Abstract:
:Recent clinical trial evidence supports an inflammatory etiology in acute ischemic heart disease. When a segment of coronary artery becomes inflamed, important cytokines, such as tissue factor, are released, facilitating thrombosis. Serum inflammatory markers are elevated in most acute coronary syndrome patients at presentation. Mortality risk has been shown to be associated with increased levels of high-sensitivity C-reactive protein (CRP), interleukin 6, and serum vascular cell adhesion molecule. Platelets, which are rich in inflammatory mediators (CD40 and its ligand thrombospondin, and phospholipase A2), also supply important triggers for the inflammatory cascade. In addition, more than 35 platelet-associated messenger ribonucleic acid mediators involved in arterial injury and inflammation have been found. The use of biomarkers of inflammation, such as CRP, and of the sequelae of embolization, such as troponin, provide a window into the underlying pathophysiology of acute ischemic heart disease. New agents from three distinct drug classes have recently flooded the therapeutic armamentarium. Decision-making is further complicated by the choice of an invasive (aggressive) or a medical (conservative) strategy of management with respect to coronary revascularization. For patients at highest risk, aspirin, beta-blockers, nitrates, and a statin should be given, and clopidogrel, enoxaparin, a glycoprotein (GP) IIb/IIIa inhibitor, plus an invasive strategy should be considered. For intermediate- and low-risk patients, a "sliding-scale" approach may be best. Decisions about the three classes of antithrombotics--low-molecular-weight heparins, GP IIb/IIIa inhibitors, and thienopyridines--along with whether to adopt an early invasive strategy, should be made on an individual basis.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Topol EJdoi
10.1016/s0735-1097(02)02689-xsubject
Has Abstractpub_date
2003-02-19 00:00:00pages
S123-9issue
4 Suppl Seissn
0735-1097issn
1558-3597pii
S073510970202689Xjournal_volume
41pub_type
杂志文章,评审abstract::The goal of this study was to review the prognostic value of cardiac magnetic resonance (CMR) imaging findings for future cardiovascular events in patients with a recent myocardial infarction (MI) and patients with suspected or known coronary artery disease (CAD). Although the diagnostic value of CMR findings is estab...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2013.11.048
更新日期:2014-03-25 00:00:00
abstract::An international survey identified 40 patients less than 20 years old who underwent surgical implantation of an automatic implantable cardioverter-defibrillator (AICD). There was a history of aborted sudden cardiac death or sustained ventricular tachycardia in 92.5% of these patients. Twenty-two patients (55%) had str...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80338-9
更新日期:1990-10-01 00:00:00
abstract:OBJECTIVES:This study investigated the effects of androgens on gene expression in male- and female-donor macrophages. BACKGROUND:Men have more severe coronary disease than women. Androgen exposure increases foam cell formation in male but not female macrophages, and male macrophages express >4-fold more androgen recep...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2003.07.002
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:This study was designed to examine the use of cardiovascular medications and outcomes in patients with heart failure (HF) and renal dysfunction. BACKGROUND:Renal insufficiency is associated with poorer outcomes in patients with HF, but the mechanisms are uncertain. In particular, the degree of therapeutic n...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.06.072
更新日期:2004-10-19 00:00:00
abstract::Each trainee in vascular medicine must be eligible for the board certification examination of the American Board of Internal Medicine or its equivalent. Training faculty, preferably at least two members, should meet the qualifications and training requirements described in this report. They must be dedicated, effectiv...
