MedWorm: Angioplasty

Emerging Interventional Radiology Treatment With Drug-Eluting Stents Saves Limbs

Drugs.com - Clinical Trials — Sun, 21 Mar 2010 14:15:31 +0100

New Technology Offers Set of Peripheral Arterial Disease (PAD) Patients With Critical Limb Ischemia Excellent Way to Avoid Amputation; Results Rival Bypass Surgery and Are Superior to Balloon Angioplasty Alone TAMPA, Fla., March 15... (Source: Drugs.com - Clinical Trials)

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Journal Scan: Differences in Patient Survival After Acute Myocardial Infarction by Hospital Capability of Performing Percutaneous Coronary Intervention: Implications for Regionalization (Arch Intern Med 2010;170:433-439.)

Cardiosource — Sat, 20 Mar 2010 09:54:50 +0100

The authors evaluated Medicare claims data to assess outcome of patients hospitalized with AMI between January 1, 2004, and December 31, 2006. Hospital level data were evaluated to estimate 30-day risk-standardized mortality rates (RSMRs). The RSMRs for PCI and local non-PCI hospitals were compared . . . (Source: Cardiosource)

Patches of different types for carotid patch angioplasty.

Cochrane Database of Systematic Reviews — Sat, 20 Mar 2010 06:22:03 +0100

CONCLUSIONS: The number of outcome events is too small to allow reliable conclusions to be drawn and more trial data are required to establish whether any differences do exist. Nevertheless, there is some evidence that other synthetic (e.g. PTFE) patches may be superior to collagen impregnated Dacron grafts in terms of perioperative stroke rates and restenosis. Pseudoaneurysm formation may be more common after use of a vein patch compared with a synthetic patch. PMID: 20238308 [PubMed - in process] (Source: Cochrane Database of Systematic Reviews)

Statins in Acute Coronary Syndromes and Genetic Insight

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:34 +0100

This report is similar to the original PROVE IT–TIMI 22 (Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22) results and raises 3 additional questions of clinical importance. First, was the MACE benefit primarily in favor of carriers of the KIF6 polymorphism? Second, was the time to benefit shorter in carriers of the KIF6 polymorphism? And third, why were differences in LDL-C and hs-CRP levels not associated with clinical outcome? (Source: Journal of the American College of Cardiology)

Coronary “Reverse” Steal Phenomenon: Secret Passageway Out of Castle

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:33 +0100

A 46-year-old man without significant previous medical history was admitted to our hospital with chest pain. His electrocardiogram revealed an anterior myocardial infarction, and he was immediately taken to the catheterization laboratory for emergent angiography. Angiography showed total occlusion of the left anterior descending artery immediately distal to first diagonal branch. Additionally, a coronary fistula stemming from the proximal circumflex artery and draining to pulmonary artery was noted (A, Online Video 1). We decided to treat the left anterior descending artery lesion, and balloon angioplasty with stenting was performed. Surprisingly, after complete alleviation of the lesion, repeat angiograms showed that the fistula had vanished (B, Online Video 2). A coronary angiogram with ...

Alpha-Adrenergic Coronary Vasoconstriction in Humans

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:33 +0100

I read with interest the study of Jensen et al. () and the accompanying editorial (). Jensen et al. demonstrated the abundance of the α1D-adrenoceptor subtype on the mRNA and by radioligand binding on the protein level in epicardial coronary arteries of explanted healthy and diseased human hearts. This information is novel and potentially important for the development of more specific α-adrenoceptor blockers to treat hypertension and/or prostate hyperplasia. The accompanying editorial correctly emphasizes the importance of studies in human rather than animal tissue. The original study and the editorial, however, do not acknowledge the limitations of the in vitro nature of the study. Specifically, no information on the morphological and/or functional status of the analyzed coronary arteri...

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Reperfusion Injury: Putting the Genie Back in the Bottle?⁎

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:26 +0100

Genie: A supernatural creature which occupies a parallel world to that of mankind … Possessing free will, … can be either good or evil. —Wikipedia () In this issue of the Journal, Mewton et al. () describe a rare event: a negative study with potentially enormous impact. Their work, using cardiac magnetic resonance, demonstrates that administration of a single dose of cyclosporine at the time of percutaneous coronary intervention for ST-segment elevation myocardial infarction (STEMI), which prevents or reduces reperfusion injury, does not have adverse consequences for left ventricular (LV) remodeling in the post-infarction period (). To put this in context requires consideration of a long line of basic research and clinical frustration on the subject of reperfusion injury in myocardi...

Impact of Stent Overlap on Angiographic and Long-Term Clinical Outcome in Patients Undergoing Drug-Eluting Stent Implantation

Journal of the American College of Cardiology — Fri, 19 Mar 2010 14:00:25 +0100

Conclusions: DES overlap occurs in >10% of patients undergoing percutaneous coronary intervention in routine clinical practice and is associated with impaired angiographic and long-term clinical outcome, including death or myocardial infarction. (Sirolimus-Eluting Versus Paclitaxel-Eluting Stents for Coronary Revascularization; NCT00297661). (Source: Journal of the American College of Cardiology)

Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting

Neurological Conditions Specialist Library — Fri, 19 Mar 2010 12:21:32 +0100

Citation: Touzé E, Trinquart L, Chatellier G, Mas JL. Systematic review of the perioperative risks of stroke or death after carotid angioplasty and stenting. Stroke. 2009 Dec;40(12):e683-93. Epub 2009 Nov 5 Methods: We sought articles published between January 1990 and June 2008 by using MEDLINE, EMBASE, the COCHRANE databases, hand-searching, abstract books from conferences, and official websites. Two reviewers independently and in duplicate selected articles on the risks of CAS, irrespective of the type of treatment, study design, setting, or language. The 2 reviewers abstracted data and assessed the quality of the studies. Results: Two hundred six independent studies (with 54 713 patients) were included. The overall 30-day risk of stroke or death was 4.7% (95% CI, 4.1 to 5.2) with s...

Clinical Trial Of Minimally Invasive Stenting System For Carotid Arteries Available At Cedars-Sinai Medical Center

Cardiovascular / Cardiology News From Medical News Today — Fri, 19 Mar 2010 10:00:00 +0100

Patients who suffer from plaque-related narrowing of a carotid artery but are not good candidates for open surgery may be eligible to participate in a clinical trial at Cedars-Sinai Medical Center of a minimally invasive procedure designed to open carotid arteries the way angioplasty and stenting clear arteries of the heart. The carotid arteries of the neck supply oxygenated blood to the brain... (Source: Cardiovascular / Cardiology News From Medical News Today)

Clinical Trial Of Minimally Invasive Stenting System For Carotid Arteries Available At Cedars-Sinai Medical Center

Health News from Medical News Today — Fri, 19 Mar 2010 10:00:00 +0100

Patients who suffer from plaque-related narrowing of a carotid artery but are not good candidates for open surgery may be eligible to participate in a clinical trial at Cedars-Sinai Medical Center of a minimally invasive procedure designed to open carotid arteries the way angioplasty and stenting clear arteries of the heart. The carotid arteries of the neck supply oxygenated blood to the brain. Plaque buildup can lead to stroke by restricting the flow of blood and increasing the risk of clot formation... (Source: Health News from Medical News Today)

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Coronary Artery Graft Dilatation Aided by Multidetector Computed Tomography [CASE STUDIES]

Asian Cardiovascular and Thoracic Annals — Fri, 19 Mar 2010 09:53:54 +0100

We describe a successful case of percutaneous coronary intervention for occluded coronary artery bypass grafts with the aid of multidetector computed tomography. (Source: Asian Cardiovascular and Thoracic Annals)

[Comment] Carotid stenting: more risky than endarterectomy and often no better than medical treatment alone

LANCET — Fri, 19 Mar 2010 00:00:00 +0100

Carotid endarterectomy is an effective treatment for the secondary prevention of stroke in selected patients with recently symptomatic carotid stenosis. Carotid stenting is a potential alternative and the two interventions have now been compared in randomised trials. Initial small trials showed that angioplasty and stenting had a higher procedural risk of stroke and death than did endarterectomy, but increasing experience and technical developments in stenting procedures might have been expected to narrow the gap. However, subsequent trials continued to report a higher procedural risk of stroke and death with stenting than with endarterectomy. This excess risk of stroke is highlighted again in each of the three latest reports: the International Carotid Stenting Study (ICSS), the ICSS imagi...

Myocardial Viability Detected by Myocardial Contrast Echocardiography—Prognostic Value in Patients after Myocardial Infarction

Echocardiography — Fri, 19 Mar 2010 00:00:00 +0100

This study aimed to assess the role of myocardial contrast echocardiography (MCE) as a predictor of cardiac events and death in patients with acute myocardial infarction (AMI). Methods: Eighty-six patients underwent primary percutaneous coronary angioplasty for AMI. Segmental perfusion was estimated by MCE in real time at mean 5 days after PCI using low MI (0.3) after 0.3[ndash]0.5 ml bolus injection of intravenous Optison. MCE was scored semiquantitatively as: (1) normal perfusion (homogenous contrast effect), (2) partial perfusion (patchy myocardial contrast enhancement), (3) lack of perfusion (no visible contrast effect). A contrast score index (CSI) was calculated as the sum of MCE scores in each segment divided by the total number of segments. The patients were followed up for cardiac...

