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coronary stent;PCI

Raffaele Piccolo, Gennaro Galasso, Ingo Eitel, Alberto Dominguez-Rodriguez, Allan Zeeberg Iversen, Youlan L Gu, Pedro Abreu-Gonzalez, Bart J G L de Smet, Giovanni Esposito, Stephan Windecker, Holger Thiele, Federico Piscione
Cigarette smokers with ST-segment elevation myocardial infarction (STEMI) may present different response to potent antithrombotic therapy compared to nonsmokers. We assessed the impact of smoking status and intracoronary abciximab in patients with STEMI undergoing primary percutaneous coronary intervention (PCI). We pooled data from 5 randomized trials comparing intracoronary versus intravenous abciximab bolus in patients undergoing primary PCI. The primary end point was the composite of death or reinfarction at a mean follow-up of 292 ± 138 days...
September 13, 2016: American Journal of Cardiology
Dae Young Hyun, Myung Ho Jeong, Doo Sun Sim, Yun Ah Jeong, Kyung Hoon Cho, Min Chul Kim, Hyun Kuk Kim, Hae Chang Jeong, Keun Ho Park, Young Joon Hong, Jun Han Kim, Youngkeun Ahn, Jung Chaee Kang
Background/Aims: This study appraised the long term clinical outcomes of patients treated with percutaneous coronary intervention (PCI) for unprotected left main coronary artery (ULMCA) disease. There are limited data regarding long-term clinical outcomes after PCI for ULMCA disease. Methods: From 2001 to 2011, a total of 448 patients who underwent PCI for ULMCA disease and had 2-year clinical follow-up, were analyzed. The study patients were divided into two groups: group I (stable angina pectoris [SAP], n = 60, 48 men, 62 ± 10 years) and group II (acute coronary syndrome [ACS], n = 388, 291 men, 64 ± 10 years)...
October 18, 2016: Korean Journal of Internal Medicine
Rha Seung-Woon, Choi Byoung Geol, Li Hu, Na Jin Oh, Choi Cheol Ung, Park Chang Gyu, Seo Hong Seog, Oh Dong Joo, Kim Yong Hoon, Her Ae-Young, Park Sang-Ho
OBJECTIVE: Hypertension (HTN) and its organ damage such as left ventricular hypertrophy (LVH) can lead to worsening heart failure, cardiovascular morbidity and mortality. However, there are limited data regarding the impact of LVH in HTN patients (pts) who underwent successful percutaneous coronary intervention (PCI) with drug eluting stents (DESs) on long-term clinical outcomes. DESIGN AND METHOD: A total of 1,704 consecutive HTN pts who underwent PCI from 2004 to 2014 were enrolled...
September 2016: Journal of Hypertension
Mikkel M Schoos, Giuseppe De Luca, George D Dangas, Peter Clemmensen, Girma Minalu Ayele, Roxana Mehran, Gregg W Stone
AIMS: In the HORIZONS-AMI trial, bivalirudin compared to unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) improved net clinical outcomes in patients undergoing primary percutaneous coronary intervention (PCI) at the cost of an increased rate of acute stent thrombosis. We sought to examine whether these effects are dependent on time to treatment. METHODS AND RESULTS: The interaction between anticoagulation regimen and symptom onset to first balloon inflation time (SBT) on the 30-day and three-year rates of major adverse cardiac events (MACE) was examined in 3,199 randomised patients according to SBT ≤3 hours versus >3 hours...
October 20, 2016: EuroIntervention
Sunil Kr Verma
A 62-year-old male was undergoing treatment of NHL with bone marrow involvement with thrombocytopenia. After 15min of starting of IV infusion of rituximab, he started having severe retrosternal chest pain, diagnosed as acute ST elevation inferior wall MI. Patient was pre-loaded with dual anti platelets. Coronary angiogram showed 100% occlusion of proximal RCA. Thrombosuction of this culprit RCA revealed underlying 90% stenosis. After that, PCI with balloon angioplasty of RCA was done. The procedure was terminated in the view of successful balloon angioplasty with good TIMI flow...
