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https://www.readbyqxmd.com/read/28927193/timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-myocardial-infarction-a-swedeheart-study
#1
Daniel Lindholm, Joakim Alfredsson, Oskar Angerås, Felix Böhm, Fredrik Calais, Sasha Koul, Bo Lagerqvist, Henrik Renlund, Giovanna Sarno, Christoph Varenhorst
Aims: Although routine invasive management is recommended in NSTEMI patients, the optimal timing of the procedure is not defined. The aim of this study was to assess outcomes in relation to timing of PCI in NSTEMI patients. Methods and results: This was an observational, prospective, multicentre cohort study from the SWEDEHEART registry including all Swedish PCI centres. We included 40 494 consecutive PCI-treated patients who were admitted to any coronary care unit from 2006 to 2013...
January 1, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/28890792/multicentre-analysis-of-current-st-elevation-myocardial-infarction-acute-care-pathways
#2
Joppe Tra, Carolien de Blok, Ineke van der Wulp, Martine C de Bruijne, Cordula Wagner
BACKGROUND: Rapid reperfusion with percutaneous coronary intervention (PCI) is vital for patients with ST segment elevation myocardial infarction (STEMI). However, the guideline-recommended time targets are regularly exceeded. The goal of this study was to gain insight into how Dutch PCI centres try to achieve these time targets by comparing their care processes with one another and with the European guideline-recommended process. In addition, accelerating factors perceived by care providers were identified...
2017: Open Heart
https://www.readbyqxmd.com/read/28888267/sex-based-differences-in-quality-of-care-and-outcomes-in-a-health-system-using-a-standardized-stemi-protocol
#3
MULTICENTER STUDY
Janet Wei, Puja K Mehta, Elizabeth Grey, Ross F Garberich, Robert Hauser, C Noel Bairey Merz, Timothy D Henry
BACKGROUND: Recent data from the National Cardiovascular Data Registry indicate that women with ST-segment-elevation myocardial infarction (STEMI) continue to have higher mortality and reported delays in treatment compared with men. We aimed to determine whether the sex difference in mortality exists when treatment disparities are reduced. METHODS: Using a prospective regional percutaneous coronary intervention (PCI)-based STEMI system database with a standardized STEMI protocol, we evaluated baseline characteristics, treatment, and clinical outcomes of STEMI patients stratified by sex...
September 2017: American Heart Journal
https://www.readbyqxmd.com/read/28886785/reducing-door-in-door-out-intervals-in-helicopter-st-segment-elevation-myocardial-infarction-interhospital-transfers
#4
Michael A Schneider, Jason T McMullan, Christopher J Lindsell, Kimberly W Hart, Diana Deimling, Debra Jump, Todd Davis, William R Hinckley
BACKGROUND: Many health systems rely on helicopter EMS (HEMS) to transfer ST-elevation myocardial infarction (STEMI) patients for percutaneous coronary intervention (PCI) to a hospital with a catheterization laboratory. Mortality rates increase with the time to reperfusion, so reducing delays is imperative. For interhospital STEMI transfers, the time spent in the initial hospital from arrival until departure (door-in to door-out interval or DIDO) should be minimized. OBJECTIVE: To evaluate the impact of a series of process improvements to reduce DIDO intervals for STEMI patients transferred via a hospital based HEMS program...
September 2017: Air Medical Journal
https://www.readbyqxmd.com/read/28865875/photochemical-internalization-pci-of-bleomycin-is-equally-effective-in-two-dissimilar-leiomyosarcoma-xenografts-in-athymic-mice
#5
Simen Sellevold, Qian Peng, Ane Sofie Viset Fremstedal, Kristian Berg
BACKGROUND: Photochemical internalization (PCI) is a novel technique for delivery of active macromolecules into cancerous cells, via light activation of a specific photosensitizer and a low dose systemic drug. Numerous pre-clinical studies and one clinical trial have confirmed the treatment potential in carcinomas. Soft tissue sarcomas are rare and generally resistant to radio- and chemotherapy. Due to treatment resistance and surgical morbidity in sarcoma care, we seek to increase knowledge on PCI effects in sarcomas by studying two different, but closely related leiomyosarcomas...
