American heart journal
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Prompt reversal of anticoagulation by protamine administration could be an important therapeutic option to treat serious procedural complications such as vessel rupture or major bleeding from the puncture site during coronary stent implantation. However, this therapeutic option is rarely used because of the possible risk of stent thrombosis. ⋯ Reversal of anticoagulation by protamine after stent implantation does not predispose to stent thrombosis. This result has important clinical consequences because it allows the use of protamine in the treatment of coronary perforation and serious bleeding complications that may occur during coronary stent deployment.
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American heart journal · Jul 1999
Editorial CommentPulmonary embolism thrombolysis: Do we need another agent?
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American heart journal · Jun 1999
Randomized Controlled Trial Multicenter Study Clinical TrialEfficacy and safety of intravenously administered dofetilide in acute termination of atrial fibrillation and flutter: a multicenter, randomized, double-blind, placebo-controlled trial. Danish Dofetilide in Atrial Fibrillation and Flutter Study Group.
This study was designed to assess the efficacy and safety of intravenous dofetilide in acute termination of atrial fibrillation (AF) and flutter (AFL). Dofetilide, an investigational class III antiarrhythmic agent, selectively inhibits the rapid component of the delayed rectifier potassium current, thus prolonging the effective refractory period and duration of the action potential. Dofetilide can be administered intravenously and has a rapid onset of electrophysiologic action. ⋯ Intravenous dofetilide is effective in acute termination of AF and AFL of medium duration, with a particularly high efficacy rate in AFL. A small but serious risk of proarrhythmia must be anticipated.
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American heart journal · Jun 1999
Comparative StudyCardiac troponin T as a marker for myocardial ischemia in patients seen at the emergency department for acute chest pain.
Identification of patients with acute chest pain at high risk for cardiovascular complications is a common and difficult challenge for clinicians and must be based initially on data from the history, physical examination, electrocardiogram, and chest radiograph. Some data suggest that elevations in cardiac troponin T (cTnT) may be useful for detection of less severe degrees of myocardial injury that may occur in some patients with unstable angina. Therefore we designed a prospective follow-up study to assess the diagnostic performance and prognostic value of cTnT in a population of patients presenting to the emergency department with acute chest pain. ⋯ In a heterogeneous population of patients seen in the emergency department with acute chest pain, cTnT was similar to CK-MB (activity and mass assays) for detection of AMI and superior to the CK-MB mass assay as a marker for major cardiac events early in the hospital course among those who were ruled out for an AMI. Further study is required to determine how this assay can be used to provide more appropriate, cost-effective care.
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American heart journal · Jun 1999
Comparative StudyEffect of long-term beta-blockade on aortic root compliance in patients with Marfan syndrome.
This study was undertaken to assess the effect of long-term beta-blockade on the aortic root stiffness index and distensibility in patients with Marfan syndrome. ⋯ There was a heterogeneous response in the aortic root elastic properties after long-term treatment with atenolol in asymptomatic patients with Marfan syndrome. Stiffness index and distensibility are more likely to respond when the baseline end-diastolic aortic root diameter is <40 mm.