Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Dec 2013
Randomized Controlled Trial Comparative StudyZotarolimus- versus everolimus-eluting stents for unprotected left main coronary artery disease.
This study sought to compare the safety and efficacy of the zotarolimus-eluting stent (ZES) and the everolimus-eluting stent (EES) for treatment of unprotected left main coronary artery (uLMCA) disease. ⋯ Within the statistical limitations of the present study, treatment of uLMCA lesions with a ZES or an EES provided comparable clinical and angiographic outcomes at 1-year follow-up.
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J. Am. Coll. Cardiol. · Dec 2013
Comparative StudySurgical valvotomy and repair for neonatal and infant congenital aortic stenosis achieves better results than interventional catheterization.
This study sought to compare outcomes after surgical valvuloplasty and balloon dilation of the aortic valve in neonates and infants. ⋯ Surgical valvuloplasty remains the best approach to treat neonates and infants with congenital aortic stenosis. After surgery, a higher proportion of patients remain free of re-intervention than after interventional catheterization and the relief of their stenosis lasts longer.
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J. Am. Coll. Cardiol. · Dec 2013
Cardiac arrest at exercise facilities: implications for placement of automated external defibrillators.
This study sought to characterize the relative frequency, care, and survival of sudden cardiac arrest in traditional indoor exercise facilities, alternative indoor exercise sites, and other indoor sites. ⋯ We observed a higher rate of cardiac arrests at some alternative exercise facilities than at traditional exercise sites. Survival was higher at exercise sites than at nonexercise indoor sites. These data have important implications for automated external defibrillator placement.
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J. Am. Coll. Cardiol. · Dec 2013
Impaired cardiac baroreflex sensitivity predicts response to renal sympathetic denervation in patients with resistant hypertension.
This study sought to evaluate cardiac baroreflex sensitivity (BRS) as a predictor of response to renal sympathetic denervation (RDN). ⋯ Impaired cardiac BRS identifies patients with resistant hypertension who respond to RDN.
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J. Am. Coll. Cardiol. · Nov 2013
ReviewStent thrombosis with drug-eluting stents: is the paradigm shifting?
First-generation drug-eluting stents (DES), which impart the controlled release of sirolimus or paclitaxel from durable polymers to the vessel wall, have been consistently shown to reduce the risk of restenosis and target vessel revascularization compared with bare metal stents (BMS). However, stent thrombosis (ST) emerged as a major safety concern with first-generation DES early after their adoption in clinical practice, requiring prolonged dual antiplatelet therapy. Pathological studies have shown that first-generation DES are associated with delayed arterial healing and polymer hypersensitivity reactions resulting in chronic inflammation, predisposing to late and very late ST. ⋯ The thin-strut structure of the stent platform, the thromboresistant properties of the fluoropolymer, and the reduced polymer and drug load may contribute to the low rate of ST with CoCr-EES. The notion of DES being safer than BMS represents a paradigm shift in the evolution of percutaneous coronary intervention. The relative safety and efficacy of fluoropolymer-coated CoCr-EES, DES with bioabsorbable polymers, and fully bioresorbable scaffolds are the subject of numerous ongoing large-scale trials.