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Aliment Pharmacol Ther 2019 Jan 16. Epub 2019 Jan 16.

Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan.

Background: The role of hepatitis C (HCV) eradication on the long-term complications of type 2 diabetes mellitus remains incompletely studied.

Aim: We investigated whether antiviral treatment impacted risk of acute coronary syndrome, end-stage renal disease, ischaemic stroke, and retinopathy among diabetic patients from the four US health systems comprising the Chronic Hepatitis Cohort Study (CHeCS).

Methods: We included CHeCS HCV patients with diagnosis codes for type 2 diabetes who were on antidiabetic medications. Read More

Acta Cardiol 2019 Jan 16:1-7. Epub 2019 Jan 16.

c Cardiology Department , University Hospital Monklands , Lanarkshire , Scotland.

Background: Patients with chest pain are risk-stratified using serial high-sensitivity troponin (T) assays (hsTnT). Those with change in (Δ)hsTnT <20% are often categorised as low-risk and are less likely to be managed as acute coronary syndromes (ACS). We sought to characterise such a population of 'low-risk' chest pain presenters. Read More

Acta Cardiol 2019 Jan 16:1-7. Epub 2019 Jan 16.

a University Hospital of Liège, GIGA Cardiovascular Sciences, Acute Care Unit, Heart Failure Clinic, CHU Sart Tilman , Liège , Belgium.

Objective: Hypoalbuminemia is common in heart failure (HF), especially in elderly patients. It is associated with an increased risk of death. The present study sought to examine the prognostic significance of serum albumin level in the prediction of long-term mortality in patients admitted for acute HF. Read More

Acta Cardiol 2019 Jan 16:1-6. Epub 2019 Jan 16.

b Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.

Background: Red blood cell distribution width (RDW) is a measure of the degree of heterogeneity of erythrocyte volume. Higher RDW levels are associated with increased mortality among patients with acute coronary syndrome (ACS), heart failure and other cardiovascular diseases. The association between RDW levels and clinical outcomes in patients admitted for further evaluation of chest pain is not known. Read More

Ann Card Anaesth 2019 Jan-Mar;22(1):89-91

Department of Radiology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.

Pulmonary embolism (PE) may be potentially fatal if not diagnosed and treated in time. Although specific electrocardiogram (ECG) findings often suggest the diagnosis of PE, occasionally, the ECG may mimic that of an acute coronary syndrome (ACS). We report an interesting case of a 45-year-old female presenting with sudden onset chest pain and shortness of breath with widespread ST depression in anterior precordial leads. Read More

J Diabetes Res 2018 16;2018:1631263. Epub 2018 Dec 16.

Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.

Introduction: We investigated the association of diabetic retinopathy and neuropathy with increased risk of recurrent cardiovascular (CV) events in 6068 patients with type 2 diabetes mellitus (T2DM) and recent acute coronary syndrome (ACS) enrolled in the Evaluation of Lixisenatide in Acute Coronary Syndrome (ELIXA).

Methods: History of retinopathy and neuropathy as well as duration of T2DM were self-reported at screening. Proportional hazards regression models were used to assess relationships between retinopathy, neuropathy, and recurrent CV events. Read More

Case Rep Cardiol 2018 13;2018:5498052. Epub 2018 Dec 13.

Department of Cardiology, Maimonides Medical Center, Brooklyn, NY 11219, USA.

A 73-year-old female with multiple comorbidities including coronary artery disease was admitted for an elective PCI of a lesion detected in the RCA. On the day of the planned PCI, shortly after right femoral artery cannulation, the patient developed a sudden complete heart block requiring the administration atropine and insertion of a temporary pacemaker. Concomitantly, the patient developed acute pulmonary edema, hypotension, and hypoxia requiring intubation for mechanical ventilation. Read More

Dis Markers 2018 17;2018:9731374. Epub 2018 Dec 17.

Department of Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

Background: Whether serum uric acid (UA) is associated with all-cause mortality in patients with acute coronary syndrome (ACS) following percutaneous coronary intervention (PCI) remains unclear.