PCI in octogenarians more common but survival not increasing

MedWire News - Cardiology — Fri, 19 Mar 2010 00:00:00 +0100

A Dutch study suggests that the numbers of octogenarians treated with primary percutaneous coronary intervention for ST-segment elevation myocardial infarction is increasing, but survival rates are not improving. (Source: MedWire News - Cardiology)

A Novel Approach to the Balloon Angioplasty of a Native Discrete Severe Coarctation of the Aorta in the Management of Hypertension

The Journal of Clinical Hypertension — Fri, 19 Mar 2010 00:00:00 +0100

(Source: The Journal of Clinical Hypertension)

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In response to some of your questions about the ataluren survey, PPMD has posted FAQs. And if your child took part in the ataluren trial, and you have not participated in the survey, please do so today.www.parentprojectmd.org

Parent Project Muscular Dystrophy — Fri, 19 Mar 2010 00:00:00 +0100

The Voice of the Patient: A Re-Examination of the ataluren Data Again last week we spoke with a number of parents about their experiences with ataluren. They shared their thoughts about the trial and about what changes they noticed. In parallel, PTC’s analysis of the data continues. While the trial(s) produced a wealth of data that will inform all future trials, we are interested in plans, next steps, and WHEN. We are not finished with this conversation and are not giving up on ataluren. For all of us, this is about buying time. To that end, we want to be responsive as parents and responsible as partners in this research, to move ataluren (and all strategies) forward, if there is a chance for benefit for the boys. We must understand the nitty gritty of who may benefit, at what specific...

Bivalirudin Is Superior to Unfractionated Heparin in PCI Patients

Medscape Medical News Headlines — Thu, 18 Mar 2010 17:52:18 +0100

Bivalirudin is superior to unfractionated heparin plus protamine after percutaneous coronary intervention (PCI), Italian researchers say. Reuters Health Information (Source: Medscape Medical News Headlines)

Current status of percutaneous coronary intervention in China

Heart — Thu, 18 Mar 2010 12:24:39 +0100

(Source: Heart)

Gender perspective on risk factors, coronary lesions and long-term outcome in young patients with ST-elevation myocardial infarction

Heart — Thu, 18 Mar 2010 12:24:39 +0100

Conclusions STEMI below age 46 is a more rare condition in women than in men and more often related to cardiovascular risk factors. More than 90% of both men and women had coronary lesions, in women more often single vessel lesions. Female sex is associated with higher in-hospital mortality, while long-term mortality is low without difference between genders. (Source: Heart)

Antiplatelet Therapy Prasugrel: A Novel Platelet ADP P2Y12 Receptor Antagonist

Clinical and Applied Thrombosis/Hemostasis — Thu, 18 Mar 2010 11:48:34 +0100

Novel adenosine diphosphate (ADP) P2Y12 antagonists, including prasugrel, ticagrelor, cangrelor and elinogrel, are in various phases of clinical development. These ADP P2Y12 antagonists have advantages over clopidogrel ranging from faster onset to greater and less variable inhibition of platelet function. Novel ADP P2Y12 antagonists are under investigation to determine whether their use can result in improved antiplatelet activity, faster onset of action, and/or greater antithrombotic effects than clopidogrel, without an unacceptable increase in hemorrhagic or other side effects. Prasugrel (CS-747; LY-640315), a novel third-generation oral thienopyridine, is a specific, irreversible antagonist of the platelet ADP P2Y12 receptor. Preclinical and early phase clinical studies have shown prasu...

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Coronary Stent Thrombosis in Patients With Chronic Renal Insufficiency

Angiology — Thu, 18 Mar 2010 11:46:14 +0100

Renal insufficiency (RI) is a strong predictor of unfavorable outcomes after percutaneous coronary intervention (PCI). After PCI, stent thrombosis (ST) is a considerable concern. The risk of ST in RI has not been independently evaluated before. The mechanism of ST is frequently related to dual antiplatelet underuse. We reviewed the publications listed on Medline, Scopus, and EBSCO Host research database in the last two decades to identify the risk of ST in patients with RI. There are no enough data on the incidence of ST in RI patients. Platelet reactivity, appropriate period of dual antiplatelet therapy, coronary anatomy, selection of stent, and patient compliance are vital issues that warrant detailed evaluation in RI patients. Moreover, prospective trials and new therapeutic strategies ...

Therapeutic Ultrasound-Enhanced Thrombolysis in Patients With Acute Myocardial Infarction

Angiology — Thu, 18 Mar 2010 11:46:13 +0100

Thrombolytic therapy is widely used to treat the patients with ST elevation acute myocardial infarction (STE-MI). Due to logistic and economic reasons, only 10% of patients with acute myocardial infarction can be treated with the percutaneous coronary intervention (PCI). Optimal flow (TIMI (Thrombolysis In Myocardial Infarction) 3 flow) is achieved in only about 60% of cases by enzymatic thrombolysis. Therapeutic ultrasound (US) exerts an effect on thrombolysis by micromechanical processes or indirectly by supporting enzymatic thrombolysis. This review examines relevant experimental and clinical published data. Technical issues in therapeutic US-enhanced thrombolysis in patients with acute myocardial infarction and advancements of the techniques during recent 10 years are discussed. (Sourc...

Anti-Atherothrombogenic Properties of PEDF.

Current Molecular Medicine — Thu, 18 Mar 2010 00:00:00 +0100

This article summarizes the pathophysiological role of PEDF in atherothrombosis and its potential therapeutic implication in CVD. We also discuss here the kinetics and regulation of PEDF in high-risk patients for atherothrombosis. PMID: 20236055 [PubMed - as supplied by publisher] (Source: Current Molecular Medicine)

For Left Main Coronary Blockages, Hybrid Revascularization Effective

Health News from Medical News Today — Wed, 17 Mar 2010 07:00:00 +0100

The left main coronary artery provides most of the blood to the heart, and current guidelines call for patients with blockages in this artery to undergo bypass surgery. Hybrid revascularization is a combination of coronary artery bypass surgery and percutaneous coronary intervention (PCI). Emory physicians have been performing these procedures "off-pump" in a minimally invasive fashion, without breaking open the chest. This technique is also known as "endo-ACAB" (endoscopic atraumatic coronary artery bypass)... (Source: Health News from Medical News Today)

For Left Main Coronary Blockages, Hybrid Revascularization Effective

Cardiovascular / Cardiology News From Medical News Today — Wed, 17 Mar 2010 07:00:00 +0100

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Mayo Clinic Study On How To Minimize Radiation Risks Of Angioplasty Shows Highest Doses In Men, Large Body Mass, Complex Cases

Health News from Medical News Today — Wed, 17 Mar 2010 03:00:00 +0100

Body size, gender and the complexity of heart disease significantly influence how much cumulative radiation skin dose that patients receive during percutaneous coronary intervention (PCI) therapy, also known as angioplasty, according to a new Mayo Clinic study. The study was undertaken as a quality control initiative to reduce the potential radiation risks of cancer to patients and PCI operators... (Source: Health News from Medical News Today)

Mayo Clinic Study On How To Minimize Radiation Risks Of Angioplasty Shows Highest Doses In Men, Large Body Mass, Complex Cases

Cardiovascular / Cardiology News From Medical News Today — Wed, 17 Mar 2010 03:00:00 +0100

Abbott Vascular-Cardiac Therapies dba Guidant Corporation - XACT Carotid Stent System - Class 2 Recall

Medical Device Recalls since July 07, 2006 — Wed, 17 Mar 2010 01:00:08 +0100

Xact 9 mm x 20 mm x 136 cm (Part Number 82089-01) The Xact Carotid Stent System, used in conjunction with Emboshield Embolic Protection System is indicated for the improvement of the lumen diameter of carotid arteries in patients considered at high risk for adverse events from carotid endarterectomy who require percutaneous carotid angioplasty and stenting for occlusive artery disease. (Source: Medical Device Recalls since July 07, 2006)

Abbott Vascular-Cardiac Therapies dba Guidant Corporation - XACT Carotid Stent System - Class 2 Recall

Medical Device Recalls since July 07, 2006 — Wed, 17 Mar 2010 01:00:08 +0100

Xact 10 mm x 20 mm x 136 cm (Part Number 82099-01) The Xact Carotid Stent System, used in conjunction with Emboshield Embolic Protection System is indicated for the improvement of the lumen diameter of carotid arteries in patients considered at high risk for adverse events from carotid endarterectomy who require percutaneous carotid angioplasty and stenting for occlusive artery disease. (Source: Medical Device Recalls since July 07, 2006)

Zotarolimus-eluting stent inferior in practice to sirolimus-eluting stent

NeLM - News — Wed, 17 Mar 2010 00:00:00 +0100

Source: Lancet Area: News A controlled trial has compared outcomes with coronary stents eluting either sirolimus or zotarolimus, an analogue in development, and found the sirolimus-eluting stent to be superior. Initial trials suggested that the second-generation zotarolimus-eluting coronary stent gave better outcomes than existing devices, however the trial population studied was poorly representative of patients in routine practice. This trial aimed to compare it with a standard, sirolimus-eluting stent in a routine clinic population. Participants were patients from five Danish percutaneous coronary intervention (PCI) clinics who were aged over 18 and had acute coronary syndrome or chronic stable angina. They were randomised single-blind to either sirolimus or zotarolimus-elut...

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High Index of Microcirculatory Resistance Level After Successful Primary Percutaneous Coronary Intervention Can Be Improved by Intracoronary Administration of Nicorandil.

