Publications by authors named "Neil Yager"

Article Synopsis
  • Chronic kidney disease (CKD) increases the risk of complications after percutaneous coronary intervention (PCI), and it's unclear how genetic factors like CYP2C19 loss of function (LOF) alleles affect this risk or the safety of genotype-guided therapy.
  • A study with 5,815 patients analyzed outcomes based on CKD status and found no significant interaction between treatment strategy and CKD for major cardiovascular events or bleeding risks after 12 months.
  • The findings suggest that while escalating P2Y inhibitor therapy via a genotype-guided approach doesn't reduce complications in CKD patients, it also doesn't increase bleeding risks, indicating the need for larger studies to confirm these results.
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Background: Patients with chronic kidney disease are underrepresented in registries and in randomized trials of coronary artery disease management. To investigate effects of chronic kidney disease on outcomes of nonemergent percutaneous coronary intervention in patients with left main or left main-equivalent coronary artery disease, we analyzed data from the New York State Percutaneous Coronary Intervention Registry during the calendar year 2015, involving 2,956 elective percutaneous coronary intervention cases. Outcomes of percutaneous coronary intervention in patients with various degrees of chronic kidney disease and stable left main or left main-equivalent coronary artery disease were compared.

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Background Notwithstanding the guideline endorsement of various anti-anginal medications, there is a paucity of data on whether one anti-anginal regimen or medication is superior to another. It is also unknown how anti-anginal medications affect outcomes of elective percutaneous coronary intervention (PCI). To fill this knowledge gap, we investigated an association between commonly used anti-anginal medications and elective PCI outcomes in stable ischemic heart disease (SIHD) patients.

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Flash pulmonary oedema can occur as a result of multiple triggers that may act independently or in concert. One such precipitating factor is bilateral renal artery stenosis which can be treated either with revascularisation or with medical therapy. Unilateral renal artery stenosis, however, is a rare cause of flash pulmonary oedema, especially when the contralateral kidney is still functional.

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Ventricular septal rupture (VSR) is a devastating complication of acute myocardial infarction (MI) and is often associated with cardiogenic shock. Although considered to be very rare in the reperfusion era, recent reports have demonstrated an increased frequency of post-MI VSR cases during the COVID-19 pandemic. Despite advances in surgical repair and management strategies over the past decades, mortality rate has remained high, especially in hemodynamically unstable patients.

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A 65-year-old man presented to emergency department with progressive worsening dyspnoea, which was preceded by crushing, substernal chest pain 3 weeks prior that lasted for over 2 days. At the time the patient thought that this was a symptom of COVID-19 so he stayed at home and self-quarantined, until his symptoms worsened to the point of needing hospitalisation. The patient was found to have had myocardial infarction, with coronary angiography showing 100% occlusion of the Left Anterior Descending artery (LAD).

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Introduction: The effects of coronary anatomy, lesion complexity, and comorbidities on outcomes of elective percutaneous coronary intervention (PCI) in high-risk patients with left main (LM) and/or multivessel coronary artery disease (CAD) are not well studied, as these patients are typically underrepresented in the clinical trials.

Methods: This cohort study involved 33,568 consecutive elective PCI cases, excluding patients with prior coronary artery bypass graft, acute coronary syndrome within 24 hr of index PCI, or shock. All data were obtained from the New York State's PCI Reporting System from the calendar year 2015.

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Background: Acute kidney injury (AKI) complicating cardiogenic shock is associated with increased mortality. We hypothesize that renal replacement therapy (RRT) improves survival in cardiogenic shock supported by Impella-CP (Abiomed, Danvers, MA) complicated by AKI.

Methods: A retrospective chart review identified 34 patients on Impella-CP for cardiogenic shock between January 2015 and December 2017.

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We present a case of sinus arrest and junctional escape rhythm from sinus node artery (SNA) thrombus in a 55-year-old man after revascularisation of right coronary and proximal circumflex arteries for infero-posterior wall ST-segement elevation myocardial infarction (STEMI). Sinus arrest from occlusion of the SNA is uncommon. The ensuing bradycardia may have haemodynamic consequences requiring temporary pacing but is almost always self-limited.

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Purpose Of Review: There is a growing cohort of complex high-risk patients with stable ischemic heart disease (SIHD) who present for coronary artery bypass graft (CABG) surgery and percutaneous coronary intervention (PCI). These patients are older, have complex coronary disease, and a substantial comorbidity burden including frailty. The procedural risks and outcomes of CABG and PCI in these patients are more difficult to assess based on the available literature, which has generally studied a younger population with a lower comorbidity burden.

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An 81-year-old woman presented with acute decompensated heart failure due to new-onset atrial fibrillation and a flail myxomatous mitral valve which necessitated surgical mitral valve repair. No atrial thrombi were noted on transoesophageal echocardiograms performed prior to surgery and intraoperatively. Immediately postoperatively, while treated with unfractionated heparin, the patient developed thrombocytopaenia with positive platelet factor 4 antibodies and an abnormal serotonin functional platelet assay, consistent with heparin-induced thrombocytopaenia.

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Removal of the percutaneous Impella CP assist device while maintaining femoral artery access site is not always possible. This case highlights a technique of Impella removal with access site salvage.

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Purpose Of Review: Patients with cardiogenic shock (CS) continue to have high rates of morbidity and mortality. We aimed to describe current principles in the management of CS including coronary revascularization, medical management, mechanical circulatory support, and supportive care.

Recent Findings: Revascularization is still recommended, but trials have not found a benefit in the revascularization of nonculprit artery lesions.

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A 63 year old male presents with anterior ST elevation myocardial infarction. Two years prior he had PCI with DES to the proximal left anterior descending (LAD) and circumflex arteries following an abnormal stress test. Clopidogrel was discontinued several weeks prior to this presentation.

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Isolated congenital single coronary artery (SCA) is rare (incidence 0.024-0.066%).

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We present a case of a 69-year-old woman presenting with polymorphic ventricular tachycardia caused by QT prolongation. Owing to known intolerances to a majority of antiarrhythmic medications, one remaining option was to initiate phenytoin. Phenytoin's narrow therapeutic window, multiple drug interactions and side effect profile make it an infrequently used antiarrhythmic.

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scikit-image is an image processing library that implements algorithms and utilities for use in research, education and industry applications. It is released under the liberal Modified BSD open source license, provides a well-documented API in the Python programming language, and is developed by an active, international team of collaborators. In this paper we highlight the advantages of open source to achieve the goals of the scikit-image library, and we showcase several real-world image processing applications that use scikit-image.

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The biometric menagerie.

IEEE Trans Pattern Anal Mach Intell

February 2010

It is commonly accepted that users of a biometric system may have differing degrees of accuracy within the system. Some people may have trouble authenticating, while others may be particularly vulnerable to impersonation. Goats, wolves, and lambs are labels commonly applied to these problem users.

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