AIM: Critically ill patients often need catecholamines, but these agents could be associated with an increased risk of death and other adverse cardiac events. Levosimendan is a calcium sensitizer that is able to enhance myocardial contractility without increasing myocardial oxygen use. We conducted a meta-analysis to determine the impact of ...

While there are convergent data suggesting that overall cardiovascular mortality is increased in patients with rheumatoid arthritis, the relative contributions of myocardial infarction and stroke remain unclear. We sought to clarify this issue by conducting a meta-analysis of cohort studies on myocardial infarction and stroke in patients with rheumatoid arthritis. ...

OBJECTIVES: Five drug classes have been shown to improve the prognosis of acute myocardial infarction in clinical trials: aspirin, beta-blockers, statins, renin angiotensin system (RAS) blockers and thienopyridines. We aimed to assess whether the benefits of combining these drugs (termed optimal medical therapy, OMT), will result in a reduction of ...

The Danish Acute Myocardial Infarction 2 (DANAMI-2) study found that primary angioplasty (primary percutaneous coronary intervention [pPCI]) compared with fibrinolysis reduced 30-day adverse events in patients with ST-segment elevation myocardial infarction. The present study investigated whether the benefit of pPCI was maintained at a long-term follow-up. We randomly assigned 1572 ...

A previous genetic analysis of the Cholesterol and Recurrent Events (CARE) trial found that carriers of the 719Arg allele of the kinesin family member 6 gene (KIF6) (rs20455), but not noncarriers, received significant event reduction from pravastatin therapy. However, that previous analysis of CARE included only Caucasian patients and was ...

Zotarolimus-eluting stents (ZESs) demonstrated greater in-segment late luminal loss and in-segment binary restenosis rates compared to sirolimus-eluting stents (SESs) in several studies. However, no data are available in direct comparison between the clinical outcomes of the 2 stents in unselected patients with ST-segment elevation acute myocardial infarction (STEMI). The aim ...

Recent genetic studies identified the rs1333049 variant on chromosome 9p21 as a major susceptibility locus for coronary artery disease and myocardial infarction (MI). Here, we evaluated whether this variant also contributes to recurrent MI or cardiac death following an acute coronary syndrome (ACS). A total of 3247 patients with ACS ...

BACKGROUND: We investigated the predictive value of plasma calprotectin levels for mortality in patients with ST segment elevation myocardial infarction (STEMI) successfully treated with primary percutaneous coronary intervention (pPCI). METHODS AND RESULTS: Plasma calprotectin levels were measured in 141 STEMI patients with acute occlusion of the left anterior descending artery ...

To investigate the relationship between central venous pressure (CVP) at presentation to the emergency room (ER) and the risk of cardiac rehospitalization and mortality in patients with decompensated heart failure (DHF). Central venous pressure was determined non-invasively using high-resolution compression sonography at presentation in 100 patients with DHF. Cardiac hospitalizations ...

BACKGROUND: Niacin or nicotinic acid (vitamin B3) raises the levels of high-density lipoprotein cholesterol (HDL) by about 30% to 35%. In patients with prior coronary disease, 7 trials have been published on clinical cardiovascular disease outcomes and the results, not surprisingly, are inconsistent. Hence, we performed this meta-analysis of randomized ...

We conducted this cohort study involving ethnic Chinese population to explore the association between left ventricular mass and cardiovascular events and all-cause death, and to define the cutoff value of left ventricular mass for risk stratification. We evaluated 2604 participants aged ≥35years in the Chin-Shan Community Cardiovascular Cohort (CCCC) study ...

Previous studies have documented gender-ethnic disparities in outcomes following acute myocardial infarction (AMI). This study evaluates such disparities in the Negev, Israel, and reviews potentially responsible mechanisms. Patients discharged with AMI were classified into young (<70 years), elders (≥70 years) and gender-ethnicity groups: Female Bedouins (FB), Female Jews (FJ), Male ...

