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PCI, ACS, stent

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https://www.readbyqxmd.com/read/28495247/hospital-variation-in-treatment-and-outcomes-in-acute-coronary-syndromes-insights-from-the-alberta-contemporary-acute-coronary-syndrome-patients-invasive-treatment-strategies-coapt-study
#1
Kevin R Bainey, Padma Kaul, Paul W Armstrong, Anamaria Savu, Cynthia M Westerhout, Colleen M Norris, Neil Brass, Dean Traboulsi, Blair O'Neill, Jayan Nagendran, Imtiaz Ali, Merril Knudtson, Robert C Welsh
BACKGROUND: We examined variation in hospital treatment and its relationship to clinical outcome in a large population-based cohort of ACS patients within a single payer-government funded health care system. METHODS: Patients hospitalized in 106 hospitals in Alberta, Canada with a primary diagnosis of ACS were included (July 1, 2010-March 31, 2013) with comparisons made across the three cardiac catheterization-capable hospitals (Sites A-C). Cox proportional-hazard regression models were used to examine the multivariable-adjusted association between site and 1-year death or repeat cardiovascular (CV) hospitalization (primary endpoint)...
May 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28455489/st-segment-elevation-myocardial-infarction-with-acute-stent-thrombosis-presenting-as-intractable-hiccups-an-unusual-case
#2
Fan Zhang, Nosakhare Douglas Tongo, Victoria Hastings, Parisa Kanzali, Ziqiang Zhu, Hal Chadow, Shahrokh E Rafii
BACKGROUND Acute coronary syndrome (ACS) can present with atypical chest pain or symptoms not attributed to heart disease, such as indigestion. Hiccups, a benign and self-limited condition, can become persistent or intractable with overlooked underlying etiology. There are various causes of protracted hiccups, including metabolic abnormalities, psychogenic disorders, malignancy, central nervous system pathology, medications, pulmonary disorders, or gastrointestinal etiologies. It is rarely attributed to cardiac disease...
April 29, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28424434/high-dose-bolus-tirofiban-versus-low-dose-bolus-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#3
Taner Ulus, Utku Şenol, Senan Tahmazov, Kemal Iskenderov, Fezan Mutlu, Yüksel Çavuşoğlu
OBJECTIVE: Aim of the present study was to determine effects of high-dose versus low-dose intravenous (IV) bolus tirofiban on angiographic measures, ST resolution, enzymatic infarct size, and clinical outcomes in patients with acute coronary syndrome (ACS) who were undergoing percutaneous coronary intervention (PCI) and received current pharmacoinvasive therapy. METHODS: Acute coronary syndrome patients (n=271, 85.6% male; mean age: 57.9±12.6 years) from between 2009 and 2015 who received IV tirofiban therapy following PCI were retrospectively analyzed...
March 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
https://www.readbyqxmd.com/read/28377232/comparison-of-safety-and-efficacy-of-unfractionated-heparin-versus-bivalirudin-in-patients-undergoing-percutaneous-coronary-intervention
#4
Ahmed Rehmani, Chris Judkins, Alan Whelan, Michael Nguyen, Carl Schultz
BACKGROUND: Anti-platelet and anti-coagulant adjunctive therapies are associated with a clinically significant increased risk of major bleeding. We retrospectively assessed in hospital major adverse clinical events (MACE) and major bleeding in patients undergoing percutaneous coronary intervention (PCI) who received either unfractionated heparin (UFH) or bivalirudin. METHOD: Consecutive patients undergoing PCI for acute coronary syndrome (ACS) at Fremantle Hospital from August 2008 to December 2013 were identified...
February 28, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28320990/comorbidities-and-complications-in-nonagenarians-undergoing-coronary-angiography-and-intervention
#5
Mohamed Gayed, Nour Yadak, Waad Qamhia, Yunis Daralammouri, Marc-Alexander Ohlow
Elderly people represent the fastest growing portion of cardiovascular patients. We aimed to analyze the clinical presentation, risk factors, co-morbidities, complications, and mortality in patients 90 years or more who underwent coronary angiography and intervention.We retrospectively studied 108 (0.25% of 43,385) consecutive patients ≥ 90 years undergoing cardiac catheterization and/or intervention in a tertiary specialist hospital between 2003 and 2014.Most patients (68.5%) were introduced on an emergency basis, especially with acute coronary syndrome (ACS) (63...
