A secondary prevention lipid clinic reaches low-density lipoprotein cholesterol goals more often than usual cardiology care with coronary heart disease.

Objective: The objective of this study was to determine whether enrollment in a multidisciplinary secondary prevention lipid clinic (SPLC) for 3 or more years was associated with improved adherence to lipid guidelines as compared with usual care provided by cardiologists.

Methods: Patients with documented coronary artery disease (CAD), enrolled in a SPLC, and followed for at least 3 years were identified by the use of a computer database. The comparison group included patients with CAD who received usual care from a cardiologist during the same time period.

Myocardial infarction as a presentation of clinical in-stent restenosis.

Background: In-stent restenosis is considered to be a gradual and progressive condition and there is scant data on myocardial infarction (MI) as a clinical presentation.

Methods And Results: Of 2,462 consecutive patients who underwent percutaneous coronary intervention between June 2001 and December 2002, clinical in-stent restenosis occurred in 212 (8.6%), who were classified into 3 groups: ST elevation MI (STEMI), non-ST elevation MI (NSTEMI) and non-MI.

Submassive pulmonary embolism and paradoxical embolic stroke treated with percutaneous rheolytic thrombectomy and closure of the patent foramen ovale.

The presence of patent foramen ovale (PFO) in patients with large pulmonary emboli (PE) is associated with an increased risk of stroke and mortality. Many patients are ineligible to receive thrombolytic therapy. We present a patient with bilateral PE and cryptogenic stroke who was treated effectively with rheolytic thrombectomy with AngioJet, PFO closure with CardioSeal device, and placement of an inferior vena cava filter.

Thrombus-in-transit and paradoxical embolism.

Paradoxical embolism is an uncommon but clinically important phenomenon. Elements of diagnosis include the presence of: (1) a venous thrombus, (2) an arterial embolus, (3) a communication between the right and left heart, and (4) a thrombus traversing such a communication. Unfortunately, all of these elements can be rarely demonstrated in each case but the probability should be considered in any patient with 2 or more present.

Cardiac manifestations of the antiphospholipid antibody syndrome: a review.

The antiphospholipid antibody syndrome (APLAS), though an uncommon entity involves multiple organs in the body. The antiphospholipid antibodies (APLA) refer to several groups of autoantibodies against negatively charged phospholipids occurring independently or in association with systemic lupus erythematosus (SLE) and related autoimmune disorders. Several studies to date found those patients with APLA, predominantly IgG and to lesser extent IgM isotype and lupus anticoagulant (LAC) are associated with arterial and venous thrombosis, recurrent fetal loss, thrombocytopenia, and livedo reticularis.