Cause and preventability of in-hospital mortality after PCI: A statewide root-cause analysis of 1,163 deaths.

Background: Mortality is the most devastating complication of percutaneous coronary interventions (PCI). Identifying the most common causes and mechanisms of death after PCI in contemporary practice is an important step in further reducing periprocedural mortality.

Objectives: To systematically analyze the cause and circumstances of in-hospital mortality in a large, multi-center, statewide cohort.

Short-Term Outcomes of Cardiac Arrhythmias Among COVID-19 Patients: A Propensity Matched National Study.

The risk of arrhythmia is high in patients with COVID-19. The current literature is limited in understanding the clinical impact of arrhythmias and the extent of healthcare utilization in COVID-19 patients. The Nationwide In-patient Sample Database (NIS) from 2019 to 2020 was queried to identify COVID-19 patients who developed arrhythmias vs those without.

Giant right coronary artery aneurysm in a dominant right system.

Giant coronary artery aneurysms (GCAAs) are unusual and extremely rare. Due to their rarity, there is a lack of data on managing GCAAs. A man in his 70s who presented with worsening shortness of breath and bilateral lower extremity oedema was found to have non-ST elevation myocardial infarction.

Gas in the myocardium: a fatal presentation of : a case report.

Background: is a well-known cause of gas gangrene with a very high mortality rate. Multiple cases of internal organs have been reported in the literature; however, non-traumatic spontaneous gas gangrene due to with solely cardiac involvement in a patient without any risk factors has not been reported before.

Case Summary: A 52-year-old male presented to the emergency department with chest pain and exertional dyspnoea for three days.

A giant left atrial myxoma causing mitral valve pseudostenosis - a mimicker.

The clinical features of cardiac myxoma vary significantly from asymptomatic to severe cardiovascular complications like atrioventricular valve obstruction and thromboembolism depending on the location, size, and mobility of the tumor. Echocardiography is the diagnostic study of choice, and surgical resection is the method of choice to prevent complications. We report a case of a 47-year-old female who presented with exertional dyspnea, malaise, and weight loss.

Systematic Review and Meta-Analysis: Can We Compare Direct Oral Anticoagulants to Warfarin in Patients With Atrial Fibrillation and Bio-Prosthetic Valves?

Background There are no clear consensus guidelines on the indications and types of anticoagulation therapies in patients with bio-prosthetic valves either with concomitant atrial fibrillation (AF) or sinus rhythm. In our meta-analysis, we assessed the safety and efficacy of DOACs as compared to the standard treatment with warfarin in patients with AF and bioprosthetic valves. Methods We included randomized controlled trials (RCTs), cohort studies in the English language, and studies reporting patients with valvular heart disease that included bioprosthetic valvular disease.

In-hospital outcomes after percutaneous coronary interventions in cardiac allograft recipients.

Introduction: The average age and survival of heart transplant recipients have improved significantly over the last 10 years. In these long-term survivors, coronary allograft vasculopathy is one of the most common causes of death. There is a paucity of large-data research highlighting the short-term outcomes of percutaneous coronary interventions in cardiac allograft recipients.

Inspiratory Muscle Training in Patients With Heart Failure With Preserved Ejection Fraction: A Meta-Analysis.

Objectives To explore the role of inspiratory muscle training (IMT) in improving cardiorespiratory fitness of stable heart failure with preserved ejection fraction (HFpEF) patients. Background There is a paucity of data on the role of IMT in patients with HFpEF. HFpEF is a growing problem in the developed world, especially in the aging population.

A Giant Right-Heart Thrombus-in-Transit in a Patient with COVID-19 Pneumonia.

BACKGROUND Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread to more than 200 countries across the world. Studies have shown that patients with COVID-19 are prone to thrombotic disease resulting in increased mortality. We present a case of COVID-19 pneumonia in a warehouse worker with a giant thrombus-in-transit involving the right ventricle and tricuspid valve.

A case report of absolute thrombocytopenia with ticagrelor.

Background: We report a rare case of absolute thrombocytopenia with ticagrelor after 6 h of single loading dose of ticagrelor.

Case Summary: A 68-year-old male with ischaemic cardiomyopathy, hypertension, and dyslipidaemia presented with chest pain. He was found to be in new-onset atrial flutter and ruled in for a non-ST-segment elevation myocardial infarction.

Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention in Patients with Left Ventricular Systolic Dysfunction.

Purpose: There is a paucity of comparative data examining the optimal revascularization strategy in patients with left ventricular systolic dysfunction (LVD).

Methods: We performed an aggregate data meta-analysis of clinical outcomes comparing percutaneous coronary intervention (PCI) versus coronary artery bypass (CABG) in patients with LVD (left ventricle ejection fraction (LVEF) of ≤ 40%), using the random effects model. Effects size is reported as odds ratio (OR) and a 95% confidence interval.

Coronary artery occlusion following low-power catheter ablation.

