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Coronary intervention

Christoph B Olivier, Hillary Mulder, William R Hiatt, W Schuyler Jones, F Gerry R Fowkes, Frank W Rockhold, Jeffrey S Berger, Iris Baumgartner, Peter Held, Brian G Katona, Lars Norgren, Juuso Blomster, Manesh R Patel, Kenneth W Mahaffey
Importance: Patients with peripheral artery disease (PAD) are at high risk for myocardial infarction (MI). Objective: To characterize the incidence and types of MI in a PAD population, identify factors associated with MI, and determine the association of MI with cardiovascular mortality and acute limb ischemia. Design, Setting, and Participants: The Study Comparing Cardiovascular Effects of Ticagrelor and Clopidogrel in Patients With Peripheral Artery Disease (EUCLID) was a double-blind randomized clinical trial conducted at 811 sites in 28 countries that randomized 13 885 patients with symptomatic PAD to monotherapy with ticagrelor or clopidogrel...
December 12, 2018: JAMA Cardiology
Gabrielle L Anderson, Jennifer L Osborn, Scott D Nei, Malcolm R Bell, Gregory W Barsness, Kristin C Mara, Narith N Ou
Potent platelet inhibition is one of the most important medical interventions to prevent ischemic complications during and after percutaneous coronary intervention (PCI). Practice has evolved with the introduction of potent oral P2Y12 inhibitors that provide quick, effective platelet inhibition, and the need for routine glycoprotein IIb/IIIa inhibitors (GPIs) has decreased. Additionally, a shorter duration of GPI infusion has been shown to be safe with adequate oral antiplatelet loading, but clinical outcome data are limited to eptifibatide...
January 1, 2019: American Journal of Cardiology
Chun Shing Kwok, Sunil V Rao, Ian C Gilchrist, Jessica Potts, Vinayak Nagaraja, Mark Gunning, James Nolan, Evangelos Kontopantelis, Olivier F Bertrand, Mamas A Mamas
The cost of inpatient percutaneous coronary interventions (PCI) procedure is related to length of stay (LOS). It is unknown, how LOS may be associated with readmission rates and costs of index PCI and readmissions in elective PCI. This study aims to evaluate rates, predictors, causes, and costs associated with 30-day unplanned readmissions according to lLOS in patients, who underwent elective PCI. We included patients in the Nationwide Readmission Database, who were admitted to hospital from 2010 to 2014, who underwent uncomplicated elective PCI...
January 1, 2019: American Journal of Cardiology
Zhu Zhaowei, Peng Xiaofan, Xie Hebin, Tian Cuihong, Xing Haoran, Liu Qinna, Liu Zhenzhen, Hu Xinqun, Fang Zhenfei, Tang Jianjun, Zhao Yanshu, Yuan Hong, Shi Chun, Tai Shi, Liu Qiming, Jiang Hejun, Lv Xiaoling, Zhou Shenghua
Patients with acute coronary syndrome (ACS) face high postevent mortality. This study aims to evaluate the impact of living without spouse on 1-year mortality of ACS patients. This retrospective study enrolled a total of 600 consecutive patients (≥75 years of age) with ACS hospitalized in our hospital between January 2013 and December 2016. Patients' clinical characteristics, laboratory values, hospital course, demographic characteristics, and angiographic data were collected. Patients were divided into 2 groups according to living with (n = 396) or without (n = 204) spouse...
January 1, 2019: American Journal of Cardiology
Youlin Koh, Hashrul Rashid, Stephanie Khaw, Arthur Nasis
Patients often experience emotional distress after acute coronary syndrome (ACS). These may lead to symptoms of depression or anxiety and greater morbidity/mortality. We sought to determine whether flowering plants in the coronary care ward reduced depressive and anxiety symptoms in these patients. Patients with ACS were randomly allocated to flowering plants (intervention) or no plants (control) in their room during index hospitalisation. Baseline data were collected. The primary outcome was the Hospital Anxiety and Depression Scale (HADS) depressive and anxiety symptom scores at discharge...
