Background: In patients with ischemic stroke, data on the real-world effectiveness of statin therapy for clinical and patient-centered outcomes are needed to better inform shared decision making.
Thrombotic complications of pregnancy are a major cause of morbidity and mortality to the mother and fetus. Pulmonary embolism is a leading cause of maternal death and accounts for 10.3% of all maternal deaths in the United States.1,2 Overall, pregnancy increases the risk of venous thromboembolism (VTE) 5-fold, with an additional increase in risk in the postpartum period.
Venous thromboembolism (VTE), which encompasses deep vein thrombosis and pulmonary embolism (PE), is now recognized as a chronic recurrent disease. Short-term anticoagulation after VTE includes the initiation phase and the early maintenance phase, usually for a duration of 3 months (Figure). Whether to consider an extended phase of anticoagulation in individual patients has become a major challenge for care providers but logically depends on the risks of VTE recurrence and bleeding.1 This decision can be further refined by patient preferences, a theoretically highly desirable criterion that, however, is often difficult to assess objectively, and by the efficacy/safety balance of available therapies.
A 48-year-old man presents to the Emergency Department and complains of new onset of chest pain with exertion. He has a history of tobacco use, hypercholesterolemia, type 2 diabetes mellitus, and chronic renal disease (baseline serum creatinine concentration [SCr] 1.7 mg/dL; estimated glomerular function [eGFR] 47 mL/min per 1.73m2). Initially, he undergoes coronary computed tomography (CT) angiography, which demonstrates >75% narrowing of the proximal left anterior descending coronary artery. The next day he undergoes coronary catheterization with successful drug-eluting stent placement to an 80% stenosis of the left anterior descending coronary artery. He receives a total of 211 mL contrast agent (320 mgI/mL; 67.52 g iodine) from both examinations. His SCr level increases to a peak of 2.4 mg/dL at 48 hours after percutaneous intervention, returning to baseline over the next 72 hours. He recovers uneventfully. The treating physicians diagnose him with postinterventional contrast-induced nephropathy (CIN).
Background: With improved event-free survival of patients undergoing primary bioprosthetic aortic valve replacement (AVR), reoperation to relieve severe prosthetic aortic stenosis (PAS) is increasing. We sought to (1) identify of the characteristics of patients with severe bioprosthetic PAS undergoing redo AVR, and (2) assess the outcomes of these patients, along with factors associated with adverse outcomes.
Background and Purpose: Shunt dependent hydrocephalus after aneurysmal subarachnoid hemorrhage (aSAH) is a common sequela that may lead to poor neurological outcome and predisposes to various interventions, admissions, and complications. We reviewed post-aSAH shunt dependency in a population-based sample and tested the feasibility of a clinical risk score to identify subgroups of aSAH patients with increasing risk of shunting for hydrocephalus.
Background and Purpose: Although recommended by guidelines, the benefits of treating patients with atrial fibrillation with a low–stroke risk score, with aspirin or anticoagulants, have not been clearly established. With advent of safer non–vitamin K antagonist oral anticoagulant, we assessed the clinical and economic implications of 5 mg BID of apixaban versus aspirin among patients with a relative low risk of stroke as assessed using the CHADS2 (congestive heart failure, hypertension, age>75, diabetes mellitus, stroke/transient ischemic attack) and CHA2DS2–VASc (congestive heart failure, hypertension, age, diabetes mellitus, stroke/transient ischemic attack, vascular disease) stroke risk classification.
Background and Purpose: Specific coagulation assays for non–vitamin K antagonist oral anticoagulants (NOAC) are relatively slow and often lack availability. Although specific point-of-care tests (POCT) are currently not available, NOAC are known to affect established coagulation POCT. This study aimed at determining the diagnostic accuracy of the CoaguChek POCT to rule out relevant concentrations of rivaroxaban, apixaban, and dabigatran in real-life patients.
Background: The Absorb bioresorbable vascular scaffold (BVS) was developed to address long-term safety issues of metallic drug-eluting stents. However, it may be associated with an increased event risk during the first year.
Background: Previously, we examined the difference in stent designs across different sizes for six widely used Drug Eluting Stents (DESs).
Background: This purpose of this study is to evaluate, concomitantly with quantitative coronary angiography (QCA), the potential discrepancy between frequency domain optical coherence tomography (FD-OCT) and intravascular ultrasound (IVUS) measurements in a phantom coronary model and in human coronary arteries within and outside stented segments.
Introduction: This is the fourth in a series of papers describing the burden of cardiovascular disease (CVD) within Europe.1–3 CVD remains the most common cause of death worldwide, with the 2013 Global Burden of Disease (GBD) study estimating that CVD caused 17.3 million deaths globally. It accounted for 31.5% of all deaths and 45% of all non-communicable disease deaths, more than twice that caused by cancer, as well as more than all communicable, maternal, neonatal and nutritional disorders combined.
A 13-year-old boy presented with mild exercise-induced shortness of breath; he reported being otherwise healthy. Physical examination revealed a reduced arterial oxygen saturation level (82%) and mild cyanosis with clubbed fingers and toes. Chest radiography showed a tubular opacity in the right lower pulmonary lobe (Panels A and B, arrows).
Aims: The feasibility, safety, and clinical utility of percutaneous coronary intervention (PCI) without radio-contrast medium in patients with advanced chronic kidney disease (CKD) are unknown. In this series, we investigated a specific strategy for ‘zero contrast’ PCI with the aims of preserving renal function and preventing the need for renal replacement therapy (RRT) in patients with advanced CKD.
Aims: Metal absorbable scaffolds constitute a conceptually attractive alternative to polymeric scaffolds. Promising 6-month outcomes of a second-generation drug-eluting absorbable metal scaffold (DREAMS 2G), consisting of an absorbable magnesium scaffold backbone, have been reported. We assessed the 12-month safety and performance of this novel device.
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