Correlation between the timi risk score and high risk angiographic findings
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The document discusses a study that evaluated the correlation between the TIMI risk score, a tool used to predict risks of death and other ischemic events in patients with non-ST elevation acute coronary syndromes, and high-risk angiographic findings in those patients. The study used data from 1491 patients in the PRISM-PLUS trial, finding a relationship between higher TIMI risk scores at presentation and more severe thrombus, worse epicardial blood flow, and more severe coronary lesions seen on angiography.
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ponencia-de-mª-rosa-rotondo-presidenta-de-apri-jornadas-laboral-u py-d-2011
Contoh surat undangan tahlil 40, 100, 1000 hari (haul)
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Similar to Correlation between the timi risk score and high risk angiographic findings
J clin exp card analysis of bleeding complications in acute coronary syndrome
J clin exp card analysis of bleeding complications in acute coronary syndromeAlexandria University, Egypt
This study analyzed bleeding complications in 150 patients with acute coronary syndrome (ACS) who received antiplatelet and anticoagulant therapy, comparing outcomes in diabetic and non-diabetic patients. There was no statistically significant difference in major bleeding as defined by TIMI criteria between diabetic and non-diabetic patients or between those who received heparin alone versus heparin plus tirofiban. The most common site of bleeding was the cardiac catheterization access site. While GRACE and CRUSADE risk scores were higher in diabetics, indicating greater disease severity, rates of all TIMI bleeding and blood transfusions were similar between diabetic and non-diabetic patients.Atrial fib journal club
This study examined the association between blood cell count parameters and the development of new onset atrial fibrillation (AF) after acute myocardial infarction (AMI). The study found that patients who developed AF after AMI had significantly higher hemoglobin, hematocrit, and erythrocyte count levels compared to controls without AF. Logistic regression analysis revealed an independent association between higher hemoglobin, hematocrit, and erythrocyte count and increased odds of developing AF after AMI. However, the pathophysiological mechanisms for these associations require further investigation.
Dual antiplatelet therapy duration based on ischemic and bleeding risks after...
The PRECISE-DAPT score is a 5-item bleeding risk prediction model developed to estimate the bleeding risk in patients who receive dual antiplatelet therapy (DAPT) after stent implantation
The categorization of patients based on the PRECISE-DAPT score was shown to be useful to inform decision-making for duration of DAPT in stented patients
Risk scores in nste acs
1) Risk scores help identify patients with NSTE-ACS who are at higher risk of death and recurrent cardiac events in both the short and long term.
2) Studies have found reductions in mortality rates for NSTE-ACS patients in recent years, which is due in part to improvements in pharmacological and invasive coronary strategies.
3) The GRACE risk score is the most widely used and has been shown to accurately predict mortality in NSTE-ACS patients at both 30 days and 1 year. It helps guide clinical decision making regarding treatment strategies.
Ajc suppl 1 2009-7
The renin–angiotensin–aldosterone system (RAAS) plays a central role in blood pressure regulation and sodium balance, and its overactivity contributes to conditions like hypertension and heart failure. Inhibition of the RAAS with angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) lowers blood pressure and reduces cardiovascular risk. Studies have shown that ACE inhibitors and ARBs can slow the progression of renal disease in patients with diabetes, although their impact on long-term cardiovascular outcomes requires further investigation. The ONTARGET trial found that the ARB telmisartan had comparable reno- and cardioprotective effects as the ACE inhibitor
Serum uric acid as a marker of left ventricular failure in acute myocardial i...
IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Migraine and risk of stroke
The document discusses the relationship between migraine and stroke. It finds that migraine, particularly migraine with aura, is associated with an increased risk of ischemic stroke. The risk is higher in women, younger women, women using oral contraceptives or who smoke. Neuroimaging studies show a higher prevalence of asymptomatic brain lesions in migraine patients. While the mechanism is unknown, the risk of stroke seems greater in migraine patients without traditional risk factors.
Pulmonary embolism update on management and controversies.pdf
This document summarizes recent advances in the diagnosis, risk assessment, and management of pulmonary embolism (PE). Key points include:
1) Direct oral anticoagulants (DOACs) such as apixaban, edoxaban, and rivaroxaban are now preferred over warfarin for treating PE due to similar or lower risk of bleeding.
2) Use of clinical probability adjusted or age adjusted D-dimer testing can help reduce unnecessary imaging to diagnose PE.
3) Only a small portion of PE patients have high risk features, but identifying these patients may help determine if additional therapies like thrombolysis are needed.
