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Ali H, Patel P, Lowell J, Dahiya DS, Singh S, Hammami AS, Poola S, Leland W, Adler DG, Mohan BP. Delaying Cardiac Catheterization in Favor of Endoscopy in Non-ST Elevation Myocardial Infarction Patients Is Associated with Worse Outcomes: A Nationwide Analysis. Dig Dis Sci 2023; 68:3913-3920. [PMID: 37620712 DOI: 10.1007/s10620-023-08033-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/02/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND Non-variceal upper gastrointestinal bleeding (NVUGIB) in non-ST-elevation myocardial infarction (NSTEMI) is associated with substantial morbidity and mortality. We evaluated inpatient outcomes of esophagogastroduodenoscopy (EGD) before cardiac catheterization in patients with NSTEMI and NVUGIB. METHODS We utilized the National Readmission Database (2016-2019) to identify all index hospitalizations with a primary diagnosis of NSTEMI and a secondary diagnosis of NVUGIB that underwent EGD before cardiac catheterization (cases). A matched comparison cohort of similar hospitalizations that undergo EGD after cardiac catheterization were identified (controls) after 1:1 propensity score matching for age, gender, cardiac comorbidities, causes, and severity of bleeding. RESULTS A total of 796 cases were matched with 796 controls. There was a higher median length of hospital stay (8 vs. 5 days, P = 0.01) and median hospital charges ($111,218 vs. $99,115, P = 0.002) for cases compared to controls. There was a higher all-cause inpatient mortality in cases compared to controls (5.5% vs. 3.9%, P = 0.26). Furthermore, there was a higher proportion of patients with ICU admission (7% vs. 3%, P < 0.001), septic shock (7.1% vs. 5.8%, P = 0.41), atrial fibrillation (27.1% vs. 19.8%, P < 0.001) and acute kidney injury (42.8% vs. 29.1%, P < 0.001) for cases compared to controls. CONCLUSION Delaying cardiac catheterization in favor of EGD is associated with increased hospital stay, costs, and cardiac complications. Further studies are warranted to establish our findings.
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Affiliation(s)
- Hassam Ali
- Department of Gastroenterology, East Carolina University/Brody School of Medicine, Greenville, NC, 27834, USA.
| | - Pratik Patel
- Department of Gastroenterology, Mather Hospital/Hofstra University Zucker School of Medicine, Port Jefferson, NY, 11777, USA
| | - Jeffery Lowell
- Department of Internal Medicine, Mather Hospital/Hofstra University Zucker School of Medicine, Port Jefferson, NY, 11777, USA
| | - Dushyant Singh Dahiya
- Department of Internal Medicine, Central Michigan College of Medicine, Saginaw, MI, 48601, USA
| | - Sukhvir Singh
- Department of Internal Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, 27834, USA
| | - Ahmed Sami Hammami
- Department of Internal Medicine, East Carolina University/Brody School of Medicine, Greenville, NC, 27834, USA
| | - Shiva Poola
- Department of Gastroenterology, East Carolina University/Brody School of Medicine, Greenville, NC, 27834, USA
| | - William Leland
- Department of Gastroenterology, East Carolina University/Brody School of Medicine, Greenville, NC, 27834, USA
| | - Douglas G Adler
- Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Centura Health, Denver, CO, USA
| | - Babu P Mohan
- Department of Gastroenterology & Hepatology, University of Utah Health School of Medicine, Salt Lake City, UT, USA
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Fujisaki T, Kuno T, Briasoulis A, Misumida N, Takagi H, Latib A. P2Y12 Inhibitors for Non-ST-Segment Elevation Acute Coronary Syndrome: A Systematic Review and Network Meta-Analysis. Tex Heart Inst J 2023; 50:493517. [PMID: 37302149 DOI: 10.14503/thij-22-7916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND For patients with non-ST-segment elevation acute coronary syndrome (NSTE-ACS), prasugrel was recommended over ticagrelor in a recent randomized controlled trial, although more data are needed on the rationale. Here, the effects of P2Y12 inhibitors on ischemic and bleeding events in patients with NSTE-ACS were investigated. METHODS Clinical trials that enrolled patients with NSTE-ACS were included, relevant data were extracted, and a network meta-analysis was performed. RESULTS This study included 37,268 patients with NSTE-ACS from 11 studies. There was no significant difference between prasugrel and ticagrelor for any end point, although prasugrel had a higher likelihood of event reduction than ticagrelor for all end points except cardiovascular death. Compared with clopidogrel, prasugrel was associated with decreased risks of major adverse cardiovascular events (MACE) (hazard ratio [HR], 0.84; 95% CI, 0.71-0.99) and myocardial infarction (HR, 0.82; 95% CI, 0.68-0.99) but