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https://www.readbyqxmd.com/read/29242062/rationale-and-design-of-the-sail-trial-for-intramuscular-injection-of-allogeneic-mesenchymal-stromal-cells-in-no-option-critical-limb-ischemia
#1
Joep G J Wijnand, Martin Teraa, Hendrik Gremmels, Femke C C van Rhijn-Brouwer, Gert J de Borst, Marianne C Verhaar
BACKGROUND: Critical limb ischemia (CLI) represents the most severe form of peripheral artery disease and has an immense impact on quality of life, morbidity, and mortality. A considerable proportion of CLI patients are ineligible for revascularization, leaving amputation as the only option. Mesenchymal stromal cells (MSCs), because of their vasculoregenerative and immunomodulatory characteristics, have emerged as a potential new treatment. METHODS: The primary objective of this trial is to investigate whether intramuscular administration of allogeneic bone marrow (BM)-derived MSCs is safe and potentially effective...
December 11, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29242033/the-evidence-and-rationale-for-the-perioperative-use-of-loop-diuretics-during-kidney-transplantation-a-comprehensive-review
#2
REVIEW
Shaifali Sandal, Pannya Bansal, Marcelo Cantarovich
PURPOSE: Loop diuretics (LD) attenuate ischemic injury in nephrons. They are thought to decrease delayed graft function (DGF) during kidney transplantation (KT). This review aimed to summarize the current evidence for the perioperative use of LD during KT. METHODS: We performed an analysis of all articles that were published since the inception of Medline and Embase: 26 studies were selected for inclusion. Scope was LD use during the perioperative phase of KT only...
November 23, 2017: Transplantation Reviews
https://www.readbyqxmd.com/read/29239459/ischemic-left-ventricle-systolic-dysfunction-an-evidence-based-approach-in-diagnostic-tools-and-therapeutics
#3
Eduardo Gomes Lima, Felipe Pereira Câmara de Carvalho, Jaime Paula Pessoa Linhares Filho, Fabio Grunspun Pitta, Carlos Vicente Serrano
Coronary artery disease (CAD) associated with left ventricular systolic dysfunction is a condition related to poor prognosis. There is a lack of robust evidence in many aspects related to this condition, from definition to treatment. Ischemic cardiomyopathy is a spectrum ranging from stunned myocardium associated with myocardial fibrosis to hibernating myocardium and repetitive episodes of ischemia. In clinical practice, relevance lies in identifying the myocardium that has the ability to recover its contractile reserve after revascularization...
September 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/29227414/the-diagnostic-process-of-stable-angina-still-many-doubts-since-heberden-s-first-description-250-years-ago
#4
Irene Raso, Ilaria Passarelli, Gioacchino Valenti, Gabriele Crimi, Stefano de Servi
: Since Heberden's first description, stable angina has represented a challenge for the clinicians. Even the most recent guidelines seem ineffective to correctly identify patients who should be sent to cath labs. Still too many patients who undergo coronary angiography are found not to have significant lesions; moreover, its extensive use as the first diagnostic test leads to revascularizations with uncertain appropriateness and prognostic significance. These considerations underline the importance of noninvasive testing before sending patients to invasive coronary angiography...
December 8, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29226578/ischemia-reperfusion-injury-and-ischemic-post-conditioning-in-acute-myocardial-infarction-lost-in-translation
#5
EDITORIAL
Gennaro Giustino, George D Dangas
Ischemic post-conditioning (IPoC) has been proposed as a strategy to mitigate the risk of ischemia-reperfusion injury during primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). In this comprehensive and updated meta-analysis of randomized controlled trials, IPoC during primary PCI for STEMI had no significant effect on all-cause mortality, re-infarction, or new-onset heart failure compared with no post-conditioning. Further strategies need to be prospectively evaluated to improve outcomes in patients with STEMI undergoing primary PCI...
