American heart journal
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American heart journal · Sep 2000
D-Dimer is an early diagnostic marker of coronary ischemia in patients with chest pain.
Chest pain is a frequent symptom in the emergency department and often presents a diagnostic challenge. Because coronary thrombosis is a hallmark of acute ischemic syndromes, the substrates of the coagulation and fibrinolysis cascades may be markers of coronary ischemia. The objective of this study was to determine the diagnostic value of several hemostatic markers in patients presenting to the emergency department (ED) with chest pain syndromes. ⋯ D-Dimer, an expression of ongoing thrombus formation and lysis, is a marker of substantial incremental value for the early diagnosis of acute coronary syndromes presenting with chest pain. It adds independent information to the traditional assessment for myocardial infarction. D-Dimer can be incorporated into clinical decision models in the ED.
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American heart journal · Sep 2000
Clopidogrel for prevention of major cardiac events after coronary stent implantation: 30-day and 6-month results in patients with smaller stents.
We developed this study to assess the procedural outcome, complications, and clinical follow-up in patients treated with different antiplatelet regimens after intracoronary stent implantation with small stents. Three hundred sixty-one consecutive patients, in whom at least one 3.0-mm intracoronary stent was implanted, were studied. ⋯ Our observations suggest that clopidogrel can be used instead of ticlopidine in patients treated with stents with a diameter of
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American heart journal · Aug 2000
Carotid Doppler high-intensity transient signals in dilated cardiomyopathy.
Thromboembolism is an infrequent but serious complication in dilated cardiomyopathy (DCM), and the role of primary preventive antithrombotic or anticoagulation therapy is undetermined. High-intensity transient signals (HITS) by Doppler ultrasound representing microemboli have been described in various clinical settings associated with increased risk of stroke. This study assessed the feasibility, reproducibility, and prevalence of HITS in patients with DCM. ⋯ The prevalence of CCA HITS in patients with clinically stable heart failure who are not receiving anticoagulation/antithrombotic therapy and are not in atrial fibrillation is low and not significantly different from normal patients. These data suggest that HITS monitoring is not a viable surrogate marker for increased thromboembolic risk in such patients with DCM.
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American heart journal · Aug 2000
Effect of sex, hemodynamics, body size, and other clinical variables on the corrected thrombolysis in myocardial infarction frame count used as an assessment of coronary blood flow.
Compared with the conventional Thrombolysis In Myocardial Infarction (TIMI) flow grade system, the corrected TIMI frame count (CTFC) quantifies coronary blood flow in a more reproducible fashion. The purpose of this study was to determine if the CTFC is affected by sex, body size, hemodynamics, or other selected clinical variables. ⋯ CTFC provides a quantitative assessment of coronary blood flow that varies only a small amount in association with body size, systemic arterial pressure, age, and sex.
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American heart journal · Aug 2000
Left ventricular diastolic filling pattern predicts cardiopulmonary determinants of functional capacity in patients with congestive heart failure.
Abnormalities of diastolic function are an important determinant of exercise intolerance in patients with heart failure. However, the relation between left ventricular filling pattern and cardiopulmonary exercise performance has not been adequately studied. ⋯ In patients with heart failure, abnormalities of diastolic function are the most important determinant of exercise intolerance. A restrictive transmitral flow pattern by Doppler echocardiography is a marker of diminished cardiopulmonary exercise performance in these patients.