to overcome these limitations, providing a more rapid, more reliable and more potent P2Y12-receptor inhibition. These pharmacodynamic benefits of new-generation antiplatelet agents were translated into significant clinical advantage among patients with acute coronary syndrome (ACS), especially in preventing stent thrombosis. However, the downsides of the ...
Acute Coronary Syndromes : Review in-depth clinical information, latest medical news, and guidelines about acute coronary syndrome, classified as either ST segment elevation myocardial infarction (STEMI myocardial infarction) or non-STEMI myocardial infarction (NSTE or non-ST myocardial infarction) as reflected on ECG. Read about the latest angina and STEMI treatment.
CHEST PAIN SUGGESTIVE OF ACUTE CORONARY SYNDROME. Expert Panel on Cardiac Imaging: Leena Mammen, MD1; Suhny Abbara, MD2; Sharmila Dorbala, MD3; Cylen Javidan-Nejad, MD4; Paul R. Julsrud, MD5; Jacobo Kirsch, MD6; Christopher M. Kramer, MD7; Rajesh Krishnamurthy, MD8; Archana T. Laroia, MD9; Amar B. Shah, MD10; Jens Vogel-Claussen, MD11; Richard D. White, MD12; Pamela K. Woodard, MD.13. Summary of Literature Review. Introduction/Background. Acute chest pain is a frequent presenting complaint in emergency departments. Along with other important disease entities such as aortic dissection and pulmonary embolus, such patient symptoms may question the possibility of acute myocardial ischemia. Acute coronary syndromes (ACS) include ST-segment elevation myocardial infarction (STEMI), non -STEMI (NSTEMI), and unstable angina (UA) [1]. Being able to establish the diagnosis rapidly and accurately may be lifesaving. The immediate cardiac workup consists of an electrocardiogram (ECG) and cardiac biomarkers. ...
Coronary Artery Disease is a chapter in the book, Cardiovascular Medicine, containing the following 20 pages: Spontaneous Coronary Artery Dissection, Myocardial Ischemia in Intensive Care, Stable Coronary Artery Disease, Cocaine-Induced Coronary Vasospasm, Vasospastic Angina, Acute Coronary Syndrome, Acute Coronary Syndrome Immediate Management, Acute Coronary Syndrome Adjunctive Therapy, High Risk Acute Coronary Syndrome Management, Moderate Risk Acute Coronary Syndrome Management, Low Risk Acute Coronary Syndrome Management, Myocardial Infarction Stabilization, Post Myocardial Infarction Evaluation, Post Myocardial Infarction Medications, Cardiac Rehabilitation, Angina Pectoris, Angina Diagnosis, Unstable Angina, Unstable Angina Prognosis, Abnormal Coronary Arteries.
Aims: Few data exist on kidney dysfunction (KD) and glycoprotein IIb/IIIa inhibitors (GPI) in acute coronary syndrome (ACS) patients treated by percutaneous coronary intervention (PCI) and whether they impact on long-term outcome since most frequently patients with various degrees of KD are excluded. Study Design: Comparison of independent but concomitant arms of a randomized investigation on GPI. Place and Duration of Study: The SantANna TIrofiban Safety study (SANTISS www.clinicaltrials.gov Identifier: NCT00566891) was an open-label investigator-initiated single centre registry at SantAnna Hospital, Catanzaro, during a 5-year enrollment period. Methodology: We considered 726 ACS patients with PCI under either triple (aspirin, clopidogrel including high-dose tirofiban) or double (aspirin and clopidogrel) antiaggregating drugs (AAD). Serum creatinine levels, creatinine clearance (CrCl, using the Cockcroft-Gault formula) and estimated glomerular filtration rate (eGFR, using both MDRD and ...
Acute coronary syndromes affect thousands of Australians each year. It is estimated that 69,900 people aged 25 and over had a heart attack in 2011, which equates to around 190 heart attacks a day. Coronary heart disease (the main cause of acute coronary syndromes) kills more people in Australia than any other disease, and contributed to 15 per cent of all deaths in 2011.1. While there are well-developed guidelines for managing acute coronary syndromes, not all people receive appropriate treatment and there is variation in the type of care received by people in metropolitan compared to non-metropolitan areas.2 There is also strong evidence that Aboriginal and Torres Strait Islander people experience coronary events, such as heart attacks, at rates three times those of other Australians.3 Compared with other patients, Aboriginal and Torres Strait Islander peoples admitted to hospital with acute coronary syndromes are twice as likely to die in hospital from coronary heart disease, while also ...
Cardiogenic shock complicating an acute coronary syndrome is observed in up to 10% of patients and is associated with high mortality still approaching 50%. The extent of ischaemic myocardium has a profound impact on the initial, in-hospital, and post-discharge management and prognosis of the cardiogenic shock patient. Careful risk assessment for each patient, based on clinical criteria, is mandatory, to decide appropriately regarding revascularization by primary percutaneous coronary intervention or coronary artery bypass grafting, drug treatment by inotropes and vasopressors, mechanical left ventricular support, additional intensive care treatment, triage among alternative hospital care levels, and allocation of clinical resources. This chapter will outline the underlying causes and diagnostic criteria, pathophysiology, and treatment of cardiogenic shock complicating acute coronary syndromes, including mechanical complications and shock from right heart failure. There will be a major focus on potential
TY - JOUR. T1 - Hs-troponin i followed by CT angiography improves acute coronary syndrome risk stratification accuracy and work-up in acute chest pain patients results from ROMICAT II trial. AU - Ferencik, Maros. AU - Liu, Ting. AU - Mayrhofer, Thomas. AU - Puchner, Stefan B.. AU - Lu, Michael T.. AU - Maurovich-Horvat, Pal. AU - Pope, J. Hector. AU - Truong, Quynh A.. AU - Udelson, James E.. AU - Peacock, W. Frank. AU - White, Charles S.. AU - Woodard, Pamela K.. AU - Fleg, Jerome L.. AU - Nagurney, John T.. AU - Januzzi, James L.. AU - Hoffmann, Udo. N1 - Publisher Copyright: © 2015 American College of Cardiology Foundation. Copyright: Copyright 2015 Elsevier B.V., All rights reserved.. PY - 2015/11. Y1 - 2015/11. N2 - Objectives This study compared diagnostic accuracy of conventional troponin/traditional coronary artery disease (CAD) assessment and highly sensitive troponin (hsTn) I/advanced CAD assessment for acute coronary syndrome (ACS) during the index hospitalization. Background hsTnI ...
TY - JOUR. T1 - Elevation of ceramide and activation of secretory acid sphingomyelinase in patients with acute coronary syndromes. AU - Pan, Wei. AU - Yu, Jing Jia. AU - Shi, Rui Zheng. AU - Yan, Lei. AU - Yang, Tian Lun. AU - Li, Yuan Jian. AU - Zhang, Zhuohua. AU - Yu, Guo Long. AU - Bai, Yong Ping. AU - Schuchman, Edward. AU - He, Xing Xuan. AU - Zhang, Guo Gang. PY - 2014/5. Y1 - 2014/5. N2 - BACKGROUND: Although there are several reported evidences for a pathogenic role of sphingolipid signaling in atherosclerosis, peripheral blood levels of ceramide and secretory acid sphingomyelinase (S-SMase) activity in patients with acute coronary syndromes (ACS) have not been evaluated. METHODS AND RESULTS: A total of 304 CAD patients and 52 healthy individuals were divided into four groups: control group (n=52), stable angina pectoris (SAP) group (n=98), unstable angina pectoris (UAP) group (n=92), and acute myocardial infarction (AMI) group (n=114). Plasma levels of sphingomyelin (SPM) were elevated ...
Title:Prognostic Significance of Relative Hyperglycemia after Percutaneous Coronary Intervention in Patients with and without Recognized Diabetes. VOLUME: 18 Author(s):Qi Zhao, Tingyu Zhang , Yujing Cheng, Yue Ma, Yingkai Xu , Jiaqi Yang and Yujie Zhou*. Affiliation:Beijing Anzhen hospital, Cardiology Department , Beijing Anzhen hospital, Cardiology Department, Beijing Anzhen hospital, Cardiology Department, Beijing FuWai Hospital, Cardiology Department, Beijing Anzhen hospital, Cardiology Department, Beijing Anzhen hospital, Cardiology Department, Beijing Anzhen hospital, Cardiology Department. Keywords:non-ST-segment elevation acute coronary syndrome, Percutaneous coronary intervention, Post-procedural glycemic index. Abstract:Background: The research on the association between relative glycemic level post-percutaneous coronary intervention (PCI) and adverse prognosis in non-ST-segment elevation acute coronary syndrome (NSTE-ACS) patients is relatively inadequate. Objective: To identify ...
Inflammation is increasingly recognized as having an important role in patients with acute coronary syndromes. We sought to determine whether an elevated white blood cell (WBC) count would predict subsequent mortality and whether revascularization would have a protective effect. We analyzed data from 10,480 patients with acute coronary syndromes enrolled in the PURSUIT trial who had a WBC count measured on admission. WBC count values were stratified by quartiles, and death rates at 6 months were examined in univariate and multivariate analyses. Propensity analysis was performed to assess the effect of revascularization on the relation between WBC count and mortality. In the lowest quartile of WBC count, mortality was 4.0%; it was 5.8% in the second quartile, 6.7% in the third quartile, and 8.0% in the fourth quartile (p ...
TY - JOUR. T1 - Endotoxemia is associated with acute coronary syndrome in patients with end stage kidney disease. AU - Hsu, Chien Chin. AU - Wei, Tsui Shan. AU - Huang, Chien Cheng. AU - Chen, Yi Ming. PY - 2017/7/12. Y1 - 2017/7/12. N2 - Background: Cardiovascular disease is the major cause of death in patients with end-staged kidney disease (ESRD). Most ESRD patients have systemic inflammation, and increasing the risk of cardiovascular event. Endotoxin derived from lipopolysaccharide of Gram negative bacteria accounts for 70% of intestinal bacteria, leading to release of proinflammatory cytokines and negative cardiovascular effect. Impaired intestinal barriers have been found in some ESRD patients, and may lead to bacteria translocation from gastrointestinal tract. We aim to investigate the association of endotoxemia in ESRD patients and acute coronary syndrome (ACS). Methods: We collected serum from adult ESRD patients who presented to emergency department (ED) with ACS (30 patients) or ...
The cost of inpatient death associated with acute coronary syndrome Robert L Page II,1 Vahram Ghushchyan,2 Jill Van Den Bos,3 Travis J Gray,3 Greta L Hoetzer,4 Durgesh Bhandary,4 Kavita V Nair1 1Department of Clinical Pharmacy, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO, 2College of Business and Economics, American University of Armenia, Yerevan, Armenia; 3Milliman, Inc, Denver, CO, 4AstraZeneca, US Medical Affairs, Wilmington, DE, USA Background: No studies have addressed the cost of inpatient mortality during an acute coronary syndrome (ACS) admission. Objective: Compare ACS-related length of stay (LOS), total admission cost, and total admission cost by day of discharge/death for patients who died during an inpatient admission with a matched cohort discharged alive following an ACS-related inpatient stay. Methods: Medical and pharmacy claims (2009–2012) were used to identify admissions with a primary diagnosis of ACS from
Rationale: To address the inaccessibility of interventional cardiac services in North Queensland a new cardiac catheterisation laboratory (CCL) was established in Mackay Base Hospital (MBH) in February 2014.. Objective: To determine whether the provision of in-house angiography and/or percutaneous coronary intervention (PCI) 1) minimises treatment delays 2) further reduces the risk of mortality, recurrent myocardial infarction (MI) and recurrent ischaemia 3) improves patient satisfaction and 4) minimises cost expenditure compared with inter-hospital transfer for patients with acute coronary syndrome (ACS).. Methods: We compared ACS patients who were transferred to tertiary centres from July 2012 to June 2013 with those who received in-house angiography and/or PCI from February 2015 to January 2016. The primary outcome was the composite of all-cause mortality, recurrent myocardial infarction (MI) or recurrent ischaemia at six months. Pre-specified secondary outcomes were the composite of ...
TY - JOUR. T1 - Early and long-term outcomes after surgical and percutaneous myocardial revascularization in patients with non-st-elevation acute coronary syndromes and unprotected left main disease. AU - Buszman, Piotr P.. AU - Bochenek, Andrzej. AU - Konkolewska, Magda. AU - Trela, Blazej. AU - Kiesz, R. Stefan. AU - Wilczyńnski, Mirosław. AU - Cisowski, Marek. AU - Krejca, Michał. AU - Banasiewicz-Szkróobka, Iwona. AU - Krol, Marek. AU - Kondys, Marek. AU - Wiernek, Szymon. AU - Orlik, Bartłomiej. AU - Martin, Jack L.. AU - Tendera, Michał. AU - Buszman, Pawel E.. PY - 2009/11/1. Y1 - 2009/11/1. N2 - Surgical myocardial revascularization (CABG) in patients with unprotected left main coronary artery disease (ULMCA) is a Class I recommendation in the AHA/ACC guidelines, however it is associated with increased perioperative risk in non-ST elevation acute coronary syndromes (NSTE-ACS). The aim of this study was to compare early and late results after percutaneous coronary intervention (PCI) ...
We performed a meta-analysis of published trials to determine the predictive value of cardiac troponin I (cTnI) and T (cTnT) levels for adverse events (death and myocardial infarction) in acute coronary syndrome without ST elevation (ACS). The accumulated odds ratio (OR) for adverse events (30 days) in ACS with elevated cTnI (n = 5,759) and cTnT (n = 5,483) was 4.9 (95% confidence interval, CI, 3.9-6.2) and 4.6 (95% CI 3.8-5.5), respectively. Trials that mandated timed serum sampling (6 or more hours after symptom onset) had an improved predictive value for elevated cTnI (n = 2,807, OR 8.8; 95% CI 5.9-13.2) and cTnT (n = 1,990, OR 8.5; 95% CI 5.9-12.5). In conclusion, cTnI and cTnT provide similar information in ACS. The risk of adverse events is 4-fold higher in patients with suspected ACS and elevated serum cTn. For patients with an elevated timed (6-hour) sample the risk is over 8-fold higher.
BACKGROUND Most patients with acute coronary syndrome (ACS) are treated with statins, which reduce atherogenic triglyceride-rich lipoproteins. It is uncertain whether triglycerides predict risk after ACS on a background of statin treatment. OBJECTIVES This study examined the relationship of fasting triglyceride levels to outcomes after ACS in patients treated with statins. METHODS Long-term and short-term relationships of triglycerides to risk after ACS were examined in the dal-OUTCOMES trial and atorvastatin arm of the MIRACL (Myocardial Ischemia Reduction with Acute Cholesterol Lowering) trial, respectively. Analysis of dal-OUTCOMES included 15,817 patients (97% statin-treated) randomly assigned 4 to 12 weeks after ACS to treatment with dalcetrapib (a cholesteryl ester transfer protein inhibitor) or placebo and followed for a median 31 months. Analysis of MIRACL included 1,501 patients treated with atorvastatin 80 mg daily beginning 1 to 4 days after ACS and followed for 16 weeks. Fasting ...
