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Intracranial haemorrhage in acute myocardial infarction: A rare but dramatic complication
The shift from thrombolysis to primary percutaneous coronary intervention (PCI) and the use of multidrug antithrombotic therapy in the management of acute myocardial infarction (AMI) have led to both a substantial improvement in outcomes and a reduction in bleeding complications [1,2]. In particular, in AMI, the rate of haemorrhagic stroke, the most dreaded haemorrhagic complication, decreased by 50% from 1998 to 2008 [1]. Despite its low incidence, intracranial haemorrhage (ICH) is often devastating, being associated with severe disability and high mortality rates.
Source: International Journal of Cardiology - August 29, 2023 Category: Cardiology Authors: Filippo Trombara, Nicola Cosentino, Giancarlo Marenzi Tags: Editorial Source Type: research

Geographic variations in percutaneous versus surgical coronary revascularization: A global perspective from the SYNTAXES trial
The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial [1] was a landmark trial published by Serruys et al. in 2009 that compared percutaneous coronary intervention (PCI) with first-generation paclitaxel-eluting stents versus coronary artery bypass grafting (CABG) among 1,800 participants with de-novo three-vessel and left main coronary artery disease. The primary endpoint of major adverse cardiac and cerebrovascular events (i.e., death, stroke, myocardial infarction, or repeat revascularization at 12 months) occurred in 17.8% of cases in the PCI group and 12.4% of cases in the CABG group (P=0.002) [1].
Source: International Journal of Cardiology - September 8, 2022 Category: Cardiology Authors: Felice Gragnano, Francesco Pelliccia, Arturo Cesaro, Paolo Calabr ò Tags: Editorial Source Type: research

Predictive value of left atrial strain in relation to atrial fibrillation following acute myocardial infarction
This study aimed to determine the prognostic value of left atrial (LA) strain, obtained by speckle tracking echocardiography (STE), in predicting incident AF outcomes following STEMI treated with primary percutaneous coronary intervention (pPCI).Methods and results:This prospective study comprised of 392 STEMI patients treated with pPCI.
Source: International Journal of Cardiology - May 13, 2022 Category: Cardiology Authors: Anne-Sophie Winther Svartstein, Mats H øjbjerg Lassen, Kristoffer Grundtvig Skaarup, Gabriela Lladó Grove, Frederikke Vyff, Kirstine Ravnkilde, Sune Pedersen, Søren Galatius, Daniel Modin, Tor Biering-Sørensen Source Type: research

E-wave propagation index (EPI) – A promising echocardiographic marker to improve left ventricular thrombus detection after STEMI?
Left ventricular (LV) thrombus formation remains a challenging complication following primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI). During the early phase following STEMI, LV thrombi are reported to occur in about 6% of all patients [1] and pose an increased risk of stroke and systemic thromboembolisms [2,3]. Given the great burden of these complications, effective strategies to detect and treat LV thrombi remain desirable for clinical care of STEMI patients [2,3].
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: Martin Reindl, Sebastian J. Reinstadler Tags: Editorial Source Type: research

E-wave propagation index (EPI) - A promising echocardiographic marker to improve left ventricular thrombus detection after STEMI?
Left ventricular (LV) thrombus formation remains a challenging complication following primary percutaneous coronary intervention (PCI) for acute ST-elevation myocardial infarction (STEMI). During the early phase following STEMI, LV thrombi are reported to occur in about 6% of all patients [1] and pose an increased risk of stroke and systemic thromboembolisms [2,3]. Given the great burden of these complications, effective strategies to detect and treat LV thrombi remain desirable for clinical care of STEMI patients [2,3].
Source: International Journal of Cardiology - January 25, 2021 Category: Cardiology Authors: Martin Reindl, Sebastian J. Reinstadler Tags: Editorial Source Type: research

