Literature Publications Archive

Emergency Medicine Cardiac Research and Education Group

NAVIGATION

ACTION Registry®–GWTG™ is a national, risk-adjusted, outcomes-based quality improvement program that helps participating facilities measure and improve care for high-risk ACS patients with STEMI and NSTEMI. The result of the collaboration between the two leading national coronary artery disease registries, the NCDR® ACTION Registry® and the American Heart Association (AHA) Get With The GuidelinesSM-CAD Registry, ACTION Registry–GWTG will be the largest, most comprehensive national cardiovascular patient database ever developed by the medical profession.

Combining the strengths of the two programs, ACTION Registry–GWTG will collect a comprehensive set of data elements that provide healthcare professionals and their facilities with the information they need to monitor and improve adherence to the most current, science-based ACC/AHA treatment guidelines. Participation will greatly facilitate quality improvement efforts, optimize clinical care, and improve clinical outcomes for acute coronary syndrome patients.

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Date	Article
16 November 2010	Nesiritide safe but little effect on HF symptoms or mortality: ASCEND-HF:

11 November 2010	STEMI door-to-balloon time improvements fail to reduce mortality:

2 November 2010	Prehospital tirofiban improves STEMI platelet inhibition:

5 October 2010	Risk underestimation results in suboptimal NSTE ACS treatment:

13 September 2010	Low-dose heparin provides no improvement in PCI outcomes:

2 September 2010	Double-dose clopidogrel in PCI questioned: CURRENT OASIS-7:

27 August 2010	Dyspnea relief should be a focus for HF treatment:

18 August 2010	Reducing system delay key to improving STEMI care:

9 August 2010	Fisrt reversible anticoagulation system shows promise:

2 August 2010	SITS-ISTR supports thrombolysis window extension:

27 July 2010	Important AHA statement on low risk chest pain in the ED:

19 July 2010	Early routine PCI after fibrinolysis bests standard STEMI therapy:

19 July 2010	New guideline advocates MRI over CT for stroke diagnosis:

21 June 2010	TIMI risk score useful for emergency chest pain diagnosis:

18 June 2010	Evidence-based ACS treatments investigated for survival benefit:

11 June 2010	New risk score can identify ACS patients at high risk for bleeding:

8 June 2010	Time to STEMI reperfusion strongly predicts mortality:

8 June 2010	ACE inhibitor effects in ACS may depend on NT-proBNP elevation:

19 May 2010	New anti-inflammatory drug shows promise in ACS: The investigational anti-inflammatory drug VIA-2291 reduces leukotriene production preventing the formation of new coronary plaques in ACS patients.

19 May 2010	CTCA useful in intermediate-risk CAD patients: CTCA found to be useful for predicting need for invasive coronary angiography in intermediate-risk CAD patients

17 May 2010	QRISK2 more accurate than NICE version of Framingham: Researchers report that QRISK2 is more accurate at identifying people at high risk for cardiovascular disease (CVD) than the Framingham equation previously recommended by NICE

26 April 2010	Cardiac deaths common among patients discharged with ‘noncardiac’ chest pain: Recent study shows that cardiac death is common among patients dismissed from hospital with noncardiac chest pain

13 April 2010	Routine invasive strategy in NSTE ACS supported: A routine invasive strategy reduces long-term death or myocardial infarction rates NSTE ACS patients.

7 April 2010	ACUITY results show delayed PCI increases mortality risk: ACUITY data shows that delayed angioplasty in ACS patients results in increased risk for MI and death.

7 April 2010	Dyspnea in acute HF rapidly improves with conventional therapy: Data from the URGENT trial show that dyspnea in the sitting position with acute heart failure improves rapidly with conventional treatment.

29 March 2010	German researchers develop novel antithrombotic agent: Selective factor (F)XIIa inhibitor was created by fusing recombinant human albumin with Infestin-4 shows promise as an antithrombotic without increased bleeding risk.

26 March 2010	BNP-guided HF therapy associated with reduced all-cause mortality: Recent study reports that BNP-guided therapy reduces all-cause mortality in patients with chronic heart failure, particularly patients younger than 75 years of age.

22 March 2010	Experts call for improved risk stratification strategies before elective angiography: A large registry reports that only about one third of patients without known CAD who underwent elective coronary angiography actually had obstructive disease.

16 March 2010	ACS diagnosis improved by high-sensitivity troponin T assay: Researchers report that a high-sensitivity troponin T assay showed increase sensitivity for ACS detection.

5 March 2010	64-slice CT shows promise in cardiac risk stratification.: Computed tomography angiography provides important additional prognostic information, but it's role in clinical practice is still not known.

11 February 2010	Novel biomarker-guided strategy optimizes dosing in highest-risk HF patients.: Researchers report that a novel method for using natriuretic-peptide testing can optimize postdischarge therapy after acute heart-failure decompensation, reduce hospitalization, and improve outcomes.

28 January 2010	Serial NT-proBNP measurements help in elderly HF risk prediction.: Serial measurement of NT-proBNP predicts new-onset heart failure and cardiovascular mortality in elderly.

28 January 2010	TIMI score predicts ACS outcome in emergency-setting: Study results show that the TIMI risk score predicts outcomes in emergency department with suspected ACS.

15 January 2010	Ticagrelor beneficial in ACS patients undergoing invasive treatment.: Results of the PLATO trial show that the reversible P2Y12 inhibitor ticagrelor reduces death and cardiovascular events compared with clopidogrel therapy in ACS patients.

15 January 2010	Individual risk profiling for ACS patients can optimize antithrombotic treatment: Individual risk profiling of ACS patients could optimize therapeutic treatment choices.

5 January 2010	High sensitive cardiac troponin I level found to be a good prognostic marker in chronic HF: Study shows that high sensitive cardiac troponin I level is a useful prognostic marker of mortality in chronic heart failure patients.

23 December 2009	Largest meta-analysis ever reports that CRP not causal for CVD.: The largest and most comprehensive meta-analysis ever concludes that CRP is unlikely to be a causal factor for cardiovascular disease.

16 December 2009	Day and time of STEMI presentation may explain continued fibrinolytic therapy at PCI capable centers.: Research shows that a substantial number of STEMI patients still receive fibrinolytic therapy at PCI capable centers.

11 December 2009	Bleeding risk associated with AMI antithrombotic treatment increases the more antithrombotic drugs used.: Denmark researchers report in Lancet that relative risk for hospitalization for bleeding increased with all drug combinations and with each additional drug used.

3 December 2009	Prehospital triage of STEMI PCI patients independently improves outcome: Researchers report that prehospital triage significantly reduces treatment delay and improves outcomes in STEMI patients who undergo PCI.

30 November 2009	"Ischemic time" determines degree of reversible myocardial injury in PCI for STEMI.: Researchers report that the to reperfusion, beginning with symptom onset time, determines the extent of reversible myocardial injury in STEMI patients undergoing PCI.

19 November 2009	High-risk STEMI angioplasty patients benefit from GP IIb/IIIa inhibitors: Recent meta-analysis reveals that high-risk STEMI patients given adjunctive glycoprotein (GP) IIb/IIIa inhibitor therapy and undergo primary angioplasty have a reduced risk for death.

19 November 2009	Dabigatran safe in phase II ACS trial.: Data presented at the AHA 2009 Scientific Sessions shows that dabigatran when added to dual anti-platelet therapy results in a “low and acceptable bleeding rate” in AMI patients.

19 November 2009	2009 ACC/AHA focused update for STEMI management.: A must-read update for the management of acute coronary syndrome.

19 November 2009	CTA faster and cheaper than standard of care for CAD diagnosis.: Data presented at the AHA 2009 Scientific Sessions indicates that CT angiography in the emergency room can successfully triage at-risk chest-pain patients faster and cheaper than standard of care testing.

9 November 2009	Updated US and European guidelines for STEMI management compared.: Recent paper compares and contrasts the most important recommendations in recently updated US and European guidelines for STEMI management.

5 November 2009	Prehospital stroke triage "immediately successful" in increasing use of thrombolytic therapy: A citywide prehospital protocol focusing on early triage of stroke patients has significantly increased the rates of thrombolytic treatment.

29 October 2009	Guidelines for ACS triple therapy use need improved.: US researchers report that guidelines need improved for anticoagulation and dual antiplatelet agent use (triple therapy) in ACS patients.

26 October 2009	NT-proBNP is a robust predictor of atrial fibrillation development.: Results suggest that N-terminal pro-B-type natriuretic peptide (NT-proBNP) is a very robust predictor incident atrial fibrillation.

22 October 2009	New ECASS 3 analyses support use of tPA up to 4.5 hours after stroke: Additional analyses of the ECASS 3 data suggest benefit to use of tPA (alteplase) to treat stroke up to 4.5 hours after symptom onset in patients without exclusions for treatment but who miss the approved 3 hour time window.

21 October 2009	Exercise-induced ST-elevation indicates severe CAD: Study results report that Exercise-induced ST-segment elevation in chest pain patients with no prior history of MI are at a higher risk for severe CAD.

21 October 2009	Only 1/3 of heart-failure patients receive recommended aldosterone antagonists: Study reports that only 1/3 of eligible heart-failure patients are prescribed aldosterone-antagonist therapy at discharge.

19 October 2009	Pre-hospital ECG by paramedics improves STEMI reperfusion times: Findings show a pre-hospital electrocardiogram can significantly reduce time to reperfusion in STEMI patients.

19 October 2009	Emergency department chest pain patients should be treated aggressively regardless of a prior coronary artery calcium score.: MESA data shows that ED patients with chest pain should be treated aggressively regardless of a prior coronary artery calcium score.

19 October 2009	Acute heart-failure prediction model blends subjective clinical impression with objective natriuretic peptide results.: Researchers have developed a combined subjective and objective prediction model for acute heart failure patients with dyspnea.

3 October 2009	High readmission rates for heart failure and AMI: Medicare data reveals that mortality rates for AMI and heart failure vary but that readmission rates are consistently high.

29 September 2009	Biomarkers show strong mortality prediction in heart failure: Elevated levels of biomarkers C-reactive protein, B-type natriuretic peptide, and troponin T are robust and independent predictors for mortality in heart failure patients.

