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https://www.readbyqxmd.com/read/28917544/effects-on-the-incidence-of-cardiovascular-events-of-the-addition-of-pioglitazone-versus-sulfonylureas-in-patients-with-type-2-diabetes-inadequately-controlled-with-metformin-tosca-it-a-randomised-multicentre-trial
#1
Olga Vaccaro, Maria Masulli, Antonio Nicolucci, Enzo Bonora, Stefano Del Prato, Aldo P Maggioni, Angela A Rivellese, Sebastiano Squatrito, Carlo B Giorda, Giorgio Sesti, Paolo Mocarelli, Giuseppe Lucisano, Michele Sacco, Stefano Signorini, Fabrizio Cappellini, Gabriele Perriello, Anna Carla Babini, Annunziata Lapolla, Giovanna Gregori, Carla Giordano, Laura Corsi, Raffaella Buzzetti, Gennaro Clemente, Graziano Di Cianni, Rossella Iannarelli, Renzo Cordera, Olga La Macchia, Chiara Zamboni, Cristiana Scaranna, Massimo Boemi, Ciro Iovine, Davide Lauro, Sergio Leotta, Elisabetta Dall'Aglio, Emanuela Cannarsa, Laura Tonutti, Giuseppe Pugliese, Antonio C Bossi, Roberto Anichini, Francesco Dotta, Antonino Di Benedetto, Giuseppe Citro, Daniela Antenucci, Lucia Ricci, Francesco Giorgino, Costanza Santini, Agostino Gnasso, Salvatore De Cosmo, Donatella Zavaroni, Monica Vedovato, Agostino Consoli, Maria Calabrese, Paolo di Bartolo, Paolo Fornengo, Gabriele Riccardi
BACKGROUND: The best treatment option for patients with type 2 diabetes in whom treatment with metformin alone fails to achieve adequate glycaemic control is debated. We aimed to compare the long-term effects of pioglitazone versus sulfonylureas, given in addition to metformin, on cardiovascular events in patients with type 2 diabetes. METHODS: TOSCA.IT was a multicentre, randomised, pragmatic clinical trial, in which patients aged 50-75 years with type 2 diabetes inadequately controlled with metformin monotherapy (2-3 g per day) were recruited from 57 diabetes clinics in Italy...
September 12, 2017: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/28913627/everolimus-eluting-bioresorbable-vascular-scaffold-in-daily-clinical-practice-a%C3%A2-single-centre-experience
#2
W S Remkes, R S Hermanides, M W Kennedy, E Fabris, E Kaplan, J P Ottervanger, A W J van 't Hof, E Kedhi
BACKGROUND: Recent evidence has raised concerns regarding the safety of the everolimus-eluting bioresorbable vascular scaffold (E-BVS) (Absorb, Abbott Vascular, Santa Clara, CA, USA). Following these data, the use of this device has diminished in the Netherlands; however, daily practice data are limited. Therefore we studied the incidence of safety and efficacy outcomes with this device in daily clinical practice in a single large tertiary centre in the Netherlands. METHODS: All E‑BVS treated patients were included in this analysis...
September 14, 2017: Netherlands Heart Journal
https://www.readbyqxmd.com/read/28893701/impact-of-vascular-calcifications-on-long-femoropopliteal-stenting-outcomes
#3
Adrien Kaladji, Pierre-Alexandre Vent, Aurore Danvin, Philippe Chaillou, Alain Costargent, Béatrice Guyomarch, Thibaut Quillard, Yann Gouëffic
OBJECTIVE: Vascular calcifications (VCs) may be a prognostic factor for outcome after endovascular treatment of peripheral arterial disease (PAD). Semi-quantitative analysis with X-ray imaging is the main limiting factor for assessing VCs. The aim of the present study was to find a correlation between the amount of VC with a CT scan quantification and mid-term results of endovascular treatment of TASC C/D femoropopliteal (FP) lesions. METHODS: Patients belonging to two previously published registries (STELLA and STELLA PTX) and who underwent a preoperative CT scan were retrospectively included in the study...