December 11, 2018: Heart and Vessels
Marayam Narimani, Ali Ansari Jaberi, Tayebeh Negahban Bonabi, Tabandeh Sadeghi
Background: Considering the contradictory results on the role of complementary therapies in correcting post-operative side effects, the aim of this study was to evaluate the effect of acupressure on pain severity in patients undergoing coronary artery graft admitted to a coronary care unit. Methods: In this double-blind, randomized, clinical trial, 70 patients were selected randomly after coronary artery bypass grafting (CABG) surgery based on inclusion criteria and then assigned to two groups (35 in acupressure and 35 in control) randomly by the minimization method...
October 2018: Anesthesiology and Pain Medicine
Rabih Tabet, Nikhil Nalluri, Farshid Daneshvar, James Malpeso
A left main coronary artery (LMCA) iatrogenic dissection is a rare but potentially life-threatening complication of coronary angioplasty. It can range from a simple tear in the artery wall to a severe dissection, causing complete blood flow obstruction. We report the case of a 63-year-old male patient who was presented to our catheterization laboratory following a positive stress test. An angiogram showed a proximal left anterior descending (LAD) artery tight lesion. Balloon inflation was complicated by an ostial LAD dissection that rapidly extended into the left main and the left circumflex arteries treated with angioplasty and stenting...
October 4, 2018: Curēus
Mei-Tzu Wang, Cheng Ken Tsai, Shu-Hung Kuo, Wei-Chun Huang, Kun-Chang Lin, Wang-Ting Hung, Chin-Chang Cheng, Pei-Ling Tang, Cheng Chung Hung, Jin-Shiou Yang, Hsin-Li Liang, Guang-Yuan Mar, Chun-Peng Liu
Background and Purpose: No previous study has compared the impact of dipyridamole-based triple antiplatelet therapy on secondary stroke prevention and long-term outcomes to that of dual antiplatelet therapy (DAPT) in patients with acute myocardial infarction (AMI) and previous stroke. This study aimed to evaluate the impact of dipyridamole added to DAPT on stroke prevention and long-term outcomes in patients with cerebral infarction after first AMI. Methods: This nationwide, case-control study included 75,789 patients with cerebral infarction after first AMI...
2018: Frontiers in Neurology
Tomo Ando, Shunsuke Aoi, Said Ashraf, Pedro A Villablanca, Tesfaye Telila, Alexandros Briasoulis, Hisato Takagi, Luis Afonso, Cindy L Grines
OBJECTIVES: To assess the efficacy and safety of transradial (TR) versus transfemoral (TF) percutaneous coronary intervention (PCI) in left main (LM) lesion. BACKGROUND: TR-PCI is the preferred approach compared with TF approach because of less bleeding risk. LM-PCI is often challenging because of the anatomical complexity and uniqueness of supplying a large myocardium territory. We performed a systematic review and meta-analysis to assess the safety and efficacy of TR-PCI compared with TF-PCI of the LM lesions...
December 10, 2018: Catheterization and Cardiovascular Interventions
Thierry Corcos
Since its introduction by Lucien Campeau three decades ago, percutaneous radial artery approach at the forearm has been shown to provide advantages over the femoral approach and has become the standard approach for coronary angiography and intervention. Though infrequent, vascular complications still remain, mainly radial artery occlusion. Therefore, a more distal radial approach at the snuffbox or at the dorsum of hand has been suggested, initially by anethesiologists for perioperative patient monitoring, and more recently by Babunashvili et al...
December 11, 2018: Catheterization and Cardiovascular Interventions
Shahnaz Akil, Fredrik Hedeer, Marcus Carlsson, Håkan Arheden, Jenny Oddstig, Cecilia Hindorf, Jonas Jögi, David Erlinge, Henrik Engblom
BACKGROUND: To relate findings of qualitative evaluation of first-pass perfusion-CMR and anatomical evaluation on coronary angiography (CA) to the reference standard of quantitative perfusion, cardiac PET, in patients with suspected or known stable coronary artery disease (CAD). METHODS AND RESULTS: Forty-one patients referred for CA due to suspected stable CAD, prospectively performed adenosine stress/rest first-pass perfusion-CMR as well as 13 N-NH3 PET on the same day, 4 ± 3 weeks before CA...
