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https://www.readbyqxmd.com/read/27907885/complete-revascularization-versus-culprit-only-revascularization-in-st-segment-elevation-myocardial-infarction-and-multivessel-disease-patients-undergoing-primary-percutaneous-coronary-intervention-a-meta-analysis-and-trial-sequential-analysis
#1
REVIEW
Chong-Hui Wang, Shu-Yang Zhang, Xiao-Feng Jin
The present study compared the outcomes of complete revascularization (CR) and culprit-only revascularization (COR) performed during primary percutaneous coronary intervention (PCI) in patients with ST-segment elevation myocardial infarction (STEMI) and multivessel disease through a meta-analysis in order to determine which strategy is more appropriate. Published randomized controlled trials (RCTs) were retrieved from the PubMed, EMBASE, and CENTRAL databases. Eight RCTs with 2060 patients were selected (1080 patients underwent CR [immediate (ICR) or staged (SCR)] and 980 patients underwent COR)...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27899408/percutaneous-coronary-intervention-using-drug-eluting-stents-versus-coronary-artery-bypass-grafting-for-unprotected-left-main-coronary-artery-stenosis-a-meta-analysis-of-randomized-trials
#2
Nitesh Nerlekar, Francis J Ha, Kunal P Verma, Martin R Bennett, James D Cameron, Ian T Meredith, Adam J Brown
BACKGROUND: Current guidelines suggest that coronary artery bypass grafting (CABG) should be the preferred revascularization method for unprotected left main coronary artery stenosis. In light of evidence from recent randomized trials, we assessed whether percutaneous coronary intervention (PCI) using drug-eluting stents is as safe and effective as CABG for the treatment of unprotected left main coronary artery disease. METHODS AND RESULTS: Digital databases and manual searches were performed for randomized trials comparing PCI and CABG for unprotected left main coronary artery stenosis...
December 2016: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/27898433/transcatheter-aortic-valve-implantation-in-nonagenarians
#3
Adam Penkalla, Joerg Kempfert, Axel Unbehaun, Semih Buz, Thorsten Drews, Miralem Pasic, Volkmar Falk
OBJECTIVE: In this report, we assess the outcome of transcatheter aortic valve implantation (TAVI) in nonagenarians at our institution during a 6-year period. METHODS: Between April 2008 and July 2014, 40 patients with a mean ± SD age of 91.8 ± 2.3 years (range, 90-98 years) underwent TAVI. Thirty-three patients (82.5%) received transapical TAVI, and seven patients (17.5%) received transfemoral TAVI. Baseline characteristics were as follows: mean ± SD EuroSCORE II, 23...
November 28, 2016: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/27896904/contrast-induced-encephalopathy-following-cardiac-catheterization
#4
Roberto Spina, Neil Simon, Romesh Markus, David Wm Muller, Krishna Kathir
OBJECTIVES: To describe the epidemiology, pathophysiology, clinical presentation, and management of contrast-induced encephalopathy (CIE) following cardiac catheterization. BACKGROUND: CIE is an acute, reversible neurological disturbance directly attributable to the intra-arterial administration of iodinated contrast medium. METHODS: The PubMed database was searched and all cases in the literature were retrieved and reviewed. RESULTS: 52 reports of CIE following cardiac catheterization were found...
November 29, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27894260/high-platelet-reactivity-affects-the-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#5
Jun-Jie Zhang, Xiao-Fei Gao, Zhen Ge, Nai-Liang Tian, Zhi-Zhong Liu, Song Lin, Fei Ye, Shao-Liang Chen
BACKGROUND: The association of platelet reactivity and clinical outcomes, especially stent thrombosis, was not so clear. We sought to investigate whether high platelet reactivity affects clinical outcomes of patients with drug eluting stents (DESs) implantation. METHODS: All enrolled individuals treated with DESs implantation were evaluated by PL-11, using sequentially platelet counting method. The primary end point was the occurrence of definite and probable stent thrombosis at 2 years...
