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Tag Archives: percutaneous coronary intervention

Anticoagulation in patients with non-valvular AF undergoing PCI: clinical evidence from PIONEER AF-PCI

August 2018 Br J Cardiol 2018;25(suppl 1):S6–S11 doi:10.5837/bjc.2018.s02

Anticoagulation in patients with non-valvular AF undergoing PCI: clinical evidence from PIONEER AF-PCI

Tarek Nafee, Gerald Chi, Fahad AlKhalfan, Serge Korjian, Yazan Daaboul, Seyedmahdi Pahlavani, Usama Talib, Aravind Reddy Kuchkuntla, Mahshid Mir, Mathieu Kerneis, C Michael Gibson

Abstract

Background, epidemiology and rationale for study The PIONEER AF-PCI (Open-Label, Randomized, Controlled, Multicenter Study Exploring Two Treatment Strategies of Rivaroxaban and a Dose-Adjusted Oral Vitamin K Antagonist Treatment Strategy in Subjects with Atrial Fibrillation who Undergo Percutaneous Coronary Intervention) trial addressed an important medical question, which is potentially relevant for the 20–45% of atrial fibrillation (AF) patients who also have coronary artery disease and are likely to undergo percutaneous coronary intervention (PCI). Prior to the PIONEER AF-PCI trial, there was an unmet need for evidence-based recommendati

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November 2017 Br J Cardiol 2017;24:129

REDUCE shows non-inferiority of short versus long DAPT in acute coronary syndrome

BJC Staff

Abstract

The COMBO™ dual therapy stent REDUCE (Short-term Dual Anti Platelet Therapy in Patients with ACS Treated with the COMBO Dual-therapy Stent), a physician-initiated, prospective, multi-centre, randomised study, was conducted in 36 hospitals in Europe and Asia, enrolling a total of 1,496 ACS patients. The study was designed to demonstrate non-inferiority of a strategy of short-term (three months) dual antiplatelet therapy (DAPT) compared to standard 12-month DAPT in patients with ACS treated with a dual-therapy stent. The stent used in the study COMBO™ (OrbusNeich) is a sirolimus-eluting stent with an abluminal biodegradable polymer matrix,

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October 2017

ESC 2017: RE-DUAL PCI shows benefits for dabigatran

BJC staff

Abstract

Approximately 20–30% of patients with AF, who are continuously taking an oral anticoagulant to reduce their risk of AF-related stroke, have coexisting coronary artery disease and may require PCI. The current practice of administering triple therapy with warfarin and two antiplatelet agents in patients with AF after a PCI is associated with high rates of major bleeding. RE-DUAL PCI tested an alternative treatment strategy: dual therapy with dabigatran and a single antiplatelet agent (P2Y12 inhibitor). Selected for one of the meeting’s hotline sessions and simultaneously published in the New England Journal of Medicine (https://doi.org/10.

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Risk factors for femoral arterial complications and management

November 2016 Br J Cardiol 2016;23:155–8 doi:10.5837/bjc.2016.040

Risk factors for femoral arterial complications and management

Shabnam Rashid, Stephanie Hughes

Abstract

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When you can’t obtain a history…

April 2016 Br J Cardiol 2016;23:78 doi:10.5837/bjc.2016.017 Online First

When you can’t obtain a history…

Luciano Candilio, Juliana Duku, Alexander W Y Chen

Abstract

Figure 1. Patient chest X-ray showing a ‘full metal jacket’ Her physical examination and vital signs were unremarkable. Routine blood tests had been requested. Resting 12-lead electrocardiogram (ECG) showed left bundle branch block; no previous ECGs were available for comparison. A chest X-ray was performed, which gave another clue to the diagnosis… The chest radiograph (figure 1) shows clear lung fields, normal cardiac contour and, more importantly, a radio-opaque structure across the anterior surface of her heart. This is sometimes termed a ‘full metal jacket’, implying extensive stenting of a coronary artery in its entirety f

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February 2015 Br J Cardiol 2015;22:27–30 doi:10.5837/bjc.2015.003 Online First

Incidence of cardiac surgery following PCI: insights from a high-volume, non-surgical, UK centre

Andrew Whittaker, Peregrine Green, Giles Coverdale, Omar Rana, Terry Levy

Abstract

Introduction It is accepted that coronary revascularisation with coronary artery bypass graft surgery (CABG) provides both symptomatic and prognostic benefit in patients with multi-vessel coronary artery disease (mvCAD).1,2 Both percutaneous coronary intervention (PCI) and CABG provide better relief of angina symptoms than medical therapy alone.1,3 Large, randomised-controlled trials (RCTs), in recent years, have demonstrated that CABG offers an improved outcome in patients with complex three-vessel coronary artery disease (CAD), especially in those with co-existing diabetes mellitus.4,5 However, in patients with one- or two-vessel CAD, PCI o

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September 2014 Br J Cardiol 2014;21:98

New NICE guidance published

BJCardio Staff

Abstract

The National Institute for Health and Care Excellence (NICE) has said that thousands of people with atrial fibrillation (AF) could be prevented from having strokes, disability or death if its new guidance is followed. It says many patients with AF are not being appropriately anticoagulated and highlights how there has not been widespread uptake of novel oral anticoagulant drugs (NOACs) which were approved by NICE in 2012. Clinical guideline 180 published in June 2014 updates and replaces the 2006 NICE clinical guideline 36. The full guidance can be found at http://www.nice.org.uk/guidance/CG180 NICE Chair, Professor David Haslam writes on the

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September 2014 Br J Cardiol 2014;21:90

Correspondence: gender and outcome from acute myocardial infarction and secondary stroke

Professor Ivy Shiue; Dr Krasimira Hristova; Professor Jagdish Sharma

Abstract

Dear Sirs, Research on sex difference in mortality after myocardial infarction (MI) since the 1990s has been debated and increased. Several observational studies have shown that younger women, in particular, seemed to have higher mortality rates than men of similar age during the two-year or longer follow-up, although these studies were mainly from the USA.1-3 Recent American studies have also found that, even after full adjustment for potential risk factors, excess risk for in-hospital mortality for women was still noted, particularly among those <50 years old with acute ST-segment elevation MI, leading to 98% (odds ratio [OR] 1.98, 95% c

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February 2014 Br J Cardiol 2014;21:7–8 doi:10.5837/bjc.2014.001 Online First

Ageism and coronary angiography

Thomas Green, John Baxter, Sam McClure

Abstract

The study The research is presented as a retrospective case-control study in the modern era of coronary intervention, and gives some insight into current practice. Data from 100 randomly selected patients aged over 80 years and a control group aged below 70 years were taken from a district general hospital (DGH) DCA database. This method of patient selection is perhaps the major weakness of the study. There will inevitably have been a high degree of case selection – particularly of older patients – with those put forward deemed appropriate for DCA (and by implication also considered ‘reasonable’ candidates for revascularisation). The

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Percutaneous coronary intervention in old age – effective or intrusive?

March 2013 Br J Cardiol 2013;20:6–7 doi:10.5837/bjc.2013.004

Percutaneous coronary intervention in old age – effective or intrusive?

Krishnaraj Rathod, Charles Knight

Abstract

First, there is a much higher incidence of comorbidities in the elderly, which increases the potential for complications and may limit the scope for symptomatic improvement. For example, there may be little point in treating exertional angina when the patient is more limited by an arthritic knee. Second, care needs to be exercised when considering the benefits of prognostic interventions in a group that statistically have a relatively short remaining lifespan. These concerns emphasise the importance of studies specifically examining the response of the elderly to cardiovascular treatments – historically an area that has been overlooked. We

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