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Intervention, angioplasty, myocardial infarction

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https://www.readbyqxmd.com/read/29132196/carotid-endarterectomy-the-change-in-practice-over-11%C3%A2-years-in-a-stroke-centre
#1
Gabrielle T W Tse, Monique F Kilkenny, Chris Bladin, Michael Grigg, Helen M Dewey
BACKGROUND: Recent research evidence has impacted the practice of carotid endarterectomy (CEA). We aim to characterize changes in the practice and outcome of CEA over time in a single large-volume stroke centre. METHODS: All patients who underwent CEA from 2004 to 2014 and carotid angioplasty and stenting (CAS) from 2003 to 2008 at an Australian metropolitan tertiary stroke centre hospital were included. Clinical data were analysed to identify time trends in choice of intervention, patient selection, preoperative imaging utilization, surgical timing and outcome...
November 13, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/29126947/transradial-versus-transfemoral-access-in-patients-undergoing-peripheral-artery-angioplasty-stenting-a-meta-analysis
#2
REVIEW
George Galyfos, Fragiska Sigala, Konstantinos Filis
Transradial (TR) access has been extensively compared to transfemoral (TF) access in patients undergoing percutaneous coronary interventions, with TR method showing a clear benefit over the latter. However, comparative data concerning peripheral artery endovascular interventions has been limited in the literature. Therefore, a systematic review was conducted in order to compare main outcomes between TR and TF access in patients undergoing peripheral artery angioplasty and/or stenting. Main outcomes included technical success, major/minor bleeding risk, access site complications, hospital stay, death, myocardial infarction, neurological events and other procedural parameters...
September 30, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29118947/in-hospital-and-long-term-results-of-primary-angioplasty-and-medical-therapy-in-nonagenarian-patients-with-acute-myocardial-infarction
#3
Muslum Sahin, Lutfi Ocal, Ali Kemal Kalkan, Alev Kilicgedik, Mehmet Emin Kalkan, Burak Teymen, Ugur Arslantas, Mehmet Muhsin Turkmen
Introduction: Although percutaneous coronary intervention is an accepted "first-line" therapy in acute ST elevation myocardial infarction (STEMI) in general population, few data are available on the short- and long-term outcomes of very old patients (age >90 years). Our aim is to evaluate and compare the short and long-term outcomes after primary percutaneous coronary intervention (PPCI) or medical therapy in nonagenarian patients with STEMI. Methods: We retrospectively identified patients older than 90 years old in our clinic, with acute STEMI who presented within 12 hours after symptoms onset, either underwent PPCI or medically treated...
2017: Journal of Cardiovascular and Thoracic Research
https://www.readbyqxmd.com/read/29113999/index-of-microcirculatory-resistance-at-the-time-of-primary-percutaneous-coronary-intervention-predicts-early-cardiac-complications-insights-from-the-oxami-oxford-study-in-acute-myocardial-infarction-cohort
#4
Gregor Fahrni, Mathias Wolfrum, Giovanni Luigi De Maria, Florim Cuculi, Sam Dawkins, Mohammad Alkhalil, Niket Patel, John C Forfar, Bernard D Prendergast, Robin P Choudhury, Keith M Channon, Adrian P Banning, Rajesh K Kharbanda
BACKGROUND: Early risk stratification after primary percutaneous coronary intervention (PPCI) for ST-segment-elevation myocardial infarction is currently challenging. Identification of a low-risk group may improve triage of patients to alternative clinical pathways and support early hospital discharge. Our aim was to assess whether the index of microcirculatory resistance (IMR) at the time of PPCI can identify patients at low risk of early major cardiac complications and to compare its performance against guideline-recommended risk scores...
November 7, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29113867/clinical-significance-of-intracoronary-thrombus-aspirated-during-primary-percutaneous-intervention-an-immunohistopathological-study
#5
Neeraj Parakh, Basavaraj Utagi, Sudhir Arava, Sunil Verma, Ganesan Karthikeyan, Sandeep Singh, Balram Bhargava, Ruma Ray, Chetan D Patel, Vinay K Bahl
BACKGROUND: Manual thrombus aspiration during primary percutaneous intervention provides us with aspirated thrombus sample, that may contain material from the disrupted plaque. Immunohistopathological analysis of thrombus can yield valuable information about the clinical and cardiovascular outcomes and possible mechanisms of myocardial infarction. MATERIAL AND METHODS: We studied and analysed the immunohistopathological features of coronary thrombus aspirated from patients undergoing primary percutaneous coronary angioplasty...
