28 results on '"Cohen, Mauricio G."'
Search Results
2. Treatment of Higher-Risk Patients With an Indication for Revascularization: Evolution Within the Field of Contemporary Percutaneous Coronary Intervention.
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Kirtane AJ, Doshi D, Leon MB, Lasala JM, Ohman EM, O'Neill WW, Shroff A, Cohen MG, Palacios IF, Beohar N, Uriel N, Kapur NK, Karmpaliotis D, Lombardi W, Dangas GD, Parikh MA, Stone GW, and Moses JW
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- Clinical Competence, Comorbidity, Forecasting, Humans, Interdisciplinary Communication, Patient Care Team, Patient Selection, Risk, Risk Assessment, Coronary Disease therapy, Percutaneous Coronary Intervention trends
- Abstract
Patients with severe coronary artery disease with a clinical indication for revascularization but who are at high procedural risk because of patient comorbidities, complexity of coronary anatomy, and/or poor hemodynamics represent an understudied and potentially underserved patient population. Through advances in percutaneous interventional techniques and technologies and improvements in patient selection, current percutaneous coronary intervention may allow appropriate patients to benefit safely from revascularization procedures that might not have been offered in the past. The burgeoning interest in these procedures in some respects reflects an evolutionary step within the field of percutaneous coronary intervention. However, because of the clinical complexity of many of these patients and procedures, it is critical to develop dedicated specialists within interventional cardiology who are trained with the cognitive and technical skills to select these patients appropriately and to perform these procedures safely. Preprocedural issues such as multidisciplinary risk and treatment assessments are highly relevant to the successful treatment of these patients, and knowledge gaps and future directions to improve outcomes in this emerging area are discussed. Ultimately, an evolution of contemporary interventional cardiology is necessary to treat the increasingly higher-risk patients with whom we are confronted., (© 2016 American Heart Association, Inc.)
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- 2016
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3. The kinetics of integrilin limited by obesity: a multicenter randomized pharmacokinetic and pharmacodynamic clinical trial.
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Vavalle JP, Stevens SR, Hassinger N, Cohen MG, Arnold A, Kandzari DE, Aguirre FV, Gretler DD, and Alexander JH
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- Angioplasty, Balloon, Coronary, Coronary Disease complications, Dose-Response Relationship, Drug, Eptifibatide, Female, Humans, Male, Middle Aged, Obesity physiopathology, Peptides blood, Platelet Aggregation drug effects, Platelet Aggregation Inhibitors blood, Stents, Coronary Disease therapy, Obesity complications, Peptides pharmacokinetics, Platelet Aggregation Inhibitors pharmacokinetics
- Abstract
Background: KILO tested 2 novel weight-based eptifibatide dosing strategies compared with standard dosing in obese patients undergoing elective percutaneous coronary intervention (PCI). Eptifibatide dosing is weight adjusted for patients up to 121 kg. Patients above this weight receive the same maximal dose, although it is unknown if this provides adequate eptifibatide concentration or platelet inhibition., Methods: Sixty-seven patients weighing ≥125 kg undergoing elective PCI were randomized to 1 of 3 eptifibatide dosing regimens: standard dosing using a weight of 121 kg, actual body weight (ABW)-based dosing with no upper limit, or ideal body weight (IBW)-based dosing. Boluses of 180 μg/kg were given 10 minutes apart, followed by a 2.0 μg/kg per minute infusion. Plasma eptifibatide concentrations were drawn at 12 to 18 hours after initiating the infusion. Platelet aggregation was assessed at baseline and 10 minutes after the second bolus., Results: Sixty-seven patients were randomized to standard (n = 22), ABW (n = 23), or IBW (n = 22) dosing. The median (25th, 75th) steady-state plasma eptifibatide concentrations were 1,740 ng/mL (1,350, 2,350), 1,780 ng/mL (1,510, 2,350), and 1,055 ng/mL (738, 1,405), respectively (P < .001). Ten-minute median (25th, 75th) platelet aggregation units were 7 (0, 21), 2 (0, 8), and 14 (8, 20), respectively (P = .001)., Conclusions: Actual body weight eptifibatide dosing leads to higher plasma concentrations and greater platelet inhibition than standard or IBW dosing in obese patients undergoing PCI. Current recommendations for eptifibatide dosing may be inadequate in patients >121 kg. Further study is warranted to define the optimal dosing of eptifibatide and other medications in obese patients., (Copyright © 2011 Mosby, Inc. All rights reserved.)
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- 2011
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4. Left or right, transradial access for all.
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Martinez CA and Cohen MG
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- Aged, Cardiac Catheterization adverse effects, Coronary Angiography adverse effects, Female, Humans, Male, Cardiac Catheterization methods, Coronary Angiography methods, Coronary Disease diagnostic imaging, Radial Artery
- Published
- 2010
5. First clinical application of an actively reversible direct factor IXa inhibitor as an anticoagulation strategy in patients undergoing percutaneous coronary intervention.
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Cohen MG, Purdy DA, Rossi JS, Grinfeld LR, Myles SK, Aberle LH, Greenbaum AB, Fry E, Chan MY, Tonkens RM, Zelenkofske S, Alexander JH, Harrington RA, Rusconi CP, and Becker RC
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- Aged, Anticoagulants adverse effects, Anticoagulants pharmacology, Aptamers, Nucleotide adverse effects, Aptamers, Nucleotide therapeutic use, Coronary Disease blood, Coronary Disease therapy, Factor IXa metabolism, Feasibility Studies, Female, Heparin adverse effects, Heparin analogs & derivatives, Heparin therapeutic use, Humans, Male, Middle Aged, Oligonucleotides adverse effects, Oligonucleotides therapeutic use, Angioplasty, Balloon, Coronary adverse effects, Angioplasty, Balloon, Coronary methods, Anticoagulants therapeutic use, Coronary Disease drug therapy, Factor IXa antagonists & inhibitors
- Abstract
Background: The ideal anticoagulant should prevent ischemic complications without increasing the risk of bleeding. Controlled anticoagulation is possible with the REG1 system, an RNA aptamer pair comprising the direct factor IXa inhibitor RB006 and its active control agent RB007., Methods and Results: This phase 2a study included a roll-in group (n=2) treated with REG1 plus glycoprotein IIb/IIIa inhibitors followed by 2 groups randomized 5:1 to REG1 or unfractionated heparin. In group 1 (n=12), RB006 was partially reversed with RB007 after percutaneous coronary intervention and fully reversed 4 hours later. In group 2 (n=12), RB006 was fully reversed with RB007 immediately after percutaneous coronary intervention. Femoral sheaths were removed after complete reversal. Patients were pretreated with aspirin and clopidogrel. End points included major bleeding within 48 hours; composite of death, myocardial infarction, or urgent target vessel revascularization within 14 days; and pharmacodynamic measures. All cases were successful, with final Thrombolysis in Myocardial Infarction grade 3 flow and no angiographic thrombotic complications. There were 2 ischemic end points in the REG1 group and 1 in the unfractionated heparin group, with 1 major bleed in the unfractionated heparin group. Median activated clotting time values rose from 151 to 236 seconds after RB006. Administration of the partial RB007 dose reversed anticoagulation to an intermediate activated clotting time value of 186 seconds. Complete reversal with RB007 returned the median activated clotting time value to 144 seconds. Both reversal strategies enabled scheduled femoral sheath removal., Conclusions: This study demonstrates the clinical translation of a novel platform of anticoagulation targeting factor IXa and its active reversal to percutaneous coronary intervention and provides the basis for further investigation., Clinical Trial Registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT00715455.
