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J Cardiopulm Rehabil Prev 2019 May;39(3):168-174

Departamento de Medicina Interna-Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile (Drs Seron and Lanas and Ms Velásquez); Departamento de Medicina Interna, Universidad de La Frontera, Temuco, Chile (Mss Gaete and Oliveros); Complejo Hospitalario San José, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile (Ms Román); Facultad de Ciencias Jurídicas y Empresariales, Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile (Dr Reveco); Departamento de Salud Pública, Centro de Excelencia CIGES, Universidad de La Frontera, Temuco, Chile (Mr Bustos); and Unidad de Evaluación de Tecnologías Sanitarias, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile (Mr Rojas).

Purpose: To assess the cost-effectiveness of 3 models of exercise-based cardiac rehabilitation (CR) compared with standard care in survivors of acute coronary syndrome (ACS) within the public health system in Chile.

Methods: A Markov model was designed using 5 health states: ACS survivor, second ACS, complications, general mortality, and cardiovascular mortality. The transition probabilities between health states for standard care and corresponding relative risk for CR were calculated from a systematic review. Read More

J Am Heart Assoc 2019 May;8(9):e011444

1 TIMI Study Group Division of Cardiovascular Medicine Brigham and Women's Hospital and Harvard Medical School Boston MA.

Background Small studies have suggested an association between markers of collagen turnover and adverse outcomes in heart failure ( HF ). We examined C-terminal telopeptide (beta- CT x) and the risk of cardiovascular death or new or worsening HF in non- ST -elevation acute coronary syndrome. Methods and Results We measured baseline serum beta- CT x, NT -pro BNP (N-terminal pro-B-type natriuretic peptide), hsTnT (high-sensitivity cardiac troponin T) and hs CRP (high-sensitivity C-reactive protein) (Roche Diagnostics) in a nested biomarker analysis (n=4094) from a study of patients with non- ST -elevation acute coronary syndrome. Read More

Clin Cardiol 2019 Apr 24. Epub 2019 Apr 24.

Department of Cardiovascular Medicine, Osaka City University Graduate School of Medicine, Osaka, Japan.

Background: Although ankle-brachial index (ABI) and brachial-ankle pulse wave velocity (baPWV) are significant predictors of major adverse cardiovascular event (MACE), their prognostic value in association with biomarkers has not been fully evaluated in patients with end-stage kidney disease (ESKD). We hypothesized that ABI/baPWV would provide better prognostic value independent of biomarkers in ESKD patients.

Methods: This study included 104 ESKD patients treated with maintenance hemodialysis who underwent ABI and baPWV examinations and laboratory tests, including brain-natriuretic peptide, high-sensitive cardiac troponin T (hs-cTnT), and high-sensitive C-reactive protein (hs-CRP). Read More

J Nephrol 2019 Apr 24. Epub 2019 Apr 24.

Division of Nephrology, Department of Clinical and Molecular Medicine, Sant'Andrea University Hospital, "Sapienza" University of Rome, Via di Grottarossa, 1035-1039, 00189, Rome, Italy.

Introduction: Increased levels of cardiac troponins (cTn) are a hallmark of acute myocardial infarction (AMI), along with symptoms and electrocardiographic (ECG) changes. Stably elevated cTn concentrations are frequently observed in asymptomatic patients with chronic kidney disease (CKD) and/or on hemodialysis (HD); the meaning of this elevation, as assessed by conventional techniques, remains unclear. Aim of our study was to evaluate the clinical significance of cTnI levels in asymptomatic HD patients by employing a newer high-sensitive cTnI (hs-cTnI) assay. Read More

Herz 2019 Apr 24. Epub 2019 Apr 24.

Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Liebigstraße 20, 04103, Leipzig, Deutschland.