Circulation Journal — Wed, 17 Mar 2010 00:00:00 +0100

Conclusions: High IMR levels in patients with STEMI after successful primary PCI can be improved by intracoronary administration of nicorandil. PMID: 20234097 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Stenting May Save Legs

MedlinePlus Health News — Tue, 16 Mar 2010 20:00:00 +0100

Many with severe peripheral arterial disease can avoid amputation, researchers find Source: HealthDay Related MedlinePlus Pages: Angioplasty, Peripheral Arterial Disease (Source: MedlinePlus Health News)

Drugs equal to angioplasty for relieving angina: study

CTV Health — Tue, 16 Mar 2010 17:05:01 +0100

New Canadian research has found many patients with stable angina can be treated just fine with medicines alone, and may not need to have angioplasty. (Source: CTV Health)

Long-Term Safety of Drug-Coated Stents Questioned

MedlinePlus Health News — Tue, 16 Mar 2010 17:03:06 +0100

New research shows more patients who got drug-coated stents right after suffering a severe heart attack later died from heart-related problems than those who received older, cheaper bare-metal models. Source: Reuters Health Related MedlinePlus Pages: Angioplasty, Medical Device Safety (Source: MedlinePlus Health News)

How To Minimize Radiation Risks Of Angioplasty Shows Highest Doses In Men, Large Body Mass, Complex Cases

Men's health News From Medical News Today — Tue, 16 Mar 2010 13:00:00 +0100

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How To Minimize Radiation Risks Of Angioplasty Shows Highest Doses In Men, Large Body Mass, Complex Cases

Health News from Medical News Today — Tue, 16 Mar 2010 13:00:00 +0100

Inappropriate Use of Antithrombotics in Patients Undergoing Percutaneous Coronary Intervention

Medscape Today Headlines — Tue, 16 Mar 2010 11:04:24 +0100

An "alarmingly high" number of dialysis patients receive an inappropriate antithrombotic during percutaneous coronary intervention, increasing their risk of bleeding. Journal Watch (Source: Medscape Today Headlines)

Clinical Trial Summary: Paclitaxel-Eluting Stent Versus Conventional Stent in ST-Segment Elevation Myocardial Infarction (PASSION: 5-Year Follow-Up)

Cardiosource — Tue, 16 Mar 2010 11:00:00 +0100

The goal of the trial was to evaluate treatment with paclitaxel-eluting stents compared with bare-metal stents among patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). (Source: Cardiosource)

New Analysis Assesses Impact Of Common Genetic Variation On Benefit Of Antiplatelet Therapy

Health News from Medical News Today — Tue, 16 Mar 2010 08:00:00 +0100

A new analysis of the TRITON-TIMI 38 study evaluated response rates in patients with a common genetic variant in the ABCB1 gene. Patients enrolled in the TRITON-TIMI 38 study were treated with dual antiplatelet therapy with either Plavix® (clopidogrel) plus aspirin or Effient® (prasugrel) plus aspirin and managed with percutaneous coronary intervention (PCI) following an acute coronary syndrome (ACS) event. The results of this retrospective genetic sub-study were presented today at the American College of Cardiology annual meeting... (Source: Health News from Medical News Today)

Stent News from the ACC.10: Monday

News from Angioplasty.Org — Tue, 16 Mar 2010 03:50:00 +0100

All four U.S. stent manufacturers were represented in various studies presented at today's 59th Annual Scientific Sessions of the American College of Cardiology in Atlanta, GA, an event attended by an estimated 16,000 cardiology professionals. The studies revealed data about old vs. new devices, and the results ranged from unsurprising to controversial to unparalleled. (Source: News from Angioplasty.Org)

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Medtronic Responds to SORT-OUT III Stent Study

News from Angioplasty.Org — Tue, 16 Mar 2010 02:00:00 +0100

Medtronic, Inc. (NYSE: MDT), responded today to the questionable findings of SORT-OUT III, a Danish study comparing the Endeavor and Cypher drug-eluting stents. The company's criticisms cover the study's unconventional design and analytical methods, which are biased against Medtronic's Endeavor stent in favor of Johnson & Johnson's Cypher stent. (Source: News from Angioplasty.Org)

Meta-analysis: PCI vs. medical therapy for relief of angina symptoms

NeLM - News — Tue, 16 Mar 2010 00:00:00 +0100

Source: Ann Intern Med Area: News Percutaneous coronary intervention (PCI) in patients with angina may have limited benefits on symptoms compared to evidence-based medical therapy, according to a meta-analysis. PCI is widely used in the US for treatment of angina, despite evidence that it is no better than medical therapy for major cardiovascular outcomes according to previous meta-analyses. There has been no systematic appraisal of the evidence for symptomatic relief, however, and the authors of this paper aimed to address that gap. They carried out a comprehensive literature search for randomised trials that compared medical therapy with PCI in patients with stable angina (defined similarly to previous meta-analyses). They used results from the longest available follow-up for...

SIR: Drug-Eluting Stents Save Limbs in Critical Limb Ischemia

Modern Medicine — Tue, 16 Mar 2010 00:00:00 +0100

In patients with critical limb ischemia, implantation of drug-eluting stents to treat a suboptimal angioplasty in an infrapopliteal artery may be a safe and effective therapy, according to research presented at the Annual Scientific Meeting of the Society of Interventional Radiology, held from March 13 to 18 in Tampa, Fla. (Source: Modern Medicine)

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Parent Project Muscular Dystrophy — Tue, 16 Mar 2010 00:00:00 +0100

Meta-analysis: Effects of Percutaneous Coronary Intervention Versus Medical Therapy on Angina Relief.

Annals of Internal Medicine — Tue, 16 Mar 2010 00:00:00 +0100

Conclusion: Percutaneous coronary intervention was associated with greater freedom from angina compared with medical therapy, but this benefit was largely attenuated in contemporary studies. This observation may be related to greater use of evidence-based medications in contemporary trials. Primary Funding Source: Canadian Institutes of Health Research. PMID: 20231568 [PubMed - in process] (Source: Annals of Internal Medicine)

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PERSEUS Trial Results Demonstrate Positive Safety and Efficacy Outcomes for Boston Scientific's Novel Platinum Chromium TAXUS(r) Element(tm) Stent System

News from Angioplasty.Org — Mon, 15 Mar 2010 22:10:00 +0100

Boston Scientific Corporation (NYSE: BSX) today announced 12-month results from its PERSEUS clinical program that demonstrated positive safety and efficacy outcomes in workhorse lesions for the platinum chromium TAXUS(r) Element(tm) Paclitaxel-Eluting Stent System compared to the TAXUS(r) Express2(tm) Paclitaxel-Eluting Stent System. (Source: News from Angioplasty.Org)

Abbott Announces Positive Data From ABSORB Trial on Its Bioresorbable Vascular Scaffold Technology

News from Angioplasty.Org — Mon, 15 Mar 2010 21:50:00 +0100

Abbott today announced positive 30-day results from the first 101 patients enrolled in the second phase of the ABSORB trial. Patients treated with Abbott's bioresorbable vascular scaffold (BVS), under clinical investigation in Europe, demonstrated no cases of blood clots (thrombosis), no need for repeat procedures (ischemia-driven target lesion revascularization) and a very low rate of major adverse cardiac events (MACE rate of 2.0 percent) at 30 days. (Source: News from Angioplasty.Org)

Point-of-Care Assessment of Platelet Reactivity After Clopidogrel to Predict Myonecrosis in Patients Undergoing Percutaneous Coronary Intervention

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions Easily assessed by a point-of-care assay, HPR after clopidogrel is a frequent finding and is associated with increased risk of myonecrosis in low-to-intermediate risk patients undergoing planned PCI. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

Mortality and Morbidity Reduction by Primary Percutaneous Coronary Intervention Is Independent of the Patient's Age

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions In this analysis of randomized trials, the reduction in clinical end points by PPCI was not influenced by age. Hence, age per se should not be considered an exclusion criterion for the application of PPCI. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

Efficacy of High-Dose Atorvastatin Loading Before Primary Percutaneous Coronary Intervention in ST-Segment Elevation Myocardial Infarction: The STATIN STEMI Trial

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions High-dose atorvastatin pre-treatment before PCI did not show a significant reduction of MACEs compared with low-dose atorvastatin but did show improved immediate coronary flow after primary PCI. High-dose atorvastatin may produce an optimal result for STEMI patients undergoing PCI by improving microvascular myocardial perfusion. (Efficacy of High-Dose AtorvaSTATIN Loading Before Primary Percutaneous Coronary Intervention in ST-Elevation Myocardial Infarction [STATIN STEMI]; NCT00808717). (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

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Prior Coronary Artery Bypass Graft Patients With ST-Segment Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Journal of the American College of Cardiology: Cardiovascular Interventions — Mon, 15 Mar 2010 20:59:21 +0100

Conclusions Prior CABG patients with STEMI are less likely to undergo acute reperfusion, have worse angiographic outcomes following primary PCI, and higher 90-day mortality. These findings are especially applicable when the IRA was a bypass graft. (Source: Journal of the American College of Cardiology: Cardiovascular Interventions)

Risk profile and benefits from Gp IIb-IIIa inhibitors among patients with ST-segment elevation myocardial infarction treated with primary angioplasty: a meta-regression analysis of randomized trials

European Heart Journal — Mon, 15 Mar 2010 16:45:23 +0100

(Source: European Heart Journal)

Primary angioplasty vs. thrombolysis: the end of the controversy?

