2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline)

Wright, R. Scott; Anderson, Jeffrey L.; Adams, Cynthia D.; Bridges, Charles R.; Casey, Donald E.; Ettinger, Steven M.; Fesmire, Francis M.; Ganiats, Théodore G.; Jneid, Hani; Lincoff, A. Michael; Peterson, Eric D.; Philippides, George J.; Théroux, Pierre; Wenger, Nanette K.; Zidar, James P.

doi:10.1016/j.jacc.2011.02.009

Cited by 343 publications

(133 citation statements)

References 189 publications

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“…All patients received nonionic, low‐osmolarity contrast agents (either Iopamiron or iopromide, both 370 mg I/mL). Treatment was based on the American Heart Association/American College of Cardiology Foundation guidelines 5. According to the local institutional protocol,6 the serum creatinine concentrations were measured in all patients at hospital admission and 1, 2, and 3 days post‐PCI.…”

Section: Methodsmentioning

confidence: 99%

“…Pearson's chi‐square test or Fisher's exact test was used, as appropriate, for categorical data, which were expressed as percentages. The odds ratios (ORs) of CI‐AKI for subgroups with different HV/W ratios (cut‐off values determined by the quartiles and previous studies cited by the guidelines [25 mL/kg])4, 5 were estimated using univariate and multivariate logistic regression analyses. After considering the trade‐off between overfitting and control of unbalanced factors, we finally used the following factors with P <0.05 on baseline analysis: age, female sex, smoking status, eGFR, mL/min per 1.73 m 2 , congestive heart failure, diabetes mellitus, emergent PCI, anemia, contrast volume >200 mL, use of diuretics, lesions, and number of stents implanted for the multivariate logistic regression, along with the clinically important factors.…”

Section: Methodsmentioning

confidence: 99%

“…The most effective methods for controlling risk of CI‐AKI have been reported to include preventive measures aimed at reducing risk of PCI‐induced renal complications. According to existing PCI guidelines, the key prophylaxes include identifying high‐risk patients, individually reducing the dose of the contrast medium, and providing adequate hydration with isotonic saline 3, 4, 5, 6, 7, 8. However, no well‐defined protocols currently exist regarding the optimal rate and duration of normal saline administration to prevent CI‐AKI in patients with renal insufficiency undergoing PCI 9, 10.…”

Section: Introductionmentioning

confidence: 99%

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Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Liu¹,

Li²,

Chen³

et al. 2016

JAHA

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BackgroundNo well‐defined protocols currently exist regarding the optimal rate and duration of normal saline administration to prevent contrast‐induced acute kidney injury (CI‐AKI) in patients with renal insufficiency.Methods and ResultsHydration volume ratios (hydration volume/weight; HV/W) were calculated in 1406 patients with renal insufficiency (estimated glomerular filtration rate [eGFR], <90 mL/min per 1.73 m2) undergoing percutaneous coronary intervention (PCI) with routine speed hydration (1 or 0.5 mL/kg per hour). We investigated the relationship between hydration volume, risk of CI‐AKI (increase in serum creatinine ≥0.5 mg/dL or 25% within 48–72 hours), and prognosis. Mean follow‐up duration was 2.85±0.88 years. Individuals with higher HV/W were more likely to develop CI‐AKI (quartiles: Q1, Q2, Q3, and Q4: 4.3%, 6.6%, 10.9%, and 15.0%, respectively; P<0.001). After adjusting 12 confounders, including age, sex, eGFR, anemia, emergent PCI, diabetes mellitus, chronic heart failure, diuretics, contrast volume, lesions, smoking status, and number of stents, multivariate analysis showed that a higher HV/W ratio was not associated with a decreased CI‐AKI risk (Q2 vs Q1: adjusted odds ratio [OR], 1.13; Q3 vs Q1: adjusted OR, 1.51; Q4 vs Q1: adjusted OR, 1.87; all P>0.05) and even increased CI‐AKI risk (HV/W >25 mL/kg: adjusted OR, 2.11; 95% CI, 1.24–3.59; P=0.006). Additionally, higher HV/W was significantly associated with an increased risk of death (Q4 vs Q1: adjusted hazard ratio, 3.44; 95% CI, 1.20–9.88; P=0.022).ConclusionsExcessively high hydration volume at routine speed might be associated with increased risk of CI‐AKI and death post‐PCI in patients with renal insufficiency.

