18,901 results match your criteria Unstable Angina


High Sensitivity C-Reactive Protein Predictive Value for Cardiovascular Disease: A Nested Case Control from Isfahan Cohort Study (ICS).

Glob Heart 2020 Feb 6;15(1). Epub 2020 Feb 6.

Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, IR.

Background: High sensitivity C-reactive protein (hs-CRP) was proven to be an independent risk factor for cardiovascular diseases (CVDs). The aim of this study was to investigate the benefits of assessing hs-CRP among individuals with different cardiovascular risk factors.

Methods: This nested case-control study was obtained from the Isfahan Cohort Study (ICS). Read More

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http://dx.doi.org/10.5334/gh.367DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218777PMC
February 2020

CD4+/CD8+ ratio positively correlates with coronary plaque instability in unstable angina pectoris patients but fails to predict major adverse cardiovascular events.

Ther Adv Chronic Dis 2020 18;11:2040622320922020. Epub 2020 May 18.

Department of Cardiology, Nanjing First Hospital, No. 68 Changle Road, Nanjing, 210006, China.

Background: The association between CD4+/CD8+ ratio and coronary plaque instability in patients with unstable angina pectoris (UAP) has not been investigated. We sought to elucidate the correlation between CD4+/CD8+ ratio and plaque instability in this patient population.

Methods: We enrolled 266 UAP patients who underwent pre-intervention optical coherence tomography (OCT) examination and percutaneous coronary intervention in our center from January 2016 to January 2018. Read More

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http://dx.doi.org/10.1177/2040622320922020DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7238310PMC

Analytical and Clinical Characterization of a Novel High-Sensitivity Cardiac Troponin Assay in a United States Population.

Clin Biochem 2020 May 30. Epub 2020 May 30.

Department of Emergency Medicine, Baylor College of Medicine, Houston, Texas.

Background: Cardiac troponin (cTn) is the keystone for diagnosis of acute myocardial infarction (AMI). We examined the analytical and clinical diagnostic characteristics of the ACCESS hsTnI assay in a United States (US) population.

Methods: All measurements and studies were conducted using a lithium heparin matrix. Read More

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http://dx.doi.org/10.1016/j.clinbiochem.2020.05.014DOI Listing

Intracoronary and peripheral blood levels of TNF-like Cytokine 1A (TL1A) in patients with acute coronary syndrome.

Medicine (Baltimore) 2020 May;99(22):e20305

School of Humanities and Management, Fujian University of Traditional Chinese Medicine, Fuzhou, China.

Background: TNF-like cytokine 1A (TL1A) is a subgroup of the tumor necrosis factor superfamily that exerts pleiotropic effects on cell proliferation, inflammation, activation, and differentiation of immune cells. The purpose of the current study is to investigate the clinical significance of TL1A expression in coronary and peripheral blood of patients with acute coronary syndrome (ACS) to determine if TL1A levels can serve as an accurate prognostic indicator.

Methods: A total of 141 patients undergoing coronary angiography were divided into 4 groups: Control (n = 35), Unstable Angina (UA) (n = 35), acute non-ST segment elevation myocardial infarction (NSTEMI) (n = 37), and acute ST segment elevation myocardial infarction (STEMI) (n = 34). Read More

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http://dx.doi.org/10.1097/MD.0000000000020305DOI Listing

Lower levels of high-density lipoprotein cholesterol are associated with increased cardiovascular events in patients with acute coronary syndrome.

Atherosclerosis 2020 May 18;303:21-28. Epub 2020 May 18.

Department of Cardiology, The Heart Institute of Japan, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.

Background And Aims: This study aimed to elucidate whether high-density lipoprotein cholesterol (HDL-C) at 3-month follow-up for patients receiving contemporary lipid-lowering therapy after acute coronary syndrome (ACS) could predict cardiac events.

Methods: The HIJ-PROPER study was a multicenter, prospective, randomized trial comparing intensive lipid-lowering therapy (pitavastatin + ezetimibe) and conventional lipid-lowering therapy (pitavastatin monotherapy) after ACS. The entire cohort was divided into three groups according to tertiles of HDL-C levels at 3-month follow-up (Group 1, HDL-C ≤43 mg/dL; Group 2, HDL-C >43, <53. Read More

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http://dx.doi.org/10.1016/j.atherosclerosis.2020.05.005DOI Listing

Coronary artery disease in dialysis patients: evidence synthesis, controversies and proposed management strategies.

J Nephrol 2020 May 29. Epub 2020 May 29.

