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coronary stent;PCI

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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
#1
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...
November 28, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27914492/ticagrelor-with-aspirin-or-alone-in-high-risk-patients-after-coronary-intervention-rationale-and-design-of-the-twilight-study
#2
Usman Baber, George Dangas, David J Cohen, C Michael Gibson, Shamir R Mehta, Dominick J Angiolillo, Stuart J Pocock, Mitchell W Krucoff, Adnan Kastrati, E Magnus Ohman, Philippe Gabriel Steg, Juan Badimon, M Urooj Zafar, Jaya Chandrasekhar, Samantha Sartori, Melissa Aquino, Roxana Mehran
BACKGROUND: Dual antiplatelet therapy (DAPT) is necessary to prevent thrombosis yet increases bleeding after percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Antiplatelet monotherapy with a potent P2Y12 receptor antagonist may reduce bleeding while maintaining anti thrombotic efficacy compared with conventional DAPT. METHODS: TWILIGHT is a randomized, double-blind placebo-controlled trial evaluating the comparative efficacy and safety of antiplatelet monotherapy versus DAPT in up to 9000 high-risk patients undergoing PCI with DES...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914490/bleeding-risk-following-percutaneous-coronary-intervention-in-patients-with-diabetes-prescribed-dual-anti-platelet-therapy
#3
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-syndromes
#4
Gonzalo J Martinez, Jennifer Y Barraclough, Shirley Nakhla, Vivian Kienzle, Stacy Robertson, Ziad Mallat, David S Celermajer, Sanjay Patel
AIMS: 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). BACKGROUND: Microparticles 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 destabilisation and shed neutrophil-derived microparticles have the potential to drive significant pro-inflammatory and thrombotic downstream effects...
December 2, 2016: Bioscience Reports
https://www.readbyqxmd.com/read/27904973/platelet-reactivity-and-clinical-outcomes-in-patients-using-cyp3a4-metabolized-statins-with-clopidogrel-in-percutaneous-coronary-intervention
#5
Jin Sup Park, Kwang Soo Cha, Hye Won Lee, Jun-Hyok Oh, Jung Hyun Choi, Han Cheol Lee, Taek Jong Hong, Hyo Soo Kim
Statins are primarily metabolized by cytochrome P450 3A4 (CYP3A4), which reduces clopidogrel to its active metabolite. Recent studies suggest that CYP3A4-metabolized statins attenuate clopidogrel's anti-aggregatory effect on platelets. We aimed to assess the impact of concomitant CYP3A4-metabolized statin and clopidogrel use on antiplatelet activity and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI). We enrolled 1187 patients from the HOST-ASSURE trial with platelet reactivity unit (PRU) values at both baseline and 1 month...
November 30, 2016: Heart and Vessels
https://www.readbyqxmd.com/read/27902833/evaluation-of-ischemic-and-bleeding-risks-associated-with-2-parenteral-antiplatelet-strategies-comparing-cangrelor-with-glycoprotein-iib-iiia-inhibitors-an-exploratory-analysis-from-the-champion-trials
#6
Muthiah Vaduganathan, Robert A Harrington, Gregg W Stone, Efthymios N Deliargyris, Ph Gabriel Steg, C Michael Gibson, Christian W Hamm, Matthew J Price, Alberto Menozzi, Jayne Prats, Steven Elkin, Kenneth W Mahaffey, Harvey D White, Deepak L Bhatt
Importance: In the context of contemporary pharmacotherapy, optimal antiplatelet management with percutaneous coronary intervention (PCI) has not been well established. Objective: To compare the ischemic and bleeding risks associated with glycoprotein IIb/IIIa inhibitors (GPIs) and a potent P2Y12 antagonist, cangrelor, in patients undergoing PCI. Design, Setting, and Participants: An exploratory analysis of pooled patient-level data from the 3 phase 3 Cangrelor vs Standard Therapy to Achieve Optimal Management of Platelet Inhibition (CHAMPION PCI, CHAMPION PLATFORM, and CHAMPION PHOENIX) trials of patients undergoing elective or nonelective PCI...
November 30, 2016: JAMA Cardiology
https://www.readbyqxmd.com/read/27899941/influence-of-increased-epicardial-adipose-tissue-volume-on-1-year-in-stent-restenosis-in-patients-who-received-coronary-stent-implantation
#7
Ying Zhou, Hua-Wei Zhang, Feng Tian, Jin-Song Chen, Tian-Wen Han, Ya-Hang Tan, Jia Zhou, Tao Zhang, Jing Jing, Yun-Dai Chen
BACKGROUND: Epicardial adipose tissue (EAT) is significantly associated with the formation and composition of coronary atherosclerotic plaque, cardiac events and the clinical prognosis of coronary heart disease. But, whether increased EAT deposition may affect the incidence of in-stent restenosis (ISR) is currently unclear. This study used coronary computed tomography angiography (CCTA) as a mean to investigate whether increased EAT volume was associated with ISR. METHODS: A total of 364 patients who underwent 64-slice CCTA examination for the evaluation of suspected coronary artery disease, and subsequently underwent percutaneous coronary intervention (PCI) for the first time, and then accepted coronary angiography (CA) follow-up for ISR examination in one year, were retrospectively included in this study...