Enoxaparin and Fondaparinux are potential anticoagulants which are used peri-operatively in the management of patients with Acute Coronary Syndrome (ACS). We aimed to compare the adverse clinical outcomes which are associated with the use of these anticoagulants in patients who were treated for ACS. Online databases (PubMed/Medline, EMBASE, Cochrane library) were searched for studies which compared differences in clinical outcomes observed with the use of enoxaparin and fondaparinux in patients who were treated peri-operatively for ACS. Statistical analysis was carried out by Revman 5.3 software with odds ratio (OR) and 95% confidence intervals (CI) as the analytical parameters. Seven studies with a total number of 9618 patients (mainly composed of non-ST elevated myocardial infarction/NSTEMI) were included. This analysis showed mortality to be similarly observed between enoxaparin and fondaparinux with OR: 1.05, 95% CI: 0.67-1.63; P = 0.84. Myocardial infarction (MI) and stroke were also not
BACKGROUND: Patients undergoing acute left main (LM) coronary artery revascularization have a high mortality and natriuretic peptides such as N-terminal pro-B-type (NT-proBNP) have been shown to have prognostic value in patients with acute coronary syndromes. The present study looked at the prognostic value of NT-proBNP in these patients. METHODS AND RESULTS: We studied all consecutive patients undergoing acute LM coronary artery percutaneous coronary intervention between January 2005 and December 2008 in whom NT-proBNP was measured (n=71). We analyzed the clinical characteristics and the short- and long-term outcomes in relation to NT-proBNP level at admission. Median NT-proBNP was 1,364 ng/L, ranging from 46 to 70,000 ng/L. NT-proBNP was elevated in 63 (89%) patients and was ≥1,000ng/L in 42 (59%). Log NT-proBNP (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.55-7.97, P=0.003) and left ventricular ejection fraction (HR 0.95, 95%CI 0.91-0.99, P=0.007) were predictors for all-cause ...
Minimal lipoprotein(a) [Lp(a)] target values are advocated for high-risk cardiovascular patients. We investigated the prognostic value of Lp(a) in the acute setting of patients with acute coronary syndromes (ACS). Plasma levels of Lp(a) were collected at time of angiography from 1711 patients hospitalized for ACS in a multicentre Swiss prospective cohort. Associations between elevated Lp(a) ≥30 mg/dL (cut-off corresponding to the 75th percentile of the assay) or Lp(a) tertiles at baseline, and major adverse cardiovascular events (MACE) at 1 year, defined as a composite of cardiac death, myocardial infarction or stroke, were assessed using hazard ratios (HR) and 95% confidence intervals (CI) adjusting for traditional cardiovascular risk factors (age, sex, smoking, diabetes, hypertension, low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C] and triglycerides. Lp(a) levels range between 2.5 and 132 mg/dL with a median value of 6 mg/dL and a mean value
Free Online Library: Risk stratification in acute coronary syndrome using cardiac troponin I.(Editorial) by Clinical Chemistry; Cardiac patients Coronary heart disease Geology, Stratigraphic Stratigraphy Troponin
The World Health Organization (WHO) has warned in 2005 that: Coronary heart disease is now one of the leading causes of death worldwide. It is on the rise and has become a true pandemic that respects no borders (WHO, 2005). The Heart and Stroke Foundation of South Africa more specifically estimates that approximately 33 (thirty‐three) people per day will die of a heart attack in South Africa. Despite the already high death toll resulting from AIDS in South Africa, death from a chronic disease, also including heart disease, will increase from 565 deaths per day in the year 2000, to 666 deaths per day by 2010 (Steyn, 2007). Acute coronary syndrome (ACS) is an umbrella term describing a heterogeneous spectrum of clinical symptoms compatible with acute myocardial ischaemia (Monaco, Mathur, Martin, 2005; ACC/AHA, 2007) and an ongoing inflammatory process resulting from atherosclerosis. ACS can either be treated medically (pharmacological treatment), by percutaneous coronary intervention (PCI), ...
Takotsubo cardiomyopathy (TTC) is an acute cardiac condition resembling in symptoms acute coronary syndrome (ACS), but without obstructive coronary artery disease. TTC develops almost solely in post-menopausal women and usually after preceding stress. Of all patients with ACS symptoms, TTC incidence is 2%. Due to similar symptoms and findings, differential diagnosis requires coronary angiography (CAG). The pathophysiology of TTC is unknown. Even though the accumulated evidence suggests a causative role for a catecholamine surge, other theories exist. Aborted myocardial infarction (MI) produces similar electrocardiography (ECG) and biochemical findings as in TTC. In such cases, because of non-stenotic coronary artery plaques, a dissolved coronary thrombus might show no any signs in the CAG, which could lead to an assumption of non-atherothrombotic etiology for the heart attack. In ACS, altered levels of proteolytic enzyme called matrix metalloproteinase 8 (MMP-8), and its inhibitor, the tissue ...
Jaguszewski, Milosz; Gaemperli, Oliver; Lüscher, Thomas F; Templin, Christian (2013). Optical coherence tomography to reveal strut malapposition due to thrombus resolution 3 weeks after acute coronary syndrome. European Heart Journal, 34(22):1691. ...
Acute esophageal necrosis (AEN) also known as black esophagus or acute necrotizing esophagus is a rare entity characterized by striking endoscopic findings of circumferential black coloring of the esophagus. AEN most frequently seen in the distal esophagus and can extend proximally along the entire esophagus. Characteristically, the circumferential black mucosa stops abruptly at the EGJ. AEN tends to present as acute upper gastrointestinal bleeding, though other symptoms including dysphagia and epigastric pain have been described. The etiology of AEN is multifactorial including a combination of ischemic insult, mucosal barrier defect, and a backflow injury of gastric secretions. Described is a case of AEN in a patient with history of uncontrolled diabetes who presented with an atypical chest pain mimicking acute coronary syndrome with negative subsequent cardiovascular workup.. ...
Fingerprint Dive into the research topics of Gender-specific 11-dehydro-thromboxane B2 levels in acute coronary syndrome and its association with clinical outcomes. Together they form a unique fingerprint. ...
Kim, Sung-Wan, Kang, Hee-Ju, Bae, Kyung-Yeol, Shin, Il-Seon, Hong, Young Joon, Ahn, Young-Keun, Jeong, Myung Ho, Berk, Michael, Yoon, Jin-Sang and Kim, Jae-Min 2018, Interactions between pro-inflammatory cytokines and statins on depression in patients with acute coronary syndrome, Progress in neuro-psychopharmacology and biological psychiatry, vol. 80, Part C, pp. 250-254, doi: 10.1016/j.pnpbp.2017.07.003. ...
TY - JOUR. T1 - Acute Coronary Syndrome Screening and Diagnostic Practice Variation. AU - Yiadom, Maame Yaa A.B.. AU - Liu, Xulei. AU - McWade, Conor M.. AU - Liu, Dandan. AU - Storrow, Alan B.. AU - Herdon-Meadors, Patricia. AU - Shuler, Wesley. AU - Goldlust, Eric. AU - Sawyer, Charles. AU - Wong, Andrew. AU - Tanski, Mary. AU - Patterson, Brian. AU - Wiener, Dan. AU - Baugh, Christopher W.. AU - Carlson, Jestin N.. AU - Strout, Tania D.. AU - Hill, Charles D.. AU - Turturro, Michael. AU - Whitcomb, Carlene. AU - Dunlap, Patricia. AU - McPheeters, Rick A.. AU - Gavin, Nicholas. AU - Hansen, Johnathan. AU - Web, Cindy. AU - Calichman, Meghan. AU - Chen, Paul. AU - Salazar, Gilberto. AU - Shepard, Brooke. AU - Milligan, Benjamin. AU - Rudd, Kenneth. AU - Lee, Adrea. AU - Spiegel, Thomas. AU - Garvey, Lee. AU - Rodi, Scott. AU - Caterino, Jeff. AU - Furlong, Brendan. AU - Dubin, Jeff. AU - Imperato, Jason. AU - Vohra, Anju. AU - Mills, Angela. AU - Hager, David. AU - Podolsky, Seth. AU - Novotny, ...
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Background: Readmissions for ACS are common, costly, and potentially preventable. According to Medicare 13.4% of AMI admissions were followed by a rehospitalization within 15 days. A 2007 MedPAC report declared 76% of 30-day readmissions preventable. These rates are used as quality indicators despite lack of consensus on the definition of avoidable and unavoidable readmissions. We sought to define these terms and to analyze the effect of these definitions on 30-day outcomes.. Methods: BRIDGE (Bridging the Discharge Gap Effectively) is an NP-led transitional care program for cardiac patients within 14 days of discharge. Retrospective data were abstracted on ACS patients readmitted before their appointments between 2008-2010. All readmissions were characterized as avoidable or unavoidable. Definitions were developed from the literature and in concert with senior cardiologists. Avoidable readmission was defined as being the result of a patient or provider issue that if managed may have prevented ...
In the general population, mild renal impairment is associated with increases risk for coronary artery disease and stroke, suggesting that cardiovascular disease begins to develop early in the natural history of renal dysfunction. Patients with renal failure are known to be at increased risk of death following acute myocardial infarction or congestive heart failure. In such sense, anticoagulation in addition to antiplatelet inhibitor drugs became the standard of care, particularly, among high risk unstable angina patients associated with a scarce side effects. The Nadroparin calcium Versus Enoxaparin (NaVe) Study will evaluate in a head to head basis the anti Xa activity reached by nadroparine or enoxaparine, both low molecular weight heparins, in patients at high risk for ischemic episodes, and renal insufficiency to eventually be undergone to angiographic diagnosis studies, and in consequence proposing the best anticoagulant strategies for these patients before being invasively treated. Patients will
Frailty and quality of life in elderly patients with acute coronary syndrome Magdalena Lisiak,1 Izabella Uchmanowicz,1 Radosław Wontor2 1Department of Clinical Nursing, Wroclaw Medical University, 2Department of Cardiology, T. Marciniak Lower Silesian Specialist Hospital, Wroclaw, Poland Background: Frail elderly people are at risk of developing adverse health outcomes such as disability, hospitalization, and mortality. In recent years, the literature has drawn attention to the role of frailty syndrome (FS) in acute coronary syndrome (ACS). There are few studies regarding the relationship between two multidimensional variables such as FS and quality of life (QoL).Objective: The aim of the study was to investigate the relationship between FS and early QoL of elderly patients with ACS (≥65 years old).Methods: The study was conducted among 91 patients aged 65 years and over with ACS. The MacNew questionnaire was used to evaluate QoL and the Tilburg frailty indicator to evaluate frailty.Results: FS
TY - JOUR. T1 - An evaluation of the effectiveness of self‐management interventions for people with type 2 diabetes after an acute coronary syndrome: a systematic review. AU - Tanash, Muath. AU - Fitzsimons, Donna. AU - Coates, Vivien. AU - Deaton, Christi. N1 - UIR compliant but 18 month embargo was set instead of 12 so it is non-compliant for REF. UIR dates added to PURE link. PY - 2017/6/30. Y1 - 2017/6/30. N2 - BackgroundType 2 diabetes is highly prevalent in patients with acute coronary syndrome and impacts negatively on health outcomes and self‐management. Both conditions share similar risk factors. However, there is insufficient evidence on the effectiveness of combined interventions to promote self‐management behaviour for people with diabetes and cardiac problems. Identifying critical features of successful interventions will inform future integrated self‐management programmes for patients with both conditions.ObjectivesTo assess the evidence on the effectiveness of existing ...
TY - JOUR. T1 - Safety and efficacy of bivalirudin in high-risk patients admitted through the emergency department. AU - Miller, Chadwick D.. AU - Blomkalns, Andra L.. AU - Gersh, Bernard J.. AU - Pollack, Charles V.. AU - Brogan, Gerard X.. AU - Diercks, Deborah B.. AU - Peacock, W. Frank. AU - Stone, Gregg W.. AU - Hollander, Judd E.. AU - Manoukian, Steven V.. AU - Hoekstra, James W.. PY - 2009/8/1. Y1 - 2009/8/1. N2 - Objectives: The objective was to assess the safety and efficacy of bivalirudin monotherapy in patients with high-risk acute coronary syndrome (ACS) presenting to the emergency department (ED). Methods: Data from the Acute Catheterization and Urgent Intervention Triage StrategY (ACUITY) trial were used to conduct a post hoc subgroup analysis of high-risk ACS patients (cardiac biomarker elevation or ST-segment deviation) who initially presented to the ED. The ACUITY trial randomized patients to receive heparin (unfractionated [UFH] or enoxaparin) plus glycoprotein IIb/IIIa ...
In group 1 we found just over a fifth had ED compared to nearly two-thirds in group 3 (22% versus 65%) and the control group had an ED rate similar to group 1 (24%). Group 2s ED rate was significantly different from group 1 with over half (55%) having ED. In fact, it was similar to group 3, which suggests that despite the two ACS groups having a similar clinical presentation the ED rate in ACS differs according to the extent of the coronary artery disease. So, if more than one vessel is affected in those with acute coronary syndrome, their rate of ED is actually more like that of men with chronic coronary syndrome.. Dr Montorsi said: Age, multi-vessel coronary involvement, and CCS, were independent predictors of ED. Conversely, we were able to evaluate whether ED could predict coronary artery involvement in acute coronary syndrome and found it was associated with a four-fold risk of having multi-vessel disease as opposed to single vessel disease, independently of other conventional risk ...
We will investigate the ability of colchicine to stabilise vulnerable coronary plaque via suppression of neutrophil function in ACS patients undergoing percutaneous coronary intervention.
Acute coronary syndrome[edit]. Acute coronary syndrome frequently presents with retrosternal chest discomfort and difficulty ... acute coronary syndrome, or a large pulmonary embolism.[14] Imaging[edit]. A chest x-ray is useful to confirm or rule out a ... Acute shortness of breath is usually connected with sudden physiological changes, such as laryngeal edema, bronchospasm, ... Pneumothorax presents typically with pleuritic chest pain of acute onset and shortness of breath not improved with oxygen.[2] ...
"Acute Coronary Syndrome Workup". Medscape. Archived from the original on 6 August 2016. Retrieved 14 August 2016.. ... These are the left main coronary artery and the right coronary artery. The left main coronary artery splits shortly after ... Main articles: Coronary artery disease, Coronary artery bypass surgery, and Coronary stent ... Aorta,[a] pulmonary trunk and right and left pulmonary arteries,[b] right coronary artery, left main coronary artery[c]. ...
acute. Acute bronchitis. chronic. COPD Chronic bronchitis. Acute exacerbations of chronic bronchitis. Acute exacerbation of ... Acute renal failure. Acute respiratory distress syndrome. Acute liver failure. Respiratory failure. Multiple organ dysfunction ... Acute respiratory distress syndrome. Synonyms. Respiratory distress syndrome (RDS), adult respiratory distress syndrome, shock ... acute lung injury, and acute respiratory distress syndrome: time for a reevaluation". Critical Care Medicine. 28 (1): 232-235. ...
"Smoke-free legislation and hospitalizations for acute coronary syndrome". The New England Journal of Medicine. 359 (5): 482-91 ... in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers.[238] ... Although nicotine does play a role in acute episodes of some diseases (including stroke, impotence, and heart disease) by its ... The usage of tobacco has also been linked to Buerger's disease (thromboangiitis obliterans) the acute inflammation and ...
Acute coronary syndromeEdit. Acute coronary syndrome frequently presents with retrosternal chest discomfort and difficulty ... acute coronary syndrome, or a large pulmonary embolism.[15]. ImagingEdit. A chest x-ray is useful to confirm or rule out a ... 2009). "Acute breathlessness in adults". InnovAiT. 2 (5): 307-15. doi:10.1093/innovait/inp055.. ... Acute shortness of breath is usually connected with sudden physiological changes, such as laryngeal edema, bronchospasm, ...