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- 2010
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6. Starting a transradial vascular access program in the cardiac catheterization laboratory.
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Cohen MG and Alfonso C
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- Humans, Patient Care Team, Program Development, Staff Development organization & administration, Angioplasty, Balloon, Coronary education, Angioplasty, Balloon, Coronary methods, Cardiac Catheterization, Coronary Disease therapy, Education, Medical, Continuing organization & administration, Radial Artery
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Over the past 20 years, since the first reports, transradial vascular access for coronary angiography and intervention has flourished in many countries while still accounting for less than 2% of all cases performed in the United States due, in part, to difficulties in introducing change to established practice patterns. The benefits of transradial access include decreased bleeding risk, increased patient comfort, lessened post-procedure nursing workload, and decreased hospital costs. A learning curve to gain the specific set of skills for transradial access has been well described. Although published data suggest that 100-200 cases are necessary to become proficient, the learning curve is likely highly individual, and some operators may become proficient sooner. The equipment to start a transradial program is minimal and includes modified sheaths and catheters. Patients with morbid obesity, peripheral vascular disease, and anticoagulation clearly benefit from this approach. To establish a transradial program and offer the benefits of this approach to most patients, a dedicated interventionalist must incorporate peers and hospital staff to create a multidisciplinary team.
- Published
- 2009
7. Racial differences among high-risk patients presenting with non-ST-segment elevation acute coronary syndromes (results from the SYNERGY trial).
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Echols MR, Mahaffey KW, Banerjee A, Pieper KS, Stebbins A, Lansky A, Cohen MG, Velazquez E, Santos R, Newby LK, Gurfinkel EP, Biasucci L, Ferguson JJ, and Califf RM
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- Acute Disease, Aged, Angioplasty, Balloon, Coronary, Coronary Artery Bypass, Coronary Disease physiopathology, Coronary Disease therapy, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Risk Factors, Syndrome, Thrombolytic Therapy, Black or African American, Coronary Disease ethnology, Electrocardiography, Hispanic or Latino, White People
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Management and outcomes of patients with acute coronary syndromes (ACSs) may vary according to patient race and ethnicity. To assess racial differences in presentation and outcome in high-risk North American patients with non-ST-segment elevation (NSTE) ACS, we analyzed baseline racial/ethnic differences and all-cause death or nonfatal myocardial infarction (MI) in 6,077 white, 586 African-American, and 344 Hispanic patients through 30-day, 6-month, and 1-year follow-up. Frequencies of hypertension were 66% for whites, 83% for African-Americans, and 78% for Hispanics (overall p <0.001). Use of angiography was similar across groups. Use of percutaneous coronary intervention (46% for whites, 41% for African-Americans, and 45% for Hispanics, overall p = 0.046) and coronary artery bypass grafting (20% for whites, 16% for African-Americans, and 22% for Hispanics, overall p = 0.044) differed. African-American patients had significantly fewer diseased vessels compared with white patients (p = 0.0001). Thirty-day death or MI was 14% for whites, 10% for African-Americans, and 14% for Hispanics (overall p = 0.034). After adjustment for baseline variables, African-American patients had lower 30-day death or MI compared with white patients (odds ratio 0.73, 95% confidence interval 0.55 to 0.98). There were no differences in 6-month death or MI across racial/ethnic groups. In conclusion, baseline clinical characteristics differed across North American racial/ethnic groups in the SYNERGY trial. African-American patients had significantly better adjusted 30-day outcomes but similar 6-month outcomes compared with white patients.
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- 2007
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8. A simple prediction rule for significant renal artery stenosis in patients undergoing cardiac catheterization.
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Cohen MG, Pascua JA, Garcia-Ben M, Rojas-Matas CA, Gabay JM, Berrocal DH, Tan WA, Stouffer GA, Montoya M, Fernandez AD, Halac ME, and Grinfeld LR
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- Adult, Aged, Argentina epidemiology, Blood Pressure, Cholesterol blood, Coronary Angiography, Female, Germany epidemiology, Humans, Male, Middle Aged, Multivariate Analysis, Peripheral Vascular Diseases epidemiology, Regression Analysis, Cardiac Catheterization, Coronary Disease complications, Coronary Disease diagnostic imaging, Renal Artery Obstruction epidemiology
- Abstract
Background: Renal artery stenosis (RAS) is a potentially reversible cause of hypertension and renal insufficiency and is associated with poor prognosis., Methods: We aimed to identify simple predictors of significant RAS among patients undergoing coronary angiography. Prospective data were collected on 843 consecutive patients who underwent cardiac catheterization and abdominal aortography. Stenoses > or = 75% were considered significant. Multivariable logistic regression was used to assess the relationship between baseline characteristics and coronary anatomy with significant RAS. A simple risk score was derived from the model., Results: The prevalence of RAS > or = 75% was 11.7%. Independent predictors of significant RAS were older age, higher creatinine levels, peripheral vascular disease, number of cardiovascular drugs, hypertension, female sex, and 3-vessel coronary artery disease or previous coronary artery bypass graft. The concordance index of the model was 0.802. These variables were used to develop a simple predictive score of significant RAS for patients undergoing cardiac catheterization. The prevalence of RAS increased stepwise with increasing score values: 0.6% for a score < or = 5, 1.5% for 6 to 7, 6.1% for 8 to 9, 12.2% for 10 to 11, 18.7% for 12 to 14, 35.7% for 15 to 17, and 62.1% for > or = 18 (P < .001). Approximately one third of the patients had a score > or = 11, which yielded a sensitivity of 76% and a specificity of 71%., Conclusions: Renal artery stenosis is a relatively common finding among patients referred for coronary angiography. A simple score can predict the presence of significant RAS among patients referred for cardiac catheterization.
