Patients with ST elevation acute myocardial infarction (STEMI) have different outcome depending on the reperfusion strategy. To discern if the presence of initial Q waves in the infarct leads is a useful prognostic parameter in STEMI patients within 6h of symptom onset treated by different reperfusion strategies (fibrinolysis, fibrinolysis followed ...

AIMS: We sought to investigate the long-term prognostic significance of two- and three-dimensional echocardiography. METHODS AND RESULTS: One hundred and seventy-eight consecutive outpatients underwent two-dimensional echocardiography and three-dimensional echocardiography for the assessment of LV volumes, mass, ejection fraction, and LA maximum and minimum volumes. After 45 months of follow-up, 31 ...

Immediate defibrillation is the traditional approach to resuscitation of cardiac arrest due to ventricular fibrillation or tachycardia (VF/VT). Delaying defibrillation to provide chest compressions may improve survival. We examined the effect of the duration of Emergency Medical Services (EMS) cardiopulmonary resuscitation (CPR) prior to first defibrillation on survival in patients ...

To investigate whether pregnancy-associated plasma protein-A (PAPP-A) is a prognostic marker in patients admitted with high-risk acute coronary syndrome. In patients admitted with high-risk non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and ST-segment elevation myocardial infarction (STEMI), risk stratification is primarily determined by the markers of myocardial necrosis and known demographic ...

We have recently observed that intracoronary autologous bone marrow cell (BMC)-transfer improves parameters of diastolic function in patients after acute myocardial infarction at 6 and 18 months. There is no clinical study addressing the long-term effect of BMC transfer on diastolic function. Therefore, we conducted a 5-year follow-up of the ...

BACKGROUND/AIMS: The aim of the present work was to evaluate the association between exclusive olive oil consumption and the development of left ventricular systolic dysfunction (LVSD) in patients with a previous acute coronary syndrome (ACS). METHODS: From 2006 to 2007, 651 consecutive ACS patients were enrolled. In 288 males (64 ...

OBJECTIVE: Patients with rheumatoid arthritis have an increased risk for accelerated atherosclerosis. It is not known, however, whether this disorder is associated with a higher risk of complications after coronary artery revascularization. METHODS: We conducted a cross-sectional study of patients in the 2003-2005 Nationwide Inpatient Sample. To determine whether patients ...

Recent studies have raised concerns about the reduced efficacy of clopidogrel when used concurrently with proton pump inhibitors (PPIs), but those studies may have overestimated the risk. We studied the potential for increased risk of adverse cardiovascular events among users of clopidogrel with versus without concurrent use of PPIs in ...

Many patients have palpitations and seek advice from general practitioners. Differentiating benign causes from those resulting from clinically significant cardiac arrhythmia can be challenging and the clinical examination may aid in this process. To systematically review the accuracy of historical features, physical examination, and cardiac testing for the diagnosis of ...

AIMS: The primary objective of the Nurse-led Intervention for Less Chronic Heart Failure (NIL-CHF) Study is to develop a programme of care that cost-effectively prevents the development of chronic heart failure (CHF). Methods NIL-CHF is a randomized controlled trial of a hybrid, home- and clinic-based, nurse-led multidisciplinary intervention targeting hospitalized ...

GRACE, TIMI, Zwolle, and CADILLAC are risk scores designed for predicting short-term outcome after acute coronary syndromes. The aim of our study was to test their utility for a prognosis of 5-year survival in a "real-life" population of patients with ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary interventions ...

OBJECTIVES: This study analyzed the association of left ventricular end-systolic diameter (LVESD) with survival after diagnosis in organic mitral regurgitation (MR) due to flail leaflets. BACKGROUND: LVESD is a marker of left ventricular function in patients with organic MR but its association to survival after diagnosis is unknown. METHODS: The ...