September 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28891183/primary-percutaneous-coronary-intervention-for-inferior-st-segment-elevation-myocardial-infarction-in-a-patient-supported-by-the-heartware-left-ventricular-assist-device
#4
Roberto Spina, Maithri Siriwardena, Nicole Bart, Mayooran Namasivayam, Mark Connellan, Paul Jansz, Philip Spratt, Christopher S Hayward, Eugene Kotlyar, Brendan Gunalingam
A 63-year-old man with an ischaemic cardiomyopathy, supported by the HeartWare left ventricular assist device (LVAD), presented with ventricular tachycardia and inferior ST-elevation myocardial infarction (STEMI) with associated acute right ventricular (RV) dysfunction. He underwent primary percutaneous coronary intervention with balloon angioplasty and placement of three drug-eluting stents in the proximal-to-mid right coronary artery. Post-procedure, ventricular arrhythmias abated, RV systolic dysfunction resolved and RV size normalised...
September 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28886989/factors-associated-with-contralateral-deep-venous-thrombosis-after-iliocaval-venous-stenting
#5
S A Khairy, R J Neves, O Hartung, G J O'Sullivan
BACKGROUND: The majority of iliac venous obstructions occur on the left side, and endovascular therapy has become the first line treatment for this condition. A left common iliac venous stent will protrude into the inferior vena cava (IVC) to some extent, thereby covering the contralateral common iliac vein (CIV) outflow. This may increase the risk of thrombosis of the contralateral iliac vein. The aim of this paper was to determine the rate of, and factors associated with, contralateral lower limb venous thrombosis after stenting, and to evaluate the results of salvage revascularisation...
September 5, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28878945/gated-metabolic-myocardial-imaging-a-surrogate-for-dual-perfusion-metabolism-imaging-by-positron-emission-tomography
#6
Abdallah AlMohammad, Murdoch Y Norton, Andrew E Welch, Peter F Sharp, Stephen Walton
OBJECTIVE: Perfusion-metabolism mismatch pattern on positron emission tomography (PET) predicts hibernating myocardium. We assess the ECG-gated metabolic PET as a surrogate for the perfusion-metabolism mismatch pattern on PET imaging. METHODS: (13)N-Ammonia (NH3) and (18)F-fluorodeoxyglucose (FDG) are respectively perfusion and metabolism PET tracers. We used ECG gating to acquire FDG-PET to collect wall thickening (mechanical) data. These allow detection of metabolic activity in regions with reduced contraction (metabolism-mechanical mismatch pattern)...
2017: Open Heart
https://www.readbyqxmd.com/read/28877948/appropriateness-of-percutaneous-coronary-interventions-in-patients-with-ischaemic-heart-disease-in-italy-the-apache-pilot-study
#7
Sergio Leonardi, Marcello Marino, Gabriele Crimi, Florinda Maiorana, Diego Rizzotti, Corrado Lettieri, Luca Bettari, Marco Zuccari, Paolo Sganzerla, Simone Tresoldi, Marianna Adamo, Sergio Ghiringhelli, Carlo Sponzilli, Giampaolo Pasquetto, Andrea Pavei, Luigi Pedon, Luciano Bassan, Mario Bollati, Paola Camisasca, Daniela Trabattoni, Marta Brancati, Arnaldo Poli, Claudio Panciroli, Maddalena Lettino, Giuseppe Tarelli, Giuseppe Tarantini, Leonardo De Luca, Ferdinando Varbella, Giuseppe Musumeci, Stefano De Servi
OBJECTIVES: To first explore in Italy appropriateness of indication, adherence to guideline recommendations and mode of selection for coronary revascularisation. DESIGN: Retrospective, pilot study. SETTING: 22 percutaneous coronary intervention (PCI)-performing hospitals (20 patients per site), 13 (59%) with on-site cardiac surgery. PARTICIPANTS: 440 patients who received PCI for stable coronary artery disease (CAD) or non-ST elevation acute coronary syndrome were independently selected in a 4:1 ratio with half diabetics...
