Intravenous glucose-insulin-potassium (GIK) is postulated to be beneficial in acute ischaemic syndromes via two mechanisms: by providing metabolic support to ischaemic myocardium, and by preventing arrhythmias and cardiac arrest due to ischaemia-related metabolic derangements. Importantly, these benefits are most likely to be seen if GIK is started as soon as possible after the onset of […]
Tag: acute coronary syndrome
Early diagnosis of MI using serial troponin measurements
The recent introduction of high sensitivity troponin assays (hsT) has improved the sensitivity of this assay for the detection of myocardial infarction, whilst simultaneously decreasing specificity. To overcome this problem, the use of troponin kinetics – to identify acute myocardial damage – has been proposed, either alone or in combination with other diagnostic markers of […]
Novel diagnostic pathway improves chest pain assessment
Although 75-85% of patients presenting to the emergency department with chest pain ultimately do not receive a diagnosis of acute coronary syndrome, a lengthy assessment process is still mandatory as patients with a missed diagnosis of myocardial infarction are at increased risk for a cardiovascular event. Than et al. prospectively validated the safety of a […]
Fasting blood glucose levels identify high-risk individuals across the ACS spectrum
Elevated blood glucose at hospital admission, and elevated fasting blood glucose levels during admission, have been shown to predict worse outcome among patients with STEMI, however, the contribution of glucose levels to risk predictive algorithms involving patients with acute coronary syndromes (ACS) remains unclear. […]
Fasting blood glucose levels identify high-risk individuals across the ACS spectrum
Elevated blood glucose at hospital admission, and elevated fasting blood glucose levels during admission, have been shown to predict worse outcome among patients with STEMI, however, the contribution of glucose levels to risk predictive algorithms involving patients with acute coronary syndromes (ACS) remains unclear. […]
Assessing Risk in ACS – Risk Scores More Reliable
How well do physicians assess risk in non-ST elevation (NSTEMI) acute coronary syndrome (ACS) patients? Recent studies have suggested that often high-risk patients are the ones who receive less aggressive therapy – the so called “treatment-risk paradox”. This study sought to identify the patient characteristics that physicians considered to be high-risk, and to examine how […]
Cardiogenic shock rates show evidence of decline
It remains uncertain whether the sweeping changes in the treatment of acute coronary syndromes have had a substantial impact on the incidence of cardiogenic shock. […]