Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (PART I)
Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (PART I) Acute Coronary Syndromes: Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (PART I) - David E. Kandzari, MD and Matthew T. Roe, MD, MHS Overview. Role of GP IIb/IIIa in acute coronary syndromes. GP...
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Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (Part II)
Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (Part II) Acute Coronary Syndromes: Integrating GP IIb/IIIa Inhibition into Treatment Strategies for Acute ST-Elevation Myocardial Infarction (Part II) - David E. Kandzari, MD and Matthew T. Roe, MD, MHS ? With the aim of reducing hemorrhagic complications, more recent studies have evaluated the safety and...
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Present and Potential Future Paradigms for the Treatment of ST-Segment Elevation Acute Myocardial Infarction (Part I)
Present and Potential Future Paradigms for the Treatment of ST-Segment Elevation Acute Myocardial Infarction (Part I) Feature: Present and Potential Future Paradigms for the Treatment of ST-Segment Elevation Acute Myocardial Infarction (Part I) - Derek P. Chew, MBBS, David J. Moliterno, MD, *Howard C. Herrmann, MD Among patients with acute myocardial infarction (AMI), the efficacy of treatments that decrease mortality by coronary reperfusion and control of arrhythmia is dependent on time and ...
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Rheolytic Thrombectomy in Patients with ST-elevation Myocardial Infarction and Large Thrombus Burden: The Thoraxcenter Experience
ABSTRACT: Objectives determine the impact of Rheolytic? thrombectomy (RT) on the clinical and angiographic outcome of patients with ST-elevation myocardial infarction (STEMI) and large thrombus burden (LTB). Methods. Two hundred sixty-six consecutive patients who presented from April 2002 until December 2004 with STEMI and LTB were retrospectively analyzed. LTB was defined as definite presence of thrombus with the greatest dimension ≥ 2 vessel diameters by visual assessment. RT, as well as the interventional procedure and the peri-procedural pharmacological therapy, was at the discretion of the operator. All patients were followed for major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction (MI) and infarct-related artery revascularization. Pre- and post-procedural thrombolysis in myocardial infarction (TIMI) flow and thrombus burden as well as myocardial blush, distal embolization and no reflow were also determined. Results. Complete follow-up was available in all patients; mean duration was 17 ± 8.7 months. RT was used in 75 patients (28.2%). Stents were implanted in 251 (94.4%) patients; drug-eluting stents in 210 (84.6%) patients (15.5% sirolimus- eluting stents and 69.1% paclitaxel-eluting stents). The 2-year cumulative survival and MACE-free survival were higher in the RT compared to the non-RT group (92% vs. 82.7%, p = 0.051 and 87.7% vs. 69.9%, p = 0.004, respectively). Post-procedure indices (TIMI 3 flow, absence of thrombus and myocardial blush grade 3) of angiographic outcome were significantly better in the RT group. RT was an independent predictor of MACE (HR: 0.45, 95% CI: 0.22?0.93, p = 0.03). Conclusions. RT significantly improves the clinical and angiographic outcome of patients with STEMI and large thrombus burden.
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High Incidence of Focal Left Ventricular Wall Motion Abnormalities and Normal Coronary Arteries in Patients with Myocardial Infarctions Presenting to a Community Hospital
ABSTRACT: Background. Myocardial infarction with normal coronary arteries (MINCA) is a well-documented syndrome often associated with global left ventricular wall motion abnormalities (LVWMAs). Recent literature has emphasized the occurrence of Takotsubo cardiomyopathy associated with MINCA. What has not been reported is the incidence of MINCA in the general population and the relative frequency of other types of associated LVWMAs. Methods and Results. Data were retrospectively collected on 165 consecutive patients with ST-elevation myocardial infarction (STEMI) and 244 patients with non-ST-elevation myocardial infarction (NSTEMI) who underwent cardiac catheterization at a single institution in Marin County, California. Thirty-two of the 409 (7.8%) patients had MINCA. Of the patients presenting with STEMI, 10.3% had MINCA, and 6.1% of the patients presenting with NSTEMI had MINCA. Females were more likely to present with MINCA than males, both for STEMI (21.6% vs. 5.3%; p < 0.001) and NSTEMI (12.1% vs. 2.6%; p < 0.001). Of the 32 patients who presented with MINCA, 7 (21.9%) females had Takotsubo cardiomyopathy, while 10 (31.3%) patients (9 females, 1 male) had other previously undescribed focal anterior and inferior LVWMAs. A recent stressful event was noted in 50% (47.8% of females, 55.6% of males) of the patients with MINCA. Conclusions. An unexpectedly high incidence of MINCA with newly-described focal anterior and inferior LVWMAs as well as Takotsubo cardiomyopathy was observed in our community hospital. This syndrome occurred predominantly in females and was often associated with a recent stressful event. As these results were from a community, rather than a referral hospital, this finding challenges the current thought about the incidence of this syndrome in the general population.
