Coronary artery disease
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Coronary artery disease · Nov 2009
Comparative StudyOutcome of patients with acute coronary syndromes enrolled in clinical trials.
The objective of this study was to evaluate in-hospital and 1-year outcomes of patients with acute coronary syndrome (ACS) enrolled in clinical studies. Among patients included in the Canadian ACS Registries, patients enrolled in clinical studies (n = 883, 13.4%) were compared with patients who were not enrolled. Enrolled patients were younger, more likely to be smokers, had less diabetes, less hypertension, less previous myocardial infarction, and less previous percutaneous coronary intervention and coronary artery bypass grafting. ⋯ After multivariable analysis, enrollment in clinical studies showed a trend towards decreased in-hospital and 1-year death. Patients with ACS in Canada who participate in clinical studies are more likely to receive evidence-based therapies and interventions throughout hospitalization. After multivariable analysis, enrollment in a clinical trial may also contribute to better in-hospital and 1-year outcome.
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Coronary artery disease · Sep 2009
Predictors of 30-day and 1-year mortality after primary percutaneous coronary intervention for ST-elevation myocardial infarction.
Predictors of 30-day mortality may differ from predictors of mortality at 1 year among 30-day survivors of ST-elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). We aimed to evaluate the predictors of 30-day and 1-year mortality in unselected patients with STEMI treated with PCI. ⋯ Despite the fact that most characteristics of 30-day and 1-year mortality among 30-day survivors are similar, we found that variables that affect mortality beyond the acute phase may not necessarily be the same as those that influence early mortality.
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Coronary artery disease · Aug 2009
Comparative StudySafety and efficacy of a prolonged bivalirudin infusion after urgent and complex percutaneous coronary interventions: a descriptive study.
Bivalirudin, a direct thrombin inhibitor, provides similar ischemic outcomes with significantly less major bleeding compared with unfractionated heparin (UFH) plus a glycoprotein IIb/IIIa inhibitor (GPI) in patients undergoing percutaneous coronary interventions (PCI). Although the approved labeling for bivalirudin allows for low-dose prolonged postprocedure administration, this practice is not routine. Therefore, we sought to evaluate the safety and efficacy of longer post-PCI infusion. ⋯ A prolonged bivalirudin infusion after urgent PCI seems effective in protecting myocardium without increasing bleeding rates, and represents an attractive alternative to the standard pharmacological treatment of UFH+GPI in the catheterization laboratory.
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Coronary artery disease · Aug 2009
Randomized Controlled TrialRanolazine improves endothelial function in patients with stable coronary artery disease.
We investigated the effect of ranolazine on endothelial-dependent vasodilatation (EDV), serum markers of endothelial dysfunction, and inflammation. ⋯ Ranolazine improves endothelial function, asymmetric dimethylarginine, and C-reactive protein levels in a group of patients with stable CAD. Our results suggest a novel mechanism of action of ranolazine.