LIVIVO - The Search Portal for Life Sciences

zur deutschen Oberfläche wechseln
Advanced search

Search results

Result 1 - 6 of total 6

Search options

  1. Article: High-sensitivity troponin in chronic kidney disease: Considerations in myocardial infarction and beyond.

    Chuang, Anthony Ming-Yu / Nguyen, Mau T / Kung, Woon-Man / Lehman, Sam / Chew, Derek P

    Reviews in cardiovascular medicine

    2020  Volume 21, Issue 2, Page(s) 191–203

    Abstract: Acute myocardial infarction (MI) represents one of the most common hospital encounters, with significant short-term and long-term morbidity and mortality, and frequently occurs in patients with chronic kidney disease (CKD). Cardiac troponin is an ... ...

    Abstract Acute myocardial infarction (MI) represents one of the most common hospital encounters, with significant short-term and long-term morbidity and mortality, and frequently occurs in patients with chronic kidney disease (CKD). Cardiac troponin is an exquisitely sensitive biomarker for myocardial injury and plays an essential role in the diagnosis, risk-stratification, and management of MI. In 2017, the United States Food and Drug Administration approved Roche Diagnostics' 5
    MeSH term(s) Animals ; Biomarkers/blood ; Comorbidity ; Humans ; Myocardial Infarction/blood ; Myocardial Infarction/diagnosis ; Myocardial Infarction/epidemiology ; Myocardial Infarction/therapy ; Predictive Value of Tests ; Prognosis ; Renal Insufficiency, Chronic/blood ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Renal Insufficiency, Chronic/therapy ; Reproducibility of Results ; Risk Assessment ; Risk Factors ; Troponin/blood ; Up-Regulation
    Chemical Substances Biomarkers ; Troponin
    Language English
    Publishing date 2020-07-24
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2108910-3
    ISSN 1530-6550
    ISSN 1530-6550
    DOI 10.31083/j.rcm.2020.02.17
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6410: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  2. Article ; Online: Troponin elevation pattern and subsequent cardiac and non-cardiac outcomes: Implementing the Fourth Universal Definition of Myocardial Infarction and high-sensitivity troponin at a population level.

    Chuang, Anthony Ming-Yu / Nguyen, Mau T / Khan, Ehsan / Jones, Dylan / Horsfall, Matthew / Lehman, Sam / Smilowitz, Nathaniel R / Lambrakis, Kristina / Than, Martin / Vaile, Julian / Sinhal, Ajay / French, John K / Chew, Derek P

    PloS one

    2021  Volume 16, Issue 3, Page(s) e0248289

    Abstract: Background: The Fourth Universal Definition of Myocardial Infarction (MI) differentiates MI from myocardial injury. We characterised the temporal course of cardiac and non-cardiac outcomes associated with MI, acute and chronic myocardial injury.: ... ...

