Early revascularization and long-term mortality in high-risk patients with non–ST-elevation myocardial infarction. The CARDIOCHUS-HUSJ registry

This study sought to analyze the association of early coronary angiography with all-cause mortality and cardiovascular mortality in patients with non–ST-segment elevation acute coronary syndrome (NSTEACS) using a large contemporary cohort of patients with NSTEACS from 2 Spanish tertiary hospitals.MethodsThis retrospective observational study included 5673 consecutive NSTEACS patients from 2 Spanish hospitals between 2005 and 2016. We performed propensity score matching to obtain a well-balanced subset of patients with the same probability of undergoing an early strategy, resulting in 3780 patients. Survival analyses were performed by Cox regression models once proportional risk test were verified.ResultsAmong the study participants, only 2087 patients (40.9%) underwent early invasive coronary angiography. The median follow-up was 59.0 months [interquartile range, 25.0-80.0 months]. All-cause mortality was 19.0%, cardiovascular mortality was 12.8%, and 51.1% patients experienced at least 1 major cardiovascular adverse event in the follow-up. After propensity score matching, the early strategy was associated with significantly lower mortality (hazard ratio: 0.79; 95% confidence interval 0.62-0.98) in high-risk NSTEACS patients. The darly strategy showed a nonsignificant inverse tendency in patients with GRACE score
Source: Revista Espanola de Cardiologia - Category: Cardiology Source Type: research

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CONCLUSION: In patients with CSF and an otherwise normal coronary angiogram, a history of a previous MI is associated with unfavorable long-term outcomes. PMID: 31187194 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
CONCLUSIONS: A novel risk score incorporating 8 readily available clinical and angiographic variables had high discrimination for 30-day death after PCI across a wide range of clinical scenarios. PMID: 31186218 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
ConclusionAs a novel inflammation-based risk score, the CRP/albumin ratio may be an easily accessible marker for assessment of stent restenosis risk.ResumoObjetivoA reestenose de stent permanece como um desafio clínico em doentes com cardiopatia isquémica. A reestenose de stent está associada a intervenções coronárias recorrentes bem como a aumento de internamentos e de custos médicos. A inflamação tem um papel significativo. Embora a associação entre reestenose de stent e o aumento dos níveis de proteína C-reativa (PCR) e a diminui&...
Source: Revista Portuguesa de Cardiologia - Category: Cardiology Source Type: research
Conclusion The use of a novel SCB in native coronary arteries was associated with good angiographic outcome at 6-month follow-up.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Research articles: Interventional cardiology. Coronary artery disease Source Type: research
I was texted this ECG with the words " sudden onset CP in a 20-something " :What do you think?This was my response:" This is abnormal in lateral leads. It probably is a normal variant but I would get a stat echo.It is out of the bounds of the usual with normal variant because the ST Elevation is so focal to the lateral wall. Most normal variant has as much inferior STE as lateral (and of course without ST depression in aVL).  This is myocarditis versus myocardial infarction. He should get an immediate echo.  Problem is, even myocarditis will have a wall motion abnormality. And then the on...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Coronary CT angiography (CCTA) is a well-established, non-invasive imaging modality with excellent diagnostic accuracy in the identification of coronary atherosclerosis and detection of obstructive coronary artery disease (CAD) when compared to invasive coronary angiography (ICA) as reference standard.1 Moreover, several randomized controlled trials have shown how the use of CCTA in the management of symptomatic patients with stable CAD improves patients ’ outcomes, reducing the risk of long-term fatal and non-fatal myocardial infarction.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Editorial Source Type: research
We present the following case to illustrate the role of Coronary Computed Tomography Angiogram (CCTA) in the evaluation of LV thrombus and its clinical significance in demonstrating fine surface details of the thrombus compared to Echo and CMR.
Source: Journal of Cardiovascular Computed Tomography - Category: Radiology Authors: Tags: Case report Source Type: research
This study, discussed on Salim Rezaie's fine site REBEL EM, implies you can trust the computer interpretation of " normal. " (http://rebelem.com/triage-ecgs-reducing-interruptions-busy-ed/)We recently wrote an editorial debunking this study: Litell, John M., H. Pendell Meyers, and Stephen W. Smith. 2019. “Emergency Physicians Should Be Shown All Triage ECGs, Even Those with a Computer Interpretation of ‘Normal.’”Journal of Electrocardiology 54 (March): 79 –81. https://doi.org/10.1016/j.jelectrocard.2019.03.003.What to do?Recording serial ECGs would be useful. The ...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
Publication date: Available online 8 June 2019Source: Reproductive BioMedicine OnlineAuthor(s): Justin Tan, Omur Taskin, Mahmoud Iews, Arthur J Lee, Arohumam Kan, Timothy Rowe, Mohamed A. BedaiwyABSTRACTEndometriosis and atherosclerotic cardiovascular disease (ASCVD) share similar pathogenic mechanisms. Hence, this systematic review evaluates the association between endometriosis and lifetime ASCVD risk including co-prevalence with dyslipidemia, atherosclerosis, and non-invasive markers of endothelial dysfunction. Among 12 studies (401 patients with surgically proven endometriosis and 557 controls), two prospective-cohort ...
Source: Reproductive BioMedicine Online - Category: Reproduction Medicine Source Type: research
Publication date: Available online 6 June 2019Source: Journal of the Saudi Heart AssociationAuthor(s): Rajaa Matahen
Source: Journal of the Saudi Heart Association - Category: Cardiology Source Type: research
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