16 September 2009	Continued beta blockade safe in randomized acute heart-failure trial: The B-CONVINCED study reports that the common practice of discontinuing beta-blocker therapy during hospitalization for an acute exacerbation of heart failure is counterproductive.

3 September 2009	Delayed intervention in NSTE-ACS patients does not affect outcomes.: Delaying catheterization in patients with acute coronary syndromes without ST-segment elevation does not adversely impact clinical outcomes.

2 September 2009	Continued beta-blockers therapy in hospitalized acutely decompensated HF patients is supported.: Trial data supports continuing beta-blocker (BB) therapy in patients who are hospitalized for acutely decompensated heart failure (ADHF).

2 September 2009	Rapid transfer to cath lab best for remote STEMI patients: NORDISTEMI data reports STEMI patients who live in remote areas do better with thrombolysis and early angioplasty.

2 September 2009	PPIs useful with thienopyridines in ACS patients: TRITON TIMI-38 data shows that using proton pump inhibitors (PPIs) does not need to be avoided in combination with clopidogrel or prasugrel in patients with ACS undergoing PCI.

27 August 2009	New sensitive cardiac troponin assays improve MI detection: Diagnosing MI in chest pain patients could be improved with a new sensitive cardiac troponin assays.

26 August 2009	Clinical and angiographic factors contribute to gender differences in ACS mortality: Researchers show differences in 30-day ACS mortality between men and women, with STEMI death more likely in women and UA and NSTEMI death more likely in men.

25 August 2009	ACS comorbidities are barrier to evidence-based treatment: Researchers report that many ACS patients do not receive evidence-based treatments because of the presence of comorbid risk factors.

14 August 2009	CHARM data reports albumin excretion is prognostic marker in heart failure: CHARM data indicates that an increased urinary-albumin-to-creatinine ratio predicted mortality and HF hospitalization in the large heart-failure trials.

12 August 2009	Prasugrel also reduces cardiovascular events in patients on GP Iib/IIIa inhibitors: TRITON-TIMI 38 data shows that prasugrel significantly reduced the risk of cardiovascular events even in patients on GP IIb/IIIa inhibitors.

11 August 2009	Door-to-balloon time focus questioned: Study findings suggest that national campaigns focus to minimize reperfusion delays in the AMI treatment have reduced door-to-balloon times but had little impact on other performance measures or outcomes.

10 August 2009	Updated Framingham risk score increases range of cardiovascular risk: Updated Framingham risk score includes noncoronary end points widening range of predicted risks.

6 August 2009	Study questions multivessel PCI in STEMI: Study suggest that multivessel PCI does not improve survival among STEMI patients, even with cardiogenic shock.

4 August 2009	Stacking UFH on to enoxaparin should be avoided: Research finding suggest that “stacking" UFH in PCI patients already receiving enoxaparin therapy should be avoided.

1 July 2009	Biomarkers have limited benefit in cardiovascular risk prediction: Researchers report in JAMA that multiple biomarkers improved the accuracy of risk prediction very little and did not reclassify a substantial proportion of individuals to higher or lower risk categories.

26 June 2009	NSTEMI patients have greater long-term death risk than STEMI patients: Recent data suggests PCI patients with STEMI have a higher short-term risk but lower long-term risk for mortality than patients with NSTEMI.

25 June 2009	TRANSFER-AMI results support early PCI after fibrinolysis: TRANSFER-AMI results support routine early PCI compared with an ischemia-driven strategy after initial fibrinolysis in STEMI patients.

18 June 2009	Phase II results published for rivaroxaban in ACS: The oral factor Xa inhibitor rivaroxaban may reduce the risk for ischemic events after ACS.

17 June 2009	Early BNP response ‘predicts acute heart failure outcome’: Patients with reductions in BNP levels over the first days of treatment for ADHF have better survival compared with those with little or no change.

17 June 2009	MDCT may be a useful option in acute chest pain assessment: Researchers report that multidetector computed tomography may be a useful alternative in the assessment of acute chest pain for some patients.

15 June 2009	Mechanism of platelet aggregation reconsidered: Australian researchers report that shear micro-gradients play a major role in initiating the formation of stabilized platelet aggregates during the early phases of thrombus development.

5 June 2009	Elderly mis-perceived as ‘low-risk’ hampers elderly NSTE-ACS catheterization: GRACE data suggests that elderly NSTE ACS patients don't receive cardiac catheterization because they are mistakenly considered to "low risk".

22 May 2009	Door-to-balloon delays increase mortality: Researchers report that any delay in PCI door-to-balloon time for ST-elevation myocardial infarction is associated with increased mortality

21 May 2009	Early invasive strategy advantageous in high-risk NSTE ACS patients: TIMACS study reports that early invasive revascularization in patients with NSTE ACS provides little advantage over a delayed approach

20 May 2009	Novel score identifies low-risk NSTE-ACS patients: Researchers develop a novel risk score for non-ST elevation acute coronary syndromes patients who are at low risk for adverse in-hospital events

18 May 2009	Admission NT-proBNP prognostic in elderly with AMI: Researchers report that Admission NT-proBNP peptide levels retain their prognostic value in elderly people with AMI, despite being generally higher in older age groups.

30 April 2009	Failure of STEMI fibrinolysis linked to altered levels of hemostasis biomarkers: Fibrinolysis failure in STEMI is linked to higher plasma levels of tissue factor associated microparticles (TF-MP), increased thrombin production, and lower plasminogen activation.

30 April 2009	Aspirin shown to change clot properties: Researechers report that aspirin directly alters clot structure leading to the formation of clots with thicker fibers, bigger pores, and reduced rigidity, which are easier to lyse.

14 April 2009	Risk Score Predicts Bleeding in NSTEMI Patients: A risk score based on the CRUSADE registry data predicts the risk of in-hospital major bleeding in patients with NSTEMI.

2 April 2009	Troponin-I elevation may predict HF in seemingly healthy patients: Researchers report that elevated cardiac troponin-I levels are associated with a substantially increased risk for heart failure asymptomatic men.

31 March 2009	Rosuvastatin cuts venous thromboembolism risk by 43%: The lipid-lowering drug rosuvastatin reduces risk for VTE by 43% in apparently healthy people, according to the JUPITER trial investigators.

31 March 2009	Relaxin gives dyspnea relief in acute HF: Phase II trial results show that the hormone relaxin relieves dyspnea in patients with acute heart failure with normal-to-increased blood pressure.

31 March 2009	Early eptifibatide no better than delayed therapy for high-risk ACS: In high-risk ACS patients, early, routine use of eptifibatide before PCI does not improve outcomes compared to delayed use of the drug after angiography.

16 March 2009	PCI innovations have not improved major outcomes in non-acute CAD: Researchers reports that serial innovations in PCI have not improved the outcomes for non-acute coronary artery disease compared with medical therapy.

16 March 2009	Unfractionated heparin initially ineffective in STEMI: Recent study reports that despite adherence to a standard weight-based nomogram, most STEMI patients treated with UFH initially do not achieve therapeutic anticoagulation.

6 March 2009	Physician NSTE-ACS risk assessments needs improvement: When physicians risk stratify patients presenting with NSTE ACS, they succeed at identifying high risk, however, these initial risk assessments are not based on evidence-based proven standardized risk scores.

6 March 2009	Prasugrel bests clopidogrel without bleeding risk in TRITON-TIMI 28: In STEMI patients undergoing PCI, treatment with the new antiplatelet agent prasugrel significantly reduced ischemic events compared with clopidogrel, without significant increase in bleeding risks.

6 March 2009	Framingham Heart Study data after 40 years shows biomarker effect on MI epidemiology: Framingham Heart Study data over 40 years supports MI epidemiology thinking that the incidence and hospitalization rate for acute MI in the US could remain more or less consistent throughout the past several decades despite steady improvements in risk-factor management and falling MI mortality.

25 February 2009	Many cardiovascular guideline recommendations based on poor evidence: Study reports that many of the recommendations contained in ACC/AHA guidelines are based on weak evidence and expert opinion rather than strong clinical trials or meta-analyses.

23 February 2009	Q-waves identify STEMI patients at high risk for in-hospital mortality: Q-waves are becoming less common and now only occurs in a minority of patients hospitalized with ST-elevation ACS.

3 February 2009	NT-proBNP has limited utility in predicting CAD: Research suggests that NT-proBNP is more useful than some biomarkers but less useful than traditional risk factors for identifying significant coronary artery disease.

3 February 2009	ECG evidence innaccurate and inconsistent for diagnosing STEMI: Researchers report that there are troubling inaccuracy and inconsistency among electrocardiographer interpretation of ECGs from patients with ST-segment elevation and symptoms of MI.

28 January 2009	Heart failure outcomes not improved by BNP-guided therapy: Clinical trial data reports that N-terminal brain natriuretic peptide guided therapy of heart failure offers no advantages.

26 January 2009	CTA program reduces the frequency of normal findings on invasive angiograms: Researchers report that the use of a computed-tomography coronary angiography program reduces the rate of normal findings on invasive angiography tests compared with centers without such a program.

20 January 2009	Angiography notably underused in high-risk ACS patients: GRACE investigators report that many nearly half of NSTE ACS patients do not undergoing angiography.

13 January 2009	Pre-Hospital ECGs benefit STEMI patients: STEMI patients who receive a pre-hospital ECG receive more and faster reperfusion therapy and may be suffer less mortality.

8 January 2009	Pre-hospital ECGs reduce reperfusion time and may reduce mortality: Use of pre-hospital ECGs is associated with greater use of, and faster, reperfusion therapy, with a trend towards lowered mortality in STEMI patients.

8 January 2009	NT-proBNP cutoff could help HF management: Researchers identify a new prognostic threshold for the NT-proBNP that can be used to identify patients with suspected heart failure who need echocardiography.

6 January 2009	Thrombocytopenia risks highlighted for ACS patients: GRACE study shows ACS patients who develop thrombocytopenia have a greater risk for a poor outcome.

1 December 2008	H-FABP might be a novel biomarker for early AMI diagnosis: A proof-of-concept study suggests heart fatty acid-binding protein (H-FABP) may be a promising new biomarker in patients with acute chest pain.