December 1, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29226477/cell-therapy-for-critical-limb-ischemia-an-integrated-review-of-pre-clinical-and-clinical-studies
#6
REVIEW
Mohammad Qadura, Daniella C Terenzi, Subodh Verma, Mohammed Al-Omran, David A Hess
Critical limb ischemia (CLI), the most severe form of peripheral artery disease, is characterized by pain at rest and non-healing ulcers in the lower extremities. For patients with CLI, where the extent of atherosclerotic artery occlusion is too severe for surgical bypass or percutaneous interventions, limb amputation remains the only treatment option. Thus, cell-based therapy to restore perfusion and promote wound healing in patients with CLI is under intense investigation. Despite promising preclinical studies in animal models, transplantation of bone marrow (BM) derived cell populations in patients with CLI has shown limited benefit preventing limb amputation...
December 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29222229/visual-aids-for-patient-family-and-physician-decision-making-about-endovascular-thrombectomy-for-acute-ischemic-stroke
#7
Ivie Tokunboh, Marta Vales Montero, Matheus Fellipe Zopelaro Almeida, Latisha Sharma, Sidney Starkman, Viktor Szeder, Reza Jahan, David Liebeskind, Nestor Gonzalez, Andrew Demchuk, Michael T Froehler, Mayank Goyal, Maarten G Lansberg, Helmi Lutsep, Lee Schwamm, Jeffrey L Saver
BACKGROUND AND PURPOSE: Rapid decision making optimizes outcomes from endovascular thrombectomy for acute cerebral ischemia. Visual displays facilitate swift review of potential outcomes and can accelerate decision processes. METHODS: From patient-level, pooled randomized trial data, 100 person-icon arrays (Kuiper-Marshall personographs) were generated showing beneficial and adverse effects of endovascular thrombectomy for patients with acute cerebral ischemia and large vessel occlusion using (1) automated (algorithmic) and (2) expert-guided joint outcome table specification...
December 8, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29217675/ten-year-mortality-in-the-wise-study-women-s-ischemia-syndrome-evaluation
#8
Tanya S Kenkre, Pankaj Malhotra, B Delia Johnson, Eileen M Handberg, Diane V Thompson, Oscar C Marroquin, William J Rogers, Carl J Pepine, C Noel Bairey Merz, Sheryl F Kelsey
BACKGROUND: The WISE study (Women's Ischemia Syndrome Evaluation) was a prospective cohort study of 936 clinically stable symptomatic women who underwent coronary angiography to evaluate symptoms and signs of ischemia. Long-term mortality data for such women are limited. METHODS AND RESULTS: Obstructive coronary artery disease (CAD) was defined as ≥50% stenosis on angiography by core laboratory. We conducted a National Death Index search to assess the mortality of women who were alive at their final WISE contact date...
December 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29217001/long-term-safety-and-efficacy-of-platinum%C3%A2-chromium-everolimus-eluting-stents-in-coronary-artery-disease-5-year-results-from-the-platinum-trial
#9
Christopher R Kelly, Paul S Teirstein, Ian T Meredith, Bruno Farah, Christophe L Dubois, Robert L Feldman, Joseph Dens, Nobuhisa Hagiwara, Abram Rabinowitz, Didier Carrié, Vincent Pompili, Alain Bouchard, Shigeru Saito, Dominic J Allocco, Keith D Dawkins, Gregg W Stone
OBJECTIVES: The authors sought to evaluate the final 5-year safety and effectiveness of the platinum-chromium everolimus-eluting stent (PtCr-EES) in the randomized trial, as well as in 2 single-arm substudies that evaluated PtCr-EES in small vessels (diameter <2.5 mm; n = 94) and long lesions (24 to 34 mm; n = 102). BACKGROUND: In the multicenter, randomized PLATINUM (PLATINUM Clinical Trial to Assess the PROMUS Element Stent System for Treatment of De Novo Coronary Artery Lesions), the PtCr-EES was noninferior to the cobalt-chromium everolimus-eluting stent (CoCr-EES) at 1 year in 1,530 patients undergoing percutaneous coronary intervention...
December 11, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29205487/the-impact-of-unfractionated-heparin-or-bivalirudin-on-patients-with-stable-coronary-artery-disease-undergoing-percutaneous-coronary-intervention
#10
Fabio V Lima, Luis Gruberg, Usman Aslam, Melissa Ramgadoo, Kydanis Clase, Alessandra Trevisan, Allen Jeremias
OBJECTIVES: To compare bleeding and clinical events of patients with stable angina or silent ischemia undergoing percutaneous coronary intervention (PCI) treated with unfractionated heparin (UFH) or bivalirudin. BACKGROUND: Few direct comparisons between UFH monotherapy versus bivalirudin exist for patients with stable ischemic heart disease undergoing PCI. METHODS: A prospective, investigator-initiated, single-center, single-blinded, randomized trial of UFH versus bivalirudin was conducted...
