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https://www.readbyqxmd.com/read/29451075/short-term-outcomes-of-preoperative-intra-aortic-balloon-pump-use-in-patients-undergoing-adjunctive-coronary-endarterectomy-a-retrospective-observational-study
#1
Liangshan Wang, Xing Hao, Xiaomeng Wang, Chengxiong Gu, Hong Wang, Xiaotong Hou
BACKGROUND: Coronary artery bypass grafting (CABG) combined with coronary endarterectomy (CE) can be associated with high operative mortality and morbidity. An intra-aortic balloon pump (IABP) has been the most widely used mechanical circulatory support device during perfusion treatment. However, the benefits of preoperative IABP in CABG combined with CE remain unknown. We conducted a retrospective observational study to evaluate the efficacy of preoperative IABP therapy in patients undergoing adjunctive right coronary artery (RCA) endarterectomy...
February 1, 2018: Perfusion
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
#2
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/29447787/rationale-and-design-of-the-comparison-between-a-p2y12-inhibitor-monotherapy-versus-dual-antiplatelet-therapy-in-patients-undergoing-implantation-of-coronary-drug-eluting-stents-smart-choice-a-prospective-multicenter-randomized-trial
#3
Young Bin Song, Seok Kyu Oh, Ju-Hyeon Oh, Eul-Soon Im, Deok-Kyu Cho, Byung Ryul Cho, Jong-Young Lee, Joo Myung Lee, Taek Kyu Park, Jeong Hoon Yang, Jin-Ho Choi, Seung-Hyuck Choi, Sang Hoon Lee, Hyeon-Cheol Gwon, Joo-Yong Hahn
BACKGROUND AND RATIONALE: Dual antiplatelet therapy (DAPT) with aspirin and a P2Y12 inhibitor reduces thrombotic events in patients undergoing percutaneous coronary intervention (PCI), but these benefits come at the expense of increased risk of bleeding when compared with aspirin monotherapy. It is unclear whether P2Y12 inhibitor monotherapy might maintain anti-ischemic efficacy while reducing the bleeding risk compared with DAPT after implantation of the current generation of drug-eluting stents (DES)...
March 2018: American Heart Journal
https://www.readbyqxmd.com/read/29439831/routine-invasive-versus-selective-invasive-strategy-in-elderly-patients-older-than-75-years-with-non-st-segment-elevation-acute-coronary-syndrome-a-systematic-review-and-meta-analysis
#4
Aakash Garg, Lohit Garg, Manyoo Agarwal, Amit Rout, Hitesh Raheja, Sahil Agrawal, Sunil V Rao, Marc Cohen
OBJECTIVE: To evaluate outcomes of routine invasive strategy (RIS) compared with selective invasive strategy (SIS) in elderly patients older than 75 years with non-ST-segment elevation acute coronary syndrome (NSTE-ACS). METHODS: We systematically searched databases for randomized controlled trials (RCTs) between January 1, 1990, and October 1, 2016, comparing RIS with SIS for elderly patients (age>75 years) with NSTE-ACS. Random effects meta-analysis was conducted to estimate odds ratio (OR) with 95% CIs for composite of death or myocardial infarction (MI), and individual end points of all-cause death, cardiovascular (CV) death, MI, revascularization, and major bleeding...
February 10, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29435272/optimal-antithrombotic-therapy-in-patients-with-atrial-fibrillation-following-percutaneous-coronary-intervention-a-systemic-review-and-meta-analysis
#5
Jing-Xiu Li, Yang Li, Shu-Jun Yan, Bai-He Han, Zhao-Yan Song, Wei Song, Shi-Hao Liu, Ji-Wei Guo, Shuo Yin, Ye-Ping Chen, De-Jun Xia, Xin Li, Xue-Qi Li, En-Ze Jin
A challenge for antithrombotic treatment is patients who present with atrial fibrillation (AF) and acute coronary syndrome, particularly in patients who have undergone coronary percutaneous intervention with stenting (PCIS). In the present study, a total of nine observational trials published prior to July 2017 that investigated the effects of dual antiplatelet therapy (DAPT; aspirin + clopidogrel) and triple oral antithrombotic therapy (TOAT; DAPT + warfarin) among patients with AF concurrent to PCIS were collected from the Medline, Cochrane and Embase databases and conference proceedings of cardiology, gastroenterology and neurology meetings...
