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https://www.readbyqxmd.com/read/29352691/adopting-an-early-invasive-strategy-for-non-st-elevation-myocardial-infarction-analysis-of-the-portuguese-registry-on-acute-coronary-syndromes
#1
Gonçalo Morgado, Hélder Pereira, Daniel Caldeira
INTRODUCTION: In patients with non-ST-elevation myocardial infarction (NSTEMI), the best timing for coronary angiography is not definitely established, although it is recognized that in high-risk patients it should be performed within the first 24 hours. The aim of this work was to describe the evolution over time of the use of an invasive strategy in the treatment of NSTEMI and in-hospital mortality. METHODS: We performed a retrospective analysis of patients admitted with NSTEMI included in the Portuguese Registry on Acute Coronary Syndromes (ProACS) between 2002 and 2015...
January 15, 2018: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/29352151/effects-of-genetic-variants-on-platelet-reactivity-and-one-year-clinical-outcomes-after-percutaneous-coronary-intervention-a-prospective-multicentre-registry-study
#2
Hyung Joon Joo, Sung Gyun Ahn, Jae Hyoung Park, Ji Young Park, Soon Jun Hong, Seok-Yeon Kim, WoongGil Choi, HyeonCheol Gwon, Young-Hyo Lim, Weon Kim, Woong Chol Kang, Yun-Hyeong Cho, Yong Hoon Kim, JungHan Yoon, WonYong Shin, Myeong-Ki Hong, Scot Garg, Yangsoo Jang, Do-Sun Lim
Clopidogrel is the mainstay for antiplatelet treatment after percutaneous coronary intervention (PCI). The relationship of platelet reactivity and genetic polymorphism with clinical outcomes with newer-generation drug-eluting stents is unclear. We analysed 4,587 patients for the most powerful single-nucleotide polymorphisms (CYP2C19, CYP2C9, ABCB1, PON1, and P2Y12) related to on-treatment platelet reactivity (OPR). The optimal cut-off value of high OPR for major adverse thrombotic events was 266. CYP2C19 was significantly associated with high OPR and the number of CYP2C19*R (*2 or *3) alleles was proportional to the increased risk of high OPR...
January 19, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29350380/patients-treated-with-bivalirudin-still-at-higher-risk-of-stent-thrombosis-a-comprehensive-meta-analysis-of-randomized-clinical-trials-of-bivalirudin-and-heparin-for-percutaneous-coronary-interventions
#3
Stefan Grajek, Michał Michlak, Adrian Gwizdała, Aleksander Araszkiewicz, Marek Grygier, Jarosław Hiczkiewicz, Maciej Lesiak
BACKGROUND: Although the current practice guidelines recommend using both heparin and bivalirudin for percutaneous coronary interventions (PCI), the research data are ambiguous. AIM: To compare the impact of bivalirudin- and heparin on major clinical endpoints in PCI patients with particular emphasis on periprocedural stent thrombosis. METHODS: Total of 18 randomised clinical trials involving 41752 subjects were included. The endpoints comprised: net adverse clinical event (NACE: death, myocardial infarction [MI], unscheduled revascularisation, major bleeding [MB]), major adverse cardiovascular event (MACE: death, MI or stroke), acute/subacute stent thrombosis (ST)...
January 19, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29350374/extension-of-a-coronary-intramural-hematoma-after-blunt-chest-trauma
#4
Maeng Real Park, Mun Ki Min, Ji Ho Ryu, Dae Sub Lee, Kang Ho Lee
Coronary artery dissection and intramural hematoma after blunt chest trauma are rare, but life-threatening, complications. Coronary intramural hematoma extension is even rarer. A 31-year-old man was transferred to our hospital for worsening left chest pain during while he was admitted at a nearby hospital due to blunt chest trauma. Bedside echocardiography showed akinesis of the left ventricular apex and anterior wall as well as hypokinesis of the mid-to-basal anteroseptal wall and mid-to-basal lateral and posterior walls of the left ventricle...
January 2018: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/29350305/percutaneous-mechanical-circulatory-support-devices-for-high-risk-percutaneous-coronary-intervention
#5
REVIEW
Subrata Kar
PURPOSE OF REVIEW: Percutaneous mechanical circulatory support devices (PMCSD) consist of the intra-aortic balloon pump (IABP), Impella (Abiomed Inc., Danvers, Massachusetts), Tandem Heart (Cardiac Assist, Inc., Pittsburgh, Pennsylvania), or extracorporeal membranous oxygenation (ECMO). They augment cardiac output, cardiac index, and cardiac power which allow the operator to mitigate hemodynamic perturbations during high-risk percutaneous coronary intervention (HR-PCI). This review discusses PMCSD and their contemporary literature...
