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Ihab Elsokkari, Ratika Parkash, Chris J Gray, Martin J Gardner, Amir M AbdelWahab, Steve Doucette, Anthony S Tang, George A Wells, William G Stevenson, John L Sapp
BACKGROUND: Patients with ventricular tachycardia (VT) post myocardial infarction (MI) are a higher risk group with significant morbidity and mortality. We examined the impact of prior coronary revascularization on clinical outcomes in patients with ischemic cardiomyopathy (ICM) and VT. METHODS: The VANISH trial randomized 259 patients with prior MI and antiarrhythmic drug-refractory VT to receive escalated medical therapy or catheter ablation. Clinical outcomes were compared according to whether patients have undergone prior revascularization procedures...
May 11, 2018: Pacing and Clinical Electrophysiology: PACE
Elizabeth C Pino, Yi Zuo, Christina Pc Borba, David C Henderson, Bindu Kalesan
Depression and anxiety are common among patients who have a major cardiovascular event. However, despite their frequency, there is a lack of evidence regarding the relationship between depression and/or anxiety and receiving revascularization in ST-elevation myocardial infarction (STEMI) hospitalizations. Using data from the Nationwide Inpatient Sample (NIS) from the years 2004 to 2013, we assessed whether a clinical co-diagnosis of depression and/or anxiety decreases the likelihood of revascularization among STEMI hospitalizations...
March 20, 2018: Psychiatry Research
Gregorio Laguna, Salvatore DI Stefano, Laura Maroto, Enrique Fulquet, Jose R Echevarría, Ana Revilla, Noelia Urueña, Teresa Sevilla, Román Arnold, Benigno Ramos, Hipólito Gutiérrez, Ana Serrador, Jose A San Román
BACKGROUND: To assess the efficacy and safety of intramyocardial autologous bone marrow mononuclear stem cells (BMMNC) grafting combined with coronary artery bypass grafting (CABG) on ventricular remodeling and global and regional wall motion after acute transmural myocardial infarction (AMI). METHODS: Randomized controlled trial including 20 patients with non-revascularized transmural AMI, left ventricular ejection fraction (LVEF) lower than 50% and surgical indication for CABG...
April 2018: Journal of Cardiovascular Surgery
Osamu Iida, Mitsuyoshi Takahara, Yoshimitsu Soga, Nobuyoshi Azuma, Shinsuke Nanto, Masaaki Uematsu
OBJECTIVES: The authors sought to investigate the prognostic impact of revascularization for poor-risk CLI patients in real-world settings. BACKGROUND: Critical limb ischemia (CLI) is often accompanied with various comorbidities, and frailty is not rare in the population. Although previous studies suggested favorable outcomes of revascularization for CLI patients, those studies commonly included the healthier, that is, less frail patients. METHODS: This was a multicenter prospective observational study, registering patients who presented with CLI and who required assistance for their daily lives because of their disability in activities of daily living (ADL) and/or impairment of cognitive function...
June 12, 2017: JACC. Cardiovascular Interventions
Deepak Voora, Adrian Coles, Kerry L Lee, Udo Hoffmann, James A Wingrove, Brian Rhees, Lin Huang, Susan E Daniels, Mark Monane, Steven Rosenberg, Svati H Shah, William E Kraus, Geoffrey S Ginsburg, Pamela S Douglas
BACKGROUND: Identifying predictors of coronary artery disease (CAD)-related procedures and events remains a priority. METHODS: We measured an age- and sex-specific gene expression score (ASGES) previously validated to detect obstructive CAD (oCAD) in symptomatic nondiabetic patients in the PROMISE trial. The outcomes were oCAD (≥70% stenosis in ≥1 vessel or ≥50% left main stenosis on CT angiography [CTA]) and a composite endpoint of death, myocardial infarction, revascularization, or unstable angina...
