Sabina A Murphy

..On the basis of these findings, 1 death was prevented for every 95 patients treated with high-dose statin therapy for 2 years. The results of this pooled analysis provide further evidence for early intensive statin therapy after ACS...

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..We sought to examine the relationship between gender and cardiac biomarkers in patients with unstable angina (UA)/non-ST-segment elevation myocardial infarction (NSTEMI)...

..We analyzed the design, implementation, and results of the two trials in an attempt to clarify the effects of early intensive statin therapy...

..A variety of imaging modalities have implicated impaired myocardial perfusion in the pathogenesis of acute coronary syndromes (ACSs)...

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..In conclusion, compared with patients with ACS without previous CABG, those with previous CABG have a higher risk for adverse cardiac events and may derive similar benefit from intensive statin therapy...

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..We sought to evaluate the effect of nonemergent PCI on mortality among patients with STEMI treated with fibrinolytic administration and the consequence of clopidogrel pretreatment on this effect...

..This new end point is proposed to evaluate the success of reperfusion therapy in patients who undergo early angiography...

..We sought to examine the effect of these advances on clinical outcomes and the benefits of an early invasive strategy in UA/NSTEMI...

..This study sought to investigate whether pregnancy-associated plasma protein-A (PAPP-A) is useful for risk assessment in non-ST-segment elevation acute coronary syndrome (NSTE-ACS)...

..Whether these advantages translate into greater infarct-related artery patency and fewer adverse clinical events in patients with ST-elevation myocardial infarction (STEMI) receiving fibrinolytic therapy remains under study...

..In patients with a LAD culprit lesion, proximal lesion location is a multivariate correlate of adverse outcomes even after adjustment for coronary blood flow and other covariates...

..The goal of this analysis was to evaluate the association of impaired Thrombolysis In Myocardial Infarction myocardial perfusion grade (TMPG) with sustained ventricular tachycardia (VT) or ventricular fibrillation (VF)...

..This effect must be balanced against an increased bleeding risk. We aimed to characterize the effect of prasugrel with respect to the type, size, and timing of MI using the universal classification of MI...

..This study was designed to determine the relationship between clopidogrel and early ST-segment resolution (STRes) and the interaction of the two with clinical outcomes after fibrinolysis...

..High TRS at presentation is associated with abnormal myocardial perfusion, even after adjusting for possible confounders...

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..These data support the value of combining markers of hemodynamic stress with traditional approaches to risk assessment in acute myocardial infarction...

..2, p = 0.045). CLC is independently associated with indexes of poorer epicardial flow and a higher incidence of adverse clinical outcomes after fibrinolytic administration in patients who have ST-elevation myocardial infarction...

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..These data suggest that ST2 may be a useful biomarker and that this novel inflammatory receptor may play a role in cardiac pathophysiology...

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..MCP-1 appears to play a critical role at multiple stages in atherosclerosis, including the initiation of the fatty streak, promotion of plaque instability, and remodeling after myocardial infarction...

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..Early restoration of epicardial flow before primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) has been associated with improved clinical outcomes...

..To evaluate the association of bleeding with mortality in ST-elevation myocardial infarction (STEMI)...

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..Troponin testing is useful for evaluating patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS); however, a significant percentage of patients are troponin negative at presentation and develop late rise of the marker...

..Unfractionated heparin is often used as adjunctive therapy with fibrinolysis in patients with ST-elevation myocardial infarction. We compared a low-molecular-weight heparin, enoxaparin, with unfractionated heparin for this purpose...

..In prior studies, sex-based treatment differences have been observed with the antiischemic ranolazine, with a possibly diminished effect in women...

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..At 30 days, Lp-PLA2 activity is significantly lowered with high-dose statin therapy and is associated with an increased risk of CV events independent of C-reactive protein and LDL cholesterol levels...

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..We aimed to evaluate the efficacy and safety of ranolazine in a larger and more diverse group of patients with angina than previously studied...

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..Potent antithrombotic therapies may offer particular benefit for these high-risk patients and must be balanced against the potential for increased bleeding...

..8, p = 0.02) and 30-day congestive heart failure (OR 4.4, p = 0.02). In STEMI, angiographic indices of incomplete reperfusion are associated with an elevated LVEDP, and elevated LVEDP is associated with adverse clinical outcomes...

..These data provide insight into potential mechanistic differences between these 2 clinical syndromes...

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..The more widespread use of CrCl or other estimates of renal function over Cr may lead to more appropriate dose adjustments of eptifibatide...

..Dual-antiplatelet therapy with aspirin and a thienopyridine is a cornerstone of treatment to prevent thrombotic complications of acute coronary syndromes and percutaneous coronary intervention...

..Whether the disparate outcomes exist independently of potential biases in treatment patterns remains unclear...

..043). In multivariate analyses, angiographically evident thrombus was associated with higher corrected TIMI frame counts and worsened myocardial perfusion independent of clinical and angiographic covariates, including TIMI grade 3 flow...