not an increased risk of major bleeding (HR, 1.30; 95% CI, 0.97-1.74). Similarly, compared with clopidogrel, ticagrelor was associated with a reduced risk of cardiovascular death (HR, 0.79; 95% CI, 0.66-0.94) and an increased risk of major bleeding (HR, 1.33; 95% CI, 1.00-1.77; P = .049). For the primary efficacy end point (MACE), prasugrel showed the highest likelihood of event reduction (P = .97) and was superior to ticagrelor (P = .29) and clopidogrel (P = .24). CONCLUSION Prasugrel and ticagrelor had comparable risks for every end point, although prasugrel had the highest probability of being the best treatment for reducing the primary efficacy end point. This study highlights the need for further studies to investigate optimal P2Y12 inhibitor selection in patients with NSTE-ACS.
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Affiliation(s)
- Tomohiro Fujisaki
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Morningside, and Mount Sinai West, New York, New York
- Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Toshiki Kuno
- Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Alexandros Briasoulis
- Division of Cardiovascular Diseases, Section of Heart Failure and Transplant, University of Iowa Hospitals and Clinics, Iowa City, Iowa
| | - Naoki Misumida
- Division of Cardiovascular Medicine, Gill Heart and Vascular Institute, University of Kentucky, Lexington, Kentucky
| | - Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Shizuoka, Japan
| | - Azeem Latib
- Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
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Fischer BG, Evans AT. High-Sensitivity Cardiac Troponin Algorithms and the Value of Likelihood Ratios. J Gen Intern Med 2023:10.1007/s11606-023-08103-9. [PMID: 36882634 PMCID: PMC10361949 DOI: 10.1007/s11606-023-08103-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 02/09/2023] [Indexed: 03/09/2023]
Abstract
High-sensitivity cardiac troponin (hs-cTn) is now the recommended biomarker for diagnosis of non-ST-elevation myocardial infarction, but proper interpretation varies based on the assay being used. Nearly uniformly, suggested interpretations of assay-specific hs-cTn results are based on predictive values, which are not applicable to most patients. Through application of a published hs-cTn algorithm to several patient scenarios, we will demonstrate that likelihood ratios are superior to predictive values for patient-centered test interpretation and decision-making. Furthermore, we will provide a blueprint for how to use existing published data presented with predictive values to calculate likelihood ratios. Changing the output of diagnostic accuracy studies and diagnostic algorithms from predictive values to likelihood ratios can improve patient care.
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Affiliation(s)
- Brett G Fischer
- Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA.
| | - Arthur T Evans
- Weill Department of Medicine, Weill Cornell Medicine, New York, NY, USA
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Barsha SY, Akiful Haque MM, Rashid MU, Rahman ML, Hossain MA, Zaman S, Bhuiyan E, Sultana R, Hossian M, Nabi MH, Hawlader MDH. A case of acute encephalopathy and non-ST segment elevation myocardial infarction following mRNA-1273 vaccination: possible adverse effect? Clin Exp Vaccine Res 2021; 10:293-297. [PMID: 34703815 PMCID: PMC8511584 DOI: 10.7774/cevr.2021.10.3.293] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 09/05/2021] [Indexed: 12/21/2022] Open
Abstract
A 77-year-old man with a past medical history of type 2 diabetes mellitus, peripheral neuropathy, and chronic obstructive pulmonary disease was admitted to the intensive care unit of Bangladesh Medical College Hospital with acute encephalopathy and non-ST segment elevation myocardial infarction (NSTEMI). The patient was on antidiabetic medicine along with H2 blocker and multivitamins for his existing diseases. The patient's attendant reported that the patient had received his first dose of the Moderna coronavirus disease 2019 (COVID-19) vaccine just 2 days ago. Physical examination revealed that he had a Glasgow Coma Scale of 8/15; a pulse of 106 beats/min; a respiratory rate of 30 breaths/min; oxygen saturation of 80% on room air, which became with 10 L of oxygen and blood pressure of 90/60 mm Hg at the time of admission. During the hospital stay, the patient was treated conservatively with intravenous antibiotics and other necessary medication. Although we have observed the onset of encephalopathy and NSTEMI following COVID vaccination for this patient, we, as healthcare professionals, cannot directly attribute the cause of the complications to the Moderna vaccine without further epidemiological studies with large samples.
