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1.
Effect of comprehensive remote ischemic conditioning in anterior ST‐elevation myocardial infarction undergoing primary percutaneous coronary intervention: Design and rationale of the CORIC‐MI randomized trial 下载免费PDF全文
Li Song Hongbing Yan Peng Zhou Hanjun Zhao Chen Liu Zhaoxue Sheng Yu Tan Chen Yi Jiannan Li Jinying Zhou 《Clinical cardiology》2018,41(8):997-1003
Remote ischemic conditioning (RIC) applied during or after ST‐segment elevation myocardial infarction (STEMI) is currently the most promising adjuvant therapy to reduce reperfusion injury. Recent animal studies showed that RIC may help the myocardium recover if applied daily during the month after STEMI. The Comprehensive Remote Ischemic Conditioning in Myocardial Infarction (CORIC‐MI) trial is a single‐center randomized controlled study in which 200 patients undergoing primary percutaneous coronary intervention (PPCI) for anterior STEMI will be randomized in a 1:1 ratio into comprehensive RIC (CORIC) or no intervention (control) groups. CORIC consists of per‐RIC (5 cycles of 5‐minute ischemia and 5‐minute reperfusion of the lower limb immediately after randomization and before reperfusion), post‐RIC (5 cycles of 5‐minute ischemia and 5‐minute reperfusion of the lower limb immediately post‐PPCI), and delayed RIC (5 cycles of 5‐minute ischemia and 5‐minute reperfusion of the lower limb once daily on 2–28 days). Primary endpoint is left ventricular ejection fraction assessed by cardiac magnetic resonance imaging at 30 days. Major secondary endpoints include infarct size and left ventricular volume assessed by cardiac magnetic resonance imaging at 30 days, left ventricular ejection fraction assessed by echocardiography, and major adverse cardiovascular events up to 12 months. This report presents the baseline characteristics of 93 patients (CORIC group, n = 49; control group, n = 44) enrolled into the study as of March 31, 2018. The CORIC‐MI trial aims to test the hypothesis that CORIC will improve cardiac function and remodeling in patients with anterior STEMI undergoing PPCI. 相似文献
2.
《Clinical cardiology》2017,40(12):1285-1290
Background
It is unclear whether more severe coronary atherosclerosis is a prerequisite to an initial acute coronary event in women vs men.Hypothesis
Women may have more severe coronary atherosclerosis than men in patients with acute coronary event.Methods
We used intravascular optical coherence tomography (OCT) to evaluate gender differences in culprit‐plaque morphology in patients with a first ST‐segment elevation myocardial infarction (STEMI).We retrospectively enrolled 211 consecutive patients who experienced a first STEMI and underwent an OCT examination of their infarct‐related artery before primary percutaneous coronary intervention.Results
Of the 211 patients enrolled, 162 (76.7%) were men and 49 (23.2%) were women. The women were significantly older than the men (mean age, 60.2 ± 8.2 vs 55.7 ± 11.2 years; P = 0.01) and less likely to be current smokers (P = 0.02). Moreover, the delay from symptom onset to reperfusion was longer in women than in men (7.6 ± 6.1 vs 5.5 ± 4.4 hours; P = 0.01). The OCT data indicated that there were no gender differences in culprit‐plaque morphology, including lipid length, lipid arc, minimum fibrous cap thickness, or minimum lumen area. Additionally, no gender differences were found in the prevalence of plaque rupture, thin‐cap fibroatheroma, residual thrombus, microvessels, macrophages, cholesterol crystals, or calcification.Conclusions
Among patients presenting with a first STEMI, there were no differences in culprit plaque features between women and men.3.
4.
Cardiovascular disease continues to represent a significant and growing source of morbidity and mortality despite advances
in traditional treatments. As a result, increasing interest and research in regenerative therapies has emerged in recent years.