April 6, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28284365/initiation-and-duration-of-dual-antiplatelet-therapy-after-inpatient-percutaneous-coronary-intervention-with-stent-implantation-in-germany-an-electronic-healthcare-database-cohort-study
#6
Andres Luque Ramos, Christoph Ohlmeier, Dirk Enders, Roland Linder, Dirk Horenkamp-Sonntag, Jürgen H Prochaska, Rafael Mikolajczyk, Edeltraut Garbe
BACKGROUND: Studies assessing the routine outpatient dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) in Germany are scarce. The aim of this study was (i) to investigate the initiation and duration of DAPT after inpatient PCI with stent implantation in Germany, and (ii) to identify factors associated with DAPT discontinuation during the recommended treatment period. METHODS: This retrospective cohort study was based on data from a large German electronic healthcare database of the years 2004 to 2009...
February 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28267384/comparison-of-p2y12-inhibitors-for-mortality-and-stent-thrombosis-in-patients-with-acute-coronary-syndromes-single-center-study-of-10-793-consecutive-real-world-patients
#7
Rebecca Gosling, Momina Yazdani, Yasir Parviz, Ian R Hall, Ever D Grech, Julian P Gunn, Robert F Storey, Javaid Iqbal
Three oral platelet P2Y12 inhibitors, clopidogrel, prasugrel, and ticagrelor, are available for reducing the risk of cardiovascular death and stent thrombosis in patients with acute coronary syndromes (ACS). We sought to compare the efficacy of these antiplatelet drugs in contemporary practice. Data were collected for 10 793 consecutive ACS patients undergoing coronary angiography at Sheffield, UK (2009-2015). Since prasugrel use was mostly restricted to the STEMI subgroup, clopidogrel and ticagrelor were compared for all ACS patients, and all three agents were compared in the STEMI subgroup...
March 7, 2017: Platelets
https://www.readbyqxmd.com/read/28242212/out-of-hospital-cardiac-arrest-and-stent-thrombosis-ticagrelor-versus-clopidogrel-in-patients-with-primary-percutaneous-coronary-intervention-under-mild-therapeutic-hypothermia
#8
Gustavo Jiménez-Brítez, Xavier Freixa, Eduardo Flores-Umanzor, Rodolfo San Antonio, Gala Caixal, John Garcia, Marco Hernandez-Enriquez, Rut Andrea, Ander Regueiro, Mónica Masotti, Salvatore Brugaletta, Victoria Martin, Manel Sabaté
BACKGROUND: Out-of-Hospital Cardiac Arrest (OHCA) and mild therapeutic hypothermia (MTH) have been linked to increased risk of Stent Thrombosis (ST) in comatose survivors who undergo percutaneous coronary intervention (PCI). In this sense, there is no formal recommendation about which antiplatelet regimen should be used in patients with acute coronary syndromes (ACS) after OHCA. AIMS: To compare the incidence of probable/definite ST and bleeding events between ticagrelor and clopidogrel, in patients with ACS under MTH after an OHCA...
May 2017: Resuscitation
https://www.readbyqxmd.com/read/28052754/the-burden-of-major-adverse-cardiac-events-in-patients-with-coronary-artery-disease
#9
I-Ting Tsai, Chao-Ping Wang, Yung-Chuan Lu, Wei-Chin Hung, Cheng-Ching Wu, Li-Fen Lu, Fu-Mei Chung, Chia-Chang Hsu, Yau-Jiunn Lee, Teng-Hung Yu
BACKGROUND: Patients with a history of cardiovascular disease are at high risk of developing secondary major adverse cardiac events (MACE). This study aimed to identify independent predictors of MACE after hospital admission which could be used to identify of high-risk patients who may benefit from preventive strategies. METHODS: This study included 1,520 consecutive patients with coronary artery disease (CAD) (654 with acute coronary syndrome (ACS) and 866 with elective percutaneous coronary intervention (PCI) patients) who received PCI and/or stenting...
January 4, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28042404/in-hospital-and-one-year-clinical-outcome-of-percutaneous-coronary-intervention-in-a-tertiary-hospital-in-oman-oman-pci-registry
#10
Prashanth Panduranga, Majdah Al-Rashidi, Fatma Al-Hajri
OBJECTIVES: The aim of the study was to investigate the in-hospital and one-year clinical outcome of patients treated with percutaneous coronary intervention (PCI) in a tertiary hospital in Oman. METHODS: We conducted a retrospective, single-center, observational study looking at patients > 18 years old who underwent a PCI from 1 January to 31 December 2013. The primary end point was the occurrence of a major adverse cardiovascular event (MACE), defined as death, any myocardial infarction (MI), cerebrovascular accident (CVA), and target vessel revascularization (TVR) with either repeat PCI or coronary artery bypass surgery (CABG)...