Echocardiography is a non-invasive, versatile imaging modality for the diagnostics and monitoring of life-threatening cardiac diseases. This article summarizes the currently valid recommendations on emergency echocardiography of the German Cardiac Society and the European Association of Cardiovascular Imaging and provides practical guidance for their implementation in emergency medicine. Echocardiography is especially important for the diagnostics of acute coronary syndrome and its potential complications, of pulmonary embolism and endocarditis as well as the differential diagnosis of patients in shock and in emergencies. Read More

Eur Heart J Case Rep 2019 Mar 4;3(1):ytz021. Epub 2019 Mar 4.

Department of Cardiology, St Vincent's Hospital, 41 Royal Parade, Fitzroy, Victoria, Australia.

Background: Spontaneous coronary artery dissection (SCAD) is an infrequent but potentially life-threatening condition in patients with acute myocardial infarction. Conservative medical therapy is recommended in patients with SCAD. However, very little evidence exists in the management of recurrent SCAD when conservative medical therapy fails. Read More

Eur Heart J Case Rep 2019 Mar 18;3(1):ytz013. Epub 2019 Feb 18.

Division of Cardiology, Department of Internal Medicine, The Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, Japan.

Background: Immunoglobulin G4-related disease (IgG4-RD) is an autoimmune condition associated with high serum IgG4 levels which was first reported as autoimmune pancreatitis in 2001. Since then, many additional organs, such as bile duct, salivary gland, retroperitoneal organs, and liver, have been reported with high serum IgG4 levels in cases of IgG4-RD. However, evidence of the relationship between IgG4-RD and coronary artery disease (CAD) has been scare. Read More

Eur Heart J Case Rep 2019 Mar 12;3(1):yty168. Epub 2019 Jan 12.

Cardiology Department, Cardiovascular Institute (ICCV), Hospital Clínic, IDIBAPS, University of Barcelona, C/Villarroel, 170, 08036 Barcelona, Spain.

Background: Spontaneous coronary artery dissection (SCAD) is an infrequent and often misdiagnosis of a non-atherosclerotic cause of acute coronary syndrome (ACS). It is an important cause of ACS in young women, responsible for up to 25% of all cases in women <50 years of age without cardiovascular risk factors. Clinical presentation ranges from ST-segment-elevation myocardial infarction (MI) to ventricular fibrillation and sudden death. Read More

Eur Heart J Case Rep 2019 Mar 28;3(1):yty156. Epub 2018 Dec 28.

Cardiology Department, Ballarat Health Services, 1 Drummond Street, Ballarat, VIC, Australia.

Background: Ticagrelor is an oral anti-platelet agent that is a reversible and direct inhibitor of the adenosine diphosphate P2Y12 receptor. Ticagrelor's brady-arrhythmic potential was investigated in a sub-study of the PLATO trial, which concluded that the effects were transient and not clinically significant beyond the acute initiation phase. Since then, there have been emerging reports of ticagrelor-associated high-degree heart block, requiring drug discontinuation and pacemaker insertion. Read More

Eur Heart J Case Rep 2019 Mar 22;3(1):yty154. Epub 2018 Dec 22.

Department of Internal Medicine-Cardiology, Faculty of Medicine and Dentistry, Palacký University and University Hospital Olomouc, Olomouc, Czech Republic.

Background: Fabry disease is an inherited rare metabolic disease caused by mutation in the gene, encoding lysosomal enzyme alpha-galactosidase A. The disorder is a systemic disease that manifests as cerebrovascular and cardiac disease, chronic renal failure, skin lesion, peripheral neuropathy, and other abnormalities. Ventricular tachycardia as a Fabry disease presentation is very rare. Read More

Eur Heart J Case Rep 2019 Mar 19;3(1):yty152. Epub 2018 Dec 19.

Cardiology Department, St. Vincent's Hospital, Victoria St, Darlinghurst, Sydney, Australia.