European Heart Journal — Mon, 15 Mar 2010 16:45:22 +0100

(Source: European Heart Journal)

Acceptable reperfusion delay to prefer primary angioplasty over fibrin-specific thrombolytic therapy is affected (mainly) by the patient's mortality risk: 1 h does not fit all

European Heart Journal — Mon, 15 Mar 2010 16:45:22 +0100

Conclusion Baseline mortality risk of ST elevation myocardial infarction patients is a major determinant of the acceptable time delay to choose the most appropriate therapy. Although a longer delay lowers the survival advantage of PPCI, a longer PPCI-related delay could be acceptable in high-risk STEMI patients. (Source: European Heart Journal)

Aspirin Alone Works Best to Prevent Clots a Year After Stenting

MedlinePlus Health News — Mon, 15 Mar 2010 16:00:00 +0100

Adding Plavix didn't boost outcomes after 12 months, new study finds Source: HealthDay Related MedlinePlus Pages: Angioplasty, Blood Thinners, Pain Relievers (Source: MedlinePlus Health News)

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Mayo Clinic Study on How to Minimize Radiation Risks of Angioplasty Shows Highest Doses in Men, Large Body Mass, Complex Cases

Mayo Clinic Rochester News — Mon, 15 Mar 2010 15:57:27 +0100

Mayo Clinic Study on How to Minimize Radiation Risks of Angioplasty Shows Highest Doses in Men, Large Body Mass, Complex Cases

News from Mayo Clinic — Mon, 15 Mar 2010 15:57:27 +0100

Mayo Clinic Study on How to Minimize Radiation Risks of Angioplasty Shows Highest Doses in Men, Large Body Mass, Complex Cases

Mayo Clinic Research News — Mon, 15 Mar 2010 15:57:27 +0100

AngioScore Announces Favorable Results From The MASCOT Trial

Health News from Medical News Today — Mon, 15 Mar 2010 11:00:00 +0100

AngioScore, Inc., a developer of novel angioplasty catheters for use in the treatment of cardiovascular disease, announced today favorable clinical trial results from the MASCOT Trial, an important study evaluating the AngioSculpt® PTA Scoring Balloon Catheter for the treatment of femoro-popliteal PAD (peripheral artery disease). "PAD is one of the fastest-growing segments of the Endovascular Market, with an estimated two million annual procedures worldwide... (Source: Health News from Medical News Today)

Mayo Clinic study on how to minimize radiation risks of angioplasty shows highest doses in men

EurekAlert! - Medicine and Health — Mon, 15 Mar 2010 04:00:00 +0100

(Mayo Clinic) Body size, gender and the complexity of heart disease significantly influence how much cumulative radiation skin dose that patients receive during percutaneous coronary intervention (PCI) therapy, also known as angioplasty, according to a new Mayo Clinic study. The study was undertaken as a quality control initiative to reduce the potential radiation risks of cancer to patients and PCI operators. (Source: EurekAlert! - Medicine and Health)

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Hybrid revascularization effective for left main coronary blockages

EurekAlert! - Medicine and Health — Mon, 15 Mar 2010 04:00:00 +0100

(Emory University) Hybrid revascularization is a combination of coronary artery bypass surgery and percutaneous coronary intervention.Researchers will report on outcomes from 21 Emory patients with blockages in the left main coronary artery treated using hybrid revascularization. (Source: EurekAlert! - Medicine and Health)

Endeavor Stent: 5-Year Data Show Safety and Efficacy Advantage

News from Angioplasty.Org — Mon, 15 Mar 2010 02:40:00 +0100

The presentation at today's American College of Cardiology meeting of the 5-Year clinical results from ENDEAVOR III, along with the results of Medtronic's (NYSE: MDT) pooled Endeavor Trials Program, offers what may be a new paradigm for judging clinical trial results. Especially when taken together with recent findings from such studies as FAME and ODESSA, angiographic late lumen loss, one of the standards by which the performance of drug-eluting stents initially has been judged, may not be as significant a factor as once thought. (Source: News from Angioplasty.Org)

[Correspondence] Carotid artery stenting versus surgery: adequate comparisons? – Triallists' reply

Lancet Neurology — Mon, 15 Mar 2010 00:00:00 +0100

Roffi and colleagues criticise the ethics of the recent randomised trials of carotid stenting versus carotid endarterectomy in patients with symptomatic carotid stenosis. This is a bold step, considering that the trials received research ethics approval in about 20 countries. Moreover, the three most recent trials, the Endarterectomy Versus Angioplasty in Patients with Symptomatic Severe Carotid Stenosis (EVA-3S) trial, the Stent-Protected Angioplasty versus Carotid Endarterectomy (SPACE) trial in symptomatic patients, and the International Carotid Stenting Study (ICSS) included more than 100 academic vascular centres where surgeons, interventionalists, and neurologists all considered the designs of the individual trials appropriate and ethical. Nevertheless, Roffi and colleagues' argument...

Medtronic's Endeavor Stent Continues to Demonstrate Compelling and Consistent Long-Term Clinical Results

News from Angioplasty.Org — Sun, 14 Mar 2010 22:30:00 +0100

The consistency and quality of the long-term clinical results for the Endeavor(R) drug-eluting stent (DES) from Medtronic, Inc. continue to distinguish it as a treatment for coronary artery disease, according to newly released data. Five-year findings from the comprehensive ENDEAVOR program were released today at ACC.10, the American College of Cardiology's 59th Scientific Session. (Source: News from Angioplasty.Org)

Cardiac release and kinetics of cytokines after elective bare metal coronary stenting

Journal of Thrombosis and Thrombolysis — Sun, 14 Mar 2010 12:27:11 +0100

Abstract The study was designed to assess the cardiac release kinetics of the cytokines interleukin-1ß (IL-1ß), interleukin-6 (IL-6) and tumor-necrosis-factor-α (TNF-α) in patients with significant stenosis of the ramus interventricularis anterior. Ten patients were treated by bare metal stent implantation, 11 patients who underwent a diagnostic coronary angiography without intervention served as a control group. Cytokines paired blood samples were withdrawn from the coronary sinus and a peripheral vein immediately before and 1, 2, 6 h after the intervention. Myocardial ischemia was monitored by means of cardiac lactate metabolism and 12-lead electrocardiogram. After coronary intervention IL-6 gradually increased from a common baseline level of 1.34 ± 1....

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Long-term prognosis in ethnic Chinese patients with unprotected left main coronary artery disease

Clinical Research in Cardiology — Sun, 14 Mar 2010 12:25:11 +0100

Conclusion For Chinese patients with unprotected left main coronary artery disease, a significant higher risk of cardiovascular death was noted in the medical therapy group. Overall the long-term cardiovascular survival was similar in LMCA patients treated with either PCI or CABG, but CABG provided better survival outcome in high-risk subgroup patients. Content Type Journal ArticleCategory Original PaperDOI 10.1007/s00392-010-0139-5Authors Hui-Chun Huang, National Taiwan University Hospital, National Taiwan University College of Medicine Division of Cardiology, Department of Internal Medicine, Graduate Institute of Clinical Medicine No. 7 Chung-Shan South Road Taipei 100 TaiwanHsien-Li Kao, National Taiwan University Hospital, National Taiwan University College of M...

Medtronic Starts International Study of CoreValve Transcatheter Aortic Valve System

News from Angioplasty.Org — Sun, 14 Mar 2010 04:50:00 +0100

Moving to expand the evidence base for the future of structural heart disease therapy, Medtronic, Inc. (NYSE: MDT), today announced the start of the first of several new initiatives in a robust international clinical program for its CoreValve transcatheter aortic valve system, a minimally-invasive alternative to open-heart surgery for aortic valve replacement. (Source: News from Angioplasty.Org)

Transradial Hands-On Learning Labs Offered by Terumo at American College of Cardiology Meeting

News from Angioplasty.Org — Sun, 14 Mar 2010 02:00:00 +0100

Terumo Interventional Systems is sponsoring two days of hands-on training in the transradial approach to angiography and angioplasty for attendees of this year's American College of Cardiology 59th Scientific Sessions in Atlanta, Georgia. Building on its industry-leading transradial education focus, these sessions will be held in Lab #3636 on Sunday, March 14 and Monday, March 15 from 9:00am - 4:30pm. (Source: News from Angioplasty.Org)

Excel Trial Will Determine Safety and Efficacy of Drug-Eluting Stents vs. Bypass Surgery in Patients with Left Main Coronary Artery Disease

News from Angioplasty.Org — Sun, 14 Mar 2010 00:30:00 +0100

The announcement of a new clinical trial, EXCEL (Evaluation of Xience Prime versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization), that will compare drug-eluting stents to coronary artery bypass graft surgery in patients with left main coronary artery disease, was made today at "Optimizing PCI Outcomes: Evolving Paradigms," a symposium presented by the Cardiovascular Research Foundation. (Source: News from Angioplasty.Org)

Coronary blood flow and perfusion pressure during coronary angiography in patients with ongoing mechanical chest compression: A report on 6 cases

Resuscitation — Sat, 13 Mar 2010 14:14:49 +0100

Abstract: Patients with pulseless electrical activity or refractory ventricular fibrillation have a very bad prognosis. Coronary angiography and angioplasty may be required to restore an effective circulation, but this must be performed whilst chest compressions are continued. The LUCAS chest compression device is suitable for this purpose. So far there are no reports on the effect of this device on coronary circulation in humans. We monitored the coronary perfusion pressure assessed invasively as the difference between the diastolic pressures at the coronary ostium and right atrium, and compared these pressures with coronary flow graded using the TIMI scale in 6 patients. In 4 out of 6 we found a satisfactory coronary artery perfusion pressure and TIMI grade 3 flow (normal) on coronary an...