Acute coronary syndrome *Stable or unstable angina. *Myocardial infarction ("heart attack") - People usually complained of a ... If acute coronary syndrome ("heart attack") is suspected, many people are admitted briefly for observation, sequential ECGs, ... Castle N (February 2003). "Effective relief of acute coronary syndrome". Emergency Nurse. 10 (9): 15-9. doi:10.7748/en2003.02. ... Aspirin increases survival in people with acute coronary syndrome and it is reasonable for EMS dispatchers to recommend it in ...
If acute coronary syndrome ("heart attack") is suspected, many people are admitted briefly for observation, sequential ECGs, ... Acute coronary syndrome Stable or unstable angina Myocardial infarction ("heart attack"): People usually complained of a ... However, both atypical and typical symptoms of acute coronary syndrome can occur, and in general a history cannot be enough to ... The rate of chest pain as a symptom of acute coronary syndrome varies among populations based upon age, sex, and previous ...
2001). "Acute coronary syndromes. The diagnostic role of troponins". Thromb. Res. 103 (1): 63-69. CiteSeerX 10.1.1.500.6908. ... October 1996). "Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes ... in people with chest pain or acute coronary syndrome. A person who recently had a myocardial infarction would have an area of ... "2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes: A Report of the American ...
... s should not be used as a first-line treatment in the acute setting for cocaine-induced acute coronary syndrome ( ... "Should beta-blockers be used in the treatment of cocaine-associated acute coronary syndrome?". The Annals of Pharmacotherapy. ... Wolff-Parkinson-White Syndrome[52]. Asthma[edit]. Beta blockers are contraindicated in patients with asthma as stated in the ... "Acute myocardial infarction: Role of beta blocker therapy". www.uptodate.com. Retrieved August 10, 2019.. ...
Recent studies have shown that in patients suffering from acute coronary syndrome, high-dose statin treatment may play a plaque ... "Update on the efficacy of statin treatment in acute coronary syndromes". European Journal of Clinical Investigation. 44 (5): ... suggesting that high-dose statin therapy plays a plaque-stabilizing role in people suffering from acute coronary syndrome and ... Very rarely, atorvastatin may cause rhabdomyolysis,[31] and it may be very serious leading to acute renal failure due to ...
Prima- vista multi-vessel percutaneous coronary intervention in haemodynamically stable patients with acute coronary syndromes ... on Percutaneous Coronary Intervention (PCI) Registry (2008-2010) Euro Hear Survey (EHS) on Acute Coronary Syndrome III (ACS III ... "Predictors of hospital mortality in the elderly undergoing percutaneous coronary intervention for acute coronary syndromes and ... Acute Coronary Syndrome (ACS) snapshot Registry Puymirat, Etienne; Battler, Alex; Birkhead, John; Bueno, Hector; Clemmensen, ...
It is a type of acute coronary syndrome, which describes a sudden or short-term change in symptoms related to blood flow to the ... Unlike the other type of acute coronary syndrome, unstable angina, a myocardial infarction occurs when there is cell death, ... December 2014). "2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report ... August 2017). "Optimal timing of an invasive strategy in patients with non-ST-elevation acute coronary syndrome: a meta- ...
"Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome". N Engl J Med. 379 (22): 2097-2107. doi:10.1056/ ...
Didangelos A, Simper D, Monaco C, Mayr M (May 2009). "Proteomics of acute coronary syndromes". Current Atherosclerosis Reports ... A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or ... A number of procedures may also be carried out such as percutaneous coronary intervention, coronary artery bypass graft, or ... Werner syndrome (WS) is a premature aging condition in humans. WS is caused by a genetic defect in a RecQ helicase that is ...
... arrhythmias and acute coronary syndromes; sport cardiology, cardiac remodelling of elite athletes. Since 1994, he has been ...
The use of bivalirudin has mostly been studied in the setting of acute coronary syndrome. A few studies indicate that ... of 11 randomized trials involving hirudin and other DTIs versus heparin in the treatment of acute coronary syndrome (ACS) it ... Uchino, K.; Hernandez, A. V. (9 January 2012). "Dabigatran Association With Higher Risk of Acute Coronary Events: Meta-analysis ... Percutaneous transluminal coronary angioplasty, PCI: percutaneous coronary intervention, FDA: Food and Drug Administration, AF ...
"Phentolamine therapy for cocaine-association acute coronary syndrome (CAACS)". Journal of Medical Toxicology. 2 (3): 108-11. ... Rowbotham MC (June 2006). "Pharmacologic management of complex regional pain syndrome". The Clinical Journal of Pain. 22 (5): ... Phentolamine also has diagnostic and therapeutic roles in complex regional pain syndrome (reflex sympathetic dystrophy). ... as they can cause unopposed α-adrenergic mediated coronary vasoconstriction, worsening myocardial ischemia and hypertension. It ...
Aggarwal, RK; Showkathali, R (June 2013). "Rosuvastatin calcium in acute coronary syndromes". Expert Opinion on Pharmacotherapy ... 2006). "Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial" (PDF). JAMA ...
Section 5. Initial management of acute coronary syndromes". Resuscitation. 67 Suppl 1: S87-96. doi:10.1016/j.resuscitation. ... expertly performed primary percutaneous coronary intervention over thrombolytic therapy for acute ST elevation myocardial ... American College of Cardiology (ACC) Door to Balloon (D2B) Initiative Q&A: Improving door-to-balloon time for acute MI - ... As of 2006 in the United States, fewer than half of STEMI patients received reperfusion with primary percutaneous coronary ...
... and metabolic syndrome.[46] Reduced plasma levels of NGF and BDNF have been associated with acute coronary syndromes and ... "Reduced plasma levels of NGF and BDNF in patients with acute coronary syndromes". International Journal of Cardiology. 102 (1 ... "Neurotrophin presence in human coronary atherosclerosis and metabolic syndrome: a role for NGF and BDNF in cardiovascular ... Rett syndrome and autism often show similar signs early in life, such as slowing development and intellectual disability. One ...
Its use for acute coronary syndrome is of unknown benefit. In Britain and Canada, Entonox and Nitronox are used commonly by ... 2010). "Part 10: acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and ... oral surgery and acute coronary syndrome (includes heart attacks). Its use during labour has been shown to be a safe and ...
Maestroni A, Zecca B, Triggiani M (2006). "Cardiac papillary fibroelastoma presenting with acute coronary syndrome and syncope ... In particular, chest pain or syncope may be due to transient occlusion of the left main coronary artery by the tumor, while a ... a sudden death case of coronary embolism with myocardial infarction". Forensic Sci Int. 113 (1-3): 209-14. doi:10.1016/S0379- ... heart attack or sudden cardiac death may be due to embolization of a portion of the tumor into a coronary artery. Papillary ...
"Migrating Kirschner wire in the heart mimics acute coronary syndrome". Eur Heart J. 30 (7): 754. doi:10.1093/eurheartj/ehn548. ...
2006). "The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk ... acute coronary syndrome, chronic obstructive pulmonary disease (COPD), and in older nursing home residents. In people with ... "The obesity paradox in acute coronary syndrome: a meta-analysis". European Journal of Epidemiology. 29 (11): 801-12. doi: ... "Association of overweight and obesity with patient mortality after acute myocardial infarction: A meta-analysis of prospective ...
Imazio M, Andreis A, Brucato A, Adler Y, De Ferrari GM (July 2020). "Colchicine for acute and chronic coronary syndromes". ... "Is There a Role for Colchicine in Acute Coronary Syndromes? A Literature Review". Cureus. 12 (5): e8166. doi:10.7759/cureus. ... July 29, 2009, colchicine won FDA approval in the United States as a stand-alone drug for the treatment of acute flares of gout ... According to one review, colchicine poisoning by overdose (range of acute doses of 7 to 26 mg) begins with a gastrointestinal ...
"Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review". ... VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (PDF). United ... Herman JL (July 1992). "Complex PTSD: A syndrome in survivors of prolonged and repeated trauma". Journal of Traumatic Stress. 5 ... See also: Rape trauma syndrome. An individual that has been exposed to domestic violence is predisposed to the development of ...
2002). "Adherence with statin therapy in elderly patients with and without acute coronary syndromes". JAMA. 288 (4): 462-467. ... Hodgkin's disease, acute lymphocytic leukemia (ALL). Biological markers. Level lower than expected. 50% ... Patients with diabetes are at high risk of developing coronary heart disease and usually have related conditions that make ... UK local education authority areas found educational attainment at 15-16 years of age to be strongly associated with coronary ...
"Acute coronary syndromes". The Merck manual (angleščina). Pridobljeno dne 2012-02-24.. ... "Acute Myocardial Infarction". Disease Management Project. Cleveland Clinic Center for Continuing Education. Pridobljeno dne ... "Characteristics and baseline clinical predictors of future fatal versus nonfatal coronary heart disease events in older adults ...
Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the ... "Diagnosis and management of acute coronary syndrome: an evidence-based update". Journal of the American Board of Family ... "2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment ... If a coronary artery suddenly becomes very narrowed or completely blocked, interrupting or severely reducing blood flow through ...
A New Infantile Acute Febrile Mucocutaneous Lymph Node Syndrome (MLNS) Prevailing in Japan. Lühikokkuvõte, PEDIATRICS, 54. ... Marked Acceleration of Atherosclerosis After Lactobacillus casei-Induced Coronary Arteritis in a Mouse Model of Kawasaki ...
... starting at higher doses may cause acute coronary syndrome or an arrhythmia.[11] ... Acute overdose may cause fever, hypoglycemia, heart failure, coma, and unrecognized adrenal insufficiency. ... Acute massive overdose may be life-threatening; treatment should be symptomatic and supportive. Massive overdose can be ... people with acute myocardial infarction, and people with thyrotoxicosis of any etiology.[15] Levothyroxine is also ...
... especially with respect to acute coronary syndrome admissions.[72][73] However, other studies came to the conclusion that ... A 2009 report by the Institute of Medicine concluded that smoking bans reduced the risk of coronary heart disease and heart ... An epidemiology report says that the risk of coronary heart disease is increased to around 25-30% when one is exposed to ... "significant reduction in acute MI [myocardial infarction] risk", but noted that "studies with smaller population in the United ...
... such as diverticulitis and acute coronary syndrome.[36][106] Diagnosis of late-stage Lyme disease is often complicated by a ... Garin-Bujadoux syndrome, Bannwarth syndrome, Afzelius's disease,[255] Montauk Knee or sheep tick fever. Since 1976 the disease ... "Post-Treatment Lyme Disease Syndrome".. Further reading[edit]. *. Richard Ostfeld (2012). Lyme Disease: The Ecology of a ... The full syndrome now known as Lyme disease was not recognized until a cluster of cases originally thought to be juvenile ...
House, J.S. (1974). Occupational stress and coronary heart disease: A review and theoretical integration. Journal of Health and ... Theorell, T.; Hasselhorn, H.; Vingård, E.; Andersson, B. (2000). "Interleukin 6 and cortisol in acute musculoskeletal disorders ... De Quervain syndrome. *Exposure to human nail dust. *Farmer's lung. *Fiddler's neck ... 2017). Effort-reward imbalance at work and incident coronary heart disease: A multi-cohort study of 90,164 individuals. ...
stroke following acute coronary syndrome (clogging of the artery)[note 1][7]:12[29] ... Al-Motarreb, A. L.; Broadley, K. J. (October-December 2003). "Coronary and aortic vasoconstriction by cathinone, the active ...
The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk stratification of ... 肥胖是幾個症候群的主要特徵,比如說普瑞德威利症候群(俗稱小胖威利症候群)、巴德-畢德氏症候群、科恩症候群、以及MOMO症候群(英语:MOMO syndrome);因此有時會用「非症候群相關的肥胖」這個名詞來排除這些疾病造成的肥胖[120]。患有早發
... and performance in patients with acute myelogenous leukemia and myelodysplastic syndrome". Clin Infect Dis. 39 (2): 199-205. ... Soluble fiber from certain foods and risk of coronary heart disease (CHD).[3] ... Soluble fiber from certain foods and risk of coronary heart disease (CHD) ... of at least 3.0 g of β-glucan from oats per day decreased absorption of dietary cholesterol and reduced the risk of coronary ...
Acute renal failure. Acute respiratory distress syndrome. Acute liver failure. Respiratory failure. Multiple organ dysfunction ... Multiple organ dysfunction syndrome. Other shock. Cardiogenic shock. Distributive shock. Anaphylaxis. Obstructive shock. ... Coronary care unit (CCU). *Critical illness insurance. Conditions. Organ system failure. Shock sequence. SIRS. Sepsis. Severe ...
It is therefore used to indicate deep-vein thrombosis, pulmonary embolism, DIC and efficacy of treatment in acute myocardial ... They are given following a heart attack to dissolve the thrombus blocking the coronary artery; experimentally after a stroke to ... Nevertheless, excess levels of PAI and alpha 2-antiplasmin have been implicated in the metabolic syndrome and various other ...
This may be attributed to a genetic predisposition to metabolic syndrome and adverse changes in coronary artery vasodilation. ... Shortages of healthcare providers, poor intra-partum and newborn care, diarrheal diseases and acute respiratory infections also ... Indians are at particularly high risk for atherosclerosis and coronary artery disease. ...
General syndromes. *Nephritis. *Nephrosis. *Renal failure *Acute renal failure. *Chronic kidney disease ... Coronary artery aneurysm. *head / neck *Intracranial aneurysm. *Intracranial berry aneurysm. *Carotid artery dissection ...
Acute side effects[edit]. Nausea and vomiting. This is not a general side effect of radiation therapy, and mechanistically is ... coronary artery disease, heart arrhythmia and peripheral artery disease. Radiation-induced fibrosis, vascular cell damage and ... Lee VH, Ng SC, Leung TW, Au GK, Kwong DL (2012). "Dosimetric predictors of radiation-induced acute nausea and vomiting in IMRT ... Higher doses can cause varying side effects during treatment (acute side effects), in the months or years following treatment ( ...
... acute coronary syndrome and anxiety disorder.[23] Significantly restricting the proportion of carbohydrate in diet risks ... High-protein diets may also be associated with increased risk for coronary heart disease due to intakes of saturated fat, ...
... associated with human conjunctivitis and a fatal case of acute respiratory distress syndrome". Proceedings of the National ... and influenza may cause worsening of coronary heart disease or congestive heart failure.[153] Smoking is another risk factor ... In some cases, an autoimmune response to an influenza infection may contribute to the development of Guillain-Barré syndrome.[ ... Sometimes, influenza may have abnormal presentations, like confusion in the elderly and a sepsis-like syndrome in the young.[34 ...
Acute coronary syndrome *Myocardial infarction. *Unstable angina. Sequelae. *hours *Hibernating myocardium. *Myocardial ... https://www.merckmanuals.com/professional/cardiovascular-disorders/arrhythmias-and-conduction-disorders/long-qt-syndrome-and- ...
Cholecalciferol is an acute (single-feeding) and/or chronic (multiple-feeding) rodenticide toxicant with unique activity for ... The levels of the active form of vitamin D, calcitriol, are inversely correlated with coronary calcification.[23] Moreover, the ... B1: Beriberi / Wernicke-Korsakoff syndrome (Wernicke's encephalopathy. *Korsakoff's syndrome). *B2: Riboflavin deficiency ... Cholecalciferol differs from conventional acute rodenticides in that no bait shyness is associated with consumption and time to ...
julij 2006). "The obesity paradox in non-ST-segment elevation acute coronary syndromes: Results from the Can Rapid risk ... Grundy SM (2004). "Obesity, metabolic syndrome, and cardiovascular disease". J. Clin. Endocrinol. Metab. Vol. 89 no. 6. str. ... Dentali F; Squizzato A; Ageno W (julij 2009). "The metabolic syndrome as a risk factor for venous and arterial thrombosis". ... "Case Study: Cataplexy and SOREMPs Without Excessive Daytime Sleepiness in Prader Willi Syndrome. Is This the Beginning of ...