November 29, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27890301/thrombolytic-therapy-associated-acute-myocardial-infarction-in-patients-with-acute-ischemic-stroke-a-treatment-dilemma
#6
Chih-Jen Yang, Po-Chuan Chen, Chin-Sheng Lin, Chia-Lin Tsai, Shih-Hung Tsai
Acute myocardial infarction (AMI) is uncommon in the acute phase of acute ischemic stroke (AIS) and occurs in approximately 1% of the population. Here, we report a paradoxical case of AMI during tissue plasminogen activator (t-PA) infusion for AIS. We review and analyze the previously reported cases. We found that only patients with AMI which occurred after thrombolytic therapy for AIS who received an adequate combination of anticoagulation plus percutaneous coronary intervention survived their events. Several mechanisms have been proposed for the development of AMI after thrombolytic therapy...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27886825/antiplatelet-and-antithrombotic-therapy-in-patients-with-atrial-fibrillation-undergoing-coronary-stenting
#7
REVIEW
Mikhail S Dzeshka, Richard A Brown, Davide Capodanno, Gregory Y H Lip
Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months...
January 2017: Interventional cardiology clinics
https://www.readbyqxmd.com/read/27881850/relationship-between-asymptomatic-intra-cranial-lesions-and-brachial-ankle-pulse-wave-velocity-in-coronary-artery-disease-patients-without-stroke
#8
Noriaki Tabata, Daisuke Sueta, Takayoshi Yamashita, Daisuke Utsunomiya, Yuichiro Arima, Eiichiro Yamamoto, Kenichi Tsujita, Sunao Kojima, Koichi Kaikita, Seiji Hokimoto
Little is known about the significance of asymptomatic intra-cranial lesions (ICL) identified by brain MRI in coronary artery disease (CAD) patients. Silent cerebral lesions are suggested to be associated with arterial stiffness in healthy subjects. We investigated whether subclinical ICL are associated with arterial stiffness and the prognosis in CAD patients without medical history of cerebrovascular diseases. We recruited CAD patients who required percutaneous coronary intervention (PCI), did not meet exclusion criteria, and agreed with MRI before PCI...
November 24, 2016: Hypertension Research: Official Journal of the Japanese Society of Hypertension
https://www.readbyqxmd.com/read/27879000/impact-of-prior-permanent-pacemaker-on-long-term-clinical-outcomes-of-patients-undergoing-percutaneous-coronary-intervention
#9
Yan-Jie Li, Wei-Wei Zhang, Xiao-Xiao Yang, Ning Li, Xing-Biao Qiu, Xin-Kai Qu, Wei-Yi Fang, Yi-Qing Yang, Ruo-Gu Li
BACKGROUND: The impact of permanent pacemaker (PPM) on long-term clinical outcomes of patients undergoing percutaneous coronary intervention (PCI) has not been studied. HYPOTHESIS: PPM may increase heart failure (HF) burden on patients undergoing PCI. METHODS: We recruited consecutive patients undergoing PCI and carried out a nested case-control study. Patients with confirmed PPM undergoing first PCI were identified and matched by age and sex in 1:1 fashion to patients without PPM undergoing first PCI...
November 23, 2016: Clinical Cardiology
https://www.readbyqxmd.com/read/27869561/successful-drug-coated-balloon-angioplasty-and-single-anti-platelet-therapy-to-treat-an-ischaemic-stroke-patient-with-haemorrhage-and-acute-coronary-syndrome
#10
Hee Hwa Ho, Kwang How Mok
A 55-year-old male presented with two challenging problems, i.e. acute coronary syndrome (ACS) and a major bleeding episode. He first presented with ischaemic stroke and was treated with thrombolysis. However this was complicated by haemorrhagic transformation. He subsequently developed ACS with urgent coronary angiography demonstrating a critical stenosis in the proximal left anterior descending artery. Percutaneous coronary intervention (PCI) was deemed necessary but we were mindful of causing bleeding complications from the use of anti-thrombotic therapy...
