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Coronary Intervention & Surgery

 - PCI

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. 

 - Sleepy physician

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.

 - transradial, wrist

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.

 - blood, clot, vein, platelet

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.

 - drug label, medication, pharmaceutical

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.

 

More Stories

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. 

Shunning FFR, most physicians choose to eyeball angiography results

Most cardiologists who participated in an international web survey used angiography results to assess intermediate stenoses over requesting fractional flow reserve (FFR) measurements or other techniques, contrary to guidelines. This was the case even when resources were not an obstacle.

Cardiologist dies in plane crash near Chicago

A small plane crash outside Chicago claimed the lives of three physicians Oct. 12, including a cardiologist from Kansas.

Ischemia differs in men, women under mental stress

At the heart of things, men and women do react differently to stress. According to a study published in the Oct. 21 issue of the Journal of the American College of Cardiology, the physical impact of mental and emotional stress on the heart and its function differs between men and women.

Almost half of 30-day readmissions post-PCI deemed preventable

Readmission rates following PCI could be nearly halved, according to research published online Sept. 26 in the Journal of the American Heart Association. The key, researchers wrote, starts with changing clinician behaviors.  

Liberal glucose control proves effective in reducing CABG mortality

In coronary artery bypass surgery (CABG), glucose control has shown to be important for survival. One research team, however, has questioned whether a strict or liberal glucose strategy was as effective or superior for improving survival. 

Unbalanced: Women die more often after STEMI PCI

Women are almost twice as likely as men to die of any cause in hospital after a STEMI-related primary PCI, according to a study published online Sept. 29 in JAMA: Internal Medicine. This disparity occurs in spite of increased awareness of modifiable risks, researchers wrote.

ACC takes revascularization off its ‘beware’ list

The American College of Cardiology (ACC) revised its Choosing Wisely list, removing a recommendation that questioned the necessity of coronary interventions that extend beyond revascularization of a culprit lesion.

Rates of stroke following acute MI drop as treatments improve

Risk of ischemic stroke within one year of acute MI dropped by 20 percent over a 10-year span in the general Swedish population in a study published online Sept. 18 in Stroke.

CABG raises quality of life in patients with ischemic left ventricular dysfunction

When treated for ischemic left ventricular dysfunction, patients who underwent CABG reported better quality-of-life compared with guideline therapy patients at different time points throughout follow-up of nearly five years. The CABG group also had lower depression scores.

Risks higher for women undergoing STEMI PCI

When treating ST-segment elevation myocardial infarction (STEMI) with percutaneous coronary intervention (PCI), does the patient’s sex have a role in their outcomes? According to a study published online Aug. 12 in Catheterization and Cardiovascular Outcomes, the answer is yes.