September 2016: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/27899940/staged-versus-one-time-multivessel-intervention-in-elderly-patients-with-non-st-elevation-acute-coronary-syndrome
#8
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
https://www.readbyqxmd.com/read/27899850/evaluation-of-short-and-long-term-efficacy-of-combined-intracoronary-administration-of-high-dose-adenosine-and-tirofiban-during-primary-percutaneous-coronary-intervention
#9
Yanbing Li, Qiang Li, Feiou Li, Min Zong, Guobin Miao, Xinchun Yang, Zichuan Tong, Jianjun Zhang
BACKGROUND: To assess the influence of combined intracoronary application of high-dose adenosine and tirofiban in primary percutaneous coronary intervention (PCI) on clinical events and cardiac function. METHODS: Our study evaluated consecutive patients with acute ST-segment elevation myocardial infarction undergoing primary PCI, who were randomly divided into adenosine group (n = 130) and control group (n = 128). Combined with thrombus aspiration and then intracoronary tirofiban, the adenosine group received intracoronary adenosine (2 mg) through the aspiration catheter 2 times...
November 2016: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#10
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27891384/bioresorbable-scaffolds-current-evidences-in-the-treatment-of-coronary-artery-disease
#11
REVIEW
Bhargav Dave
Percutaneous coronary revascularization strategies have gradually progressed over a period of last few decades. The advent of newer generation drug-eluting stents has significantly improved the outcomes of Percutaneous Coronary Intervention (PCI) by substantially reducing in-stent restenosis and stent thrombosis. However, vascular inflammation, restenosis, thrombosis, and neoatherosclerosis due to the permanent presence of a metallic foreign body within the artery limit their usage in complex Coronary Artery Disease (CAD)...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27888672/incidence-of-coronary-intervention-in-cardiac-arrest-survivors-with-non-shockable-initial-rhythms-and-no-evidence-of-st-elevation-mi-stemi
#12
Matthew Wilson, Anne V Grossestreuer, David F Gaieski, Benjamin S Abella, William Frohna, Munish Goyal
OBJECTIVE: With the demonstrated benefit of an early-invasive strategy for STEMI and VF/VT arrest patients, there is interest in assessing the potential benefit of early angiography for non-shockable (PEA/Asystole) arrest patients. We hypothesized that in cardiac arrest patients who obtain return of spontaneous circulation (ROSC) after a non-shockable initial rhythm and do not have STEMI the incidence of coronary intervention would be clinically insignificant (<5%). METHODS: Retrospective multicenter US clinical registry study of post-cardiac arrest patients at 18 hospitals between 1/00 and 5/14...
November 23, 2016: Resuscitation
https://www.readbyqxmd.com/read/27887799/procedural-and-longer-term-outcomes-of-wire-versus-device-based-antegrade-dissection-and-re-entry-techniques-for-the-percutaneous-revascularization-of-coronary-chronic-total-occlusions
#13
Lorenzo Azzalini, Rustem Dautov, Emmanouil S Brilakis, Soledad Ojeda, Susanna Benincasa, Barbara Bellini, Aris Karatasakis, Jorge Chavarría, Bavana V Rangan, Manuel Pan, Mauro Carlino, Antonio Colombo, Stéphane Rinfret
BACKGROUND: There are few data regarding the procedural and follow-up outcomes of different antegrade dissection/re-entry (ADR) techniques for chronic total occlusion (CTO) percutaneous coronary intervention (PCI). METHODS: We compiled a multicenter registry of consecutive patients undergoing ADR-based CTO PCI at four high-volume specialized institutions. Patients were divided according to the specific ADR technique used: subintimal tracking and re-entry (STAR), limited antegrade subintimal tracking (LAST), or device-based with the CrossBoss/Stingray system (Boston Scientific, Marlborough, MA)...
November 16, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27887590/comparing-the-adverse-clinical-outcomes-in-patients-with-non-insulin-treated-type-2-diabetes-mellitus-and-patients-without-type-2-diabetes-mellitus-following-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis
#14
Nuo Li, Ye-Gui Yang, Meng-Hua Chen
BACKGROUND: Several studies showed Type 2 Diabetes Mellitus (T2DM) to be associated with worse adverse clinical outcomes compared to non-T2DM (NDM) following Percutaneous Coronary Intervention (PCI). In addition, patients with insulin-treated T2DM (ITDM) showed worse clinical outcomes compared to patients with non-insulin treated T2DM (NITDM). Since NITDM and NDM have seldom been systematically analyzed, this study aimed to compare the short and long term adverse clinical outcomes observed in patients with NITDM and patients without T2DM following PCI...
