non-ST-segment Elevation Acute Coronary Syndromes (non-st-segment + elevation_acute_coronary_syndrome)

Distribution by Scientific Domains


Selected Abstracts


Efficacy and Safety of Tirofiban in High-Risk Patients With Non-ST-Segment Elevation Acute Coronary Syndromes

CLINICAL CARDIOLOGY, Issue 9 2009
Zhenxian Yan MD
Objective To evaluate the safety and efficacy of tirofiban in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) after percutaneous coronary intervention (PCI). Methods A total of 240 patients were randomized to either a tirofiban group or a control group. Results Compared with the control group, the platelet aggregation rate in the tirofiban group was lower (P < 0.01); the plasma levels of CK-MB and troponin I, cardiac form (cTnI) were lower (P < 0.05); ECG improved significantly (P < 0.05); the incidence of major adverse cardiac events (MACE) was lower (P < 0.05); and there was no difference in bleeding complications between the 2 groups (P = 0.1). Conclusions The administration of tirofiban in high risk patients with NSTE-ACS after PCI is safe and effective. Copyright © 2009 Wiley Periodicals, Inc. [source]


Clinical Assessment of Ischemia-modified Albumin and Heart Fatty Acid,binding Protein in the Early Diagnosis of Non-ST-elevation Acute Coronary Syndrome in the Emergency Department

ACADEMIC EMERGENCY MEDICINE, Issue 1 2010
Sandrine Charpentier MD
Abstract Objectives:, Heart fatty acid,binding protein (h-FABP) and ischemia-modified albumin (IMA) have recently been evaluated, but to the best of our knowledge, no study has reported an analysis of these two markers for the detection of early myocardial infarction and myocardial ischemia in a large cohort of consecutive patients presenting to an emergency department (ED). This study evaluates the diagnostic accuracy and the clinical utility of h-FABP and IMA for non-ST-segment elevation acute coronary syndrome (ACS) diagnosis in the first hour of management in an ED. Methods:, In a prospective 11-month study, 677 patients admitted to the ED with chest pain and suspected non-ST-segment elevation ACS were enrolled. On presentation, blood samples were obtained for the measurement of the biomarkers h-FABP (immunodetection with CardioDetect) and IMA (albumin cobalt-binding test). Two physicians, blinded to the results of the markers, independently categorized patients as having or not having non-ST-segment elevation ACS. Results:, Of the 677 patients who were prospectively recruited, non-ST-segment elevation ACS was diagnosed in 185 (27.3%). While IMA was not predictive of the ACS diagnosis (odds ratio [OR] = 1.23; 95% CI = 0.87 to 1.81), h-FABP was predictive of ACS diagnosis (OR = 4.65; 95% CI = 2.39 to 9.04) with specificity at 96.8% (95% CI = 95.4% to 98.1%) and sensitivity at 13.5% (95% CI = 10.9% to 16.1%). However, h-FABP did not add significant additional information to a predictive model that included the usual diagnostic tools for non-ST-elevation ACS management (p = 0.40). Conclusions:, In this study on a large cohort of patients admitted to an ED for chest pain, IMA and h-FABP did not provide valuable information for ACS diagnosis. ACADEMIC EMERGENCY MEDICINE 2010; 17:27,35 © 2010 by the Society for Academic Emergency Medicine [source]


Efficacy and Safety of Tirofiban in High-Risk Patients With Non-ST-Segment Elevation Acute Coronary Syndromes

CLINICAL CARDIOLOGY, Issue 9 2009
Zhenxian Yan MD
Objective To evaluate the safety and efficacy of tirofiban in high risk patients with non-ST-segment elevation acute coronary syndromes (NSTE-ACS) after percutaneous coronary intervention (PCI). Methods A total of 240 patients were randomized to either a tirofiban group or a control group. Results Compared with the control group, the platelet aggregation rate in the tirofiban group was lower (P < 0.01); the plasma levels of CK-MB and troponin I, cardiac form (cTnI) were lower (P < 0.05); ECG improved significantly (P < 0.05); the incidence of major adverse cardiac events (MACE) was lower (P < 0.05); and there was no difference in bleeding complications between the 2 groups (P = 0.1). Conclusions The administration of tirofiban in high risk patients with NSTE-ACS after PCI is safe and effective. Copyright © 2009 Wiley Periodicals, Inc. [source]


