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Coronary Risk Stratification of Chest Pain

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181. Acute and Chronic Heart Failure Full Text available with Trip Pro

to recovery BTT bridge to transplantation BUN blood urea nitrogen CABANA Catheter ABlation versus ANtiarrhythmic drug therapy for Atrial fibrillation CABG coronary artery bypass graft/grafting CAD coronary artery disease CARE-HF CArdiac REsynchronization in Heart Failure CASTLE-AF Catheter Ablation versus Standard conventional Treatment in patients with LEft ventricular dysfunction and Atrial Fibrillation CCB calcium-channel blocker CCM cardiac contractility modulation CCS Canadian Cardiovascular Society (...) anticoagulant NP natriuretic peptide NPPV non-invasive positive pressure ventilation NSAID non-steroidal anti-inflammatory drug NSTE-ACS non-ST elevation acute coronary syndrome NT-proBNP N-terminal pro-B type natriuretic peptide NYHA New York Heart Association o.d. omne in die (once daily) OMT optimal medical therapy OSA obstructive sleep apnoea PaCO 2 partial pressure of carbon dioxide in arterial blood PAH pulmonary arterial hypertension PaO 2 partial pressure of oxygen in arterial blood PARADIGM-HF

2016 European Society of Cardiology

182. Efficacy Evaluation of the HEART Pathway in Emergency Department Patients With Acute Chest Pain

, 2018 Last Verified: August 2018 Layout table for additional information Studies a U.S. FDA-regulated Drug Product: No Studies a U.S. FDA-regulated Device Product: No Keywords provided by Wake Forest University Health Sciences: Acute Coronary Syndrome Chest pain Risk Stratification HEART Pathway Emergency Department Additional relevant MeSH terms: Layout table for MeSH terms Emergencies Acute Coronary Syndrome Chest Pain Disease Attributes Pathologic Processes Myocardial Ischemia Heart Diseases (...) troponin measurements, is a recently developed care pathway designed to identify chest pain patients for early discharge without objective testing. Primary Hypothesis: The HEART Pathway, when compared to usual care, will reduce 30 day objective cardiac testing, hospital length of stay, and cost, while maintaining patient safety. Methods: Participants (n=282) at risk for ACS will be recruited into a clinical trial from Wake Forest Baptist Medical Center (WFBMC) ED. Patients will be equally randomized

2012 Clinical Trials

183. Design of the Rule Out Myocardial Ischemia/Infarction Using Computer Assisted Tomography: a multicenter randomized comparative effectiveness trial of cardiac computed tomography versus alternative triage strategies in patients with acute chest pain in the Full Text available with Trip Pro

was a randomized comparative effectiveness trial enrolling patients 40 to 74 years old without known coronary artery disease who presented to the ED with chest pain but without ischemic electrocardiographic (ECG) changes or elevated initial troponin and who required further risk stratification. Overall, 1000 patients at 9 sites within the United States were randomized to either CCTA as the first diagnostic test following serial biomarkers or to standard of care, which included no testing or functional testing (...) . Tertiary end points were institutional, physician, and patient characteristics associated with primary and secondary outcomes. Rate of missed acute coronary syndrome within 28 days was the safety end point. The ROMICAT II will provide rigorous data on whether CCTA is more efficient than standard of care in the management of patients with acute chest pain at intermediate risk for acute coronary syndrome.Copyright © 2012 Mosby, Inc. All rights reserved.

2012 American heart journal Controlled trial quality: uncertain

184. What is the incidence of major adverse cardiac events in emergency department chest pain patients with a normal ECG, Thrombolysis in Myocardial Infarction score of zero and initial troponin <=99th centile: an observational study? (Abstract)

-study of a prospective observational study of adult patients with potentially cardiac chest pain who underwent evaluation for acute coronary syndrome in an urban teaching hospital. Adult patients with non-traumatic chest pain were eligible for inclusion. Those with ECG evidence of acute ischaemia or an alternative diagnosis were excluded. Data collected included demographic, clinical, ECG, biomarker and outcome data. Low risk was defined as a TIMI risk score of 0 and initial TnI ≤99th centile (...) What is the incidence of major adverse cardiac events in emergency department chest pain patients with a normal ECG, Thrombolysis in Myocardial Infarction score of zero and initial troponin <=99th centile: an observational study? To determine the rate of major adverse cardiac events (MACE) in patients assessed in an emergency department (ED) for chest pain with a non-ischaemic ECG, Thrombolysis in Myocardial Infarction (TIMI) score of 0 and initial troponin I (TnI) ≤99th centile.This was a sub