September 5, 2017: BMJ Open
https://www.readbyqxmd.com/read/28877868/impact-of-risk-factors-associated-with-cardiovascular-outcomes-in-patients-with-rheumatoid-arthritis
#8
Cynthia S Crowson, Silvia Rollefstad, Eirik Ikdahl, George D Kitas, Piet L C M van Riel, Sherine E Gabriel, Eric L Matteson, Tore K Kvien, Karen Douglas, Aamer Sandoo, Elke Arts, Solveig Wållberg-Jonsson, Lena Innala, George Karpouzas, Patrick H Dessein, Linda Tsang, Hani El-Gabalawy, Carol Hitchon, Virginia Pascual Ramos, Irazú Contreras Yáñez, Petros P Sfikakis, Evangelia Zampeli, Miguel A Gonzalez-Gay, Alfonso Corrales, Mart van de Laar, Harald E Vonkeman, Inger Meek, Anne Grete Semb
OBJECTIVES: Patients with rheumatoid arthritis (RA) have an excess risk of cardiovascular disease (CVD). We aimed to assess the impact of CVD risk factors, including potential sex differences, and RA-specific variables on CVD outcome in a large, international cohort of patients with RA. METHODS: In 13 rheumatology centres, data on CVD risk factors and RA characteristics were collected at baseline. CVD outcomes (myocardial infarction, angina, revascularisation, stroke, peripheral vascular disease and CVD death) were collected using standardised definitions...
September 6, 2017: Annals of the Rheumatic Diseases
https://www.readbyqxmd.com/read/28864716/trajectories-and-characteristics-of-work-disability-before-and-after-acute-myocardial-infarction
#9
Mo Wang, Marjan Vaez, Thomas Ernst Dorner, Jari Tiihonen, Margaretha Voss, Torbjörn Ivert, Ellenor Mittendorfer-Rutz
OBJECTIVE: Scientific knowledge on work disability in terms of sickness absence and disability pension (SA/DP) among patients with acute myocardial infarction (AMI) is scarce. The study aimed to investigate trajectories of SA/DP among individuals with or without AMI and examined the associations between sociodemographic, morbidity and coronary revascularisation characteristics with such trajectories among patients with AMI. METHODS: This is a population-based cohort study of 10 255 individuals aged 30-60 years who had a first AMI during 2008-2010 and were alive 30 days after AMI...
September 1, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28861274/long-term-left-ventricular-remodelling-after-revascularisation-for-st-segment-elevation-myocardial-infarction-as-assessed-by-cardiac-magnetic-resonance-imaging
#10
Mariella Ecj Hassell, Wieneke Vlastra, Lourens Robbers, Alexander Hirsch, Robin Nijveldt, Jan Gp Tijssen, Albert C van Rossum, Felix Zijlstra, Jan J Piek, Ronak Delewi
OBJECTIVE: Left ventricular remodelling following a ST-segment elevated myocardial infarction (STEMI) is an adaptive response to maintain the cardiac output despite myocardial tissue loss. Limited studies have evaluated long term ventricular function using cardiac magnetic resonance imaging (CMR) after STEMI. METHODS: Study population consisted of 155 primary percutaneous coronary intervention treated first STEMI patients. CMR was performed at 4±2 days, 4 months and 24 months follow-up...
