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GMG Interventional

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519 papers 100 to 500 followers Papers related to PCI therapy for CAD
By Gregory Gustafson Interventional Cardiologist
Felipe Díez-Delhoyo, Enrique Gutiérrez-Ibañes, Ricardo Sanz-Ruiz, María Eugenia Vázquez-Álvarez, Hugo González Saldívar, Allan Rivera Juárez, Fernando Sarnago, Manuel Martínez-Sellés, Javier Bermejo, Javier Soriano, Jaime Elízaga, Francisco Fernández-Avilés
BACKGROUND: Approximately half of the patients presenting with ST-segment-elevation myocardial infarction (STEMI) have multivessel disease. The physiology of the nonculprit artery has not been thoroughly studied to date. We sought to characterize the coronary physiology of the nonculprit artery in the early phase after STEMI and determine the real prevalence of microvascular and endothelial dysfunction. METHODS AND RESULTS: Patients with STEMI and another coronary artery lesion in a different territory were prospectively included in an observational single-center study...
February 2019: Circulation. Cardiovascular Interventions
Hirohisa Endo, Tomotaka Dohi, Katsumi Miyauchi, Shoichi Kuramistu, Yoshiteru Kato, Iwao Okai, Miho Yokoyama, Takayuki Yokoyama, Kenji Ando, Shinya Okazaki, Kazunori Shimada, Satoru Suwa, Hiroyuki Daida
BACKGROUND: The use of serial intravascular ultrasound (IVUS) for coronary atherosclerosis has offered valuable insight into plaque regression (PR) or progression. However, the beneficial effects of PR on the long-term clinical outcomes in patients with acute coronary syndrome (ACS) remain unclear. We aimed to evaluate the impact of coronary plaque change in patients following primary percutaneous coronary intervention. METHODS: We retrospectively analyzed data from 4 prospective clinical trials involving 173 patients with ACS who underwent serial IVUS of non-culprit lesions on statin treatment at baseline and at 6 or 8 months of follow-up...
February 5, 2019: Journal of Cardiology
Hetal H Mehta, Mackenzie Morris, David L Fischman, John J Finley, Nicholas Ruggiero, Paul Walinsky, Melissa McCarey, Michael P Savage
OBJECTIVE: An under-recognized cause of chest pain, the coronary slow-flow (CSF) phenomenon is characterized by delayed coronary opacification during diagnostic angiography in the absence of epicardial coronary artery disease (CAD). Given its angiographic resemblance to no-reflow during percutaneous coronary intervention, a condition associated with microvascular spasm responsive to calcium-channel blockers, we hypothesized that spontaneous CSF may similarly be reversed by intracoronary (IC) nicardipine...
December 15, 2018: Journal of Invasive Cardiology
M A Beijk, W V Vlastra, R Delewi, T P van de Hoef, S M Boekholdt, K D Sjauw, J J Piek
Vasospastic angina (VSA) is considered a broad diagnostic category including documented spontaneous episodes of angina pectoris produced by coronary epicardial vasospasm as well as those induced during provocative coronary vasospasm testing and coronary microvascular dysfunction due to microvascular spasm. The hallmark feature of VSA is rest angina, which promptly responds to short-acting nitrates; however, VSA can present with a great variety of symptoms, ranging from stable angina to acute coronary syndrome and even ventricular arrhythmia...
January 28, 2019: Netherlands Heart Journal
Salvior Mok, David Majdalany, Gosta B Pettersson
Background: Myocardial bridge is defined as a segment of a coronary artery that takes an intramyocardial course. The presence of myocardial bridge has been observed in as many as 40%-80% of cases on autopsy, angiographically from 0.5% to 16.0%, and often asymptomatic. However, it has been associated with angina, coronary spasm, myocardial infarction, arrhythmias, syncope, sudden cardiac arrest, and death. Conflicting opinions exist on the timing of surgical intervention for myocardial bridge...
2019: SAGE open medical case reports
Huan Cai, Christine Y Chuang, Siriluck Vanichkitrungruang, Clare L Hawkins, Michael J Davies
The extracellular matrix (ECM) influences the structure and function of the arterial wall and modulates the behavior of vascular cells through the ECM-cell interactions. Alterations to the ECM have been implicated in multiple pathological processes, including atherosclerosis which is characterized by low-grade chronic inflammation and the infiltration and proliferation of smooth muscle cells during disease development. Considerable evidence has been presented for a role for inflammation-derived oxidation in atherogenesis, with enzymatically-active myeloperoxidase (MPO), elevated levels of 3-chlorotyrosine (a biomarker of MPO-catalyzed damage) and oxidized ECM materials in advanced human atherosclerotic lesions...
