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https://www.readbyqxmd.com/read/27920235/successful-reversal-of-bradycardia-and-dyspnea-with-aminophylline-after-ticagrelor-load
#1
Sarah A Minner, Pamela Simone, Benjamin B Chung, Atman P Shah
A 69-year-old male underwent elective percutaneous coronary intervention requiring placement of a drug-eluting stent to the first obtuse marginal artery. Four hours following the administration of a ticagrelor loading dose, he developed dyspnea and sinus pauses. Aminophylline was administered and resulted in immediate and sustained symptom resolution. Ticagrelor has been associated with dyspnea and bradyarrhythmias, both attributed to increased adenosine exposure. Ticagrelor inhibits reuptake of intracellular adenosine...
December 5, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27920074/a-critical-appraisal-of-aspirin-in-secondary-prevention-is-less-more
#2
Giuseppe Gargiulo, Stephan Windecker, Pascal Vranckx, Charles Michael Gibson, Roxana Mehran, Marco Valgimigli
Aspirin represents the sine qua non for antiplatelet pharmacotherapy in patients with cardiovascular diseases because of its well-established role in secondary prevention and its widespread availability and affordability. Historical studies, conducted in an era that bears little resemblance to contemporary clinical practice, demonstrated large reductions in thrombotic risk when aspirin was compared with placebo, thus forming the evidence base promulgated in practice guidelines and recommendations. P2Y12 inhibitors have mostly been studied in addition to aspirin; dual-antiplatelet therapy proved superiority compared with aspirin monotherapy for the prevention of ischemic events, despite increased bleeding risks...
December 6, 2016: Circulation
https://www.readbyqxmd.com/read/27916744/does-acute-coronary-syndrome-impact-on-the-incidence-of-thrombosis-after-the-implantation-of-absorb-bioresorbable-vascular-scaffold
#3
Yohei Sotomi, Yosuke Miyazaki, Carlos Colet, Taku Asano, Pannipa Suwannasom, Jan Tijssen, Robbert J de Winter, Ron Waksman, Michael J Lipinski, Yoshinobu Onuma, Patrick W Serruys
AIMS: In the drug eluting stent (DES) era, patients with acute coronary syndrome (ACS) had a higher risk of early stent thrombosis compared with stable patients. The present study evaluated whether the same is true for the bioresorbable vascular scaffold (BVS: Abbott Vascular, Santa Clara CA). METHODS AND RESULTS: We assessed the relationship between the incidence of definite/probable scaffold thrombosis (ScT) (overall ScT and early ScT) and ACS percentage with the latest publications including the most recent large randomized controlled trials...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916742/angiographic-and-clinical-outcomes-of-patients-treated-with-drug-coated-balloon-angioplasty-for-in-stent-restenosis-after-coronary-bifurcation-stenting-with-a-two-stent-technique
#4
Yukinori Harada, Roisin Colleran, Susanne Pinieck, Daniele Giacoppo, Jonathan Michel, Sebastian Kufner, Salvatore Cassese, Michael Joner, Tareq Ibrahim, Karl-Ludwig Laugwitz, Adnan Kastrati, Robert A Byrne
AIMS: We conducted this study to evaluate the efficacy of drug-coated balloon therapy for in-stent restenosis after coronary bifurcation stenting. METHODS AND RESULTS: Patients who underwent angioplasty with at least one paclitaxel-coated balloon for in-stent restenosis after bifurcation intervention using a two-stent approach were included. Two types of paclitaxel-coated balloon were used, with either iopromid (iopromide-PCB) or butyryltri-n-hexyl citrate excipient (BTHC-PCB)...
December 6, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27916002/long-term-effect-of-stents-eluting-6-mercaptopurine-in-porcine-coronary-arteries
#5
Matthijs S Ruiter, Albert Doornbos, Vivian de Waard, Robbert J de Winter, Nico J M Attevelt, Rob Steendam, Carlie J M de Vries
BACKGROUND: Drug-eluting stents (DES) have dramatically reduced restenosis rates compared to bare metal stents and are widely used in coronary artery angioplasty. The anti-proliferative nature of the drugs reduces smooth muscle cell (SMC) proliferation effectively, but unfortunately also negatively affects endothelialization of stent struts, necessitating prolonged dual anti-platelet therapy. Cell-type specific therapy may prevent this complication, giving rise to safer stents that do not require additional medication...
