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Tag Archives: myocardial infarction

High-sensitivity troponin: six lessons and a reading

September 2013 Br J Cardiol 2013;20:109–12 doi:10.5837/bjc.2013.026

High-sensitivity troponin: six lessons and a reading

James H P Gamble, Edward Carlton, William Orr, Kim Greaves

Abstract

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July 2013 Br J Cardiol 2013;20:88-9 doi:10.5837/bjc.2013.023 Online First

Cardiac magnetic resonance imaging in the UK – an end to status anxiety but no room for complacency

Charlotte Manisty, James C Moon

Abstract

That CMR is the gold standard for heart size and function, and for congenital and inherited heart disease is little disputed. The additional benefit of CMR for tissue characterisation has gained widespread acceptance, particularly now with convincing prognostic data across a wide variety of disorders,1 and the large EuroCMR registry (27,000 patients, 15 countries),2 showing that CMR entirely changed diagnosis in nearly 10% of subjects. CMR adoption as a ‘workhorse’ for ischaemia and viability testing has, however, been slower, with continued calls for cost-effectiveness and head-to-head comparison data with other modalities. These data ar

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March 2012 Br J Cardiol 2012;19:10

MI deaths continue to fall sharply in England

News from the world of cardiology

Abstract

Overall, just over half of the decline is attributed to a fall in event rate and just less than half to a decline in case fatality, so advances in both primary prevention and secondary prevention appear to have contributed. The latest data come from a study conducted by researchers led by Kate Smolina (Unit of Health-Care Epidemiology, Oxford), who used national hospital and mortality data to identify 840,175 patients who had suffered a myocardial infarction (MI) during the eight year period. The standardised mortality rate from MI decreased in men from 78.7 to 39.2 (38.6 to 39.9) per 100,000 population and in women from 37.3 to 17.7. A decli

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August 2011 Br J Cardiol 2011;18:178

Lifestyle advice and drug therapy post-myocardial infarction: a survey of UK current practice

Julian Halcox, Steven Lindsay, Alan Begg, Kathryn Griffith, Alison Mead, Beverly Barr 

Abstract

Introduction Myocardial infarction (MI) is a common condition, estimated to affect almost 150,000 people per year in the UK.1 Without effective treatment, the immediate mortality of MI approaches 40% with a further 10% of patients dying in the subsequent year.2 In those who survive the initial post-MI period, an increased risk of death from cardiovascular causes (5% per year) persists indefinitely.2 However, effective secondary prevention measures can significantly reduce this risk.3 An estimated 1.4 million people in the UK have had an MI.4 Reducing morbidity and mortality among this group requires effective secondary prevention measures. In

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Drugs for diabetes: part 1 metformin

September 2010 Br J Cardiol 2010;17:231–4

Drugs for diabetes: part 1 metformin

James G Boyle, Gerard A McKay, Miles Fisher

Abstract

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July 2010 Br J Cardiol 2010;17:163-5

England sees MI reduction after smoking ban 

BJ Cardio Staff

Abstract

The study, published online in the British Medical Journal on June 8, 2010, found that, after accounting for a pre-existing decline in admissions, trends in population size, and seasonal variation in admissions, there was a 2.4% drop in the number of emergency admissions for MI after the smoking ban legislation came into force on July 1, 2007. This equates to 1,200 fewer emergency admissions in the first year after the law came into effect (1,600 including readmissions). The researchers, from the University of Bath, note that the largest impacts of smoking bans on MI rates have been reported in smaller studies in the US, with reductions in th

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News from the 59th Annual Scientific Session of the American College of Cardiology

May 2010 Br J Cardiol 2010;17:111-5

News from the 59th Annual Scientific Session of the American College of Cardiology

BJ Cardio Staff

Abstract

ACCORD/INVEST: do not aim for normal blood pressure in diabetes patients with CAD The results of two trials comparing intensive versus more conventional blood pressure lowering in patients with diabetes at high cardiovascular risk have suggested that intensive treatment is not necessary and may be harmful in this population. In the ACCORD BP (Action to Control Cardiovascular Risk in Diabetes – Blood Pressure) trial, while intensive blood pressure treatment did reduce the risk of stroke, it failed to reduce the overall risk of cardiovascular events in patients and was associated with an increase in adverse events due to antihypertensive ther

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Achieving the dose: an audit of discharge medication for the secondary prevention of myocardial infarction

May 2010 Br J Cardiol 2010;17:142-3

Achieving the dose: an audit of discharge medication for the secondary prevention of myocardial infarction

Kyle J Stewart, Pippa Woothipoom, Jonathan N Townend

Abstract

Introduction This retrospective audit was performed to assess whether patients discharged from the cardiology ward at the Queen Elizabeth Hospital, Birmingham, following ST-segment elevation myocardial infarction (STEMI) or non-ST-segment elevation myocardial infarction (NSTEMI) were prescribed the recommended medication at appropriate doses. The evidence for the prognostic benefit of drugs such as angiotensin-converting enzyme (ACE) inhibitors, beta blockers and statins after a myocardial infarction (MI) is derived from studies in which these drugs were used at high doses, such as Acute Infarction Ramipril Efficacy (AIRE),1 Carvedilol Post-I

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January 2009 Br J Cardiol 2009;16:43

Multi-modality imaging of myocardial infarction

Edward D Nicol, James Stirrup, Jonathan C Lyne

Abstract

A computed tomography (CT) coronary angiogram (CTA) was performed, as the patient was not keen on an invasive angiogram, and demonstrated sub-endocardial hypoattenuation at rest in the anterior wall, apex and apical inferior walls (figure 1B). It was not clear if there was any reversible ischaemia so a myocardial perfusion scintigraphy (SPECT) was performed, and demonstrated a partial thickness infarction involving the anterior wall, apex and apical inferior wall (figure 1A). A research cardiac magnetic resonance (CMR) scan demonstrated late Gadolinium enhancement in the same territories as the other two studies (figure 1C). Figure 1. A. Myoc

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September 2008 Br J Cardiol 2008;15:225

Referral: four principles and 10 steps

Terry McCormack, Henry Purcell

Abstract

An extreme example is the terminally ill patient with severe central chest pain. Even if they are suffering a myocardial infarction, urgent admission may not be the best option in their care. Unnecessary referral wastes the time of both clinicians and patients. It adds to waiting times for more needy patients. Equally we could be guilty of under referral and could be providing less than perfect care for our patients. The clinician needs to ask four principle questions before referral. First: will the referral improve the accuracy of diagnosis and provide better management of the disorder? Second: have all the appropriate examinations and inve

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