Publications by authors named "Joseph Zenisek"
Heparin Dosing During Percutaneous Coronary Intervention and Obesity.
J Cardiovasc Pharmacol
March 2024
Unfractionated heparin is the most common anticoagulant used during percutaneous coronary intervention. Practice guidelines recommend an initial weight-based heparin bolus dose between 70 and 100 U/kg to achieve target activated clotting time (ACT) of 250-300 seconds. The impact of severe obesity on weight-based heparin dosing is not well studied.
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- Major adverse cardiac events (MACE) are a significant health risk after orthotopic liver transplantation (OLT), and cirrhotic cardiomyopathy (CCM) is a contributing factor to MACE in these patients.
- A study involving 131 adult patients who underwent OLT found that those who had ascites and hepatorenal syndrome, along with those meeting the 2005 CCM criteria, were more likely to experience MACE within a year.
- The 2005 CCM criteria were better predictors of MACE and showed a 34% reversibility post-OLT, while the newer 2019 criteria were less effective and only showed a 57% reversibility rate among fewer patients.
Article Synopsis
- Coronary artery disease (CAD) is prevalent among patients with cirrhosis facing orthotopic liver transplantation (OLT) evaluation, and traditional stress echocardiograms can miss it.
- This study involved 88 patients with obstructive CAD and 97 without, using stress echo, CT scans, and cardiac catheterization to evaluate the role of vascular and valvular calcification in detecting CAD.
- The combination of calcification data from CT and echo with stress echo significantly enhanced CAD detection accuracy (area under the curve improved from 0.58 to 0.73), especially when considering age, gender, and diabetes history (further increased to 0.80).
Article Synopsis
- * In a study involving 173 liver transplant patients, transthoracic echocardiography (TTE) was used to evaluate heart function one day post-surgery, revealing that 82% had hIRI, but there was no significant decline in left ventricular ejection fraction (LVEF) after the transplant.
- * The findings suggest that while hIRI is prevalent, it does not seem to cause an immediate drop in heart function, indicating that other factors may contribute to post-transplant heart issues.
Background: Femoral arterial access remains widely used despite recent increase in radial access for cardiac catheterization and percutaneous coronary intervention (PCI). Various femoral artery closure devices have been developed and are commonly used to shorten vascular closure times, with variable rates of vascular complications observed in clinical trials. We sought to examine the rates of contemporary outcomes during diagnostic catheterization and PCI with the most common femoral artery closure devices.
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