Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Jun 2007
Impact of platelet reactivity after clopidogrel administration on drug-eluting stent thrombosis.
We sought to determine whether nonresponsiveness to clopidogrel as revealed by high in vitro post-treatment platelet reactivity is predictive of drug-eluting stent (DES) thrombosis. ⋯ Nonresponsiveness to clopidogrel is a strong independent predictor of stent thrombosis in patients receiving sirolimus- or paclitaxel-eluting stents.
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J. Am. Coll. Cardiol. · Jun 2007
An elastic, biodegradable cardiac patch induces contractile smooth muscle and improves cardiac remodeling and function in subacute myocardial infarction.
Our objective in this study was to apply an elastic, biodegradable polyester urethane urea (PEUU) cardiac patch onto subacute infarcts and to examine the resulting cardiac ventricular remodeling and performance. ⋯ Implantation of a novel biodegradable PEUU patch onto a subacute myocardial infarction promoted contractile phenotype smooth muscle tissue formation and improved cardiac remodeling and contractile function at the chronic stage. Our findings suggest a new therapeutic option against post-infarct cardiac failure.
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J. Am. Coll. Cardiol. · Jun 2007
ReviewThe role of coenzyme Q10 in statin-associated myopathy: a systematic review.
Statins (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors) are currently the most effective medications for reducing low-density lipoprotein cholesterol concentrations. Although generally safe, they have been associated with a variety of myopathic complaints. Statins block production of farnesyl pyrophosphate, an intermediate in the synthesis of ubiquinone or coenzyme Q10 (CoQ10). ⋯ Nevertheless, there are no known risks to this supplement and there is some anecdotal and preliminary trial evidence of its effectiveness. Consequently, CoQ10 can be tested in patients requiring statin treatment, who develop statin myalgia, and who cannot be satisfactorily treated with other agents. Some patients may respond, if only via a placebo effect.
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Perioperative coronary stent thrombosis is a catastrophic complication that can occur in patients receiving both bare-metal and drug-eluting stents. Noncardiac surgery appears to increase the risk that recently-placed stents thrombose, especially when surgery is performed early after stenting, and particularly if dual antiplatelet therapy is discontinued. ⋯ We also reviewed the data about the impact of preoperative revascularization in patients known to require noncardiac surgery. Based on these published data, we offer recommendations that can be used to guide the treatment of patients who require noncardiac surgery after having received a stent.