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.
"ESC Guidelines on Acute Coronary Syndromes (ACS) in patients presenting without persistent ST-segment elevation (Management of ... "Acute Coronary Syndrome , Pharmacotherapy: A Pathophysiologic Approach, 11e , AccessPharmacy , McGraw-Hill Medical". ... "Meta-Analysis of the Relative Efficacy and Safety of Oral P2Y12 Inhibitors in Patients With Acute Coronary Syndrome". The ... This disease can be classified into acute and chronic coronary heart disease. This disease caused 8.9 million deaths in 2019 ...
"The Pathogenesis of Coronary Artery Disease and the Acute Coronary Syndromes". New England Journal of Medicine. 326 (5): 310- ... Fuster, V.; Fayad, Z. A.; Badimon, J. J. (1999). "Acute coronary syndromes: biology". Lancet. 353 Suppl 2: SII5-9. doi:10.1016/ ... 1990s: Demonstrating that acute coronary events arise from small plaques, explaining their unpredictability, and developing ... 2000s: Following upon experience with CABG and DES for revascularization in patients with diabetes and multivessel coronary ...
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 ...
"Acute Coronary Syndrome Workup". Medscape. Archived from the original on 6 August 2016. Retrieved 14 August 2016. Davidson's ... These are the left main coronary artery and the right coronary artery. The left main coronary artery splits shortly after ... Long QT syndrome is the most common form of cardiac channelopathy. Long QT Syndrome (LQTS) - Mostly hereditary. On EKG can be ... A small amount of blood from the coronary circulation also drains into the right atrium via the coronary sinus, which is ...
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 ...
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 ...
Aggarwal RK, Showkathali R (June 2013). "Rosuvastatin calcium in acute coronary syndromes". Expert Opinion on Pharmacotherapy. ... April 2006). "Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial". 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 ...
Malik J, Javed N, Ishaq U, Khan U, Laique T (May 2020). "Is There a Role for Colchicine in Acute Coronary Syndromes? A ... Imazio M, Andreis A, Brucato A, Adler Y, De Ferrari GM (October 2020). "Colchicine for acute and chronic coronary syndromes". ... On 29 July 2009, colchicine won FDA approval in the United States as a stand-alone drug for the treatment of acute flares of ... According to one review, colchicine poisoning by overdose (range of acute doses of 7 to 26 mg) begins with a gastrointestinal ...
... in hospital admissions for acute coronary syndrome. 67% of the decrease occurred in non-smokers. Smoking most commonly leads to ... "Smoke-free legislation and hospitalizations for acute coronary syndrome" (PDF). The New England Journal of Medicine. 359 (5): ... in relation to reports that smokers appeared to have unexpectedly good short-term outcomes following acute coronary syndrome or ... Xu C, Lu HX, Wang YX, Chen Y, Yang SH, Luo YJ (2016). "Association between smoking and the risk of acute mountain sickness: a ...
He was later diagnosed with acute coronary syndrome. The following day, he underwent an angioplasty. "Abid Ali". ESPN Cricinfo ...
Takashi Tachibana, 80, Japanese journalist, acute coronary syndrome. Chandro Tomar, 89, Indian sharpshooter, COVID-19. Jevgeni ...
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, ...
... and urgent coronary revascularization compared with placebo in acute coronary syndrome patients treated with standard medical ... "GSK announces phase III study with darapladib did not meet primary endpoint in patients following an acute coronary syndrome". ... Thompson PL, Nidorf SM, Eikelboom J (August 2013). "Targeting the unstable plaque in acute coronary syndromes". Clinical ... GSK announced that the drug had failed to meet Phase III endpoints in a trial of 16,000 patients with acute coronary syndrome ( ...
The enzyme is one of the "new cardiac markers" which are discussed to improve early diagnosis in acute coronary syndrome. A ... May 2005). "Future biomarkers for detection of ischemia and risk stratification in acute coronary syndrome". Clin. Chem. 51 (5 ... 2005). "Glycogen phosphorylase BB in acute coronary syndromes". Clin. Chem. Lab. Med. 43 (12): 1351-8. doi:10.1515/CCLM. ...
"Alirocumab and Cardiovascular Outcomes after Acute Coronary Syndrome". N Engl J Med. 379 (22): 2097-2107. doi:10.1056/ ...
... and nonfatal stroke in patients after acute coronary syndromes. This agent consists of eicosapentaenoic acid (EPA), an omega-3 ... "Ezetimibe Added to Statin Therapy after Acute Coronary Syndromes". New England Journal of Medicine. 372 (25): 2387-2397. doi: ... of ezetimbe/simvastatin versus simvastatin monotherapy on cardiovascular outcomes in patients with acute coronary syndromes". ... "The Lipid Research Clinics Coronary Primary Prevention Trial Results: I. Reduction in Incidence of Coronary Heart Disease". ...
Clinical use: Acute coronary syndromes, percutaneous transluminal coronary angioplasty. Toxicity: Bleeding, thrombocytopenia. ...
Danese, E; Montagnana, M (2016). "An historical approach to the diagnostic biomarkers of acute coronary syndrome". Annals of ... 59(3): p. 172-8. Tanindi, Asil; Cemri, Mustafa (2011). "Troponin elevation in conditions other than acute coronary syndromes". ... as a prognostic marker in patients with acute coronary syndrome and to identify the risk (low, moderate and elevated) of future ... 2016). "High-Sensitivity Cardiac Troponin, Statin Therapy, and Risk of Coronary Heart Disease". Journal of the American College ...
... in people with acute coronary syndrome (ACS) who are to be managed with percutaneous coronary intervention (PCI). Prasugrel is ... November 2007). "Prasugrel versus clopidogrel in patients with acute coronary syndromes". The New England Journal of Medicine. ... "Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a systematic review and ... "Pretreatment with Prasugrel in Non-ST-Segment Elevation Acute Coronary Syndromes". New England Journal of Medicine. 369 (11): ...
"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 ...
2012). "Thrombin-Receptor Antagonist Vorapaxar in Acute Coronary Syndromes". New England Journal of Medicine. 366 (1): 20-33. ... by a pooled analysis of data that studied 42000 patients with history of thrombotic vascular disease or acute coronary syndrome ... trial comparing vorapaxar with placebo in addition to standard therapy in 12,944 patients who had acute coronary syndromes, ... stroke or urgent coronary revascularization by 12 percent compared to placebo plus standard of care (11.2 percent vs. 12.4 ...
"Comparison of fondaparinux and enoxaparin in acute coronary syndromes". The New England Journal of Medicine. 354 (14): 1464- ... Fifth Organization to Assess Strategies in Acute Ischemic Syndromes Investigators) (April 2006). " ... February 2008). "The role of fondaparinux as an adjunct to thrombolytic therapy in acute myocardial infarction: a subgroup ...
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- ...
October 2019). "Ticagrelor or Prasugrel in Patients with Acute Coronary Syndromes". The New England Journal of Medicine. 381 ( ... October 2014). "Reappraisal of thienopyridine pretreatment in patients with non-ST elevation acute coronary syndrome: a ... remains the first-line treatment for acute coronary syndrome. A 2019 randomized trial suggested that prasugrel is superior to ... addition to aspirin should be administered for up to 12 months to most patients with non-ST-elevation acute coronary syndrome. ...
Takahiro Satō, 41, Japanese manga writer, acute coronary syndrome. Bradford A. Smith, 86, American astronomer, complications of ...
"Myocardial perfusion imaging versus biochemical markers in acute coronary syndromes". Nuclear Medicine Communications. 24 (10 ... He has contributed to a number of clinical trials, including the first trials of Carvedilol, in heart failure and acute ... Sabharwal, N K (2003). "Role of myocardial perfusion imaging for risk stratification in suspected or known coronary artery ... Coronary Artery Calcium Scanning) in the UK. Contributed in early diagnostic imaging in asymptomatic diabetes. Referenced in ...
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 ...