"Posttraumatic stress disorder prevalence and risk of recurrence in acute coronary syndrome patients: a meta-analytic review". ... VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder (PDF). United ... Herman JL (July 1992). "Complex PTSD: A syndrome in survivors of prolonged and repeated trauma". Journal of Traumatic Stress. 5 ... See also: Rape trauma syndrome. An individual that has been exposed to domestic violence is predisposed to the development of ...
Acute respiratory distress syndrome. Acute liver failure. Respiratory failure. Multiple organ dysfunction syndrome. *Neonatal ... Multiple organ dysfunction syndrome. Other shock. Cardiogenic shock. Distributive shock. Anaphylaxis. Obstructive shock. ... Known bleeding diathesis (e.g., hemophilia) except for acute coagulopathy related to sepsis ... sepsis associated with acute organ dysfunction) who have a high risk of death (as determined by APACHE II scores of 25 or ...
Cardiovascular system damage can include myocardial ischemia/infarction, acute left ventricular dysfunction, acute pulmonary ... Coronary perfusion pressures are decreased by these factors, which also increase myocardial oxygen consumption, possibly ... Budd-Chiari syndrome. *May-Thurner syndrome. *Portal vein thrombosis. *Renal vein thrombosis ... Acute end-organ damage may occur, affecting the neurological, cardiovascular, renal, or other organ systems. Some examples of ...
急性肝功能衰竭(英语:acute liver failure). 呼吸衰竭. 多重器官衰竭症候群. *新生兒感染(英语:Neonatal infection) ... 敗血症的定義為由於感染所引起的全身性發炎反應症候群(英語
Discontinuation syndrome[edit]. As with SSRIs, the abrupt discontinuation of an SNRI usually leads to withdrawal, or " ... Patients suffering from coronary artery disease should avoid the use of SNRIs. Furthermore, due to some SNRIs' actions on ... The drug is used to treat acute and chronic pain. It has shown effectiveness in the treatment of fibromyalgia, though it is not ... Discontinuation syndrome has been reported to be markedly worse for venlafaxine when compared to other SNRIs. As such, as ...
Acute coronary syndrome *Myocardial infarction. *Unstable angina. Sequelae. *hours *Hibernating myocardium. *Myocardial ...
Acute coronary syndrome *Myocardial infarction. *Unstable angina. Sequelae. *hours *Hibernating myocardium. *Myocardial ... Inherited arrhythmic syndromes (congenital long QT syndrome, short QT syndrome, Brugada syndrome) ... short QT syndrome, Wolff Parkinson White syndrome, and other forms of supraventricular tachycardia (e.g., AV nodal reentrant ... In acute-onset AF associated with chest pain, cardiac troponins, or other markers of damage to the heart muscle may be ordered ...
ICU delirium, formerly and inaccurately referred to as ICU psychosis, is a syndrome common in intensive care and cardiac units ... acute renal failure, or the cumulative effects of multiple organ failure, more commonly referred to now as multiple organ ... such as the coronary intensive care unit (CCU or sometimes CICU) for heart disease, medical intensive care unit (MICU), ... hemofiltration equipment for acute renal failure; monitoring equipment; intravenous lines for drug infusions fluids or total ...
Acute renal failure. Acute respiratory distress syndrome. Acute liver failure. Respiratory failure. Multiple organ dysfunction ... It is the second-leading cause of death in non-coronary intensive care unit (ICU) and the tenth-most-common cause of death ... Lungs: acute respiratory distress syndrome (ARDS) (PaO2/FiO2 ratio, 300), different ratio in pediatric acute respiratory ... "Acute respiratory distress syndrome, sepsis, and cognitive decline: A review and case study". Southern Medical Journal. 102 (11 ...
... such as Ehlers-Danlos syndrome type 4 and, more rarely, Marfan syndrome.[1][2] Ehlers-Danlos syndrome type 4, caused by ... Siegmund, GP; Winkelstein, BA; Ivancic, PC; Svensson, MY; Vasavada, A (April 2009). "The anatomy and biomechanics of acute and ... Coronary artery aneurysm. *head / neck *Intracranial aneurysm. *Intracranial berry aneurysm. *Carotid artery dissection ... Callewaert B, Malfait F, Loeys B, De Paepe A (March 2008). "Ehlers-Danlos syndromes and Marfan syndrome". Best Pract Res Clin ...
Reye's syndrome[edit]. Main article: Reye's syndrome. Reye's syndrome, a rare but severe illness characterized by acute ... After percutaneous coronary interventions (PCIs), such as the placement of a coronary artery stent, a U.S. Agency for ... Aspirin overdose can be acute or chronic. In acute poisoning, a single large dose is taken; in chronic poisoning, higher than ... a b Pubmed: "Does aspirin cause acute or chronic renal failure in experimental animals and in humans?", Am J Kidney Dis. 1996 ...
The process is particularly important in staunching hemorrhage and acute blood loss. When blood vessels constrict, the flow of ... Are coronary heart disease and peripheral arterial disease associated with tobacco or cannabis consumption ... Postural orthostatic tachycardia syndrome. *Hemostasis. ReferencesEdit. *^ "Medihaler Ergotamine". drugs.com. Retrieved 2016-05 ...
Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the ... Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the ... Giugliano RP, Braunwald E. Non-ST elevation acute coronary syndromes. In: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, ... 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American ...
... and guidelines about acute coronary syndrome, classified as either ST segment elevation myocardial infarction (STEMI myocardial ... Acute Coronary Syndromes : Review in-depth clinical information, latest medical news, ...
The American Heart Association explains that acute coronary syndrome is an umbrella term for situations where the blood ... Acute coronary syndromes, just like heart failure and stroke, are much more likely in people who have certain risk factors. ... Chest pain caused by acute coronary syndromes can come on suddenly, as is the case with a heart attack. Other times, the pain ... Treatment for acute coronary syndrome includes medicines and a procedure known as angioplasty, during which doctors inflate a ...
... (ACS) is a term given to a group of symptoms. They are associated with chest pain at rest or during ... is given to all patients suspected of acute coronary syndrome. * Anti-ischemic drugs, such as nitroglycerin. , are used to help ... Value and limitations of chest pain history in the evaluation of patients with suspected acute coronary syndromes. JAMA . 2005; ... Contemporary management of acute coronary syndrome. Postgrad Med J . 2005; 81:217-222. ...
Acute coronary syndrome - Overview covers symptoms, causes and treatment of this condition that causes low blood flow to the ... Acute coronary syndromes. BMJ. 2015;351:h5153.. *Reeder GS, et al. Initial evaluation and management of suspected acute ... Updates and current recommendations for the management of patients with non-ST-elevation acute coronary syndromes: What it ... Acute coronary syndrome. Merck Manual Professional Version. http://www.merckmanuals.com/professional/SearchResults?query=acute+ ...
Women younger than 55 years of age who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are ... Patients with acute coronary syndromes (ACS) who are at high risk for bleeding have significantly lower rates of target lesion ... Patients with Type 2 diabetes and acute coronary syndromes have a substantially increased risk of death in the 18 months after ... drug-coated stent gives markedly better outcomes than a bare metal stent in patients with acute coronary syndromes and risk ...
... acute myocardial infarction, and sudden cardiac death, are commonly associated with the presence of vulnerable plaques in ... Acute coronary syndromes (ACS), such as unstable angina, ... Acute coronary syndromes (ACS), such as unstable angina, acute ... Acute Coronary Syndrome Hyaluronic Acid Atherosclerotic Lesion Plaque Rupture Vulnerable Plaque These keywords were added by ... Libby P: Molecular bases of the acute coronary syndromes. Circulation 1995, 91:2844-2850.PubMedGoogle Scholar ...
Acute coronary syndrome is usually caused by one of three problems: ST elevation myocardial infarction (STEMI, 30%), non ST ... is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function ... Sitagliptin Pretreatment in Diabetes Patients Presenting with Acute Coronary Syndrome: Results from the Acute Coronary Syndrome ... Sitagliptin Pretreatment in Diabetes Patients Presenting with Acute Coronary Syndrome: Results from the Acute Coronary Syndrome ...
... Topic Overview. What is acute coronary syndrome?. Acute coronary syndrome happens when the heart is ... What causes acute coronary syndrome?. Acute coronary syndrome happens because blood flow has slowed or stopped in the arteries ... Acute coronary syndrome is typically caused by coronary artery disease. Coronary artery disease, also called heart disease, is ... Can acute coronary syndrome be prevented?. A heart-healthy lifestyle can help prevent heart disease, which can lead to acute ...
Acute coronary syndrome refers to many conditions that cause sudden, low blood flow to the heart. Know the symptoms, causes and ... Acute coronary syndromes. BMJ. 2015;351:h5153.. *Reeder GS, et al. Initial evaluation and management of suspected acute ... www.merckmanuals.com/professional/cardiovascular-disorders/coronary-artery-disease/overview-of-acute-coronary-syndromes-acs. ... This test is done only when there are no signs of acute coronary syndrome or another life-threatening heart condition when you ...
High-sensitivity troponin testing months after an acute coronary syndrome: noise or notable results Peter Kavsak, PJ Devereaux ... Bedside mental status and outcome in elderly patients admitted for acute coronary syndromes Clément Briet, Katrien Blanchart, ... Development and validation of a cardiovascular risk score for patients in the community after acute coronary syndrome Katrina K ... Convalescent troponin and cardiovascular death in patients with acute coronary syndrome Tomoyuki Kawada ...
Acute coronary syndrome (ACS) is a common and sometimes lethal event, usually precipitated by sudden rupture and thrombosis of ... "Acute Coronary Syndrome." In Modern Concepts and Practices in Cardiothoracic Critical Care, ed. Adam S. Evans, Gregory E. Kerr ... "Acute Coronary Syndrome." Modern Concepts and Practices in Cardiothoracic Critical Care. IGI Global, 2015. 136-167. Web. 14 Dec ... Acute Coronary Syndrome. Brandon W. Calenda (Icahn School of Medicine at Mount Sinai, USA) and Umesh K. Gidwani (Icahn School ...
Acute Coronary SyndromeA Study to Evaluate the Safety of Apixaban in Acute Coronary Syndrome (ACS) Japanese Patients ... Acute Coronary SyndromeEffectiveness And Safety Of Dalteparin In Patients With Acute Coronary Syndromes Without ST Elevations ... Acute Coronary SyndromeAtorvastatin Pre-Treatment Study In Asian Patients With Acute Coronary Syndrome NCT00728988 ... Acute Coronary Syndrome Intervention Drug: Dalteparin Patients prescribed dalteparin for non-ST segment elevated acute coronary ...
Acute coronary syndrome (ACS) results from thrombus formation at the site of ruptured or eroded atherosclerotic plaques, which ... Routine thienopyridine pretreatment for acute coronary syndrome without ST elevation BMJ 2014; 349 :g6282 ... Routine thienopyridine pretreatment for acute coronary syndrome without ST elevation. BMJ 2014; 349 doi: https://doi.org/ ... West Hertfordshire Hospitals NHS Trust: Consultant Physicians in Acute Medicine (Acute Physicians) ...
Acute coronary syndrome is a broad category of coronary heart disease that ranges from unstable angina to ST elevation ... Among patients with acute coronary syndrome who are not at high risk of bleeding who undergo PCI, either prasugrel or ... Apixaban and rivaroxaban are oral direct factor Xa inhibitors that have been evaluated in acute coronary syndrome (Table 340,41 ... Recent advances in antithrombotic therapy after acute coronary syndrome Message Subject (Your Name) has sent you a message from ...
Care guide for Acute Coronary Syndrome (Discharge Care). Includes: possible causes, signs and symptoms, standard treatment ... Learn more about Acute Coronary Syndrome (Discharge Care). Associated drugs. *Acute Coronary Syndrome ... Acute coronary syndrome (ACS) is sudden decreased blood flow to your heart. This causes a lack of oxygen to your heart and can ... Acute Coronary Syndrome. Medically reviewed by Drugs.com. Last updated on Feb 3, 2020. ...
... life-threatening syndromes.Examines the molecular mechanisms of acute coronary syndromes, inflammation and immunity. Explains ... and more.Discusses special considerations for the care of acute coronary syndromes in the ED and CCU.Offers guidance on the ... management of special populations and chronic patients.Includes guidelines for management of acute coronary syndromes from the ... scientific and clinical information needed to facilitate rapid evaluation and immediate management of acute coronary syndromes ...
In acute coronary syndrome, common electrocardiographic abnormalities include T-wave tenting or inversion, ST-segment elevation ... Troponin T or I generally is the most sensitive determinant of acute coronary syndrome, although the MB isoenzyme of creatine ... Early markers of acute ischemia include myoglobin and creatine kinase-MB subforms (or isoforms), when available. In the future ... encompasses a range of thrombotic coronary artery diseases, including unstable angina and both ST-segment elevation and non-ST- ...
Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome ... Fibrinolysis is not recommended in patients with non-ST elevation acute coronary syndrome; therefore, these patients should be ... which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with ... If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be ...
... a patient developed an unusually complicated course of acute coronary syndrome. One day after initial stabilization of a non-ST ... In his second week of severe acute respiratory syndrome (SARS) illness, ... Coronary plaque instability in severe acute respiratory syndrome Int J Cardiol. 2005 Mar 30;99(3):471-2. doi: 10.1016/j.ijcard. ... a patient developed an unusually complicated course of acute coronary syndrome. One day after initial stabilization of a non-ST ...
Learn about acute coronary syndrome from the Cleveland Clinic, including the different types of heart attack like STEMI & ... Heart Attack: An Acute Coronary Syndrome. Acute Coronary Syndrome is a name given to three types of coronary artery disease ... Cleveland Clinic cardiologists specialize in prompt diagnosis and treatment of heart attack and acute coronary syndromes. If ... Unstable angina is an acute coronary syndrome and should be treated as a medical emergency. ...
Learn more about Acute Coronary Syndrome at St. Davids HealthCare DefinitionCausesRisk FactorsSymptomsDiagnosisTreatment ... T116779/Acute-coronary-syndromes: Bennett MH, Lehm JP, Jepson M. Hyperbaric oxygen therapy for acute coronary syndrome. ... Acute coronary syndromes. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116779/Acute-coronary ... Acute coronary syndrome (ACS) is a set of features related to poor blood flow to the heart muscle that leads to a heart attack ...
Echocardiography in acute coronary syndrome diagnosis, treatment and prevention / Saved in: Corporate Author:. SpringerLink ( ... Acute Coronary Syndrome , diagnosis. Acute Coronary Syndrome , prevention & control. Acute Coronary Syndrome , therapy. ...
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... *Written By: Rahul Patwari, MD, Rush University Medical School, Chicago Illinois ... Coronary syndromes incorporate a spectrum of diseases ranging from unstable angina (UA), non-ST-elevation myocardial infarction ... Right Coronary Artery. need. Cardiac Enzymes. Serial enzyme testing is another staple of ACS diagnosis. Usually only the first ... Right Coronary Artery or. Left Circumflex. need. Right Ventricular MI. V1, V4R. I, aVL. ...