August 30, 2017: Photodiagnosis and Photodynamic Therapy
https://www.readbyqxmd.com/read/28844991/recalibrating-reperfusion-waypoints
#6
Paul W Armstrong, Robert C Welsh
The realization that thrombus was the cause and not the consequence of acute myocardial infarction was a transformative pathophysiologic insight. An even more stunning observation was the subsequent discovery that restoration of coronary patency could salvage ischemic myocardium and improve clinical outcomes in ST-elevation acute myocardial infarction (STEMI). Assertive clinical investigations of both the content and process of STEMI care over the subsequent 4 decades has demonstrated that the ultimate success of reperfusion is modulated by the timeliness, efficiency, and efficacy with which it is applied...
August 27, 2017: Circulation
https://www.readbyqxmd.com/read/28844990/efficacy-and-safety-of-a-pharmaco-invasive-strategy-with-half-dose-alteplase-versus-primary-angioplasty-in-st-segment-elevation-myocardial-infarction-early-myo-trial-early-routine-catheterization-after-alteplase-fibrinolysis-versus-primary-pci-in-acute-st-segment
#7
Jun Pu, Song Ding, Heng Ge, Yaling Han, Jinchen Guo, Rong Lin, Xi Su, Heng Zhang, Lianglong Chen, Ben He
Background -Timely primary percutaneous coronary intervention (PPCI) cannot be offered to all patients with ST-segment-elevation myocardial infarction (STEMI). Pharmaco-invasive (PhI) strategy has been proposed as a valuable alternative for eligible patients with STEMI. We conducted a randomized study to compare the efficacy and safety of a PhI strategy with half-dose fibrinolytic regimen versus PPCI in patients with STEMI. Methods -The EARLY-MYO trial (Early Routine Catheterization After Alteplase Fibrinolysis Versus Primary PCI in Acute ST-Segment-Elevation Myocardial Infarction) was an investigator-initiated, prospective, multicenter, randomized, noninferiority trial comparing a PhI strategy with half-dose alteplase versus PPCI in patients with STEMI 18 to 75 years of age presenting ≤6 hours after symptom onset but with an expected PCI-related delay...
August 27, 2017: Circulation
https://www.readbyqxmd.com/read/28836970/comprehensive-comparison-of-three-different-animal-models-for-systemic-inflammation
#8
Semjon Seemann, Franziska Zohles, Amelie Lupp
BACKGROUND: To mimic systemic inflammation in humans, different animal models have been developed. Since these models are still discussed controversially, we aimed to comparatively evaluate the most widely used models with respect to the systemic effects, the influence on organ functions and to the underlying pathophysiological processes. METHODS: Systemic inflammation was induced in C57BL/6N mice with lipopolysaccharide (LPS) treatment, peritoneal contamination and infection (PCI), or cecal ligation and puncture (CLP)...
August 24, 2017: Journal of Biomedical Science
https://www.readbyqxmd.com/read/28820396/the-role-of-mtor-inhibitors-and-hmg-coa-reductase-inhibitors-on-young-and-old-endothelial-cell-functions-critical-for-re-endothelialisation-after-percutaneous-coronary-intervention-an-in-vitro-study
#9
K Korybalska, E Kawka, A Breborowicz, J Witowski
Percutaneous coronary intervention (PCI) has become a standard treatment in patients with acute coronary syndrome. However, it is associated with endothelial cell denudation, which may predispose to in-stent thrombosis and restenosis. Pharmacological methods which prevent restenosis can delay post-PCI re-endothelialisation. We have therefore examined how atorvastatin (HMG-CoA reductase inhibitor), sirolimus and everolimus (mTOR inhibitors) affect young and old endothelial cell functions which are responsible for wound healing after PCI...
June 2017: Journal of Physiology and Pharmacology: An Official Journal of the Polish Physiological Society
https://www.readbyqxmd.com/read/28750924/global-geographical-variations-in-st-segment-elevation-myocardial-infarction-management-and-post-discharge-mortality
#10
Xavier Rosselló, Yong Huo, Stuart Pocock, Frans Van de Werf, Chee Tang Chin, Nicolas Danchin, Stephen W-L Lee, Jesús Medina, Ana Vega, Héctor Bueno
BACKGROUND: There is a shortage of information on regional variations in ST-segment elevation myocardial infarction (STEMI) management and prognosis at a global level. We aimed to compare patient profiles, in-hospital management and post-discharge mortality across several world regions. METHODS: In total, 11,559 patients with STEMI were enrolled in two prospective studies of acute coronary syndrome survivors: EPICOR (4943 patients from 555 hospitals in 20 countries in Europe and Latin America recruited between September 2010 and March 2011) and EPICOR Asia (6616 patients from 218 hospitals in eight Asian countries recruited between June 2011 and May 2012)...