January 19, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29349698/third-generation-dual-source-ct-enables-accurate-diagnosis-of-coronary-restenosis-in-all-size-stents-with-low-radiation-dose-and-preserved-image-quality
#6
Yuehua Li, Mengmeng Yu, Wenbin Li, Zhigang Lu, Meng Wei, Jiayin Zhang
OBJECTIVES: To investigate the diagnostic performance of low dose stent imaging in patients with large (≥ 3 mm) and small (< 3 mm) calibre stents by third-generation dual-source CT. METHODS: Symptomatic patients suspected of having in-stent restenosis (ISR) were prospectively enrolled. Coronary computed tomography angiography (CCTA) and invasive coronary angiography (ICA) were performed within 1 month for correlation. Binary ISR was defined as an in-stent neointimal proliferation with diameter stenosis ≥ 50%...
January 18, 2018: European Radiology
https://www.readbyqxmd.com/read/29349686/two-year-results-after-coronary-stenting-of-small-vessels-in-japanese-population-using-2-25-mm-diameter-sirolimus-eluting-stent-with-bioresorbable-polymer-primary-and-long-term-outcomes-of-century-jsv-study
#7
Shigeru Saito, Kenji Ando, Yoshiaki Ito, Tetsuya Tobaru, Junji Yajima, Takeshi Kimura, Kazushige Kadota
Percutaneous coronary intervention (PCI) in coronary artery disease (CAD) with very small vessels remains challenging. The aim of this study is to evaluate the safety and effectiveness of the 2.25-mm diameter Ultimaster sirolimus-eluting stent in the treatment of Japanese patients with CAD due to lesions in very small vessels. The CENTURY JSV study is a prospective, multicentre, single-arm study. Seventy patients with lesions deemed suitable for implantation of a 2.25-mm diameter stent were enrolled at seven hospitals in Japan...
January 18, 2018: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/29349545/risk-of-discontinuation-of-clopidogrel-after-1-month-following-bare-metal-stents-a-propensity-score-adjusted-comparison-with-continued-administration-of-clopidogrel-after-drug-eluting-stents
#8
Christian M Valina, Sebastian Merz, Nikolaus Löffelhardt, Michael Amann, Miroslaw Ferenc, Christian Stratz, Franz-Josef Neumann, Willibald Hochholzer
In patients at high risk for bleeding undergoing percutaneous coronary intervention (PCI) the use of bare-metal-stent (BMS) is considered an option that allows discontinuation of clopidogrel after 4 weeks. We sought to investigate the risk of early discontinuation of clopidogrel in patients with BMS as compared with a 6-month course of clopidogrel after DES in patients with or without high on-treatment platelet reactivity (HTPR). In 765 consecutive patients undergoing PCI after loading with clopidogrel 600 mg, HTPR was tested by optical aggregometry and defined as residual platelet reactivity > 14%...
January 18, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29348285/vancomycin-induced-coronary-artery-spasm-a-case-of-kounis-syndrome
#9
Eric Martinez, Sonu Sahni, Muhammad Ai Cheema, Asma Iftikhar
Kounis syndrome defined as the appearance of acute coronary syndrome in the context of an allergic reaction is a relatively rare phenomenon. There are three variants of this syndrome in which the patient presents with symptoms of an acute chest. Herein, we describe a case of an 83-year-old woman who demonstrated type I variant of Kounis syndrome in response to vancomycin administration. After initialisation of vancomycin, she became unresponsive and an ECG demonstrated ST changes consistent with inferior-lateral myocardial infarction...
January 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29345594/should-stemi-patients-receive-opiate-analgesia-the-morphine-paradox
#10
Mohamed Farag, Nikolaos Spinthakis, Manivannan Srinivasan, Diana Adrienne Gorog
BACKGROUND: The very significant benefit of P2Y12 receptor inhibitor administration in patients with ST-elevation myocardial infarction (STEMI), in reducing future ischaemic events and stent thrombosis, is undisputed. Morphine analgesia is very frequently co-administered to these patients for pain relief, along with antiplatelet therapy, at the time of presentation, and prior to reperfusion with primary percutaneous coronary intervention. METHODS: Research and online content related to opiates use in STEMI was reviewed...
