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Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
Andrew Worster, Peter Kavsak
No abstract text is available yet for this article.
September 19, 2017: Annals of Internal Medicine
José R López-Mínguez, Juan M Nogales-Asensio, Sebastián Romani, Fernando Rivero-Crespo, Victor M Aragón-Extremera, Jesús M Jiménez-Mazuecos, Fernando Carrasco, Juan Francisco Oteo-Domínguez, Francisco Bosa-Ojeda, Joan A Gómez-Hospital
OBJECTIVES: To compare the safety and efficacy of the new cobalt-chromium bioactive stent Titan Optimax(®) (Hexacath, France) with its predecessor, Titan-2(®) . BACKGROUND: The TIOMAX registry includes 784 patients who underwent percutaneous coronary intervention with these stents in 21 Spanish hospitals. METHODS: Analysis of all patients in the registry without exclusion criteria, candidates for revascularization (March-2013/July-2014)...
September 30, 2017: Catheterization and Cardiovascular Interventions
M Bilal Iqbal, Robert D Smith, Rebecca Lane, Niket Patel, Wala Mattar, Tito Kabir, Vasileios Panoulas, Mark Mason, Miles C Dalby, Richard Grocott-Mason, Charles D Ilsley
BACKGROUND: More than half of the patients undergoing percutaneous coronary intervention (PCI) have multivessel disease. Whether complete revascularization impacts long-term mortality or whether selected patients or those with specific coronary anatomy benefit from complete revascularization is unclear. METHODS: A total of 14,452 patients underwent PCI between 2004 and 2015 at Harefield Hospital, UK. Of these, 7,076 patients had multivessel disease. We excluded 321 patients with left main-stem stenosis ≥50%, with 6,755 patients included in the analysis (936 patients had complete revascularization)...
September 30, 2017: Catheterization and Cardiovascular Interventions
Aída Escudero-González, Xacobe Flores-Ríos, Cayetana Barbeito-Caamaño, Patricia Pardo-Martínez, Nicolás Vázquez-González, José M Vázquez Rodríguez
No abstract text is available yet for this article.
June 21, 2017: Revista Española de Cardiología
Yader Sandoval, Stephen W Smith, Sara A Love, Anne Sexter, Karen Schulz, Fred S Apple
BACKGROUND: This study examined the performance of single high-sensitivity cardiac troponin I (hs-cTnI) measurement strategies to rule out acute myocardial infarction. METHODS: This was a prospective, observational study of consecutive patients presenting to the emergency department (n = 1631) in whom cTnI measurements were obtained using an investigational hs-cTnI assay. The goals of the study were to determine 1) negative predictive value (NPV) and sensitivity for the diagnosis of acute myocardial infarction, type 1 myocardial infarction, and type 2 myocardial infarction; and 2) safety outcome of acute myocardial infarction or cardiac death at 30 days using hs-cTnI less than the limit of detection (LoD) (<1...
September 2017: American Journal of Medicine
E V Oshchepkova, V V Dmitriev
AIM: to study rate and type of life-threatening complications (LC) in patients with ST-Elevation (STE) Acute Coronary Syndrome (ACS) and their relation to implementation of reperfusion measures. MATERIAL AND METHODS: Database of the Federal Register of patients with ACS (FRACS) which functioned from 01/01/2009 to 01/01/2014 contains information on 212304 patients with verified diagnosis of ACS. From this pool using random number generator we selected a cohort comprising 10348 patients with STEACS (60% men, mean age 63...
April 2016: Kardiologiia
A D Erlikh, N A Gratsiansky On Behalf Of Record-Participants
Acute Coronary Syndrome (ACS) Registries RECORD 1-2 (2007-2001) gave valuable information on management of ACS patients in Russia. RECORD-3 was carried out in March-April, 2015. Here we present characteristics of included patients (pts) and data on their treatment during initial hospitalization. MATERIAL AND METHODS: RECORD-3 recruited pts with suspected ACS consecutively hospitalized in participating hospitals (n=47, 55% "invasive") during 1 month. RESULTS: Number of included pts was 2370 (39% women, mean age 64...