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Affiliation(s)
| | | | - Md Utba Rashid
- International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
| | - Mohammad Lutfor Rahman
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka, Bangladesh
| | | | - Sanjana Zaman
- Department of Public Health, Daffodil International University, Dhaka, Bangladesh
| | - Elias Bhuiyan
- Bangladesh Medical College and Hospital, Dhaka, Bangladesh
| | | | - Mosharop Hossian
- Public Health Professional Development Initiative (PPDI), Dhaka, Bangladesh
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Griesinger L, Weil J. [Finger pain and personality changes after chemotherapy initiation via a central venous port system in a 67-year-old female patient]. Internist (Berl) 2020; 61:1055-8. [PMID: 32757047 DOI: 10.1007/s00108-020-00848-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Central venous port systems are an integral part of chemotherapy. Early recognition and management of arterial malposition are crucial to prevent further complications. A 67-year-old female with breast cancer underwent central venous port implantation for adjuvant chemotherapy. After administration of the first chemotherapy the patient developed acute bihemispheric cerebral infarction and myocardial ischemia due to arterio-arterial emboli with a toxic encephalopathic component. After systemic lysis and surgical removal of the central venous port system, the patient showed a complete recovery.
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Breuckmann F, Hochadel M, Grau AJ, Giannitsis E, Münzel T, Senges J. Quality benchmarks for chest pain units and stroke units in Germany. Herz 2020; 46:89-93. [PMID: 31970463 DOI: 10.1007/s00059-019-04881-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 10/05/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Chest pain units (CPUs) and stroke units (SUs) provide specialized multidisciplinary in-hospital management for acute chest pain and ischemic stroke. We analyzed exemplary equivalent quality benchmarks in both concepts. MATERIAL AND METHODS Data from the German CPU registry (2012-2015; 45 certified CPUs, 5881 patients) were compared with data from the SU registry of Rhineland-Palatinate (2011-2015; 29 SUs; 40,380 patients). Parameters comprised demographics, symptoms, diagnosis, medication, critical time intervals, therapeutics, and in-unit outcome. RESULTS Non-ST-segment elevation myocardial infarction (47.4%) and ischemic stroke (63.0%) were the most frequent entities. An electrocardiogram was performed on average within 7 min in CPUs, cranial imaging within 49 min in SUs. The mean time interval from admission until coronary intervention or lysis was 42 min or 57 min, respectively. Rates of antiplatelet therapy (90.1% vs. 96.0%), brain imaging, and coronary angiography were high (99.3% vs. 81.1%) and the mortality was low (0.8% for CPUs vs. 3.6% for SUs). The length of stay was shorter in CPUs (1.5 days vs. 4.4 days). CONCLUSION As reimbursement for emergency medicine in Germany was recently rearranged, quality benchmarking has gained incremental importance. Mandatory joint quality measurement in both concepts ensuring gap analysis and process improvement is encouraged.
