1,721,323 research outputs found
Marijuana influence on cardiac modulation and heart rate: novel hypotheses and gaps in evidence
No full textAre Atherogenic Lipoprotein Phenotype and Inflammation Indicative of Plaque Phenotype and Clinical Stability in Coronary Artery Disease?-Reply
No full textOptical coherence tomography assessment and quantification of intracoronary thrombus: Status and perspectives
No full textCoronary angiography is the "golden standard" imaging technique in interventional cardiology and it is still widely used to guide interventions. A major drawback of this technique, however, is that it is inaccurate in the evaluation and quantification of intracoronary thrombus burden, a critical prognosticator and predictor of intraprocedural complications in acute coronary syndromes. The introduction of optical coherence tomography (OCT) holds the promise of overcoming this important limitation, as near-infrared light is uniquely sensitive to hemoglobin, the pigment of red blood cells trapped in the thrombus. This narrative review will focus on the use of OCT for the assessment, evaluation and quantification of intracoronary thrombosis
Double or triple antithrombotic therapy for patients with atrial fibrillation undergoing percutaneous coronary intervention: not a matter of faith
No full textAbdominal Infrarenal Aortic Stenosis Approached Through a Full Transradial Approach: A Case Series
No full textSix consecutive patients (3 men; mean age, 63 ± 14 years; age range, 38-81 years) with infrarenal abdominal aortic stenosis underwent unilateral or bilateral transradial approach for stenting of the aortic lesion. In 4 cases, isolated aortic stenting was performed through single transradial approach (in 2 cases with precise alignment to the proximal end of previously deployed iliac stents), whereas in the other 2 cases bilateral transradial approach was used for aortic stenting followed by bilateral stenting of the proximal iliac arteries. Either a "bare-on-the-wire" or a "support-catheter" technique was used, according to patient anatomy and technical requirements. The median follow-up was 14.3 months, at which time all patients had relief of symptoms without thromboembolic or bleeding complications. In this performance and safety evaluation, full transradial approach was effective and safe for treating infrarenal aortic stenosis that is isolated or associated with iliac disease
Statin therapy after myocardial infarction in patients with renal failure. The longer, the merrier!
No full text: Among the ongoing clinical challenges for cardiologists in the 21 th century, there is the necessity of being able to cope with multimorbidity and polypharmacy. Irrespectively, beneficial drugs should be continued long-term, to ensure mortality and morbidity benefits continue to be accrued. This is evidently the case for the use of statins to improve long-term outcomes in chronic kidney disease (CKD) patients with acute coronary syndromes (ACS), as the combination of CKD and ACS represents a veritable crucible of adverse risk factors. Furthermore, statins have pleiotropic effects, including anti-inflammatory, antioxidant and endothelial-protective effects. Even though these effects are debated in CKD patients, it is biologically plausible that statins may reduce the inflammatory burden and improve glomerular hemodynamics. Awaiting for further clinical studies, for instance focused on the identification of possible biomarkers of statins action on renal function, it is pivotal to maintain our CKD patients with history of ACS on lifesaving medications such as statins
Glucose-6-Phosphate Dehydrogenase (G6PDH) Deficiency in a Patient with ST-Segment Elevation Acute Myocardial Infarction Successfully Treated by Simple Thrombectomy
No full textWe report the case of an 82-year-old Sardinian woman affected by "favism" (i.e. intolerance to fava beans) with chest pain associated with persistent massive ST elevation in V2-V6 leads, admitted to our department after transfer from a rural hospital without catheterization facilities. On immediate transfer to the catheterization laboratory for primary percutaneous intervention (PCI), coronary angiogram showed proximal left anterior descending (LAD) thrombotic occlusion. In consideration of her history of glucose-6 phosphate dehydrogenase deficiency and "loss of consciousness" at a young age after taking aspirin, which contraindicated aspirin therapy, we treated this patient using a new, two-step strategy, with an emergency minimalist intervention using manual thrombectomy and intracoronary glycoprotein IIb/IIIa (GPIIbIIIa) inhibition with abciximab. Subsequent angiography control confirmed the persistence of Thrombolysis in Myocardial Infarction Trial (TIMI) grade 3 flow and the presence of an intermediate proximal LAD coronary lesion, which was not treated, also due to the persisting contraindication to aspirin. In our opinion, minimalist intervention with a thrombectomy device (especially in patients characterized by a high intracoronary thrombus burden) and/or with the use of a small balloon or gentle dilation, sustained by maximized antithrombotic therapy may represent an interesting and rational approach, allowing interventionalists to postpone stenting in the setting of primary PCI in special cases
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