December 10, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
Kris G Vargas, Paul M Haller, Bernhard Jäger, Maximilian Tscharre, Ronald K Binder, Christian Mueller, Bertil Lindahl, Kurt Huber
OBJECTIVE: Classifying myocardial infarction into type 1 (T1MI) or type 2 (T2MI) remains a challenge in clinical practice. We aimed to identify factors contributing to variation in the classifications of MI into type 1 or type 2. In addition, pooled analyses of long-term mortality and reinfarction outcomes were performed. METHODS: We searched Medline, Embase and Web of Science through January 2018 for observational studies or clinical trials classifying patients as either T1MI or T2MI...
December 7, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Graham R McClure, Emilie P Belley-Cote, John Harlock, Andre Lamy, Michael Stacey, P J Devereaux, Richard P Whitlock
PURPOSE: Postoperative infection, particularly in cardiac surgery, results in significant morbidity, mortality, and healthcare cost. Identification of novel predictors of postoperative infection can target high-risk populations for prophylactic intervention. METHODS: Steroids in cardiac surgery (SIRS) was a multi-centre randomized-controlled trial assessing intraoperative administration of methylprednisone during cardiac surgery, which enrolled 7,507 patients across 80 centres in 18 countries...
December 10, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
Jeff M Smit, Gerhard Koning, Alexander R van Rosendael, Mohammed El Mahdiui, Bart J Mertens, Martin J Schalij, J Wouter Jukema, Victoria Delgado, Johan H C Reiber, Jeroen J Bax, Arthur J Scholte
Aims: Quantitative flow ratio (QFR) is a recently developed technique to calculate fractional flow reserve (FFR) based on 3D quantitative coronary angiography and computational fluid dynamics, obviating the need for a pressure-wire and hyperaemia induction. QFR might be used to guide patient selection for FFR and subsequent percutaneous coronary intervention (PCI) referral in hospitals not capable to perform FFR and PCI. We aimed to investigate the feasibility to use QFR to appropriately select patients for FFR referral...
December 11, 2018: European Heart Journal Cardiovascular Imaging
Tetsuo Shoji, Masaaki Inaba, Masafumi Fukagawa, Ryoichi Ando, Masanori Emoto, Hisako Fujii, Akira Fujimori, Mitsuru Fukui, Hiroki Hase, Tetsuya Hashimoto, Hideki Hirakata, Hirokazu Honda, Tatsuo Hosoya, Yuji Ikari, Daijo Inaguma, Toru Inoue, Yoshitaka Isaka, Kunitoshi Iseki, Eiji Ishimura, Noritomo Itami, Chiharu Ito, Toshitaka Kakuta, Toru Kawai, Hideki Kawanishi, Shuzo Kobayashi, Junko Kumagai, Kiyoshi Maekawa, Ikuto Masakane, Jun Minakuchi, Koji Mitsuiki, Takashi Mizuguchi, Satoshi Morimoto, Toyoaki Murohara, Tatsuya Nakatani, Shigeo Negi, Shinichi Nishi, Mitsushige Nishikawa, Tetsuya Ogawa, Kazumichi Ohta, Takayasu Ohtake, Mikio Okamura, Senji Okuno, Takashi Shigematsu, Toshitsugu Sugimoto, Masashi Suzuki, Hideki Tahara, Yoshiaki Takemoto, Kenji Tanaka, Yoshihiro Tominaga, Yoshiharu Tsubakihara, Yoshihiro Tsujimoto, Kazuhiko Tsuruya, Shinichiro Ueda, Yuzo Watanabe, Kunihiro Yamagata, Tomoyuki Yamakawa, Shozo Yano, Keitaro Yokoyama, Noriaki Yorioka, Minoru Yoshiyama, Yoshiki Nishizawa
Importance: Patients with chronic kidney disease have impaired vitamin D activation and elevated cardiovascular risk. Observational studies in patients treated with hemodialysis showed that the use of active vitamin D sterols was associated with lower risk of all-cause mortality, regardless of parathyroid hormone levels. Objective: To determine whether vitamin D receptor activators reduce cardiovascular events and mortality in patients without secondary hyperparathyroidism undergoing hemodialysis...