2017: Open Heart
https://www.readbyqxmd.com/read/28859947/clinical-efficacy-and-safety-of-achieving-very-low-ldl-cholesterol-concentrations-with-the-pcsk9-inhibitor-evolocumab-a-prespecified-secondary-analysis-of-the-fourier-trial
#11
Robert P Giugliano, Terje R Pedersen, Jeong-Gun Park, Gaetano M De Ferrari, Zbigniew A Gaciong, Richard Ceska, Kalman Toth, Ioanna Gouni-Berthold, Jose Lopez-Miranda, François Schiele, François Mach, Brian R Ott, Estella Kanevsky, Armando Lira Pineda, Ransi Somaratne, Scott M Wasserman, Anthony C Keech, Peter S Sever, Marc S Sabatine
BACKGROUND: LDL cholesterol is a well established risk factor for atherosclerotic cardiovascular disease. How much one should or safely can lower this risk factor remains debated. We aimed to explore the relationship between progressively lower LDL-cholesterol concentrations achieved at 4 weeks and clinical efficacy and safety in the FOURIER trial of evolocumab, a monoclonal antibody to proprotein convertase subtilisin-kexin type 9 (PCSK9). METHODS: In this prespecified secondary analysis of 25 982 patients from the randomised FOURIER trial, the relationship between achieved LDL-cholesterol concentration at 4 weeks and subsequent cardiovascular outcomes (primary endpoint was the composite of cardiovascular death, myocardial infarction, stroke, coronary revascularisation, or unstable angina; key secondary endpoint was the composite of cardiovascular death, myocardial infarction, or stroke) and ten prespecified safety events of interest was examined over a median of 2·2 years of follow-up...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28855273/acute-chest-pain-evaluation-using-coronary-computed-tomography-angiography-compared-with-standard-of-care-a-meta-analysis-of-randomised-clinical-trials
#12
Carlos A Gongora, Chirag Bavishi, Seth Uretsky, Edgar Argulian
OBJECTIVE: Coronary CT angiography (CCTA) has certain advantages compared with stress testing including greater accuracy in identifying obstructive coronary disease. The aim of the study was to perform a systematical review and meta-analysis comparing CCTA with other standard-of-care (SOC) approaches in evaluation of patients with acute chest pain. METHODS: Electronic databases were systematically searched to identify randomised clinical trials of patients with acute chest pain comparing CCTA with SOC approaches...
August 30, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28854987/-non-st-segment-elevation-acute-coronary-syndrome-recent-developments-in-diagnostics-and-treatment
#13
P Damman, R J de Winter
- This paper covers recent developments in diagnostics and treatment of patients presenting with non-ST segment elevation acute coronary syndrome.- For the diagnostic phase we focus on the role of the clinical presentation, the ECG and biomarkers.- In the acute phase, treatment mainly consists of pharmacological therapy and revascularisation; long-term treatment mainly involves pharmacological therapy, cardiac rehabilitation, and lifestyle changes.
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28851504/ultrathin-bioresorbable-polymer-sirolimus-eluting-stents-versus-thin-durable-polymer-everolimus-eluting-stents-in-patients-undergoing-coronary-revascularisation-bioflow-v-a-randomised-trial
#14
David E Kandzari, Laura Mauri, Jacques J Koolen, Joseph M Massaro, Gheorghe Doros, Hector M Garcia-Garcia, Johan Bennett, Ariel Roguin, Elie G Gharib, Donald E Cutlip, Ron Waksman
BACKGROUND: The development of coronary drug-eluting stents has included use of new metal alloys, changes in stent architecture, and use of bioresorbable polymers. Whether these advancements improve clinical safety and efficacy has not been shown in previous randomised trials. We aimed to examine the clinical outcomes of a bioresorbable polymer sirolimus-eluting stent compared with a durable polymer everolimus-eluting stent in a broad patient population undergoing percutaneous coronary intervention...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28851450/open-vascular-treatment-of-median-arcuate-ligament-syndrome
#15
Mansur Duran, Florian Simon, Neslihan Ertas, Hubert Schelzig, Nikolaos Floros
BACKGROUND: Median arcuate ligament syndrome is a rare condition with abdominal symptoms. Accepted treatment options are open release of median arcuate ligament, laparoscopic release of edian arcuate ligament, robot-assisted release of median arcuate ligament and open vascular treatment. Here we aimed to evaluate the central priority of open vascular therapy in the treatment of median arcuate ligament syndrome. METHODS: We conducted a monocentric retrospective study between January 1996 and June 2016...