Antithrombotic therapy after acute coronary syndromes in patients with atrial fibrillation: Shouldn't we pay more attention to the risk of ischemic and thromboembolic events?
The management of antithrombotic therapy in patients with atrial fibrillation (AF) presenting an acute coronary syndrome (ACS) or undergoing percutaneous coronary intervention (PCI) is particularly complex. Oral anticoagulation (OAC) is superior to single or dual antiplatelet therapy (DAPT) for the prevention of thromboembolic complications (stroke and systemic embolism) due to AF, whereas DAPT with low-dose aspirin and a P2Y12 inhibitor is the recommended antithrombotic treatment to prevent ischemic events (myocardial infarction and stent thrombosis) in patients with ACS or undergoing PCI.
Source: International Journal of Cardiology - November 29, 2018 Category: Cardiology Authors: Jos é Luis Ferreiro, Joan Antoni Gómez-Hospital Tags: Editorial Source Type: research

Finding the right balance
Patients with an indication for oral anticoagulation (OAC) that receive antiplatelet therapy after percutaneous coronary intervention (PCI) are challenging for the treating physician. It is of importance to balance their antithrombotic treatment to protect them from ischemic events, such as stent thrombosis as well as ischemic stroke without exposing them to an excess in bleeding. The current guidelines recommend a so-called triple therapy consisting of aspirin, clopidogrel and OAC for 1 –6 months after PCI depending on the patient's ischemic risk [1].
Source: International Journal of Cardiology - September 27, 2018 Category: Cardiology Authors: Alexander Goedel, Nikolaus Sarafoff Tags: Editorial Source Type: research

Determinants of Stroke Following Percutaneous Coronary Intervention in Acute Myocardial Infarction (from ORPKI Polish National Registry)
Both hemorrhagic and ischemic cerebrovascular events are rare but serious complications after acute myocardial infarction (MI) and coronary angiography / percutaneous coronary intervention (PCI). The most threatening one is intracranial hemorrhage related to antiplatelet and antithrombotic treatment of acute MI. In up to 10% of patients with acute MI ischemic stroke can result from embolisation of intraventricular or intraatrial thrombi [1]. It may occur within the first 2weeks, but also as early as in the first 24h.
Source: International Journal of Cardiology - August 10, 2016 Category: Cardiology Authors: Artur Dziewierz, Zbigniew Siudak, Tomasz Tokarek, Tomasz Rakowski, Dariusz Dudek Source Type: research

Stroke Risk from Manual Aspiration Thrombectomy during Primary Percutaneous Coronary Intervention: An Updated Comprehensive Meta-Analysis of Randomized Controlled Trials
Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for patients with acute ST segment elevation myocardial infarction (STEMI), but it is often associated with distal micro-embolization complicated by no-reflow phenomenon leading to poor outcomes [1]. Previously small to medium sized randomized controlled trials (RCTs) have suggested that manual aspiration thrombectomy (MAT) during primary PCI will improve clinical outcomes. However larger, more recent RCTs have shown that routine MAT during primary PCI does not improve outcomes [2,3].
Source: International Journal of Cardiology - August 3, 2016 Category: Cardiology Authors: Rahman Shah, Abdul Rashid Source Type: research

Risk of stroke with “no-touch” — As compared to conventional off-pump coronary artery bypass grafting. An updated meta-analysis of observational studies
In patients with multivessel coronary disease, compared with percutaneous coronary intervention (PCI) coronary artery bypass grafting (CABG) leads to an unequivocal reduction in long-term mortality, myocardial infarctions and need of repeat revascularization. Previous randomized trial [1] and meta-analysis [2] pointed to that benefit being offset by excess of early and mid-term cerebral strokes after CABG which are associated with increased morbidity and mortality. Alternatively performed off-pump CABG (OPCAB) was shown to reduce some of the complications associated with cardiopulmonary bypass, and in particular cerebrovascular events [3].
Source: International Journal of Cardiology - August 2, 2016 Category: Cardiology Authors: Mariusz Kowalewski, Piotr Suwalski, Wojciech Pawliszak, Federico Benetti, Giuseppe Maria Raffa, Pietro Giorgio Malvindi, Thierry Carrel, Domenico Paparella, Lech Anisimowicz Tags: Correspondence Source Type: research