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FDA Alert: Plavix May Be Less Effective in Some Patients with Genetic Variation

News from Angioplasty.Org — Fri, 12 Mar 2010 21:45:00 +0100

What some clinicians have known about for some time is now official: the U.S. Food and Drug Administration today added a boxed warning to the drug Plavix (clopidogrel) stating that, in some patients with a genetic variation of the cytochrome CYP2C19, Plavix may not be metabolized properly and therefore may not be effective for the indicated therapy. (Source: News from Angioplasty.Org)

Volcano Expands Access to FFR with Ability to Integrate with the Majority of Hemodynamic Monitoring Systems

News from Angioplasty.Org — Fri, 12 Mar 2010 16:50:00 +0100

The value of Fractional Flow Reserve in guiding PCI (percutaneous coronary interventions) has been shown in the FAME studies, as well as others. Yet the number of labs using FFR shows that it is an underused modality. Integrating FFR into standing hemodynamic monitoring systems simplifies the use of this valuable tool. Today Volcano announced that it is offering FFR technology integrated with the existing systems manufactured by GE, Siemens, McKesson, and Mennen. (Source: News from Angioplasty.Org)

Volcano Announces Activities at the ACC 2010

News from Angioplasty.Org — Fri, 12 Mar 2010 16:45:00 +0100

The company announced its activities today at Annual Scientific Sessions of the American College of Cardiology (ACC) Conference taking place in Atlanta from March 14th to March 16th. Presentations and new product launches will continue Volcano's mission to demonstrate the limitations of angiography and the value of IVUS, FFR and OCT. (Source: News from Angioplasty.Org)

[Transient subclavian artery spasm observed during percutaneous coronary intervention for acute myocardial infarction.]

Turk Kardiyoloji Dernegi arsivi — Fri, 12 Mar 2010 11:50:04 +0100

Authors: Karakurt O, Kılıç H, Akdemir R A 68-year-old man with a history of two coronary artery bypass operations was admitted with acute inferior myocardial infarction (AMI) and cardiogenic shock. The electrocardiogram showed ST-segment elevation in leads D2, D3, and aVF. Coronary angiography demonstrated a 75% thrombotic stenosis in the right coronary artery (RCA), 90-99% stenosis in the intermediate coronary artery, and plaques in the circumflex artery. While assessing the patency of bypass grafts, a 99% stenosis was noted in the distal subclavian artery. The culprit artery was deemed to be the RCA, and after direct stenting, TIMI III flow was achieved. Ten days later, stent implantation was performed for the intermediate coronary artery, at which time distal subcla...

Interview with Dr. Fausto Feres: Is Three Months of Antiplatelet Therapy After the Endeavor Zotarolimus-Eluting Stent Enough?

News from Angioplasty.Org — Fri, 12 Mar 2010 01:15:00 +0100

In this exclusive interview, Dr. Feres explains the novel nature of this 3,000 patient trial which is measuring patient outcomes after only three months of dual antiplatelet therapy when used with Medtronic's Endeavor ZES. OPTIMIZE is unique because, due to concerns over late stent thrombosis, other trials are testing periods of one to three years -- Dr. Feres' hypothesis is that the Endeavor zotarolimus-eluting stent heals more quickly and therefore patients do not need to be taking aspirin plus Plavix for more than three months. If borne out, these finding could have important implications for cost-savings as well as patient safety. (Source: News from Angioplasty.Org)

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Clinical Experience with a Novel Intracoronary Perfusion Catheter to Treat No-Reflow Phenomenon in Acute Coronary Syndromes

Journal of Interventional Cardiology — Fri, 12 Mar 2010 00:00:00 +0100

Conclusion:The infusion of intracoronary drugs using the novel perfusion CW RX catheter seems to be safe and could help to improve myocardial perfusion in a selected group of patients presenting with ACS who developed no-reflow during PCI. (J Interven Cardiol 2010;**:1[ndash]5) (Source: Journal of Interventional Cardiology)

Plasma Calprotectin Predicts Mortality in Patients with ST Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

Journal of Interventional Cardiology — Fri, 12 Mar 2010 00:00:00 +0100

Conclusion:Plasma calprotectin levels, determined at admission in STEMI patients successfully treated with pPCI, predict mortality over a period of 12 months, indicating that plasma calprotectin may be a new important prognostic biomarker in acute ischemic heart disease. (J Interven Cardiol 2010;**:1[ndash]7) (Source: Journal of Interventional Cardiology)

The Relative Effects of Abciximab and Tirofiban on Platelet Inhibition and C-Reactive Protein during Coronary Intervention

Medscape Diabetes Headlines — Thu, 11 Mar 2010 19:04:09 +0100

The battle for the best platelet inhibition after percutaneous coronary intervention continues. How does CRP figure into the picture? The Journal of Invasive Cardiology (Source: Medscape Diabetes Headlines)

The Use of Coronary Revascularisation Procedures in Urban Australian Aboriginals and a Matched General Population: Coronary Procedures in Aboriginals

Heart, Lung & Circulation — Thu, 11 Mar 2010 13:57:54 +0100

Conclusions: Coronary revascularisation procedures for IHD were used with equal frequency in Aboriginal people and matched non-Aboriginals. Aboriginal people were more likely to have CABG than PCI. Revascularisation rate and type in ACS admissions were the same. (Source: Heart, Lung & Circulation)

The Value of Dual-source 64-Slice CT Coronary Angiography in the Assessment of Patients Presenting to an Acute Chest Pain Service

Heart, Lung & Circulation — Thu, 11 Mar 2010 13:57:53 +0100

Conclusions: The CTCA findings were significantly correlated with those of selective angiography and with troponin status and increased the ascertainment of coronary artery disease in a cohort of patients at low risk for clinically significant ischaemic heart disease. (Source: Heart, Lung & Circulation)

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Reply

Journal of the American College of Cardiology — Thu, 11 Mar 2010 13:54:41 +0100

We thank Dr. Alfonso for interest in our manuscript and very insightful comments. We agree that feasibility of noninvasive identification of plaques vulnerable to rupture might have significant clinical implications, and clarify here the methodological issues raised. As described in our paper (), acute coronary syndromes (ACS) included acute myocardial infarction with the elevation of troponin level and unstable angina without troponin elevation. Our report characterized the plaques that resulted in ACS and excluded the lesions already subjected to intervention or those selected for intervention. As noted in the report, 3 patients developed ACS involving the previously treated lesion and were excluded from the analysis. Also, target lesion could not be identified in 8 patients with ACS, be...

Long-term effects of intracoronary bone marrow cell transfer on diastolic function in patients after acute myocardial infarction: 5-year results from the randomized-controlled BOOST trial--an echocardiographic study

European Journal of Echocardiography — Thu, 11 Mar 2010 09:46:28 +0100

Conclusion Intracoronary autologous BMC transfer provides an overall treatment effect on echocardiographic parameters of diastolic function in patients after AMI. However, this effect is basically related to an early improvement of parameters of diastolic function without a sustained effect on long-term follow-up. (Source: European Journal of Echocardiography)

Revascularization for coronary artery disease in diabetes mellitus: Angioplasty, stents and coronary artery bypass grafting

Reviews in Endocrine & Metabolic Disorders — Thu, 11 Mar 2010 08:06:56 +0100

Abstract Patients with diabetes mellitus (DM) are prone to a diffuse and rapidly progressive form of atherosclerosis, which increases their likelihood of requiring revascularization. However, the unique pathophysiology of atherosclerosis in patients with DM modifies the response to arterial injury, with profound clinical consequences for patients undergoing percutaneous coronary intervention (PCI). Multiple studies have shown that DM is a strong risk factor for restenosis following successful balloon angioplasty or coronary stenting, with greater need for repeat revascularization and inferior clinical outcomes. Early data suggest that drug eluting stents reduce restenosis rates and the need for repeat revascularization irrespective of the diabetic state and with no signifi...

Ischemix Initiates Phase 2a Trial Of CMX-2043 For The Prevention Of Ischemia-Reperfusion Injury

Health News from Medical News Today — Thu, 11 Mar 2010 08:00:00 +0100

Ischemix announced the initiation of patient accrual in a multi-center Phase 2a clinical trial of CMX-2043 for the prevention of peri-operative ischemia-reperfusion injury in patients undergoing elective percutaneous coronary intervention (PCI) procedures. CMX-2043 is a cardio-protective drug that combines Akt pathway-mediated cell survival effects and anti-oxidant activity in a single small molecule... (Source: Health News from Medical News Today)

Ischemix Initiates Phase 2a Trial Of CMX-2043 For The Prevention Of Ischemia-Reperfusion Injury

Cardiovascular / Cardiology News From Medical News Today — Thu, 11 Mar 2010 08:00:00 +0100

Ischemix announced the initiation of patient accrual in a multi-center Phase 2a clinical trial of CMX-2043 for the prevention of peri-operative ischemia-reperfusion injury in patients undergoing elective percutaneous coronary intervention (PCI) procedures... (Source: Cardiovascular / Cardiology News From Medical News Today)

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The SYNTAX study

Clinical Research in Cardiology Supplements — Wed, 10 Mar 2010 15:43:48 +0100

Abstract The SYNTAX study randomized patients (pts) with three-vessel or left main coronary artery disease (CAD) into pts who underwent bypass grafting (CABG) or percutaneous coronary intervention (PCI). The primary endpoint of the study was a major adverse cardiac or cerebrovascular event (death from any cause, stroke, myocardial infarction, repeated revascularization)(MACCE). Rates of MACCE at 12 months were significantly higher in the PCI group (17.8%) than in the CAGB group (12.4%, p < 0.002). This was caused by an increased rate of repeated revascularizations in PCI pts (13.5%) compared to CABG pts (5.9%, p < 0.001). The rates of death and myocardial infarction were similar between the two groups. Stroke was significantly more likely to occur with C...