January 17, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345592/prolonging-ticagrelor-beyond-a-year-of-acute-coronary-syndrome-worth-or-harmful
#11
Daniel Aradi, Dome Dezsi, Gabor Veress, Bela Merkely
Platelet activation plays a central role in triggering and complicating acute coronary syndromes, especially in case of stent thrombosis and myocardial infarction. On top of aspirin, P2Y12-inhibitors are successfully used to treat and prevent these events for a duration of one year after an acute coronary episode or 6 months after drug-eluting stent implantation. However, patients with acute coronary syndromes remain at heightened risk for recurrent ischemic events after the recommended durations of P2Y12-inhibitors and therefore, prolonging treatment is often considered in clinical practice...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345590/what-is-the-role-for-glycoprotein-iib-iiia-inhibitor-use-in-the-catheterisation-laboratory-in-the-current-era
#12
Andrea Rubboli, Giuseppe Patti
BACKGROUND: In the era of dual antiplatelet therapy of aspirin and clopidogrel and systematic stent implantation, glycoprotein IIb/IIIa inhibitors (GPI), including abciximab, eptifibatide and tirofiban, proved beneficial in improving early outcome of percutaneous coronary intervention (PCI), especially in higher risk clinical and/or anatomical subsets. This was associated however, with an increased incidence of bleeding complications. OBJECTIVE: To review whether the established results of GPI in PCI are maintained in the contemporary era of more effective antiplatelet agents (i...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29345585/mandatory-reporting-of-coronary-artery-calcifications-incidentally-noted-on-chest-multi-detector-computed-tomography-a-multicentre-experience
#13
Salvatore Cappabianca, Maria Paola Belfiore, Alfonso Reginelli, Raffaella Capasso, Alessandra Del Prete, Mario Petrillo, Paola Mascia, Claudia Rossi, Francesco Romano, Massimo De Filippo, Michele Scialpi, Felice Gragnano, Paolo Calabro, Giuseppe Belfiore, Luca Brunese, Roberto Grassi, Antonio Rotondo
BACKGROUND Coronary artery calcifications (CACs) are associated with coronary atherosclerosis and cardiovascular (CV) events. In "non-cardiovascular" settings, CACs can be easily detected on chest multi-detector computed tomography (MDCT). Their evaluation may help to better stratify CV risk in the general population, especially for primary prevention. AIMS We retrospectively evaluated the relationship between CAC distribution and CV risk, determined by Framingham Risk Score (FRS), in a cohort of patients who underwent chest MDCT performed for several clinical indications...
January 16, 2018: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/29344756/the-current-state-of-left-main-percutaneous-coronary-intervention
#14
REVIEW
Harshith R Avula, Andrew N Rassi
PURPOSE OF REVIEW: While coronary artery bypass grafting (CABG) remains the standard of care, advances in stenting technology and procedural technique are changing the role of percutaneous coronary intervention (PCI) in the treatment of severe left main coronary artery (LMCA) disease. We review contemporary evidence comparing PCI and CABG for the treatment of severe LMCA disease, discuss optimal techniques during left main PCI, and provide guidance on studied revascularization strategies within specific patient subgroups...
January 17, 2018: Current Atherosclerosis Reports
https://www.readbyqxmd.com/read/29344373/multianalysis-with-optical-coherence-tomography-and-vasomotion-in-everolimus-eluting-stents-and-everolimus-eluting-biovascular-scaffolds-the-moves-trial
#15
Diego A Arroyo, Sara Schukraft, Zacharenia Kallinikou, Jean-Christophe Stauffer, Gérard Baeriswyl, Jean-Jacques Goy, Mario Togni, Stéphane Cook, Serban Puricel
Aims: To compare endothelium-dependent vasomotor function and vascular healing 15 months after implantation of two new-generation drug-eluting stents and biovascular scaffolds (BVS). Methods and results: A total of 28 patients previously treated with a SYNERGY stent (bioabsorbable polymer everolimus-eluting stents (BP-EES)), a PROMUS stent (persistent polymer everolimus-eluting stents (PP-EES)) or an ABSORB (BVS) underwent control coronary angiography, 15 months after implantation, coupled with optical coherence tomography imaging and supine bicycle exercise...