September 2016: Indian Heart Journal
Andreas Baumbach, Dik Heg, Lorenz Räber, Miodrag Ostoijc, Salvatore Brugaletta, Julian W Strange, Thomas W Johnson, Peter Juni, Thomas Engstrøm, Patrick W Serruys, Manel Sabate, Stephan Windecker
AIMS: Selective use of DES only in patients at higher risk of MACE is common practice, particularly in health care systems with a large premium payable for DES. We aimed to identify subgroups of patients in which the use of BMS in primary percutaneous coronary intervention (PPCI) for STEMI can still be justified. METHODS AND RESULTS: We performed a patient-level pooled analysis of COMFORTABLE-AMI and EXAMINATION comparing contemporary DES with BMS in PPCI. A risk score was applied using three parameters: lesion length>15mm, vessel size <3mm, and diabetes mellitus...
October 18, 2016: EuroIntervention
Vivian W Y Lee, Franco W Cheng, Adrian Y Choi, Sam T Fong, Cheuk Man Yu, Bryan P Yan
BACKGROUND: Percutaneous coronary intervention (PCI) is one of the most performed interventions for ischemic heart diseases. In Hong Kong, the total number of patient discharges and deaths for ischemic heart diseases in 2009 was 33,363, including 4,360 deaths. There are over 5,000 cases of PCI yearly. This study aimed to compare clinical, economic and humanistic outcomes among patients receiving drug-eluting stent (DES) or bare metal stent (BMS) in Hong Kong. METHODS: Patients who received stent implantation between 15(th) September, 2009 and 11(th) October, 2010 in Prince of Wales Hospital, Hong Kong, were recruited and followed for 18 months...
October 14, 2016: Journal of Medical Economics
F Economou, S Katranas, G Giannoglou, K Gemitzis, I Styliadis, G Efthimiadis, H Karvounis, A Ziakas
BACKGROUND: Endothelial shear stress (ESS) may play a key role in the pathobiology of stent restenosis (SR). Nevertheless, limited data are available about ESS and its relation to SR. PATIENTS AND METHODS: We enrolled 14 patients who underwent successful percutaneous coronary intervention (PCI) in this study. Three-dimensional (3D) reconstruction of 14 coronary arteries before and after stent implantation was performed. Using computational fluid dynamics, mean ESS was calculated proximally, in tertiles within and distal to the stent, both before and after stent implantation...
October 12, 2016: Herz
Yohei Shibata, Hideki Ishii, Susumu Suzuki, Akihito Tanaka, Yosuke Tatami, Shingo Harata, Tomoyuki Ota, Yusaku Shimbo, Yohei Takayama, Ayako Kunimura, Kenshi Hirayama, Kazuhiro Harada, Naohiro Osugi, Toyoaki Murohara
AIMS: Previous studies have shown that aortic valve calcification (AVC) was associated with cardiovascular events and mortality. On the other hand, periprocedural myocardial injury (PMI) in percutaneous coronary intervention (PCI) is a well-known predictor of subsequent mortality and poor clinical outcomes. The purpose of the study was to assess the hypothesis that the presence of AVC could predict PMI in PCI. METHODS: This study included 370 patients treated with PCI for stable angina pectoris...
October 13, 2016: Journal of Atherosclerosis and Thrombosis
Muhammad Dzafir Ismail, Wan Azman Wan Ahmad, Matthias Leschke, Matthias Waliszewski, Michael Boxberger, Imran Zainal Abidin, Ahmad Syadi Mahmood Zuhdi
BACKGROUND: Percutaneous coronary interventions (PCI) in coronary artery disease (CAD) with very small vessel diameters remains controversial and challenging. These lesions are usually more diffuse, calcified and tortuous. The usage of thin strut bare metal stents (BMS) with excellent crossing profiles in a very small caliber coronary lesions has increased the likelihood of procedural success. OBJECTIVES: This observational study assessed the 9-month clinical outcomes in an 'all-comers' population with very small caliber CAD after implantation of thin strut cobalt chromium BMS...
