The efficacy of statin therapy in patients with acute coronary syndromes and concomitant carotid disease.

Background: Statins prevent recurrent ischemic coronary events after acute coronary syndrome (ACS) and improve cardiovascular outcome of patients with peripheral artery disease.

Aim: We sought to evaluate the interrelationship between statin use, phenotype of carotid plaques as assessed by ultrasound, and outcome of patients with ACS and concomitant carotid disease.

Methods: A total of 337 consecutive patients with ACS were assessed by coronary angiography and Doppler ultrasound of the carotid arteries and followed up for a median period of 19 months.

Quality of life and behavioral compliance in cardiac rehabilitation patients: a longitudinal survey.

Background: Few data regarding inter-relations between health-related quality of life (HRQoL) and compliance are available. The aim of present study was to assess which aspects of HRQoL might predict patients' behavioral compliance to medical suggestions and whether questionnaires might be useful for patients undergoing cardiac rehabilitation.

Methods: HRQoL and compliance were measured in 52 consecutive patients undergoing cardiovascular rehabilitation.

Predictive value of associations between carotid and coronary artery disease in patients with acute coronary syndromes.

The present study evaluated the association among sonographic characteristics of carotid plaques, angiographic morphology of coronary lesions, and outcomes of patients who had acute coronary syndromes. In treatment-stratified Cox's proportional hazards regression analysis, hard carotid plaques and coronary lesions of complex morphology were found to be independent predictors of future cardiac events.

Impact of carotid arterial narrowing on outcomes of patients with acute coronary syndromes.

The present prospective observational study was conducted in 323 consecutive patients with acute coronary syndrome, 101 (31%) of whom were diagnosed with carotid arterial narrowing by ultrasonography. At follow-up, patients with carotid disease had a greater incidence of cardiovascular events than did those with normal carotid arteries. Outcomes of patients with concomitant carotid disease who underwent cardiac revascularization were similar to those who received conservative treatment.

Cost of strategies after myocardial infarction (COSTAMI): a multicentre, international, randomized trial for cost-effective discharge after uncomplicated myocardial infarction.

Aims: Risk stratification after uncomplicated acute myocardial infarction is mostly applied by either symptom-limited post discharge exercise electrocardiography or pre-discharge submaximal exercise test. Aim of the present study was to determine if early pharmacological stress echocardiography and discharge within 24 hours of the test in cases without induced myocardial ischemia leads to lower costs and similar clinical outcome during 1 year follow up when compared to clinical evaluation and exercise electrocardiography after discharge.

Methods And Results: Four-hundred fifty-eight patients from 10 participating centers with a recent uncomplicated myocardial infarction were randomized to pharmacological stress echocardiography on day 3-5 followed by early discharge in the case of negative test result (early discharge strategy) (n=233) or clinical evaluation with hospital discharge on day 7-9 and symptom-limited post-discharge exercise electrocardiography at 2-4 weeks after myocardial infarction (usual care strategy) (n=225).

Predischarge exercise electrocardiogram and stress echocardiography can predict long-term clinically driven revascularization following acute myocardial infarction.

Background: Predischarge stress testing provides suboptimal prediction of spontaneous hard events following uncomplicated acute myocardial infarction (AMI).

Hypothesis: This study was aimed at assessing whether soft cardiac ischemic events requiring late revascularization could be predicted more accurately.

Methods: In all, 428 patients undergoing exercise electrocardiography (ECG) and stress echocardiography (SE, 345 dobutamine and 83 dypiridamole) within 15 days of uncomplicated AMI were followed up for 425 (range 20-2220) days.

Evidence of reverse mismatch with positron emission tomography imaging in a patient with reversible myocardial dysfunction.

We describe the case of a patient who came to our attention because of a reversible depression of myocardial contractility, probably due to myocarditis. A positron emission tomography study showed, in correspondence to the malfunctioning segments, a decreased F18-2-fluoro-2-deoxyglucose (F18-FDG) uptake in the presence of a normal perfusion as assessed by means of N13-labeled ammonia uptake. This phenomenon, called "reverse mismatch", shows that viability is not always dependent on FDG uptake and that it could be associated with the recovery of myocardial contractility.