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Affiliation(s)
- Frank Breuckmann
- Department of Cardiology, Herz-Jesu-Krankenhaus Dernbach, Südring 8, 56428, Dernbach, Germany.
| | - Matthias Hochadel
- Institute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany
| | - Armin J Grau
- Department of Neurology, Klinikum Ludwigshafen, Ludwigshafen am Rhein, Germany
| | - Evangelos Giannitsis
- Department of Internal Medicine III, Heidelberg University Hospital, Heidelberg, Germany
| | - Thomas Münzel
- Cardiology I, Center for Cardiology, University Medical Center Mainz, Mainz, Germany
| | - Jochen Senges
- Institute for Myocardial Infarction Research Foundation Ludwigshafen, University of Heidelberg, Heidelberg, Germany
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Choi Y, Lee JH, Seo JI. Change in T/QRS ratio can be a supplementary diagnostic tool in predicting coronary artery disease in patients with NSTEMI. Am J Emerg Med 2020; 39:48-54. [PMID: 31954545 DOI: 10.1016/j.ajem.2020.01.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 01/03/2020] [Accepted: 01/06/2020] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Changes in the electrocardiographic findings, namely the ratio T sum to QRS sum (T/QRS ratio), between the initial electrocardiogram (ECG) and the baseline ECG have rarely been investigated in patients with non-ST elevation myocardial infarction (NSTEMI). Thus, we aimed to determine whether changes in various parameters on ECG, including T/QRS ratio, can assist in distinguishing between coronary artery disease (CAD) and NSTEMI without CAD with low to moderate risk. METHODS This retrospective study enrolled 2572 patients who presented ischemic symptoms, who were diagnosed with NSTEMI, and who underwent coronary angiography. Overall, 388 patients had prior ECG and echocardiography data available; 110 patients were included after excluding patients with other cardiac diseases except CAD. The population divided into two groups: a coronary stenosis group (n = 78); normal coronary group (n = 32) were analyzed. RESULTS We found that acute dynamic change in the most deviated T/QRS ratio in each region of leads of initial ECG from those of remote/recent ECG was an extremely strong predictor of acute CAD (odds ratio, 110; p < .001) compared to that of initial serum troponin I levels, new-onset regional wall motion abnormalities, and new-onset T inversion or ST depression. T/QRS ratio change > 1.5 or <0.5 times in injured regional leads was a significant predictor of CAD. CONCLUSION Change in the most deviated T/QRS ratio in the regional leads on initial ECG from the T/QRS ratio in the same lead on remote ECG can assist in predicting CAD risk between patients with CAD and patients with no CAD in NSTEMI.
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Affiliation(s)
- Yuri Choi
- Department of Emergency Medicine, Dong-A University College of Medicine, Busan, South Korea.
| | - Jae Hoon Lee
- Department of Emergency Medicine, Dong-A University College of Medicine, Busan, South Korea.
| | - Jung In Seo
- Department of Statistics, Daejeon University, 62 Daehak-Ro, Dong-Gu, Daejeon, South Korea.
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Kim I, Kim MC, Park KH, Sim DS, Hong YJ, Kim JH, Jeong MH, Cho JG, Park JC, Cho MC, Kim JJ, Kim YJ, Ahn Y. Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction. Korean J Intern Med 2018; 33:1111-1118. [PMID: 29117666 PMCID: PMC6234387 DOI: 10.3904/kjim.2017.071] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Accepted: 03/27/2017] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND/AIMS Chest pain is an essential symptom in the diagnosis of acute coronary syndrome (ACS). One-third of patients with ACS present atypically, which can influence their receiving timely lifesaving therapy. METHODS A total of 617 NSTEMI patients from the Korea Acute MI Registry (KAMIR) and the Korea Working Group on MI (KorMI) databases were analyzed. The study population was divided into two groups by symptoms at presentation (typical symptoms group, 128; atypical symptoms groups, 128). RESULTS In this study population, 23% of patients presented without chest pain. After propensity score matching, the contact-to-device time (2,618 ± 381 minutes vs. 1,739 ± 241 minutes, p = 0.050), the symptoms-to-balloon time (3,426 ± 389 minutes vs. 2,366 ± 255 minutes, p = 0.024), and the door-to-balloon time (2,339 ± 380 minutes vs. 1,544 ± 244 minutes, p = 0.002) were significantly higher in the patients with atypical symptoms than in those with typical symptoms, respectively. Atypical symptoms were an independent predictor for 1-year mortality (hazard ratio, 2.820; 95% confidence interval, 1.058 to 7.515; p = 0.038). The Kaplan-Meier estimates showed higher risk for 12-month mortality in patients with atypical symptoms (p = 0.048) and no significant difference for 12-month major adverse cardiac events (p = 0.487). CONCLUSION Acute myocardial infarction patients with atypical symptoms were not rare in clinical practice and showed a high risk of delayed reperfusion therapy. After imbalance between the groups was minimized by use of propensity score matching, patients who presented atypically had a high mortality rate.