4) After PE, assessing risk factors can guide duration
NST-ACS guidelines
The document defines acute myocardial infarction (AMI) and unstable angina, and outlines the management of non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in six steps: 1) initial evaluation and pathway, 2) diagnosis validation and risk assessment, 3) antithrombotic treatment, 4) invasive strategy, 5) revascularization modalities, and 6) discharge and post-discharge management. It provides details on risk stratification, antithrombotic and antiplatelet therapies such as aspirin, P2Y12 inhibitors, and anticoagulants. Clinical trials comparing drugs for NSTE-ACS are summarized, including findings on prasugrel, ticagrelor,
Interesting cases discussion.pptx
- The patient presented with new onset AF after recent PCI for NSTEMI. Managing anticoagulation and antiplatelet therapy in such patients is challenging due to risk of bleeding from triple therapy. Shortening triple therapy duration does not significantly reduce bleeding risk. Dual antiplatelet and anticoagulant therapy may reduce bleeding compared to triple therapy.
Lyons SCCM poster Feb 07
This study compared measurements of cardiac index and stroke volume obtained from impedance cardiography (ICG) to those obtained from thermodilution pulmonary artery catheterization (TD PAC) in 20 post-operative cardiac surgery patients over 8 hours. The correlation between ICG and TD PAC was significant for cardiac index but not stroke volume. When adjusted for fluid balance, the correlation was only significant for patients receiving small volumes of fluid. The study concludes ICG is unlikely to be valuable for hemodynamic monitoring in this patient population.
Non st elevation myocardial infarction and unstable angina
This document outlines the definition, pathophysiology, clinical presentation, risk stratification, and management of unstable angina and non-ST elevation myocardial infarction (NSTEMI). It defines unstable angina and NSTEMI and describes the pathophysiologic process involving plaque rupture, thrombosis, and vasoconstriction. It discusses the clinical examination, electrocardiogram, cardiac markers, and high-risk subgroups. Scoring systems like the TIMI risk score and GRACE risk score are presented to aid in risk stratification and prognostication.
Chapter 24.2 lmwh in cancer asso thrombosis
The document discusses cancer-associated thrombosis (CAT). It notes that cancer increases the risk of venous thromboembolism (VTE) due to alterations in the coagulation system and inflammatory response to cancer that result in a hypercoagulable state. Several risk assessment scores are used to stratify cancer patients' risk of VTE, with the goal of identifying those who could benefit from thromboprophylaxis. The pathophysiology of CAT involves Virchow's triad of stasis, vessel injury, and hypercoagulability due to factors from cancer cells and cytokines that promote coagulation and clot formation.
Increased Cardiac Troponin T in Patients without Myocardial Infarction
According to the World Health Organization, the diagnosis of acute myocardial infarction AMI is based on two of the three main criteria changes in the ECG up to 25 of myocardial infarctions are not reflected in the ECG , anginous pain, and increased markers of myocardial necrosis. In 2000, the European Scientific Society and the American College of Cardiology made a correction to the definition of AMI, according to which the determining factor in the diagnosis of AMI is the detection of an increased level of specific markers of myocardial necrosis — cardiac troponins in the blood. Troponin is a protein that is part of myofibrils. Cardiac troponin contains three subunits T, I, and C. Troponin C is non specific for the myocardium, in contrast to the T and I subunits, whose structure in the contractile fibers of cardiomyocytes differs from similar proteins of other muscle cells. The widespread use of the determination of cardiac troponins in the blood significantly increased the detection of AMI by 30 200 . Until recently, it was believed that troponins enter the blood only as a result of the death of cardiomyocytes. However, in recent years, it has been shown that troponins can penetrate into the interstitial space, and then into the blood, when cardiomyocytes are damaged with an increase in the permeability of their cell membranes, which can be caused not only by AMI, but also by conditions accompanied by hyper production of pro inflammatory cytokines tumor necrosis factor a, interleukin 1, etc. . The aim of this study was to analyze the final diagnoses in patients with increased cardiac troponin T levels without a clinical picture and characteristic ECG changes in AMI. Khusainova Munira Alisherovna "Increased Cardiac Troponin-T in Patients without Myocardial Infarction" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Special Issue | Innovative Development of Modern Research , April 2021, URL: https://www.ijtsrd.com/papers/ijtsrd40034.pdf Paper URL : https://www.ijtsrd.com/medicine/other/40034/increased-cardiac-troponint-in-patients-without-myocardial-infarction/khusainova-munira-alisherovna
Risk factors of Acute Coronary Syndrome at Prince Ali Bin Alhussein hospital
Objective:The aim of this survey to identify the relationship between ACS and its risk factors and the association between the risks factors themselves. Method: A retrospective study depends on the registered files of the admitted patients to Prince Ali Bin Alhussein hospital with ACS since April 2013 till October of 2013 included 174 patients. Result:The above mentioned data and results show a strong relationship between ACS and the mentioned risk factors. Conclusion: There is a strong relationship between risks factors themselves as D.M and hypertension, and between hypertension with the sex and smoking.There's an association between D.M and the patient's gender
How to Stratify Ischemic and Bleeding Risks in a Given Patient - Dr. Ariza
How to Stratify Ischemic and Bleeding Risks in a Given Patient - Dr. ArizaSociedad Española de Cardiología
Ponencia presentada por el Dr. Albert Ariza en la Reunión EuroIMAT 2020, celebrada en Barcelona (20 y 21 de febrero de 2020).Trials and errors in cardiovascular medicine 2013
1. A study found that early treatment of a first episode of acute pericarditis with colchicine in addition to standard anti-inflammatory therapy reduced the risk of recurrence compared to anti-inflammatory therapy alone.
