Circulation. Cardiovascular interventions
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Circ Cardiovasc Interv · Oct 2012
Randomized Controlled Trial Comparative StudyPharmacodynamic effect of switching therapy in patients with high on-treatment platelet reactivity and genotype variation with high clopidogrel Dose versus prasugrel: the RESET GENE trial.
High on-treatment platelet reactivity (HTPR) is associated with adverse outcomes. We aim to compare the novel thienopyridine prasugrel versus double-dose clopidogrel in patients with HTPR and explore the interaction between CYP2C19 genotype and both drugs. ⋯ URL: http://www.clinicaltrials.gov. Unique identifier: NCT01465828.
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Circ Cardiovasc Interv · Oct 2012
Multicenter StudyBlood transfusion and the risk of acute kidney injury after transcatheter aortic valve implantation.
Blood transfusion is associated with acute kidney injury (AKI) after transcatheter aortic valve implantation (TAVI). We sought to elucidate in more detail the relation between blood transfusion and AKI and its effects on short- and long-term mortality. ⋯ AKI occurred in 21% of the patients after TAVI. The number of blood transfusions but not the indication of transfusion predicted AKI. AKI was a predictor of both short- and long-term mortality, whereas blood transfusion predicted long-term mortality. These findings indicate that outcome of TAVI may be improved by more restrictive use of blood transfusions.
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Circ Cardiovasc Interv · Oct 2012
Randomized Controlled TrialMentored simulation training improves procedural skills in cardiac catheterization: a randomized, controlled pilot study.
Despite valuable supplemental training resources for surgical skill acquisition, utility of virtual reality simulators to improve skills relevant to performing cardiac catheterization has not been evaluated. ⋯ Skills required to perform cardiac catheterization can be learned via mentored simulation training and are transferable to actual procedures in the catheterization laboratory. Less proficient operators derive greater benefit from simulator training than more proficient operators.
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Circ Cardiovasc Interv · Oct 2012
Dimensions of socioeconomic status and clinical outcome after primary percutaneous coronary intervention.
The association between low socioeconomic status (SES) and high mortality from coronary heart disease is well-known. However, the role of SES in relation to the clinical outcome after primary percutaneous coronary intervention remains poorly understood. ⋯ Even in a tax-financed healthcare system, low-SES patients treated with primary percutaneous coronary intervention face a worse prognosis than high-SES patients. The poor outcome seems to be largely explained by differences in baseline patient characteristics. Employment status and income (but not education level) were associated with clinical outcomes.
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Circ Cardiovasc Interv · Oct 2012
Valve-in-valve implantation of Medtronic CoreValve prosthesis in patients with failing bioprosthetic aortic valves.
Transcatheter aortic valve implantation (TAVI) using the Medtronic CoreValve (MCV) system might represent an alternative to conventional redo surgery in older high-risk patients with a failing aortic valve bioprosthesis. ⋯ These results suggest that transfemoral mcv implantation into a wide range of degenerated aortic bioprosthetic valves - irrespective of the failure mode - is feasible, safe, and improves hemodynamics in older patients with higher risk for conventional aortic valve redo surgery.