Methods: We performed a retrospective cohort study of 2296 patients with ACS. Curve-fitting and Cox proportional-hazard regression models with a hazard ratio (HR) and 95% confidence interval (CI) were used. Read More

Kardiochir Torakochirurgia Pol 2018 Dec 31;15(4):238-240. Epub 2018 Dec 31.

Department of Family Medicine, Lviv National Medical University named after Danylo Halytsky, Lviv, Ukraine.

Introduction: Estimation of cardiosurgical intervention risk according to EuroSCORE is an important aspect of cardiosurgery. EuroSCORE allows prediction of the probability of a post-operational fatal outcome.

Aim: To estimate the influence of gallbladder condition on the prognosis after coronary artery bypass grafting (CABG) and and the interactions between metabolic background and cardiosurgical intervention risk. Read More

Vopr Pitan 2016 23;85(3):96-103. Epub 2016 Jun 23.

Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow.

The use of selenium-containing specialized food products in prophylactic and therapeutic diets is based on hypothesis that selenium as antioxidant can potentially decrease the risk of oxidative stress induced diseases. There is a hypothesis, which is strongly supported during last 10-15 years that the reactive oxygen species are generated during ischemic myocardium reperfusion and cardiomyocyte damage. In addition selenium as an important component of glutationperoxidaze, it promotes protection against ischemic damage, improvement of functional regeneration and reduction of morphological changes in cardiomyocytes. Read More

Prescrire Int 2016 Oct;25(175):245-246

After an acute coronary syndrome, the 6-year results of the "IMPROVE-IT" randomized trial showed a 1.6% reduction in the number of nonfatal myocardial infarctions with the ezetimibe + simvastatin combination compared with simvastatin alone, but no reduction in mortality. Read More

JAMA Netw Open 2018 Aug 3;1(4):e181405. Epub 2018 Aug 3.

Center of Innovation in Long Term Services and Supports, Providence Veterans Affairs Medical Center, Providence, Rhode Island.

Importance: Delirium at admission is associated with increased hospital morbidity and mortality, but it may be missed in up to 70% of cases. Use of a predictive algorithm in an electronic medical record (EMR) system could provide critical information to target assessment of those with delirium at admission.

Objectives: To develop and assess a prediction rule for delirium using 2 populations of veterans and compare this rule with previously confirmed rules. Read More

Health Qual Life Outcomes 2019 Jan 14;17(1):10. Epub 2019 Jan 14.

Department of Health Education & Promotion, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.

Background: Cardiovascular diseases (CVD) as a most frequent and costly NCDs account for about 17.3 million annual deaths worldwide. About 80% of these deaths are taking place in low and middle income countries (LMIC). Read More

J Am Heart Assoc 2019 Jan;8(2):e010373

2 Center for Outcomes Research and Evaluation Yale-New Haven Hospital New Haven CT.

Background Certificate of need ( CON ) regulations are intended to coordinate new healthcare services, limit expansion of unnecessary new infrastructure, and limit healthcare costs. However, there is limited information about the association of CON regulations with the appropriateness and outcomes of percutaneous coronary interventions ( PCI ). The study sought to characterize the association between state CON regulations and PCI appropriateness. Read More

Int J Surg Case Rep 2019 Jan 9;55:7-10. Epub 2019 Jan 9.

Department of Surgery, Kendall Regional Medical Center, Miami, FL, United States.

Introduction: Pheochromocytoma are neuroendocrine tumors that arise from sympathetic chromaffin cells within the adrenal medulla. They principally secrete catecholamines, potentially causing life-threatening cardiovascular complications. A myriad of symptomatology and clinical findings are associated with pheochromocytoma, including a catecholamine-induced dilated cardiomyopathy. Read More

Adv Med Sci 2019 Jan 11;64(1):131-136. Epub 2019 Jan 11.

1st Department of Nephrology and Transplantation with Dialysis Unit, Medical University of Bialystok, Bialystok, Poland.

