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1,349 results for

Coronary Risk Stratification of Chest Pain

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1341. Growth-differentiation factor-15 for early risk stratification in patients with acute chest pain. Full Text available with Trip Pro

Growth-differentiation factor-15 for early risk stratification in patients with acute chest pain. Growth-differentiation factor-15 (GDF-15) has emerged as a biomarker of increased mortality and recurrent myocardial infarction (MI) in patients diagnosed with non-ST-elevation acute coronary syndrome. We explored the usefulness of GDF-15 for early risk stratification in 479 unselected patients with acute chest pain.Sixty-nine per cent of the patients presented with GDF-15 levels above (...) -reactive protein, and cystatin C, GDF-15 remained an independent predictor of the composite endpoint. The ability of the ECG combined with peak cTnI(0-2 h) to predict the composite endpoint was markedly improved by addition of GDF-15 (c-statistic, 0.74 vs. 0.83; P < 0.001).GDF-15 improves risk stratification in unselected patients with acute chest pain and provides prognostic information beyond clinical characteristics, the ECG, and cTnI.

2008 European Heart Journal

1342. Risk stratification of patients with acute chest pain and normal troponin concentrations. Full Text available with Trip Pro

mellitus (OR 2.3, 95% CI 1.1 to 4.7, p = 0.03), previous coronary surgery (OR 3.1, 95% CI 1.3 to 7.6, p = 0.01), and ST segment depression (OR 2.8, 95% CI 1.3 to 6.3, p = 0.003). A risk score proved useful for patient stratification according to the presence of 0-1 (2.7% event rate), 2 (10.2%, p = 0.008), and 3-4 predictors (29.2%, p = 0.0001).A negative troponin result does not assure a good prognosis for patients coming to the emergency room with chest pain. Early exercise testing and clinical data (...) Risk stratification of patients with acute chest pain and normal troponin concentrations. To investigate the outcome of patients with acute chest pain and normal troponin concentrations.Prospective cohort design.Single centre study in a teaching hospital in Spain.609 consecutive patients with chest pain evaluated in the emergency department by clinical history (risk factors and a chest pain score according to pain characteristics), ECG, and early (< 24 hours) exercise testing for low risk

2005 Heart

1343. Early symptom-limited exercise test for risk stratification in post menopausal women with unstable coronary artery disease. FRISC study group. Fragmin during Instability in Coronary Artery Disease. Full Text available with Trip Pro

in the analysis. The aim of the study was to evaluate an early symptom-limited exercise test as a tool for risk stratification in women with unstable coronary artery disease admitted to the coronary care unit.Of the 543 women in the FRISC I study, 395 stabilized on medical treatment and performed a symptom-limited exercise test 5-8 days after inclusion. Sixteen patients with a cardiac event before the scheduled exercise test were excluded. During the 6 months follow-up 17% of the women who did not perform (...) with unstable coronary artery disease who do not stabilize within a few days have a high event rate early during follow-up. For women who are medically stabilized, considering not only variables like ST depression and chest pain but also parameters reflecting the cardiac performance such as maximal workload and increase in rate-pressure product, an early symptom-limited exercise test is a good predictor of future cardiac events.Copyright 2000 The European Society of Cardiology.

2000 European heart journal Controlled trial quality: uncertain

1344. The impact of B-type natriuretic peptide in addition to troponin I, creatine kinase-MB, and myoglobin on the risk stratification of emergency department chest pain patients with potential acute coronary syndrome. (Abstract)

The impact of B-type natriuretic peptide in addition to troponin I, creatine kinase-MB, and myoglobin on the risk stratification of emergency department chest pain patients with potential acute coronary syndrome. The emergency department (ED) evaluation of chest pain patients with potential acute coronary syndrome is limited by the initial sensitivity of cell injury markers. BNP is increased during myocardial ischemia and is associated with adverse outcomes. We determine whether the addition (...) of B-type natriuretic peptide (BNP) to troponin I, creatine kinase-MB (CK-MB), and myoglobin increases the sensitivity and negative predictive value (NPV) for acute myocardial infarction, acute coronary syndrome, and 30-day adverse events among chest pain patients with potential acute coronary syndrome.A convenience sample of patients aged 30 years or older and presenting to an urban academic ED with nontraumatic chest pain, thus prompting an ECG, was enrolled, and consent was obtained. Blood

2007 Annals of Emergency Medicine

1345. Performance of a population-based cardiac risk stratification tool in Asian patients with chest pain. (Abstract)

Performance of a population-based cardiac risk stratification tool in Asian patients with chest pain. Most contemporary cardiac risk stratification tools have been derived and validated in mixed-race populations. Their validity in single-race populations has not been tested. The authors sought to compare the performance of a risk stratification tool between a mixed-race U.S. patient population and an Asian patient population.This study is an analysis of data from the Internet Tracking Registry (...) ; 95% CI = 0.149 to 1.122), and chest pain as a primary complaint (LOR, 0.237; 95% CI = 0.139 to 0.613) had little predictive power in patients from Singapore.Differences exist in presentation and factors associated with ACS among patients from the United States and Singapore that may affect the performance of risk stratification tools. These findings suggest that cardiac clinical decision rules need international validation.