2018: Open Heart
https://www.readbyqxmd.com/read/29343478/treatment-of-gastrointestinal-bleeding-with-idarucizumab-in-a-patient-receiving-dabigatran
#16
Jennifer Mourafetis, Norman Doctor, Simon Leung
PURPOSE: A case report describing use of idarucizumab for dabigatran reversal without the use of hemostatic agents in a patient who developed acute upper gastrointestinal (GI) bleeding while receiving triple antithrombotic therapy is presented. SUMMARY: A 77-year-old man with a complex cardiac history presented to the emergency room with chief complaints of black tarry stools and low blood pressures for 4 days. His past medical history included recent percutaneous coronary intervention (PCI) and drug-eluting stent (DES) placement, atrial fibrillation, hypertension, hyperlipidemia, coronary artery disease, coronary artery bypass graft surgery, stage 3 chronic kidney disease, and cholecystectomy...
January 17, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29341060/rationale-of-decreasing-low-density-lipoprotein-cholesterol-below-70-mg-dl-in-patients-with-coronary-artery-disease-a-retrospective-virtual-histology-intravascular-ultrasound-study
#17
Young Hoon Seo, Duck-Jun Seo, In Geol Song, Ki-Hong Kim, Taek-Geun Kwon, Jang-Ho Bae
BACKGROUND: The associations between statin and coronary plaque compositional changes were reported according to the use of high dose or not. An evaluation of the impact of low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL by using real world dosages of statin on coronary plaque composition was undertaken. METHODS: The study subjects consisted of 61 patients (mean 59.9 years old, 45 males) who underwent percutaneous coronary intervention, baseline and follow-up (F/U; mean 8...
January 17, 2018: Cardiology Journal
https://www.readbyqxmd.com/read/29340741/-platelet-inhibition-in-patients-with-coronary-cerebral-and-peripheral-macroangiopathy-what-when-and-how-long
#18
REVIEW
M Halbach, S Baldus
BACKGROUND: Inhibition of platelet aggregation can reduce the rate of vascular events in patients with coronary artery disease, carotid artery stenosis and symptomatic peripheral arterial disease. The choice of platelet inhibitors in monotherapy and combination therapy as well as the duration of dual platelet inhibition depend on the clinical situation and individual patient characteristics. GOAL: The present review summarizes the latest data from clinical trials and recommendations regarding platelet inhibition in coronary, cerebral and peripheral arterial disease...
January 16, 2018: Der Internist
https://www.readbyqxmd.com/read/29340719/treatment-with-48-mm-everolimus-eluting-stents-procedural-safety-and-12-month-patient-outcome
#19
C K Tan, Z L Tin, M K M Arshad, J K K Loh, F H Jafary, H H Ho, P J L Ong, T Watson
BACKGROUND: Lesion length is a major predictor of adverse outcomes after percutaneous coronary intervention. Long lesions often require multiple stents with variable overlap, which increases the probability of geographical miss and the incidence of mechanical complications, such as side-branch occlusion, restenosis, and stent thrombosis. These pitfalls may be avoided by use of an ultra-long device. METHODS: We retrospectively assessed the performance of the 48-mm Xience Xpedition everolimus-eluting stent (EES) at our institution...
January 16, 2018: Herz
https://www.readbyqxmd.com/read/29340630/sutureless-prosthesis-for-failed-small-mitroflow-valves-the-perceval-after-mitroflow-procedure
#20
Giovanni A Chiariello, Emmanuel Villa, Antonio Messina, Margherita Dalla Tomba, Marco Cirillo, Federico Brunelli, Zean Mhagna, Giovanni Troise
Because of its favourable haemodynamic characteristics and easy implantability, Mitroflow aortic valve bioprosthesis has been the valve of choice for many surgeons in patients with small aortic annulus. Disappointingly, early structural valve deterioration and high transvalvular gradients have been reported mostly in older patients with small prostheses. Reimplanting a new stented prosthesis sutured in a narrow and damaged annulus is technically challenging and demanding mainly in high-risk patients. Valve-in-valve transcatheter aortic valve implantation has been proposed as a viable option; however, it presents significant limitations because of residual high transprosthetic pressure gradients and risk of coronary occlusion...
January 11, 2018: Interactive Cardiovascular and Thoracic Surgery
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