Coronary artery disease
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Coronary artery disease · Nov 2012
Review Meta AnalysisProphylactic intra-aortic balloon pump in high-risk patients undergoing coronary artery bypass surgery: a meta-analysis of randomized controlled trials.
The aim of this study was to assess the efficacy of a prophylactic intra-aortic balloon pump (IABP) in high-risk patients undergoing coronary artery bypass graft surgery. ⋯ This meta-analysis supports the use of prophylactic IABP in high-risk patients to reduce hospital mortality.
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Coronary artery disease · Nov 2012
Gated-SPECT myocardial perfusion imaging and coronary calcium score for evaluation of patients with acute chest pain and a normal or nondiagnostic electrocardiogram.
To assess the ability of rest myocardial perfusion imaging (MPI) to rule out an acute coronary syndrome (ACS) in emergency department patients, as well as to investigate whether there exists a concordance between MPI and coronary calcium. ⋯ Patients presenting with acute chest pain and a low-to-intermediate likelihood of coronary artery disease with a normal rest MPI have a very low probability of cardiac events during the first year. Coronary calcium score was not helpful in risk-stratifying these patients.
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Coronary artery disease · Nov 2012
Review Meta AnalysisPercutaneous coronary intervention among patients with left ventricular systolic dysfunction: a review and meta-analysis of 19 clinical studies.
Coronary artery disease (CAD) is the most common cause for left ventricular dysfunction. Coronary artery bypass surgery (CABG) has not reduced mortality among patients with CAD and left ventricular systolic dysfunction receiving guideline-indicated pharmacological therapy. However, the benefit of percutaneous coronary intervention (PCI) among patients with left ventricular systolic dysfunction is not clear. ⋯ The present meta-analysis demonstrates that on the basis of available clinical studies, PCI among patients with left ventricular systolic dysfunction is feasible with acceptable in-hospital and long-term mortality and yields similar outcomes to CABG. However, neither intervention may improve outcome compared with pharmacological therapy alone.
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Coronary artery disease · Nov 2012
Randomized Controlled TrialThe impact of successful manual thrombus aspiration on in-stent restenosis after primary PCI: angiographic and clinical follow-up.
This study sought to investigate the impact of successful manual thrombus aspiration on angiographic in-stent restenosis and clinical outcome in patients treated by bare metal stent implantation for ST-segment elevation acute myocardial infarction. ⋯ Successful upfront manual thrombus aspiration during primary PCI showed beneficial effects on the reduction of in-stent restenosis after bare metal stent implantation compared with standard PCI.
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Coronary artery disease · Nov 2012
Comparative StudyDelayed versus immediate stenting for the treatment of ST-elevation acute myocardial infarction with a high thrombus burden.
High thrombus burden (HTB) is an independent predictor of no flow or low reflow during a primary percutaneous coronary intervention. This study aimed to compare immediate versus delayed stenting in ST-elevation myocardial infarction (STEMI) patients with HTB. ⋯ For STEMI patients with HTB who have undergone initial thrombectomy, delayed stenting is safe and feasible, and may be associated with better immediate myocardial perfusion, more LV function recovery, and less occurrence of MACE at the 1-year follow-up.