Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 7 de 7
Filtrar
1.
Scand J Clin Lab Invest ; 82(2): 96-103, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-35253566

RESUMO

Measurement of cardiac troponin (cTn) is the cornerstone in the diagnosis of myocardial infarction (MI). Potential disparities in concentrations of cTn, trajectories and mortality, following initial measurement warrant further investigation. Such data may guide clinicians treating patients suspected of MI. Plasma concentrations of cTnT and cTnI were measured in 503 consecutive patients at Aarhus University Hospital between June 13th and June 27th, 2019. cTnT was measured with the Roche cobas® E602 hs-cTnT assay, while cTnI was measured with the Siemens ADVIA Centaur® XPT hs-cTnI assay. Analytical agreement was determined based on assay-specific 99th percentiles. Medical records were reviewed for adjudication of the MI diagnosis. MI was the final diagnosis in 65 patients (12.9%) and the analytical agreement between cTnT and cTnI assays was 95.2%. For patients diagnosed with MI, cTnI reached higher peak concentrations in shorter time, compared to cTnT. All-cause mortality risk increased with increasing levels of both biomarkers. In this study, the analytical agreement of two cTn assays was high. However, some disparities in troponin trajectories were observed.


Assuntos
Infarto do Miocárdio , Troponina T , Biomarcadores , Humanos , Infarto do Miocárdio/diagnóstico , Estudos Prospectivos , Troponina I
2.
J Interv Cardiol ; 2019: 7348167, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31772545

RESUMO

BACKGROUND: The transradial approach is generally associated with few complications. However, periprocedural pain is still a common issue, potentially related to sheath insertion and/or arterial spasm, and may result in conversion to femoral access. Radial artery occlusion (RAO) following the procedure is also a potential risk. We evaluate whether the design of the sheath has any impact on these variables. METHODS: A total of 1,000 patients scheduled for radial CAG or PCI were randomized (1:1) to the use of a Slender or a Standard sheath during the procedure. Randomization was stratified according to chosen sheath size (5, 6, 7 French) and gender. A radial band was used to obtain hemostasis after the procedure, employing a rapid deflation technique. A reverse Barbeau test was performed to evaluate radial artery patency after removal of the radial band, and level of pain was assessed using a numeric rating scale (NRS). RESULTS: Use of the Slender sheath was associated with less pain during sheath insertion (median NRS 1 versus 2, p=0.02), whereas no difference was observed in pain during the procedure, radial procedural success rates, use of analgesics and sedatives during the procedure, and radial artery patency following the procedure. Rate of RAO was 1.5% with no difference between groups. CONCLUSION: The use of the hydrophilic coated Slender sheath during radial CAG or PCI was associated with less pain during sheath insertion, whereas no difference in other endpoints was observed. A rapid deflation technique was associated with RAO of only 1.5%.


Assuntos
Cateterismo Periférico , Angiografia Coronária , Dor Processual , Artéria Radial , Idoso , Cateterismo Periférico/efeitos adversos , Cateterismo Periférico/instrumentação , Cateterismo Periférico/métodos , Angiografia Coronária/efeitos adversos , Angiografia Coronária/instrumentação , Angiografia Coronária/métodos , Dinamarca , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Medição da Dor , Dor Processual/diagnóstico , Dor Processual/etiologia , Dor Processual/prevenção & controle , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/instrumentação , Intervenção Coronária Percutânea/métodos , Artéria Radial/fisiopatologia , Artéria Radial/cirurgia , Grau de Desobstrução Vascular
4.
Rev. esp. cardiol. (Ed. impr.) ; 66(3): 212-218, mar. 2013. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-110036

RESUMO

Los avances tecnológicos que se han producido en las últimas décadas han permitido mejorar el diagnóstico y la monitorización de los pacientes con síndromes coronarios agudos y los pacientes con insuficiencia cardiaca avanzada. Los registros digitales de alta calidad transmitidos de manera inalámbrica a través de redes de telefonía móvil han aumentado el uso prehospitalario de aparatos de electrocardiografía transportables y dispositivos implantables para la monitorización y el tratamiento de la arritmia. No se debe subestimar la importancia de los registros de electrocardiogramas prehospitalarios y su interpretación para pacientes con sospecha de infarto agudo de miocardio. Su empleo permite un acceso más amplio a una terapia de reperfusión rápida, con lo que se reducen el retraso en la aplicación del tratamiento, la morbilidad y la mortalidad. Además, la monitorización continua del electrocardiograma ha mejorado el diagnóstico de la arritmia, y se ha demostrado que la valoración de los cambios dinámicos del segmento ST aporta una información pronóstica importante para los pacientes con infarto de miocardio con elevación aguda del ST. De igual modo, parece que el registro o la monitorización a distancia de las arritmias y las constantes vitales mejora los resultados y reduce la necesidad de nuevos ingresos o contactos asistenciales ambulatorios de los pacientes con insuficiencia cardiaca o arritmias. En el futuro, es de prever que la telemonitorización y el diagnóstico influyan aún más en la práctica de la cardiología y aporten una mejor asistencia para el paciente con enfermedad cardiovascular (AU)