Nephrology Clinic, Dialysis and Renal Transplant Center-'C.I. Parhon' University Hospital, and 'Grigore T. Popa' University of Medicine, Iasi, Romania.

Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality among patients with end-stage renal disease (ESRD). Clustering of traditional atherosclerotic and non-traditional risk factors drive the excess rates of coronary and non-coronary CVD in this population. The incidence, severity and mortality of coronary artery disease (CAD) as well as the number of complications of its therapy is higher in dialysis patients than in non-chronic kidney disease patients. Read More

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http://dx.doi.org/10.1007/s40620-020-00758-5DOI Listing

Neutrophil Phenotypes in Coronary Artery Disease.

J Clin Med 2020 May 25;9(5). Epub 2020 May 25.

Department of Cardiology, University of Liège Hospital, 4000 Liège, Belgium.

Clinical evidence indicates that innate immune cells may contribute to acute coronary syndrome (ACS). Our prospective study aimed at investigating the association of neutrophil phenotypes with ACS. 108 patients were categorized into chronic stable coronary artery disease ( = 37), unstable angina (UA) ( = 19), Non-ST-Elevation Myocardial Infarction (NSTEMI) ( = 25), and ST-Elevation Myocardial Infarction (STEMI) ( = 27). Read More

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http://dx.doi.org/10.3390/jcm9051602DOI Listing

Vitamin D supplementation, cardiac events and stroke: A systematic review and meta-regression analysis.

Int J Cardiol Heart Vasc 2020 Jun 20;28:100537. Epub 2020 May 20.

PennState Health, Hershey Medical Center, Department of Cardiology, Hershey, PA, United States.

Introduction: Observational data has suggested a link between vitamin D deficiency and coronary heart disease (CHD). However, randomized controlled trials (RCTs) have failed to show benefit. The objective of this study is to analyze the RCTs investigating vitamin D supplementation and the risk of CHD and stroke. Read More

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http://dx.doi.org/10.1016/j.ijcha.2020.100537DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240168PMC

Comprehensive analysis of T-cell receptor repertoire in patients with acute coronary syndrome by high-throughput sequencing.

BMC Cardiovasc Disord 2020 May 27;20(1):253. Epub 2020 May 27.

Clinical Core Laboratory, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China.

Background: This study aims to investigate the T-cell receptor (TCR) repertoire in patients with acute coronary syndrome (ACS).

Methods: The TCR repertoires of 9 unstable angina patients (UA), 14 acute myocardial infarction patients (AMI) and 9 normal coronary artery (NCA) patients were profiled using high-throughput sequencing (HTS). The clonal diversity of the TCR repertoires in different groups was analyzed, as well as the frequencies of variable (V), diversity (D) and joining(J) gene segments. Read More

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http://dx.doi.org/10.1186/s12872-020-01538-6DOI Listing

[Algorithm to stratify the risk of myocardial infarction in patients with acute coronary syndrome at primary examination.]

Klin Lab Diagn 2020 ;65(6):111-222

I.P. Pavlov First Saint Petersburg State Medical University, 197022, Saint-Petersburg, Russian Federation.

The episode of acute coronary syndrome is most often preceded by the development of systemic and local inflammation, which plays a significant role in the pathogenesis of the disease. General clinical blood analysis, directly or indirectly reflecting systemic pathological processes in the patient's body based on quantitative and morphological assessment of blood composition, is one of the most affordable methods of laboratory diagnostics in modern public health. Taking into account the growing number of digital data obtained by diagnosticians from analytical systems, there is a growing potential for the use of machine learning methods to increase the effectiveness of provided diagnostic information in the interests of the patient. Read More

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http://dx.doi.org/10.18821/0869-2084-2020-65-6-111-222DOI Listing
January 2020

Is Cardiac Rehabilitation Equally Effective in Improving Dietary Intake in All Patients with Ischemic Heart Disease?

J Am Coll Nutr 2020 May 27:1-8. Epub 2020 May 27.

Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.

To investigate the association between sociodemographic characteristics and changes in dietary intake in patients with ischemic heart disease who were following a cardiac rehabilitation program. Longitudinal study among patients with first-time admission to outpatient cardiac rehabilitation after ST-elevation myocardial infarction, non-ST-elevation myocardial infarction, unstable angina pectoris or stable angina pectoris. We used a validated self-administered food frequency questionnaire to assess the dietary intake before rehabilitation, post rehabilitation and 6 months after baseline. Read More

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http://dx.doi.org/10.1080/07315724.2020.1755910DOI Listing

Association between serum phosphorus and subclinical coronary atherosclerosis in asymptomatic Korean individuals without kidney dysfunction.