November 21, 2016: Acute Cardiac Care
https://www.readbyqxmd.com/read/27865182/early-initiation-of-eicosapentaenoic-acid-and-statin-treatment-is-associated-with-better-clinical-outcomes-than-statin-alone-in-patients-with-acute-coronary-syndromes-1-year-outcomes-of-a-randomized-controlled-study
#11
Kazumasa Nosaka, Toru Miyoshi, Mutsumi Iwamoto, Masahito Kajiya, Keisuke Okawa, Saori Tsukuda, Fumi Yokohama, Masahiro Sogo, Tomoyuki Nishibe, Naoaki Matsuo, Satoshi Hirohata, Hiroshi Ito, Masayuki Doi
BACKGROUND: Early initiation of EPA treatment in combination with a statin within 24h after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (MI) reduces inflammation and ventricular arrhythmia compared with statin monotherapy; however, the impact of early initiation of EPA treatment on cardiovascular events is unclear. We determined whether early eicosapentaenoic acid (EPA) treatment in patients with acute coronary syndrome (ACS) reduces adverse cardiovascular events...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27864479/epicardial-adipose-tissue-and-cardiovascular-outcome-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention
#12
Maximilian Tscharre, Christina Hauser, Miklos Rohla, Matthias K Freynhofer, Johann Wojta, Kurt Huber, Thomas W Weiss
AIMS: We investigated the association between epicardial adipose tissue (EAT) thickness and cardiovascular outcomes in a cohort of high-risk patients with acute coronary syndrome undergoing percutaneous coronary intervention. METHODS: Of 1198 patients undergoing percutaneous coronary intervention, transthoracic echocardiography was performed in 438 patients during the index hospitalization. EAT thickness was measured in the parasternal long-axis view perpendicularly on the free wall of the right ventricle at end-systole in three consecutive cardiac cycles and then averaged...
November 18, 2016: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/27863361/transradial-approach-for-coronary-angiography-and-intervention-in-the-elderly-a-meta-analysis-of-777-841-patients
#13
Sami M Alnasser, Akshay Bagai, Sanjit S Jolly, Warren J Cantor, Payam Dehghani, Sunil V Rao, Asim N Cheema
BACKGROUND: Studies showing an advantage of transradial approach (TR) for coronary angiography and intervention (PCI) compared to the transfemoral approach (TF) predominantly included a younger population. Therefore, we conducted a meta-analysis of published studies to determine the efficacy of TR in the elderly population. METHODS AND RESULTS: A comprehensive search identified 16 studies [3 randomized controlled studies, 13 observational] comprising 777,841 elderly patients undergoing PCI...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27858918/global-longitudinal-strain-predicts-incident-atrial-fibrillation-and-stroke-occurrence-after-acute-myocardial-infarction
#14
Flemming Javier Olsen, Sune Pedersen, Jan Skov Jensen, Tor Biering-Sørensen
Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients.The study comprised of 373 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27856952/clinical-outcomes-of-posterior-versus-anterior-circulation-infarction-with-low-national-institutes-of-health-stroke-scale-scores
#15
Joon-Tae Kim, Man-Seok Park, Kang-Ho Choi, Beom Joon Kim, Moon-Ku Han, Tai Hwan Park, Sang-Soon Park, Kyung Bok Lee, Byung-Chul Lee, Kyung-Ho Yu, Mi Sun Oh, Jae Kwan Cha, Dae-Hyun Kim, Hyun-Wook Nah, Jun Lee, Soo Joo Lee, Youngchai Ko, Jae Guk Kim, Jong-Moo Park, Kyusik Kang, Yong-Jin Cho, Keun-Sik Hong, Jay Chol Choi, Dong-Eog Kim, Wi-Sun Ryu, Dong-Ick Shin, Min-Ju Yeo, Wook-Joo Kim, Juneyoung Lee, Ji Sung Lee, Hee-Joon Bae, Jeffrey L Saver, Ki-Hyun Cho
BACKGROUND AND PURPOSE: We compared baseline characteristics and outcomes at 3 months between patients with minor anterior circulation infarction (ACI) versus minor posterior circulation infarction (PCI), including the influence of large vessel disease on outcomes. METHODS: This study is an analysis of a prospective multicenter registry database in South Korea. Eligibility criteria were patients with ischemic stroke admitted within 7 days of stroke onset, lesions in either anterior or posterior circulation, and National Institutes of Health Stroke Scale score of ≤4 at baseline...