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- 2005
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9. Pulmonary artery catheterization in acute coronary syndromes: insights from the GUSTO IIb and GUSTO III trials.
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Cohen MG, Kelly RV, Kong DF, Menon V, Shah M, Ferreira J, Pieper KS, Criger D, Poggio R, Ohman EM, Gore J, Califf RM, and Granger CB
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- Acute Disease, Aged, Female, Humans, Male, Middle Aged, Multivariate Analysis, Proportional Hazards Models, Retrospective Studies, Risk Adjustment, Survival Rate, Catheterization, Swan-Ganz adverse effects, Coronary Disease diagnosis, Coronary Disease mortality
- Abstract
Purpose: To correlate pulmonary artery catheterization (PAC) use and 30-day outcomes and to characterize the use of pulmonary artery catheters among patients with acute coronary syndromes (ACS)., Subjects and Methods: We retrospectively studied 26437 ACS patients from two large multicenter, international randomized clinical trials. Multivariable and causal inference analyses were applied to adjust for differences in baseline risk., Results: PAC was performed in 735 patients (2.8%), with a median time to insertion of 24 hours. Patients undergoing PAC were older (median, 67 vs. 64 years), more often diabetic (25.7% vs.16.2%), and more likely to present with ST-segment elevation (81.6% vs. 70.2%) or Killip class III or IV (7.9% vs. 1.4%). US patients were 3.8 times more likely than non-US patients to undergo PAC. Patients managed with PAC also underwent more procedures, including percutaneous intervention (40.7% vs. 18.1%), coronary artery bypass grafting (12.5% vs. 7.7%), and endotracheal intubation (29.3% vs. 2.2%). Mortality at 30 days was substantially higher among patients with PAC for both unadjusted (odds ratio [OR] 8.7; 95% confidence interval [CI] 7.3-10.2) and adjusted analyses (OR 6.4; 95% CI 5.4-7.6) in all groups except in patients with cardiogenic shock (OR 0.99; 95% CI 0.80-1.23)., Conclusions: PAC was associated with increased mortality, both before and after adjustment for baseline patient differences and subsequent events that may have led to PAC use, except in patients with cardiogenic shock. The definitive role of PAC in managing patients with ACS is still to be determined.
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- 2005
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10. Association between anti-human heat shock protein-60 and interleukin-2 with coronary artery calcium score.
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Damluji, Abdulla A., Ramireddy, Archana, Al-Damluji, Mohammed S., Marzouka, George R., Otalvaro, Lynda, Viles-Gonzalez, Juan F., Chunming Dong, Alfonso, Carlos E., Hendel, Robert C., Cohen, Mauricio G., Moscucci, Mauro, Bishopric, Nanette H., and Myerburg, Robert J.
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ATHEROSCLEROTIC plaque ,CORONARY disease ,HEAT shock proteins ,INTERLEUKIN-2 ,PATIENTS - Abstract
The article focuses on the research conducted to analyse the association with the anti-heat shock protein-60 (anti-HSP60) and interleukin-2 (IL-2) with coronary artery calcium (CAC) score, which marks subclinical atherosclerosis. It states that 998 asymptomatic adult patients from the Multi-Ethnic Study of Atherosclerosis (MESA), who had no known coronary heart disease and had anti-HSP60 measured at baseline, were used for the research activity.
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- 2015
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11. The Transradial Approach to Percutaneous Coronary Intervention: Historical Perspective, Current Concepts, and Future Directions
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Rao, Sunil V., Cohen, Mauricio G., Kandzari, David E., Bertrand, Olivier F., and Gilchrist, Ian C.
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ANGIOPLASTY , *HEART disease related mortality , *CLINICAL trials , *COMPLICATIONS of cardiac surgery , *CORONARY disease , *LENGTH of stay in hospitals ,HEART hemorrhage - Abstract
Periprocedural bleeding complications after percutaneous coronary intervention (PCI) are associated with increased short- and long-term morbidity and mortality. Although clinical trials have primarily assessed pharmacological strategies for reducing bleeding risk, there is a mounting body of evidence suggesting that adoption of a transradial rather than a transfemoral approach to PCI may permit greater reductions in bleeding risk than have been achieved with pharmacological strategies alone. However, despite a long history of use, a lack of widespread uptake by physicians coupled with the technological limitations of available devices has in the past confined transradial PCI to the status of a niche procedure, and many operators lack experience in this technique. In this review, we examine the history of the transradial approach to PCI and discuss some of the circumstances that have hitherto limited its appeal. We then review the current state of the peer-reviewed literature supporting its use and summarize the unresolved issues affecting broader application of this technique, including lack of operator familiarity and an insufficient evidence base for guiding practice. Finally, we describe potential directions for future investigation in the transradial realm. [Copyright &y& Elsevier]
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- 2010
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12. Therapeutic Goals in Patients With Refractory Chronic Angina.
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Cohen, Mauricio G., Pascual, Mario, Sciric, Benjamin M., and Magnus Ohman, E.
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ANGINA pectoris treatment ,QUALITY of life ,ATHEROSCLEROSIS treatment ,CORONARY disease ,STATINS (Cardiovascular agents) ,MYOCARDIAL revascularization ,HEMODYNAMICS - Abstract
Copyright of Revista Española de Cardiología (18855857) is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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- 2010
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13. The Contrast Media Iohexol Causes Vasoconstriction of the Proximal Left Anterior Descending Coronary Artery: Implications for Appropriate Stent Sizing.
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Kelly, Robert V., Gillespie, Michael J., Cohen, Mauricio G., McLaughlin, David P., Ohman, E. Magnus, and Stouffer, George A.
