Publications by authors named "Chandrasekhar J"

Background And Aims: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of acute coronary syndrome (ACS). Recent data suggest a harmful association of dual antiplatelet therapy compared with single antiplatelet therapy following SCAD. This study investigated independent predictors of major adverse cardiovascular events (MACEs) and recurrence in patients with SCAD.

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Objective This study aimed to evaluate the role of 2-Deoxy-D-Glucose (2-DG) in moderate to severe Coronavirus Disease 2019 (COVID-19) cases. Methodology This study retrospectively analyzed the effects of 2-DG alongside Standard of Care (SOC) for moderate to severe COVID-19 in 150 patients. Eligible patients were aged 18-65, with confirmed COVID-19, who met clinical criteria for moderate or severe illness.

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Background: Embolic protection devices were developed to reduce the risk of common complications encountered during percutaneous coronary intervention (PCI) of saphenous vein grafts, however, in the setting of contemporary multi-modality medical management, their overall efficacy has been called into question. This study aimed to assess the evolving utilization and clinical outcomes associated with distal filter wire embolic protection devices in saphenous vein PCI.

Methods: Consecutive patients undergoing PCI to a saphenous vein graft in a registry were included.

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Article Synopsis
  • The DAPT score helps identify PCI patients likely to benefit or be harmed by extended dual antiplatelet therapy (DAPT) beyond one year, focusing on ischemic and bleeding outcomes.
  • A study analyzed data from over 27,000 patients to assess the relationship between DAPT scores and long-term mortality, finding that a significant number scored ≥ 2 and experienced higher mortality rates.
  • Results indicated that patients with a DAPT score ≥ 2 faced greater risks of in-hospital mortality, bleeding events, and long-term mortality, suggesting the DAPT score can inform treatment duration and intensity.
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Background: The American College of Cardiology / American Heart Association (ACC/AHA) introduced a coronary lesion classification in 1988 to stratify coronary lesions for probability of procedural success and complications after coronary angioplasty. Our aim is to assess the validity of the ACC/AHA lesion classification in predicting outcomes of percutaneous coronary intervention (PCI) in a contemporary cohort of patients.

Methods: Consecutive PCI procedures performed between 2005 and 2018, were divided into three periods.

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Disparities in mental health care and access to care disproportionately affect youth from minoritized and low-income communities. School-based prevention programs have the potential to offer a non-stigmatized approach to mental health care as well as the ability to reach many students simultaneously. Advocates 4 All Youth (ALLY) is a program developed for 5-6th grade students aimed at improving self-efficacy and resilience via individualized sessions with a trusted adult (ALLYs).

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Metabolic syndrome (MetS) provides significant risk for coronary disease, however long-term prognosis after percutaneous coronary intervention (PCI) has been understudied. We assessed the prevalence and outcomes of patients with MetS from an Australian PCI cohort. We retrospectively examined data from the Melbourne Interventional Group multicenter PCI registry using a modified definition for MetS including ≥3 of the following: hypertension, diabetes mellitus, dyslipidemia, and body mass index ≥30 kg/m.

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Coronary vasospasm is a relatively well-documented cause for ischemia and myocardial infarction in patients with nonobstructive coronary artery disease. Patients with coexisting eosinophilia present with severe manifestations and are often refractory to traditional therapies. There are few reported cases in the literature.

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Background: Adolescents from historically racial and ethnic minoritized and low-income communities have higher rates of early-life and chronic difficulties with anxiety and depression compared to non-Hispanic White youth. With mental health distress exacerbated during and in the wake of the COVID-19 pandemic, there is a need for accessible, equitable evidence-based programs that promote psychological well-being, strengthen one's ability to adapt to adversity, and build self-efficacy prior to adolescence.

Methods: An evidenced-based resiliency-focused health coaching intervention was adapted using a health equity implementation framework to meet the needs of a Title I elementary school in rural Alabama (AL) that serves over 80% Black and Hispanic students.

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Women are under-represented among transcatheter aortic valve replacement (TAVR) and transcatheter mitral valve repair (TMVr) operators. This review assesses the representation of women as patients and as proceduralists and trial authors in major structural interventions. Women are under-represented as proceduralists in structural interventions: only 2% of TAVR operators and 1% of TMVr operators are women.