April 2016: Kardiologiia
Andrew R Chapman, Atul Anand, Jasper Boeddinghaus, Amy V Ferry, Dennis Sandeman, Philip D Adamson, Jack Andrews, Stephanie Tan, Sheun F Cheng, Michelle D'Souza, Kate Orme, Fiona E Strachan, Thomas Nestelberger, Raphael Twerenbold, Patrick Badertscher, Tobias Reichlin, Alasdair Gray, Anoop S V Shah, Christian Mueller, David E Newby, Nicholas L Mills
BACKGROUND: High-sensitivity cardiac troponin assays enable myocardial infarction to be ruled out earlier, but the optimal approach is uncertain. We compared the European Society of Cardiology rule-out pathway with a pathway that incorporates lower cardiac troponin concentrations to risk stratify patients. METHODS: Patients with suspected acute coronary syndrome (n=1218) underwent high-sensitivity cardiac troponin I measurement at presentation and 3 and 6 or 12 hours...
April 25, 2017: Circulation
Tatsuya Nakachi, Masami Kosuge, Naoki Iinuma, Hidekuni Kirigaya, Shingo Kato, Kazuki Fukui, Kazuo Kimura
BACKGROUND: Several studies have shown higher early mortality for ST-segment elevation acute coronary syndrome (STEACS), but late mortality remains consistently higher for non-ST-segment elevation acute coronary syndrome (NSTEACS). We hypothesized that ST-segment category at acute presentation is associated with the time course of coronary artery disease progression (CP) of nonculprit lesions in patients with acute coronary syndrome (ACS). METHODS: A total of 226 patients (182 men, age 65 ± 10 years) with STEACS (n = 95) or NSTEACS (n = 131) who underwent percutaneous coronary intervention (PCI) during initial hospitalization were studied...
June 2017: Heart and Vessels
Michael DeGiorgio, Noah A Rosenberg
In the last few years, several statistically consistent consensus methods for species tree inference have been devised that are robust to the gene tree discordance caused by incomplete lineage sorting in unstructured ancestral populations. One source of gene tree discordance that has only recently been identified as a potential obstacle for phylogenetic inference is ancestral population structure. In this article, we describe a general model of ancestral population structure, and by relying on a single carefully constructed example scenario, we show that the consensus methods Democratic Vote, STEAC, STAR, R(∗) Consensus, Rooted Triple Consensus, Minimize Deep Coalescences, and Majority-Rule Consensus are statistically inconsistent under the model...
August 2016: Theoretical Population Biology
Anoop S V Shah, Atul Anand, Yader Sandoval, Kuan Ken Lee, Stephen W Smith, Philip D Adamson, Andrew R Chapman, Timothy Langdon, Dennis Sandeman, Amar Vaswani, Fiona E Strachan, Amy Ferry, Alexandra G Stirzaker, Alan Reid, Alasdair J Gray, Paul O Collinson, David A McAllister, Fred S Apple, David E Newby, Nicholas L Mills
BACKGROUND: Suspected acute coronary syndrome is the commonest reason for emergency admission to hospital and is a large burden on health-care resources. Strategies to identify low-risk patients suitable for immediate discharge would have major benefits. METHODS: We did a prospective cohort study of 6304 consecutively enrolled patients with suspected acute coronary syndrome presenting to four secondary and tertiary care hospitals in Scotland. We measured plasma troponin concentrations at presentation using a high-sensitivity cardiac troponin I assay...
December 19, 2015: Lancet
Michael J Lipinski, Lowell F Satler
Intraprocedural thrombotic events (IPTE) during PCI occur in 4% of patients with NSTEACS and 12% of STEACS. IPTE increases hospital cost by $3,592. With an incidence of 4%, additional therapy to completely prevent IPTE in 100 patients would need to cost $144 to make it cost neutral. Further studies are necessary to determine cost-benefit of therapies to prevent IPTE such as cangrelor or newer P2Y12 inhibitors with more rapid onset.
July 2015: Catheterization and Cardiovascular Interventions
Carlos M Laborde, Sergio Alonso-Orgaz, Laura Mourino-Alvarez, José Moreu, Fernando Vivanco, Luis R Padial, María G Barderas
BACKGROUND: Acute coronary syndrome is the major cause of death in developed countries. Despite its high prevalence, there is still a strong need for new biomarkers which permit faster and more accurate diagnostics and new therapeutic drugs. The basis for this challenge lay in improving our understanding of the whole atherosclerotic process from atherogenesis to atherothrombosis. In this study, we conducted two different proteomic analyses of peripheral blood plasma from non-ST elevation acute coronary syndrome and ST elevation acute coronary syndrome patients vs healthy controls...
