1,721,031 research outputs found
Contributors to survival benefit of dual versus single antithrombotic therapy in chronic coronary syndrome: Survival benefit of dual antithrombotic therapy in CCS
Comparison of Access-Related Bleeding Complications in Women Versus Men Undergoing Percutaneous Coronary Catheterization Using the Radial Versus Femoral Artery
Endothelial progenitor cells in patients with coronary artery disease and left ventricular dysfunction
Visualization of coronary arteries and coronary stents by low dose 320-slice multi-detector computed tomography in a patient with atrial fibrillation
Abstract Cardiac multi-detector computed tomography (MDCT) is widely used in the diagnosis of coronary disease. However, the predictive value of this technique is limited in the presence of atrial fibrillation and coronary stents. Here we present a case showing the ability of the new 320-slice MDCT to assess coronary anatomy in a patient with atrial fibrillation and coronary stents
Role of endothelial progenitor cells in restenosis and progression of coronary atherosclerosis after percutaneous coronary intervention. a prospective study
OBJECTIVES: We prospectively investigated the relationship of circulating endothelial progenitor cells at time of percutaneous coronary intervention to the subsequent development of in-stent restenosis or progression of coronary atherosclerosis. BACKGROUND: Endothelial progenitor cells provide an endogenous repair mechanism of the dysfunctional endothelium and therefore can play a pathogenic role in coronary atherosclerosis. METHODS: We studied 155 consecutive stable angina patients (92 men, age 60 +/- 11 years). All patients had flow cytometry the day before elective percutaneous coronary intervention in order to derive subpopulations of endothelial progenitor cells. A control group of 20 normal subjects was considered for comparison. RESULTS: At 8-month control angiography, 30 patients showed in-stent restenosis (restenosis group), 22 patients showed progression of coronary atherosclerosis (progression group), whereas the remaining 103 patients had neither in-stent restenosis nor progression of coronary atherosclerosis (stable group). Comparison of the 3 groups did not show any difference in risk factors, cardiac morphology and function, extension of coronary artery disease, and treatment. Absolute numbers of CD34+/KDR+/CD45- cells (i.e., progenitors of endothelial lineage) measured in the restenosis group (1.41 +/- 0.64 cells/microl) were significantly higher than in the progression, stable, and control groups (1.03 +/- 0.53 cells/microl, 1.07 +/- 0.46 cells/microl, and 0.95 +/- 0.44 cells/microl, respectively, p < 0.05). Similarly, CD133+/KDR+/CD45- cells (i.e., progenitors of endothelial cells at an earlier stage) were significantly higher in the restenosis (0.63 +/- 0.23 cells/microl) compared with progression, stable, and control groups (0.33 +/- 0.19 cells/microl, 0.41 +/- 0.32 cells/microl, and 0.36 +/- 0.15 cells/microl, respectively, p < 0.001). Also, numbers of CD14+/CD45+ cells (i.e., which have a role in angiogenesis via a paracrine effect) were significantly different among the restenosis, progression, stable, and control groups (0.72 +/- 0.56 cells/microl vs. 0.51 +/- 0.52 cells/microl vs. 0.28 +/- 0.54 cells/microl vs. 0.62 +/- 0.67 cells/microl, respectively, p < 0.05), whereas CD105+/CD45-/CD34- cells (i.e., which have a receptor for transforming growth factor-beta) were similar among groups. CONCLUSIONS: Patients with restenosis have higher numbers of subpopulations of endothelial progenitor cells that incorporate into endothelial cells or play a role in arteriogenesis compared with controls and patients with either progression of coronary atherosclerosis or stable disease
Alcohol septal ablation for hypertrophic obstructive cardiomyopathy: the emerging role of the Cardiomyopathy Team
Alcohol septal ablation is a minimally invasive, safe, and effective procedure for the treatment of left ventricular outflow tract (LVOT) obstruction in patients with hypertrophic obstructive cardiomyopathy (HOCM) who remain symptomatic despite maximal medical therapy. Originally performed by Ulrich Sigwart in 1994, the procedure causes a iatrogenic infarction - through the injection of absolute alcohol - of the basal portion of the interventricular septum and aims at reducing LVOT obstruction in order to improve patient's hemodynamics and symptoms. Numerous studies have demonstrated the effectiveness and safety of the procedure, making it a valid alternative to surgical myectomy. The success of alcohol septal ablation depends upon the selection of the patient and the experience of both the operators and the center where the procedure is performed. In this review, we summarize current evidence on alcohol septal ablation, describe its procedural aspects and propose a multidisciplinary approach that involves a team of clinical cardiologists, interventionists, and cardiac surgeons, the Cardiomyopathy Team, with high experience in the clinical management of these patients
Endothelial progenitor cells in coronary atherosclerosis and percutaneous coronary intervention. a systematic review and meta-analysis
The role of endothelial progenitor cells (EPCs) in atherosclerosis progression and neointimal growth after percutaneous coronary intervention (PCI) remains controversial. The purpose of this study was to perform a systematic review and meta-analysis of studies on EPCs in patients who had PCI
A prognostic index for risk stratification for acute heart failure and death in subjects with ischemic cardiomyopathy and cardiac defibrillator
To propose a clinical prognostic index for death and heart failure in patients with ischemic cardiomyopathy implanted with an ICD. This prospective study included 192 consecutive patients (age 68 ± 10) recruited from 2004 to 2009 and implanted with an ICD for MADIT II criteria. All patients performed 24-h ambulatory blood pressure monitoring after discharge and common haematological samples. The prognostic index (PI) was built according to the formula: 120 - age + mean 24 h systolic blood pressure - (creatinine * 10). Other variables were assessed: EF, haemoglobin concentration, mean 24 h heart rate and diastolic blood pressure, sodium level, pacing mode and diabetes. Non-arrhythmic cardiac death and new hospitalizations for heart failure during 1-year follow-up were the combined end point. A total of 48 events (25 %) occurred during the follow-up: 7 cardiac deaths and 41 hospitalizations for acute heart failure. Cox proportionalhazards model showed that PI was the only predictor of
events (HR = 0.96; CI 95 % 0.944–0.976, p<0.0001). ROC curve showed that PI best cut-off was 144, with AUC 0.79, p<0.0001; sensitivity 77 %, specificity 74 %, positive predictive value 50 %, negative predictive value 90 %. PI was predictive of events in a clinical setting where EF had no predictive value. PI works according to the rule ‘‘the lower the worse’’. The high negative predictive value (90 %) of PI allows to identify subjects at
lower risk for death and heart failure. PI can be a practical
tool to stratify risk in ischemic cardiomyopathy
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