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Holzmann MJ, Andersson T, Doemland ML, Roux S. Recurrent myocardial infarction and emergency department visits: a retrospective study on the Stockholm Area Chest Pain Cohort. Open Heart 2023; 10:e002206. [PMID: 37385732 DOI: 10.1136/openhrt-2022-002206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/23/2023] [Indexed: 07/01/2023] Open
Abstract
BACKGROUND Patients who experience acute myocardial infarction (AMI) are at risk of recurrent AMI. Contemporary data on recurrent AMI and its association with return emergency department (ED) visits for chest pain are needed. METHODS This Swedish retrospective cohort study linked patient-level data from six participating hospitals to four national registers to construct the Stockholm Area Chest Pain Cohort (SACPC). The AMI cohort included SACPC participants visiting the ED for chest pain diagnosed with AMI and discharged alive (first primary diagnosis of AMI during the study period not necessarily the patient's first AMI). The rate and timing of recurrent AMI events, return ED visits for chest pain and all-cause mortality were determined during the year following index AMI discharge. RESULTS Among 1 37 706 patients presenting to the ED with chest pain as principal complaint from 2011 to 2016, 5.5% (7579/137 706) were hospitalised with AMI. In total, 98.5% (7467/7579) of patients were discharged alive. In the year following index AMI discharge, 5.8% (432/7467) of AMI patients experienced ≥1 recurrent AMI event. Return ED visits for chest pain occurred in 27.0% (2017/7467) of index AMI survivors. During a return ED visit, recurrent AMI was diagnosed in 13.6% (274/2017) of patients. One-year all-cause mortality was 3.1% in the AMI cohort and 11.6% in the recurrent AMI cohort. CONCLUSIONS In this AMI population, 3 in 10 AMI survivors returned to the ED for chest pain in the year following AMI discharge. Furthermore, over 10% of patients with return ED visits were diagnosed with recurrent AMI during that visit. This study confirms the high residual ischaemic risk and associated mortality among AMI survivors.
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Affiliation(s)
- Martin J Holzmann
- Theme of Acute and Reparative Medicine, Karolinska University Hospital, and, Global Clinical Development, Karolinska Institutet, Stockholm, Sweden
| | - Tomas Andersson
- Institute of Environmental Medicine, Karolinska Institutet, and, Center for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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Safety and Efficacy of Perioperative Use of Evolocumab in Myocardial Infarction Patients: Study Protocol for a Multicentre Randomized Controlled Trial. Adv Ther 2021; 38:1801-1810. [PMID: 33638801 DOI: 10.1007/s12325-021-01662-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/10/2021] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The SECURE-PCI study supports a perioperative loading dose of statins, although whether an intensive lipid-lowering strategy prior to percutaneous coronary intervention further benefits acute coronary syndrome patients remains controversial. Evolocumab, a proprotein-converting enzyme subtilisin/kexin type 9 (PCSK9) inhibitor, acts more quickly and effectively than statins and reduces the risk of cardiovascular events in post-myocardial infarction (MI) patients. Nonetheless, whether it can be safely used in perioperative MI patients and whether perioperative application can benefit patients are still unknown. This study aims to evaluate the safety and efficacy of this treatment regimen. METHODS A multicentre, prospective, randomized, controlled superiority trial will be conducted in 530 statin-naïve MI patients. All eligible patients will be randomized to the evolocumab group (140 mg subcutaneously injected once before revascularization + 14 days after the first dose) or the control group (no evolocumab injection). Evolocumab will then be administered depending on the patient's lipid profile. Both groups will be treated simultaneously with standardized secondary preventive medications. The primary end points are major adverse cardiovascular events (a composite of death, recurrent MI, unanticipated revascularization, stroke and any rehospitalization for ischaemic causes) within 12 months. The secondary end point is post-infarction angina after pain relief. The safety end points include myopathy, impaired liver or renal function, and other adverse events during the follow-up period. OUTCOMES This is the first trial to evaluate the safety and efficacy of evolocumab pre-treatment on prognosis in MI patients. Perioperative evolocumab injection may be a new, safe way to improve prognosis. TRIAL REGISTRATION Chinese Clinical Trial Registry ( http://www.chictr.org.cn ; ChiCTR1900024526). Registered on 13 July 2019 and updated on 31 May 2020. The study is currently recruiting patients.