"2015 ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment ... "Swiss Working Group for Interventional Cardiology and Acute Coronary Syndromes". Retrieved 23 November 2016. "2016-2018 EAPC ... "Interventional Cardiology and Acute Coronary Syndrome" of the Swiss Society for Cardiology, board member of the group " ... Task Force for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation of the ...
While in acute cases, patients take antibiotics for complications such as abscesses, pain control, and nothing to eat until a ... Postcholecystectomy syndrome (cholesterosis, hydrops, perforation, fistula). *Xanthogranulomatous cholecystitis is a rare form ... "Effect of estrogen plus progestin on risk for biliary tract surgery in postmenopausal women with coronary artery disease. The ... Additionally, in acute cases, a leukocytosis, an increase in white blood cell count, is found. In chronic cases, a ...
Meigs's syndrome (ascites and pleural effusion due to a benign ovarian tumor), and ovarian hyperstimulation syndrome.[6] ... coronary artery bypass surgery, abdominal surgery, endoscopic variceal sclerotherapy, radiation therapy, liver or lung ... Nephrotic syndrome, leading to the loss of large amounts of albumin in urine and resultant low albumin levels in the blood and ... Nephrotic syndrome. *Acute atelectasis[4]. *Myxedema. *Peritoneal dialysis. *Meigs's syndrome. *Obstructive uropathy ...
Acute renal failure. Acute respiratory distress syndrome. Acute liver failure. Respiratory failure. Multiple organ dysfunction ... Acute lung injury, including acute respiratory distress syndrome (ARDS),[7] trauma, or COVID-19[8] ... tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome". ... One of the primary complications that presents in patients mechanically ventilated is acute lung injury (ALI)/acute respiratory ...
"17 beta-Estradiol attenuates acetylcholine-induced coronary arterial constriction in women but not men with coronary heart ... Males with certain sex chromosome genetic conditions, such as Klinefelter's syndrome, will have a higher level of estradiol.[20 ... "Identification of a regulatory loop for the synthesis of neurosteroids: a steroidogenic acute regulatory protein-dependent ... Improvement in arterial blood flow has been demonstrated in coronary arteries.[39] ...
"Proteomics of acute coronary syndromes" (PDF). Current atherosclerosis reports. 11 (3): 188-95. doi:10.1007/s11883-009-0030-x. ...
Specifically, acute and chronic stress have been shown to raise serum lipids and are associated with clinical coronary events.[ ... Acute stressors affect an organism in the short term; chronic stressors over the longer term. The general adaptation syndrome ( ... chronic fatigue syndrome,[57] depression,[58] as well as other mental illnesses[5] and functional somatic syndromes.[59] ... Acute time-limited stressors, or stressors that lasted less than two hours, results in an up regulation of natural immunity and ...
Acute coronary syndrome *Myocardial infarction. *Unstable angina. Sequelae. *hours *Hibernating myocardium. *Myocardial ... Sudden arrhythmic death syndrome[edit]. Sudden arrhythmic death syndrome (SADS), is a term used as part of sudden unexpected ... Causes of SADS in young people include viral myocarditis, long QT syndrome, Brugada syndrome, Catecholaminergic polymorphic ... Wolff-Parkinson-White syndrome is due to an extra pathway in the heart that is made up of electrical muscle tissue. This tissue ...
... acute coronary syndromes: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency ...
Those with underlying coronary disease are at greater risk of cardiac effects from anaphylaxis.[17] The coronary spasm is ... "Acute symptoms of drug hypersensitivity (urticaria, angioedema, anaphylaxis, anaphylactic shock)" (PDF). The Medical Clinics ... Allergic reaction, angioedema, asthma exacerbation, carcinoid syndrome[2]. Treatment. Epinephrine, intravenous fluids[1]. ... Coronary artery spasm may occur with subsequent myocardial infarction, dysrhythmia, or cardiac arrest.[3][14] ...
Gilbert's syndrome and Crigler-Najjar syndrome have defects in the UDP-glucuronyl-transferase enzyme, affecting bilirubin ... In acute appendicitis, total bilirubin can rise from 20.52 μmol/L to 143 μmol/L. In pregnant women, the total bilirubin level ... T and I and creatine kinase-MB as markers of myocardial injury and predictors of outcome following percutaneous coronary ... In hyperemesis gravidarum, GGT level value can reach 45 IU/L, 17 IU/L in pre-eclampsia, and 35 IU/L in HELPP syndrome.[7] ...
... acute eosinophilic leukemia have a propensity for developing bronchospasm as well as symptoms of the acute coronary syndrome ... Acute eosinophilic leukemia (AEL) is a rare subtype of acute myeloid leukemia with 50 to 80 percent of eosinophilic cells in ... "Acute Myeloid Leukemia (AML) Subtypes and Prognostic Factors". www.cancer.org. Retrieved 2022-02-03.. ... It can arise de novo or may develop in patients having the chronic form of a hypereosinophilic syndrome. Patients with ...
Acute coronary syndrome *Myocardial infarction. *Unstable angina. Sequelae. *hours *Hibernating myocardium. *Myocardial ... This syndrome, which may also referred to as His bundle tachycardia, is resistant to therapy and can be difficult to treat.[3][ ... Junctional ectopic tachycardia (JET) is a rare syndrome of the heart that manifests in patients recovering from heart surgery.[ ... a rough triangle with points at the coronary sinus, the tendon of Todaro, and the tricuspid valve).[4] ...
"Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation" (PDF). ... Reye's syndromeEdit. 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 ...
2003). "Effects of aspirin dose when used alone or in combination with clopidogrel in patients with acute coronary syndromes: ... "Symptom presentation of women with acute coronary syndromes: myth vs reality". Arch. Intern. Med. 167 (22): 2405-13. doi: ... acute coronary syndrome)[17]. நெஞ்சு வலி வெவ்வேறு சந்தர்ப்பங்களில் தோன்றலாம், எனவே நெஞ்சு வலியினை உருவாக்கும் பிற பெருங்கேடுகள் ... www.heart.org/HEARTORG/Conditions/HeartAttack/AboutHeartAttacks/Acute-Coronary-Syndrome_UCM_428752_Article.jsp#.T1HskxzCqYk. ...
Other acute and subacute forms of ischemic heart disease 411.0 Postmyocardial infarction syndrome 411.1 Intermediate coronary ... acute, inferoposterior 410.4 MI, acute, other inferior wall, NOS 410.5 MI, acute, other lateral wall 410.6 MI, acute, true ... benign 410 Acute myocardial infarction 410.0 MI, acute, anterolateral 410.1 MI, acute, anterior, NOS 410.2 MI, acute, ... acute, nonspecific 421 Acute and subacute endocarditis 421.0 Endocarditis, acute, bacterial 422 Acute myocarditis 422.9 Other ...
"Zecuity Approved by the FDA for the Acute Treatment of Migraine". nupathe.com. Archived from the original on 7 January 2016. ... Serious side effects may include serotonin syndrome, heart attacks, strokes, and seizures. With excessive medication overuse ... Events reported have included coronary artery vasospasm, transient myocardial ischemia, myocardial infarction, ventricular ... Clinical trial number NCT00724815 for "The Efficacy and Tolerability of NP101 Patch in the Treatment of Acute Migraine (NP101- ...
In Dubin-Johnson syndrome, impaired biliary excretion of bilirubin glucuronide is due to a mutation in the canalicular multiple ... Press, Dove (2018-03-07). "Acute bilirubin encephalopathy and its progression to kernicterus: cur - RRN". Research and Reports ... there were some studies that showed an inverse correlation between serum bilirubin level and prevalences of ischemic coronary ... Dubin-Johnson syndrome is associated with inability of the hepatocytes to secrete conjugated bilirubin after it has been formed ...
"Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high‐risk combination. A statement from the Acute ... "Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high-risk combination. A statement from the Acute ... "Acute coronary syndromes and acute heart failure: a diagnostic dilemma and high-risk combination. A statement from the Acute ... He is widely recognized for his scholarly contributions to the domains of acute coronary syndrome, left ventricular repair and ...
