Coronary artery disease
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Coronary artery disease · Jan 2015
Controlled Clinical TrialPharmacodynamic effects during the transition between cangrelor and prasugrel.
The aim of this study was to determine the impact of cangrelor and prasugrel on the pharmacodynamic effects of each agent. ⋯ Prasugrel did not alter the antiplatelet effects of cangrelor, but transient recovery of platelet reactivity was apparent during the transition from cangrelor to prasugrel. Recovery of platelet reactivity was limited when prasugrel was administered 30 min before the end of the cangrelor infusion.
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Coronary artery disease · Nov 2014
Impact of intra-aortic balloon pumping on hypotension and outcomes in acute right ventricular infarction.
This study investigated the immediate hemodynamic effects of intra-aortic balloon pump (IABP) support and clinical outcomes in patients with acute right ventricular infarction (RVI) complicated by hypotension. ⋯ IABP support results in immediate hemodynamic improvement in patients with acute RVI complicated by shock. The majority of these shock patients survived and the magnitude of mean arterial pressure and peak systolic blood pressure augmentation may impart prognostic value.
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Coronary artery disease · Sep 2014
ReviewFunctional assessment of multivessel coronary artery disease: ischemia-guided percutaneous coronary intervention.
Invasive evaluation and treatment of coronary artery disease (CAD) has traditionally been based upon coronary angiography to determine the need for and the success of revascularization. However, coronary angiography augmented with fractional flow reserve (FFR) creates a paradigm shift, providing a more complete functional assessment of coronary lesions. Measuring FFR to identify ischemic lesions and guide revascularization results in fewer adverse outcomes, including persistent angina, myocardial infarction, and mortality. ⋯ Although the mechanism explaining this is unclear, it is likely multifactorial, including the impact of mechanical forces, upregulation of inflammatory mediators, and the amount of distal myocardial tissue at risk. Using both anatomic and ischemia-guided assessments (such as the Functional SYNTAX Score) aids in the therapeutic decision-making process in patients with multivessel CAD. This review focuses on the evidence for FFR-guided management of multivessel CAD.