November 25, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27886821/cangrelor-pharmacology-clinical-data-and-role-in-percutaneous-coronary-intervention
#15
REVIEW
Matthew J Price
In clinical trials that assessed the safety and efficacy of cangrelor during percutaneous coronary intervention (PCI), cangrelor was administered as a 30-μg/kg bolus followed by a 4-μg/kg/min infusion for at least 2 hours or the duration of the PCI, whichever was longer. Cangrelor is currently indicated as an adjunct to PCI to reduce the risk of myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27886820/optimal-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention
#16
REVIEW
Arjun Majithia, Deepak L Bhatt
Dual antiplatelet therapy (DAPT) is an essential component of treatment in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). Recommendations for duration of DAPT after PCI should consider patient-specific risk, clinical presentation, stent characteristics, and procedural factors. Prolonged DAPT results in a reduction of stent thrombosis (ST) and myocardial infarction (MI) at the cost of increased bleeding. Studies of shorter-duration DAPT demonstrate similar mortality, MI, ST, and less bleeding when compared with longer DAPT duration...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27884628/skirt-followed-by-trouser-stenting-technique-true-anatomical-preservation-of-coronary-y-shaped-bifurcation-lesions-while-using-vanishing-bioresorbable-scaffolds-a-report-of-two-cases
#17
Wael Elabbassi, Arif Al Nooryani
We report on two cases in which Y-shaped coronary bifurcations were treated with the use of Bioresorbable scaffolds. The first case was of a 50-year-old man with NSTEMI. Coronary angiography showed stenosis involving a Y-shaped bifurcation of proximal to mid LAD and diagonal. The lesion was wired using two 0.14 BMW guide wires, followed by serial pre-dilatation of LAD and Diagonal branch. The stent into proximal LAD was deployed first as a skirt (3.5 × 12 BVS). Stent was post-dilated. A second 2.5 × 28 BVS was deployed into diagonal branch, protruding backwards; along with a 2...
November 3, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/27875735/superior-long-term-outcome-associated-with-native-vessel-versus-graft-vessel-pci-following-secondary-pci-in-patients-with-prior-cabg
#18
Chrysostomos A Mavroudis, Tushar Kotecha, Omar Chehab, Jonathan Hudson, Roby D Rakhit
BACKGROUND: Secondary percutaneous coronary intervention (PCI) in patients with prior coronary artery bypass graft surgery is increasingly common. Graft vessel PCI has higher rates of adverse events compared with native coronary vessel PCI. AIM: To investigate the clinical outcomes of patients with prior CABG who underwent secondary PCI of either a graft vessel (GV), a native coronary vessel (NV) or both graft and native (NG) vessels. METHODS: 220 patients (84% male) who underwent PCI in our institution to either GV (n=89), NV (n=103) or both GV and NV (NG group) (n=28) were studied...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27870977/longitudinal-treatment-patterns-with-adp-receptor-inhibitors-after-myocardial-infarction-insights-from-the-canadian-observational-antiplatelet-study
#19
Akshay Bagai, Tracy Y Wang, Shaun G Goodman, Harold N Fisher, Robert C Welsh, Jean-Pierre Dery, Xiang Zhang, Yajun E Zhu, Asim N Cheema, Payam Dehghani, Saleem A Kassam, John Ducas, Neil Brass, Hahn Hoe Kim, Anthony Fung, Erick Schampaert, Ata Ur Rehman Quraishi, Shamir R Mehta
BACKGROUND: After myocardial infarction (MI) treated with percutaneous coronary intervention (PCI), guidelines recommend dual antiplatelet therapy (DAPT) with aspirin and an ADP receptor inhibitor (ADPri) for at least 1year. However, whether real-world Canadian practice patterns reflect this recommendation is unknown. METHODS: We studied 2175 MI patients treated with PCI and discharged from 26 Canadian hospitals between 12/2011 and 05/2013 in the Canadian Observational Antiplatelet sTudy (COAPT)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27867580/understanding-and-managing-in-stent-restenosis-a-review-of-clinical-data-from-pathogenesis-to-treatment
#20
REVIEW
Dario Buccheri, Davide Piraino, Giuseppe Andolina, Bernardo Cortese
The lumen diameter reduction after percutaneous coronary intervention (PCI) is well known as "restenosis". This phenomenon is due to vessel remodeling/recoil in case of no-stent strategy or, in case of stent employ, "neointimal proliferation" that consists in an excessive tissue proliferation in the luminal surface of the stent otherwise by a further new-occurring atherosclerotic process called "neoatherosclerosis". The exact incidence of in-stent restenosis (ISR) is not easy to determine caused by different clinical, angiographic and operative factors...
October 2016: Journal of Thoracic Disease
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