December 11, 2018: JAMA: the Journal of the American Medical Association
Mohamed Hasham Varwani, Mohamed Jeilan, Mzee Ngunga, Anders Barasa
BACKGROUND: Coronary artery disease and its acute presentation are being increasingly recognised and treated in sub-Saharan Africa. It is just over a decade since the introduction of interventional cardiology for coronary artery disease in Kenya. Local and regional data, and indeed data from sub-Saharan Africa on long-term outcomes of acute coronary syndromes (ACS) are lacking. METHODS: A retrospective review of all ACS admissions to the Aga Khan University Hospital, Nairobi (AKUHN) between January 2012 and December 2013 was carried out to obtain data on patient characteristics, treatment and in-patient outcomes...
December 4, 2018: Cardiovascular Journal of Africa
Giovanna Leoni, Oliver Soehnlein
Cardiovascular diseases, including myocardial infarction and its complications such as heart failure, are the leading cause of death worldwide. To date, basic and translational research becomes necessary to unravel the mechanisms of cardiac repair post-myocardial infarction. The local inflammatory tissue response after acute myocardial infarction determines the subsequent healing process. The diversity of leukocytes such as neutrophils, macrophages and lymphocytes contribute to the clearance of dead cells while activating reparative pathways necessary for myocardial healing...
2018: Frontiers in Pharmacology
Ko Yamamoto, Masahiro Natsuaki, Takeshi Serikawa, Masanori Okabe, Yusuke Yamamoto
Nodular calcification is sometimes detected in the native coronary artery. However, it is very rare to find in a saphenous vein graft (SVG). We herein report a rare case of stable angina pectoris (AP) due to nodular calcification. A 75-year-old man who had previously undergone coronary artery bypass grafting was admitted to our hospital due to stable AP. On angiography, significant stenosis was detected in the proximal SVG. Based on the findings of coronary angiography and optical coherence tomography, a red thrombus was suspected at the culprit lesion...
2018: Case Reports in Cardiology
Amanda Cai, Courtney Kramer, Rani Bandisode, Valerian L Fernandes
Percutaneous coronary intervention (PCI) is a routine procedure undertaken in adult patients. In children, the procedure remains rare and challenging due to a multitude of factors including but not limited to complex congenital heart disease anatomy, catheter and stent to patient size mismatch, and lack of data for post-PCI antiplatelet therapy. We present a case of PCI in an 8-month-old infant with anomalous left coronary artery from pulmonary artery (ALCAPA) who developed severe ostial kinking of the left main coronary artery (LMCA) after surgical reimplantation of the anomalous coronary...
2018: Case Reports in Cardiology
Jose Jayme G De Lima, Luis Henrique W Gowdak, Flavio J de Paula, Henrique Cotchi S Muela, Elias David-Neto, Luiz A Bortolotto
Background: Coronary artery disease (CAD) is prevalent in older patients on dialysis, but the prognostic relevance of coronary assessment in asymptomatic subjects remains undefined. We tested the usefulness of a protocol, based on clinical, invasive, and noninvasive coronary assessment, by answering these questions: Could selecting asymptomatic patients for coronary invasive assessment identify those at higher risk of events? Is CAD associated with a worse prognosis? Methods: A retrospective study including 276 asymptomatic patients at least 65 years old on the waiting list, prospectively evaluated for CAD and followed up until death or renal transplantation, were classified into two groups: 1) low-risk patients who did not undergo coronary angiography (n=63) and 2) patients who did undergo angiography (n=213)...
2018: International Journal of Nephrology and Renovascular Disease
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