December 5, 2016: Journal of Negative Results in Biomedicine
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
#6
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
#7
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/27914491/impact-of-lesion-characteristics-on-the-prediction-of-optimal-poststent-fractional-flow-reserve
#8
Hirohiko Ando, Hiroaki Takashima, Akihiro Suzuki, Shinichiro Sakurai, Soichiro Kumagai, Akiyoshi Kurita, Katsuhisa Waseda, Tetsuya Amano
BACKGROUND: Poststent fractional flow reserve (FFR) is a useful indicator of optimal percutaneous coronary intervention, and higher poststent FFR is associated with favorable long-term clinical outcome. However, little is known about the factors influencing poststent FFR. The purpose of this study was to determine the impact of lesion characteristics on poststent FFR. METHODS: For patients who had scheduled stent implantation for stable angina, FFR measurements at maximum hyperemia were performed before and after coronary stent implantation...
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
#9
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/27914489/rationale-and-design-of-the-east-west-late-lumen-loss-study-comparison-of-late-lumen-loss-between-eastern-and-western-drug-eluting-stent-study-cohorts
#10
Robert W Harrison, Vaishnavi Radhakrishnan, Peter S Lam, Dominic J Allocco, Sandeep Brar, Martin Fahy, Rebecca Fisher, Fumiaki Ikeno, Philippe Généreux, Takeshi Kimura, Minglei Liu, Weng Kit Lye, Gary S Mintz, Hirofumi Nagai, Yuka Suzuki, Roseann White, John C Allen, Mitchell W Krucoff
BACKGROUND: The contemporary evaluation of novel drug-eluting stents (DES) includes mechanistic observations that characterize postdeployment stent behavior. Quantification of late lumen loss due to neointimal hyperplasia 8-13 months after stent implantation, via quantitative coronary angiography (QCA), constitutes such an observation and is required by most regulatory authorities. Late lumen loss, as determined by QCA, has been validated as a surrogate for clinical endpoints such as target vessel revascularization...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914488/safety-of-6-month-duration-of-dual-antiplatelet-therapy-after-percutaneous-coronary-intervention-in-patients-with-acute-coronary-syndromes-rationale-and-design-of-the-smart-angioplasty-research-team-safety-of-6-month-duration-of-dual-antiplatelet-therapy-after
#11
Joo Myung Lee, Deok-Kyu Cho, Joo-Yong Hahn, Young Bin Song, Taek Kyu Park, Ju-Hyeon Oh, Jin Bae Lee, Joon-Hyung Doh, Sang-Hyun Kim, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) is a fundamental treatment that optimizes clinical outcomes after percutaneous coronary intervention, especially in patients with acute coronary syndrome (ACS). Although current international guidelines recommend DAPT for at least 12 months after implantation of a drug-eluting stent in patients with ACS, these recommendations are not based on randomized controlled trials dedicated to ACS population. STUDY DESIGN: The SMART-DATE trial is a prospective, multicenter, randomized, and open-label study to demonstrate the noninferiority of 6-month DAPT compared with 12 months or longer DAPT in patients with ACS undergoing percutaneous coronary intervention...
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
#12
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/27912202/bioresorbable-stents-current-and-upcoming-bioresorbable-technologies
#13
REVIEW
Hui Ying Ang, Heerajnarain Bulluck, Philip Wong, Subbu S Venkatraman, Yingying Huang, Nicolas Foin
Bioresorbable scaffolds (BRS) represent a novel horizon in interventional cardiology for the treatment of coronary artery disease. The technology was introduced to overcome limitations of current metallic drug-eluting stents such as late in-stent restenosis and permanently caging the vessel. The concept of the BRS is to provide temporal support to the vessel during healing before being degraded and resorbed by the body, promoting restoration of the vessel vasomotion. Currently, there are several BRS that are under development or already commercially available...
