scholarly journals TCT-174 Baseline hemoglobin level, anemia and adverse events in patients with acute coronary syndromes; Lessons from ACUITY and HORIZONS-AMI

2015 ◽  
Vol 66 (15) ◽  
pp. B65
Author(s):  
Sorin Brener ◽  
Roxana Mehran ◽  
Girma M. Ayele ◽  
Gregg W. Stone
Keyword(s):  
Adverse Events ◽  
Acute Coronary Syndromes ◽  
Hemoglobin Level ◽  
Coronary Syndromes ◽  
Baseline Hemoglobin

Statins in Acute Coronary Syndromes

2018 ◽  
Vol 23 (46) ◽  
pp. 7086-7098 ◽  
Author(s):  
Manolis Vavuranakis ◽  
Maria Kariori ◽  
Gerasimos Siasos ◽  
Konstantinos Kalogeras ◽  
Dimitris Tousoulis
Keyword(s):  
Clinical Trials ◽  
Coronary Artery ◽  
Adverse Events ◽  
Secondary Prevention ◽  
Acute Coronary Syndromes ◽  
Lipid Lowering ◽  
Line Treatment ◽  
First Line ◽  
Coronary Syndromes ◽  
First Line Treatment

Background: Patients with acute coronary syndrome (ACS) frequently experience recurrent adverse events from the cardiovascular system comparing to either healthy individuals or individuals with stable coronary artery disease. This is attributed to the inflammatory cascade that is activated during ACS resulting in increased risk for rupture of vulnerable plaques. </P><P> Objective: Therefore, it is of great importance to avoid recurrent events with treatment aiming at secondary prevention which includes the management of lipid profile besides alteration in the lifestyle and habits. </P><P> Methods: This review will present current data concerning present status of treatment with statins, and refer to non-statin strategies as well as novel and promising agents for the secondary prevention therapy after ACS. A thorough search of PubMed and the Cochrane Database was conducted in order to identify the majority of trials, studies, current guidelines and novel articles related to the subject. </P><P> Results: Statins have been proved to play very significant role in the part of secondary prevention since they decrease the burden of atherosclerotic plaques, the risk of adverse events and the need for revascularization in symptomatic patients with CAD. Therefore, they were established and suggested by both European and American guidelines as first-line treatment option for lipid-lowering management. Several clinical trials, meta- analyses and randomized trials strongly recommended the application of early and intensive treatment with statins in patients with ACS. Nevertheless, a vast majority of individuals neither tolerated statins nor achieved the optimal value for LDL-C with the highest tolerated dose of statins resulting in poor clinical outcome. Furthermore, recent clinical trials indicated further benefit of combined treatment of statins with non-statins drugs on the decrease of cardiovascular events as well as progress of coronary artery plaque. Finally, novel agents that are still evaluated with ongoing clinical trials have been turned into a very promising treatment option. </P><P> Conclusion: In conclusion, statins are established as the first-line treatment for the secondary prevention after acute coronary syndromes in order to avoid the recurrence of thrombotic events. However, the research field on the field of lipid-lowering therapies is still ongoing and very promising for the future.

scholarly journals High-Sensitivity Troponin T and Copeptin in Non-ST Acute Coronary Syndromes: Implications for Prognosis and Role of hsTnT and Copeptin in Non-STEACS

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Diana Hernández-Romero ◽  
José María García-Salas ◽  
Ángel López-Cuenca ◽  
Patricio Pérez-Berbel ◽  
Carmen Puche ◽  
...  
Keyword(s):  
Adverse Events ◽  
Acute Coronary Syndromes ◽  
Troponin T ◽  
High Sensitivity ◽  
Healthy Controls ◽  
Invasive Approach ◽  
Coronary Syndromes ◽  
Prognostic Implications ◽  
High Sensitivity Troponin T