December 4, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29201378/time-to-re-think-the-use-of-dobutamine-in-sepsis
#11
Ryota Sato, Michitaka Nasu
Dobutamine is commonly used worldwide and included in the protocol for early goal-directed therapy (EGDT). Since the use of dobutamine in EGDT was reported, it has been considered to be an important component, especially in the treatment of septic patients with myocardial dysfunction. However, it is questionable whether dobutamine improves the mortality of sepsis and septic shock. In three recent randomized controlled trials (ProCESS, ProMISe, and ARISE trials), the frequency of dobutamine use was significantly higher in the EGDT group than in the standard care group, but there were no significant differences in the mortality between the groups...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/29189828/-coronary-revascularization-in-patients-with-st-elevation-myocardial-infarction-and-multivessel-disease
#12
Giulia Bugani, Valerio Lanzillotti, Elisa Filippini, Giuseppe Di Pasquale, Gianluca Campo
Forty to 60% of ST-elevation myocardial infarction (STEMI) patients present with multivessel coronary artery disease, identified during primary percutaneous coronary intervention (pPCI) of the culprit lesion. At present, data about revascularization of non-culprit coronary lesions are conflicting. Nevertheless, patients with multivessel coronary artery disease have a worse outcome. Recently, several randomized controlled trials and meta-analyses compared a strategy of culprit-only revascularization vs complete revascularization (during pPCI or staged PCI of the non-culprit lesion)...
December 2017: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29187908/interleukin-6-mediates-post-infarct-repair-by-cardiac-explant-derived-stem-cells
#13
Audrey E Mayfield, Pushpinder Kanda, Alex Nantsios, Sandrine Parent, Seth Mount, Somya Dixit, Bin Ye, Richard Seymour, Duncan J Stewart, Darryl R Davis
Although patient-sourced cardiac explant-derived stem cells (EDCs) provide an exogenous source of new cardiomyocytes post-myocardial infarction, poor long-term engraftment indicates that the benefits seen in clinical trials are likely paracrine-mediated. Of the numerous cytokines produced by EDCs, interleukin-6 (IL-6) is the most abundant; however, its role in cardiac repair is uncertain. In this study, a custom short-hairpin oligonucleotide lentivirus was used to knockdown IL-6 in human EDCs, revealing an unexpected pro-healing role for the cytokine...
2017: Theranostics
https://www.readbyqxmd.com/read/29173598/mechanisms-clinical-significance-and-prevention-of-cognitive-impairment-in-patients-with-atrial-fibrillation
#14
REVIEW
Lena Rivard, Paul Khairy
Atrial fibrillation (AF) and dementia are major health issues, with growing evidence suggesting a consistent association between AF and all forms of dementia. Although dementia and AF share several risk factors, the association appears to be independent of a history of clinical stroke and other comorbidities such as hypertension, heart failure, and diabetes. Proposed mechanisms linking AF to cognitive decline include altered hemodynamics resulting in cerebral hypoperfusion, inflammation, genetic factors, and silent cerebral ischemia due to subclinical microemboli...
December 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29171362/complications-of-endovascular-treatment-for-acute-ischemic-stroke-prevention-and-management
#15
Joyce S Balami, Philip M White, Peter J McMeekin, Gary A Ford, Alastair M Buchan
Endovascular mechanical thrombectomy (MT) for the treatment of acute stroke due to large vessel occlusion has evolved significantly with the publication of multiple positive thrombectomy trials. MT is now a recommended treatment for acute ischemic stroke. Mechanical thrombectomy is associated with a number of intra-procedural or post-operative complications, which need to be minimized and effectively managed to maximize the benefits of thrombectomy. Procedural complications include: access-site problems (vessel/nerve injury, access-site hematoma and groin infection); device-related complications (vasospasm, arterial perforation and dissection, device detachment/misplacement); symptomatic intracerebral hemorrhage; subarachnoid hemorrhage; embolization to new or target vessel territory...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29171198/ischemia-based-coronary-revascularization-beyond-anatomy-and-fractional-flow-reserve
#16
REVIEW
Hong Seok Lim, Kyoung Woo Seo, Myeong Ho Yoon, Hyoung Mo Yang, Seung Jea Tahk
Treatment strategies for patients with coronary artery disease (CAD) should be based on objective evidence of inducible ischemia in the subtended myocardium to improve clinical outcomes, symptoms, and cost-effectiveness. Fractional flow reserve (FFR) is the most verified index to-date for invasively evaluating lesion-specific myocardial ischemia. Favorable results from large clinical trials that applied FFR-guided percutaneous coronary intervention (PCI) prompted changes in coronary revascularization guidelines to emphasize the importance of this ischemia-based strategy using invasive coronary physiology...