January 2017: Oman Medical Journal
https://www.readbyqxmd.com/read/28034708/influence-of-age-and-gender-on-clinical-outcomes-following-percutaneous-coronary-intervention-for-acute-coronary-syndromes
#11
Hanan Idris, John K French, Ibrahim M Shugman, Andrew P Hopkins, Craig P Juergens, Liza Thomas
BACKGROUND: Gender and age are non-modifiable factors influencing clinical outcomes in acute coronary syndromes (ACS). There is evidence that coronary artery disease pathophysiology varies in women. We therefore evaluated the effect of age and gender on clinical outcomes in patients with ACS undergoing percutaneous coronary interventions (PCI). METHODS: Among 3178 (25% female) consecutive ACS patients who underwent PCI at Liverpool Hospital, Sydney from 2003 to 2010, using femoral access in 98% of cases, we determined late events including mortality, myocardial infarction and bleeding according to Bleeding Academic Research Consortium (BARC) criteria...
December 2, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28017258/long-term-follow-up-after-near-infrared-spectroscopy-coronary-imaging-insights-from-the-lipid-core-plaque-association-with-clinical-events-oracle-nirs-registry
#12
Barbara Anna Danek, Aris Karatasakis, Judit Karacsonyi, Aya Alame, Erica Resendes, Pratik Kalsaria, Phuong-Khanh J Nguyen-Trong, Bavana V Rangan, Michele Roesle, Shuaib Abdullah, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Coronary lipid core plaque may be associated with the incidence of subsequent cardiovascular events. METHODS: We analyzed outcomes of 239 patients who underwent near-infrared spectroscopy (NIRS) coronary imaging between 2009-2011. Multivariable Cox regression was used to identify variables independently associated with the incidence of major adverse cardiovascular events (MACE; cardiac mortality, acute coronary syndromes (ACS), stroke, and unplanned revascularization) during follow-up...
April 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27980542/antithrombotic-management-in-patients-with-percutaneous-coronary-intervention-requiring-oral-anticoagulation
#13
REVIEW
Jarosław Zalewski, Anetta Undas
The dynamic evolution of therapeutic options including the use of vitamin K antagonists (VKA), non-vitamin K oral anticoagulants (NOAC), more potent antiplatelet drugs as well as new generation drug-eluting stents could lead to the view that the current recommendations on the management of patients with percutaneous coronary intervention (PCI) requiring oral anticoagulation do not keep up with the results of several clinical studies published within the last 5 years. In the present overview, we summarize the recent advances in antithrombotic management used in atrial fibrillation patients undergoing PCI for stable coronary artery disease or acute coronary syndrome (ACS)...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/27976460/interventional-therapies-and-in-hospital-outcomes-in-acute-coronary-syndromes-complicated-by-von-willebrand-disease
#14
P F Fogarty, A Blair, R Vega, W H Matthai, P A Gimotty
INTRODUCTION: von Willebrand disease (VWD) is one of the most common inherited bleeding disorders. AIM: Investigate the impact of the VWD bleeding tendency on in-hospital management of acute coronary syndromes (ACS). METHODS: Using discharge data from the National Inpatient Sample (NIS), the features of presentation and in-hospital treatment among ACS hospital discharges with and without a VWD diagnosis were investigated. A total of 264 case discharges and 705 860 control discharges were identified...
December 14, 2016: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/27931181/platelet-aggregation-and-risk-of-stent-thrombosis-or-bleeding-in-interventionally-treated-diabetic-patients-with-acute-coronary-syndrome
#15
K Kukula, M Klopotowski, P K Kunicki, J Jamiolkowski, A Debski, P Bekta, M Polanska-Skrzypczyk, Z Chmielak, A Witkowski
BACKGROUND: Platelet aggregation monitoring in diabetic patients treated with coronary interventions (PCI) for an acute coronary syndrome (ACS) is a promising way of optimizing treatment and outcomes in this high risk group. The aim of the study was to verify whether clopidogrel response measured by Multiplate analyzer (ADPtest) in diabetic ACS patients treated with PCI predicts the risk of stent thrombosis or cardiovascular mortality and bleeding. METHODS: Into this prospective, observational study 206 elective PCI patients were enrolled...