Am J Clin Nutr 2020 May 26. Epub 2020 May 26.

Division of Cardiology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Background: There are limited data regarding the relation between serum phosphorus concentration (SPC) and subclinical coronary atherosclerosis in the asymptomatic healthy population without kidney dysfunction.

Objectives: We aimed to investigate the relation between SPC and characteristics of atherosclerotic plaques and cardiac events according to SPCs using a large cohort of asymptomatic Korean individuals.

Methods: We evaluated 6329 asymptomatic Korean individuals [mean age: 53. Read More

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http://dx.doi.org/10.1093/ajcn/nqaa091DOI Listing

Design and rationale of the Danish trial of beta-blocker treatment after myocardial infarction without reduced ejection fraction: study protocol for a randomized controlled trial.

Trials 2020 May 23;21(1):415. Epub 2020 May 23.

Department of Cardiology, Bispebjerg University Hospital, Copenhagen, Denmark.

Background: Treatment with beta-blockers is currently recommended after myocardial infarction (MI). The evidence relies on trials conducted decades ago before implementation of revascularization and contemporary medical therapy or in trials enrolling patients with heart failure or reduced left ventricular ejection fraction (LVEF ≤ 40%). Accordingly, the impact of beta-blockers on mortality and morbidity following acute MI in patients without reduced LVEF or heart failure is unclear. Read More

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http://dx.doi.org/10.1186/s13063-020-4214-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7245032PMC

Challenges in the management of older patients with acute coronary syndromes in the COVID-19 pandemic.

Heart 2020 May 22. Epub 2020 May 22.

Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK

Ischaemic heart disease (IHD), in particular acute coronary syndrome (ACS), comprising ST-elevation myocardial infarction, non-ST-elevation myocardial infarction and unstable angina, is the leading cause of death worldwide. Age is a major predictor of adverse outcome following ACS. COVID-19 infection seems to escalate the risk in older patients with heart disease. Read More

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http://dx.doi.org/10.1136/heartjnl-2020-317011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7253225PMC

Prospective randomized controlled trial study of Luofengning granule in the treatment of unstable angina.

Medicine (Baltimore) 2020 May;99(20):e20025

Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing.

Introduction: Although the current western treatment plans for unstable angina (UA) has been optimized in past decades, UA still is a common phenotype of acute coronary syndrome and significantly influence the quality of life and endanger lives. In China, the clinical application of Chinese herb medicine is considered as an effective approach to treating UA and widely recognized by patients. In clinical practices, we found Luofengning granule (LFN-G) could improve clinical manifestations of patients with UA, but there is lack of rigorous proof of evidence-based medicine. Read More

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http://dx.doi.org/10.1097/MD.0000000000020025DOI Listing

Adjudication of cardiovascular events in patients with chronic obstructive pulmonary disease: SUMMIT trial.

Clin Trials 2020 May 22:1740774520920897. Epub 2020 May 22.

Research & Development, GSK, Research Triangle Park, Durham, NC, USA.

Background: Adjudicated cause-specific mortality has been used in major trials of chronic obstructive pulmonary disease. However, there is less experience with adjudicated major adverse cardiovascular events as a key efficacy outcome in chronic obstructive pulmonary disease trials. The Study to Understand Mortality and Morbidity in chronic obstructive pulmonary disease trial required a Clinical Endpoint Committee to adjudicate the outcomes of modified major adverse cardiovascular events and cause-specific mortality. Read More

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http://dx.doi.org/10.1177/1740774520920897DOI Listing

NMR-based plasma metabolic profiling in patients with unstable angina.

Iran J Basic Med Sci 2020 Mar;23(3):311-320

Zanjan Metabolic Diseases Research Center, Zanjan University of Medical Sciences, Zanjan, Iran.

Objectives: Unstable angina (UA) is a form of the acute coronary syndrome (ACS) that affects more than a third of the population before age 70. Due to the limitations of diagnostic tests, appropriate identification of UA is difficult. In this study, we proceeded to investigate metabolite profiling in UA patients compared with controls to determine potential candidate biomarkers. Read More

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http://dx.doi.org/10.22038/IJBMS.2020.39979.9475DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7229510PMC

Efficacy of Evolocumab on Cardiovascular Outcomes in Patients With Recent Myocardial Infarction: A Prespecified Secondary Analysis From the FOURIER Trial.

JAMA Cardiol 2020 May 20. Epub 2020 May 20.

