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https://www.readbyqxmd.com/read/27836132/gender-differences-in-associations-between-intraprocedural-thrombotic-events-during-percutaneous-coronary-intervention-and-adverse-outcomes
#1
Mikkel M Schoos, Roxana Mehran, George D Dangas, Jennifer Yu, Usman Baber, Peter Clemmensen, Frederick Feit, Bernard J Gersh, Giulio Guagliumi, E Magnus Ohman, Stuart J Pocock, Bernhard Witzenbichler, Gregg W Stone
Women are frequently reported to have increased morbidity after presentation with acute coronary syndromes and myocardial infarction; however, whether a greater thrombotic tendency contributes to gender differences in clinical outcomes of urgent percutaneous coronary intervention is unknown. Intraprocedural Thrombotic Events (IPTEs) are defined as new or increasing thrombus, abrupt vessel closure, no reflow or slow reflow, or distal embolization at any time during percutaneous coronary intervention. IPTEs were evaluated in this pooled analysis of 6,591 patients with stent implantation and blinded quantitative coronary angiography (QCA) analysis, from the ACUITY and HORIZONS-AMI trials...
October 11, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27475844/efficacy-and-safety-of-thrombectomy-combined-with-intracoronary-administration-of-tirofiban-in-st-segment-elevation-myocardial-infarction-stemi
#2
Lu Gao, Zhenhua Cao, Hong Zhang
BACKGROUND No/slow reflow gives rise to serious complications in STEMI patients undergoing PCI, and can lead to worse outcomes. Several measures are used to prevent no/slow reflow, including thrombus removal processes and intensive use of anticoagulant agents. Our study was designed to evaluate the efficacy and safety of thrombectomy and intracoronary administration of GPIIb/IIIa inhibitors in STEMI patients undergoing PPCI. MATERIAL AND METHODS We randomly assigned 240 STEMI patients into 3 groups. Before PPCI, patients in group A received thrombectomy and intracoronary administration of tirofiban...
2016: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/27249789/effect-of-intracoronary-nitroprusside-injection-time-point-on-flow-recovery-during-primary-percutaneous-coronary-intervention-in-patients-with-st-elevation-acute-myocardial-infarction
#3
Lixia Yang, Lihua Mu, Linhui Sun, Feng Qi, Ruiwei Guo
BACKGROUND: The no/slow reflow phenomenon during primary percutaneous coronary intervention (PPCI) causes the destruction of the coronary microcirculation and further myocardial damage. Some studies have shown that intracoronary nitroprusside infusion is a safe and effective method for managing the no/slow reflow phenomenon. However, it is uncertain whether the injection of nitroprusside at a specific time point during PPCI can most effectively prevent no-reflow. In this study, we investigated the effect of the timing of an intracoronary nitroprusside injection on flow recovery during PPCI in patients with ST elevation acute myocardial infarction (STEMI)...
June 1, 2016: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/27122896/early-administration-of-intracoronary-nitroprusside-compared-with-thrombus-aspiration-in-myocardial-perfusion-for-acute-myocardial-infarction-a-3-year-clinical-follow-up-study
#4
Wei-Chieh Lee, Shyh-Ming Chen, Chu-Feng Liu, Chien-Jen Chen, Wen-Jung Chung, Shu-Kai Hsueh, Tzu-Hsien Tsai, Hsiu-Yu Fang, Hon-Kan Yip, Chi-Ling Hang
BACKGROUND: Intracoronary nitroprusside and thrombus aspiration have been demonstrated to improve myocardial perfusion during percutaneous coronary interventions (PCI) for ST-segment elevation acute myocardial infarction (STEMI) However, no long-term clinical studies have been performed comparing these approaches. METHODS: A single medical center retrospective study was conducted to evaluate the effects of intracoronary nitroprusside administration before slow/no-reflow phenomena versus thrombus aspiration during primary PCI...
September 2015: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27076950/impact-of-attenuated-plaques-on-timi-grade-flow-and-clinical-outcomes-of-coronary-artery-disease-patients-a-systematic-review-and-meta-analysis
#5
Ruofei Jia, Xiaolu Nie, Hong Li, Huagang Zhu, Lianmei Pu, Xiang Li, Jing Han, Duo Yang, Shuai Meng, Zening Jin
BACKGROUND: Plaques with a large necrotic core or lipid pool and thin-cap fibroatheroma manifest as attenuated plaques on intravascular ultrasound (IVUS). Their impact on TIMI grade flow and clinical outcomes remains undefined. We performed a systematic review and meta-analysis to summarize the association between attenuated plaque and distal embolization and clinical outcomes of coronary artery disease (CAD) from pooled data of published eligible cohort studies. METHODS: We searched the literature on TIMI grade flow and clinical outcomes on PubMed, Ovid, EMBASE, the Cochrane Library, CNKI and WanFang databases...