February 2018: Biomedical Reports
https://www.readbyqxmd.com/read/29432119/anticoagulant-use-among-patients-with-end-stage-renal-disease-undergoing-percutaneous-coronary-intervention-an-analysis-from-the-national-cardiovascular-data-registry
#6
Jeffrey B Washam, Lisa A Kaltenbach, Daniel M Wojdyla, Manesh R Patel, Andrew J Klein, J Dawn Abbott, Sunil V Rao
BACKGROUND: Patients with end-stage renal disease undergoing percutaneous coronary intervention (PCI) have largely been excluded from trials of antithrombotic therapies leaving little data to guide agent choice in this population. METHODS AND RESULTS: The National Cardiovascular Data Registry CathPCI Registry was used to identify patients with end-stage renal disease undergoing PCI who received monotherapy with either bivalirudin or unfractionated heparin (UFH) (n=71 675)...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29421012/clinical-features-and-outcomes-of-patients-with-type-2-myocardial-infarction-insights-from-the-thrombin-receptor-antagonist-for-clinical-event-reduction-in-acute-coronary-syndrome-tracer-trial
#7
Patrícia O Guimarães, Sergio Leonardi, Zhen Huang, Lars Wallentin, Frans Van de Werf, Philip E Aylward, Claes Held, Robert A Harrington, David J Moliterno, Paul W Armstrong, Harvey D White, Karen P Alexander, Renato D Lopes, Kenneth W Mahaffey, Pierluigi Tricoci
BACKGROUND: Type 2 myocardial infarction (MI) is characterized by an imbalance between myocardial blood supply and demand, leading to myocardial ischemia without coronary plaque rupture, but its diagnosis is challenging. METHODS: In the TRACER trial, patients with non-ST-segment elevation acute coronary syndromes were included. We aimed to describe provoking factors, cardiac biomarker profiles, treatment patterns, and clinical outcomes of patients with type 2 MIs...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29417147/direct-oral-anticoagulants-in-addition-to-antiplatelet-therapy-for-secondary-prevention-after-acute-coronary-syndromes-a-systematic-review-and-meta-analysis
#8
Mauro Chiarito, Davide Cao, Francesco Cannata, Cosmo Godino, Corrado Lodigiani, Giuseppe Ferrante, Renato D Lopes, John H Alexander, Bernhard Reimers, Gianluigi Condorelli, Giulio G Stefanini
Importance: Patients with acute coronary syndrome (ACS) remain at high risk for experiencing recurrent ischemic events. Direct oral anticoagulants (DOAC) have been proposed for secondary prevention after ACS. Objective: To evaluate the safety and efficacy of DOAC in addition to antiplatelet therapy (APT) after ACS, focusing on treatment effects stratified by baseline clinical presentation (non-ST-segment elevation ACS [NSTE-ACS] vs ST-segment elevation myocardial infarction [STEMI])...
February 7, 2018: JAMA Cardiology
https://www.readbyqxmd.com/read/29416215/a-difference-in-bleeding-and-use-of-blood-and-blood-products-in-patients-who-were-preoperatively-on-aspirin-or-dual-antiplatelet-therapy-before-coronary-artery-bypass-grafting
#9
Slavenka Straus, Ilirijana Haxhibeqiri-Karabdic, Sanja Granov Grabovica, Nermir Granov
Background: Postoperative bleeding in patients who underwent elective coronary artery bypass surgery (CABG) may increase due to preoperative anticoagulant therapy indicative of their disease - acute coronary syndrome or implanted coronary artery stent. Increased bleeding in many cases requires the use of blood and blood derivatives, and sometimes even reoperation. Their use poses the risk of complications, may extend the hospitalization. Methods: Our observation retrospective study included 131 patients, 41 treated with aspirin and 90 treated with aspirin and clopidogrel...