Background: The inter-arterial anomalous course of the left main coronary artery (LMCA) originating from the right coronary sinus of Valsalva is a rare, though potentially lethal pathology. Coronary artery bypass grafting is a potential surgical therapy with previously reported success, however, there is concern for the possibility of graft occlusion in the setting of competitive native vessel flow.

Case Summary: A 48-year-old gentleman presented to our facility with a non-ST elevation acute coronary syndrome. Read More

Eur Heart J Case Rep 2019 Mar 22;3(1):yty151. Epub 2018 Dec 22.

Departamento de Medicina Interna, Universidad de Valparaíso, 4 Poniente 332, Viña del Mar, Chile.

Background: Takotsubo cardiomyopathy (TCM) is a reversible acute cardiac disease that mimics acute myocardial infarction (AMI). In patients with a history of an old myocardial infarction who develop TCM, cardiac magnetic resonance imaging (CMRI) is the first-line non-invasive diagnostic tool for clearly discriminating between AMI and TCM.

Case Summary: A 65-year-old woman who suffered a myocardial infarction in 2012, was admitted to undergo sigmoid colon tumour surgery in January 2017. Read More

Eur Heart J Case Rep 2018 Dec 7;2(4):yty145. Epub 2018 Dec 7.

Coronary and Vascular Heart Disease, Heart and Vascular Theme, Department of Medicine, Karolinska Institute and Karolinska University Hospital, Huddinge, Stockholm, Sweden.

Background: Spontaneous coronary artery dissection (SCAD) is an under-recognized acute cardiac disease entity. It is often missed, or misdiagnosed as coronary spasm, coronary atherosclerotic lesion, or thrombotic coronary occlusion. During the last years, SCAD also has been reported to be 'misdiagnosed as takotsubo syndrome (TS)' in patients with features consistent with both conditions. Read More

Eur Heart J Case Rep 2018 Sep 3;2(3):yty091. Epub 2018 Aug 3.

Department of Cardiology, Fundacion Cardioinfantil Instituto de Cardiologia, Calle 163a No. 13b - 60, Bogotá, Colombia.

Background: Cardiogenic shock secondary to coronary involvement in large vessel vasculitis (LVV) is an unsuspected finding, even more, when no other vascular territories are compromised and when it constitutes the initial clinical manifestation. This case report illustrates a case in which a complete diagnostic study uncovered this aetiology.

Case Summary: A 33-year-old woman with cough and chest pain who was diagnosed with acute bronchitis returned with worsening dyspnoea, chest pain, and developed cardiogenic shock. Read More

Eur Heart J Case Rep 2018 Sep 23;2(3):yty085. Epub 2018 Jul 23.

Coronary Care Unit, Instituto Nacional de Cardiología Ignacio Chávez Juan Badiano 1, Belisario Domínguez-Sección XVI, Tlalpan, Mexico City, Mexico.

Background: The diagnosis of acute ischaemic coronary syndromes in presence of an intra-ventricular conduction disturbance represents a clinical challenge. In the cardiac segmentation model the posterior wall is replaced by the basal inferior segment. However, in the clinical scenario of acute coronary syndrome the concept of posterior myocardial infarction (PMI) endures. Read More

Eur Heart J Case Rep 2018 Sep 21;2(3):yty075. Epub 2018 Sep 21.

Department of Cardiology, King's College Hospital, Denmark Hill, London, UK.

Background: Eosinophilic granulomatosis with polyangiitis (EGPA, formerly known as Churg-Strauss syndrome) is a rare autoimmune condition characterized by inflammation of small- and medium-sized blood vessels, which usually presents with systemic vasculitis preceded by airway allergic hypersensitivity.

Case Summary: Here, we report a highly unusual case of acute ST-elevation myocardial infarction in a young and fit man with no cardiovascular risk factors. His emergency coronary angiography revealed disproportionately severe widespread coronary artery disease. Read More

Eur Heart J Case Rep 2018 Jun 15;2(2):yty044. Epub 2018 May 15.

