The long-term outcomes of transcoronary ablation of septal hypertrophy compared to surgical myectomy in patients with symptomatic hypertrophic obstructive cardiomyopathy.

Objectives: The aim of this study was to compare the long-term outcomes of transcoronary ablation of septal hypertrophy (TASH) with open surgical myomectomy (SM) in patients with symptomatic hypertrophic obstructive cardiomyopathy (HOCM).

Methods: We reviewed patients who underwent either procedure at our institution. The demographics, clinical outcomes, echocardiographic parameters, and complications were compared.

Cardiac troponin may be released by ischemia alone, without necrosis.

Whilst it is formally stated that cardiac troponin is only released when cardiac myocytes undergo necrosis, there are a number of clinical situations where troponin is present in the circulation, without any apparent cardiac injury. In these cases, troponin half-life in the circulation is usually substantially shorter than that seen when troponin is released following myocardial infarction with frank necrosis. A mechanism has been described in liver, where large cytoplasmic molecules can pass from the intra- to extra-cellular space without cellular necrosis occurring.

Differences in treatment and management of indigenous and non-indigenous patients presenting with chest pain: results of the Heart Protection Partnership (HPP) study.

Background: Indigenous patients with acute coronary syndromes represent a high-risk group. There are however few contemporary datasets addressing differences in the presentation and management of Indigenous and non-Indigenous patients with chest pain.

Methods: The Heart Protection Project, is a multicentre retrospective audit of consecutive medical records from patients presenting with chest pain.

Percutaneous balloon mitral commissurotomy in indigenous versus non-indigenous Australians.

Background: Rheumatic heart disease remains a serious health issue amongst the Australian indigenous population. Percutaneous balloon mitral commissurotomy (PBMC) has become the treatment of choice in patients with symptomatic pure mitral stenosis with favourable valve morphology. There is little published data on the efficacy of PBMC in indigenous Australians.

Comparison of abciximab with "high-dose" tirofiban in patients undergoing percutaneous coronary intervention.

Background: The TARGET study has been criticised for sub-optimal platelet inhibition with tirofiban. We aimed to compare a high-dose bolus regimen of tirofiban (hd-tirofiban) to standard dose of abciximab for patients undergoing percutaneous coronary intervention (PCI).

Methods: We assessed consecutive patients who received either hd-tirofiban (25 mcg/kg bolus followed by 0.

Point-of-care testing shows clinically relevant variation in the degree of inhibition of platelets by standard-dose abciximab therapy during percutaneous coronary intervention.

Administration of GP IIb/IIIa inhibitors during percutaneous coronary intervention (PCI) has proven clinical benefit, but is administered at a dose allowing for the patients' weight but not other variables. This study of 75 patients evaluated platelet inhibition achieved by standard-dose abciximab therapy during PCI as measured by two point-of-care (POC) instruments, Plateletworks (PW) and whole blood aggregation (WB). Results were related to the decrease of platelet activation produced as well as patients' return of angina within 30 days.

Coronary stenting for a muscular bridge in a patient with hypertrophic obstructive cardiomyopathy.

A young woman with hypertrophic cardiomyopathy presented with intractable chest pain due to a myocardial bridge over the left anterior descending artery, producing severe compression during systole. Percutaneous intracoronary stenting was performed. The patient, however, developed severe and diffuse restenosis within 30 days of the procedure.

Perceived stress as a predictor of the self-reported new diagnosis of symptomatic CHD in older women.

This article describes one aspect of a prospective cohort study of 10,432 women aged between 70 and 75 years. After a 3-year period, 503 women self-reported a new diagnosis by a doctor of angina or myocardial infarction (symptomatic coronary heart disease [CHD]). Time one psychosocial variables (Duke Social Support Index, time pressure, Perceived Stress Scale, Mental Health Index, having a partner, educational attainment, and location of residence) were analyzed using univariate binary logistic regression for their ability to predict subsequent symptomatic CHD.

Use of an accelerated chest pain assessment protocol in patients at intermediate risk of adverse cardiac events.

Objective: To determine the feasibility, safety and effectiveness of a structured clinical pathway for stratification and management of patients presenting with chest pain and classified as having intermediate risk of adverse cardiac outcomes in the subsequent six months.

Design: Prospective clinical audit.

Participants And Setting: 630 consecutive patients who presented to the emergency department of a metropolitan tertiary care hospital between January 2000 and June 2001 with chest pain and intermediate-risk features.