Publications by authors named "Mir Basir"
Background: Proximal vessel tortuosity can hinder wiring and equipment delivery during chronic total occlusion (CTO) percutaneous coronary intervention (PCI).
Aims: We sought to examine the association of proximal vessel tortuosity with the short and long-term outcomes of patients undergoing CTO PCI.
Methods: We examined the association of proximal vessel tortuosity with clinical outcomes in patients who underwent CTO PCI at 50 US and non-US centers between 2012 and 2024.
Blueprint for Building and Sustaining a Cardiogenic Shock Program: Qualitative Survey of 12 US Programs.
J Soc Cardiovasc Angiogr Interv
November 2024
Background: Multidisciplinary cardiogenic shock (CS) programs have been associated with improved outcomes, yet practical guidance for developing a CS program is lacking.
Methods: A survey on CS program development and operational best practices was administered to 12 institutions in diverse sociogeographic regions and practice settings. Common steps in program development were identified.
Objective: Evaluate the effect of fathers' participation in the Preemie Prep for Parents (P3) program on maternal learning and fathers' preterm birth knowledge.
Methods: Mothers with preterm birth predisposing medical condition(s) enrolled with or without the baby's father and were randomized to the P3 intervention (text-messages linking to animated videos) or control (patient education webpages). Parent Prematurity Knowledge Questionnaire assessed knowledge, including unmarried fathers' legal neonatal decision-making ability.
Article Synopsis
- * Out of 200,130 burn hospitalizations, only 1% (1997 patients) developed acute MI, mainly affecting older men with cardiovascular risk factors; burns greater than 20% BSA or affecting the trunk/respiratory tract increased MI risk.
- * Patients with MI had a significantly higher in-hospital mortality rate (18.7% vs. 3% for those without MI), and interventions like revascularization decreased mortality rates.
Left atrial veno-arterial extracorporeal membrane oxygenation (LAVA-ECMO) in cardiogenic shock (CS) is a novel mechanical cardiocirculatory support strategy that provides robust cardiocirculatory support and simultaneous left and right atrial venting by way of a multifenestrated transeptal catheter. We performed a single-center retrospective analysis of all patients aged ≥18 years with CS who underwent LAVA-ECMO at a quaternary care institution from 2018 to 2023. Clinical outcomes and prehemodynamics and posthemodynamics were evaluated.
View Article and Find Full Text PDFOutcomes of Left Main Chronic Total Occlusion Percutaneous Coronary Interventions.
Catheter Cardiovasc Interv
November 2024
Article Synopsis
- The study looked at the outcomes of patients undergoing percutaneous coronary intervention (PCI) for left main (LM) chronic total occlusions (CTO) compared to non-LM CTOs across multiple centers from 2012 to 2024.
- Out of over 15,000 CTO PCIs, only 85 involved LM CTOs, which were associated with older patients who commonly had higher rates of health issues like heart failure and previous bypass surgeries.
- Despite higher complications and angiographic complexity in LM CTO cases, the technical success rates were similar to non-LM PCIs, indicating that they can be performed safely despite their challenges.
Article Synopsis
- Mechanical circulatory support with veno-arterial extracorporeal membrane oxygenation (VA-ECMO) has improved treatment for cardiogenic shock, but neurological complications, especially strokes, are a major concern and can affect patient outcomes.
- A study at a quaternary center analyzed 244 patients on VA-ECMO from 2018-2022, finding that 14.7% developed a stroke, with ischemic and hemorrhagic strokes occurring almost equally.
- Key risk factors for stroke included the use of P2Y antagonists, limb ischemia, and the need for blood transfusions, while there was no significant link between stroke incidence and overall mortality or the length of VA-EC
Background: The J-CTO investigators recently developed angiographic difficulty scores for each of the three major coronary arteries in patients undergoing first-attempt chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in de novo occlusions.
Methods: We examined the performance of the individual J-CTO scores in a large multicenter registry.
Results: The CTO lesion location was as follows: right coronary artery (RCA) 3,805 (54%), left anterior descending artery (LAD) 2,303 (33%), and left circumflex (LCX) 935 (13%).
Article Synopsis
- This study analyzed the link between the SAVE score, SOFA score, and lactate levels after VA-ECMO treatment to see how they relate to mortality in patients with severe cardiogenic shock.
- The retrospective review included 244 patients, revealing a high in-hospital mortality rate of 70%, with significant correlations found between higher SAVE and SOFA scores, as well as elevated lactate levels shortly after cannulation, and increased mortality risk.
- The findings suggest that both the SAVE and SOFA scores, along with lactate levels at 8 hours post-cannulation, are valuable for predicting patient outcomes, providing essential information for improving treatment decisions.
There are limited comparative data on the use of plaque modification devices during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We compared intravascular lithotripsy (IVL) with rotational atherectomy (RA) for lesion preparation in patients who underwent CTO PCI across 50 US and non-US centers from 2019 to 2024. Of 15,690 patients who underwent CTO PCI during the study period, 436 (2.
View Article and Find Full Text PDFAs the field of percutaneous coronary intervention grows in volume, expertise, and available tools, interventional cardiologists are increasingly performing more complex and higher-risk coronary artery procedures. Mechanical circulatory support devices, previously used only in urgent situations, are now being utilized as supplementary tools to enhance outcomes in elective complex cases. This shift has sparked significant discussions about patient and device selection, as well as the potential risks involved.