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

Importance: The 2018 American Heart Association/American College of Cardiology Multisociety Guideline on the Management of Blood Cholesterol identified patients with recent (past 12 months) myocardial infarction (MI) as very high risk, in whom a PCSK9 inhibitor is reasonable to add to maximally tolerated statin combined with ezetimibe if their low-density lipoprotein cholesterol level is 70 mg/dL or greater or non-high-density lipoprotein cholesterol level is 100 mg/dL or greater.

Objective: To examine the clinical efficacy of evolocumab in patients with recent MI.

Design, Setting, And Participants: This was a prespecified secondary analysis of the Further Cardiovascular Outcomes Research With PCSK9 Inhibition in Subjects With Elevated Risk (FOURIER) trial, in which 27 564 patients with atherosclerotic cardiovascular disease treated with a statin were randomized to evolocumab vs placebo. Read More

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http://dx.doi.org/10.1001/jamacardio.2020.0882DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7240652PMC

Association Between Uric Acid and N-Terminal Pro-B-Type Natriuretic Peptide in Patients With Unstable Angina Pectoris.

Am J Med Sci 2020 Apr 10. Epub 2020 Apr 10.

Department of Geriatric Cardiology, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, People's Republic of China. Electronic address:

Background: The association between uric acid and N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP) in patients with unstable angina pectoris (UAP) is unclear.

Methods: We recruited 260 patients with UAP admitted to the first affiliated Hospital of Guangxi Medical University from February 2018 to August 2018. According to the level of uric acid, patients were divided into 4 groups (Q1 = 48. Read More

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http://dx.doi.org/10.1016/j.amjms.2020.04.004DOI Listing

Analysis of the Molecular Mechanism of Acute Coronary Syndrome Based on circRNA-miRNA Network Regulation.

Evid Based Complement Alternat Med 2020 29;2020:1584052. Epub 2020 Apr 29.

The First Hospital of Xinxiang Medical University, Xinxiang, Henan 453100, China.

Background: With the development of biological technology, biomarkers for the prevention and diagnosis of acute coronary syndrome (ACS) have become increasingly evident. However, the study of novel circular RNAs (circRNAs) in ACS is still in progress. This study aimed to investigate whether the regulation of circRNA-miRNA networks is involved in ACS pathogenesis. Read More

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http://dx.doi.org/10.1155/2020/1584052DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7206869PMC
April 2020
1.880 Impact Factor

Successful Coronary Angiography Following Rapid Intravenous Desensitization for Refractory Contrast Allergy.

Can J Cardiol 2020 Mar 5. Epub 2020 Mar 5.

Department of Medicine, University of Toronto, Toronto, Ontario, Canada; Division of Clinical Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada.

Most allergic reactions to radiocontrast media can be managed with a pretreatment protocol of steroids and antihistamines. However, in rare circumstances, patients can have severe allergic symptoms despite pretreatment. In this case, we highlight the use of a novel desensitization protocol in a patient with a severe breakthrough contrast allergy and unstable angina that allowed for successful percutaneous coronary intervention. Read More

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http://dx.doi.org/10.1016/j.cjca.2020.02.097DOI Listing

Omega-3 fatty acid therapy for cardiovascular disease: justified or not?

Curr Opin Cardiol 2020 Jul;35(4):417-422

Midwest Biomedical Research, Addison, Illinois, Boca Raton, Florida.

Purpose Of Review: To discuss the current evidence regarding the relationship between omega-3 fatty acid intake and atherosclerotic cardiovascular disease (ASCVD) risk.

Recent Findings: Combined results from randomized controlled trials using low-dosage (≤1.8 g/day of ethyl esters) eicosapentaenoic acid (EPA) or EPA + docosahexaenoic acid (DHA) suggest a small benefit for reducing coronary heart disease risk. Read More

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http://dx.doi.org/10.1097/HCO.0000000000000741DOI Listing

Myocardial Ischemic Syndromes, Heart Failure Syndromes, Electrocardiographic Abnormalities, Arrhythmic Syndromes and Angiographic Diagnosis of Coronary Artery Spasm: Literature Review.

Int J Med Sci 2020 27;17(8):1071-1082. Epub 2020 Apr 27.

University of California, Riverside, Riverside, California, USA.