1 December 2008	Type 2 diabetics have a heightened response to glycoprotein (GP) IIb/IIIa inhibitors.: Type 2 diabetics have hyperactive platelets resulting in a hyperprocoagulant state and a heightened response to glycoprotein IIb/IIIa inhibitors.

25 November 2008	New anti-inflammatory compound shows promise for ACS: Researchers report that a novel anti-inflammatory compound, VIA-2291, shows promise in a phase 2 ACS trial.

25 November 2008	Early antiplatelet efficacy maintained over time: Research shows that the early inhibition of platelet aggregation achieved with clopidogrel and aspirin is maintained at 1 year in patients undergoing PCI.

25 November 2008	"Facilitated" PCI show better STEMI outcomes in real world setting: Researchers report that facilitated PCI is safe for STEMI patients facing a delay for PCI of 91 to 150 minutes.

20 November 2008	Re-assessment of antiplatelet use recommended for AMI bleeding patients: Physicians should reconsider the use of antiplatelet agents in AMI patients who develop bleeding.

18 November 2008	Early GPI Use provides short and long-term benefits for STEMI patients: Early administration of GPI in STEMI patients undergoing primary PCI resulted in significantly better 2-year clinical outcomes compared to GPI administration just prior to revascularization.

17 November 2008	Thrombolysis and aspirin are strongest predictors of in-hospital mortality in STEMI patients.: Out-of-hospital thrombolysis and aspirin therapy are the best predictors of in-hospital survival for STEMI patients.

12 November 2008	New targets for TAFI inhibition reported: Researchers have uncovered new mechanisms and molecular targets for the inhibition of activated thrombin activatable fibrinolysis inhibitor (TAFIa).

12 November 2008	Early invasive management safe in NSTE ACS and improves outcomes in high-risk patients.: TIMACS investigators concluded that early invasive management is safe in patients with unstable angina or NSTEMI but overall has the same impact on the risk of death, new MI, or stroke compared with a delayed invasive strategy.

11 November 2008	New ACC-AHA Performance Measures Issued for AMI Care: The ACC/AHA have published newly revised performance measures to improve care for patients with AMI.

11 November 2008	Increasing BMI shown to be inversely correlated with plasma levels of NTproBNP in CHF: Increasing BMI shown to be inversely correlated with plasma levels of NTproBNP in CHF even in patients matched for known influencing factors.

11 November 2008	Repeat scanning rates for CT pulmonary angiography increasing: At least one-third of ED patients undergoing first-time CT pulmonary angiography have a repeat scan within 5 years.

10 November 2008	Acute hemodynamic effects may explain tolvaptan's benefits: The ECLIPSE trial suggests that tolvaptan's symptomatic benefits in ADHF may be due to the drug’s impact on filling pressures and subsequent urine output.

7 November 2008	Invasive strategy for ACS used "indiscriminately": Researchers evaluating invasive procedures for NSTE ACS report “no obvious benefit” of this strategy in a real-world setting, primarily due to incorrect patient selection.

3 November 2008	Admission CRP level useful for AMI risk-stratification: Findings suggest that admission C-reactive protein levels are a strong method of risk-stratifying patients with AMI, particularly those without ST-segment elevation.

3 November 2008	Prasugrel offers sustained reduction in ACS ischemic events: The TRITON-TIMI 38 data indicates that the potent antiplatelet agent prasugrel, provides sustained protection against cardiovascular events in ACS patients.

3 November 2008	Knowledge gap blamed for undertreatment of cardiovascular patients: Researchers report that a knowledge gap is contributing to physicians underprescribing antiplatelet drugs, ACE inhibitors, and statins to high-risk cardiovascular patients.

31 October 2008	ST2 predicts acute HF outcome: A JACC article reports that the interleukin-1 receptor family member ST2 is a powerful predictor of mortality in patients with acute heart failure.

22 October 2008	Studies highlight factors influencing quality of AMI care: Three CMAJ publication highlight how updated quality measures could reduce the influence of hospital, physician, and patient characteristics over quality of care of elderly AMI patients.

22 October 2008	Drug-loaded microparticles show early promise in MI: In animal studies, researchers have developed a method for delivering anti-inflammatory drugs directly into the heart, which reduced scarring after MI and improved cardiac function

16 October 2008	Bivalirudin infusion essential to prevent PCI catheter thrombosis: Preliminary study reports that a continuous infusion of bivalirudin anticoagulation is essential for patients undergoing PCI.

10 October 2008	Barriers to primary angioplasty for STEMI identified: A study of patients with AMI reports that some subgroups are much less likely than others to receive primary PCI.

9 October 2008	Anticoagulation absence feasible for some PCI patients: Study results challenge the notion that patients undergoing elective PCI always require anticoagulation therapy.

8 October 2008	Revascularization, not early invasive strategy, key in NSTE ACS patients: High-risk patients with NSTE-ACS who undergo in-hospital revascularization have significantly lower odds of dying or suffering a non-procedure-related MI than similar patients treated with medical therapy. However, there is no evidence that, as a general strategy, an early invasive approach is superior to conservative management in this patient group.

8 October 2008	Albumin increase in AMI predicts long-term outcomes: An early increase in urinary albumin levels in aMI patients is a strong independent predictor of long-term prognosis.

7 October 2008	Cytokine GDF-15 helps early risk-stratification of patients with acute chest pain: The cytokine growth differentiation factor (GDF)-15 is a useful biomarker in acute chest pain patients, providing prognostic information beyond standard risk markers.

25 September 2008	Alteplase may be effective up to 4.5 hours after symptom onset in patients with acute ischemic stroke: In patients who presented between 3 and 4.5 hours after the onset of stroke, clinical outcomes were modestly better in patients treated with alteplase.

23 September 2008	Bedside test for clopidogrel resistance determines early risk: A rapid point-of-care assay that measures residual platelet reactivity after clopidogrel in patients undergoing PCI can help identify those who are at increased risk of ischemic complications which could alert clinicians to need for an alternate antiplatelet strategy.

23 September 2008	Novel oral FXa shows promise for anticoagulation: A novel oral selective factor Xa inhibitor could help prevent and treat thromboembolism.

23 September 2008	A novel and sensitive D-dimer assay allows quick and accurate VTE exclusion: Researchers reports that a particle-enhanced D-dimer assay can rule out VTE in outpatients with low clinical probability of thrombosis.

17 September 2008	Cardiac troponin may be valuable screening tool in the elderly: Cardiac troponin I elevations are common in the elderly and may indicate raised cardiovascular risk and impaired cardiac function

16 September 2008	Echocardiography is cost-effective for emergency chest pain evaluation: Research suggests that myocardial contrast echocardiography is useful and cost-effective for the emergency evaluation of patients with chest pain with a nondiagnostic electrocardiogram

16 September 2008	Revascularization uncommon in ACS patients with HF: Researchers suggest that in-hospital revascularization might be useful for NSTE ACS patients with congestive heart failure

12 September 2008	Researchers suggest MI risk stratification should include multiple risk factors: A recent study reports that ACS risk stratification should include multiple risk factors rather than ST shift alone.

9 September 2008	Neutrophil/lymphocyte ratio provides additional risk stratification in ACS: Researchers report that an easily measured blood marker of inflammation provides additional prognostic information and risk stratification in patients admitted to hospital with ACS.

9 September 2008	'Get With The Guidelines' program reported to be a success: A report states that the The AHA's 'Get With The Guidelines' program is succeeding at improving the quality of care for patients hospitalized with coronary artery disease.

5 September 2008	NT-proBNP predicts sudden death and stroke in diabetics with renal disease: Researchers report that elevated NT-proBNP is a strong risk factor for sudden death and stroke in patients with Type 2 diabetes on hemodialysis.

26 August 2008	Early invasive strategy without revascularization for ACS has worse prognosis.: Recent study reports that up to one-third of intermediate- to high-risk patients with NSTE ACS receive medical management instead of revascularization, even though this strategy puts such patients at increased risk.

26 August 2008	ACUITY results show equivalent 1 year outcomes for bivalirudin monotherapy compared to GPI plus heparin.: ACUITY 1-year results indicate bivalirudin monotherapy has equivalent outcomes compared with heparin plus a glycoprotein IIb/IIIa inhibitor in ACS patients undergoing PCI.

22 August 2008	AHA advises improved pre-hospital ECG implementation: A recent AHA statement highlights the need to implement prehospital 12-lead electrocardiogram assessments to improve ACS care.

21 August 2008	Von Willebrand factor more predictive of ACS than stable angina: Study reports that von Willebrand factor is more predictive of ACS than stable angina.

21 August 2008	Presentation delay does not affect NSTE-ACS outcomes.: Researchers report that patients presenting to the hospital with NSTE-ACS soon after symptom onset have similar outcomes to those with delayed presentation.

21 August 2008	AHA statement suggests integrating prehospital ECGs into care for ACS patients: AHA statement suggests the use of prehospital ECGs to improve the quality of care delivered to patients with ST-segment-elevation MI.

20 August 2008	NT-pro-BNP predicts HF outcome in CKD patients.: NT-pro-BNP independently predicts outcome for heart failure patients with and without CKD.

19 August 2008	Early tirofiban improves PCI outcomes in STEMI patients: On-TIME 2 results show that giving a pre-hospital high bolus dose of tirofiban to patients with an STEMI before PCI improves clinical outcome.

19 August 2008	Bivalirudin Equivalent to UFH but with less bleeding: ISAR-REACT 3 data reports that in low-risk patients undergoing PCI after clopidogrel preloading, bivalirudin was equivalent to UFH, but it did significantly reduce the incidence of major bleeding.

12 August 2008	Positive troponin associated with higher mortality in unsuspected ACS detected by elective PCI.: About 6% of EVENT-registry elective-PCI patients had positive troponin tests prior to PCI and had greater than five times the one year mortality.

12 August 2008	CRUSADE data reports that medical records commonly incomplete.: Results from CRUSADE show that medical records of patients with NSTE ACS frequently lack important information like cardiac history, performance status, and a planned evidence-based medicine treatment approach.

7 August 2008	An elevated BNP predictive of poor PE outcome.: High levels of BNP in pulmonary embolism patients indicated increased risk.

