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Prognostic value of glucose metabolism for non-ST-segment elevation infarction patients with diabetes mellitus and single concomitant chronic total occlusion following primary percutaneous coronary intervention
Abstract Glucose metabolism status may play a predictive role in the severity of the complications among patients with type 2 diabetes mellitus (DM). However, few studies have focused on the prognostic value of glycosylated hemoglobin (HbA1c) and Homeostatic Model Assessment 2 for Insulin Resistance (HOMA2-IR) in patients with DM, non-ST-segment elevation infarction (NSTEMI), and single concomitant chronic total occlusion (CTO) following primary percutaneous coronary intervention (PCI). Short- and long-term prognostic value of HbA1c and HOMA2-IR in patients with DM with NSTEMI and single CTO who received primary percutan...
Source: Medicine - November 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

The safety and efficacy of oral anticoagulants with dual versus single antiplatelet therapy in patients after percutaneous coronary intervention: A meta-analysis
Conclusion: In patients on OAC undergoing PCI with stent implantation, compared with DT, TT shows equal effectiveness in terms of MACE, stroke, all-cause mortality, and stent thrombosis and lower risks of myocardial infarction and major bleeding. However, similar efficacy and safety outcomes were observed between the TT group and the OAC along with clopidogrel group.
Source: Medicine - September 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Association of lymphocyte-to-monocyte ratio with in-hospital and long-term major adverse cardiac and cerebrovascular events in patients with ST-elevated myocardial infarction
Abstract: In recent years, lymphocyte-to-monocyte ratio (LMR) has become a novel indirect marker of inflammation, which has been demonstrated to be associated with poor prognosis of oncology and cardiovascular disease. The aim of the study was to assess the relationship between LMR on admission and in-hospital and long-term major adverse cardiac and cerebrovascular events (MACCE) in patients with ST-elevated myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). A total of 306 STEMI patients were enrolled and grouped according to tertiles of LMR from the blood samples obtained in the emergen...
Source: Medicine - August 1, 2017 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Worse clinical outcomes following percutaneous coronary intervention with a high SYNTAX score: A systematic review and meta-analysis
Conclusions: Compared with CABG, worse clinical outcomes were observed following PCI in patients with a high SYNTAX score, confirming with evidence, published clinical literatures. Therefore, CABG should be recommended to CAD patients who have been allotted a high SYNTAX score.
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Impact of type 2 diabetes mellitus on the long-term mortality in patients who were treated by coronary artery bypass surgery: A systematic review and meta-analysis
Background: Recent scientific reports have mainly focused on the comparison between coronary artery bypass surgery (CABG) and percutaneous coronary intervention. However, the impact of type 2 diabetes mellitus (T2DM) on mortality in patients who were treated by CABG was often ignored. Therefore, we aimed to compare the long-term mortality following CABG in patients with and without T2DM. Methods: Studies comparing the long-term adverse outcomes following CABG in patients with and without T2DM were searched from electronic databases. Total number of deaths (primary outcome) and events of myocardial infarction (MI), major a...
Source: Medicine - June 1, 2017 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Recurrent contrast ‐induced encephalopathy following coronary angiography
Contrast‐induced encephalopathy (CIE) is an acute and reversible neurological disturbance associated with the intra‐arterial administration of iodinated contrast medium during cardiac catheterisation. It may manifest with encephalopathy, motor and sensory disturbances; vision disturbances, including cortical blindness, ophthalmoplegia, aphasia; and seizures. Disruption of the blood–brain barrier and direct neuronal toxicity are believed to be implicated in the pathophysiology of the syndrome. Symptoms appear soon after contrast administration and resolve completely within 24–48 h. Risk factors may include hypertens...
Source: Internal Medicine Journal - February 14, 2017 Category: Internal Medicine Authors: Roberto Spina, Neil Simon, Romesh Markus, David W. M. Muller, Krishna Kathir Tags: Brief Communication Source Type: research

Clinical Outcomes in Diabetic Patients Who Underwent Percutaneous Coronary Intervention during the Plain Old Balloon Angioplasty (POBA)-, Bare Metal Stents (BMS)- and Drug-eluting Stents (DES)-eras from 1984 to 2010.
Conclusion The incidence of 3-year cardiovascular events decreased from 1984 to 2010 in patients with diabetes following PCI, despite the higher risk profiles in the DES-era. PMID: 28049984 [PubMed - in process]
Source: Internal Medicine - January 6, 2017 Category: Internal Medicine Tags: Intern Med Source Type: research

Antithrombotic treatment in anticoagulated atrial fibrillation patients undergoing percutaneous coronary intervention.
Abstract Coronary artery disease coexists in a clinically relevant number of patients with atrial fibrillation and it often requires percutaneous coronary intervention. These patients represent a particular challenge for clinicians in terms of antithrombotic management. They require combined antiplatelet-anticoagulant therapy to reduce the risk of recurrent ischemic cardiac events and stroke; however, this antithrombotic strategy is associated with an increased risk of bleeding complications. In the absence of randomized, controlled clinical trials, the majority of current recommendations rely on the results of co...
Source: European Journal of Internal Medicine - January 4, 2017 Category: Internal Medicine Authors: Dézsi CA, Dézsi BB, Dézsi DA Tags: Eur J Intern Med Source Type: research

