Rev Cardiovasc Med
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Obesity is a known risk factor for developing cardiovascular disease, including heart failure. However, the impact of obesity on patients with heart failure is unclear. ⋯ Even more, increases of weight in cachectic heart failure patients might improve survival, although patients with heart failure who are overweight or mildly to moderately obese have better outcomes than patients with heart failure who are at ideal or normal weight. In heart failure patients, weight reduction through diet regulation, moderate exercise, and bariatric surgery can improve quality of life and New York Heart Association functional class, but it is yet unclear if these measures will improve survival.
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Patients with drug-eluting stents appear to be at increased risk of thrombosis beyond 30 days (late) or even 1 year (very late) after stent placement. Patients with recent placement of drug-eluting stents who are receiving dual-antiplatelet therapy pose a challenge in the perioperative period. ⋯ There are currently no universal recommendations for decreasing the risk of stent thrombosis. We herein outline a strategy involving the use of glycoprotein IIb/IIIa inhibitors as "bridging therapy" during the high-risk perioperative period and report on 8 patients who successfully underwent bridging therapy with no adverse cardiac outcomes (death, myocardial infarction, or stent thrombosis) or bleeding complications.
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Review Case Reports
Treatment of intractable angina pectoris utilizing spinal cord stimulation.
Intractable angina pectoris affects approximately 5% to 15% of patients with ischemic heart disease. Current treatment options for refractory angina can be divided into 3 groups: pharmacological, nonpharmacological noninvasive, and invasive. The newest pharmacological treatment option for intractable angina pectoris is ranolazine. ⋯ Spinal cord stimulation (SCS) as a palliative intervention for refractory angina has been underutilized in the United States. This case review describes application of SCS in a 43-year-old woman with a 10-year history of symptomatic ischemic heart disease who was unresponsive to all available treatment options for intractable severe chest pain. Following spinal cord stimulator placement, the patient reported no further angina, discontinued nitroglycerine, had improved sleep quality, and resumed full-time employment.