Acute coronary syndrome (ACS) represents the continuum of disease representing decreased coronary blood flow and acute ... Acute Coronary Syndrome (ACS). Author: Eric Blazar, MD, Inspira Medical Center, Rowan University, ... If there is any suspicion of an acute coronary syndrome, labs including blood count, electrolytes, cardiac enzymes, a chest ... Discuss the continuum of disease in acute coronary syndromes.. *Understand the necessary immediate diagnostic work up and ...
Client Outreach: Massage Therapy + Acute Coronary Syndrome. Client Outreach: Massage Therapy + Acute Coronary Syndrome. ... "Effect of hand and foot surface stroke massage on anxiety and vital signs in patients with acute coronary syndrome: A ... ability to help people better manage anxiety could be imperative for the health of patients with acute coronary syndrome (ACS). ...
In patients who had had a recent acute coronary syndrome, dalcetrapib increased HDL cholesterol levels but did not reduce the ... Effects of dalcetrapib in patients with a recent acute coronary syndrome N Engl J Med. 2012 Nov 29;367(22):2089-99. doi: ... Methods: We randomly assigned 15,871 patients who had had a recent acute coronary syndrome to receive the CETP inhibitor ... Conclusions: In patients who had had a recent acute coronary syndrome, dalcetrapib increased HDL cholesterol levels but did not ...
Implications of diabetes in patients with acute coronary syndromes. The Global Registry of Acute Coronary Events. Arch Intern ... Global Use of Strategies to Open Occluded Coronary Arteries in Acute Coronary Syndromes (GUSTO IIb) Angioplasty Substudy ... Use of secondary preventive drugs in patients with acute coronary syndromes treated medically or with coronary angioplasty: ... Admitted patients in a Unit of Coronary Intensive Care (USIC) for a acute coronary syndrome ...
If this happens in a large coronary artery, a heart attack results. We call this "acute coronary syndrome" (ACS). This happens ... Senior Living: Acute Coronary Syndrome versus… Share this:. *Click to share on Facebook (Opens in new window) ... If you can get an ACS victim to the cardiac catheter lab within a few hours and identify the occluded coronary artery, it is ... The onset is usually abrupt, when an atheroma ulcerates and a clot forms, blocking a coronary artery. Most victims describe ...
  • Women younger than 55 years of age who undergo percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) are more likely to experience one-year adverse cardiovascular events due to risk factors such as diabetes and chronic kidney disease, yet they are less likely to receive potent antiplatelet therapy than men. (news-medical.net)
  • When choosing how to revascularize, hemodynamically stable patients with diabetes mellitus and complex coronary disease benefit more from coronary artery bypass grafting rather than percutaneous coronary intervention. (igi-global.com)
  • To collect data on safety and effectiveness of dalteparin in the management of non-ST segment elevated acute coronary syndromes in nursing home patients who will be treated conservatively (without percutaneous corornary intervention [PCI] or coronary artery bypass graft [CABG] within 48 hours). (pfizer.com)
  • The cornerstone of treatment for ST elevation MI is rapid reperfusion, which can be achieved either by fibrinolysis or primary percutaneous coronary intervention (PCI). (cmaj.ca)
  • Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation. (aafp.org)
  • Coupled with appropriate medical management, percutaneous coronary intervention can improve short- and long-term outcomes following myocardial infarction. (aafp.org)
  • If percutaneous coronary intervention cannot be performed rapidly, patients with ST elevation myocardial infarction can be treated with fibrinolytic therapy. (aafp.org)
  • therefore, these patients should be treated with medical management if they are at low risk of coronary events or if percutaneous coronary intervention cannot be performed. (aafp.org)
  • IDR was any refractory ischemia-driven repeat percutaneous intervention or bypass graft surgery involving any native coronary or pre-existing bypass graft vessel. (clinicaltrials.gov)
  • Compared with angiographically guided percutaneous coronary intervention (PCI), physiology-guided PCI is associated with improved clinical outcomes and cost-effectiveness. (springer.com)
  • Reperfusion refers to primary angioplasty or thrombolysis and revascularization to in-hospital or planned percutaneous coronary intervention or coronary artery bypass grafting. (diabetesjournals.org)
  • The multiple logistic regression model identified the following as risk factors for death regarding demographic factors and interventions: female gender (OR=1.45), diabetes mellitus (OR=1.59), body mass index (OR=1.27) and percutaneous coronary intervention (OR=0.70). (scielo.br)
  • Patients presenting with cardiogenic shock should undergo percutaneous coronary intervention (PCI) as soon as possible. (medscape.com)
  • NEW ORLEANS, March 30 -- When patients are being evaluated for antithrombin therapy in association with percutaneous coronary interventions, doctors have multiple choices that make it possible to tailor therapy, said a Cleveland Clinic investigator. (medpagetoday.com)
  • Dr. Lincoff said that at one time clinicians accepted the idea of higher bleeding rates among patients undergoing percutaneous coronary interventions in order to maintain antithrombin levels in their patients. (medpagetoday.com)
  • is non-inferior in regard to ischemic outcomes, and is associated with less death or myocardial infarction at six months, but requires co-administration with unfractionated heparin when being used in percutaneous coronary interventions. (medpagetoday.com)
  • The primary difference with invasive management of ACS is that it includes percutaneous coronary intervention (PCI), in which an intracoronary stent is placed to restore blood flow to the compromised myocardium. (uspharmacist.com)
  • These days, DAPT therapy emerged with a main role to reduce cardiac adverse events after percutaneous coronary interventions (PCI) in patients with ACS. (eurekalert.org)
  • If the patient presents with signs of evolving acute MI, i.e., an electrocardiogram (ECG) with unequivocal ST-segment elevation, then the patient in most cases is subjected to thrombolysis or primary percutaneous transluminal coronary angioplasty. (thefreelibrary.com)
  • Percutaneous coronary intervention has emerged as a primary treatment for the majority of these patients, often on an urgent or emergency basis. (springer.com)
  • A comparison of pharmacologic therapy with/without timely coronary intervention vs. primary percutaneous intervention early after ST-elevation myocardial infarction: the WEST (which early ST-elevation myocardial infarction therapy) study. (springer.com)
  • Early routine percutaneous coronary intervention after fibrinolysis vs. standard therapy in ST-segment elevation myocardial infarction: a meta-analysis. (springer.com)
  • Some clinicians state that CK-MB is the preferred biomarker for detection of reinfarction, infarct sizing, or infarct after percutaneous coronary intervention, but its utility in these settings is controversial. (neurologyadvisor.com)
  • for a subset of patients invasive measures are also employed (coronary angiography and percutaneous coronary intervention). (wikipedia.org)
  • This is achieved with reperfusion therapy, which is based on invasive reopening of the afflicted coronary artery with primary percutaneous coronary intervention, or non-invasive breaking up of the responsible blood clot with a thrombolytic drug. (wikipedia.org)
  • Those at moderate to high risk benefit from an early invasive strategy, which includes coronary angiography and, if necessary, revascularization with percutaneous coronary intervention or coronary artery bypass surgery. (wikipedia.org)
  • People who experience chronic chest pain resulting from years of cholesterol buildup in their arteries can develop an acute coronary syndrome if a blood clot forms on top of the plaque buildup. (heart.org)
  • Treatment for acute coronary syndrome includes medicines and a procedure known as angioplasty, during which doctors inflate a small balloon to open the artery ( View an illustration of coronary arteries ). (heart.org)
  • ACS is caused by a narrowing of the coronary arteries. (empowher.com)
  • Acute coronary syndromes (ACS), such as unstable angina, acute myocardial infarction, and sudden cardiac death, are commonly associated with the presence of vulnerable plaques in coronary arteries. (springer.com)
  • Acute coronary syndrome (ACS) is a syndrome due to decreased blood flow in the coronary arteries such that part of the heart muscle is unable to function properly or dies. (scirp.org)
  • The coronary arteries supply oxygen-rich blood to the heart muscle. (rexhealth.com)
  • Unstable angina happens when blood flow to the heart is suddenly slowed by narrowed coronary arteries. (rexhealth.com)
  • Or small blood clots form in the coronary arteries and slow blood flow. (rexhealth.com)
  • Acute coronary syndrome happens because blood flow has slowed or stopped in the arteries that supply blood to the heart. (rexhealth.com)
  • Coronary artery disease, also called heart disease, is caused by atherosclerosis , or hardening of the arteries. (rexhealth.com)
  • Atherosclerosis causes a substance called plaque to build up in the coronary arteries. (rexhealth.com)
  • These images can detect narrowed or blocked coronary arteries. (mayoclinic.org)
  • ACS is caused by a sudden blockage of the coronary arteries. (stdavids.com)
  • Coronary artery bypass surgery -Arteries or veins are taken from other areas in your body. (stdavids.com)
  • Recent studies have shown such intensive medical therapy is just as effective at preventing symptoms and future ACS events as is subjecting stable angina patients to the risks of cardiac catheterization to stent their coronary arteries. (pasadenastarnews.com)
  • In their interesting article, Rioufol et al 1 found that patients with acute coronary syndromes frequently had findings on intravascular ultrasound (IVUS) of ruptured plaques in coronary arteries remote from the artery with the culprit lesion. (ahajournals.org)
  • However, it does not show directly the coronary arteries itself. (coursera.org)
  • It shows wall motion abnormalities, which can be caused by blocked coronary arteries. (coursera.org)
  • to assess the coronary arteries even look inside and show plaques itself. (coursera.org)
  • Destructive changes in epicardial arteries and coronary microcirculation in women with non st elevation acute coronary syndrome, depending on hormonal status. (bioportfolio.com)
  • Acute coronary syndrome (ACS) refers to a spectrum of myocardial ischemic states caused by the disruption of atherosclerotic plaques in the coronary arteries. (marketpublishers.com)
  • The primary cause of the acute coronary syndrome is atherosclerosis , which is the thickening of blood vessels and arteries due to the presence of excessive cholesterol in the coronaries. (organicfacts.net)
  • Because of its importance, the heart has a well-developed system of coronary arteries that feed the myocardial muscle. (dummies.com)
  • These arteries are fairly small and become easily blocked with a rupture of plaque (a layer of fat and minerals that embeds within the inner layers of an artery) or emboli (small particles of plaque) that float in from other parts of the body and lodge within the coronary artery itself. (dummies.com)
  • In cases of stable AP, myocardial ischemia commonly results from increases in myocardial oxygen demand that outstrip the ability of stenosed coronary arteries to increase oxygen delivery (1). (thefreelibrary.com)
  • In those who have ACS, atheroma rupture is most commonly found 60% when compared to atheroma erosion (30%), thus causes the formation of thrombus which block the coronary arteries. (wikipedia.org)
  • After the coronary arteries are unblocked, there is a risk of reperfusion injury due spreading inflammatory mediators throughout the body. (wikipedia.org)
  • Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. (limamemorial.org)
  • The coronary arteries bring blood and oxygen to the heart. (limamemorial.org)
  • Coronary angiography is a procedure that uses a special dye (contrast material) and x-rays to see how blood flows through the arteries in your heart. (limamemorial.org)
  • The precipitating event is blockage in the coronary arteries or a mismatch between cardiac tissue demand and supply. (arupconsult.com)
  • Acute coronary syndrome (ACS) refers to any group of symptoms attributed to obstruction of the coronary arteries . (wikidoc.org)
  • The endothelium of coronary arteries are damaged by the risk factors resulting in endothelial dysfunction , leading to the formation of atherosclerotic plaque . (wikidoc.org)
  • Management of acute coronary syndrome is targeted against the effects of reduced blood flow to the afflicted area of the heart muscle, usually because of a blood clot in one of the coronary arteries, the vessels that supply oxygenated blood to the myocardium. (wikipedia.org)
  • Acute coronary syndromes are caused by sudden and critical reduction of blood flow in one of the coronary arteries, the vessels that supply oxygenated blood to the myocardium (heart muscle), typically by a blood clot. (wikipedia.org)
  • Patients with acute coronary syndrome and ST elevation are said to suffer from ST-elevation myocardial infarction (STEMI) and they tend to have one of their coronary arteries totally blocked. (wikipedia.org)
  • Coronary angiography may be done right away or when you are more stable. (medlineplus.gov)
  • The outcome measures will be NPV, PPV, sensitivity, specificity for CardioFlux magnetocardiography against ECG and/or troponin-based identification of cardiac ischemia/injury (ie STEMI or NSTEMI diagnosed by SOC pathway prior to discharge or coronary angiography). (clinicaltrials.gov)
  • Overall, coronary revascularization appears to be performed in a similar proportion of women and men - once angiography has been performed and the coronary anatomy is known. (ingentaconnect.com)
  • However, substantial geographic variation exists in the relative rate of coronary angiography in men and women. (ingentaconnect.com)
  • Although coronary artery disease (CAD), the most common cause of morbidity and mortality in the USA, is identified principally by coronary angiography, the relationship between the degrees of angiographic narrowing (% stenosis) is poorly correlated to its functional response (e.g., stress testing or intracoronary physiology). (springer.com)
  • Over the past two decades, the use of in-lab coronary physiology has demonstrated that angiography alone is not accurate in determining ischemia for intermediate lesions. (springer.com)
  • In a prospective, natural-history study of coronary atherosclerosis, patients underwent 3-vessel coronary angiography and gray-scale and radiofrequency intravascular ultrasonographic imaging after PCI. (medscape.com)
  • 3 Compared with other patients, Aboriginal and Torres Strait Islander peoples admitted to hospital with acute coronary syndromes are twice as likely to die in hospital from coronary heart disease, while also experiencing lower levels of angiography and invasive procedures. (safetyandquality.gov.au)
  • B. Coronary angiography showing left anterior descending coronary artery stenosis (arrow). (em-consulte.com)
  • 4 The need for revascularization in the management of non-ST elevation acute coronary syndrome relies on risk stratification, which is based on risk factors, clinical presentation, electrocardiogram and cardiac biomarkers. (cmaj.ca)
  • books.google.com - One of the leading experts in the field and a stellar cast of contributors provide all of the scientific and clinical information needed to facilitate rapid evaluation and immediate management of acute coronary syndromes using today's full range of strategies-from pharmaceutical approaches to revascularization. (google.com)
  • all cause mortality, myocardial infarction and coronary revascularization) in their short term future. (saem.org)
  • In United Kingdom coronary revascularization tends to be done less frequently in women. (ingentaconnect.com)
  • 2 , 3 Acute coronary syndrome (ACS), with its broad range of manifestations, takes on a leading role in these statistics, and myocardial revascularization procedures and antithrombotic pharmacotherapy are fundamental pillars of its treatment. (scielo.br)
  • The clinical significance of incomplete coronary revascularization (ICR) following PCI in patients with ACS was examined in 2,954 patients from the Acute Catheterization and Urgent Intervention Triage Strategy (ACUITY) trial. (medscape.com)
  • Between April 29, 2017 and Nov. 20, 2017, researchers conducted a prospective observational study of 21 patients older than 18 years who were admitted for acute coronary syndrome, had coronary revascularization during admission and underwent inpatient overnight sleep studies. (healio.com)
  • In patients presenting with acute coronary syndromes (ACS) either with or without ST-segment elevation MI (STEMI and NSTEMI), dual antiplatelet therapy (DAPT) is recommended for at least 1 year independently of whether revascularization is performed. (eurekalert.org)
  • In this chapter, we discuss the approaches for managing acute coronary syndromes, with emphasis on revascularization strategies and essential ancillary topics associated with revascularization. (springer.com)