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3
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Shmidt EA, Berns SA, Ponasenko AV, Klimenkova AV, Tumanova SA, Litvinova MN, Barbarash OL. [Predicting the development of adverse events in patients with acute coronary syndrome including genetics in the long-term follow-up]. ACTA ACUST UNITED AC 2020; 60:77-85. [PMID: 32394861 DOI: 10.18087/cardio.2020.4.n635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 10/02/2019] [Accepted: 10/08/2019] [Indexed: 11/18/2022]
Abstract
Aim To study a relationship of several factors (clinical and genetical markers) with unfavorable outcomes in patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS) in long-term follow-up.Material and methods This full-design, prospective study included 415 patients with NSTE-ACS. 266 patients were evaluated for the presence of multifocal atherosclerosis (MFA). Typing of polymorphic variants rs1041981 LTA, rs1800629 TNF, rs4986790, and rs498679 TLR4, and also rs3024491 and rs1800872 IL10 was performed. Follow-up period lasted for 67±4 months. By the end of this period, information about clinical outcomes for 396 patients became available.Results During the entire follow-up period, unfavorable outcomes were observed in 239 (57.5 %) patients with NSTE-ACS. The following clinical signs were associated with unfavorable outcomes: history of myocardial infarction, age >56 years, left ventricular ejection fraction (LV EF) ≤50 % and GRACE score ≥100, significant stenosis of brachiocephalic arteries, MFA, carriage of genotype А / А rs1041981 LTA (OR, 6.1; р=0.02) and allele А (OR, 1.9; р=0.01). According to results of a multifactorial analysis, the most significant predictors included LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.Conclusion Stratification of patients with NSTE-ACS into groups of high or low risk for having an unfavorable outcome within the next 6 years is possible using the prognostic model developed and presented in this study. The model includes the following signs: LV EF <50 %, MFA, and carriage of genotype А / А rs1041981 LTA.
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Affiliation(s)
- E A Shmidt
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - S A Berns
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A V Ponasenko
- Research Institute for Complex Issues of Cardiovascular Diseases
| | - A V Klimenkova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - S A Tumanova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - M N Litvinova
- State Budgetary Healthcare Institution of the Kemerovo Region "Kemerovo Regional Clinical Cardiac Dispensary named Academic L.S. Barbaraşh»
| | - O L Barbarash
- Research Institute for Complex Issues of Cardiovascular Diseases
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4
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Roule V, Verdier L, Blanchart K, Ardouin P, Lemaitre A, Bignon M, Sabatier R, Alexandre J, Beygui F. Systematic review and meta-analysis of the prognostic impact of cancer among patients with acute coronary syndrome and/or percutaneous coronary intervention. BMC Cardiovasc Disord 2020; 20:38. [PMID: 32000685 PMCID: PMC6993442 DOI: 10.1186/s12872-020-01352-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 01/20/2020] [Indexed: 12/22/2022] Open
Abstract
Background Patients with cancer admitted for an acute coronary syndrome (ACS) and/or percutaneous coronary intervention (PCI) represent a growing and high-risk population. The influence of co-existing cancer on mortality remains unclear in such patients. We aimed to assess the impact of cancer on early and late, all-cause and cardiac mortality in the setting of ACS and/or PCI. Methods We performed a systematic review and meta-analysis of studies comparing outcomes of patients with and without a history of cancer admitted for ACS and/or PCI. Results Six studies including 294,528 ACS patients and three studies including 39,973 PCI patients were selected for our meta-analysis. Patients with cancer had increased rates of in-hospital all-cause death (RR 1.74 [1.22; 2.47]), cardiac death (RR 2.44 [1.73; 3.44]) and bleeding (RR 1.64 [1.35; 1.98]) as well as one-year all-cause death (RR 2.62 [1.2; 5.73]) and cardiac death (RR 1.89 [1.25; 2.86]) in ACS studies. Rates of long term all-cause (RR 1.96 [1.52; 2.53]) but not cardiac death were higher in cancer patients admitted for PCI. Conclusion Cancer patients represent a high-risk population both in the acute phase and at long-term after an ACS or PCI. The magnitude of the risk of mortality should however be tempered by the heterogeneity among studies. Early and long term optimal management of such patients should be promoted in clinical practice.