November 17, 2016: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/27856669/efficacy-and-safety-of-percutaneous-coronary-intervention-for-elderly-patients-in-the-second-generation-drug-eluting-stent-era-the-shinano-registry
#16
Takashi Miura, Yusuke Miyashita, Hirohiko Motoki, Hideki Kobayashi, Masanori Kobayashi, Hiroyuki Nakajima, Hikaru Kimura, Hiroshi Akanuma, Eiichiro Mawatari, Toshio Sato, Shoji Hotta, Yuichi Kamiyoshi, Takuya Maruyama, Noboru Watanabe, Takayuki Eisawa, Shinichi Aso, Naoto Hashizume, Soichiro Ebisawa, Uichi Ikeda
BACKGROUND: We evaluated the 1-year outcomes of percutaneous coronary intervention (PCI) for elderly patients (aged ≥ 80 years) in the second-generation drug-eluting stent (DES) era. METHODS AND RESULTS: Between August 2012 and July 2013, 1923 consecutive patients (mean age, 71 ± 11 years; ≥80 years, 23%; men, 77%) who underwent 2250 elective/urgent PCI procedures were enrolled in the Shinshu Prospective Multicenter Analysis for Elderly Patients with Coronary Artery Disease Undergoing Percutaneous Coronary Intervention registry...
November 16, 2016: Angiology
https://www.readbyqxmd.com/read/27855640/long-term-secondary-prevention-of-acute-myocardial-infarction-sepat-guidelines-adherence-and-outcome
#17
Constantinos Ergatoudes, Erik Thunström, Annika Rosengren, Lena Björck, Kristina Bengtsson Boström, Kristin Falk, Michael Fu
BACKGROUND: A number of registry studies have reported suboptimal adherence to guidelines for cardiovascular prevention during the first year after acute myocardial infarction (AMI). However, only a few studies have addressed long-term secondary prevention after AMI. This study evaluates prevention guideline adherence and outcome of guideline-directed secondary prevention in patients surviving 2 years after AMI. METHODS: Patients aged 18-85 years at the time of their index AMI were consecutively identified from hospital discharge records between July 2010 and December 2011 in Gothenburg, Sweden...
November 17, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27846459/simplifying-electrocardiographic-assessment-in-stemi-reperfusion-management-pros-and-cons
#18
REVIEW
Cheuk-Kit Wong
Current guidelines on STEMI reperfusion management do not incorporate further electrocardiographic details over the presence of significant ST elevation. Fibrinolysis is considered an alternative therapy to primary PCI if there is a long PCI-related delay, but the 2 therapies should not be combined. Meanwhile, reperfusion for ischemic stroke has evolved on mechanistic understanding - reperfusion benefit being greatest in the patient with small "core" infarct and large ischemic "penumbra". Fibrinolysis is not regarded as an alternative to mechanical thrombectomy, and the 2 therapies can be combined...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27836373/clinical-significance-of-platelet-reactivity-during-prasugrel-therapy-in-patients-with-acute-myocardial-infarction
#19
Tetsuya Sato, Yusuke Namba, Yuya Kashihara, Masamichi Tanaka, Soichiro Fuke, Akihisa Yumoto, Hironori Saito
BACKGROUND: Although some studies have examined platelet reactivity (PR) during prasugrel treatment, little is known about PR during the early treatment period and its clinical significance in Japan. METHODS: We investigated the early and medium-term efficacy and safety of prasugrel in patients with acute myocardial infarction (AMI) undergoing primary percutaneous coronary intervention (PCI). Seventy-eight patients were enrolled and PR was measured (in P2Y12 reaction units; PRU) by the VerifyNow P2Y12 assay (Accumetrics, San Diego, CA, USA)...
November 8, 2016: Journal of Cardiology
https://www.readbyqxmd.com/read/27832467/second-generation-drug-eluting-stents-in-the-elderly-patients-with-acute-coronary-syndrome-the-in-hospital-and-12-month-follow-up-of-the-all-comer-registry
#20
Wojciech Wańha, Damian Kawecki, Tomasz Roleder, Beata Morawiec, Sylwia Gładysz, Adam Kowalówka, Tomasz Jadczyk, Barbara Adamus, Tomasz Pawłowski, Grzegorz Smolka, Maciej Kaźmierski, Andrzej Ochała, Ewa Nowalany-Kozielska, Wojciech Wojakowski
BACKGROUND: Katowice-Zabrze registry provides data that can be used to evaluate clinical outcomes of percutaneous coronary interventions in elderly patients (≥70 y/o) treated with either first- (DES-I) or second-generation (DES-II) drug-eluting stents (DES). METHODS: The registry consisted of data from 1916 patients treated with coronary interventions using either DES-I or DES-II stents. For our study, we defined patients ≥70 years of age as elderly. We evaluated any major adverse cardiac and cerebral events (MACCE) at 12-month follow-up...
November 10, 2016: Aging Clinical and Experimental Research
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