2012 Emergency Medicine Journal

185. Soluble Urokinase Plasminogen Activator Receptor for Risk Prediction in Patients Admitted with Acute Chest Pain. Full Text available with Trip Pro

Soluble Urokinase Plasminogen Activator Receptor for Risk Prediction in Patients Admitted with Acute Chest Pain. Plasma concentrations of soluble urokinase plasminogen activator receptor (suPAR) predict mortality in several clinical settings, but the long-term prognostic importance of suPAR in chest pain patients admitted on suspicion of non-ST-segment elevation acute coronary syndrome (NSTEACS) is uncertain.suPAR concentrations were measured on admission in 449 consecutive chest pain patients (...) improved the predictive accuracy of abnormal ECG findings and increased troponin concentrations regarding all-cause mortality (c statistics, 0.751-0.805; P < 0.0001).suPAR is a strong predictor of adverse long-term outcomes and improves risk stratification beyond traditional risk variables in chest pain patients admitted with suspected NSTEACS.

2013 Clinical Chemistry

186. 2013 ACCF/AHA Key Data Elements and Definitions for Measuring the Clinical Management and Outcomes of Patients With Acute Coronary Syndromes and Coronary Artery Disease Full Text available with Trip Pro

Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Acute Coronary Syndromes and Coronary Artery Disease Clinical Data Standards) , MD, FACC , MD, MPH, FACC , MD, FACC , MD, MSC , MD, MPH , MD, FACC , MD, FACEP , MD, FACC , MD, FACC, FAHA , MB, ChB , MD, ScD, FAHA , MD, FACC, FAHA , MD, FACC , MD, FACEP , MD, SM, FACC , MD, MPH, PhD , MSN, ACNP, FAHA , MD, FACC, FAHA, FACP , MICT, AAS , MD, FACC, FAHA , MD, FACC, FAHA , MD, MHS, FACC , RN, BS, MHA, CEN , MD, MSPH (...) Cardiovascular Nurses Association Representative. National Heart, Lung, and Blood Institute Representative. The findings and conclusions in this report are those of the author and do not necessarily represent the official positions of the National Heart, Lung, and Blood Institute. National Association of Emergency Medical Technicians Representative. Emergency Nurses Association Representative. Society of General Internal Medicine Representative. Society of Thoracic Surgeons Representative. The Joint

2013 American Heart Association

187. Acute Coronary Syndromes: Overview & Summary

February 2011 SUMMARY OF THE GUIDELINES Guideline 14 Introduction to Acute Coronary Syndromes (ACS) Guideline 14.1 Presentation with ACS ? Symptoms and Signs ? The 12 lead ECG ? Cardiac Biomarkers ? Decision Rules ? Chest Pain Observation Units (CPUs) ? Imaging Guideline 14.2 Initial Medical Therapy ? Oxygen and analgesia ? Anti platelet agents and Anticoagulants ? Optimal Medical Therapy for Primary and Secondary Prevention Guideline 14.3 Reperfusion Strategy ? Introduction ? Primary Percutaneous (...) unchanged in the recent decade. This is thought to be because two thirds of patients who die from STEMI do so before they reach hospital for treatment for definitive treatment 7 . Further, ACS are the most common underlying cause leading to sudden cardiac arrest 3, 8, 9 . These guidelines are designed to address in the first hours after the onset of symptoms, the out of hospital treatment and the initial emergency department management, diagnosis and risk stratification. Guideline 14 Page 3 of 5

2016 Australian Resuscitation Council

188. Acute Coronary Syndromes: Presentation with ACS

presentation of acute myocardial infarction in patients older than 65 years of age to younger patients: the Multicenter Chest Pain Study experience. Am J Cardiol 1989;63:772-6. 10. Peberdy MA, Ornato JP. Coronary artery disease in women. Heart Dis Stroke 1992;1:315-9. 11. Foraker RE, Rose KM, McGinn AP, et al. Neighborhood income, health insurance, and prehospital delay for myocardial infarction: the atherosclerosis risk in communities study. Arch Intern Med 2008;168:1874-9. 12. Sari I, Acar Z, Ozer O, et (...) Laboratory Medicine Practice Guidelines: analytical issues for biochemical markers of acute coronary syndromes. Clin Chem 2007;53:547-51. 50. Lee-Lewandrowski E, Januzzi JL, Green SM, et al. Multi-center validation of the Response Biomedical Corporation RAMP NT-proBNP assay with comparison to the Roche Diagnostics GmbH Elecsys proBNP assay. Clin Chim Acta 2007;386:20-4. 51. Apple FS, Jaffe AS. Bedside multimarker testing for risk stratification in chest pain units: The chest pain evaluation by creatine

