Body mass index, periprocedural bleeding, and outcome following percutaneous coronary intervention (from the British Columbia Cardiac Registry).

The incidence of obesity is increasing throughout the industrialized world and is a major public health concern. Some studies have shown a paradoxical protective effect of moderate obesity on outcome after percutaneous coronary intervention (PCI). The association between bleeding, body mass, and outcome is not well established and formed the basis for the present study, which examined major bleeding rates and mortality after PCI in British Columbia during a 6-year period.

Safety of same day discharge radial PCI in patients under and over 75 years of age.

To check the safety of same day discharge radial PCI in patients under or over 75 years of age. A total of 943 patients who had same day discharge radial PCI between April 1998 and March 2001 were contacted. Patient health status, entry site complications, and repeat interventions during the first month after the procedure were compared in patients under 75 years of age (< 75) with those 75 or over (> or = 75).

Day procedure intervention is safe and complication free in higher risk patients undergoing transradial angioplasty and stenting. The discharge study.

Objectives: To assess the timeframe of postprocedural complications following transradial percutaneous intervention in selected nonlow-risk risk patients as a feasibility study for same day discharge.

Background: Percutaneous coronary intervention (PCI) is traditionally performed as an inpatient procedure. Transradial access with its lower complication rate facilitates safe and same day discharge.

A comparison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervention for acute myocardial infarction in the elderly.

Background: Access site complications are reduced using radial percutaneous coronary intervention (PCI). There is concern that technical difficulties using this approach can delay achievement of reperfusion during primary or rescue PCI for acute myocardial infarction (AMI) especially in elderly patients.

Methods And Results: We studied 155 patients (pts) > or = 70 years who underwent primary or rescue PCI for AMI; radial (Group1; 87 pts) or femoral (Group2; 68 pts).

Systemic nanoparticle paclitaxel (nab-paclitaxel) for in-stent restenosis I (SNAPIST-I): a first-in-human safety and dose-finding study.

Background: Paclitaxel-eluting stents inhibit restenosis; however, this technology has drawbacks (e.g., stent thrombosis, requirement for long-term antiplatelet therapy, and cost--particularly for patients with multivessel disease).

Vascular communications of the hand in patients being considered for transradial coronary angiography: is the Allen's test accurate?

Objectives: The purpose of this study was to assess the accuracy of the Allen's test (AT) in predicting hand ischemia in patients undergoing transradial coronary angiography.

Background: Patients with poor vascular communications between the radial artery (RA) and ulnar artery (UA), as indicated by an abnormal AT, are usually excluded from transradial coronary angiography to avoid ischemic hand complications.

Methods: Over a four-month period, patients undergoing coronary angiography were screened for AT time.

A comparison of the radial and the femoral approach in vein graft PCI. A retrospective study.

Background: Transradial PCI is a safe and effective method of percutaneous revascularization. However, there is limited data on the efficacy of the transradial approach for saphenous vein graft (SVG) PCI.

Methods: We studied 334 patients who underwent SVG PCI between January 2000 and December 2003, and compared the radial (132 patients) and the femoral (202 patients) approach.

Same-day discharge is preferred by the majority of the patients undergoing radial PCI.

There is limited data on patient preference for same-day discharge PCI. We contacted 953 patients who had same-day discharge radial PCI between 1998 and 2001 and checked whether they were satisfied with same-day discharge and whether they had any complications within 30 days post-PCI (vascular, repeat angiogram/PCI). Complications and health status were also verified by checking hospital records, our province-wide cath lab database and provincial vital statistics, as well as by contacting the referring doctor.

Comparison of the radial and femoral approaches in left main PCI: a retrospective study.

Transradial percutaneous coronary intervention (PCI) is a safe and effective method of percutaneous revascularization. However, there are no data on the efficacy of the transradial approach in left main (LM) PCI. We studied 80 patients (pts) who underwent LM PCI between February 1994 and January 2002, and compared the radial (27 pts) and femoral (53 pts) approaches.

Effectiveness of nifedipine GITS in combination with atenolol in chronic stable angina.

Nifedipine gastrointestinal therapeutic system (GITS) is a once-daily formulation of nifedipine that provides stable plasma concentrations over the entire 24 h dosing interval. Two-hundred and one patients with Canadian Cardiovascular Society class II to III angina who were on 50 mg of atenolol yet still experiencing angina symptoms were randomized to receive either placebo or nifedipine GITS 30, 60 or 90 mg/day. After four weeks of treatment, the changes in time from baseline to onset of 1 mm ST segment depression in the 183 eligible patients were 26.

Effect of diltiazem on symptomatic and asymptomatic episodes of ST segment depression occurring during daily life and during exercise.

Background: Silent myocardial ischemia is an adverse prognostic marker in patients with coronary disease; however, controlled data on the effect of treatment are sparse and contradictory, and the relations among the occurrence of ST segment depression, drug efficacy, and heart rate are unclear.

Methods And Results: Sixty patients with stable coronary artery disease, a positive treadmill exercise test and asymptomatic ST segment depression on ambulatory electrocardiographic recording were assessed in a multicenter, double-blind, placebo-controlled, cross-over trial. Treadmill exercise tests and 72-hour electrocardiographic recordings were obtained at the end of two 2-week treatment periods with sustained-release diltiazem 180 mg b.

Role of diltiazem in the treatment of silent myocardial ischemia.

Silent myocardial ischemia is a frequent finding when Holter monitoring is done in patients with advanced coronary disease. Silent ischemia is associated with a worse prognosis in patients with stable or unstable angina, survivors of myocardial infarction, and populations at risk for coronary disease. Whether medical therapy for silent ischemia improves prognosis is not known.