SWEDEHEART-1-year data show no benefit of newer generation drug-eluting stents over bare-metal stents in patients with severe kidney dysfunction following percutaneous coronary intervention

Background We hypothesized that the transition from bare-metal stents (BMS) to newer generation drug-eluting stents (n-DES) in clinical practice may have reduced the risk also in patients with kidney dysfunction. Methods: Observational study in the national SWEDEHEART registry, that compared the 1-year risk of in-stent restenosis (RS) and stent thrombosis (ST) in all percutaneous coronary intervention treated patients(n = 92 994) during 2007–2013. Results: N-DES patients were younger than BMS, but had more often diabetes, previous myocardial infarction, previous revascularization and were more often treated with potent platelet inhibition. N-DES versus BMS, was associated with lower 1-year risk of RS in patients with estimated glomerular filtration rate (eGFR)>60 with a cumulative probability of 2.1% versus 5.3%, adjusted hazard ratio 0.30, 95% CI (0.27–0.34) and with eGFR 30–60: 3.0% versus 4.9%; hazard ratio 0.46 (0.36–0.60) but not in patients with eGFR 60 and eGFR 30–60: 0.5% versus 0.9%; hazard ratio 0.52 (0.40–0.68) and 0.6% versus 1.3%; hazard ratio 0.54 (0.54–0.72) but not for eGFR
Source: Coronary Artery Disease - Category: Cardiology Tags: Myocardial Infarction/Cardiogenic Shock Source Type: research

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Publication date: Available online 16 January 2020Source: Progress in Neuro-Psychopharmacology and Biological PsychiatryAuthor(s): Minjing Shao, Chuanjun Zhuo, Xiangyang Gao, Ce Chen, Yong Xu, Hongjun Tian, Gongying Li, Deguo Jiang, Wenqiang WangAbstractImportanceIt has been suggested that patients with schizophrenia have higher than expected mortality following acute coronary events. However, the in-hospital revascularization rate in patients with schizophrenia and acute myocardial infarction (AMI) compared to mentally healthy patients remains unknown.ObjectiveTo evaluate the revascularization rate in schizophrenic patien...
Source: Progress in Neuro Psychopharmacology and Biological Psychiatry - Category: Psychiatry Source Type: research
Authors: Skalický T, Skalický A Abstract The presented case report describes primarily an unrecognized liver injury after the resuscitation with cardiac massage due to myocardial infarction. After myocardial revascularization, the hemodynamic instability and anaemia in the patient persisted. The performed CT scan confirmed a liver injury, namely the rupture of liver parenchyma with hemoperitoneum, which had to be treated surgically. It represents a complication of cardiac massage that occurs, though less frequently. Key words: resuscitation, liver trauma. PMID: 31941573 [PubMed - in process]
Source: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca - Category: Orthopaedics Tags: Acta Chir Orthop Traumatol Cech Source Type: research
We report recent trends and predictors of ACS hospitalisation LOS in New Zealand. METHODS: Using routine national hospitalisation datasets, we calculated mean LOS for ACS admissions annually from 2006 to 2016, by demographics, ACS subtype and ACS procedures (coronary angiography, percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG)). We also identified predictors of longer LOS. RESULTS: Among 185,962 ACS hospitalisations, mean LOS decreased from 7.8 to 6.7 days between 2006 and 2016 (adjusted decrease = -0.18 days/year). Decline in LOS was observed for all demographic subgroups by age...
Source: New Zealand Medical Journal - Category: General Medicine Tags: N Z Med J Source Type: research
Conclusion: Administration of CoQ10 for 3 months in T1DM pediatric patients was well tolerated but had no favorable effect on ED or metabolic parameters. PMID: 31942840 [PubMed - as supplied by publisher]
Source: International Journal for Vitamin and Nutrition Research - Category: Nutrition Tags: Int J Vitam Nutr Res Source Type: research
Conclusion: Sirolimus-eluting Stentys stent may represent a potential solution for specific coronary anatomies such as bifurcation, ectasic, or tapered vessels. Risk of stent thrombosis appears related to clinical presentation with STEMI and to anatomic features, stressing the importance of the use of intracoronary imaging for self-expandable stents implantation.
Source: Coronary Artery Disease - Category: Cardiology Tags: Myocardial Infarction/Cardiogenic Shock Source Type: research
Authors: Ginanjar E, Yulianto Y, Salim S, Setyawan W Abstract Myocardial infarction simultaneously involving two or more culprit lesions is extremely rare and usually has a poor clinical outcomes including mortality. Management of this complicated condition is challenging and limited time. Nevertheless, autopsy studies revealed that thrombotic occlusion of more than one major epicardium coronary artery is not uncommon. A 68-year-old woman presented with sudden onset of limited breath and chest discomfort since two hours prior to admission. She also felt exert dyspnoea since one month ago. She has two risk factors t...
Source: Acta medica Indonesiana - Category: Internal Medicine Tags: Acta Med Indones Source Type: research
Background: Acute myocardial infarction (AMI) occurs as a result of irreversible damage to cardiac myocytes secondary to lack of blood supply. Cardiogenic shock complicating AMI has significant associated morbidity and mortality, and data on postdischarge outcomes are limited. Methods and Results: We derived the study cohort of patients with AMI and cardiogenic shock from the 2013 to 2014 Healthcare Cost and Utilization Project National Readmission Database. Incidence, predictors, and causes of 30-day readmissions were analyzed. From 43 212 index admissions for AMI with cardiogenic shock, 26 016 (60.2%) survived to discha...
Source: Circulation: Heart Failure - Category: Cardiology Authors: Tags: Heart Failure, Complications, Mortality/Survival, Quality and Outcomes, Acute Coronary Syndromes Original Articles Source Type: research
I was reading through ECGs on the system when I saw this one:Sinus tachycardia, rate 120Computerized QTc = 380 msWhat do you think? I was immediately worried about a proximal LAD occlusion.  Although sinus tachycardia generally argues against ACS, a large anterior MI may result in such poor stroke volume that there is compensatory tachycardia and possibly impending cardiogenic shock. I looked to see if there was an ED cardiac ultrasound, and there was:Parasternal Long Axis:Poor image, but one can see that there is poor apical functionParasternal short axis:This shows poor contractility of the anterior wall.C...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
ConclusionMedina 001 lesion is an infrequent type of coronary lesion. Drug‐coated balloon—Dior is a safe and technically easy therapeutic option, associated with acceptable mid‐term clinical outcomes. (J Interven Cardiol 2016;29:285–292)
Source: Journal of Interventional Cardiology - Category: Cardiology Authors: Tags: Original Investigation Source Type: research
ConclusionMedina 001 lesion is an infrequent type of coronary lesion. Drug‐coated balloon—Dior is a safe and technically easy therapeutic option, associated with acceptable mid‐term clinical outcomes. (J Interven Cardiol 2016;29:285–292)
Source: Journal of Interventional Cardiology - Category: Cardiology Authors: Tags: Original Investigation Source Type: research
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