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Affiliation(s)
- Vincent Roule
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France. .,Normandie Univ, UNICAEN, EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France.
| | - Laurine Verdier
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Katrien Blanchart
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Pierre Ardouin
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Adrien Lemaitre
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Mathieu Bignon
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Rémi Sabatier
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France
| | - Joachim Alexandre
- Normandie Univ, UNICAEN, EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France.,CHU de Caen Normandie, Service de Pharmacologie, 14000, Caen, France
| | - Farzin Beygui
- CHU de Caen Normandie, Service de Cardiologie, Caen University Hospital, Avenue Cote de Nacre, 14033, Caen, France.,Normandie Univ, UNICAEN, EA 4650 Signalisation, électrophysiologie et imagerie des lésions d'ischémie-reperfusion myocardique, 14000, Caen, France
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Taglieri N, Saia F, Bacchi Reggiani ML, Ghetti G, Bruno AG, Rosetti C, Bruno M, Corsini A, Battistini P, Lanati G, Di Dio MT, Della Riva D, Compagnone M, Marrozzini C, Rapezzi C. Prognostic significance of shockable and non-shockable cardiac arrest in ST-segment elevation myocardial infarction patients undergoing primary angioplasty. Resuscitation 2018; 123:8-14. [DOI: 10.1016/j.resuscitation.2017.12.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 12/01/2017] [Accepted: 12/05/2017] [Indexed: 12/22/2022]
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Liu CH, Lin JR, Liou CW, Lee JD, Peng TI, Lee M, Lee TH. Causes of Death in Different Subtypes of Ischemic and Hemorrhagic Stroke. Angiology 2017; 69:582-590. [DOI: 10.1177/0003319717738687] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Causes of death in both ischemic stroke (IS) and hemorrhagic stroke (HS) subtypes are not comprehensively studied. Between 2008 and 2011, we enrolled 11 215 first-ever stroke patients from the Stroke Registry of Chang-Gung Healthcare System and linked these data to the national death registry. The main causes of death in each stroke subtype were assessed. Patients with HS had higher overall mortality than IS (32.0% vs 18.1%, P < .001). In IS subtypes, large-artery atherosclerosis plus cardioembolism had the worst mortality (40.7%, P < .001). Stroke was the leading cause of death in both IS and HS within the first year. Stroke remained the major cause of death in HS, but cancer was the leading cause of death in IS after the first year. After excluding the patients with previous cancer history, cancer was still an important cause of death in IS and HS, particularly in the IS subtypes of small vessel occlusion, stroke of undetermined etiology, and transient ischemic attack.
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Affiliation(s)
- Chi-Hung Liu
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Jr-Rung Lin
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Chia-Wei Liou
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Jiann-Der Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tsung-I Peng
- Department of Neurology, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Meng Lee
- Department of Neurology, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Tsong-Hai Lee
- Stroke Center and Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan, Taiwan
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Colivicchi F, Gulizia MM, Arca M, Abrignani MG, Perna GP, Mureddu GF, Nardi F, Riccio C. ANMCO Scientific Statement: clinical management of hypercholesterolaemia in patients with acute coronary syndromes. Eur Heart J Suppl 2017; 19:D64-D69. [PMID: 28751835 PMCID: PMC5526473 DOI: 10.1093/eurheartj/sux018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
LDL cholesterol (LDL-C) reduction after Acute Coronary Syndromes (ACS) is associated with a significant decrease in subsequent atherosclerotic cardiovascular events. Accordingly, international guidelines recommend a reduction of LDL-C below 70 mg/dL in ACS patients. Such a result can be effectively accomplished in most cases by using high intensity statins. In selected cases, the association with ezetimibe may be necessary in order to achieve recommended LDL-C targets. This document outlines management strategies that can be consistently implemented in clinical practice in order to achieve and maintain guidelines recommended therapeutic goals.
