European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Sep 2017
Randomized Controlled Trial Multicenter StudyAcute versus subacute angiography in patients with non-ST-elevation myocardial infarction - the NONSTEMI trial phase I.
The 2015 European Society of Cardiology non-ST-elevation myocardial infarction (NSTEMI) guidelines recommend angiography within 24 h in high-risk patients with NSTEMI. An organized STEMI-like approach with pre-hospital or immediate in-hospital triage for acute coronary angiography (CAG) may be of therapeutic benefit but it remains unknown whether the patients can be properly diagnosed in the pre-hospital setting. We aim to evaluate whether it is feasible to diagnose patients with NSTEMI in the pre-hospital phase or immediately upon admission. ⋯ Diagnosing NSTEMI patients in the pre-hospital phase or immediately upon hospital admission is feasible. Acute CAG may impact the mode of revascularization and is associated with earlier revascularization and shorter hospital stay. The clinical benefit of acute CAG in NSTEMI patients remains to be clarified.
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Eur Heart J Acute Cardiovasc Care · Sep 2017
EditorialClinical impact of delirium and antipsychotic therapy: 10-Year experience from a referral coronary care unit.
Little is known about safety of antipsychotic therapy for delirium in the coronary care unit (CCU). Our aim was to examine the effect of delirium and antipsychotic therapy among CCU patients. ⋯ In patients admitted to the CCU, delirium was associated with an increase in both in-hospital and one-year mortality. Low doses of haloperidol and quetiapine appeared to be safe, without an increase in risk of sudden cardiac death, in-hospital mortality, or one-year mortality in carefully monitored patients.
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Eur Heart J Acute Cardiovasc Care · Sep 2017
The impact of delirium on outcomes in acute, non-intubated cardiac patients.
Because of progress in cardiovascular management, many critically ill geriatric patients undergo various procedures and intensive cardiovascular care treatments. Although delirium frequently affects geriatric patients post-procedurally and after intensive cardiovascular care, the impact of delirium on acute cardiac patients has not been well understood. The objective of this study was to investigate the impact of delirium on outcomes in acute, non-intubated cardiac patients. ⋯ Acute delirium is common and predicts mortality in non-intubated cardiac patients. Cardiac critical care providers should be aware of this neurological condition.