Among them, cell therapy represents an area of significant potential. An expanding clinical literature now exists involving
the use of bone marrow-derived stem cells in the treatment of ischemic heart disease. These early studies appear to provide
promising results in patient populations that include those with refractory angina, ischemic cardiomyopathy with left ventricular
dysfunction, and end-stage heart failure. This review serves to provide a comprehensive examination of these clinical trials
focused on several components including cell preparation, cell delivery, safety, and efficacy of these trials. 相似文献
5.
《Clinical cardiology》2017,40(11):955-961
The YOUNG‐MI registry is a retrospective study examining a cohort of young adults age ≤ 50 years with a first‐time myocardial infarction. The study will use the robust electronic health records of 2 large academic medical centers, as well as detailed chart review of all patients, to generate high‐quality longitudinal data regarding the clinical characteristics, management, and outcomes of patients who experience a myocardial infarction at a young age. Our findings will provide important insights regarding prevention, risk stratification, treatment, and outcomes of cardiovascular disease in this understudied population, as well as identify disparities which, if addressed, can lead to further improvement in patient outcomes. 相似文献
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7.
《Clinical cardiology》2017,40(12):1303-1308
Background
Chronic kidney disease (CKD) is a well‐known risk factor for coronary artery disease and is associated with poor outcomes following an acute coronary syndrome (NSTE‐ACS). The optimal timing of an invasive strategy in patients with CKD and NSTE‐ACS is unclear.Hypothesis
Timing of PCI in CKD patients will not affect the risk of mortality or incidence of dialysis.Methods
We queried the National Inpatient Sample database (NIS) to identify cases with NSTEMI and CKD. Patients who underwent percutaneous coronary intervention (PCI) day 0 or 1 vs day 2 or 3 after admission were categorized as early vs delayed PCI, respectively. The primary outcomes of the study were in‐hospital mortality and acute kidney injury requiring hemodialysis (AKI‐D). The secondary outcomes were length of stay and hospital charges. Baseline characteristics were balanced using propensity score matching (PSM).Results
After PSM, 3708 cases from the delayed PCI group were matched with 3708 cases from the early PCI group. The standardized mean differences between the 2 groups were substantially reduced after PSM. All other recorded variables were balanced between the 2 groups. In the early and delayed PCI groups, the incidence of AKI‐D (2.5% vs 2.3%; P = 0.54) and in‐hospital mortality (1.9% vs 1.4%; P = 0.12) was similar. Hospital charges and length of stay were higher in the delayed PCI group.Conclusions
The incidence of AKI‐D and in‐hospital mortality among patients with CKD and NSTE‐ACS were not significantly affected by the timing of PCI. However, delayed PCI added significant cost and length of stay. A prospective randomized study is required to validate this concept.8.
9.
Ketil Lunde 《Journal of cardiovascular translational research》2009,2(1):139-141
Meta-analyses and some randomized clinical trials have shown modest improvement in left ventricular function after intracoronary
injection of bone marrow cells (BMC) in patients with acute myocardial infarction (AMI). This has been shown even though several
limitations like ignorance about the best cell(s) to use, the optimal dose, an effective administration mode, and the mechanism
of action remain. The potential of BMC therapy will not be realized until these hurdles are passed. And even though BMC therapy
seems to be relatively safe, it is invasive and expose the patients to the possibility of procedure-related complications.
Thus, at the current stage of development, it will probably be better to use resources on more basic research and small- to
intermediate-sized clinical trials instead of a large-scale outcome trial. 相似文献
10.
