In vivo optical coherence tomography of very late drug-eluting stent thrombosis compared with late in-stent restenosis.

Background: Autopsy findings have suggested delayed arterial healing as a primary cause of very late stent thrombosis (VLST) after drug-eluting stent (DES) implantation.

Methods And Results: Optical coherence tomography of DES-treated lesions that developed VLST (n = 6) was compared with that of DES-treated lesions that developed late in-stent restenosis (L-ISR: n = 32) among patients with recurrent ischemia >1 year after DES implantation (mean, 37 ± 17 months), and with the stented segment without any evidence of VLST or L-ISR (no-event: n = 20; mean, 38 ± 19 months). The proportion of uncovered and malapposed struts in each stented segment was evaluated.

The potential benefits and risks of the use of dual antiplatelet therapy beyond 6 months following sirolimus-eluting stent implantation for low-risk patients.

Background: The optimal duration of dual antiplatelet therapy (DAT) in patients undergoing intracoronary sirolimus-eluting stent implantation remains controversial.

Objective: To evaluate the clinical effects of long duration DAT in patients undergoing intracoronary sirolimus-eluting stent implantation in daily practice. In addition, to attempt to identify the optimal duration of DAT after implantation of a sirolimus-eluting stent.

The impact of gender difference on the effects of preinfarction angina on microvascular damage with reperfused myocardial infarction.

Background: Few studies have addressed gender differences in evoking preconditioning. In an experimental study, it was reported that the preconditioning effect disappeared after gonadectomy.

Objectives: We sought to determine the effects of preinfarction angina (PA) on myocardial damage using intravenous contrast echocardiography.

Waist circumference reduction is more strongly correlated with the improvement in endothelial function after acute coronary syndrome than body mass index reduction.

Background: Endothelial function predicts recurrence of adverse cardiac events in patients with acute coronary syndromes (ACS). Moreover, the recovery of endothelial function correlates with cardiac event-free survival.

Objectives: The aim of this study was to determine which clinical factors correlate with the improvement in endothelial function after ACS.

Relationship of admission neutrophil count to microvascular injury, left ventricular dilation, and long-term outcome in patients treated with primary angioplasty for acute myocardial infarction.

Background: The relationship of admission neutrophil count to the degree of microvascular injury, left ventricular (LV) volume, and long-term outcome after acute myocardial infarction (AMI) was examined in the present study.

Methods And Results: The study group comprised 228 consecutive patients with a first anterior wall AMI who underwent primary angioplasty within 12 h of onset. The degree of microvascular injury was evaluated by Doppler guidewire.

Usefulness of coronary flow reserve immediately after primary coronary angioplasty for acute myocardial infarction in predicting long-term adverse cardiac events.

Coronary flow reserve (CFR) evaluated immediately after reperfusion is thought to reflect the degree of microvascular injury and predict left ventricular (LV) functional recovery after acute myocardial infarction. It was hypothesized that CFR immediately after reperfusion would be predictive of the occurrence of long-term adverse cardiac events. Using a Doppler guidewire, CFR was evaluated immediately after primary coronary angioplasty in 118 consecutive patients with first anterior acute myocardial infarctions.

Effects of smoking cessation on coronary endothelial function in patients with recent myocardial infarction.

Background: Smoking is associated with an increased risk and extent of advanced atherosclerotic vascular disease, but few studies have examined the clinical effect of smoking cessation on human coronary endothelial function.

Objectives: We sought to determine the effects of smoking cessation on endothelial function in patients with recent myocardial infarction.

Methods: Infarcted-not-related coronary arteries of 53 patients with acute myocardial infarction undergoing successful angioplasty were examined in two groups: smoking cessation group (n=35, 28 males, mean age 56 years) and non-smoking group (n=18, 10 males, mean age 65 years).

Relation between neutrophil counts on admission, microvascular injury, and left ventricular functional recovery in patients with an anterior wall first acute myocardial infarction treated with primary coronary angioplasty.

Increased neutrophil counts have been associated with an increased risk of adverse clinical events after acute myocardial infarction (AMI). We examined the association of neutrophil counts on admission with degree of microvascular injury and left ventricular functional recovery after primary coronary angioplasty in AMI. We studied 116 patients with a first anterior wall AMI who underwent primary coronary angioplasty within 12 hours of onset.

Usefulness of ultrasonic strain measurements to predict regional wall motion recovery in patients with acute myocardial infarction after percutaneous coronary intervention.

Strain Doppler echocardiography can detect systolic regional myocardial dysfunction. This study assessed whether strain could predict recovery of regional left ventricular function in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention. Forty-three patients with anterior AMI undergoing successful percutaneous coronary intervention of the left anterior descending coronary artery were studied.