March 2016: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/26984932/outcomes-after-orbital-atherectomy-of-severely-calcified-left-main-lesions-analysis-of-the-orbit-ii-study
#6
Michael S Lee, Evan Shlofmitz, Richard Shlofmitz, Sheila Sahni, Brad Martinsen, Jeffrey Chambers
OBJECTIVES: The ORBIT II trial reported excellent outcomes in patients with severely calcified coronary lesions treated with orbital atherectomy. Severe calcification of the left main (LM) artery represents a complex coronary lesion subset. This study evaluated the safety and efficacy of coronary orbital atherectomy to prepare severely calcified protected LM artery lesions for stent placement. METHODS: The ORBIT II trial was a prospective, multicenter clinical trial that enrolled 443 patients with severely calcified coronary lesions in the United States...
September 2016: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/26803422/which-intraprocedural-thrombotic-events-impact-clinical-outcomes-after-percutaneous-coronary-intervention-in-acute-coronary-syndromes-a-pooled-analysis-of-the-horizons-ami-and-acuity-trials
#7
Jeffrey D Wessler, Philippe Généreux, Roxana Mehran, Girma Minalu Ayele, Sorin J Brener, Margaret McEntegart, Ori Ben-Yehuda, Gregg W Stone, Ajay J Kirtane
OBJECTIVES: This study sought to determine the extent to which individual components of intraprocedural thrombotic events (IPTEs) are associated with adverse events. BACKGROUND: IPTEs occurring during percutaneous coronary intervention (PCI) are associated with adverse in-hospital and late outcomes in patients with acute coronary syndromes. METHODS: A total of 6,591 patients who underwent PCI for non-ST-segment elevation acute coronary syndromes/ST-segment elevation myocardial infarction in the ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) and HORIZONS-AMI (Harmonizing Outcomes with RevascularIZatiON and Stents in Acute Myocardial Infarction) trials underwent detailed frame-by-frame core laboratory angiographic analysis to assess for IPTEs...
February 22, 2016: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/26474832/deferred-vs-immediate-stenting-in-st-elevation-myocardial-infarction-potential-interest-in-selected-patients
#8
COMPARATIVE STUDY
Brahim Harbaoui, Pierre-Yves Courand, Cyril Besnard, Raphael Dauphin, Emmanuel Cassar, Pierre Lantelme
BACKGROUND: Slow flow, no reflow and distal embolization often occur during primary angioplasty in ST segment elevation myocardial infarction (STEMI), compromising optimal myocardial reperfusion. AIMS: This study aimed at assessing the impact of deferred stenting (DS) on periprocedural events as compared to immediate stenting (IS). The second objective was to gather the reasons advocated by the physicians for deferring stenting. METHODS: All consecutive patients referred for primary angioplasty were included between September 2010 and November 2011...
November 2015: La Presse Médicale
https://www.readbyqxmd.com/read/26393231/evaluation-of-the-clinical-and-procedural-predictive-factors-of-no-reflow-phenomenon-following-primary-percutaneous-coronary-intervention
#9
Seifollah Abdi, Omid Rafizadeh, Mohammadmehdi Peighambari, Hoseinali Basiri, Hooman Bakhshandeh
BACKGROUND: The no-reflow phenomenon is an uncommon and critical occurrence which myocardial reperfusion does not restore to its optimal level. Several predisposing factors of the no-reflow phenomenon have been identified. However, at present we know little about clinical predictors of no-reflow after percutaneous coronary intervention (PCI). OBJECTIVES: In this study, we evaluated clinical predictors of no-reflow phenomenon after PCI in patients with acute STEMI, to plan a better treatment of these patients...
May 2015: Research in Cardiovascular Medicine
https://www.readbyqxmd.com/read/26156698/-mguard-dacron-mesh-covered-stent-implantation-in-patients-with-st-elevation-myocardial-infarction-and-high-thrombotic-burden-in-hospital-and-long-term-outcome-in-a-single-high-volume-center
#10
Enrico Cerrato, Cristina Rolfo, Francesco Tomassini, Nicolò Montali, Alfonso Gambino, Vincenzo Infantino, Sara Palacio Restrepo, Denise Baricocchi, Rosa Nevola, Andrea Gagnor, Ferdinando Varbella
BACKGROUND: The MGuard (MG) is a stainless-steel closed cell stent covered with an ultra-thin polymer mesh sleeve, which has the purpose of ensuring reduced distal embolization of thrombotic material, thus lowering the risk of no-reflow/slow-flow phenomena. Only few data are available that evaluated the usefulness of the MG stent in patients with ST-elevation myocardial infarction (STEMI) with a high thrombotic burden. METHODS: We prospectively collected data of patients presenting with STEMI and high thrombotic burden (thrombus burden grade 4 or 5 according to the TIMI score) who underwent primary percutaneous coronary intervention (PCI) with MG stent implantation in our center...
