Early rule-out of acute coronary syndrome using undetectable levels of high sensitivity troponin T.

Aims: To examine whether undetectable high sensitivity troponin T (hsTnT) can be used to safely rule out non-ST-elevation acute coronary syndrome (NSTE-ACS) (using the limit of detection (LOD) as the cut-off) and to compare this strategy to serial hsTnT and the use of combined hsTnT and copeptin.

Methods: In this prospective observational study, 478 patients presenting with chest pain were consecutively included. A combined primary endpoint of ACS, non-elective revascularization and/or death of all causes was used.

Predictors of successful cardioversion with vernakalant in patients with recent-onset atrial fibrillation.

Background: Vernakalant is a novel atrial-selective antiarrhythmic drug able to convert recent-onset atrial fibrillation (AF) with reportedly low proarrhythmic risk. Successful cardioversion predictors are largely unknown. We sought to evaluate clinical and electrocardiographic predictors of cardioversion of recent-onset AF with vernakalant.

Acute right ventricular failure caused by concomitant coronary and pulmonary embolism: successful treatment with endovascular coronary and pulmonary thrombectomy.

Patent foramen ovale (PFO) is present in approximately 25% of the general population. PFO is characterized by intermittent shunting of blood from the right to the left atrium, especially in the context of increased right-sided filling pressures, with risk of paradoxical embolism. We describe a 69-year-old woman presenting with acute chest pain, severe dyspnoea, and acute inferolateral ST-segment elevation on the electrocardiogram.

The combination of high sensitivity troponin T and copeptin facilitates early rule-out of ACS: a prospective observational study.

Background: The combination of the new high sensitivity troponin T (hsTnT) assays and copeptin, a biomarker of endogenous stress, has been suggested to have the potential of early rule-out of acute coronary syndrome (ACS). The aim of this study was to examine the ability of this combination to rule out ACS in patients presenting with chest pain and to compare the diagnostic performance to hsTnT alone.

Method: In this prospective observational study, patients with chest pain admitted for observation were consecutively included.

High-sensitivity troponin T as a diagnostic tool for acute coronary syndrome in the real world: an observational study.

Background: The 2011 European Society of Cardiology guidelines state that acute coronary syndrome (ACS) may be excluded with a rapid 3 h high-sensitivity troponin T (HsTnT) sampling protocol. We aimed to evaluate the diagnostic and prognostic performance of HsTnT in patients with chest pain admitted with possible ACS in routine care.

Methods: A total of 773 consecutive patients admitted for in-hospital care for chest pain suspicious of ACS were included retrospectively.

Epidemiology and characteristics of hyponatremia in the emergency department.

Background: Hyponatremia is the most common electrolyte abnormality and it is associated with increased morbidity and mortality. The aim of the study was to investigate the underlying causes and management of hyponatremia in an unselected population presenting with hyponatremia to the emergency department.

Methods: A descriptive, retrospective hospital record study was performed.

Job strain, job demands and adrenergic beta1-receptor-polymorphism: a possible interaction affecting blood pressure in men.

Background: Job strain and the Arg389Gly polymorphism in the adrenergic beta1-receptor gene have been linked to hypertension. We aimed to study whether there is an interaction between the Arg389Gly polymorphism and job strain and its components (job demand and decision latitude) in relation to blood pressure.

Methods: From the Malmö Diet and Cancer population cohort, 6095 individuals were randomly selected to be followed regarding cardiovascular risk factors.

Job strain, decision latitude and alpha2B-adrenergic receptor polymorphism significantly interact, and associate with higher blood pressures in men.

Background: Job strain (high demands and low decision latitude) and the DD genotype of an I/D polymorphism in the adrenergic alpha2B-receptor have been associated with hypertension, respectively. We hypothesized that the I/D polymorphism interacts with external stress, such as job strain, in the development of hypertension.

Methods: A sample of 3045 employed men and women from the population cohort of Malmö Diet and Cancer Study, n = 28 098, with baseline data regarding work characteristics and cardiovascular risk factors, were genotyped for the adrenergic alpha2B-receptor I/D polymorphism.

Job strain in men, but not in women, predicts a significant rise in blood pressure after 6.5 years of follow-up.

Background: Job strain (high demands and low decision latitude) has been associated with hypertension and cardiovascular disease, especially in men. Most studies on job strain and hypertension have been cross-sectional, and prospective data are inconsistent.

Objective: To prospectively describe the effects of different psychosocial work characteristics on office blood pressure changes.