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Protocolo de dor toracica

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118 papers 25 to 100 followers
By Eduardo Roque Cardiologista com foco em cardiologia hospitalar e cuidados intensivos. Professor de clínica médica.
Niall P Morris, Richard Body
The De Winter ECG pattern has been reported to indicate acute left anterior descending coronary artery occlusion and is often considered to be an 'ST elevation myocardial infarction (STEMI) equivalent'. We aimed to investigate the morphology of the 'De Winter ECG pattern' and evaluate the test characteristics of the De Winter pattern for the diagnosis of acute coronary occlusion. We identified papers through the Medline, EMBASE and COCHRANE databases and screened for bias using QUADAS-2. First, measurements were recorded from every ECG reported in the literature and aggregated...
August 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
Zhi Jian Wang, Lin Lin Zhang, Sammy Elmariah, Hong Ya Han, Yu Jie Zhou
OBJECTIVE: To evaluate the prevalence, clinical characteristics, and risk of cardiac events in patients with nonobstructive coronary artery disease (CAD). PATIENTS AND METHODS: We searched PubMed, EMBASE, and the Cochrane Library from January 1, 1990, to November 31, 2015. Studies were included if they reported prevalence or prognosis of patients with nonobstructive CAD (≤50% stenosis) among patients with known or suspected CAD. Patients with nonobstructive CAD were further grouped as those with no angiographic CAD (0% or ≤20%) and those with mild CAD (>0% or >20% to ≤50%)...
March 2017: Mayo Clinic Proceedings
Robin Ducas, Vignendra Ariyarajah, Roger Philipp, John Ducas, Jason Elliott, Davinder Jassal, James Tam, Philip Garber, Nasir Shaikh, Farrukh Hussain
INTRODUCTION: Electrocardiographic (ECG) predictors of significant angiographic left main coronary artery stenosis (LMCS>50%) have been described in acute myocardial infarction using ST-segment elevation in lead aVR (aVR-STE). However, there is a paucity of data on its association with LMCS>50% in the setting of cardiogemic shock (CGS). METHODS: We investigated 210 consecutive, unselected, patients from Sept. 2002-2006 with CGS due to acute myocardial infarction undergoing cardiac catheterization...
June 20, 2013: International Journal of Cardiology
Aws Alherbish, Cynthia M Westerhout, Yuling Fu, Harvey D White, Christopher B Granger, Galen Wagner, Paul W Armstrong
BACKGROUND: Lead aVR ST-segment deviation has been associated with increased mortality in ST-elevation myocardial infarction patients treated with fibrinolysis. However, its prognostic value in a contemporaneous population undergoing primary percutaneous coronary intervention is unknown. METHODS AND RESULTS: A core laboratory examined the 12-lead baseline electrocardiogram in 5,683 patients presenting within 6 hours of symptom onset in the APEX-AMI trial, and readers were blinded to study treatment and clinical outcomes...
August 2013: American Heart Journal
Xu-Miao Chen, Cheng-Cheng Ji, Yun-Jiu Cheng, Li-Juan Liu, Wei-Qi Zhu, Ying Huang, Wei-Ying Chen, Su-Hua Wu
BACKGROUND: Just as high-risk populations for cardiac arrest exist in patients with Brugada syndrome or long QT syndrome, high-risk and low-risk populations for cardiac arrest also exist in patients with early repolarization pattern (ERP). HYPOTHESIS: Electrocardiographic (ECG) characteristics can aid the risk stratification of patients with ERP. METHODS: Electrocardiographic parameters such as magnitude of J-point elevation and J/R ratio were measured...
November 2016: Clinical Cardiology
Joseph G Mancini, Kristian B Filion, Sarah B Windle, Bettina Habib, Mark J Eisenberg
American College of Cardiology Foundation/American Heart Association guidelines no longer recommend the use of routine aspiration thrombectomy during primary percutaneous coronary intervention (PCI). This is based on evidence from recent randomized controlled trials (RCTs) that suggests that the long-term benefits of aspiration thrombectomy were previously overestimated. We conducted a systematic review and meta-analysis of RCTs to examine the effect of routine aspiration thrombectomy during primary PCI versus primary PCI alone on markers of reperfusion immediately after PCI and on clinical outcomes at ≥6 months...
July 1, 2016: American Journal of Cardiology
Christiaan J M Vrints, Roxy Senior, Filippo Crea, Udo Sechtem
No abstract text is available yet for this article.