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Article Synopsis
  • The COMBO stent, developed by OrbusNeich Medical, combines sirolimus for reducing cell overgrowth with a special coating to attract endothelial progenitor cells for quicker healing after coronary procedures.
  • The Mega COMBO collaboration analyzed data from multiple studies involving 6,753 patients undergoing PCI with the COMBO stent, focusing on the rate of target lesion failure (TLF) and other related complications over a year.
  • Results showed a TLF rate of 4.6% and low stent thrombosis rates, indicating that the COMBO stent performs well and might be a viable option compared to other drug-eluting stents.
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Introduction: Spontaneous coronary artery dissection (SCAD) is an under-recognised cause of acute coronary syndrome (ACS) with a strong female predominance. There are currently limited prospective studies and no randomised controlled trials that inform on SCAD's best clinical care. Little is also known about predictors of acute SCAD deterioration or recurrence.

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Atropisomerism is a type of axial chirality resulting from hindered rotation about a σ bond that gives rise to nonsuperimposable stereoisomers (termed "atropisomers"). The inversion of chirality of an atropisomeric axis is a time- and temperature-dependent dynamic process occurring by simple bond rotation. For this reason, the rotational energy barrier (Δ) and the interconversion rate between an atropisomeric pair of biologically active molecules are important parameters to consider in drug discovery.

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Background: Managing percutaneous coronary intervention (PCI) patients with atrial fibrillation (AF) presents challenges given that there are several potential antithrombotic therapy (ATT) strategies.

Aims: We examined ATT patterns, agreement between subjective physician ratings and validated risk scores, physician-patient perceptions influencing ATT and 1-year outcomes.

Methods: The AVIATOR 2 prospective registry enrolled 514 non-valvular AF-PCI patients from 11 sites.

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Purpose: To examine the role of sleep in a school-based resiliency intervention.

Design: Single group feasibility study.

Setting: Urban middle school.

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Aims: The use of angiotensin-converting enzyme inhibitors (ACEi) or angiotensin II-receptor blockers (ARBs) post-myocardial infarction (MI) is supported by evidence based on trials performed in the thrombolysis era. This was prior to primary percutaneous coronary intervention (PCI) being routine practice, and with little direct evidence for the use of these medications in patients with preserved left ventricular (LV) function. This study sought to determine whether there is an association between ACEi/ARB use after PCI for acute coronary syndrome (ACS) and long-term all-cause mortality, with a particular focus on patients with preserved LV function.

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Objectives: To describe the incidence, predictors, and clinical impact of permanent pacemaker insertion (PPI) following transcatheter aortic valve replacement (TAVR) in women.

Background: Data on pacemaker insertion complicating TAVR in women are scarce.

Methods: The Women's International Transcatheter Aortic Valve implantation (WIN-TAVI) is a prospective registry evaluating the safety and efficacy of TAVR in women.

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Background: Acute kidney injury (AKI) is not uncommon in patients undergoing transcatheter aortic valve replacement (TAVR).

Objective: We examined the incidence, predictors, and outcomes of AKI from the BRAVO 3 randomized trial.

Methods: The BRAVO-3 trial included 802 patients undergoing transfemoral TAVR randomized to bivalirudin vs.

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Purpose: The COMBO biodegradable polymer sirolimus-eluting stent includes endothelial progenitor cell capture (EPC) technology for rapid endothelialization, which may offer advantage in acute coronary syndromes (ACS). We sought to analyze the performance of the COMBO stent by ACS status and ACS subtype.

Methods: The COMBO collaboration (n = 3614) is a patient-level pooled dataset from the MASCOT and REMEDEE registries.

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Article Synopsis
  • Acute kidney injury (AKI) is a significant concern for patients undergoing primary percutaneous coronary intervention (PCI) due to its impact on long-term outcomes in those suffering from STEMI.
  • This study analyzed data from the SAFARI-STEMI trial, comparing the incidence of AKI in patients who underwent PCI via radial artery (RA) versus femoral artery (FA) access.
  • The results showed no significant difference in AKI rates between the two access methods, suggesting that the choice of access site may not influence AKI occurrence in STEMI patients as previously thought.
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