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Coronary Intervention & Surgery

 - Medical Money

Cardinal Health is offering to buy the stent pioneering company Cordis for almost $2 billion, Johnson & Johnson announced.

 - doctor consults woman

Many younger women think they’re too young for a heart attack, and healthcare providers don’t take their initial symptoms seriously enough, researchers concluded after interviewing 30 women hospitalized for acute MI.

 - Doctor and older patient

Rates of optimal care following PCI or CABG surgery were uncomfortably low, according to a study published online Feb. 24 in Circulation. The analysis revealed that by five years of follow-up, only around a third of patients in either group were receiving guideline-based therapies.

 - yelling doctor

People with quick tempers have another reason to try to curb their rage. A small study found that stress related to anger had a significant impact on the risk for MI with coronary occlusion.

 - No radiation

Draping a lead apron over patients during transradial PCIs reduced radiation to operators but it almost doubled exposure to their patients. Still, researchers argued that the benefit to physicians outweighed the risk to patients.

 

More Stories

Guidewire coating debris found in nearly half of thrombus samples

Foreign material found in emboli and histological samples of cardiac tissue may be a sign that hydrophilic guidewire coating detaches more frequently than previously reported. The study published in the February issue of Circulation: Cardiovascular Interventions suggested that embolized guidewire coating may put patients at greater risk for complications. 

Sleepless in the cath lab? Next-day patients still safe

Operators who pull an all-nighter in the cath lab don’t appear to put the patients they treat the next day at risk, according to one study. The likelihood of bleeding complications increased under the care of chronically sleep-deprived physicians, though.

Key Antiplatelet Presentations Yield More Questions Than Answers

The Dual Antiplatelet Therapy study presented at the American Heart Association conference shows that knowledge gaps still exist.

Ultrasound beats touch for quick, accurate transradial access

First-pass success for transradial access of cardiac catheterization improved by more than 20 percent when ultrasound was used to guide the puncture, according to a study published online Jan. 14 in Journal of the American College of Cardiology: Cardiovascular Interventions.

Morphine may dull antiplatelet loading in STEMI patients

Treating pain with morphine may slow down oral antiplatelet therapy in STEMI patients. The odds of high residual platelet reactivity were nearly three times higher for patients taking morphine two hours after administration of oral antiplatelet therapy.

Bivalirudin holds lead over heparin amid changing practices

Improved PCI procedural methods have not changed bivalirudin’s edge over heparin, according to a study published in the Jan. 6 issue of the Journal of the American College of Cardiology.

Ups & downs of revascularization

The price for cardiac revascularization keeps rising while the need for procedures appears to be in decline. Go figure.

PCI, CABG rates march steadily lower in Mass.

Coronary revascularization rates dipped by 39 percent over a decade in Massachusetts, according to an analysis published online Jan. 5 in JAMA Internal Medicine. Elective PCIs saw the steepest decline.

Bleeding complications may continue first year after TAVR

While periprocedural safety of transcatheter aortic valve replacement (TAVR) procedures has improved, late bleeding complications may still be an issue. 

Active trend analysis helps hospitals find & correct PCI device issues

Active and real-time is better, especially when assessing device safety in the general population. A Massachussetts-based hospital network analyzing the safety of PCI-related devices found that a real-time safety alert was able to change practices to improve patient safety and outcomes.

LVAD replacement approach leads to better outcomes

Surgeons using a nonsternotomy approach to replace continuous flow left ventricular assist devices (LVADs) found patients had better survival, according to a study published online Dec. 10 in Annals of Thoracic Surgery.

In 5-year analysis, PCI wins over CABG for cost but not outcomes

Some things don’t make decisions easier: PCI may be more cost-effective, but CABG has fewer long-term major adverse events, according to a study published in the Dec. 1 issue of Catheterization and Cardiovascular Interventions.

Hospital transfer times shape care for some STEMI patients

When every minute counts, delaying treatment can have enormous repercussions. An analysis of U.S. data finds that while door-to-balloon times have improved, many patients may still not receive care within the recommended 120 minutes, due in part to transfers to STEMI care centers.

Biodegradable DES passes in best-of-class analysis

A biodegradable drug-eluting stent (DES) proved to be noninferior to durable-polymer DES and both showed benefits over bare-metal stents (BMS) in the BASKET-PROVE II clinical trial. The results published online Nov. 19 in Circulation also raise questions about triggers for late complications.

Key antiplatelet presentation yields more questions than answers

Paul A. Gurbel, MD, director of the Sinai Center for Thrombosis Research in Baltimore, provides perspective on the Dual Antiplatelet Therapy study results presented at the American Heart Association conference in Chicago and future directions.  

Many heart disease patients disregard risks of second-hand smoke

Coronary heart disease patients may not understand the risks second-hand smoke have on their health. While 89.7 percent of patients in a study published online Nov. 11 in JAMA: Internal Medicine stated they understood that second-hand tobacco smoke was harmful, only about half realized the relevance to their own lives.

Culprit-vessel PCI in STEMI improves outcomes through 1 year

For multivessel disease, “if it isn’t broken, don’t fix it” may also apply to PCI. A retrospective look at a London cohort points to treating only the culprit vessel of STEMI as the best method for improved patient outcomes through one year.

Treatment periods, fatality rates illuminate DAPT choices

A comparison of randomized clinical trials that assessed dual-antiplatelet therapy (DAPT) durations showed such trials should include treatment periods and case fatality rates to better understand the risks and benefits. Using this approach, researchers saw hints of a mortality advantage with 12-month DAPT.

Patients with nonobstructive CAD still at risk for MI, death

Coronary artery disease (CAD) may not have to be obstructive to increase patients’ risks for MI or all-cause mortality. According to a study published online Nov. 4 in JAMA, patients diagnosed with nonobstructive CAD through coronary angiography were two times more likely to experience MI within one year of diagnosis as those with no apparent CAD. 

Two 2nd-gen drug-eluting stents equally safe, effective at 3 years

Three-year outcomes post-stenting reveal favorable and similar results for patients with and without bifurcated lesions treated with second-generation drug-eluting stents.