Clinical Use of Ischemic Markers and Echocardiography in the Emergency Department.

We searched the medical literature for articles containing markers of cardiac ischemia and echocardiography in the evaluation of patients presenting to the emergency department to determine their combined clinical use. Several published articles indicate two-dimensional echocardiography is a useful and cost-effective imaging technique for the evaluation of patients with chest pain in the emergency department. New studies are emerging that evaluate ischemic markers in combination with echocardiography to assess patients presenting to the emergency department with chest pain.

Risk stratification of emergency department patients with acute coronary syndromes using P-selectin.

Objectives: We compared the predictive properties of P-selectin to creatine kinase, MB fraction (CK-MB) for detecting acute myocardial infarction (AMI), acute coronary syndromes (ACS) and serious cardiac events upon emergency department (ED) arrival.

Background: Practioners detecting early diagnosis of ACS have focused on cardiac markers of myocardial injury. Plaque rupture/platelet aggregation precedes myocardial ischemia.

Sustained inhibition of intimal thickening. In vitro and in vivo effects of polymeric beta-cyclodextrin sulfate.

Intimal thickening after vascular injury may be modulated in part by heparin binding growth factors. We hypothesized that placement of a therapeutic polymer in the periadventitial space capable of tightly binding growth factors might alter the vascular response to injury. We first demonstrated that incubation of rat aortic smooth muscle cells with an insoluble, sulfated polymer of beta-cyclodextrin (P-CDS) was associated with a dose-dependent inhibition of proliferation induced by fetal calf serum, fibroblast growth factor-2 (FGF-2), platelet-derived growth factor BB, or epidermal growth factor.

Inhibition of human vascular smooth muscle cell migration and proliferation by beta-cyclodextrin tetradecasulfate.

Smooth muscle cell migration and proliferation are important regulatory processes in the development of intimal thickening after vascular injury. beta-cyclodextrin tetradecasulfate, an orally active synthetic heparin mimic, is effective in inhibiting rabbit aortic smooth muscle cell proliferation in vitro and in limiting restenosis in an experimental angioplasty restenosis model in rabbits (Hermann et al., 1993).