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Affiliation(s)
- Furio Colivicchi
- Cardiology Department, Ospedale S. Filippo Neri, ASL Roma 1, Via Giovanni Martinotti, 20 - 00135, Rome, Italy
| | - Michele Massimo Gulizia
- Cardiology Department, Ospedale Garibaldi-Nesima, Azienda di Rilievo Nazionale e Alta Specializzazione "Garibaldi", Catania, Italy
| | - Marcello Arca
- Atherosclerosis Center, Policlinico Umberto I, Sapienza Università di Roma, Rome, Italy
| | | | | | | | - Federico Nardi
- Cardiology Department, Ospedale Castelli, Verbania, Italy
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8
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Iannaccone M, D'Ascenzo F, Vadalà P, Wilton SB, Noussan P, Colombo F, Raposeiras Roubín S, Abu Assi E, González-Juanatey JR, Simao Henriques JP, Saucedo J, Kikkert WJ, Nuñez-Gil I, Ariza-Sole A, Song XT, Alexopoulos D, Liebetrau C, Kawaji T, Moretti C, Garbo R, Huczek Z, Nie SP, Fujii T, Correia LC, Kawashiri MA, García Acuña JM, Southern D, Alfonso E, Terol B, Garay A, Zhang D, Chen Y, Xanthopoulou I, Osman N, Möllmann H, Shiomi H, Giordana F, Kowara M, Filipiak K, Wang X, Yan Y, Fan JY, Ikari Y, Nakahashi T, Sakata K, Gaita F, Yamagishi M, Kalpak O, Kedev S. Prevalence and outcome of patients with cancer and acute coronary syndrome undergoing percutaneous coronary intervention: a BleeMACS substudy. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2017; 7:631-638. [PMID: 28593789 DOI: 10.1177/2048872617706501] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND The prevalence and outcome of patients with cancer that experience acute coronary syndrome (ACS) have to be determined. METHODS AND RESULTS The BleeMACS project is a multicentre observational registry enrolling patients with acute coronary syndrome undergoing percutaneous coronary intervention worldwide in 15 hospitals. The primary endpoint was a composite event of death and re-infarction after one year of follow-up. Bleedings were the secondary endpoint. 15,401 patients were enrolled, 926 (6.4%) in the cancer group and 14,475 (93.6%) in the group of patients without cancer. Patients with cancer were older (70.8±10.3 vs. 62.8±12.1 years, P<0.001) with more severe comorbidities and presented more frequently with non-ST-segment elevation myocardial infarction compared with patients without cancer. After one year, patients with cancer more often experienced the composite endpoint (15.2% vs. 5.3%, P<0.001) and bleedings (6.5% vs. 3%, P<0.001). At multiple regression analysis the presence of cancer was the strongest independent predictor for the primary endpoint (hazard ratio (HR) 2.1, 1.8-2.5, P<0.001) and bleedings (HR 1.5, 1.1-2.1, P=0.015). Despite patients with cancer generally being undertreated, beta-blockers (relative risk (RR) 0.6, 0.4-0.9, P=0.05), angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (RR 0.5, 0.3-0.8, P=0.02), statins (RR 0.3, 0.2-0.5, P<0.001) and dual antiplatelet therapy (RR 0.5, 0.3-0.9, P=0.05) were shown to be protective factors, while proton pump inhibitors (RR 1, 0.6-1.5, P=0.9) were neutral. CONCLUSION Cancer has a non-negligible prevalence in patients with acute coronary syndrome undergoing percutaneous coronary intervention, with a major risk of cardiovascular events and bleedings. Moreover, these patients are often undertreated from clinical despite medical therapy seems to be protective. Registration:The BleeMACS project (NCT02466854).
