Search results for "ACUTE CORONARY SYNDROME"

Coronary artery disease: Risk stratification and patient selection for more aggressive secondary prevention.

2017

In patients with stable coronary artery disease, clinical outcomes are predominantly characterized by the consequences of atherosclerosis on the myocardium, but also by complications of atherosclerosis, notably recurrent acute coronary syndrome or stroke. Secondary prevention therapy is therefore key in this patient population. Intensification of secondary prevention therapy is possible, at the price of a therapeutic risk or a high cost, therefore justifying careful selection of patients with a high residual risk and low therapeutic risk. Two lines of therapy can be intensified, independently of each other, namely anti-thrombotics and lipid-lowering agents. Intensification of anti-thromboti…

INFLUENCE OF CAROTID AND PERIPHERAL ATHEROSCLEROSIS ON THE OUTCOME OF PATIENTS WITH ACUTE CORONARY SYNDROME

2006

Ģimenes anamnēzes raksturojums pacientiem ar primāru hiperlipidēmiju

2018

Tēmas aktualitāte: Ģimenes hiperholesterinēmija (ĢH) ir autosomāli ominant slimība, kas savlaicīgi neatpazīstot un neuzsākot atbilstošu terapiju, var rezultēties agrīnos kardiovaskulāros notikumos. Latvija ir pirmā no Baltijas valstīm, kur funkcionē ĢH reģistrs. Mērķis: Raksturot ģimenes anamnēzes datu pieejamību pacientiem, kas iekļauti LĢRH. Materiāli un metodes: Tika analizēta ģimenes slimības vēstures datu pieejamība, izmantojot LĢHR pacientu anketas. Rezultāti: Līdz 2017. gada oktobrim LĢHR tika iekļauti 356 pacienti, no kuriem 294 (82.6%) bija probandi un 62 ( 17.4%) pirmās pakāpes radinieki. Klīniska ĢH tika diagnosticēta 164 pacientiem (131 probandam un 33 pirmās pakāpes radiniekiem…

Exercise as the master polypill of the 21st century for the prevention of cardiovascular disease

2015

To the Editor,The growing pandemic of cardiovascular diseases (CVD) has para-doxically paralleled advances in pharmacology, and CVD remains theleading cause of death worldwide. Therapeutic strategies aiming atcontrolling several CVD risk factors simultaneously in individualswithout evidence of CVD are expensive and difficult to implement.Thus, the development of fixed-dose drug combinations of antiplatelettogether with blood pressure (BP) and cholesterol-lowering drugs,i.e., polypills, is gaining attention to prevent CVD [1,2] and all-causemortality [3], even after an acute coronary syndrome [4]. Despite thepotential of polypills to increase adherence at a lower cost [5], peoplerandomized to …

The German CPU Registry: Dyspnea independently predicts negative short-term outcome in patients admitted to German Chest Pain Units.

2015

While dyspnea is a common symptom in patients admitted to Chest Pain Units (CPUs) little is known about the impact of dyspnea on their outcome. The purpose of this study was to evaluate the impact of dyspnea on the short-term outcome of CPU patients.We analyzed data from a total of 9169 patients admitted to one of the 38 participating CPUs in this registry between December 2008 and January 2013. Only patients who underwent coronary angiography for suspected ACS were included. 2601 patients (28.4%) presented with dyspnea.Patients with dyspnea at admission were older and frequently had a wide range of comorbidities compared to patients without dyspnea. Heart failure symptoms in particular wer…

Response by Meneveau and Ecarnot to Letter Regarding Article, “Optical Coherence Tomography to Optimize Results of Percutaneous Coronary Intervention…

2017

We read with interest the letters by Vallurupalli and Uretsky and also Dr Nadir relating to the results of the DOCTORS study (Does Optical Coherence Tomography Optimize Results of Stenting).1 We thank the authors for their insightful remarks. Vallurupalli and Uretsky raise an interesting point when they underline that a prolonged inflation time is superior to a rapid inflation/deflation technique in terms of both stent expansion and apposition. We acknowledge that we did not take stent inflation time into account in the case report form of the DOCTORS study. The arguments put forward by Vallurupalli and Uretsky suggest that this variable should be systematically recorded and reported. Howev…

Clinical Appropriateness of Coronary Angiography

2012

Background: The study evaluates the appropriateness of coronary angiography and the agreement between the used method and the presence of coronary artery disease by the indications proposed from American College of Cardiology/American Heart Association (1999). Method: The guidelines allow us to associate to Class I and IIa the judgment of appropriateness, to the Class IIb of uncertainty; to Class III of inappropriateness. Result: On 761 coronary angiography 76.74% were appropriate, 23.13% unsuitable, 0.13% uncertain. The group with the greater value of appropriateness is that one with unstable angina (97.9% appropriate); that one with the lower value is the group with non-specific symptomat…

Imaging techniques for the vulnerable coronary plaque

2007

The goal of this article is to illustrate the main invasive and noninvasive diagnostic modalities to image the vulnerable coronary plaque, which is responsible for acute coronary syndrome. The main epidemiologic and histological issues are briefly discussed in order to provide an adequate background. Comprehensive coronary atherosclerosis imaging should involve visualization of the entire coronary artery tree and plaque characterization, including three-dimensional morphology, relationship with the lumen, composition, vascular remodelling and presence of inflammation. No single technique provides such a comprehensive description, and no available modality extensively identifies the vulnerab…

takotsubo cardiomiopathy after acute diarrhea

2010

Takotsubo cardiomyopaty is a recently described syndrome characterized by transient left ventricular dysfunction, mimicking an acute coronary syndrome and usually precipitated by a physical or emotional stress. We report the first case of Takotsubo cardiomyopathy after acute diarrhea in a man. It may be argued that severe diarrhea in predisposed individuals may cause an acute stress resulting in increased sympathetic activity leading to this syndrome. Probably the relationship between the adrenergic system and the heart is more complex than general thought and the stimuli which favor an autonomic imbalance and precipitate the syndrome are very disparate in clinical practice.

The association of depression and all-cause and cause-specific mortality: An umbrella review of systematic reviews and meta-analyses

2018

Background Depression is a prevalent and disabling mental disorder that frequently co-occurs with a wide range of chronic conditions. Evidence has suggested that depression could be associated with excess all-cause mortality across different settings and populations, although the causality of these associations remains unclear. Methods We conducted an umbrella review of systematic reviews and meta-analyses of observational studies. PubMed, PsycINFO, and Embase electronic databases were searched through January 20, 2018. Systematic reviews and meta-analyses that investigated associations of depression and all-cause and cause-specific mortality were selected for the review. The evidence was g…