International journal of cardiology
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Multicenter Study Observational Study
ST-elevation myocardial infarction in the elderly--temporal trends in incidence, utilization of percutaneous coronary intervention and outcomes in the United States.
Elderly patients with ST-elevation myocardial infarction (STEMI) are often underrepresented in major percutaneous coronary intervention (PCI) trials. Use of PCI for STEMI, and associated outcomes in patients aged ≥65 years with STEMI needed further investigation. ⋯ In this large, multi-institutional cohort of elderly patients, a decreasing trend in STEMI, an increasing trend in PCI utilization for STEMI, and reduction in in-hospital mortality were observed from 2001 to 2010.
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Randomized Controlled Trial
Association of migraine aura with patent foramen ovale and atrial septal aneurysms.
The relationship between migrainous aura and patent foramen ovale (PFO) remains uncertain ⋯ The prevalence of moderate or large patent foramen ovale was 35% and was not associated with the presence of aura or the frequency of the headache.
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Observational Study
Impact of prosthesis-patient mismatch on tricuspid valve regurgitation and pulmonary hypertension following mitral valve replacement.
Mitral PPM can be equated to residual mitral stenosis, which may halt the expected postoperative improvement of PH and concomitant functional tricuspid regurgitation (fTR). Aim of the present study is to evaluate the impact of mitral prosthesis-patient mismatch (PPM) on late tricuspid valve regurgitation and pulmonary hypertension (PH). ⋯ This study shows that mitral PPM is associated with the persistence of fTR and PH following MVR. These findings support the realization of tricuspid valve annuloplasty when PPM is anticipated at the time of operation.
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Pulmonary arterial hypertension (PAH) after shunt closure is associated with a poor prognosis. The aim of this study was to assess retrospectively the hemodynamics of patients developing PAH after shunt closure. ⋯ High baseline values of PVR (≥5 Wood units), PVRi (≥6 Wood units∗m(2)) and PVR/SVR (≥0.33) are common findings in patients who develop PAH late after shunt closure. Large prospective clinical trials are needed to establish the safe limits for shunt closure.