Preface
Intensive cardiac care (procedures) saves lives and reduce cardiac disability in acute cardiac patients. This treatment is to be delivered by specially trained and accredited cardiologists, nurses and paramedics working in specially designed and equipped facilities. The urgent nature of some acute cardiac presentations dictates the need to apply acute cardiac care as early as possible, at the prehospital and or emergency room scenario. Prompt and accurate diagnosis, meticulous monitoring and urgent treatment are indicated in a wide variety of cardiovascular conditions, including acute coronary syndromes, acute decompensated heart failure, life-threatening rhythm disturbances, myocarditis, pulmonary embolism, infective endocarditis, as well as complications of cardiac interventions and other acute maladies (i.e. infection, haemorrhage, trauma) whereby chronic heart disease may jeopardize the short-term prognosis.
The Association for Acute CardioVascular Care (ACVC) of the European Society of Cardiology (ESC) has set out to pioneer this subspeciality of cardiology. The ESC Textbook of Intensive and Acute Cardiovascular Care is a major asset. It is the only textbook completely dedicated to the field of acute cardiovascular and intensive care. It contains all the basic necessary comprehensive, yet practical information needed for the optimal implementation of acute cardiac care. This includes the recommended organization and function of the service, detailed description of the laboratory tests, special cardiac evaluation techniques, procedures, pharmacological and invasive therapeutic interventions used for the practice of intensive cardiac care. A detailed description and recommendations for the management of the various diseases in need for acute cardiac care is also included.
Cardiology in general, and specifically the field of intensive cardiac care, is constantly evolving. There is a constant new inflow of information, introduction of updated evidence-based guidelines and new and improved therapeutic techniques (including organ supportive therapy for the critically ill patients). Currently, the
ACVC has expanded the recommended treatment from a previous focus on in-hospital intensive care, with emphasis on the intensive cardiac care units (ICCUs), to intensive and acute cardiovascular care wherever it is needed (including pre-hospital, ambulances, emergency rooms, ICCUs, wards, operating theaters, etc.). This is in accord with the realization of the need for a continuum mode of treatment and the incorporation of the specific groups under the ACVC. Therefore, the effort for this new edition of the ESC Textbook of Acute and Intensive Cardiovascular Care is timely and highly appreciated.
For simplicity and consecutiveness, the table of contents in the current edition has been maintained similar to that of the second edition. However, the content has been improved and updated and a new chapter (Chapter 50) is now fully dedicated to implanted cardiac support devices. A special mention is to be dedicated to Chapter 3 on ‘Intensive Cardiovascular Care Units: structure, organization and staffing’ which reflects the reality that three levels of acute cardiac care may function in different hospitals. Some can apply only limited acute coronary care, while others can provide the full scope of advanced, comprehensive, intensive, and acute cardiac care (level III).
As in the previous editions, the print textbook is accompanied by an expanded and more comprehensive online edition, which is expected to be yearly updated.
The editors and authors of the third edition of the ESC Textbook of Intensive and Acute Cardiovascular Care should be congratulated on the completion of this major task. I am confident that this endeavor will contribute to the daily conductance of acute cardiac care and provide mandatory learning material for the education of cardiologists and allied staff training in the field.
Professor Yonathan Hasin Founding chairperson of the Working Group on Acute Cardiac Care of the ESC Ariel University Medical School
Symbols and abbreviations xi
Contributors xxix
1 Intensive and acute cardiovascular care: an introduction 1
Eric Bonnefoy-Cudraz, Susanna Price, Marco Tubaro, Pascal Vranckx, and Christiaan Vrints
SECTION I
Intensive and acute cardiovascular care
2 Training and certification in intensive and acute cardiovascular care 5
Susanna Price and Eric Bonnefoy-Cudraz
3
Intensive cardiovascular care units: structure, organization, and staffing 11
Eric Bonnefoy-Cudraz and Tom Quinn
4 The heart team 25
Sergio Leonardi, Thomas Modine, and Stephan Windecker
5 Patient safety and clinical governance 33
Matthew Parkin and Tom Quinn
6 Ethical issues in cardiac arrest and acute cardiac care: a European perspective 43
Jean-Louis Vincent and Jacques Creteur
7 Quality of care assessment in acute cardiac care 54
Fiona Ecarnot and François Schiele
SECTION II
The pre-hospital phase and the emergency department
8 The emergency medical system 65
Olivier Hoogmartens, Michiel Stiers, Koen Bronselaer, and Marc Sabbe
9 Out-of-hospital cardiac arrest 76
Jerry P Nolan and Christian Hassager
10 Chest pain in the emergency department and the chest pain unit 88
Christiaan Vrints, Janina Stepinska, and Marc J Claeys
11 Acute dyspnoea in the emergency department 103
Eleni Michou, Nikola Kozhuharov, Jasmin Martin, and Christian Mueller
12
SECTION III
Monitoring and investigations in the intensive cardiovascular care unit
Pathophysiology and clinical assessment of the cardiovascular system (including pulmonary artery catheterization) 115
Alessandro Sionis, Etienne Gayat, and Alexandre Mebazaa
13 The respiratory system 127
Antoine Vieillard-Baron
14 Neurological assessment of the acute cardiac care patient 134
Mathieu van der Jagt, Jeroen JH Bunge, and Fabio S Taccone
15 Monitoring of the kidneys, liver, and other vital organs 147
Karl Werdan, Brijesh Patel, Matthias Girndt, Henning Ebelt, Jochen Schröder, and Sebastian Nuding
16 Blood gas analysis: acid–base, fluid, and electrolyte disorders 165
Farah Shariff and Richard Paul
17 Interpretation and clinical use of chest radiographs 181
Alexander Parkhomenko, Olga S Gurjeva, and Tetyana Yalynska
18.1 Echocardiography and thoracic ultrasound 201
Frank A Flachskampf, Pavlos Myrianthefs, and Ruxandra Beyer
18.2 Echocardiography and thoracic ultrasound 218
Frank A Flachskampf, Pavlos Myrianthefs, and Ruxandra Beyer
19 Computerized tomography: coronary angiography and cardiac imaging 224
Jeff M Smit, Mohammed El Mahdiui, Michiel A de Graaf, Arthur JHA Scholte, Lucia Kroft, and Jeroen J Bax
20 Cardiac magnetic resonance in the intensive and cardiac care unit 246
Juerg Schwitter and Jens Bremerich
SECTION IV
Procedures in the intensive cardiovascular care unit
21 Non-invasive ventilation 267
Josep Masip, Kenneth Planas, and Arantxa Mas
22 Mechanical ventilation 284
Luigi Camporota and Francesco Vasques
23 Temporary pacing 306
Bulent Gorenek
24 Ultrasound-guided vascular access in intensive/acute cardiac care 314
Richard Paul
25 Pericardiocentesis 323
Caterina C De Carlini and Stefano Maggiolini
26 Chest tubes 331
Giulio Maurizi, Camilla Vanni, and Erino Angelo Rendina
27 Renal support therapy 338
Claudio Ronco, Stefano Romagnoli, and Zaccaria Ricci
28 Percutaneous (short-term) mechanical circulatory support 351
Holger Thiele and Pascal Vranckx
29 Nutrition support in acute cardiac care 360
Michael P Casaer and Greet Van den Berghe