... starting at higher doses may cause an acute coronary syndrome or an abnormal heart rhythm. Hypothyroidism is common among ... Acute overdose may cause fever, hypoglycemia, heart failure, coma, and unrecognized adrenal insufficiency. Acute massive ... Levothyroxine absorption is increased by fasting and decreased in certain malabsorption syndromes, by certain foods, and with ... people with acute myocardial infarction, and people with thyrotoxicosis of any etiology. Levothyroxine is also contraindicated ...
... may be used to treat coronary artery disease. These heart problems may sometimes lead to ischemia, a condition where ... This, in summary, shows that meldonium given in acute doses could be beneficial for the treatment of seizures and alcohol ... It is also used in cases of cerebral ischemia, ocular ischemic syndrome and other ocular disease caused by disturbed arterial ... Zvejniece, L; Svalbe, B; Makrecka, M; Liepinsh, E; Kalvinsh, I; Dambrova, M (2010). "Mildronate exerts acute anticonvulsant and ...
... such as diverticulitis and acute coronary syndrome. Diagnosis of late-stage Lyme disease is often complicated by a multifaceted ... Garin-Bujadoux syndrome, Bannwarth syndrome, Afzelius's disease, Montauk Knee or sheep tick fever. Since 1976 the disease is ... In this syndrome, radicular pain tends to start in the same body region as the initial erythema migrans rash, if there was one ... The full syndrome now known as Lyme disease was not recognized until a cluster of cases originally thought to be juvenile ...
H-FABP is recommended to be measured with troponin to identify myocardial infarction and acute coronary syndrome in patients ... "Heart-type fatty acid-binding protein predicts long-term mortality after acute coronary syndrome and identifies high-risk ... protein predicts long-term mortality and re-infarction in consecutive patients with suspected acute coronary syndrome who are ... H-FABP has been proven to significantly predict 30-day mortality in acute pulmonary embolism. H-FABP is more effective than ...
Ischemic heart diseases Angina pectoris Acute coronary syndrome Acute myocardial infarction See also Category:Valvular heart ... Angina Acute coronary syndrome Anomic aphasia Aortic dissection Aortic regurgitation Aortic stenosis Apoplexy Apraxia ... Lenegre-Lev syndrome) Long QT syndrome Lown-Ganong-Levine syndrome Multifocal atrial tachycardia Wolff-Parkinson-White syndrome ... Andersen syndrome, Long QT syndrome 7; Periodic paralysis, potassium-sensitive cardiodysrhythmic type) Ashman phenomenon ( ...
Any episode of acute psychosis that accompanies cannabis use usually abates after six hours, but in rare instances, heavy users ... Chocron, Yaniv; Zuber, Jean-Philippe; Vaucher, Julien (2019). "Cannabinoid hyperemesis syndrome". BMJ. 366: l4336. doi:10.1136/ ... particularly those with some degree of coronary artery or cerebrovascular disease, poses greater risks due to the resulting ... Acute effects while under the influence can sometimes include euphoria. Although some assert that cannabidiol (CBD), another ...
Acute coronary syndromes: ST elevation MI (STEMI), non-ST Elevation MI (NSTEMI), and unstable angina Evaluation of coronary ... Coronary angiography is a diagnostic procedure that allows visualization of the coronary vessels. Fluoroscopy is used to ... A common example of cardiac catheterization is coronary catheterization that involves catheterization of the coronary arteries ... where it can be maneuvered into the coronary arteries through the coronary ostia. In this position, the interventional ...
Acute Renal Failure: Several reports have detailed rhabdomyolysis (rapid skeletal muscle breakdown) leading to acute kidney ... Multiple organ dysfunction syndrome (MODS): Caused by an elevated inflammatory response, multiple organ dysfunction is a severe ... Norepinephrine (a catecholamine) is hypothesized to result in damaged cardiac tissue by inhibiting coronary blood flow and ... Furthermore, if an acute adrenal hemorrhage is suspected in a pheochromocytoma patient, ultrasound is a quick, painless, ...
described the case of a woman with severe coronary heart disease. One week after undergoing coronary artery bypass grafting, ... Actually, when AHS originates from focal injury of acute onset, recovery usually occurs within a year. One theory is that ... Alien hand syndrome (AHS) or Dr. Strangelove syndrome is a category of conditions in which a person experiences their limbs ... Apraxia and Related Syndromes at eMedicine Kischka, U; Ettlin, TM; Lichtenstern, L; Riedo, C (1996). "Alien hand syndrome of ...
Premature aging syndromes including Werner syndrome, Progeria, Ataxia telangiectasia, Ataxia-telangiectasia like disorder, ... "Dynamics of telomerase activity in response to acute psychological stress". Brain, Behavior, and Immunity. 24 (4): 531-9. doi: ... they report that their emotional stress is at a maximum and that telomerase was active at the site of blockages in coronary ... Bloom syndrome, Fanconi anemia and Nijmegen breakage syndrome are associated with short telomeres. However, the genes that have ...
... caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was confirmed to have reached Turkey on 11 ... Reported mortality from coronary heart disease (CHD) amongst Turkish women is the highest in Europe. Despite the public health ... "Istanbul Journal; 'Natasha Syndrome' Brings On a Fever in Turkey". New York Times. 17 April 1993. Retrieved 1 March 2019. ...
Some of the CT derived plaque characteristics can help predict for acute coronary syndrome. In addition, because these lesions ... quantification of coronary artery disease using cardiac CT-angiography to predict for future acute coronary syndrome". J Am ... "Frequency of Cholesterol Crystals in Culprit Coronary Artery Aspirate During Acute Myocardial Infarction and Their Relation to ... While a single ruptured plaque can be identified during autopsy as the cause of a coronary event, there is currently no way to ...
Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from those for ST-segment elevation ... encoded search term (Acute Coronary Syndrome) and Acute Coronary Syndrome What to Read Next on Medscape ... for the Acute Coronary Syndrome Chapter Collaborators. Part 5: Acute coronary syndromes: 2015 international consensus on ... Fast Five Quiz: Atrial Fibrillation and Acute Coronary Syndrome * Fast Five Quiz: Test Your Knowledge of Acute Coronary ...
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: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, ... 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: a report of the American ...
Improving outcomes for acute coronary syndrome in the Russian Federation: an example of regionalization of services for ... In-hospital complications and 1-year outcome of acute coronary syndrome in patients with hypertension: findings from the 2nd ... Within the framework of the Federal Cardiovascular Programme, services for acute coronary syndrome (‎ACS)‎ were transformed ... in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome [‎ACS]‎ in patients with ...
Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from those for ST-segment elevation ... encoded search term (Acute Coronary Syndrome) and Acute Coronary Syndrome What to Read Next on Medscape ... for the Acute Coronary Syndrome Chapter Collaborators. Part 5: Acute coronary syndromes: 2015 international consensus on ... Fast Five Quiz: Atrial Fibrillation and Acute Coronary Syndrome * Fast Five Quiz: Test Your Knowledge of Acute Coronary ...
Improving outcomes for acute coronary syndrome in the Russian Federation: an example of regionalization of services for ... In-hospital complications and 1-year outcome of acute coronary syndrome in patients with hypertension: findings from the 2nd ... Within the framework of the Federal Cardiovascular Programme, services for acute coronary syndrome (‎ACS)‎ were transformed ... in 2008-09 we investigated the in-hospital complications and 1-year outcome of acute coronary syndrome [‎ACS]‎ in patients with ...
Laws and regulations prohibiting smoking in public areas and workplaces can reduce rates of acute myocardial infarction. ... Secondhand smoke is a risk factor for coronary heart disease. ... Table 1. Change in Rate of Acute Coronary Syndrome Hospital ... We obtained hospital admission data for acute coronary syndrome (ACS) and acute myocardial infarction from all acute care ... Figure 1. Age-adjusted rates of hospital admissions for acute coronary syndrome, by sex, 2000-2008. Data were obtained from the ...