February 2017: American Heart Journal
Sean D Pokorney, Amy L Miller, Anita Y Chen, Laine Thomas, Gregg C Fonarow, James A de Lemos, Sana M Al-Khatib, Eric J Velazquez, Eric D Peterson, Tracy Y Wang
BACKGROUND: Guidelines recommend that patients with low ejection fraction (EF) after myocardial infarction (MI) have their EF reassessed 40 days after MI for implantable cardioverter-defibrillator (ICD) candidacy. This study examines rates of EF reassessment and their association with 1-year ICD implantation in post-MI patients with low EF. METHODS: We examined rates of postdischarge EF reassessment and ICD implantation among 10 289 Medicare-insured patients ≥65 years of age with an EF≤35% during the index MI admission from January 2007 through September 2010 in ACTION Registry-GWTG (Acute Coronary Treatment and Intervention Outcomes Network Registry(-)Get With The Guidelines)...
January 3, 2017: Circulation
Isabella Possagnoli, Christian Bianchi, Jason Chiriano, Theodore Teruya, Vicki Bishop, Ahmed Abou-Zamzam
BACKGROUND: To evaluate the long-term outcome of patients presenting with peripheral artery disease (PAD) and tissue loss that were stratified in our limb preservation program to receive aggressive wound care without revascularization. METHODS: Veterans presenting with PAD and nonhealing wounds were prospectively enrolled into our Prevention of Amputation in Veterans Everywhere (PAVE) program. Patients were stratified according to management strategies, which include: revascularization, primary amputation, palliative limb care, and aggressive local wound care without revascularization (conservative group)...
February 2017: Annals of Vascular Surgery
Robert Ward, Joie Dunn, Leonardo Clavijo, David Shavelle, Vincent Rowe, Karen Woo
BACKGROUND: Patients presenting to a public hospital with critical limb ischemia (CLI) typically have advanced disease with significant comorbidities. The purpose of this study was to assess the influence of revascularization on 1-year amputation rate of CLI patients presenting to Los Angeles County USC Medical Center, classified according to the Society for Vascular Surgery Wound, Ischemia and foot Infection (WIfI). METHODS: A retrospective review of patients who presented to a public hospital with CLI from February 2010 to July 2014 was performed...
January 2017: Annals of Vascular Surgery
Wuyang Yang, Xiaoming Rong, Maria Braileanu, Bowen Jiang, Tomas Garzon-Muvdi, Justin M Caplan, Geoffrey P Colby, Alexander L Coon, Rafael J Tamargo, Judy Huang
OBJECTIVE: The safety of carotid revascularization in patients with concomitant extracranial carotid stenosis and cerebral aneurysm is rarely reported. We examine the risk of subarachnoid hemorrhage, aneurysm growth, ipsilateral transient ischemic attack, or stroke after revascularization in patients with both carotid stenosis and cerebral aneurysms. METHODS: A retrospective cohort study of patients with concomitant diagnosis of aneurysm and carotid stenosis evaluated in the neurosurgical department at our institution from 1990 to 2013 was carried out...
September 2016: World Neurosurgery
Yan-Fang Wan, Xiao-Li Ma, Chen Yuan, Ling Fei, Jing Yang, Jun Zhang
Limited data are available with regard to the impact of daily lifestyle choices in patients with coronary heart disease (CHD) who have undergone stent placement. Thus, the aim of the present study was to investigate the impact of daily lifestyle factors in patients with CHD following stent implantation. Between March 2005 and March 2006, 129 consecutive patients with CHD were admitted to Cangzhou Central Hospital at Hebei Medical University (Cangzhou, China). The patients underwent coronary stenting and participated in a 7-year clinical follow-up that analyzed the impact of their daily lifestyle choices on CHD following the stent placement...
September 2015: Experimental and Therapeutic Medicine
Lan Shen, Bimal R Shah, Shuang Li, Laine Thomas, Tracy Y Wang, Karen P Alexander, Eric D Peterson, Ben He, Matthew T Roe
BACKGROUND: Interhospital transfer invasive management patterns and implications for older non-ST-segment elevation myocardial infarction (NSTEMI) patients initially presenting to non-revascularization-capable hospitals have not been explored. HYPOTHESIS: Patients admitted to hospitals with a higher transfer proportion have lower risk of long-term mortality. METHODS: We linked CRUSADE Registry data on 5678 patients age ≥65 years from 65 United States non-revascularization-capable hospitals (2003-2006) with inpatient Medicare longitudinal claims...