30 Physiotherapy in critically ill patients 373
Rik Gosselink and Jean Roeseler
SECTION V
The laboratory in intensive and acute cardiovascular care
31 The use of biomarkers for acute cardiovascular disease 387
Allan S Jaffe
32 Biomarkers in acute coronary syndromes 400 Jasper Boeddinghaus, Thomas Nestelberger, Raphael Twerenbold, and Christian Mueller
33 Biomarkers in acute heart failure 409
Rajiv Choudhary, Nicholas Wettersten, Kevin Shah, and Alan Maisel
34 Biomarkers of coagulation and thrombosis 425 Anne-Mette Hvas, Erik L Grove, and Steen Dalby Kristensen
35 Biomarkers of renal and hepatic failure 434
Mario Plebani, Monica Maria Mion, and Martina Zaninotto
SECTION VI
Acute coronary syndromes
36 Atherosclerosis and thrombosis 447
Lina Badimon and Gemma Vilahur
37 The universal definition of myocardial infarction 463
Kristian Thygesen, Joseph S Alpert, Allan S Jaffe, and Harvey D White
38 ST-segment elevation myocardial infarction 479
Borja Ibanez and Stefan James
39 Fibrinolytic, antiplatelet, and anticoagulant drugs in acute coronary syndromes 494
Sigrun Halvorsen, Giuseppe Gargiulo, Marco Valgimigli, and Kurt Huber
40 Mechanical complications of myocardial infarction 513
Elena Puerto and Héctor Bueno
41 Non-ST-segment elevation acute coronary syndromes 531
Héctor Bueno and José A Barrabés
42 Percutaneous coronary interventions in acute coronary syndromes 549
Andreas Mitsis and Marco Valgimigli
43 Coronary artery bypass graft surgery 565
Piroze M Davierwala and Michael A Borger
44 Sex considerations in acute coronary syndromes 585
Eva Swahn, Joakim Alfredsson, and Sofia Sederholm Lawesson
SECTION VII
Acute heart failure (including cardiogenic shock)
45 Acute heart failure: epidemiology, classification, and pathophysiology 603
Dimitrios Farmakis and Gerasimos Filippatos
46 Acute heart failure: early pharmacological therapy 617
Kieran F Docherty, Jonathan R Dalzell, Mark C Petrie, and John JV McMurray
47 Low cardiac output states and cardiogenic shock 633
Holger Thiele and Suzanne de Waha-Thiele
48 Non-pharmacological therapy of acute heart failure: when drugs alone are not enough 651
Jeroen Dauw, Wilfried Mullens, Johan Vijgen, and Pascal Vranckx
49 Heart failure surgery and transplantation 664
Felix Schoenrath, Jan Klages, and Volkmar Falk
50 Implanted cardiac support devices 680
Andrew C Morley-Smith, André R Simon, and John Pepper
51 Donor organ management 691
Arne P Neyrinck, Patrick Ferdinande, Dirk Van Raemdonck, and Marc Van de Velde
52 Palliative care in the intensive cardiovascular care unit 706
Jayne Wood SECTION VIII Arrhythmias
53 Atrial fibrillation and supraventricular arrhythmias 719
Demosthenes G Katritsis and A John Camm
54 Ventricular tachyarrhythmias 740
Paolo Della Bella, Dagmara Dilling, and Francesca Baratto
55 Pacemaker and ICDs: troubleshooting 755
Neasa Starr and Haran Burri
SECTION IX
Specific acute cardiovascular conditions
56 Myocarditis and pericarditis 767
Massimo Imazio and Stephane Heymans
57 Acute valve disease and endocarditis 778
Gregory Ducrocq, Franck Thuny, Bernard Iung, and Alec Vahanian
58 Congenital heart disease in adults 795
Susanna Price, Brian F Keogh, and Lorna Swan
59 Aortic emergencies 805
Marc Schepens and Eric Graulus
60 Cardiac complications in trauma 820
Lydia Lam, Leslie Kobayashi, and Demetrios Demetriades
61 Cardiac emergencies in pregnancy 830
Mark Johnson and Jolien Roos-Hesselink
62 Pulmonary hypertension 839
Massimiliano Palazzini, Nazzareno Galiè, and Alessandra Manes
63 Pulmonary embolism 849
Stavros Konstantinides, Marcin Kurzyna, and Adam Torbicki
Concomitant acute conditions
64 Acute respiratory failure and acute respiratory distress syndrome 863
Luciano Gattinoni, Mattia Busana, and Eleonora Carlesso
65 Stroke 880
Didier Leys, Solène Moulin, and Valeria Caso
66 Acute kidney injury 895
Sofie A Gevaert, Eric Hoste, and John A Kellum
67 Stress hyperglycaemia and endocrine emergencies 912
Jan Gunst, Yves Debaveye, and Greet Van den Berghe
68 Bleeding and haemostasis disorders 926
Pier Mannuccio Mannucci and Maddalena Lettino
69 Anaemia and transfusion 938
Pascal Vranckx, Davide Cao, Philippe Vandekerckhove, and Roxana Mehran
70 Infection, sepsis, and multiorgan dysfunction syndrome 945
Jean-Louis Vincent
71 Pain in the intensive cardiovascular care unit 956
Siân Jaggar and Helen Laycock
72 Delirium in the intensive cardiovascular care unit 969
Stephen Keane, Kevin Clarkson, and John W McEvoy
73 Special considerations in the immunosuppressed patient 979
Anne-Sophie Moreau and Raphaël Favory
74 Perioperative cardiac care of the high-risk non-cardiac patient 990
Martin Balik
75 Perioperative management of the high-risk surgical patient: cardiac surgery 1009
Marco Ranucci, Serenella Castelvecchio, and Andrea Ballotta
Index 1025
Symbols and abbreviations
£ pound sterling
$ dollar
€ euro
° degree
°C degree Celsius
% per cent
± plus or minus
= equal to
> greater than
< less than
≥ equal to or greater than
≤ equal to or less than
α alpha
β beta
δ delta
γ gamma
κ kappa
σ sigma
Ω ohm
π pi
τ tau
® registered trademark
© copyright
™ trademark
Δ change
↑ increase
↓ decrease
→ leads to
3CPO Three Interventions in Cardiogenic Pulmonary Oedema (trial)
2D two-dimensional
3D three-dimensional
5-FU 5-fluorouracil
AAD antiarrhythmic drug
AAR aspartate transaminase-to-alanine transaminase ratio
ABC adenosine triphosphate-binding cassette; airway, breathing, circulation
ABG arterial blood gas
ABMS American Board of Medical Specialties
ABOARD Angioplasty to Blunt the Rise of Troponin in Acute Coronary Syndromes Randomized for an Immediate or Delayed Intervention (trial)
ACCF American College of Cardiology Foundation
ACCOAST Comparison of Prasugrel at the Time of Percutaneous Coronary Intervention (PCI) or as Pretreatment at the Time of Diagnosis in Patients with Non-ST Elevation Myocardial Infarction (trial)
ACCP American College of Chest Physicians
ACD active compression–decompression
ACE angiotensin-converting enzyme
ACEF age, creatinine, and ejection fraction (score)
ACE-I angiotensin-converting enzyme inhibitor
ACGME Accreditation Council for Graduate Medical Education
ACHD adult congenital heart disease
ACLS advanced cardiac life support
ACP American College of Physicians
ACPO acute cardiogenic pulmonary oedema
ACR albumin/creatinine ratio
ACRIN American College of Radiology Imaging Network-Pennsylvania (trial)
ACS acute coronary syndrome
ACT activated clotting time
ACTH adrenocorticotrophic hormone
ACTION Acute Coronary Treatment and Intervention Outcomes Network
ACTION Registry–GWTG Acute Coronary Treatment and Intervention Outcomes Network Registry—Get With The Guidelines
ACUITY Acute Catheterization and Urgent Intervention Triage Strategy (trial)
ACVC Association for Acute CardioVascular Care
ADA adenosine deaminase
ADAM a disintegrin and metalloproteinase
ADAPT 2-Hour Accelerated Diagnostic protocol to Assess Patients with chest pain symptoms using contemporary Troponins as the only biomarker (trial)
ADCHF acutely decompensated chronic heart failure
ADH antidiuretic hormone
ADHERE Acute Decompensated HEart Failure National REgistry
ADHF acute decompensated heart failure
ADM adrenomedullin
ADP accelerated diagnostic protocol; adenosine diphosphate
ADQI Acute Dialysis Quality Initiative
ADSORB Acute Dissection: Stent graft OR Best medical therapy (trial)
AE adverse event
AECC American-European Consensus Conference
AED automated external defibrillator; antiepileptic drug