6 August 2008	Elevated cTn predicts PCI outcomes at 1-year.: Study reports that CAD patients with elevated cardiac troponin at the time of PCI are have increased morbidity and mortality over the following year.

6 August 2008	Testing and treatment delays impact on ADHF outcome: Researchers report that BNP level measurement delays and treating patients hospitalized with acute decompensated heart failure are strongly linked, and may impact on patient outcomes.

6 August 2008	Improved TIMIT flow with PCI predicts ACS survival: German researchers reports that the TIMI flow rate achieved in patients with ACS treated with PCI predicts one year mortality.

5 August 2008	Even minimal biomarker increases raise CVD death risk: Researchers report that even slight increases in two cardiac disease biomarkers raise the risk for CVD death in apparently healthy individuals.

5 August 2008	Eplerenone benefits in hypertensive AMI patients confirmed: EPHESUS investigators confirm the benefit of eplerenone was limited to reduced heart failure hospitalization in AMI without previous hypertension, but the drug improved all primary endpoints.

5 August 2008	HF hospitalizations continue to rise in the USA: The number of people hospitalized for heart failure in the USA has tripled since the late 1970s.

25 July 2008	OPTIMIZE-HF highlights mortality risk predictors: Data from OPTIMIZE report that factors like older age, low systolic blood pressure, and elevated heart rate and serum creatinine increase the risk for in-hospital death in heart failure.

24 July 2008	Emergency physicians correctly diagnose emerging myocardial infarction: Emergency room physicians are correctly diagnosing emerging myocardial infarction (EMI) based on their initial clinical impression.

22 July 2008	Body surface mapping improves 12-lead ECG in AMI detection: Researchers report that 80-lead body surface mapping improves detection of AMI compared with 12-lead ECG.

17 July 2008	Copeptin is a strong predictor of HF mortality: Copeptin is a potent predictor of mortality in heart failure patients regardless of severity.

17 July 2008	MRI agent reveals thrombosis, atherosclerosis platelet behavior: Researchers say a new MRI contrast agent which uses antibodies against the platelet fibrinogen receptor activated glycoprotein IIb/IIIa allows in vivo imaging of carotid artery thrombi and atherosclerotic plaques.

2 July 2008	Invasive treatment beneficial for women with high-risk NSTE ACS: Researchers report aht women with NSTE ACS can benefit from an invasive treatment strategy if they have a high risk for cardiac events.

30 June 2008	Risk scores help identify high-risk STEMI patients: The CADILLAC, TIMI, and PAMI risk scores improve risk stratification of STEMI patients undergoing PCI.

25 June 2008	Echo indices point to PE diagnosis: Researchers have identified two transthoracic echocardiography (TTE) markers that are sensitive for the pulmonary embolism detection.

23 June 2008	Ularitide preserves renal function in decompensated HF: A phase II trials shows that a Ularitide infusion over 24 hours preserves short-term renal function decompensated heart failure patients.

20 June 2008	Elevated TpT is a predictor of poor ACS outcome: Study findings report that the biomarker TpT could be used for the prognosis of ACS patients.

17 June 2008	Door-to-Balloon Times Improve, Still Not Ideal.: AHA database shows that overall door-to-balloon times have decreased for STEMI patients undergoing PCI, the improvements have been modest, with delays persisting for elderly, women, and minorities.

17 June 2008	Bivalirudin may benefit AMI patients with cardiogenic shock: A recent study reports that AMI patients and cardiogenic shock can safely and effectively receive the anticoagulant bivalirudin during PCI.

13 June 2008	Little predictive value in CRP level measurement in ACS patients: A recent study reports that CRP measurements taken admission, discharge, and at 30 days, failed to predict the risk of death, MI, or unstable angina at one year.

5 June 2008	Novel inotropic agent for acute heart failure looks promising: Intravenous therapy with the investigational inotrope istaroxime improved various acute heart failure hemodynamic measures, apparently without serious side effects or changes in renal function,

3 June 2008	Direct ambulance admission to cath lab significantly reduces time to PCI: Researchers report that STEMI patients are more likely to reach 90-minute treatment target for primary PCI if admitted directly from the ambulance service to the cath laboratory.

2 June 2008	No role for nesiritide for acute decompensated heart failure in the ED: An 8-hour infusion of nesiritide in conjunction with standard therapy was no more effective than standard therapy alone.

2 June 2008	Physicians not adhering to HF guidelines: Many physicians are not giving heart failure patients the best evidence-based care because they are not adhering to guidelines.

27 May 2008	Lack of patient ACS knowledge shows importance of follow-up care: Patient understanding of ACS symptoms and treatment is poor, emphasizing the importance of cardiac rehabilitation and follow-up care.

22 May 2008	Researchers reports that bivalirudin id beneficial in primary PCI for STEMI: HORIZON-AMI investigators reports that benefits of anticoagulation with bivalirudin alone over heparin and routine glycoprotein (GP)IIb/IIIa inhibitors in primary percutaneous coronary intervention (PCI) extend to STEMI.

22 May 2008	Facilitated PCI does not improve STEMI outcomes: A recent study reports that facilitated PCI does not significantly improve the clinical outcomes of patients with STEMI.

21 May 2008	Internists must understand and be able to manage MI: AJM editor argues that Internal medicine specialists need to be familiar with management of AMI.

21 May 2008	Revascularization beneficial to elderly with high-risk NSTE ACS: Despite revascularization showing significant benefits irrespective of age, coronary angiography is underperformed in the elderly with high-risk non-ST-elevation acute coronary syndrome.

21 May 2008	High IL-10 levels may predict cardiovascular events in ACS: A study indicates that ACS patients are at increased risk for cardiovascular events if they have high levels of interleukin (IL)-10.

20 May 2008	Prognostic importance of restrictive filling after AMI: A meta analysis reports that restrictive filling independently predicts mortality after AMI, regardless of EF, end-systolic volume index, and Killip class.

15 May 2008	Cardiac troponin predicts acute decompensated heart failure mortality: A recent NEJM article reports that cardiac troponin elevation is associated with increased in-hospital mortality in patients with acute decompensated heart failure

15 May 2008	Multiple biomarkers can predict cardiovascular death risk: Research suggests that the use of multiple biomarkers of renal and cardiovascular abnormalities improves cardiovascular disease risk stratification.

13 May 2008	Vulnerable patients have longer delays in STEMI presentation: A study reports that STEMI patients with combined factors such as older age, female gender, Hispanic or Black race, and diabetes have much longer delays in STEMI presentation.

12 May 2008	Bivalirudin switch reduces ACS bleeding risk: Bleeding risk cut in half in ACS patients by switching from unfractionated heparin or low molecular weight heparin to bivalirudin.

9 May 2008	Cardiac troponin-based MI diagnosis supported: Researchers report that the additional patients diagnosed with MI rather than UA since the definition of MI was redefined have an even higher long-term mortality.

9 May 2008	Discrepancies between ACC-AHA and ESC anticoagulant guidelines are being criticized: Experts suggest that discrepancies in recommendations for optimal anticoagulation treatment in updated US and European ACS management guidelines are confusing for clinicians.

8 May 2008	Combination of A- and B-type natriuretic peptide provide additional AMI prognostic information: Researchers report that "midregional" pro-atrial natriuretic peptide is a strong predictor of adverse outcome after AMI, and gives complementary information when combined with measurement of the prohormone of BNP.

7 May 2008	Portable ultrasound device offers effective PE triage: A study reports effective triage using a portable ultrasound device that can accurately screen emergency department patients with dyspnea for venous thromboembolism.

1 May 2008	Transient STEMI management proposed: immediate and intense: Researchers in Israel propose that patients with transient ST-elevation myocardial infarction (TSTEMI) may benefit from immediate, intense medical therapy and an early invasive approach.

28 April 2008	Serial NT-proBNP better than clinical assessment in predicting HF prognosis: Research suggests that monitoring levels of NT-proBNP is better than clinical assessment at predicting outcome in heart failure outpatients.

25 April 2008	Point-of-care D-dimer assay rules out VTE: Researchers test a new 15-minute rapid point-of-care D-dimer assay with diagnostic performance comparable to conventional laboratory D-dimer tests.

24 April 2008	Bivalirudin monotherapy optimal for diabetic ACS patients: The ACUITY data suggests ACS patients with diabetes are likely to have more ischemia and bleeding than other patients, but these adverse events can be minimized by bilvalirudin monotherapy

17 April 2008	Heparin reduces MI at expense of minor bleeding in UA/NSTEMI: Cochrane review reports that giving acute UFH or LMWH to patients with UA and NSTEMI reduces the risk for myocardial infarction.

17 April 2008	Can B-type natriuretic peptide be a treatment rather than diagnostic marker?: A pilot study suggested that giving patients nesiritide, a human recombinant form of BNP, soon after AMIcauses increased cardioprotective biomarkers and favorable ventricular remodeling.

16 April 2008	Increasing C-reactive protein levels predict all-cause mortality: Researcher report that patients with increasing levels of the C-reactive protein (CRP) are at higher risk of death.

14 April 2008	Get With the Guidelines-based pathway improves referral to cardiac rehabilitation after AMI: Researchers report that AMI patients on a Get With the Guidelines-based clinical pathway more likely to be referred to cardiac rehabilitation

9 April 2008	STEMI patients get worse reperfusion therapy if they delay getting help: Researchers report that the longer the delay between symptom onset and presentation, the less likely STEMI patients are to receive reperfusion therapy, and the longer those who are reperfused wait before they receive the treatment.

9 April 2008	Troponin levels predict short-term PE-specific mortality: Cardiac troponin I levels could help guide treatment for pulmonary embolism with high levels being associated with an increased short-term risk of thromboembolism-specific mortality.

2 April 2008	ECG transmission to mobile phones can cut PCI times: 12-lead ECG transmission from the ambulance to an attending cardiologist's mobile telephone may cut the time to PCI by more than an hour for STEMI patients.

28 March 2008	Enhanced ECG could help in decision for thrombolytic therapy or PCI: Researchers have developed a risk prediction model that could aid emergency care teams decide whether a patient with STEMI should receive thrombolytic therapy or undergo PCI

27 March 2008	Concomitant markers improve prediction of renal-dysfunction-related CV risk: Researchers suggest measuring both urinary albumin excretion and estimated glomerular filtration rate could improve assessment of patients' cardiovascular (CV) risk.

