Dual Antiplatelet Therapy Can Be Discontinued at Three Months after Implantation of Zotarolimus-Eluting Stent in Patients with Coronary Artery Disease

Dual antiplatelet therapy (DAPT) after percutaneous coronary intervention increases the risk of bleeding. We studied the safety and clinical outcomes of switching from DAPT to aspirin monotherapy at 3 months after ZES implantation. We retrospectively evaluated 168 consecutive patients with coronary artery disease who had been implanted with a ZES from June 2009 through March 2010. After excluding 40 patients according to exclusion criteria such as myocardial infarction, 128 patients were divided into a 3-month DAPT group (67 patients, 88 lesions) and a 12-month conventional DAPT group (61 patients, 81 lesions). Coronary angiographic followup and clinical followup were conducted at more than 8 months and at 12 months after ZES implantation, respectively. Minor and major bleeding events, stent thrombosis (ST), and major adverse cardiac events (MACE) (death, myocardial infarction, cerebrovascular accident, target lesion revascularization, and target vessel revascularization) were evaluated. There were no statistically significant differences in the incidences of ST and MACE between the two groups. The incidence of bleeding events was significantly lower in the 3-month group than in the 12-month group (1.5% versus 11.5%, ). DAPT can be safely discontinued at 3 months after ZES implantation, which reduces bleeding risk

A study of normal vectorcardiograms employing the Frank lead system : Classification by patterns of QRS loops

Vectorcardiograms obtained with the Frank lead system were recorded in 258 healthy subjects (139 men, 119 women) and were classified according to QRS loop patterns. Sex and age effects on the vectorcardiograms were studied. We classified the vectorcardiograms into 4 types according to the frontal axis of the maximum QRS vector (A≧60>B≧30>C≧10>D). Type B was frequent among young persons and the number of persons with type C increased with aging. The magnitude of the maximum QRS vector diminished with aging in both sexes. The axis deviated horizontally and posteriorly in men and horizontally in women. The magnitude of the maximum T vector was larger in men than in women. The axis was more anterior in men than in women. The axis of the 20-msec QRS vector deviated from the right anterior to the left anterior. The terminal QRS vector demonstrated no sex or age defference. The percentage of the QRS Bite increased with aging

Effects of pneumoperitoneum on the vectorcardiogram obtained with the Frank lead system

Vectorcardiograms were recorded with the Frank lead system during laparoscopy. Pneumoperitoneum produced the following significant vectorcardiographic changes: (1) The maximum spatial QRS vector increased in magnitude and shifted horizontally and slightly anteriorly. (2) The L/W ratio of the frontal QRS loop decreased. (3) The scalar data of each X, Y, Z lead of the QRS loop increased. In particular, the increases in R of all three leads and in S of lead Z were significant. These results suggest that the changes in the cardiac anatomic position due to lift of the diaphragma and a decrease of left ventricular end-diastolic volume might produce these vectorcardiographic changes during laparoscopy