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https://www.readbyqxmd.com/read/27912739/comparing-the-adverse-clinical-outcomes-associated-with-fraction-flow-reserve-guided-versus-angiography-guided-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-randomized-controlled-trials
#1
Pravesh Kumar Bundhun, Chandra Mouli Yanamala, Feng Huang
BACKGROUND: Recently published randomized controlled trials have shown different results compared to the Fraction Flow Reserve Versus Angiography for Multi-vessel Evaluation (FAME) study. Therefore, this current analysis aimed to compare the adverse clinical outcomes associated with Fraction Flow Reserve (FFR)-guided versus standard angiography-guided Percutaneous Coronary Intervention (PCI) using a large number of randomized patients. METHODS: PubMed/Medline, EMBASE and the Cochrane library were searched for studies comparing FFR-guided with angiography-guided PCI...
December 3, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27912129/incidence-of-complications-in-young-onset-diabetes-comparing-type-2-with-type-1-the-young-diab-study
#2
Anandakumar Amutha, Ranjit Mohan Anjana, Ulagamathesan Venkatesan, Harish Ranjani, Ranjit Unnikrishnan, K M Venkat Narayan, Viswanathan Mohan, Mohammed K Ali
BACKGROUND: There is little data on the incidence of diabetes complications in young onset type 1 diabetes (T1DM) and type 2 diabetes (T2DM) in non European populations. METHODS: From a tertiary diabetes centre, Chennai, India, we recruited 108 T1DM (defined by abrupt onset of symptoms or diabetic ketoacidosis, absent insulin reserve requiring insulin treatment) and 90 T2DM participants (defined by absence of ketosis, good beta-cell reserve, and good response to oral agents) who were diagnosed between the ages of 10 and 25years, and without any evidence of diabetes complications at diagnosis...
November 17, 2016: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/27909767/interventional-therapies-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock
#3
S de Waha, S Desch, G Fuernau, J Pöss, J Ledwoch, A Jobs, I Eitel, H Thiele
Cardiogenic shock remains the most common cause of death in patients with acute myocardial infarction. Early revascularization of the infarct-related artery has been shown to reduce mortality and is the therapeutic cornerstone. The optimal revascularization strategy of additional non-culprit lesions remains yet to be determined. Further, uncertainties exist with respect to access site choice, antiplatelet regimen as well as mechanical support devices. This review outlines current evidence on the interventional management of cardiogenic shock complicating acute myocardial infarction...
December 1, 2016: Herz
https://www.readbyqxmd.com/read/27907885/complete-revascularization-versus-culprit-only-revascularization-in-st-segment-elevation-myocardial-infarction-and-multivessel-disease-patients-undergoing-primary-percutaneous-coronary-intervention-a-meta-analysis-and-trial-sequential-analysis
#4
REVIEW
Chong-Hui Wang, Shu-Yang Zhang, Xiao-Feng Jin
The present study compared the outcomes of complete revascularization (CR) and culprit-only revascularization (COR) performed during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease through a meta-analysis in order to determine which strategy is more appropriate. Published randomized controlled trials (RCTs) were retrieved from the PubMed, EMBASE, and CENTRAL databases. Eight RCTs with 2060 patients were selected (1080 patients underwent CR [immediate (ICR) or staged (SCR)] and 980 patients underwent COR)...
November 10, 2016: International Journal of Cardiology
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
#5
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
#6
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/27904524/integration-of-medical-therapy-and-mechanical-circulatory-support-in-the-management-of-acute-heart-failure
#7
Patrick Horn, Malte Kelm, Ralf Westenfeld
Acute heart failure is still characterized by poor prognosis with high mortality. Diagnosis is based on clinical symptoms and hemodynamic measurements. Early coronary revascularization in cardiogenic shock complicating myocardial infarction improves outcome. The further contemporary therapeutic options in the management of acute heart failure are limited to a merely symptomatic effect with relief of dyspnea, reduction of volume overload and improvement of hemodynamic parameters by vasodilators (in hypertension) or inotropic and vasopressor agents (in hypotension)...
