Publications by authors named "Anil Ranchord"
Objectives: We aimed to assess the effectiveness of the sheathless Eaucath guiding catheter (SEGC) in overcoming severe spasm.
Background: Radial spasm is a frequent challenge in transradial access (TRA) and can be difficult to manage.
Methods: We performed a prospective observational study of 1000 consecutive patients undergoing coronary angiography with or without percutaneous coronary intervention.
Objective: To determine the association between high flow supplementary oxygen and 30 day mortality in patients presenting with a suspected acute coronary syndrome (ACS).
Design: Pragmatic, cluster randomised, crossover trial.
Setting: Four geographical regions in New Zealand.
Background: Patients with acute coronary syndromes (ACS) and a history of atrial fibrillation (AF) have indications for both dual antiplatelet therapy (DAPT) and oral anticoagulation (OAC). Triple therapy (TT), the combination of DAPT and OAC, is recommended in guidelines. We examined studies comparing clinical outcomes on DAPT versus TT for patients with AF and ACS.
View Article and Find Full Text PDFIntroduction: Although β-blockers reduce mortality after acute myocardial infarction (AMI), early reports linking β-blocker use with subsequent depression have potentially limited their use in vulnerable patients. We sought to provide empirical evidence to support or refute this concern by examining the association between β-blocker initiation and change in depressive symptoms in AMI patients.
Methods: Using data from 2 US multicenter, prospective registries of AMI patients, we examined 1-, 6-, and 12-month changes in depressive symptoms after the index hospitalization among patients who were β-blocker-naïve on admission.
Background: The optimal approach to oxygen therapy in ST-elevation myocardial infarction (STEMI) is uncertain.
Methods: A randomized controlled trial was undertaken in which 136 patients presenting with their first STEMI uncomplicated by cardiogenic shock or marked hypoxia were randomized to receive high-concentration (6 L/min via medium concentration mask) or titrated oxygen (to achieve oxygen saturation 93%-96%) for 6 hours after presentation. The main outcome variables were 30-day mortality and infarct size assessed by troponin T level at 72 hours.
Background: International guidelines recommend the use of oxygen for angina, based on Level C evidence. We aimed to determine whether high concentration oxygen influences the time to exercise-induced ischaemia or angina in patients with stable ischaemic heart disease (IHD).
Methods: 22 subjects with IHD and a positive exercise treadmill test (ETT) awaiting coronary angiography were randomised to two further ETTs according to a double-blind, crossover study design, during which they breathed oxygen or air at 15 L/min via a non-rebreather mask.
Background: Same-day discharge after elective percutaneous coronary intervention (PCI) is safe in the majority of patients. However, the elderly have more comorbidities and less favorable coronary and peripheral arterial anatomy, which may preclude safe same-day discharge after PCI. We assessed the feasibility and safety of same-day discharge in an elderly cohort of patients.
View Article and Find Full Text PDFIntroduction: The Kapiti Coast region is remote from Wellington Hospital with an ambulance transport time of 1 hour. To reduce delays in the treatment of myocardial infarction (MI), a prehospital thrombolysis (PHT) programme was initiated in 2003.
Methods: This study evaluated outcomes of the Kapiti PHT programme between 2003 and 2007.
Background: International guidelines recommend the routine use of oxygen in the initial treatment of myocardial infarction, yet it is uncertain what effect this might have on physiologic and clinical outcomes.
Methods: We undertook a systematic search of Medline, Cochrane Database of Systematic Reviews, EMBASE, and CINHAL using the key words "oxygen," "coronary blood flow," "hyperoxia," and "coronary circulation" to identify human studies involving a measure of coronary blood flow while breathing oxygen and room air. The primary outcome measure was coronary blood flow; secondary outcomes included coronary vascular resistance and myocardial oxygen consumption.
Objective: To determine the opinion of New Zealand doctors and nurses on the possible training needs of international medical graduates (IMGS) in New Zealand hospitals.
Design: A postal questionnaire sent to hospital doctors and nurses.
Methods: All doctors working at Wellington, Kenepuru, and Hutt Hospitals in the greater Wellington region, and nurses working in acute medical wards at the same hospitals, were asked to complete a questionnaire based on the Northern Clinical Training Network and Capital Coast District Health Board resident medical officer assessment forms regarding an overseas-trained doctor they had worked with in the last year.