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BET 3: Evaluation of intra-aortic balloon support in cardiogenic shock
A short-cut review was carried out to establish whether intra-aortic balloon pumps (IABP) improve mortality in cardiogenic shock after acute myocardial infarction (AMI). Two studies and one systematic review were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are shown in table 3. The clinical bottom line is that the IABP does not improve mortality in cardiogenic shock after AMI when percutaneous coronary intervention is available. When only thrombolysis is possible then it may improve mortality.
Source: Emergency Medicine Journal - November 14, 2013 Category: Emergency Medicine Tags: EMJ Best evidence topic reports, Drugs: cardiovascular system, Stroke, Acute coronary syndromes, Percutaneous intervention Source Type: research

Results of Primary Percutaneous Coronary Intervention in Patients ≥75 Years Treated by the Transradial Approach
In conclusion, TRA-PPCI was feasible in the vast majority of elderly patients with STEMI. In-hospital mortality, 1-year mortality, and 1-year MACE were lower than reported for transfemoral access, suggesting a benefit of the TRA in these patients.
Source: The American Journal of Cardiology - November 11, 2013 Category: Cardiology Authors: Oriol Rodriguez-Leor, Eduard Fernandez-Nofrerias, Xavier Carrillo, Josepa Mauri, Carlos Labata, Carolina Oliete, Maria del Carmen Rivas, Antoni Bayes-Genis Tags: Coronary Artery Disease Source Type: research

Comparison of Procedural Complications With Versus Without Interventional Cardiology Fellows-in-Training During Contemporary Percutaneous Coronary Intervention
In conclusion, in contemporary practice at a large academic medical center, PCI complication rates were not adversely affected by the presence of an ICFIT.
Source: The American Journal of Cardiology - October 28, 2013 Category: Cardiology Authors: Joshua M. Stolker, Drew S. Allen, David J. Cohen, Kevin F. Kennedy, Steven B. Laster, Andrew D. Frutkin, Sameer K. Mehta, Kelly R. O'Neal, Steven P. Marso Tags: Coronary Artery Disease Source Type: research

Radial versus femoral approach comparison in percutaneous coronary intervention with intraaortic balloon pump support: The RADIAL PUMP UP Registry
Background: The role of intraaortic balloon pump (IABP) during percutaneous coronary intervention (PCI) in high-risk acute patients remains debated. Device-related complications and the more complex patient management could explain such lack of clinical benefit. We aimed to assess the impact of transradial versus transfemoral access for PCI requiring IABP support on vascular complications and clinical outcome.Methods: We retrospectively analyzed 321 consecutive patients receiving IABP support during transfemoral (n = 209) or transradial (n = 112) PCI. Thirty-day net adverse clinical events (NACEs) (composite of postprocedu...
Source: American Heart Journal - October 14, 2013 Category: Cardiology Authors: Enrico Romagnoli, Maria De Vita, Francesco Burzotta, Bernardo Cortese, Giuseppe Biondi-Zoccai, Francesco Summaria, Roberto Patrizi, Chiara Lanzillo, Valerio Lucci, Caterina Cavazza, Fabio Tarantino, Giuseppe M. Sangiorgi, Ernesto Lioy, Filippo Crea, Sunil Tags: Interventional Cardiology Source Type: research

Outcome of Percutaneous Coronary Intervention Following Recent Surgery
The objective of this study was to determine clinical outcomes of patients undergoing PCI within 7 days after a surgical procedure. We assessed outcomes of 517 patients who underwent PCI within 7 days after a surgery across 44 hospitals from January 2010 to December 2011 from the Blue Cross Blue Shield of Michigan Cardiovascular Consortium registry. Patients with postoperative PCI were compared with all other patients with PCI using propensity-matched analysis. Of the 65,175 patients who underwent PCI within the study period, 517 patients had undergone surgery within the previous 7 days. In unadjusted analysis, patients...
Source: The American Journal of Cardiology - September 3, 2013 Category: Cardiology Authors: John R. Hoyt, Milan Seth, Ivan Hanson, Simon Dixon, David Share, Thomas Lalonde, David Wohns, Mauro Moscucci, Hitinder S. Gurm Tags: Coronary Artery Disease Source Type: research