University Hospital Zurich, Rämistrasse 100, Zurich, Switzerland.

Introduction: Management of coronary anomalies continues to be a controversial topic in medicine, for which only in specific clinical scenarios recommendations for management are clearly defined. We are presenting a previously healthy 18-year-old patient who survived sudden cardiac death (SCD). Multiple potential aetiologies were evaluated, including malignant coronary anomaly, acute myocarditis, potential Brugada type 3 electrocardiographic pattern, and urine drug screening positive for lysergic acid diethylamide (LSD). Read More

Eur Heart J Case Rep 2018 Mar 23;2(1):yty032. Epub 2018 Mar 23.

Coronary Care Unit, Albacete University Hospital, C/Hermanos Falcó 37, 02006 Albacete, Spain.

Introduction: Embolic myocardial infarction is an uncommon but increasingly recognized complication of infective endocarditis (IE). Its incidence ranges between 1% and 10%, but it has a high mortality rate. A high index of suspicion is required to diagnose it. Read More

Cardiol Res 2019 Apr 11;10(2):114-119. Epub 2019 Apr 11.

Department of Cardiothoracic Surgery, NYU Winthrop Hospital, Mineola, NY 11501, USA.

Penetrating cardiac injuries are highly lethal and carry high mortality rate. Both blunt and penetrating cardiac injuries in patients who survive are known to present with well-known sequelae that often appear days to weeks after the initial insult. In the literature there have been documented cases of cardiac injury induced myocardial infarction, ventricular aneurysms, valvular dysfunction and even fistulous tracts between the coronary vessels and chamber. Read More

Int Heart J 2019 Apr 25. Epub 2019 Apr 25.

Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University.

Blood glucose variability is considered to be one of the risk factors for coronary heart disease, and there is growing evidence that blood glucose fluctuation is closely related to the characteristics of plaques. The aim of the study was to investigate the influence of blood glucose variability on the vulnerability of culprit plaques in elderly non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients.Coronary angiography and VH-IVUS were applied to evaluate the components of culprit plaque in NSTE-ACS patients. Read More

Heart 2019 Apr 24. Epub 2019 Apr 24.

Cardiovascular Research Institute Basel, Department of Cardiology, University Hospital Basel, University Basel, Basel, Switzerland.

Objective: Assess the relative incidence and compare characteristics and outcome of unstable angina (UA) and non-ST-elevation myocardial infarction (NSTEMI).

Design: Two independent prospective multicentre diagnostic studies (Advantageous Predictors of Acute Coronary Syndromes Evaluation [APACE] and High-Sensitivity Troponin in the Evaluation of Patients With Acute Coronary Syndrome [High-STEACS]) enrolling patients with acute chest discomfort presenting to the emergency department. Central adjudication of the final diagnosis was done by two independent cardiologists using all clinical information including serial measurements of high-sensitivity cardiac troponin (hs-cTn). Read More

Circ Cardiovasc Interv 2019 May;12(5):e007019

Department of Cardiology, First Affiliated Hospital of Nanjing Medical University, Jiangsu, China (K.X., S.Y., S.Z., M.Y., J.Z., Y.F., L. Ying, X.H., X.Z., C.L.).

Background: The genetic determinants of response to clopidogrel and aspirin are incompletely characterized. Recently, PEAR1 (platelet endothelial aggregation receptor-1) rs12041331 polymorphism has been shown to influence the platelet reactivity, but its impact on cardiovascular outcomes remains unclear in patients treated with antiplatelet agents.

Methods And Results: In this prospective cohort study, 2439 Chinese patients with acute coronary syndrome or stable coronary artery disease undergoing coronary stent implantation and receiving clopidogrel and aspirin were consecutively recruited. Read More

Eur Heart J Acute Cardiovasc Care 2019 Apr 24:2048872619846334. Epub 2019 Apr 24.