June 14, 2017: European Heart Journal
Jea-Geun Lee, Joon Hyouk Choi, Song-Yi Kim, Ki-Seok Kim, Seung-Jae Joo
BACKGROUND AND OBJECTIVES: A cardiologist's evaluation of psychiatric symptoms in patients with chest pain is rare. This study aimed to determine the psychiatric characteristics of patients with and without coronary artery disease (CAD) and explore their relationship with the intensity of chest pain. SUBJECTS AND METHODS: Out of 139 consecutive patients referred to the cardiology outpatient department, 31 with atypical chest pain (heartburn, acid regurgitation, dyspnea, and palpitation) were excluded and 108 were enrolled for the present study...
March 2016: Korean Circulation Journal
Morten Schmidt, Morten Lamberts, Anne-Marie Schjerning Olsen, Emil Fosbøll, Alexander Niessner, Juan Tamargo, Giuseppe Rosano, Stefan Agewall, Juan Carlos Kaski, Keld Kjeldsen, Basil S Lewis, Christian Torp-Pedersen
No abstract text is available yet for this article.
April 1, 2016: European Heart Journal
Trishna Gunnoo, Nazeeha Hasan, Muhammad Saleem Khan, Julia Slark, Paul Bentley, Pankaj Sharma
OBJECTIVE: Following an acute stroke, there is a high risk of recurrence. However, the leading cause of mortality following a stroke is due to coronary artery disease (CAD) and myocardial infarction (MI) but that risk has not been robustly quantified. We sought to reliably quantify the risk of ischaemic heart disease (IHD) in patients presenting with acute ischaemic stroke (AIS) in the absence of a known cardiac history. SETTING: A meta-analysis study. PubMed, MEDLINE, EMBASE and Google Scholar were searched for potential studies up to October 2015...
January 20, 2016: BMJ Open
Gilles Montalescot, Filippo Crea
No abstract text is available yet for this article.
January 14, 2016: European Heart Journal
Hideki Miyachi, Atsushi Takagi, Katsumi Miyauchi, Masao Yamasaki, Hiroyuki Tanaka, Masatomo Yoshikawa, Mike Saji, Makoto Suzuki, Takeshi Yamamoto, Wataru Shimizu, Ken Nagao, Morimasa Takayama
Limited data exists on ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) managed by a well-organized cardiac care network in a metropolitan area. We analyzed the Tokyo CCU network database in 2009-2010. Of 4329 acute myocardial infarction (AMI) patients including STEMI (n = 3202) and NSTEMI (n = 1127), percutaneous coronary intervention (PCI) was performed in 88.8 % of STEMI and 70.4 % of NSTEMI patients. Mean onset-to-door and door-to-balloon times in STEMI patients were shorter than those in NSTEMI patients (167 vs 233 and 60 vs 145 min, respectively, p < 0...
November 2016: Heart and Vessels
H Pendell Meyers, Alexander T Limkakeng, Elias J Jaffa, Anjni Patel, B Jason Theiling, Salim R Rezaie, Todd Stewart, Cassandra Zhuang, Vijaya K Pera, Stephen W Smith
BACKGROUND: The modified Sgarbossa criteria were proposed in a derivation study to be superior to the original criteria for diagnosing acute coronary occlusion (ACO) in left bundle branch block (LBBB). The new rule replaces the third criterion (5 mm of excessively discordant ST elevation [STE]) with a proportion (at least 1 mm STE and STE/S wave ≤-0.25). We sought to validate the modified criteria. METHODS: This retrospective case-control study was performed by chart review in 2 tertiary care center emergency departments (EDs) and 1 regional referral center...
December 2015: American Heart Journal
Daniela Cassar Demarco, Alexandros Papachristidis, Damian Roper, Ioannis Tsironis, Jonathan Byrne, Khaled Alfakih, Mark Monaghan
OBJECTIVES: To compare how patients with chest pain would be investigated, based on the two guidelines available for UK cardiologists, on the management of patients with stable chest pain. The UK National Institute of Clinical Excellence (NICE) guideline which was published in 2010 and the European society of cardiology (ESC) guideline published in 2013. Both guidelines utilise pre-test probability risk scores, to guide the choice of investigation. DESIGN: We undertook a large retrospective study to investigate the outcomes of stress echocardiography...
