Relation of Multivessel Primary Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction to Outcome and/or Non-Infarct Artery Intervention of a Chronic Total Occlusion
We read with interest the recent report by Cavender et al, questioning the guidelines and use of multivessel percutaneous coronary intervention (PCI) in the setting of ST elevation myocardial infarction (STEMI). The investigators concluded that multivessel primary PCI for STEMI does not improve in-hospital outcomes, even in patients with cardiogenic shock. (Source: The American Journal of Cardiology)...
POSTED 03/09/2010 at 07:57 AM --
|
Differences in Patient Survival After Acute Myocardial Infarction by Hospital Capability of Performing Percutaneous Coronary Intervention: Implications for Regionalization [Original Investigation]
Conclusions The magnitude of benefit from comprehensively regionalizing AMI care to PCI hospitals appears to vary greatly across HRRs. These findings support a tailored regionalization policy that targets areas with the greatest outcome differences between PCI and local non-PCI hospitals. (Source: Archives of Internal Medicine)...
POSTED 03/08/2010 at 02:50 PM --
|
Avoiding Intelligence Failures in the Cardiac Catheterization Laboratory: Strategies for the Safe and Rational Use of Dalteparin or Enoxaparin During Percutaneous Coronary Intervention
LMWH approaches in the cath lab can be readily monitored with the point-of-care activated clotting time (ACT) assay. This review explains how and why. The Journal of Invasive Cardiology (Source: Medscape Today Headlines)...
POSTED 03/08/2010 at 06:04 AM --
|
Vanishing platelets: rapid and extreme tirofiban-induced thrombocytopenia after percutaneous coronary intervention for acute myocardial infarction.
Authors: Rahman N, Jafary FH
Glycoprotein IIb/IIIa inhibitors are established treatment for patients who develop acute coronary syndromes. Thrombocytopenia is known to occur following the administration of various drugs, including heparin and glycoprotein IIb/IIIa inhibitors. In the case of glycoprotein IIb/IIIa inhibitors, the mechanism is thought to be drug-dependent antibodies. In most cases, the thrombocytopenia is mild or moderate in severity. Severe thrombocytopenia (platelet count, <50 x 109/L) is distinctly rare.Herein, we report a case of tirofiban-induced thrombocytopenia in which the overall platelet count dropped precipitously to <1 x 109/L within 12 hours of administration; recovery was relatively prolonged, possibly owing to concomitant renal insufficiency. The seve......
POSTED 03/06/2010 at 05:20 PM --
|
Revascularization options in patients with chronic kidney disease.
Authors: Ashrith G, Elayda MA, Wilson JM
Cardiovascular disease is the leading cause of death in patients who have chronic kidney disease or end-stage renal disease and are undergoing hemodialysis. Chronic kidney disease is a recognized risk factor for premature atherosclerosis. Unfortunately, most major randomized clinical trials that form the basis for evidence-based use of revascularization procedures exclude patients who have renal insufficiency. Retrospective, observational studies suggest that patients with end-stage renal disease and severe coronary occlusive disease have a lower risk of death if they undergo coronary revascularization rather than medical therapy alone. Due to a lack of prospective studies, however, the relative merits of percutaneous versus surgical revasculari......
POSTED 03/06/2010 at 05:20 PM --
|
The Paclitaxel-Eluting Coroflex™ Stent Study II (PECOPS II) Acute and 6-Month Clinical and Angiographic Follow-Up, 1-Year Clinical Follow-Up
Conclusion: The data of the Paclitaxel-eluting Coroflex[trade] Please stent evaluated in PECOPS II are within the range of the other currently available Paclitaxel-eluting stent. (J Interven Cardiol 2009;**:1[ndash]7) (Source: Journal of Interventional Cardiology)...
POSTED 03/04/2010 at 06:00 PM --
|
Journal Scan: A Randomized Comparison of the Endeavor Zotarolimus-Eluting Stent Versus the TAXUS Paclitaxel-Eluting Stent in de novo Native Coronary Lesions: 12-Month Outcomes From the ENDEAVOR IV Trial (J Am Coll Cardiol 2009;55:543-54.)