2. The STOP-HF trial found that screening high-risk patients for heart failure with BNP and providing further assessment and care for those with elevated BNP resulted in less left ventricular dysfunction, heart failure, and emergency hospitalizations compared to usual care.
3. The EchoCRT trial of CRT in patients with narrow QRS found no benefit of CRT and more deaths with CRT, suggesting CRT is not recommended for patients with narrow QRS.
Clinical Profile of Acute Coronary Syndrome among Young Adults
Acute Coronary Syndrome accounts for 30% of hospital admissions with cardiovascular diseases. The risk of this syndrome is increasing among the younger adults, and a deep insight into the clinical profile among these patients will help in devising a preventive strategy, in order to alleviate the morbidity and mortality due to the syndrome. A cross sectional study was done among 125 subjects admitted to our tertiary care hospital with Acute Coronary Syndrome. Their risk factors were assessed and a 12 Lead electrocardiogram and 2D Echocardiogram were taken. Cardio III panel which consists of Troponin I, CK MB, BNP by COBAS meter machine was also measured. STEMI was present in 73.6% of the patients, while unstable angina was present in 16%. About 90% of STEMI patients were males and 62% of them were hypertensives. LV Ejection Fraction <30% was found in 9% of STEMI patients. This study elucidates the need for a preventive strategy for primordial prevention of cardiovascular events among young adults. The study envisaged the male, urban preponderance towards these events.
Angina pectoris
This document discusses ischaemic heart disease and angina pectoris. It defines IHD as a condition where there is inadequate blood supply and oxygen to the myocardium. Angina pectoris is defined as a clinical syndrome characterized by precordial discomfort due to myocardial ischemia, typically brought on by exertion and relieved by rest. The document covers the epidemiology, risk factors, pathophysiology, clinical manifestations, diagnosis and treatment of these conditions. It emphasizes that risk factor identification and modification are important for managing patients with known or suspected IHD.
LMWH in ACS.pptx
The document discusses the role of low molecular weight heparin (LMWH) in the management of acute coronary syndrome (ACS). It provides an overview of ACS globally and in India. It then covers the diagnosis of ACS and current treatment guidelines, which involve the use of antiplatelet and anticoagulant therapies. Specifically, it discusses the pharmacological properties and clinical evidence for the use of LMWH, such as enoxaparin, in ACS. Studies show LMWH provides benefits over unfractionated heparin (UFH) in reducing risks during coronary interventions and improving outcomes in ACS patients.
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J clin exp card analysis of bleeding complications in acute coronary syndrome
J clin exp card analysis of bleeding complications in acute coronary syndrome
Dual antiplatelet therapy duration based on ischemic and bleeding risks after...
Dual antiplatelet therapy duration based on ischemic and bleeding risks after...
Serum uric acid as a marker of left ventricular failure in acute myocardial i...
Serum uric acid as a marker of left ventricular failure in acute myocardial i...
Pulmonary embolism update on management and controversies.pdf
Pulmonary embolism update on management and controversies.pdf
Non st elevation myocardial infarction and unstable angina
Non st elevation myocardial infarction and unstable angina
Increased Cardiac Troponin T in Patients without Myocardial Infarction
Increased Cardiac Troponin T in Patients without Myocardial Infarction
Risk factors of Acute Coronary Syndrome at Prince Ali Bin Alhussein hospital
Risk factors of Acute Coronary Syndrome at Prince Ali Bin Alhussein hospital
How to Stratify Ischemic and Bleeding Risks in a Given Patient - Dr. Ariza
How to Stratify Ischemic and Bleeding Risks in a Given Patient - Dr. Ariza
Clinical Profile of Acute Coronary Syndrome among Young Adults
Clinical Profile of Acute Coronary Syndrome among Young Adults
More from Dr Bhageerath Atthe
Diphtheria myocarditis osmania general hospital
When no cases are reported in usa and China in last 10 years hundreds of cases are reported in single Indian state per year with 50 percent mortality
Remodelling
Glagov et al. found in a study of 136 human coronary arteries that the internal elastic lamina area and plaque area were positively correlated and luminal area was unaffected by plaque growth until it reached 40% area stenosis. Positive remodeling describes an expansion in external elastic membrane area at the lesion site, while negative remodeling describes a shrinkage in external elastic membrane area, as observed by Glagov et al. Mintz et al. used intravascular ultrasound to examine 603 coronary lesions and found that inadequate or negative remodeling, defined as a ratio of lesion external elastic membrane area to proximal reference area of ≤0.78, was present in 15% of lesions.