2016: SpringerPlus
Kensuke Takagi, Yusuke Fujino, Toru Naganuma, Yusuke Watanabe, Hiroto Yabushita, Satoru Mitomo, Hiroyoshi Kawamoto, Satoko Tahara, Tsuyoshi Kobayashi, Takayuki Warisawa, Kenichi Karube, Takahiro Matsumoto, Tomohiko Sato, Hisaaki Ishiguro, Naoyuki Kurita, Shotaro Nakamura, Koji Hozawa, Sunao Nakamura
BACKGROUND: There is no consensual opinion regarding the percutaneous coronary intervention (PCI) procedure for unprotected distal left main (UDLM) lesion. METHODS: Between April 2005 and August 2011, 586 consecutive patients with UDLM stenosis treated with drug-eluting stents were recruited for this study to clarify the impact of combination of full-coverage stenting and proximal optimization technique (POT) for UDLM lesion. An optimal strategy of full-coverage stenting and POT was performed in 353 patients and the other 233 patients were not optimally treated...
September 4, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Muhammad Muzaffar Mahmood, David Austin
Spontaneous coronary artery dissection (SCAD) is an uncommon but important cause of acute coronary syndrome. The diagnosis of SCAD by an angiogram alone can be challenging and the increasing use of intracoronary imaging has proven an invaluable diagnostic adjunct in this regard. The appropriate initial management of SCAD has been a matter of significant debate. Owing to frequent spontaneous healing of coronary dissection and a higher risk of complications with percutaneous coronary intervention (PCI) in the setting of SCAD, a default approach of mechanical revascularization is not recommended...
September 18, 2016: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Gian Marco Rosa, Daniele Bianco, Alberto Valbusa, Laura Massobrio, Francesco Chiarella, Claudio Brunelli
After acute coronary syndromes (ACS), the so-called dual antiplatelet therapy (DAPT), which usually consists of low-dose of aspirin in combination with a thienopyridine (clopidogrel, prasugrel) or with a cyclopentyltriazolopyrimidine (ticagrelor), reduces the risk of ischemic events. Ticagrelor, un particular, is an effective drug as it isn' a prodrug, doesn't require metabolic activation and demonstrates a rapid onset and faster offset of action. Areas covered: This article evaluates the pharmacokinetics, efficacy, safety and tolerability of ticagrelor during DAPT after ACS and its potential use beyond the canonical twelve months after PCI...
October 7, 2016: Expert Opinion on Drug Metabolism & Toxicology
Michał Kowara, Kajetan Grodecki, Zenon Huczek, Dominika Puchta, Katarzyna Paczwa, Bartosz Rymuza, Karol Zbroński, Krzysztof J Filipiak, Grzegorz Opolski
BACKGROUND: Platelets' role in pathophysiology of acute coronary syndromes (ACS) is undeniable, but precise relationships between platelet activity and treatment outcomes are matter of continuant investigation. Among platelet indices, mean platelet volume (MPV) has proven to be valuable predicting factor in cardiac patients. However platelet distribution width (PDW) is reported to be more specific marker of platelet reactivity. Thus, application of PDW in risk stratification of ACS treatment is up-to-date subject of research...
October 7, 2016: Kardiologia Polska
Takumi Higuma, Tsunenari Soeda, Masahiro Yamada, Takashi Yokota, Hiroaki Yokoyama, Kei Izumiyama, Fumie Nishizaki, Yoshiyasu Minami, Lei Xing, Erika Yamamoto, Hang Lee, Ken Okumura, Ik-Kyung Jang
OBJECTIVES: The aim of this study was to evaluate if residual thrombus burden after aspiration thrombectomy affects the outcomes of primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction (STEMI). BACKGROUND: Recent studies failed to show clinical benefit of aspiration thrombectomy in STEMI patients. This might be due to insufficient removal of thrombus at the culprit lesion. METHODS: A total of 109 STEMI patients who underwent aspiration thrombectomy followed by stenting within 24 h from symptom onset were included...