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Reducing Myocardial Free Wall Rupture Following Acute ST-Segment Elevation Myocardial Infarction: A Case for Primary Angioplasty
Reducing Myocardial Free Wall Rupture Following Acute ST-Segment Elevation Myocardial Infarction: A Case for Primary Angioplasty Commentary: Reducing Myocardial Free Wall Rupture Following Acute ST-Segment Elevation Myocardial Infarction: A Case for Primary Angioplasty - Nicolas W. Shammas, MS, MD, FACC, FSCAI Myocardial free wall rupture (FWR) continues to be a dreadful complication of acute ST-segment elevation myocardial infarction (STEMI) ...
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Myocardial Infarction and the Culprit Plaque: Myths, Data and Statistics
Myocardial Infarction and the Culprit Plaque: Myths, Data and Statistics Acute Coronary Syndromes: Myocardial Infarction and the Culprit Plaque: Myths, Data and Statistics - Rajesh Mohan, MD and Warren Laskey, MD Identification of the coronary endoluminal lesion(s) responsible for the process now called acute coronary syndrome (ACS) has become a central focus of both non-invasive and invasive treatment modalities in patients with coronary heart disease. Mode of death, frequency of healed and...
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Predictors of Survival After Contemporary Percutaneous Coronary Revascularization for Acute Myocardial Infarction in the Real World
Management strategies for ST-elevation myocardial infarction (STEMI) have undergone great evolution over the past decade. The objectives of this study were to evaluate the in-hospital and long-term clinical outcomes, as well as predictors of survival, among patients who received the most contemporary percutaneous coronary revascularization strategies for STEMI in real clinical practice. During the period from October 1, 2000 to April 30, 2002, 316 patients have undergone primary percutaneous coronary intervention (PCI) in a tertiary University hospital, the in-hospital (11.1%), 30-day (13.9%) and long-term (21.8%) mortality rates were higher than that reported in randomized studies. This is likely to be due to the higher prevalence of adverse clinical profiles. Multivariable analysis show that age >65, cardiogenic shock, resuscitated cardiac arrest and intubation independently predicted in-hospital and long-term mortality, whilst multi-vessel disease predicted major adverse cardiac event (MACE). Among patients with cardiogenic shock, similar mortality was observed in patients with anterior myocardial infarction (MI) or inferior MI with/without right ventricle involvement.
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The GUSTO-V Clinical Trial
In patients receiving combination therapy with abciximab and reduced-dose reteplase, the TIMI 3 flow rate was 47% at 60 minutes. ASSENT-3. The ASSENT-3 trial recently examined full-dose tenecteplase and enoxaparin (a low-molecular-weight heparin) compared with half-dose tenecteplase and standard-dose abciximab with weight-adjusted, low-dose heparin or full-dose tenecteplase in combination with weight-adjusted heparin in 6,095 patients with ST-segment elevation AMI. These findings suggest ...
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Long-Term Cardiac Function and Outcome in Patients Receiving Primary Angioplasty for Acute Myocardial Infarction at a Community Hospital Without On-Site Surgical Back-Up
Background. Short- and long-term comparative follow-up studies of patients receiving primary angioplasty or thrombolytic therapy for acute myocardial infarction show higher 30-day survival, and sustained benefits in mortality, reinfarction and ejection fraction in patients treated with primary angioplasty. Long-term benefits of primary angioplasty on cardiac function performed in community hospitals without surgical back-up have not been fully assessed. Methods. Sixty-one patients who underwent primary angioplasty were compared with patients receiving thrombolytic therapy who were matched for age, gender and location of acute myocardial infarction. Clinical information, reviewed through August 2000, was provided by retrospective analysis of healthcare databases and office and hospital charts. Mortality data were confirmed by the social security death index. Results. Of the original 61 primary angioplasty patients, two died during initial hospitalization. Of the 59 surviving patients, fifty-four (92%) had complete follow-up averaging 57 months. Of the original 61 thrombolytic therapy patients, three died during initial hospitalization. Of the 58 surviving patients, fifty-two (90%) had complete follow-up averaging 46 months. At follow-up, averaging 57 months, ejection fraction was significantly higher in the primary angioplasty group, as compared with the thrombolytic therapy group (51.4% versus 45.8%, respectively; p = 0.038). There was no statistical difference between the two groups regarding reinfarction, revascularization at >= 6 months after the initial presentation or cardiac death. Conclusions. Primary angioplasty performed in a community hospital without surgical back-up results in improved cardiac function when compared to thrombolytic therapy. These results are similar to those reported from large tertiary centers with on-site surgical back-up, and provide an explanation for the improved long-term outcome that is observed in patients with acute myocardial infarction treated with primary angiopla
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 Electrophysiologic Perspective on the BIPOLAR RF EPICARDIAL ABLATION Procedure for Atrial Fibrillation
Complimentary Accredited Breakfast Symposium
Click Here for More Info.
