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Ischemic heart disease

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23 papers 100 to 500 followers
By Faye Kehler Family Physician and GP Anesthetist since 1987 interested in all aspects of Medicine
Edward L Hannan, Ye Zhong, Gary Walford, David R Holmes, Ferdinand J Venditti, Peter B Berger, Alice K Jacobs, Nicholas J Stamato, Jeptha P Curtis, Samin Sharma, Spencer B King
BACKGROUND: Few recent studies have compared the outcomes of coronary artery bypass graft (CABG) surgery with percutaneous coronary interventions (PCIs) in patients with isolated (single vessel) proximal left anterior descending (PLAD) coronary artery disease in the era of drug-eluting stents (DES). OBJECTIVES: The goal of this study was to compare outcomes in patients with PLAD who underwent CABG and PCI with DES. METHODS: New York's Percutaneous Coronary Interventions Reporting System was used to identify and track all patients who underwent CABG surgery and received DES for isolated PLAD disease between January 1, 2008 and December 31, 2010, and who were followed-up through December 31, 2011...
December 30, 2014: Journal of the American College of Cardiology
Laura Mauri, Dean J Kereiakes, Robert W Yeh, Priscilla Driscoll-Shempp, Donald E Cutlip, P Gabriel Steg, Sharon-Lise T Normand, Eugene Braunwald, Stephen D Wiviott, David J Cohen, David R Holmes, Mitchell W Krucoff, James Hermiller, Harold L Dauerman, Daniel I Simon, David E Kandzari, Kirk N Garratt, David P Lee, Thomas K Pow, Peter Ver Lee, Michael J Rinaldi, Joseph M Massaro
BACKGROUND: Dual antiplatelet therapy is recommended after coronary stenting to prevent thrombotic complications, yet the benefits and risks of treatment beyond 1 year are uncertain. METHODS: Patients were enrolled after they had undergone a coronary stent procedure in which a drug-eluting stent was placed. After 12 months of treatment with a thienopyridine drug (clopidogrel or prasugrel) and aspirin, patients were randomly assigned to continue receiving thienopyridine treatment or to receive placebo for another 18 months; all patients continued receiving aspirin...
December 4, 2014: New England Journal of Medicine
Ali Yilmaz, Udo Sechtem
No abstract text is available yet for this article.
December 2014: Heart: Official Journal of the British Cardiac Society
Aaron S Kesselheim, Katsiaryna Bykov, Jerry Avorn, Angela Tong, Michael Doherty, Niteesh K Choudhry
BACKGROUND: Generic prescription drugs made by different manufacturers may vary in color or shape, and switching among these drug products may interrupt medication use. OBJECTIVE: To determine whether nonpersistent use of generic drugs among patients with cardiovascular disease after myocardial infarction (MI) is associated with inconsistent appearance of their medications. DESIGN: Cohort and nested case-control studies. SETTING: Claims from a commercial health insurance database in the United States...
July 15, 2014: Annals of Internal Medicine
Christoph Varenhorst, Ulrica Alström, Oscar Ö Braun, Robert F Storey, Kenneth W Mahaffey, Maria Bertilsson, Christopher P Cannon, Benjamin M Scirica, Anders Himmelmann, Stefan K James, Lars Wallentin, Claes Held
OBJECTIVE: To describe specific causes of death and evaluate whether bleeding events and infection contributed to mortality in all ticagrelor-treated and clopidogrel-treated patients with acute coronary syndromes. METHODS: In the PLATelet inhibition and patient Outcomes (PLATO) trial, ticagrelor significantly reduced rates of vascular and total death compared with clopidogrel. In the 905 patients who died postenrolment in the PLATO trial (n=18 624), reviewers, blinded to study treatment, subclassified direct causes of death and evaluated whether infection or bleeding events contributed to fatal events...
November 2014: Heart: Official Journal of the British Cardiac Society
Stephan D Fihn, James C Blankenship, Karen P Alexander, John A Bittl, John G Byrne, Barbara J Fletcher, Gregg C Fonarow, Richard A Lange, Glenn N Levine, Thomas M Maddox, Srihari S Naidu, E Magnus Ohman, Peter K Smith
No abstract text is available yet for this article.
November 4, 2014: Circulation
Stefan B Puchner, Michael T Lu, Thomas Mayrhofer, Ting Liu, Amit Pursnani, Brian B Ghoshhajra, Quynh A Truong, Stephen D Wiviott, Jerome L Fleg, Udo Hoffmann, Maros Ferencik
PURPOSE: To determine the association between nonalcoholic fatty liver disease (NAFLD) and the presence of high-risk coronary atherosclerotic plaque as assessed with coronary computed tomographic (CT) angiography. MATERIALS AND METHODS: This study was approved by the local ethics committees; informed consent was obtained. Patients randomized to the coronary CT angiography arm of the Rule Out Myocardial Infarction using Computer Assisted Tomography, or ROMICAT, II trial who underwent both nonenhanced CT to assess calcium score and contrast material-enhanced coronary CT angiography were included...