AER albumin excretion rate
AF atrial fibrillation
AFE amniotic fluid embolism
AG anion gap
AGI acute gastrointestinal injury
AHA American Heart Association
AHF acute heart failure
AHFS acute heart failure syndromes
AHQR Agency for Healthcare Quality and Research
AI asynchrony index; aortic insufficiency; adrenal insufficiency; artificial intelligence
AIDS acquired immune deficiency syndrome
AIH amiodarone-induced hyperthyroidism
AIMS Australian Incident Monitoring System
AIVR accelerated idioventricular rhythm
AKD acute kidney disease
AKI acute kidney injury
AKIN Acute Kidney Injury Network
ALARM-HF
Acute Heart Failure Global Survey of Standard Treatment (registry)
ALD adjustable loop diuretics
ALI acute lung injury
ALS advanced life support
ALT alanine aminotransferase
AMACING
A MAastricht Contrast-Induced Nephropathy Guideline (trial)
AMI acute myocardial infarction
AMP adenosine monophosphate
AMPA α-amino-3-hydroxy-5-methyl-4isoxazole propionic acid
AMPK adenosine monophosphateactivated protein kinase
AMR antibody-mediated rejection
ANC absolute neutrophil count
ANCA anti-neutrophilic cytoplasmic antibodies
ANP atrial natriuretic peptide
AP action potential; anteroposterior
APACE Advantageous Predictors of Acute Coronary Syndromes Evaluation
APACHE Acute Physiology and Chronic Health Evaluation
APC adaptive pressure control
APEX AMI Assessment of Pexelizumab in Acute Myocardial Infarction (trial)
APP abdominal perfusion pressure
APPRAISE-2 Apixaban for Prevention of Acute Ischemic Events 2 (trial)
APPROACH Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (study)
APROCCHSS Activated Protein C and Corticosteroids for Human Septic Shock (trial)
APRI aspartate transaminase-to-platelet ratio index
aPTT activated partial thromboplastin time
AR aortic regurgitation
ARB angiotensin receptor blocker
ARC-HBR Academic Research Consortium for High Bleeding Risk
ARDS acute respiratory distress syndrome
ARF acute respiratory failure; ascending reticular formation
ARNI angiotensin receptor–neprilysin inhibitor
ARVC arrhythmogenic right ventricular cardiomyopathy
AS aortic stenosis
ASCEND-HF
Acute Study of Clinical Effectiveness of Nesiritide in Decompensated Heart Failure (trial)
ASIC acid-sensing ion channel
ASPECT ASia Pacific Evaluation of Chest pain Trial
ASSENT-2
Assessment of the Safety and Efficacy of a New Thrombolytic (trial)
AST aspartate aminotransferase
ASV adaptative servoventilation
AT atrial tachycardia
ATACH II
Antihypertensive Treatment of Acute Cerebral Hemorrhage II (trial)
ATC automatic tube compensation; Antithrombotic Trialists’ Collaboration
ATG antithymocyte globulin
ATIII antithrombin III
ATLANTIC Administration of Ticagrelor in the Cath Lab or in the Ambulance for New ST Elevation Myocardial Infarction to Open the Coronary Artery
ATLAS ACS 2 Anti-Xa Therapy to Lower Cardiovascular Events in Addition to Standard Therapy in Subjects with Acute Coronary Syndrome (trial)
ATN acute tubular necrosis
ATOLL Acute Myocardial Infarction
Treated with primary angioplasty and intravenous enoxaparin Or unfractionated heparin to Lower ischemic and bleeding events at short- and Long-term follow-up (trial)
AVA
aortic valve area
AVM arteriovenous malformation
AVNRT atrioventricular nodal re-entrant tachycardia
AVOID-HF
ATOMIC-HF
Acute Treatment with Omecamtiv Mecarbil to Increase Contractility in Acute Heart Failure (trial)
ATP adenosine triphosphate
AUC area under the curve
AUF adjustable ultrafiltration
AUGUSTUS Open-Label, 2 × 2 Factorial, Randomized, Controlled Clinical Trial to Evaluate the Safety of Apixaban vs Vitamin K Antagonist and Aspirin vs Aspirin Placebo in Patients with Atrial Fibrillation and Acute Coronary Syndrome and/or Percutaneous Coronary Intervention (trial)
AV atrioventricular
Aquapheresis versus Intravenous Diuretics and Hospitalizations for Heart Failure (trial)
AVP arginine vasopressin
AVR aortic valve replacement
AVRT atrioventricular re-entrant tachycardia
BACH Biomarkers in Acute Heart Failure (trial)
BARC Bleeding Academic Research Consortium
BART Blood Conservation Using Antifibrinolytics in a Randomized Trial
BATTLESCARRED NT-proBNP-Assisted Treatment To Lessen Serial Cardiac Readmissions and Death (trial)
BAV balloon aortic valvuloplasty
BEST Randomized Comparison of Coronary Artery Bypass Surgery and Everolimus- Eluting Stent Implantation in the Treatment of Patients with Multivessel Coronary Artery Disease (trial)
bio-ADM bioactive adrenomedullin
BiPAP bilevel positive airway pressure
BIS bispectral index; Berlin Initiative Study
BITA bilateral internal thoracic artery
BiVAD biventricular ventricular assist device
BLS basic life support
BLS-TOR basic life support termination of resuscitation
BMI body mass index
BMS bare-metal stent
BNP B-type natriuretic peptide
BOLD Beta-agonists for Oxygenation in Lung Donors (trial)
BPA balloon pulmonary angioplasty
bpm beats per minute
BPS Behavioural Pain Scale
BRIDGE Maintenance of Platelet inihiBition With cangRelor After dIscontinuation of ThienopyriDines in Patients Undergoing surGEry (trial)
BRIGHT Bivalirudin in Acute Myocardial Infarction versus Heparin and GPI Plus Heparin (trial)
BSA body surface area
BTC bridge to transplantation candidacy
BTD bridge to decision
BTR bridge to recovery
BTS British Thoracic Society
BTT bridge to transplantation
BUN blood urea nitrogen
BV biological variability
Ca2+ calcium ion
CABG coronary artery bypass grafting
CAC coronary artery calcium/calcification
CAD coronary artery disease
CADASIL cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy
CAM-ICU Confusion Assessment Method for the Intensive Care Unit
cAMP cyclic adenosine monophosphate
CANGRELOR CANgrelor and Crushed TICagrelor in STEMI Patients Undergoing Primary Percutaneous Coronary Intervention (trial)
CANTOS Canakinumab Anti-Inflammatory Thrombosis Outcomes Study
CANVAS CANagliflozin cardioVascular Assessment Study
CAP community-acquired pneumonia
CARP Coronary Artery Revascularization Prophylaxis (trial)
CARRESS-HF Cardiorenal Rescue Study in Acute Decompensated Heart Failure (trial)
cART combination antiretroviral therapies
CAS carotid angioplasty and stenting
CASTLE-AF Catheter Ablation versus Standard Conventional Therapy in Patients with Left Ventricular Dysfunction and Atrial Fibrillation (trial)
CAV cardiac allograft vasculopathy
CAVH continuous arteriovenous haemofiltration
CAVHD continuous arteriovenous haemodiafiltration
CBF cerebral blood flow
CBV cerebral blood volume
CC core curriculum
CCB calcium channel blocker
CCSS Critical Care Safety Study
CCTA coronary computerized tomography angiography
CCU coronary care unit; critical care unit
CCW compliance of the chest wall
CD cluster of differentiation
CE cholesterol ester
CEA carotid endarterectomy
CEC Clinical Event Committee
cEEG continuous electroencephalogram
cfDNA cell-free deoxyribonucleic acid
cGMP cyclic guanosine monophosphate
CHAMPION Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (trial)
CHAMPION PHOENIX Cangrelor versus Standard Therapy to Achieve Optimal Management of Platelet Inhibition (trial)
CHANCE
Clopidogrel in High-Risk Patients with Acute Nondisabling Cerebrovascular Events (trial)
CHD coronary heart disease; congenital heart disease
CI critical incident; confidence interval; cardiac index
CICU cardiac intensive care unit
CIH cardiogenic ischaemic hepatitis
CIN contrast medium-induced nephropathy
CIRCI critical illness-related corticosteroid insufficiency
CK creatine kinase
CKD chronic kidney disease
