Design of the Randomized, Placebo ‐Controlled Evolocumab for Early Reduction of LDL‐Cholesterol Levels in Patients with Acute Coronary Syndromes (EVOPACS) Trial

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Source: Clinical Cardiology - Category: Cardiology Authors: Tags: TRIAL DESIGNS Source Type: research

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This study suggests that for most, managing CAD with medications alone (the conservative approach) is as safe and effective as the more invasive strategy of cardiac catheterization and opening of the blocked artery. Findings of the ISCHEMIA trial ISCHEMIA followed over 5,000 patients with significant narrowing in one or more coronary arteries. Half of the patients were randomly selected to receive conservative treatment with optimal medical therapy (OMT) and lifestyle changes to treat risk factors such as high blood pressure and high cholesterol. The other half were given OMT and also sent for cardiac catheterization (thre...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Source Type: blogs
Conclusion: Early rule out protocol is effective and safe.We refer interested readers to the following excellent reviews of high-sensitivity troponin implementation:Twerenbold, R. et al.JACC70 (8): 996 –1012.https://doi.org/10.1016/j.jacc.2017.07.718.Yader S. et al. 2016. Am J Med 129 (4): 354 –65.https://doi.org/10.1016/j.amjmed.2015.12.005.Response to the 2nd “Myth-busting” articleInterestingly, on Nov 5, Dr. Spiegel publishedanother “Myths in EM” piece in EM News: “Is hs-cTnT Worth the Downstream Testing?. The piece assesses a new randomized trial of the Roche hs -cTnT...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Authors: Hou C, Zheng B, Wang XG, Zhang B, Shi QP, Chen M Abstract Previous studies have reported that short-term statin loading effectively protects statin-naive patients with mild renal insufficiency from contrast-induced acute kidney injury (CI-AKI). The aim of the present study was to determine whether patients with more advanced chronic kidney disease (CKD) and long-term statin therapy also benefit from high-loading statin pretreatment. A total of 256 consecutive patients with moderate-to-severe CKD receiving long-term statin therapy and undergoing percutaneous coronary intervention (PCI) or coronary artery an...
Source: Experimental and Therapeutic Medicine - Category: General Medicine Tags: Exp Ther Med Source Type: research
ConclusionStatin therapy demonstrated significantly reduced incidences of MACE, all ‐cause death and CD compared with non‐users after PCI in AMI patients with or without dyslipidemia during 2‐year follow‐up period in the era of new‐generation DES.
Source: Catheterization and Cardiovascular Interventions - Category: Cardiovascular & Thoracic Surgery Authors: Tags: CORONARY ARTERY DISEASE Source Type: research
Publication date: Available online 9 November 2018Source: American Heart JournalAuthor(s): Neha J. Pagidipati, Adrian Coles, Kshipra Hemal, Kerry L. Lee, Rowena J. Dolor, Patricia A. Pellikka, Daniel B. Mark, Manesh R. Patel, Sheldon E. Litwin, Melissa A. Daubert, Svati H. Shah, Udo Hoffmann, Pamela S. Douglas, on behalf of the PROMISE InvestigatorsAbstractBackgroundAlthough sex differences exist in the management of acute coronary syndromes, less is known about the management and outcomes of women and men with suspected coronary artery disease (CAD) being evaluated with non-invasive testing (NIT).MethodsWe investigated se...
Source: American Heart Journal - Category: Cardiology Source Type: research
​BY MELINDA HUANG, DO; CATHERINE KELLY, DO; &STEVEN SATTLER, DOA 36-year-old man presented to the emergency department with chest pain that had begun 30 minutes earlier. The patient was a mechanic, and said he was working on his car when he developed sharp, constant, mid-sternal, 5/10 chest pain that radiated to his left arm. He had associated nausea and dyspnea. The patient denied fever, cough, recent travel, recent surgery, malignancy, blood clots, hormone use, calf pain, and calf swelling. He did not take any medication for the pain. He denied smoking cigarettes, and had no family history of cardiac disease.The pa...
Source: The Case Files - Category: Emergency Medicine Tags: Blog Posts Source Type: research
IgE to the Mammalian Oligosaccharide Galactose-α-1,3-Galactose Is Associated With Increased Atheroma Volume and Plaques With Unstable Characteristics. Arterioscler Thromb Vasc Biol. 2018 Jun 14;: Authors: Wilson JM, Nguyen AT, Schuyler AJ, Commins SP, Taylor AM, Platts-Mills TAE, McNamara CA Abstract OBJECTIVE: Emerging evidence suggests a link between coronary artery disease and type 2 immunity. We sought to test the hypothesis that IgE sensitization to the mammalian oligosaccharide galactose-α-1,3-galactose (α-Gal)-the target allergen of delayed anaphylaxis to red meat-is associate...
Source: Arteriosclerosis, Thrombosis and Vascular Biology - Category: Cardiology Authors: Tags: Arterioscler Thromb Vasc Biol Source Type: research
Abstract BACKGROUND: Acute myocardial infarction (AMI) sex disparities in management and outcomes have long been attributed to multiple factors, although questions regarding their relevance have not been fully addressed. OBJECTIVE: The aim of this study was to identify current factors associated with sex-related AMI management and outcomes disparities in hospitals with comparable quality care standards. METHODS: This is a cross-sectional study of 299 women and 540 men with AMI discharged in 2013 from 3 southern California hospitals with tertiary cardiac care. Outcomes (adjusted by demographic/clinical va...
Source: The Journal of Cardiovascular Nursing - Category: Nursing Authors: Tags: J Cardiovasc Nurs Source Type: research
ConclusionsSex differences in diagnosis and treatment after presentation to the ED with chest pain are not explained by differences in chest pain features or levels of cTn. Even when females have cardiac chest pain and cTn levels > 99th percentile, they are less likely to be diagnosed with MI, less likely to undergo diagnostic cardiac catheterization within 7 days, and less likely to use evidence‐based cardiac medications, but they have the highest 1‐year MACE rate. The higher MACE rate appears to be driven by the higher burden of comorbid conditions.
Source: Academic Emergency Medicine - Category: Emergency Medicine Authors: Tags: Original Contribution Source Type: research
Conclusions Although non-HDL-C reduction at six months following a non-urgent CV procedure was not significant in the overall cohort, an increased uptake in high potency statins may translate into improved long-term health outcomes and cost reductions.
Source: American Heart Journal - Category: Cardiology Source Type: research
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