7 Department of Medical Sciences, Cardiology Uppsala University, Sweden.

Aims: We investigated the dynamics, associations with patient characteristics, other biomarkers, and clinical outcomes of pentraxin 3 in acute coronary syndrome.

Methods And Results: In multivariate analyses, pentraxin 3 measured in 5154 patients randomised in the Platelet Inhibition and Patients Outcomes (PLATO) trial (NCT00391872) was compared with leukocytes, high-sensitivity C-reactive protein, interleukin-6, cystatin C, N-terminal prohormone brain natriuretic peptide, high-sensitivity troponin T and growth differentiation factor 15 concerning prediction of clinical outcome. Pentraxin 3 peaked earlier than high-sensitivity C-reactive protein and was more strongly correlated with N-terminal prohormone brain natriuretic peptide and high-sensitivity troponin T than with high-sensitivity C-reactive protein. Read More

J Investig Allergol Clin Immunol 2019 Apr;29(2):162-164

Department of Allergology and Immunology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.

Cureus 2019 Feb 13;11(2):e4065. Epub 2019 Feb 13.

Cardiology, University of Toledo Medical Center, Toledo, USA.

Spontaneous coronary artery dissection (SCAD) is a rare and deadly cause of acute myocardial infarction (MI). It remains greatly misdiagnosed and carries a high in-hospital mortality rate. Herein, we report a healthy 38-year-old female who presented to our institution for non-ST segment myocardial infarction, in which subsequent coronary angiogram revealed a type 2 spontaneous coronary artery dissection of the obtuse marginal branch with diffuse single-vessel disease of the circumflex artery. Read More

Pharm Pract (Granada) 2019 Jan-Mar;17(1):1372. Epub 2019 Mar 11.

Specialist Mental Health and Prescribing Support Pharmacist Primary Care, Pharmacy and Prescribing Support Unit, NHS Greater Glasgow and Clyde, West Glasgow Ambulatory Care Hospital. Glasgow, Scotland (United Kingdom).

Background: Optimal prescribing of secondary prevention medications after acute coronary syndrome (ACS) events has been shown to reduce morbidity and mortality. However, it is unknown whether these medications are optimally prescribed at discharge from acute care in Iraq.

Objective: To evaluate whether patients with ACS received optimal secondary prevention medications: antiplatelets, statins, angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARBs), and beta-blockers at discharge from a cardiology unit, and to assess whether statins, ACEI/ARBs and beta-blockers were prescribed at target doses based on the American Heart Association/American College of Cardiology (AHA/ACC) guidelines. Read More

Rev Port Cardiol 2019 Apr 20. Epub 2019 Apr 20.

Department of Cardiology, Centro Hospitalar de Vila Nova de Gaia Espinho, Vila Nova de Gaia, Portugal.

Introduction: Single coronary artery (SCA) with no associated congenital heart disease is a rare congenital anomaly. Most cases are asymptomatic and incidental findings, but SCA can cause ischemia, congestive heart failure, and sudden cardiac death (SCD).

Case Report: A 44-year-old woman presented with Takotsubo cardiomyopathy and cardiogenic shock. Read More

J Emerg Med 2019 Apr 20. Epub 2019 Apr 20.

Department of Emergency Medicine, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia.

Background: Kounis syndrome (allergic myocardial infarction) is the rare occurrence of systemic anaphylaxis with spontaneous electrocardiographic changes in response to an exogenous agent. Often the syndrome is caused by a drug reaction involving drugs such as non-steroidal anti-inflammatory drugs, antibiotics, or opioids. There are a few reported cases in the literature regarding diclofenac-induced Kounis syndrome, and little is known about the management of this clinical entity. Read More

Cardiovasc Diabetol 2019 Apr 23;18(1):52. Epub 2019 Apr 23.

Department of Cardiovascular Medicine, The First Affiliated Hospital, Xi'an Jiaotong University, 277 West Yanta Rd., Xi'an, 710061, Shaanxi, People's Republic of China.