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Affiliation(s)
- Inna Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Min Chul Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Keun Ho Park
- Department of Cardiology, Chosun University Hospital, Gwangju, Korea
| | - Doo Sun Sim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Young Joon Hong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Ju Han Kim
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myung Ho Jeong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jeong Gwan Cho
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Jong Chun Park
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
| | - Myeong Chan Cho
- Department of Cardiology, Chungbuk National University Hospital, Cheongju, Korea
| | - Jong Jin Kim
- Department of Cardiology, Kyung Hee University Hospital, Seoul, Korea
| | - Young Jo Kim
- Department of Cardiology, Yeungnam University Medical Center, Daegu, Korea
| | - Youngkeun Ahn
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, Korea
- Correspondence to Youngkeun Ahn, M.D. Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, 42 Jebongro, Dong-gu, Gwangju 61469, Korea Tel: +82-62-220-4764 Fax: +82-62-224-4764 E-mail:
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Liebetrau C, Hamm CW. [Management of acute coronary syndrome without ST-segment elevation]. Herz 2017; 42:211-228. [PMID: 28233037 DOI: 10.1007/s00059-017-4541-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Acute coronary syndrome without persistent ST-segment elevation (non-ST segment elevation myocardial infarction and instable angina pectoris NSTEMI-ACS) is common and is associated with a high mortality. In addition to 12-channel echocardiograph (ECG) assessment, measurement of cardiac troponins I and T are important for risk stratification and diagnosis. The introduction of high-sensitivity cardiac troponin assays and their implementation into clinical practice has influenced risk stratification and treatment of these patients. Additional diagnostic validation must supplement routine clinical chemistry testing following the initial measurement to distinguish between different possible causes of troponin elevation above the 99th percentile. The time point for the additional troponin measurement depends on the different protocols and troponin assays and is stipulated in the current guidelines. The use of both 1‑hour and 3‑hour protocols together with the clinical presentation and work-up of possible differential diagnoses provide optimal care of patients. Patients who test positive for troponin dynamics should undergo invasive diagnostics and treatment within 24 h of presentation and within 2 h is recommended for unstable patients. Clopidogrel is indicated only in patients requiring oral anticoagulation.
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Affiliation(s)
- C Liebetrau
- Abteilung Kardiologie, Kerckhoff-Klinik, Zentrum für Herz-, Thorax- und Rheumaerkrankungen, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland.
- Medizinische Klinik I, Abteilung Kardiologie/Angiologie, Universitätsklinikum Gießen, Gießen, Deutschland.
- Partner Site RheinMain, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Frankfurt am Main, Deutschland.
| | - C W Hamm
- Abteilung Kardiologie, Kerckhoff-Klinik, Zentrum für Herz-, Thorax- und Rheumaerkrankungen, Benekestr. 2-8, 61231, Bad Nauheim, Deutschland
- Medizinische Klinik I, Abteilung Kardiologie/Angiologie, Universitätsklinikum Gießen, Gießen, Deutschland
- Partner Site RheinMain, Deutsches Zentrum für Herz-Kreislauf-Forschung (DZHK), Frankfurt am Main, Deutschland
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Zencir C, Akpek M, Onay S, Selvi M. Huge saphenous vein graft aneurysm presenting as non-ST elevation myocardial infarction and compressing the heart. Indian Heart J 2016; 68 Suppl 2:S148-50. [PMID: 27751269 DOI: 10.1016/j.ihj.2015.11.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Revised: 11/17/2015] [Accepted: 11/25/2015] [Indexed: 11/23/2022] Open
Abstract
Coronary artery bypass grafting (CABG) surgery maintains an important role in the treatment of coronary artery disease. The huge saphenous vein graft aneurysm (HSVGA) is rare and occurs as a late complication after CABG. Here, we reported a case of HSVGA presenting as non-ST elevation myocardial infarction.
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