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Affiliation(s)
- Mario Iannaccone
- 1 San Giovanni Bosco Hospital, Turin, Italy.,2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | - Fabrizio D'Ascenzo
- 2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | - Paolo Vadalà
- 2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | | | | | | | | | - Emad Abu Assi
- 4 University Clinical Hospital, Santiago de Compostela, Spain
| | | | | | | | - Wouter J Kikkert
- 5 University Academic Medical Center, Amsterdam, the Netherlands
| | | | | | - Xian-Tao Song
- 9 Beijing Anzhen Hospital, Capital Medical University, China
| | | | | | | | - Claudio Moretti
- 2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | | | | | - Shao-Ping Nie
- 14 Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | | | | | - Masa-Aki Kawashiri
- 17 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | | | | | | | - Belén Terol
- 17 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | | | - Dongfeng Zhang
- 9 Beijing Anzhen Hospital, Capital Medical University, China
| | - Yalei Chen
- 9 Beijing Anzhen Hospital, Capital Medical University, China
| | | | - Neriman Osman
- 11 Kerckhoff Heart and Thorax Center, Frankfurt, Germany
| | | | | | - Francesca Giordana
- 2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | | | | | - Xiao Wang
- 14 Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yan Yan
- 14 Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Jing-Yao Fan
- 14 Institute of Heart, Lung and Blood Vessel Disease, Beijing, China
| | - Yuji Ikari
- 15 Tokai University School of Medicine, Tokyo, Japan
| | - Takuya Nakahashi
- 17 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Kenji Sakata
- 17 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Fiorenzo Gaita
- 2 Dipartimento di Scienze Mediche, Città della Salute e della Scienza, Italy
| | - Masakazu Yamagishi
- 17 Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | - Oliver Kalpak
- 18 University Clinic of Cardiology, Skopje, Macedonia
| | - Sasko Kedev
- 18 University Clinic of Cardiology, Skopje, Macedonia
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Campo G, Menozzi M, Guastaroba P, Vignali L, Belotti LMB, Casella G, Berti E, Solinas E, Guiducci V, Biscaglia S, Pavasini R, De Palma R, Manari A. Same-day transfer for the invasive strategy of patients with non-ST-segment elevation acute coronary syndrome admitted to spoke hospitals: Data from the Emilia-Romagna Regional Network. EUROPEAN HEART JOURNAL-ACUTE CARDIOVASCULAR CARE 2016; 5:428-434. [DOI: 10.1177/2048872615610867] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 09/20/2015] [Indexed: 11/16/2022]
Affiliation(s)
- Gianluca Campo
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria S. Anna, Italy
- Laboratorio per le Tecnologie delle Terapie Avanzate (LTTA) Center, Italy
| | - Mila Menozzi
- Unità Operativa di Cardiologia, Ospedale degli Infermi, Rimini, Italy
| | | | - Luigi Vignali
- Divisione di Cardiologia, Ospedale Maggiore, Parma, Italy
| | | | - Gianni Casella
- Unità Operativa di Cardiologia, Ospedale Maggiore, Bologna, Italy
| | - Elena Berti
- Agenzia Sanitaria Regionale Regione Emilia-Romagna, Italy
| | - Emilia Solinas
- Divisione di Cardiologia, Ospedale Maggiore, Parma, Italy
| | - Vincenzo Guiducci
- Unità Operativa di Cardiologia Interventistica, Ospedale S. Maria Nuova, Italy
| | - Simone Biscaglia
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria S. Anna, Italy
| | - Rita Pavasini
- Cardiovascular Institute, Azienda Ospedaliero-Universitaria S. Anna, Italy
| | | | - Antonio Manari
- Unità Operativa di Cardiologia Interventistica, Ospedale S. Maria Nuova, Italy
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