July 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28689443/does-having-a-gastrectomy-delay-time-to-feeding-and-prolong-hospital-stay-in-patients-undergoing-cytoreductive-surgery-and-hyperthermic-intraperitoneal-chemotherapy
#11
Nicholas Brian Shannon, Grace Hwei Ching Tan, Claramae Shulyn Chia, Khee Chee Soo, Melissa Ching Teo
AIM: Cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) is routinely used to treat selected patients with peritoneal carcinomatosis, but can be associated with prolonged hospital stay, significant morbidity and mortality. Our objective was to assess whether patients undergoing gastrectomy as part of CRS/HIPEC were at increased risk of delayed feeding time and prolonged hospital stay. METHODS: Two hundred and fourteen consecutive patients with peritoneal carcinomatosis treated with CRS/HIPEC between 2001 and 2016 were stratified by whether CRS included gastrectomy (n = 19, 9%) and compared...
July 26, 2017: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/28667804/balloon-assisted-tracking-use-reduces-radial-artery-access-failure-in-an-experienced-radial-center-and-is-feasible-during-primary-pci-for-stemi
#12
Daniel Obaid, Ahmed Hailan, Alexander Chase, Stephen Dorman, Geraint Jenkins, Adrian Raybould, Mark Ramsey, Phillip Thomas, David Smith, Adrian Ionescu
OBJECTIVE: This prospective study assesses balloon-assisted tracking (BAT) in reducing radial access failure during percutaneous coronary intervention (PCI). BACKGROUND: Arterial spasm prevents PCI from the radial artery in a small percentage of cases. METHODS: A total of 2223 consecutive patients undergoing PCI from the radial approach were analyzed. Radial access failure mode and requirement for crossover to femoral access during a 12-month run-in period were compared with the following 14-month period with routine BAT usage...
July 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/28648948/randomized-phase-ii-study-comparing-prophylactic-cranial-irradiation-alone-to-prophylactic-cranial-irradiation-and-consolidative-extracranial-irradiation-for-extensive-disease-small-cell-lung-cancer-ed-sclc-nrg-oncology-rtog-0937
#13
Elizabeth M Gore, Chen Hu, Alexander Y Sun, Daniel F Grimm, Suresh S Ramalingam, Neal E Dunlap, Kristin A Higgins, Maria Werner-Wasik, Aaron M Allen, Puneeth Iyengar, Gregory M M Videtic, Russell K Hales, Ronald C McGarry, James J Urbanic, Anthony T Pu, Candice A Johnstone, Volker W Stieber, Rebecca Paulus, Jeffrey D Bradley
INTRODUCTION: NRG Oncology RTOG 0937 is a randomized phase II trial evaluating 1-year overall survival (OS) with prophylactic cranial irradiation (PCI) or PCI plus consolidative radiation therapy (PCI+cRT) to intrathoracic disease and extracranial metastases for extensive-disease SCLC. METHODS: Patients with one to four extracranial metastases were eligible after a complete response or partial response to chemotherapy. Randomization was to PCI or PCI+cRT to the thorax and metastases...
June 23, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28625402/comparison-between-catheter-based-delivery-of-paclitaxel-after-bare-metal-stenting-and-drug-eluting-stents-in-coronary-artery-disease-patients-at-high-risk-for-in-stent-restenosis
#14
Mostafa El-Mokadem, Mohamed El-Ramly, Amr Hassan, Hesham Boshra, Amir AbdelWahab
BACKGROUND: Drug eluting stents reduce the risk of in-stent restenosis but delay healing of the vascular wall. Recent data on late and very late stent thrombosis after drug-eluting stent (DES) implantation have raised concerns about the long-term safety. High lipophilicity of paclitaxel promotes rapid cellular uptake and prolongs its action. This makes paclitaxel a very promising candidate for local drug therapy intended to inhibit the proliferative and migratory processes involved in restenosis following PCI...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28600021/st-segment-elevation-myocardial-infarction-in-patients-hospitalized-for-non-cardiac-conditions
#15
Justin Tiulim, Kevin Mak, David M Shavelle
BACKGROUND: Timely use of primary percutaneous coronary intervention (PCI) is the standard of care for patients with ST segment elevation myocardial infarction (STEMI). Most patients with STEMI present via emergency medical services or self-transport to the emergency department (ED) and relatively little is known about the minority of patients that develop STEMI while hospitalized for non-cardiac conditions. The objective of this study was to analyze treatment times and clinical outcome for in-hospital STEMI patients...