Background: Despite revascularisation, a large proportion of acute coronary syndrome (ACS) patients continue to experience major adverse cardiovascular events (MACEs), which are worsened by diabetes mellitus (DM). Fibrinogen (FIB) is a risk factor for MACEs in coronary artery disease and often elevated in DM. However, the relationships between FIB, glucose metabolism (haemoglobin A1c [HbA1c] and fasting blood glucose [FBG]) and MACEs following percutaneous coronary intervention (PCI) in DM, non-DM or whole patients with ACS remains unknown. Read More

Heart Surg Forum 2019 Apr 12;22(2):E162-E164. Epub 2019 Apr 12.

Department of Cardiovascular Diseases, University Hospital Dubrava, Avenija Gojka Šuška 6, 10 000 Zagreb, Croatia.

Primary cardiac neoplasms are extremely rare and often overlooked as differential diagnosis. Angiosarcomas are the most common primary malignant neoplasms of the heart often with nonspecific symptoms. We present a 43-year-old woman admitted to our hospital with chest pain and inferoposterolateral myocardial infarction. Read More

EuroIntervention 2019 04 23. Epub 2019 Apr 23.

Ludwig-Maximilians University, Department of Cardiology, Munich, Germany.

Aims: A guided de-escalation of P2Y12 inhibitor treatment is considered as an alternative treatment strategy in ACS patients undergoing PCI. However, the safety and efficacy of this strategy may differ in diabetic vs. non-diabetic patients. Read More

EuroIntervention 2019 04 23. Epub 2019 Apr 23.

Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands.

Aims: To demonstrate the feasibility and safety of prasugrel monotherapy without aspirin post procedure in selected patients undergoing successful percutaneous coronary intervention (PCI) with the SYNERGY stent.

Methods And Results: The ASET Pilot study is designed as a multicenter, single arm, open-label, proof-of-concept trial with a stopping rule based on the occurrence of definite stent thrombosis (def-ST). Two hundred patients with a SYNTAX score of <23 requiring PCI for stable angina or stabilized acute coronary syndrome with normal or decreasing cardiac enzyme will be screened and considered eligible for the study. Read More

J Diabetes 2019 Apr 22. Epub 2019 Apr 22.

Peter Munk Cardiac Centre and Heart and Stroke Richard Lewar Centre, University of Toronto, Toronto, Canada.

Med Sci (Basel) 2019 Apr 19;7(4). Epub 2019 Apr 19.

Monash University, Clayton, Victoria 3168, Australia.

The aim of this study was to investigate the impact of bedside discharge education on activity levels and healthcare utilization for patients with acute coronary syndrome (ACS) in the first 30 days post-discharge. Knowledge recall and objective activity and location data were collected by global positioning systems (GPS). Participants were asked to carry the tracking applications (apps) for 30⁻90 days. Read More

J Urol 2019 May;201(5):842-843

Eur Stroke J 2016 Sep 21;1(3):205-212. Epub 2016 Jun 21.

Neurovascular Research Laboratory, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.

Purpose: The importance of troponin elevation at stroke presentation remains uncertain. We aimed to assess whether baseline ultrasensitive Troponin I (hs-TnI) predicts cardiac complications and outcome in acute stroke patients.

Method: Stroke patients admitted within 6 h were consecutively enrolled from May 2013 to March 2014. Read More

Medicine (Baltimore) 2019 Apr;98(16):e15190

Rationale: Takotsubo syndrome (TTS) is a form of acute and usually reversible heart failure syndrome. Transient left ventricular dysfunction and electrocardiographic changes could mimic acute coronary syndrome but there are actually no obstructive coronary lesions.

