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Acute myocardial infarction complicating ischemic stroke: is there room for cangrelor?
We report two cases of patients with AMI complicating ischemic stroke, successfully treated with cangrelor infusion, which was started during PCI and maintained up to 48 h at bridge therapy dosage (0.75 mcg/kg/min). Both patients underwent successful PCI in the acute phase, and neither ischemic nor hemorrhagic complications occurred during in-hospital stay. PMID: 31066332 [PubMed - as supplied by publisher]
Source: Platelets - May 10, 2019 Category: Hematology Tags: Platelets Source Type: research

Prevalence and Determinants of Atrial Fibrillation-associated In-hospital Ischemic Stroke in patients with Acute Myocardial Infarction undergoing Percutaneous Coronary Intervention
Atrial Fibrillation (AF) is an established risk factor ischemic stroke (IS) and is commonly encountered in patient hospitalized with acute myocardial infarction (AMI). Uncommonly, IS can occur as a complication resulting from percutaneous coronary intervention (PCI). There is limited real world data regarding AF-associated in-hospital IS (IH-IS) in patients admitted with AMI undergoing PCI. We queried the National Inpatient Sample database from January 2010 to December 2014 to identify patients admitted with AMI who underwent PCI.
Source: The American Journal of Cardiology - December 29, 2020 Category: Cardiology Authors: Shivaraj Patil, Karthik Gonuguntla, Chaitanya Rojulpote, Manish Kumar, Srinivas Nadadur, Robert J. Nardino, Christopher Pickett Source Type: research

An Asian Perspective on Gender Differences in In-Hospital and Long-Term Outcome of Cardiac Mortality and Ischemic Stroke after Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction
Sex and gender-specific differences in cardiovascular disease and outcomes have been a subject of ongoing debate, as differences in clinical course, management and clinical outcomes in ischemic heart disease have been established.1 –3 While in-hospital and longer-term mortality seemed to be decreasing, it has appeared to be a less dramatic improvement in women compared to men.4-7
Source: Journal of Stroke and Cerebrovascular Diseases - November 20, 2021 Category: Neurology Authors: Jinghao Nicholas Ngiam, Elizabeth Hui-en Thong, Poay Huan Loh, Koo Hui Chan, Mark Y Chan, Chi-Hang Lee, Adrian F Low, Huay Cheem Tan, Joshua P Loh, Hui Wen Sim Source Type: research

The management of patients with atrial fibrillation undergoing percutaneous coronary intervention with stent implantation
Current recommendations on the management of patients with atrial fibrillation (AF) undergoing percutaneous coronary intervention with stent (PCI‐S) essentially derive from small, single‐center, retrospective datasets. To obtain larger and better quality data, we carried out the prospective, multicenter Atrial Fibrillation undergoing Coronary Artery Stenting (AFCAS) study. Therefore, consecutive patients with history of or ongoing AF undergoing PCI‐S were enrolled, and occurrence of adverse ischemic and bleeding events recorded during 12 months follow‐up. In this article, we report the in‐hospital observations. O...
Source: Catheterization and Cardiovascular Interventions - August 28, 2013 Category: Cardiovascular & Thoracic Surgery Authors: Axel Schlitt, Andrea Rubboli, Gregory Y.H. Lip, Heli Lahtela, Josè Valencia, Pasi P. Karjalainen, Michael Weber, Mika Laine, Paulus Kirchhof, Matti Niemelä, Saila Vikman, Michael Buerke, K.E. Juhani Airaksinen, Tags: Coronary Artery Disease Source Type: research

Guided de-escalation of antiplatelet treatment in patients with acute coronary syndrome undergoing percutaneous coronary intervention (TROPICAL-ACS): a randomised, open-label, multicentre trial
This study is registered with ClinicalTrials.gov, number NCT01959451, and EudraCT, 2013-001636-22. Findings Between Dec 2, 2013, and May 20, 2016, 2610 patients were assigned to study groups; 1304 to the guided de-escalation group and 1306 to the control group. The primary endpoint occurred in 95 patients (7%) in the guided de-escalation group and in 118 patients (9%) in the control group (pnon-inferiority=0·0004; hazard ratio [HR] 0·81 [95% CI 0·62–1·06], psuperiority=0·12). Despite early de-escalation, there was no increase in the combined risk of cardiovascular death, myocardial infarction, or stroke in the de-es...
Source: The Lancet - August 29, 2017 Category: General Medicine Source Type: research

Short-term and long-term mortality associated with ventricular arrhythmia in patients hospitalized with acute coronary syndrome: findings from the Gulf RACE registry-2
Objectives: Ventricular arrhythmia (VA) in the setting of acute coronary syndrome (ACS) carries an ominous prognosis; however, long-term prognosis associated with VA in ACS in the Middle East is unknown. Accordingly, we sought to assess the incidence, in-hospital outcomes, and 1-year mortality of in-hospital VA in patients with ACS. Methods and results: The Second Gulf Registry of Acute Coronary Events (Gulf RACE-2) is a multinational observational study of patients with ACS, which enrolled 7930 patients. Of these, 333 (4.2%) developed VA during hospitalization. Patients with VA were significantly older (mean age 58.3 vs. ...
Source: Coronary Artery Disease - January 30, 2013 Category: Cardiology Tags: Therapy and Prevention Source Type: research