August 29, 2017: BMC Surgery
https://www.readbyqxmd.com/read/28844035/state-of-the-art-optimal-medical-therapy-competing-with-or-complementary-to-revascularisation-in-patients-with-coronary-artery-disease
#16
Javaid Iqbal, Robert Widmer, Bernard J Gersh
The role of coronary revascularisation with PCI and CABG in patients with stable and unstable coronary artery disease (CAD) is well established and there is a general consensus among guidelines as regards the indications for coronary revascularisation. Although revascularisation has undoubtedly revolutionised the treatment of CAD, it is vital to understand the recent advances and importance of the concomitant use of evidence-based optimal medical therapy (OMT). In contemporary practice, OMT should include an antiplatelet agent (or dual antiplatelet therapy when indicated) and a lipid-lowering drug for all patients, and a beta-blocker and an ACE inhibitor (or angiotensin receptor blocker) for the vast majority of patients, along with addressing cardiac risk factors and lifestyle management...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844031/state-of-the-art-evolving-concepts-in-the-treatment-of-heavily-calcified-and-undilatable-coronary-stenoses-from-debulking-to-plaque-modification-a-40-year-long-journey
#17
Emanuele Barbato, Evan Shlofmitz, Anastasios Milkas, Richard Shlofmitz, Lorenzo Azzalini, Antonio Colombo
Since the first balloon angioplasty by Andreas Grüntzig 40 years ago, interventional cardiology has witnessed the introduction of countless tools and techniques that have significantly contributed to broadening the application of percutaneous coronary interventions (PCI) in unprecedented anatomic settings. Heavily calcified, fibrotic coronary stenosis has traditionally represented a very challenging scenario for PCI, and a very common indication for surgical revascularisation. This was mostly due to the difficulty in adequately dilating these lesions and/or to the inability to deliver and implant stents appropriately, which is often associated with high rates of procedural complications and suboptimal long-term clinical outcomes...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28844029/state-of-the-art-pressure-wire-and-coronary-functional-assessment
#18
Mauro Echavarría-Pinto, Carlos Collet, Javier Escaned, Jan J Piek, Patrick W Serruys
The pressure wire has revolutionised cardiology by moving the focus of revascularisation from anatomy to physiology. This review provides a comprehensive viewpoint on the foundations of the field of intracoronary physiology, with emphasis on the development and clinical evidence of fractional flow reserve (FFR). Additionally, we critically appraise clinical decision making based on the evolving area of resting coronary physiology. The emerging role of coronary flow reserve and its complementariness with FFR is also discussed, and the importance of the invasive assessment of the coronary microcirculation in outlining prognosis is put into perspective...
August 25, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28838637/calcification-volume-reduces-stretch-capability-and-predisposes-plaque-to-rupture-in-an-in%C3%A2-vitro-model-of-carotid-artery-stenting
#19
H E Barrett, E M Cunnane, H Hidayat, J M O Brien, E G Kavanagh, M T Walsh
OBJECTIVE/BACKGROUND: Carotid artery stenting (CAS) in calcified arteries carries a higher peri-operative risk. This study investigates the relationship between the stretching limits of carotid plaque samples and calcification in order to determine a stretch tolerance criterion for endovascular intervention. METHODS: Seventeen carotid plaque samples were acquired from standard endarterectomy procedures. The maximum stretch capability of the global plaque was determined by circumferentially extending the tissue to complete failure...
August 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28835456/systematic-review-of-pharmacological-therapies-for-the-management-of-ischaemic-pain-in-patients-with-non-reconstructable-critical-limb-ischaemia
#20
REVIEW
Áine Ní Laoire, Fliss E M Murtagh
BACKGROUND: Critical limb ischaemia (CLI) is a severe manifestation of peripheral arterial disease, characterised by chronic ischaemic rest pain, ulcers or gangrene. Management of ischaemic pain is challenging in patients with no options for revascularisation and optimal pharmacological therapies have not been established. OBJECTIVES: To identify and evaluate the effectiveness of pharmacological therapies to treat ischaemic pain secondary to non-reconstructable CLI...
August 23, 2017: BMJ Supportive & Palliative Care
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