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Background: Elderly patients with ST‐elevation myocardial infarction (STEMI) who undergo percutaneous coronary intervention (PCI) are usually excluded from major trials. Hyopthesis: This study sought to assess 1‐year clinical outcomes following PCI with a drug‐eluting stent in patients older than 80 years old with STEMI. Methods: The large all‐comer, multicontinental e‐ULTIMASTER registry included 7507 patients with STEMI who underwent PCI using the Ultimaster stent. The primary clinical endpoint was 1‐year target lesion failure, a composite of cardiac death (CD), target vessel‐related myocardial infarction (TV‐MI), or clinically driven target lesion revascularization (CD‐TLR). Results: There were 457 (6.1%) patients in the elderly group (≥80 years old) that were compared to 7050 (93.9%) patients <80 years. The elderly patients included more female patients and had significantly more comorbidities and had more complex coronary anatomy. The primary endpoint occurred in 7.2% of the elderly, compared to 3.1% of the younger group (p <.001). All‐cause mortality was significantly higher among the elderly group compared to the younger group (10.1% vs. 2.3%, p <.0001), as well as CD (6.1% vs. 1.6%, p <.0001), but not TV‐MI (1.1% vs. 0.7%, p =.34) or CD‐TLR (1.1% vs. 1.4%, p =.63). Conclusion: Elderly patients with STEMI presentation had a higher incidence of the composite endpoint than younger patients. All‐cause and CD were higher for elderly patients compared to patients younger than 80 years old. However, there was no difference in the incidence of TV‐MI or target lesion revascularizations. These findings suggest that PCI for STEMI in elderly patients is relatively safe. [ABSTRACT FROM AUTHOR]

Background: Hemodialysis (HD) triggers recurrent and cumulative ischemic insults to the brain and the heart. Cooled dialysate may have a protective effect on major organs and improve hemodynamic tolerability of dialysis. The aim of the study was to compare HD with cooled dialysate with routine dialysis in terms of hemodynamic stability and levels of high‐sensitivity Troponin I (hs‐TnI) and N‐terminal pro b‐type natriuretic peptide (NTproBNP) pre and postdialysis. Methods: The 45 patients were randomized into two groups. The first group received a 35.5°C dialysate first (hypothermic dialysis) and the second group a 36.5°C dialysate first (routine dialysis). Then groups crossed over, so each group received the alternate dialysate (self‐controls) For each patient, the first sample was collected at the beginning of dialysis, and a second sample was taken at the end of dialysis. Results and conclusion: hs‐TnI and NTproBNP increased after routine HD by 10.7 ng\ml (p < 0.001) and (12.0 pg/μl) (p < 0.001), respectively, and by −3.1 ng\ml (p = 0.25) and (4.3 pg/μl) (p < 0.001), respectively after hypothermic HD. Our study results showed a tendency towards less rise in hsTnI and NTproBNP during hypothermic HD (35.5°C) as compared to routine HD (36.5°C). Neither arm experienced statistically significant changes in blood pressure. Further studies in larger cohorts and long follow up are warranted in order to confirm that lower rise in (hs‐TnI) and NTproBNP actually translate into lower clinical risk for cardiovascular events. [ABSTRACT FROM AUTHOR]

Amiodarone can induce TdP; therefore, it should be avoided as a first choice for therapy in patients without heart disease. Careful QT interval monitoring, especially during intravenous use, can prevent development of this life‐threatening arrhythmia. [ABSTRACT FROM AUTHOR]

Simultaneous occlusion of two coronary arteries in acute MI is infrequent and may be accompanied by cardiogenic shock. Prompt restoration of normal coronary flow can salvage the myocardium and decrease a possible risk of death from complications. [ABSTRACT FROM AUTHOR]

Sheathless guiding catheters are a valuable tool in the catheterization labor and may assist the operator when dealing with heavily calcified and tortuous vessels. Nevertheless, when hostile anatomy prevents successful percutaneous coronary interventions (PCI) from the radial access, transfemoral use of sheathless guide can assist in overcoming these challenges in a safe manner. [ABSTRACT FROM AUTHOR]

Background Red cell distribution width (RDW) is a measure of the size variation of erythrocytes. Its prognostic value has been described in a variety of cardiac and noncardiac diseases. Implantable cardioverter defibrillator (ICD) is useful in preventing sudden cardiac death in high-risk patients, but many of these patients continue to survive without needing ICD therapy. We sought to examine whether RDW, with its prognostic values, can benefit in risk stratification of patients with ICD by predicting death and ICD therapy, and thus help in the selection of patients who will benefit the most from ICD, and minimizing its implantation in others at low risk of death and arrhythmias. Methods In a retrospective study, we enrolled patients with ICD implanted for both primary and secondary prevention of sudden cardiac death. Baseline RDW values, demographics, and clinical characteristics, as well as the occurrence of death or first appropriate ICD therapy in postimplantation follow-up were collected. We examined whether RDW can predict higher-risk ICD-implanted patients prone to death and first appropriate ICD therapy (the combined outcome). Results Final population included 432 patients. Compared to others, patients in the upper RDW tertile were older and had more comorbidities and outcomes. In multivariate analysis including RDW, age, gender, and ejection fraction, RDW was the only predictor of the combined outcome. Conclusion RDW may be useful in risk stratification of patients selected for ICD implantation. But larger prospective randomized trials are needed. [ABSTRACT FROM AUTHOR]

The cover image is based on the Case Report I Complicated Acute Myocardial Infarction with Simultaneous Occlusion of Two Coronary Arteries i by Irina Nordkin, Zeev Israeli, Majdi Halabi et al., https://doi.org/10.1002/ccr3.2685. GLO:H4ZE/01mar20:ccr32821-toc-0001.jpg PHOTO (COLOR): . gl. [Extracted from the article]