Patient Concerns: A 76-year-old woman with chronic lung disease developed spontaneous tension pneumothorax with the presentation of severe dyspnea, respiratory failure, left ventricular dysfunction, and anterior wall ST-segment elevation on 12-lead electrocardiogram. Read More

J Arrhythm 2019 Apr 24;35(2):182-189. Epub 2019 Jan 24.

Division of Cardiology Department of Internal Medicine Memorial Heart Center Iwate Medical University Morioka Iwate Japan.

Background: The purpose of this study was to evaluate the prognostic value of atrial fibrillation (AF) in patients with acute coronary syndrome (ACS).

Methods: A total 648 of consecutive ACS patients were divided into non-AF and all-AF groups. The all-AF group was further subdivided into new-onset AF and pre-existing AF groups. Read More

Am J Emerg Med 2019 Apr 12. Epub 2019 Apr 12.

Department of Emergency Medicine, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. Electronic address:

Hiccups are usually benign, while myocardial infarction (MI) has the potential for morbidity and mortality. Here, we report 3 cases of MI, with hiccups being the only symptom on presentation to the emergency department. Attention should be given to patients who present with hiccups and multiple risk factors for acute coronary syndrome, especially those with factors predisposing them to atypical presentations, such as diabetes mellitus, and old age. Read More

Heart Lung Circ 2019 Mar 28. Epub 2019 Mar 28.

Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany; Klinikum der Stadt Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany.

Background: Patients suffering an acute coronary syndrome (ACS) are at increased risk for future cardiovascular events. Effective management of hyperlipidaemia in such patients is essential. We aimed to document the use of lipid-lowering therapy (LLT) and low-density lipoprotein cholesterol (LDL-C) target achievement in patients hospitalised with an ACS in Thailand. Read More

Clin Chem Lab Med 2019 Apr 22. Epub 2019 Apr 22.

Clinical Laboratory, Catharina Hospital, Eindhoven, The Netherlands.

JACC Cardiovasc Imaging 2019 Mar 17. Epub 2019 Mar 17.

Department of Radiology, Providence Health Care, St. Paul's Hospital, University of British Columbia, Vancouver, Canada.

Objectives: The 1-year data from the international ADVANCE (Assessing Diagnostic Value of Non-invasive FFR in Coronary Care) Registry of patients undergoing coronary computed tomography angiography (CTA) was used to evaluate the relationship of fractional flow reserve derived from coronary CTA (FFR) with downstream care and clinical outcomes.

Background: Guidelines for management of chest pain using noninvasive imaging pathways are based on short- to intermediate-term outcomes.

Methods: Patients (N = 5,083) evaluated for clinically suspected coronary artery disease and in whom atherosclerosis was identified by coronary CTA were prospectively enrolled at 38 international sites from July 15, 2015, to October 20, 2017. Read More

Int J Cardiol 2019 Apr 14. Epub 2019 Apr 14.

Interventional Cardiology Division, Cardio-Thoracic-Vascular Department, San Raffaele Scientific Institute, Milan, Italy.

Background: Complex percutaneous coronary intervention (PCI) is associated with increased procedural challenges and high contrast load. We aimed to evaluate the association between complex PCI and contrast-induced nephropathy (CIN).

Methods: This single-center retrospective study included all-comers undergoing PCI between January 2012 and December 2016. Read More

Am Heart J 2019 Mar 5;212:134-143. Epub 2019 Mar 5.

Centre of Cardiovascular Research and Education in Therapeutics (CCRE), Monash University, Melbourne, Australia; Department of Cardiovascular Medicine, Alfred Hospital, Melbourne, Australia. Electronic address:

Background: Repeat hospitalizations for recurrent acute coronary syndrome (ACS) or unplanned revascularization after acute myocardial infarction (MI) are common, costly and potentially preventable. We aim to describe 10-year trends and identify independent risk factors of these repeat hospitalizations.

Methods: We analyzed data from 9615 patients from the Melbourne Interventional Group registry (2005-2014) who underwent percutaneous coronary intervention (PCI) for their index MI and survived to discharge. Read More

J Thromb Thrombolysis 2019 Apr 19. Epub 2019 Apr 19.

