The American journal of cardiology
-
Comparative Study Clinical Trial
Comparison of transcatheter closure of secundum atrial septal defect using the Amplatzer septal occluder associated with deficient versus sufficient rims.
To evaluate the feasibility of transcatheter closure of secundum atrial septal defects (ASDs) associated with deficient rims (<5 mm) using the Amplatzer septal occluder (ASO), 23 patients (median age 10.7 years) underwent an attempted transcatheter closure. The patients had a deficient anterior rim of 0 to 4 mm (n = 20), an inferior rim of 2 mm (n = 2), or a posterior rim of 4 mm (n = 1) as assessed by transesophageal echocardiography (TEE) or intracardiac echocardiography (ICE). Forty-eight patients with sufficient rims (>5 mm) who underwent closure served as controls. ⋯ No major complications were encountered either during or after the closure procedure in both groups. Thus, transcatheter closure of ASDs associated with small anterior, inferior, or posterior rims is feasible using an ASO. Long-term follow-up data are still needed to assess long-term safety and efficacy.
-
Randomized Controlled Trial Clinical Trial
Effectiveness of clopidogrel versus aspirin in preventing acute myocardial infarction in patients with symptomatic atherothrombosis (CAPRIE trial).
-
Comparative Study
Prevalence of coronary occlusion and outcome of an immediate invasive strategy in suspected acute myocardial infarction with and without ST-segment elevation.
The prevalence of flow-limiting coronary lesions at the time of presentation in patients with non-ST-segment elevation myocardial infarction (NSTEMI) is unknown. Because rational reperfusion strategies depend on early, accurate identification of coronary flow limitation, we performed coronary angiography at the time of presentation of patients with suspected NSTEMI. We also evaluated outcomes of an immediate interventional strategy. ⋯ An additional 1.9% and 2.5% died at 6 months. The prevalence of coronary flow limitation in clinically suspected NSTEMI is almost as high as in suspected STEMI. Short- and long-term outcomes of an immediate invasive strategy are similar for the 2 conditions.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Amplified benefit of clopidogrel versus aspirin in patients with diabetes mellitus.