Thrombus aspiration in late presenters with ST‐elevation myocardial infarction: A single‐center randomized trial 下载免费PDF全文
Objectives
To examine whether routine thrombus aspiration (TA) is associated with improved myocardial salvage in patients with ST‐elevation myocardial infarction (STEMI) presenting ≥12 h after onset of symptoms.Background
TA is a recognized treatment option in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI) especially in the setting of heavy thrombus burden. However, data on the role of TA in STEMI patients presenting late after onset of symptoms are limited.Methods
In this single‐center prospective randomized study, patients with subacute STEMI presenting ≥12 and ≤48 h after symptom onset were randomized to primary PCI with or without manual TA in a 1:1 ratio. The primary endpoint was the myocardial salvage index assessed with Single Photon Emission Computed Tomography (SPECT) on admission and 4 days later.Results
A total of 60 patients underwent randomization. Baseline characteristics were comparable between groups. TA was associated with improved myocardial salvage index compared with control group (60.1 ± 11.1% vs 28.1 ± 21.3%; P = <0.001). Furthermore, TA was associated with improved post‐procedural TIMI flow (2.9 ± 0.3 vs 2.5 ± 0.6; P = 0.003), myocardial blush grade (2.9 ± 0.3 vs 2.2 ± 0.8, P = <0.001), and reduction in left ventricular end‐diastolic dimensions (50.4 ± 4.3 mm vs 54.4 ± 5.8 mm, P = 0.004) compared with the control group. Clinical outcomes at 30 days and 6 months were similar between both groups.Conclusions
TA might be associated with improved reperfusion and myocardial salvage especially in STEMI patients presenting after 12 h from symptom onset who are likely to have a heavy thrombus burden.11.
Pilar Jimenez‐Quevedo Salvatore Brugaletta Angel Cequier Andrs Iiguez Antonio Serra Vicente Mainar Gianluca Campo Maurizio Tespili Luis Nombela‐Franco Maria del Trigo Nieves Gonzalo Javier Escaned Pablo Salinas Ivan Nuez‐Gil Cristina Fernandez‐Perez Antonio Fernndez‐Ortiz Carlos Macaya Patrick W. Serruys Manel Sabate Tenas 《Catheterization and cardiovascular interventions》2019,94(7):917-925
12.
Dylan L. Steen Amarachi A. Umez‐Eronini Jianping Guo Naseer Khan Christopher P. Cannon 《Clinical cardiology》2018,41(1):68-73
Background
For decades, fasting for 8 to 12 hours has been recommended for measurement of lipid profiles. The effect of fasting on low‐density lipoprotein cholesterol (LDL‐C) and triglycerides (TG) has been described in healthy cohorts and those with stable disease states. Recently, guidelines suggested that fasting may not be necessary due to its small effect on lipid measures. Little is known, however, regarding whether the impact of fasting is altered in the setting of an acute coronary syndrome (ACS).Hypothesis
We hypothesized that the post‐ACS period would minimally effect the impact of fasting status on lipid measurements.Methods
We evaluated the association of fasting on lipid and other biomarkers at the randomization visit, which occurred at a median of 7 days after the onset of an ACS, as well as during follow‐up, in a cohort of 4177 subjects from the Pravastatin or Atorvastatin Evaluation and Infection Therapy–Thrombolysis In Myocardial Infarction 22 (PROVE IT–TIMI 22) trial.Results
Fasting samples were independently associated with a higher LDL‐C of 4.1 mg/dL and apolipoprotein‐B 100 of 2.6 mg/dL as well as a lower TG of 21.0 mg/dL and high‐sensitivity C‐reactive protein of 0.48 mg/dL. The relative difference was 3.8% for LDL‐C and ?11.3% for TG. Fasting did not change total cholesterol, high‐density lipoprotein cholesterol, apolipoprotein A‐I, lipoprotein(a), or apolipoprotein C‐III.Conclusions
Although fasting does impact lipid measurements, the effect on LDL‐C is small (about 4 mg/dL), both early after ACS and during follow‐up. These data provide support for recent guidelines that no longer advocate for fasting lipid samples, including in the setting of ACS.13.