November 6, 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/29169500/1-year-results-of-a-multicenter-randomized-controlled-trial-comparing-heparin-bonded-endoluminal%C3%A2-to-femoropopliteal-bypass
#17
Michel M P J Reijnen, Laurens A van Walraven, Wilbert M Fritschy, Mare M A Lensvelt, Clark J Zeebregts, M Suzanna Lemson, Otmar R M Wikkeling, Luuk Smeets, Suzanne Holewijn
OBJECTIVES: This study sought to compare heparin-bonded endografts with femoropopliteal bypass, including quality of life, using general health and disease-specific questionnaires as well as patency rates. BACKGROUND: Endovascular treatment continues to advance and is gaining acceptance as primary treatment for long occlusive or stenotic lesions in the superficial femoral artery. Heparin-bonded expanded polytetrafluoroethylene endografts have been related to outcomes comparable to bypass surgery, but this has not been tested in a randomized fashion...
November 27, 2017: JACC. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29166720/-long-term-safety-and-efficacy-of-a-novel-abluminal-groove-filled-biodegradable-polymer-sirolimus-eluting-stent-for-the-treatment-of-coronary-de-novo-lesions
#18
C J Li, B Xu, C D Guan, R L Gao
Objective: To compare the long term safety and efficacy of the novel abluminal groove-filled biodegradable polymer sirolimus-eluting stent(Firehawk stent) and permanent polymer coating everolimus eluting stent(Xience V stent) for the treatment of coronary de novo lesions. Methods: This prospective, multi-center, non-inferiority, randomized control trial(TARGETⅠ trial) was performed between August 2010 and April 2011, a total of 460 patients with primary, de novo, single vessel and single coronary lesion from 16 medical centers were enrolled...
November 24, 2017: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29158449/induced-hypertension-for-delayed-cerebral-ischemia-after-aneurysmal-subarachnoid-hemorrhage-a-randomized-clinical-trial
#19
Celine S Gathier, Walter M van den Bergh, Mathieu van der Jagt, Bon H Verweij, Jan Willem Dankbaar, Marcella C Müller, Annemarie W Oldenbeuving, Gabriel J E Rinkel, Arjen J C Slooter
BACKGROUND AND PURPOSE: Induced hypertension is widely used to treat delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage, but a literature review shows that its presumed effectiveness is based on uncontrolled case-series only. We here report clinical outcome of aneurysmal subarachnoid hemorrhage patients with DCI included in a randomized trial on the effectiveness of induced hypertension. METHODS: Aneurysmal subarachnoid hemorrhage patients with clinical symptoms of DCI were randomized to induced hypertension or no induced hypertension...
November 20, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29157293/effect-of-memantine-on-post-operative-cognitive-dysfunction-after-cardiac-surgeries-a-randomized-clinical-trial
#20
Saba Ghaffary, Padideh Ghaeli, Azita Hajhossein Talasaz, Abbasali Karimi, Maryam Noroozian, Abbas Salehiomran, Arash Jalali
BACKGROUND: Post-operative cognitive dysfunction (POCD) is an important complication of cardiac surgeries. Glutamate plays a critical role in physiologic and pathologic conditions in the brain. Due to the role of glutamate in ischemia, this study is designed to identify the effect of memantine in prevention of POCD early and late after cardiac surgeries. METHODS: In this randomized clinical trial, 172 patients with ages 45-75 years old who underwent elective cardiac surgery were enrolled...
November 21, 2017: Daru: Journal of Faculty of Pharmacy, Tehran University of Medical Sciences
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