Skip header and navigation

Refine By

5 records – page 1 of 1.

Canada Acute Coronary Syndrome Risk Score: a new risk score for early prognostication in acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature112576
Source
Am Heart J. 2013 Jul;166(1):58-63
Publication Type
Article
Date
Jul-2013
Author
Thao Huynh
Simon Kouz
Andrew T Yan
Andrew Yan
Nicolas Danchin
Jennifer O'Loughlin
Jennifer O Loughlin
Erick Schampaert
Raymond T Yan
Raymond Yan
Stephane Rinfret
Jean-Claude Tardif
Mark J Eisenberg
Marc Afilalo
Alice Chong
Jean-Pierre Dery
Michel Nguyen
Claude Lauzon
Samer Mansour
Dennis T Ko
Jack V Tu
Shaun Goodman
Author Affiliation
Division of Cardiology, McGill Health University Center, Quebec, Canada. thao.huynhthanh@mail.mcgill.ca
Source
Am Heart J. 2013 Jul;166(1):58-63
Date
Jul-2013
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - epidemiology
Aged
Canada - epidemiology
Electrocardiography
Female
Hospital Mortality - trends
Humans
Male
Middle Aged
Prognosis
Registries
Risk Assessment - methods
Risk factors
Survival Rate - trends
Abstract
Despite the availability of several acute coronary syndrome (ACS) prognostic risk scores, there is no appropriate score for early-risk stratification at the time of the first medical contact with patients with ACS. The primary objective of this study is to develop a simple risk score that can be used for early-risk stratification of patients with ACS.
We derived the risk score from the Acute Myocardial Infarction in Quebec and Canada ACS-1 registries and validated the risk score in 4 other large data sets of patients with ACS (Canada ACS-2 registry, Canada-GRACE, EFFECT-1, and the FAST-MI registries). The final risk score is named the Canada Acute Coronary Syndrome Risk Score (C-ACS) and ranged from 0 to 4, with 1 point assigned for the presence of each of these variables: age =75 years, Killip >1, systolic blood pressure 100 beats/min. The primary end points were short-term (inhospital or 30-day) and long-term (1- or 5-year) all-cause mortality.
The C-ACS has good predictive values for short- and long-term mortality of patients with ST-segment elevation myocardial infarction and non-ST-segment elevation ACS. The negative predictive value of a C-ACS score =1 is excellent at =98% (95% CI 0.97-0.99) for short-term mortality and =93% (95% CI 0.91-0.96) for long-term mortality. In other words, a C-ACS score of 0 can potentially identify correctly =97% short-term survivors and =91% long-term survivors.
The C-ACS risk score permits rapid stratification of patients with ACS. Because this risk score is simple and easy to memorize and calculate, it can be rapidly applied by health care professionals without advanced medical training.
Notes
Erratum In: Am Heart J. 2013 Sep;166(3):604Yan, Andrew [corrected to Yan, Andrew T]; Loughlin, Jennifer O [corrected to O'Loughlin, Jennifer]; Yan, Raymond [corrected to Yan, Raymond T]
PubMed ID
23816022 View in PubMed
Less detail