Troponin measurement is one of crucial assessments facilitating diagnosis of acute coronary syndrome. Patients with chronic kidney disease are decimated by cardiovascular disease. Unfortunately, elevated concentration of serum troponin is commonly faced in clinical practice creating a challenge to rule out acute cardiac ischaemia in this vulnerable population. Read More

Clin Chim Acta 2019 Jan 9. Epub 2019 Jan 9.

Department of Neurology, Shengjing Hospital of China Medical University, Shenyang, Liaoning, PR China. Electronic address:

Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), a scavenger receptor of oxidized low-density lipoprotein (ox-LDL) found in various cells, plays a crucial role in the formation and progression of atherosclerotic plaques. Animal studies have suggested that LOX-1 mediates the balance between internalization and degeneration of endothelial cells, thereby contributing to various steps in the atherosclerotic process, from initiation to plaque rupture. Under pathological conditions, the extracellular domain of membrane bound LOX-1 can be largely proteolytically cleaved into a soluble form (sLOX-1), which is proportional and linked to the LOX-1 expression level. Read More

Int J Cardiol 2018 Dec 21. Epub 2018 Dec 21.

Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Anesthesiology and Intensive Care Medicine, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Sweden.

Background: Takotsubo syndrome (TS) is an acute cardiac syndrome characterized by regional myocardial akinesia that is not caused by coronary artery occlusion. Exogenous as well as endogenous excess catecholamines can induce TS. The aim of this study was to explore the effects of pharmacological cardio-simulative and cardio-depressing drugs on the development of isoprenaline-induced takotsubo-like cardiac dysfunction, a rat model of TS. Read More

Can J Cardiol 2018 Nov 29. Epub 2018 Nov 29.

Emergencias 2018 Dic;30(6):439-440

Unidad de Hemodinámica, Servicio de Cardiología, Hospital Universitario de Guadalajara, SESCAM, España.

G Ital Cardiol (Rome) 2019 Jan;20(1):46-61

Presidente SIC, Struttura Cardiologica, Policlinico Universitario, Cagliari.

Palliative care is recognized as an approach that improves quality of life of patients and families facing life-threatening illnesses. This is achieved through prevention, early identification, assessment and treatment of symptoms and other psycho-social, spiritual and economic issues. Palliative care is not dependent on prognosis and can be delivered as "simultaneous care", together with disease-modifying treatments and adequate symptom relief. Read More

Curr Cardiol Rep 2019 Jan 12;21(1). Epub 2019 Jan 12.

Department of Internal Medicine, Duke University Health System, 2301 Erwin Rd, Durham, NC, 27707, USA.

The treatment of patients requiring anticoagulation who develop acute coronary syndrome (ACS) and/or require percutaneous coronary intervention (PCI) must balance the reduction in major adverse cardiovascular events, stroke, and major bleeding. The development of direct oral anticoagulants (DOACs) for the treatment of atrial fibrillation has ushered in an era of potential treatment options for these complex patients. PURPOSE OF REVIEW: To review the clinical evidence underlying the use of DOACs for the treatment of patients with atrial fibrillation and ACS or PCI. Read More

J Am Coll Clin Pharm 2018 Dec 14;1(2):58-61. Epub 2018 Apr 14.

University of Utah School of Medicine, Division of Cardiovascular Medicine, Salt Lake City, USA.

Study Objective: Data from randomized controlled trials support a mortality benefit with ticagrelor versus clopidogrel among patients with acute myocardial infarction (AMI). Many healthcare providers preferentially treat patients with AMI with ticagrelor. The goal of this study was to determine the association between out-of-pocket drug costs and ticagrelor continuation compared with switching to clopidogrel among patients hospitalized for AMI, following a pharmacist-led discussion on outpatient co-payment costs for ticagrelor. Read More

World J Clin Cases 2019 Jan;7(1):89-94

Department of Laboratory Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, Jiangsu Province, China.

Background: Cardiac toxic effect of tegafur (S-1) is extremely rare, and there has been no report on this issue so far.

