Cardiology
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Randomized Controlled Trial Comparative Study
Comparison of Effects of Low- versus High-Dose Heparin on Access-Site Complications during Transradial Coronary Angiography: A Double-Blind Randomized Study.
Although heparin is highly effective in reducing the rate of radial artery occlusion after transradial catheterization, the optimal heparin dose is still controversial. The aim of this study was to evaluate the efficacy and safety of two different heparin doses during transradial coronary angiography. ⋯ A lower dose of heparin (i.e. 2,500 U) decreases bleeding during transradial band deflation without an increase in radial artery occlusion.
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Endothelial dysfunction is involved in the development of the acute coronary syndrome (ACS). Plasma microparticles(MPs) from other diseases have been demonstrated to initiate coagulation and endothelial dysfunction.However, whether MPs from ACS patients impair vasodilatation and endothelial function remains unclear. ⋯ Our data indicate that MPs from ACS patients negatively affect endothelial-dependent vasodilatation via Akt/eNOS-Hsp90 pathways.
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Multicenter Study Clinical Trial
Aortic Size Distribution in the General Population: Explaining the Size Paradox in Aortic Dissection.
Current guidelines recommend a diameter of 5-5.5 cm as the threshold for surgery on the ascending aorta. However, a study from the International Registry of Acute Aortic Dissection showed that nearly 60% occurred at <5.5 cm (the 'aortic size paradox')--leading to a debate whether the size threshold should be lowered. However, the study showing dissection at small size had no knowledge of the population at risk. Herein, we aim to calculate the relative risk of aortic dissection at sizes<5.5 cm by analyzing both the number of occurring dissections (numerator) and the population at risk at each aortic size (denominator). ⋯ The normal aorta is deceptively small, most commonly <3.5 cm. The aortic size paradox is a byproduct of the very large number of patients in small size ranges. This study fully supports current recommendations for surgical intervention at 5-5.5 cm.
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An intra-aortic balloon pump (IABP) is the most commonly used circulatory assist device in cardiac surgery. We hypothesized that prophylactic application of an IABP improves early clinical outcome of high-risk patients undergoing scheduled off-pump coronary artery bypass grafting (OPCABG). ⋯ Prophylactic application of an IABP improves postoperative cardiac performance, reduces respiratory and renal complications, and consequently lowers surgical mortality in high-risk patients undergoing scheduled OPCABG.