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https://www.readbyqxmd.com/read/29096903/-management-of-high-thrombus-burden-in-primary-pci
#1
L Mangin, M Lotfi, P Puie, K Yayehd, A Ispas, L Belle
A large thrombus burden is not uncommon in primary percutaneous coronary intervention, and is associated with more frequent complications. The role of intracoronary thrombolysis and glycoprotein IIb/IIIa inhibitors in the management of a large thrombus burden is discussed. The use of thromboaspiration must follow a particular logic and used with rigorous manipulations; the capacities of the protective filters are often exceeded. Stents dedicated to thrombus management can be used. Interest and limits of these stents are developed...
October 30, 2017: Annales de Cardiologie et D'angéiologie
https://www.readbyqxmd.com/read/29089969/patients-with-st-segment-elevation-of-myocardial-infarction-miss-out-on-early-reperfusion-when-to-undergo-delayed-revascularization
#2
Wen Zheng, Cheuk-Man Yu, Jing Liu, Wu-Xiang Xie, Miao Wang, Yu-Jiao Zhang, Jian Sun, Shao-Ping Nie, Dong Zhao
OBJECTIVE: There are still a high proportion of patients with ST-segment elevation myocardial infarction (STEMI) missing out early reperfusion even in the primary percutaneous coronary intervention (PCI) era. Most of them are stable latecomers, but the optimal time to undergo delayed PCI for stable ones remains controversial. METHODS: We investigated all STEMI patients who underwent delayed PCI (2-28 days after STEMI) during 2007-2010 in Beijing and excluded patients with hemodynamic instability...
August 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/29072379/-early-rather-than-immediate-pci-in-nstemi-is-time-equal-to-muscle-once-again
#3
Shemy Carasso, Ali Nassar, Fabio Kuzniec, Yevgeni Hazanov, Nabeeh Salman, Yussra Halhla, Offer Amir, Diab Ghanem
BACKGROUND: Current guidelines advocate immediate vs. non-immediate percutaneous coronary intervention (PCI) strategy in ST elevation vs. non ST elevation myocardial infarction (STEMI, NSTEMI). There is however increasing concern that "next-day PCI" in NSTEMI may adversely affect LV systolic and/or diastolic function and a more urgent aggressive approach should be taken in NSTEMI, similar to that in STEMI. In the current study we compared echocardiographic data between patients with STEMI and NSTEMI who had either primary or early PCI respectively...
October 2017: Harefuah
https://www.readbyqxmd.com/read/29067927/observational-study-comparing-pharmacoinvasive-strategy-with-primary-percutaneous-coronary-intervention-in-patients-presenting-with-st-elevation-myocardial-infarction-to-a-tertiary-care-centre-in-india
#4
A G Alex, A Lahiri, T Geevar, O K George
OBJECTIVE: The objective was to study whether the incidence of composite end points (mortality, cardiogenic shock and re-myocardial infarction [re-MI]) in pharmacoinvasive strategy was noninferior to primary percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). METHODS: This was an observational study which included 138 patients. The study included patients admitted with a diagnosis of STEMI within 24 h of symptom onset, who underwent primary PCI or pharmacoinvasive therapy in a single center over a 9-month period...
October 23, 2017: Journal of Postgraduate Medicine
https://www.readbyqxmd.com/read/29054183/appropriateness-of-elective-percutaneous-coronary-intervention-and-impact-of-government-health-insurance-scheme-a-tertiary-centre-experience-from-western-india
#5
Devendra Patil, Charan Lanjewar, Goutam Vaggar, Juhi Bhargava, Girish Sabnis, Jivtesh Pahwa, Ankur Phatarpekar, Hetan Shah, Prafulla Kerkar
BACKGROUND: There is a dearth of data regarding the appropriateness of elective percutaneous coronary intervention (PCI) in a limited-resource country such as India. In an attempt to rationalise the use of PCI, Appropriate Use Criteria (AUC) were developed for cardiovascular care in the USA. In the Indian context, considering the high prevalence of coronary artery disease, the dramatic rise in the number of revascularization procedures and an increasing role of government/private reimbursements, application of AUC could potentially guide policy to optimize the utilization of resources and the benefit-risk ratio for individual patients...