BACKGROUND: Recently, mean platelet volume (MPV) was reported to predict venous thromboembolism. Moreover, MPV correlates with platelet reactivity and indicates poor outcome in acute coronary syndromes. OBJECTIVE: To examine the hypothesis that in acute pulmonary embolism (APE) MPV is elevated and may predict mortality. METHODS AND RESULTS: The study included ...

BACKGROUND: Left ventricular ejection fraction is a powerful independent predictor of survival in cardiac patients, especially those with coronary artery disease. Delayed-enhancement magnetic resonance imaging (DE-MRI) can accurately identify irreversible myocardial injury with high spatial and contrast resolution. To date, relatively limited data are available on the prognostic value of ...

Elevated concentrations of cystatin C are associated with greater cardiovascular morbidity and mortality. We sought to determine whether elevated concentrations of cystatin C were associated with inducible ischemia in patients with coronary heart disease (CHD). We measured serum cystatin C and performed exercise treadmill testing with stress echocardiography in a ...

OBJECTIVES: Left ventricular (LV) dysfunction is a major cause of poor outcome after myocardial infarction. We sought to investigate the factors that might contribute to the prediction of postinfarct LV dysfunction progression, and whether the addition of cystatin C (CystC) to this assessment might be useful. METHODS: NT-proBNP, CRP, CystC, ...

Thoracic endografts (stent grafts) have emerged as a less invasive modality to treat various thoracic aortic lesions. The intentional coverage of the left subclavian artery (LSA) during the placement of these endografts is associated with several complications including stroke, spinal cord ischemia, and arm ischemia. In this review, we synthesize ...

Non-ST-elevation myocardial infarction (NSTEMI) and unstable angina (UA) resulted in different degrees of damage to the heart muscle, and yet, when factors related to in-hospital outcomes were examined, these two subsets were often lumped together as non-STelevation acute coronary syndrome. Therefore, we investigated predictors of in-hospital heart failure (HF) in ...

The aim of this study was to evaluate the effect of a concurrent chronic total occlusion (CTO) in patients with ST-segment elevation myocardial infarction (STEMI) on long-term mortality and left ventricular ejection fraction (LVEF). The impact of a CTO in a non-infarct-related artery (IRA) on prognosis after STEMI is unknown. ...

Light chain amyloidosis (AL) is associated with high mortality. The aim was to identify echocardiographic parameters that predict AL long-term mortality. Forty-two subjects with biopsy-proven AL (43% were female; aged 61 +/- 12 years) underwent echocardiography and were followed 29 +/- 16 months (median 29.4 months). Standard echocardiographic and clinical ...

To determine whether predictors of sudden cardiac death (SCD) vary with time after myocardial infarction (MI). We analysed 11 256 patients enrolled in VALIANT. Landmark analysis and Cox proportional hazards modelling were used to predict SCD during hospitalization, from discharge to 30 days, 30 days to 6 months, and 6 ...

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 ...

BACKGROUND: The rate of death, including sudden cardiac death, is highest early after a myocardial infarction. Yet current guidelines do not recommend the use of an implantable cardioverter-defibrillator (ICD) within 40 days after a myocardial infarction for the prevention of sudden cardiac death. We tested the hypothesis that patients at ...

Left atrial (LA) size is considered a marker of poor prognosis in heart failure (HF) patients. Prior studies have recruited relatively few subjects limiting their power to adequately analyse the interaction between LA size, left ventricular (LV) systolic and diastolic function, and prognosis. The MeRGE collaboration combines prospective data from ...

BACKGROUND: Hyperglycaemia in the acute phase of stroke has been established as a predictor of higher mortality. But recent data regarding active treatment of hyperglycaemia showed no clinical benefit suggesting that hyperglycaemia may not have a detrimental effect in brain infarction. Additional data are needed to resolve this uncertainty and ...

BACKGROUND: Mortality and morbidity after acute coronary syndrome (ACS) in Japan appear to be different from those in Western countries due to different social healthcare systems, races, geographical locations, and interventional procedures, although data are limited in Japan. METHODS: With a hospital-based cohort study comprising all the new patients who ...

