Effect of Loading Dose of Atorvastatin Prior to Planned Percutaneous Coronary Intervention on Major Adverse Cardiovascular Events in Acute Coronary Syndrome: The SECURE-PCI Randomized Clinical Trial.

Importance: The effects of loading doses of statins on clinical outcomes in patients with acute coronary syndrome (ACS) and planned invasive management remain uncertain.

Objective: To determine if periprocedural loading doses of atorvastatin decrease 30-day major adverse cardiovascular events (MACE) in patients with ACS and planned invasive management.

Design, Setting, And Participants: Multicenter, double-blind, placebo-controlled, randomized clinical trial conducted at 53 sites in Brazil among 4191 patients with ACS evaluated with coronary angiography to proceed with a percutaneous coronary intervention (PCI) if anatomically feasible.

Primary Mitral Valve Regurgitation Outcome in Patients With Severe Aortic Stenosis 1 Year After Transcatheter Aortic Valve Implantation: Echocardiographic Evaluation.

Background:: Mitral valve regurgitation (MR), present in up to 74% of the patients with severe aortic stenosis (AS), can be a negative prognostic factor when moderate or severe. The outcome of MR after percutaneous transcatheter aortic valve implantation (TAVI) and predictors associated with that outcome have not been well established in the literature.

Objective:: To assess the outcome of primary MR in patients submitted to TAVI and to identify associated factors.

Treatment of massive pulmonary embolism by percutaneous fragmentation of the thrombus.

Objectives: To evaluate the safety and efficacy of percutaneous thrombus fragmentation (PTF) for massive pulmonary embolism (PE) in patients with contraindications to the administration of thrombolytics.

Methods: Between July 1999 and August 2005, 10 patients (7 males, 3 females, age 57+/-18 years) with massive PE and contraindications to the administration of thrombolytics underwent PTF. A transthoracic doppler echocardiogram was used to evaluate arterial oxygen saturation (Sat O2), the Walsh index (WI), mean pulmonary artery pressure (PAP), mean systemic blood pressure (SBP) and right ventricular function (RVF) before and after the procedure.

[Comparative study of 18 F-fluorodeoxyglucose imaging with a dual-head coincidence gamma camera with dobutamine stress echocardiography for the assessment of myocardial viability].

Objective: To compare Dual-Head coincidence gamma camera (DCD-AC) with dobutamine stress echocardiography (DSE) in viability assessment, using functional recovery as the gold standard.

Methods: Twenty-one patients were prospectively studied, with coronary artery disease and severe left ventricular dysfunction undergoing DSE and DCD-AC at baseline and DSE three months after revascularization.

Results: Of the 290 segments analyzed, 83% were akinetic, 15% hypokinetic and 2% dyskinetic at rest.

Comparative study of the use of diltiazem as an antispasmodic drug in coronary angiography via the transradial approach.

Objective: To evaluate the impact of the use, prior to the procedure, of injectable diltiazem to prevent complications.

Methods: Between September 2000 and July 2001, 50 patients underwent transradial coronary angiography and were randomized to receive placebo (GI) or diltiazem (GII) through a catheter inserted into the radial artery. All patients received isosorbide mononitrate.