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ANGIOGRAPHY ,MEDICAL imaging systems ,CORONARY disease ,INTRAVASCULAR ultrasonography ,BLOOD vessels - Abstract
The effect of the contrast agent iohexol on reference vessel size in patients with proximal left anterior descending disease is unknown. Quantitative coronary angiography and intravascular ultrasound were performed in 15 patients with atherosclerotic disease of the proximal left anterior descending. Mean proximal reference vessel diameter was 2.95 ± 0.59 mm with quantitative coronary angiography and 4.65 ± 0.66 mm with intravascular ultrasound (P < .05). Intracoronary injection of iohexol resulted in a significant decrease in intravascular ultrasound-measured proximal reference vessel diameter from 4.65 ± 0.66 mm to 4.47 ± 0.68 mm (P = .002). Vasoconstrictive response to iohexol in the proximal reference vessel ranged from ?0.04 mm to 0.5 mm with a mean of 0.18 ± 0.16 mm. This study shows that iohexol can cause significant vasoconstriction of the proximal reference vessel in patients with severe disease involving the proximal left anterior descending. [ABSTRACT FROM AUTHOR]
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- 2008
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14. 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.
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Lawton, Jennifer S. Chair, Tamis-Holland, Jacqueline E. FACC, FSCAI, Vice Chair, Bangalore, Sripal MHA, FACC, FSCAI, Bates, Eric R. FACC, FAHA, Beckie, Theresa M. FAHA, Bischoff, James M. MEd, Bittl, John A. FACC, FAHA, Cohen, Mauricio G. FACC, FSCAI, DiMaio, J. Michael, Don, Creighton W. FACC, Fremes, Stephen E. FACC, Gaudino, Mario F. FACC, FAHA, Goldberger, Zachary D. FACC, FAHA, Grant, Michael C. MSE, Jaswal, Jang B. MS, Kurlansky, Paul A. FACC, Mehran, Roxana FACC, Metkus, Thomas S. Jr FACC, Nnacheta, Lorraine C. DrPH,, and Rao, Sunil V. FACC
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VENTRICULAR ejection fraction , *CORONARY artery bypass , *CORONARY arteries , *REVASCULARIZATION (Surgery) , *MYOCARDIAL ischemia , *CORONARY disease , *CORONARY artery surgery , *MEDICAL care standards , *CARDIOVASCULAR surgery , *CARDIOLOGY , *CARDIOVASCULAR system , *MYOCARDIAL revascularization , *CORONARY artery disease - Abstract
Aim: The executive summary of the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions coronary artery revascularization guideline provides the top 10 items readers should know about the guideline. In the full guideline, the recommendations replace the 2011 coronary artery bypass graft surgery guideline and the 2011 and 2015 percutaneous coronary intervention guidelines. This summary offers a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization, as well as the supporting documentation to encourage their use.Methods: A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Recommendations from the earlier percutaneous coronary intervention and coronary artery bypass graft surgery guidelines have been updated with new evidence to guide clinicians in caring for patients undergoing coronary revascularization. This summary includes recommendations, tables, and figures from the full guideline that relate to the top 10 take-home messages. The reader is referred to the full guideline for graphical flow charts, supportive text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in the development of this guideline. [ABSTRACT FROM AUTHOR]- Published
- 2022
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15. Antiplatelet therapies and the role of antiplatelet resistance in acute coronary syndrome
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Dupont, Allison G., Gabriel, Don A., and Cohen, Mauricio G.
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ANTICOAGULANTS , *DRUG resistance , *CORONARY disease , *HEALTH outcome assessment , *PATIENTS , *CARDIOVASCULAR diseases ,DEVELOPED countries - Abstract
Abstract: Acute coronary syndrome is the number one killer in the industrialized world and, as such, continues to be one of the most well-studied disease states in all of medicine. Advancements in antiplatelet therapies for use in patients undergoing percutaneous coronary intervention have improved outcomes dramatically. However, a proportion of patients on long-term antiplatelet therapy continue to have cardiovascular events. Resistance to antiplatelet drugs may explain some of these events and this topic has become one of major interest and rapid evolution. This review describes the pathogenesis of acute coronary syndromes, outlines the evidence behind the use of the available antiplatelet agents, and examines the current data surrounding antiplatelet resistance. [Copyright &y& Elsevier]
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- 2009
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16. Two-year outcomes among stable high-risk patients following acute MI. Insights from a global registry in 25 countries.
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Brieger, David, Pocock, Stuart J., Blankenberg, Stefan, Chen, Ji Yan, Cohen, Mauricio G., Granger, Christopher B., Grieve, Richard, Nicolau, Jose C., Simon, Tabassome, Westermann, Dirk, Yasuda, Satoshi, Gregson, John, Rennie, Kirsten L., Hedman, Katarina, Sundell, Karolina Andersson, and Goodman, Shaun G.
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ANGINA pectoris , *CORONARY disease , *OLDER patients , *CHRONIC kidney failure , *CARDIOVASCULAR diseases - Abstract
Evidence is lacking on long-term outcomes in unselected patients surviving the first year following myocardial infarction (MI). The TIGRIS (long-Term rIsk, clinical manaGement and healthcare Resource utilization of stable coronary artery dISease in post-myocardial infarction patients) prospective registry enrolled 9176 eligible patients aged ≥50 years, 1–3 years post-MI, from 25 countries. All had ≥1 risk factor: age ≥ 65 years, diabetes mellitus, second prior MI, multivessel coronary artery disease, chronic kidney disease (CKD). Primary outcome was a composite of MI, unstable angina with urgent revascularization, stroke, or all-cause death at 2-year follow-up. Bleeding requiring hospitalization was also recorded. 9027 patients (98.4%) provided follow-up data: the primary outcome occurred in 621 (7.0%), all-cause mortality in 295 (3.3%), and bleeding in 109 (1.2%) patients. Events accrued linearly over time. In multivariable analyses, qualifying risk factors were associated with increased risk of primary outcome (incidence rate ratio [RR] per 100 patient-years [95% confidence interval]): CKD 2.06 (1.66, 2.55), second prior MI 1.71 (1.38, 2.10), diabetes mellitus 1.63 (1.39, 1.92), age ≥ 65 years 1.53 (1.28, 1.83), and multivessel disease 1.24 (1.05, 1.48). Risk of bleeding events was greater in older patients (vs <65 years) 65–74 years 2.68 (1.53, 4.70), ≥75 years 4.62 (2.57, 8.28), and those with CKD 1.99 (1.18, 3.35). In stable patients recruited 1–3 years post-MI, recurrent cardiovascular and bleeding events accrued linearly over 2 years. Factors independently predictive of ischemic and bleeding events were identified, providing a context for deciding on treatment options. • TIGRIS enrolled stable patients 1–3 years post-MI, all with ≥1 risk factor. • Among 9027 patients, the primary outcome occurred in 7.0%. • All qualifying risk factors were associated with increased risk of primary outcome. • Older age and chronic kidney disease were associated with increased bleeding risk. • These findings provide a context for treatment decisions. [ABSTRACT FROM AUTHOR]
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- 2020
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17. 2020 AHA/ACC Key Data Elements and Definitions for Coronary Revascularization: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Data Standards (Writing Committee to Develop Clinical Data Standards for Coronary Revascularization)
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Dehmer, Gregory J., Badhwar, Vinay, Bermudez, Edmund A., Cleveland, Joseph C., Cohen, Mauricio G., D'Agostino, Richard S., Ferguson, T. Bruce, Hendel, Robert C., Isler, Maria Lizza, Jacobs, Jeffrey P., Jneid, Hani, Katz, Alan S., Maddox, Thomas M., and Shahian, David M.