26 March 2008	Acute PE triage could benefit from Shock Index and ECHO findings: US researchers report that patients with acute pulmonary embolism with a Shock Index of at least 1 or a systolic pulmonary artery pressure above 50 mmHg have a greater chance of dying in hospital

20 March 2008	Preloading Clopidogrel improves post-PCI perfusion in STEMI patients: Researchers report that giving STEMI patients a clopidogrel loading dose before PCI significantly reduces post-procedural cardiovascular events

19 March 2008	NT-proBNP marker helps identify high-risk ACS patients: Researchers report that increased levels of N-terminal pro-brain natriuretic peptide above a certain threshold identify patients with high risk ACS and normal troponin levels

12 March 2008	Acute heart failure patients delay seeking medical care: Actue heart failure patients that seek early treatment have better outcomes, however, most patients delay seeking help.

3 March 2008	BNP adds prognostic information in absence of ST deviation or troponin elevation: NT-proBNP provides additional prognostic information to clinical history and exercise testing in patients with chest pain without ST-segment deviation or elevated troponins

28 February 2008	CRP and WBC count independently predict STEMI outcomes: Recent research reports that CRP levels predict reinfarction and 1-year mortality in STEMI patients, while white blood cell count indicates infarct size

28 February 2008	Too many STEMI patients not being reperfused: GRACE researchers report that despite PCI use and mortality rates in STEMI patients improving, way too many patients still receive no reperfusion

26 February 2008	AHA urges greater attention to hyperglycemia in patients with ACS: An AHA Scientific Statement stresses the need for a national effort aimed at addressing hyperglycemia in patients hospitalized with ACS.

26 February 2008	ECG interpretation skills cited as reason why emergency reperfusion not given to STEMI patients: Data from the EDQMI study reveals that one-fifth of eligible reperfusion patients are not given reperfusion because of clinicians' inability to correctly interpret ECG findings and identify correct patients.

19 February 2008	Size of PE can alter D-dimer test accuracy: Researchers report that the accuracy of a D-dimer tests for PE may be affected by the size of thrombotic burden.

14 February 2008	OASIS trial reports fondaparinux best for STEMI reperfusion: The OASIS trial reports that acute STEMI patients who undergo reperfusion benefit from the factor Xa inhibitor fondaparinux treatment.

13 February 2008	Fondaparinux shows benefit found for non-reperfusion STEMI patients: Recent study reports that the selective factor (F)Xa inhibitor fondaparinux is an effective anticoagulant for STEMI patients with contraindications to reperfusion therapy and are at risk for ischemic events

12 February 2008	Prasugrel appears to inhibits platelet aggregation, activity, and coagulation: Researechers report that prasugrel appears to inhibit platelet coagulation and platelet aggregation and activity

12 February 2008	Cardiac catheterization 'underused' in NSTE ACS patients: Canadain researchers report that many NSTE ACS patients are not referred for cardiac catheterization because of a misconception that they are not a high enough risk

6 February 2008	Possible 'clopidogrel rebound effect' in patients with ACS: A JAMA article reports that ACS patients who stop clopidogrel therapy are at greater risk for adverse events in the 90 days after treatment withdrawal.

25 January 2008	LMWH benefits real world STEMI patients: A study of "real world" patients demonstrates that LMWH is more effective than UFH for the treatment of acute STEMI patients.

22 January 2008	Low-dose aspirin supported in STEMI treated with fibrinolytics: Researchers report that an initial aspirin dose of 162 mg may be just as effective and safe as the higher dose of 325 mg in STEMI patients undergoing fibrinolytic therapy.

17 January 2008	Pre-hospital referral to primary PCI reduces door-to-balloon times: Canadian researchers report that pre-hospital referral of STEMI patients for primary PCI by paramedics has some clear advantages over the usual emergency referral procedure when a systematic PCI policy is adopted.

16 January 2008	Biomarkers of hemodynamic stress, renal function, and inflammation predict secondary CV risk.: Researchers report that biomarkers of hemodynamic stress, renal function, and inflammation provide greater discrimination for cardiovascular risk in patients with established CAD.

4 January 2008	ECG misdiagnosis linked to increased stemi mortality in STEMI: Researchers report that acute care physicians’ interpretation of EKG's of suspected ACS patients differs from core-lab results, highlighting that unrecognized STEMI is associated with increased mortality.

2 January 2008	NTproBNP better than TIMI risk score at death prediction after STEMI: Research reports NTproBNP predicts mortality better than does TIMI risk score in patients with STEMI

21 December 2007	Treatment guideline non-adherence increases mortality after acute MI: A recent study suggests that non-adherence to treatment guidelines appears to contribute to high mortality rates after AMI in patients with diabetes

19 December 2007	Unnecessary angiographies common in suspected STEMI patients: Research reports that patients with suspected STEMI often referred for cardiac catheterization when it's not necessary

19 December 2007	Concerns raised about PE over-diagnosis with CTPA: CTPA is a feasible alternative to ventilation–perfusion lung scanning for ruling out PE

14 December 2007	Thrombocytopenia predicts poor ACS outcome: Researcher report that thrombocytopenia in patients with NSTE ACS given heparin is a rare but significant prognostic risk factor.

12 December 2007	Atypical ACS presentation in women challenged: Findings recently published challenge the idea that women with ACS are more likely to present with "atypical" symptoms.

7 December 2007	Growth-differentiation factor (GDF)-15 predicts STEMI mortality risk: STEMI patients with high levels of growth-differentiation factor -15 are at increased risk for death.

3 December 2007	Invasive strategy supported in elderly NSTE ACS patie: ACOS investigators report that elderly NSTE ACS patients may have better outcomes if treated by an invasive instead of a conservative approach.

30 November 2007	New cardiac biomarker helps identify high-risk ACS sooner: Researchers report that a new test using the heart type fatty acid-binding protein (H-FABP) biomarker can identify ACS patients who have a poor prognosis but whose troponin assay does not show any sign of myocardial damage.

28 November 2007	GIK provides no benefit and may actually cause early harm in STEMI: Infusion of glucose, insulin, and potassium into STEMI patients immediately after hospital arrival does not provide any benefit, and may actually cause harm.

28 November 2007	New fusion protein improves anti-thrombotic activity: An experimental study reports that the novel bifunctional fusion protein SFH may be a potent alternative to current fibrinolytics and plasminogen activators

26 November 2007	Treatment delays in reperfusion therapy increase STEMI mortality: Study findings show that STEMI patients who experience long reperfusion therapy delays are at increased risk for death at 6 months

21 November 2007	MCP-1 prognostic marker for ACS: US researchers have identified a novel biomarker monocyte chemoattractant protein (MCP)-1 that has prognostic value in both the acute and chronic phases after ACS.

13 November 2007	TIMI Risk score helps guide STEMI treatment decisions: A large study reports that simple risk score based on the Thrombolysis in Myocardial Infarction (TIMI) grade is useful for predicting enoxaparin benefit as an adjunct to fibrinolysis in patients with STEMI

6 November 2007	Program coordinating hospitals and emergency systems improves STEMI care: The RACE study reports that STEMI patients could benefit from the implementation of a coordinated statewide program to improve access to coronary reperfusion therapy

2 November 2007	Reduced anticoagulant exposure in ACS/NSTEMI effective: Researchers reports that reduced-dose enoxaparin plus dual-antiplatelet therapy, followed by triplet-antiplatelet therapy alone during subsequent PCI, appears to be effective for ACS / NSTEMI patients

31 October 2007	ACS in-hospital major bleeding risk reduced: Researchers report that despite increasing use of antithrombotic and antiplatelet agents in patients with ACS, rates of in-hospital major bleeding has fallen

29 October 2007	Shock does not affect long-term STEMI outcome: Patients who survive cardiogenic shock after AMI have similar long-term outcomes as patients without shock.

26 October 2007	Better outcomes for patients treated with ANP after MI: Two trials report that patients given atrial natriuretic peptide after MI have a smaller infarct size, fewer reperfusion injuries, and improved left ventricular ejection fraction.

26 October 2007	Fondaparinux treatment reduces PCI major bleeding: The OASIS-5 trial shows that fondaparinux significantly reduces the risk of major bleeding compared with LMWH therapy in PCI patients for MI or unstable angina.

23 October 2007	Female gender reported to be an independent risk factor for bleeding, death in MI treated with fibrinolytics: A recent study reports that being female is an independent risk factor for death and bleeding complications among myocardial infarction patients treated with fibrinolytic therapy.

22 October 2007	ECG variables predict new-onset HF: Study reports that ECG recordings could be used to identify individuals at risk for heart failure.

22 October 2007	Universal definition of MI published: The revised universal definition of myocardial infarction has been released, an experts hope it is the first step in global standardization of a number of cardiovascular diseases.

18 October 2007	HIT risk low for both UFH and LMWH treatments: A recent meta-analysis reports that, contrary to popular belief, using low molecular weight heparin will not reduce a patient's risk of developing heparin-induced thrombocytopenia compared with unfractionated heparin treatment.

18 October 2007	Research highlights campaign to reduce door-to-balloon times: A New England Journal of Medicine article outlines ways to minimize time to treatment with primary percutaneous coronary intervention.

18 October 2007	64-slice CT reliable to exclude CAD in patients with non-ST ACS: Researchers report that non-ST elevation acute coronary syndrome patients can undergo 64-slice computed tomography coronary angiography to effectively rule out the presence of significant coronary artery disease.

10 October 2007	ECG score predicts PE prognosis: Researchers have developed, and successfully used, an ECG scoring system to stratify patients with PE by their risk for morbidity and mortality.

2 October 2007	Troponin predicts cardiac risk in ACS patients: Researcher demonstrates that stabilized patients after non-ST acute coronary syndrome are more likely to die if they have persistent elevated troponin levels

2 October 2007	Heparin simplified for easier production: Scientists have found that the heparin molecule can be simplified with no loss of function, which could allow for easier production of the anticoagulant agent.