June 2015: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/26086864/risk-of-no-reflow-in-culprit-lesion-versus-culprit-vessel-pci-in-acute-stemi
#11
MULTICENTER STUDY
Uğur Arslan, Mehmet Yaman, İbrahim Kocaoğlu, Oğuzhan Ekrem Turan, Huriye Yücel, Aytekin Aksakal, İlksen Atasoy Günaydin, Ahmet Hakan Ateş
OBJECTIVES: The present report describes patients with acute ST-elevation myocardial infarction who had at least two lesions in the culprit vessel (CV) during primary percutaneous coronary intervention (PCI). Here, we aimed to examine two different strategies, namely, PCI of only culprit lesion (CL) versus PCI of all lesions in the CV in the setting of acute ST-elevation myocardial infarction. PATIENTS AND METHODS: Patients who underwent primary PCI were examined for the presence of an additional lesion in the infarct-related artery and divided into two groups according to the PCI strategy: CV versus CL groups...
September 2015: Coronary Artery Disease
https://www.readbyqxmd.com/read/25697877/presence-of-myocardial-hypoenhancement-on-multidetector-computed-tomography-after-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction-predicts-poor-prognosis
#12
Shinyu Ogasawara, Hiroaki Mukawa, Takahito Sone, Hideyuki Tsuboi, Itsuro Morishima, Michitaka Uesugi, Etsushi Matsushita, Yasuhiro Morita, Kenji Okumura, Toyoaki Murohara
BACKGROUND: Recent research has suggested that patients with greater delayed contrast-enhanced size by multidetector computed tomography (MDCT) are more likely to experience adverse cardiac events and have poor prognoses over the long term. The myocardial hypoenhancement area in the delayed contrast-enhanced effect suggests microvascular obstruction. The outcomes of patients with a hypoenhancement area detected by MDCT have not been clear. We examined the clinical importance of myocardial hypoenhancement detected by delayed contrast-enhanced MDCT after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction...
April 1, 2015: International Journal of Cardiology
https://www.readbyqxmd.com/read/25563622/bioresorbable-vascular-scaffolds-in-patients-with-acute-coronary-syndromes-the-polar-acs-study
#13
COMPARATIVE STUDY
Dariusz Dudek, Łukasz Rzeszutko, Wojciech Zasada, Rafał Depukat, Zbigniew Siudak, Andrzej Ochała, Wojciech Wojakowski, Tadeusz Przewłocki, Krzysztof Żmudka, Janusz Kochman, Andrzej Lekston, Mariusz Gąsior
INTRODUCTION: The results of the ABSORB trial showed the efficacy and safety of bioresorbable vascular scaffolds (BVS) and their unique advantage, namely, the restoration of vasomotion after full biodegradation. OBJECTIVES: The aim of the registry was to evaluate procedural issues, angiographic results, and clinical outcomes of patients with acute coronary syndrome (ACS) treated with BVS implantation. PATIENTS AND METHODS: The study included 100 patients...
2014: Polskie Archiwum Medycyny Wewnętrznej
https://www.readbyqxmd.com/read/25489304/slow-flow-phenomenon-after-elective-percutaneous-coronary-intervention-of-computed-tomography-detected-vulnerable-coronary-lesion
#14
Rafał Wolny, Artur Dębski, Mariusz Kruk, Cezary Kępka
No-reflow or slow-flow phenomenon is one of the serious complications of percutaneous coronary interventions (PCI) in acute myocardial infarction, as well as during elective procedures, and is an independent predictor of myocardial infarction, and in-hospital and long-term mortality. We present a case of an elective PCI of native coronary artery lesion that was assessed to be vulnerable based on coronary computed tomography angiography, complicated with slow-flow phenomenon.
2014: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
https://www.readbyqxmd.com/read/25465924/impact-of-thrombus-burden-on-outcomes-after-standard-versus-mesh-covered-stents-in-acute-myocardial-infarction-from-the-mguard-for-acute-st-elevation-reperfusion-trial
#15
RANDOMIZED CONTROLLED TRIAL
Ricardo A Costa, Alexandre Abizaid, Chaim Lotan, Dariusz Dudek, Sigmund Silber, Jose M Dizon, Akiko Maehara, Ovidiu Dressler, Sorin J Brener, Gregg W Stone
Large thrombus burden negatively affects the results of percutaneous coronary intervention (PCI) for acute ST-segment elevation myocardial infarction (STEMI). We investigated the impact of thrombus burden in patients with STEMI undergoing primary PCI with the mesh-covered MGuard stent (InspireMD Ltd., Tel Aviv, Israel) versus a control bare-metal or drug-eluting stent. In 433 patients with STEMI randomized to the MGuard stent versus a control stent, angiographically visible thrombus was identified in 383 patients (88...