Case Summary: We herein report a typical case of single S-1 administration after radical operation for colon cancer. The patient had no background or medical history of acute coronary syndrome (ACS), and only aortic and coronary atherosclerosis was revealed by computed tomography (CT) before surgery. Read More

Pan Afr Med J 2018 30;30:301. Epub 2018 Aug 30.

Department of Cardiology B, Ibn Sina Hospital, Mohammed V University, Rabat, Morocco.

The Kounis-Zavras syndrome is defined as the coincidental occurrence of acute coronary events and hypersensitivity reactions following an allergic reaction including a mast-cell degranulation of vasospastic mediators. This report describes a case of Kounis-Zavras syndrome in the setting of aspirin-induced asthma also known as Samter-Beer triad combining nasal polyps, asthma, and aspirin allergy leading to vasospasm and myocardial infarction. All physicians should be aware of The Kounis syndrome and always keep that unique clinical entity in mind to recognize it promptly and direct the therapy at suppressing the allergic reaction. Read More

J Am Heart Assoc 2019 Jan;8(2):e010956

14 Department of Cardiology Multimedica IRCSS Milan Italy.

Background Elderly patients have high ischemic and bleeding rates after acute coronary syndrome; however, the occurrence of these complications over time has never been studied. This study sought to characterize average daily ischemic rates ( ADIRs ) and average daily bleeding rates ( ADBRs ) over 1 year in patients aged >74 years with acute coronary syndrome undergoing percutaneous coronary intervention who were randomized in the Elderly ACS 2 trial, comparing low-dose prasugrel (5 mg daily) with clopidogrel (75 mg daily). Methods and Results ADIRs and ADBRs were calculated as the total number of events, including recurrent events, divided by the number of patient-days of follow-up and assessed within different clinical phases: acute (0-3 days), subacute (4-30 days), and late (31-365 days). Read More

J Am Heart Assoc 2019 Jan;8(2):e010826

4 Department of Otolaryngology Head & Neck Surgery Beijing Anzhen Hospital Capital Medical University Beijing China.

Background The prognostic significance of obstructive sleep apnea ( OSA ) in patients with acute coronary syndrome ( ACS ) in the contemporary era is unclear. We performed a large, prospective cohort study and did a landmark analysis to delineate the association of OSA with subsequent cardiovascular events after ACS onset. Methods and Results Between June 2015 and May 2017, consecutive eligible patients admitted for ACS underwent cardiorespiratory polygraphy during hospitalization. Read More

Heart 2019 Jan 12. Epub 2019 Jan 12.

School of Healthcare Science, Manchester Metropolitan University, Manchester, UK.

Objectives: The rapid turnaround time of point-of-care (POC) cardiac troponin (cTn) assays is highly attractive for crowded emergency departments (EDs). We evaluated the diagnostic accuracy of the Troponin-only Manchester Acute Coronary Syndromes (T-MACS) decision aid with a POC cTn assay.

Methods: In a prospective diagnostic accuracy study at eight EDs, we included patients with suspected acute coronary syndromes (ACS). Read More

Aging (Albany NY) 2019 Jan 11. Epub 2019 Jan 11.

Department of Cardiology, Bern University Hospital, University of Bern, Bern 3010, Switzerland.

BMJ Case Rep 2019 Jan 10;12(1). Epub 2019 Jan 10.

Division of Cardiovascular Medicine, University of Missouri Health Care, Columbia, Missouri, USA.

Dobutamine stress echocardiogram (DSE) is considered a safe and reliable method for screening for underlying myocardial ischaemia. We report a case of a 60-year-old man who developed inferior ST-segment elevation myocardial infarction within 30 minutes of a normal DSE. The patient was found to have a 99% in-stent restenosis in the mid-right coronary artery with significant thrombosis for which successful percutaneous coronary intervention (PCI) was performed. Read More

BMJ Case Rep 2019 Jan 10;12(1). Epub 2019 Jan 10.

Cardiology, West Suffolk NHS Foundation Trust, Bury Saint Edmunds, UK.

