Understanding pathophysiological mechanisms of PCI-related AMI

The management of stable ischaemic heart disease continues to evolve with the recently presented ISCHEMIA trial demonstrating that revascularisation therapy (primarily percutaneous coronary intervention, PCI) does not reduce the risk of major adverse cardiac events in high risk stable angina patients with moderate-severe ischaemia [1]. Indeed, the ISCHEMIA trial reported more acute myocardial infarction (AMI) in the first 6  months after randomisation amongst those managed with PCI therapy as compared to those treated with optimal medical therapy alone.
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research

Related Links:

Authors: Lehto HR, Pietilä A, Niiranen TJ, Lommi J, Salomaa V Abstract Aims: To compare diabetic patients with coronary heart disease (CHD) needing revascularization to corresponding non-diabetic patients in terms of revascularization methods, comorbidities and urgency of procedure. We also examined the impact of patient characteristics and comorbidities on the revascularization method.Methods: We identified all diabetic (n = 33,018) and non-diabetic (n = 106,224) patients with first-ever, percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) from electr...
Source: Annals of Medicine - Category: Internal Medicine Tags: Ann Med Source Type: research
CONCLUSION: Current data imply that PCI for CCS does not improve outcomes in a large percentage of cases. A symptomatic benefit exists only in patients with frequent angina pectoris. The selection of CCS patients for PCI needs to be more strictly bound to the recommendations of current guidelines, particularly in Germany. PMID: 32234189 [PubMed - in process]
Source: Deutsches Arzteblatt International - Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research
This study was designed as a multicenter, double-blind, randomized, placebo-controlled, parallel-group, superiority trial. Participants were randomly assigned in a 1:1 ratio through a centrally controlled, computer-generated, simple randomization schedule. The primary outcome was left ventricular end-diastolic volume index  = left ventricular end-diastolic volume/body surface area. The combined secondary outcomes include traditional Chinese medicine syndrome score, echocardiogram results, 6-minute walk test results, Seattle Angina Questionnaire score, cardiac magnetic resonance imaging results, biological ind...
Source: Trials - Category: Research Source Type: clinical trials
This study aimed to investigate changes in exercise duration after PCI according to functional completeness of revascularization by comparing pre- and post-PCI exercise stress test (EST). METHODS: Patients with SIHD were enrolled from a prospective PCI registry, and divided into 2 groups: 1) functional complete revascularization (CR) group had a positive EST before PCI and negative EST after PCI, 2) functional incomplete revascularization (IR) group had positive EST before and after PCI. Primary outcome was change in exercise duration after PCI and secondary outcome was major adverse cardiac events (MACE, a composite o...
Source: Korean Circulation Journal - Category: Cardiology Tags: Korean Circ J Source Type: research
AbstractPurposeThe aim of this study was to explore the safety and efficacy of bivalirudin in elderly patients undergoing percutaneous coronary intervention (PCI).MethodsAn electronic search was conducted for randomized controlled trials with outcomes of interest in the elderly ( ≥ 65 years of age). Pooled risk ratios (RR) and 95% confidence interval (CI) using random effects Der Simonian–Laird models were calculated. Primary outcomes were net adverse clinical events (NACE) and major bleeding events at 30 days. Secondary outcomes were major adverse cardiac events (MA CE) at 30 days. MACE, all...
Source: Cardiovascular Drugs and Therapy - Category: Cardiology Source Type: research
Background: This meta-analysis is to evaluate the efficacy and safety of bivalirudin in patients with ST-elevation myocardial infarction (STEMI). Methods: PubMed, Cochrane Library, Embase, CNKI, CBMdisc, and VIP database were searched. Randomized controlled trial (RCT) was selected and the meta-analysis was conducted by RevMan 5.1. The primary efficacy endpoint was the incidence of major adverse cardiovascular events (MACE) and the primary safety endpoint was the incidence of major bleeding. Secondary efficacy endpoints were myocardial infarction (MI), target vessel revascularization (TVR), stent thrombosis (ST), stoc...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research
CONCLUSIONS: Age and female gender are associated with lower CFR, and age with worse CFC in an angiographically non-obstructed coronary artery. CFC seems to be less sensitive to variations in clinical and hemodynamic parameters than CFR, and therefore is a promising tool in contemporary clinical decision making in the cardiac catheterization laboratory. PMID: 31951205 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
AbstractBecause the phenomenon of no reflow has a poor prognosis in ST-segment elevation myocardial infarction (STEMI) patients and the atherogenic index of plasma (AIP) has been shown to be a strong predictor of coronary heart disease, we aimed to investigate the relationship between AIP and no-reflow in patients with acute STEMI who underwent primary percutaneous coronary intervention (PCI). A total of 763 consecutive STEMI patients (648 men; mean age 58  ± 12 years) who underwent primary PCI were recruited for this study. The patients were classified into a reflow group (n = 537) ...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
This study aimed to investigate long-term outcomes in patients undergoing elective PCI with or without EST. METHODS: We studied 2,674 patients undergoing elective PCI using drug-eluting stents for SIHD. Patients were divided into the 2 groups: the test group underwent EST with a positive result within 180 days prior to PCI (n = 668), whereas the non-test group did not undergo any noninvasive stress tests (n = 2,006). The primary outcome was all-cause death or myocardial infarction (MI). RESULTS: Over 5 years after the index PCI, the risk of all-cause death or MI was significantly lower in the test group than in t...
Source: J Korean Med Sci - Category: General Medicine Authors: Tags: J Korean Med Sci Source Type: research
AbstractPurposeThe aim of this study was to evaluate psychometric properties of the core disease-specific 14-item German HeartQoL questionnaire.MethodsAs an extension of the international HeartQol Project, cross-sectional and longitudinal health-related quality of life (HRQL) data were collected from 305 patients with angina (N  =  101), myocardial infarction (N  =  123), or ischemic heart failure (N  =  81) in Austria and Switzerland using German versions of the HeartQoL, the Short Form-36 Health Survey (SF-36), and the Hospital Anxiety and Depression Scale. The underlying factor ...
Source: Quality of Life Research - Category: Health Management Source Type: research
More News: Angioplasty | Cardiology | Coronary Angioplasty | Heart | Heart Attack | Heart Disease | Percutaneous Coronary Intervention