27 September 2007	AHA recommendations could help increase study of cardiac arrest, stroke, and emergency research: New AHA recommendations for clinical trials in patients with life-threatening conditions may help reverse a sharp decline in the USA of studies in cardiac arrest and stroke victims.

27 September 2007	A recent study shows AMI prognosis worse with ST-depression versus non-ST: A recent study shows that AMI patients with ST-segment depression have a worse prognosis than those with non-specific electrocardiographic signs (non-ST).

24 September 2007	Health status outcomes similar for UA and MI patients: Researchers report that patients with unstable angina have similar or worse health status and cardiac rehospitalization outcomes compared with patients with myocardial infarction.

24 September 2007	Primary angioplasty benefits depend on time delay: A meta analysis reveals that the benefits of primary angioplasty over fibrinolysis in STEMI are related to the reperfusion delay associated with angioplasty.

21 September 2007	Plaque morphology influences outcomes in anterior MI: Research suggests plaque rupture and embolization contribute to the progression of myocardial damage in patients with anterior myocardial infarction.

21 September 2007	Fondaparinux better than enoxaparin for NSTE ACS patients with renal dysfunction: OASIS-5 results show that fondaparinux is more effective (and better tolerated) than enoxaparin for patients presenting with NSTE ACS and renal dysfunction

14 September 2007	Idraparinux shown to be comparable to standard DVT treatment: Research shows that the long-acting activated factor X inhibitor idraparinux is effective for the treatment of deep vein thrombosis and prevention of further episodes.

14 September 2007	GRACE results show increased medical therapy use in AMI patients: GRACE results show use of both single and combination medical therapy in patients hospitalized with AMI increased from 2000 through 2005.

13 September 2007	Interesting observations from the ACUITY one-year analysis.: Data reported at the ESC included a trend toward a lower mortality in the bivalirudin group by 12 months and new data suggesting that major bleeding is related to the death rate at one year.

10 September 2007	Is GDF-15 a better marker than natriuretic peptides in heart failure?: Researchers report that growth differentiation factor (GDF)-15 may be a novel biomarker for the risk of death in patients with chronic heart failure, providing prognostic information beyond that of established markers.

10 September 2007	Recombinant protein could fight coronary thrombosis: A new study finds that arterial thrombosis could be prevented by a recombinant protein that blocks platelet aggregation induced by von Willebrand factor binding.

4 September 2007	CARESS trial supports immediate transfer for PCI after lysis: CARESS investigators report that STEMI patients admitted to hospitals where they cannot undergo primary PCI benefit from being transferred to a PCI center immediately after receiving thrombolytic therapy,

31 August 2007	Cardiac troponin I levels reveal CAD and predict further revascularization: Researchers report that measuring baseline cardiac troponin I levels helps to detect CAD and predict the need for further revascularization during follow-up.

29 August 2007	rFVIIa is antidote to newer anticoagulant drugs: Recent findings indicate that recombinant activated factor VII (rFVIIa) may reverse excessive bleeding in patients treated with anticoagulants.

28 August 2007	AMI patients with positive troponin test less likely to receive appropriate treatment compared to CK-MB-positive patients.: Guideline-based therapies remains underused in older AMI patients admitted to the hospital and testing positive for troponin.

24 August 2007	Rapid D-dimer assay shows promise for PE diagnosis: A new D-dimer assay appears to be well-tolerated and effective for ruling out pulmonary embolism in symptomatic patients.

23 August 2007	Prehospital triage improves outcome of STEMI complicated by cardiogenic shock: Recent study reports that prehospital triage is associated with a better outcome in patients with ST-elevation myocardial infarction complicated by cardiogenic shock.

14 August 2007	TIMI trials reports that diabetics face higher 30-day and one-year mortality after UA/NSTEMI and STEMI: TIMI investigators report that diabetics with UA/NSTEMI or STEMI face a much higher risk of mortality in first year of their ACS diagnosis than nondiabetics.

14 August 2007	New ACC/AHA UA/non-STEMI guidelines discuss new anticoagulants, diagnostic tests, and physician decision-making.: The ACC/AHA have updated the 2002 guidelines for the management of patients with UA/NSTEMI, including new recommendations for initial diagnostic tests, duration of antiplatelet therapy, new anticoagulants, and more.

9 August 2007	Acute beta blocker therapy effective for NSTEMI patients: CRUSADE data reports that NSTEMI patients are likely to have better clinical outcomes if they receive acute beta blocker therapy.

7 August 2007	NT-proBNP levels prove 'useful for monitoring stable heart failure': Spanish researchers report that NT-proBNP levels in plasma and urine remain steady during follow-up of stable heart failure patients, which suggest that measuring levels of the protein may be a useful tool for patient monitoring.

6 August 2007	Many eligible patients still do not receive emergency reperfusion: A recent study indicated that 10% of ideal patients still do not receive acute reperfusion therapy, despite overall improvements in use of the treatment over the past decade.

2 August 2007	Coordinated care streamlines MI patient reperfusion: Recent research reports that a "coordinated system of care" enables myocardial infarction patients living as far as 150 miles from a specialist center to receive reperfusion therapy within the optimal treatment time frame.

1 August 2007	PCI benefits extended by an integrated, rapid transfer system: Researchers reports that an integrated rapid transfer system can extend the benefits of PCI to STEMI patients with who live long distances from a specialist center.

26 July 2007	Alternative DTI monitoring approach shows promise: Researchers report that they have validated an alternative method for monitoring direct thrombin inhibition therapy for use in patients unsuited to standard approaches.

24 July 2007	CRUSADE analysis shows that improved enoxaparin dose adherence is needed.: Recent CRUSADE Trial data shows that adherence to recommended doses of enoxaparin would reduce adverse effects and improve short- and long-term outcomes in non-ST-elevation acute coronary syndrome patients.

24 July 2007	Heart failure patients show benefit from OPTIMIZE-HF trial: The OPTIMIZE-HF US national initiative to improve the care of heart failure patients reports effectiveness at increasing use of evidence-based therapy, adherence to key performance measures, and reducing the length of hospital stays.

23 July 2007	Circulating proteins predict post-STEMI intravenous thrombolysis outcomes: Investigators report that patients who receive intravenous thrombolysis within 6 hours of ST-segment elevation myocardial infarction have an increased risk of intravenous thrombolysis failure and 30-day cardiac death if they have high circulating levels of both cardiac troponin I and high-sensitivity C reactive protein.

21 July 2007	BNP and cTnT elevations predict poor chronic HF outcome: Research reports that patients with chronic heart failure are more likely to need hospitalization, cardiac transplantation, or to die if they have increased levels of cardiac troponin T or B-type natriuretic peptide.

11 July 2007	High troponin levels predict poor PE outcome: In a meta-analysis published in Circulation, researchers report that high serum troponin levels predict poor prognosis in patients with pulmonary embolism.

10 July 2007	AMI mortality lower at 'America's Best Hospitals': Researchers report that patients admitted for AMI to US hospitals ranked as the nation's best by the magazine US News & World Report are less likely to die within 30 days than those admitted to unranked hospitals.

5 July 2007	Novel inflammatory marker for CAD: myeloperoxidase (MPO)?: Scientists report the first prospective study to show that raised serum levels of a novel marker, myeloperoxidase, predict the future risk of coronary artery disease in healthy individuals. The researchers believe that MPO could become a new marker for use in clinical practice.

29 June 2007	The IMPROVE-CHF stidy reports that a natriuretic peptide test adds to ED diagnosis of HF and can lower costs.: The IMPROVE-HF study reports that the addition of natriuretic peptide testing to the traditional clinical evaluation of patients with dyspnea of suspected cardiac origin cut the duration of emergency department visits by one-fifth and reduced the 60-day risk of rehospitalization by about a third, all while lowering costs

27 June 2007	Nemotode anticoagulant helps with nSTE-ACS care: A recent study suggests that an anticoagulant protein derived from a hookworm could help reduce ischemic complications in patients with non–ST-segment elevation acute coronary syndrome (nSTE-ACS).

20 June 2007	STEMI and NSTEMI have similar prognoses: Researchers report that STEMI and NSTEMI patients have similar prognoses, and similar correlates of adverse outcomes.

18 June 2007	PE index accurately gauges mortality risk: The Pulmonary Embolism Severity Index (PESI) can accurately identify patients at low risk of mortality, clinicians say, raising the possibility of outpatient care.

13 June 2007	D-dimer predicts PE prognosis: A recent study indicates that D-dimer concentrations reflect severity of pulmonary embolism.

13 June 2007	Protocol significantly reduces door-to-balloon time: Research indicates that door-to-balloon times have been reduced by up to an hour for MI patients at one hospital after the introduction of a novel protocol including rapid activation of the catheterization laboratory.

21 May 2007	Proven treatments underused in patients with ACS and HF: Epidemiological research indicates that diastolic heart failure is common in patients with acute coronary syndromes and is associated with undertreatment and a poor prognosis.

8 May 2007	Admission BNP levels predicts ADHF in-hospital mortality: Patients with acute decompensated heart failure with elevated BNP levels on admission to hospital are at increased risk of dying in hospital.

2 May 2007	ACS treatment advances have improved outcomes: The GRACE investigators report that recent changes in the recommended treatments for patients hospitalized with ST-elevation myocardial infarction and non-ST-elevation acute coronary syndromes (NSTE-ACS) have led to reduced rates of heart failure, MI, and death.

2 May 2007	Levosimendan does not improve acute HF outcomes: A recent study in JAMA reports that levosimendan does not improve survival in patients with acute decompensated heart failure (ADHF) when compared with conventional dobutamine treatment.

25 April 2007	ACS guideline adherence benefits even very elderly patients: Research reports that patients 90 years or older presenting with acute coronary syndromes benefit from recommended therapy but are less likely to receive it than younger patients.

19 April 2007	Composite endpoints in cardiovascular trials questioned.: Researchers suggest that the use of composite endpoints in cardiovascular trials can exaggerate the impact of treatment.

18 April 2007	BNP biomarker-guided strategy improves CHF outcomes: Researchers report that a brain natriuretic peptide-guided strategy reduces the incidence of death and the need for hospital admission in patients with chronic heart failure.