2016 Australian Resuscitation Council

189. Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death Full Text available with Trip Pro

reVErses Remodeling in Systolic left vEntricular dysfunction REVERSE MIRACLE ICD Multicenter InSync ICD Randomized Clinical Evaluation RR relative risk RV right ventricular RVOT right ventricular outflow tract SA-ECG signal-averaged ECG SADS sudden arrhythmic death syndrome SCD sudden cardiac death SCD-HeFT Sudden Cardiac Death in HEart Failure Trial SCORE Systematic Coronary Risk Evaluation SIDS sudden infant death syndrome SMASH-VT Substrate Mapping and Ablation in Sinus Rhythm to Halt Ventricular (...) in the electrical or mechanical properties of the heart) with multiple transient factors that participate in triggering the fatal event. In the next section we provide a brief overview of the paucity of risk-stratification schemes for SCD in normal subjects, in patients with ischaemic heart disease and in patients with channelopathies and cardiomyopathies. 3.3.1 Individuals without known heart disease Approximately 50% of cardiac arrests occur in individuals without a known heart disease, but most suffer from

2015 European Society of Cardiology

190. Transcatheter aortic valve implantation (TAVI) in patients at intermediate surgical risk

surgical risk 1/8/2019 EUnetHTA Joint Action 3 WP4 7 LIST OF ABBREVIATIONS AS Aortic Stenosis CE Conformité Européene EACTS European Association for Cardio-Thoracic Surgery ESC European Society of Cardiology GRADE Grading of Recommendations Assessment, Development and Evaluation ICD International Classification of Diseases ICTRP International Clinical Trials Registry Platform KCCQ Kansas City Cardiomyopathy Questionnaire MeSH Medical Subject Headings NYHA New York Heart Association PAVR Percutaneous (...) for some patients, whereas, for others, the risks might outweigh the benefits. Surgical risk rises with increased age and the presence of comorbidities. The most commonly used risk algorithms include Society of Thoracic Surgeons Predicted Risk of Mortality (STS-PROM), logistic European System for Cardiac Operative Risk Evaluation (EuroSCORE), and EuroSCORE II, which has been used since 2011. A surgical risk score 8% as high. The most recent update of the European Society of Cariology/European

2018 EUnetHTA

191. Chronic Opioid Therapy for Chronic Non-Cancer Pain

appropriate category by the prescribing clinician. See “Risk stratification and intensity of monitoring,” p. 6. ? Patients on COT shall have regular COT monitoring visits that: • Occur at a frequency based on the patient’s risk stratification (see “Frequency of COT monitoring visits,” p. 6), and • Include standard components (see “Required components of a COT monitoring visit,” p. 7). ? Patients on COT shall receive all chronic pain management prescriptions from one physician and one pharmacy wherever (...) Relationship between dose and risk 5 Risk stratification and intensity of monitoring 6 Frequency of COT monitoring visits 6 Required components of a COT monitoring visit 7 Recognizing substance use disorder 9 Tapering and Discontinuing Opioids 10 Clinical indications 10 Treating opioid withdrawal symptoms 12 Minimizing Risks When Continuing to Prescribe Opioids 13 Prescribing naloxone as preventive rescue medication 13 Opioid prescribing procedures 13 Morphine equivalent dosing (MED) 14 Adverse effects

2016 Kaiser Permanente Clinical Guidelines

192. CIMT and Plaque Assessment Findings in Subjects Undergoing Stress Echocardiography For Risk Stratification

, CABG, angina) No peripheral vascular disease No history of stroke or TIA Statins, antihypertensives, ASA treatment OK Exclusion Criteria: History of CAD, CABG, PTCA, coronary or peripheral stenting History of stroke/TIA/peripheral vascular disease Inability to exercise on the treadmill Unwilling/unable to sign informed consent History of neck radiation or neck surgery or inability to obtain neck images End stage renal disease Preoperative evaluation History of chest pain Contacts and Locations Go (...) CIMT and Plaque Assessment Findings in Subjects Undergoing Stress Echocardiography For Risk Stratification CIMT and Plaque Assessment Findings in Subjects Undergoing Stress Echocardiography For Risk Stratification - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100