..However, these studies were performed prior to the widespread use of platelet glycoprotein IIb/IIIa inhibitors and intracoronary stents...

..0 vs 5.1 mg/L, p <0.001). CRP was associated with adverse cardiovascular outcomes in smokers and nonsmokers, even when adjusted for the presence of pulmonary disease...

..Partial or full angiographic perfusion scores are associated with a halving of infarct size, and no patients with full angiographic perfusion died...

..We designed a prospective evaluation of the effect of ranolazine on hyperglycemia as part of a randomized, double-blind, placebo-controlled outcomes trial...

..The goal of the present analysis was to evaluate the association of SVG markers with clinical outcomes and graft patency...

..We evaluated the efficacy and safety of prasugrel and clopidogrel in the setting of a glycoprotein (GP) IIb/IIIa inhibitor...

..This finding supports the physiologic relevance of procedural MI and the continued effort to define therapies that decrease the risk of this complication...

..We compared prasugrel with clopidogrel among subjects with DM in TRITON-TIMI 38...

..Ranolazine reduces proarrhythmic substrate and triggers such as early afterdepolarization in experimental models. However, the potential antiarrhythmic actions of ranolazine have yet to be demonstrated in humans...

..This finding emphasizes the roles of platelet aggregation and distal embolization in the pathogenesis of microvascular dysfunction in STEMI...

..CONCLUSIONS: Among patients with unstable coronary syndromes and predominantly normal or mildly reduced GFR, an elevated BUN is associated with increased mortality, independent of sCr-based estimates of GFR and other biomarkers...

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..In conclusion, patients undergoing DES implantation achieved more reductions in periprocedural markers of inflammation and necrosis than patients receiving bare metal stents among those with non-ST-elevation acute coronary syndrome...

..45, 95% CI 1.03-2.06; p=0.036 at 30 days). It was concluded that chronic hypertension remains an independent marker for major short- and long-term cardiac adverse outcomes after non-ST-segment elevation acute coronary syndrome...

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..No differences in mortality or recurrent MI rates were detected in patients who sustained a Q-wave MI and patients in whom a Q-wave MI did not evolve in the modern thrombolytic era...

..Given their high risk for adverse events, patients with secondary UAP should be treated aggressively...

..Further prospective randomized trials are warranted to evaluate the efficacy and safety of intracoronary eptifibatide...

..The sum of ST-segment resolution (sum-STRES) has a high positive predictive value (PPV) for a patent IRA, but is quite time-consuming...

..CONCLUSIONS: Primary stenting is a highly cost-effective treatment for AMI. The cost-effectiveness of abciximab in this setting is uncertain and depends primarily on whether long-term survival is enhanced...

..We developed and validated a risk score to predict which patients will develop CHF...

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..IRA patency after fibrinolytic administration is related to admission glucose independent of clopidogrel administration...

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..However, more TMPG 1 or dye staining was present on next injection, suggesting dye outflow may be impaired...

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..Although an invasive strategy is frequently used in patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS), data from some trials suggest that this strategy may not benefit women...

..In patients with ST-elevation myocardial infarction, absolute and relative neutrophilia were associated with impaired epicardial and microvascular perfusion...

..Prasugrel (CS-747, LY640315), a novel potent thienopyridine P2Y(12) receptor antagonist, has the potential to achieve higher levels of inhibition of ADP-induced platelet aggregation than currently approved doses of clopidogrel...

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..The relative antiplatelet effects of prasugrel versus high-dose clopidogrel in percutaneous coronary intervention patients are unknown...

..03). These data support the theory that distal embolization and microvascular obstruction are associated with myonecrosis following otherwise successful coronary stent placement and provide further insight into its pathophysiology...

..Dose adjustments or anti-Xa coagulation monitoring or both will be necessary rarely in routine clinical practice, with the exception of patients with severe renal insufficiency...

..Glucose levels during ACS may be an important addition to the risk stratification of patients with ACS and a potentially important target for therapy...

..The goal of this study was to define the prognostic value of serum myoglobin in patients with non-ST-elevation acute coronary syndromes (ACS)...

..While epicardial flow among CAMI patients is slightly better than TAMI patients, the incidence of little or severely impaired tissue level perfusion is nearly identical...

..Larger prospective and randomized studies are warranted to further explore the efficacy of this strategy.Intracoronary eptifibatide administration during PCI for UA/NSTEMI is feasible and safe...

..The purpose of this study was to assess the impact of on-treatment triglycerides (TG) on coronary heart disease (CHD) risk after an acute coronary syndrome (ACS)...

..Further, our data demonstrate a graded association according to the number of such medications being administered: the likelihood of a patent infarct-related artery increased to >50% as the number of these medications increased...

..The benefit of catheterization in both syndromes may depend on patient risk for adverse clinical outcomes...

..This simple electrocardiographic measure should be combined with bedside clinical and hemodynamic assessment to optimize decision making after fibrinolysis...