[Acute coronary syndromes in Latin America: lessons from the ACCESS registry].

Background: Evidence of the clinical characteristics, treatment and outcomes among Latin American (LA) patients with acute coronary syndromes (ACS) is scarce.

Methods: ACCESS, international prospective multicenter registry to evaluate risk stratification, management and outcomes in ACS (unstable angina or non-ST elevation myocardial infarction [UA/NSTEMI] or ST elevation myocardial infarction [STEMI]) in developing countries. Primary endpoint: all-cause death at 1 year; all-cause mortality within 30 days was also recorded, Patients with acute ischemic symptoms within 24 hours of symptoms onset and electrocardiographic evidence of ischemia were enrolled.

Prospective validation of the prognostic usefulness of B-type natriuretic peptide in asymptomatic patients with chronic severe aortic regurgitation.

Objectives: The purpose of this study was to determine the independent and additive prognostic value of B-type natriuretic peptide (BNP) in patients with severe asymptomatic aortic regurgitation and normal left ventricular function.

Background: Early surgery could be advisable in selected patients with chronic severe aortic regurgitation, but there are no uniform criteria to identify candidates who could benefit from this strategy. Assessment of BNP has not been studied for this purpose.

Improved diagnostic and prognostic performance of a new high-sensitive troponin T assay in patients with acute coronary syndrome.

Background: In the present study, we aimed to analyze the diagnostic and prognostic potential of a newly developed high-sensitive troponin T assay and compared these results with those of a contemporary troponin T assay in 2 distinct patient cohorts, one including patients with evident ACS and the other one including patients with general chest pain.

Methods And Results: For this study, we analyzed data from 2 independent patient cohorts, the Bad Nauheim ACS registry and the Prognosis in Acute Coronary Syndromes registry, with a total of 2,506 patients. On admission, clinical data have been recorded, and a single measurement of troponin T has been performed with a contemporary assay (TnT) and a new high-sensitive troponin T assay (hsTnT).

Prospective validation of the prognostic usefulness of brain natriuretic peptide in asymptomatic patients with chronic severe mitral regurgitation.

Objectives: The purpose of the study was to determine the independent and additive prognostic value of brain natriuretic peptide (BNP) in patients with severe asymptomatic mitral regurgitation and normal left ventricular function.

Background: Early surgery could be advisable in selected patients with chronic severe mitral regurgitation, but there are no criteria to identify candidates who could benefit from this strategy. Assessment of BNP has not been studied in asymptomatic patients with severe mitral regurgitation; hence, its prognostic value remains unclear.

N-terminal B-type natriuretic peptide assessment provides incremental prognostic information in patients with acute coronary syndromes and normal troponin T values upon admission.

Objectives: The purpose of this study was to determine the prognostic value of N-terminal B-type natriuretic peptide (NT-proBNP) in two independent samples of patients presenting with acute coronary syndromes (ACS) and normal troponin T (TnT) values.

Background: Recently assessment of NT-proBNP has been studied in patients with ACS. However, the clinical relevance in patients who present without troponin elevation is unclear.

Relative value of N-terminal probrain natriuretic peptide, TIMI risk score, ACC/AHA prognostic classification and other risk markers in patients with non-ST-elevation acute coronary syndromes.

Aims: We prospectively studied the additive value of N-terminal probrain natriuretic peptide (NT-proBNP) in relation to the Thrombolysis in Myocardial Infarction (TIMI) risk score and the American College of Cardiology/American Heart Association (ACC/AHA) joint prognostic classification, and compared the predictive capacity of NT-proBNP, troponin T (TnT), C-reactive protein (hsCRP), myoglobin, and creatine kinase-MB (CK-MB) concentrations in a cohort of 1483 consecutive patients with non-ST-segment-elevation acute coronary syndromes (NSTE-ACS).

Methods And Results: Centralised measurements of NT-proBNP, TnT, myoglobin, and hsCRP were performed 3 h (median) after admission. Adjusting by clinical, ECG variables, and biomarkers, NT-proBNP concentration was the strongest independent predictor of in-hospital (OR 1.

Early reperfusion and late clinical outcomes in patients presenting with acute myocardial infarction randomly assigned to primary percutaneous coronary intervention or streptokinase.

Background: Primary percutaneous coronary intervention (PCI) has become an alternative to thrombolytic therapy as a reperfusion strategy for ST-elevation acute myocardial infarction (AMI).

Methods: The main goal of this study was to determine whether PCI and thrombolytic therapy achieve comparable reperfusion rates, as evidenced by ST-segment resolution. Secondary end points included infarct vessel patency rates before hospital discharge and short- and long-term outcomes.