Gender-related differences in outcome after ST-segment elevation myocardial infarction treated by primary angioplasty and glycoprotein IIb–IIIa inhibitors: insights from the EGYPT cooperation

Journal of Thrombosis and Thrombolysis — Wed, 10 Mar 2010 15:34:54 +0100

This study shows that in patients with STEMI treated by primary angioplasty, female gender is associated with higher mortality rate in comparison with men, and this is mainly due to their higher clinical and angiographic risk profiles. In fact, female sex did not emerge as an independent predictor of mortality. Content Type Journal ArticleDOI 10.1007/s11239-010-0451-yAuthors Giuseppe De Luca, Eastern Piedmont University Division of Cardiology, Maggiore della Carità Hospital Novara ItalyC. Michael Gibson, Harvard Medical School Beth Israel Deaconess Medical Center Boston USAMariann Gyöngyösi, Medical University of Vienna Department of Cardiology Vienna AustriaUwe Zeymer, Herzzentrum Ludwigshafen Division of Cardiology Ludwigshafen GermanyDariusz Dudek, Jagiellonian University II...

Benefit of PCI-center directed AMI care depends on referral region

MedWire News - Cardiology — Wed, 10 Mar 2010 14:26:05 +0100

The benefit of regionalizing care of acute myocardial infarction patients to hospitals capable of performing percutaneous coronary intervention depends on the hospital referral region. (Source: MedWire News - Cardiology)

Resting Heart Rate and Metabolic Syndrome in Patients With Diabetes and Coronary Artery Disease in Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Trial

Preventive Cardiology — Wed, 10 Mar 2010 00:00:00 +0100

Prev Cardiol. ****;**:**[ndash]**. The relation between the metabolic syndrome (MetS) and resting heart rate (rHR) in patients with diabetes and coronary artery disease is unknown. The authors examined the cross-sectional association at baseline between components of the MetS and rHR and between rHR and left ventricular ejection fraction in the population from the Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) randomized clinical trial. The mean rHR in the MetS group was significantly higher than in those without (68.4±12.3 vs 65.6±11.8 beats per min, P=.0017). The rHR was higher (P (Source: Preventive Cardiology)

A Novel Approach to Transplanting Bone Marrow Stem Cells to Repair Human Myocardial Infarction: Delivery via a Noninfarct-relative Artery

Cardiovascular Therapeutics — Wed, 10 Mar 2010 00:00:00 +0100

The objective of the present study was to evaluate the safety and feasibility of autologous bone marrow mesenchymal stem cell transplantation via such an approach in patients with acute myocardial infarction (AMI). Sixteen patients with anterior AMI who had successfully undergone percutaneous coronary intervention (PCI) were enrolled in this pilot, randomized study. Three weeks after PCI, cultured bone marrow mesenchymal stem cells were injected into the myocardium via either the infarct-relative artery (left anterior descending branch artery, LAD) or a noninfarct-relative artery (right coronary artery, RCA). The safety and feasibility of the cell infusion were evaluated during the procedure and during 6 months of follow-up. In addition, 2D echocardiography, technetium-99m methoxyisobutyli...

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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

The American Journal of Cardiology — Tue, 09 Mar 2010 13:57:25 +0100

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)

Left Ventricular Remodeling and Heart Failure After Myocardial Infarction in Elderly Patients

The American Journal of Cardiology — Tue, 09 Mar 2010 13:57:25 +0100

We read with interest the recent report by Carraba et al on the effect of age on left ventricular remodeling (LVR) and heart failure (HF) in patients treated by primary angioplasty for myocardial infarction (MI). The study demonstrated that despite very few differences in LVR, elderly patients had a much greater risk of HF at long-term follow-up. As noted by the authors, their study was, however, performed in a selected population as patients receiving lytic treatment or patients with clinical signs of HF during the first week after MI were excluded. (Source: The American Journal of Cardiology)

Differences in Patient Survival After Acute Myocardial Infarction by Hospital Capability of Performing Percutaneous Coronary Intervention: Implications for Regionalization [Original Investigation]

Archives of Internal Medicine — Mon, 08 Mar 2010 20:50:40 +0100

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)

Avoiding Intelligence Failures in the Cardiac Catheterization Laboratory: Strategies for the Safe and Rational Use of Dalteparin or Enoxaparin During Percutaneous Coronary Intervention

Medscape Today Headlines — Mon, 08 Mar 2010 12:04:23 +0100

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)

Single-session endovascular treatment for symptomatic lower extremity deep vein thrombosis: a feasibility study.

Acta Radiologica — Sun, 07 Mar 2010 14:28:19 +0100

Conclusion: Single-session endovascular treatment is a feasible technique that provides acceptable technical and clinical success with excellent safety for treating symptomatic lower extremity DVT. PMID: 20201636 [PubMed - in process] (Source: Acta Radiologica)

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Clinical Trial Summary: Stent Graft Versus Balloon Angioplasty for Failing Dialysis-Access Grafts (Stent Graft Versus Balloon Angioplasty for Failing Dialysis-Access Grafts)

Cardiosource — Sun, 07 Mar 2010 00:00:00 +0100

Although hemodialysis access is traditionally done with native fistulas, especially the first time, prosthetic grafts are often used to create permanent access hemodialysis circuits. Prosthetic arteriovenous (AV) graft failure is related to stenosis at the venous site of the anastomosis, usually due. . . (Source: Cardiosource)

Vanishing platelets: rapid and extreme tirofiban-induced thrombocytopenia after percutaneous coronary intervention for acute myocardial infarction.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

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...

Myocardial Protection during Reoperative Cardiac Surgery: Early Experience with a New Technique.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

Authors: Velissaris T, Khan OA, Asopa S, Calver A, Ohri SK We recently introduced a new adjunct to myocardial preservation in patients with a patent left internal mammary artery graft who were undergoing reoperative cardiac surgery. The purpose of this study was to review our early experience with this technique.The technique consists of preoperative insertion of a suitably sized angioplasty balloon catheter into the proximal part of the graft under fluoroscopic guidance. Intraoperative inflation of the balloon results in occlusion of the graft during aortic cross-clamping. We have used this technique in 9 patients. The case records of these patients were retrospectively reviewed.There were 5 men and 4 women with a mean age of 71 +/- 11 years and a mean Euro-SCORE of 10 +/- 3. The medi...

Impact of C-Reactive Protein on In-Stent Restenosis: A Meta-Analysis.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

Authors: Li JJ, Ren Y, Chen KJ, Yeung AC, Xu B, Ruan XM, Yang YJ, Chen JL, Gao RL We sought to evaluate the impact of C-reactive protein (CRP) levels on in-stent restenosis after percutaneous coronary intervention.The plasma level of CRP is considered a risk predictor for cardiovascular diseases. However, the relationship between CRP and in-stent restenosis has been a matter of controversy. Meta-analysis reduces variability and better evaluates the correlation.We performed a systemic search for literature published in March 2008 and earlier, using MEDLINE(R), the Cochrane clinical trials database, and EMBASE(R). We also scanned relevant reference lists and hand-searched all review articles or abstracts from conference reports on this topic. Of the 245 studies that we initially searched...

Revascularization options in patients with chronic kidney disease.

Texas Heart Institute Journal — Sat, 06 Mar 2010 23:20:04 +0100

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...

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Predictors of embolization during protected renal artery angioplasty and stenting: Role of antiplatelet therapy

Catheterization and Cardiovascular Interventions — Sat, 06 Mar 2010 00:00:00 +0100

Conclusion: Capture of DE and specifically platelet DE are common during protected renal stenting using a filter-type EPD. Abciximab use, and potentially combined thienopyridine and abciximab use, decreased the rate of platelet rich DE; however, only abciximab improved renal function at 1-month. © 2010 Wiley-Liss, Inc. (Source: Catheterization and Cardiovascular Interventions)

The Paclitaxel-Eluting Coroflex™ Stent Study II (PECOPS II) Acute and 6-Month Clinical and Angiographic Follow-Up, 1-Year Clinical Follow-Up

Journal of Interventional Cardiology — Fri, 05 Mar 2010 00:00:00 +0100

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)

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.)

Cardiosource — Fri, 05 Mar 2010 00:00:00 +0100

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)

Trends During 1993-2004 in the Availability and Use of Revascularization After Acute Myocardial Infarction in Markets Affected by Certificate of Need Regulations

Medical Care Research and Review — Thu, 04 Mar 2010 23:55:16 +0100

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...

Impact of Olmesartan on Progression of Coronary Atherosclerosis: A Serial Volumetric Intravascular Ultrasound Analysis From the OLIVUS (Impact of OLmesarten on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound) Trial

Journal of the American College of Cardiology — Thu, 04 Mar 2010 13:56:39 +0100

Objectives: The aim of this study was to evaluate the impact of olmesartan on progression of coronary atherosclerosis.Background: Prior intravascular ultrasound (IVUS) trial results suggest slowing of coronary atheroma progression with some medicines but have not shown convincing evidence of regression with angiotension-II receptor blocking agents.Methods: A prospective, randomized, multicenter trial—OLIVUS (Impact of OLmesartan on progression of coronary atherosclerosis: evaluation by IntraVascular UltraSound)—was performed in 247 stable angina pectoris patients with native coronary artery disease. When these patients underwent percutaneous coronary intervention for culprit lesions, IVUS was performed in their nonculprit vessels (without angiographically documented coronary stenosis [...