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CARDIOGENIC shock , *AORTIC dissection , *TASK forces , *DEFINITIONS , *MEDICAL sciences , *CORONARY disease , *CARDIOLOGY - Published
- 2020
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18. Culprit Vessel Only Versus Multivessel Percutaneous Coronary Intervention in Acute Myocardial Infarction with Cardiogenic Shock: A Systematic Review and Meta-Analysis.
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Khalid, Muhammad Faisal, Khan, Abdul Ahad, Khattak, Furqan, Ayub, Muhammad Talha, Bagai, Jayant, Mukherjee, Debabrata, Helton, Thomas, Cohen, Mauricio G., Banerjee, Subhash, and Paul, Timir K.
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PERCUTANEOUS coronary intervention , *CARDIOGENIC shock , *MYOCARDIAL infarction , *META-analysis , *CORONARY disease - Abstract
Background: Previous studies comparing outcomes between culprit vessel only percutaneous coronary intervention (CV-PCI) versus multivessel percutaneous coronary intervention (MV-PCI) in patients with cardiogenic shock in the setting of acute myocardial infarction have shown conflicting results. This meta-analysis investigates the optimal approach for management of these patients considering recently published data.Methods: Electronic databases including MEDLINE, ClinicalTrials.gov and the Cochrane Library were searched for all clinical studies published until May 1, 2018, which compared outcomes in patients presenting with acute myocardial infarction and cardiogenic shock. Studies comparing CV-PCI versus MV-PCI in patients with multivessel coronary artery disease were screened for inclusion in final analysis. The primary end point was in-hospital/30 day mortality. Secondary endpoints included long term (>6 months) mortality, renal failure requiring renal replacement therapy, stroke, bleeding, and recurrent myocardial infarction. Odds ratio (OR) with 95% of confidence interval (CI) were computed and p values <0.05 were considered significant.Results: Patient who underwent CV-PCI had significantly lower short-term mortality (in-hospital or 30-day mortality) (OR: 0.73, CI: 0.61-0.87, p = 0.0005), and lower odds of severe renal failure requiring renal replacement therapy (OR: 0.76, CI: 0.59-0.98, p = 0.03). There was no statistically significant difference in long-term mortality, stroke, bleeding, and recurrent myocardial infarction between two groups.Conclusion: This meta-analysis showed lower short-term mortality and decreased odds of renal failure requiring renal replacement therapy with CV-PCI compared to MV-PCI. However, subgroup analysis including studies exclusively assessing STEMI patients revealed no statistically significant difference in outcomes. Further randomized trials are needed to confirm these findings and evaluate long term results. [ABSTRACT FROM AUTHOR]- Published
- 2019
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19. Safety and efficacy of radial versus femoral access for rotational Atherectomy: A systematic review and meta-analysis.
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Khan, Abdul Ahad, Panchal, Hemang B., Zaidi, Syed Imran M., Papireddy, Muralidhar R., Mukherjee, Debabrata, Cohen, Mauricio G., Banerjee, Subhash, Rao, Sunil V., Pancholy, Samir, and Paul, Timir K.
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ENDARTERECTOMY , *META-analysis , *PERCUTANEOUS coronary intervention , *LENGTH of stay in hospitals , *HOSPITAL mortality , *RADIATION exposure , *INTRAVENOUS catheterization , *INFORMATION storage & retrieval systems , *MEDICAL databases , *OPERATIVE surgery , *SYSTEMATIC reviews , *CORONARY disease , *FEMORAL artery , *RISK assessment , *TREATMENT effectiveness , *RADIAL artery , *CALCINOSIS , *MYOCARDIAL revascularization , *MEDLINE - Abstract
Introduction: Over the recent years, there has been increased interest in the use of transradial (TR) access for percutaneous coronary intervention (PCI), including rotational atherectomy (RA). However, a large proportion of operators seem to be reluctant to use TR access for complex PCI including rotational atherectomy for heavily calcified coronary lesions.Methods: We searched MEDLINE, ClinicalTrials.gov and the Cochrane Library for studies comparing radial versus femoral access in patients undergoing RA. Studies were included if they reported at least one of the following outcomes in each group separately: major adverse cardiac events (MACE), major bleeding, stent thrombosis, myocardial infarction (MI), hospital length of stay, radiation exposure, procedure time, procedure success and all-cause mortality. Odds ratio (OR) or mean difference (MD) with 95% confidence interval (CI) were calculated and a p-value of <0.05 was considered as a level of significance.Results: This meta-analysis included 5 retrospective studies with 3315 patients undergoing RA via radial access and 5838 patients via femoral access. Radial access was associated with lower major access site bleeding (OR: 0.45, 95% CI: 0.31-0.67, p < 0.001), and radiation exposure (MD: -16.1, 95%CI: -25.4--6.7 Gy cm2, p = 0.0007). There were no significant differences observed in all-cause in-hospital mortality (OR: 0.92, 95% CI: 0.69-1.23, p = 0.58); MACE (OR: 0.80, CI: 0.63, 1.02, p = 0.08), stent thrombosis (OR: 0.28, 95%CI: 0.06-1.33 p = 0.11); and MI (OR: 0.43, 95%CI: 0.15-1.24, p = 0.12). There were no significant differences in hospital stay, procedure time or procedure success between the two groups (p > 0.05).Conclusion: This meta-analysis of 9153 patients from observational studies demonstrates similar all-cause mortality, MACE, procedural success and procedural time during RA performed using TR access and TF access. However, TR access was associated with decreased access site bleeding and radiation exposure. Given the observational nature of these findings, a randomized controlled trial is warranted for further evidence. [ABSTRACT FROM AUTHOR]- Published
- 2019
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20. Influence of Total Coronary Occlusion on Clinical Outcomes (from the Bypass Angioplasty Revascularization Investigation 2 DiabetesTrial).