December 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27924429/cyp2c19-lof-and-gof-guided-antiplatelet-therapy-in-patients-with-acute-coronary-syndrome-a-cost-effectiveness-analysis
#16
Minghuan Jiang, Joyce H S You
PURPOSE: This study aimed to examine the cost-effectiveness of CYP2C19 loss-of-function and gain-of-function allele guided (LOF/GOF-guided) antiplatelet therapy in patients with acute coronary syndrome (ACS) undergoing percutaneous coronary intervention (PCI). METHODS: A life-long decision-analytic model was designed to simulate outcomes of three strategies: universal clopidogrel (75 mg daily), universal alternative P2Y12 inhibitor (prasugrel 10 mg daily or ticagrelor 90 mg twice daily), and LOF/GOF-guided therapy (LOF/GOF allele carriers receiving alternative P2Y12 inhibitor, wild-type patients receiving clopidogrel)...
February 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/27914991/antiplatelet-therapy-in-patients-with-glucose-6-phosphate-dehydrogenases-deficiency-after-percutaneous-coronary-intervention-a-reappraisal-for-clinical-and-interventional-cardiologists
#17
REVIEW
Marco Zuin, Gianluca Rigatelli, Mauro Carraro, Maria Paola Galasso, Fabio Dell'Avvocata, Rossella Paolini, Giovanni Zuliani, Loris Roncon
Glucose-6-phosphate dehydrogenase (G6PD) deficiency represents one of the most common erythrocyte enzymopathy. In the era of drug-eluting stents (DESs), the use of prolonged dual antiplatelet therapy (DAPT) with aspirin (ASA) and thienopyridine (clopidogrel or ticlopidine) has become mandatory in the treatment of patients with acute coronary syndromes (ACS) and/or after percutaneous coronary intervention (PCI). However, the use of ASA, and more in general of antiplatelet drugs in patients with G6PD deficiency remains controversial, also for the absence of specific guidelines and scientific evidences...
April 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27914490/bleeding-risk-following-percutaneous-coronary-intervention-in-patients-with-diabetes-prescribed-dual-anti-platelet-therapy
#18
Anna Grodzinsky, Suzanne V Arnold, Tracy Y Wang, Praneet Sharma, Kensey Gosch, Philip G Jones, Deepak L Bhatt, Philippe Gabriel Steg, Darren K McGuire, David J Cohen, John A Spertus, Adnan K Chhatriwalla, Marcus Lind, Garth Graham, Mikhail Kosiborod
BACKGROUND: Patients with diabetes mellitus (DM) experience higher rates of in-stent restenosis and greater benefit from drug-eluting stents implant at the time of percutaneous coronary intervention (PCI), necessitating prolonged dual anti-platelet therapy (DAPT). While DAPT reduces risk of ischemic events post-PCI, it also increases risk of bleeding. Whether bleeding rates differ among patients with and without DM, receiving long-term DAPT is unknown. METHODS: Among patients who underwent PCI and were maintained on DAPT for 1 year in a multicenter US registry, we assessed patient-reported bleeding over one year following PCI in patients with and without DM...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913753/neutrophil-derived-microparticles-are-released-into-the-coronary-circulation-following-percutaneous-coronary-intervention-in-acute-coronary-syndrome-patients
#19
Gonzalo J Martínez, Jennifer Y Barraclough, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David S Celermajer, Sanjay Patel
To evaluate (i) local coronary and systemic levels of microparticles (MP) in acute coronary syndrome (ACS) and stable angina pectoris (SAP) patients and (ii) their release after plaque disruption with percutaneous coronary intervention (PCI). MP are small vesicles originating from plasma membranes of cells after activation or apoptosis and are implicated in the pathogenesis of atherosclerosis. Neutrophils play a role in plaque destabilization and shed neutrophil-derived MP that have the potential to drive significant proinflammatory and thrombotic downstream effects...
February 28, 2017: Bioscience Reports
https://www.readbyqxmd.com/read/27899940/staged-versus-one-time-multivessel-intervention-in-elderly-patients-with-non-st-elevation-acute-coronary-syndrome
#20
Xiao-Fan Yu, Yi Li, Qian-Cheng Wang, Xiao-Zeng Wang, Ming Liang, Xin Zhao, Kai Xu, Ya-Ling Han
OBJECTIVE: To evaluate the clinical outcomes of "one-time" versus staged multivessel stenting in elderly (≥ 60 years) patients with non-ST-elevation acute coronary syndrome (NSTE-ACS) and multivessel disease (MVD). METHODS: We analyzed data of consecutive NSTE-ACS patients with multivessel percutaneous coronary intervention (PCI) who were enrolled in General Hospital of Shenyang Military Region between 2008 and 2012. A total of 1090 eligible patients aged ≥ 60 were further categorized into "one-time" group (n = 623) and staged PCI group (n = 467) according to intervention strategy...
September 2016: Journal of Geriatric Cardiology: JGC
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