Early ambulation after percutaneous coronary intervention does not increase bleeding risk compared with late ambulation
Commentary on: Tongsai S, Thamlikitkul V. The safety of early versus late ambulation in the management of patients after percutaneous coronary interventions: a meta-analysis. Int J Nurs Stud 2012;49:1084–90. Implications for practice and research Early ambulation after percutaneous coronary intervention (PCI) may facilitate earlier hospital discharge and improve patient comfort. There are a limited number of randomised clinical trials assessing the safety of this strategy. This meta-analysis suggests that earlier ambulation was not associated with an increased risk of adverse bleeding events. Context The number of PC...
Source: Evidence-Based Nursing - June 6, 2013 Category: Nursing Authors: Juergens, C. Tags: Adult nursing, Drugs: cardiovascular system, Stroke, Interventional cardiology, Ischaemic heart disease, Cardiothoracic surgery, Vascular surgery Source Type: research

High post-clopidogrel platelet reactivity assessed by a point-of-care assay predicts long-term clinical outcomes in patients with ST-segment elevation myocardial infarction who underwent primary coronary stenting
Abstract: Background: Recent studies have shown that post-clopidogrel high platelet reactivity (HPR), assessed by a point-of-care assay, is associated with a higher risk of adverse events after percutaneous coronary intervention (PCI). We assessed the clinical impact of HPR by the VerifyNow P2Y12 point-of-care assay in 181 patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI with drug-eluting stents (DES) at 3 hospitals.Methods: The primary endpoint of the study was the 12-month major adverse cardiovascular events (MACE), which comprised cardiovascular death, nonfatal MI and ischemic s...
Source: International Journal of Cardiology - June 11, 2012 Category: Cardiology Authors: Han-Young Jin, Tae-Hyun Yang, Doo-Il Kim, Sang-Ryul Chung, Jeong-Sook Seo, Jae-Sik Jang, Dae-Kyeong Kim, Dong-Kie Kim, Ki-Hun Kim, Sang-Hoon Seol, Chang-Wook Nam, Seung-Ho Hur, Woong Kim, Jong-Seon Park, Young-Jo Kim, Dong-Soo Kim Tags: Original Articles Source Type: research

Comparison of Outcomes for Patients ≥75 Years of Age Treated With Pre-Hospital Reduced-Dose Fibrinolysis Followed by Percutaneous Coronary Intervention Versus Percutaneous Coronary Intervention Alone for Treatment of ST-Elevation Myocardial Infarction
A coordinated system of care for patients with ST-segment elevation myocardial infarctions that includes prehospital administration of reduced-dose fibrinolytic agents coupled with urgent percutaneous coronary intervention (PCI), termed FAST-PCI, has been shown to be at least as effective as primary PCI (PPCI) alone. However, this reduced-dose fibrinolytic strategy could be associated with increased bleeding risk, especially in elderly patients. The purpose of this study was to examine 30-day outcomes in patients aged ≥75 years with ST-segment elevation myocardial infarctions treated with either strategy. Data from 120 p...
Source: The American Journal of Cardiology - October 28, 2013 Category: Cardiology Authors: Amirreza Solhpour, Kay-Won Chang, Prakash Balan, Chunyan Cai, Stefano Sdringola, Ali E. Denktas, Richard W. Smalling, H. Vernon Anderson Tags: Coronary Artery Disease Source Type: research

Anemia and inflammation have an additive value in risk stratification of patients undergoing coronary interventions
Aims: Anemia and inflammation are both associated with unfavorable outcomes in patients with ischemic heart disease and might be pathophysiologically linked. We aimed to analyze the additive value of anemia and inflammation on the outcomes of patients undergoing percutaneous coronary intervention. Methods: Cox regression models were fitted for hemoglobin and C-reactive protein (CRP) cut-offs and performed separately for myocardial infarction (MI) and angina pectoris patients undergoing catheterization at a tertiary hospital between 2006 and 2011. Major adverse cardiovascular events (MACEs) were defined as all-cause mortali...
Source: Journal of Cardiovascular Medicine - January 2, 2015 Category: Cardiology Tags: Original articles: Coronary revascularization Source Type: research

Fasting may not be required before percutaneous coronary intervention
Commentary on: Hamid T, Aleem Q, Lau Y, et al.. Pre-procedural fasting for coronary interventions: is it time to change practice? Heart 2014;100:658–61. Implications for practice and research The results of this study suggest that percutaneous coronary intervention (PCI) can be safely conducted without preprocedural fasting. Revision is needed of current fasting protocols. The findings of Hamid and colleagues must be confirmed by further randomised trials. Context PCI is currently performed in hospitals around the world. This procedure is generally conducted with light sedation and local anaesthesia. Patients are rou...
Source: Evidence-Based Nursing - March 19, 2015 Category: Nursing Authors: de Aguilar-Nascimento, J. E., Feguri, G. R. Tags: Adult nursing, Pneumonia (infectious disease), TB and other respiratory infections, Stroke, Diet, Interventional cardiology, Ischaemic heart disease, Cardiothoracic surgery, Vascular surgery Source Type: research