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Damluji, Abdulla A, Pomenti, Sydney F, Ramireddy, Archana, Al-Damluji, Mohammed S, Alfonso, Carlos E, Schob, Alan H, Marso, Steven P, Gilchrist, Ian C, Moscucci, Mauro, Kandzari, David E, and Cohen, Mauricio G
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DIAGNOSIS , *CORONARY heart disease treatment , *TYPE 2 diabetes diagnosis , *TYPE 2 diabetes complications , *CARDIOVASCULAR system , *CHRONIC diseases , *COMPARATIVE studies , *CORONARY artery bypass , *CORONARY disease , *RESEARCH methodology , *DIABETIC angiopathies , *MEDICAL care , *MEDICAL cooperation , *TYPE 2 diabetes , *RESEARCH , *SURVIVAL analysis (Biometry) , *EVALUATION research , *TREATMENT effectiveness , *THERAPEUTICS - Abstract
Our aim was to evaluate the influence of chronic total occlusions (CTOs) on long-term clinical outcomes of patients with coronary heart disease and diabetes mellitus. We evaluated patients with coronary heart disease and diabetes mellitus enrolled in the Bypass Angioplasty Revascularization Investigation 2 Diabetes, who underwent either prompt revascularization (PR) with intensive medical therapy (IMT) or IMT alone according to the presence or absence of CTO. Of 2,368 patients enrolled in the trial, 972 patients (41%) had CTO of coronary arteries. Of those, 482 (41%) and 490 (41%) were in the PR with IMT versus IMT only groups, respectively. In the PR group, patients with CTO were more likely to be selected for the coronary artery bypass grafting stratum (coronary artery bypass grafting 62% vs percutaneous coronary intervention 31%, p <0.001). Compared to the non-CTO group, patients with CTO had more abnormal Q wave, abnormal ST depression, and abnormal T waves. The myocardial jeopardy score was higher in the CTO versus non-CTO group (52 [36 to 69] vs 37 [21 to 53], p <0.001). After adjustment, 5-year mortality rate was significantly higher in the CTO group in the entire cohort (hazard ratio [HR] 1.35, p = 0.013) and in patients with CTO managed with IMT (HR 1.46, p = 0.031). However, the adjusted risk of death was not increased in patients managed with PR (HR 1.26, p = 0.180). In conclusion, CTO of coronary arteries is associated with increased mortality in patients treated medically. However, the presence of a CTO may not increase mortality in patients treated with revascularization. Larger randomized trials are needed to evaluate the effects of revascularization on long-term survival in patients with CTO. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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21. Predictive Factors, Management, and Clinical Outcomes of Coronary Obstruction Following Transcatheter Aortic Valve Implantation: Insights From a Large Multicenter Registry.
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Ribeiro, Henrique B., Webb, John G., Makkar, Raj R., Cohen, Mauricio G., Kapadia, Samir R., Kodali, Susheel, Tamburino, Corrado, Barbanti, Marco, Chakravarty, Tarun, Jilaihawi, Hasan, Paradis, Jean-Michel, de Brito, Fabio S., Cánovas, Sergio J., Cheema, Asim N., de Jaegere, Peter P., del Valle, Raquel, Chiam, Paul T.L., Moreno, Raúl, Pradas, Gonzalo, and Ruel, Marc
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CORONARY disease , *AORTIC valve transplantation , *ARTERIAL catheters , *CORONARY artery bypass , *HEALTH outcome assessment , *COMPUTED tomography , *MEDICAL statistics - Abstract
Objectives: This study sought to evaluate the main baseline and procedural characteristics, management, and clinical outcomes of patients from a large cohort of patients undergoing transcatheter aortic valve implantation (TAVI) who suffered coronary obstruction (CO). Background: Very little data exist on CO following TAVI. Methods: This multicenter registry included 44 patients who suffered symptomatic CO following TAVI of 6,688 patients (0.66%). Pre-TAVI computed tomography data was available in 28 CO patients and in a control group of 345 patients (comparisons were performed including all patients and a cohort matched 1:1 by age, sex, previous coronary artery bypass graft, transcatheter valve type, and size). Results: Baseline and procedural variables associated with CO were older age (p < 0.001), female sex (p < 0.001), no previous coronary artery bypass graft (p = 0.043), the use of a balloon-expandable valve (p = 0.023), and previous surgical aortic bioprosthesis (p = 0.045). The left coronary artery was the most commonly involved (88.6%). The mean left coronary artery ostia height and sinus of Valsalva diameters were lower in patients with obstruction than in control subjects (10.6 ± 2.1 mm vs. 13.4 ± 2.1 mm, p < 0.001; 28.1 ± 3.8 mm vs. 31.9 ± 4.1 mm, p < 0.001). Differences between groups remained significant after the case-matched analysis (p < 0.001 for coronary height; p = 0.01 for sinus of Valsalva diameter). Most patients presented with persistent severe hypotension (68.2%) and electrocardiographic changes (56.8%). Percutaneous coronary intervention was attempted in 75% of the cases and was successful in 81.8%. Thirty-day mortality was 40.9%. After a median follow-up of 12 (2 to 18) months, the cumulative mortality rate was 45.5%, and there were no cases of stent thrombosis or reintervention. Conclusions: Symptomatic CO following TAVI was a rare but life-threatening complication that occurred more frequently in women, in patients receiving a balloon-expandable valve, and in those with a previous surgical bioprosthesis. Lower-lying coronary ostium and shallow sinus of Valsalva were associated anatomic factors, and despite successful treatment, acute and late mortality remained very high, highlighting the importance of anticipating and preventing the occurrence of this complication. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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22. Adoption of Radial Access and Comparison of Outcomes to Femoral Access in Percutaneous Coronary Intervention An Updated Report from the National Cardiovascular Data Registry (2007–2012).
