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https://www.readbyqxmd.com/read/29453329/management-characteristics-and-outcomes-of-patients-with-acute-coronary-syndrome-in-sri-lanka
#1
Priyadarshani Galappatthy, Vipula R Bataduwaarachchi, Priyanga Ranasinghe, Gamini K S Galappatthy, Maheshi Wijayabandara, Dinuka S Warapitiya, Mythily Sivapathasundaram, Thilini Wickramarathna, Upul Senarath, Sathasivam Sridharan, Chandrika N Wijeyaratne, Ruvan Ekanayaka
BACKGROUND: Ischaemic heart disease is the leading cause of in-hospital mortality in Sri Lanka. Acute Coronary Syndrome Sri Lanka Audit Project (ACSSLAP) is the first national clinical-audit project that evaluated patient characteristics, clinical outcomes and care provided by state-sector hospitals. METHODS: ACSSLAP prospectively evaluated acute care, in-hospital care and discharge plans provided by all state-sector hospitals managing patients with ACS. Data were collected from 30 consecutive patients from each hospital during 2-4 weeks window...
February 16, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29452841/impact-of-age-following-treatment-of-severely-calcified-coronary-lesions-with-the-orbital-atherectomy-system-3-year-follow-up
#2
Michael S Lee, Richard A Shlofmitz, Brad J Martinsen, Sanjum Sethi, Jeffrey W Chambers
OBJECTIVES: We investigated the safety and efficacy of coronary orbital atherectomy to treat severely calcified lesions prior to stenting based upon age. BACKGROUND: The ORBIT II study reported the safety and efficacy with orbital atherectomy in 443 patients with severely calcified lesions. Elderly patients undergoing percutaneous coronary intervention may be at increased risk for major adverse cardiac events (MACE) and death compared with younger patients. METHODS: Patients were stratified according to age (≥75 year old [174/443, 39...
January 31, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29452756/quantification-of-thrombus-formation-in-malapposed-coronary-stents-deployed-in-vitro-through-imaging-analysis
#3
Jonathan Brown, Caroline C O'Brien, Augusto C Lopes, Kumaran Kolandaivelu, Elazer R Edelman
Stent thrombosis is a major complication of coronary stent and scaffold intervention. While often unanticipated and lethal, its incidence is low making mechanistic examination difficult through clinical investigation alone. Thus, throughout the technological advancement of these devices, experimental models have been indispensable in furthering our understanding of device safety and efficacy. As we refine model systems to gain deeper insight into adverse events, it is equally important that we continue to refine our measurement methods...
February 9, 2018: Journal of Biomechanics
https://www.readbyqxmd.com/read/29452691/recurrent-cardiovascular-events-in-survivors-of-myocardial-infarction-with-st-segment-elevation-from-the-ami-quebec-study
#4
Thao Huynh, Martine Montigny, Umair Iftikhar, Roxanne Gagnon, Mark Eisenberg, Claude Lauzon, Samer Mansour, Stephane Rinfret, Marc Afilalo, Michel Nguyen, Simon Kouz, Jean-Pierre Déry, Richard Harvey, Robert De LaRocheliere, Bernard Cantin, Eerick Schampaert, Jean-Claude Tardif
The characteristics and predictors of long-term recurrent ischemic cardiovascular events (RICEs) after myocardial infarction with ST-segment elevation (STEMI) have not yet been clarified. We aimed to characterize the 10-year incidence, types, and predictors of RICE. We obtained 10-year follow-up of STEMI survivors at 17 Quebec hospitals in Canada (the AMI-QUEBEC Study) in 2003. There were 858 patients; mean age was 60 years and 73% were male. The majority of patients receive reperfusion therapy; 53.3% and 39...
January 31, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29452688/comparison-of-the-efficacy-and-safety-of-orbital-and-rotational-atherectomy-in-calcified-narrowings-in-patients-who-underwent-percutaneous-coronary-intervention
#5
Edward Koifman, Hector M Garcia-Garcia, Kayode O Kuku, Alexandre H Kajita, Kyle D Buchanan, Arie Steinvil, Toby Rogers, Nelson L Bernardo, Robert Lager, Robert A Gallino, Itsik Ben-Dor, Augusto D Pichard, Rebecca Torguson, Jiaxiang Gai, Lowell F Satler, Ron Waksman
We aimed to compare the safety and efficacy of rotational atherectomy (RA) and orbital atherectomy (OA) during percutaneous coronary intervention in an all-comer population with severely calcified lesions. We included all patients who underwent percutaneous coronary intervention with OA or RA in our institution from October 2013 until October 2016. Comparison of baseline and procedural characteristics, along with acute complication rates and postprocedural cardiac enzyme elevation, was performed. There were 191 RA and 57 OA patients...