Technological advances over the past decades have allowed improved diagnosis and monitoring of patients with acute coronary syndromes as well as patients with advanced heart failure. High-quality digital recordings transmitted wirelessly by cellular telephone networks have augmented the prehospital use of transportable electrocardiogram machines as well as implantable devices for arrhythmia monitoring and therapy. The impact of prehospital electrocardiogram recording and interpretation in patients suspected of acute myocardial infarction should not be underestimated. It enables a more widespread access to rapid reperfusion therapy, thereby reducing treatment delay, morbidity and mortality. Further, continuous electrocardiogram monitoring has improved arrhythmia diagnosis and dynamic ST-segment changes have been shown to provide important prognostic information in patients with acute ST-elevation myocardial infarction. Likewise, remote recording or monitoring of arrhythmias and vital signs seem to improve outcome and reduce the necessity of re-admissions or outpatient contacts in patients with heart failure or arrhythmias. In the future telemonitoring and diagnosis is expected to further impact the way we practice cardiology and provide better care for the patient with cardiovascular disease (AU)


Assuntos
Humanos , Masculino , Feminino , Telemedicina/métodos , Telemedicina , Eletrocardiografia/instrumentação , Eletrocardiografia/métodos , Eletrocardiografia/tendências , Insuficiência Cardíaca , Cardiologia/educação , Telemedicina/organização & administração , Telemedicina/normas , Telemedicina/tendências , Telemetria/métodos , Eletrocardiografia Ambulatorial/tendências , Eletrocardiografia Ambulatorial , Redes de Comunicação de Computadores/organização & administração , Redes de Comunicação de Computadores
5.
Ugeskr Laeger ; 175(4): 186-9, 2013 Jan 21.
Artigo em Dinamarquês | MEDLINE | ID: mdl-23347735

RESUMO

Prehospital point of care testing (POCT) of biomarkers may be a valuable tool for optimizing prehospital diagnosis. We report the status of prehospital POCT in relation to acute myocardial infarction (AMI). No randomized studies have been performed. Eight observational studies collectively show added diagnostic value of prehospital POCT in relation to AMI. The revised European NSTEMI guidelines focus on early risk assessment in relevant timing of reperfusion strategy. We anticipate that prehospital POCT will be central in NSTEMI care in the near future.


Assuntos
Biomarcadores/sangue , Serviços Médicos de Emergência/métodos , Infarto do Miocárdio/diagnóstico , Creatina Quinase Forma MB/sangue , Glicopeptídeos/sangue , Humanos , Infarto do Miocárdio/sangue , Mioglobina/sangue , Sistemas Automatizados de Assistência Junto ao Leito , Fatores de Tempo , Tempo para o Tratamento , Troponina I/sangue , Troponina T/sangue
6.
Ugeskr Laeger ; 175(4): 181-5, 2013 Jan 21.
Artigo em Dinamarquês | MEDLINE | ID: mdl-23347734

RESUMO

The use of primary percutaneous coronary intervention (PCI) as the preferred reperfusion strategy in ST-elevation myocardial infarction (STEMI) requires optimal systems-of-care and logistics in order to enable rapid treatment of all patients. In Denmark, this has been achieved through prehospital electrocardiogram diagnosis, field triage and dedicated PCI centres 24/7. Today, primary PCI is an option for all Danish patients with STEMI, regardless of the distance to a PCI centre. This has led to a decline in both mortality and morbidity.


Assuntos
Angioplastia Coronária com Balão/normas , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea/normas , Tempo para o Tratamento/normas , Angioplastia Coronária com Balão/estatística & dados numéricos , Diagnóstico Tardio , Dinamarca , Eletrocardiografia , Serviços Médicos de Emergência/normas , Serviços Médicos de Emergência/estatística & dados numéricos , Humanos , Estimativa de Kaplan-Meier , Infarto do Miocárdio/diagnóstico , Infarto do Miocárdio/mortalidade , Reperfusão Miocárdica/normas , Reperfusão Miocárdica/estatística & dados numéricos , Intervenção Coronária Percutânea/estatística & dados numéricos , Guias de Prática Clínica como Assunto , Fatores de Tempo , Tempo para o Tratamento/estatística & dados numéricos , Transporte de Pacientes/normas , Transporte de Pacientes/estatística & dados numéricos
7.
Ugeskr Laeger ; 175(4): 198-201, 2013 Jan 21.
Artigo em Dinamarquês | MEDLINE | ID: mdl-23347738

RESUMO

Today there is solid evidence that high-risk patients with acute myocardial infarction without ST-elevation should undergo routine invasive treatment, preferably with a very short delay. Evidence suggests that acute coronary occlusions are present in many of these patients. Nevertheless, so far no studies have been powered to evaluate the impact of primary percutaneous coronary intervention on outcome in this patient population. With the advanced, prehospital, diagnostic possibilities available today it would be possible to investigate this issue further.


Assuntos
Diagnóstico Precoce , Infarto do Miocárdio/diagnóstico , Angiografia Coronária , Ecocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/terapia , Intervenção Coronária Percutânea , Risco , Fatores de Tempo , Troponina T/sangue
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA
...