Publications by authors named "C S Rihal"
Background: Mitral transcatheter edge-to-edge repair (TEER) is a minimally invasive therapy for severe mitral regurgitation (MR) in patients with high surgical risk. TEER results in a tissue bridge that decreases mitral valve area, potentially leading to elevated mean gradient. The clinical impact of elevated gradient on outcomes is unclear.
View Article and Find Full Text PDFObjective: To test the feasibility and safety of genotype guidance in the selection of P2Y monotherapy within 1 week of percutaneous coronary interventions (PCIs) among patients with high bleeding risk (HBR).
Patient And Methods: The study was a single-center, open-label, pilot trial. Patients (n=100) with HBR (as defined by an academic research consortium) after successful PCI received dual antiplatelet therapy with clopidogrel and aspirin.
Background: Coronary microvascular dysfunction (CMD) is a common cause of angina with no obstructive coronary artery disease (ANOCA), and effective treatment options are limited.
Objectives: This study aims to assess the safety and efficacy of the coronary sinus (CS) Reducer (Neovasc, Inc/Shockwave Medical) for treatment of angina in patients with CMD.
Methods: This Phase II trial enrolled 30 patients with ANOCA, invasively diagnosed CMD, and Canadian Cardiovascular Society (CCS) class 3 to 4 angina despite medical therapy.
Article Synopsis
- The study investigates the significance of cardiac troponin (cTn) levels in predicting mortality in patients with Takotsubo syndrome (TTS), analyzing data from the International Takotsubo Registry.
- It identifies that a cTn increase greater than 28.8 times the upper reference limit signals clinically relevant myocardial injury, correlating with a higher risk of mortality over 5 years (adjusted HR 1.58).
- The findings enhance understanding of patient risk profiles in TTS, emphasizing the need for increased monitoring and follow-up for those with significant troponin elevations.
Article Synopsis
- CYP2C19 loss of function carriers face a higher risk of ischemic events when treated with clopidogrel during PCI.
- In the TAILOR-PCI study, patients were randomized to receive either clopidogrel or a genotype-guided therapy where LOF carriers were prescribed ticagrelor.
- Although direct medical costs were similar between the two groups, total costs were higher for the GG group mainly due to the more expensive ticagrelor medication.