Myocardial infarction (MI) is an unusual but potentially serious complication of catheter ablation procedures. This case describes the occurrence of acute myocardial infarction following low-power ablation in a young patient and highlights the importance of maintaining high index of suspicion following catheter ablation irrespective of the ablation power used. A 22-year-old patient had low-power ablation of the right posteroseptal accessory pathway in the ostium of the coronary sinus on account of persistently symptomatic WPW syndrome with orthodromic re-entrant tachycardia.

Effect of glycemic control on mortality and infections in patients undergoing coronary artery bypass grafting: a Genesee County experience.

: We report post-coronary artery bypass outcomes and factors affecting the outcomes from the Genesee County, MI, where the population is distinctly characterized by a higher prevalence of renal failure (RF), diabetes, obesity and smoking than the national average. : We performed a retrospective cohort study on 1133 patients undergoing isolated CABG at our hospital from June 2012 to July 2017. Primary outcome was the association between preoperative hemoglobin A1c (HbA1c) and all-cause postoperative mortality after CABG, secondary outcomes included the association between HbA1c and a composite of postoperative infections including sternal-wound infections, leg harvest-site infections, pneumonia or sepsis.

Postinfarction ventricular septal defect on catheterization table, challenging and unique occurrence at a community-based hospital.

Ventricular septal defect (VSD), one of the major mechanical complications of myocardial infarction, portends a severe threat to life and hence demands a high degree of suspicion, appropriate investigations, and emergent repair, particularly in cases of cardiogenic shock. Although the development of VSD in extensive or anterior infarction is not unexpected, its occurrence during cardiac catheterization frames a unique, challenging experience and creates a learning opportunity. We present a patient who developed postinfarction VSD during cardiac catheterization.

Trends in door-to-balloon time and mortality in patients with ST-elevation myocardial infarction undergoing primary percutaneous coronary intervention.

Background: In patients with acute ST-elevation myocardial infarction (STEMI) who are undergoing percutaneous coronary intervention, current guidelines for reperfusion therapy recommend a door-to-balloon (DTB) time of less than 90 minutes. Considerable effort has focused on reducing DTB time with the assumption that a reduction in DTB time translates into a significant reduction in mortality; however, the clinical impact of this effort has not been evaluated. Therefore, our objective was to determine whether a decline in DTB time in patients with STEMI was associated with an improvement in clinical outcomes.

Temporal trends in the use of drug-eluting stents for approved and off-label indications: a longitudinal analysis of a large multicenter percutaneous coronary intervention registry.

Background: We sought to examine the temporal variations in the rate of both bare-metal stent (BMS) and drug-eluting stent (DES) use for off-label indications after the reports of an increased risk of very late stent thrombosis in patients with DES at the 2006 meeting of the European Society of Cardiology (ESC).

Hypothesis: To determine whether the decrease in use of DES has affected both on and off-label indications.

Methods: The study cohort included patients undergoing coronary intervention in a large regional registry, the Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).

Percutaneous coronary intervention complications and guide catheter size: bigger is not better.

Objectives: We evaluated the association between guiding catheter size and complications of percutaneous coronary intervention (PCI).

Background: The association between guiding catheter size and complications of PCI in contemporary practice remains controversial.

Methods: Procedure and outcome variables from 103,070 consecutive patients that underwent PCI with 6-F (n = 64,335), 7-F (n = 32,676), and 8-F (n = 6,059) guide catheters were compared.

The relative safety and efficacy of abciximab and eptifibatide in patients undergoing primary percutaneous coronary intervention: insights from a large regional registry of contemporary percutaneous coronary intervention.

Objectives: This study sought to assess whether the use of eptifibatide instead of abciximab is associated with a difference in outcomes of patients undergoing primary percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).

Background: Pooled data from randomized controlled trials suggest that the use of abciximab may be associated with a survival advantage in patients undergoing primary PCI for acute STEMI. However, a large proportion of patients in the community are treated with eptifibatide, an agent that shares some but not all pharmacological properties with abciximab.

Enhancing quality of care for acute myocardial infarction: shifting the focus of improvement from key indicators to process of care and tool use: the American College of Cardiology Acute Myocardial Infarction Guidelines Applied in Practice Project in Michigan: Flint and Saginaw Expansion.

Objectives: This project evaluated if by focusing on process changes and tool use rather than key indicator rates, the use of evidence-based therapies in patients with acute myocardial infarction (AMI) would increase.

Background: The use of tools designed to improve quality of care in the American College of Cardiology AMI Guidelines Applied in Practice Pilot Project resulted in improved adherence to evidence-based therapies for patients, but overall, tool use was modest.

Methods: The current project, implemented in five hospitals, was modeled after the previous project, but with greater emphasis on tool use.

Open-label, sequential comparison of eptifibatide with abciximab for patients undergoing percutaneous coronary intervention.

Background: Platelet glycoprotein IIb/IIIa antagonists reduce complications following percutaneous coronary intervention (PCI). There are limited data comparing different agents.

Objective: The purpose of this study was to compare in-hospital and 30-day outcomes in 2 sequential cohorts of consecutive patients undergoing PCI at our institution who received abciximab or eptifibatide.