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Feldman, Dmitriy N., Swaminathan, Rajesh V., Kaltenbach, Lisa A., Baklanov, Dmitri V., Kim, Luke K., Chiu Wong, S., Minutello, Robert M., Messenger, John C., Moussa, Issam, Garratt, Kirk N., Piana, Robert N., Hillegass, William B., Cohen, Mauricio G., Gilchrist, Ian C., and Rao, Sunil V.
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CARDIAC surgery , *REGRESSION analysis , *ACUTE coronary syndrome , *CORONARY disease - Abstract
Background-Radial access for percutaneous coronary intervention (r-PCI) is associated with reduced vascular complications; however, previous reports have shown that <2% of percutaneous coronary intervention (PCI) procedures in the United States are performed via the radial approach. Our aims were to evaluate temporal trends in r-PCI and compare procedural outcomes between r-PCI and transfemoral PCI. Methods and Results-We conducted a retrospective cohort study from the CathPCI registry (n=2 820 874 procedures from 1381 sites) between January 2007 and September 2012. Multivariable logistic regression models were used to evaluate the adjusted association between r-PCI and bleeding, vascular complications, and procedural success, using transfemoral PCI as the reference. Outcomes in high-risk subgroups such as age ≥75 years, women, and patients with acute coronary syndrome were also examined. The proportion of r-PCI procedures increased from 1.2% in quarter I 2007 to 16.1% in quarter 3 2012 and accounted for 6.3% of total procedures from 2007 to 2012 (n=178 643). After multivariable adjustment, r-PCI use in the studied cohort of patients was associated with lower risk of bleeding (adjusted odds ratio, 0.51; 95% confidence interval, 0.49-0.54) and lower risk of vascular complications (adjusted odds ratio, 0.39; 95% confidence interval, 0.31-0.50) in comparison with transfemoral PCI. The reduction in bleeding and vascular complications was consistent across important subgroups of age, sex, and clinical presentation. Conclusions-There has been increasing adoption of r-PCI in the United States. Transradial PCI now accounts for 1 of 6 PCIs performed in contemporary clinical practice. In comparison with traditional femoral access, transradial PCI is associated with lower vascular and bleeding complication rates. [ABSTRACT FROM AUTHOR]
- Published
- 2013
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23. Isolated Nonspecific ST-Segment and T-Wave Abnormalities in a Cross-Sectional United States Population and Mortality (from NHANES III)
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Badheka, Apurva O., Rathod, Ankit, Marzouka, George R., Patel, Nileshkumar, Bokhari, Syed S.I., Moscucci, Mauro, and Cohen, Mauricio G.
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CROSS-sectional method , *CORONARY disease , *ELECTROCARDIOGRAPHY , *COHORT analysis ,CARDIOVASCULAR disease related mortality - Abstract
Most clinicians regard isolated, minor, or nonspecific ST-segment and T-wave (NS-STT) abnormalities to be incidental, often transient, and benign findings in asymptomatic patients. We sought to evaluate whether isolated NS-STT abnormalities on routine electrocardiograms (ECGs) are associated with increased risk of cardiovascular mortality (CM) and all-cause mortality (AM) in a cross-sectional United States population without known coronary artery disease. We included all adults 40 to 90 years of age without known coronary artery disease or risk equivalent based on history and laboratory values, enrolled in the NHANES III from 1988 to 1994, with electrocardiographic data available, and a total follow-up period of 59,781.75 patient-years. NS-STT abnormalities were defined by Minnesota Coding. Subjects were excluded if their mortality data were missing or if they had major electrocardiographic abnormalities, heart rate >120 beats/min, nonsinus rhythm, cardiac infarction/injury score ≥20 on ECG, left ventricular hypertrophy by Minnesota Codes 3.1 and 3.3, or patient-reported history coronary artery disease, congestive heart failure, stroke, diabetes, or peripheral arterial disease. The remaining 4,426 subjects were stratified by presence or absence of NS-STT abnormalities. Mortality was judged based on International Classification of Diseases, Tenth Revision coding linked to the National Death Index. Cox proportional hazard ratio was used for multivariate analysis, showing that CM (hazards ratio 1.71, 95% confidence interval 1.04 to 2.83, p = 0.04) and AM (hazards ratio 1.37, 95% confidence interval 1.03 to 1.81, p = 0.02) were significantly higher in the isolated NS-STT abnormalities group. In conclusion, isolated NS-STT abnormalities on ECG were associated with a higher incidence of CM and AM in this large nationally representative cross-sectional cohort without known coronary artery disease or coronary artery disease risk equivalents. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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24. Impact of Iodinated Contrast Injections on Percent Diameter Coronary Arterial Stenosis and Implications for Trials of Intracoronary Pharmacotherapies in Patients With ST-Elevation Myocardial Infarction
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Gibson, C. Michael, Buros, Jacqueline, Ciaglo, Lauren N., Southard, Matthew C., Takao, Shaun, Harrigan, Caitlin, Filopei, Jason, Lew, Michelle, Marble, Susan J., Murphy, Sabina A., and Cohen, Mauricio G.
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HEART diseases , *MYOCARDIAL infarction , *CORONARY disease , *DRUG therapy - Abstract
Administration of fibrinolytic, antiplatelet, and antithrombotic agents by the intracoronary route may disaggregate clot, but the potential role of the mechanical force of the injection itself in decreasing clot burden has not been studied. Patients with ST-segment elevation myocardial infarction who were pretreated in the emergency room (ER) with unfractionated heparin and aspirin in the TITAN-TIMI 34 study were randomized to treatment with eptifibatide in the ER (n = 131) versus after diagnostic catheterization (n = 150). Quantitative coronary angiography was used to assess change in diameter stenosis from time of first contrast injection to injection before percutaneous coronary intervention (PCI) immediately preceding wire placement down the culprit artery in a matching view. Successful perfusion of the myocardium was assessed after PCI by the presence of Thrombolysis In Myocardial Infarction myocardial perfusion grade of 2 or 3. In patients treated with eptifibatide in the ER, there was a 1.3% absolute improvement in diameter stenosis from the first injection to the injection before PCI (p = 0.02), whereas there was no change in diameter stenosis in patients not treated with eptifibatide in the ER (0.0%, p = NS). Each 1% improvement in percent diameter stenosis during diagnostic injections before PCI was strongly correlated with an open muscle after PCI (adjusted odds ratio 1.09, 95% confidence interval 1.02 to 1.16, p = 0.012). In conclusion, the mechanical force of a contrast injection decreases thrombotic burden in patients with ST-segment elevation myocardial infarction pretreated with eptifibatide but not with placebo. Future trials of intracoronary pharmacotherapies should include a control arm in which saline is injected to account for the potential clot disaggregation that occurs as a result of iodinated contrast injections, particularly if the patient has been pretreated with aggressive pharmacotherapy. [Copyright &y& Elsevier]
- Published
- 2007
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25. Racial Differences Among High-Risk Patients Presenting With Non–ST-Segment Elevation Acute Coronary Syndromes (Results from the SYNERGY Trial) † [†] Disclosure: Drs. Mahaffey, Cohen, Newby, Ferguson, and Califf have received honoria for speaking from sanofi-aventis. Drs. Mahaffey, Ferguson, and Califf have acted as consultants for sanofi-aventis. Drs. Echols, Velazquez, Santos, and Gurfinkel have no financial relationships to disclose.
