European heart journal. Acute cardiovascular care
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Eur Heart J Acute Cardiovasc Care · Jun 2014
Multicenter StudyPrognostic impact of atrial fibrillation in acute coronary syndromes: results from the ARIAM registry.
The prognostic ability of atrial fibrillation (AF) in acute coronary syndromes (ACS) is unclear. Studies regarding patient outcomes with respect to the timing of AF are scarce and conflicting. The present study aimed to determine the frequency, predictors and impact on clinical outcome of AF in patients with ACS. ⋯ These findings suggest that the presence of new-onset AF during ACS is associated with a significant increase in mortality, even after adjusting for confounding variables.
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Eur Heart J Acute Cardiovasc Care · Jun 2014
Comparative StudyTowards a consistent definition of a significant delta troponin with z-scores: a way out of chaos?
We assessed the diagnostic performance of z-scores to define a significant delta cardiac troponin (cTn) in a cohort of patients with well-defined clinical outcomes. ⋯ z-scores allow the use of a single cut-off value at all cTn levels, for both cTnI and cTnT and for sensitive and highly sensitive assays, with comparable diagnostic performances. This strategy of reporting significant changes as z-scores may obviate the need for the empirical development of assay-specific cut-off rules to define significant troponin changes.
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Eur Heart J Acute Cardiovasc Care · Jun 2014
Additional value of B-type natriuretic peptide on discrimination of patients at risk for mortality after a non-ST-segment elevation acute coronary syndrome.
Few studies have addressed the additional value of B-type natriuretic peptide (BNP) on risk stratification in non-ST-elevation acute coronary syndrome (NSTE-ACS). We aimed to evaluate whether BNP levels provide additional improvement on discrimination and reclassification of patients at risk of mortality during admission and follow up after a NSTE-ACS. ⋯ Determination of BNP 24-96 hours after a NSTE-ACS improved discrimination of patients at risk for mortality during admission and follow up.
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Eur Heart J Acute Cardiovasc Care · Jun 2014
Dynamic behaviour of lactate values during mild hypothermia in patients with cardiac arrest.
The present investigation was aimed at assessing the dynamic behaviour of lactate values during hypothermia in 33 patients with cardiac arrest. ⋯ In our series, lactate values measured during hypothermia hold a prognostic role in these patients since they are related to in-ICCU death.
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Eur Heart J Acute Cardiovasc Care · Jun 2014
Case ReportsPrimary PCI: should we stent every single culprit artery?
In four selected patients presenting with ST-segment elevation myocardial infarction (STEMI), aspiration thrombectomy allowed for full filling defect angiographic 'cleaning' of the culprit arteries without need for stent implantation. Obtaining good angiographic results and uneventful early and long-term clinical outcome after thrombus aspiration alone raises the question as to whether stenting the infracted thrombotic artery is mandatory and routinely indicated in every single STEMI patient treated with primary percutaneous coronary intervention.