February 2018: Medical Archives
https://www.readbyqxmd.com/read/29415954/antiplatelet-therapy-in-acs-patients-comparing-appropriate-p2y12-inhibition-by-clopidogrel-to-the-use-of-new-p2y12-inhibitors
#10
Jessica Ristorto, Nathan Messas, Benjamin Marchandot, Marion Kibler, Sébastien Hess, Nicolas Meyer, Michael Schaeffer, Nicolas Tuzin, Patrick Ohlmann, Laurence Jesel, Olivier Morel
AIM: In percutaneous coronary intervention (PCI)-treated acute coronary syndrome (ACS) patients on clopidogrel therapy, high on-treatment platelet adenosine diphosphate (ADP) reactivity was observed in numerous studies, with significant increases in non-fatal myocardial infarction, definite/probable stent thrombosis, or cardiovascular mortality. Compared to clopidogrel, prasugrel and ticagrelor provide more potent platelet inhibition. Whether new P2Y12 inhibitors reduce thrombotic events in a similar manner compared to the rate observed with appropriate P2Y12 inhibition by clopidogrel must still be determined...
February 8, 2018: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/29407124/systematic-detection-of-polyvascular-disease-combined-with-aggressive-secondary-prevention-in-patients-presenting-with-severe-coronary-artery-disease-the-randomized-america-study
#11
Jean-Philippe Collet, Guillaume Cayla, Pierre-Vladimir Ennezat, Florence Leclercq, Thomas Cuisset, Simon Elhadad, Patrick Henry, Loic Belle, Ariel Cohen, Johanne Silvain, Olivier Barthelemy, Farzin Beygui, Abdourahmane Diallo, Eric Vicaut, Gilles Montalescot
BACKGROUND: The prevalence and associated-risk of asymptomatic multisite artery disease (MSAD) in high risk coronary patients are unknown. Whether systematic identification and aggressive management of asymptomatic MSAD is clinically relevant in high risk coronary patients has not been evaluated. METHODS: We randomly assigned 521 high risk coronary patients defined by the presence of three-vessel coronary disease (n=304) or recent acute coronary syndrome beyond the age of 75years (n=215) to either a strategy of systematic detection of asymptomatic MSAD combined with an aggressive secondary prevention (n=263) or to a more conventional strategy based on treatment of coronary artery disease only with standard of care (n=258)...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29407077/development-and-external-validation-of-a-post-discharge-bleeding-risk-score-in-patients-with-acute-coronary-syndrome-the-bleemacs-score
#12
Sergio Raposeiras-Roubín, Jonas Faxén, Andrés Íñiguez-Romo, Jose Paulo Simao Henriques, Fabrizio D'Ascenzo, Jorge Saucedo, Karolina Szummer, Tomas Jernberg, Stefan K James, José Ramón González Juanatey, Stephen B Wilton, Wouter J Kikkert, Iván Nuñez-Gil, Albert Ariza-Sole, Xiantao Song, Dimitrios Alexopoulos, Christoph Liebetrau, Tetsuma Kawaji, Claudio Moretti, Zenon Huczek, Shao-Ping Nie, Toshiharu Fujii, Luis Correia, Masa-Aki Kawashiri, Berenice Caneiro-Queija, Rafael Cobas-Paz, José María García Acuña, Danielle Southern, Emilio Alfonso, Belén Terol, Alberto Garay, Dongfeng Zhang, Yalei Chen, Ioanna Xanthopoulou, Neriman Osman, Helge Möllmann, Hiroki Shiomi, Francesca Giordana, Fiorenzo Gaita, Michal Kowara, Krzysztof Filipiak, Xiao Wang, Yan Yan, Jing-Yao Fan, Yuji Ikari, Takuya Nakahayshi, Kenji Sakata, Masakazu Yamagishi, Oliver Kalpak, Sasko Kedev, Daniel Rivera-Asenjo, Emad Abu-Assi
BACKGROUND: Accurate 1-year bleeding risk estimation after hospital discharge for acute coronary syndrome (ACS) may help clinicians guide the type and duration of antithrombotic therapy. Currently there are no predictive models for this purpose. The aim of this study was to derive and validate a simple clinical tool for bedside risk estimation of 1-year post-discharge serious bleeding in ACS patients. METHODS: The risk score was derived and internally validated in the BleeMACS (Bleeding complications in a Multicenter registry of patients discharged with diagnosis of Acute Coronary Syndrome) registry, an observational international registry involving 15,401 patients surviving admission for ACS and undergoing percutaneous coronary intervention (PCI) from 2003 to 2014, engaging 15 hospitals from 10 countries located in America, Europe and Asia...