2014: Proteome Science
Karim Ratib, Mamas A Mamas, Simon G Anderson, Gurbir Bhatia, Helen Routledge, Mark De Belder, Peter F Ludman, Douglas Fraser, James Nolan
OBJECTIVES: This study sought to determine the relationships among access site practice, clinical presentation, and procedural outcomes in a large patient population. BACKGROUND: Transradial access (TRA) has been associated with improved patient outcomes in selected populations in randomized trials. It is unclear whether these outcomes are achievable in clinical practice. METHODS: Using the BCIS (British Cardiovascular Intervention Society) database, we investigated outcomes for percutaneous coronary intervention procedures undertaken between 2007 and 2012 according to access site practice...
January 2015: JACC. Cardiovascular Interventions
B B L M IJkema, J J R M Bonnier, D Schoors, M J Schalij, C A Swenne
The major initial triaging decision in acute coronary syndrome (ACS) is whether or not percutaneous coronary intervention (PCI) is the primary treatment. Current guidelines recommend primary PCI in ST-elevation ACS (STEACS) and initial antithrombotic therapy in non-ST-elevation ACS (NSTEACS). This review probes the question whether this decision can indeed be based on the ECG. Genesis of STE/NSTE ECGs depends on the coronary anatomy, collateral circulation and site of the culprit lesion. Other causes than ischaemia may also result in ST-segment changes...
November 2014: Netherlands Heart Journal
Guoxin Tong, Ningfu Wang, Yujie Zhou, Jianhang Leng, Wei Gao, Xiaoshan Tong, Yun Shen, Jianmin Yang, Xianhua Ye, Liang Zhou, Yan Gao
The predictive value of stromal cell-derived factor-1 (SDF-1) has not been established in patients with non-ST elevation acute coronary syndrome (non-STEACS). A total of 678 consecutive patients with non-STEACS and moderate to high TIMI (Thrombolysis In Myocardial Infarction) risk scores were recruited. All patients underwent an early invasive strategy and then were followed-up for 18 months for clinical events. Left ventricular remodeling was assessed by echocardiography. Plasma concentrations of SDF-1 and N-terminal pro-B-type natriuretic peptide (NT-proBNP) were analyzed...
2014: International Heart Journal
A D Érlikh, S T Matskeplishvili, N A Gratsianskiĭ, Iu I Buziashvili
AIM: To characterize inhospital management of patients (pts) with acute coronary syndromes (ACS) using data from Moscow snapshot registry of hospitalized pts with ACS. METHODS: The registry included data on consecutive pts with ACS hospitalized with label ACS in coronary care units (CCU) or equivalents within 24 hours (h) after onset of symptoms during one week in November 2013. Data was obtained from 32 (17 percutaneous coronary intervention [PCI] capable or "invasive") city hospitals officially treating ACS patients...
2013: Kardiologiia
Amit N Vora, Sunil V Rao
Bleeding events are the most common complications following percutaneous coronary intervention (PCI) and are associated with increases in short- and long-term mortality, nonfatal myocardial infarction, stroke, hospital length of stay, and hospital cost. Over time, there has been a decrease in periprocedural bleeding, primarily due to improvements in antithrombotic therapy; however, transradial (TR) catheterization has been shown to be an important strategy to minimize access site bleeding and potentially improve outcomes among patients with ST-segment elevation myocardial infarction...
May 2014: Current Treatment Options in Cardiovascular Medicine
Michael DeGiorgio, John Syring, Andrew J Eckert, Aaron Liston, Richard Cronn, David B Neale, Noah A Rosenberg
BACKGROUND: As it becomes increasingly possible to obtain DNA sequences of orthologous genes from diverse sets of taxa, species trees are frequently being inferred from multilocus data. However, the behavior of many methods for performing this inference has remained largely unexplored. Some methods have been proven to be consistent given certain evolutionary models, whereas others rely on criteria that, although appropriate for many parameter values, have peculiar zones of the parameter space in which they fail to converge on the correct estimate as data sets increase in size...
2014: BMC Evolutionary Biology
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