NO ASSOCIATION OF PARAOXONASE-1 Q192R AND THROMBOTIC EVENTS DURING DUAL ANTI-PLATELET THERAPY IN PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION

Personalised Therapeutic

Multimodality imaging in interventional cardiology

'Multimodality' imaging-the side-by-side interpretation of data obtained from various noninvasive imaging techniques, such as echocardiography, radionuclide techniques, multidetector CT (MDCT), and MRI-allows anatomical, morphological, and functional data to be combined, increases diagnostic accuracy, and improves the efficacy of cardiovascular interventions and clinical outcomes. During the past decade, advances in software and hardware have allowed co-registration of various imaging modalities, resulting in cardiac 'hybrid' or 'fusion' imaging. In this Review, we discuss the roles of both multimodality and hybrid imaging in three broad areas of cardiology-coronary artery disease (CAD), heart failure, and valvular heart disease. In the evaluation of CAD, integration of either single-photon emission computed tomography (SPECT) or PET with CT coronary angiography provides both morphological and functional data in a single procedure. Accordingly, the functional consequences (myocardial hypoperfusion on SPECT or PET) of anatomical pathology (coronary anatomy on MDCT or MRI) can be assessed. Co-registration of PET and MRI data sets to provide cellular and molecular information on plaque composition and stability is now possible. Furthermore, novel imaging modalities have been implemented to guide electrophysiological and transcatheter-based procedures, such as cardiac resynchronization therapy (an established treatment for patients with heart failure), and transcatheter valve repair or replacement procedures.Cardiolog

The Risk of In-Hospital Bleeding and Long-Term Mortality in Patients with ST Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

Cardiolog

The Risk of In-Hospital Bleeding and Long-Term Mortality in Patients with ST Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

Cardiolog

Management of acute coronary syndrome: achievements and goals still to pursue. Novel developments in diagnosis and treatment

Acute coronary syndromes contribute a substantial part of the global disease burden. To realise a reduction in mortality and morbidity, the management of patients with these conditions involves the integration of several different approaches. Timely delivery of appropriate care is a key factor, as the beneficial effect of reperfusion is greatest when performed as soon as possible. Innovations in antithrombotic therapy have also contributed significantly to improvements in the prevention of ischaemic complications. However, with the use of such treatment an increase in the risk of bleeding is inevitable. Therefore, the greatest challenge is now to obtain an optimal balance between the prevention of ischaemic complications and the risk of bleeding. In this regard, identification of patients at highest risk of either one is essential. © 2012 The Association for the Publication of the Journal of Internal Medicine.Cardiolog

Risk and prognosis of in-hospital major bleeding after primary percutaneous coronary intervention for ST-elevation myocardial infarction

Cardiolog

In-Hospital Major Bleeding and Its Clinical Relevance in Patients With ST Elevation Myocardial Infarction Treated With Primary Percutaneous Coronary Intervention

Cardiolog

OUTCOME OF SECOND-GENERATION EVEROLIMUS- AND ZOTAROLIMUS-ELUTING STENTS IN ST-ELEVATION MYOCARDIAL INFARCTION

Cardiolog

Prognosis of complete versus incomplete revascularisation of patients with STEMI with multivessel coronary artery disease: an observational study

Contains fulltext : 182898.pdf (publisher's version ) (Open Access)OBJECTIVE: The best strategy in patients with acute ST-segment elevation myocardial infarction (STEMI) with multivessel coronary artery disease (CAD) regarding completeness of revascularisation of the non-culprit lesion(s) is still unclear. To establish which strategy should be followed, survival rates over a longer period should be evaluated. The aim of this study was to investigate whether complete revascularisation, compared with incomplete revascularisation, is associated with reduced short-term and long-term all-cause mortality in patients with first STEMI and multivessel CAD. METHODS: This retrospective study consisted of 518 patients with first STEMI with multivessel CAD. Complete revascularisation (45%) was defined as the treatment of any significant coronary artery stenosis (>/=70% luminal narrowing) during primary or staged percutaneous coronary intervention prior to discharge. The primary end point was all-cause mortality. RESULTS: Incomplete revascularisation was not independently associated with 30-day all-cause mortality in patients with acute first STEMI and multivessel CAD (OR 1.98; 95% CI 0.62to6.37; p=0.25). During a median long-term follow-up of 6.7 years, patients with STEMI with multivessel CAD and incomplete revascularisation showed higher mortality rates compared with patients who received complete revascularisation (24% vs 12%, p<0.001), and these differences remained after excluding the first 30 days. However, in multivariate analysis, incomplete revascularisation was not independently associated with increased all-cause mortality during long-term follow-up in the group of patients with STEMI who survived the first 30 days post-STEMI (HR 1.53 95% CI 0.89-2.61, p=0.12). CONCLUSION: In patients with acute first STEMI and multivessel CAD, incomplete revascularisation compared with complete revascularisation was not independently associated with increased short-term and long-term all-cause mortality