March 1, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29405601/the-promise-of-effective-p2y12-platelet-receptor-pretreatment-not-crushed-yet
#13
EDITORIAL
Arka Chatterjee, William B Hillegass
Pre-treatment with intact oral clopidogrel and prasugrel tablets in a representative observational study is not associated with altered ischemic or bleeding outcomes in acute coronary syndrome (ACS) patients. Limited by cost, cangrelor, a rapidly acting intravenous P2Y12 platelet receptor inhibitor, achieved meaningful reductions in major adverse cardiovascular events (MACE) and stent thrombosis (ST) compared to oral clopidogrel pretreatment. Crushed prasugrel and ticagrelor (CP&T) administered orally achieve accepted thresholds of therapeutic platelet inhibition in one hour in approximately 2/3rds of patients compared to 1/3rd with intact oral tablets...
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29398917/ticagrelor-toward-more-efficient-platelet-inhibition-and-beyond
#14
REVIEW
Michał J Kubisa, Mateusz P Jezewski, Aleksandra Gasecka, Jolanta M Siller-Matula, Marek Postuła
Novel antiplatelet drugs, including ticagrelor, are being successively introduced into the therapy of atherothrombotic conditions due to their superiority over a standard combination of clopidogrel with acetylsalicylic acid in patients with acute coronary syndromes (ACS). A P2Y12 receptor antagonist, ticagrelor, is unique among antiplatelet drugs, because ticagrelor inhibits the platelet P2Y12 receptor in a reversible manner, and because it demonstrates a wide palette of advantageous pleiotropic effects associated with the increased concentration of adenosine...
2018: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/29391805/role-of-rivaroxaban-in-the-management-of-atrial-fibrillation-insights-from-clinical-practice
#15
REVIEW
Kavitha Vimalesvaran, Seth J Dockrill, Diana A Gorog
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and it leads to significant morbidity and mortality, predominantly from ischemic stroke. Vitamin K antagonists, mainly warfarin, have been used for decades to prevent ischemic stroke in AF, but their use is limited due to interactions with food and other drugs, as well as the requirement for regular monitoring of the international normalized ratio. Rivaroxaban, a direct factor Xa inhibitor and the most commonly used non-vitamin K oral anticoagulant, avoids many of these challenges and is being prescribed with increasing frequency for stroke prevention in non-valvular AF...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29390064/fibrin-clot-properties-independently-predict-adverse-clinical-outcome-following-acute-coronary-syndrome-a-plato-substudy
#16
Wael Sumaya, Lars Wallentin, Stefan K James, Agneta Siegbahn, Katja Gabrysch, Maria Bertilsson, Anders Himmelmann, Ramzi A Ajjan, Robert F Storey
Aims: To determine whether fibrin clot properties are associated with clinical outcomes following acute coronary syndrome (ACS). Methods and results: Plasma samples were collected at hospital discharge from 4354 ACS patients randomized to clopidogrel or ticagrelor in the PLATelet inhibition and patient Outcomes (PLATO) trial. A validated turbidimetric assay was employed to study plasma clot lysis time and maximum turbidity (a measure of clot density). One-year rates of cardiovascular (CV) death, spontaneous myocardial infarction (MI) and PLATO-defined major bleeding events were assessed after sample collection...