CKD-EPI Chronic Kidney Disease Epidemiology Collaboration
CK-MB creatine kinase isoenzyme subunit MB
CL compliance of the lung
Cl– chloride ion
CLARITY
CLOTS
Clopidogrel as Adjunctive Reperfusion Therapy
Clots in Legs Or sTockings after Stroke (trial)
cm centimetre
CM contrast medium
CME continuing medical education
cmH2O centimetre of water
CMR cardiac magnetic resonance
CMV continuous mandatory ventilation; cytomegalovirus
c-MyC cardiac myosin-binding protein C
CNS central nervous system
CNST
Clinical Negligence Scheme for Trusts
CO2 carbon dioxide
CoA coarctation of the aorta
COCATS 4-TF 13
COGENT
COMET
COMFORTABLE AMI
Core Cardiovascular Training Statement 4 by Task Force 13
Clopidogrel and the Optimization of Gastrointestinal Events Trial
Carvedilol Or Metoprolol
European Trial
Comparison of Biolimus Eluted from an Erodible Stent Coating with BareMetal Stents in Acute ST-Elevation
Myocardial Infarction (trial)
COMMIT ClOpidogrel and Metoprolol in Myocardial Infarction Trial
COMPARE-ACUTE Comparison Between FFR Guided Revascularization Versus Conventional Strategy in Acute STEMI Patients With Multivessel disease (trial)
COPD chronic obstructive pulmonary disease
COPERNICUS Carvedilol Prospective Randomized Cumulative Survival (trial)
COX cyclo-oxygenase
CP chest pain
CPAP continuous positive airway pressure
CPAP/PS continuous positive airway pressure/ pressure support ventilation
CPB cardiopulmonary bypass
CPC Cerebral Performance Category (score)
CpcPH combined post-capillary pulmonary hypertension
CPM continuous passive motion; central pontine myelinolysis
CPOT Critical Care Pain Observation Tool
CPP coronary perfusion pressure; cerebral perfusion pressure
CPR cardiopulmonary resuscitation
CPU chest pain unit
CPVT catecholaminergic polymorphic ventricular tachycardia
CQC Care Quality Commission
CR cardiac rupture
CRBSI catheter-related bloodstream infection
CrCl creatinine clearance
CRISP-AMI Counterpulsation to Reduce Infarct Size Pre-PCI Acute Myocardial Infarction (trial)
CRM crew resource management
CRP C-reactive protein
CRRT continuous renal replacement therapy
CRS compliance of the respiratory system
CRS cardiorenal syndrome
CRT cardiac resynchronization treatment
CRT-D cardiac resynchronization treatment defibrillator
CRT-P cardiac resynchronization treatment pacemaker
CRUSADE Can Rapid Risk Stratification of Unstable Angina Patients Suppress Adverse Outcomes with Early Implementation of the ACC/AHA Guideline (registry)
CS cardiogenic shock
CSD cardiac sympathetic denervation
CSF cerebrospinal fluid
CSS Clinical SYNTAX score
CT computerized tomography
CTA computerized tomography angiography
CTCA computerized tomography coronary angiography
CTEPH chronic thromboembolic pulmonary hypertension
cTn cardiac troponin
cTnI cardiac troponin I
cTnT cardiac troponin T
CTP computerized tomography perfusion
CTPA computerized tomography pulmonary angiography
CTR cardiothoracic ratio
CULPRIT-SHOCK Culprit Lesion Only PCI versus Multivessel PCI in Cardiogenic Shock
CUORE Continuous Ultrafiltration for cOngestive heaRt failure (trial)
CURE Clopidogrel in Unstable Angina to Prevent Recurrent Events (trial)
CUS compression ultrasonography
CV coefficient of variation
CVA cerebrovascular accident
CVC central venous catheter
CVD cardiovascular disease
CvLPRIT Complete Versus Lesion-Only Primary PCI trial
CVP central venous pressure
CVR cerebral vascular resistance
CVST cerebral venous and sinus thrombosis
CVVH continuous veno-venous haemofiltration
CVVHD continuous veno-venous haemodialysis
CVVHDF continuous veno-venous haemodiafiltration
CXR chest X-ray
DAG diacylglycerol
DahLIA Dexmedetomidine to Lessen ICU Agitation (trial)
DANAMI DANish Study of Optimal Acute Treatment of Patients With STelevation Myocardial Infarction (trial)
DANAMI 3-DEFER Third DANish Study of Optimal Acute Treatment of Patients with ST-segment Elevation Myocardial Infarction: DEFERred stent implantation in connection with primary PCI
DANAMI-3–PRIMULTI Third DANish Study of Optimal Acute Treatment of Patients With STEMI: PRImary PCI in MULTIvessel Disease
DAPT dual antiplatelet therapy
DAWN DWI or CTP Assessment with Clinical Mismatch in the Triage of Wake-Up and Late Presenting Strokes Undergoing Neurointervention with Trevo
DBD donation/donor after brain death
DC dendritic cell; direct current
DCD donation/donor after circulatory death
DCM dilated cardiomyopathy
DDAVP 1-deamino-8-d-arginine-vasopressin
DECCA Delirium Epidemiology in Critical Care (study)
DECLARE-TIMI58
Dapagliflozin Effect on Cardiovascular Events–Thrombolysis in Myocardial Infarction 58 (trial)
DECREASE-2 Dutch Echocardiographic Cardiac Risk Evaluation Applying Stress
DEFUSE 3
DELIVER
Echocardiography-2 (trial)
Endovascular Therapy Following Imaging Evaluation for Ischemic Stroke 3 (trial)
Dapagliflozin Evaluation to Improve the LIVEs of Patients With PReserved Ejection Fraction Heart Failure (trial)
DES drug-eluting stent
DESTINY II
DEXACET
DEXCOM
Decompressive Surgery for the Treatment of Malignant Infarction of the Middle Cerebral Artery II (trial)
Dexmedetomidine and IV
Acetaminophen for the Prevention of Postoperative Delirium Following Cardiac Surgery (trial)
Dexmedetomidine Compared to Morphine (trial)
DG diastolic gradient
DIC disseminated intravascular coagulation
DIPOM Diabetic Postoperative Mortality and Morbidity (trial)
DKA diabetic ketoacidosis
dL decilitre
DNA deoxyribonucleic nucleic acid
DNACPR do-not-attempt-cardiopulmonaryresuscitation
DNAR do-not-attempt-resuscitation
DO2 myocardial oxygen supply
DOAC direct oral anticoagulant
DOSE
Diuretic Optimization Strategies Evaluation (trial)
DOSE-AHF
Diuretic Optimization Strategy
Evaluation in Acute Decompensated Heart Failure (trial); Determining Optimal Dose and Duration of Diuretic Treatment in People With Acute Heart Failure (trial)
DSE dobutamine stress echocardiography
DSM Diagnostic and Statistical Manual of Mental Disorders
DSM-V Diagnostic and Statistical Manual of Mental Disorders, fifth edition
DT destination therapy
DTI direct thrombin inhibitor
dTT dilute thrombin time
DVT deep vein thrombosis
DWI diffusion-weighted imaging
EACTA
EACTS
EACVI
European Association of Cardiothoracic Anaesthesiology
European Association of CardioThoracic Surgery
European Association of Cardiovascular Imaging
EAdi electrical activity of the diaphragm
EARLY-ACS Early Glycoprotein IIb/IIIa Inhibition in Non-ST-Segment Elevation Acute Coronary Syndrome (trial)
EARLY-BAMI Early-Beta blocker Administration before reperfusion primary PCI in patients with ST-elevation Myocardial Infarction (trial)
EAST
Eastern Association for the Surgery of Trauma
EBCT electron beam computerized tomography
EBM evidence-based medicine
EBV Epstein–Barr virus
ECCO2R extracorporeal carbon dioxide removal
ECF extracellular fluid
ECG electrocardiogram
ECLS extracorporeal life support
ECM extracellular matrix
ECMO extracorporeal membrane oxygenation
ECOS extracorporeal organ support
eCPR extracorporeal CPR
ECS-PSC
European Society of Cardiology position statement criteria
ED emergency department
EDACS Emergency Department Assessment of Chest Pain Score Accelerated Diagnostic Pathway
EDD extended daily dialysis
EDTA ethylenediaminetetraacetic acid
EEG electroencephalography
EES everolimus-eluting stent
EF ejection fraction
eGFR estimated glomerular filtration rate
EHRA European Heart Rhythm Association
EIT electrical impedance tomography
ELF ® Enhanced Liver Fibrosis Test®
