Journal of interventional cardiology
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To define the incidence of stent thrombosis (ST) and/or AMI (ST/AMI) associated with temporary or permanent suspension of dual antiplatelet therapy (DAPT) after coronary drug-eluting stent (DES) implantation in "real-world" patients, and additional factors influencing these events. ⋯ In real-world practice, rates of ST/AMI following DES implantation are low, but not insignificant, following aspirin and/or clopidogrel cessation. Use of uninterrupted DAPT appears more common in high-risk patients.
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Randomized Controlled Trial
Effectiveness of theophylline in preventing contrast-induced nephropathy after coronary angiographic procedures.
Contrast-induced nephropathy (CIN) is the third most common cause of hospital acquired acute renal failure and is associated with increased morbidity and mortality. The use of theophylline for prevention of CIN has yielded conflicting results. This study aimed at examining the effectiveness of theophylline in prevention of CIN when added to IV hydration and N-acetylcysteine (NAC). ⋯ Theophylline seems to be an effective prophylaxis against CIN for moderate- and high-risk patients undergoing coronary angiography or angioplasty. It offers additive protection when added to IV hydration and NAC.
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Evaluation of acute and mid-term outcomes of patients with ST-elevation myocardial infarction (STEMI) undergoing emergency PCI due to unprotected left main coronary artery (ULMCA) disease. ⋯ In patients with STEMI and ULMCA as culprit lesion, emergency PCI is a valuable therapeutic strategy. Early and mid-term survival depends on cardiogenic shock, advanced age, and PCI failure. Patients surviving the first month have good mid-term prognosis.
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Current literature recommends weaning intra-aortic balloon pump (IABP) support prior to discontinuation. To date, no studies have compared various weaning strategies for safety or efficacy. This study was designed to evaluate the impact of weaning on in-hospital clinical outcomes. ⋯ This study suggests that weaning protocols offer no hemodynamic benefits or improvement in in-hospital mortality rates. Weaning is associated with trend toward increased length of stay. We conclude that weaning offers no advantage over direct device removal and would advocate that balloon pumps be directly withdrawn when counterpulsation is terminated.
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The benefits of early abciximab administration and thrombus aspiration in ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PPCI) have previously been elaborated. However, whether there is an adjunctive effect of thrombus aspiration among STEMI patients, with angiographic evidence of thrombus, receiving early prehospital abciximab remains unclear. ⋯ Among STEMI patients treated with PPCI and in-ambulance abciximab, it appears that a selective strategy of thrombus aspiration still has additive benefit.