High-sensitivity TnT (hsTnT) has been proposed to improve the diagnosis and stratification in acute coronary syndromes. Copeptin has been proposed for a rapid and accurate rule out of acute myocardial infarction, but some doubts exist about its use out of the first hours from admission. Abnormalities of serum hsTnT and copeptin levels in non-STEACS and negative TnT, could have prognostic implications.Methods. We included 122 non-STEACS patients without raised TnT, 33 disease controls and 43 healthy controls. We measured hsTnT and copeptin levels. Clinical follow-up at 12 months was performed for adverse endpoints.Results. Non-STEACS patients had raised hsTnT compared with both control groups (P=0.036andP<0.001). Copeptin levels were higher in non-STEACS patients than healthy controls (P=0.021), without differences with disease controls. Raised levels of hs-TnT presented prognostic implications [HR 3.29 (95%CI: 1.33–7.49),P=0.010]. hs-TnT could be used for invasive approach decision, as it shows prognostic relevance in conservative approach-patients whereas remains unrelevant for catheterized-patients. Copeptin levels were not associated with adverse events.Conclusion. hsTnT levels increased in non-STEACS, were predictive of adverse events and could be important for recommending an invasive management. We cannot confirm a predictive role of copeptin out of the first hours from admission.

A multi-marker approach for the prediction of adverse events in patients with acute coronary syndromes

2007 ◽  
Vol 376 (1-2) ◽  
pp. 168-173 ◽  
Author(s):  
Scott J. Cameron ◽  
Lori J. Sokoll ◽  
Omar F. Laterza ◽  
Sanket Shah ◽  
Gary B. Green
Keyword(s):  
Adverse Events ◽  
Acute Coronary Syndromes ◽  
Coronary Syndromes

Abstract 2001: Clinical and Angiographic Predictors of 30-Day and One-Year Ischemic Cardiac Events in Patients with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention: An ACUITY Substudy

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Kenji Goto ◽  
Alexandra Lansky ◽  
Ecatarina Cristea ◽  
Michel E Bertrand ◽  
A. Michael Lincoff ◽  
...  
Keyword(s):  
Adverse Events ◽  
Acute Coronary Syndromes ◽  
Multivariable Analysis ◽  
Flow Characteristics ◽  
Coronary Vessels ◽  
Cardiac Events ◽  
Clinical Predictors ◽  
Coronary Syndromes ◽  
One Year ◽  
Ischemic Events

Background: Clinical predictors of short and long-term ischemic outcomes following PCI in acute coronary syndromes (ACS) have been well studied. However, the angiographic predictors of adverse events have not been defined. Methods: The ACUITY trial randomized 13,819 pts with moderate and high risk ACS to unfractionated heparin or enoxaparin + GP IIb/Iii inhibitors (GPI), versus bivalirudin + GPI, vs. bivalirudin alone. The angiographic substudy of ACUITY included the first 7000 consecutive randomized US patients, of which 3664 underwent PCI. All angiograms were reviewed by an independent core laboratory for complete 3 vessel assessment of extent and CAD burden (total mm length of lesions with >30%DS), as well as baseline and final lesion and flow characteristics. Clinical and angiographic predictors of composite ischemia (death, non-fatal MI, or ischemic target vessel revascularization) at 30 days and 1 year were identified by univariate and multivariable analysis using logistic regression analysis. Results: Coronary stents were used in 3429 (93.6%) pts, (84.4% DES). Composite ischemia occurred in 366 pts (10.0%) at 30 days and in 735 pts (21.0%) at one year. The independent predictors of 30 day and 1 year composite ischemic events by multivariable analysis are shown in the table . Conclusions: Beyond the clinical predictors of renal insufficiency and diabetes, CAD burden assessed by the number of diseased coronary vessels and the burden of CAD are independent predictor of 30 day and 1 year ischemic events in patients with ACS undergoing PCI. Baseline lesion specific characteristics including eccentric and calcified lesions, as well as angiographic PCI complications resulting in sustained no reflow, abrupt closure or thrombus were also independently predictive of adverse events. Table 7: Multivariate Predictors of Composite Ischemia

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