    Abstract Background: The Fourth Universal Definition of Myocardial Infarction (MI) differentiates MI from myocardial injury. We characterised the temporal course of cardiac and non-cardiac outcomes associated with MI, acute and chronic myocardial injury.
    Methods: We included all patients presenting to public emergency departments in South Australia between June 2011-Sept 2019. Episodes of care (EOCs) were classified into 5 groups based on high-sensitivity troponin-T (hs-cTnT) and diagnostic codes: 1) Acute MI [rise/fall in hs-cTnT and primary diagnosis of acute coronary syndrome], 2) Acute myocardial injury with coronary artery disease (CAD) [rise/fall in hs-cTnT and diagnosis of CAD], 3) Acute myocardial injury without CAD [rise/fall in hs-cTnT without diagnosis of CAD], 4) Chronic myocardial injury [elevated hs-cTnT without rise/fall], and 5) No myocardial injury. Multivariable flexible parametric models were used to characterize the temporal hazard of death, MI, heart failure (HF), and ventricular arrhythmia.
    Results: 372,310 EOCs (218,878 individuals) were included: acute MI (19,052 [5.12%]), acute myocardial injury with CAD (6,928 [1.86%]), acute myocardial injury without CAD (32,231 [8.66%]), chronic myocardial injury (55,056 [14.79%]), and no myocardial injury (259,043 [69.58%]). We observed an early hazard of MI and HF after acute MI and acute myocardial injury with CAD. In contrast, subsequent MI risk was lower and more constant in patients with acute injury without CAD or chronic injury. All patterns of myocardial injury were associated with significantly higher risk of all-cause mortality and ventricular arrhythmia.
    Conclusions: Different patterns of myocardial injury were associated with divergent profiles of subsequent cardiac and non-cardiac risk. The therapeutic approach and modifiability of such excess risks require further research.
    MeSH term(s) Acute Coronary Syndrome/blood ; Acute Coronary Syndrome/mortality ; Acute Coronary Syndrome/therapy ; Adult ; Aged ; Aged, 80 and over ; Arrhythmias, Cardiac/blood ; Arrhythmias, Cardiac/mortality ; Arrhythmias, Cardiac/therapy ; Chronic Disease ; Disease-Free Survival ; Female ; Follow-Up Studies ; Heart Failure/blood ; Heart Failure/mortality ; Heart Failure/therapy ; Humans ; Male ; Middle Aged ; Myocardial Infarction/blood ; Myocardial Infarction/mortality ; Myocardial Infarction/therapy ; Risk Factors ; Survival Rate ; Troponin T/blood
    Chemical Substances Troponin T
    Language English
    Publishing date 2021-03-12
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1932-6203
    ISSN (online) 1932-6203
    DOI 10.1371/journal.pone.0248289
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

    Inter-library loan at ZB MED

    Your chosen title can be delivered directly to ZB MED Cologne location if you are registered as a user at ZB MED Cologne.

  3. Article: Multidisciplinary transcatheter aortic valve replacement heart team programme improves mortality in aortic stenosis.

    Jones, Dylan R / Chew, Derek P / Horsfall, Matthew J / Chuang, Anthony Ming-Yu / Sinhal, Ajay R / Joseph, Majo X / Baker, Robert A / Bennetts, Jayme S / Selvanayagam, Joseph B / Lehman, Sam J

    Open heart

    2019  Volume 6, Issue 2, Page(s) e000983

    Abstract: Objectives: To analyse the effect of the implementation of a transcatheter aortic valve replacement (TAVR) and multidisciplinary heart team programme on mortality in severe aortic stenosis (AS).: Methods: A retrospective, observational cohort study ... ...

    Abstract Objectives: To analyse the effect of the implementation of a transcatheter aortic valve replacement (TAVR) and multidisciplinary heart team programme on mortality in severe aortic stenosis (AS).
    Methods: A retrospective, observational cohort study was performed using the echocardiography, cardiothoracic surgery and TAVR databases between 1 January 2006 and 31 December 2016. Outcomes were compared between the pre- and post-TAVR programme eras in a tertiary referral centre providing transcatheter and surgical interventions for AS.All-cause mortality within 5 years from diagnosis was determined for 3399 patients with echocardiographically defined severe AS.
    Results: Of 3399 patients, there were 210 deaths (6.2%) at 30 days and 1614 deaths (47.5%) at 5 years.Overall, patients diagnosed in the post-TAVR programme era were older, with a lower ejection fraction and more severe AS, but were less comorbid.Among 705 patients undergoing intervention, those in the post-TAVR programme era were older, with a lower ejection fraction and more severe AS but no significant differences in comorbidities.Using an inverse probability weighted cohort and a Cox proportional hazards model, a significant mortality benefit was noted between eras alone (HR=0.86, 95% CI 0.77 to 0.97, p=0.015). When matching for age, comorbidities and valve severity, this benefit was more evident (HR=0.82, 95% CI 0.73 to 0.92, p=0.001).After adjusting for the presence of aortic valve intervention, a significant benefit persisted (HR=0.84, 95% CI 0.75 to 0.95, p=0.005).
    Conclusion: The implementation of a TAVR programme is associated with a mortality benefit in the population with severe AS, independent of the expansion of access to intervention.
    Language English
    Publishing date 2019-07-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 2747269-3
    ISSN 2053-3624 ; 2044-6055
    ISSN 2053-3624 ; 2044-6055
    DOI 10.1136/openhrt-2018-000983
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  4. Article ; Online: Invasive management of acute coronary syndrome: Interaction with competing risks.