2005 Academic Emergency Medicine

1346. N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation. (Abstract)

N-terminal pro brain natriuretic peptide on admission for early risk stratification of patients with chest pain and no ST-segment elevation. The study evaluated the prognostic value of single measurement of N-terminal pro brain natriuretic peptide (NT-proBNP) obtained on admission in patients with symptoms suggestive of an acute coronary syndrome and no ST-segment elevation.Patients with symptoms suggestive of an acute coronary syndrome and no ST-segment elevation constitute a large (...) and heterogeneous population. Early risk stratification has been based on clinical background factors, electrocardiography (ECG) and biochemical markers of myocardial damage. The neurohormonal activation has, so far, received less attention.The NT-proBNP was analyzed on admission in 755 patients admitted because of chest pain and no ST-segment elevation. Patients were followed concerning death for 40 months (median).The median NT-proBNP level was 400 (111 to 1646) ng/l. Compared to the lowest quartile, patients

2002 Journal of the American College of Cardiology Controlled trial quality: uncertain

1347. Clinical, exercise electrocardiographic, and pharmacologic stress echocardiographic findings for risk stratification of hypertensive patients with chest pain. (Abstract)

Clinical, exercise electrocardiographic, and pharmacologic stress echocardiographic findings for risk stratification of hypertensive patients with chest pain. Exercise electrocardiography (ECG) is of limited usefulness in hypertensive patients, whereas pharmacologic stress echocardiography can provide diagnostic and prognostic information. The aim of this study was to compare the prognostic value of clinical data, exercise ECG, and pharmacologic stress echocardiography in hypertensive patients (...) with chest pain and to identify the best strategy for their risk stratification. Three hundred sixty-seven hypertensive patients (189 men, age 61 +/- 9 years) with chest pain of unknown origin underwent exercise ECG and pharmacologic stress echocardiography (237 with dipyridamole and 130 with dobutamine) and were followed up for 31 +/- 24 months. Positive exercise ECG (ST-segment shift of > or =1 mm at 80 ms after the J point) and stress echocardiography (new wall motion abnormalities) were found in 130

2003 American Journal of Cardiology

1348. Cardiac troponins in chest pain : Can help in risk stratification Full Text available with Trip Pro

Cardiac troponins in chest pain : Can help in risk stratification 10582913 2000 01 14 2018 11 13 0959-8138 319 7223 1999 Dec 04 BMJ (Clinical research ed.) BMJ Cardiac troponins in chest pain can help in risk stratification. 1451-2 Hillis G S GS Fox K A KA eng Editorial England BMJ 8900488 0959-8138 0 Troponin I 0 Troponin T AIM IM Chest Pain etiology metabolism Heart Rate Humans Myocardium chemistry Risk Assessment Sensitivity and Specificity Troponin I analysis Troponin T analysis 1999 12 3 (...) 1999 12 3 0 1 1999 12 3 0 0 ppublish 10582913 PMC1117190 Heart. 1999 Nov;82(5):614-20 10525520 Eur Heart J. 1998 Nov;19 Suppl N:N16-24 9857934 Circulation. 1998 Nov 3;98(18):1831-3 9799199 N Engl J Med. 1997 Dec 4;337(23):1648-53 9385123 Lancet. 1997 May 17;349(9063):1429-35 9164316 J Am Coll Cardiol. 1997 Jan;29(1):43-8 8996293 N Engl J Med. 1996 Oct 31;335(18):1342-9 8857017 N Engl J Med. 1996 Oct 31;335(18):1333-41 8857016 World Health Stat Q. 1993;46(2):91-6 8303909 Eur Heart J. 1997 May;18(5

1999 BMJ : British Medical Journal

1349. Effectiveness of a multidisciplinary chest pain unit for the assessment of coronary syndromes and risk stratification in the Florence area. (Abstract)

Effectiveness of a multidisciplinary chest pain unit for the assessment of coronary syndromes and risk stratification in the Florence area. In patients seen at the emergency department (ED) with chest pain (CP), noninvasive diagnostic strategies may differentiate patients at high or intermediate risk from those at low-risk for cardiovascular events and optimize the use of high-cost resources. However, in welfare healthcare systems, the feasibility, accuracy, and potential benefits (...) %, 1.1% mortality rate), 129 had aortic dissection (1.4%, 23.3% mortality rate), and 408 had pulmonary embolism (4%, 27.6% mortality rate). The remaining 2614 had chronic coronary heart disease in the context of multiple pathology (n = 2256) or pleural or pericardial diseases (n = 358). Among patients at low risk (n = 4427), 2672 were discharged at <6 hours (60%, 0.2% incidence rate of nonfatal CAD at 6 months) and 870 patients were discharged at <24 hours (20%, no CAD at follow-up). The remaining

2002 American Heart Journal

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