ELISA Early or Late Intervention in unStable Angina (trial)
EMA European Medicines Agency
EMB endomyocardial biopsy
EMD emergency medical dispatching
EMI electromagnetic interference
EMPA-REG OUTCOME Empagliflozin Cardiovascular Outcome Event Trial in Type 2 Diabetes Mellitus Patients–Removing Excess Glucose
EMPA-RESPONSE Effects of Empagliflozin on Clinical Outcomes in Patients With Acute Decompensated Heart Failure (trial)
EMS emergency medical services/system; electrical muscle stimulation
EMT emergency medical technician
EN enteral nutrition
ENCHANTED Enhanced Control of Hypertension and Thrombolysis Stroke Study
eNOS endothelial nitric oxide synthase
ENTRUST-AF Edoxaban-Based Antithrombotic Regimen in Patients With Atrial Fibrillation (trial)
EoLC end-of-life care
EOLCS End of Life Care Strategy
EORP EURObservational Research Program
EORTC/MSG European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group
EP emergency medicine physician; evoked potential
EPA entrustable professional activity
EPaNIC Early Parenteral Nutrition Completing Enteral Nutrition in Adult Critically Ill Patients (trial)
EPAP expiratory positive airway pressure
ePCR extracorporeal membrane oxygenation cardiopulmonary resuscitation
ERC European Resuscitation Council
EROA effective regurgitant orifice area
ERTP early releasable troponin pool
ES electrical storm
ESA erythropoietin-stimulating agent
ESC European Society of Cardiology
ESCAPE Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness (trial)
ESCeL European Society of Cardiology e-Learning
ESICM European Society of Intensive Care Medicine
ESKD end-stage kidney disease
ESPEN European Society for Clinical Nutrition and Metabolism
ESPVR end-systolic pressure–volume relationship
ESR erythrocyte sedimentation rate
ET-1 endothelin-1
ETT endotracheal tube
EU European Union
EUNetPaS European Network for Patient Safety
EUROMAX European Ambulance Acute Coronary Syndrome Angiography (trial)
EuroSCORE European System for Cardiac Operative Risk Evaluation
EUROSTAR European Collaborators on Stent Graft Techniques for Thoracic Aortic Aneurysm and Dissection Repair
EV extracellular vesicle
EVEREST
Endovascular Valve Edge-to-Edge Repair Study; Efficacy of Vasopressin Antagonism in Heart Failure Outcome Study With Tolvaptan (trial)
EVLP ex vivo lung perfusion
EVLW extravascular lung water
EVT endovascular thrombectomy
EXAMINATION clinical Evaluation of the XienceV stent in Acute Myocardial INfArcTION (trial)
EXPIRA Thrombectomy With EXPort Catheter in Infarct-Related Artery During Primary Percutaneous Coronary Intervention (trial)
EXTEND Extending the Time for Thrombolysis in Emergency Neurological Deficits (trial)
ExTRACT-TIMI 25 Enoxaparin and Thrombolysis Reperfusion for Acute Myocardial Infarction Treatment–Thrombolysis in Myocardial Infarction 25
F French; factor
FABULOS-PRO Facilitation through Aggrastat By drOpping or shortening Infusion Line in patients with ST-segment elevation myocardial infarction compared to or on top of PRasugrel given at loading dOse (trial)
FAME FFR vs Angiography for Multivessel evaluation (trial)
FANTASTIC Full ANTicoagulation versus ASpirin and TIClopidine (trial)
FAS full age spectrum
FAST focused assessment with sonography for trauma
FAST-MI French registry of Acute ST-elevation or non-ST-elevation Myocardial Infarction
FBI fast, broad, irregular
FDA Food and Drug Administration
FDG-PET 18F-fluorodeoxyglucose positron emission tomography
FEV1 forced expiratory volume in 1 second
FFR fractional flow reserve
FFRct fractional flow reserve measured by coronary computerized tomography angiography
FIMR functional ischaemic muscle rupture/ mitral regurgitation
FiO2 fraction of inspired oxygen
FL fibrinolysis
FLAIR fluid-attenuated inversion recovery
FMC first medical contact
FMEA failure modes and effects analysis
FO-BAL fibreoptic bronchoscopy with bronchoalveolar lavage
FOUR Full Outline of UnResponsiveness (score)
FPR false positive ratio
FRC functional residual capacity
FRISC Fast Revascularisation in InStability in Coronary disease (score/trial)
FUTURA OASIS-8 Fondaparinux with UnfracTionated heparin dUring Revascularization in Acute coronary syndromes (trial)
FWR free wall rupture
g gram
G gauge
GABA gamma-aminobutyric acid
GALACTIC-HF Global Approach to Lowering Adverse Cardiac outcomes Through Improving Contractility in Heart Failure (trial)
GBD Global Burden of Diseases, Injuries, and Risk Factors (study)
GCS Glasgow Coma Scale
GDF-15 growth differentiation factor-15
GDMT guideline-directed medical treatment
GEMINI ACS 1 Safety of Rivaroxaban Versus Acetylsalicylic Acid in Addition to Either Clopidogrel or Ticagrelor Therapy in Participants With Acute Coronary Syndrome (trial)
GFR glomerular filtration rate
GGT gamma glutamyltransferase
GI gastrointestinal
GICS Gastrointestinal Complication Score
GIF gastrointestinal failure
GIK glucose–insulin–potassium
GISSI Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto Miocardico
GLASSY GLOBAL LEADERS Adjudication Sub-Study
GLS global longitudinal strain
GP glycoprotein
GPI glycoprotein IIb/IIIa inhibitor
GRACE Global Registry of Acute Coronary Events
GRC Global Risk Classification
GRV gastric residual volume
GUIDE-IT Guiding Evidence Based Therapy Using Biomarker Intensified Treatment in Heart Failure (study)
GUSTO Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries (trial)
h hour
H+ hydrogen ion
HAART highly active antiretroviral therapy
Hb haemoglobin
HBD heart-beating donor
HBV hepatitis B virus
HCM hypertrophic cardiomyopathy
HCO3– carbonate ion
H2CO3 carbonic acid
HCV hepatitis C virus
HDL high-density lipoprotein
HEAT-PPCI How Effective Are Antithrombotic Therapies in Primary PCI (trial)
HEMS helicopter emergency medical services
HEPA high-efficiency particulate air
HES hydroxyethyl starch
HF haemofiltration
HFA Heart Failure Association
HFD high-flux dialysis
HFmrEF heart failure with mid-range left ventricular ejection fraction
HFNC high-flow nasal cannula
HFOV high-frequency oscillatory ventilation
HFpEF heart failure with preserved left ventricular ejection fraction
HFrEF heart failure with reduced left ventricular ejection fraction
HFSS Heart Failure Survival Score
H-Hb protonated haemoglobin
HHS hyperglycaemic hyperosmolar state
HHV6 human herpesvirus 6
HIF hypoxia-inducible factor
HIPA heparin-induced platelet activation
HIT heparin-induced thrombocytopenia
HIV human immunodeficiency virus
HOCM hypertrophic obstructive cardiomyopathy
HORIZONS-AMI Harmonizing Outcomes with Revascularization and Stents in Acute Myocardial Infarction (trial)
HPO42– hydrogen phosphate
H2PO4– dihydrogen phosphate
HR hazard ratio; hormonal resuscitation
HSCT haematopoietic stem cell transplantation
hs-cTn high-sensitivity cardiac troponin
hs-cTnI high-sensitivity cardiac troponin I
hs-cTnT high-sensitivity cardiac troponin T
HSP-27 heat shock protein 27
hs-Tn high-sensitivity troponin
hs-TnI high-sensitivity troponin I
hs-TnT high-sensitivity troponin T
HTAD heritable thoracic aortic aneurysm/ dissection
HTx heart transplant
HU Hounsfield unit
HVHF high-volume haemofiltration
Hz hertz
IABP intra-aortic balloon pump
IABP-SHOCK II Intra-Aortic Balloon Pump in Cardiogenic Shock II (trial)
IACC intensive and acute cardiovascular care
IAH intra-abdominal hypertension
IAP intra-abdominal pressure
IC indirect calorimetry
ICA invasive coronary angiography
ICAM-1 intercellular adhesion molecule 1
ICCU intensive cardiovascular care unit