January 29, 2018: European Heart Journal
https://www.readbyqxmd.com/read/29384900/a-case-report-of-acute-inferior-myocardial-infarction-in-a-patient-with-severe-hemophilia-a-after-recombinant-factor-viii-infusion
#17
Silva Zupančić-Šalek, Marijo Vodanović, Dražen Pulanić, Boško Skorić, Irina Matytsina, Jolanta Klovaite
RATIONALE: The extent of protective effects of hemophilia against thrombotic events such as myocardial infarction (MI) and other acute coronary syndromes remains to be determined, as major risk factors for cardiovascular disease exist despite factor VIII (FVIII) deficiency. We present a case report of a 41-year-old male with severe hemophilia A and several cardiovascular risk factors. PATIENT CONCERNS: This morbidly obese patient developed chest pressure, followed by chest pain and difficulty in breathing shortly after receiving on-demand treatment with intravenous recombinant FVIII (rFVIII) (turoctocog alfa) dosed per body weight...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29374936/-feasibility-and-safety-of-paclitaxel-eluting-balloon-for-the-treatment-of-de-novo-coronary-lesions
#18
Z H Ni, W H Huang, Y Liu, Z J Chen, J Li, J Q Yang, P C He, Y L Zhou, J Y Chen, J F Luo
Objective: To evaluate the safety and feasibility of treating de novo coronary lesions with paclitaxel-eluting balloon. Methods: This is a retrospective study, which enrolled 76 patients with 80 de novo coronary lesions treated with paclitaxel-eluting balloons(<30% residual stenosis and there was no blood flow limited dissection after pretreatment) from April 2015 to November 2016 in Guangdong general hospital. The data of basic characteristics,procedures,devices and follow-up information were retrieved and analyzed...
January 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
https://www.readbyqxmd.com/read/29368241/femoral-access-site-closure-without-prior-femoral-angiography-a%C3%A2-retrospective-analysis
#19
Christoph Brenner, Julian Margreitter, Alexandra Gratl, Josef Klocker, Rudolf Kirchmair, Peter Marschang, Guy Friedrich, Bernhard Metzler, Nicolas Moes
AIMS AND BACKGROUND: Although guideline recommendations have shifted towards a transradial route, femoral puncture is still an established vascular access, especially for complex coronary interventions. The FemoSeal™ vascular closure device (FVCD) helps to reduce femoral compression time and access site complications after removal of the catheter sheath. To ensure safe use, an angiography of the femoral artery prior to FVCD deployment is recommended by the manufacturer. We postulate that omitting this angiography does not relevantly increase the risk for vascular complications...
January 24, 2018: Wiener Klinische Wochenschrift
https://www.readbyqxmd.com/read/29366991/comparison-of-cardiovascular-outcomes-and-all-cause-mortality-in-patients-with-chronic-hepatitis-b-and-c-a-13-year-nationwide-population-based-study-in-asia
#20
Victor Chien-Chia Wu, Tien-Hsing Chen, Michael Wu, Chun-Wen Cheng, Shao-Wei Chen, Chun-Wei Chang, Ching-Chang Chen, Shang-Hung Chang, Kuo-Chun Hung, Ming-Shyan Chern, Fen-Chiung Lin, Pao-Hsien Chu, Cheng-Shyong Wu
BACKGROUND AND AIMS: Viral hepatitis infection has been linked to increased atherosclerosis. We therefore investigated cardiovascular outcomes in patients with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. METHODS: Electronic medical records during 2000-2012 were retrieved from the Taiwan National Health Insurance Research Database. Exclusion criteria were age <18, history of coexisting HBV and HCV infection, acute coronary syndrome, coronary intervention, venous thromboembolism, peripheral artery disease, stroke, major or gastrointestinal bleeding, malignancy, and a follow-up period <180 days...
January 12, 2018: Atherosclerosis
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