May 31, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28581994/reperfusion-options-for-st-elevation-myocardial-infarction-patients-with-expected-delays-to-percutaneous-coronary-intervention
#16
REVIEW
David M Larson, Peter McKavanagh, Timothy D Henry, Warren J Cantor
Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis...
October 2016: Interventional cardiology clinics
https://www.readbyqxmd.com/read/28581401/prospective-study-of-hippocampal-sparing-prophylactic-cranial-irradiation-in-limited-stage-small-cell-lung-cancer
#17
Kristin J Redmond, Russell K Hales, Heather Anderson-Keightly, Xian C Zhou, Megan Kummerlowe, Haris I Sair, Mario Duhon, Lawrence Kleinberg, Gary L Rosner, Tracy Vannorsdall
PURPOSE: To prospectively evaluate cognitive function and intracranial failure patterns after hippocampal-sparing prophylactic cranial irradiation (PCI) for limited-stage small cell lung cancer (SCLC). METHODS AND MATERIALS: Adults with limited-stage SCLC, achieving a complete response to chemoradiotherapy and no brain metastases, were eligible. Patients received PCI 25 Gy/10 fractions, with a mean hippocampal dose limited to <8 Gy and ≥90% of the brain receiving 90% of the prescription...
July 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28523181/surgery-after-drug-eluting-stent-implantation-it-s-not-all-doom-and-gloom
#18
EDITORIAL
Francesco Saia
Up to 15-23% of the patients with percutaneous coronary intervention (PCI) and drug-eluting stent (DES) implantation need a surgical procedure <12 months from PCI. Perioperative risk stratification in these patients is challenging and should take into account many individual clinical and anatomic variables, along with the intrinsic surgical risk for ischemic and bleeding events. The presence of DES has always been considered as a harbinger of doom. In fact, DES are associated with delayed vascular healing and require longer dual antiplatelet treatment...
April 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28515027/early-versus-delayed-invasive-strategies-in-high-risk-non-st-elevation-acute-coronary-syndrome-patients-a-systematic-literature-review-and-meta-analysis-of-randomised-controlled-trials
#19
REVIEW
Delara Javat, Clare Heal, Stefan Buchholz, Zhihua Zhang
RATIONALE: It is unclear whether it is beneficial to perform angiography and/or percutaneous coronary intervention (PCI) as an early or delayed invasive strategy amongst high-risk non-ST elevation acute coronary syndrome (NSTEACS) patients. OBJECTIVE: To determine whether an early invasive strategy could further reduce recurrent myocardial infarction (MI) and early mortality compared to a delayed invasive strategy. METHODS AND RESULTS: We searched MEDLINE, CINAHL and SCOPUS and performed a meta-analysis of nine RCTs with a total of 5274 patients...
April 11, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28498644/early-versus-late-percutaneous-revascularization-in-patients-hospitalized-with-non-st-segment-elevation-myocardial-infarction-the-atherosclerosis-risk-in-communities-surveillance-study
#20
Sameer Arora, Kunihiro Matsushita, Arman Qamar, R Brandon Stacey, Melissa C Caughey
BACKGROUND: Current guidelines recommend early invasive intervention (<24 hr) for high risk patients with non-ST-segment elevation myocardial infarction (NSTEMI). A delayed invasive strategy (24-72 hr) is considered reasonable for low risk patients. The real-world effectiveness of this strategy is unknown. METHODS: The ARIC Study has conducted hospital surveillance of acute myocardial infarction (MI) since 1987. NSTEMI was classified using a validated algorithm...
May 12, 2017: Catheterization and Cardiovascular Interventions
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