  • After adjustment for the above variables, age, sex, left ventricular systolic dysfunction, diabetes, coronary anatomy and coronary revascularization using a forward likelihood ratio Cox regression model, NT-proBNP remained the only variable with significant prognostic value (HR 1.007, 95% CI 1.003-1.011, for each 100 pg/ml increment). (unboundmedicine.com)
  • Eight hours after emergency coronary intervention to the culprit lesion, he developed another ST-elevated MI in the inferior territory. (nih.gov)
  • This pattern placed him at high risk for either left main or triple vessel disease and indicates the need for antiplatelet and anti-ischemic therapy and a trip to the catheter laboratory to evaluate coronary anatomy and possible intervention. (nursingcenter.com)
  • These disparities are likely driven at least in part by lower rates of targeted intervention and care strategies for acute heart problems among HIV-positive people, according to a new study. (poz.com)
  • However, evaluation of patients with non-ST-segment elevation is a key issue today because new treatments are focused to a great extent on this group, i.e., low-molecular weight heparins, platelet glycoprotein IIb/IIIa antagonist, direct thrombin inhibitors, and coronary intervention in the acute as well as the subacute phase. (thefreelibrary.com)
  • Updates and current recommendations for the management of patients with non-ST-elevation acute coronary syndromes: What it means for clinical practice. (mayoclinic.org)
  • 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. (aafp.org)
  • 1 It is important for primary care physicians to be able to diagnose and manage acute coronary syndrome (ACS), which comprises two clinical presentations: ST elevation myocardial infarction (STEMI) and non-ST elevation acute coronary syndrome (NSTE-ACS). (aafp.org)
  • Managing Acute Coronary Syndromes in Clinical Practice is an essential resource for the clinician in the management of ACS. (worldcat.org)
  • This practical book provides a comprehensive overview of the epidemiology and clinical presentation of acute coronary syndromes (ACS). (worldcat.org)
  • Only a few of the published clinical registries on ACS provide data on treatments dichotomized by confirmed coronary angiographic disease. (ingentaconnect.com)
  • the determination of whether the lesion was acute was more related to clinical and ECG findings. (ahajournals.org)
  • Its practical applications have expanded into other clinical situations such as acute coronary syndrome (ACS) including ST-elevation myocardial infarction (STEMI). (springer.com)
  • Understanding applied coronary physiology and the tools for measuring it in the cath lab is paramount to best clinical decision-making in interventional cardiology. (springer.com)
  • Acute Coronary Syndrome covers the spectrum of clinical conditions ranging from unstable angina to non-ST elevation myocardial infarction and ST elevation myocardial infarction. (wiley.com)
  • In the 1950s, clinical investigators first reported that proteins released from necrotic cardiac myocytes could be detected in the serum and could aid in the diagnosis of acute myocardial infarction. (ahajournals.org)
  • 1 The ensuing 40 years witnessed progressive improvement in the cardiac tissue-specificity of biomarkers of myocardial necrosis and a corresponding enhancement in the clinical sensitivity and specificity of their use for establishing the diagnosis of acute myocardial infarction. (ahajournals.org)
  • The Brazilian Registry of Acute Coronary Syndrome is a multicenter national study aiming at providing data on clinical aspects, management and hospital outcomes of acute coronary syndrome in our country. (scielo.br)
  • Impact of obstructive sleep apnea on clinical outcomes in acute coronary syndrome. (healio.com)
  • Acute coronary syndromes include a wide spectrum of clinical coronary disease states, from unstable angina with no observable electrocardiogram changes to ST-segment elevation myocardial infarction. (springer.com)
  • 2016 ACC/AHA guideline focused update on duration of dual antiplatelet therapy in patients with coronary artery disease: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. (springer.com)
  • Although a robust relationship between aberrant serum polyunsaturated fatty acids (PUFAs) profile and coronary artery disease (CAD) has been reported, the details concerning the association between aberrant PUFAs profile and clinical feature of CAD are not fully discovered. (unboundmedicine.com)
  • Low serum EPA and EPA/AA ratio correlates with clinical profiles of ACS in patients with CAD, regardless of the extent and severity of coronary artery stenosis. (unboundmedicine.com)
  • Watch presentations from the launch of the Acute Coronary Syndrome Clinical Care Standard . (safetyandquality.gov.au)
  • The Commission, in collaboration with consumers, clinicians, researchers and health organisations, has developed resources to guide and support implementation of the Acute Coronary Syndromes Clinical Care Standard. (safetyandquality.gov.au)
  • This resource provides a set of suggested indicators to assist with local implementation of the Acute Coronary Syndromes Clinical Care Standard . (safetyandquality.gov.au)
  • These resources can be used to promote and explain what the Acute Coronary Syndromes Clinical Care Standard means to health services, clinicians and patients and their carers. (safetyandquality.gov.au)
  • Why do we need an Acute Coronary Syndromes Clinical Care Standard ? (safetyandquality.gov.au)
  • Acute coronary syndrome (ACS), formerly referred to as ischemic heart disease, refers to a large spectrum of clinical conditions, including unstable angina and myocardial infarction (MI). (arupconsult.com)
  • of oral antiplatelet drugs, 2) clopidogrel resistance and need for alternative antithrombotic strategies for managing acute coronary syndromes (ACS), 3) clinical trial evidence of efficacy and safety with traditional and newer oral antiplatelet therapies, 4) guideline recommendations on dual oral antiplatelet therapy (DAPT), and 5) best practice in secondary prevention. (prlog.org)
  • These data suggest that NT-proBNP is a strong clinical predictor of prognosis in acute coronary syndromes. (unboundmedicine.com)
  • The term "acute coronary syndrome" is useful because the initial presentation and early management of unstable angina, STEMI, and NSTEMI frequently are similar. (aafp.org)
  • Coronary syndromes incorporate a spectrum of diseases ranging from unstable angina (UA), non-ST-elevation myocardial infarction (NSTEMI) to acute ST-elevation myocardial infarction (STEMI). (saem.org)
  • This chapter will be to review the different methods of invasive physiological assessment of coronary stenoses and their outcomes with a focus on their practical applications in patients with ST-elevation myocardial infarction (STEMI) and other ACS. (springer.com)
  • Elevated blood glucose at hospital admission, and elevated fasting blood glucose levels during admission, have been shown to predict worse outcome among patients with STEMI, however, the contribution of glucose levels to risk predictive algorithms involving patients with acute coronary syndromes (ACS) remains unclear. (bmj.com)
  • Acute coronary syndrome (ACS), a manifestation of CHD, is a spectrum of ailments that encompasses unstable angina (UA) and acute myocardial infarction (MI), with or without ST-segment elevation (STEMI or NSTEMI). (uspharmacist.com)
  • Baba and colleagues defined acute coronary syndrome as either ST segment elevation (STEMI) , non-ST segment elevation (non-STEMI) or unstable angina . (healio.com)
  • However, approximately 30% of patients will have complete occlusion of a coronary vessel and characteristic ST-elevation myocardial infarction (STEMI). (neurologyadvisor.com)
  • Cardiac troponin is a highly sensitive and specific biomarker for myocardial injury but concentrations in the blood rise over several hours after the onset of an acute myocardial infarction. (news-medical.net)
  • Cardiac markers (troponin T, troponin I, and/or creatine kinase-MB isoenzyme of creatine kinase) should be measured in any patient who has chest pain consistent with acute coronary syndrome. (aafp.org)
  • When used by trained physicians, the Acute Cardiac Ischemia Time-Insensitive Predictive Instrument (a computerized, decision-making program built into the electrocardiogram machine) results in a significant reduction in hospital admissions of patients who do not have acute coronary syndrome. (aafp.org)
  • 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. (aafp.org)
  • Thinking of this constellation of diseases together reminds you to consider more than just acute MI's when contemplating cardiac disease. (saem.org)
  • If there is any suspicion of an acute coronary syndrome, labs including blood count, electrolytes, cardiac enzymes, a chest radiograph and repeat EKGs will also be ordered. (saem.org)
  • If you can get an ACS victim to the cardiac catheter lab within a few hours and identify the occluded coronary artery, it is possible to inflate a balloon inside the artery and put in a stent. (pasadenastarnews.com)
  • Intravenous glucose-insulin-potassium (GIK) is postulated to be beneficial in acute ischaemic syndromes via two mechanisms: by providing metabolic support to ischaemic myocardium, and by preventing arrhythmias and cardiac arrest due to ischaemia-related metabolic derangements. (bmj.com)
  • Sophia Antipolis 11 Oct 2018: Just one-third of Chinese patients with acute coronary syndromes including heart attack receive cardiac rehabilitation guidance before discharge from hospital, according to research presented at the 29th Great Wall International Congress of Cardiology (GW-ICC). (eurekalert.org)
  • This study examined the proportion of patients in China with acute coronary syndromes including myocardial infarction (heart attack) and unstable angina who received cardiac rehabilitation guidance before discharge from hospital. (eurekalert.org)
  • Professor Dong Zhao, Chairperson of the Scientific Committee of GW-ICC 2018 and an author of the study, said: "The low proportion of acute coronary syndrome patients who receive cardiac rehabilitation guidance, based on findings of this project, may reflect the fact that it is still not integrated into routine hospital-based care for these patients in China. (eurekalert.org)
  • We have previously shown that 2- and 5-year total and cardiac mortality is decreased in the highest as compared to the lowest quartile of vitamin D in a coronary chest-pain population living at altitudes exceeding 1000 meters in subtropical northern Argentina [ 16 ], and this relationship is stronger in females than in males [ 17 ]. (hindawi.com)
  • It will be of interest to busy specialist physicians in cardiovascular medicine, cardiac and vascular surgery, and critical care, as well as primary care physicians and hospitalists who care for patients with these syndromes. (wiley.com)
  • Clinicians have become increasingly sophisticated in their application of cardiac biomarkers in the management of acute coronary syndromes (ACS). (ahajournals.org)
  • Cardiac events and procedure, such as angioplasty-stenting and coronary artery bypass surgery (CABG), will be recorded during the index ED visit, hospitalization and post-hospital follow-up period. (bioportfolio.com)
  • Jakarta acute coronary syndrome enrolled patients with acute coronary syndrome admitted to the emergency department of a national cardiac referral hospital. (bioportfolio.com)
  • Acute coronary syndrome (ACS) is the term applied in the setting of suspected myocardial ischemia based on symptoms, abnormalities on the EKG (electrocardiogram), and levels of serum markers of cardiac injury. (oncologynurseadvisor.com)
  • Drug-eluting stents are linked with fewer periprocedural risks but tend to have high incidence of postprocedural complications including myocardial infarction, repeat procedures, and 12-month major adverse cardiac and brain complications, compared with coronary bypass surgery. (medscape.com)
  • Acute Coronary Syndrome (ACS) is a spectrum of thrombotic coronary artery diseases, including unstable angina, ST-elevation myocardial infarction and non-ST elevation myocardial infarction resulting from sudden cardiac ischemia. (springer.com)
  • This occurrence marks the beginning of an acute myocardial infarction (AMI), or death of cardiac tissue. (dummies.com)
  • As a result many patients are admitted to Coronary Care Units for a period of observation which typically involves serial blood analysis and continuous cardiac monitoring. (bioportfolio.com)
  • This research supported the idea that the emotional stress of presenting to the Emergency Department with acute chest pain or shortness of breath might be an effective substitute for the stress that provocative cardiac stress tests (treadmill or pharmacologic stress testing) induce. (bioportfolio.com)
  • If true, then it would be of great interest to Emergency Physicians to measure the predictive value of TWA for cardiac ischemia in patients who are "stressed" by acute chest pain. (bioportfolio.com)
  • Risk stratification in acute coronary syndrome using cardiac troponin I. (thefreelibrary.com)
  • The interest in risk stratification of patients with acute coronary syndrome (ACS), i.e., acute myocardial infarction (MI) and unstable angina pectoris (AP), has increased considerably within recent years because of improved knowledge of pathology, progress in immunoassays of already existing biochemical markers, introduction of new biochemical markers [especially cardiac troponin I (cTnI) and T (cTnT)], and new methods of treatments. (thefreelibrary.com)
  • The morbidity and mortality due to ACS are substantial-nearly half of all deaths due to coronary heart disease occur following an ACS. (nih.gov)
  • Who is at risk for coronary heart disease? (mayoclinic.org)
  • The combination of type 2 diabetes and coronary artery disease can be deadly. (news-medical.net)
  • Long-term follow-up of the CE-MARC study suggests that cardiovascular magnetic resonance could be a better predictor of cardiovascular events than single-photon emission computed tomography in patients with coronary heart disease. (news-medical.net)
  • In the present book, fifteen typical literatures about acute coronary syndrome published on international authoritative journals were selected to introduce the worldwide newest progress, which contains reviews or original researches on medical science, ischemic heart diseases, cardiovascular disease, epidemiology, ect . (scirp.org)
  • Acute coronary syndrome is typically caused by coronary artery disease . (rexhealth.com)
  • Acute coronary syndrome is a broad category of coronary heart disease that ranges from unstable angina to ST elevation myocardial infarction (MI). (cmaj.ca)
  • She states he has a history of coronary artery disease, DM type II and hypertension. (saem.org)
  • Discuss the continuum of disease in acute coronary syndromes. (saem.org)
  • Acute coronary syndrome (ACS) represents the continuum of disease representing decreased coronary blood flow and acute myocardial ischemia and/or infarction. (saem.org)
  • At the other end of the coronary artery disease (CAD) spectrum is "stable angina," which allows a slower, more thoughtful approach. (pasadenastarnews.com)
  • The focus of our review was the relative use of effective treatments in patients with coronary angiographic evidence of obstructive coronary disease, defined as a lumen stenosis >50% of the adjacent non-diseased arterial diameter. (ingentaconnect.com)
  • Despite presenting with higher risk characteristics and having higher in-hospital and 6 months risk of death, women with ACS and obstructive coronary artery disease were apparently treated less aggressively with secondary preventive drugs than were men, being less likely to receive aspirin, beta-blockers and statins at discharge. (ingentaconnect.com)
  • Our study, therefore, demonstrates a gender bias in the delivery of secondary drug treatments for ACS, even for patients with documented significant coronary disease. (ingentaconnect.com)
  • There is a correlation between the number of ECG leads that show ST deviation and the extent and severity of coronary artery disease. (nursingcenter.com)
  • 4 If ST segment depression occurs in 8 or more leads along with ST elevation in AVR and V1, there is a high risk of either left main coronary artery disease or severe triple vessel disease. (nursingcenter.com)
  • Fractional flow reserve has been well validated in chronic stable coronary artery disease. (springer.com)
  • While FFR has been well validated in patients with chronic stable coronary artery disease, in ACS, physiological assessment of the culprit coronary artery is not performed because reduced flow to the myocardial bed can lead to false negatives. (springer.com)
  • The use of anabolic androgenic steroids could be associated with early onset coronary artery disease, according to research presented Nov. 4 at the Brazilian Congress of Cardiology. (cardiovascularbusiness.com)
  • Although the atherogenic lipoprotein(a) [Lp(a)] has been associated with incident cardiovascular disease, its concentration doesn't predict the risk of ischemic cardiovascular events following acute coronary syndrome (ACS) in patients receiving other therapies, a study published in JAMA Cardiology reports. (cardiovascularbusiness.com)