17 April 2007	Increased NT-proBNP levels predict mortality in non-STE-ACS: Research indicates that elevated plasma N-terminal pro-brain natriuretic peptide is a strong independent predictor of 1-year mortality in patients with non-ST-elevation ACS.

16 April 2007	Some patients misdiagnosed in rapid access chest pain clinic: Researchers report, some patients attending rapid access chest pain clinics are being misdiagnosed with non-cardiac chest pain, suggesting the diagnosis and treatment of patients who present with chest pain for the first time needs to be improved.

10 April 2007	MDCT improves diagnosis in patients with chest pain of uncertain origin: Researchers report that multidetector computed tomography accurately detects ACS in patients presenting to the emergency department with chest pain of unknown origin.

23 March 2007	Risk score helps identify high-risk non-ST elevation patients: A recent study proposes a practical approach to assessing the prognosis of patients with non-ST-segment elevation acute chest pain.

21 March 2007	Everyday use of LWMH bridging in question.: Research data suggests that patients may be receiving low molecular weight heparin LMWH therapy as a bridge to oral anticoagulation for longer than is necessary.

19 March 2007	ACUITY-PCI: Bivalirudin benefits ACS patients undergoing PCI: A subgroup analysis of the ACUITY trial shows that bivalirudin alone can safely replace the combination anticoagulation regimen of heparin and glycoprotein IIb/IIIa inhibitors in ACS patients undergoing percutaneous coronary intervention.

13 March 2007	Prothrombotic biomarkers linked to STEMI outcomes: Recent research reports that levels of certain biomarkers can predict spontaneous recanalization in patients with acute myocardial infarction.

12 March 2007	ICTUS: No benefit from early invasive strategy in NSTE ACS: An early invasive revascularization strategy produces similar results to a more selective revascularization approach in patients with non-ST segment elevation acute coronary syndromes long-term follow-up of ICTUS shows.

26 February 2007	GP IIb/IIIa blockers reduce mortality in primary PCI?: A new registry study suggests mortality may be reduced by about 40% with the use of one of these agents, and although most patients are receiving them, the elderly are missing out.

20 February 2007	Multislice CT angiography improves efficiency, lowers costs, in emergency-room evaluation of chest pain: A new randomized trial suggests that for patients presenting to emergency departments with chest pain, multislice computed tomography angiography (CTA) using a 64-slice scanner can definitively establish or rule out coronary disease.

16 February 2007	ACUITY Timing trial reveals delicate risk–benefit balance: The ACUITY investigators report that deciding when to administer a glycoprotein IIb/IIIa inhibitor in patients with acute coronary syndromes involves careful assessment of the likely risks and benefits.

14 February 2007	Troponin not enough for MI diagnosis: Researchers urge that the diagnosis of myocardial infarction should still be made on the basis of clinical presentation and not simply because of troponin elevation.

9 February 2007	Risk stratification not applied in selecting patients for revascularization: Analysis of GRACE data suggests that the decision to perform revascularization does not relate to a patient’s risk status in clinical practice, but instead to referral practice and angiographic findings.

26 January 2007	Non-invasive MRI may predict heart attack risk: Investigators have developed a tool for measuring the molecular activity of blood vessels that might help identify patients at risk of heart attack and stroke.

26 January 2007	Enoxaparin helps prevent silent AMI and ischemia: Two large trial sub-analyses report that enoxaparin is superior to unfractionated heparin in preventing both silent and symptomatic acute myocardial infarction

23 January 2007	Modern classification for bleeding proposed: Researchers have developed a novel means of classifying bleeding events in clinical trials, which may assesses minor events more accurately than existing systems.

19 January 2007	Platelet infusion reverses clopidogrel effect: Investigators have calculated the degree of platelet infusion needed to reverse the effects of clopidogrel.

19 January 2007	ACS registry reveals marked variations in heparin use: The GRACE registry data has shown that there are substantial variations in heparin use among patients with acute coronary syndromes, with many patients receiving no antithrombotic therapy at all.

15 January 2007	Assay reveals platelet activation occurs even after clopidogrel: A novel point-of-care test reveals that platelet activation may still occur even after the use of clopidogrel.

10 January 2007	Biomarker may predict CV morbidity and mortality in CHD: A recent study reports that testing levels of NT-proBNP can predict the risk of cardiovascular events and death in patients with stable coronary heart disease.

3 January 2007	Platelet function predicts 1-year STEMI outcomes: Recent analysis of the STRATEGY trial data suggests that platelet reactivity can be used to predict patients' response to treatment and clinical outcomes following primary percutaneous coronary intervention.

3 January 2007	APEX AMI study highlights PCI inflammation issue: Results of the APEX AMI trial published in JAMA opening up discussion of the potential of adjunctive therapies to improve primary percutaneous coronary intervention outcomes.

2 January 2007	GP IIb/IIIa inhibition reduces inflammatory markers after stenting: The CLEAR PLATELETS study reveals that adding the glycoprotein IIb/IIIa inhibitor eptifibatide to high or standard loading doses of clopidogrel helps prevent the release of inflammatory markers after elective stenting.

22 December 2006	Risk factors for acute heart failure described: Research on acute heart failure had defined independent risk factors for the development of acute heart failure (AHF) include age, male gender, lower systolic blood pressure on admission to hospital, elevated C-reactive protein, and renal dysfunction.

22 December 2006	Multiple Biomarkers for the Prediction of First Major Cardiovascular Events and Death: Framingham Heart Study data reveals that assessment of currently used biomarkers provides only slight improvements in predictions of the risk of death and major cardiovascular events when used in conjunction with traditional risk factors.

15 December 2006	N-terminal pro-B-natriuretic peptide prognostic marker in stable CHD: A recent study reports that N-terminal pro-B-natriuretic peptide (proBNP) may be a clinically useful prognostic indicator of subsequent risk of cardiovascular events in patients with stable coronary heart disease.

13 December 2006	Many NSTEMI patients not receiving beneficial early beta-blocker therapy: Researchers report that many patients with non-ST-segment elevation myocardial infarction (NSTEMI) do not receive early beta-blocker therapy and are missing out on the benefits it can give.

12 December 2006	Novel digoxin dosing method in heart failure developed: US scientists propose recommendation for digoxin in heart failure patients and a nomogram for determining the initial dose of the drug in order to take advantage of the drug's altered therapeutic window.

6 December 2006	High admission plasma aldosterone increases risk of death in STEMI: Recent research suggests that plasma aldosterone levels on admission to hospital are associated with early and late adverse outcomes, including mortality, among patients with ST-segment elevation myocardial infarction.

6 December 2006	ACS recurrence predicted by platelet function test: Research data suggests that platelet function assessed with a simple, point-of-care analyzer can identify patients with acute coronary syndrome (ACS) at risk of recurrence.

4 December 2006	Cardiac troponin T a marker of infarct size in MI: A recent study indicates that levels of cardiac troponin T following ST/non-ST segment elevation myocardial infarction provide a reliable estimate of the infarct mass.

1 December 2006	Adiponectin 'protects against acute coronary syndromes': Mayo Clinic researchers report that adiponectin levels are inversely associated with the risk of acute coronary syndromes.

29 November 2006	D-dimer test informs on ACS without cardiac enzyme elevation: Assessing D-dimer levels Recent study suggests that using enzyme-linked immunosorbent assay can provide useful clinical data on hospital admission for patients with an acute coronary syndrome but normal cardiac enzymes.

27 November 2006	Bivalirudin - a new antithrombotic option in ACS patients: The ACUITY trial shows that the anticoagulation drug bivalirudin is as effective as standard combination therapy, and results in less bleeding, in patients with acute coronary syndromes.

27 November 2006	EuroHeart Failure Survey II describes acute heart failure population: Results of the EuroHeart Failure Survey (EHFS) II provide a important description of patients presenting with acute heart failure, and reveal some important differences with the more extensively documented population of chronic HF patients.

21 November 2006	Cardiac risk underestimated for dialysis patients: US scientists report that using the standard Framingham score for predicting cardiovascular disease risk substantially underestimates the true rate of coronary heart disease among patients with end-stage renal disease.

21 November 2006	Medicaid ACS patients receive poorer care than private patients in USA: The CRUSADE study reveals that Non-ST segment elevation acute coronary syndrome patients in the USA who have Medicaid insurance are less likely to receive recommended care than those with private insurance coverage.

15 November 2006	Bivalirudin proposed as alternative PCI anticoagulant: Researchers claim that bivalirudin should be considered as an alternative anticoagulant to unfractionated heparin during percutaneous coronary intervention for acute myocardial infarction.

14 November 2006	No advantage of late angioplasty over medical therapy for MI: Results of the Occluded Artery Trial indicate that late percutaneous coronary intervention does not reduce major cardiovascular complications compared with optimal medical therapy in stable myocardial infarction patients with persistent total occlusion of the infarct-related artery.

14 November 2006	D2B study identifies strategies to shorten door-to-balloon times: Researchers have identified key hospital strategies that significantly reduce the interval between arriving at hospital and intracoronary balloon inflation, or "door-to-balloon" time, in patients undergoing primary percutaneous intervention.

3 November 2006	B-type natriuretic peptide predicts death in women: Recent study findings suggest elevated BNP plasma levels are a stronger predictor of death in women than in men.

31 October 2006	Eptifibatide benefits in PCI improved by early administration: Researchers report that a strategy of early administration of eptifibatide in the emergency department, rather than in the cardiac catheterization laboratory, results in superior epicardial flow and myocardial perfusion before primary percutaneous coronary intervention.

23 October 2006	Ischemia grade can help choose reperfusion strategy: Research suggests that patients presenting late with ischemia grade 3 ST-elevation myocardial infarction may be at increased risk of reinfarction if they are treated with thrombolysis instead of PCI.

23 October 2006	Risk calculator aids ACS management: GRACE study findings show pioneering computer software helps physicians to effectively manage patients admitted to hospital with acute coronary syndrome.

10 October 2006	Key factors in optimal care delivery to NSTE ACS patients identified: A US survey indicates that Strategies that have full support of the hospital administration, focus on collaboration between emergency doctors and other health care providers, and use a common management algorithm are most successful for improving care and outcomes of non-ST-segment elevation acute coronary syndromes.

