Angiology
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Randomized Controlled Trial
Remote ischemic preconditioning stimulus does not reduce microvascular resistance or improve myocardial blood flow in patients undergoing elective percutaneous coronary intervention.
Remote ischemic preconditioning (RIPC) may limit myocardial infarction by improving microvascular function and maintaining myocardial blood flow. We hypothesized that a RIPC stimulus would reduce coronary microvascular resistance and improve coronary blood flow during elective percutaneous coronary intervention (PCI). ⋯ RIPC stimuli during elective PCI do not affect coronary microvascular resistance or coronary flow in humans.
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Comparative Study
Evaluation of point-of-care activated partial thromboplastin time testing by comparison to laboratory-based assay for control of intravenous heparin.
Patients on intravenous heparin require regular activated partial thromboplastin time monitoring. Laboratory-based activated partial thromboplastin time assays necessitate a delay between blood sampling and dose adjustment. Point-of-care testing could permit immediate dose adjustments, potentially enabling tighter control of anticoagulation. ⋯ The Hemochron Response system is not sufficiently accurate for routine ward use compared with laboratory activated partial thromboplastin time assays.
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Antithrombotic therapy coupled with early use of cardiac catheterization and revascularization have decreased morbidity and mortality rates in patients who have acute ischemic heart disease but who carry a risk for bleeding. Bleeding complications in patients with acute coronary syndromes are associated with worse clinical outcomes, including recurrent ischemic events and death. ⋯ In this review, the incidence, predictors, and clinical outcomes associated with bleeding are discussed. Furthermore, the association between antithrombotic agents and bleeding and propose strategies to prevent bleeding complications are also discussed.