Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
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Catheter Cardiovasc Interv · Feb 2010
Multicenter StudyImpact of the prehospital ECG on door-to-balloon time in ST elevation myocardial infarction.
National guidelines have been set to achieve door-to-balloon time (D2B) is less than 90 minutes to improve outcomes for patients with STEMI. The purpose of this study is to see if a more aggressive approach utilizing prehospital ECGs could improve reperfusion times. ⋯ Utilizing the prehospital ECG as a tool to bypass ER triage significantly decreases D2B times in patients with STEMI. This technology has the potential to substantially expedite reperfusion therapy in patients with STEMI.
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Catheter Cardiovasc Interv · Feb 2010
A comparison of the VASP index between patients with hemodynamically complicated and uncomplicated acute myocardial infarction.
Critically-ill patients with ST-segment elevation myocardial infarction (STEMI) often present with insufficient gastroduodenal motility, liver hypoperfusion, and higher levels of circulating catecholamines. All of these factors can lead to reduced efficacy of clopidogrel, which is only available as a p.o. medication. The aim of the study was to compare clopidogrel effectiveness in unstable STEMI patients on mechanical ventilation with stable STEMI patients. ⋯ Laboratory clopidogrel efficacy is lower in patients with MI and severe hemodynamic instability, probably due to splanchnic and liver hypoperfusion and catecholamine use.
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Catheter Cardiovasc Interv · Feb 2010
Transcatheter closure of postsurgical residual ventricular septal defects: early and mid-term results.
The incidence of residual ventricular septal defects (VSDs) after surgery is 5-25%. Redo surgery is associated with higher risks. ⋯ Transcatheter closure of postsurgical residual VSD is safe and efficacious management option and obviates the need for further surgery and by-pass.
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Catheter Cardiovasc Interv · Jan 2010
Comparative StudyLong-term outcomes of drug-eluting stents versus bare-metal stents in saphenous vein graft disease: results from the Prairie "Real World" Stent Registry.
This study was designed to compare long-term clinical outcomes of drug-eluting stents (DES) versus bare metal stents (BMS) in patients with saphenous vein graft (SVG) disease in the "real world." ⋯ Three-year adverse event rates are similar among patients treated with DES or BMS in SVG lesions. Therefore, while DES are safe, they do not appear to offer an advantage in terms of long-term graft patency.