December 1, 2016: Archives of Medical Science: AMS
https://www.readbyqxmd.com/read/27904028/prognostic-value-of-eosinophil-to-leukocyte-ratio-in-patients-with-st-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention
#8
Takao Konishi, Naohiro Funayama, Tadashi Yamamoto, Toru Morita, Daisuke Hotta, Hiroshi Nishihara, Shinya Tanaka
AIM: Leukocyte profile has been related to clinical outcome in patients with ST-segment elevation (STE) myocardial infarction (MI). However, whether eosinophil to leukocyte ratio (ELR) predicts clinical outcome in patients who have undergone primary percutaneous coronary intervention (PCI) remains unclear. Therefore, we examined the prognostic value of ELR in this patient population. METHODS: We retrospectively analyzed the data of 331 consecutive patients who underwent primary PCI for STEMI between January 2009 and March 2015...
December 1, 2016: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/27903475/technical-aspects-of-open-repair-for-degenerative-aneurysmal-evolution-despite-early-thoracic-endovascular-repair-of-type-b-aortic-dissection
#9
Sonia Aguir, Salma El Batti, Paul Achouh, Pierre Julia, Alain Bel, Jean-Noël Fabiani, Jean-Marc Alsac
: Closure of the proximal tear by Thoracic Endovascular Aortic Repair (TEVAR) at the acute phase appears to be an safe effective treatment to prevent aneurysmal degeneration type B dissection. However, it appears to be inefficient in up to a third of the patient. We report the technical aspects of our experience with patients undergoing secondary open repair after TEVAR for dissecting thoraco-abdominal aneurysm despite early closure proximal tear by TEVAR. METHODS: During a period of 5 years, 96 patients presenting acute Type B Aortic Dissections (TBAD) were treated by TEVAR and followed-up in our institution...
November 26, 2016: Annals of Vascular Surgery
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
#10
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/27901002/shorter-versus-longer-duration-dual-antiplatelet-therapy-in-patients-with-diabetes-mellitus-undergoing-drug-eluting-stents-implantation-a-meta-analysis-of-randomized-controlled-trials
#11
He Huang, Ya Li, Yu Chen, Guo-Sheng Fu
BACKGROUND: Patients with diabetes mellitus (DM) have a higher risk of thromboembolic events; however, the optimal duration of dual antiplatelet therapy (DAPT) remains unclear. The goal of this study was to assess the efficacy and safety of various DAPT durations in patients with DM undergoing drug-eluting stent implantation. METHODS: We conducted a literature search for randomized controlled trials (RCTs). We searched databases including EMBASE, PubMed, Cochrane Library, and Scopus up to June 2016...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27900642/ischemia-burden-on-stress-spect-mpi-predicts-long-term-outcomes-after-revascularization-in-stable-coronary-artery-disease
#12
Hendrik J Boiten, Jan C van den Berge, Roelf Valkema, Ron T van Domburg, Felix Zijlstra, Arend F L Schinkel
BACKGROUND: It is not entirely clear whether ischemia burden on stress single-photon emission computed tomography (SPECT) effectively identifies patients who have a long-term benefit from coronary revascularization. METHODS: The study population consisted of 719 patients with ischemia on stress SPECT. Early coronary revascularization was defined as percutaneous coronary intervention or coronary artery bypass grafting ≤90 days after SPECT. Patients who underwent late revascularization (>90 days after SPECT) were excluded (n = 164)...
November 29, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27899940/staged-versus-one-time-multivessel-intervention-in-elderly-patients-with-non-st-elevation-acute-coronary-syndrome
#13
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/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
#14
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/27899203/bioresorbable-scaffold-implantation-in-patients-with-indication-for-oral-anticoagulation-a-propensity-matched-analysis
#15
Niklas F Boeder, Victoria Johnson, Oliver Dörr, Jens Wiebe, Albrecht Elsässer, Helge Möllmann, Christian W Hamm, Holger M Nef, Timm Bauer
OBJECTIVES: To examine ischemic and bleeding outcomes in patients on triple antithrombotic therapy (TAT) compared with dual antiplatelet therapy (DAPT) after the implantation of bioresorbable scaffolds (BRS). BACKGROUND: The optimal antithrombotic regimen in patients undergoing percutaneous coronary intervention that have an indication for oral anticoagulation is unclear, in particular among those undergoing BRS implantation. METHODS: Consecutive patients of a single-center, all-comers BRS registry were included...
