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BackgroundAutopsy studies suggest that implanting stents in lipid-rich plaque (LRP) may be associated with adverse outcomes.ObjectivesThe purpose of this study was to evaluate the association between LRP detected by near-infrared spectroscopy (NIRS) and clinical outcomes in patients with coronary artery disease treated with contemporary drug-eluting stents.MethodsIn this prospective, multicenter registry, NIRS was performed in patients undergoing coronary angiography and possible percutaneous coronary intervention (PCI). Lipid core burden index (LCBI) was calculated as the fraction of pixels with the probability of LRP >0.6 within a region of interest. MaxLCBI4mm was defined as the maximum LCBI within any 4-mm-long segment. Major adverse cardiac events (MACE) included cardiac death, myocardial infarction, definite or probable stent thrombosis, or unplanned revascularization or rehospitalization for progressive angina or unstable angina. Events were subcategorized as culprit (treated) lesion-related, nonculprit (untreated) lesion-related, or indeterminate.ResultsAmong 1,999 patients who were enrolled in the COLOR (Chemometric Observations of Lipid Core Plaques of Interest in Native Coronary Arteries Registry), PCI was performed in 1,621 patients and MACE occurred in 18.0% of patients, of which 8.3% were culprit lesion-related, 10.7% were nonculprit lesion-related, and 3.1% were indeterminate during 2-year follow-up. Complications from NIRS imaging occurred in 9 patients (0.45%), which resulted in 1 peri-procedural myocardial infarction and 1 emergent coronary bypass. Pre-PCI NIRS imaging was obtained in 1,189 patients, and the 2-year rate of culprit lesion-related MACE was not significantly associated with maxLCBI4mm (hazard ratio of maxLCBI4mm per 100: 1.06; 95% confidence interval: 0.96 to 1.17; p = 0.28) after adjusting clinical and procedural factors.ConclusionsFollowing PCI with contemporary drug-eluting stents, stent implantation in NIRS-defined LRPs was not associated with increased periprocedural or late adverse outcomes compared with those without significant lipid.

A study was conducted to evaluate the efficacy and safety of transcatheter aortic-valve implantation (TAVI) for aortic stenosis in patients who cannot undergo surgery. Results indicated that such form of treatment was found to significantly reduce mortality, despite a higher incidence of strokes and major vascular events.

Unstable angina combined with non-ST-segment elevation myocardial infarction (UA/NSTEMI) acute coronary syndromes (ACS) is the most common manifestations of coronary heart disease that lead to death. More than twenty thousand patients were studied across the ACS spectrum, and it was found that enoxaparin is more effective than unfractionated heparin in preventing combined end point of death or myocardial infarction.

The year 2000 computer problem also poses societal problems. Solving these problems require a collaborative effort between businesses and communities. Communities need to evaluate where they will be most affected, while businesses need to set aside competitive pressures., When the year 2000 dawns, the sun will first rise over human civilization in the independent republic of Kiribati, a group of some 30 low-lying coral islands in the Pacific [...]

The year 2000 computer data conversion problem affects not only computer systems used in inventories, banks and insurance companies. The highly interconnected systems of every sector of society are in danger of crashing since a failure in just one of its components is enough to trigger a total systems crash. Furthermore, all equipment with imbedded microchips might also be affected. Some of these microchips are date sensitive and may suddenly malfunction or shut off on the first day of the second millennium., The millennial sun will first rise over human civilization in the independent republic of Kiribati, a group of some thirty low lying coral islands in the Pacific Ocean that straddle [...]

John L. Petersen is president of The Arlington Institute. He is a recently retired reserve officer who worked in the office of the Secretary of Defense and in the White [...]

Here's a new wrinkle on the widespread discussion of ways to transform the US military, redefine national security, and turn our attention as a nation to the environmental and educational [...]