January 15, 2015: American Journal of Cardiology
https://www.readbyqxmd.com/read/25444760/effects-of-eicosapentaenoic-acid-on-peri-procedural-type-iva-myocardial-infarction-following-elective-coronary-stenting
#16
Akiyoshi Kurita, Hiroaki Takashima, Hirohiko Ando, Soichiro Kumagai, Katsuhisa Waseda, Masahiko Gosho, Tetsuya Amano
OBJECTIVES: The aim of this study was to assess the effect of eicosapentaenoic acid (EPA) on peri-procedural (type IVa) myocardial infarction (MI) following elective percutaneous coronary intervention (PCI). METHODS AND RESULTS: We analyzed data from 165 of 178 consecutive patients with stable angina pectoris who underwent de novo successful stent implantation in the native coronary artery. Patients were assigned to receive statin therapy in combination with 1800mg/day of EPA or statin alone...
August 2015: Journal of Cardiology
https://www.readbyqxmd.com/read/25393956/free-radical-scavengers-improve-liver-function-but-not-morphological-changes-induced-by-reperfusion-injury
#17
Hossein-Ali Arab, Neal I Walker, Kee Cheung, Peter E Hickman, Jolia M Potter, Mehri Kadkhodaee, Michael S Roberts
OBJECTIVE: Reperfusion injury (RI) is associated with high generation of reactive oxygen species (ROS), but the extent of involvement of these agents in the injury remains controversial. The present study aimed to examine the effectiveness of ROS scavengers against hepatic reperfusion injury in the rat. METHODS: The RI was induced in the liver using an isolated slow-flow, reflow perfused rat liver in both anterograde and retrograde perfusion. The effects of gentisic acid, N-acetyl cysteine, and trolox C on the superoxide production, liver function, and morphological changes were examined using different biochemical and histological assays...
April 2015: Journal of Investigative Surgery: the Official Journal of the Academy of Surgical Research
https://www.readbyqxmd.com/read/25330502/thrombus-capture-by-withdrawal-of-an-open-filter-device-a-useful-treatment-for-large-non-occlusive-coronary-thrombus
#18
Samer Arnous, Maria Agelaki, Nizar Shakhshir, Damien Kelly, Farzin Fath Ordoubadi, Mamas A Mamas, Douglas Fraser
The aim of this study was to assess the safety and feasibility of manual removal of a non-occlusive coronary thrombus using an open filter device. Between April 2006 and December 2011, 1,102 patients were treated percutaneously for acute coronary syndrome at our institution. Of these, nine (1%) had a large "cannon-ball" non-occlusive intracoronary thrombus, which did not improve with standard thrombectomy aspiration catheters. In these patients, we describe a novel technique of thrombus removal using the ev3 Spider™ filter device...
October 2014: EuroIntervention
https://www.readbyqxmd.com/read/25230304/effect-of-intracoronary-anisodamine-and-diltiazem-administration-during-primary-percutaneous-coronary-intervention-in-acute-myocardial-infarction
#19
RANDOMIZED CONTROLLED TRIAL
Yuhong Peng, Xianghua Fu, Wei Li, Wei Geng, Kun Xing, Leisheng Ru, Jiaan Sun, Yuying Zhao
OBJECTIVE: The aim of this study was to examine the role of intracoronary anisodamine and diltiazem administration performed before stenting on the immediate angiographic and clinical outcome in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI). METHODS: STEMI patients during primary PCI were randomized to two bolus injections of intracoronary anisodamine (1 mg/5 ml) and diltiazem (2 mg/5 ml) (COM group, n=54) or saline (5 ml) and diltiazem (2 mg/5 ml) (diltiazem group, n=54) before stenting...
December 2014: Coronary Artery Disease
https://www.readbyqxmd.com/read/25183306/long-term-prognostic-impact-of-the-attenuated-plaque-in-patients-with-acute-coronary-syndrome
#20
COMPARATIVE STUDY
Hiroyuki Okura, Toru Kataoka, Minoru Yoshiyama, Junichi Yoshikawa, Kiyoshi Yoshida
Several intravascular ultrasound studies have reported that culprit lesion-attenuated plaque (AP) is related to slow flow/no reflow after percutaneous coronary intervention (PCI). Long-term prognostic impact of the AP is unknown. The aim of this study was to investigate acute and long-term clinical impact of the AP in patients with acute coronary syndrome (ACS). A total of 110 ACS patients who underwent successful PCI were enrolled. Acute and long-term clinical outcomes were compared between patients with AP (AP group: n = 73) and those without AP (non-AP group: n = 37)...
January 2016: Heart and Vessels
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