ICD implantable cardioverter–defibrillator
ICDSC Intensive Care Delirium Screening Checklist
ICF intracellular fluid
ICG indocyanine green
ICH intracranial haemorrhage
ICNARC Intensive Care National Audit and Research Centre
ICON-RELOADED ICON: Re-evaluation of Acute Diagnostic Cut-Offs in the Emergency Department (study)
ICP intracranial pressure
ICU intensive care unit
ICU-AW intensive care unit-acquired weakness
IDF incident dark field (imaging)
IDSA Infectious Diseases Society of America
IE infective endocarditis
IFCC International Federation of Clinical Chemistry and Laboratory Medicine
IFI invasive fungal infection
IFN interferon
iFR instantaneous wave-free ratio
Ig immunoglobulin
IGFBP
IGFBP-7
insulin-like growth factor-binding protein
insulin-like growth factor-binding protein-7
IgG immunoglobulin G
IgM immunoglobulin M
IHCA in-hospital cardiac arrest
IHD intermittent haemodialysis; ischaemic heart disease
IHI Institute for Healthcare Improvement
IIE ineffective inspiratory efforts
IL interleukin
ILCOR International Liaison Committee on Resuscitation
IL-2RA interleukin-2 receptor antagonist
IM intramuscular
IMACS International Society for Heart and Lung Transplantation Mechanically Assisted Circulatory Support
IMCA Independent Mental Capacity Advocate
IMH intramural haematoma
IMPROVE-CHF
IMPROVE-IT
Improved Management of Patients With Congestive Heart Failure (study)
Improved Reduction of Outcomes: Vytorin Efficacy International Trial
IMV intermittent mandatory ventilation
iNOS inducible nitric oxide synthase
INR international normalized ratio
INSTEAD INvestigation of STEnt grafts in patients with type B Aortic Dissection (trial)
INTERACT 2 Intensive Blood Pressure Reduction in Acute Cerebral Hemorrhage Trial 2
INTERMACS Interagency Registry for Mechanically Assisted Circulatory Support
IO intraosseous
IoM Institute of Medicine
IP3 inositol triphosphate
IPAH idiopathic pulmonary arterial hypertension
IPAP inspiratory positive airway pressure
IpcPH isolated post-capillary pulmonary hypertension
IPPV intermittent positive pressure ventilation
IPTW inverse probability of treatment weight
IPV intrapulmonary percussive ventilation
IQR interquartile range
IRA infarct-related artery
IRAD International Registry of Acute Aortic Dissection
IRI ischaemia and reperfusion injury
IS incentive spirometry; ischaemic stroke
ISAR Intracoronary Stenting and Antithrombotic Regimen (trial)
ISAR-CABG Is Drug-Eluting-Stenting Associated with Improved Results in Coronary Artery Bypass Grafts (trial)
ISAR-COOL Intracoronary Stenting With Antithrombotic Regimen Cooling-Off (trial)
ISAR-REACT 4 Intracoronary Stenting and Antithrombotic Regimen: Rapid Early Action for Coronary Treatment 4 (trial)
ISDN isosorbide dinitrate
ISICEM International Symposium on Intensive Care and Emergency Medicine
ISIS International Study of Infarct Survival (trial)
ISMICS International Society of Minimally Invasive Coronary Surgery
ISS Injury Severity Score
ISTH International Society on Thrombosis and Haemostasis
ITA internal thoracic artery
ITD impedance threshold device
ITP intrathoracic pressure
IU international unit
IV intravenous
IVIG intravenous immunoglobulin
I-VT International Ventricular Tachycardia (score)
IVUS intravascular ultrasound
IVUS-VH intravascular ultrasound virtual histology
J joule
JCAHO Joint Commission on Accreditation of Healthcare Organizations
JVP jugular venous pressure
K+ potassium ion
kcal kilocalorie
kDa kilodalton
KDIGO Kidney Disease: Improving Global Outcomes
kg kilogram
KIM 1 kidney injury molecule 1
KLF4 kruppel-like factor 4
km kilometre
kV kilovolt
Kw dissociation constant
L litre
LA left atrial; left atrium
LAD left anterior descending (artery)
LAP left atrial pressure
LAVA local abnormal ventricular activity
LAX long-axis (view, ultrasound)
LBBB left bundle branch block
LCX left circumflex
LDB load-distributing band
LDH lactate dehydrogenase
LDL low-density lipoprotein
LFA-1 lymphocyte associated antigen-1
LFABP liver fatty acid-binding protein
LGE late gadolinium enhancement
LGE-CMR late gadolinium enhancement cardiac magnetic resonance
LGE-MRI late gadolinium enhancement magnetic resonance imaging
LiDCO lithium dilution cardiac output
LIDO Levosimendan Infusion versus Dobutamine (trial)
LIMA left internal mammary artery
LIS lung injury score
LITA left internal thoracic artery
LMWH low-molecular-weight heparin
LOC loss of consciousness
LoE level of evidence
LOX1 lectin-like oxidized low-density lipoprotein receptor 1
Lp(a) lipoprotein (a)
LPS lipopolysaccharide
LQTS long QT syndrome
LRP-1 low-density lipoprotein receptor-related protein 1
LT laryngeal tube
LUCAS Lund University Cardiac Arrest System
LV left ventricular
LVA left ventricular aneurysm
LVAD left ventricular assist device
LVEDD left ventricular end-diastolic diameter
LVEDP left ventricular end-diastolic pressure
LVEF left ventricular ejection fraction
LVESD left ventricular end-systolic diameter
LV-ESV left ventricular end-systolic volume
LVOT left ventricular outflow tract
LVWR left ventricular wall rupture
m metre
mA milli ampere
MAAVR minimal-access aortic valve replacement
MAC mitral annulus calcification
MAC-1 macrophage antigen 1
MACCE major adverse cardiac and cerebrovascular event
MACE major adverse cardiac event
MACS Manchester Acute Coronary Syndromes
MAP mean arterial pressure
MAPSE mitral annular plane systolic excursion
MATRIX Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of Angiox (trial)
MATTIS Multicenter Aspirin and Ticlopidine Trial after Intracoronary Stenting (trial)
MaVS Metoprolol after Vascular Surgery (trial)
MBG myocardial blush grade
MC myxoedema coma; mechanical complication
MCEP medicine community educational programme
MCQ multiple choice question
MCS mechanical circulatory support
M-CSF macrophage colony-stimulating factor
MDRD Modified Diet in Renal Disease
MELD Model for End-Stage Liver Disease
MELD-XI Model for End-stage Liver Disease eXcluding INR
MENDS Maximizing Efficacy of Targeted Sedation and Reducing Neurological Dysfunction (trial)
MEq milli equivalent
MESA Multi-Ethnic Study of Atherosclerosis
METOCARD-CNIC Effect of Metoprolol in Cardioprotection During an Acute Myocardial Infarction (trial)
MFI Microvascular Flow Index
mg milligram
Mg2+ magnesium ion
mGFR measured glomerular filtration rate
mGluR metabotropic glutamate receptor
mGy milligray
MHI manual hyperinflation
MHz mega hertz
MI myocardial infarction
MIC myocardial intervention centre
MIDCAB minimally invasive direct coronary artery bypass
MIDEX Midazolam Compared to Dexmedetomidine (trial)
MI-E mechanical insufflator–exsufflator
min minute
MINAP Myocardial Ischaemia National Audit Project
MIND-USA Modifying the Impact of ICUAssociated Neurological Dysfunction–USA (trial)
MINOCA myocardial infarction with nonobstructive coronary arteries
MIP maximum intensity projection
miRNA micro ribonucleic acid
mL millilitre
MLA minimal lumen area
MLD minimal lumen diameter
mm millimetre
MMF mycophenolate mofetil
mmHg millimetre of mercury
MMI methimazole
mmLDL minimally modified low-density lipoprotein
mmol millimole
MMP matrix metalloproteinase
MODS multiorgan dysfunction syndrome
MOF multiorgan failure
mol mole
MOMENTUM-3 Multicenter Study of MagLev Technology in Patients Undergoing Mechanical Circulatory Support Therapy with HeartMate 3 (trial)
MONICA MoNItoring of trends and determinants in CArdiovascular disease
mOsmol milliosmole
MOST multiorgan support therapy
MP microparticle
