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There is a lack of clinical trials comparing Multivessel Percutaneous Coronary Intervention (MV PCI) with Coronary Artery Bypass Grafting (CABG) in patients presenting non-ST-segment elevation acute coronary syndromes (NSTE-ACS). We sought to compare long-term outcomes of MV PCI with CABG in

Presence of durable polymers may be associated with late/very late stent thrombosis occurrence and the need for prolonged dual antiplatelet therapy. Bioabsorbable polymers may facilitate stent healing, thus enhancing clinical safety. We sought to determine the 1-year clinical follow-up in patients

Immediate risk stratification of patients with acute myocardial infarction (AMI) at the time of initial presentation is important for their optimal management. Generally, prognostic scores are derived from registry or trial data and are composed of clinical or angiographic variables independently

Heart failure (HF) is the major cause of death in cardiovascular disease. In a post-STICH environment, we lack data on the role of PCI in systolic HF patients. Complete revascularization of myocardium remains one of the key unanswered questions in ischemic HF. The COMMIT-HF is an ongoing single

The aim of the present study was to evaluate the effect of chronic total occlusion (CTO) localization in nonifarct-related artery (IRA) on 12 months mortality in patients with NSTEMI and multivessel coronary artery disease (MV CAD) treated with PCI We analyzed consecutive records of 991 patients

Presence of durable polymers may be associated with late/very late stent thrombosis occurrence and the need for prolonged dual antiplatelet therapy. Bioabsorbable polymers may facilitate stent healing, thus enhancing clinical safety. We sought to determine the 1-year clinical follow-up in patients

The aim was to compare treatment and clinical outcomes of cardiogenic shock (CS) AMI patients with and without diabetes mellitus. We analyzed 896 patients with CS and AMI from PL-ACS registry. Follow-up mortality was obtained from the government database. Patients with diabetes comprised 23% of CS

Background: Recently, usefulness of intraaortic balloon pump (IABP) for patients with acute myocardial infarction (AMI) and cardiogenic shock (CS) is questioned. Therefore we analysed influence of IABP in CS AMI patients with unsuccessful and successful primary PCI on 30-day mortality. Methods: We analysed 4211 patients with CS and AMI from nationwide PL-ACS registry. Unsuccessful PCI was defined as final TIMI flow grade 0 or 1. Results: Patients with unsuccessful PCI comprised 13.5% (table). In both unsuccessful and successful PCI groups 20% of patients had IABP support and these patients were of the higher risk profile. IABP was associated with lower 30-day mortality in unsuccessful PCI group while with higher in successful PCI group. After adjustment in multivariate Cox proportional model regression IABP remained significantly associated with reduction of 30-day mortality in patients with unsuccessful PCI (HR 1⁄4 0.71, 95%CI 1⁄4 0.55-0.91, p1⁄40.0065) and increased mortality in patients with successful PCI (HR 1⁄4 1.26, 95%CI 1⁄4 1.13-1.43, p

The aim of this study was to assess the influence of pre-hospital treatment with intravenous heparin on the early patency rate olthe infarct related artery in acute myocardial infarction. The inclusion criteria were: beginning of chest pain in the 6 hours preceding admission, ST segment elevation ≥ 1 mm in at least two leads of the standard ECG and no contraindications to antithrombotic treatment. One hundred and twenty four patients with these criteria were divided into 2 groups. Forty five patients (group I) were treated with 5,000 units of heparin i.v. before admission tD hospital. Seventy nine patients (group II) did not receive heparin before hospitalisation. All patients in both groups were put on Aspirin 150 mg p.o., nitro-glycerine and analgesics before admission. The mean period from the beginning of the chest pain was 2.7 ± 1.5 hour in group I and 2.8 ± 1.4 hour in group II (p = NS). Both groups did not differ in relation to age, sex, risk factors and previous incidence of myocardial infarction. In the emergency room all patients were put on heparin and nitro-glycerine infusions i.v. and were transferred immediately to the catheterisation laboratory for coronary angiography. The flow through the infarct related artery was assessed according to the TIMI classification. Patent infarct related arteries (i.e. TIMI flow grade 1, 2 or 3) were observed in 19 patients (42.2%) in group I and in 18 (22.8%) in group II (p = 0.038). Successful reperfusion (defined as TIMI grade 2 or 3) was present in 11 patients (24.4%) in group I and in 7 (8.8%) in group II (p = 0.035). Download : Download high-res image (108KB) Download : Download full-size image This pilot study suggests that pre-hospital treatment with intravenous heparin can significantly improve flow in infarct related arteries. A prospective randomised study is needed to confirm these results.

It has been proven that presence of chronic total occlusion (CTO) in other than infarct-related artery (IRA) in patients with NSTEMI is associated with higher rates of in-hospital and long-term mortality than in patients without CTO. However, there is a lack of data regarding the influence of the