TED-Time and life saving External Defibrillator for home-use.

Sudden Cardiac Death--SCD --is a major unmet health problem that needs urgent and prompt solution. AICDs are very expensive, risky and indicated for a small group of patients, at the highest risk. AEDs--Automatic External Defibrillators--are designed for public places and although safe, cannot enter the home-market due to their cost and need for constant, high-cost maintenance.

Thrombolysis followed by coronary angiography versus primary percutaneous coronary intervention in non-anterior ST-elevation myocardial infarction.

Background: Previous studies demonstrated the superiority of primary percutaneous coronary intervention (PCI) over thrombolysis for treatment of ST-elevation myocardial infarction (STEMI); however, this advantage is less evident in low-risk populations. The aim of this study was to assess whether a strategy of thrombolysis followed by routine coronary angiography in patients with non-anterior STEMI is non-inferior to primary PCI.

Methods: Consecutive patients with non-anterior STEMI presenting within 6 hours of symptom onset who received reperfusion treatment were included.

Vorapaxar in acute coronary syndrome patients undergoing coronary artery bypass graft surgery: subgroup analysis from the TRACER trial (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome).

Objectives: This study evaluated effects of protease-activated receptor-1 antagonist vorapaxar (Merck, Whitehouse Station, New Jersey) versus placebo among the TRACER (Thrombin Receptor Antagonist for Clinical Event Reduction in Acute Coronary Syndrome) study patients with non-ST-segment elevation acute coronary syndromes undergoing coronary artery bypass grafting (CABG).

Background: Platelet activation may play a key role in graft occlusion, and antiplatelet therapies may reduce ischemic events, but perioperative bleeding risk remains a major concern. Although the TRACER study did not meet the primary quintuple composite outcome in the overall population with increased bleeding, an efficacy signal with vorapaxar was noted on major ischemic outcomes, and preliminary data suggest an acceptable surgical bleeding profile.

Cardiac structure and function in persons 85 years of age.

Individuals aged >85 years constitute the world's most rapidly growing age group. Despite the rapid growth of this population and its high incidence of cardiovascular morbidity, normative data concerning cardiac structure and function are limited. The objective of this study was to define cardiac structure and function in an age-homogenous, community-dwelling population of subjects born in 1920 and 1921.

Combination of the Killip and TIMI classifications for early risk stratification of patients with acute ST elevation myocardial infarction.

Objective: The Killip classification and the Thrombolysis in Myocardial Infarction (TIMI) score have been proven to be useful tools for the early risk stratification of patients with acute myocardial infarction (MI). The Killip classification is simpler and less time consuming compared to the TIMI score. We sought to evaluate the added value of applying the TIMI score to patients prestratified with the Killip classification.

Giant precordial T wave inversion in a patient with gastroenteritis.

Giant precordial T wave inversion (GPTI) on ECG may be the result of several pathologies, including myocardial ischemia, pulmonary edema, pulmonary embolism, subarachnoid hemorrhage, apical hypertrophy, and postpacing. We describe a case of a 75-year-old woman who developed GPTI after an episode of gastroenteritis. To our knowledge, this is the first report of this ECG pattern associated with gastroenteritis.

ST deviation pattern and infarct related artery in acute myocardial infarction.

Background: Myocardial infarction (MI) may be classified as ST-elevation MI (STEMI) or non-ST-elevation MI (NSTEMI). There is little data regarding the relationship between the infarct related artery (IRA), clinical characteristics of the patients, and the ST deviation pattern (ie, STEMI or NSTEMI).

Hypothesis: There is a predilection of any coronary artery to a particular ST deviation pattern of acute MI.

Effect of gradual computerized angioplasty on outcomes of patients undergoing coronary stenting.

Mechanical trauma caused by percutaneous coronary intervention is a major factor contributing to subsequent cardiac events, restenosis, and the need for target lesion revascularization (TLR). To minimize this trauma, we developed a Computerized Angioplasty Pressure Sensor and Inflator Device (CAPSID) for gradual inflation. The objective of the present prospective randomized study was to examine whether the use of this novel device reduced TLR, as well as cardiac events, in patients undergoing stenting.

Acute hyperglycemia and spontaneous reperfusion in acute myocardial infarction.

Background: Spontaneous reperfusion (SR) may occur in patients with ST elevation myocardial infarction (STEMI) prior to reperfusion therapy. Hyperglycemia is common on admission in patients with STEMI and is associated with a worse prognosis. Mechanisms remain unclear but may include impairment of coronary flow.

Effect of severe aortic stenosis on the outcome in elderly patients undergoing repair of hip fracture.

Background: The perioperative assessment and management of elderly patients with hip fracture and significant aortic stenosis (AS) is an increasingly common clinical problem with little data available to guide perioperative management.