Acute coronary syndrome among patients with chest pain: prevalence, incidence and risk factors. Int J Cardiol. 2016 Jul 1;214: ... Keywords: acute coronary syndrome, clinical trial, predictive factors, smoking cessation, Tunisia. Citation: Abroug H; El ... Rocha V, Guerra M, Lemos M, Maciel J, Williams G. Motivation to quit smoking after acute coronary syndrome. Acta Med Port. 2017 ... Aims: To assess smoking cessation rates at 24 weeks among patients with acute coronary syndrome. Group A had begun nicotine ...
Prehospital misdiagnosis of acute cerebral disease for acute coronary syndrome: a retrospective study.. ... Prehospital misdiagnosis of acute cerebral disease for acute coronary syndrome: a retrospective study. ... Prehospital misdiagnosis of acute cerebral disease for acute coronary syndrome: a retrospective study. ... In cerebrovascular accidents symptoms, laboratory results and electrocardiogram (ECG) changes can mimic acute coronary syndrome ...
... N Engl J Med. 2013 May 23;368(21):2004-13. doi: ...
Platelets play a central role in the pathogenesis of acute coronary syndromes (ACS) and high MPV has been associated to more ... Platelet Indices in Patients with Acute Coronary Syndrome () Silvia Cristina Costa1, Carmen Guilherme de Matos Vinagre1,2, Ana ... Platelets play a central role in the pathogenesis of acute coronary syndromes (ACS) and high MPV has been associated to more ... Costa, S. , Vinagre, C. , Chacra, A. and Azevedo, M. (2015) Platelet Indices in Patients with Acute Coronary Syndrome. Journal ...
... acute coronary syndrome or those with a provisional diagnosis of acute coronary syndrome and one or more of previous coronary ... Conclusions In intermediate risk patients with acute chest pain and suspected acute coronary syndrome, early CT coronary ... to the emergency department with suspected acute coronary syndrome or with a provisional diagnosis of acute coronary syndrome. ... population of patients with suspected acute coronary syndrome or those with a provisional diagnosis of acute coronary syndrome ...
... recovery and follow-up care for Acute coronary syndrome. ... Learn about Acute coronary syndrome, find a doctor, ... Acute coronary syndrome. Heart attack - ACS; Myocardial infarction - ACS; MI - ACS; Acute MI - ACS; ST elevation myocardial ... Heart attack and unstable angina are both acute coronary syndromes (ACS).. Causes. A fatty substance called plaque can build up ... Acute coronary syndrome is a term for a group of conditions that suddenly stop or severely reduce blood from flowing to the ...
Official ACEP 2006 NSTEMI guideline summary for evaluation and management of patients suffering from non-ST elevation acute ... In adult patients with suspected acute non-ST-elevation acute coronary syndrome who are determined to be low risk based on ... In adult patients with suspected acute non-ST-elevation acute coronary syndrome, conventional troponin testing at 0 and 3 hours ... Non-ST Elevation Acute Coronary Syndromes. (beta). Official guideline from the American College of Emergency Physicians. ...
Acute Coronary Syndrome Acute coronary syndrome refers to a category of emergency heart conditions in which the blood supply to ...
Risk of Acute Coronary Syndrome dramatically increases after mRNA jabs, new Study finds. ... Read More: Risk of Acute Coronary Syndrome dramatically increases after mRNA Covid Injections, a new Study finds ... to a study presented at the American Heart Association Scientific Sessions 2021 the risk of developing acute coronary syndrome ...
Development of Rapid Diagnostic Algorithms for Acute Coronary Syndromes (4-minute video). Dr. Rick Body, Professor of Emergency ... for acute coronary syndromes, and how it is helping to reduce unnecessary hospitalization of low-risk patients. Hear how high- ...
... is known as the most effective treatment for acute coronary syndrome (ACS). However, without proper therapy and patient ...
Acute Coronary Syndrome. Syndrome. Disease. Pathologic Processes. Myocardial Ischemia. Heart Diseases. Cardiovascular Diseases ... Finding Acute Coronary Syndromes (ACS) With Serial Troponin Testing for Rapid Assessment of Cardiac Ischemic Symptoms (FAST- ... Acute Coronary Syndromes. Non ST-Segment Elevation Myocardial Infarction. ST-Segment Elevation Myocardial Infarction. Unstable ... The subject must present to the Emergency Department with symptoms consistent with acute coronary syndromes (e.g., chest ...
Detail symptoms of acute coronary Syndrome ACS Angina Nono Q Wave MI and Myocardial infarction ... Acute Coronary Syndrome Symptoms. Detail symptoms of acute coronary Syndrome ACS Angina Nono Q Wave MI and Myocardial ... High Blood Pressure Symptoms , Causes , Diet , Treatment , Heart Diseases , Acute Coronary Syndrome Symptoms ... o Thought to be due to coronary vasospasm. * Elderly persons and those with diabetes may have particularly subtle presentations ...
Prasugrel for the treatment of acute coronary syndromes with percutaneous coronary intervention: NICE technology appraisal ... Prasugrel for the treatment of acute coronary syndromes with percutaneous coronary intervention: NICE technology appraisal ... Prasugrel for the treatment of acute coronary syndromes with percutaneous coronary intervention: NICE technology appraisal ...
... which is the main symptom of acute coronary syndrome. Other symptoms of acute coronary syndrome include shortness of breath, ... If you have acute coronary syndrome, blood flow through your coronary arteries is severely reduced or completely blocked. One ... If youve had a heart attack or have other types of acute coronary syndrome, your doctor may prescribe oxygen therapy to get ... MEDICAL ANIMATION TRANSCRIPT: If you have acute coronary syndrome, you have one or more conditions caused by a blockage of ...
Which heparin should a patient use for acute coronary syndrome? ... Which heparin should a patient use for acute coronary syndrome? ... Clinical Twisters: Choosing a heparin for acute coronary syndrome. .social-ris-container { display: flex; justify-content: ...
Home Cardiology Sleep disturbance after acute coronary syndrome: A longitudinal study over 12 months ... Sleep disturbance after acute coronary syndrome: A longitudinal study over 12 months. By ... BACKGROUND: Sleep disturbance has been associated with poor prognosis in patients with acute coronary syndrome (ACS). This ... with ACS admitted to a tertiary hospital to undergo acute coronary intervention. Sleep disturbance was interviewer-assessed at ...
Ticagrelor Compared to Clopidogrel in Acute Coronary Syndrome and Stable Coronary Artery Disease Does not reduce heart attacks ... Study Population: Patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) ... clopidogrel in Japanese, Korean and Taiwanese patients with acute coronary syndrome -- randomized, double-blind, phase III ... non-ST-elevation acute coronary syndrome and ST-elevation myocardial infarction and patients who undergo percutaneous coronary ...
Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS ... Prehospital aspirin administration for acute coronary syndrome (ACS) in the USA: an EMS quality assessment using the NEMSIS ... Introduction National practice guidelines recommend early aspirin administration to reduce mortality in acute coronary syndrome ...
Reducing patient delay with symptoms of acute coronary syndrome: a research protocol for a systematic review of previous ... Reducing patient delay with symptoms of acute coronary syndrome: a research protocol for a systematic review of previous ... INTRODUCTION: Delay to presentation with symptoms of acute coronary syndrome (ACS) is common meaning many fail to achieve ... Development of Interventions to reduce patient delay with symptoms of Acute Coronary Syndrome: identifying optimal content and ...
Acute Coronary Syndrome, Fasting blood sugar, Admission plasma sugar, Oral glucose tolerance test, Glycated haemoglobin, ... Admission hyperglycemia adversely influences the outcome of acute coronary syndrome patients. The study was conducted to ... Conclusion: Admission hyperglycaemia does not diagnose diabetes reliably in a stressful condition like acute coronary syndrome ... Comparison of Diagnostic Criteria to Detect Undiagnosed Diabetes in Acute Coronary Syndrome Patients with Admission ...
Acute Coronary Syndromes Cardiology Genetics and Genomics Health Disparities Nephrology Oncology Percutaneous Coronary ...