February 13, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29452484/comparison-of-patients-with-multivessel-disease-treated-at-centers-with-and-without-on-site-cardiac-surgery
#6
Eilon Ram, Ilan Goldenberg, Yigal Kassif, Amit Segev, Jakob Lavee, Nir Shlomo, Ehud Raanani
BACKGROUND: The regional needs and consolidation of cardiac surgery services (CSS) result in an increased number of stand-alone interventional cardiology units. We aimed to explore the impact of a heart team on the decision making and outcomes of patients with multivessel coronary artery disease referred for coronary revascularization in stand-alone interventional cardiology units. METHODS: This prospective study included 1063 consecutive patients with multivessel disease enrolled between January and April 2013 from all 22 hospitals in Israel that perform coronary angiography and percutaneous coronary intervention (PCI), with or without on-site CSS...
March 2018: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29452351/impact-of-treatment-delay-on-mortality-in-st-segment-elevation-myocardial-infarction-stemi-patients-presenting-with-and-without-haemodynamic-instability-results-from-the-german-prospective-multicentre-fitt-stemi-trial
#7
Karl Heinrich Scholz, Sebastian K G Maier, Lars S Maier, Björn Lengenfelder, Claudius Jacobshagen, Jens Jung, Claus Fleischmann, Gerald S Werner, Hans G Olbrich, Rainer Ott, Harald Mudra, Karlheinz Seidl, P Christian Schulze, Christian Weiss, Josef Haimerl, Tim Friede, Thomas Meyer
Aims: The aim of this study was to investigate the effect of contact-to-balloon time on mortality in ST-segment elevation myocardial infarction (STEMI) patients with and without haemodynamic instability. Methods and results: Using data from the prospective, multicentre Feedback Intervention and Treatment Times in ST-Elevation Myocardial Infarction (FITT-STEMI) trial, we assessed the prognostic relevance of first medical contact-to-balloon time in n = 12 675 STEMI patients who used emergency medical service transportation and were treated with primary percutaneous coronary intervention (PCI)...
February 14, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29452307/impact-of-metabolic-syndrome-on-clinical-severity-and-long-term-prognosis-in-patients-with-myocardial-infarction-with-st-segment-elevation
#8
Lovic, Dragan B Djordjevic, Ivan S Tasic, Ivana P Nedeljkovic
AIMS: The aim of this study is to evaluate the impact of metabolic syndrome (MetS) on clinical severity and long term prognosis in patients with myocardial infarction with ST segment elevation (STEMI). METHODS: We examined 507 patients with STEMI who were admitted for primary percutaneous coronary intervention classified according to the presence of MetS using American Heart Association and the National Heart, Lung and Blood Institute definition. After applying these criteria, the patients were categorized in patients with MetS and without MetS...
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/29451949/impact-of-sheath-size-and-hemostasis-time-on-radial-artery-patency-after-transradial-coronary-angiography-and-intervention-in-japanese-and-non-japanese-patients-a-substudy-from-rap-and-beat-radial-artery-patency-and-bleeding-efficacy-adverse-event-randomized
#9
Adel Aminian, Shigeru Saito, Akihiko Takahashi, Ivo Bernat, Robert Lee Jobe, Takashi Kajiya, Ian C Gilchrist, Yves Louvard, Ferdinand Kiemeneij, Niels van Royen, Maarten van Leeuwen, Seiji Yamazaki, Takashi Matsukage, Juan F Iglesias, Sunil V Rao
BACKGROUND: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. METHODS AND RESULTS: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan)...
February 16, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29451512/-antegrade-and-retrograde-approach-through-the-venous-graft-for-treating-a-chronic-total-occlusion-in-a-patient-with-acute-coronary-syndrome-complicated-by-pulmonary-edema
#10
Francesco Gallo, Matteo Tebaldi, Carlo Tumscitz
Percutaneous treatment of chronic total occlusions (CTO) is one of the major challenges in contemporary interventional cardiology. These lesions are identified in 15% to 30% of all patients referred for coronary angiography. Percutaneous coronary intervention (PCI) of CTOs is technically challenging and requires familiarity with advanced interventional techniques as well as specialty equipment. The choice of strategy and materials is based on clinical features and coronary anatomy; the correct choice is essential to improve the success probability...
