Manual Versus Mechanical Compression of the Radial Artery After Transradial Coronary Angiography: The MEMORY Multicenter Randomized Trial.

Objectives: The aim of this study was to compare manual versus mechanical compression of the radial artery after coronary angiography via transradial access regarding radial artery occlusion (RAO), access-site bleeding complications, and duration of hemostasis.

Background: Hemostasis of the radial artery after sheath removal can be achieved either by manual compression at the puncture site or by using a mechanical hemostasis device. Because mechanical compression exerts a more stable, continuous pressure on the artery, it could be hypothesized that it is more effective compared with manual compression regarding hemostasis time, bleeding, and RAO risks.

Vascular endothelial growth factor protein levels and gene expression in peripheral monocytes after stenting: a randomized comparative study of sirolimus: eluting and bare metal stents.

Aims: Although previous studies have indicated that vascular endothelial growth factor (VEGF) plays an important role in the vascular-healing process after stent implantation, its effect on in-stent restenosis is unclear. We assessed VEGF serum protein levels and gene expression in peripheral monocytes in relation to in-stent restenosis after implantation of sirolimus-eluting (SES) and bare metal stents (BMS) in a non-blinded, randomized study.

Methods And Results: Forty-two patients (28 men, age 62 +/- 11 years) with stable angina, who underwent elective single-vessel percutaneous coronary intervention, were randomized to SES (n = 21) or BMS (n = 21) implantation.

Acute effect of esmolol intravenously on coronary microcirculation in patients with idiopathic dilated cardiomyopathy.

Although coronary flow reserve (CFR) impairment was correlated with the prognosis of patients with idiopathic dilated cardiomyopathy (IDC) and microvascular ischemia was implicated in the progress of the disease, little is known about the effect of the established therapy with beta blockers on coronary microcirculation. The purpose of this study was to assess the effect of beta(1) blockade on coronary blood flow and CFR in patients with IDC. Fourteen patients with IDC and 10 control subjects underwent time-averaged peak coronary flow velocity (APCFV) measurements (centimeters per second) in the proximal left anterior descending coronary artery at baseline and at maximal hyperemia before and after beta(1) blockade with intravenous esmolol.

Drug evaluation: PB-127, a novel contrast agent for the detection of myocardial perfusion.

Point Biomedical Corp is developing PB-127 (CardioSphere) as an ultrasound imaging agent for assessing myocardial perfusion in patients with coronary artery disease. In January 2006, the company submitted an NDA for the agent; this was accepted for review in February 2006, with a Prescription Drug User Fee Act review and action date of late October 2006. PB-127 is effective for intermittent harmonic power Doppler imaging and may be the first contrast agent to receive FDA approval for myocardial perfusion imaging.

Acute coronary syndrome in an adult with anomalous origin of the left anterior descending coronary artery from the pulmonary trunk.

Anomalous origin of the left anterior descending coronary artery is a very rare coronary vascular anomaly, especially in adults. We describe the case of a 45-year-old woman who presented with an acute coronary syndrome. Coronary angiography revealed an anomalous origin of the left anterior descending coronary artery from the main pulmonary trunk, with collateral filling from both the left circumflex and the right coronary artery.

Reduced systemic inflammatory response to implantation of sirolimus-eluting stents in patients with stable coronary artery disease.

Stent implantation causes significant injury to the vascular wall, resulting in inflammatory activation. Although sirolimus-eluting stents (SES) have anti-inflammatory properties, their effect on periprocedural systemic inflammatory response has not been sufficiently investigated. Eighty-one patients with stable coronary artery disease involving severe stenosis of one major epicardial coronary artery underwent coronary angioplasty with stent implantation and randomly received either SES or bare metal stents (BMS).

Effect of inhaled salbutamol on coronary circulation in humans.

In 12 patients we assessed the effect of inhaled salbutamol on the coronary circulation. According to our results, large doses of salbutamol increase coronary flow, but not in proportion to the needs of the myocardium (as documented by the increase in coronary oxygen extraction), and decrease coronary flow reserve. These effects may have deleterious consequences in patients with coronary artery disease, causing or worsening myocardial ischemia.

AI-700 (Acusphere).

Acusphere is developing AI-700, perflubutane-filled synthetic polymer microspheres, for potential use as an ultrasound contrast agent for the assessment of myocardial perfusion. By April 2005, phase III enrollment was expected to be complete by early 2006, and the company expected to file an NDA in the first half of 2006.

Regional coronary flow and contractile reserve in patients with idiopathic dilated cardiomyopathy.

Objectives: The purpose of this study was to assess regional coronary flow and contractile reserve in patients with idiopathic dilated cardiomyopathy (IDCM).

Background: Although IDCM has been associated with alterations in coronary blood flow and contractile reserve, little is known about their regional distribution and correlation.

Methods: Fourteen patients with IDCM and 11 control subjects underwent coronary flow velocity (APV) measurements in the left anterior descending (LAD), left circumflex (LCx), and right coronary (RCA) arteries at baseline (b) and at maximal hyperemia (h).