American heart journal
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American heart journal · Jul 2000
Comparative StudyRace, baseline characteristics, and clinical outcomes after coronary intervention: The New Approaches in Coronary Interventions (NACI) registry.
The impact of race and sex on clinical outcomes after percutaneous coronary interventions remains incompletely understood. Specific data on patient demographics, lesion characteristics, and outcomes of black versus white patients are poorly described. To further evaluate these issues, we analyzed the New Approaches in Coronary Interventions (NACI) registry. ⋯ There are significant differences in baseline characteristics of black patients compared with white patients. Despite these differences in traditional risk factors, they do not affect procedural success or 1-year outcome. In black patients, only sex predicted adverse events. Additional investigation is required to understand the mechanisms for this difference.
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American heart journal · Jun 2000
Randomized Controlled Trial Multicenter StudyTransesophageal echocardiography guided enoxaparin antithrombotic strategy for cardioversion of atrial fibrillation: the ACUTE II pilot study.
Patients with atrial fibrillation >2 days' duration for whom immediate cardioversion is desired or required are commonly hospitalized for 4 or more days of antithrombotic therapy with intravenous unfractionated heparin and commencement of oral warfarin. For these early cardioversion patients, self-administered low-molecular-weight heparin (enoxaparin sodium) as "bridge" therapy to warfarin may obviate the need for hospitalization and activated partial thromboplastin time monitoring and thus potentially lower costs and enhance utility. ⋯ The results of this pilot study will have important clinical and economic implications for the antithrombotic management of patients with atrial fibrillation undergoing TEE-guided cardioversion.
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American heart journal · Apr 2000
Comparative StudyDesign and interpretation of equivalence trials.
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American heart journal · Mar 2000
Clinical TrialMitral repair in patients with a ruptured papillary muscle.
The objective of this study was to evaluate the feasibility of a modified papillary muscle repair procedure for a group of patients with ischemic mitral regurgitation when ischemia/infarction has resulted in the rupture of a papillary muscle. From January 1997 to January 1999, 843 patients underwent mitral valve surgery in our hospital. Mitral reconstruction was performed in 520 (61.7%) patients, and 6 (1.2%) of these patients were found to have a rupture of a papillary muscle at initial examination. ⋯ Our results indicate that our modified papillary muscle reimplantation procedure is a valuable surgical tool with good survival results in patients with ischemic mitral regurgitation caused by papillary muscle rupture.
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American heart journal · Mar 2000
Clinical Trial Controlled Clinical TrialThree-dimensional echocardiographic assessment of annular shape changes in the normal and regurgitant mitral valve.
To compare mitral annular shape and motion throughout the cardiac cycle in patients with normal hearts versus those with functional mitral regurgitation (FMR). ⋯ FMR is associated with annular dilation and reduced cyclic variation in annular shape and area. Normal mitral valve function may depend on normal annular 3D shape and dimensions as well as annular plasticity. These observations may have implications for design and selection of mitral annular prostheses.