Long-Term Safety and Efficacy of Durable Polymer Cobalt-Chromium Everolimus-Eluting Stents in Patients at High Bleeding Risk: A Patient-Level Stratified Analysis from Four Post-Approval Studies.
Conclusions: Compared to the non-HBR population, HBR patients experienced worse 4-year outcomes after PCI with CoCr everolimus-eluting stent. Both CTE and MB had a significant impact on subsequent risk of mortality irrespective of bleeding risk. PMID: 31992063 [PubMed - as supplied by publisher]
What have we learned about optimizing cardiorenal protection in advanced CKD from landmark papers published in 2018?Nephrology Dialysis Transplantation
Mechanical blood-immersed bearings have been used in many continuous-flow rotary blood pumps to reduce friction between relatively moving parts, but their use has been associated with a significant incidence of pump thrombosis. As newer cardiac assist devices with more advanced bearings become available, the rate of pump thrombosis will likely decrease. Nevertheless, it is important to understand the design limitations of mechanical bearings as pumps utilizing them are still in use as chronic support devices and especially in the acute setting for temporary support devices. A properly designed journal bearing should suppor...
Pump thrombosis (PT) is a serious adverse event in patients receiving left ventricular assist devices (LVAD). The study aims to determine whether pump parameters and clinical data may enable early detection of PT. This retrospective study included 88 patients who received an LVAD between 2012 and 2015 among which those with intra-PT were identified. In a propensity score–matched control group observation, time periods were matched with time before thrombosis. International normalized ratio (INR) time in therapeutic range (TTR) and lactate dehydrogenase (LDH) were analyzed for 60 days preceding PT. Furthermore, pump d...
We characterized the biologic background of prothrombotic platelet function in the setting of durable left ventricular assist devices (LVADs) evaluating the role of different antithrombotic regimens. Platelet-mediated thrombin generation was quantified using the Platelet Activity State (PAS) Assay and the Thrombin Generation Test (TGT) in 78 patients implanted with the HeartMate II (n = 10, 13%), the HeartMate 3 (HM3) (n = 30, 38%), or the HVAD (n = 38, 49%) and managed with oral anticoagulation plus aspirin (n = 46, 59%) or anticoagulation alone (n = 32, 41%). Coagulation parameters (platelet count, International Normaliz...
CONCLUSION: BPPV is the most frequent diagnosis seen in the ED; however, physicians need to document nystagmus more precisely and perform diagnostic tests systematically, in order to make an accurate diagnosis. To avoid misdiagnoses, ED physicians and ENT specialists should be able to recognize central signs in patients with an acute vestibular syndrome. Every fourth patient does not receive a definitive diagnosis. Diagnostic ED workup for patients with dizziness needs further improvement. PMID: 32221628 [PubMed - as supplied by publisher]
ConclusionsMore macrovascular and microvascular complications were found in Northern compared to Southern patients, and the largest difference also appeared in the younger age groups under 55, which may be meaningful to a screening and treatment strategy according to geographic differences.
There is ongoing uncertainty regarding the safety and efficacy of unfractionated heparin and bivalirudin when used for systemic anticoagulation in patients undergoing primary percutaneous coronary intervention (PPCI). This paper reports 12-month mortality from the HEAT-PPCI randomised trial.
ConclusionsThe identification and quantification of islets of heterogeneous myocardium within the scar might be useful for predicting VT in patients after MI.This article is protected by copyright. All rights reserved.
Aneurysmal formation is a rare but reported complication of myocardial infarction.1 However, a post-infarct aneurysm is commonly diagnosed in the left ventricle. This is most likely because of high left ventricular pressures in the setting of deteriorating myocardium associated with an absent or significantly limited blood supply. Right ventricular (RV) aneurysms develop with substantially less frequency and this may be due to generally lower intraventricular pressures in the right heart.