December 2015: Clinical Cardiology
Alberto Bouzas-Mosquera, Jesús Peteiro, Francisco J Broullón, Ramón Calviño-Santos, Víctor X Mosquera, Cayetana Barbeito-Caamaño, José María Larrañaga-Moreira, Nicolás Maneiro-Melón, Nemesio Álvarez-García, José Manuel Vázquez-Rodríguez
INTRODUCTION: Scarce data are available on the temporal patterns in clinical characteristics and outcomes of elderly patients referred for exercise stress testing. We aimed to assess the trends in baseline characteristics, tests results, referrals for invasive management, and mortality in these patients. METHODS: We evaluated 11,192 patients aged ≥65years who were referred for exercise stress testing between January 1998 and December 2013. Calendar years were grouped into four quadrennia (1998-2001, 2002-2005, 2006-2009, and 2010-2013), and trends in clinical characteristics of the patients, type and results of the tests, referrals for invasive management, and mortality across the different periods were assessed...
December 2015: European Journal of Internal Medicine
Peter Clemmensen, Matthew T Roe, Judith S Hochman, Derek D Cyr, Megan L Neely, Darren K McGuire, Jan H Cornel, Kurt Huber, Dmitry Zamoryakhin, Harvey D White, Paul W Armstrong, Keith A A Fox, Dorairaj Prabhakaran, Erik Magnus Ohman
BACKGROUND: Women with acute coronary syndromes (ACS) are less likely to undergo invasive revascularization than men, but sex-specific differences in long-term outcomes and platelet reactivity among medically managed ACS patients remain uncertain. We examined sex-specific differences in long-term ischemic and bleeding outcomes and platelet reactivity for medically managed ACS patients randomized to prasugrel versus clopidogrel plus aspirin. METHODS: Data from 9,326 patients enrolled in TRILOGY ACS were analyzed to determine differences in long-term ischemic and bleeding outcomes between women (n = 3,650 [39%]) and men (n = 5,676 [61%]) randomized to prasugrel 10 mg/d (5 mg/d for patients ≥75 years and/or <60 kg) versus clopidogrel 75 mg/d...
October 2015: American Heart Journal
Melissa A Daubert, Joseph Massaro, Lawrence Liao, Ashish Pershad, Suresh Mulukutla, Erik Magnus Ohman, Jeffrey Popma, William W O'Neill, Pamela S Douglas
BACKGROUND: Therapies that reverse pathologic left ventricular (LV) remodeling are often associated with improved outcomes. The incidence and impact of reverse LV remodeling after high-risk percutaneous coronary intervention (PCI) are unknown. METHODS: The PROTECT II study was a multicenter trial in patients with complex, multivessel coronary artery disease and reduced ejection fraction (EF) that revealed an increase in visual EF after high-risk PCI. Among patients with quantitative echocardiography (LV volumes and biplane EF), we assessed the extent and predictors of reverse LV remodeling, defined as improved systolic function with an absolute increase in EF ≥5% and correlated these findings with clinical events...
September 2015: American Heart Journal
Felix Fleissner, Hendrick Engelke, Sebastian Rojas-Hernandez, Issam Ismail, Penelope Stiefel, Serghei Cebotari, Axel Haverich, Malakh Shrestha, Andreas Martens
OBJECTIVES: Coronary artery bypass grafting is the gold standard for the treatment of patients with multiple-vessel coronary artery disease. The long-term outcome can be improved using arterial grafts. We analysed the initial series of patients who underwent total arterial revascularization at our institute using left internal thoracic artery (LITA) and radial artery (RA) composite T-grafts and had a follow-up of >10 years. METHODS: We included all patients who received an isolated, non-emergent total arterial revascularization using LITA-RA T-grafts between September 1996 and August 2001 in our institution...