BACKGROUND: Atherosclerotic plaque that shows echo signal attenuation (EA) without associated bright echoes is sometimes observed by intravascular ultrasound but its clinical significance remains unclear. We investigated the impact of EA on coronary perfusion and evaluated the pathological features of plaque with EA. METHODS AND RESULTS: We studied 687 native ...

BACKGROUND: Chronic kidney disease (CKD) is associated with increased risk of coronary heart disease. However, information regarding the histopathologic characteristics of coronary atherosclerosis in individuals with CKD is scarce. This study investigated the relationship between CKD and severity of coronary atherosclerosis in population-based autopsy samples. STUDY DESIGN: Cross-sectional study. SETTING ...

BACKGROUND: Atrial fibrillation (AF) is a common arrhythmia in patients with heart failure (HF), but its prognostic importance is controversial. The effect of AF on long-term outcomes, including mortality and rehospitalization, among unselected HF patients hospitalized with HF in routine clinical practice in Japan was assessed in the present study. ...

BACKGROUND: Cardiac risk assessment for perioperative outcomes of liver transplantation patients is limited. We examined the outcomes of an older intermediate-cardiac-risk group of patients undergoing liver transplantation surgery. METHODS AND RESULTS: Patients who had liver transplantation surgery between 2001 and 2005 were studied. The 3 outcomes analyzed were nonfatal myocardial ...

BACKGROUND AND AIM OF THE STUDY: The aim of this study was to evaluate the early and mid-term off-pump coronary artery bypass surgery (OPCAB) results in a single surgical unit, assessing the impact of completeness of revascularization. METHODS: Three hundred and twelve patients underwent OPCAB between August 2000 and January ...

OBJECTIVES: To assess the long-term effects of chocolate consumption amongst patients with established coronary heart disease. DESIGN: In a population-based inception cohort study, we followed 1169 non-diabetic patients hospitalized with a confirmed first acute myocardial infarction (AMI) between 1992 and 1994 in Stockholm County, Sweden, as part of the Stockholm ...

Timely reperfusion therapy for ST-elevation myocardial infarction (STEMI) is an important determinant of outcome, yet targets for time to treatment are frequently unmet in North America. Prehospital strategies can reduce time to reperfusion. We sought to determine the extent to which emergency medical services (EMS) use these strategies in Canada. ...

OBJECTIVE: To systematically review randomized controlled trials to compare myocardial protection profiles of sevoflurane with propofol in patients undergoing coronary artery bypass grafting (CABG) surgery. METHODS: Electronic databases were searched to identify all randomized controlled trials comparing sevoflurane with propofol for protecting myocardium in adult patients undergoing CABG surgery. Two ...

Recurrence of myocardial infarction, especially when occurring early after the prior one, carries a significant morbidity and mortality rate. The aim of this study was to investigate the characteristics of patients who experienced recurrence under secondary prevention therapy. Case record review identified myocardial infarction patients who had a history of ...

OBJECTIVE: We compared the performance characteristics of the 12-lead electrocardiography (ECG) with body surface mapping (BSM) in patients presenting for evaluation of symptoms suggestive of acute coronary syndromes. METHODS: The diagnostic test characteristics (sensitivity, specificity, likelihood ratios, and predictive values) for 12-lead ECG and BSM were computed using 3 different ...

AIMS: BEAUTIFUL found no impact of ivabradine on outcomes in patients with stable coronary artery disease (CAD) and left ventricular systolic dysfunction (LVSD). We performed a post hoc analysis of the effect of ivabradine in BEAUTIFUL patients whose limiting symptom at baseline was angina, particularly in terms of coronary outcomes. ...

Treatment of acute ST-segment elevation myocardial infarction (STEMI) has dramatically changed over the past 2 decades. The goal of this study was to determine trends in the mortality of patients with acute STEMIs in the United States over a 16-year period (1988 to 2004) on the basis of gender, race, ...