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A randomized study of prourokinase during primary percutaneous coronary intervention in acute ST‐segment elevation myocardial infarction 下载免费PDF全文
Wei Geng Qi Zhang Jingmin Liu Xiang Tian Libo Zhen Da Song Ying Yang Haiyun Meng Yafang Wang Jianjun Chen 《Journal of interventional cardiology》2018,31(2):136-143
Objectives
To evaluate the efficacy and safety of intracoronary administration of prourokinase via balloon catheter during primary percutaneous coronary interventions (PCI) in patients with acute ST‐segment elevation myocardial infarction (STEMI).Methods
Acute STEMI patients underwent primary PCI were randomly divided into two groups: intracoronary prourokinase (IP) group (n = 118) and control group (n = 112). During primary PCI, prourokinase or saline were injected to the distal end of the culprit lesion via balloon catheter after balloon catheter dilatation. Demographic and clinical characteristics, infarct size, myocardial reperfusion, and cardiac functions were evaluated and compared between two groups. Hemorrhagic complications and MACE occurred in the 6‐months follow up were recorded.Results
No significant differences were observed between two groups with respect to baseline demographic, clinical, and angiographic characteristics (P > 0.05). In IP group, more patients had complete ST segment resolution (>70%) compared with control group (P < 0.05). Patients in IP group showed lower levels of serum CK, CK‐MB and TnI, and a much higher myocardial blood flow (MBF) than those in control group (P < 0.05). No significant differences of TIMI major or minor bleeding complications were observed between the two groups (P > 0.05). At 6‐months follow‐up, there was a trend that patients in the IP group had a less chance to have MACE, though it was not statistically different (8.5% vs 12.5%, P > 0.05).Conclusions
Intracoronary administration of prourokinase via balloon catheter during primary PCI effectively improved myocardial perfusion in STEMI patients. 相似文献17.
ST‐segment elevation on intracoronary electrocardiogram after percutaneous coronary intervention is associated with worse outcome in patients with non‐ST‐segment elevation myocardial infarction 下载免费PDF全文
Keiichi Hishikari MD Tsunekazu Kakuta MD Tetsumin Lee MD Tadashi Murai MD Taishi Yonetsu MD Mitsuaki Isobe MD 《Catheterization and cardiovascular interventions》2016,87(4):E113-E121
The AMPLATZERTM Vascular Plug 4 (AVP4) is a self‐expandable, replaceable occluder made of Nitinol wire mesh, which allows the safe and effective interventional occlusion of medium size vessels. This report describes an infant diagnosed with pulmonary atresia, ventricular septal defect, and multifocal collateral lung perfusion through four major aortopulmonary collateral arteries (MAPCAs). A central aorto‐pulmonary shunt was performed at 4 months of age. Because of postoperative pulmonary hyperperfusion, one of the MAPCAs was closed interventionally using a 5 mm AVP4. This MAPCA originated from the descending aorta (DAO) near the fifth thoracic vertebra and ran behind the esophagus to the lower lobe of the right lung. The MAPCA was closed near its origin from the DAO. Four weeks later, the patient presented with severe gastrointestinal bleeding, caused by perforation of the AVP4 into the esophagus. The occluder was extracted surgically, the MAPCA was clipped and the esophageal injury was sutured. To date, there have been no reports describing esophageal perforation due to an AVP4. The perforation in this patient may have been due to implantation of the AVP4 near the aorta in a MAPCA segment located directly in front of the spine and behind the esophagus. Another possible factor may have been the requirement for a gastrointestinal feeding tube. Although the occluder is soft and flexible, the spindle‐shaped ends may cause trauma if they are located close to other structures. © 2016 Wiley Periodicals, Inc. 相似文献
18.
Pretreatment with dual antiplatelet therapy in patients with ST‐elevation myocardial infarction 下载免费PDF全文
Matias B. Yudi MBBS Omar Farouque MBBS PhD Nick Andrianopoulos MBBS MBiostat Andrew E. Ajani MBBS MD Angela Brennan RN Jeffrey Lefkovits MBBS Christopher M. Reid BA MSc PhD William Chan MBBS PhD Stephen J. Duffy MBBS PhD David J. Clark MBBS DMedSci 《Catheterization and cardiovascular interventions》2018,92(2):E98-E105
19.
Coronary artery disease and 10‐year outcome after hospital admission for heart failure with preserved and with reduced ejection fraction 下载免费PDF全文
Dan Rusinaru David Houpe Catherine Szymanski Franck Lévy Sylvestre Maréchaux Christophe Tribouilloy 《European journal of heart failure》2014,16(9):967-976
20.
《Clinical cardiology》2017,40(12):1256-1263