Rotational Atherectomy in the Management of Ruptured and Entrapped Coronary Angioplasty Balloon.

Retention and entrapment of angioplasty device fragments is a rare consequence of percutaneous coronary intervention (PCI). Due to advances in retrieval devices and introduction of new interventional techniques the need for emergency surgery has reduced significantly. There might also be clinical scenarios were remnants of retained fragments might have to be left within the coronary vessel and this might be the most appropriate option.

Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved outcomes in patients with diabetes mellitus.

Objectives: To assess the mortality in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) according to their insulin requirement and PCI setting (elective, urgent, and emergency).

Background: DM is a major risk factor to develop coronary artery disease (CAD). It is unclear if meticulous glycemic control and aggressive risk factor management in patients with DM has improved outcomes following PCI.

Blood thrombogenicity is independently associated with serum TSH levels in post-non-ST elevation acute coronary syndrome.

Context: Higher serum TSH levels, both within the reference range and in those with subclinical hypothyroidism (SCH), have been associated with increased risk of atherosclerosis and cardiovascular (CV) events in a number of cross-sectional and longitudinal studies.

Objective: Our objective was to evaluate blood thrombogenicity in patients post-non-ST elevation acute coronary syndrome (NSTE-ACS) in relation to their thyroid function. DESIGN, PATIENTS, AND OUTCOME MEASURE: At 1 week after troponin-positive NSTE-ACS, 70 patients who had been treated with optimal antiplatelet and secondary prevention therapy were studied.

Differences in thrombus structure and kinetics in patients with type 2 diabetes mellitus after non ST elevation acute coronary syndrome.

Introduction: Despite optimal secondary prevention therapy following non-ST elevation acute coronary syndrome (NSTE-ACS), recurrent thrombotic events are more frequent in patients with type 2 diabetes mellitus (T2DM).

Materials And Methods: This exploratory study was aimed to evaluate quantitative and qualitative aspects of thrombus. In 28 patients with and without T2DM treated with aspirin and clopidogrel we assessed thrombus quantity using an ex-vivo chamber, platelet reactivity, thrombus ultrastructure and thrombus kinetics one week after NSTE-ACS.

Antiplatelet therapy in patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction: a retrospective observational study of prasugrel and clopidogrel.

Background: Primary percutaneous coronary intervention (PPCI) for ST-segment elevation myocardial infarction (STEMI) is a therapeutic success when supported by dual antiplatelet therapy. Prasugrel has been introduced as a potential alternative to clopidogrel alongside aspirin. We aimed to assess prasugrel versus clopidogrel mortality outcomes in patients admitted with STEMI undergoing PPCI.

Early discharge after primary percutaneous coronary intervention for ST-elevation myocardial infarction.

Background: To assess safety of early discharge following primary percutaneous coronary intervention (PPCI) for ST-elevation myocardial infarction (STEMI).

Methods And Results: Retrospective analysis of prospectively collected data of 2448 STEMI patients treated with PPCI surviving to hospital discharge. Post-discharge all-cause mortality was reported at 1, 7, and 30 days and long-term follow up.

Admission heart rate predicts mortality following primary percutaneous coronary intervention for ST-elevation myocardial infarction: an observational study.

Background: The prognostic value of admission heart rate (HR) on long-term mortality in ST-elevation myocardial infarction (STEMI) remains uncertain in the modern era of primary percutaneous coronary intervention (PPCI). This study aimed to assess the predictive value of admission HR on long-term mortality following PPCI and the influence of beta-blockers on postdischarge survival.

Methods: Retrospective analysis of prospectively collected data on 2310 PPCI-treated STEMI patients at a regional tertiary center between March 2008 and June 2010.

Thrombus and antiplatelet therapy in type 2 diabetes mellitus. A prospective study after non-ST elevation acute coronary syndrome and a randomised, blinded, placebo-controlled study in stable angina.

Type 2 diabetes mellitus (T2DM) is associated with higher rates of thrombotic complications in patients with coronary artery disease (CAD) despite optimal medical therapy. Thrombus area was measured in T2DM and non-diabetic patients receiving aspirin and clopidogrel 7-10 days after troponin positive Non ST-elevation acute coronary syndrome (NSTE-ACS). Secondly, we assessed response to clopidogrel in naive patients with T2DM and stable CAD in a randomised controlled trial.

Increased atherothrombotic burden in patients with diabetes mellitus and acute coronary syndrome: a review of antiplatelet therapy.

Patients with diabetes mellitus presenting with acute coronary syndrome have a higher risk of cardiovascular complications and recurrent ischemic events when compared to nondiabetic counterparts. Different mechanisms including endothelial dysfunction, platelet hyperactivity, and abnormalities in coagulation and fibrinolysis have been implicated for this increased atherothrombotic risk. Platelets play an important role in atherogenesis and its thrombotic complications in diabetic patients with acute coronary syndrome.