BACKGROUND: Coronary artery disease (CAD) and chronic kidney disease (CKD) lead to high morbidity and mortality rates. Traditional and nontraditional risk factors, hypertension, fluid overloading and anemia can lead to myocardial ischemia, chamber hypertrophy and dilatation, and low left ventricular ejection fraction (LVEF) in CKD patients. The angiographic feature, ventriculographic ...

BACKGROUND: Relationships between long-term use and level of dual antiplatelet therapy and outcomes after drug-eluting stent implantation are not well established. METHODS: This is a retrospective cohort study of 9,256 patients receiving drug-eluting stents between January 2003 and August 2006. We classified patients according to tertiles of clopidogrel use during ...

BACKGROUND: Remote ischaemic preconditioning attenuates cardiac injury at elective surgery and angioplasty. We tested the hypothesis that remote ischaemic conditioning during evolving ST-elevation myocardial infarction, and done before primary percutaneous coronary intervention, increases myocardial salvage. METHODS: 333 consecutive adult patients with a suspected first acute myocardial infarction were randomly assigned ...

BACKGROUND AND PURPOSE: Premature ventricular complexes (PVCs) are frequently encountered in healthy people. But the association between PVCs and cardiac events is not well established in Japan. We investigated the association of PVCs and cardiac deaths in people without cardiovascular disease in the Jichi Medical School (JMS) Cohort study. METHODS ...

BACKGROUND: Metabolic syndrome (MetSyn) is associated with increased cardiovascular risk in the general population. Its prognostic implications are less well defined in patients with coronary artery disease. METHODS AND RESULTS: We analyzed patients in the Duke Database for Cardiovascular Disease with a diagnosis of incident obstructive coronary artery disease. Diabetes ...

BACKGROUND: It has been shown that elevated heart rate identified patients with coronary artery disease and left ventricular dysfunction at increased risk of cardiovascular outcomes. OBJECTIVE: We sought to assess the prognostic impact of heart rate at presentation in patients with ST-elevation acute myocardial infarction (STEMI) undergoing primary percutaneous coronary ...

Cerebrovascular (CVD) disease is commonly associated with coronary artery disease and adversely affects outcome. The goal of the present study was to examine the temporal management patterns and outcomes in relation to previous CVD in a contemporary "real-world" spectrum of patients with acute coronary syndrome (ACS). From 1999 to 2008, ...

PURPOSE: To examine the risk of thromboembolic cardiovascular events in users of coxibs and NSAIDs in a nationwide cohort. METHODS: Data were synchronised from three nationwide databases, the Icelandic Medicines Registry (IMR), The Icelandic National Patient Registry (INPR) and the Registry for Causes of Death at Statistics Iceland (RCD), for ...

Large-scale clinical trials have demonstrated the benefits of cardiac resynchronization therapy (CRT) in patients with New York Heart Association (NYHA) Class III/IV heart failure, systolic left ventricular dysfunction, and a wide QRS. However, additional patient groups may also benefit from CRT. We meta-analyzed clinical benefits of CRT in heart failure ...

AIM: To investigate the efficacies of point-of-care test of heart-type fatty-acid binding protein (H-FABP) and its combinations with the conventional biomarkers in the diagnosis of early acute myocardial infarction (AMI). METHODS: 227 patients suspected of AMI were consecutively recruited in two centers. Biomarkers including H-FABP, myoglobin (MYO), creatine kinase-myocardial band ...

Chronic kidney disease (CKD) and high C-reactive protein (CRP) are known risk factors of cardiovascular disease. In the drug eluting stent (DES) era, the relationship among CKD, CRP, and long-term outcomes after percutaneous coronary intervention (PCI) has not yet been demonstrated. We investigated the combined effects of renal dysfunction and ...

Increased maximal left ventricular wall thickness (LVWT; >30 mm) is a marker of risk for sudden cardiac death in hypertrophic cardiomyopathy (HCM). Patients with mild left ventricular hypertrophy (LVH) are not free of events. Regional heterogeneity of LVH may contribute to arrhythmic vulnerability. 157 HCM patients underwent assessment of maximal ...