In coronary artery spasm (CAS), an excess coronary vasoconstriction causing total or subtotal vessel occlusion could lead to syncope, heart failure syndromes, arrhythmic syndromes, and myocardial ischemic syndromes including asymptomatic myocardial ischemia, stable and unstable angina, acute myocardial infarction, and sudden cardiac death. Although the clinical significance of CAS has been underrated because of the frequent absence of symptoms, affected patients appear to be at higher risk of syncope, serious arrhythmias, and sudden death than those with classic Heberden's angina pectoris. Therefore, a prompt diagnosis has important therapeutic implications, and is needed to avoid CAS-related complications. Read More

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http://dx.doi.org/10.7150/ijms.43472DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211159PMC

Calcium Channel Blockers in Acute Care: The Links and Missing Links Between Hemodynamic Effects and Outcome Evidence.

Am J Cardiovasc Drugs 2020 May 15. Epub 2020 May 15.

Department of Anesthesiology, Yale University School of Medicine, 330 Cedar Street, TMP 3, New Haven, CT, 06520, USA.

Calcium channel blockers (CCBs) exert profound hemodynamic effects via blockage of calcium flux through voltage-gated calcium channels. CCBs are widely used in acute care to treat concerning, debilitating, or life-threatening hemodynamic changes in many patients. The overall literature suggests that, for systemic hemodynamics, although CCBs decrease blood pressure, they normally increase cardiac output; for regional hemodynamics, although they impair pressure autoregulation, they normally increase organ blood flow and tissue oxygenation. Read More

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http://dx.doi.org/10.1007/s40256-020-00410-4DOI Listing

Relative Costs of Surgical and Transcatheter Aortic Valve Replacement and Medical Therapy.

Circ Cardiovasc Interv 2020 May 14;13(5):e008681. Epub 2020 May 14.

Division of Cardiovascular Medicine, Lifespan Cardiovascular Institute, Brown University, Providence, RI (H.D.A., J.D.A.).

Background: The number of patients treated for aortic valve disease in the United States is increasing rapidly. Transcatheter aortic valve replacement (TAVR) is supplanting surgical aortic valve replacement (SAVR) and medical therapy (MT). The economic implications of these trends are unknown. Read More

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http://dx.doi.org/10.1161/CIRCINTERVENTIONS.119.008681DOI Listing

Association of -Blocker Therapy at Discharge with Clinical Outcomes after Acute Coronary Syndrome in Patients without Heart Failure.

Cardiovasc Ther 2020 24;2020:4351469. Epub 2020 Apr 24.

Department of Cardiology, The State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Aim: To evaluate the clinical impact of -blocker in patients with adequate left ventricular ejection function (LVEF) who underwent percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS).

Methods: A total of 10,724 consecutive patients who underwent PCI throughout 2013 were prospectively enrolled in the study. Among these, we analyzed 5,631 ACS patients who were discharged with LVEF ≥ 40%. Read More

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http://dx.doi.org/10.1155/2020/4351469DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7196986PMC
April 2020
2.362 Impact Factor

Pragmatic trial comparing routine versus no routine functional testing in high-risk patients who underwent percutaneous coronary intervention: Rationale and design of POST-PCI trial.

Am Heart J 2020 Mar 25;224:156-165. Epub 2020 Mar 25.

Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea. Electronic address:

Background: Although the need to detect restenosis has diminished in the contemporary practice of percutaneous coronary intervention (PCI) with drug-eluting stents (DES), the surveillance of ischemia owing to restenosis or disease progression deserves attention in high-risk PCI settings. It is unknown whether follow-up strategy of routine noninvasive functional testing potentially reduces the risk of major cardiovascular events in high-risk PCI patients.

Methods: The POST-PCI study is an investigator-initiated, multicenter, prospective randomized trial comparing the effectiveness of two follow-up strategies in patients with high-risk anatomic or clinical characteristics who underwent PCI. Read More

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http://dx.doi.org/10.1016/j.ahj.2020.03.019DOI Listing
March 2020
4.463 Impact Factor

Managed Care after Acute Myocardial Infarction (KOS-zawał) reduces major adverse cardiovascular events by 45% in 3-month follow-up - single-center results of Poland's National Health Fund program of comprehensive post-myocardial infarction care.

Arch Med Sci 2020 6;16(3):551-558. Epub 2019 Jun 6.

First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Katowice, Poland.

Introduction: Despite progress in medical and interventional treatment of acute myocardial infarction (AMI) resulting in low in-hospital mortality, the post-discharge prognosis in MI survivors is still unacceptable. The Managed Care in Acute Myocardial Infarction (MC-AMI, KOS-zawał) is a program introduced by Poland's National Health Fund aiming at comprehensive care for patients with AMI to improve prognosis. It includes acute intervention, complex revascularization, cardiac rehabilitation (CR), scheduled outpatient follow-up, and prevention of sudden cardiac death. Read More

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http://dx.doi.org/10.5114/aoms.2019.85649DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7212237PMC

Short-term prognosis of unstable angina in the era of high-sensitivity cardiac troponin: insights for early rule-out strategies.