September 22, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29113720/spanish-cardiac-catheterization-and-coronary-intervention-registry-26th-official-report-of-the-spanish-society-of-cardiology-working-group-on-cardiac-catheterization-and-interventional-cardiology-1990-2016
#6
Ana María Serrador Frutos, Pilar Jiménez-Quevedo, Armando Pérez de Prado, Manuel Pan Álvarez-Ossorio
INTRODUCTION AND OBJECTIVES: The Working Group on Cardiac Catheterization and Interventional Cardiology presents its annual report on the activity data for 2016. METHODS: All Spanish hospitals with catheterization laboratories were invited to voluntarily contribute their activity data. The information was collected online and was analyzed mainly by an independent company. RESULTS: In 2016, 106 centers participated in the national registry; 80 of these centers are public...
November 4, 2017: Revista Española de Cardiología
https://www.readbyqxmd.com/read/29095731/understanding-myocardial-infarction-evolution-infarct-size-and-index-of-microvascular-resistance-new-clinical-perspective
#7
Massimo Fineschi
: Approximately 40% of patients after ST elevation acute myocardial infarction (STEMI) have evidence of ineffective myocardial revascularization due to microvascular damage despite a successful target vessel recanalization by means of primary angioplasty (PPCI). Microvascular dysfunction is associated with the extension of the infarct size and with higher morbidity and mortality. Early identification of this phenomenon could be useful both for therapeutic and prognostic purposes. Index of microvascular resistance (IMR) could be assessed invasively at the end of PPCI and is a measure of microvascular function...
November 8, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29079252/effect-of-an-intensified-multifactorial-intervention-on-cardiovascular-outcomes-and-mortality-in-type-2-diabetes-j-doit3-an-open-label-randomised-controlled-trial
#8
Kohjiro Ueki, Takayoshi Sasako, Yukiko Okazaki, Masayuki Kato, Sumie Okahata, Hisayuki Katsuyama, Mikiko Haraguchi, Ai Morita, Ken Ohashi, Kazuo Hara, Atsushi Morise, Kazuo Izumi, Naoki Ishizuka, Yasuo Ohashi, Mitsuhiko Noda, Takashi Kadowaki
BACKGROUND: Limited evidence suggests that multifactorial interventions for control of glucose, blood pressure, and lipids reduce macrovascular complications and mortality in patients with type 2 diabetes. However, safe and effective treatment targets for these risk factors have not been determined for such interventions. METHODS: In this multicentre, open-label, randomised, parallel-group trial, undertaken at 81 clinical sites in Japan, we randomly assigned (1:1) patients with type 2 diabetes aged 45-69 years with hypertension, dyslipidaemia, or both, and an HbA1c of 6·9% (52·0 mmol/mol) or higher, to receive conventional therapy for glucose, blood pressure, and lipid control (targets: HbA1c <6·9% [52·0 mmol/mol], blood pressure <130/80 mm Hg, LDL cholesterol <120 mg/dL [or 100 mg/dL in patients with a history of coronary artery disease]) or intensive therapy (HbA1c <6·2% [44·3 mmol/mol], blood pressure <120/75 mm Hg, LDL cholesterol <80 mg/dL [or 70 mg/dL in patients with a history of coronary artery disease])...
October 24, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/29038413/percutaneous-coronary-intervention-for-coronary-bifurcation-lesions
#9
William Finch, Michael S Lee
Percutaneous coronary intervention (PCI) of lesions at coronary bifurcations poses a technical challenge. Short-term complications, including periprocedural myocardial infarction, and long-term complications such as in-stent restenosis and stent thrombosis, are higher in patients with bifurcation lesions. Techniques for PCI of bifurcation lesions include stenting of the main branch alone, and the use of two or more stents to cover the main and side branches. Two- or three-stent techniques include T-stenting, crush, culotte, simultaneous kissing stents, V-stenting, and Y-stenting...
2017: Reviews in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28984467/the-9p21-rs-1333040-polymorphism-is-associated-with-coronary-microvascular-obstruction-in-st-segment-elevation-myocardial-infarction-treated-by-primary-angioplasty
#10
Francesco Fracassi, Giampaolo Niccoli, Vincenzo Vetrugno, Michele Cauteruccio, Antonino Buffon, Ilaria Gatto, Igor Giarretta, Paolo Tondi, Roberto Pola, Filippo Crea
BACKGROUND: Microvascular obstruction (MVO) after primary percutaneous coronary intervention (pPCI) leads to higher incidence of both early and late complications. A number of single nucleotide polymorphisms in 9p21 chromosome have been shown to affect angiogenesis in response to ischaemia. In particular, Rs1333040 with its three genotypic vriants C/C, T/C and T/T might influence the occurrence of MVO after pPCI. METHODS: We enrolled ST-elevation myocardial infarction (STEMI) patients undergoing pPCI...
