Invasive Treatment Strategy for Older Patients with Myocardial Infarction.

Background: Whether a conservative strategy of medical therapy alone or a strategy of medical therapy plus invasive treatment is more beneficial in older adults with non-ST-segment elevation myocardial infarction (NSTEMI) remains unclear.

Methods: We conducted a prospective, multicenter, randomized trial involving patients 75 years of age or older with NSTEMI at 48 sites in the United Kingdom. The patients were assigned in a 1:1 ratio to a conservative strategy of the best available medical therapy or an invasive strategy of coronary angiography and revascularization plus the best available medical therapy.

Clinical Presentations and Outcomes of Coronavirus Disease 2019 in Patients With Solid Tumors.

Background Coronavirus disease 2019 (COVID-19) is a global health crisis. The literature suggests that cancer patients are more prone to be affected by COVID-19 because cancer suppresses the immune system and such patients usually present poor results. The objective of this study is to present all clinical, laboratory, and demographic characteristics of COVID-19 patients with solid tumors.

Scoliosis and Gastroesophageal Reflux Disease in Adults.

Introduction Degenerative scoliosis most commonly presents with lower back pain. Literature suggests that adults who have degenerative scoliosis are at greater risk of both hiatal hernia and gastroesophageal reflux disease (GERD). The objective of this study was to evaluate scoliosis as being the risk factor of GERD in adults.

Corrigendum to "Gender and Ethnicity Based Differences in Clinical and Laboratory Features of Myasthenia Gravis".

[This corrects the article DOI: 10.1155/2015/197893.].

Short and long terms clinical outcomes of Paclitaxel drug-eluting balloons applied for de-novo coronary artery lesions in the context of acute coronary syndrome: A real world experience.

A single-centre retrospective observational study aimed at observing the outcomes of using DEB in ACS patients. All-comer ninety patients were included with a follow-up of 12-36 months. DEBs were deployed successfully yielding TIMI 3 without significant coronary dissection.

Real-world performance and accuracy of stress echocardiography: the EVAREST observational multi-centre study.

Aims: Stress echocardiography is widely used to identify obstructive coronary artery disease (CAD). High accuracy is reported in expert hands but is dependent on operator training and image quality. The EVAREST study provides UK-wide data to evaluate real-world performance and accuracy of stress echocardiography.

Acute coronary syndrome: which age group tends to delay call for help?

Background: Early diagnosis and treatment of ACS can reduce the risk of complications and death. Delay calling for help can increase morbidity and mortality. It is unclear which age group among patients with acute coronary syndrome tend to delay their call for help.

Cobalt-related cardiomyopathy: A real concern! A review of published evidence.

Background: Cobalt (Co) toxicity-related cardiomyopathy (CMP) in hip arthroplasty has recently been reported in the literature. The purpose of this review was to identify and assess available published evidence of CMP in hip arthroplasty patients and to derive recommendations for management.

Methods: We evaluated 23 cases reported till October 2018 and stratified into three categories, based on pre-existing risk factors for CMP, histological confirmation and evidence of systemic signs of Co toxicity.

Cobalt cardiomyopathy in hip arthroplasty.

Background: Cobalt toxicity-related cardiomyopathy in hip arthroplasty has recently been reported in the literature. The purpose of this review is to identify and assess available published evidence of cardiomyopathy in hip arthroplasty patients and to derive recommendations for management.

Methods: We evaluated 23 cases reported until October 2018 and stratified them into 3 categories, based upon pre-existing risk factors for cardiomyopathy, histological confirmation, and evidence of systemic signs of cobalt toxicity.

A retrospective cohort study of the association between smoking and mortality after acute ST-segment elevation myocardial infarction.

Background: Several studies have shown a 'smoker's paradox', where following an acute myocardial infarction, smokers have a paradoxically lower mortality than non-smokers. To date, no large study has investigated this paradox in unselected patients with acute ST-segment elevation myocardial infarction (STEMI) managed by primary percutaneous coronary intervention (PCI) alone.

Objectives: We aimed to examine the association of smoking status and 1-year mortality in patients who had STEMI managed by primary PCI.

Pronounced increase in risk of acute ST-segment elevation myocardial infarction in younger smokers.

Objectives: Previous studies have shown that smokers presented with ST-segment elevation myocardial infarction (STEMI) a decade earlier than non-smokers. However, no account has been made for population smoking trends, an important deficit addressed by this study.

Methods: The combination of admission data on patients with acute STEMI undergoing percutaneous coronary intervention and demographic data supplied by the Office for National Statistics for the South Yorkshire population between 2009-2012 were analysed to generate incidence rates and rate ratios (RR) to quantify the relative risk of STEMI from smoking, overall and by age group.

Association of endothelial dysfunction and no-reflow during primary percutaneous coronary intervention for ST-elevation myocardial infarction.

Background: Coronary no-reflow during primary percutaneous coronary intervention (PPCI) is a predictor of poorer cardiovascular outcome. Both endothelial dysfunction and no-reflow involves abnormal vascular function and hemostasis. Our aim was to assess the association between endothelial dysfunction and no reflow during primary PCI.

Impact of frailty on outcomes after percutaneous coronary intervention: a prospective cohort study.

Background: Average life expectancy is rising, resulting in increasing numbers of elderly, frail individuals presenting with coronary artery disease and requiring percutaneous coronary intervention (PCI). PCI can be of value for this population, but little is known about the balance of benefit versus risk, particularly in the frail.

Objective: To determine the relationship between frailty and clinical outcomes in patients undergoing PCI.

A retrospective cross-sectional study on the association between tobacco smoking and incidence of ST-segment elevation myocardial infarction and cardiovascular risk factors.

Background: Cigarette smoking is a well-established risk factor for the development of coronary heart disease. However, the relationship between smoking and acute ST-segment elevation myocardial infarction (STEMI) is less well described.

Objective: To determine the relative risk of acute STEMI in smokers and ex-smokers, compared with individuals who had never smoked.

Short-term outcomes in patients with acute coronary syndrome treated with direct bioresorbable scaffold deployment.

Background: Direct coronary stenting is a validated therapeutic option for coronary lesions. We studied the feasibility of direct deployment with a bioresorbable vascular scaffold (BVS) in acute coronary syndrome (ACS).

Methods: Demographic, procedural, and survival data were obtained for patients who had direct scaffold deployment with BVS from 1 May 2013 to 1 April 2014.

Multimodality imaging for assessment of coronary embolus.

Caseous mitral annulus calcification involving aortomitral curtain is a rare occurrence. We report a case of a 64-year-old woman with end-stage renal failure and a candidate for renal transplant who presented with late ST-elevation myocardial infarction. Intracoronary imaging, computed tomography cardiac imaging, and histopathology confirmed coronary embolus into the left main stem artery from an extensive caseous mitral annulus calcification.

Role of frailty assessment in patients undergoing cardiac interventions.

Average life expectancy is increasing in the western world resulting in a growing number of frail individuals with coronary heart disease, often associated with comorbidities. Decisions to proceed to invasive interventions in elderly frail patients is challenging because they may gain benefit, but are also at risk of procedure-related complications. Current risk scores designed to predict mortality in cardiac procedures are mainly based on clinical and angiographic factors, with limitations in the elderly because they are mainly derived from a middle-aged population, do not account for frailty and do not predict the impact of the procedure on quality of life which often matters more to elderly patients than mortality.