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Echols, Melvin R., Mahaffey, Kenneth W., Banerjee, Anindita, Pieper, Karen S., Stebbins, Amanda, Lansky, Alexandra, Cohen, Mauricio G., Velazquez, Eric, Santos, Renato, Newby, L. Kristin, Gurfinkel, Enrique P., Biasucci, Luigi, Ferguson, James J., and Califf, Robert M.
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CORONARY disease , *MYOCARDIAL infarction , *CORONARY artery bypass , *RACIAL differences - Abstract
Management and outcomes of patients with acute coronary syndromes (ACSs) may vary according to patient race and ethnicity. To assess racial differences in presentation and outcome in high-risk North American patients with non–ST-segment elevation (NSTE) ACS, we analyzed baseline racial/ethnic differences and all-cause death or nonfatal myocardial infarction (MI) in 6,077 white, 586 African-American, and 344 Hispanic patients through 30-day, 6-month, and 1-year follow-up. Frequencies of hypertension were 66% for whites, 83% for African-Americans, and 78% for Hispanics (overall p <0.001). Use of angiography was similar across groups. Use of percutaneous coronary intervention (46% for whites, 41% for African-Americans, and 45% for Hispanics, overall p = 0.046) and coronary artery bypass grafting (20% for whites, 16% for African-Americans, and 22% for Hispanics, overall p = 0.044) differed. African-American patients had significantly fewer diseased vessels compared with white patients (p = 0.0001). Thirty-day death or MI was 14% for whites, 10% for African-Americans, and 14% for Hispanics (overall p = 0.034). After adjustment for baseline variables, African-American patients had lower 30-day death or MI compared with white patients (odds ratio 0.73, 95% confidence interval 0.55 to 0.98). There were no differences in 6-month death or MI across racial/ethnic groups. In conclusion, baseline clinical characteristics differed across North American racial/ethnic groups in the SYNERGY trial. African-American patients had significantly better adjusted 30-day outcomes but similar 6-month outcomes compared with white patients. [Copyright &y& Elsevier]
- Published
- 2007
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26. Regional Outcomes After Admission for High-Risk Non-ST-Segment Elevation Acute Coronary Syndromes
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Menon, Venu, Rumsfeld, John S., Roe, Matthew T., Cohen, Mauricio G., Peterson, Eric D., Brindis, Ralph G., Chen, Anita Y., Pollack, Charles V., Smith, Sidney C., Gibler, W. Brian, and Ohman, E. Magnus
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HEALTH risk assessment , *CORONARY disease , *MYOCARDIAL infarction - Abstract
Abstract: Purpose: An analysis of reginal variation across the United States in the treatment and outcomes of patients with non-ST-segment elevation acute coronary syndromes (NSTE ACS) has not been previously performed. Subjects and Methods: We assessed contemporary practice and outcomes in 56,466 high-risk patients with NSTE ACS (positive cardiac markers and/or ischemic ST-segment changes) admitted to 310 hospitals across four defined regions in the United States from January 1, 2001, to September 30, 2003. Patient clinical characteristics, acute (<24 hours) and discharge medications, in-hospital procedures, and in-hospital case-fatality rates were evaluated. Results: Statistically significant but clinically small differences in baseline characteristics including age, gender, rates of diabetes, hypertension, and smoking, as well as medical treatment, including a greater than 5% variation in acute use of beta-blockers, clopidogrel, and statins use, were noted across regions. Adjusted rates of revascularization were similar across regions. Overall in-hospital case-fatality rate was 4.1%, with the highest rates in the Midwest (4.6%) and the lowest in the Northeast (3.5%). Adjusted odds ratios (OR) (95% confidence interval [CI] for death were significantly higher in the Midwest (OR 1.42, CI 1.19-1.70), West (OR 1.40 CI 1.05-1.87), and South (OR 1.33, CI 1.08-1.62), compared with the Northeast. Conclusions: Management of high-risk patients with NSTE ACS is relatively uniform across the United States. However, in-hospital case-fatality rates vary significantly by region, and the differences are not explained by adjustment for standard clinical variables. [Copyright &y& Elsevier]
- Published
- 2006
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27. MULTI-MORBIDITY, FUNCTIONAL IMPAIRMENT AND MORTALITY IN OLDER PATIENTS AFTER ACUTE MYOCARDIAL INFARCTION: A REPORT FROM THE TIGRIS REGISTRY.
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Bagai, Akshay, Ali, Faeez Mohamad, Gregson, John, Alexander, Karen P., Cohen, Mauricio G., Sundell, Karolina Andersson, Brieger, David, Goodman, Shaun G., Nicolau, Jose C., Granger, Christopher B., and Pocock, Stuart
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MORTALITY , *DISABILITIES , *CORONARY disease - Published
- 2020
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28. DIRECT ORAL ANTICOAGULANTS STRATEGIES IN ACUTE CORONARY SYNDROMES: SYSTEMATIC REVIEW AND NETWORK META-ANALYSIS.
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Knijnik, Leonardo Mees, Fernandes, Marcelo, Maza, Manuel Rivera, Montanez-Valverde, Raul, Cardoso, Rhanderson, Fernandes, Amanda, Fernandes, Gilson, and Cohen, Mauricio G.
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ACUTE coronary syndrome , *META-analysis , *CORONARY disease - Published
- 2020
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