October 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28980300/cha2ds2-vasc-score-predicts-contrast-induced-nephropathy-in-patients-with-st-segment-elevation-myocardial-infarction-who-were-undergoing-primary-percutaneous-coronary-intervention
#11
Gokhan Cicek, Ersin Yıldırım
BACKGROUND: We aimed to investigate the predictive value of the CHA₂DS₂-VASc score in the development of Contrast Induced Nephropathy (CIN). METHODS: A total of 2972 patients who had been diagnosed with ST elevation-MI and who had undergone primary coronary angioplasty were included in the study. The patients were divided into 3 groups according to the CHA₂DS₂-VASc score as low risk (1 point), intermediate risk (2 points) and high risk (≥3 points). The groups were followed-up with regard to CIN development...
October 5, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28963747/prognosis-is-similar-for-patients-who-undergo-primary-pci-during-regular-hours-and-off-hours-a-report-from-scaar
#12
Björn Redfors, Christian Dworeck, Oskar Angerås, Inger Haraldsson, Petur Petursson, Jacob Odenstedt, Dan Ioanes, Sebastian Völz, Magnus Hiller, Per Fransson, Jason Stewart, Henrik Fryklund, Per Albertsson, Truls Råmunddal, Elmir Omerovic
BACKGROUND: Timely percutaneous coronary intervention (PCI) improves prognosis in ST-elevation myocardial infarction (STEMI). However, recent reports indicate that patients with STEMI who present during non-regular working hours (off-hours) have a worse prognosis. The aim of this study was to compare outcome between patients with STEMI who underwent primary PCI during off-hours and regular hours. METHODS: We retrieved data from the Swedish Coronary Angiography and Angioplasty Registry (SCAAR) for all patients who underwent primary PCI in Region Västra Götaland due to STEMI between January 2004 and May 2013...
September 30, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28891183/primary-percutaneous-coronary-intervention-for-inferior-st-segment-elevation-myocardial-infarction-in-a-patient-supported-by-the-heartware-left-ventricular-assist-device
#13
Roberto Spina, Maithri Siriwardena, Nicole Bart, Mayooran Namasivayam, Mark Connellan, Paul Jansz, Philip Spratt, Christopher S Hayward, Eugene Kotlyar, Brendan Gunalingam
A 63-year-old man with an ischaemic cardiomyopathy, supported by the HeartWare left ventricular assist device (LVAD), presented with ventricular tachycardia and inferior ST-elevation myocardial infarction (STEMI) with associated acute right ventricular (RV) dysfunction. He underwent primary percutaneous coronary intervention with balloon angioplasty and placement of three drug-eluting stents in the proximal-to-mid right coronary artery. Post-procedure, ventricular arrhythmias abated, RV systolic dysfunction resolved and RV size normalised...
September 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28890058/reversal-of-acute-mesenteric-ischemia-by-salvation-of-the-meandering-mesenteric-artery-with-stenting-of-the-left-internal-iliac%C3%A2-artery
#14
Thomas Kotsis, Panagitsa Christoforou, Constantinos Nastos, Achilles Chatziioannou, Theodosios Theodosopoulos
The presence of the meandering mesenteric artery, which is a nonconstant tortuous arterial component unifying the peripheral intestinal circulation, is evidence of chronic occlusive disease of the main intestinal arteries. This collateral intestinal arterial pathway, when present, must be preserved in any abdominal intervention, as it is often the only remaining arterial supply of the intestine; its ligation can be accompanied by intestinal ischemia. We present herein, the case of a 42-year-old man, heavy smoker, who had chronic mesenteric ischemia without particular clinical manifestations till the hospitalization for acute myocardial infarction for which he underwent balloon angioplasty and stenting of the left circumflex coronary artery...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28844990/efficacy-and-safety-of-a-pharmaco-invasive-strategy-with-half-dose-alteplase-versus-primary-angioplasty-in-st-segment-elevation-myocardial-infarction-early-myo-trial-early-routine-catheterization-after-alteplase-fibrinolysis-versus-primary-pci-in-acute-st-segment
#15
RANDOMIZED CONTROLLED TRIAL
Jun Pu, Song Ding, Heng Ge, Yaling Han, Jinchen Guo, Rong Lin, Xi Su, Heng Zhang, Lianglong Chen, Ben He
BACKGROUND: Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the efficacy and safety of a PhI strategy with half-dose fibrinolytic regimen versus PPCI in patients with STEMI. METHODS: The EARLY-MYO trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction) was an investigator-initiated, prospective, multicenter, randomized, noninferiority trial comparing a PhI strategy with half-dose alteplase versus PPCI in patients with STEMI 18 to 75 years of age presenting ≤6 hours after symptom onset but with an expected PCI-related delay...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28836672/whole-grain-cereals-for-the-primary-or-secondary-prevention-of-cardiovascular-disease
#16
REVIEW
Sarah Am Kelly, Louise Hartley, Emma Loveman, Jill L Colquitt, Helen M Jones, Lena Al-Khudairy, Christine Clar, Roberta Germanò, Hannah R Lunn, Gary Frost, Karen Rees
BACKGROUND: There is evidence from observational studies that whole grains can have a beneficial effect on risk for cardiovascular disease (CVD). Earlier versions of this review found mainly short-term intervention studies. There are now longer-term randomised controlled trials (RCTs) available. This is an update and expansion of the original review conducted in 2007. OBJECTIVES: The aim of this systematic review was to assess the effect of whole grain foods or diets on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible RCTs...