The effects of atorvastatin on coronary endothelial function in patients with recent myocardial infarction.

Background: Endothelial dysfunction is a key early event in atherosclerosis that occurs in acute coronary syndrome. It was reported that atorvastatin improves the endothelial function of skeletal muscle vessels, but the effect on the coronary artery is unknown.

Hypothesis: The purpose of this study is to determine the effects of atorvastatin on coronary endothelial function in humans.

Impact of hydroxymethylglutaryl coenzyme A reductase inhibition on left ventricular remodeling in patients with acute anterior myocardial infarction after primary coronary angioplasty.

Hydroxymethyglutaryl coenzyme A reductase inhibition (statin) therapy has been shown to reduce cardiac hypertrophy in vitro and in vivo. We assessed the influence of short-term statin therapy on left ventricular (LV) remodeling after acute myocardial in-farction. Thirty-five patients with first anterior acute myocardial infarction, who underwent primary coronary angioplasty within 12 hours of onset, were divided into 2 groups.

Ultrasonic tissue characterization predicts left ventricular remodeling in patients with acute anterior myocardial infarction after primary coronary angioplasty.

Objectives: The aim of this study was to assess the role of cyclic variation (CV) of myocardial integrated backscatter (IBS) in the prediction of left ventricular (LV) remodeling in patients with anterior acute myocardial infarction (AMI) after primary coronary angioplasty.

Background: Some studies have shown that the CV of myocardial IBS predicts myocardial viability for patients with AMI.

Methods: We recorded short-axis IBS images within 24 hours of angioplasty in 80 patients with anterior AMI.

Acute myocardial infarction caused by simultaneous occlusion of the right coronary artery and the left anterior descending coronary artery probably due to coronary spasm: a case report.

A 56-year-old man had an attack of chest pain associated with ST-segment elevation in both the inferolateral and anteroseptal leads on electrocardiography. Emergency coronary angiography showed thrombus in the mid right coronary artery and total occlusion in the distal left anterior descending coronary artery. Intravenous heparin infusion and antiplatelet therapy were given without other coronary intervention.

Left ventricular free wall rupture in transient left ventricular apical ballooning.

A 79-year-old woman presented with chest pain. Her symptoms, combined with the results of an electrocardiogram, echocardiogram and laboratory investigations were compatible with an extensive acute anterior myocardial infarction. However, emergency coronary angiography showed no stenotic lesion in any coronary artery, but left ventriculography revealed apical ballooning akinesis and basal hyperkinesis and she was diagnosed as having transient left ventricular apical ballooning.

Usefulness of coronary flow reserve immediately after primary coronary stenting in predicting wall motion recovery in patients with anterior wall acute myocardial infarction.

This study examined whether coronary flow reserve (CFR) measured immediately after primary coronary stenting could predict wall motion recovery in patients who have acute myocardial infarction. CFR significantly correlated with the change of wall motion score (r = 0.68, p <0.

Primary cardiac tumor presenting as obstruction of the left ventricular outflow tract.

A transthoracic echocardiogram revealed 3 tumors in the left atrium of a 64-year-old woman, who died suddenly 8 months after resection of the tumors. Primary cardiac tumors are unusual and a case of postoperative left ventricular metastases of the atrial tumors resulting in left ventricular outflow tract obstruction is very rare occurrence.

Specific findings of the standard 12-lead ECG in patients with 'Takotsubo' cardiomyopathy: comparison with the findings of acute anterior myocardial infarction.

The clinical course of 'Takotsubo' cardiomyopathy closely resembles that of acute myocardial infarction (AMI) and coronary angiography (CAG) is usually performed to distinguish the 2 conditions during the acute phase. The present study was designed to determine whether the standard 12-lead electrocardiogram (ECG) findings could help to distinguish 'Takotsubo' cardiomyopathy from anterior AMI. The study group comprised 13 patients with 'Takotsubo' cardiomyopathy and 13 consecutive patients with anterior AMI.

Influence of diabetes mellitus on outcome in the era of primary stenting for acute myocardial infarction.

The purpose of the present study was to examine the influence of diabetes mellitus (DM) on the clinical and angiographic outcomes in 62 diabetic and 152 nondiabetic patients with acute myocardial infarction (AMI) treated with primary coronary stenting within 12 h of the onset of symptoms. The diabetic patients had a greater incidence of hyperlipidemia, prior myocardial infarction (MI) and multivessel disease. There were no statistically significant differences in other variables.