... the first examination of the latent structure of PTSD symptoms after suspected ACS in 399 adults in the REactions to Acute Care ... and some have suggested that PTSD triggered by acute coronary syndrome (ACS) may differ from PTSD due to prototypical traumas. ... Dimensional structure and correlates of posttraumatic stress symptoms following suspected acute coronary syndrome. Sumner, ... and some have suggested that PTSD triggered by acute coronary syndrome (ACS) may differ from PTSD due to prototypical traumas. ...
  • Acute coronary syndrome (ACS) refers to a spectrum of clinical presentations ranging from those for ST-segment elevation myocardial infarction (STEMI) to presentations found in non-ST-segment elevation myocardial infarction (NSTEMI) or in unstable angina. (medscape.com)
  • Laws and regulations prohibiting smoking in public areas and workplaces can reduce rates of acute myocardial infarction. (cdc.gov)
  • We obtained hospital admission data for acute coronary syndrome (ACS) and acute myocardial infarction from all acute care hospitals serving Kanawha County, West Virginia, for 2000 through 2008. (cdc.gov)
  • Platelets play a central role in the pathogenesis of acute coronary syndromes (ACS) and high MPV has been associated to more reactive platelets and regarded as an independent risk factor for myocardial infarction. (scirp.org)
  • Khode, V., Sindhur, J., Kanbur, D., Ruikar, K. and Nallulwar, S. (2012) Mean Platelet Volume and Other Platelet Volume Indices in Patients with Stable Coronary Artery Disease and Acute Myocardial Infarction: A Case Control Study. (scirp.org)
  • In adult patients without evidence of ST-elevation acute coronary syndrome, other risk-stratification tools, such as Thrombolysis in Myocardial Infarction ( TIMI ), can be used to predict a rate of 30-day major adverse cardiac event. (mdcalc.com)
  • Do not routinely use further diagnostic testing (coronary computed tomography [CT] angiography, stress testing, myocardial perfusion imaging) prior to discharge in low-risk patients in whom acute myocardial infarction has been ruled out to reduce 30-day major adverse cardiac events. (mdcalc.com)
  • For patients presenting with clinical suspicion of Acute Coronary Syndromes (ACS), high sensitivity-cardiac Troponin I (hs-cTnI) provides improved diagnostic accuracy for ACS (including Acute Myocardial Infarction (AMI) and/or Unstable Angina (UA)) within the first two (2) hours after emergency department presentation when compared to currently available troponin assays. (clinicaltrials.gov)
  • MI is caused by rupture of an atherosclerotic plaque in a coronary artery, leading to platelet aggregation and thrombus formation to an extent that oxygenation of the myocardial tissue is completely interrupted (i.e., total occlusion), with the occurrence of some degree of myocardial necrosis. (clinicaltrials.gov)
  • The 2016 ACC/AHA Guideline "Focused Update on Duration of Dual Antiplatelet Therapy in Patients With Coronary Artery Disease," makes a class IIa recommendation that ticagrelor is preferential to clopidogrel for both non-ST-elevation acute coronary syndrome and ST-elevation myocardial infarction and patients who undergo percutaneous coronary intervention. (thennt.com)
  • The PRECISE-DAPT, PARIS, and DAPT (bleeding component) risk scores were applied in the TRILOGY ACS population to evaluate their performance to predict adjudicated non-coronary artery bypass grafting-related GUSTO (Global Use of Strategies to Open Occluded Coronary Arteries) severe/life-threatening/moderate and TIMI (Thrombolysis in Myocardial Infarction) major/minor bleeding with time-dependent c-indices. (duke.edu)
  • Acute coronary syndrome (ACS) is a clinical entity that is characterized by the rupture of a vulnerable atheromatous plaque existing in a coronary vessel, accompanied by the formation of an intracoronary thrombus triggered by the processes of platelet aggregation, activation of the coagulation cascade, and thrombosis, all of which result in different degrees of myocardial ischemia. (anejo.eu)
  • Due to the obstruction of coronary flow and the decrease in oxygen supply, the onset of unstable angina or acute myocardial infarction can be observed. (anejo.eu)
  • Patients were divided into three groups based on final diagnosis of acute myocardial infarction or unstable angina and all others with noncardiac chest pain. (cdc.gov)
  • There were no differences in time to ECG for women compared with men with acute myocardial infarction or unstable angina, but women received an ECG significantly slower than men for noncardiac chest pain. (cdc.gov)
  • Was the death specific clinical conditions (i.e. acute myocardial infarction, coronary of this patient expected? (who.int)
  • 2] A prediction model that and transparency of such risk adjustment models, and to widen uses a `history of coronary heart disease' as a risk factor to predict discussion on the strengths and limitations of risk adjustment models death from an acute myocardial infarction (AMI) is always going based on service claims data. (who.int)
  • History of coronary heart disease (a condition caused by narrowing of the arteries that supply blood to the heart) included a reported history of coronary heart disease, myocardial infarction, or angina pectoris. (cdc.gov)
  • For instance, lipid profiles are well acknowledged to be associated with the risk of coronary artery disease (CAD) and myocardial infarction (MI) [ 1 ]. (biomedcentral.com)
  • Tako-tsubo-like left ventricular dysfunction': a clinical entity mimicking acute myocardial infarction with a favorable prognosis. (stanfordhealthcare.org)
  • Acute hypoxia causes an increase in heart rate, myocardial contractility, and cardiac output. (marinemedicalsociety.in)
  • Optional ACS mode provides higher sensitivity 12SL analysis for the detection of acute coronary syndrome in patients suspected of acute myocardial infarction or ischemia. (georgiananesthesia.com)
  • Atherosclerotic cardiovascular disease (ASCVD) involves the buildup of cholesterol plaque in arteries and includes acute coronary syndrome, peripheral arterial disease, and events such as myocardial infarction and stroke. (kingfisherbeerusa.com)
  • Yang, A., Pizulli, L. and Lüderitz, B. (2006) Mean Platelet Volume as Marker of Restenosis after Percutaneous Transluminal Coronary Angioplasty in Patients with Stable and Unstable Angina Pectoris. (scirp.org)
  • Guan W, Lu H, Yang K. Choosing between ticagrelor and clopidogrel following percutaneous coronary intervention: A systematic review and Meta-Analysis (2007-2017). (thennt.com)
  • Dual antiplatelet therapy with compared to aspirin alone after percutaneous coronary intervention modestly reduces nonfatal events like heart attack and stroke. (thennt.com)
  • The systematic review summarized here 3 included 11 trials and 5 observational studies that in aggregate enrolled 25,805 subjects with acute coronary syndrome undergoing percutaneous coronary intervention as well as those with stable CAD. (thennt.com)
  • Angioplasty (almost always with stenting), also called percutaneous coronary intervention (PCI), is a procedure that should be performed within 90 minutes of arriving at the hospital. (adam.com)
  • BACKGROUND: Longitudinal bleeding risk scores have been validated in patients treated with dual antiplatelet therapy (DAPT) following percutaneous coronary intervention. (duke.edu)
  • CONCLUSIONS: Among medically managed patients with ACS treated with DAPT, the performances of the PRECISE-DAPT, PARIS, and DAPT (bleeding component) scores were reasonable and similar to their performances in the derivation percutaneous coronary intervention populations. (duke.edu)
  • Trans-radial approach versus trans-femoral approach in patients with acute coronary syndrome undergoing percutaneous coronary intervention: An updated meta-analysis of randomized controlled trials. (bvsalud.org)
  • Trans-radial approach (TRA) is recommended over trans-femoral approach (TFA) in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). (bvsalud.org)
  • Figure 4: Successful percutaneous coronary intervention for chronic total occlusion is associated with reduced angina frequency. (nature.com)
  • Annual operator volume among patients treated using percutaneous coronary interventions with rotational atherectomy and procedural outcomes : analysis based on a large national registry. (krakow.pl)
  • Clinical outcomes in patients undergoing complex, high-risk percutaneous coronary intervention and haemodynamic support with intra-aortic balloon versus Impella pump : real-life single-centre preliminary results. (krakow.pl)
  • Comparison of safety and effectiveness between the right and left radial artery approach in percutaneous coronary intervention. (krakow.pl)