The authors reported the 1-year results of the ENDEAVOR IV trial. This trial randomized 1,548 patients undergoing percutaneous coronary intervention to PES or ZES. The primary endpoint of the trial was 9-month target vessel failure defined as cardiac death, myocardial infarction, or target vessel re. . . (Source: Cardiosource)...
POSTED 03/04/2010 at 06:00 PM --
|
Trends During 1993-2004 in the Availability and Use of Revascularization After Acute Myocardial Infarction in Markets Affected by Certificate of Need Regulations
This study examines trends in the diffusion of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI) during 1993-2004 for patients with acute myocardial infarction in markets with and without Certificate of Need (CON) regulations for open-heart surgery or cardiac catheterization and in markets that repealed CON for either of these procedures. In contrast to prior studies, this study accounts for regional hospital markets that cross state boundaries—often with different CON activities in each state. The overall use of CABG increased modestly throughout the 1990s and subsequently decreased, corresponding to a dramatic increase in PCI. There was a greater rise in the number of CABG programs in markets with significant reduction in CON regulations during 1993-2......
POSTED 03/04/2010 at 05:55 PM --
|
Effects of stent implementation on plasma levels of asymmetric dimethylarginine in patients with or without ST-segment elevation acute myocardial infarction.
Authors: Ajtay Z, Németh A, Sulyok E, Cziráki A, Szabados S, Martens-Lobenhoffer J, Awiszus F, Szabó C, Bode-Böger SM
The study was designed to compare the response pattern of plasma l-arginine and methylarginines to stent placement in patients with or without ST segment elevation myocardial infarction (STEMI). Two groups of patients with obstructive coronary artery disease (OCAD) undergoing percutaneous coronary intervention (PCI) with stenting were enrolled in the study. Group I consisted of 16 patients with STEMI, whereas group II included 24 patients without STEMI (controls). Before PCI and at <1 h, 5 and 30 days after reperfusion, blood samples were taken for measurement of l-arginine and methylarginines. L-arginine, asymmetric dimethylarginine (ADMA), symme......
POSTED 03/04/2010 at 07:22 AM --
|
Outcomes of Patients with Coronary Artery Perforation Complicating Percutaneous Coronary Intervention and Correlations with the Type of Adjunctive Antithrombotic Therapy: Pooled Analysis from REPLACE-2, ACUITY, and HORIZONS-AMI Trials. Heparin Only Should be Considered for Lesions at High Risk For Perforation
(J Interven Cardiol 2009;**:1) (Source: Journal of Interventional Cardiology)...
POSTED 03/03/2010 at 06:00 PM --
|
Prognostic Value of Exercise Myocardial Scintigraphy in Patients with Coronary Chronic Total Occlusions
Conclusions: Among patients with a residual CTO left untreated after PCI, myocardial perfusion imaging provides significant independent information concerning the subsequent risk of cardiac events. (J Interven Cardiol 2010;**:1[ndash]10) (Source: Journal of Interventional Cardiology)...
POSTED 03/03/2010 at 06:00 PM --
|
Recanalization of Complex Coronary Chronic Total Occlusions Using High-Frequency Vibrational Energy CROSSER Catheter as First-Line Therapy: A Single Center Experience
Conclusion: In the present study, the CROSSER System was safe and obtained a high rate of success in complex CTO similar to conventional dedicated guidewire techniques for noncomplex CTO; however, the CROSSER Catheter obtained CTO recanalization with lower contrast load administration, less time of procedure, and lower fluoroscopy exposure. (J Interven Cardiol 2009;**:1[ndash]9) (Source: Journal of Interventional Cardiology)...
POSTED 03/03/2010 at 06:00 PM --
|
Does Inability To Express Emotions Affect Outcome Of Coronary Angioplasty?
A French investigation published in the current issue of Psychotherapy and Psychosomatics has explored the outcome in terms of physical functioning of coronary angioplasty. Although anxiety and depressive symptoms have been reported to be predictive of poorer functional recovery in coronary heart disease (CHD) patients, little data are available on their effects after percutaneous transluminal coronary angioplasty (PTCA). Alexithymia is a psychological construct that encompasses a deficiency in understanding, processing, or describing emotions... (Source: Health News from Medical News Today)...
POSTED 03/03/2010 at 05:00 AM --
|
Does Inability To Express Emotions Affect Outcome Of Coronary Angioplasty?
