Efficacy and safety of novel oral anticoagulants in patients with bioprosthetic valves.

Purpose: Prosthetic valve replacement is performed in several hundred thousand patients worldwide annually, and many of these patients have or will ultimately develop atrial fibrillation or flutter (AF). Novel oral anticoagulants (NOACs) are not recommended in patients with AF and mechanical valves but have not been evaluated in patients with bioprosthetic valves. This study sought to evaluate the efficacy and safety of NOACs in patients with AF and bioprosthetic valves.

Clinical experience and patient outcomes associated with the TandemHeart percutaneous transseptal assist device among a heterogeneous patient population.

There is a paucity of literature describing the outcomes associated with the use of TandemHeart percutaneous ventricular assist device (PVAD). The literature is limited by analyzing only subsets of patients. We present the clinical outcomes and safety associated with the use of TandemHeart among a series of heterogeneous patients requiring PVAD support.

Angiographic and magnetic resonance imaging evaluation of in-hospital delay in primary percutaneous intervention delivery on myocardial salvage.

Shortening symptom-to-reperfusion time improves prognosis in patients with ST-segment elevation myocardial infarction. Accordingly, current guidelines target a door-to-balloon time <90 minutes, irrespective of symptom-to-door time; nevertheless, the relation between door-to-balloon and symptom-to-door time and its potential impact on myocardial salvage remains largely unknown. We investigated the influence of door-to-balloon guideline fulfillment on myocardial salvage in patients presenting with different symptom-to-door times.

Off-label use of drug-eluting versus bare metal stents: a lesion-specific systematic review of long-term outcomes.

Objective: The purpose of this systematic review was to evaluate differences in lesion-specific outcomes with the "off-label" use of drug-eluting stents (DES) versus bare metal stents (BMS).

Methods: MEDLINE, PubMed, the Cochrane databases, and other Web were searched for studies evaluating off-label use of DES and BMS with the same characteristics. Of 1,258 abstracts or manuscripts reviewed, 112 studies were included (total N = 23,438).

Drug-eluting versus bare-metal stents in unprotected left main coronary artery stenosis a meta-analysis.

Objectives: We undertook a meta-analysis to assess outcomes for drug-eluting stents (DES) and bare-metal stents (BMS) in percutaneous coronary intervention for unprotected left main coronary artery (ULMCA) stenosis.

Background: Uncertainty exists regarding the relative performance of DES versus BMS in percutaneous coronary intervention for unprotected left main coronary stenosis.

Methods: Of a total of 838 studies, 44 met inclusion criteria (n = 10,342).

Determinants of myocardial salvage during acute myocardial infarction: evaluation with a combined angiographic and CMR myocardial salvage index.

Objectives: This study examined the contribution of symptom-to-reperfusion time, collateral flow, and antegrade flow in the infarct-related artery on myocardial salvage using a combined angiographic-cardiac magnetic resonance (CMR) method.

Background: The myocardium supplied by an acutely occluded artery defines the anatomical area at risk for infarction. This area can be determined independently of residual coronary flow to the risk region.

Unrecognized non-Q-wave myocardial infarction: prevalence and prognostic significance in patients with suspected coronary disease.

Background: Unrecognized myocardial infarction (UMI) is known to constitute a substantial portion of potentially lethal coronary heart disease. However, the diagnosis of UMI is based on the appearance of incidental Q-waves on 12-lead electrocardiography. Thus, the syndrome of non-Q-wave UMI has not been investigated.

Correspondence between the 17-segment model and coronary arterial anatomy using contrast-enhanced cardiac magnetic resonance imaging.

Objectives: The purpose of this study was to investigate the correspondence between the coronary arterial anatomy and supplied myocardium based on the proposed American Heart Association 17-segment model.

Background: Standardized assignment of coronary arteries to specific myocardial segments is currently based on empirical assumptions.

Methods: A cardiac magnetic resonance study was performed in 93 subjects following acute myocardial infarction treated with primary percutaneous coronary intervention.

Detection of stent fractures: a comparison of 64-slice CT, conventional cine-angiography, and intravascular ultrasonography.

