Delayed release of brain natriuretic peptide to identify myocardial ischaemia.

Background: A recent pilot study suggested that exercise-induced myocardial ischaemia may lead to a delayed release of cardiac biomarkers, so that later sampling, for example, at 4 h after exercise could be used for diagnostic purpose.

Materials And Methods: In an observational study, we enrolled 129 consecutive patients referred for evaluation of a suspected coronary artery disease by rest/stress myocardial perfusion single-photon emission computed tomography. The treating cardiologist used all available clinical information to quantify clinical judgment regarding the presence of myocardial ischaemia using a visual analogue scale twice: prior and after stress testing.

Incidence and timing of serious arrhythmias after early revascularization in non ST-elevation myocardial infarction.

Background: In contrast to ST-elevation myocardial infarction (STEMI), in non-STEMI (NSTEMI) patients the need for continuous rhythm monitoring in a coronary care unit, respective incidence and timing of serious arrhythmias are poorly defined.

Methods: We used a derivation-validation design and data from two independent prospective cohorts of consecutive haemodynamically stable NSTEMI patients to evaluate the incidence and timing of serious arrhythmias after successful early percutaneous revascularization. Serious arrhythmia was prospectively defined as any arrhythmia that requires immediate medical attention including persistent ventricular tachycardia (>30 s), ventricular fibrillation, asystole, and high degree atrioventricular (AV)-block requiring pacemaker insertion during hospitalization.