Coron Artery Dis 2020 May 8. Epub 2020 May 8.

IRCCS Ospedale San Raffaele, Università Vita-Salute San Raffaele, Milan.

Background: It is unclear if strategies to rule-out myocardial infarction (MI) based on a single high-sensitivity troponin T (hsTnT) measurement at the emergency department (ED) presentation may also exclude unstable angina.

Methods: We measured hsTnT ex-post on the admission frozen blood sample of 644 subjects with Braunwald IIIB CK-MB-negative unstable angina. This analysis included the 240 patients with hsTnT value ≤99th percentile reference limit (UA). Read More

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http://dx.doi.org/10.1097/MCA.0000000000000906DOI Listing

Plasma vaspin is an effective biomarker for evaluation of future cardiovascular events in patients with chest pain: a 5-year retrospective observational study.

Ann Transl Med 2020 Apr;8(7):479

Department of Cardiology, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072 China.

Background: Our previous study showed that visceral adipose tissue-derived serpin (vaspin) was an independent predictor of coronary artery disease (CAD). Further, plasma vaspin levels in patients with unstable angina pectoris were lower than those in patients with stable angina pectoris. In this study, we investigated the prognostic relevance of plasma vaspin levels in patients with CAD and non-CAD. Read More

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http://dx.doi.org/10.21037/atm.2020.03.29DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210128PMC

Incidentally discovered cold hemagglutinin disease with massive blood clots in the cardioplegia line and coronary artery, during coronary artery bypass graft.

J Cardiothorac Surg 2020 May 11;15(1):79. Epub 2020 May 11.

Department of Cardiothoracic Surgery, School of Medicine, Inje University, Sanggye Paik Hospital, 1342, Dongil-ro, Nowon-gu, Seoul, South Korea.

Background: Cold hemagglutinin disease (CHAD) is a rare autoimmune disease, in which patients manifest symptoms when the body temperature decreases. It causes critical problems with blood clotting and hemolysis during hypothermia in cardiac surgery. Although various methods are recommended, the CHAD discovered incidentally during cardiac surgery is still a clinical challenge. Read More

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http://dx.doi.org/10.1186/s13019-020-01130-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7216728PMC

Anti-inflammatory therapy for preventing stroke and other vascular events after ischaemic stroke or transient ischaemic attack.

Cochrane Database Syst Rev 2020 May 11;5:CD012825. Epub 2020 May 11.

Department of Neurology, Mater Misericordiae University Hospital, Dublin 7, Ireland.

Background: An increasing body of evidence suggests that inflammation plays a key role in stroke, in particular stroke of atherosclerotic origin. Anti-inflammatory medications are a widely heterogeneous group of drugs that are used to suppress the innate inflammatory pathway and thus prevent persistent or recurrent inflammation. Anti-inflammatory agents have the potential to stabilise atherosclerotic plaques by impeding the inflammatory pathway. Read More

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http://dx.doi.org/10.1002/14651858.CD012825.pub2DOI Listing

Lipoprotein-Associated Phospholipase A2 in Cardiac Disease: a Potential Early Biomarker of Unstable Coronary Artery Disease.

Clin Lab 2020 May;66(5)

Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a serine lipase that deteriorates the stability of atherosclerotic plaques. This study aims to investigate Lp-PLA2 activity and its diagnostic potential in the early period of acute coronary syndromes (ACS).

Methods: Two hundred sixty-two patients referred for acute chest pain within 6 hours of symptom onset were included. Read More

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http://dx.doi.org/10.7754/Clin.Lab.2019.190719DOI Listing

Long-Term Effects of High Exposure to Ambient Fine Particulate Matter on Coronary Heart Disease Incidence: A Population-Based Chinese Cohort Study.

Environ Sci Technol 2020 Jun 15;54(11):6812-6821. Epub 2020 May 15.

Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100037, P. R. China.

Evidence of long-term effects of high exposure to ambient fine particulate matter (PM) on coronary heart disease (CHD) remains limited. We incorporated the high-resolution satellite-based PM estimates with a large-scale, population-based Chinese cohort comprising 118 229 individuals, to assess the CHD risk of long-term exposure to high PM. During the follow-up of 908 376 person-years, 1586 incident CHD cases were identified. Read More

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http://dx.doi.org/10.1021/acs.est.9b06663DOI Listing
June 2020
5.330 Impact Factor

A Novel Index for Prompt Prediction of Severity in Patients with Unstable Angina Pectoris.