mPAP mean pulmonary arterial pressure
MPI myocardial perfusion imaging
MPO myeloperoxidase
MPR multiplanar reconstruction
MPS myocardial perfusion scanning
MR magnetic resonance; mitral regurgitation
MRA mineralocorticoid receptor antagonist
MRC Medical Research Council
MRI magnetic resonance imaging
mRNA messenger ribonucleic acid
MR-proADM mid-regional pro-adrenomedullin
MR-proANP mid-regional pro-atrial natriuretic peptide
mRS modified Rankin scale
MRSA methicillin-resistant Staphylococcus aureus
ms millisecond
MS mitral stenosis
MSCT multi-slice computerized tomography
mSv milli sievert
MTHFR methylenetetrahydrofolate reductase
mTOR mammalian target of rapamycin
mU milli unit
MULTISTRATEGY
Multicentre Evaluation of Single HighDose Bolus Tirofiban vs Abciximab With Sirolimus-Eluting Stent or Bare Metal Stent in Acute Myocardial Infarction Study
mV millivolt
MV minute ventilation
MVA mitral valve area
MVO microvascular obstruction
n number
Na+
sodium ion
NAC N-acetylcysteine
NaCl
sodium chloride
NAFLD non-alcoholic fatty liver disease
NaHCO3
sodium bicarbonate
NASA National Aeronautics and Space Administration
NASH non-alcoholic steatohepatitis
NAVA neurally adjusted ventilatory assist
NCC MERP National Coordinating Council on Medical Error Reporting and Prevention
NCEPOD National Confidential Enquiry into Patient Outcome and Death
NEFA non-esterified fatty acid
NEMS neuromuscular electrical stimulation
NET neutrophil extracellular trap
NF nuclear factor
ng nanogram
NG nasogastric
NGAL neutrophil gelatinase-associated lipocalin
NH3 ammonia
NH4+ ammonium ion
NHANES National Health and Nutrition
Examination Survey
NHBD non-heart-beating donor
NHS National Health Service
NHSLA National Health Service Litigation Authority
NICE National Institute for Health and Care Excellence
NICE-SUGAR Normoglycemia in Intensive Care Evaluation–Survival Using Glucose Algorithm Regulation (trial)
NIH National Institutes of Health
NIPPV non-invasive positive pressure ventilation
NIPSV non-invasive pressure support ventilation
NIRS near-infrared spectroscopy
NIS Nationwide Inpatient Sample
NIST National Institute of Standards and Technology
NIV non-invasive ventilation
NK natural killer
NLRP3 NLR family pyrin domain-containing 3
NMDA N-methyl-D-aspartate
nmol nanomole
NO nitric oxide
NOAC non-vitamin K antagonist oral anticoagulant
NOMI non-occlusive mesenteric ischaemia
NORSTENT Norwegian Coronary Stent Trial
NOS nitric oxide synthase
NP natriuretic peptide
NPV negative predictive value; negative pressure ventilation
NRCPR National Registry of Cardiopulmonary Resuscitation
NRLS National Reporting and Learning System
NRS numerical rating scale
NSAID non-steroidal anti-inflammatory drug
NSE neuron-specific enolase
NSTE-ACS non-ST-segment elevation acute coronary syndrome
NSTEMI non-ST-segment elevation myocardial infarction
NSVT non-sustained ventricular tachycardia
NT-proBNP N-terminal pro-B-type natriuretic peptide
NYHA New York Heart Association
O2 oxygen
OASIS Organization for the Assessment of Strategies for Ischemic Syndromes
OASIS-5 Fifth Organization to Assess Strategies in Acute Ischemic Syndromes (trial)
OASIS 6 Organization for the Assessment of Strategies for Ischemic Syndromes 6 (trial)
OAT Occluded Artery Trial
OCT optical coherence tomography
O2ER oxygen extraction ratio
OFA omega-3 fatty acid
OFR oxygen free radical
OH– hydroxide ion
OHCA out-of-hospital cardiac arrest
OI oxygenation index
OMT optimal medical treatment
ONT Organización Nacional de Trasplantes
OPCABG off-pump coronary artery bypass graft
OPTIMA-CC Study Comparing the Efficacy and Tolerability of Epinephrine and Norepinephrine in Cardiogenic Shock
OPTIME-CHF Outcomes of a Prospective Trial of Intravenous Milrinone for Exacerbations of Chronic Heart Failure
OPTIMIZE-HF Organized Program To Initiate Lifesaving Treatment In Hospitalized Patients With Heart Failure (registry)
OR odds ratio
ORBI Observatoire Régional Breton sur l’Infarctus
OSA obstructive sleep apnoea
OSCAR Oscillation in ARDS (trial)
OSCILLATE Oscillation for Acute Respiratory Distress Syndrome Treated Early (trial)
oxLDL oxidized low-density lipoprotein
P probability
PA posteroanterior
PAC pulmonary artery catheter/ catheterization
PaCO2 arterial partial pressure of carbon dioxide
PACO2 alveolar pressure of carbon dioxide
PADIS Prevention and management of pain, Agitation/sedation, Delirium, Immobility, and Sleep disruption
PAF platelet-activating factor
PAH pulmonary arterial hypertension
PAI-1 plasminogen activator inhibitor type-1
PAIRWAY airway pressure
PALS Patient Advice and Liaison Service
PALV alveolar pressure
PAMI Primary Angioplasty in Myocardial Infarction (trial)
PAMP pathogen-associated molecular pattern
PaO2 arterial partial pressure of oxygen
PAO2 alveolar pressure of oxygen
PAOP pulmonary artery occlusion pressure
PAP pulmonary artery pressure
PAPI pulmonary artery pulsatility index
PAR protease-activated receptor
PAR-1 protease-activated receptor 1
PARAGON Platelet IIb/IIIa Antagonism for the Reduction of Acute Coronary Syndrome Events in a Global Organization Network (trial)
PARP-1 poly(ADP-ribose) polymerase 1
PAU penetrating aortic ulcer
PAV proportional assist ventilation
PAWP pulmonary artery wedge pressure
PBW predicted body weight
PCA patient-controlled analgesia
PC-ACV pressure-controlled assist-control ventilation
PC-APRV pressure-controlled airway pressure release ventilation
PCAS post-cardiac arrest syndrome
PC-BIPAP pressure-controlled biphasic positive airway pressure
PCBS percutaneous cardiopulmonary bypass support
PCC prothrombin complex concentrate
PC-CMV pressure-controlled continuous mechanical ventilation
PCI percutaneous coronary intervention
PCI-CURE Percutaneous Coronary InterventionClopidogrel in Unstable angina to prevent Recurrent Events (trial)
PCOS polycystic ovary syndrome
PCR polymerase chain reaction
PCS pulse contour system; post-cardiotomy cardiogenic shock
PC-SIMV pressure-controlled synchronized intermittent mandatory ventilation
PCSK9 proprotein convertase subtilisin/ kexin type 9
PCT procalcitonin
PCWP pulmonary capillary wedge pressure
PD peritoneal dialysis
PDIRRT prolonged daily intermittent renal replacement therapy
PDRICG plasma disappearance rate of indocyanine green
PE pulmonary embolus/embolism
PEA pulseless electric activity
PEEP positive end-expiratory pressure
PEEPi intrinsic positive end-expiratory pressure
PEGASUS-TIMI 54 Prevention of Cardiovascular Events in Patients with Prior Heart Attack Using Ticagrelor Compared to Placebo on a Background of Aspirin–Thrombolysis in Myocardial Infarction 54
PER protein excretion rate
PERT Pulmonary Embolism Response Team
PESI Pulmonary Embolism Severity Index
PET positron emission tomography
PFT platelet function test
pg picogram
PGI2 prostacyclin
PH pulmonary hypertension; prolyl hydroxylase
PH-LHD pulmonary hypertension secondary to left heart disease
PI protease inhibitor
PICC peripherally inserted central catheter
PiCCO pulse-induced contour cardiac output
PIO2 inspired pressure of oxygen
PIONEER-HF Comparison of Sacubitril–Valsartan versus Enalapril on Effect on NT-proBNP in Patients Stabilized from an Acute Heart Failure Episode (trial)
PIRRT prolonged intermittent renal replacement therapy
PIS pulmonary interstitial syndrome
PLATO Study of Platelet Inhibition and Patient Outcomes (trial)
PLC phospholipase C
pLVAD percutaneous left ventricular assist device
PM performance measure
PMC percutaneous mitral commissurotomy