April 2016: European Journal of Cardio-thoracic Surgery
Joo Myung Lee, Ji-Hyun Jung, Kyung Woo Park, Eun-Seok Shin, Seok Kyu Oh, Jang-Whan Bae, Jay Young Rhew, Namho Lee, Dong-Bin Kim, Ung Kim, Jung-Kyu Han, Sang Eun Lee, Han-Mo Yang, Hyun-Jae Kang, Bon-Kwon Koo, Sanghyun Kim, Yun Kyeong Cho, Won-Yong Shin, Young-Hyo Lim, Seung-Woon Rha, Seok-Yeon Kim, Sung Yun Lee, Young-Dae Kim, In-Ho Chae, Kwang Soo Cha, Hyo-Soo Kim
BACKGROUND: Antiplatelet treatment is an important component in optimizing the clinical outcomes after percutaneous coronary intervention (PCI) especially in patients with acute coronary syndrome (ACS). Prasugrel, which is a new P2Y12 inhibitor, has been confirmed as efficacious in a large trial in Western countries, and a similar trial is also to be launched in Asian countries. Although a 60-mg loading dose of prasugrel followed by 10 mg per day should be acceptable, there have been no data regarding the optimal dose in Asian patients...
September 15, 2015: Trials
Ismail Bolat, Ozgur Akgul, Huseyin Altug Cakmak, Hamdi Pusuroglu, Umut Somuncu, Sinem Ozbey, Vesile Ornek, Mehmet Erturk, Mehmet Gul
BACKGROUND: Mean platelet volume to platelet count (MPV/Plt) ratio has been demonstrated to be a good indicator of long-term mortality in patients with non-ST-segment elevation myocardial infarction (NSTEMI). However, the prognostic value of MPV/Plt in ST-elevation myocardial infarction (STEMI) is not reported. AIM: To determine whether the MPV/Plt ratio on admission has any predictive value for major adverse cardiac events including short- and long-term mortality in STEMI...
2016: Kardiologia Polska
Jacek Gacoń, Anna Kabłak-Ziembicka, Ewa Stępień, Francisco J Enguita, Izabela Karch, Bogusław Derlaga, Krzysztof Żmudka, Tadeusz Przewłocki
BACKGROUND: Coronary artery occlusion does not always manifest with ST-elevation, and some patients can have patent coronary vessel. AIM: We evaluated circulating microRNA (miRNA) profiles to discriminate subjects with infarct-related artery (IRA) occlusion. METHODS AND RESULTS: Patients (n = 43) with uncomplicated acute coronary syndrome and positive troponins were classified with respect to patent vs. occluded IRA or ST-elevation vs. non-ST elevation MI (STEMI vs...
2016: Kardiologia Polska
Said Alsidawi, Mohamed Effat, Shahid Rahman, Mouhamad Abdallah, Massoud Leesar
BACKGROUND: The routine use of vascular imaging including intravascular ultrasound (IVUS) and optical coherence tomography (OCT) in guiding percutaneous coronary interventions (PCI) is still controversial especially when using drug-eluting stents. A meta-analysis of trials using bare metal stents was previously published. METHODS: We conducted a meta-analysis of available published trials that compared imaging-guided PCI and angiography-guided PCI in patients undergoing routine PCI only...
December 2015: Cardiovascular Therapeutics
Alexander Weissgerber, Markus Scholz, Andrej Teren, Marcus Sandri, Daniel Teupser, Stephan Gielen, Joachim Thiery, Gerhard Schuler, Frank Beutner
BACKGROUND: Despite the widespread use of noninvasive testing prior to invasive coronary diagnostic the diagnostic yield of elective coronary angiography has been reported low in subjects with suspected obstructive CAD. OBJECTIVE: To determine the predictive value of noncoronary atherosclerosis (NCA) in subjects with suspected stable coronary artery disease (CAD) intended to invasive coronary angiography. METHODS: Ultrasound-based assessment of carotid artery plaque (CAP), carotid intima-media thickness (CIMT) and ankle-brachial index (ABI) was performed in 2216 subjects with suspected CAD prior to coronary angiography...
February 2016: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
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