Emerg Med Int 2020 3;2020:7651610. Epub 2020 Jan 3.

Bozyaka Research and Training Hospital, Department of Emergency Medicine, Izmir, Turkey.

Objectives: Rapid risk stratification by emergency department (ED) physicians to evaluate patients with chest pain for predicting the short-term occurrence of major adverse cardiac event (MACE) is crucial. The aim of this study was to investigate the predictive value of platelet-lymphocyte ratio (PLR) levels and compare with the modified heart score (m-HS) and stress testing to predict the severity of high-risk patients with unstable angina pectoris (UAP) in the ED.

Methods: This study is prospective which included 316 patients with UAP and 316 control healthy subjects. Read More

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http://dx.doi.org/10.1155/2020/7651610DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199558PMC
January 2020

A Case of Wellens Syndrome in a 30-Year-Old Woman From Sub-Saharan Africa: A Perplexing Clinical Entity With Invaluable Lessons.

J Investig Med High Impact Case Rep 2020 Jan-Dec;8:2324709620918552

Jakaya Kikwete Cardiac Institute, Dar es Salaam, Tanzania.

With an estimated contribution of up to 6% of all acute coronary events, young adults are experiencing an escalating burden and mortality attributable to coronary artery disease (CAD) worldwide. Wellens syndrome, a preinfarction clinical entity with distinctive electrocardiographic (ECG) features and high propensity for extensive anterior wall infarctions, affects about 15% of unstable angina subpopulation. We report challenges and lessons learnt from the first ever documented case of Wellens syndrome in Tanzania. Read More

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http://dx.doi.org/10.1177/2324709620918552DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218459PMC

A Case of Postoperative Covid-19 Infection After Cardiac Surgery: Lessons Learned.

Heart Surg Forum 2020 04 21;23(2):E231-E233. Epub 2020 Apr 21.

Cardiothoracic Surgery Department, New Cross Hospital, Wolverhampton, United Kingdom.

While the focus of the medical community is on the management of COVID-19 and its associated complex presentations, it is critical to recognize that patients will continue to present with other medical problems that require urgent therapeutic interventions. There is growing concern that such interventions might have an impact on the natural history of COVID-19. We present a case of a patient who presented with unstable angina and multivessel coronary artery disease for which coronary artery bypass surgery was indicated and performed. Read More

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http://dx.doi.org/10.1532/hsf.3011DOI Listing

Understanding context specificity: the effect of contextual factors on clinical reasoning.

Diagnosis (Berl) 2020 May 2. Epub 2020 May 2.

Department of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.

Background Situated cognition theory argues that thinking is inextricably situated in a context. In clinical reasoning, this can lead to context specificity: a physician arriving at two different diagnoses for two patients with the same symptoms, findings, and diagnosis but different contextual factors (something beyond case content potentially influencing reasoning). This paper experimentally investigates the presence of and mechanisms behind context specificity by measuring differences in clinical reasoning performance in cases with and without contextual factors. Read More

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http://dx.doi.org/10.1515/dx-2020-0016DOI Listing

ASPIRE-3-PREVENT: a cross-sectional survey of preventive care after a coronary event across the UK.

Open Heart 2020 Apr;7(1)

NHLI, Imperial College London, London, UK.

Objective: To quantify the implementation of the third Joint British Societies' Consensus Recommendations for the Prevention of Cardiovascular Disease (JBS3) after coronary event.

Methods: Using a cross-sectional survey design, patients were consecutively identified in 36 specialist and district general hospitals between 6 months and 2 years, after acute coronary syndrome or revascularisation procedure and invited to a research interview. Outcomes included JBS3 lifestyle, risk factor and therapeutic management goals. Read More

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http://dx.doi.org/10.1136/openhrt-2019-001196DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7228656PMC

Diagnostic Role of Plasma MicroRNA-21 in Stable and Unstable Angina Patients and Association with Aging.

Cardiol Res Pract 2020 13;2020:9093151. Epub 2020 Apr 13.

Department of Internal Medicine, Cardiology, College of Medicine, Jouf University, Sakaka, Aljouf, Saudi Arabia.

The present study explored the clinical value of plasma microRNA-21 as a novel biomarker for early prediction of stable and unstable angina patients and its relationship with aging. A total of 255 participants, 123 patients with chronic stable angina, 82 patients with unstable angina, and 50 healthy subjects, were included in our study. Stable coronary and unstable coronary patients were confirmed following AHA/ACC clinical protocols. Read More

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http://dx.doi.org/10.1155/2020/9093151DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7174930PMC

Proteomics Profiling Reveals Insulin-Like Growth Factor 1, Collagen Type VI α-2 Chain, and Fermitin Family Homolog 3 as Potential Biomarkers of Plaque Erosion in ST-Segment Elevated Myocardial Infarction.