    Chuang, Anthony Ming-Yu / Hancock, David G / Halabi, Amera / Horsfall, Matthew / Vaile, Julian / De Pasquale, Carmine / Sinhal, Ajay / Jones, Dylan / Brogan, Richard / Chew, Derek P

    International journal of cardiology

    2018  Volume 269, Page(s) 13–18

    Abstract: Background: The aim of this study was to characterise the interaction between ACS- and non-ACS-risk on the benefits of invasive management in patients presenting with acute coronary syndrome (ACS).: Methods: Consecutive patients admitted to a ... ...

    Abstract Background: The aim of this study was to characterise the interaction between ACS- and non-ACS-risk on the benefits of invasive management in patients presenting with acute coronary syndrome (ACS).
    Methods: Consecutive patients admitted to a tertiary hospital's Cardiac Care Unit in the months of July-December, 2003-2011 with troponin elevation (>30 ng/L) were included. "ACS-specific-risk" was estimated using the GRACE score and "non-ACS-risk" was estimated using the Charlson-Comorbidity-Index (CCI). Inverse-probability-of-treatment weighting was used to adjust for baseline differences between patients who did or did not receive invasive management. A multivariable flexible parametric model was used to characterise the time-varying hazard.
    Results: In total, 3057 patients were included with a median follow-up of 9.0 years. Based on CCI, 1783 patients were classified as 'low-non-ACS risk' (CCI ≤ 1; invasive management 81%; 12-month mortality 5%), 820 as 'medium-non-ACS risk' (CCI 2-3; invasive management 68%; 12-month mortality 13%), and 468 as 'high-non-ACS risk' (CCI ≥ 4; invasive management 47%; 12-month mortality 29%). After adjustment, invasive management was associated with a significant reduction in one-year overall-mortality in the 'low-risk' and 'medium-risk' groups (HR = 0.38, 95%CI:0.26-0.56; HR = 0.46, 95%CI:0.32-0.67); but not in the 'high-risk' group (HR = 1.02, 95%CI:0.67-1.56). The absolute benefit of invasive management was greatest with higher baseline ACS-risk, with a non-linear interaction between ACS- and non-ACS-risk.
    Conclusions: There is a complex interaction between ACS- and non-ACS-risk on the benefit of invasive management. These results highlight the need to develop robust methods to objectively quantify risk attributable to non-ACS comorbidities in order to make informed decisions regarding the use of invasive management in individuals with numerous comorbidities.
    MeSH term(s) Acute Coronary Syndrome/diagnosis ; Acute Coronary Syndrome/mortality ; Acute Coronary Syndrome/surgery ; Aged ; Aged, 80 and over ; Disease Management ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Mortality/trends ; Percutaneous Coronary Intervention/methods ; Percutaneous Coronary Intervention/trends ; Prospective Studies ; Registries ; Risk Factors
    Language English
    Publishing date 2018-07-19
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 779519-1
    ISSN 1874-1754 ; 0167-5273
    ISSN (online) 1874-1754
    ISSN 0167-5273
    DOI 10.1016/j.ijcard.2018.07.078
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 1673: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
    Jg. 1995 - 2021: Lesesall (1.OG)
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  5. Article ; Online: The appropriateness of coronary investigation in myocardial injury and type 2 myocardial infarction (ACT-2): A randomized trial design.