A 51-year-old woman with known primary antiphospholipid syndrome presented with a 4-day history of chest and abdominal pain, inferior ST-segment elevation on a 12-lead ECG and a subtherapeutic international normalised ratio. In view of a significantly raised high-sensitivity troponin I assay, inferior wall hypokinesis on transthoracic echocardiography and despite unobstructed epicardial vessels on emergency coronary angiography, a diagnosis of myocardial infarction was made. Furthermore, the patient also developed both bilateral adrenal haemorrhages leading to acute adrenal insufficiency and microvascular thrombotic renal disease concurrently. Read More

J Psychosom Res 2019 Jan 3. Epub 2019 Jan 3.

Department of Psychosomatic Medicine and Psychotherapy, University of Göttingen Medical Center, Göttingen, and German Center for Cardiovascular Research (DZHK), partner site Göttingen, Göttingen, Germany. Electronic address:

J Transl Med 2019 Jan 11;17(1):21. Epub 2019 Jan 11.

Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, 514031, People's Republic of China.

Background: T cells are key regulators of immunity and one of the cells recruited in atherosclerosis and participated in various stages of the development of atherosclerosis. Characterizing T-cell receptor (TCR) repertoires is a priority of great scientific interest and potential clinical utility for the early diagnosis, risk stratification and prognostic evaluation of acute myocardial infarction (AMI).

Methods: The TCR repertoires in 21 subjects including 7 patients with non-ST-segment elevation myocardial infarction (NSTEMI), 6 patients with ST-segment elevation myocardial infarction (STEMI) and 8 subjects with normal coronary artery (NCA) as control were characterized by using high-throughput sequencing. Read More

J Ayub Med Coll Abbottabad 2018 Oct-Dec;30(4):611-613

Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan.

Postoperative diaphragmatic hernia (PDH) is an increasingly reported complication of esophageal cancer surgery. It occurs more frequently with minimally invasive techniques and very little is known about its pathogenesis. Currently, no consensus exists concerning preventive measures and its management. Read More

Emerg Radiol 2019 Jan 10. Epub 2019 Jan 10.

Radiology Department, Vancouver General Hospital, 889 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada.

Purpose: It is uncertain whether patients with elevated troponin and non-classical presentation of acute coronary syndrome (ACS) should receive coronary CT angiography (CCTA). A proportion of these patients will have no coronary artery disease (CAD) and would benefit from non-invasive investigations and expedited discharge. Objectives were to determine most common diagnoses and rate of ACS among patients with positive troponin and low clinical suspicion of ACS who received CCTA. Read More

Curr Cardiol Rep 2019 Jan 10;21(1). Epub 2019 Jan 10.

Division of Cardiovascular Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center El Paso, 4800 Alberta Ave, El Paso, TX, 79905, USA.

Purpose Of Review: This review discusses the outcomes of percutaneous coronary intervention (PCI) in women who experience acute myocardial infarction (AMI) and are treated with drug-eluting stents (DES). The review also describes the role of the new-generation DES compared with the early generation.

Recent Findings: Recent literature shows that the new-generation DES can be effective in women who present with AMI. Read More

PeerJ 2019 4;7:e5652. Epub 2019 Jan 4.

Department of the Fifth Affiliated Hospital, Zhengzhou University, Zhengzhou, China.

Background: This study evaluated changes in interleukin (IL)-27 levels in patients with acute coronary syndrome (ACS) and their influence on Th1, Th2, and Th17 cells.

Methods: Serum levels of IL-27, IL-4, IL-17, and interferon (IFN)-γ in healthy subjects as well as patients with ACS, including stable angina pectoris (SA), unstable angina pectoris (UA), and acute myocardial infarction (AMI), were determined using an enzyme-linked immunosorbent assay. The proportions of Th1, Th2, and Th17 cells among peripheral blood mononuclear cells (PBMCs), were measured using flow cytometry, after incubation with phorbol myristate acetate (PMA) for 4 h. Read More

F1000Res 2018 29;7. Epub 2018 Nov 29.

Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA.

Despite the growing awareness of adverse events with acute coronary syndrome and vigilance to refine pharmacological and interventional therapies, the understanding of how these events present in and affect women and the elderly remains limited. Pathophysiological differences in these subgroups and under-representation in large trials create a medical gap in sex- and age-related outcomes and in our knowledge of how best to detect, diagnose, and treat acute coronary syndrome. This review provides a general overview of recent advances in non-ST elevation myocardial infarction management in women and the elderly and elucidates areas where further exploration is needed. Read More

Arch Cardiovasc Dis 2019 Jan 7. Epub 2019 Jan 7.

Service de cardiologie et maladies vasculaires, CIC-IT 804, hôpital Pontchaillou, CHU de Rennes, 35033 Rennes, France; Inserm U1099, laboratoire de traitement du signal et de l'image, université de Rennes 1, 35000 Rennes, France.

Background: Several randomized studies have shown that bioresorbable vascular scaffold (BVS) technology is associated with an increased risk of stent thrombosis.

Aim: This study aimed to assess the rates of adverse outcomes at 1 year in patients treated with the Absorb BVS (Abbott Vascular, Santa Clara, CA, USA), using data from a large nationwide prospective multicentre registry (FRANCE ABSORB).

Methods: All patients receiving the Absorb BVS in France were included prospectively in the study. Read More

BMC Cardiovasc Disord 2019 Jan 10;19(1):12. Epub 2019 Jan 10.

Department of Cardiology, National Center of Gerontology, China, Beijing Hospital, NO.1 DaHua Road, Dong Dan, Beijing, 100730, People's Republic of China.

Background: Percutaneous coronary interventions (PCI) of bifurcation lesions is technically challenging and associated with lower success rates and higher frequency of adverse outcomes. In the present study, we aimed to evaluate the immediate and long-term treatment effect and adverse events of a new modified jailed-balloon technique on side branch (SB) during PCI on coronary bifurcation lesions.

Methods: This was a prospective study of 60 patients (49 males, 11 females, mean age 66 ± 10 years) with coronary bifurcation lesions treated at the Beijing Hospital between September 2014 and October 2015. Read More

BMC Cardiovasc Disord 2019 Jan 10;19(1):13. Epub 2019 Jan 10.

Clinical Physiology and Nuclear Medicine, Skane University Hospital, Lund, Sweden.

Background: In the standard ECG display, limb leads are presented in a non-anatomical sequence: I, II, III, aVR, aVL, aVF. The Cabrera system is a display format which instead presents the limb leads in a cranial/left-to-caudal/right sequence, i.e. Read More

Circ Cardiovasc Qual Outcomes 2019 Jan;12(1):e005041

Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC (A.M.N., M.T.R., J.A.W., Y.L., L.K.N., M.A.B.).

Background: Although cholesterol-lowering medications can reduce the risk of recurrent cardiovascular events, premature discontinuation limits effectiveness. Discontinuation rates have not been systematically reported for lipid-lowering trials.

Methods And Results: We evaluated medication discontinuation in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial), which evaluated placebo+simvastatin versus ezetimibe+simvastatin in patients hospitalized with the acute coronary syndrome and followed longitudinally postdischarge. Read More

Angiology 2019 Jan 10:3319718822630. Epub 2019 Jan 10.

5 Cardiac Sciences Department, College of Medicine, King Saud University-Medical City, Riyadh, Saudi Arabia.

Background:: Hajj is the largest human gathering with over 2 million people. We evaluated the effect of bundle care intervention on mortality.

Methods:: A population-based, before and after study compared the effect of an intervention on mortality. Read More

PLoS One 2019 10;14(1):e0210502. Epub 2019 Jan 10.

Department of Surgery, Division of Emergency Medicine, Duke University Medical Center, Durham, North Carolina, United States of America.

Background: Little is known about the utilization of cardiac diagnostic testing in Brazil and how such testing is related with local rates of acute coronary syndrome (ACS)-related mortality.