journal_title:Journal of the American College of Cardiology
pub_type: 指南,杂志文章
doi:10.1016/0735-1097(93)90077-e
更新日期:1993-08-01 00:00:00
abstract:BACKGROUND:It is unclear whether the non-vitamin K antagonist oral anticoagulant agents rivaroxaban and dabigatran are superior to warfarin for efficacy and safety outcomes in Asians with nonvalvular atrial fibrillation (NVAF). OBJECTIVES:The aim of this study was to compare the risk for thromboembolic events, bleedin...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2016.06.062
更新日期:2016-09-27 00:00:00
abstract::Forty patients with coronary artery disease and nonsustained ventricular tachycardia on ambulatory electrocardiographic monitoring underwent programmed electrical stimulation. In 22 patients, monomorphic ventricular tachycardia was induced at baseline drug-free electrophysiologic testing; 9 of these patients subsequen...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90066-1
更新日期:1989-07-01 00:00:00
abstract::Between December 1985 and April 1990, 50 infants with a variety of congenital cardiac lesions other than the hypoplastic left heart syndrome underwent surgical relief of aortic outflow obstruction by creation of a pulmonary artery to aorta anastomosis. The patients were grouped anatomically by ventriculoarterial align...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(91)90806-k
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVES:Because the renin-angiotensin-aldosterone system (RAS) modifies cardiovascular autonomic regulation, we studied the possible associations between baroreflex sensitivity (BRS) and polymorphism in the RAS genes. BACKGROUND:Wide intersubject variability in BRS is not well explained by cardiovascular risk facto...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(99)00506-9
更新日期:2000-01-01 00:00:00
abstract:OBJECTIVES:We administered pilsicainide chloride, a class Ic pure sodium channel blocker, to patients with Brugada syndrome (BS) and evaluated the occurrence of ventricular arrhythmia (VA) and T-wave alternans (TWA). BACKGROUND:Ventricular arrhythmia and TWA are sometimes induced by a sodium channel blocker challenge ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2003.06.004
更新日期:2003-11-05 00:00:00
abstract:BACKGROUND:The BAG3 (BLC2-associated athanogene 3) gene codes for an antiapoptotic protein located on the sarcomere Z-disc. Mutations in BAG3 are associated with dilated cardiomyopathy (DCM), but only a small number of cases have been reported to date, and the natural history of BAG3 cardiomyopathy is poorly understood...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jacc.2018.08.2181
更新日期:2018-11-13 00:00:00
abstract:BACKGROUND:P2Y12 inhibitor monotherapy with ticagrelor after a brief period of dual antiplatelet therapy can reduce bleeding without increasing ischemic harm after percutaneous coronary intervention (PCI). The impact of this approach among patients with diabetes mellitus (DM) remains unknown. OBJECTIVES:The purpose of...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jacc.2020.03.008
更新日期:2020-05-19 00:00:00
abstract:BACKGROUND:Familial hypercholesterolemia is typically caused by LDL receptor (LDLR) mutations that result in elevated levels of LDL cholesterol (LDL-C). In homozygous FH, the prevalence of aortic valve calcification (AoVC) reaches 100% and is often symptomatic. OBJECTIVES:The objective of this study was to investigate...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2015.09.087
更新日期:2015-12-22 00:00:00
abstract:OBJECTIVES:We sought to evaluate the impact of dobutamine stress echocardiography (DSE) in patients with known rheumatic mitral stenosis (MS) in order to assess its safety, feasibility, and prognostic correlation to well-known clinical outcomes. BACKGROUND:Noninvasive prognostic assessment of MS still represents an un...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2003.09.037
更新日期:2004-02-04 00:00:00
abstract::Accurate quantification and timing of regional myocardial function allows early identification of dysfunction, and therefore becomes increasingly important for clinical risk assessment, patient management, and evaluation of therapeutic efficacy. For this purpose, the application of tissue Doppler echocardiography has ...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2006.07.048
更新日期:2006-11-21 00:00:00
abstract::Calcium channel blockers and beta-receptor blockers improve symptoms of myocardial ischemia by potentially different mechanisms. Accordingly, combination therapy may entail additive benefits. Twenty-four patients with symptomatic stable effort angina despite full beta-blockade were randomized to a double-blind Latin s...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(86)80500-9
更新日期:1986-02-01 00:00:00
abstract::Previous studies of the effects of bundle branch block on ventriculoatrial (VA) intervals during orthodromic reciprocating tachycardia have focused on the timing of the atrial electrograms. However, left bundle branch block importantly affects the timing of initial ventricular activation, and this effect would also be...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(89)90573-1
更新日期:1989-01-01 00:00:00
abstract:OBJECTIVES:The goal of this study was to investigate the effect of three different doses of acetylsalicylic acid (aspirin) (ASA) on the late phase of ischemic preconditioning (PC) against myocardial stunning. BACKGROUND:Although recent evidence indicates that the late phase of ischemic PC is mediated by cyclooxygenase...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(03)00086-x
