Cardiovascular revascularization medicine : including molecular interventions
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Cardiovasc Revasc Med · Dec 2016
Review Meta AnalysisComparison of heparin, bivalirudin, and different glycoprotein IIb/IIIa inhibitor regimens for anticoagulation during percutaneous coronary intervention: A network meta-analysis.
Numerous GPIs are available for PCI. Although they were tested in randomized controlled trials, a comparison between the different GPI strategies is lacking. Thus, we performed a Bayesian network meta-analysis to compare different glycoprotein IIb/IIIa inhibitor (GPI) strategies with heparin and bivalirudin for percutaneous coronary intervention (PCI). ⋯ Our network meta-analysis of 38,645 patients demonstrated that GPI regimens were associated with a reduction in recurrent myocardial infarction or major adverse cardiovascular events for PCI, while bivalirudin was associated with the lowest risk of bleeding.
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Cardiovasc Revasc Med · Dec 2016
Multicenter Study Comparative Study Observational StudyAssociation of radial versus femoral access with contrast-induced acute kidney injury in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction.
Patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) are at an increased risk of developing contrast-induced acute kidney injury (CI-AKI). Data on the association between transradial (TRA) vs. transfemoral (TFA) access and the risk of CI-AKI in this setting are limited. ⋯ In patients with STEMI undergoing primary PCI, the overall incidence of contrast-induced acute kidney injury (CI-AKI) was low (6.7%). Transradial access was not associated with a lower risk of CI-AKI as compared with transfemoral access.
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Cardiovasc Revasc Med · Dec 2016
Comparative Study Observational StudyPre-hospital ticagrelor in patients with ST-segment elevation myocardial infarction with long transport time to primary PCI facility.
Pre-hospital ticagrelor, given less than 1h before coronary intervention (PCI), failed to improve coronary reperfusion in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary PCI. It is unknown whether a longer interval from ticagrelor administration to primary PCI might reveal any improvement of coronary reperfusion. ⋯ In a real world STEMI network, pre-treatment with ticagrelor in spoke hospitals or in ambulance loading at least 1.5h before primary PCI is safe and might improve pre-PCI coronary reperfusion, in comparison with ticagrelor administration immediately before PCI.