  • Coronary CT angiography (CCTA) may be an option in those with a low-to-modest clinical likelihood of unstable angina as a normal scan excludes coronary artery disease (CAD): It has a high negative predictive value (NPV) to rule out ACS (by excluding CAD) and a positive outcome in patients presenting to the emergency department with a low-to-intermediate pretest probability for ACS and a normal CCTA. (medscape.com)
  • Coronary angiography may be done right away or when you are more stable. (medlineplus.gov)
  • Objectives To establish if the use of early computed tomography (CT) coronary angiography improves one year clinical outcomes in patients presenting to the emergency department with acute chest pain and at intermediate risk of acute coronary syndrome and subsequent clinical events. (bmj.com)
  • Interventions Early CT coronary angiography and standard of care compared with standard of care only. (bmj.com)
  • Results Between 23 March 2015 and 27 June 2019, 1748 participants (mean age 62 years (standard deviation 13), 64% men, mean global registry of acute coronary events (GRACE) score 115 (standard deviation 35)) were randomised to receive early CT coronary angiography (n=877) or standard of care only (n=871). (bmj.com)
  • Median time from randomisation to CT coronary angiography was 4.2 (interquartile range 1.6-21.6) hours. (bmj.com)
  • The primary endpoint occurred in 51 (5.8%) participants randomised to CT coronary angiography and 53 (6.1%) participants who received standard of care only (adjusted hazard ratio 0.91 (95% confidence interval 0.62 to 1.35), P=0.65). (bmj.com)
  • Invasive coronary angiography was performed in 474 (54.0%) participants randomised to CT coronary angiography and 530 (60.8%) participants who received standard of care only (adjusted hazard ratio 0.81 (0.72 to 0.92), P=0.001). (bmj.com)
  • Early CT coronary angiography was associated with a slightly longer time in hospital (median increase 0.21 (95% confidence interval 0.05 to 0.40) days from a median hospital stay of 2.0 to 2.2 days). (bmj.com)
  • Conclusions In intermediate risk patients with acute chest pain and suspected acute coronary syndrome, early CT coronary angiography did not alter overall coronary therapeutic interventions or one year clinical outcomes, but reduced rates of invasive angiography while modestly increasing length of hospital stay. (bmj.com)
  • These findings do not support the routine use of early CT coronary angiography in intermediate risk patients with acute chest pain and suspected acute coronary syndrome. (bmj.com)
  • A coronary angiography test can show your doctor how well blood is moving through your heart. (mountsinai.org)
  • Methods: A prospective study was conducted in patients ≥55 years old undergoing coronary angiography for an acute coronary syndrome. (elsevier.com)
  • In adult patients without evidence of ST-elevation acute coronary syndrome, the History, electrocardiogram [ECG], Age, Risk factors, Troponin ( HEART ) score can be used as a clinical prediction instrument for risk stratification. (mdcalc.com)
  • Clinical Policy: Critical Issues in the Evaluation and Management of Adult Patients with Non-ST-segment Elevation Acute Coronary Syndromes. (mdcalc.com)
  • The MEDIMACS project is an academically funded, prospective, randomized, controlled and mechanistic clinical trial designed to address the effects of an active randomized intervention with the Mediterranean diet on atherosclerotic plaque vulnerability, coronary endothelial dysfunction and other mechanistic endpoints. (biomedcentral.com)
  • Clinical predictors of future ischemic events in patients with acute coronary syndrome (ACS) are also risk factors for bleeding, with patients often at high-risk of both outcomes. (elsevier.com)
  • Increases in CRP concentration are non-specific and should be used in conjunction with traditional clinical laboratory evaluation of acute coronary syndromes. (cdc.gov)
  • includes background demographic and clinical information of the acute episode of COVID-19. (who.int)
  • A hard substance called plaque can build up in the walls of your coronary arteries. (mountsinai.org)
  • If blood moves slowly, or not at all through your coronary arteries, you have either a narrowed, or blocked artery. (mountsinai.org)
  • Connected to your aorta are small arteries called coronary arteries. (smartimagebase.com)
  • Blood flows from your aorta, through the coronary arteries, to supply your heart muscle with oxygen and nutrients. (smartimagebase.com)
  • If you have acute coronary syndrome, blood flow through your coronary arteries is severely reduced or completely blocked. (smartimagebase.com)
  • In this condition, a build-up of a fatty substance called plaque can narrow your coronary arteries. (smartimagebase.com)
  • During a coronary artery dissection, the inside wall of one of your coronary arteries separates, which can block blood flow. (smartimagebase.com)
  • Drugs such as nitroglycerin and morphine will relax your coronary arteries and relieve the pain of angina. (smartimagebase.com)
  • CABG is a surgical procedure in which the blocked areas of the coronary arteries are bypassed with veins or artificial graft material. (smartimagebase.com)
  • To perform this strenuous task, the heart muscle itself needs a plentiful supply of oxygen-rich blood, provided through a network of coronary arteries. (adam.com)
  • Most heart attacks are caused by a blood clot that blocks one of the coronary arteries. (stlukes-stl.com)
  • The coronary arteries bring blood and oxygen to the heart. (stlukes-stl.com)
  • 16 STEMI and 12 NSTEMI, and 25 patients with stable coronary artery disease (CAD). (krakow.pl)
  • Secondhand smoke is a risk factor for coronary heart disease. (cdc.gov)
  • Subsequently, other diseases and adverse effects of secondhand smoke were established, including increased risk for coronary heart disease (CHD) (2). (cdc.gov)
  • Smoking is the main preventable cause of morbidity and premature death worldwide (1) and is a major and independent risk factor for coronary heart disease (CHD) (2). (who.int)
  • Prehospital misdiagnosis of acute cerebral disease for acute coronary syndrome: a retrospective study. (iasp-pain.org)
  • Participants Adults with suspected or a provisional diagnosis of acute coronary syndrome and one or more of previous coronary heart disease, raised levels of cardiac troponin, or abnormal electrocardiogram. (bmj.com)
  • Diabetes mellitus is one of the most important risk factors of coronary artery disease. (banglajol.info)
  • HIV-positive patients are increasingly being affected by non-communicable diseases such as coronary artery disease (CAD). (biomedcentral.com)
  • Antiretroviral therapy (ART) treated HIV-positive patients are experiencing fewer HIV-related opportunistic infections and are increasingly being affected by the same age-associated spectrum of atherosclerotic disease, including coronary artery disease (CAD), as the general population [ 2 ]. (biomedcentral.com)
  • MAIN OUTCOMES AND MEASURES: The primary end point (major coronary events)was the composite of coronary heart disease (CHD) death, MI, or urgent coronary revascularization formyocardial ischemia. (eur.nl)
  • Atherosclerosis causes coronary artery disease (CAD), the most prevalent non-communicable disease in Western countries. (biomedcentral.com)
  • Among adults at low risk, prevalence of coronary heart disease is low, and cardiac screening is of low predictive value. (medscape.com)
  • Background: Epidemiological studies have shown a higher risk of cardiovascular mortality associated with early menopause, but the relation between menopausal age and extent of coronary artery disease after menopause is unknown. (elsevier.com)
  • We assessed the relation between menopausal age and extent of coronary disease in postmenopausal women with an acute coronary syndrome. (elsevier.com)
  • Both acute and long-term exposure to elevated levels of ozone in air are associated with negative health effects ranging from increased morbidity and mortality due to respiratory and cardiovascular disease (Crouse et al. (cdc.gov)
  • A growing number of patients, particularly those with advanced, chronic coronary artery disease, experience symptoms of angina that are refractory to treatment with β-blockers, calcium-channel blockers, and long-acting nitrates, despite revascularization. (nature.com)
  • In the United States, lipoprotein apheresis is potentially covered and can be considered for Lp(a) reduction among people with LDL≥100 mg/dL, Lp(a)≥60 mg/dL, and coronary or peripheral artery disease. (cdc.gov)