Rational And Objectives: We evaluated the ability of 64-slice computed tomography (CT), conventional cine-angiography, and intravascular ultrasound (IVUS) to detect stent fractures under ideal conditions. Coronary stent fracture has been implicated as one of the mechanisms of stent thrombosis and, perhaps, in-stent restenosis. However, the preferred imaging modality in detecting fractures in coronary stents has not been well established.

Accelerating restrictive cardiomyopathy after liver transplantation in a patient with familial amyloidotic polyneuropathy: a case report.

Introduction: Hereditary amyloidodis is a rare disease process with a propensity to cause polyneuropathies, autonomic dysfunction, and restrictive cardiomyopathy. It is transmitted in an autosomal dominant manner, with disease onset usually in the 20s-40s. The most common hereditary amyloidogenic protein, transthyretin, is synthesized in the liver and lies on Chromosome 18.

Three-dimensional breathhold magnetization-prepared TrueFISP: a pilot study for magnetic resonance imaging of the coronary artery disease.

Purpose: X-ray angiography is currently the standard test for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this work was the evaluation of the accuracy of a three-dimensional (3D) breathhold coronary magnetic resonance angiography (MRA) technique in detecting hemodynamically significant coronary artery stenoses in a patient population with x-ray angiographic correlation.

Angiographic estimates of myocardium at risk during acute myocardial infarction: validation study using cardiac magnetic resonance imaging.

Aims: Global angiographic scores have been developed to determine the extent of myocardium jeopardized by significant coronary stenosis. We adapted these scores to quantify the anatomic area at risk during acute myocardial infarction. We used contrast-enhanced magnetic resonance (CMR) infarct imaging to measure the portion of myocardium that developed necrosis within the so defined angiographic area at risk.

Outcomes and complications associated with off-label and untested use of drug-eluting stents.

Context: Limited data exist regarding use of drug-eluting stents outside of approved indications in real-world settings.

Objectives: To determine the frequency, safety, and effectiveness of drug-eluting stents for off-label (restenosis, bypass graft lesion, long lesions, vessel size outside of information for use recommendation) and untested (left main, ostial, bifurcation, or total occlusion lesions) indications in percutaneous coronary intervention (PCI).

Design, Setting, And Patients: Observational, prospective, multicenter registry to evaluate in-hospital, 30-day, and 1-year outcomes among patients undergoing PCI between January and June 2005 in 140 US academic and community medical centers.

Coronary magnetic resonance angiography using magnetization-prepared contrast-enhanced breath-hold volume-targeted imaging (MPCE-VCATS).

Objectives: Coronary artery x-ray angiography (XRA) is currently the gold standard for the assessment of coronary artery disease. A substantial minority of patients referred for coronary angiography have no significant coronary artery disease. The purpose of this study is to evaluate magnetization-prepared contrast-enhanced breath-hold volume-targeted imaging (MPCE-VCATS), a new 3-dimensional breath-hold coronary magnetic resonance angiography (MRA) technique, in detecting hemodynamically significant coronary artery stenoses in a patient population, with XRA correlation.

Angiographically silent left main disease detected by intravascular ultrasound: a marker for future adverse cardiac events.

Background: Concomitant moderate obstructive left main (LM) disease is associated with future cardiac events and poor prognosis in patients undergoing percutaneous intervention (PCI). Whether prognosis is similarly effected by LM disease not detected by angiography, but evident on intravascular ultrasound (IVUS) imaging, is not known. The purpose of this study was to evaluate the long-term prognosis of patients with angiographically insignificant LM coronary artery disease undergoing PCI.

A comparison of arterial closure devices to manual compression in liver transplantation candidates undergoing coronary angiography.

Whether arterial closure devices can be used safely in a coagulopathic population undergoing cardiac catheterization and at high risk for groin complications, such as liver transplant candidates, is unknown. In this prospective, non-randomized consecutive series of 80 liver transplant candidates undergoing coronary angiography, manual compression and arterial closure devices were compared. Ilio-femoral angiography was performed to determine suitability for use of the closure device.

Post-cardiac catheterization access site complications and low-molecular -weight heparin following cardiac catheterization.

The low molecular weight heparin enoxaparin is often administered to patients on long-term anticoagulation regimens who temporarily discontinue warfarin prior to undergoing invasive procedures. The clinical outcome of all enoxaparin-treated patients who underwent cardiac catheterization or coronary artery interventional procedures (n = 119) was evaluated. A total of 5 patients (4.