INTRODUCTION: Ischemia-modified albumin (IMA) has been proposed as a useful rule-out marker for the diagnosis of acute coronary syndrome (ACS) in the emergency department. This study evaluated the ability of IMA to predict the acute myocardial infarction (AMI) diagnosis in a population of chest pain patients. METHODS: The study population ...

American Indians/Alaska Natives (AIAN) experience a high burden of cardiovascular disease with rates for fatal and nonfatal heart disease approximately twofold higher than the U.S. population. To determine if disparities exist in cardiac procedure rates among AIAN compared to non-Hispanic whites hospitalized in California for ischemic heart disease defined as ...

1. The aim of the present study was to evaluated the impact of prior cerebrovascular disease (CVD) on the clinical characteristics and mid-term clinical outcomes of patients with acute myocardial infarction (AMI) in the era of drug-eluting stents. 2. Data from 12 914 patients with acute myocardial infarction who were ...

Several studies indicated that an elevated body mass index (BMI) is associated with a lower rate of mortality in patients with acute myocardial infarction (AMI). However, the existence of the obesity paradox in AMI patients remains controversial. We examined the association of BMI and clinical outcomes in 2157 patient with ...

BACKGROUND: We assessed the age-related differences in pre-intervention virtual histology-intravascular ultrasound (VH-IVUS) findings at target lesion sites in patients with coronary artery disease. METHODS: A total of 553 patients who underwent pre-intervention VH-IVUS imaging were grouped according to age: non-elderly (< or = 70 years, n=429) and elderly (>70 years, ...

The aim of the present study was to explore the association of 3 coronary scores with major adverse cardiovascular events (MACE) in patients with acute coronary syndrome (ACS). The 958 consecutive patients with ACS were followed up until either MACE or 31(st) December 2008 occurred; 257 patients reached clinical endpoints. ...

BACKGROUND: The Revised Cardiac Risk Index (RCRI) is widely used to predict perioperative cardiac complications. PURPOSE: To evaluate the ability of the RCRI to predict cardiac complications and death after noncardiac surgery. DATA SOURCES: MEDLINE, EMBASE, and ISI Web of Science (1966 to 31 December 2008). STUDY SELECTION: Cohort studies ...

BACKGROUND: Platelets play a critical role in arterial thrombosis, acute coronary syndrome (ACS) and stroke. Platelet collagen receptor glycoprotein VI (GPVI) is associated with acute coronary events and a poor clinical outcome. METHODS: Between January 2006 and March 2009, we evaluated 2,213 consecutive patients in a prospective study design, who ...

Studies of the effect of right ventricular ejection fraction (RVEF) on outcomes in heart failure (HF) are limited by small sample size and short follow-up. We examined the effect of baseline RVEF on outcomes in 2008 Beta-Blocker Evaluation of Survival Trial (BEST) participants with HF and left ventricular ejection fraction ...

OBJECTIVES: We present the 5-year clinical outcomes according to treatment strategy with additional risk stratification of the ICTUS (Invasive versus Conservative Treatment in Unstable coronary Syndromes) trial. BACKGROUND: Long-term outcomes may be relevant to decide treatment strategy for patients presenting with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) and elevated troponin ...

Oxygen (O(2)) is widely recommended for patients with myocardial infarction yet a narrative review has suggested it may do more harm than good. Systematic reviews have concluded that there was insufficient evidence to know whether oxygen reduced, increased or had no effect on the heart ischaemia or infarct size. To ...

To examine the short term relation between ambient temperature and risk of myocardial infarction. Daily time series regression analysis. 15 conurbations in England and Wales. 84,010 hospital admissions for myocardial infarction recorded in the Myocardial Ischaemia National Audit Project during 2003-6 (median 57 events a day). Change in risk of ...

BACKGROUND: Stem cell transplantation for chronic myocardial infarction (MI) provides variable benefits. Most clinical trials have relied on surgical delivery, where results are biased by simultaneous coronary bypass. When bypass is not indicated, percutaneous delivery may provide comparable efficacy with reduced risk. We evaluated in vivo by cardiovascular magnetic resonance ...