February 1, 2019: Free Radical Biology & Medicine
Francesco Franchi, Fabiana Rollini, Andrea Rivas, Mustafa Wali, Maryuri Briceno, Malhar Agarwal, Zubair Shaikh, Ahmed Nawaz, Gabriel Silva, Latonya Been, Ramez Smairat, Marc Kaufman, Andres Pineda, Siva Suryadevara, Daniel Soffer, Martin M Zenni, Theodore A Bass, Dominick J Angiolillo
BACKGROUND: The platelet inhibitory effects induced by oral P2Y12 receptor antagonists are delayed in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (P-PCI). In turn, this leads to a gap in platelet inhibition exposing patients to an increased risk of early thrombotic complications underscoring the need to define strategies associated with more effective platelet inhibition in the peri-PCI period. Cangrelor is an intravenous P2Y12 inhibitor with prompt and potent antiplatelet effects...
January 11, 2019: Circulation
Marco Zuin, Gianluca Rigatelli, Loris Roncon
Over the last years, fentanyl, a potent synthetic μ receptor-stimulating opioid, has become one of the most used drugs for both procedural analgesia and sedation in patients undergoing coronary angiography (CA) and/or percutaneous coronary intervention (PCI). However, few studies have been performed to evaluate the efficacy and the impact of this drug in patients with coronary artery disease (CAD) treated with PCI. Most of the previous studies have investigated the self-reported discomfort pain, demonstrating that patients premedicated with fentanyl generally reported a lower pain/discomfort when compared to placebo, benzodiazepines, or local anesthesia at the site of the artery cannulation, without significant variation in the hemodynamic response...
December 2018: Cardiovascular Drugs and Therapy
Pontus Andell, Karolina Berntorp, Evald H Christiansen, Ingibjörg J Gudmundsdottir, Lennart Sandhall, Dimitrios Venetsanos, David Erlinge, Ole Fröbert, Sasha Koul, Christian Reitan, Matthias Götberg
OBJECTIVES: The authors sought to compare reclassification of treatment strategy following instantaneous wave-free ratio (iFR) and fractional flow reserve (FFR). BACKGROUND: iFR was noninferior to FFR in 2 large randomized controlled trials in guiding coronary revascularization. Reclassification of treatment strategy by FFR is well-studied, but similar reports on iFR are lacking. METHODS: The iFR-SWEDEHEART (Instantaneous Wave-Free Ratio Versus Fractional Flow Reserve in Patients With Stable Angina Pectoris or Acute Coronary Syndrome Trial) study randomized 2,037 participants with stable angina or acute coronary syndrome to treatment guided by iFR or FFR...
October 22, 2018: JACC. Cardiovascular Interventions
Tommaso Gori, Remzi Anadol
Up to 50% of the patients undergoing coronary angiography present no epicardial disease. Most of these patients are women. Takotsubo cardiomyopathy, coronary microvascular dysfunction, and spontaneous coronary artery dissection are the most common syndromes that affect these patients. Their mechanisms are complex, with a interplay between neurohormonal factors and a number of other systems. The present review describes how changes in the estrogen state may lead to changes in vasomotor tone and endothelial dysfunction which result in coronary epicardial and microvascular spasm and coronary arterial wall instability in these three conditions...
October 11, 2018: Clinical Hemorheology and Microcirculation
Thomas F Lüscher
No abstract text is available yet for this article.
September 14, 2018: European Heart Journal
Rasha K Al-Lamee, Alexandra N Nowbar, Darrel P Francis
The adverse consequences of stable coronary artery disease (CAD) are death, myocardial infarction (MI) and angina. Trials in stable CAD show that percutaneous coronary intervention (PCI) does not reduce mortality. PCI does appear to reduce spontaneous MI rates but at the expense of causing some periprocedural MI. Therefore, the main purpose of PCI is to relieve angina. Indeed, patients and physicians often choose PCI rather than first attempting to control symptoms with anti-anginal medications as recommended by guidelines...
January 2019: Heart: Official Journal of the British Cardiac Society
Matthew Allan, Dominic Vickers, Mark Pitney, Nigel Jepson
BACKGROUND: Refractory coronary in-stent restenosis remains a clinically relevant problem in interventional cardiology despite the use of drug coated balloon angioplasty and further drug eluting stent deployment. In this study, we investigated whether the novel approach of lesion debulking with rotational atherectomy prior to drug coated balloon angioplasty for challenging coronary in-stent restenosis is safe and effective. METHODS: Procedural and registry data was retrospectively analysed for 26 patients who underwent rotational atherectomy immediately followed by drug coated balloon angioplasty to 43 coronary in-stent restenosis lesions with mean follow up of 19 months...
