Genetic testing for antiplatelet therapy post-PCI misses cut in cardiovascular events

(American College of Cardiology) An international clinical trial that used genetic testing to guide which antiplatelet medication was given to patients following percutaneous coronary intervention (PCI) did not meet its stated goal for cutting in half the incidence of serious adverse cardiovascular events, such as heart attack and stroke, in the year following the procedure, according to study results presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).
Source: EurekAlert! - Biology - Category: Biology Source Type: news

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Few data exist on the clinical outcomes of selective aspiration thrombectomy during primary percutaneous coronary intervention (PPCI). This was a nationwide retrospective cohort study. Patients who were diagnosed with ST-elevation myocardial infarction (STEMI) and received primary percutaneous coronary intervention (PCI) from July 2009 to December 2011 were identified from the National Health Insurance Research Database of Taiwan. Propensity score weighting was used to balance the covariates between the 2 study groups. The primary endpoints were all-cause mortality and stroke during hospitalization and at 30 days and 1 ye...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Conclusion: In Mexico, only 5 out of 10 patients with STEMI have access to reperfusion therapy. Pharmacoinvasive strategy is takes advantage of the accessibility of fibrinolysis and the effectiveness of PCI. The present research protocol aims to provide information that serves as a link between information derived from controlled clinical trials and records derived from real world experience. PMID: 32459215 [PubMed - as supplied by publisher]
Source: Archivos de Cardiologia de Mexico - Category: Cardiology Authors: Tags: Arch Cardiol Mex Source Type: research
CONCLUSION: For patients with ULMCA disease and LVSD, there was no significant difference between DES and CABG in terms of efficacy and safety. Treatment with DES was an acceptable alternative to CABG. PMID: 32435839 [PubMed - as supplied by publisher]
Source: Herz - Category: Cardiology Tags: Herz Source Type: research
Authors: Wada H, Dohi T, Miyauchi K, Nishio R, Takeuchi M, Takahashi N, Endo H, Ogita M, Iwata H, Kasai T, Okazaki S, Isoda K, Suwa S, Daida H Abstract Although an elevated neutrophil to lymphocyte ratio (NLR) has been associated with the adverse outcomes of coronary artery disease (CAD), less is known about its prognostic value among patients with low high-sensitivity C-reactive protein (hs-CRP) levels. We enrolled 2,591 consecutive patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) and had available data on preprocedural hs-CRP and NLR between 2000 and 2016. Of these patients...
Source: International Heart Journal - Category: Cardiology Tags: Int Heart J Source Type: research
AbstractIntroductionOptimal dual antiplatelet therapy (DAPT) duration for medically managed acute coronary syndrome (ACS) (MMACS) patients is still unknown. We explored the efficacy and safety of  ≥ 12-month DAPT among MMACS patients.MethodsIn this sub-analysis of the optimal antiplatelet therapy for Chinese Patients with Coronary Artery Disease study (NCT01735305), clinical outcomes among MMACS patients were compared between the  
Source: Advances in Therapy - Category: Drugs & Pharmacology Source Type: research
This study found no difference between the two treatments for the main endpoint. The stenting group had a slightly higher rate of death, but it wasn’t due to cardiac causes. (There were slightly more patients in the stenting group who died from infection and cancer, which was felt to be unrelated to the procedure.) Similar to NOBLE, EXCEL also found that patients undergoing stenting had higher rates of needing bypass surgery or repeat stenting. There was no difference in stroke rates. A recent meta-analysis (a study that pools together and analyzes many studies) found that bypass surgery and stenting were equal in te...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Heart Health Surgery Source Type: blogs
In this study we aim to determine and compare short term outcomes of all type bundle branch blocks (BBB) according to their onset time among those patients presented with ST-Segment elevation myocardial infarction (STEMI) and underwent primary percutaneous coronary intervention (pPCI).Method: Three thousand fifty-seven ST-segment elevation myocardial infarction patients who underwent pPCI were retrospectively evaluated. Those patients with BBB in their ECG on admission were re-evaluated for their prior ECG records. A composite of death, recurrent myocardial infarction (re-MI) and stroke in one moth follow up were defined a...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
AbstractObjectivesCoronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) are common procedures for managing coronary artery disease (CAD); however, optimal methods of comparing post-procedure outcomes are unclear. We evaluated the reliability of Synergy between percutaneous coronary intervention with Taxus and cardiac surgery (SYNTAX) scores and investigated differences in long-term outcomes after CABG among groups with different SYNTAX scores.MethodsAccording to patient selection criteria used in the SYNTAX trial, 368 patients who underwent isolated initial CABG between 2003 and 2014 at Kurash...
Source: General Thoracic and Cardiovascular Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
Percutaneous coronary intervention (PCI) with drug-eluting stents (DES) has emerged as an acceptable revascularization strategy for select patients with unprotected left main coronary disease (LMCA).1 The EXCEL trial showed no difference between DES and coronary artery bypass surgery (CABG) at 5 years for the composite of death, procedure and non-procedure related myocardial infarction (MI), or stroke,2 however; all-cause mortality was higher with DES at 5 years, which was a secondary end-point.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
This study sought to evaluate the impact of clot strength on prevalence and major adverse CV events (MACE) of PAD in high-risk patients. We enrolled patients undergoing percutaneous coronary intervention (PCI) (n  = 1667) with available platelet–fibrin clot strength [thrombin-induced maximal amplitude (MAthrombin) measured by thromboelastography] and inflammation [high sensitivity C-reactive protein (hs-CRP)]. PAD was defined with abnormal ankle-brachial index ( ≤ 0.9 or >  1.4). MACE was defined as a composite of CV death, myocardial infarction or stroke. PAD was observed in ...
Source: Journal of Thrombosis and Thrombolysis - Category: Hematology Source Type: research
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