Volume 18 - Issue 12 - December, 2006
GENOMICS AND CELLULAR THERAPY: Successful Mobilization of Peripheral Blood Stem Cells by Use of Granulocyte-Colony Stimulating F
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There is increasing evidence that the liberation of stem cells by use of granulocyte-colony stimulating factor (G-CSF) with or without their transcoronary transplantation is feasible and can improve cardiac function in humans after acute myocardial infarction (AMI).1–3 However, patients with severe hemodynamic deterioration due to extensive loss of contractile tissue after AMI have not been enrolled in stem cell programs up to now. We report on the case of a patient with acute anterior wall myocardial infarction who suffered from cardiogenic shock despite successful primary percut
COMMENTARY: Vasoconstriction and Coronary Artery Spasm after Drug-Eluting Stent Placement
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In this issue of the Journal, Brott et al1 report a series of 13 patients who developed severe, life-threatening coronary artery spasms after implantation of a drug-eluting stent. Symptoms occurred either during or immediately after the procedure or within the first 4 weeks after stent implantation. In 1 patient, vasoconstriction was present in a follow-up angiogram at 1 year. Spasms resolved in most patients after administration of vasodilators, however, 2 patients did not respond to treatment and died. Another 2 patients required placement of an intra-aortic balloon pump for cardi
Strategies for Optimizing Outcomes in the NSTE-ACS Patient: The CATH (Cardiac Catheterization and Antithrombotic Therapy in th
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Target Audience: Clinical Cardiologists, Interventional Cardiologists and Nurses.
Release Date: 12-01-06 Expiration Date: 11-30-07
Learning Objectives: Upon completion of this educational activity, participants should be able to: Educate clinicians about the latest pharmacological treatment options for ACS patients; Review proper utilization of thrombolytic and antiplatelet drugs; Discuss the risks and benefits of device treatment versus pharmacologic treatment.
Method of Participation: Read the journal supplement and complete the Post-Test and Evaluation form
Troponin-Positive Chest Pain with Unobstructed Coronary Arteries: A Role for Delayed Enhanced Cardiovascular Magnetic Resonance
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Acute coronary syndromes represent a significant health burden and convey a prognosis that is far from benign. Indeed, United Kingdom registry data reveal that 6 months following admission for a non-ST elevation myocardial infarction (NSTEMI), there is a 12.2% rate of death or non-fatal MI, and a 30% rate of death, MI, refractory angina or readmission for unstable angina.1 A number of trials have demonstrated that early revascularization has a significant beneficial impact on patients with NSTEMI,2,3,4 prompting international guidelines to recommend early angiography and
PCI with and without Abciximab after Upstream Eptifibatide Use: Outcomes in High-Risk Patients
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Several clinical trials have demonstrated that platelet glycoprotein (GP) IIb/IIIa receptor inhibition reduces the ischemic complications of percutaneous coronary interventions (PCI).1–4 Comparative data between agents, however, are very limited,5 and no large, randomized trials exist comparing the efficacy and safety of the two most commonly used agents, eptifibatide and abciximab. Based on clinical trials demonstrating a clear benefit of abciximab in high-risk patients1,2,4 and a more modest benefit of eptifibatide use in the ESPRIT trial,4 a str
Severe, Diffuse Coronary Artery Spasm after Drug-Eluting Stent Placement
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Drug-eluting stents have dramatically changed the care of patients with coronary artery disease, leading to decreased neointimal proliferation and clinical restenosis.1 However, concerns have been raised regarding hypersensitivity reactions.2 In addition, a case of localized hypersensitivity and late coronary thrombosis resulting in death has been described.3 A recently published analysis demonstrates that there is abnormal vasomotion with vasoconstriction during exercise 6 months after Cypher™ stent (Cordis Corp., Miami, Florida) placement compared to
COMMENTARY: Bugs and Clots: The Value of Transesophageal Echocardiography in Defining Permanent Pacemaker Lead Infections
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The number of patients receiving pacemaker and implantable cardioverter-defibrillator (ICD) implants is rapidly increasing. The number of permanent pacemaker implants in the United States increased from about 95,000 in 1990 to 250,000 in 2002, while the number of ICD implants increased from 10,000 in 1990 to 100,000 in 2002.1
Improvements in resolution and greater utilization of transesophageal echocardiography (TEE) in clinical practice have led to increased detection of abnormalities on implanted leads. The reported incidence of such masses is highly variable, but fortunately app
Clinical Outcomes following Percutaneous Coronary Intervention with Drug-Eluting vs. Bare-Metal Stents in Dialysis Patients
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Late mortality rates following percutaneous coronary intervention (PCI) among dialysis patients markedly exceed those in patients without end-stage renal disease,1,2 and data preceding the approval and widespread use of drug-eluting stents indicate that PCI compared with surgical revascularization is associated with higher mortality rates in these patients.3 Though drug-eluting stents have been shown to reduce the risk of restenosis in populations consisting predominantly of patients with normal or mildly impaired renal function,4–6 the safety and clinical ef
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