Timing of invasive coronary angiography, management, and in-hospital outcomes among patients with non-ST-segment elevation myocardial infarction: A comprehensive nationwide analysis.

Background: The impact of timing of invasive coronary angiography (ICA) and management strategies on in-hospital outcomes among unselected all-comers with non-ST-segment elevation myocardial infarction (NSTEMI) presents an equipoise in clinical practice.

Methods: Patients with NSTEMI from the US NIS database during 2016 to 2021 were included in the analysis. In-hospital outcomes were examined according to the timing of ICA - early (<24 h), intermediate (24-72 h), and delayed (>72 h).

Pathophysiology of Congestion in Heart Failure: A Contemporary Review.

Acutely decompensated heart failure is one of the leading causes of hospitalisation worldwide, with a significant majority of these cases attributed to congestion. Although congestion is commonly mistaken for volume overload, evidence suggests that decompensation can occur without significant water accumulation, being attributed to volume redistribution. Yet, the distinction between intravascular and extravascular congestion in heart failure often blurs, as patients frequently exhibit overlapping features of both, and as patients may transition between phenotypes over time.

Myocardial work in patients with heart failure and ischemic cardiomyopathy according to the mode of coronary revascularization.

Background: The association of percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) on myocardial function, as reflected in myocardial work (MyW) parameters, in patients with ischemic cardiomyopathy and heart failure (HF) is unknown.

Methods: We analyzed data from 68 patients who were hospitalized with chronic HF due to ischemic cardiomyopathy and stratified them according to the mode of revascularization. All patients underwent a 2D speckle tracking echocardiography exam performed by the same expert sonographer and had complete MyW data including global work index (GWI), global constructive work (GCW), global wasted work (GWW), and global work efficiency (GWE).

Emerging Therapies for the Treatment of Atherosclerotic Cardiovascular Disease: From Bench to Bedside.

Primarily a consequence of sedentary lifestyle, atherosclerosis has already reached pandemic proportions, and with every year the burden of it is only increasing. As low-density lipoprotein cholesterol (LDL-C) represents a crucial factor in atherosclerosis formation and progression, stringent lipid-lowering therapy could conceivably be the key to preventing the unfavorable outcomes that arise as a consequence of atherosclerosis. The use of statins in lipid-lowering is often burdened by adverse events or is insufficient to prevent cardiovascular events as a monotherapy.

Conservative Management of Spontaneous Left Main Coronary Artery Dissection (SCAD) Triggered by Emotional Stress in the Late Postpartum Period: Case Report and Pathophysiology.

A spontaneous coronary artery dissection (SCAD) during the postpartum period is a serious medical emergency and the most important non-atherosclerotic cause of coronary artery disease (CAD) in this population. While conservative management is recommended in most SCAD scenarios, cases complicated by hemodynamic instability or cardiogenic shock are particularly challenging and might be amenable only with invasive percutaneous or cardiothoracic surgical management. Herein, we present a case of a 35-year-old otherwise healthy woman that suffered an intense emotional stress event and was subsequently admitted with crushing chest pain to the emergency department.

Feasibility and safety of catheter-directed thrombolysis via superficial cubital vein for the treatment of acute massive and submassive pulmonary embolism.

Introduction: Proximal venous approaches (femoral or jugular) for catheter-directed thrombolysis (CDT) of acute pulmonary embolism (PE) dominate in clinical practice.

Aim: We investigated the feasibility and safety of CDT in acute PE by using the superficial cubital venous approach.

Material And Methods: All patients with acute PE received intravenous unfractionated heparin plus CDT.

Right ventricular free wall strain in acutely decompensated heart failure patients with ischemic and non-ischemic cardiomyopathy.

Aims: Right ventricular (RV) dysfunction is a predictor of adverse outcomes among patients with HF with reduced ejection fraction (HFrEF); however, differences in RV parameters in HFrEF patients with ischemic (ICM) and non-ischemic cardiomyopathies (NICM) are not well understood. We investigated echocardiographic characteristics, including RV strain, in patients with acute decompensated heart failure (ADHF) and compared patients with ICM and NICM etiology.

Methods: Consecutive patients who presented with ADHF and NYHA class III-IV were prospectively enrolled if they had LVEF < 40% and history of ICM or NICM.

The use of Smith-modified Sgarbossa criteria to diagnose an extensive anterior acute myocardial infarction in a patient presenting with a left bundle branch block.

Patients with LBBB of unknown onset presenting with chest pain can pose a diagnostic challenge in the ED while Smith-Modified-Sgarbossa (SMS) ECG criteria might facilitate AMI diagnosis. We demonstrate a case of a 79-year-old man that presented to the ED with chest pain. Original Sgarbossa criteria were negative for AMI while SMS criteria were applied showing proportionally excessive discordance between ST-segment and preceding S-wave thus fulfilling diagnostic criterion for AMI.

Left-Ventricular Function After 3 Months of Sacubitril-Valsartan in Acute Decompensated Heart Failure.

There is limited data on the effect of sacubitril-valsartan on the echocardiographic parameters in acute decompensated heart failure (ADHF). We prospectively enrolled 68 consecutive patients with ADHF who received sacubitril-valsartan (N = 34, S/V group) or angiotensin inhibition-based therapy (N = 34, ACEi/ARB group). Two-dimensional echocardiography with speckle tracking (2D-STE) was performed at baseline and after 3 months of treatment.

In-hospital mortality of patients with acute myocardial infarction before and after introduction of PCI in Split University Hospital Center, Croatia.

Aim of the study was to estimate the in-hospital mortality and death rate in patients with AMI according to gender and location of infarction during 5 years before and after the introduction of percutaneous coronary intervention (PCI) procedures in Split University Hosptial Center, Croatia. The hospitalized patients were divided in two groups, from 2000 to 2004 and from 2005 to 2009. The analysis included total mortality and mortality according to gender and location of AMI.

Differences in epidermal thickness and expression of apoptosis regulatory proteins in the skin of patients with chronic renal failure and pruritus.

Chronic renal failure is often associated with skin itching (pruritus) in dialysis patients. In order to investigate the possible causes of pruritus, the epidermis of the thigh of 12 dialysis patients and 4 controls from patients without renal disease were examined. The sections of the epidermis were measured and immunohistochemically analyzed using antibodies to Bcl-2, Bax, caspase-3 proteins and TUNEL method.

Awareness and use of evidence-based medicine databases and Cochrane Library among physicians in Croatia.

Aim: To assess awareness and use of evidence-based medicine (EBM) databases and The Cochrane Library among physicians in Croatia.

Methods: A cross-sectional study with a telephone survey was performed among 573 physicians (88.6% response rate from 647 contacted physicians) from family practice and 4 major university hospital centers in Croatia.