Immediate rescue operations after failed diagnostic or therapeutic cardiac catheterization procedures
CONCLUSIONS With rapid transfer to an operation room, minimizing the time of warm myocardial ischaemia, and by performing complete coronary revascularization, it is possible to obtain equally low operative mortality in patients with life-threatening cardiac catheterization-associated complications, as is the case with open cardiac operations in general.
Source: Interactive CardioVascular and Thoracic Surgery - July 18, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Almdahl, S. M., Veel, T., Halvorsen, P., Rynning, S. E. Tags: Adult Cardiac Source Type: research

Stroke After Primary Percutaneous Coronary Intervention in Patients With ST-Segment Elevation Myocardial Infarction: Timing, Characteristics, and Clinical Outcomes Coronary Artery Disease
Conclusions— Stroke is an infrequent complication in the setting of ST-segment elevation myocardial infarction treated with primary PCI but is associated with increased morbidity and mortality. Studies to determine mechanisms that may be responsible for strokes that occur >48 hours from primary PCI are warranted. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00091637.
Source: Circulation: Cardiovascular Interventions - April 16, 2013 Category: Cardiology Authors: Guptill, J. T., Mehta, R. H., Armstrong, P. W., Horton, J., Laskowitz, D., James, S., Granger, C. B., Lopes, R. D. Tags: Coronary Artery Disease Source Type: research

The outcome of intra-aortic balloon pump support in acute myocardial infarction complicated by cardiogenic shock according to the type of revascularization: A comprehensive meta-analysis
Aims: Despite the recommendations of the current guidelines, scientific evidence continue to challenge the effectiveness of intra-aortic balloon pump (IABP) in acute myocardial infarction (AMI) complicated by cardiogenic shock. Moreover, 2 recent meta-analyses showed contrasting results. The aim of this study is to test the effect of IABP according to the type of therapeutic treatment of AMI: percutaneous coronary intervention (PCI), thrombolytic therapy (TT), or medical therapy without reperfusion. Articles published from January 1, 1986, to December 31, 2012, were collected and analyzed by meta-analysis.Methods and resul...
Source: American Heart Journal - March 27, 2013 Category: Cardiology Authors: Francesco Romeo, Maria Cristina Acconcia, Domenico Sergi, Alessia Romeo, Saverio Muscoli, Serafina Valente, Gian Franco Gensini, Flavia Chiarotti, Quintilio Caretta Tags: Curriculum in Cardiology Source Type: research

Risk Factors, Therapeutic Approaches, and In‐Hospital Outcomes in Mexicans With ST‐Elevation Acute Myocardial Infarction: The RENASICA II Multicenter Registry
ConclusionsLargely modifiable risk factors and preventable short‐term complications are responsible for most STEMI cases and outcomes in this Mexican population.
Source: Clinical Cardiology - March 14, 2013 Category: Cardiology Authors: Úrsulo Juárez‐Herrera, Carlos Jerjes‐Sánchez, Tags: Quality and Outcomes Source Type: research

Transradial percutaneous coronary intervention in cardiogenic shock: A single-center experience
Conclusions: Transradial approach for PCI is possible and safe in up to two-thirds of patients with CS. Absence of radial pulse was the main factor preventing use of TRA. In multivariate analysis, TRA was associated with a lower risk of mortality.
Source: American Heart Journal - March 1, 2013 Category: Cardiology Authors: Oriol Rodriguez-Leor, Eduard Fernandez-Nofrerias, Xavier Carrillo, Josepa Mauri, Carolina Oliete, Maria del Carmen Rivas, Antoni Bayes-Genis Tags: Transradial Angiography and Intervention Source Type: research

Lack of intra-aortic balloon pump effectiveness in high-risk percutaneous coronary interventions without cardiogenic shock: A comprehensive meta-analysis of randomised trials and observational studies
Conclusions: The results suggest that PCI plus P-IABP support does not result in reduced in-hospital mortality or MACCE nor in significant higher access-site complications or stroke incidence compared with PCI alone in patients at high risk for peri-procedural PCI complications.
Source: International Journal of Cardiology - January 7, 2013 Category: Cardiology Authors: Francesco Romeo, Maria Cristina Acconcia, Domenico Sergi, Alessia Romeo, Gian Franco Gensini, Flavia Chiarotti, Quintilio Caretta Tags: Reviews Source Type: research

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