Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Nov 1996
Comparative StudyCoronary angioplasty versus repeat coronary artery bypass grafting for patients with previous bypass surgery.
We attempted to determine the relative risks and benefits of percutaneous transluminal coronary angioplasty (PTCA) and repeat coronary artery bypass grafting (re-CABG) in patients with previous coronary bypass surgery (CABG). ⋯ In this nonrandomized series of patients with previous CABG requiring revascularization, an initial stategy of either PTCA or re-CABG resulted in equivalent overall survival, event-free survival and relief of angina. PTCA offers lower procedural morbidity and mortality risks, although it is associated with less complete revascularization and a greater need for subsequent revascularization procedures.
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J. Am. Coll. Cardiol. · Nov 1996
Thrombogenicity of radiofrequency lesions: results with serial D-dimer determinations.
By measuring plasma levels of D-dimer, a product of fibrin degradation, we sought to investigate whether the application of radiofrequency (RF) energy might activate endogenous thrombotic mechanisms. ⋯ As reflected by elevated plasma D-dimer levels, RF ablation has a thrombogenic effect that persists through 48 h after the procedure. This effect needs to be taken into account when considering antithrombotic therapy in patients undergoing RF ablation.
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J. Am. Coll. Cardiol. · Nov 1996
Mode of onset of torsade de pointes in congenital long QT syndrome.
We sought to describe the mode of onset of spontaneous torsade de pointes in the congenital long QT syndrome. ⋯ The "long-short" sequence, which has been recognized as a hallmark of torsade de pointes in the acquired LQTS, plays a major role in the genesis of torsade in the congenital LQTS as well. Our findings have important therapeutic implications regarding the use of pacemakers for prevention of torsade in the congenital LQTS.
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J. Am. Coll. Cardiol. · Nov 1996
Marked expression of plasma brain natriuretic peptide is a special feature of hypertrophic obstructive cardiomyopathy.
We examined whether plasma brain natriuretic peptide levels are abnormally elevated in hypertrophic obstructive cardiomyopathy compared with other cardiac diseases. ⋯ Abnormal elevations of plasma brain natriuretic peptide levels are difficult to explain on the basis of hemodynamic and echocardiographic data and are a special feature of hypertrophic obstructive cardiomyopathy.
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J. Am. Coll. Cardiol. · Nov 1996
Creatine kinase-mb fraction and cardiac troponin T to diagnose acute myocardial infarction after cardiopulmonary resuscitation.
This study sought to evaluate the diagnostic value of the biochemical markers creatine kinase (CK), creatine kinase-MB fraction (CK-MB) and cardiac troponin T (cTNT) to diagnose acute myocardial infarction (AMI) after cardiopulmonary resuscitation (CPR). ⋯ Cardiac TNT and CK-MB are valuable tools in detecting AMI as the cause of sudden cardiac death. However, there is a considerable lack of sensitivity and specificity. Cardiac injury is probably caused not only by AMI, but also by myocardial damage related to CPR efforts.