Relation between previous angiotensin-converting enzyme inhibitor use and in-hospital outcomes in acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature129701
Source
Am J Cardiol. 2012 Feb 1;109(3):332-6
Publication Type
Article
Date
Feb-1-2012
Author
Sheldon M Singh
Shaun G Goodman
Raymond T Yan
Jean-Pierre Dery
Graham C Wong
Richard Gallo
Francois R Grondin
Kevin Lai
Jose Lopez-Sendon
Keith A A Fox
Andrew T Yan
Author Affiliation
Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.
Source
Am J Cardiol. 2012 Feb 1;109(3):332-6
Date
Feb-1-2012
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - complications - drug therapy - mortality
Aged
Angiotensin-Converting Enzyme Inhibitors - therapeutic use
Canada - epidemiology
Confidence Intervals
Disease Progression
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Inpatients
Male
Middle Aged
Myocardial Infarction - diagnosis - epidemiology - etiology
Prognosis
Prospective Studies
Registries
Risk factors
Survival Rate - trends
Abstract
Angiotensin-converting enzyme (ACE) inhibitor use in patients at high risk of coronary artery disease has been associated with a decrease in the risk of myocardial infarction (MI) and death. However, it is unclear whether chronic use of these agents modifies the course and outcome of an acute coronary syndrome (ACS). This study assessed the association between chronic use of ACE inhibitors and clinical outcomes in patients with ACS. From 1999 through 2008, 13,632 Canadian patients with ACS were identified in the Global Registry of Acute Coronary Events (GRACE), the expanded GRACE (GRACE(2)), and the Canadian Registry of Acute Coronary Events (CANRACE). Patients were stratified by previous use of an ACE inhibitor. Clinical characteristics, in-hospital treatment, and outcomes were compared between the 2 groups. Multivariable logistic regression analysis adjusting for GRACE risk score and other clinical factors was performed. Patients receiving an ACE inhibitor before the ACS had a higher prevalence of diabetes (40.6% vs 21.2%, p
PubMed ID
22078966 View in PubMed
Less detail

Temporal changes in the management and outcome of Canadian diabetic patients hospitalized for non-ST-elevation acute coronary syndromes.

https://arctichealth.org/en/permalink/ahliterature132265
Source
Am Heart J. 2011 Aug;162(2):347-355.e1
Publication Type
Article
Date
Aug-2011
Author
Basem Elbarouni
Nabeel Ismaeil
Raymond T Yan
Keith A A Fox
Kim A Connelly
Carolyn Baer
J Paul DeYoung
Richard Gallo
Krishnan Ramanathan
Yves Pesant
Lawrence A Leiter
Shaun G Goodman
Andrew T Yan
Author Affiliation
Canadian Heart Research Centre, Division of Cardiology, St. Michael's Hospital, University of Toronto, ON, Canada.
Source
Am Heart J. 2011 Aug;162(2):347-355.e1
Date
Aug-2011
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - complications - diagnosis - surgery
Aged
Canada - epidemiology
Coronary Angiography
Diabetes Mellitus - epidemiology - therapy
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Incidence
Male
Middle Aged
Myocardial Revascularization
Prospective Studies
Registries
Time Factors
Treatment Outcome
Abstract
There are limited data on the contemporary management and outcomes of non-ST-elevation acute coronary syndrome (NSTE-ACS) patients with diabetes in the "real world." We sought to evaluate (1) the temporal changes in the medical and invasive management and (2) in-hospital outcome of NSTE-ACS patients with and without diabetes.
We included Canadian patients hospitalized for NSTE-ACS enrolled in 4 consecutive, prospective, multicenter registries: Canadian ACS-I (n = 3259; 1999-2001), ACS-II (n = 1,956; 2002-2003), Global Registry of Acute Coronary Events (GRACE/GRACE2 [n = 7,561; 2004-2007]) and Canadian Registry of Acute Coronary Events (n = 1,326; 2008). Participants were stratified by the presence or absence of preexisting diabetes on admission. Temporal changes in patient management and outcomes were evaluated across the 4 registries. Multivariable analyses were performed to determine the independent prognostic significance of diabetes.
Of the 14,102 NSTE-ACS patients, 4,046 (28.7%) had previously diagnosed diabetes. Patients with diabetes were older; were more likely to have prior cardiac history including myocardial infarction, revascularization, and heart failure; and had worse Killip class and higher GRACE risk score (all P
PubMed ID
21835297 View in PubMed
Less detail

Temporal patterns of lipid testing and statin therapy in acute coronary syndrome patients (from the Canadian GRACE Experience).

