Journal of cardiology
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Journal of cardiology · Jan 2014
Comparative StudyUsefulness of a surface cooling device (Arctic Sun®) for therapeutic hypothermia following cardiac arrest.
Cardio-pulmonary resuscitation and therapeutic hypothermia (TH) have improved the neurological outcomes of patients who have suffered sudden cardiac arrest; however, the benefits of and differences between cooling devices remain unclear. The aim of this study was to clarify the significance of the Arctic Sun(®) for surface cooling in patients treated with TH. ⋯ The use of TH with the Arctic Sun 2000(®) following cardiac arrest is safe and effective in precisely maintaining the target body temperature, and can be used to reduce the infusion dose of dobutamine to treat heart failure during TH.
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Journal of cardiology · Jan 2014
Favorable outcomes of patients with vasospastic angina associated with cardiac arrest.
The long-term survival of vasospastic angina (VSA) patients is generally good, so long as they remain on calcium channel blockers (CCBs) and avoid smoking. However, the pathogenesis, appropriate treatments, and prognosis of VSA associated with cardiac arrest remain unclear. This study aimed to elucidate the clinical features and long-term outcomes of patients with VSA associated with cardiac arrest. ⋯ Appropriate medical treatment can achieve favorable long-term outcomes even for patients with VSA associated with cardiac arrest.
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Journal of cardiology · Jan 2014
Association of triglyceride-rich lipoproteins-related markers and low-density lipoprotein heterogeneity with cardiovascular risk: effectiveness of polyacrylamide-gel electrophoresis as a method of determining low-density lipoprotein particle size.
Despite well-controlled low-density lipoprotein cholesterol (LDL-C), hypertriglyceridemia is an independent predictor of coronary events. We investigated the risk of atherosclerotic cardiovascular disease through examining the relation between triglyceride (TG) metabolism and LDL-heterogeneity as assessed by polyacrylamide-gel electrophoresis (PAGE). ⋯ To further reduce the risk of atherosclerotic cardiovascular disease, it may be of particular importance to pay attention not only to the quantitative change in the serum LDL-C, but also TG-metabolism associated with LDL-heterogeneity. Combined evaluation of TRLs-related markers and LDL-Rm value may be useful for assessing the risk of atherosclerotic cardiovascular disease.
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Journal of cardiology · Dec 2013
Multicenter Study Comparative StudyHigh-sensitivity cardiac troponin T for earlier diagnosis of acute myocardial infarction in patients with initially negative troponin T test--comparison between cardiac markers.
An early diagnosis is essential for therapeutic decision and risk stratification in patients with suspected acute myocardial infarction (AMI). We analyzed and compared the diagnostic value of high-sensitivity troponin T (hs-TnT) and other cardiac markers in patients with an initially negative troponin T test at presentation. ⋯ The hs-TnT displayed 100% sensitivity and negative predictive value for the patients admitted more than 120 min from the onset, however the specificity was limited. The absolute change from T0 to T3 (22 ng/L) improved the total diagnostic performance.
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Journal of cardiology · Oct 2013
ReviewIncreasing specificity of high-sensitivity troponin: new approaches and perspectives in the diagnosis of acute coronary syndromes.
In the past years, new generations of assays to detect cardiac troponin (cTn), called sensitive or high sensitivity troponin (hs-Tn), have been introduced. Progressive improvement in the analytical sensitivity of cTn assays has led to a more rapid diagnosis of acute myocardial infarction (AMI) and improved risk stratification in patients with non ST-elevation acute coronary syndromes (NSTE-ACS) but, at the same time, has introduced the problem of a lower diagnostic specificity. ⋯ The reduced specificity of hs-Tn versus the previous generation cTn assays may, therefore, lead to an increased number of inappropriate hospitalizations, i.e. patients with high cTn due to no-ACS conditions, and requires a more careful evaluation, not only on the clinical side, but also on the information that hs-Tn assessment may provide. Several approaches to increase this specificity have been used, but the most promising appear to be the "delta approach", which tries to quantify the relative or absolute change in cTn concentration, and the "age approach", which highlights the need for a different cutoff with a better diagnostic efficiency in the elderly population, often affected by other conditions, different from ACS, that can cause an increased level of cTn.