October 10, 2016: JACC. Cardiovascular Interventions
Nathaniel R Smilowitz, Navdeep Gupta, Yu Guo, John T Coppola, Sripal Bangalore
OBJECTIVES: Human immunodeficiency virus (HIV) seropositive individuals are predisposed to acute myocardial infarction (AMI). We sought to evaluate management strategies and outcomes of AMI in patients with HIV in the contemporary era. METHODS: We analyzed data from the National Inpatient Sample from 2002 to 2011 for patients admitted with AMI with or without HIV. Propensity-score matching was used to identify HIV seropositive AMI patients with similar characteristics who were managed invasively (cardiac catheterization, percutaneous coronary intervention [PCI], or coronary artery bypass graft surgery [CABG]) or conservatively...
October 2016: Journal of Invasive Cardiology
Ashan Gunarathne, Shahana Hussain, Anthony H Gershlick
Dual antiplatelet therapy (DAPT) with aspirin combined with either a thienopyridine (clopidogrel or prasugrel) or acyclopentyl-triazolo-pyrimidine (ticagrelor) plays a vital role in the management of acute coronary syndrome (ACS) especially in those undergoing percutaneous coronary intervention (PCI) but even those being managed medically. Observational studies and some formal studies have shown patients on the standard dual antiplatelet regimen (clopidogrel and aspirin) continue to have further ischemic events and can suffer stent thrombosis...
October 4, 2016: Expert Review of Cardiovascular Therapy
Joo Myung Lee, Jeehoon Kang, Euijae Lee, Doyeon Hwang, Tae-Min Rhee, Jonghanne Park, Hack-Lyoung Kim, Sang Eun Lee, Jung-Kyu Han, Han-Mo Yang, Kyung Woo Park, Sang-Hoon Na, Hyun-Jae Kang, Bon-Kwon Koo, Hyo-Soo Kim
OBJECTIVES: The purpose of this study was to evaluate the clinical impact of chronic kidney disease (CKD) on clinical outcomes in contemporary practice of percutaneous coronary intervention (PCI) using second-generation drug-eluting stents (DES). BACKGROUND: Although second-generation DES have improved the safety and efficacy issues in PCI, data regarding the performance of second-generation DES in patients with CKD are still limited. METHODS: We performed a patient-level pooled analysis on 12,426 patients undergoing PCI using second-generation DES from the Korean Multicenter Drug-Eluting Stent Registry...
October 24, 2016: JACC. Cardiovascular Interventions
Daisuke Ueshima, Takashi Ashikaga, Shunji Yoshikawa, Taro Sasaoka, Yu Hatano, Ken Kurihara, Yasuhiro Maejima, Mitsuaki Isobe
BACKGROUND: Long-term dual antiplatelet therapy (DAPT) for patients treated with coronary stents has been reported to be effective. However the effectiveness of long-term DAPT for everolimus-eluting stent (EES) implanted patients has been controversial. We assessed the major adverse cardiac and cerebral events (MACCE: a composite of death, myocardial infarction, or cerebral arterial disease) in patients free from MACCE during the first 2 years after EES implantation. METHODS AND RESULTS: A total of 1918 patients who underwent successful percutaneous coronary intervention (PCI) with EES at 22 centers in Japan in 2010-2011 were enrolled, and 742 patients were free from MACCE for 2 years...
September 27, 2016: Journal of Cardiology
Vjekoslav Tomulić, David Gobić, Davorka Lulić, David Židan, Luka Zaputović
Adhesion molecules play an important role in inflammation, atherosclerosis and coronary artery disease (CAD). These molecules are expressed on the surface of dysfunctional endothelial cells, causing inflammatory cells from the circulation to adhere and migrate through the endothelium. Their expression is upregulated in acute coronary syndrome (ACS) and after percutaneous coronary intervention (PCI). The contact between stent struts and endothelium upregulates endothelial cell gene expression, endothelial cell activation and inflammation...
October 2016: Medical Hypotheses
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