A French investigation published in the current issue of Psychotherapy and Psychosomatics has explored the outcome in terms of physical functioning of coronary angioplasty... (Source: Psychology / Psychiatry News From Medical News Today)...
POSTED 03/03/2010 at 05:00 AM --
|
Real World, Long-Term Outcomes Comparison Between Paclitaxel-Eluting and Sirolimus-Eluting Stent Platforms
We compare real-world, extended target vessel revascularization (TVR)-free survival following percutaneous coronary intervention (PCI) for patients receiving either sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) following an index drug-eluting stent (DES) supported procedure. We analyzed 2,363 consecutive patients having first DES-supported PCI at receiving PES (n = 1,012) or SES (n = 1,332) from April 2004 to July 2006. Baseline clinical and procedural characteristics and in-hospital outcomes were recorded during the time of the index procedure and extended clinical outcomes data were obtained thereafter. TVR and all cause mortality were identified during the study period. Adjusted Kaplan-Meier and Cox's proportional hazard survival methods were performed. TVR-free surv......
POSTED 03/02/2010 at 06:00 PM --
|
Safety and effectiveness of bivalirudin in routine care of patients undergoing PCI
Source: Eur Heart J
Area: News
Recent trials have found that bivalirudin is non-inferior to heparin with respect to death and repeat revascularisation, with a decrease in the risk of major bleeds. However, the use of bivalirudin in the context of routine care has not been evaluated.
To further investigate, researchers identified 127 185 individuals from a US cohort of patients who underwent inpatient percutaneous coronary intervention (PCI) between June 2003 and December 2006 and were administered either bivalirudin plus provisional glycoprotein IIb/IIIa inhibitor (GPI) or heparin (at least 1000 units) plus GPI. The primary outcome was blood transfusions, as represented in the database by order of any blood product.
The adjusted hazard ratio (HR) for blood t......
POSTED 03/02/2010 at 06:00 PM --
|
Determinants of functional recovery after myocardial infarction of patients treated with bone marrow-derived stem cells after thrombolytic therapy
Conclusions
The global LVEF recovers most significantly after intracoronary infusion of BMC in patients with the most severe impairment of LVEF on admission. The baseline levels of natriuretic peptides seem also to be associated with LVEF recovery after BMC treatment.
Trial registration
ClinicalTrials.gov number, NCT00363324. (Source: Heart)...
POSTED 03/02/2010 at 08:19 AM --
|
Leading interventional cardiologist suggests robotic system from Corindus can potentially raise the standard of care for percutaneous coronary intervention (PCI); podium presentation made at 'CRT 2010'
Clinical trials imminent for CorPath™ System
NATICK, Mass.--(HSMN NewsFeed)--Corindus Vascular Robotics—an emerging medical technology company focused on precision vascular robotic systems designed to improve patient outcomes while protecting physicians... Devices, Interventional CardiologyCorindus Vascular Robotics, CorPath, vascular robotic system, angioplasty (Source: HSMN NewsFeed)...
POSTED 03/01/2010 at 06:43 PM --
|
Two-Year Clinical Registry Follow-up of Endothelial Progenitor Cell Capture Stent Versus Sirolimus-Eluting Bioabsorbable Polymer-Coated Stent Versus Bare Metal Stents in Patients Undergoing Primary Percutaneous Coronary Intervention for ST Elevation Myocardial Infarction
Conclusion: EPC stent appeared to be safe and had comparable clinical efficacy with a BMS when used in the AMI setting. At 2-year follow-up, the EPC group showed favorable, single-digit TVR rate and stent thrombosis remained a low-event occurrence. (J Interven Cardiol 2010;**:1[ndash]8) (Source: Journal of Interventional Cardiology)...
POSTED 03/01/2010 at 06:00 PM --
|
Contrast medium nephrotoxicity after renal artery and coronary angioplasty.
Conclusion: In this preliminary study patients submitted to PTRA showed a lower susceptibility to renal damage induced by CM administration than PCI patients. The effectiveness of PTRA on renal function seems to be barely influenced by CM toxicity.
PMID: 20192893 [PubMed - as supplied by publisher] (Source: Acta Radiologica)...
POSTED 03/01/2010 at 06:00 PM --
|