PMI perioperative myocardial ischaemia
pmol picomole
pmp patient per million (inhabitants)
PMR papillary muscle rupture
PN parenteral nutrition
PO orally
pO2 partial oxygen pressure
POCT point-of-care test
POINT Platelet-Oriented Inhibition in New TIA and Minor Ischemic Stroke (trial)
POISE Perioperative Ischemic Evaluation (trial)
PP plasmapheresis
PPCM peripartum cardiomyopathy
Ppeak airway peak pressure
PPI proton pump inhibitor
PPL pleural pressure
PPLATEAU plateau pressure
PPV positive predictive value; positive pressure ventilation
PRAGUE PRimary Angioplasty in patients transferred from General community hospitals to specialized PTCA Units with or without Emergency thrombolysis (trial)
PRAGUE-18 Comparison of Prasugrel and Ticagrelor in the Treatment of Acute Myocardial Infarction (trial)
PRAMI Preventive Angioplasty in Acute Myocardial Infarction (trial)
PRECISE-DAPT Predicting Bleeding Complication in Patients Undergoing Stent Implantation and Subsequent Dual Antiplatelet Therapy (trial)
PRECOMBAT Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease (trial)
PRESERVE Prevention of Serious Adverse Events Following Angiography (trial)
PRIDE Pro-BNP Investigation of Dyspnea in the Emergency Department (trial)
PRODEX Propofol Compared to Dexmedetomidine (trial)
PROTECT Placebo-controlled Randomized Study of the Selective A1 Adenosine Receptor Antagonist Rolofylline for Patients Hospitalized with Acute Decompensated Heart Failure and Volume Over- load to Assess Treatment Effect on Congestion and Renal Function (trial)
PRR pattern recognition receptor
PS pressure support ventilation
PSI patient safety incident
P-SILI patient-self-induced lung injury
PT prothrombin time
PTA percutaneous transluminal angioplasty
PTCA percutaneous transluminal coronary angioplasty
PTLD post-transplantation lymphoproliferative disorder
PTU propylthiouracil
PURSUIT Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy (trial)
P/V pressure/volume
PVA patient–ventilator asynchrony
PVC premature ventricular contraction; premature ventricular complex
PVR pulmonary vascular resistance; paravalvular regurgitation
pVT pulseless ventricular tachycardia
PWI perfusion-weighted imaging
PWR papillary wall rupture
QCT quantitative computerized tomography angiography
QD dialysate flow
QI quality indicator
Qp pulmonary flow
Qs systemic flow
qSOFA quick SOFA
RAAS renin–angiotensin–aldosterone system; Richmond Agitation Sedation Scale
RALT right anterolateral thoracotomy
RAS radiological 5-point atelectasis score
RBBB right bundle branch block
RBC red blood cell
RBF renal blood flow
RCA right coronary artery
RCRI Revised Cardiac Risk Index
RCT randomized controlled trial
RCV reference change value
REDEEM Randomised Dabigatran Etexilate Dose Finding Study in Patients With Acute Coronary Syndromes (trial)
RELAX-AHF Serelaxin, Recombinant Human Relaxin2, for Treatment of Acute Heart Failure (trial)
REM rapid eye movement
REMATCH Randomized Evaluation of Mechanical Assistance for the Treatment of Congestive Heart Failure (trial)
REPLACE-2 Randomized Evaluation in PCI Linking Angiomax to Reduced Clinical Events 2 (trial)
RHC right heart catheterization
RI resistive index
RIFLE
Risk of renal dysfunction, Injury to the kidney, Failure of kidney function, Loss of kidney function, End-stage kidney disease
RIFLE-STEACS Radial Versus Femoral Randomized Investigation in ST-Elevation Acute Coronary Syndrome (trial)
RITA right internal thoracic artery
RITA 3 Randomized Intervention Trial of Unstable Angina 3 (trial)
RIVAL RadIal Vs femorAL access for coronary intervention (trial)
RNA ribonucleic acid
ROC receiver operating characteristic
ROPAC Registry of Pregnancy and Cardiac disease
ROSC return of spontaneous circulation
ROSE-AHF
Renal Optimization Strategies Evaluation in Acute Heart Failure (trial)
rpm revolution per minute
RR respiratory rhythm
RRT renal replacement therapy
RSCD Regional Study of Care for the Dying
rSO2 regional oxygen saturation
RT resuscitative thoracotomy
rtPA recombinant tissue plasminogen activator
RT-PCR real-time polymerase chain reaction
RV right ventricular; right ventricle
RVAD right ventricular assist device
RVEF right ventricular ejection fraction
RVOT right ventricular outflow tract
RWPT R wave peak time
s second
SAH subarachnoid haemorrhage
SALT San Antonio Lung Transplant
SaO2 arterial oxygen saturation
SAPS Simplified Acute Physiology Score
SAT spontaneous awakening trial
SAVR surgical aortic valve replacement
SAX short-axis (view, ultrasound)
SBP systolic blood pressure
SBT spontaneous breathing trial
SC subcutaneous
SCAAR Swedish Coronary Angiography and Angioplasty Register
SCAD spontaneous coronary artery dissection
SCAI Society for Cardiovascular Angiography and Interventions
SCD sudden cardiac death
SCr serum creatinine
SCUF slow continuous ultrafiltration
ScvO2 central venous oxygen saturation; superior vena cava oxygenation saturation
SD standard deviation
SDF sidestream dark field (imaging)
SDI sidestream dark field imaging
SE sentinel event
SEDCOM Safety and Efficacy of Dexmedetomidine Compared with Midazolam (trial)
SEES Sentinel Events Evaluation Study
SFL Stent for Life (initiative)
SGA supraglottic airway
SGLT2 sodium–glucose cotransporter 2
SGOT serum glutamic-oxaloacetic transaminase
SHFM Seattle Heart Failure Model
SHOCK Should We Emergently Revascularize Occluded Coronaries for Cardiogenic Shock (trial)
SHOCK-COOL Mild Hypothermia in Cardiogenic Shock Complicating Myocardial Infarction (trial)
SIADH syndrome of inappropriate antidiuretic hormone
SILI self-inflicted lung injury
SIMV synchronized intermittent mandatory ventilation
SIRS systemic inflammatory response syndrome
SLEDD slow low-efficiency extended daily dialysis
SMUR emergency mobile resuscitation services
SNF systemic nephrogenic fibrosis
SNP sodium nitroprusside
SOAP Sepsis Occurrence in Acutely Ill Patients (trial)
SOAP II Sepsis Occurrence in Acutely Ill Patients II (trial)
SOD superoxide dismutase
SOFA Sequential Organ Failure Assessment (score)
SOLOIST-WHF Effect of Sotagliflozin on Cardiovascular Events in Patients With Type 2 Diabetes Post Worsening Heart Failure (trial)
S1P sphingosine-1-phosphate
SPC specialist palliative care
SPECT single-photon emission computerized tomography
sPESI simplified Pulmonary Embolism Severity Index
SQTS short QT syndrome
SR scavenger receptor
SSEP somatosensory evoked potential
SSFP steady-state free precession
sST2 soluble suppression of tumorigenicity-2
ST2 suppression of tumorigenicity 2
STARRT-AKI STandard versus Accelerated Initiation of Renal Replacement Therapy in Acute Kidney Injury (trial)
STARS Stent Anticoagulation Restenosis Study
STARS-BNP Systolic Heart Failure Treatment Supported by BNP (trial)
STE-ACS ST elevation acute coronary syndrome
STEMI ST-segment elevation myocardial infarction
STEMI-RADIAL ST Elevation Myocardial Infarction treated by RADIAL or femoral approach (trial)
STICH Surgical Treatment for Ischemic Heart Failure (trial); Surgical Trial in Spontaneous Intracerebral Haemorrhage (trial)
STICHES STICH Extension Study
STREAM Strategic Reperfusion Early after Myocardial Infarction (trial)
STS Society of Thoracic Surgeons
SUPPORT Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment
SURVIVE Survival of Patients with Acute Heart Failure in Need of Intravenous Inotropic Support (trial)
SV stroke volume
SvO2 mixed venous oxygen saturation
SVR systemic vascular resistance
SVT supraventricular tachycardia