March 2015: Radiology
Ravi R Bajaj, Shaun G Goodman, Raymond T Yan, Alan J Bagnall, Gabor Gyenes, Robert C Welsh, Kim A Eagle, David Brieger, Krishnan Ramanathan, Francois R Grondin, Andrew T Yan
The early diagnosis of acute coronary syndrome (ACS) remains challenging, and a considerable proportion of patients are diagnosed with "possible" ACS on admission. The Global Registry of Acute Coronary Events (GRACE/GRACE(2)) and Canadian Registry of Acute Coronary Events (CANRACE) enrolled 16,618 Canadian patients with suspected ACS in 1999 to 2008. We compared the demographic and clinical characteristics, use of cardiac procedures, prognostic accuracy of the GRACE risk score, and in-hospital outcomes between patients given an admission diagnosis of "definite" versus "possible" ACS by the treating physician...
January 15, 2013: American Journal of Cardiology
Erik P Hess, Jeffrey J Perry, Lisa A Calder, Venkatesh Thiruganasambandamoorthy, Richard Body, Allan Jaffe, George A Wells, Ian G Stiell
OBJECTIVES: This study attempted to prospectively validate a modified Thrombolysis In Myocardial Infarction (TIMI) risk score that classifies patients with either ST-segment deviation or cardiac troponin elevation as high risk. The objectives were to determine the ability of the modified score to risk-stratify emergency department (ED) patients with chest pain and to identify patients safe for early discharge. METHODS: This was a prospective cohort study in an urban academic ED over a 9-month period...
April 2010: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
Pedro de Araújo Gonçalves, Jorge Ferreira, Carlos Aguiar, Ricardo Seabra-Gomes
AIMS: Regarding prognosis, patients with a non-ST elevation acute coronary syndrome (ACS) are a very heterogeneous population, with varying risks of early and long-term adverse events. Early risk stratification at admission seems to be essential for a tailored therapeutic strategy. We sought to compare the prognostic value of three ACS risk scores (RSs) and their ability to predict benefit from myocardial revascularization performed during initial hospitalization. METHODS AND RESULTS: We studied 460 consecutive patients admitted to our coronary care unit with an ACS [age: 63+/-11 years, 21...
May 2005: European Heart Journal
Elizabeth Ann Scruth, Eugene Cheng, Linda Worrall-Carter
BACKGROUND: Accurate risk stratification is important in the management of acute coronary syndrome (ACS) patients. Several risk scores have been developed to stratify patients hospitalized with ACS. AIM: To compare the prognostic value of three risk scores used to determine the risk for secondary events in patients diagnosed with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). METHODS: A retrospective analysis of patients with an ACS experiencing a STEMI treated with PCI presenting to a Kaiser Permanente Foundation Hospital in Northern California from January 2007 to January 2008 (n=186)...
August 2013: European Journal of Cardiovascular Nursing
Fabrizio D'Ascenzo, Giuseppe Biondi-Zoccai, Claudio Moretti, Mario Bollati, Pierluigi Omedè, Filippo Sciuto, Davide G Presutti, Maria Grazia Modena, Mauro Gasparini, Matthew J Reed, Imad Sheiban, Fiorenzo Gaita
BACKGROUND: Acute coronary syndromes (ACS) represent a difficult challenge for physicians. Risk scores have become the cornerstone in clinical and interventional decision making. METHODS AND RESULTS: PubMed was systematically searched for ACS risk score studies. They were divided into ACS studies (evaluating Unstable Angina; UA, Non ST Segment Elevation Myocardial Infarction; NSTEMI, and ST Segment Elevation Myocardial Infarction; STEMI), UA/NSTEMI studies or STEMI studies...
May 2012: Contemporary Clinical Trials
Anibal P Abelin, Renato B David, Carlos A Gottschall, Alexandre S Quadros
BACKGROUND: Comparisons between dedicated risk scores in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (pPCI) in real-world clinical practice are scarce. The aim of this study was to assess the diagnostic performance of the Global Registry of Acute Coronary Events (GRACE), Primary Angioplasty in Myocardial Infarction (PAMI), Thrombolysis in Myocardial Infarction (TIMI), and Zwolle scores in STEMI patients undergoing pPCI in contemporary clinical practice...
January 2014: Canadian Journal of Cardiology
Bilal Bawamia, Roxana Mehran, Weiliang Qiu, Vijay Kunadian
Patients with acute coronary syndrome (ACS) need to be risk stratified to deliver the most appropriate therapy. The GRACE and TIMI risk scores have penetrated contemporary guidelines with the former most commonly used in clinical practice. However, ACS prediction models need to be re-evaluated in contemporary practice with evolving diagnostic and treatment options. Moreover, the increased availability of percutaneous coronary intervention (PCI) as a treatment option for ACS combined with an expanding case mix and emphasis on quality control have triggered the creation of PCI specific prognostic models...
