Publications by authors named "Tarek Chami"

Unlabelled: The Sars coronavirus 2019 (COVID-19) pandemic has resulted in increased morbidity and mortality; however, there is limited understanding of how excess mortality is distributed among different racial and ethnic subgroups and vascular diseases.

Methods: We conducted a retrospective, cross-sectional study design using data from the United States (US) Center for Disease Control (CDC) Wide Ranging Online Data for Epidemiologic Research (Wonder) database. The database contains death certificate information for all US residents by cause of death as ascertained by the treating physician.

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Article Synopsis
  • The study investigates the impact of the COVID-19 pandemic and iodinated contrast shortage on the educational experience of first-year interventional cardiology (IC) fellows in the U.S. and Canada.
  • A survey of 111 fellows revealed that most worked long hours, predominantly in university programs, and had varied competencies with advanced procedures and technologies.
  • The results show significant gaps in training, particularly in intravascular imaging, complication management, and psychological support, along with high levels of stress among fellows.
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Double kissing crush (DK crush) is one of the preferred strategies for bifurcation stenting due to the lower risk of target vessel failure but can be difficult to perform. Difficulty in wiring the jailed side branch after stenting the main vessel is not uncommon. The retrograde crossing can provide a solution in selected cases when antegrade rewiring of a jailed side branch fails during DK crush (or other bifurcation stenting techniques).

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Acute myelogenous leukemia (AML) is one of the most common leukemias experienced in adults and conveys significant morbidity and mortality. While the traditional anthracycline based treatments of AML involves cytarabine, developments in alternatives (liposomal cytarabine, fludarabine, cladribine, azacitidine, decitabine), and targeted agents (midostaurin, gilteritinib, enasidenib, ivosidenib, gemtuzumab ozogamicin, and venetoclax) exist. Multiple cardiovascular adverse events, notably pericardial toxicity, have been observed in small studies; however, to date little is known about the comparative pericardial toxicity among these newer regimens.

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Background Despite the known significant morbidity and mortality associated with cardiovascular disease and peripheral vascular disease (PVD), contemporary data describing racial demographics in PVD mortality are scarce. Methods and Results Using the multiple causes of death file from the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research, we analyzed the trends of age-adjusted mortality (AAMR) for PVD and its subtypes (aortic aneurysm/dissection, arterial thrombosis, venous thrombosis/disease, pulmonary embolism), by race and sex between 1999 and 2019. Of the 17 826 871 deaths attributed to cardiovascular disease, a total of 888 187 (5.

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Background: Massive or high-risk pulmonary embolism (PE) is a potentially life-threatening diagnosis with significant morbidity and mortality if treatment is delayed. Extracorporeal membrane oxygenation (ECMO) and large bore thrombectomy (LBT) in isolation have been used to stabilize and treat patients with massive PE, however, literature describing the combination of both modalities is lacking. We present a case series involving 9 patients who underwent combined ECMO and LBT and their outcomes.

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Despite significant progress, chronic total occlusion (CTO) percutaneous coronary interventions (PCI) are often challenging and carry increased risk of complications. We present a highly complex CTO PCI case that was successfully completed despite numerous complications (perforation, donor vessel closure, stent loss, guide extension tip fracture, access site bleeding and cardiac arrest) to highlight the importance of appropriate patient selection, pre-procedural planning, comprehensive patient-centered risk/benefit discussion, and prompt recognition and treatment of intra-procedural complications.

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Article Synopsis
  • Research indicates that heart failure (HF) is a significant health issue for patients with chronic kidney disease (CKD), necessitating better early prediction methods.
  • A study analyzed blood samples from 3,182 CKD patients to assess 11 biomarkers, identifying four key ones (BNP, FGF23, fibrinogen, hsTnT) that predict HF risk.
  • Results showed that higher biomarker scores correlated with increased HF incidence, emphasizing the potential of a multi-variable biomarker approach for early intervention in CKD patients.
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Percutaneous coronary intervention of heavily calcified coronary vessels can be challenging due to difficult equipment delivery and suboptimal stent expansion, leading to worse clinical outcomes. Supportive guidewires are designed to facilitate equipment delivery. We present two cases of heavily calcified and tortuous coronary lesions in which use of support guidewires hindered balloon and stent delivery, possibly by increasing friction between equipment and the wall of the coronary vessel.

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Vascular closure devices (VCD) are effective at achieving hemostasis. VCD failure is attributed to underlying arterial disease, leading to a hazardous situation for obtaining contralateral femoral access. Radial-to-peripheral (R2P) access has emerged as a safe option to rescue these procedural complications.

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Objectives: Evaluation of the safety and efficacy of the Penumbra device as an adjunct to percutaneous coronary intervention (PCI) in patients with myocardial infarction (MI) and a large thrombus burden that requires thrombectomy.

Background: For patients with acute MI, PCI is the primary reperfusion method. Large thrombus burden has always been a limitation of successful reperfusion.

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Cardiac allograft vasculopathy (CAV) is the leading cause of long-term graft dysfunction in patients with heart transplantation and is linked with significant morbidity and mortality. Currently, the gold standard for diagnosing CAV is coronary imaging with intravascular ultrasound during traditional invasive coronary angiography. Invasive imaging, however, carries increased procedural risk and expense to patients in addition to requiring an experienced interventionalist.

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Chronic kidney disease (CKD) is associated with high cardiovascular risk and mortality. Myeloperoxidase (MPO) has been linked to adverse events in patients with mild-moderate CKD. We sought to investigate whether MPO levels are associated with adverse outcomes in patients with CKD.

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Background: Diaphragmatic pacemakers are used to assist respiration in ventilator-dependent patients. Electromagnetic interference with intrinsic cardiac electrical activity is a theoretical risk but has never been reported in the literature. This case highlights a serious complication of cardiac arrest as a result of diaphragmatic pacing.

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Pericarditis is a rare but debilitating complication of cytarabine therapy. While echocardiography can aid with the diagnosis, cardiac MRI has superior accuracy in establishing the diagnosis. In this case, we describe a 65-year-old patient receiving cytarabine as part of induction chemotherapy for acute myeloid leukemia who developed acute pericarditis.

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Background: Atrial fibrillation ablation increased over the last two decades by its high success rate. However, the trend of inpatient adverse outcomes is limited. The aim of this study to examine the frequency and predictors of acute pericarditis resulting from catheter ablation.

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