更新日期:2003-04-02 00:00:00
abstract:OBJECTIVES:The goal of this study was to identify differences in shear-induced platelet aggregation (SIPA) between patients who did or did not experience subacute stent thrombosis (SAT). BACKGROUND:Despite dual antiplatelet therapy, SAT after coronary stenting occurs in approximately 1% of patients. There is no accept...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2004.10.079
更新日期:2005-06-07 00:00:00
abstract::Stroke survivors carry a high risk of recurrence. Antithrombotic medications are paramount for secondary prevention and thus crucial to reduce the overall stroke burden. Appropriate antithrombotic agent selection should be based on the best understanding of the physiopathological mechanism that led to the initial isch...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2019.06.039
更新日期:2019-08-13 00:00:00
abstract::The noninferiority design is used extensively in current clinical research, but its complex features may hamper the appropriate interpretation of such trials. Thus, understanding the pillars of noninferiority design is indispensable. The authors discuss fundamental concepts regarding the design and interpretation of n...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2017.06.039
更新日期:2017-08-15 00:00:00
abstract::Viral respiratory infections are risk factors for cardiovascular disease (CVD). Underlying CVD is also associated with an increased risk of complications following viral respiratory infections, including increased morbidity, mortality, and health care utilization. Globally, these phenomena are observed with seasonal i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,评审
doi:10.1016/j.jacc.2020.08.028
更新日期:2020-10-13 00:00:00
abstract:OBJECTIVES:We examined compliance with performance measures for 14,464 patients enrolled from July 2008 through June 2009 into the American College of Cardiology's PINNACLE (Practice Innovation And Clinical Excellence) program to provide initial insights into the quality of outpatient cardiac care. BACKGROUND:Little i...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/j.jacc.2010.03.043
更新日期:2010-06-29 00:00:00
abstract::Signal-averaged electrocardiograms (ECGs) and programmed ventricular stimulation were serially performed in 12 dogs (3 weeks of age) after experimental anteroapical myocardial infarction. At electrophysiologic study, sustained ventricular tachyarrhythmia was induced in seven dogs on at least one occasion. Of a total o...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(10)80027-0
更新日期:1990-05-01 00:00:00
abstract:OBJECTIVES:We sought to determine an anticoagulation protocol for use during cardiac catheterization in children. BACKGROUND:There are few data to indicate which dose of heparin represents adequate anticoagulation or how best to monitor its efficacy. In this study, adequate anticoagulation was defined as the amount of...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/0735-1097(94)00438-V
更新日期:1995-03-01 00:00:00
abstract:OBJECTIVES:This study aimed to compare changes in coronary endothelial function, systemic endothelin-1 (ET-1) levels, and vascular remodeling in heart transplant recipients randomized to cyclosporin A (CyA) or tacrolimus (Tac) immunosuppression. BACKGROUND:Functional endothelial abnormalities and intimal thickening ar...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2005.10.073
更新日期:2006-04-18 00:00:00
abstract:BACKGROUND:A lack of clarity exists about the role of complete coronary revascularization in patients presenting with non-ST-segment elevation myocardial infarction. OBJECTIVES:The aim of our study was to compare long-term outcomes in terms of major adverse cardiovascular and cerebrovascular events of 2 different comp...
journal_title:Journal of the American College of Cardiology
pub_type: 评论,杂志文章
doi:10.1016/j.jacc.2015.10.082
更新日期:2016-01-26 00:00:00
abstract:OBJECTIVE:We studied the effects of sildenafil, a phosphodiesterase 5 inhibitor, on coronary and peripheral vascular function, platelet activation, and myocardial ischemia. BACKGROUND:Nitric oxide vasodilates and inhibits platelet activation by generating cyclic guanosine 5'-monophosphate, which is metabolized by phos...
journal_title:Journal of the American College of Cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0735-1097(02)02139-3
更新日期:2002-10-02 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine whether contractile recovery induced by dobutamine in dysfunctioning viable myocardium supplied by nearly occluded vessels is related to an increase in blood flow in the absence of collaterals. BACKGROUND:Dobutamine is used to improve contractility in ventricular d...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章
doi:10.1016/s0735-1097(98)00625-1
更新日期:1999-03-01 00:00:00
abstract:BACKGROUND:In the SYNTAX (Synergy Between Percutaneous Coronary Intervention With Taxus and Cardiac Surgery) trial, patients with 3-vessel or left main coronary artery disease (CAD) had improved long-term outcomes with coronary artery bypass graft (CABG) surgery compared with percutaneous coronary intervention (PCI) wi...
journal_title:Journal of the American College of Cardiology
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jacc.2017.02.031
更新日期:2017-04-25 00:00:00