Circ J 2020 May 29;84(6):985-993. Epub 2020 Apr 29.

Department of Cardiology, the Second Affiliated Hospital of Harbin Medical University.

Background: Plaque erosion (PE) has been considered a secondary pathogenesis of ST-segment elevated myocardial infarction (STEMI) following plaque rupture (PR). Previous studies demonstrated that they had different demographic and histology characteristics and need different treatment strategy. But there are few non-invasive plasma biomarkers for distinguishing them. Read More

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http://dx.doi.org/10.1253/circj.CJ-19-1206DOI Listing

Cardiovascular Outcomes Among Patients with Type 2 Diabetes Newly Initiated on Sodium-Glucose Cotransporter-2 Inhibitors, Glucagon-Like Peptide-1 Receptor Agonists, and Other Antidiabetic Medications.

J Manag Care Spec Pharm 2020 May;26(5):610-618

College of Pharmacy, University of Texas at Austin.

Background: Cardiovascular disease (CVD) remains the most prevalent cause of morbidity and mortality in patients with type 2 diabetes (T2D) and is a primary driver for health care costs associated with diabetes management. Sodium-glucose cotransporter-2 inhibitors (SGLT-2is) and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated significant reductions in cardiovascular endpoints in clinical trials compared with placebo. However, it is uncertain whether these findings can be applied to the broader T2D population because these trials specifically included high-risk patients with established CVD. Read More

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http://dx.doi.org/10.18553/jmcp.2020.26.5.610DOI Listing

[The Role of Residual Stenosis of the Coronary Arteries in the Dynamics Systolicdiastolic Left Ventricular Function after Acute Coronary Syndrome].

Kardiologiia 2020 Mar 5;60(2):33-40. Epub 2020 Mar 5.

Kursk State Medical University, Kursk.

Objective: The aim of the research under consideration was to study the dynamics of a local systolic-diastolic function of patients with various ischemic heart disease (IHD) progressions after survival of an acute coronary syndrome (ACS) provided there are residual stenoses of coronary arteries.

Materials And Methods:  There were 112 patients suffering from ACS who took part in the research. The diagnosis was verified (acute myocardial infarction or unstable angina) in accordance with the recommendations of European Society of Cardiology (ESC). Read More

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http://dx.doi.org/10.18087/cardio.2020.2.n853DOI Listing

Noncoding RNAs as Biomarkers for Acute Coronary Syndrome.

Biomed Res Int 2020 1;2020:3298696. Epub 2020 Apr 1.

Department of Cardiology, The Fourth Affiliated Hospital of China Medical University, Shenyang, Liaoning 110032, China.

Acute coronary syndrome (ACS), consisting of acute myocardial infarction and unstable angina, is the most dangerous and fatal form of coronary heart disease. Acute coronary syndrome has sudden onset and rapid development, which may lead to malignant life-threatening conditions at any time. Therefore, early detection and diagnosis are critical for patients with ACS. Read More

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http://dx.doi.org/10.1155/2020/3298696DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7154975PMC

Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Coronary Heart Disease (PROSPECTIVE).

J Atheroscler Thromb 2020 Apr 24. Epub 2020 Apr 24.

Sumitomo Hospital.

Aims: Although intensive statin therapy reduced cardiovascular risks, cardiovascular events have not been completely prevented. Probucol is a potent antioxidant and reduces tendon xanthomas in familial hypercholesterolemia patients despite reduction of high-density lipoprotein (HDL)-cholesterol (HDL-C). We investigated whether probucol can reduce cardiovascular events on top of conventional lipid-lowering therapy in patients with coronary heart disease (CHD). Read More

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http://dx.doi.org/10.5551/jat.55327DOI Listing

The Reply.

Am J Med 2020 04;133(4):e164-e165

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

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http://dx.doi.org/10.1016/j.amjmed.2019.09.009DOI Listing
April 2020
5.003 Impact Factor

Increased Rate of Hospitalization With Prinzmetal Angina: What Exactly Is Happening?

Am J Med 2020 04;133(4):e162-e163

Basil Hetzel Institute, University of Adelaide, Australia. Electronic address:

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http://dx.doi.org/10.1016/j.amjmed.2019.07.032DOI Listing