To determine whether the 681 G>A (*2) polymorphism of cytochrome P450 (CYP2C19) is related to suboptimal reperfusion and mortality in patients with acute myocardial infarction (AMI) pretreated with clopidogrel. The study included 276 consecutive patients with AMI in whom percutaneous coronary intervention (PCI) with stenting was attempted. Four-year follow-up for ...

PURPOSE: The present study investigated the factors related to neurological deterioration in pontine infarction. METHODS: Consecutive patients with acute pontine infarction without basilar artery (BA) occlusion were enrolled. Patients were classified into two groups (D, group with neurological deterioration; ND, group without neurological deterioration). After magnetic resonance angiography was performed ...

To explore a possible link between authors' financial conflicts of interest and their position on the association of rosiglitazone with increased risk of myocardial infarction in patients with diabetes. On 10 April 2009, we searched Web of Science and Scopus for articles citing and commenting on either of two index ...

After the introduction of highly active antiretroviral therapies (HAART), an increased incidence of insulin resistance, diabetes mellitus (DM), and cardiovascular diseases has been described. The impact of such conditions on mortality in the post-HAART era has been also assessed in various modes in the literature. In this paper, we report ...

The amount of myocardial perfusion required for successful defibrillation after prolonged cardiac arrest is not known. Coronary perfusion pressure (CPP) is a surrogate for myocardial perfusion. One limited clinical study reported that a threshold of 15 mmHg was necessary for return of spontaneous circulation (ROSC), and that CPP was predictive ...

BACKGROUND: Hyperglycemia in acute coronary syndrome is associated with an increased risk of death in patients without previously known diabetes but the prognostic role of postrevascularization hyperglycemia in these patients is so far incompletely elucidated. MATERIALS AND METHODS: In 175 consecutive patients without previously known diabetes and with ST elevation ...

BACKGROUND: In patients with unstable angina and non-ST elevation myocardial infarction (UA/NSTEMI) two strategies are possible, either a routine invasive strategy where all patients undergo coronary angiography shortly after admission and, if indicated, coronary revascularization; or a conservative strategy where medical therapy alone is used initially, with selection of patients ...

BACKGROUND: Left ventricular remodeling (LVR), an increase in left ventricular end-diastolic volume index > or = 20%, is an adverse consequence of myocardial infarction. The aim of this study was to assess the association between LVR and adiponectin, which has been shown to protect against myocardial ischemia-reperfusion injury. METHODS: In ...

To investigate whether calcium supplements increase the risk of cardiovascular events. Patient level and trial level meta-analyses. Medline, Embase, and Cochrane Central Register of Controlled Trials (1966-March 2010), reference lists of meta-analyses of calcium supplements, and two clinical trial registries. Initial searches were carried out in November 2007, with electronic ...

Although ST-segment depression (STD) on the admission electrocardiogram (ECG) confers adverse prognosis in patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS), the implications of STD on follow-up ECG remain uncertain. We determined the prognostic significance of STD on follow-up ECG performed within 12-24 h of admission and whether its quantitative ...

Increased red blood cell distribution width (RDW) has been associated with adverse outcomes in heart failure and stable coronary disease. We studied the association between baseline RDW and changes in RDW during hospital course with clinical outcomes in patients with acute myocardial infarction (AMI). Baseline RDW and RDW change during ...

BACKGROUND: Hypoenhanced regions on multidetector CT (MDCT) coronary angiography correlate with myocardial hyperperfusion. In addition to a limited capillary density, chronic myocardial infarction (MI) commonly contains a considerable amount of adipose tissue. OBJECTIVE: We explored whether regional myocardial hypoenhancement on contrast-enhanced MDCT could be identified with standard coronary artery calcium ...

BACKGROUND: Patients with ischemic heart disease and preserved ventricular function experience considerable morbidity and mortality despite standard medical therapy. PURPOSE: To compare benefits and harms of using angiotensin-converting enzyme (ACE) inhibitors, angiotensin II-receptor blockers (ARBs), or combination therapy in adults with stable ischemic heart disease and preserved ventricular function. DATA ...