Location: The St. Regis San Francisco
125 3rd Street
San Francisco, CA 94103
3rd and Mission Streets
Gallery Ballroom, 2nd floor
This activity is supported by an educational grant from AtriCure, Inc.
This program is not part of the Heart Rhythm 2008 Official Scientific Sessions as planned by the Heart Rhythm Society Scientific Sessions Committee. This event is neither sponsored nor endorsed by the Heart Rhythm Society.
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 Newest Perspectives on Drug-Eluting Stents
Complimentary CME Accredited Dinner Meetings Click Here for More Info.
Miami, FL - Date: Friday, April 4, 2008 6:00pm EST -8:00 pm EST
Birmingham, AL - Date: Friday, May 9, 2008 6:00pm EST -8:00 pm EST
This activity is supported by an educational grant from Abbott Vascular.
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 CLINICAL EXPERIENCE WITH A NEW HYBRID CORONARY WIRE
On Demand Web Archive
Non-Accredited
This activity is supported by an educational grant from Terumo Medical Corporation.
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 Pharmacoinvasive Management of Acute Coronary Syndrome: Incorporating the 2007 ACC/AHA Guidelines
Complimentary Accredited CME Program
This activity is supported by an educational grant from Sanofi-Aventis.
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 Varicose Veins: Causes, Symptoms, Diagnosis and Treatment of Chronic Venous Insufficiency
A Complimentary Accredited ON-DEMAND Webcast
This activity is supported by an educational grant from Diomed, Inc.
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 Create a Successful Vena Cava Filter Practice
Accredited CD
This activity is supported by an educational grant from Cook Incorporated and has been designed for Interventional Cardiologists, Vascular Surgeons, Fellows and Interventional Cardiovascular Nurses and Technologists.
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Webcast and Web Archives |
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 Achieving Optimal Outcomes in Carotid Stenting: Lessons Learned from Recent Clinical Trials
Complimentary Accredited ON DEMAND Webcast
Topics
1. EVA-3S & Space-Bumps in the road
2. CAPTURE 3500-Lesion morphology & Predictors for Stroke
3. CAPTURE II vs. EXACT 1500-Does open or Closed Cell Stent design really matter?
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Neurologists, Interventional Nurses and Technologists with an interest in the diagnosis and treatment of peripheral artery disease. |
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 Anticoagulation Techniques for Peripheral Vascular Interventions
Complimentary Accredited ON DEMAND Webcast
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Podiatric Physicians, Endovascular Allied Professionals, Endocrinologists, Wound Care Specialists, Directors of the Wound Care Clinic, and Primary Care Physicians, Pharmacists, Nurses and Technologists.
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 New Treatment Strategies for the Endovascular Approach to Critical Limb Ischemia: ADVANCEMENTS IN LIMB SALVAGE MEDICINE
Complimentary Accredited ON DEMAND Webcast
This activity has been developed for Interventional Cardiologists, Vascular Surgeons, Interventional Radiologists, Podiatric Physicians, Endovascular Allied Professionals, Endocrinologists, Wound Care Specialists, Directors of the Wound Care Clinic, and Primary Care Physicians, Pharmacists, Nurses and Technologists.
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 Reducing the Incidence of CIN during Cardiac Catheterization and PCI
Complimentary Accredited ON DEMAND
Educational Web Archive
This activity has been developed for nurses and technologists. |
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March 2007 Supplement
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On-Demand Webcast
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Archived Webcast
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Release Date: December 8, 2006