2014 Clinical Trials

193. Suspected Pulmonary Embolism

of the incidental diagnosis of clinically unsuspected central pulmonary artery thromboembolism in treatment of critically ill patients. Chest. 1994;105(4):986-990. 41. Toosi MS, Merlino JD, Leeper KV. Prognostic value of the shock index along with transthoracic echocardiography in risk stratification of patients with acute pulmonary embolism. Am J Cardiol. 2008;101(5):700-705. 42. Kluge A, Luboldt W, Bachmann G. Acute pulmonary embolism to the subsegmental level: diagnostic accuracy of three MRI techniques (...) contrast 2 O US echocardiography transthoracic resting 2 O CT chest without and with IV contrast 1 ??? Arteriography pulmonary with right heart catheterization 1 ???? MRA chest without IV contrast 1 O US echocardiography transesophageal 1 O Rating Scale: 1,2,3 Usually not appropriate; 4,5,6 May be appropriate; 7,8,9 Usually appropriate *Relative Radiation Level ACR Appropriateness Criteria ® 2 Suspected Pulmonary Embolism Variant 2: Suspected pulmonary embolism. Intermediate probability with a positive

2016 American College of Radiology

194. The approach to patients with possible cardiac chest pain. (Abstract)

. In patients with ongoing symptoms of chest pain, without an obvious other cause, ST-segment-elevation myocardial infarction should be excluded with a 12-lead electrocardiogram at the first available opportunity. Significant recent advances in the clinical approach to patients with acute chest pain, including better understanding of risk stratification, increasingly sensitive cardiac biomarkers and new non-invasive tests for coronary disease, can help clinicians minimise the risk of unexpected short-term (...) The approach to patients with possible cardiac chest pain. Chest pain is a common reason for presentation in hospital emergency departments and general practice. Some patients presenting with chest pain to emergency departments and, to a lesser extent, general practice will be found to have a life-threatening cause, but most will not. The challenge is to identify those who do in a safe, timely and cost-effective manner. An acute coronary syndrome cannot be excluded on clinical grounds alone

1 Medical Journal of Australia

195. Is Coronary Computed Tomography Angiography a Resource Sparing Strategy in the Risk Stratification and Evaluation of Acute Chest Pain? Results of a Randomized Controlled Trial. Full Text available with Trip Pro

Is Coronary Computed Tomography Angiography a Resource Sparing Strategy in the Risk Stratification and Evaluation of Acute Chest Pain? Results of a Randomized Controlled Trial. Annually, almost 6 million U.S. citizens are evaluated for acute chest pain syndromes (ACPSs), and billions of dollars in resources are utilized. A large part of the resource utilization results from precautionary hospitalizations that occur because care providers are unable to exclude the presence of coronary artery (...) , perceptions of the value of accessing health care, and clinical outcomes. Resource utilization included services received from both the primary in-network and the primary out-of-network providers. The prospectively defined primary endpoint was the total amount of resources utilized over a 90-day follow-up period when adding CCTA to the SC risk stratification in ACPSs.The mean (± standard deviation [SD]) for total resources utilized at 90 days for in-network plus out-of-network services was less

2011 Academic Emergency Medicine Controlled trial quality: predicted high

196. Evaluation of Patients With Suspected Acute Pulmonary Embolism: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians Full Text available with Trip Pro

estimates to educate patients with chest pain about their risk for acute coronary syndrome result in both lower health care resource utilization and higher patient satisfaction scores ( ). Similarly, at least one study has shown that the use of evidence-based decision aids (to demonstrate to patients the comparative risks for PE and of any diagnostic tests) may reduce imaging in patients with suspected acute PE ( ). Ideally, this kind of shared decision-making model would allow patients to weigh (...) experience matter? Chest 2005 127 1627 30 Kline JA , Stubblefield WB . Clinician gestalt estimate of pretest probability for acute coronary syndrome and pulmonary embolism in patients with chest pain and dyspnea. Ann Emerg Med 2014 63 275 80 Wells PS , Anderson DR , Rodger M , Ginsberg JS , Kearon C , Gent M . et al Derivation of a simple clinical model to categorize patients probability of pulmonary embolism: increasing the models utility with the SimpliRED d -dimer. Thromb Haemost 2000 83 416 20 Gibson

