International journal of cardiology
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Multicenter Study
Copeptin for rapid rule out of acute myocardial infarction in emergency department.
Copeptin, in combination with conventional troponin (cTn), has been suggested as a means of rapid rule out of the diagnosis of acute myocardial infarction (AMI). This study aims to assess the value of copeptin for rule out of AMI, according to the pre-test probability (PTP). ⋯ In triage of chest pain patients, the additional use of copeptin with conventional cTnI might allow a rapid and reliable rule out of the diagnosis of AMI regardless of the PTP.
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CVD has the ability to interrupt an individual's ability to participate in the labour force, and this can have considerable follow-up on impacts to both the individual and the state. This study aimed to quantify the personal cost of lost income and the cost to the state from lost income taxation, increased benefit payments and lost GDP as a result of early retirement due to CVD in Australians aged 45-64 in 2009. ⋯ The costs of CVD to both individuals and the state are considerable. Whilst individuals bear the economic costs of lost income in addition to the burden of the condition itself, the state impacts are loss of productivity from reduced workforce participation, lost income taxation revenue, and increasing government support payments - in addition to direct health care costs.
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Today, more patients with congenital heart disease (CHD) reach adulthood. There are conflicting findings concerning the relationship between quality of life (QoL) or health state for adults with CHD and the complexity of their CHD. The aim of the study was, firstly, to compare the reported health status and health perception of adult patients with CHD and, secondly, to investigate what variables influenced the patients' health status and health perception. ⋯ The health status of adults with CHD is influenced by symptoms, NYHA-classification, age and gender. Adults with CHD report a lower occurrence of problems in comparison to previously published results from a general population, but the importance of actively asking about the patient's experience is demonstrated by the high degree of asymptomatic patients reporting problems on EQ-5D.
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Editorial Comparative Study
Exploring the reduction in myocardial infarctions in the PLATO trial: which patients benefited on ticagrelor vs. clopidogrel?
Ticagrelor showed significant reductions in myocardial infarctions (MIs) compared to clopidogrel in the Platelet Inhibition and Patient Outcomes (PLATO) trial. However, there was no explanation as to whether there was an equal distribution of benefit throughout acute coronary syndrome (ACS) types. ⋯ Ticagrelor significantly reduced MIs compared to clopidogrel only in STEMI patients, with those receiving early PCI having worse outcomes with ticagrelor. Despite, NSTEMI patients showing no significant reduction in MI with ticagrelor vs. clopidogrel, CV mortality was significantly reduced. In summary, we cannot be sure what is driving the STEMI-MI benefit, the NSTEMI-CV mortality benefit, nor the overall mortality benefit for ticagrelor-treated patients compared to clopidogrel treated patients.