International journal of cardiology
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Mortality rates after acute myocardial infarction (AMI) have declined, but there is uncertainty regarding the extent of improvements in early mortality in the elderly. ⋯ In England and Wales, for patients with AMI there are age and sex-dependent differences in improvements in 30-day mortality. Whereas young males with AMI have reached an acceptable performance plateau, all other groups are either improving or, more importantly, are yet to demonstrate this.
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Persons with a clinically recognized myocardial infarction are at increased risk for atrial fibrillation. However a large proportion of all myocardial infarctions remain clinically unrecognized. Whether subjects with electrocardiographic signs of an unrecognized myocardial infarction are also at an increased risk of developing atrial fibrillation is unknown. The objective of this study was to investigate whether unrecognized myocardial infarction was associated with an increased risk of atrial fibrillation in a prospective population-based cohort study. ⋯ The presence of an unrecognized myocardial infarction is associated with a twofold increased risk of atrial fibrillation in men, independent of known cardiovascular risk factors.
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There is a need for reliable prognostic parameters in pulmonary arterial hypertension (PAH), especially in children. Pulsatile components of the right ventricular afterload, represented by pulmonary arterial compliance (PACi) and pulmonary stroke volume (PSVi), may provide important additional prognostic information to conventional static haemodynamic parameters. The aim of this study was to determine the prognostic value of PACi and PSVi in paediatric PAH. ⋯ The parameters of both the pulsatile and static pulmonary circulations are strong independent predictors for transplant-free survival, and therefore can be of complementary value in assessing disease severity, predicting survival and guiding treatment in paediatric PAH.
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Cardiac troponins are diagnostic markers in acute coronary syndrome and prognostic markers in stable coronary disease. Small increases are occasionally observed in patients with non-cardiac disease, but the prevalence and prognostic value of increased troponin in the general hospitalized population are unknown. ⋯ More than half of the hospitalized patients had hs-TnT levels above the 99(th) percentile. Elevated hs-TnT is a strong mortality risk marker in general hospitalized older patients.