2015 American College of Physicians

197. Pediatric Pulmonary Hypertension: ATS/AHA Clinical Practice Guidelines

Heart Association and American Thoracic Society, a panel of experienced clinicians and clinician-scientists was assembled to review the current literature and to make recommendations on the diagnosis, evaluation, and treatment of pediatric pulmonary hypertension. This publication presents the results of extensive literature reviews, discussions, and formal scoring of recommendations for the care of children with pulmonary hypertension. (Circulation. 2015;132:00-00. DOI: 10.1161/CIR.0000000000000329 (...) .) Key Words: AHA Scientific Statements ? bronchopulmonary dysplasia ? congenital diaphragmatic hernia ? congenital heart disease ? genetics ? persistent pulmonary hypertension of the newborn ? sickle cell disease © 2015 by the American Heart Association, Inc., and the American Thoracic Society. Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0000000000000329 †Deceased. The American Heart Association and the American Thoracic Society make every effort to avoid any actual

2015 American Thoracic Society

198. Pediatric Pulmonary Hypertension Full Text available with Trip Pro

Pediatric Pulmonary Hypertension AHA/ATS Guideline 2037 Abstract—Pulmonary hypertension is associated with diverse cardiac, pulmonary, and systemic diseases in neonates, infants, and older children and contributes to significant morbidity and mortality. However, current approaches to caring for pediatric patients with pulmonary hypertension have been limited by the lack of consensus guidelines from experts in the field. In a joint effort from the American Heart Association and American Thoracic (...) ? bronchopulmonary dysplasia ? congenital diaphragmatic hernia ? congenital heart disease ? genetics ? persistent pulmonary hypertension of the newborn ? sickle cell disease © 2015 by the American Heart Association, Inc., and the American Thoracic Society. Circulation is available at http://circ.ahajournals.org DOI: 10.1161/CIR.0000000000000329 †Deceased. The American Heart Association and the American Thoracic Society make every effort to avoid any actual or potential conflicts of interest that may arise

2015 American Heart Association

199. The Updated NICE Guidelines: Cardiac CT as the First-Line Test for Coronary Artery Disease Full Text available with Trip Pro

The Updated NICE Guidelines: Cardiac CT as the First-Line Test for Coronary Artery Disease Cost-effective care pathways are integral to delivering sustainable healthcare programmes. Due to the overestimation of coronary artery disease using traditional risk tables, non-invasive testing has been utilised to improve risk stratification and initiate appropriate management to reduce the dependence on invasive investigations. In line with recent technological improvements, cardiac CT is a modality (...) that offers a detailed anatomical assessment of coronary artery disease comparable to invasive coronary angiography.The recent publication of the National Institute for Health and Care Excellences (NICE) Clinical Guideline 95 update assesses the performance and cost utility of different non-invasive imaging strategies in patients presenting with suspected anginal chest pain. The low cost and high sensitivity of cardiac CT makes it the non-invasive test of choice in the evaluation of stable angina

2017 Current cardiovascular imaging reports

200. Cardiac magnetic resonance assessment of diastolic dysfunction in acute coronary syndrome Full Text available with Trip Pro

studies have investigated more sensitive and specific imaging modalities that can be used. Diastolic dysfunction occurs early following coronary artery occlusion and its detection is useful in confirming the diagnosis, risk stratification, and prognosis post-ACS. Cardiac magnetic resonance provides a single imaging modality for comprehensive evaluation of chest pain in the acute setting. In particular, cardiac magnetic resonance has many imaging techniques that assess diastolic dysfunction post (...) Cardiac magnetic resonance assessment of diastolic dysfunction in acute coronary syndrome Chest pain is an important presenting symptom. However, few cases of chest pain are diagnosed as acute coronary syndrome (ACS) in the acute setting. This results in frequent inappropriate discharge and major delay in treatment for patients with underlying ACS. The conventional methods of assessing ACS, which include electrocardiography and serological markers of infarct, can take time to manifest. Recent

2017 The Journal of international medical research

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