Coronary artery disease
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Coronary artery disease · Sep 2013
Clinical TrialShort-term follow-up of tirofiban as alternative therapy for urgent surgery patients with an implanted coronary drug-eluting stent after ST-elevation myocardial infarction.
Patients with a recently diagnosed ST-elevation myocardial infarction (STEMI) and implanted coronary drug-eluting stent (DES) who need urgent surgery are at increased risk of surgical bleeding unless aspirin and clopidogrel are discontinued beforehand. However, discontinuation of aspirin and clopidogrel is associated with a high rate of recurrent myocardial infarction, heart failure, and malignant arrhythmias because of stent thrombosis. The main point of debate is how to treat these patients. We hypothesized that perioperative intravenous administration of tirofiban, a GPIIb/IIIa inhibitor, would allow the safe withdrawal of aspirin and clopidogrel without increasing the risk of surgical bleeding. ⋯ In patients who need urgent surgery after recently diagnosed STEMI and implanted DES, a strategy using tirofiban may allow temporary withdrawal of dual antiplatelet drugs without increasing the risk of bleeding. This conclusion needs to be further confirmed by large-scale randomized clinical trials.
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Coronary artery disease · Sep 2013
Comparative Study Observational StudyMedium-term neurological complications after off-pump coronary artery bypass grafting with and without aortic manipulation.
This study aimed to assess the impact of aortic manipulation during off-pump coronary artery bypass (OPCAB) on neurological complications. ⋯ Although there was no difference in the incidence of immediate postoperative neurological complications, there were fewer medium-term neurological complications in OPCAB cases without aortic manipulation.
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Coronary artery disease · Aug 2013
Comparative StudyMonocyte heterogeneity in myocardial infarction with and without ST elevation and its association with angiographic findings.
Monocytes and mature macrophages play significant roles after myocardial infarction. Here, our aim is to investigate the monocyte heterogeneity in acute ST elevation myocardial infarction (STEMI) and non-STEMI separately and determine any possible relationships between monocyte heterogeneity and coronary angiographic characteristics. ⋯ Monocyte heterogeneity differs in STEMI and non-STEMI. Peak levels of CD14++CD16- monocytes were higher and were reached later in the STEMI group compared with the non-STEMI group. More importantly, worse angiographic characteristics related to prognosis are associated with monocyte heterogeneity in both STEMI and non-STEMI patients.
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Coronary artery disease · Jun 2013
The relationship between γ-glutamyl transferase levels and the clinical outcomes in patients with ST-segment elevation myocardial infarction undergoing primary percutaneous coronary intervention.
Serum γ-glutamyl transferase (GGT) activity has been shown to be related to the development of atherosclerosis and cardiovascular events. The aim of this study was to evaluate the prognostic value of GGT in patients with ST-segment elevation myocardial infarction (STEMI) undergoing a primary percutaneous coronary intervention (PCI). ⋯ GGT is a readily available clinical laboratory value associated with in-hospital adverse outcomes in patients with STEMI who undergo primary PCI. However, there was no association with long-term mortality.
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Coronary artery disease · Jun 2013
Angiogenesis imaging in myocardial infarction using 68Ga-NOTA-RGD PET: characterization and application to therapeutic efficacy monitoring in rats.
Ga-NOTA-RGD PET is a newly developed molecular imaging for angiogenesis. In this study, Ga-NOTA-RGD PET was used to investigate imaging characteristics in a rat myocardial infarction (MI) model and to monitor the efficacy of an angiogenesis induction therapy. ⋯ Ga-NOTA-RGD PET would be a useful angiogenesis imaging modality in MI for assessment of pathophysiology or monitoring of therapeutic efficacy.