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Tag Archives: percutaneous coronary intervention

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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March 2013 Br J Cardiol 2013;20:27–31 doi:10.5837/bjc.2013.006

Percutaneous coronary intervention in the very elderly (≥85 years): trends and outcomes

Omar Rana, Ryan Moran, Peter O’Kane, Stephen Boyd, Rosie Swallow, Suneel Talwar, Terry Levy

Abstract

Introduction Over the last several years, the UK has witnessed a gradual ageing of its population.1 Moreover, the proportion of the very elderly (≥85 years old) in the general population is expected to rise fastest with a three-fold increase by the year 2035.1 Advancing age is perhaps the strongest predictor of de novo cardiovascular disease (CVD).2 As a consequence, cardiovascular (CV) mortality rates demonstrate a linear association with increasing age beyond the seventh decade. For example, octogenarians have a 10-fold greater risk of developing CVD in comparison with patients <50 years of age.2 Furthermore, mortality rates from CVD a

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In brief

March 2012 Br J Cardiol 2012;19:12–3

In brief

BJCardio Staff

Abstract

NICE updates A new ‘Evidence Update’ has been produced by the National Institute for Health and Clinical Excellence (NICE), which summarises selected new evidence relevant to the NICE guideline on the management of chronic heart failure (CHF) in adults in primary and secondary care (clinical guideline 108).NICE says “Whilst Evidence Updates do not replace current accredited guidance, they do highlight new evidence that might generate a future changes in practice.”  It says it will welcome feedback from societies and individuals in developing this service. The update is available from www.evidence.nhs.uk/evidence-update-2. New guides

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October 2011 Br J Cardiol 2011;18:246-248 doi:10.5837/bjc.2011.009

Recurrent stent thrombosis with dual antiplatelet resistance: the role of platelet function testing

Sunil Nadar, Farhan Gohar, James Cotton

Abstract

Introduction Activated platelets play a pivotal role in the pathophysiology of acute coronary syndromes, and dual antiplatelet therapy with both aspirin and clopidogrel has become one of the cornerstones of their treatment.1 Similarly, dual antiplatelet therapy is mandated following percutaneous coronary intervention (PCI) with stent insertion to prevent stent thrombosis.2 Recently, there has been considerable interest in the phenomenon of inter-patient variability of clopidogrel response (sometimes termed ‘clopidogrel resistance’)3 and, to a lesser degree, the variability of aspirin response. This has led to interest in tailoring the dos

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Clopidogrel and proton-pump inhibitor interaction: viewpoint and practical clinical approach

April 2011 Br J Cardiol 2011;18:84−7

Clopidogrel and proton-pump inhibitor interaction: viewpoint and practical clinical approach

Mohaned Egred

Abstract

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April 2011 Br J Cardiol 2011;18:73−6

Evolving trends in percutaneous coronary intervention

Ronak Rajani, Malin Lindblom, Gaynor Dixon, Muhammed Z Khawaja, David Hildick-Smith, Stephen Holmberg, Adam de Belder

Abstract

In 2008 there were 1.3 million members of the population of the UK above the age of 85 years.1 By 2033 this number is expected to more than double to 3.2 million.1 This would represent approximately 5% of the population. Given the marked prevalence of coronary disease in the elderly it is likely that in the future cardiologists will be treating an increasing number of octogenarians as part of their patient population. Despite this, there remains a reluctance to perform percutaneous coronary intervention (PCI) in this patient group. Cardiologists often opt for medical treatment, and perceive this to be an acceptable strategy given the co-mo

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November 2009 Br J Cardiol 2009;16:292–4

The joint cardiology–cardiothoracic multi-disciplinary team (MDT) meeting: patient characteristics and revascularisation outcomes

Wai Kah Choo, Rajiv Amersey

Abstract

Introduction Approximately 77,000 percutaneous coronary interventions (PCI) and 25,000 coronary artery bypass grafting (CABG) surgeries are performed in the UK every year.1 Revascularisation strategies may vary between institutions, medical attendants, and based upon patients’ preferences. Anatomic considerations are also important, and lesion location, severity and extent may influence decisions on revascularisation. The multi-disciplinary team (MDT) approach provides clinicians with an opportunity for peer consultations and provides ‘best-practice’ treatment strategies after review of angiographic recordings. Our weekly MDT meetings a

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May 2009 Br J Cardiol 2009;16:135

Incidental radial endarterectomy

Mohaned Egred, Raphael A Perry

Abstract

Case report Figure 1. A shows an elongated cylindrical piece of tissue shown upon aspirating the sheath; B shows that on histopathology, this tissue was confirmed as arterial endothelium A 62-year-old woman was admitted with troponin positive acute coronary syndrome and was transferred to our centre for intervention. She underwent PCI via the right radial artery (RA). The RA was easily cannulated and a guide-wire passed. Due to resistance, a short non-hydrophilic introducer sheath could not be advanced and was changed to a long hydrophilic-coated sheath, which was introduced without difficulty. Aspirating the sheath showed an elongated cylind

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September 2008 Br J Cardiol 2008;15:244–47

Percutaneous coronary angioplasty in a district general hospital: safe and effective – the Bournemouth model

Dominic Kelly, Manas Sinha, Rosie Swallow, Terry Levy, Johannes Radvan, Adrian Rozkovec, Suneel Talwar

Abstract

Introduction Over the last 15 years there has been an almost exponential growth in the percutaneous coronary intervention (PCI) rate in the UK from less than 10,000 procedures in 1991 to over 70,000 in 2005 (British Cardiovascular Intervention Society [BCIS] audit data 2005). The National Service Framework (NSF) for Cardiology (http://www.csp.org.uk/uploads/documents/ebb_cr.pdf) has recommended revascularisation rates of 1,500 per million of population with either cardiac surgery or PCI as the mode of revascularisation. During the same time period the rate of coronary artery bypass graft (CABG) has remained relatively static with the ratio of

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