BACKGROUND It is unclear whether an evaluation incorporating coronary computed tomographic angiography (CCTA) is more effective than standard evaluation in the emergency department in patients with symptoms suggestive of acute coronary syndromes. METHODS In this multicenter trial, we randomly assigned patients 40 to 74 years of age with symptoms suggestive of acute coronary syndromes but with...

THE BEST THERAPY for a given morbid condition is possible only when both its pathoanatomy and pathophysiology are clearly understood. This certainly applies to the acute ischemic syndromes of the heart. Early in the study of myocardial infarction the term was considered to be synonymous with acute coronary thrombosis." 2 This theory remained intact for many years, to be challenged only within t...

Short-term fatality of patients admitted with acute coronary syndromes is the end-point followed most often in randomized pharmacological and interventional studies dealing with acute myocardial infarction or unstable angina. Usually, follow-ups in most trials are prolonged up to 1 year. The long-term prognosis beyond 1 year is virtually unknown. Meanwhile short-term (1 month) fatality in patie...

OBJECTIVE The goal of the present study was to compare the prognoses of patients with non-ST-elevation acute coronary syndromes who were treated with invasive or conservative treatment strategies. METHODS We performed a meta-analysis of studies of patients with non-ST-elevation acute coronary syndromes to assess the benefits of an invasive strategy vs. a conservative strategy for short- and l...

1. SCHWARTZ G, OLSSON A, EZEKOWITZ M, GANZ P, OLIVER M, WATERS D ET AL. Effects of Atorvastatin on Early Recurrent Ischemic Events in Acute Coronary Syndromes: The MIRACL Study: A Randomized Controlled Trial. JAMA 2001; 285: 1711-8. 2. LIEM A, VAN BOVEN A, VEEGER N, WITHAGEN A, ROBLES DE MEDINA R, TIJSSEN J ET AL. Effect of fluvastatin on ischaemia following acute myocardial infarction: a rando...

This case report describes for the first time acute coronary syndrome in a 67-year old patient after oral intake of naratriptan for migraine. So far in the literature, only sumatriptan, zolmitriptan and frovatriptan have been described to cause acute coronary syndromes. A 67-year old Swiss woman with thoracic pain after intake of 2.5 mg naratriptan presented with T-wave inversions in the ECG an...

There has been a surge of interest in the role of inflammation in causation of atherosclerosis and acute coronary syndromes. This interest is spurred both by pathological studies showing that ruptured coronary plaques manifest inflammatory characteristics1 and by the demonstration that inflammatory biomarkers in the plasma correlate with risk for acute coronary syndromes.2,3 Among the biomarker...

OBJECTIVES The purpose of this study was to examine clinical characteristics of patients with acute coronary syndromes to identify factors that influence the mode of presentation. BACKGROUND In acute coronary syndromes, presentation with myocardial infarction or unstable angina has major prognostic implications, yet clinical factors affecting the mode of presentation are not well defined. M...

OBJECTIVE To determine whether patients with non-ST elevation acute coronary syndromes requiring coronary angiography and revascularisation have inferior access to these services if admitted to district general hospitals (DGHs) compared with similar patients admitted to a base hospital containing a tertiary cardiac centre. DESIGN Prospective, consecutive monitoring of all patients with acute ...