August 24, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28802735/incidence-of-cardiovascular-events-and-vascular-interventions-in-patients-with-type-2-diabetes
#17
Suzanne E Engelen, Yolanda van der Graaf, Manon C Stam-Slob, Diederick E Grobbee, Maarten J Cramer, L Jaap Kappelle, Gert J de Borst, Frank L J Visseren, Jan Westerink
OBJECTIVE: Diabetes mellitus is associated with an increased risk for cardiovascular morbidity and mortality. The vascular burden in terms of incidence of cardiovascular events (CVE) and vascular interventions is however poorly quantified. In this study we evaluated the incidence rates of CVE and vascular interventions in patients with type 2 diabetes (T2DM) with and without cardiovascular disease (CVD) in comparison to patients without type 2 diabetes. RESEARCH DESIGN AND METHODS: In a cohort of 9...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28792164/survey-of-assessment-and-management-of-coronary-heart-disease-patients-smart-in-india
#18
Amit Singh, Vikram Singh, Rupesh Ranjan
OBJECTIVE: Survey of Assessment and MAnagement of CoRonary Heart Disease PaTients was undertaken to describe profile and management pattern of adult Acute Coronary Syndrome (ACS) patients from presentation till discharge, in private tertiary care Indian hospitals. MATERIALS AND METHODS: This was an observational, prospective study. Based on standard criteria, patients were diagnosed to have ST-segment elevation myocardial infarction (STEMI), non-ST-segment elevation myocardial infarction (NSTEMI) or unstable angina (UA)...
July 2017: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/28759107/low-glycaemic-index-diets-for-the-prevention-of-cardiovascular-disease
#19
REVIEW
Christine Clar, Lena Al-Khudairy, Emma Loveman, Sarah Am Kelly, Louise Hartley, Nadine Flowers, Roberta Germanò, Gary Frost, Karen Rees
BACKGROUND: The glycaemic index (GI) is a physiological measure of the ability of a carbohydrate to affect blood glucose. Interest is growing in this area for the clinical management of people at risk of, or with, established cardiovascular disease. There is a need to review the current evidence from randomised controlled trials (RCTs) in this area. This is an update of the original review published in 2008. OBJECTIVES: To assess the effect of the dietary GI on total mortality, cardiovascular events, and cardiovascular risk factors (blood lipids, blood pressure) in healthy people or people who have established cardiovascular disease or related risk factors, using all eligible randomised controlled trials...
July 31, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28750607/are-women-with-type-2-diabetes-mellitus-more-susceptible-to-cardiovascular-complications-following-coronary-angioplasty-a-meta-analysis
#20
Pravesh Kumar Bundhun, Manish Pursun, Feng Huang
BACKGROUND: Scientific reports have shown Type 2 Diabetes Mellitus (T2DM) to be independently associated with adverse outcomes following Percutaneous Coronary Intervention (PCI). However, gender difference has also often been a controversial issue following PCI. Till date, very few meta-analyses have systematically compared the adverse cardiovascular outcomes in male versus female patients with T2DM following PCI. Therefore, we aimed to carry out this analysis in order to find out an answer to this interesting question...
July 27, 2017: BMC Cardiovascular Disorders
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