Circulation journal : official journal of the Japanese Circulation Society
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Multicenter Study
Detection of masked hypertension and the 'mask effect' in patients with well-controlled office blood pressure.
Masked hypertension (MH) is characterized by its hidden nature and poor prognosis. However, it is not practical to routinely recommend home or ambulatory blood pressure monitoring (HBP or AMBP) to all patients with apparently well-controlled BP. The purpose of this study is to present, within the group of patients with well-controlled office BP (OBP), the clinical predictors of MH and to evaluate the gap (ie, the `mask effect' (ME)) between OBP and HBP. ⋯ To recognize MH, it is practical to investigate those patients who are taking multiple antihypertensive drugs and have a high OBP with a high FBG level. The term "ME" identifies MH more appropriately than the term "negative white-coat effect".
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Multicenter Study Comparative Study Clinical Trial
Heart fatty acid-binding protein offers similar diagnostic performance to high-sensitivity troponin T in emergency room patients presenting with chest pain.
The aim of the present study was to evaluate the diagnostic accuracy of high-sensitivity troponin T (hsTnT) in patients with suspected acute coronary syndrome (ACS) in comparison to heart fatty acid-binding protein (H-FABP), high-sensitivity C-reactive protein, myeloperoxidase (MPO), and pentraxin 3 (PTX3). ⋯ The hsTnT assay offers excellent diagnostic performance to rule out ACS, but it is prone to false-positive results. H-FABP offers similar overall diagnostic performance, while the combination of H-FABP and MPO assays may improve the diagnosis of ACS, particularly in patients with recent onset of chest pain.
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Patients undergoing acute left main (LM) coronary artery revascularization have a high mortality and natriuretic peptides such as N-terminal pro-B-type (NT-proBNP) have been shown to have prognostic value in patients with acute coronary syndromes. The present study looked at the prognostic value of NT-proBNP in these patients. ⋯ NT-proBNP is a strong predictor of outcome in patients undergoing acute LM coronary artery stenting. Mortality in such patients is high, but those with NT-proBNP < 1,000ng/L may have a favorable short- and long-term prognosis. Further research, including a larger patient population, is needed to determine the optimal cut-off value for NT-proBNP in patients undergoing acute LM coronary artery intervention.
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Toll-like receptors (TLRs) are expressed on cardiomyocytes and recognize pathogen-associated molecular patterns. Whether endogenous molecules produced by tissue injury (damage associated molecular patterns, DAMPs) can induce cardiomyocyte inflammation via TLR signalling pathways and/or reduce cardiomyocyte contractility is unknown. ⋯ Extracellular HSP70 acting via TLR2 and its obligate downstream adaptor molecule, MyD88, activate NFκB. This causes cardiomyocyte inflammation and decreased contractility.
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Multicenter Study Clinical Trial
Incidence and outcome of out-of-hospital cardiac arrest with public-access defibrillation. A descriptive epidemiological study in a large urban community.
Detailed characteristics of those who experience an out-of-hospital cardiac arrest (OHCA) with public-access defibrillation (PAD) are unknown. ⋯ Railway stations are the most common places where shocks by public-access AEDs were delivered in large urban communities of Japan, and among lay-rescuers railway station workers use AEDs more frequently.