April 2013: American Heart Journal
Charles V Pollack, Frank D Sites, Frances S Shofer, Keara L Sease, Judd E Hollander
OBJECTIVES: Patients presenting with chest pain or related symptoms suggestive of myocardial ischemia, without ST-segment elevation (NSTE) on their presenting electrocardiograms, often present a diagnostic challenge in the emergency department (ED). Prompt and accurate risk stratification to identify those patients with NSTE chest pain who are at highest risk for adverse events is essential, however, to optimal management. Although validated and used frequently in patients already enrolled in acute coronary syndrome trials, the Thrombolysis in Myocardial Infarction (TIMI) risk score never has been examined for its value in risk stratification in an all-comers, non-trial-based ED chest pain population...
January 2006: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
E M Antman, M Cohen, P J Bernink, C H McCabe, T Horacek, G Papuchis, B Mautner, R Corbalan, D Radley, E Braunwald
CONTEXT: Patients with unstable angina/non-ST-segment elevation myocardial infarction (MI) (UA/NSTEMI) present with a wide spectrum of risk for death and cardiac ischemic events. OBJECTIVE: To develop a simple risk score that has broad applicability, is easily calculated at patient presentation, does not require a computer, and identifies patients with different responses to treatments for UA/NSTEMI. DESIGN, SETTING, AND PATIENTS: Two phase 3, international, randomized, double-blind trials (the Thrombolysis in Myocardial Infarction [TIMI] 11B trial [August 1996-March 1998] and the Efficacy and Safety of Subcutaneous Enoxaparin in Unstable Angina and Non-Q-Wave MI trial [ESSENCE; October 1994-May 1996])...
August 16, 2000: JAMA: the Journal of the American Medical Association
Erik P Hess, Dipti Agarwal, Subhash Chandra, Mohammed H Murad, Patricia J Erwin, Judd E Hollander, Victor M Montori, Ian G Stiell
BACKGROUND: The Thrombolysis in Myocardial Infarction (TIMI) risk score uses clinical data to predict the short-term risk of acute myocardial infarction, coronary revascularization or death from any cause. It was originally developed for use in patients with unstable angina or non-ST-elevation myocardial infarction. We sought to expand the clinical application of the TIMI risk score by assessing its prognostic accuracy in patients in the emergency department with potential acute coronary syndromes...
July 13, 2010: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Dimitrios Karmpaliotis, Minang P Turakhia, Ajay J Kirtane, Sabina A Murphy, Ioanna Kosmidou, David A Morrow, Robert P Giugliano, Christopher P Cannon, Elliott M Antman, Eugene Braunwald, C Michael Gibson
In the setting of ST-segment elevation myocardial infarction (STEMI), the Thrombolysis In Myocardial Infarction (TIMI) risk score (TRS) and indexes of epicardial and myocardial perfusion are associated with mortality. The association between TRS at presentation and angiographic indexes of epicardial and myocardial perfusion after reperfusion therapy has not been investigated. We hypothesized that TRS, TIMI flow grade (TFG), and TIMI myocardial perfusion grade (TMPG) would provide independent prognostic information and that angiographic indexes of poor flow and perfusion would be associated with a higher TRS...
November 1, 2004: American Journal of Cardiology
Jörg Haasenritter, Stefan Bösner, Paul Vaucher, Lilli Herzig, Monika Heinzel-Gutenbrunner, Erika Baum, Norbert Donner-Banzhoff
BACKGROUND: The Marburg Heart Score (MHS) aims to assist GPs in safely ruling out coronary heart disease (CHD) in patients presenting with chest pain, and to guide management decisions. AIM: To investigate the diagnostic accuracy of the MHS in an independent sample and to evaluate the generalisability to new patients. DESIGN AND SETTING: Cross-sectional diagnostic study with delayed-type reference standard in general practice in Hesse, Germany...
June 2012: British Journal of General Practice: the Journal of the Royal College of General Practitioners
Kunal Patel, Fady Alattar, Jayanth Koneru, Fayez Shamoon
Wellens' syndrome, also known as LAD coronary T-wave inversion syndrome, is a characteristic ECG pattern that highly suggests critical stenosis of the proximal left anterior descending (LAD) coronary artery. 75% of patients with this finding go on to develop acute anterior wall myocardial infarction within one week unless prevented by early intervention on the culprit lesion. Most instances of ST-elevation occurring during cardiac stress testing have been observed with exercise, with only seven cases reported in the literature with pharmacologic stress...
2014: Case Reports in Emergency Medicine
2014-10-30 03:23:58
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