  • The prevalences of awareness of all five common heart attack symptoms, as well as the appropriate response when recognizing a heart attack (unadjusted and adjusted for age, sex, race/ethnicity, level of education, history of coronary heart disease, and number of CVD risk factors) were estimated overall and by selected demographic characteristics and CVD risk factors in 2008, 2014, and 2017. (cdc.gov)
  • Recent randomized controlled trials have challenged the concept that increased high density lipoprotein cholesterol (HDL-C) levels are associated with coronary artery disease (CAD) risk reduction. (biomedcentral.com)
  • Coronary artery disease (CAD) is one of the leading causes of death worldwide. (who.int)
  • The aim of this study was to explore the association between hepatitis C viral infection and coronary artery disease. (who.int)
  • A consecutive sample of 50 patients with abnormal angiographic findings was matched with another 50 consecutive patients with normal angiographic findings regarding age, sex, and major risk factors for coronary artery disease (diabetes mellitus, hypertension and smoking). (who.int)
  • The possible association between HCV positivity and extension of coronary artery disease may refer to the role of HCV in coronary artery disease pathology. (who.int)
  • El Amroosy M. Association between coronary artery disease and hepatitis C virus seropositivity. (who.int)
  • Objective: to assess the prevalence of pharmacological adherence in patients with coronary artery disease and to identify factors associated with adherence. (bvsalud.org)
  • Method: a crosssectional, correlational study, including 198 patients with a previous diagnosis of coronary artery disease. (bvsalud.org)
  • We are suspending all but the most urgent and emergent cardiac interventions, including surgery for coronary artery and valvular heart disease. (nwcdonline.com)
  • Heart attack and unstable angina are both acute coronary syndromes (ACS). (medlineplus.gov)
  • Acute coronary syndrome refers to a category of emergency heart conditions in which the blood supply to the heart muscle becomes suddenly obstructed - as occurs in a heart attack or when a blood clot causes chest pain called "unstable angina. (adventhealth.com)
  • If you have angina when you're at rest, or frequent angina that prevents even moderate physical activity, you have unstable angina, which is the main symptom of acute coronary syndrome. (smartimagebase.com)
  • This guideline covers the early and longer-term (rehabilitation) management of acute coronary syndromes. (bvsalud.org)
  • Long-Term Bleeding Risk Prediction with Dual Antiplatelet Therapy After Acute Coronary Syndromes Treated Without Revascularization. (duke.edu)
  • Other symptoms of acute coronary syndrome include shortness of breath, dizziness, nausea, and sweating. (smartimagebase.com)
  • Seek treatment immediately if you have the symptoms of acute coronary syndrome. (smartimagebase.com)
  • Farquharson B, Dombrowski SU, Pollock A, Johnston M, Treweek S, Williams B, Smith K, Dougall N, Jones C & Pringle S (2014) Reducing patient delay with symptoms of acute coronary syndrome: a research protocol for a systematic review of previous interventions to investigate which behaviour change techniques are associated with effective interventions. (stir.ac.uk)
  • INTRODUCTION: Delay to presentation with symptoms of acute coronary syndrome (ACS) is common meaning many fail to achieve optimal benefit from treatments. (stir.ac.uk)
  • [ 1 , 104 ] The updates place increased reliance on high-sensitivity cardiac troponin testing (hs-cTn) for diagnosis, embrace coronary computed tomography (CT) imaging to rule out lower-risk patients, as well as highlight the need for personalized antiplatelet regimens, systems of care, and quality improvement. (medscape.com)
  • In late August 2020, the European Society of Cardiology (ESC) released their updated guidelines for the diagnosis and management of non ST-elevation (NSTE) acute coronary syndrome (ACS). (medscape.com)
  • In adult patients with suspected acute non-ST-elevation acute coronary syndrome, conventional troponin testing at 0 and 3 hours among low-risk acute coronary syndrome patients (defined by HEART score 0 to 3) can predict an acceptable low rate of 30-day major adverse cardiac events. (mdcalc.com)
  • In adult patients with suspected acute non-ST-elevation acute coronary syndrome who are determined to be low risk based on validated accelerated diagnostic pathways that include a nonischemic electrocardiogram (ECG) result and negative serial high-sensitivity troponin testing results both at presentation and at 2 hours can predict a low rate of 30-day major adverse cardiac events allowing for an accelerated discharge pathway from the emergency department. (mdcalc.com)
  • Background: Little is known about the characteristics of patients who were admitted to the coronary care unit (CCU) in the 1990s with non-ST elevation acute coronary syndromes (ACS) compared with those admitted to medical and cardiology wards in hospitals in the United Kingdom (UK). (qub.ac.uk)
  • The prognostic value of troponin in patients with non-ST elevation acute coronary syndromes: a meta-analysis. (medscape.com)
  • Influence of comorbid conditions on one-year outcomes in non-ST-segment elevation acute coronary syndrome. (medscape.com)
  • 2014 AHA/ACC guideline for the management of patients with non-ST-elevation acute coronary syndromes: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. (dicardiology.com)
  • In cerebrovascular accidents symptoms, laboratory results and electrocardiogram (ECG) changes can mimic acute coronary syndrome (ACS) and is subsumed as neurogenic stunned myocardium. (iasp-pain.org)
  • To assess smoking cessation rates at 24 weeks among patients with acute coronary syndrome. (who.int)
  • Performance could be further improved by using summary risk prediction scores such as the EUROSCORE II for coronary artery bypass graft surgery or the GRACE risk score for acute coronary syndrome. (who.int)
  • Conclusions: The first screening test for acute coronary syndrome, the ECG, took longer to obtain for nonwhite patients, regardless of final diagnosis. (cdc.gov)
  • 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes. (nih.gov)
  • Few randomized controlled trials have examined the efficacy time of smoking cessation in hospitalized patients with acute coronary syndrome, either during hospitalization or after discharge. (who.int)
  • Pocock SJ et al.Predicting two-year mortality from discharge after acute coronary syndrome: An internationally-based risk score. (gpnotebook.com)
  • Methods An initial prospective audit of 37 acute coronary syndrome patients admitted to Leeds General Infirmary in January 2013 assessed inpatient up-titration of bisoprolol and ramipril, discharge advice and doses at 6 weeks after discharge. (bmj.com)
  • Following a collective multidisciplinary effort with education, posters and discharge advice templates, a re-audit of 34 acute coronary syndrome patients admitted from November to December 2014 assessed the impact of these interventions. (bmj.com)
  • Acute coronary syndrome patients are precluded from maximum mortality benefit due to suboptimal dosing after discharge. (bmj.com)
  • However, to support standardization and data comparability, it should preferably be completed 4 to 8 weeks and 6 months after hospital discharge from the acute ward or after acute il ness for individuals who have not been hospitalized. (who.int)
  • In case of persistent symptoms/signs after hospital discharge or after acute il ness, it is recommended to complete the CRF at 3-month intervals, for as long as needed, or at 6 months interval, if no symptoms persist (see figure below). (who.int)
  • Member of the European Society of Cardiology Working Group on Acute Cardiac Care. (amj.net.au)
  • This new updated edition of the textbook continues to comprehensively approach all the different issues relating to intensive and acute cardiovascular care and addresses all those involved in intensive and acute cardiac care, not only cardiologists but also critical care specialists, emergency physicians and healthcare professionals. (harperandharley.org)
  • METHODS: Study participants were 180 patients (mean age 59.6 years, 81.7% men) with ACS admitted to a tertiary hospital to undergo acute coronary intervention. (docwirenews.com)
  • Is my rate of heart failure readmissions artery bypass graft (CABG) surgery, pneumonia and acute stroke). (who.int)
  • Acute coronary syndromes (ACS), acute decompensated heart failure (ADHF), and serious arrhythmias form SECTIONS 6-8. (harperandharley.org)
  • they are prognostic factors and key elements of the Global Registry of Acute Coronary Events (GRACE) risk score (superior assessment to subjective physician assessment for the occurrence of death or MI). (medscape.com)