November 2015: JRSM Open
Sally Aldous, A Mark Richards, Louise Cullen, John W Pickering, Martin Than
OBJECTIVE: In patients with acute chest pain and normal range cardiac troponin (cTn), accurate risk stratification for acute coronary syndrome is challenging. This study assesses the incremental value of stress testing to identify patients for angiography with a view to revascularisation. METHODS: A single-centre observational study recruited patients with acute chest pain in whom serial cTn tests were negative and stress testing (exercise tolerance testing/dobutamine stress echocardiography) was performed...
May 2016: Emergency Medicine Journal: EMJ
Sanjit S Jolly, John A Cairns, Salim Yusuf, Michael J Rokoss, Peggy Gao, Brandi Meeks, Sasko Kedev, Goran Stankovic, Raul Moreno, Anthony Gershlick, Saqib Chowdhary, Shahar Lavi, Kari Niemela, Ivo Bernat, Warren J Cantor, Asim N Cheema, Philippe Gabriel Steg, Robert C Welsh, Tej Sheth, Olivier F Bertrand, Alvaro Avezum, Ravinay Bhindi, Madhu K Natarajan, David Horak, Raymond C M Leung, Saleem Kassam, Sunil V Rao, Magdi El-Omar, Shamir R Mehta, James L Velianou, Samir Pancholy, Vladimír Džavík
BACKGROUND: Two large trials have reported contradictory results at 1 year after thrombus aspiration in ST elevation myocardial infarction (STEMI). In a 1-year follow-up of the largest randomised trial of thrombus aspiration, we aimed to clarify the longer-term benefits, to help guide clinical practice. METHODS: The trial of routine aspiration ThrOmbecTomy with PCI versus PCI ALone in Patients with STEMI (TOTAL) was a prospective, randomised, investigator-initiated trial of routine manual thrombectomy versus percutaneous coronary intervention (PCI) alone in 10,732 patients with STEMI...
January 9, 2016: Lancet
Hussam F AlFaleh, Alawi A Alsheikh-Ali, Anhar Ullah, Khalid F AlHabib, Ahmad Hersi, Jassim Al Suwaidi, Kadhim Sulaiman, Shukri Al Saif, Wael Almahmeed, Nidal Asaad, Haitham Amin, Ahmed Al-Motarreb, Tarek Kashour
BACKGROUND: Several risk scores have been developed for acute coronary syndrome (ACS) patients, but their use is limited by their complexity. The new Canada Acute Coronary Syndrome (C-ACS) risk score is a simple risk-assessment tool for ACS patients. This study assessed the performance of the C-ACS risk score in predicting hospital mortality in a contemporary Middle Eastern ACS cohort. HYPOTHESIS: The C-ACS score accurately predicts hospital mortality in ACS patients...
September 2015: Clinical Cardiology
Louise Cullen, William Parsonage, Martin Than
No abstract text is available yet for this article.
December 19, 2015: Lancet
Stephen G Ellis, Dean J Kereiakes, D Christopher Metzger, Ronald P Caputo, David G Rizik, Paul S Teirstein, Marc R Litt, Annapoorna Kini, Ameer Kabour, Steven O Marx, Jeffrey J Popma, Robert McGreevy, Zhen Zhang, Charles Simonton, Gregg W Stone
BACKGROUND: In patients with coronary artery disease who receive metallic drug-eluting coronary stents, adverse events such as late target-lesion failure may be related in part to the persistent presence of the metallic stent frame in the coronary-vessel wall. Bioresorbable vascular scaffolds have been developed to attempt to improve long-term outcomes. METHODS: In this large, multicenter, randomized trial, 2008 patients with stable or unstable angina were randomly assigned in a 2:1 ratio to receive an everolimus-eluting bioresorbable vascular (Absorb) scaffold (1322 patients) or an everolimus-eluting cobalt-chromium (Xience) stent (686 patients)...
November 12, 2015: New England Journal of Medicine
Serena F Carville, Robert Henderson, Huon Gray
Acute ST-segment-elevation myocardial infarction (STEMI) results from complete obstruction to coronary artery blood flow accompanied by the appearance of ST-segment-elevation on the electrocardiogram. Emergency treatment is required to restore coronary perfusion, thereby limiting the extent of damage to the myocardium and the likelihood of early death or future heart failure. This concise guideline summarises key recommendations from the National Institute for Health and Care Excellence clinical guideline on acute management of STEMI (CG167), of relevance to all healthcare professionals involved...
August 2015: Clinical Medicine: Journal of the Royal College of Physicians of London
2015-10-11 19:53:39
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