View Article and Find Full Text PDFBackground: Cardiogenic shock remains highly associated with early mortality, with mortality often exceeding 50%. We sought to determine the association between prognostic factors and in-hospital and 30-day mortality in cardiogenic shock.
Methods: We performed a systematic review and meta-analysis of prognostic factors in cardiogenic shock, searching MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials for records up to June 5, 2023.
•Black women receiving the smartphone P3 program had more preterm birth knowledge.•Black women receiving the P3 program were more prepared for healthcare decisions.•Black women receiving the P3 program talked more with partners about preterm birth.
View Article and Find Full Text PDFArticle Synopsis
- In a study analyzing patients during high-risk percutaneous coronary intervention (HR-PCI), nearly half (49%) experienced loss of pulse pressure (LOPP), defined as a mean pulse pressure below 20 mm Hg for 5 seconds or more.
- Patients with LOPP demonstrated significantly lower baseline systolic and mean arterial blood pressures and a higher heart rate compared to those without LOPP.
- The occurrence of LOPP was linked to a higher incidence of serious complications including major adverse cardiac events, acute kidney injury, and death within 90 days, with low systolic blood pressure and cardiomyopathy identified as strong predictors of LOPP.
Article Synopsis
- Right ventricular dysfunction (RVD) affects 30-40% of patients experiencing acute myocardial infarction and cardiogenic shock, leading to concerns about their survival outcomes when treated with left ventricular mechanical support.
- A study conducted across 80 sites analyzed 361 patients, finding that 28% had RVD, which correlated with lower survival rates to discharge (61.8% vs. 73.4%) and higher instances of severe shock and active CPR during treatment.
- Despite initial lower survival for RVD patients, hemodynamic parameters measured within 24 hours showed no significant differences between those with and without RVD, indicating that early left ventricular support may not immediately affect RV function.
Article Synopsis
- The study investigates the use of cangrelor in patients with myocardial infarction (MI) who also have cardiogenic shock (CS), focusing on the infusion duration and transition to oral medications.
- A total of 249 patients with CS were analyzed, with significant observations on demographics, infusion times, and the occurrence of major adverse cardiovascular events (MACEs) and bleeding risks.
- The findings showed that patients with CS had longer cangrelor infusions compared to others, and that the use of mechanical circulatory support (MCS) was linked to longer infusion times and an increased risk of bleeding.
Article Synopsis
- A study analyzed the outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI) specifically in patients with anomalous coronary arteries (ACA) from a large dataset of over 14,000 patients between 2012 and 2023.
- Among 14,470 CTO procedures, only 36 (0.24%) were performed on patients with ACA, who displayed similar baseline characteristics to those without ACA, but had more complicated lesions, requiring longer procedures and greater contrast volume.
- Despite the increased complexity, ACA patients achieved similar procedural success rates to non-ACA patients, with no major adverse cardiac events reported in the ACA group, indicating a favorable outcome for CTO PCI in
Objective: Evaluate the effect of fathers' participation in the Preemie Prep for Parents (P3) program on maternal learning and fathers' preterm birth knowledge.
Methods: Mothers with preterm birth predisposing medical condition(s) enrolled with or without the baby's father and were randomized to the P3 intervention (text-messages linking to animated videos) or control (patient education webpages). Parent Prematurity Knowledge Questionnaire assessed knowledge, including unmarried fathers' legal neonatal decision-making ability.
Background: Mitral valve regurgitation (MR) is associated with worse outcomes in patients undergoing percutaneous coronary intervention (PCI). We sought to evaluate outcomes of Impella-supported high-risk PCI (HRPCI) patients according to MR severity.
Methods: Patients from the PROTECT III study undergoing Impella-supported HRPCI were stratified into 4 groups according to MR severity: No or trace MR, mild MR, moderate MR, and severe MR.
Background: The smartphone Preemie Prep for Parents (P3) program was developed to address the gap in prenatal education of preterm birth in high-risk pregnancies. Despite a higher incidence of preterm birth, Black women are less likely to receive prenatal education.
Methods: Pregnant women with medical conditions that predisposed them to preterm birth were randomized to receive the P3 program or links to American College of Obstetricians and Gynecologists webpages (control).
Background: Patients with complex coronary artery disease, as defined by high SYNTAX scores, undergoing percutaneous coronary intervention (PCI) have poorer outcomes when compared with patients with lower SYNTAX I scores. This study aimed to assess if mechanical circulatory support using Impella mitigates the effect of the SYNTAX I score on outcomes after high-risk percutaneous coronary intervention (HRPCI).
Methods: Using data from the PROTECT III study, patients undergoing Impella-assisted HRPCI between March 2017 and March 2020 were divided into 3 cohorts based on SYNTAX I score-low (≤22), intermediate (23-32), and high (≥33).
Risk of Bleeding Among Cangrelor-Treated Patients Administered Upstream P2Y Inhibitor Therapy: The CAMEO Registry.
J Soc Cardiovasc Angiogr Interv
February 2024
Article Synopsis
- The study investigated the bleeding risk associated with cangrelor in patients with myocardial infarction (MI) who had previously taken an oral P2Y inhibitor before angiography.
- The CAMEO registry analyzed 1802 patients treated with cangrelor, finding that 21.4% had also received an oral P2Y inhibitor within the previous 24 hours.
- Results showed no significant difference in bleeding rates between patients with and without prior oral P2Y inhibitor exposure, indicating that cangrelor use does not substantially increase bleeding risk in either group.