TIMI myocardial perfusion grade (TMPG) reflects the integrity of microvasculature in ST-elevation myocardial infarction (STEMI). We sought to investigate whether TMPG evolution during primary angioplasty (pPCI) in spontaneously reperfused STEMI patients might predict long-term outcomes. 392 patients with TIMI-3 flow before pPCI were analyzed. According to pre- and post-pPCI TMPG ...

INTRODUCTION: In patients with coronary disease at risk of acute coronary events it is unclear which biological factors could predict the type of acute coronary syndrome clinical presentation. The aim of the study was to investigate the role of genetic polymorphisms in key proteins in fibrinolysis in the type of ...

Acute organophosphate and carbamate pesticide poisonings result in adverse cardiac outcomes. The cardiac effects of chronic low-level pesticide exposure have not been studied. The authors analyzed self-reported lifetime use of pesticides reported at enrollment (1993-1997) and myocardial infarction mortality through 2006 and self-reported nonfatal myocardial infarction through 2003 among male ...

OBJECTIVE: Posterior pericardiotomy is considered a method to reduce the incidence of atrial fibrillation after cardiac surgery. Its efficacy in preventing atrial fibrillation and supraventricular arrhythmias after coronary artery bypass surgery has been evaluated in the present meta-analysis. METHODS: This meta-analysis was performed in accordance with the Cochrane Handbook for ...

We sought to investigate the impact of body mass index (BMI) on long-term all-cause mortality in patients following first-time elective percutaneous coronary intervention (PCI). We used the Scottish Coronary Revascularisation Register to undertake a cohort study of all patients undergoing elective PCI in Scotland between April 1997 and March 2006 ...

Cerebrovascular disease (CVD) may contribute to mild cognitive impairment (MCI). We sought to determine the relation of white matter hyperintensity (WMH) volume and infarcts in brain MRI to MCI in a community-based sample. A total of 679 elderly persons without dementia underwent brain MRI. WMH and infarcts were quantified using ...

OBJECTIVES: We sought to evaluate whether global 2-dimensional (2D) strain offers additional benefit over left ventricular ejection fraction (LVEF) to predict clinical events in heart failure. BACKGROUND: Although 2D strain based on speckle tracking has been proposed as a simple and reproducible tool to detect systolic dysfunction, the relationship of ...

This study sought to understand the total weight of evidence regarding outcomes in coronary artery bypass grafting (CABG) versus percutaneous coronary intervention (PCI) in unprotected left main coronary artery (ULMCA) stenosis. Following a diagnosis of significant ULMCA stenosis in an individual that is a candidate for surgery, CABG is recommended ...

BACKGROUND: Although patients with idiopathic dilated cardiomyopathy (DCM) have no coronary artery disease, regional impairment of myocardial perfusion combined with preserved metabolism has been found using positron emission tomography (PET). Our aim was to assess the prognostic relevance of PET-mismatch between stress myocardial perfusion and glucose uptake on clinical outcome ...

BACKGROUND: Enoxaparin was superior to unfractionated heparin (UFH), regardless of fibrinolytic agent in ST-elevation myocardial infarction (STEMI) patients receiving fibrinolytic therapy in ExTRACT-TIMI 25 (Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment - Thrombolysis in Myocardial Infarction 25) trial. OBJECTIVE: This post hoc analysis compared outcomes with streptokinase plus ...

BACKGROUND AND PURPOSE: Concurrent atherosclerosis of the intracranial and extracranial cerebrovascular system is common in Asians. The typical lesion patterns and the mechanisms of stroke in patients with concurrent stenoses are unclear. This study aimed to determine these stroke features of such patients in Hong Kong. METHODS: We conducted a ...

OBJECTIVES: The aim of this study was to assess risk prediction by different biomarkers in patients with an ongoing non-ST-segment elevation acute coronary syndrome (NSTE-ACS) and after clinical stabilization. BACKGROUND: Different biomarkers reflect different aspects of the pathobiology in NSTE-ACS. However, there is little information regarding their relative prognostic value ...