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Liu¹,

Li²,

Chen³

et al. 2016

JAHA

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“…Our information on ACS was collected by professional cardiologists primarily based on the diagnostic criteria of ACS by AHA 1, 36. In the present study the outcome was suicide death, which was more accurate than the definition of suicide ideation or attempts.…”

Section: Discussionmentioning

confidence: 89%

Acute Coronary Syndrome and Suicide: A Case‐Referent Study

Liu¹,

Yeh

Wang

et al. 2016

JAHA

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BackgroundThe high prevalence of acute coronary syndrome (ACS) represents a significant burden on healthcare resources. A robust association exists between depression and increased morbidity and mortality after ACS. This study examined the relationship between suicide and ACS after adjusting for depression and other comorbidities.Methods and ResultsIn this case‐referent study conducted in Taiwan, the cases were people aged 35 years or older who died from suicide between 2000 and 2012 and 4 live referents, each matched by age, sex, and area of residence. The covariates adjusted for in the analysis were sociodemographic characteristics, physical comorbidities, and psychiatric disorders. We identified 41 050 persons who committed suicide and 164 200 referents. In the case and referent groups, 1027 (2.5%) and 2412 (1.5%) patients had ACS, respectively. After potential confounders were adjusted, ACS was significantly associated with increased odds of suicide (aOR=1.15, 95% confidence interval [CI]=1.05‐1.26). The odds of suicide were highest during the initial 6 months post‐ACS diagnosis (OR=3.05, 95% CI=2.55‐3.65) and remained high for at least 4 years after ACS diagnosis.Conclusions ACS patients are at an increased risk of suicide compared with otherwise healthy people. The risk of suicide is particularly high in the 6 months after ACS diagnosis. Our results suggest that we need to identify efficacious methods to recognize those at risk for suicide and to develop effective interventions to prevent such deaths.

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“…Further studies are therefore required to better understand the role for P2Y 12 inhibition in controlling ischemic limb complications in patients with PAD. Prasugrel, a third‐generation thienopyridine antiplatelet agent used clinically to treat patients with acute coronary syndrome who are undergoing percutaneous coronary intervention,13 has been shown to provide effective inhibition of platelet activation and aggregation via the selective inhibition of platelet P2Y 12 14, 15. Furthermore, it has also been shown to be more potent and consistent than clopidogrel for P2Y 12 inhibition 16.…”

Section: Introductionmentioning

confidence: 99%

Prasugrel, a Platelet P2Y ₁₂ Receptor Antagonist, Improves Abnormal Gait in a Novel Murine Model of Thrombotic Hindlimb Ischemia

Ohno

Tomizawa

Mizuno

et al. 2016

JAHA

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BackgroundThe efficacy of P2Y12 inhibition for the prevention of cardiovascular events in patients with peripheral arterial disease (PAD) has been established. However, the therapeutic effects on ischemic limb complications are less clear. Accordingly, we aimed to develop a novel murine model of thrombotic hindlimb ischemia to reflect that found in patients with PAD exhibiting ischemic limb symptoms. We further investigated the effects of P2Y12 deficiency and P2Y12 inhibition by prasugrel in this model.Methods and ResultsThrombus formation induced by application of ferric chloride to the femoral artery resulted in a significant reduction in blood flow in the injured limb. In gait analysis using the CatWalk system, moderate difficulties in grounding and weight bearing of the ischemic limb, including reduction of maximum contact area and stance phase duration and increasing in swing phase duration in the ischemic limb, were observed in this model. Blood flow reduction and gait abnormalities gradually recovered over 21 days to levels present before arterial injury. Compared to wild‐type (WT) mice, significant increases in blood flow and improvement in gait were observed in P2Y12‐deficient mice. In addition, daily oral administration of prasugrel (3 mg/kg per day) to WT mice resulted in significant inhibition of blood flow reduction and gait abnormalities to levels found in P2Y12 deficient mice.ConclusionsAcute femoral artery thrombosis resulted in hindlimb ischemia and moderate gait abnormalities in mice. In addition, the present study suggests a possible role of P2Y12 in the complications with thrombotic limb ischemia.

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2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline)

Cited by 343 publications

References 189 publications

Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Acute Coronary Syndrome and Suicide: A Case‐Referent Study

Prasugrel, a Platelet P2Y ₁₂ Receptor Antagonist, Improves Abnormal Gait in a Novel Murine Model of Thrombotic Hindlimb Ischemia

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2011 ACCF/AHA Focused Update of the Guidelines for the Management of Patients With Unstable Angina/Non–ST-Elevation Myocardial Infarction (Updating the 2007 Guideline)

Cited by 343 publications

References 189 publications

Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Excessively High Hydration Volume May Not Be Associated With Decreased Risk of Contrast‐Induced Acute Kidney Injury After Percutaneous Coronary Intervention in Patients With Renal Insufficiency

Acute Coronary Syndrome and Suicide: A Case‐Referent Study

Prasugrel, a Platelet P2Y 12 Receptor Antagonist, Improves Abnormal Gait in a Novel Murine Model of Thrombotic Hindlimb Ischemia

Contact Info

Product

Resources

About

Prasugrel, a Platelet P2Y ₁₂ Receptor Antagonist, Improves Abnormal Gait in a Novel Murine Model of Thrombotic Hindlimb Ischemia