Methods And Results: Using data from DATASUS, the public national healthcare database, absolute counts of diagnostic tests performed were calculated for each of the 5570 municipalities and mapped. Spatial error regression and geographic weighted regression models were used to describe the geographic variation in the association between ACS mortality, income, and access to diagnostic testing. Read More

Turk Kardiyol Dern Ars 2019 Jan;47(1):38-44

Department of Cardiology, Pamukkale University Hospitals, Denizli, Turkey.

Objective: Acute coronary syndrome (ACS) has become more frequent in the elderly population due to increased life expectancy. The aim of this trial was to determine clinical and laboratory factors related to in-hospital mortality in patients over 80 years of age who presented with ACS.

Methods: A total 171 patients (86 men, median age 83 years) who were over 80 years of age and were hospitalized due to a diagnosis of ACS were enrolled in this study. Read More

Catheter Cardiovasc Interv 2019 Jan 10. Epub 2019 Jan 10.

Brigham and Women's Hospital Heart & Vascular Center, Harvard Medical School, Boston, Massachusetts.

Objectives: This study aimed to evaluate the efficacy and safety of genotype- and phenotype-guided intensified antiplatelet therapy compared with conventional therapy in patients undergoing stent implantation.

Background: Although potent P2Y receptor inhibitors are recommended for percutaneous coronary intervention (PCI)-treated acute coronary syndrome, their usage is limited by a high bleeding risk. Therefore, personalized antiplatelet therapy could provide a valuable foundation for selection of antiplatelet therapy in this population. Read More

Herz 2019 Jan 9. Epub 2019 Jan 9.

, Hildesheim, Deutschland.

The timing of an invasive diagnosis and treatment strategy in patients with an acute coronary syndrome without ST-elevation (NSTE-ACS) depends on the patient's risk profile. In addition to the clinical symptoms, ST/T alterations in the resting ECG as well as an increase and kinetics of troponin are of crucial importance in this setting. For the majority of patients the highly sensitive troponin enables a rapid rule in or rule out strategy of a non-ST-segment elevation myocardial infarction (NSTEMI) with a 0/3 h algorithm. Read More

Herz 2019 Jan 9. Epub 2019 Jan 9.

, Aschaffenburg, Deutschland.

The current guidelines of the European Society of Cardiology have up-dated and confirmed the role of a primary percutaneous coronary intervention (PCI) as the preferred reperfusion therapy in patients with acute coronary syndrome and ST-elevation. The establishment of regional network structures for implementation of this reperfusion strategy is recommended and described. Primary PCI should preferably be carried out via the transradial route and should include the implantation of modern drug-eluting stents. Read More

Am J Med Case Rep 2018 7;6(10):218-221. Epub 2018 Dec 7.

Division of Rheumatology, Department of Internal Medicine, State University of New York, Downstate Medical Center, Brooklyn, NY 11203 USA.

Spontaneous coronary artery dissection (SCAD) is a rare illness often misdiagnosed, that accounts for up to 4% of cases of acute coronary syndrome in young women. Interestingly, SCAD is the most common cause of myocardial infarction related to pregnancy. Here, we present a case of a 35-year old postpartum patient who presented in cardiac arrest due to ventricular fibrillation and was found to have a ST-segment elevation myocardial infarction. Read More

Case Rep Cardiol 2018 5;2018:5243419. Epub 2018 Dec 5.

Department of Cardiology, The Brooklyn Hospital Center, Academic Affiliate of the Icahn School of Medicine at Mount Sinai, Clinical Affiliate of the Mount Sinai Hospital, 121 DeKalb Avenue, Brooklyn, NY 11201, USA.

Stress-induced cardiomyopathy, also known as Takotsubo cardiomyopathy, presents as an acute coronary syndrome. However, the physiology and pathogenesis are different. It is imperative to treat stress-induced cardiomyopathy as an acute coronary syndrome, and once diagnosed, it is imperative to assess and treat heart failure and wait for the impaired myocardial energetics to resolve. Read More