September 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/29046319/effect-of-intravenous-fentanyl-on-ticagrelor-absorption-and-platelet-inhibition-among-patients-undergoing-percutaneous-coronary-intervention-the-pacify-randomized-clinical-trial
#6
John W McEvoy, Khalil Ibrahim, Thomas S Kickler, William A Clarke, Rani K Hasan, Matthew J Czarny, Ali R Keramati, Rakesh R Goli, Travis P Gratton, Jeffrey A Brinker, Matthews Chacko, Chao-Wei Hwang, Peter V Johnston, Julie M Miller, Jeffrey C Trost, William R Herzog, Roger S Blumenthal, David R Thiemann, Jon R Resar, Steven P Schulman
Fentanyl is a potent opiate commonly administered during cardiac catheterization procedures in North America. The question of whether fentanyl could have adverse consequences in patients undergoing percutaneous coronary intervention (PCI) is raised by recent research demonstrating that intravenous morphine significantly delays the absorption of oral P2Y12 platelet inhibitors. The presumed mechanism is slowed gastric emptying. The single-center Platelet Aggregation with tiCagrelor Inhibition and FentanYl (PACIFY) trial randomized adults undergoing clinically-indicated elective coronary angiography to receive the procedure with or without intravenous fentanyl (NCT02683707)...
October 18, 2017: Circulation
https://www.readbyqxmd.com/read/29026706/development-of-novel-drug-eluting-stents-for-acute-myocardial-infarction
#7
REVIEW
Doo Sun Sim, Myung Ho Jeong
Delayed arterial healing at culprit sites after drug-eluting stent (DES) placement for acute myocardial infarction (AMI) is associated with increased risk of late stent thrombosis. The Korea Acute Myocardial Infarction Registry was established in commemoration of the 50(th) anniversary of Korea Circulation Society. Between November 2005 and December 2016, more than 62,000 patients were registered from 50 primary percutaneous coronary intervention (PCI) centers in Korea. DES in AMI may be safe and effective, however, there is concern about increased stent thrombosis after DES implantation in AMI patients, requiring longer-term dual anti-platelet therapy to reduce the risk of late stent thrombosis...
September 2017: Chonnam Medical Journal
https://www.readbyqxmd.com/read/28964609/multicentric-initial-experience-with-the-use-of-the-pressurized-intraperitoneal-aerosol-chemotherapy-pipac-in-the-management-of-unresectable-peritoneal-carcinomatosis
#8
Mohammad Alyami, Johan Gagniere, Olivia Sgarbura, Delphine Cabelguenne, Laurent Villeneuve, Denis Pezet, Francois Quenet, Olivier Glehen, Naoual Bakrin, Guillaume Passot
BACKGROUND: PIPAC is a recent approach for intraperitoneal chemotherapy with promising results for patients with peritoneal carcinomatosis (PC). We aimed to evaluate the postoperative outcome of PIPAC in patients with non-resectable PC during our initial experience of the technique. METHODS: All patients who underwent PIPAC for non-resectable PC in three centers were analyzed regarding postoperative outcomes. RESULTS: Seventy-three patients underwent 164 PIPAC...
September 21, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28942868/gender-differences-in-the-management-of-acute-coronary-syndrome-patients-one-year-results-from-hpiar-hp-india-acs-registry
#9
Kunal Mahajan, Prakash Chand Negi, Rajeev Merwaha, Nitin Mahajan, Vivek Chauhan, Sanjeev Asotra
INTRODUCTION: Data from high-income countries suggest that women receive less intensive diagnostic and therapeutic management than men for acute coronary syndrome (ACS). There is a paucity of such data in the Indian population, which is 69% rural and prior studies focused mostly on urban populations. The objective of the present study was to identify the gender based differences in ACS management, if any, in a predominantly rural population. METHODS: Data from 35 hospitals across Himachal Pradesh covering >90% of state population were collected for one year (July 2015-June 2016)...
December 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28927193/timing-of-percutaneous-coronary-intervention-in-patients-with-non-st-elevation-myocardial-infarction-a-swedeheart-study
#10
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
#11
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
#12
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
#13
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
#14
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
#15
EDITORIAL
Paul W Armstrong, Robert C Welsh
No abstract text is available yet for this article.
October 17, 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
#16
RANDOMIZED CONTROLLED TRIAL
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...
October 17, 2017: Circulation
https://www.readbyqxmd.com/read/28836970/comprehensive-comparison-of-three-different-animal-models-for-systemic-inflammation
#17
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
#18
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
#19
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)...
October 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
#20
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
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