Aortic stiffness and endothelial function in patients
The study examined young patients under 45 who had acute myocardial infarction. It measured the aortic diameter using echocardiogram and assessed arterial stiffness by measuring pulse wave velocity in the brachioradial artery segment. It also assessed endothelial function in the brachial artery by measuring vasodilation in response to induced reactive hyperemia using ultrasound and Doppler.
Scd
The document discusses sudden cardiac death (SCD) in various populations. It notes that SCD accounts for 12-15% of natural deaths and almost 90% have cardiac causes. The peak ages for SCD are within the first year of life and between 45-75 years. The most common causes of SCD in children are congenital heart defects while in those over 35 it is coronary heart disease. Rare causes like hypertrophic cardiomyopathy also contribute to SCD in young adults. Exercise-related SCD is often due to congenital anomalies or premature heart disease in young and older athletes respectively.
Ferric carboxymaltose in patients with heart failure and
This study aimed to determine if intravenous iron (ferric carboxymaltose) would improve symptoms in patients with heart failure, reduced left ventricular function, and iron deficiency anemia. Patients with chronic heart failure classified as NYHA class II or III, a left ventricular ejection fraction of 40% or less (II) or 45% or less (III), and microcytic hypochromic anemia were randomly assigned to receive either 200 mg of intravenous iron or a saline placebo. The primary endpoints were self-reported health status and NYHA functional class at 24 weeks, with secondary endpoints including 6-minute walk distance and quality of life.
Levosimendan vs dobutamine for patients with acute decompensated
The SURVIVE study was a randomized, double-blind trial that compared the efficacy and safety of intravenous levosimendan vs dobutamine in 1,327 patients hospitalized with acute decompensated heart failure who required inotropic support. The trial found no significant difference in all-cause mortality at 180 days between the levosimendan and dobutamine groups. However, the levosimendan group had greater decreases in B-type natriuretic peptide levels over the first 5 days. Both drugs showed side effects, with higher rates of cardiac failure in the dobutamine group and atrial fibrillation, hypokalemia, and headache in the levosimendan
Change of white blood cell count more prognostic
Changes in white blood cell count after primary percutaneous coronary intervention are more prognostic of outcomes for patients with ST elevation myocardial infarction than baseline values. The study measured serial white blood cell counts before and after PCI in STEMI patients and found that persistent white blood cell elevation was an even stronger predictor of poor prognosis and increased mortality than a single high baseline count.
Randomized comparison of everolimus eluting stents and sirolimus-eluting stents
This study compared everolimus-eluting stents (EES) to sirolimus-eluting stents (SES) in 500 STEMI patients undergoing primary angioplasty. No significant differences were found between the EES and SES groups in major adverse cardiac events, death, reinfarction, or target vessel revascularization. However, the EES group had a significantly lower rate of stent thrombosis compared to the SES group at 3-year follow-up. Therefore, among STEMI patients undergoing primary angioplasty, EES was found to have similar efficacy as SES but was associated with a reduced risk of stent thrombosis.
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Aortic stiffness and endothelial function in patients
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Ferric carboxymaltose in patients with heart failure and
Ferric carboxymaltose in patients with heart failure and
Levosimendan vs dobutamine for patients with acute decompensated
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Randomized comparison of everolimus eluting stents and sirolimus-eluting stents
Randomized comparison of everolimus eluting stents and sirolimus-eluting stents
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1. Define an electrocardiogram (ECG) and electrocardiography
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6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
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Correlation between the timi risk score and high risk angiographic findings
- 1. Correlation between the TIMI risk score and high-risk angiographic findings in non-ST-elevation acute coronary syndromes: observations from the Platelet Receptor Inhibition in Ischemic Syndrome Management in Patients Limited by Unstable Signs and Symptoms (PRISM-PLUS) trial.
- 2. • The TIMI risk score for unstable angina and non-ST elevation myocardial infarction is an effective tool for predicting the risk of death and ischemic events among patients with non- ST elevation acute coronary syndromes, as well as for identifying those who are likely to benefit most from low-molecular-weight heparin and glycoprotein IIb/IIIa inhibition.
- 3. • To explore the pathobiologic basis for this interaction, we evaluated the relationship between the risk score, assessed at presentation, and angiographic findings among patients with non-ST elevation acute coronary syndromes. Angiographic data regarding thrombus, epicardial flow, and lesion severity were available for 1491 patients from the angiographic substudy of PRISM-PLUS.