Clinical cardiology
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Clinical cardiology · Oct 2019
Elevation of high-sensitivity cardiac troponin T at admission is associated with increased 3-month mortality in acute ischemic stroke patients treated with thrombolysis.
Elevated levels of cardiac troponin T (cTnT) have been associated with unfavorable outcomes in cardiac patients. However, no studies, to date, have discussed the prognostic value of high-sensitivity cTnT (hs-cTnT) in thrombolyzed patients with acute ischemic stroke (AIS). ⋯ Elevation of hs-cTnT at admission is associated with an increased risk of 90-day mortality in AIS patients treated with IV tPA.
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Clinical cardiology · Oct 2019
Use of Impella heart pump for management of women with peripartum cardiogenic shock.
Percutaneous mechanical circulatory support (MCS), such as the Impella heart pump is a valuable option for cardiogenic shock (CS), although the use of Impella in CS due to peripartum cardiomyopathy (PPCM) is limited. ⋯ MCS with Impella devices can be successfully used as a bridge to early improvement, heart recovery, or successful implantation of durable LVAD in women with PPCM complicated by severe LV dysfunction.
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Clinical cardiology · May 2019
Observational StudyClinical impact of using a more sensitive troponin assay in patients with acute chest pain.
More sensitive troponin assays have the potential to better evaluate patients with suspected acute coronary syndrome (ACS). Meanwhile, they may result in avoidable diagnostic testing. ⋯ The introduction of the more sensitive troponin assay appeared to result in less time spent in the ED regarding patients discharged home directly, but prompted more hospitalizations and procedures without impacting the incidence of MACE.
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Clinical cardiology · May 2019
Randomized Controlled Trial Comparative StudyEfficacy and safety of apixaban vs warfarin in patients with atrial fibrillation and prior bioprosthetic valve replacement or valve repair: Insights from the ARISTOTLE trial.
The optimal anticoagulation strategy for patients with atrial fibrillation (AF) and bioprosthetic valve (BPV) replacement or native valve repair remains uncertain. ⋯ In patients with AF and a history of BPV replacement or repair, the safety and efficacy of apixaban compared with warfarin was consistent with results from ARISTOTLE. These data suggest that apixaban may be reasonable for patients with BPVs or prior valve repair, though future larger randomized trials are needed. CLINICALTRIALS.GOV: NCT00412984.
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Clinical cardiology · Apr 2019
Effective combination of isolated symptom variables to help stratifying acute undifferentiated chest pain in the emergency department.
Symptom is still indispensable for the stratification of chest pain in the emergency department. However, it is a sophisticated aggregation of several aspects of characteristics and effective combination of those variables remains deficient. We aimed to develop and validate a chest pain symptom score (CPSS) to address this issue. ⋯ The effective combination of isolated variables was meaningful to make the most stratification value of symptoms. This model should be considered as part of a comprehensive strategy for chest pain triage.