Outcomes of ≤6-month versus 12-month dual antiplatelet therapy after drug-eluting stent implantation: A meta-analysis and meta-regression
Conclusion: DAPT for ≤6 months is associated with similar mortality and ischemic outcomes but less bleeding events compared with 12-month DAPT after PCI with DES.
Source: Medicine - December 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Comparing the clinical outcomes in patients with atrial fibrillation receiving dual antiplatelet therapy and patients receiving an addition of an anticoagulant after coronary stent implantation: A systematic review and meta-analysis of observational studies
Background: Data regarding the clinical outcomes in patients with atrial fibrillation (AF) receiving dual antiplatelet therapy (DAPT) and an anticoagulant in addition to DAPT (DAPT + vitamin K antagonist [VKA]) after coronary stent implantation are still controversial. Therefore, in order to solve this issue, we aim to compare the adverse clinical outcomes in AF patients receiving DAPT and DAPT + VKA after percutaneous coronary intervention and stenting (PCI-S). Methods: Observational studies comparing the adverse clinical outcomes such as major bleeding, major adverse cardiovascular events, stroke, myocardial inf...
Source: Medicine - December 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Global longitudinal strain predicts incident atrial fibrillation and stroke occurrence after acute myocardial infarction
Abstract: Patients with acute myocardial infarction are at increased risk of developing atrial fibrillation. We aimed to evaluate whether speckle tracking echocardiography improves risk stratification for atrial fibrillation in these patients. The study comprised of 373 patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention. Patients had an echocardiogram performed at a median of 2 days after their STEMI. The echocardiograms consisted of conventional measurements and myocardial strain analysis by speckle tracking from 3 apical projections. The endpoint was ...
Source: Medicine - November 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Prospective study of the impact of diabetes mellitus newly diagnosed by glycated hemoglobin on outcomes in patients undergoing percutaneous coronary intervention.
CONCLUSION: Newly diagnosed DM based on peri-procedural HbA1c is common and associated with increased short and long term risk for adverse outcomes. Ours may warrant routine screening for DM in all patients undergoing PCI. PMID: 27665509 [PubMed - as supplied by publisher]
Source: European Journal of Internal Medicine - September 20, 2016 Category: Internal Medicine Authors: Tailakh MA, Friger M, Zahger D, Sidi A, Mazor-Dray E, Novack V Tags: Eur J Intern Med Source Type: research

CYP2C19 loss-of-function alleles are not associated with clinical outcome of clopidogrel therapy in patients treated with newer-generation drug-eluting stents
Abstract: CYP2C19 loss-of-function (LOF) alleles adversely affect clinical outcome of clopidogrel therapy. Recent introduction of a newer-generation drug-eluting stent (DES) has significantly reduced the occurrence of stent thrombosis. The aim of this study was to evaluate the impact of CYP2C19 LOF alleles on clinical outcome in patients treated with the newer-generation DES. The effects of CYP2C19 genotypes were evaluated on clinical outcome of clopidogrel therapy in 2062 patients treated with percutaneous coronary intervention using either first-generation DES (sirolimus- and paclitaxel-eluting stent, n = 1349) or newe...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research

Bleeding events associated with fibrinolytic therapy and primary percutaneous coronary intervention in patients with STEMI: A systematic review and meta-analysis of randomized controlled trials
This study aimed to compare the bleeding events associated with fibrinolytic therapy and primary angioplasty in patients with STEMI. Randomized controlled trials (RCTs) comparing fibrinolysis and primary angioplasty in patients with STEMI were searched from Medline, PubMed, EMBASE, and the Cochrane databases. Bleeding complications following 30 days from hospitalization were considered as the primary clinical endpoints in this study. Secondary endpoints included all-cause mortality, re-infarction, stroke, and shock. Antiplatelet and anticoagulating drugs used during these 2 different procedures were compared. Odds ratios (...
Source: Medicine - June 1, 2016 Category: Internal Medicine Tags: Research Article: Systematic Review and Meta-Analysis Source Type: research

Drug-eluting stents and drug-eluting balloons are the best strategies to treat coronary in-stent restenosis
Commentary on: Giacoppo D, Gargiulo G, Aruta P, et al.. Treatment strategies for coronary in-stent restenosis: systematic review and hierarchical Bayesian network meta-analysis of 24 randomised trials and 4880 patients. BMJ 2015;351:h5392. Context Drug-eluting stents (DES) drastically improved the efficacy of percutaneous coronary intervention by reducing the risk of in-stent restenosis (ISR) and subsequent need of target lesion revascularisation (TLR). However, despite the advances in DES technology, the incidence of ISR is still significant and considering that more than five million DES are implanted each year worldwide...
Source: Evidence-Based Medicine - May 22, 2016 Category: Internal Medicine Authors: Giustino, G., Mehran, R. Tags: Clinical trials (epidemiology), Immunology (including allergy), Stroke, Interventional cardiology, Radiology, Clinical diagnostic tests, Radiology (diagnostics) Therapeutics/Prevention Source Type: research

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