January 2018: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/29450819/familial-hypercholesterolemia-cascade-screening-in-children-and-relatives-of-the-affected
#11
Nitika Setia, Renu Saxena, J P S Sawhney, Ishwar C Verma
OBJECTIVE: Familial Hypercholesterolemia (FH) is an inherited disorder of lipid metabolism characterized by very high low density lipoprotein (LDL) cholesterol since birth, resulting in premature atherosclerosis and coronary artery disease (CAD). Cascade screening of children and family members of proven FH individuals can identify more subjects who have high LDL cholesterol or the family mutation and appropriate intervention can reduce their risk of atherosclerosis and prevent its complications...
February 15, 2018: Indian Journal of Pediatrics
https://www.readbyqxmd.com/read/29450765/impact-of-platelet-reactivity-on-5-year-clinical-outcomes-following-percutaneous-coronary-intervention-a-landmark-analysis
#12
Fabio Mangiacapra, Iginio Colaiori, Elisabetta Ricottini, Antonio Creta, Giuseppe Di Gioia, Ilaria Cavallari, Edoardo Bressi, Marialessia Capuano, Emanuele Barbato, Germano Di Sciascio
We investigated the impact of suboptimal platelet reactivity on clinical outcomes after percutaneous coronary intervention (PCI). We enrolled 500 patients with stable coronary artery disease undergoing elective PCI. Platelet reactivity was measured before PCI using the VerifyNow P2Y12 assay. Primary endpoint was the incidence of ischemic or bleeding events at 1 month and 5 years. Patients with high platelet reactivity (HPR) showed significantly higher rates of ischemic events both during the 1st month after PCI (HR 2...
February 15, 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29450741/utility-of-cardiac-computed-tomography-scanning-in-the-diagnosis-and-pre-operative-evaluation-of-patients-with-infective-endocarditis
#13
Jason R Sims, Nandan S Anavekar, Krishnaswamy Chandrasekaran, James M Steckelberg, Walter R Wilson, Bernard J Gersh, Larry M Baddour, Daniel C DeSimone
Transesophageal echocardiography (TEE) is the gold standard imaging study used in the diagnosis of infective endocarditis (IE). Computed tomography angiography (CTA) has undergone rapid advancement as a cardiac imaging technique and has previously shown promise in small non-randomized studies for evaluation of IE. We hypothesized that cardiac CTA would perform similarly to TEE in the detection of endocarditic lesions and that there would be no difference in clinical outcomes whether the coronary arteries were evaluated by CTA or invasive coronary angiography (ICA)...
February 15, 2018: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/29450719/coronary-plaque-characteristics-on-baseline-ct-predict-the-need-for-late-revascularization-in-symptomatic-patients-after-percutaneous-intervention
#14
Mengmeng Yu, Zhigang Lu, Wenbin Li, Meng Wei, Jing Yan, Jiayin Zhang
OBJECTIVES: To assess pre-procedural plaque characteristics as determined by coronary CT angiography (CCTA) and their associations with late revascularization in symptomatic post-procedural patients. METHODS: Symptomatic patients with pre-procedural CCTA were prospectively enrolled and referred for invasive coronary angiography (ICA). Plaque characterization was performed on the basis of baseline CCTA data. Multivariate logistic regression analysis with a stepwise selection method was performed to identify independent predictors of late revascularization...
February 15, 2018: European Radiology
https://www.readbyqxmd.com/read/29450524/effect-of-a-quality-improvement-intervention-on-clinical-outcomes-in-patients-in-india-with-acute-myocardial-infarction-the-acs-quik-randomized-clinical-trial
#15
Mark D Huffman, Padinhare P Mohanan, Raji Devarajan, Abigail S Baldridge, Dimple Kondal, Lihui Zhao, Mumtaj Ali, Mangalath N Krishnan, Syam Natesan, Rajesh Gopinath, Sunitha Viswanathan, Joseph Stigi, Johny Joseph, Somanathan Chozhakkat, Donald M Lloyd-Jones, Dorairaj Prabhakaran
Importance: Wide heterogeneity exists in acute myocardial infarction treatment and outcomes in India. Objective: To evaluate the effect of a locally adapted quality improvement tool kit on clinical outcomes and process measures in Kerala, a southern Indian state. Design, Setting, and Participants: Cluster randomized, stepped-wedge clinical trial conducted between November 10, 2014, and November 9, 2016, in 63 hospitals in Kerala, India, with a last date of follow-up of December 31, 2016...