    Lambrakis, Kristina / French, John K / Scott, Ian A / Briffa, Tom / Brieger, David / Farkouh, Michael E / White, Harvey / Chuang, Anthony Ming-Yu / Tiver, Kathryn / Quinn, Stephen / Kaambwa, Billingsley / Horsfall, Matthew / Morton, Erin / Chew, Derek P

    American heart journal

    2018  Volume 208, Page(s) 11–20

    Abstract: Background: Elevated troponin level findings among patients presenting with suspected acute coronary syndrome (ACS) or another intercurrent illness undeniably identifies patients at increased risk of mortality. Whilst enhancing our capacity to ... ...

    Abstract Background: Elevated troponin level findings among patients presenting with suspected acute coronary syndrome (ACS) or another intercurrent illness undeniably identifies patients at increased risk of mortality. Whilst enhancing our capacity to discriminate risk, the use of high-sensitivity troponin assays frequently identifies patients with myocardial injury (i.e. troponin rise without acute signs of myocardial ischemia) or type 2 myocardial infarction (T2MI; oxygen supply-demand imbalance). This leads to the clinically challenging task of distinguishing type 1 myocardial infarction (T1MI; coronary plaque rupture) from myocardial injury and T2MI in the context of concurrent acute illness. Diagnostic discernment in this context is crucial because MI classification has implications for further investigation and care. Early invasive management is of well-established benefit among patients with T1MI. However, the appropriateness of this investigation in the heterogeneous context of T2MI, where there is high competing mortality risk, remains unknown. Although coronary angiography in T2MI is advocated by some, there is insufficient evidence in existing literature to support this opinion as highlighted by current national guidelines.
    Objective: The objective is to evaluate the clinical and economic impact of early invasive management with coronary angiography in T2MI in terms of all-cause mortality and cost effectiveness.
    Design: This prospective, pragmatic, multicenter, randomized trial among patients with suspected supply demand ischemia leading to troponin elevation (n=1,800; T2MI [1,500], chronic myocardial injury [300]) compares the impact of invasive angiography (or computed tomography angiography as per local preference) within 5 days of randomization versus conservative management (with or without functional testing at clinician discretion) on all-cause mortality by 2 years. Randomized treatment allocation will be stratified by baseline estimated risk of mortality using the Acute Physiology, Age, and Chronic Health Evaluation (APACHE) III risk score. Cost-effectiveness will be evaluated by follow-up on clinical events, quality of life, and resource utilization over 24 months.
    Summary: Ascertaining the most appropriate first-line investigative strategy for these commonly encountered high-risk T2MI patients in a randomized comparative study will be pivotal in informing evidence-based guidelines that lead to better patient and health care outcomes.
    MeSH term(s) Acute Coronary Syndrome/blood ; Biomarkers/blood ; Coronary Angiography/economics ; Diagnosis, Differential ; Heart Injuries/blood ; Heart Injuries/diagnostic imaging ; Humans ; Myocardial Infarction/blood ; Myocardial Infarction/diagnostic imaging ; Myocardial Infarction/etiology ; Myocardial Infarction/therapy ; Plaque, Atherosclerotic/complications ; Rupture/complications ; Sample Size ; Troponin/blood
    Chemical Substances Biomarkers ; Troponin
    Language English
    Publishing date 2018-10-25
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Pragmatic Clinical Trial ; Randomized Controlled Trial ; Research Support, Non-U.S. Gov't
    ZDB-ID 80026-0
    ISSN 1097-6744 ; 0002-8703
    ISSN (online) 1097-6744
    ISSN 0002-8703
    DOI 10.1016/j.ahj.2018.09.016
    Database MEDical Literature Analysis and Retrieval System OnLINE

    Full text online

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Ui IV Zs.15: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

  6. Article ; Online: Transcatheter Tricuspid Valve Replacement With the EVOQUE System: 1-Year Outcomes of a Multicenter, First-in-Human Experience.