  • Last week, the Cardiology Advisor reported that according to a study presented at the American Heart Association Scientific Sessions 2021 the risk of developing acute coronary syndrome ("ACS") significantly increased in patients after receiving mRNA Covid injections. (davidicke.com)
  • Dr. Rick Body, Professor of Emergency Medicine at the University of Manchester and Honorary Consultant in Emergency Medicine at Manchester University NHS Foundation Trust, describes the development and implementation of a rapid diagnostic algorithm* for acute coronary syndromes, and how it is helping to reduce unnecessary hospitalization of low-risk patients. (siemens-healthineers.com)
  • This study will evaluate the ability of a high sensitivity cardiac troponin I (hs-cTnI) assay to detect and to rule-out high-risk ischemic cardiac injury in emergency room patients experiencing signs and symptoms consistent with acute coronary syndromes (ACS). (clinicaltrials.gov)
  • Data from high-income countries (HICs) indicate that HIV-positive patients have different risk-factor profiles for acute coronary syndrome (ACS) as well as different cardiac manifestations of this syndrome compared to HIV-negative patients. (biomedcentral.com)
  • CONCLUSIONS AND RELEVANCE: In patients who experienced an ACS event, direct inhibition of Lp-PLA2with darapladib added to optimal medical therapy and initiated within 30 days of hospitalization did not reduce the risk of major coronary events. (eur.nl)
  • The results of this trial will address the key effects of dietary habits on atherosclerotic risk and will provide initial data on the complex interplay of immunological, microbiome-, proteome- and metabolome-related mechanisms by which non-pharmacological factors may impact the progression of coronary atherosclerosis after an ACS. (biomedcentral.com)
  • Cardiac-specific troponin I levels to predict the risk of mortality in patients with acute coronary syndromes. (medscape.com)
  • IMSEAR at SEARO: Acute coronary syndromes: risk stratification. (who.int)
  • ObjectiveTo summarize data on the prevalence/incidence, risk factors and prognosis of atrial fibrillation (AF) in patients with acute coronary syndromes (ACS).MethodsMEDLINE, Embase, and Web of Science were searched to identify all published studies providing relevant data through August 23, 2020. (ox.ac.uk)
  • Acute exposure to elevated levels of PM2.5 can lead to irritation of eyes, nose, throat and lungs , and increases relative risk of acute cardiovascular events including admission to a hospital for stoke (Rajagopalan et al. (cdc.gov)
  • An observational study to assesss the risk factors in acute coronary syndrome at a tertiary cate hospital. (kolkataheartdoctor.com)
  • The controversy over beta blockade in the ED (early in ACS) is for patients at risk for cardiogenic shock, principally patients with acute STEMI, especially anterior STEMI. (blogspot.com)
  • Aim: To understand if there were systematic differences in the characteristics of patients who were admitted to UK critical care units (CCU), intermediate care environments (cardiology wards) or generalist wards (acute medical ward) in an observational study carried out in the 1990s. (qub.ac.uk)
  • This analysis compares the characteristics of 860 of these patients dependent on whether they were cared for in a coronary care unit, acute medical ward or cardiology ward. (qub.ac.uk)
  • This was discussed extensively during the acute coronary syndrome panel session on cardiology including Dr. Laila Abdel-Wareth of Cleveland Clinic Abu Dhabi, among others. (roche-middleeast.com)
  • The study was conducted to compare the various diagnostic methods for the detection of undiagnosed diabetes mellitus in acute coronary syndrome patients with admission hyperglycaemia in Bangladeshi population. (banglajol.info)
  • METHODS AND RESULTS: TRILOGY ACS (Targeted Platelet Inhibition to Clarify the Optimal Strategy to Medically Manage Acute Coronary Syndromes) was a double-blind, placebo-controlled randomized trial conducted from 2008 to 2012 over a median follow-up of 17.0 months in 966 sites (52 countries). (duke.edu)
  • How these scores apply to the population of patients with acute coronary syndrome (ACS) treated without revascularization remains unknown. (duke.edu)
  • Introduction National practice guidelines recommend early aspirin administration to reduce mortality in acute coronary syndrome (ACS). (bmj.com)
  • Objectives Suboptimal dosing of angiotensin-converting enzyme inhibitors and β-blockers limits the mortality benefit for acute coronary syndrome patients. (bmj.com)
  • Due to the complex of vague sepsis syndrome definitions, unknown sources of infection and higher mortality, it is necessary to establish a reliable and effective prognostic model for sepsis. (biomedcentral.com)
  • Admission hyperglycemia adversely influences the outcome of acute coronary syndrome patients. (banglajol.info)
  • Comparison of acute coronary syndrome in patients receiving versus not receiving chronic dialysis (from the Global Registry of Acute Coronary Events [GRACE] Registry). (medscape.com)
  • New treatment principles are emerging in current practice, such as metabolic modulation, therapeutic angiogenesis, and novel interventional techniques (coronary in-flow redistribution and approaches to chronic total occlusion). (nature.com)
  • This guideline covers managing acute and chronic pancreatitis in children, young people and adults. (bvsalud.org)
  • We conducted the first examination of the latent structure of PTSD symptoms after suspected ACS in 399 adults in the REactions to Acute Care and Hospitalization (REACH) study, an observational cohort study of patients recruited from the emergency department during evaluation for ACS. (columbia.edu)
  • The CRF can be administered either as part of routine fol ow up or at a specific time point to any patient in the post- acute phase of COVID-19, regardless of hospitalization. (who.int)
  • Atrial fibrillation incidence, prevalence, predictors, and adverse outcomes in acute coronary syndromes: A pooled analysis of data from 8 million patients. (ox.ac.uk)
  • IMSEAR at SEARO: Incidence of Impaired Glucose Tolerance Test in Non- Diabetic Patients of Acute Coronary Syndrome and its Adverse Outcomes. (who.int)
  • A blocked coronary artery may also cause you to feel sudden pain, discomfort, tightening, or a burning sensation in your chest called angina. (smartimagebase.com)
  • Admission glycaemia and its association with acute coronary syndrome in Emergency Department patients with chest pain. (medscape.com)
  • Our objective was to describe hospital admission rates for acute coronary events, based on smoking status, diabetes status, and sex, in the presence of a long-standing (2000-2008) county clean indoor air regulation (CIAR). (cdc.gov)
  • Therefore, the objective of our study was to describe hospital admission rates over time (2000-2008) for acute coronary events, by smoking status, diabetes status, and sex, in the presence of an existing county-wide clean indoor air regulation (CIAR or regulation). (cdc.gov)
  • Admission hyperglycaemia does not diagnose diabetes reliably in a stressful condition like acute coronary syndrome. (banglajol.info)
  • Although neither admission plasma glucose, fasting plasma glucose, nor HbA1c level were as good as oral glucose tolerance test in detecting true diabetes, but combined fasting plasma glucose & HbA1c were found to be more sensitive & specific screening tool for detecting unknown diabetes in acute coronary syndrome patients with admission hyperglycaemia. (banglajol.info)
  • Conclusion: Patients with acute coronary syndrome who have IGT on admission have longer hospital stay and more complications related to acute MI. (who.int)
  • Fast Five Quiz: Test Your Knowledge of Acute Coronary Syndrome - Medscape - Apr 26, 2017. (medscape.com)
  • Thiamine-responsive megaloblastic anaemia (TRMA) is a syndrome associated with megaloblastic anaemia, diabetes mellitus and sensorineural deafness, due to mutations in the SLC19A2 gene, which codes for a thiamine carrier protein. (bvsalud.org)
  • Usefulness of elevations in serum choline and free F2)-isoprostane to predict 30-day cardiovascular outcomes in patients with acute coronary syndrome. (medscape.com)
  • Although clopidogrel is still frequently used in patients with acute coronary syndromes (ACS), its efficacy is hampered by interpatient response variability caused by genetic polymorphisms associated with clopidogrel's metabolism. (dundee.ac.uk)
  • BACKGROUND: Sleep disturbance has been associated with poor prognosis in patients with acute coronary syndrome (ACS). (docwirenews.com)
  • Intravascular imaging in acute coronary syndromes. (escardio.org)