February 13, 2018: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/29449442/design-and-rationale-of-the-ripcord-2-trial-does-routine-pressure-wire-assessment-influence-management-strategy-at-coronary-angiography-for-diagnosis-of-chest-pain-a-randomized-controlled-trial-to-compare-routine-pressure-wire-assessment-with-conventional-angiography
#16
REVIEW
Mostafa Elguindy, Rod Stables, Zoe Nicholas, Ian Kemp, Nick Curzen
BACKGROUND: Investigation of anginal chest pain has traditionally involved either assessment of the coronary anatomy by angiography or noninvasive testing for reversible ischemia. Invasive pressure wire assessment at the time of angiography offers information on both anatomy and physiology. Fractional flow reserve-guided percutaneous coronary intervention is associated with lower resource utilization and improved clinical outcome compared with angiographic guidance alone. However, the value of routine fractional flow reserve of all major coronary vessels at the time of diagnostic angiography has not been established in a randomized trial despite persuasive observational data...
February 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29449273/novel-patient-centered-approach-to-facilitate-same-day-discharge-in-patients-undergoing-elective-percutaneous-coronary-intervention
#17
Amit P Amin, Patricia Crimmins-Reda, Samantha Miller, Brandon Rahn, Mary Caruso, Andrew Pierce, Brandy Dennis, Marissa Pendegraft, Katrine Sorensen, Howard I Kurz, John M Lasala, Alan Zajarias, Richard G Bach, Hemant Kulkarni, Jasvindar Singh
BACKGROUND: Same-day discharge (SDD) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in low-risk patients, if at all. To increase the appropriate use of SDD in more complex patients, we implemented a "patient-centered" protocol based on risk of complications at Barnes-Jewish Hospital. METHODS AND RESULTS: Our objectives were as follows: (1) to evaluate time trends in SDD; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by SDD versus no SDD (NSDD); and (3) to compare SDD eligibility by our patient-centered approach versus Society for Cardiovascular Angiography and Interventions guidelines...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29448978/effect-of-gender-on-unplanned-readmissions-after-percutaneous-coronary-intervention-from-the-nationwide-readmissions-database
#18
Chun Shing Kwok, Jessica Potts, Martha Gulati, Mirvat Alasnag, Muhammad Rashid, Ahmad Shoaib, Muhammad Ayyaz Ul Haq, Rodrigo Bagur, Mamas Andreas Mamas
Women who undergo percutaneous coronary intervention (PCI) are at higher risk of adverse outcomes compared with men, but it is unknown whether gender affects early unplanned rehospitalization. We analyzed 832,753 patients who underwent PCI from 2013 to 2014 in the Nationwide Readmissions Database. We compared gender differences in incidences, predictors, causes, and cost of unplanned 30-day readmissions and examined the effect of co-morbidity. A total of 832,753 men and women who survived the index PCI and were not admitted for a planned readmission were included in the analysis...
January 10, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29448818/managing-in-hospital-quality-improvement-an-importance-performance-analysis-to-set-priorities-for-st-elevation-myocardial-infarction-care
#19
Daan Aeyels, Deborah Seys, Peter R Sinnaeve, Marc J Claeys, Sofie Gevaert, Danny Schoors, Walter Sermeus, Massimiliano Panella, Luk Bruyneel, Kris Vanhaecht
BACKGROUND: A focus on specific priorities increases the success rate of quality improvement efforts for broad and complex-care processes. Importance-performance analysis presents a possible approach to set priorities around which to design and implement effective quality improvement initiatives. Persistent variation in hospital performance makes ST-elevation myocardial infarction care relevant to consider for importance-performance analysis. AIMS: The purpose of this study was to identify quality improvement priorities in ST-elevation myocardial infarction care...
February 1, 2018: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/29448810/safety-and-effectiveness-of-zotarolimus-eluting-stents-for-percutaneous-coronary-intervention-a-systematic-review
#20
Jesse X Yang, Robert W Yeh
Drug-eluting stents revolutionized the treatment of coronary artery disease with vastly improved outcomes compared with bare metal stents. As stent technology has evolved, a wide variety of antiproliferative drugs have been developed to prevent stent restenosis and stent thrombosis. The Resolute stent system (Medtronic, CA, USA) elutes zotarolimus from a multipolymer blend to prevent early and late stent-related complications. The Resolute stents have evolved from the initial Resolute stent, to the Resolute Integrity™ and most recently, the Resolute Onyx™...
February 16, 2018: Future Cardiology
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