Clinical cardiology
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Clinical cardiology · Nov 2009
A new electrocardiographic algorithm to locate the occlusion in left anterior descending coronary artery.
Early prediction of proximal left anterior descending coronary artery (LAD) occlusion is essential from a clinical point of view ⋯ This sequential ECG algorithm based on ST-segment deviations in different leads allowed us to predict the location of occlusion in LAD with good accuracy. Cases with proximal LAD occlusion present the most markers of poor prognosis. We recommend the use of the algorithm in everyday clinical practice.
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Clinical cardiology · Oct 2009
Comparative StudyQuartiles of peak troponin are associated with long-term risk of death in type 1 and STEMI, but not in type 2 or NSTEMI patients.
The prognostic value of peak cardiac troponin (cTn) in different types of acute myocardial infarction (AMI) under the universal clinical classification is unknown. ⋯ Overall, peak cTn predicts the risk of MACE and death but not the risk of AMI. While in Type 1 and STEMI patients, QPTL are associated with risk of MACE and death, no association exists in type 2 or NSTEMI patients.
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Clinical cardiology · Oct 2009
Neutrophil count on admission predicts major in-hospital events in patients with a non-ST-segment elevation acute coronary syndrome.
Inflammation plays a key role in the pathogenesis of acute coronary syndromes (ACS). In this context we assessed neutrophil count as a predictor of major in-hospital events in patients admitted for a non-ST-segment elevation (NSTE) ACS. ⋯ In patients with a NSTE ACS of moderate or high risk, neutrophil count on admission may identify those who are at risk of having an adverse in-hospital outcome.
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Most of my time these days (at least 26 weeks out of every year) is spent on an inpatient cardiology service. Patients are general cardiology patients, mostly admitted from our emergency department (ED). Approximately half of these patients have a principle diagnosis of acute chest pain.
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Clinical cardiology · Sep 2009
Multicenter Study Comparative StudyThe usage patterns of cardiac bedside markers employing point-of-care testing for troponin in non-ST-segment elevation acute coronary syndrome: results from CRUSADE.
Point-of-care (POC) testing may expedite the care of emergency department (ED) patients suspected of having acute coronary syndromes (ACS). We evaluated the use patterns of cardiac bedside markers or POC testing for troponin in patients with non-ST-segment elevation (NSTE) ACS. ⋯ Differences existed in how hospitals used POC testing and the care given based on those results. Positive POC results are associated with expedited and higher use of anti-ischemic therapies.