August 25, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Evan Shlofmitz, Allen Jeremias, Alec Goldberg, Thomas Pappas, Andrew Berke, George Petrossian, Theofanis Tsiamtsiouris, Andrew Lituchy, Michael Lee, Richard Shlofmitz
BACKGROUND: Severely calcified lesions present many challenges to percutaneous coronary intervention (PCI). Orbital atherectomy (OA) aids vessel preparation and treatment of severely calcified coronary lesions. Same-day discharge (SDD) after PCI has numerous advantages including cost savings and improved patient satisfaction. The aim of this study is to evaluate the safety of SDD among patients treated with OA in a real-world setting. METHODS: This was a single-center retrospective analysis of patients undergoing OA...
September 6, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Kyle D Buchanan, Paul Kolm, Micaela Iantorno, Deepakraj Gajanana, Toby Rogers, Jiaxiang Gai, Rebecca Torguson, Itsik Ben-Dor, William O Suddath, Lowell F Satler, Ron Waksman
BACKGROUND/PURPOSE: Appropriate patient selection for mechanical circulatory support following percutaneous coronary intervention (PCI) remains a challenge. This study aims to evaluate the role of coronary perfusion pressure and other left ventricular hemodynamics to predict cardiovascular collapse following PCI. METHODS/MATERIALS: We retrospectively analyzed all patients who underwent PCI for acute coronary syndrome (ACS) from 2003 to 2016. Coronary perfusion pressure was calculated for each patient and defined as the difference in mean arterial pressure and left ventricular end diastolic pressure (LVEDP)...
January 2019: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Shozo Sueda, Kaori Fujimoto, Yasuhiro Sasaki, Tomoki Sakaue, Hirokazu Habara, Hiroaki Kohno
Objectives The clinical characteristics in patients with catheter-induced spasm in the proximal right coronary artery (RCA) are controversial. We performed a clinical analysis of catheter-induced spasm in the RCA. Methods We retrospectively analyzed 5,352 consecutive patients who underwent diagnostic or follow-up angiography during a 26-year period. During this period, we found 40 patients with catheter-induced spasm in the RCA. We compared the clinical characteristics and procedures of cardiac catheterization in patients with catheter-induced spasm in the RCA with those in patients without such spasm...
August 10, 2018: Internal Medicine
Peter Ong, Giancarlo Pirozzolo, Anastasios Athanasiadis, Udo Sechtem
PURPOSE: Coronary spasm is frequently found in patients with angina and unobstructed coronaries. The pathophysiology is incompletely understood, although sex differences have been described. Often a positive family history (PFH) is encountered. We assessed the relationship between sex, coronary spasm, and a PFH for cardiovascular disease. METHODS: This single-center observational study recruited 415 stable angina patients with unobstructed coronaries (no stenosis >50%) between 2008 and 2011 (mean [SD] age, 62 [10] years; 38% men)...
August 16, 2018: Clinical Therapeutics
Toshiki Sawai, Yu Tajima, Atsuya Hirota, Shigetada Yamamoto, Hiroshi Nakajima, Katsutoshi Makino, Masaaki Ito
A 69-year-old man who had been hospitalized with acute coronary syndrome (ACS), underwent urgent percutaneous coronary intervention. In the subacute phase, he developed sudden chest pain and hemodynamic deterioration, and urgent coronary angiogram showed multiple coronary artery spasms. The discontinuation of beta-blocker treatment and the administration of a calcium antagonist helped prevent angina attacks. In Japanese patients who tend to have coronary artery spasm, the routine administration of beta-blockers for post-ACS patients with a preserved left ventricular systolic function should be considered carefully...
August 24, 2018: Internal Medicine
Fabien Picard, Neila Sayah, Vincent Spagnoli, Julien Adjedj, Olivier Varenne
Vasospastic angina (VSA) is a variant form of angina pectoris, in which angina occurs at rest, with transient electrocardiogram modifications and preserved exercise capacity. VSA can be involved in many clinical scenarios, such as stable angina, sudden cardiac death, acute coronary syndrome, arrhythmia or syncope. Coronary vasospasm is a heterogeneous phenomenon that can occur in patients with or without coronary atherosclerosis, can be focal or diffuse, and can affect epicardial or microvasculature coronary arteries...
September 6, 2018: Archives of Cardiovascular Diseases
John C Moscona, Jason D Stencel, Gregory Milligan, Christopher Salmon, Rohit Maini, Paul Katigbak, Qusai Saleh, Ryan Nelson, Sudesh Srivastav, Owen Mogabgab, Rohan Samson, Thierry Le Jemtel
Background: An accurate diagnostic assessment of coronary artery disease is crucial for patients undergoing coronary artery bypass grafting (CABG). Fractional flow reserve (FFR) and instantaneous wave-free ratio (iFR) to guide complete revascularization have not been adequately studied in patients prior to CABG. We compared an anatomic to a physiologic assessment of moderate coronary lesions (40-70% stenosis) in patients referred for CABG. Methods: We retrospectively reviewed 109 medical records of patients who underwent CABG at Tulane Medical Center from 2014 to 2016...
August 2018: Annals of Translational Medicine
2018-09-15 23:55:08
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