https://arctichealth.org/en/permalink/ahliterature126547
Source
Am J Cardiol. 2012 May 15;109(10):1418-24
Publication Type
Article
Date
May-15-2012
Author
Basem Elbarouni
S Behnam Banihashemi
Raymond T Yan
Robert C Welsh
Jan M Kornder
Graham C Wong
Frederick A Anderson
Frederick A Spencer
François R Grondin
Shaun G Goodman
Andrew T Yan
Author Affiliation
Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Source
Am J Cardiol. 2012 May 15;109(10):1418-24
Date
May-15-2012
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - blood - drug therapy - mortality
Aged
Aged, 80 and over
Biological Markers - blood
Canada - epidemiology
Confidence Intervals
Disease Progression
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage - therapeutic use
Lipids - blood
Male
Middle Aged
Odds Ratio
Prospective Studies
Registries
Survival Rate - trends
Treatment Outcome
Abstract
Current guidelines recommend the measurement of fasting lipid profile and use of statins in all patients with acute coronary syndrome (ACS). However, the temporal trends of lipid testing and statin therapy in "real-world" patients with ACS are unclear. From January 1999 through December 2008, the prospective, multicenter, Global Registry of Acute Coronary Events (GRACE/GRACE(2)/CANRACE) enrolled 13,947 patients with ACS in Canada. We stratified the study population based on year of presentation into 3 groups (1999 to 2004, 2005 to 2006, and 2007 to 2008) and compared the use of lipid testing and use of statin therapy in hospital. Overall, 70.8% of patients underwent lipid testing and 79.4% received in-hospital statin therapy; these patients were younger and had lower GRACE risk scores (p 130 mg/dl (3.4 mmol/L) were more likely to be treated with in-hospital statins. In conclusion, there has been a significant temporal increase in the use of in-hospital statin therapy but only a minor increase in lipid testing. Lipid testing was strongly associated with in-hospital statin use. A substantial proportion of patients with ACS, especially those at higher risk, still do not receive these guideline-recommended interventions in contemporary practice.
PubMed ID
22381155 View in PubMed
Less detail

Treatment and outcomes of patients with suspected acute coronary syndromes in relation to initial diagnostic impressions (insights from the Canadian Global Registry of Acute Coronary Events [GRACE] and Canadian Registry of Acute Coronary Events [CANRACE]).

https://arctichealth.org/en/permalink/ahliterature119230
Source
Am J Cardiol. 2013 Jan 15;111(2):202-7
Publication Type
Article
Date
Jan-15-2013
Author
Ravi R Bajaj
Shaun G Goodman
Raymond T Yan
Alan J Bagnall
Gabor Gyenes
Robert C Welsh
Kim A Eagle
David Brieger
Krishnan Ramanathan
Francois R Grondin
Andrew T Yan
Author Affiliation
Department of Medicine, Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, Ontario, Canada.
Source
Am J Cardiol. 2013 Jan 15;111(2):202-7
Date
Jan-15-2013
Language
English
Publication Type
Article
Keywords
Acute Coronary Syndrome - diagnosis - mortality - surgery
Aged
Canada - epidemiology
Electrocardiography
Female
Follow-Up Studies
Hospital Mortality - trends
Humans
Male
Middle Aged
Percutaneous Coronary Intervention
Predictive value of tests
Prognosis
Prospective Studies
Registries
Risk Assessment - methods
Risk factors
Survival Rate - trends
Abstract
The early diagnosis of acute coronary syndrome (ACS) remains challenging, and a considerable proportion of patients are diagnosed with "possible" ACS on admission. The Global Registry of Acute Coronary Events (GRACE/GRACE(2)) and Canadian Registry of Acute Coronary Events (CANRACE) enrolled 16,618 Canadian patients with suspected ACS in 1999 to 2008. We compared the demographic and clinical characteristics, use of cardiac procedures, prognostic accuracy of the GRACE risk score, and in-hospital outcomes between patients given an admission diagnosis of "definite" versus "possible" ACS by the treating physician. Overall, 11,152 and 5,466 patients were given an initial diagnosis of "definite" ACS and "possible" ACS, respectively. Patients with a "possible" ACS had higher GRACE risk score (median 130 vs 125) and less frequently received aspirin, clopidogrel, heparin, or ß blockers within the first 24 hours of presentation and assessment of left ventricular function, stress testing, cardiac catheterization, and percutaneous coronary intervention (all p
PubMed ID
23122889 View in PubMed
Less detail