November 12, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27905692/remote-pre-procedural-ischemic-stroke-was-the-strongest-risk-for-stroke-and-death-associated-with-carotid-stenting-a-single-center-experience
#14
Mária Rašiová, Ľubomír Špak, Ľudmila Farkašová, Štefan Pataky, Martin Koščo, Marek Hudák, Matej Moščovič, Norbert Leško
BACKGROUND: The goal of carotid artery stenting (CAS) is to decrease the stroke risk in patients with carotid stenosis. This procedure carries an immediate risk of stroke and death and many patients do not benefit from it, especially asymptomatic patients. Patient selection for carotid procedure who benefit from procedure and who is the procedure hazardous for is important. Remote ischemic stroke is known risk factor for stroke reccurence during surgery. The aim of our study was to determine the periprocedural complication risk (within 30 days after CAS) associated with carotid stenting (stroke, death) between patients with remote pre- procedural ischemic stroke and without it; to analyse periprocedural risk in other specific patient subgroups treated with CAS and to determine the impact of observed variables on all- cause mortality during long-term follow-up...
December 1, 2016: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/27905013/impact-of-stent-type-and-prolonged-dual-antiplatelet-therapy-on-long-term-clinical-outcomes-in-hemodialysis-patients-with-coronary-artery-disease
#15
Masahiko Asami, Jiro Aoki, Tatsuyuki Sato, Shuzou Tanimoto, Mika Watanabe, Yu Horiuchi, Koichi Furui, Kentaro Yasuhara, Yu Sato, Takuya Hashimoto, Sen Yachi, Kazuhiro Hara, Kengo Tanabe
The aim of this study was to address 7-year clinical outcomes and impact of prolonged dual antiplatelet therapy (DAPT) after coronary stenting in hemodialysis patients. Our study included 123 consecutive hemodialysis patients who had undergone percutaneous coronary intervention with a drug-eluting stent (DES) or bare-metal stent (BMS) (DES: 64, BMS: 59) in our institution. We compared long-term clinical outcomes following DES with BMS implantation as well as clinical outcomes in patients on DAPT for ≥1 year (DAPT on group, 89) with those on DAPT for <1 year (DAPT off group, 34)...
November 30, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27904973/platelet-reactivity-and-clinical-outcomes-in-patients-using-cyp3a4-metabolized-statins-with-clopidogrel-in-percutaneous-coronary-intervention
#16
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/27903575/early-severe-coronary-artery-disease-and-aortic-coarctation-in-a-child-with-familial-hypercholesterolaemia
#17
Dina Labib, Haytham Soliman, Kareem Said, Khaled Sorour
An 11-year-old boy presented with easy fatigability, multiple xanthomas, and absent pedal pulsations. Laboratory workup showed severe hypercholesterolaemia and non-invasive imaging revealed 'normally functioning' bicuspid aortic valve and tight aortic coarctation. Coronary angiography showed severe right coronary artery (RCA) stenosis. Medical treatment resulted in significant improvement of dyslipidaemia. We successfully performed balloon dilation and stenting of his coarctation, as well as percutaneous coronary intervention for RCA lesion...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27903378/-cardiac-perforation-complicated-by-cardiac-tamponade-during-coronary-artery-stent-implantation-a-case-report
#18
Y Tian, Q Wu, C Y Zhang
No abstract text is available yet for this article.
October 24, 2016: Zhonghua Xin Xue Guan Bing za Zhi
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
#19
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/27900191/deaths-in-triathletes-immersion-pulmonary-oedema-as-a-possible-cause
#20
Richard E Moon, Stefanie D Martina, Dionne F Peacher, William E Kraus
BACKGROUND/AIM: To address the question as to whether immersion pulmonary oedema (IPO) may be a common cause of death in triathlons, markers of swimming-induced pulmonary oedema (SIPO) susceptibility were sought in triathletes' postmortem examinations. METHODS: Deaths while training for or during triathlon events in the USA and Canada from October 2008 to November 2015 were identified, and postmortem reports requested. We assessed obvious causes of death; the prevalence of left ventricular hypertrophy (LVH); comparison with healthy triathletes...
2016: BMJ Open Sport & Exercise Medicine
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