occurence of left main occlusion on tuesday chronobiology of acute myocardial infarction due to left main disease

Abstract Objectives The existence of a "weekend effect" for onset of acute myocardial infarction has been suggested in the past, but the relation with the culprit vessel has not been investigated. Myocardial infarction due to left main coronary artery lesion represents a particularly serious life-threatening condition. Our study was aimed to assess the chronobiology of admission to the emergency department for acute myocardial infarction considered to be induced by a left main culprit lesion. Methods We retrospectively reviewed patients who experienced an acute myocardial infarction due to a left main culprit lesion between the 1st January 2008 and the 1st January 2018 stratifying them according the day of admission, on the basis on the time of symptom onset; 30-day cardiovascular mortality was also analysed on the basis of the time of symptom onset. Results Out of 1789 patients with acute myocardial infarction, 130 patients (7.2%, 104 males and 26 females, mean age 74.5±8.1 years), had left main disease as the culprit lesion. Tuesday was significantly over-represented as the admission day (p Conclusion The relation between acute myocardial infarction onset and the day of the week is confirmed by our study, which also suggests that in case of a left main lesion some delay of the week-end effect might be expected

Acute Pulmonary Embolism and Paradoxical Embolism in Patients with Patent Foramen Ovale: to Close or Not to Close…That is the Question!

Nowadays, the treatment of patent foramen ovale (PFO) after acute pulmonary embolism (PE) remains matter of speculation. Absence of both randomized trials and recommendations in current international guidelines complicate the decisions making in such patients. In the present manuscript we discuss about the reasons for which PFO should be closed after acute PE.</p

Acute Pulmonary Embolism and Paradoxical Embolism in Patients with Patent Foramen Ovale: to Close or Not to Close…That is the Question!

Nowadays, the treatment of patent foramen ovale (PFO) after acute pulmonary embolism (PE) remains matter of speculation. Absence of both randomized trials and recommendations in current international guidelines complicate the decisions making in such patients. In the present manuscript we discuss about the reasons for which PFO should be closed after acute PE

The short-term supplementation of monacolin K improves the lipid and metabolic patterns of hypertensive and hypercholesterolemic subjects at low cardiovascular risk

A nutraceutical compound containing 10 mg of MK appeared to be safe, well tolerated and effective at improving lipid and glucose patterns

Congenital coronary artery anomalies silent until geriatric age: non-invasive assessment, angiography tips, and treatment

Coronary artery anomalies (CAAs) may be discovered more often as incidental findings during the normal diagnostic process for other cardiac diseases or less frequently on the basis of manifestations of myocardial ischemia. The cardiovascular professional may be involved in their angiographic diagnosis, functional assessment and eventual endovascular treatment. A complete angiographic definition is mandatory in order to understand the functional effects and plan any intervention in CAAs: computed tomography and magnetic resonance imaging are useful non-invasive tools to detect three-dimensional morphology of the anomalies and its relationships with contiguous cardiac structures, whereas coronary arteriography remains the gold standard for a definitive anatomic picture. A practical idea of the possible functional significance is mandatory for deciding how to manage CAAs: non-invasive stress tests and in particular the invasive pharmacological stress tests with or without intravascular ultrasound monitoring can assess correctly the functional significance of the most CAAs. Finally, the knowledge of the particular endovascular techniques and material is of paramount importance for achieving technical and clinical success. CAAs represent a complex issue, which rarely involve the cardiovascular professional at different levels. A timely practical knowledge of the main issues regarding CAAs is important in the management of such entities

Edge-to-Edge Technique to Minimize Ovelapping of Multiple Bioresorbable Scaffolds Plus Drug Eluting Stents in Revascularization of Long Diffuse Left Anterior Descending Coronary Artery Disease

Background: Implantation of Drug Eluting Stents (DES) plus bioresorbable scaffolds (BVS) in very long diffuse left anterior descending coronary artery (LAD) disease may be problematic because of multiple devices overlapping. We sought to assess the short and mid-tern outcomes of combined implantation of DES and BVS using a novel "edge-to-edge" technique in patients with diffuse LAD disease. Methods: Patients with long diffuse LAD disease were enrolled in a prospective registry from 1st August 2014 to 1st August 2015 and treated with IVUS-aided percutaneous coronary intervention using a DES plus a single or multiple BVS using a novel "edge-to-edge" technique. Clinical follow up and invasive follow up driven by clinical justification was performed. Results: Twenty-three patients (5 females, mean age 59.1 +/- 9.1 years) were enrolled. Mean length of LAD disease was 73.1 +/- 20.6 mm. Mean number of DES and BVS implanted was 1.2 +/- 0.4 and 1.7 +/- 1.3, respectively. At a mean follow-up of 11.3 +/- 3.8 months, no stent thrombosis or MACE were observed. Angiographic and IVUS follow-up at a mean of 6.6 +/- 0.7 months showed no significant angiographic restenosis and no appreciable stent gaps. Conclusions: In revascularization of long diffuse disease of the LAD, the edge-to-edge implantation technique appears to be feasible resulting in no restenosis or thrombosis on the short-term follow-up