  • In Switzerland alone, the risk to develop a coronary heart disease during life time is around 25% for men and 18% for women. (coursera.org)
  • It was conducted within the Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome (CCC-ACS) project, a nationwide registry and quality improvement programme of the Chinese Society of Cardiology and American Heart Association. (eurekalert.org)
  • CONCLUSIONS -Aspirin, but not other secondary prevention agents, is associated with less effective mortality reduction in patients with diabetes and unstable coronary artery disease. (diabetesjournals.org)
  • We assessed whether this relationship remained in patients with unstable coronary artery disease. (diabetesjournals.org)
  • Cardiovascular disease is a composite of coronary, cerebral, or peripheral vascular disease. (diabetesjournals.org)
  • The prevalence of Coronary Artery Disease (CAD) in the adult population is estimated at 5-8% 2 . (scielo.br)
  • Coronary artery disease remains the leading cause of death worldwide, with 1 in 6 deaths occurring in the USA. (lww.com)
  • Coronary heart disease (CHD) is a very prevalent medical condition, with estimated direct and indirect costs for 2009 of $165.4 billion. (uspharmacist.com)
  • Associations of coronary heart disease risk factors with the intermediate lesion of atherosclerosis in youth. (medscape.com)
  • Coronary artery disease may present clinically as stable AP or ACS. (thefreelibrary.com)
  • Other causes of acute coronary syndrome include spontaneous coronary artery dissection and myocardial infarction in the absence of obstructive coronary artery disease (MINOCA), however these are far less common. (wikipedia.org)
  • 2013 ESC guidelines on the management of stable coronary artery disease: the task force on the management of stable coronary artery disease of the European Society of Cardiology. (springer.com)
  • While most allopathic medicine approaches to heart disease of this nature with angioplasties or other invasive procedures, the tried and true way of treating acute coronary syndrome is through prevention. (organicfacts.net)
  • These are often cited as the main contributor to heart disease, and it is no surprise that as these fats made their way into products and meals around the world through globalization and the spread of cheap food processing, levels of acute coronary syndrome also increased dramatically in the past few decades. (organicfacts.net)
  • Coronary heart disease is a common illness, causing much morbidity and mortality worldwide. (omicsonline.org)
  • Risk factors for the coronary disease like diabetes mellitus are alarmingly increasing, due to rapid urbanization, bad eating habits, and lack of physical activity [ 4 , 5 ]. (omicsonline.org)
  • Coronary heart disease (the main cause of acute coronary syndromes) kills more people in Australia than any other disease, and contributed to 15 per cent of all deaths in 2011. (safetyandquality.gov.au)
  • Aboriginal and Torres Strait Islander people with coronary heart disease: further perspectives on health status and treatment. (safetyandquality.gov.au)
  • Acute Coronary Syndrome - Ischemic Heart Disease. (arupconsult.com)
  • The most common cause of ACS is atherosclerotic coronary artery disease (CAD), which progresses from being ayspmtomatic through angina to infarction. (neurologyadvisor.com)
  • This case raises the issue of the coexistence of biventricular dysplasia with acute coronary syndrome, or more likely, biventricular dysplasia mimicking an acute coronary syndrome during acute progression of the disease. (em-consulte.com)
  • Patients with known coronary artery disease who have been prescribed nitroglycerin should promptly take one dose, and call emergency medical services if their symptoms do not improve within 2-5 minutes. (wikipedia.org)
  • Although in their introduction they quote studies that note a high risk of future events within a year and an increase in the "incidence of coronary atherosclerosis in the months after a coronary accident," they do not quantify the period of time during which the "pancoronaritis" may persist. (ahajournals.org)
  • Haft JI, Al-Zarka AM. Comparison of the natural history of irregular and smooth coronary lesions: insights into the pathogenesis, progression and prognosis of coronary atherosclerosis. (ahajournals.org)
  • Premature atherosclerosis and acute coronary syndrome in systemic lupus erythematosus. (freemd.com)
  • Fruits, vegetables, and nuts help to improve circulation , relax blood vessels, lower blood pressure, and relax the muscles in the coronary system that typically go into spasms when atherosclerosis reaches a dangerous level, thereby causing the episode or heart attack. (organicfacts.net)
  • The cholesterol sticks around, clogging up the works and resulting in atherosclerosis and eventually, an acute coronary syndrome. (organicfacts.net)
  • The information from these two tests - as well as your signs and symptoms - is used to make a primary diagnosis of acute coronary syndrome. (mayoclinic.org)
  • Do not test for myoglobin or creatine kinase-MB in the diagnosis of acute myocardial infarction. (aafp.org)
  • This article is part of a series on the electrocardiogram (ECG) diagnosis of acute coronary syndrome and myocardial infarction (MI) mimics. (nursingcenter.com)
  • Although 75-85% of patients presenting to the emergency department with chest pain ultimately do not receive a diagnosis of acute coronary syndrome, a lengthy assessment process is still mandatory as patients with a missed diagnosis of myocardial infarction are at increased risk for a cardiovascular event. (bmj.com)
  • Artificial Intelligence for Diagnosis of Acute Coronary Syndromes: A Meta-Analysis of Mixed Methods of Machine Learning. (scirp.org)
  • 1 Creatine kinase myocardial isoenzyme and myoglobin are no longer useful for diagnosis of acute coronary syndromes (ACS). (lww.com)
  • Serial testing to observe a rise and/or fall of a biomarker is necessary for the diagnosis of acute, evolving, or recent MI. (neurologyadvisor.com)
  • The answer you're looking for is Choice (B). Although this episode may in fact be a gastrointestinal event, the symptoms also point to possible acute coronary syndrome. (dummies.com)
  • people who present with angina must prompt evaluation for possible acute coronary syndrome. (wikipedia.org)
  • Because of the relationship between the duration of myocardial ischemia and the extent of damage to heart muscle, public health services encourage people experiencing possible acute coronary syndrome symptoms or those around them to immediately call emergency medical services. (wikipedia.org)
  • 11% went to coronary artery bypass surgery and 32% were treated medically in each of the groups. (medpagetoday.com)
  • Acute coronary syndrome (ACS) is a common and sometimes lethal event, usually precipitated by sudden rupture and thrombosis of an atherosclerotic plaque. (igi-global.com)
  • With its ability to view atherosclerotic lesions in vivo with such high resolution, OCT provides cardiologists with the tool they need to better understand the thrombosis-prone vulnerable plaques and acute coronary syndromes. (hindawi.com)
  • The alarmin family member myeloid-related protein (MRP)-14 (S100A9), which has been identified by platelet transcriptional profiling as an acute myocardial infarction gene, regulates vascular inflammation and thrombosis. (sigmaaldrich.com)
  • these include (1) plaque rupture with acute thrombosis, (2) progressive mechanical obstruction, (3) inflammation, (4) secondary unstable angina, and (5) dynamic obstruction (coronary vasoconstriction). (ahajournals.org)
  • In ACS, the accepted cause of acute MI is a plaque disruption, or fissuring, leading to coronary thrombosis with or without vasospasm, and thereby intermittent or persistent coronary occlusion. (thefreelibrary.com)
  • Though ACS is usually associated with coronary thrombosis, it can also be associated with cocaine use. (wikipedia.org)
  • New onset angina however should be considered as a part of acute coronary syndrome, since it suggests a new problem in a coronary artery .Though ACS is usually associated with coronary thrombosis , it can also be associated with cocaine use. (wikidoc.org)
  • In addition to plaque rupture and the accompanying acute thrombosis, ACS is also associated with progressive mechanical obstruction of the vessel as plaque enlarges, inflammation, secondary unstable angina from anemia or hyperthyroidism, and dynamic obstruction of coronary vessels due to vasoconstriction. (neurologyadvisor.com)
  • The knowledge of hospital behavior of patients with ACS is essential for immediate in-hospital risk stratification and in the long term, for the acute episode survivors, as well as to show how these patients are managed in our country. (scielo.br)
  • Therefore, our diagnostic strategy of ACS is concentrated primarily on confirmation/ exclusion of acute MI and the detection of minor myocardial damage (MMD) to facilitate risk stratification and treatment. (thefreelibrary.com)
  • Its role in risk stratification in patients with acute coronary syndromes (ACS) is still under evaluation. (unboundmedicine.com)
  • A polymer-free, drug-coated stent gives markedly better outcomes than a bare metal stent in patients with acute coronary syndromes and risk factors for bleeding, report researchers. (news-medical.net)
  • PURPOSE OF REVIEW: Thrombocytopenia is relatively common in patients with acute coronary syndromes and is associated with an increased risk of adverse outcomes, regardless of the etiology of the low platelet count. (biomedsearch.com)
  • Among people hospitalized for health outcomes related to acute coronary syndrome (ACS) , including heart attack or unstable angina, individuals with HIV have higher rates of death and readmission to the hospital, compared with their HIV-negative counterparts. (poz.com)
  • Moriel M, Behar S, Tzivoni D, Hod H, Boyko V, Gottlieb S. Management and outcomes of elderly women and men with acute coronary syndromes in 2000 and 2002. (freemd.com)
  • Elucidating the effects of obstructive sleep apnea on cardiovascular outcomes in acute coronary syndrome is crucial in risk assessments and therapeutic recommendations for affected individualism," Ridhwan Y. Baba, MB BS , pulmonary and critical care fellow at the MetroHealth System in Cleveland, and colleagues wrote in the abstract. (healio.com)
  • April 12, 2013 -- The American College of Physicians (ACP) today unveiled two evidence-based interventions and two videos to improve the health outcomes of patients in the first year following an initial acute coronary syndrome (ACS) event such as heart attack and unstable angina (chest pain or discomfort but no part of the heart muscle dies), the most common indications of ACS. (rxpgnews.com)
  • Acute coronary syndrome (ACS) is a term given to a group of symptoms. (empowher.com)
  • Call 911 or other emergency services immediately if you have symptoms of acute coronary syndrome. (rexhealth.com)
  • If you have signs or symptoms associated with acute coronary syndrome, an emergency room doctor will likely order several tests. (mayoclinic.org)
  • Acute coronary syndromes (ACS) is an umbrella term used to describe a series of signs and symptoms indicative of myocardial ischemia, comprising unstable angina, non-ST segment elevation myocardial infarction, and ST segment elevation myocardial infarction. (worldcat.org)
  • Thuresson M, Jarlov MB, Lindahl B, Svensson L, Zedigh C, Herlitz J. Symptoms and type of symptom onset in acute coronary syndrome in relation to ST elevation, sex, age, and a history of diabetes. (freemd.com)
  • Many people with acute coronary syndromes present with symptoms other than chest pain, particularly women, older patients, and patients with diabetes mellitus. (wikipedia.org)
  • Acute coronary syndrome (ACS) is a complex group of symptoms associated with acute myocardial ischemia. (neurologyadvisor.com)
  • Doctors worried about dangerous blood clots in patients undergoing a coronary artery procedure- such as angioplasty to treat a heart attack - will often administer antiplatelet therapy to head off complications. (news-medical.net)
  • In this context, antiplatelet therapy occupies a prominent role in the management of pathologies arising from this process, notably acute coronary syndromes. (scielo.br)
  • Troponin T or I generally is the most sensitive determinant of acute coronary syndrome, although the MB isoenzyme of creatine kinase also is used. (aafp.org)
  • Yilmaz H, Basarici I. Troponin levels and acute coronary syndrome. (freemd.com)
  • There is a difference between an acute coronary syndrome (unstable coronary plaque) and a non-ACS elevation of troponin. (healio.com)
  • Other medical conditions such as pulmonary embolus, hypertensive emergency and septic shock can elevate the troponin and is NOT a true acute coronary syndrome. (healio.com)
  • Patients with Type 2 diabetes and acute coronary syndromes have a substantially increased risk of death in the 18 months after hospital admission for subsequent major nonfatal cardiovascular events, US researchers report. (news-medical.net)
  • A dedicated RCT on ASA dose, the CURRENT-OASIS 7 (Clopidogrel and Aspirin Optimal Dose Usage to Reduce Recurrent Events-Seventh Organization to Assess Strategies in Ischemic Syndromes) trial, showed that low-dose and high-dose ASA are associated with similar rates of cardiovascular death, MI or stroke at 30 days (hazard ratio [HR] 0.97, 95% confidence interval [CI] 0.86-1.09). (cmaj.ca)
  • Introduction: Acute forms of cardiovascular are a major problem in the structure of morbidity and mortality, especially among perimenopausal women. (bioportfolio.com)
  • Wallentin L. Prevention of cardiovascular events after acute coronary syndrome. (freemd.com)
  • Demographic and cardiovascular risk factors were obtained from ninety-nine patients with acute coronary syndrome admitted to the coronary care unit at King Khalid Hospital during the period from June 2014 to April 2015. (omicsonline.org)
  • Death from any cause or hospitalization because of a major acute cardiovascular event (whichever occurred first) was defined as the end-point. (unboundmedicine.com)
  • Acute coronary syndrome (ACS) results from thrombus formation at the site of ruptured or eroded atherosclerotic plaques, which restricts coronary blood flow resulting in myocardial ischemia and injury. (bmj.com)
  • Early markers of acute ischemia include myoglobin and creatine kinase-MB subforms (or isoforms), when available. (aafp.org)
  • In the absence of pain, new ST segment changes indicative of ischemia, acute pulmonary edema, ventricular arrhythmias, or hemodynamic instability presumed to be ischemic in origin, will constitute sufficient evidence of ischemia. (clinicaltrials.gov)
  • The syndrome is precipitated by coronary artery occlusion (stenosis), which results in ischemia and myocardial necrosis. (marketpublishers.com)
  • Medical therapy for acute coronary syndromes is based on drugs that act against ischemia and resultant angina and limit the infarct size (i.e., the area of myocardium that is affected), as well as drugs that inhibit clot formation. (wikipedia.org)
  • An acute coronary syndrome occurs when atherosclerotic coronary plaque becomes unstable, leading to a series of events eventually resulting in partial or total thrombotic occlusion of a coronary artery. (healio.com)
  • Patients without ST segment elevation are said to suffer from non-ST-elevation acute coronary syndrome and tend not to have full occlusion of a coronary artery. (wikipedia.org)
  • Recent studies have shown that OCT is useful for the assessment of coronary atherosclerotic plaques, in particular the assessment of plaque rupture, erosion, and intracoronary thrombus in patients with acute coronary syndrome. (hindawi.com)
  • The term acute coronary syndrome (ACS) refers to the pathophysiologic continuum that begins with plaque rupture in a coronary artery and ultimately results in total occlusion of the artery by thrombus unless the process is arrested. (nursingcenter.com)
  • Unfortunately, the coronary arteriographic appearance of a ruptured plaque does not tell how recently the plaque rupture has occurred. (ahajournals.org)
  • Multiple atherosclerotic plaque rupture in acute coronary syndrome: a three-vessel intravascular ultrasound study. (ahajournals.org)
  • Chest pain caused by acute coronary syndromes can come on suddenly, as is the case with a heart attack . (heart.org)
  • What Decides the Suspicion of Acute Coronary Syndrome in Acute Chest Pain Patients? (scirp.org)
  • The likelihood of acute coronary syndrome (low, intermediate, high) should be determined in all patients who present with chest pain. (aafp.org)
  • Differentiating acute coronary syndrome from noncardiac chest pain is the primary diagnostic challenge. (aafp.org)
  • The main aim of our study was to evaluate the prognostic utility of vitamin D measured as serum 25-hydroxyvitamin D [25(OH)D] in a Norwegian coastal coronary chest-pain population exposed to temperate sun activity at low altitudes and with a high consumption of fish as reflected by the omega-3 index. (hindawi.com)
  • Relationship of coronary calcium and myocardial perfusion in individuals with chest pain. (freemd.com)
  • Specifically, there are no reports of the applicability of TWA testing to Emergency Department patients with acute chest pain. (bioportfolio.com)