Effect of the REG1 anticoagulation system versus bivalirudin on outcomes after percutaneous coronary intervention (REGULATE-PCI): a randomised clinical trial
Publication date: Available online 5 November 2015 Source:The Lancet Author(s): A Michael Lincoff, Roxana Mehran, Thomas J Povsic, Steven L Zelenkofske, Zhen Huang, Paul W Armstrong, P Gabriel Steg, Christoph Bode, Mauricio G Cohen, Christopher Buller, Peep Laanmets, Marco Valgimigli, Toomas Marandi, Viliam Fridrich, Warren J Cantor, Bela Merkely, Jose Lopez-Sendon, Jan H Cornel, Jaroslaw D Kasprzak, Michael Aschermann, Victor Guetta, Joao Morais, Peter R Sinnaeve, Kurt Huber, Rod Stables, Mary Ann Sellers, Marilyn Borgman, Lauren Glenn, Arnold I Levinson, Renato D Lopes, Vic Hasselblad, Ri...
Source: The Lancet - November 6, 2015 Category: Journals (General) Source Type: research

A randomised trial on platelet function-guided de-escalation of antiplatelet treatment in ACS patients undergoing PCI. Rationale and design of the Testing Responsiveness to Platelet Inhibition on chronic Antiplatelet Treatment for Acute Coronary Syndromes (TROPICAL-ACS) Trial.
ieber J, Mudra H, Hausleiter J, Huber K, Neumann FJ, Koltowski L, Huczek Z, Mehilli J, Massberg S, TROPICAL-ACS Investigators Abstract Outcomes of acute coronary syndrome (ACS) patients undergoing percutaneous coronary intervention (PCI) have been significantly improved with the use of potent P2Y12 receptor inhibitors like prasugrel. While most of the ischaemic risk reduction for prasugrel versus clopidogrel was demonstrated in the early treatment period, the risk of bleeding became particularly prominent during the chronic course of therapy. It may therefore be a valid approach to substitute prasugrel for clopido...
Source: Thrombosis and Haemostasis - September 21, 2016 Category: Hematology Authors: Sibbing D, Aradi D, Jacobshagen C, Gross L, Trenk D, Geisler T, Orban M, Gori T, Hadamitzky M, Merkely B, Kiss RG, Komócsi A, Dézsi CA, Thalmeier A, Löw A, Holdt L, Teupser D, Ince H, Felix SB, Parma R, Malek L, Horstkotte J, Baylacher M, Schwinger R, Tags: Thromb Haemost Source Type: research

Factors Associated With Initial Prasugrel Versus Clopidogrel Selection for Patients With Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention: Insights From the Treatment With ADP Receptor Inhibitors: Longitudinal Assessment of Treatment Patterns and Events After Acute Coronary Syndrome (TRANSLATE-ACS) Study Coronary Heart Disease
We examined patients presenting with acute myocardial infarction treated with percutaneous coronary intervention at 233 US hospitals in the TRANSLATE‐ACS observational study from April 2010 to October 2012. We developed a multivariable logistic regression model to identify factors associated with prasugrel selection. Prasugrel use rates and associated 1‐year risk‐adjusted major adverse cardiovascular events and Global Utilization of Streptokinase and t‐PA for Occluded Coronary Arteries (GUSTO) moderate/severe bleeding outcomes were also examined in relation to predicted mortality and bleeding using the validated Ac...
Source: JAHA:Journal of the American Heart Association - September 22, 2016 Category: Cardiology Authors: Vora, A. N., Peterson, E. D., McCoy, L. A., Effron, M. B., Anstrom, K. J., Faries, D. E., Zettler, M. E., Fonarow, G. C., Baker, B. A., Stone, G. W., Wang, T. Y. Tags: Acute Coronary Syndromes, Coronary Artery Disease Original Research Source Type: research

Prevention of contrast-induced nephropathy by limb ischemic preconditioning: Underlying mechanisms and clinical effects.
Abstract Contrast-induced nephropathy (CIN) is an important complication following diagnostic radiographic imaging and interventional therapy. It results from administration of intravascular iodinated contrast media (CM) and is currently the third most common cause of hospital-acquired acute kidney injury. CIN is associated with increased morbidity, prolonged hospitalization and higher mortality. Although the importance of CIN is widely appreciated, and its occurrence can be mitigated by the use of pre- and post-hydration protocols and low osmolar instead of high osmolar iodine-containing CM, specific prophylactic...
Source: American Journal of Physiology. Renal Physiology - May 31, 2017 Category: Physiology Authors: Dugbartey G, Redington AN Tags: Am J Physiol Renal Physiol Source Type: research

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