Department of Cardiology, LMU München, Marchioninistraße 15, 81377, Munich, Germany.

De-escalation from ticagrelor to clopidogrel in acute coronary syndrome (ACS) may occur for a variety of reasons, including side effects (bleeding and non-bleeding) and costs. This study sought to assess the prevalence of de-escalation from ticagrelor to clopidogrel and the occurrence of adverse clinical outcomes following de-escalation. We conducted a systematic review of clinical trials and real-world studies in ACS patients treated with ticagrelor. Read More

J Emerg Med 2019 Apr 16. Epub 2019 Apr 16.

Department of Cardiology, Faculty of Medicine, Muğla University, Muğla, Turkey.

Background: Gemifloxacin given once daily for 5-7 days has been shown to be non-inferior to, or in some instances superior to, comparator agents for the treatment of common lower respiratory tract infections. Gemifloxacin is generally well tolerated and is as safe as many frequently empirically prescribed antimicrobials.

Case Report: We report a case of a 46-year-old woman given gemifloxacin for an upper respiratory tract infection who developed allergic myocardial infarction 15 min after taking an oral dose of 320 mg gemifloxacin. Read More

Am J Med Sci 2019 Feb 13. Epub 2019 Feb 13.

Department of Emergency Medicine, Medipol University Hospital, Istanbul, Turkey. Electronic address:

Background: The Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) score is an anatomic scoring system based on coronary angiography that quantifies lesion severity and complexity and predicts morbidity and mortality to guide decision making between coronary artery bypass graft surgery and percutaneous coronary intervention in patients with acute coronary syndrome. The present study aimed to compare nitric oxide levels with the SYNTAX score in terms of predicting coronary complexity and the treatment decision for unstable angina pectoris in the emergency department.

Methods: The study included 120 patients with unstable angina pectoris and 120 control group subjects. Read More

Indian Heart J 2019 Jan - Feb;71(1):74-79. Epub 2018 Dec 10.

Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, Tamilnadu, India. Electronic address:

Objective: Fractional flow reserve (FFR) using adenosine has been the gold standard in the functional assessment of intermediate coronary stenoses in the catheterization laboratory. We aim to study the correlation of adenosine-free indices such as whole cycle Pd/Pa [the ratio of mean distal coronary pressure (Pd) to the mean pressure observed in the aorta (Pa)], instantaneous wave-free ratio (iFR), and contrast-induced submaximal hyperemia (cFFR) with FFR.

Methods: This multicenter, prospective, observational study included patients with stable angina or acute coronary syndrome (>48 h since onset) with discrete intermediate coronary lesions (40-70% diameter stenosis). Read More

Indian Heart J 2019 Jan - Feb;71(1):25-31. Epub 2019 Jan 3.

Ruby Hospital, Pune, India.

Background: Acute coronary syndrome (ACS) is associated with emergency hospitalizations, and there are limited real-world data on clinical outcomes in post-ACS Asian patients. This article presents data on the Indian subgroup from the Long-term Follow-up of Antithrombotic Management Patterns in Acute Coronary Syndrome Patients in Asia (EPICOR-Asia) study.

Methods: EPICOR included patients with ACS [ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI), or unstable angina (UA)]. Read More

Indian Heart J 2019 Jan - Feb;71(1):15-24. Epub 2019 Jan 25.

University Hospital of State Medical University of Semey, Department of Endovascular Surgery, Semey, Kazakhstan.

Objective: We aimed to assess the efficacy and safety of ticagrelor compared to clopidogrel in Asian patients with acute coronary syndrome (ACS) in real-world practice.

Methods: PubMed, Web of Science and Scopus databases were searched systematically to obtain relevant Asian observational studies.

Results: The meta-analysis included six studies with 27959 participants. Read More