Emergency Medicine Cardiac Research and Education Group


CRUSADE
CRUSADE Quality Improvement Initiative

Launched in 2001, CRUSADE is a national quality improvement initiative, designed to increase the practice of evidence-based medicine for patients diagnosed with non-ST segment elevation acute coronary syndromes (NSTE ACS) (i.e., unstable angina or NSTE myocardial infarction).

Through a continuous cycle of data collection, performance feedback and quality improvement interventions, over 500 participating sites in the US are consistently improving the standard of care for patients with NSTE ACS. Because of the dedication of the participating hospitals to this mission, over 200,000 cases have been submitted to the CRUSADE database. For more information visit the CRUSADE website.

In 2007, a milestone occurred. Duke Clinical Research Institute and its CRUSADE leadership joined forces with the American College of Cardiology Foundation's National Cardiovascular Data Registry (NCDR™) to launch a new initiative to improve the safety and outcomes for patients with ACS through the development of NCDR-ACTION™. This initiative will combine the data collection and quality reporting features of two leading national ACS registries to create the largest and most comprehensive national cardiovascular patient database ever developed. For more information visit the NCDR-ACTION Registry™ visit the website or call 800-257-4737 for more information.


Date
Article
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.
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.
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
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
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
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
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
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
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
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).
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.
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
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.
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.
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
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.
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.
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
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.
13 June 2007
D-dimer predicts PE prognosis :
A recent study indicates that D-dimer concentrations reflect severity of pulmonary embolism.
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
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.
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.
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
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.
19 January 2007
Platelet infusion reverses clopidogrel effect :
Investigators have calculated the degree of platelet infusion needed to reverse the effects of clopidogrel.
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
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.
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.
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
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.
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.
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
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.
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.
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
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
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.
11 June 2006