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Effects of stent implementation on plasma levels of asymmetric dimethylarginine in patients with or without ST-segment elevation acute myocardial infarction.

International Journal of Molecular Medicine — Thu, 04 Mar 2010 13:22:21 +0100

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...

Innovative Respiratory Stress Test Can Quickly Detect Significant Coronary Artery Disease In A Noninvasive Setting

Health News from Medical News Today — Thu, 04 Mar 2010 08:00:00 +0100

Newly published data shows using a Respiratory Modulation Response (RMR) is a novel, non-invasive measure to quickly and accurately detect the presence of significant coronary artery disease (sCAD). Patients in the study with sCAD had a lower RMR compared to patients without, regardless of their risk factors or clinical history of angina, previous myocardial infarction (MI), or angioplasty... (Source: Health News from Medical News Today)

Innovative Respiratory Stress Test Can Quickly Detect Significant Coronary Artery Disease In A Noninvasive Setting

Cardiovascular / Cardiology News From Medical News Today — Thu, 04 Mar 2010 08:00:00 +0100

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

Journal of Interventional Cardiology — Thu, 04 Mar 2010 00:00:00 +0100

(J Interven Cardiol 2009;**:1) (Source: Journal of Interventional Cardiology)

Prognostic Value of Exercise Myocardial Scintigraphy in Patients with Coronary Chronic Total Occlusions

Journal of Interventional Cardiology — Thu, 04 Mar 2010 00:00:00 +0100

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)

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Recanalization of Complex Coronary Chronic Total Occlusions Using High-Frequency Vibrational Energy CROSSER Catheter as First-Line Therapy: A Single Center Experience

Journal of Interventional Cardiology — Thu, 04 Mar 2010 00:00:00 +0100

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)

Clinical Development of Selective Anticoagulants: A State of the Art.

Reviews on Recent Clinical Trials — Thu, 04 Mar 2010 00:00:00 +0100

Authors: Capranzano P, Capodanno D, Tamburino C Although standard anticoagulation, including heparins and vitamin K antagonists (VKA), is clinically beneficial, several unmet needs remain due to several pharmacokinetic and pharmacodymamic limitations. Selective anticoagulant agents have been developed to overcome the drawbacks associated with both heparins and. VKA. Agents selectively targeting factor Xa, IXa and thrombin are alternative anticoagulants in the most advanced phases of clinical development. Compared to traditional anticoagulants these drugs have the potential to be more effective, safer and easier to use and to provide a more predictable dose response, without need for routine monitoring and dose adjustment. This review will summarize the current status of selective antic...

Demographic and Clinical Determinants of Moderate to Vigorous Physical Activity During Home-Based Cardiac Rehabilitation: THE HOME-BASED DETERMINANTS OF EXERCISE (HOME) STUDY.

Journal of Cardiopulmonary Rehabilitation and Prevention — Thu, 04 Mar 2010 00:00:00 +0100

CONCLUSIONS: The MVPA levels of patients attending home-based CR tend to vary depending on gender, whether or not metabolic syndrome was present, and prior MVPA levels, suggesting the need to potentially target these particular groups in future behavioral interventions aimed at increasing MVPA. PMID: 20216322 [PubMed - as supplied by publisher] (Source: Journal of Cardiopulmonary Rehabilitation and Prevention)

Daily aspirin 'not for the healthy'

NHS News Feed — Wed, 03 Mar 2010 15:45:00 +0100

Conclusion This trial has tried to answer an important question regarding who should be given aspirin to prevent a heart attack or stroke. It used a systematic method to screen people and followed a reasonably large group of patients for up to 10 years in some cases. The finding of “no statistical significance” can be an important result, and in this case suggests that any benefits from taking aspirin for this group of people are likely to be small. The risk of bleeding was also small and not technically of statistical significant. There is a non-significant trend in the results towards aspirin being harmful. As there is also a suggestion that the study may have been underpowered (planned for too few people), this implies that a larger study may have detected a significant increase ...

Does Inability To Express Emotions Affect Outcome Of Coronary Angioplasty?

Health News from Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

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)

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Does Inability To Express Emotions Affect Outcome Of Coronary Angioplasty?

Psychology / Psychiatry News From Medical News Today — Wed, 03 Mar 2010 11:00:00 +0100

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)

Real World, Long-Term Outcomes Comparison Between Paclitaxel-Eluting and Sirolimus-Eluting Stent Platforms

Journal of Interventional Cardiology — Wed, 03 Mar 2010 00:00:00 +0100

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...

Safety and effectiveness of bivalirudin in routine care of patients undergoing PCI

NeLM - News — Wed, 03 Mar 2010 00:00:00 +0100

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...

Long-Term Clinical Outcome of Chronic Total Occlusive Lesions Treated With Drug-Eluting Stents:

Circulation Journal — Wed, 03 Mar 2010 00:00:00 +0100

Conclusions: CTO lesions treated with SES showed better angiographic and long-term clinical outcomes than those treated with PES. Factors such as stent type, infarct-related CTO, diabetes and CKD affect the outcome of CTO intervention. PMID: 20197629 [PubMed - as supplied by publisher] (Source: Circulation Journal)

Long term outcomes of diabetic patients with critical limb ischemia followed in a thertiary referral diabetic foot clinic.

Diabetes Care — Wed, 03 Mar 2010 00:00:00 +0100

Conclusion. The early diagnosis of CLI, the aggressive treatment of infection, extensive use of PA in ischemic affected ulcers offers improved outcome for many previously at risk limbs. Ulcer size>5cm(2) indicates reduced chance of healing and increased risk of major amputation. It was felt that all ulcers warrant aggressive treatment including PA and that treatment should be considered even in the presence of small ischemic ulcers. PMID: 20200304 [PubMed - as supplied by publisher] (Source: Diabetes Care)

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Below-the-ankle Angioplasty is a Feasible and Effective Intervention for Critical leg ischaemia.

PubMed: Eur J Vasc Endovasc ... — Wed, 03 Mar 2010 00:00:00 +0100

CONCLUSIONS: BTA angioplasty for pedal and plantar arterial occlusive disease is technically feasible. It has good medium-term clinical outcome and limb salvage in a group of patients with poor surgical options. PMID: 20206557 [PubMed - as supplied by publisher] (Source: PubMed: Eur J Vasc Endovasc ...)

Determinants of functional recovery after myocardial infarction of patients treated with bone marrow-derived stem cells after thrombolytic therapy

Heart — Tue, 02 Mar 2010 14:19:58 +0100

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)

New research shows innovative respiratory stress test can quickly detect significant coronary artery disease in a noninvasive setting

EurekAlert! - Medicine and Health — Tue, 02 Mar 2010 05:00:00 +0100

(Edelman Public Relations) Newly published data shows using a Respiratory Modulation Response is a novel, noninvasive measure to quickly and accurately detect the presence of significant coronary artery disease (sCAD). Patients in the study with sCAD had a lower RMR compared to patients without, regardless of their risk factors or clinical history of angina, previous myocardial infarction or angioplasty. (Source: EurekAlert! - Medicine and Health)

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'

HSMN NewsFeed — Tue, 02 Mar 2010 00:43:30 +0100

Clinical trials imminent for CorPath System NATICK, Mass.--(HSMN NewsFeed)--Corindus Vascular Roboticsan 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)

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

Journal of Interventional Cardiology — Tue, 02 Mar 2010 00:00:00 +0100

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)

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Contrast medium nephrotoxicity after renal artery and coronary angioplasty.

Acta Radiologica — Tue, 02 Mar 2010 00:00:00 +0100

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)

Chronic stable coronary artery disease: drugs vs. revascularization

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Coronary artery disease remains the leading cause of mortality in most industrialized countries, although age-standardized mortality related to coronary artery disease (CAD) has decreased by more than 40% during the last two decades. Coronary atherosclerosis may cause angina pectoris, myocardial infarction, heart failure, arrhythmia, and sudden death. Medical management of atherosclerosis and its manifestation aims at retardation of progression of plaque formation, prevention of plaque rupture, and subsequent events and treatment of symptoms, when these occur as well as treatment of the sequelae of the disease. Revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is performed as treatment of flow-limiting coronary stenosis to reduce ...

Safety and effectiveness of bivalirudin in routine care of patients undergoing percutaneous coronary intervention

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Conclusion In our non-randomized study of routine care, we observed a reduction in blood transfusions and in short-term mortality for patients treated with bivalirudin compared with heparin plus GPI. The mortality benefit was more pronounced in our study than in randomized trials. (Source: European Heart Journal)

Bivalirudin vs. unfractionated heparin during percutaneous coronary interventions in patients with stable and unstable angina pectoris: 1-year results of the ISAR-REACT 3 trial

European Heart Journal — Mon, 01 Mar 2010 08:05:56 +0100

Conclusion Bivalirudin and unfractionated heparin during PCI provide comparable outcomes at 1 year in biomarker negative patients undergoing PCI after pre-treatment with 600 mg of clopidogrel. Clinical trial registration information: URL www.clinicaltrials.gov; Unique identifier NCT00262054. (Source: European Heart Journal)

Budd-Chiari syndrome: Long term success via hepatic decompression using transjugular intrahepatic porto-systemic shunt

BMC Gastroenterology — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Our results confirm the role of TIPS in the management of patients with acute, subacute and chronic BCS. The limited number of patients with OLT does not allow to draw a meaningful conclusion. However, the underlying disease may generate major complications, a reason why OLT should be limited to patients who cannot be managed by TIPS. (Source: BMC Gastroenterology)

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National Survey of Cardiologists' Standard of Practice for Continuous ST-Segment Monitoring.