November 24, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27898505/clinical-role-of-post-angioplasty-hyperemic-microvascular-resistances-in-chronic-ischemic-left-ventricular-dysfunction
#16
Riccardo Gorla, Edoardo Verna, Simone Scotti, Sergio Ghiringhelli, Laura Zoli, Stefano Provasoli, Silvana Garancini, Roberto De Ponti, Jorge A Salerno-Uriarte
AIMS: To investigate the impact of hyperemic microvascular resistances (HMRs) on myocardial perfusion and contractility after percutaneous coronary intervention (PCI) in chronic ischemic left ventricular dysfunction (CILVD). METHODS: The current retrospective study included 48 patients with CILVD of the left anterior descending territory undergoing HMRs assessment before and after PCI with a dual-sensor intracoronary pressure-flow wire. The severity of resting myocardial underperfusion and contractile dysfunction of the left anterior descending territory was scored as summed rest score (SRS-T) by single photon emission tomography, wall motion score index (WMSI-T) and left ventricular ejection fraction (LVEF) by transthoracic echocardiography before PCI and after 3 months...
November 24, 2016: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/27896897/expanded-clinical-use-of-everolimus-eluting-bioresorbable-vascular-scaffolds-for-treatment-of-coronary-artery-disease
#17
Roberto Diletti, Yuki Ishibashi, Cordula Felix, Yoshinobu Onuma, Shimpei Nakatani, Nicolas M van Mieghem, Eveliyn Regar, Marco Valgimigli, Peter P de Jaegere, Nienke van Ditzhuijzen, Jiang Ming Fam, Jurgen M R Ligthart, Mattie J Lenzen, Patrick W Serruys, Felix Zijlstra, Robert Jan van Geuns
BACKGROUND: Limited data are currently available on the performance of everolimus eluting bioresorbable vascular scaffold (BVS) for treatment of complex coronary lesions representative of daily practice. METHODS: This is a prospective, mono-center, single-arm study, reporting data after BVS implantation in patients presenting with stable, unstable angina, or non-ST segment elevation myocardial infarction caused by de novo stenotic lesions in native coronary arteries...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27894787/safety-and-efficacy-of-liraglutide-treatment-in-japanese-type-2-diabetes-patients-after-acute-myocardial-infarction-a-non-randomized-interventional-pilot-trial
#18
Masataka Kajiwara, Atsushi Tanaka, Tomohiro Kawasaki, Koichi Nakao, Tomohiro Sakamoto, Shigeru Toyoda, Teruo Inoue, Nobuhiko Koga, Koichi Node
BACKGROUND: Glucagon-like peptide 1 analogs are expected to exert a cardio-protective action due to their effective glucose-lowering action and favorable potency on multifactorial metabolic pathways. However, the safety and tolerability of liraglutide treatment after a recent acute coronary syndrome (ACS) in Japanese patients with type 2 diabetes mellitus (T2DM) have yet to be fully established. METHODS: A total of eight T2DM patients were recruited within 2 weeks after the onset of a ST-elevation myocardial infarction (STEMI) followed by successful percutaneous coronary intervention (PCI)...
November 25, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27894260/high-platelet-reactivity-affects-the-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#19
Jun-Jie Zhang, Xiao-Fei Gao, Zhen Ge, Nai-Liang Tian, Zhi-Zhong Liu, Song Lin, Fei Ye, Shao-Liang Chen
BACKGROUND: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation. METHODS: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27894070/the-strategy-study-stress-cardiac-magnetic-resonance-versus-computed-tomography-coronary-angiography-for-the-management-of-symptomatic-revascularized-patients-resources-and-outcomes-impact
#20
Gianluca Pontone, Daniele Andreini, Andrea I Guaricci, Cristina Rota, Marco Guglielmo, Saima Mushtaq, Andrea Baggiano, Virginia Beltrama, Laura Fusini, Anna Solbiati, Chiara Segurini, Edoardo Conte, Paola Gripari, Andrea Annoni, Alberto Formenti, Maria Petulla', Federico Lombardi, Giuseppe Muscogiuri, Antonio L Bartorelli, Mauro Pepi
BACKGROUND: Computed tomography coronary angiography (cTCA) and stress cardiac magnetic resonance (stress-CMR) are suitable tools for diagnosing obstructive coronary artery disease in symptomatic patients with previous history of revascularization. However, performance appraisal of noninvasive tests must take in account the consequent diagnostic testing, invasive procedures, clinical outcomes, radiation exposure, and cumulative costs rather than their diagnostic accuracy only. We aimed to compare an anatomic (cTCA) versus a functional (stress-CMR) strategy in symptomatic patients with previous myocardial revascularization procedures...
October 2016: Circulation. Cardiovascular Imaging
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