Coronary surgery is superior to drug eluting stents in multivessel disease. Systematic review and meta-analysis of contemporary randomized controlled trials
Current randomized controlled trials (RCTs) comparing percutaneous coronary intervention with drug eluting stent (DES-PCI) with coronary artery bypass grafting (CABG) in multivessel disease are underpowered to detect a difference in hard clinical end-points such as mortality, myocardial infarction and stroke. We aimed to overcome this limitation by conducting a meta-analysis of contemporary RCTs.
Source: International Journal of Cardiology - February 17, 2016 Category: Cardiology Authors: Umberto Benedetto, Mario Gaudino, Colin Ng, Giuseppe Biondi-Zoccai, Fabrizio D'Ascenzo, Giacomo Frati, Leonard N. Girardi, Gianni D. Angelini, David P. Taggart Source Type: research

Association between hyperuricemia and outcomes in patients undergoing percutaneous coronary intervention
Uric acid is the end product of purine catabolism. Lot of previous studies have found that hyperuricemia (HU) as a risk factor for cardiovascular disease such as atrial fibrillation and coronary artery disease [1,2]. Also, HU is a predictor of adverse prognosis in different cardiocerebral disease, such as acute ST segment elevation myocardial infarction, congestive heart failure and acute stroke. However, the predictive value of HU in the prognosis in patients undergoing percutaneous coronary intervention (PCI) is less known.
Source: International Journal of Cardiology - November 28, 2015 Category: Cardiology Authors: Lei Wu, Lan-Ju Yang, Xiao-Yan Meng, Lan-Hua Wang, Yan-Hong Zhou, Tao Liu, Qian-Feng Han, De-Yong Zhang, Heng-Chen Yao Source Type: research

Percutaneous left atrial appendage occlusion: Device thrombosis in clopidogrel non-responders
Percutaneous left atrial appendage closure (LAAC) has been recently proposed as a safe and effective strategy to reduce the embolic stroke risk in patients with atrial fibrillation that are not amenable to long lasting oral anticoagulation [1]. After LACC, a temporary double anti-platelets regimen with aspirin and clopidogrel is suggested to prevent closure device thrombosis and enhance its endothelization [2]. Although clopidogrel resistance has been associated with recurrent cardiac events after percutaneous coronary intervention [3], no reports exist concerning the occurrence of LAAC device thrombosis in patients with c...
Source: International Journal of Cardiology - November 24, 2015 Category: Cardiology Authors: Ulrike Ketterer, Giuseppe D´ Ancona, Isabel Siegel, Jasmin Ortak, Hueseyin Ince, Stephan Kische Tags: Correspondence Source Type: research

Predictive Accuracy Of CHADS-VASc and HAS-BLED Scores In Patients Without Atrial Fibrillation Undergoing Percutaneous Coronary Intervention And Discharged On Dual Antiplatelet Therapy
The CHA2DS2-VASc and HAS-BLED are well-validated stroke risk prediction scores for atrial fibrillation (AF), but their role in risk stratification of major adverse cardiac events (MACE) and major bleeding for non-AF patients undergoing percutaneous coronary intervention (PCI) is unknown.
Source: International Journal of Cardiology - July 25, 2015 Category: Cardiology Authors: Davide Capodanno, Roberta Rossini, Giuseppe Musumeci, Corrado Lettieri, Michele Senni, Orazio Valsecchi, Dominick J. Angiolillo, Gregory Y.H. Lip Source Type: research

Comparison of the incidence of postoperative neurologic complications after on-pump versus off-pump coronary artery bypass grafting in high-risk patients: A meta-analysis of 11 studies
Neurological complications, such as stroke and transient ischemic attack, are major adverse cardiac events (MACE) following coronary artery bypass grafting (CABG) and markedly reduce patient short-term and long-term survival [1]. Farkouh et al. found that the 5-year rate of stroke was significantly higher after CABG than after percutaneous coronary intervention in patients with diabetes and multivessel coronary artery disease [2]. Thus, strategies to reduce neurological complications after CABG can improve patient outcomes.
Source: International Journal of Cardiology - March 11, 2015 Category: Cardiology Authors: Jiayang Wang, Chengxiong Gu, Mingxin Gao, Wenyuan Yu, Haitao Li, Fan Zhang, Yang Yu Tags: Letters to the Editor Source Type: research

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