American Journal of Critical Care — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion Respondents (55%) were unaware of published monitoring guidelines. Hospital leaders could raise awareness by multidisciplinary review of evidence and possibly incorporating continuous ST-segment monitoring into hospitals' standards of practice. PMID: 20194608 [PubMed - in process] (Source: American Journal of Critical Care)

Acute Myocardial Infarction Hospitalization in the United States, 1979 to 2005

The American Journal of Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: During the past quarter century, hospitalization for acute myocardial infarction increased until the mid-1990s, but has declined since then. At the same time, in-hospital case-fatality rates declined steadily. This decline has been associated with more aggressive therapeutic intervention. (Source: The American Journal of Medicine)

Percutaneous intervention in axillary loop-configured arteriovenous grafts for chronic hemodialysis patients.

Korean J Radiol — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Dysfunctional axillary loop-configured arteriovenous grafts almost always had subclavian venous and graft-related stenosis. Interventional treatments are helpful to overcome this and these treatments are expected to play a major role in restoring and maintaining the axillary loop-configured arteriovenous loop grafts. PMID: 20191067 [PubMed - in process] (Source: Korean J Radiol)

Postcardiac injury syndrome after percutaneous coronary intervention.

Yonsei Medical Journal — Mon, 01 Mar 2010 00:00:00 +0100

Authors: Park JS, Kim DH, Choi WG, Woo SI, Kwan J, Park KS, Lee WH, Lee JJ, Choi YJ The post cardiac injury syndrome is characterized by the development of a fever, pleuropericarditis, and parenchymal pulmonary infiltrates in the weeks following trauma to the pericardium or myocardium. According to previous reports, almost all cases develop after major cardiac surgery or a myocardial infarction. Recently, a few reports have described post cardiac injury syndrome as a complication of endovascular procedures such as percutaneous cardiac intervention. Here we describe an unusual case of post cardiac injury syndrome after a percutaneous coronary intervention. PMID: 20191025 [PubMed - in process] (Source: Yonsei Medical Journal)

Catheter-directed thrombolysis with conventional aspiration thrombectomy for lower extremity deep vein thrombosis.

Yonsei Medical Journal — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: Catheter-directed thrombolysis with conventional aspiration thrombectomy is an effective treatment for lower extremity deep vein thrombosis and produces satisfactory clinical results. PMID: 20191009 [PubMed - in process] (Source: Yonsei Medical Journal)

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Effect of Rosiglitazone on Progression of Coronary Atherosclerosis in Patients With Type 2 Diabetes Mellitus and Coronary Artery Disease. The Assessment on the Prevention of Progression by Rosiglitazone on Atherosclerosis in Diabetes Patients With Cardiovascular History Trial.

Circulation — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions-Rosiglitazone did not significantly decrease the primary end point of progression of coronary atherosclerosis more than glipizide in patients with type 2 diabetes mellitus and coronary atherosclerosis. Clinical Trial Registration-http://www.clinicaltrials.gov. Unique Identifier: NCT00116831. PMID: 20194881 [PubMed - as supplied by publisher] (Source: Circulation)

Early treatment with abciximab in patients with ST elevation myocardial infarction results in a high rate of normal or near normal blood flow in the infarct related artery.

Acute Cardiac Care — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSION: In this single centre registry study of unselected patients with STEMI early given abciximab was associated with a significantly higher rate of TIMI 2-3 flow compared to abciximab given after the acute angiography. PMID: 20201657 [PubMed - in process] (Source: Acute Cardiac Care)

Short-term Outcomes of Borderline Stenoses in Vascular Accesses with PTFE Grafts

Journal of Vascular Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Borderline stenoses associated with polytetrafluoroethylene (PTFE) dialysis access grafts can be safely followed up and do not require transluminal angioplasty. Summary: The authors previously performed a randomized trial indicating ultrasound surveillance significantly prolongs patency of PTFE dialysis access grafts (Kidney Int 2005;65:1554-8). They identified certain stenoses they termed “borderline.” They believed a “watch and wait” strategy for such stenoses that were asymptomatic was appropriate but had a relatively small number of patients in the original study. The present study tested the hypothesis that it is safe to delay treatment of borderline stenoses in patients without evidence of impaired dialysis function. They also sought to determine possible risk fa...

Period Prevalence of Iliofemoral Venous Occlusive Disease by Doppler Ultrasound Imaging and Corresponding Treatment in a Tertiary Care Facility

Journal of Vascular Surgery — Mon, 01 Mar 2010 00:00:00 +0100

Patients with iliofemoral deep venous thrombosis (DVT) are at highest risk for post-thrombotic morbidity, including the post-thrombotic syndrome. Invasive therapies such as catheter-directed thrombolysis (CDL), thrombectomy with or without balloon angioplasty, and stenting improves venous patency, venous valve function, and quality of life in patients with acute iliofemoral DVT. What is the current prevalence of acute iliofemoral DVT and how aggressively is it being treated? We hypothesized that the 10-year period prevalence of iliofemoral DVT among acute DVT cases is greater than previously reported and that thrombus removal to treat acute iliofemoral DVT is little utilized in current practice. (Source: Journal of Vascular Surgery)

Clinical relevance of clopidogrel unresponsiveness during elective coronary stenting: Experience with the point-of-care Platelet Function Assay–100 C/ADP

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Unresponsiveness to clopidogrel as assessed by the point-of-care test PFA-100C/ADP is an independent major risk factor for thrombotic complications after coronary intervention. (Source: American Heart Journal)

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Mechanisms of nonfatal acute myocardial infarction late after stent implantation: The relative impact of disease progression, stent restenosis, and stent thrombosis

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: In a “real world” population, late after stent implantation, a patient has an almost equal probability to have suffered a nonfatal AMI from either stent restenosis/thrombosis or disease progression at another site. Continuous research efforts are necessary to equally address both stent therapy and disease progression. (Source: American Heart Journal)

Does “late catch-up” exist in drug-eluting stents: Insights from a serial quantitative coronary angiography analysis of sirolimus versus paclitaxel-eluting stents

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusion: Late catch-up occurs in both PES and SES with greater delayed late loss in SES. Our data suggest that the process of neointima formation after SES and PES implantation may follow a slightly different timeline. (Source: American Heart Journal)

Health-related quality of life and long-term mortality in patients treated with percutaneous coronary intervention

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

Conclusions: Health status domains as measured with the SF-36 predicted death at 6-year follow-up in PCI patients treated with drug-eluting stenting, independent of demographic and clinical characteristics. In contrast, a decline in health status between 1 and 12 months post index procedure, as measured with the SF-36, was not associated with 6-year mortality in PCI patients treated with drug-eluting stenting. (Source: American Heart Journal)

“High-intensity interval training may reduce in-stent restenosis following percutaneous coronary intervention with stent implantation: A randomized controlled trial evaluating the relationship to endothelial function and inflammation.” Am Heart J 2009;158:734-41

American Heart Journal — Mon, 01 Mar 2010 00:00:00 +0100

The paper of Munk et al adds potential reduction of in-stent restenosis to the list of the multiple benefits of high-intensity aerobic interval training (HIIT) in a broad spectrum of patients with cardiovascular disease, which have been extensively studied by several Norwegian groups. (Source: American Heart Journal)

Drug-Eluting Stents for Primary PCI Superfluous?

Cardiology News — Mon, 01 Mar 2010 00:00:00 +0100

SNOWMASS, COLO. — The added value of using a drug-eluting stent rather than a bare-metal one in primary percutaneous coronary intervention for ST-elevation MI may be marginal at best. (Source: Cardiology News)

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Predictors of nonoptimal coronary flow after primary percutaneous coronary intervention with stent implantation for acute myocardial infarction.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: Killip class >/=3 at admission is an independent predictor of the final nonoptimal flow in AMI patients undergoing primary PCI with stent implantation. PMID: 20206075 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Efficacy of thrombectomy for acute myocardial infarction-Special focus on its efficacy according to different infarct-related arteries.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: Manual thrombectomy for STEMI can improve myocardial reperfusion after PCI and left ventricular function late after the procedure. With respect to different IRAs, manual thrombectomy for STEMI is more effective in proximal LAD and RCA lesions. PMID: 20206071 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

Efficacy of N-acetylcysteine and aminophylline in preventing contrast-induced nephropathy.

Journal of Cardiology — Mon, 01 Mar 2010 00:00:00 +0100

CONCLUSIONS: These results suggest that both prophylactic NAC and aminophylline administration are effective in preventing CIN, but not with hydration alone. It appears that the two compounds work in different ways against CIN. PMID: 20206069 [PubMed - as supplied by publisher] (Source: Journal of Cardiology)

The loading dose of clopidogrel in patients with ST-segment elevation myocardial infarction undergoing primary angioplasty

The American Journal of Emergency Medicine — Mon, 01 Mar 2010 00:00:00 +0100

Dangas et al reported that in patients with ST-segment elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) with contemporary anticoagulation regimens, a 600-mg loading dose of clopidogrel may safely reduce 30-day ischemic adverse event rates compared with a 300-mg loading dose. Although the higher dose demonstrated better 30-day clinical outcomes in multivariable and propensity score analysis, the emphasis should be put on whether the statistic advantages were mainly present in higher risk groups in this setting. (Source: The American Journal of Emergency Medicine)