Therapeutic strategies, immediate and mid-term outcomes in non-ST-segment elevation acute coronary syndromes with respect to age: A single-center registry of 488 consecutive patients

CLINICAL CARDIOLOGY, Issue 8 2004
Mario Leoncini M.D.
Abstract Background: Elderly patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) may receive benefit from an early invasive strategy. However, aged patients often suffer from comorbidities that may contraindicate an invasive approach and affect prognosis adversely. The impact of comorbidities on an invasive approach to NSTE-ACS in the elderly has not been fully investigated. Hypothesis: This study sought to examine the outcome of an unselected population of patients with NSTE-ACS stratified according to age and treatment approach. Methods: The feasibility and efficacy of an invasive strategy for NSTE-ACS and the 6-month outcome were assessed in 253 unselected consecutive patients , 70 years (elderly) and compared with those of 235 unselected consecutive patients < 70 years. Results: Angiography was not performed in 69 patients (86% , 70 years) because of contraindications. In the whole population, the 6-month event rate was significantly higher in elderly compared with younger patients (22 vs. 14%; odds ratio 1.8, 95% confidence interval 1.1-2.9; p<0.02). This difference was driven by the high event rate observed in the elderly with contraindications to angiography (47 vs. 16% in the elderly treated invasively; p < 0.002). On the other hand, no significant difference was observed in the 6-month event rate between elderly and younger patients undergoing an invasive approach (16 vs. 13%; p=0.36). Contraindications to angiography,namely, creatinine , 1.5 mg/dl and elevated troponin I at admission,were the only independent predictors of 6-month outcome. Conclusions: The invasive approach was feasible in 77% of patients , 70 years. Those with contraindications to angiography showed a poor mid-term prognosis. The early invasive strategy was associated with more favorable outcomes regardless of age. [source]


Management of patients with non,ST-segment elevation acute coronary syndromes: Insights from the pursuit trial

CLINICAL CARDIOLOGY, Issue S5 2000
Dan J. Fintel M.D
The glycoprotein (GP) IIb-IIIa inhibitor eptifibatide (INTEGRILIN®, COR Therapeutics, Inc., South San Francisco, California, and Key Pharmaceuticals, Inc., Kenilworth, New Jersey) is a novel and highly potent antithrombotic agent indicated for the management of patients with non-ST-segment elevation acute coronary syndromes (ACS) and those undergoing percutaneous coronary intervention. The approval of eptifibatide for non-ST-segment elevation ACS was based on the positive results of the Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (PURSUIT) trial. With enrollment of almost 11,000 patients, not only is the PURSUIT trial the largest trial of a GP IIb-IIIa inhibitor to date, but it is also the largest clinical study ever conducted in patients with non-ST-segment elevation ACS. The key feature of the PURSUIT trial is that patient management closely resembled standard clinical practice, because decisions about the use and timing of invasive cardiac procedures were made by the individual physicians rather than being prespecified in the study protocol. Eptifibatide therapy was associated with a significant reduction in the incidence of the primary endpoint,a composite of death or myocardial infarction at 30 days (14.2 vs. 15.7% in the placebo group; p = 0.042). Of importance is the fact that the beneficial effect of eptifibatide was independent of the management strategy pursued during study drug infusion (invasive or conservative), and it was achieved with few major safety concerns. These findings demonstrate that the use of eptifibatide should be considered for all patients presenting with signs and symptoms of intermediate- to high-risk non-ST-segment elevation ACS. [source]