Search results for " stratification"
showing 10 items of 144 documents
Diagnostic and prognostic value of H-FABP in acute coronary syndrome: Still evidence to bring
2018
Abstract The assessment of chest pain patients presenting to the emergency area (EA) is still a clinical challenge, as the majority of patients are not diagnosed with acute coronary syndrome (ACS). New generation high sensitivity c-Tn (hs-cTn) assays have showed better performances compared to the standard c-Tn. However, hs-Tn still presents some limitations. Hence, novel, early biomarkers are needed in this setting. Among all, heart-type fatty acid binding protein (H-FABP) has been largely investigated. This article reviews the studies evaluating H-FABP performance in diagnosing acute myocardial infarction (AMI) and stratifying chest pain patients by risk. H-FABP optimal performances in AC…
5877Comorbidity assessment for mortality risk stratification in elderly patients with acute coronary syndrome
2019
Abstract Background The Charlson's is the most used comorbidity index. It comprises 19 comorbidities, some of which are infrequent in elderly patients with acute coronary syndrome (ACS), while some others are manifestations of cardiac disease rather than comorbidities. Purpose Our goal was to simplify comorbidity assessment in elderly non-ST-segment elevation ACS patients. Methods The study group consisted of 1 training (n=920, 76±7 years) and 1 testing (n=532; 84±4 years) cohorts. The end-point was all-cause mortality at 1-year follow-up. Comorbidities were assessed selecting those medical disorders other than cardiac disease that were independently associated with mortality by multivariab…
Home treatment of patients with low-risk pulmonary embolism with the oral factor Xa inhibitor rivaroxaban: Rationale and design of the HoT-PE Trial
2016
SummaryPulmonary embolism (PE) is a potentially life-threatening acute cardiovascular syndrome. However, more than 95 % of patients are haemodynamically stable at presentation, and among them are patients at truly low risk who may qualify for immediate or early discharge. The Home Treatment of Pulmonary Embolism (HoT-PE) study is a prospective international multicentre single-arm phase 4 management (cohort) trial aiming to determine whether home treatment of acute lowrisk PE with the oral factor Xa inhibitor rivaroxaban is feasible, effective, and safe. Patients with confirmed PE, who have no right ventricular dysfunction or free floating thrombi in the right atrium or ventricle, are eligib…
Elevated systolic pulmonary artery pressure for prediction of myocardial necrosis and right ventricular dysfunction in acute pulmonary embolism
2016
Kontext: Echokardiografie je v soucasnosti hlavni metodou pro vysetřeni dysfunkce prave komory (right ventricular dysfunction, RVD) u akutni plicni embolie (PE). Dysfunkce prave komory je sice spojena s nepřiznivou prognozou, dosud vsak nebyla přijata žadna obecně uznavana definice. Systolický tlak v plicnici (systolic pulmonary artery pressure, sPAP) větsinou neni soucasti kriterii RVD. Cilem nasi studie bylo zhodnotit možnost použiti sPAP v predikci nekrozy myokardu a RVD u akutni PE.Metody: Retrospektivně byly analyzovany udaje 182 pacientů s akutni PE. Pacienti s PE a hodnotami sPAP ≤ 30 mm Hg byli srovnavani s pacienty s PE a hodnotami sPAP > 30 mm Hg. Vztahy mezi sPAP na jedne straně …
24-hour Ambulatory BP Monitoring and Home BP Measurements in Resistant Hypertension
2013
Out-of-office BP measurements, ambulatory BP monitoring (ABPM), and self-BP measurement play an important role in the evaluation of resistant hypertension. In fact 24 h ABPM has been considered mandatory at the time to evaluate resistant hypertension from the beginning of clinical use. Furthermore, clinical research has expanded the potential role of out-of-office measurements not only to the initial evaluation of resistant hypertension but also to refine cardiovascular and renal risk stratification and for a better follow-up. The widespread use of self-BP measurement at home introduced a new tool to properly assess out-of-office BP, and it has also been recommended in these patients althou…
Abstract 18060: Risk Stratification Following Mitral Valve Surgery for Chronic Ischemic Mitral Regurgitation: A Very Long-term Study
2015
Background: Very few long-term data are available on patients undergoing mitral valve surgery for chronic ischemic mitral regurgitation (CIMR). Objective:to identify determinants of survival and adverse cardiovascular events, at very long-term outcome. Methods and Results: We reviewed complete left and right ventricular echocardiographic data, six-minute walking test (6-MWT) and BNP levels at pre, peri and follow-up, on 137 consecutive patients who underwent restrictive mitral annuloplasty (RMA) or mitral valve replacement (MVR) and CABG, for CIMR. Combined adverse cardiovascular events were defined as composite of death, heart failure, angina, myocardial infarction and re-hospitalization.…
The impact of occult renal failure on the cardiovascular risk stratification in an elderly population: the PREV-ICTUS study.
2008
To analyze the impact of occult renal failure (ORF) in the individual risk stratification and on the blood pressures (BP) and low-density lipoprotein (LDL) goals in an aged population, according to the ESH/ESC Hypertension Guidelines.A cross-sectional, population-based study on individuals aged 60 years or more carried out in Primary Care Centers of Spain. Kidney function was estimated from calculated creatinine clearance (eGFR), Cockroft and Gault formula. Ten-year cardiovascular risk was estimated through the ESH/ESC table including or not including the eGFR. Estimates of the modification in BP and LDL-cholesterol (cLDL) goals were calculated.In 6419 subjects, 4242 subjects (66%) had norm…
Optimal carbohydrate antigen 125 cutpoint for identifying low-risk patients after admission for acute heart failure
2022
Introduction and objectives: Carbohydrate antigen 125 (CA125) has been shown to be useful for risk stratification in patients admitted with acute heart failure (AHF). We sought to determine a CA125 cutpoint for identifying patients at low risk of 1-month death or the composite of death/HF readmission following admission for AHF.Methods: The derivation cohort included 3231 consecutive patients with AHF. CA125 cutoff values with 90% negative predictive value (NPV) and sensitivity up to 85% were identified. The adequacy of these cutpoints and the risk of 1-month death/HF readmission was then tested using the Royston-Parmar method. The best cutpoint was selected and externally validated in a co…
Primary Biliary Cholangitis management: controversies, perspectives, and daily practice implications from an expert panel
2020
Primary biliary cholangitis (PBC) is a rare progressive immune-mediated liver disease that, if not adequately treated, may culminate in end-stage disease and need for transplantation. According to current guidelines, PBC is diagnosed in the presence of antimitochondrial antibodies (AMA) or specific antinuclear antibodies, and of a cholestatic biochemical profile, while biopsy is recommended only in selected cases. All patients receive ursodeoxycholic acid (UDCA) in first line; the only registered second-line therapy is obeticholic acid (OCA) for UDCA-inadequate responders. Despite the recent advances in understanding PBC pathogenesis and developing new treatments, many grey areas remain. Si…
New advances in radiomics of gastrointestinal stromal tumors
2020
Gastrointestinal stromal tumors (GISTs) are uncommon neoplasms of the gastrointestinal tract with peculiar clinical, genetic, and imaging characteristics. Preoperative knowledge of risk stratification and mutational status is crucial to guide the appropriate patients' treatment. Predicting the clinical behavior and biological aggressiveness of GISTs based on conventional computed tomography (CT) and magnetic resonance imaging (MRI) evaluation is challenging, unless the lesions have already metastasized at the time of diagnosis. Radiomics is emerging as a promising tool for the quantification of lesion heterogeneity on radiological images, extracting additional data that cannot be assessed b…