  • We monitored 100 acute chest pain ED patients using the HearTwave TWA monitor. (bioportfolio.com)
  • However, increased serum cTnT concentrations were also seen in approximately one-third of patients with unstable AP or in other chest pain patients in whom an acute MI had been ruled out (7). (thefreelibrary.com)
  • In the setting of acute chest pain, the electrocardiogram is the investigation that most reliably distinguishes between various causes. (wikipedia.org)
  • A 41-year old female patient was admitted with acute onset of dyspnea and chest pain. (dovepress.com)
  • A 45-year-old man without past medical history was referred for acute chest pain and suspected non-ST-segment elevation myocardial infarction. (em-consulte.com)
  • Consequently, we also accessed individual patient-level data from 3 established ACS registries: the Finnish TACOS (Tampere Acute COronary Syndrome), the British EMMACE 2 (Evaluation of Methods and Management of Acute Coronary Events) and the Argentine PACS-ITALSIA (Prognosis in Acute Coronary Syndromes and the ITALian hospital Sindrome Isquemico Agudo). (ingentaconnect.com)
  • The MRP-8/14 level was correlated with myeloperoxidase (MPO) level (R Our findings indicate that MRP-8/14 concentration increases in coronary artery blood in association with thrombus formation in ACS, co-localizes with leukocytes, and is associated with leukocyte activation. (sigmaaldrich.com)
  • Pathophysiology: ACS generally involves rupture of an atherosclerotic plaque in a coronary artery and subsequent thrombus formation. (oncologynurseadvisor.com)
  • Chapters 16-19 cover acute coronary syndromes, thrombus formation, and advanced treatment options. (elsevier.com)
  • Part of that treatment is to transport as quickly and safely as possible to the nearest hospital that's capable of rapidly restoring coronary blood flow, either through angioplasty or fibrinolytic therapy. (dummies.com)
  • If this indicates acute heart damage (elevation in the ST segment, new left bundle branch block), treatment for a heart attack in the form of angioplasty or thrombolysis is indicated immediately (see below). (wikipedia.org)
  • Routine early angioplasty after fibrinolysis for acute myocardial infarction. (springer.com)
  • Primary angioplasty vs. early routine post-fibrinolysis angioplasty for acute myocardial infarction with ST-segment elevation: the GRACIA-2 non-inferiority, randomized, controlled trial. (springer.com)
  • Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the heart muscle. (medlineplus.gov)
  • Heart attack and unstable angina are both acute coronary syndromes (ACS). (medlineplus.gov)
  • Those well-known conditions are both acute coronary syndromes, an umbrella term for situations where the blood supplied to the heart muscle is suddenly blocked. (heart.org)
  • Acute coronary syndromes, just like heart failure and stroke , are much more likely in people who have certain risk factors. (heart.org)
  • Acute coronary syndrome happens when the heart is not getting enough blood. (rexhealth.com)
  • A heart attack means a coronary artery has been blocked and the heart has been damaged. (rexhealth.com)
  • This test is done only when there are no signs of acute coronary syndrome or another life-threatening heart condition when you are at rest. (mayoclinic.org)
  • Acute coronary syndrome (ACS) is sudden decreased blood flow to your heart. (drugs.com)
  • The term non-ST elevation acute myocardial infarction (NSTEMI) is no longer used in the American College of Cardiology/American Heart Association (ACC/AHA) guidelines as a broad category with separate treatment guidelines. (aafp.org)
  • Cleveland Clinic cardiologists specialize in prompt diagnosis and treatment of heart attack and acute coronary syndromes. (clevelandclinic.org)
  • Acute coronary syndrome (ACS) is a set of features related to poor blood flow to the heart muscle that leads to a heart attack . (stdavids.com)
  • If this happens in a large coronary artery, a heart attack results. (pasadenastarnews.com)
  • New research published in PLOS One this October reports not only do more women statistically die of acute myocardial infarction (AMI) than men, but they see dramatically increased mortality in the first year after their heart attack. (cardiovascularbusiness.com)
  • NEW ORLEANS, Nov. 10 -- Acute coronary syndrome was the theme today at the American Heart Association meeting and the study causing the biggest buzz was all about timing, according to the participants in this exclusive MedPage Today roundtable. (medpagetoday.com)
  • This module focuses on different methods and approaches to deal with acute coronary syndrome, which in the worst case can lead to an acute heart attack. (coursera.org)
  • Lower rates of targeted interventions and care strategies for acute heart problems compared with HIV-negative people are a likely factor. (poz.com)
  • Acute Coronary Syndrome (ACS) describes multiple conditions associated with sudden, reduced blood flow to the heart. (hospitalmedicine.org)
  • Your heart pumps blood to every part of your body, so this syndrome where blood ceases to pump to the rest of the body can be extremely dangerous, even life-threatening. (organicfacts.net)
  • 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. (medscape.com)
  • Immediate heart catheterization revealed a distally occluded left anterior descending coronary artery, the occlusion being reversible after nitroglycerine. (dovepress.com)
  • fiber also actively scrapes negative cholesterol from the walls of the coronaries and eliminates them from the system, thereby keeping the heart healthy and fit. (organicfacts.net)
  • Maintaining a low-glycemic index in your body can also help to prevent acute coronary syndrome because heart attacks are often linked to diabetes and an inability to control the content and flow of sugars in the blood. (organicfacts.net)
  • 2 There is also strong evidence that Aboriginal and Torres Strait Islander people experience coronary events, such as heart attacks, at rates three times those of other Australians. (safetyandquality.gov.au)
  • Acute coronary syndrome is a term for any condition that suddenly stops (or severely reduces) blood from flowing to the heart. (limamemorial.org)
  • While there are well-developed guidelines for managing acute coronary syndromes, not all people receive appropriate treatment and there is variation in the type of care received by people in metropolitan compared to non-metropolitan areas. (safetyandquality.gov.au)
  • The guidelines for managing acute coronary syndromes, published in a supplement to the Journal in 2006, provide a readily accessible tool for clinicians to enhance patient care. (mja.com.au)
  • An electrocardiogram (ECG or EKG) can diagnose an acute coronary syndrome by measuring the heart's electrical activity. (heart.org)
  • A normal electrocardiogram does not rule out acute coronary syndrome. (aafp.org)
  • An electrocardiogram or ECG can be an effective tool in the evaluation of acute coronary syndrome. (freemd.com)
  • Acute coronary syndromes are classified to two major categories, according to the patient's electrocardiogram, and specifically the presence or absence of persistent (>20 min) ST segment elevation (or left bundle branch block). (wikipedia.org)
  • Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. (aafp.org)
  • OBJECTIVE -We sought to compare mortality reduction associated with secondary prevention in patients with and without diabetes after acute coronary syndrome (ACS). (diabetesjournals.org)
  • The last decade has witnessed a significant improvement in use of evidence-based therapies and mortality after acute coronary syndromes (ACSs) ( 1 ). (diabetesjournals.org)
  • The use of unfractionated heparin and low molecular weight heparins greatly reduces the risk of mortality and morbidity in acute coronary syndromes. (cochrane.org)
  • Although numerous studies have confirmed the association between stress hyperglycemia in patients with acute coronary syndrome , and increased mortality, and morbidity, however such patients were shown to be actually latent diabetic patients, in whom the stress of myocardial injury worsened their glycaemic status [ 8 ]. (omicsonline.org)
  • The role of reperfusion therapy in paced patients with acute myocardial infarction. (medscape.com)
  • Recently, other invasive indices of coronary physiology including instantaneous wave-free ratio (iFR), index of microvascular resistance (IMR), hyperemic stenosis resistance (HSR), and coronary flow reserve (CFR) have been explored in the context of ACS. (springer.com)
  • FFR is the ratio of the mean coronary pressure distal (Pd) to a stenosis to the mean aortic pressure (Pa) at maximal hyperemia when myocardial resistance is at its presumed absolute minimum. (springer.com)
  • This condition permits pressure and flow to be linearly related, and thus the ratio represents the fraction of normal coronary blood flow across a stenosis with a normal value being 1 (i.e. (springer.com)
  • Significant correlation was not observed between PUFAs profile and severity of coronary stenosis. (unboundmedicine.com)
  • BET 2: Is ST elevation in aVR a sure sign of left main coronary artery stenosis? (bmj.com)
  • How well do physicians assess risk in non-ST elevation (NSTEMI) acute coronary syndrome (ACS) patients? (bmj.com)
  • Which patients with non-ST-elevation acute coronary syndrome (unstable angina and NSTEMI) should receive anticoagulant therapy? (medscape.com)
  • In the current study, we studied hyperglycemia among patients with the coronary syndrome, excluding patients with known or latent diabetes mellitus, according to their HbA1c% at the time of coronary care unit admission. (omicsonline.org)
  • A second model for death due to major complications identified: cardiogenic shock/acute pulmonary edema (OR=4.57), reinfarction (OR=3.48), stroke (OR=21.56), major bleeding (OR=3.33), cardiopulmonary arrest (OR=40.27) and Killip functional class (OR=3.37). (scielo.br)
  • Mirghani HO, Mohammed OS, Alyoussuf AA (2015) Stress Hyperglycemia and its Relation to Acute Coronary Syndrome Complications. (omicsonline.org)
  • Stress hyperglycemia has been associated with increased acute coronary syndrome complications. (omicsonline.org)
  • No significant correlation was evident between hyperglycemia and acute coronary risk factors and complications. (omicsonline.org)
  • Long-term therapy in acute coronary syndrome survivors is targeted against recurrence and long-term complications (secondary prevention). (wikipedia.org)
  • Initial evaluation and management of suspected acute coronary syndrome (myocardial infarction, unstable angina) in the emergency room. (mayoclinic.org)
  • This chapter aims to provide the reader with an in-depth, evidence-based understanding of the principles behind the current understanding and management of acute coronary syndrome. (igi-global.com)
  • Clopidogrel has been extensively studied and has a class I recommendation (i.e., evidence or general agreement that treatment is useful and effective) for 1 year of treatment irrespective of invasive or conservative management of acute coronary syndrome. (cmaj.ca)
  • SUMMARY: Surveillance for and early recognition of thrombocytopenia, an appropriate differential diagnosis, and early institution of treatment are critically important in the management of patients with acute coronary syndromes. (biomedsearch.com)
  • Management of Acute Coronary Syndromes is designed to provide busy clinicians with a comprehensive guide to the investigation, diagnosis and treatment of these syndromes. (wiley.com)
  • Management of Acute Coronary Syndromes is the most up to date and comprehensive evidence-based guide to managing acute coronary syndromes, in a compact and usable format. (wiley.com)
  • This guideline offers best practice advice on the management of hyperglycaemia in all adults admitted to hospital for an acute coronary syndrome regardless of whether or not they have a diagnosis of diabetes. (nice.org.uk)
  • The understanding of their findings may help promote better planning and management of acute coronary syndrome care in public and private health services. (scielo.br)
  • The objective of this review is to define the role of antiplatelet drugs in the management of acute coronary syndrome, revisiting aspects that have been already consolidated and addressing current and still controversial topics on the subject. (scielo.br)
  • Acute coronary syndrome management is complicated because we don't have one-size-fits-all antithrombotic pathway because patients and conditions are different," said Dr. Lincoff, who served as moderator at the symposium, which was sponsored by the Medicines Company. (medpagetoday.com)
  • 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). (medscape.com)
  • ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. (medscape.com)
  • Basic principles of management are the same for all types of acute coronary syndrome. (wikipedia.org)
  • Massberg S, Schulz C, Gawaz M. Role of platelets in the pathophysiology of acute coronary syndrome. (springer.com)
  • Don't miss the "Updates in Acute Coronary Syndrome" session held during SHM's Annual Conference, Hospital Medicine 2018. (hospitalmedicine.org)
  • Patients admitted to the hospital for acute coronary syndrome were likely to have obstructive sleep apnea, according to preliminary findings presented at SLEEP 2018, the Annual Meeting of the Associated Professional Sleep Societies. (healio.com)
  • 2 Concurrently, advances in our understanding of the pathogenesis and consequences of acute coronary atherothrombosis have stimulated the development of new biomarkers and created the opportunity for an expanded role of multiple biomarkers, some old and others new, in the classification and individualization of treatment for ACS. (ahajournals.org)
  • The activation of coagulation mechanisms plays a central role in the pathogenesis of acute coronary syndromes (ACS). (cochrane.org)
  • Thus, OCT has been applied for the assessment of culprit lesion morphologies in patients with acute coronary syndrome (ACS). (hindawi.com)
  • Hence, until then, the presence of multiple lesions indicative of ruptured plaques does not necessarily imply that all the ruptured plaques had occurred at the time of the culprit lesion, nor does it prove that there is necessarily generalized plaque instability at the time of the patient's acute coronary syndrome. (ahajournals.org)
  • DENVER - Patients with acute MI complicated by cardiogenic shock demonstrated significantly higher 30-day survival rates with culprit lesion PCI versus multivessel PCI, according to a new study that challenges current guidelines. (cardiovascularbusiness.com)
  • It remains uncertain whether the sweeping changes in the treatment of acute coronary syndromes have had a substantial impact on the incidence of cardiogenic shock. (bmj.com)
  • New onset angina is also considered unstable angina, since it suggests a new problem in a coronary artery. (scirp.org)
  • The onset is usually abrupt, when an atheroma ulcerates and a clot forms, blocking a coronary artery. (pasadenastarnews.com)
  • Eligible patients were those who came to the emergency wards with suspected acute coronary syndrome within the first 24 hours of symptom onset, associated with compatible electrocardiographic alterations and/or altered necrosis biomarkers. (scielo.br)
  • To compare sensitivity and specificity of a CardioFlux based diagnostic algorithm versus standard of care assessment of potential acute coronary syndrome patients. (clinicaltrials.gov)
  • A formal protocol for urgent care center evaluation of potential acute coronary syndrome safely precluded emergency department visits among 84% of those eligible. (ajmc.com)
  • The protease-activated receptor 1 inhibitor vorapaxar offers the same benefits to older and younger patients with non-ST segment elevation acute coronary syndromes, shows further analysis of the TRACER trial. (news-medical.net)
  • The term "acute coronary syndrome" encompasses a range of thrombotic coronary artery diseases, including unstable angina and both ST-segment elevation and non-ST-segment elevation myocardial infarction. (aafp.org)
  • In acute coronary syndrome, common electrocardiographic abnormalities include T-wave tenting or inversion, ST-segment elevation or depression (including J-point elevation in multiple leads), and pathologic Q waves. (aafp.org)
  • Acute coronary syndromes are categorized into unstable angina , non-ST segment elevation myocardial infarctions and ST segment elevation myocardial infarction . (healio.com)
  • Acute coronary syndrome (ACS), includes acute myocardial infarction and unstable angina, is common and may prove fatal. (nih.gov)
  • Unstable angina is an acute coronary syndrome and should be treated as a medical emergency. (clevelandclinic.org)
  • Senior Living: Acute Coronary Syndrome versus Stable Angina. (pasadenastarnews.com)
  • These figures account for the total number of deaths from angina and acute myocardial infarction (AMI), corresponding to 7.05% of total deaths in the year, or 24.67% of deaths from circulatory system diseases 1 . (scielo.br)
  • Angina and AMI are part of a spectrum of conditions known as acute coronary syndrome , or ACS. (dummies.com)
  • Generally, when the symptom is of less than 30 minutes,it is Unstable Angina(UA).When symptom is prolonged to more than 30 minutes the diagnosis is Acute myocardial infarction (AMI) classified under Acute Coronary Syndrome. (wikipedia.org)