6 October 2006	Study supports rescue PCI, early PCI after fibrinolysis: Results of a meta-analysis support the strategies of rescue PCI after failed fibrinolysis, and systematic early PCI regardless of fibrinolysis outcome, in patients with STEMI.

3 October 2006	Excessive GP IIb/IIIa dosing increases bleeding risk in women: Analysis of CRUSADE data reveals that up to a quarter of the increased risk of bleeding associated with glycoprotein IIb/IIIa inhibitor use among women with non-ST elevation acute coronary syndromes compared with men is the result of excessive dosing.

27 September 2006	ACS benefit from early, intensive statin therapy: Early, intensive statin therapy in patients with an ACS is associated with a decreased risk of death and cardiovascular events after 4 months of treatment, a meta-analysis of trials has shown.

27 September 2006	Enoxaparin benefits over UFH shown in high-risk ACS patients: Antithrombin pre-treatment before randomization may have an impact on study drug effects, with results from a multinational study suggesting that consistent enoxaparin therapy may be superior to unfractionated heparin in reducing death or nonfatal myocardial infarction in high-risk patients.

20 September 2006	Biomarkers predict early revascularization outcome in NSTE-ACS: International researches report that levels of troponin T and N-terminal pro-B Type natriuretic peptide could be used to select non-ST-elevation acute coronary syndrome patients suitable for early coronary revascularization.

18 September 2006	Protein clue to heart attack risk in ACS patients.: GUSTO-IV sub-study reports that high blood levels of two specific proteins are associated with a significantly increased risk of potentially fatal heart attacks in people with ACS.

11 September 2006	STEEPLE suggests possible PCI benefits with enoxaparin: IV low-dose enoxaparin may be associated with a reduced risk of bleeding compared with unfractionated heparin in patients undergoing elective PCI.

5 September 2006	Enoxaparin anticoagulation best for PCI STEMI patients: Recent finding report that the low molecular weight heparin enoxaparin offers significant clinical benefits for patients undergoing PCI for acute ST-segment elevation myocardial infarction.

9 August 2006	Hospital CRP does not reflect later ACS outcomes: nationwide, cross-sectional, French study suggests that C-reactive protein levels prior to hospital discharge poorly reflect 1-year outcomes in patients with acute coronary syndromes.

3 August 2006	ACS in-hospital fatality varies by region 03 August 2006: In-hospital mortality from acute coronary syndromes varies widely across the USA, although the reasons are not clear.

11 July 2006	CRP value in doubt: A large study suggests that C-reactive protein assessment may not provide additional prognostic information over traditional cardiovascular risk factors.

10 July 2006	AMI prevalence linked to its definition: A recent study suggests that changing definitions for acute myocardial infarction have dramatically increased the frequency with which the condition is diagnosed.

5 July 2006	AMI hospital measures relate poorly to mortality: A recent JAMA article reports Hospital performance measures for acute myocardial infarction explain little of the variation in short-term mortality between these institutions.

29 June 2006	Enoxaparin recommended for non-ST-elevation ACS patients: Research indicates that patients with non-ST-elevation acute coronary syndrome who are treated with enoxaparin are significantly less likely to die in hospital than those given heparin.

11 June 2006	Chest pain with normal angiography 'not benign': Researchers report that women with persistent chest pain despite normal coronary arteries are at increased risk of cardiovascular events.

11 June 2006	Three antiplatelets may have edge over two: The ELISA-2 trial findings suggest that triple antiplatelet therapy may offer some additional benefits to dual therapy in patients with a non-ST elevation acute coronary syndrome.

11 June 2006	Fast angioplasty benefits all patients: NRMI data shows that patients presenting late with ST-elevation myocardial infarction have as much to gain from speedy angioplasty as those treated soon after the onset of symptoms.

11 June 2006	Raised BNP identifies high-risk STEMI: An ASSENT 2 substudy reveals that levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) on hospital admission independently predict long-term mortality in patients with ST-elevation myocardial infarction.

2 June 2006	WBSPC shows benefits in glycoprotein IIb/IIIa antagonist assessment: Researchers report white-blood single-platelet counting assay is a more discriminating measure of the effects of tirofiban in patients with ACS than other techniques, and may be useful for monitoring the effects of glycoprotein IIb/IIIa antagonists, say UK researchers.

2 June 2006	Simple blood tests predict AMI in-hospital mortality: Researcher claim that combining the results from two routine blood tests offers useful extra prognostic information in patients hospitalized with acute myocardial infarction.

1 June 2006	'Gray-zone' BNP tied to heart failure prognosis: The REDHOT trial reports that patients with established heart failure and BNP levels in the "gray zone" have better outcomes than those with higher levels, even if their disease severity is perceived as identical.

31 May 2006	Thrombolysis before hospital improves outcomes: A real-world study suggests that pre-hospital thrombolysis improves the timeliness with which this treatment is delivered to patients with myocardial infarction, and is also associated with reduced mortality.

31 May 2006	ACS mortality differences revealed: A study has revealed significant differences in the long-term risk of death between patients with different types of acute coronary syndromes.

24 May 2006	BNP testing 'saves on costs': Two Swiss studies published in the Archives of Internal Medicine support the accuracy and cost-effectiveness of testing for B-type natriuretic peptide in the assessment of congestive heart failure.

22 May 2006	LMWH recommended over UFH for ACS patients: Non-ST-segment elevation acute coronary syndrome patients treated with low molecular weight heparin have clinical outcomes superior to those given unfractionated heparin when also treated with glycoprotein IIb/IIIa inhibitors, the results of large US study indicate.

14 May 2006	Lab tests add to AMI death prediction: Researchers report that routine laboratory tests conducted at hospital admission can add value to traditional cardiovascular risk factors in predicting the short-term risk of death after acute myocardial infarction.

10 May 2006	NT-proBNP predicts lesion complexity: Researchers report that levels of NT-pro brain natriuretic peptide predict the complexity and severity of coronary lesions in patients with non-ST elevation acute coronary syndromes.

26 April 2006	Hospital guideline adherence improves ACS survival: Recent CRUSADE data published in JAMA report greater adherence to expert guidelines by hospitals is linked with lower mortality rates in patients with non-ST elevation acute coronary syndromes.

21 April 2006	Clopidogrel underused in NSTE ACS: A USA study reports that less than half of patients with non-ST-elevation acute coronary syndromes treated with medical therapy or coronary bypass surgery go on to receive clopidogrel at hospital discharge.

30 March 2006	Enoxaparin ACS gains greatest with ST-segment depression: The low molecular weight heparin enoxaparin offers particular benefits for acute coronary syndrome patients with ST-segment depression, research suggests.

14 March 2006	Abciximab improves PCI plus clopidogrel outcomes: ISAR-REACT 2 investigators report that non-ST-segment elevation ACS undergoing percutaneous coronary intervention after clopidogrel pretreatment have a reduced risk of adverse events if they are also treated with abciximab.

14 March 2006	ACUITY advocates Bivalirudin for non-ST ACS: The ACUITY trial results indicate that the direct thrombin inhibitor bivalirudin alone is as good at preventing ischemic events as heparin or enoxaparin combined with a glycoprotein IIb/IIIa inhibitor in patients with a non-ST elevation ACS, and also incurs less major bleeding.

14 March 2006	ExTRACT-TIMI 25 reports Enoxaparin beats UFH as adjunct to fibrinolysis: Treatment with enoxaparin throughout hospitalization prevents more ischemic events than standard therapy with UFH for 48 hours in patients with ST-elevation myocardial infarction undergoing fibrinolysis.

7 March 2006	15-Hour clopidogrel loading required for PCI benefits: Analysis of the CREDO data suggest clopidogrel pre-treatment should be initiated at least 15 to 24 hours before PCI.

6 March 2006	ACS therapies underused in chronic kidney disease: Under use of effective therapies for acute coronary syndromes (ACS) in patients with chronic kidney disease amounts to "therapeutic nihilism", experts claim in the American Journal of Medicine.

1 March 2006	GUSTO best for ACS bleeding prognosis: The GUSTO Study suggests that clinical criteria may be more effective than laboratory characteristics for predicting outcome after bleeding in patients with acute coronary syndromes.

22 February 2006	Factors in speedy PCI identified: A recent reports states that hospitals that have achieved notable improvements in door-to-balloon times for PCI share common characteristics.

21 February 2006	Prehospital LMWH acceptable for STEMI PCI: A French study reports that the low molecular weight heparin enoxaparin is effective prehospital treatment before primary angioplasty for patients with ST-elevation acute myocardial infarction.

14 February 2006	Facilitated PCI value in doubt: ASSENT 4-PCI data published indicate that facilitated PCI offers no benefit over intervention alone for STEMI, and may be associated with some risks.

14 February 2006	Thrombolytic pre-treatment benefits questioned: The practice of administering thrombolytic therapy prior to angioplasty or stent placement offers no benefits over percutaneous coronary intervention alone.

11 February 2006	ECG time targets not being met in chest-pain patients: Patients with chest pain are not receiving ECGs fast enough once they reach the hospital, according to a new analysis of data from the CRUSADE study.

2 February 2006	INTERACT demonstrates long-term LMWH benefits: Results from INTERACT suggest that the short-term benefits of LMWH in patients with non-ST-segment elevation ACS are sustained over a longer follow-up period.

23 January 2006	Modified troponin protects damaged heart: A genetically engineered version of cardiac troponin I can protect the ischemic and failing heart, US scientists report in the journal Nature Medicine.

19 January 2006	Primary PCI outcome benefits from hospital specialization: Research indicates that patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention are most likely to survive in hospitals where this is the predominant reperfusion strategy.

11 January 2006	PE algorithm 'simple' and 'effective': Research shows that patients suspected of having pulmonary embolism may be managed using a simple strategy consisting of a clinical decision rule plus a D-dimer blood test, with computed tomography performed in those with high-risk results.

11 January 2006	PE fibrinolysis bleeding risk predictable: The likelihood of major hemorrhage following fibrinolysis for acute pulmonary embolism is flagged by several risk factors, US clinicians have found.

10 January 2006	MI clinical performance measures released: The American College of Cardiology and American Heart Association have released clinical performance measures for the treatment of myocardial infarction.

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