    Webb, John G / Chuang, Anthony Ming-Yu / Meier, David / von Bardeleben, Ralph Stephan / Kodali, Susheel K / Smith, Robert L / Hausleiter, Jörg / Ong, Geraldine / Boone, Robert / Ruf, Tobias / George, Isaac / Szerlip, Molly / Näbauer, Michael / Ali, Faeez M / Moss, Robert / Kreidel, Felix / Bapat, Vinayak / Schnitzler, Katharina / Ye, Jian /
    Wild, Mirjam / Akodad, Mariama / Deva, Djeven P / Chatfield, Andrew G / Mack, Michael J / Grayburn, Paul A / Peterson, Mark D / Makkar, Raj / Leon, Martin B / Hahn, Rebecca T / Fam, Neil P

    JACC. Cardiovascular interventions

    2022  Volume 15, Issue 5, Page(s) 481–491

    Abstract: Objectives: The aim of this study was to report the midterm outcomes at 1 year in the expanded first-in-human experience with the transfemoral EVOQUE system (Edwards Lifesciences) for tricuspid regurgitation (TR).: Background: Untreated TR is ... ...

    Abstract Objectives: The aim of this study was to report the midterm outcomes at 1 year in the expanded first-in-human experience with the transfemoral EVOQUE system (Edwards Lifesciences) for tricuspid regurgitation (TR).
    Background: Untreated TR is associated with excess mortality and morbidity. The first-in-human experience with the EVOQUE tricuspid valve replacement system reported favorable 30-day outcomes with no mortality in a compassionate use population.
    Methods: Twenty-seven patients with severe TR were treated with the EVOQUE system in a compassionate use experience at 7 centers between May 2019 and July 2020. All patients had clinical right-sided heart failure (HF) and were deemed inoperable and unsuitable for transcatheter edge-to-edge repair by the institutional heart teams. The clinical outcomes collected included all-cause mortality, symptom status, TR severity, HF hospitalization, and major adverse cardiovascular events.
    Results: At baseline, all patients (age: 77 ± 8 years, 89% female) were at high surgical risk (mean Society of Thoracic Surgeons score: 8.6% ± 5.5%), with 89% New York Heart Association functional class III/IV. TR was predominantly functional in etiology (19/27, 70%). At 1 year, mortality was 7% (2/27), 70% of patients were New York Heart Association functional class I/II, and 96% and 87% of patients had a TR grade ≤2+ and ≤1+, respectively. Between 30 days and 1 year, 2 patients experienced HF hospitalizations, and 1 patient required a new pacemaker implantation.
    Conclusions: In this early, compassionate use experience, the transfemoral transcatheter EVOQUE tricuspid valve replacement system demonstrated durable efficacy, persistent improvement in symptom status, and low rates of mortality and HF hospitalizations at a 1-year follow-up. Further studies are underway to validate its efficacy.
    MeSH term(s) Aged ; Aged, 80 and over ; Cardiac Catheterization/adverse effects ; Female ; Heart Valve Prosthesis Implantation/adverse effects ; Humans ; Male ; Recovery of Function ; Severity of Illness Index ; Time Factors ; Treatment Outcome ; Tricuspid Valve/diagnostic imaging ; Tricuspid Valve/surgery ; Tricuspid Valve Insufficiency/diagnostic imaging ; Tricuspid Valve Insufficiency/surgery
    Language English
    Publishing date 2022-03-10
    Publishing country United States
    Document type Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 2452157-7
    ISSN 1876-7605 ; 1936-8798
    ISSN (online) 1876-7605
    ISSN 1936-8798
    DOI 10.1016/j.jcin.2022.01.280
    Database MEDical Literature Analysis and Retrieval System OnLINE

    More links

    Kategorien

    In stock of ZB MED Cologne/Königswinter

    Zs.A 6669: Show issues Location:
    Je nach Verfügbarkeit (siehe Angabe bei Bestand)
    bis Jg. 2021: Bestellungen von Artikeln über das Online-Bestellformular
    ab Jg. 2022: Lesesaal (EG)

    Order via subito

    This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.

To top