Objectives: It was the aim of this study to examine the incidence of perioperative events in an elderly population of patients with severe AS undergoing repair of hip fracture as compared with controls without severe AS.

Methods: Patients over the age of 70 with an echocardiographic diagnosis of severe AS defined as an aortic valve area View Article and Find Full Text PDF

Computerized gradual balloon inflation: a novel strategy of coronary angioplasty superior to a standard manual approach.

Background: Mechanical trauma caused by PCI is a primary reason for restenosis and subsequent target lesion revascularization (TLR). To minimize this trauma, we developed a computerized angioplasty pressure sensor and inflator device (CAPSID) for gradual inflation. The objective of this prospective randomized study was to examine whether use of CAPSID reduces early and late cardiac events in patients undergoing PCI.

Relation of spontaneous reperfusion in ST-elevation myocardial infarction to more distal coronary culprit narrowings.

Spontaneous reperfusion (SR) of the infarct-related artery may occur in patients with ST-segment-elevation myocardial infarctions (STEMIs). Limited data are available on the angiographic characteristics of these patients. The objective of this study was to determine if there are differences in the distance of the culprit lesion from the coronary ostium in patients with STEMIs with and without SR.

Removal of contrast medium from the coronary sinus during coronary angiography: feasibility of a simple and available technique for the prevention of nephropathy.

Background: Contrast-induced nephropathy (CIN) is a major complication of percutaneous coronary interventions with currently limited preventive measures.

Objectives: To prevent CIN, we assessed the safety and feasibility of contrast removal from the coronary sinus (CS) during coronary angiography.

Methods: We attempted contrast removal on seven patients undergoing coronary angiography with preexisting renal insufficiency (mean serum creatinine=262+/-56 mg%).

ST deviation pattern in acute myocardial infarction is not related to lesion location.

Background: In ST-elevation MI (STEMI) the culprit artery is usually occluded, whereas non-STEMI (NSTEMI) it is usually patent. The location of the ruptured plaque may influence MI type. We examine whether the distance from the coronary ostium to the culprit lesion is different in STEMI as compared to NSTEMI.

Coronary artery stenting in patients treated by clopidogrel without aspirin.

Background: Combined therapy with aspirin and clopidogrel is currently the standard treatment for patients undergoing coronary artery stenting. Some stented patients do not tolerate aspirin and are treated by clopidogrel only, the risk of major adverse clinical events (MACE) in such patients is unclear.

Objective: To assess the risk of MACE in stented patients treated by clopidogrel only.

Seasonal variation in myocardial infarction is limited to patients with ST-elevations on admission.

Previous studies have demonstrated seasonal variation in the incidence of acute myocardial infarction (AMI) with an increase in cases during the winter months. However, they did not assess whether ST-elevation MI (STEMI) and non-ST-elevation MI (NSTEMI) exhibit similar changes. The object of this study was to compare the seasonal variation of STEMI and NSTEMI.

Brain natriuretic peptide levels predict perioperative events in cardiac patients undergoing noncardiac surgery: a prospective study.

Objectives: Brain natriuretic peptide (BNP) levels correlate with prognosis in patients with cardiac disease and may be useful in the risk stratification of cardiac patients undergoing noncardiac surgery (NCS). The objective of this study was to examine whether BNP levels predict perioperative events in cardiac patients undergoing NCS.

Methods: Patients undergoing NCS with at least 1 of the following criteria were included: a clinical history of congestive heart failure (CHF), ejection fraction <40%, or severe aortic stenosis.

Measurement of wall thickness alone does not accurately assess the presence of left ventricular hypertrophy.

Clinical echocardiographic assessment of left ventricular hypertrophy (LVH) is generally performed by measuring wall thickness alone (WT). The objective of this study was to compare the assessment of LVH using the measurement of WT to that using indexed LV mass. Hypertensive patients underwent echocardiography with the measurement of LV WT and LV mass.

Smoking cessation does not alter ST deviation pattern of recurrent myocardial infarctions.

Background: Myocardial infarction (MI) may be classified as ST elevation MI (STEMI) or non ST elevation MI (NSTEMI). We used the term recurrent MI (RMI's) to denote repeated MI episodes, in a particular patient, in which a different coronary site is responsible for each episode. Recently we reported that most patients with recurrent MI episodes will have either STEMI's or NSTEMI's but not both.

ST-deviation patterns in recurrent myocardial infarctions.

Myocardial infarction (MI) may be classified as ST-elevation MI (STEMI) or non-STEMI (NSTEMI). We used the term "recurrent MI" (RMI) to denote repeat MI episodes in a particular patient in which a different coronary site is responsible for each episode. We investigated whether the type of RMI is more likely to be of the same type as the index MI or whether patients may have the 2 types of MI at random.