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Journal Cover Interventional Cardiology Clinics
  [SJR: 0.253]   [H-I: 4]   [2 followers]  Follow
    
   Full-text available via subscription Subscription journal  (Not entitled to full-text)
   ISSN (Print) 2211-7458 - ISSN (Online) 2211-7466
   Published by Elsevier Homepage  [3039 journals]
  • Current Status and Outcomes of Iliac Artery Endovascular Intervention
    • Authors: Vladimir Lakhter; Vikas Aggarwal
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Vladimir Lakhter, Vikas Aggarwal
      Teaser Aortoiliac occlusive disease (AIOD) is widely prevalent and leads to significant limitations in patient quality of life. All patients with aortoiliac occlusive disease should be managed with approved medical therapies in addition to a supervised exercise program. Persistence of significant symptoms despite noninvasive therapy should prompt further management with endovascular revascularization. Although patients with the most complex cases of AIOD anatomy may ultimately require surgery, advances in endovascular techniques have made it possible to treat most of these patients with AIOD using an endovascular-first approach.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.001
       
  • Is Common Femoral Artery Stenosis Still a Surgical Disease'
    • Authors: Stephan Heo; Peter Soukas; Herbert D. Aronow
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Stephan Heo, Peter Soukas, Herbert D. Aronow
      Teaser Surgical endarterectomy has long been the standard approach for treating atherosclerotic stenosis in the common femoral artery. Its major advantage is the associated long-term patency, which approaches 95% at 5 years. Nevertheless, recent studies have suggested that percutaneous treatment may be a valid alternative to surgery.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.002
       
  • Contemporary Outcomes of Endovascular Intervention for Critical Limb
           Ischemia
    • Authors: Pratik K. Dalal; Anand Prasad
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Pratik K. Dalal, Anand Prasad
      Teaser Critical limb ischemia (CLI) remains a significant cause of morbidity and mortality in patients with peripheral arterial disease. Optimal treatment strategies for CLI remain controversial. The only randomized trial comparing surgical with endovascular revascularization suggests no significant difference in limb salvage between open surgical bypass and angioplasty. Although novel endovascular strategies are now available, their efficacies remain largely untested in a randomized fashion. This review provides an overview of the data surrounding contemporary outcomes of endovascular therapy with an emphasis on current knowledge gaps.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.008
       
  • Current Endovascular Management of Acute Limb Ischemia
    • Authors: Javier A. Valle; Stephen W. Waldo
      Abstract: Publication date: Available online 27 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Javier A. Valle, Stephen W. Waldo
      Teaser Acute limb ischemia is a vascular emergency, threatening the viability of the affected limb and requiring immediate recognition and treatment. Even with revascularization of the affected extremity, acute limb ischemia is associated with significant morbidity and mortality resulting in up to a 15% risk of amputation during the initial hospitalization and a 1 in 5 risk of mortality within 1 year of the index event. This review summarizes the current management of acute limb ischemia. Understanding the diagnosis and therapeutic options will aid clinicians in treating these critically ill patients.

      PubDate: 2017-02-02T02:58:26Z
      DOI: 10.1016/j.iccl.2016.12.003
       
  • Drug-Coated Balloons
    • Authors: Ananya Kondapalli; Barbara A. Danek; Houman Khalili; Haekyung Jeon-Slaughter; Subhash Banerjee
      Abstract: Publication date: Available online 16 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Ananya Kondapalli, Barbara A. Danek, Houman Khalili, Haekyung Jeon-Slaughter, Subhash Banerjee
      Teaser Paclitaxel-coated drug-coated balloons have significantly improved short-term and mid-term clinical outcomes in patients with symptomatic femoropopliteal peripheral artery disease. However, long-term results are awaited. Furthermore, the clinical success of drug-coated balloons in the infrapopliteal peripheral arteries has been more modest and overall similar to traditional balloon angioplasty, and remains an area of unmet clinical need. This article provides an overview of the clinical evidence for paclitaxel-coated balloons in the femoropopliteal and infrapopliteal peripheral artery distributions and future directions in this area.

      PubDate: 2017-01-19T21:53:04Z
      DOI: 10.1016/j.iccl.2016.12.005
       
  • Emerging and Future Therapeutic Options for Femoropopliteal and
           Infrapopliteal Endovascular Intervention
    • Authors: Damianos G. Kokkinidis; Ehrin J. Armstrong
      Abstract: Publication date: Available online 13 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Damianos G. Kokkinidis, Ehrin J. Armstrong
      Teaser Despite recent advances in endovascular therapy for peripheral artery disease, current technologies remain limited by rates of long-term restenosis and application to complex lesion subsets. This article presents data on upcoming therapies, including novel drug-coated balloons, drug-eluting stents, bioresorbable scaffolds, novel drug delivery therapies to target arteries, techniques to limit postangioplasty dissection, and treatment of severely calcified lesions.

      PubDate: 2017-01-19T21:53:04Z
      DOI: 10.1016/j.iccl.2016.12.011
       
  • Inframalleolar Intervention for Limb Preservation
    • Authors: Javier A. Valle; Andrew F. Prouse; Robert K. Rogers
      Abstract: Publication date: Available online 10 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Javier A. Valle, Andrew F. Prouse, Robert K. Rogers
      Teaser Critical limb ischemia (CLI) is a relatively prevalent and highly morbid condition. Patients with CLI have a poor prognosis, especially in the setting of incomplete revascularization. Traditionally, achieving optimal revascularization has been limited by the high prevalence of small-vessel disease in this population. More recently, advanced endovascular techniques, increased operator experience, and new technologies have enabled complete revascularization of inframalleolar disease with encouraging clinical results. In this article, we present an approach to endovascular therapy for inframalleolar revascularization of patients with CLI.

      PubDate: 2017-01-12T21:23:41Z
      DOI: 10.1016/j.iccl.2016.12.009
       
  • Nitinol Self-Expanding Stents for the Superficial Femoral Artery
    • Authors: Ashwin Nathan; Taisei Kobayashi; Jay Giri
      Abstract: Publication date: Available online 5 January 2017
      Source:Interventional Cardiology Clinics
      Author(s): Ashwin Nathan, Taisei Kobayashi, Jay Giri
      Teaser The superficial femoral artery is a complex artery subject to a unique set of biomechanical loading conditions in its course through the leg. Plain balloon angioplasty and balloon-expandable stents had unacceptably high rates of restenosis, necessitating target vessel revascularization. Nitinol alloy is well suited to provide the strength and flexibility needed of stents to withstand the external forces posed by the environment of the superficial femoral artery. Advances in stent technology with the addition of a slow-releasing antiproliferative agent and changes in scaffold design have shown promise in reducing the rates of stent fracture and in-stent restenosis.

      PubDate: 2017-01-12T21:23:41Z
      DOI: 10.1016/j.iccl.2016.12.006
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Matthew J. Price


      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/s2211-7458(16)30135-3
       
  • Antiplatelet and Anticoagulation Therapy in Percutaneous Coronary
           Intervention
    • Authors: Dominick J. Angiolillo; Matthew J. Price
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Dominick J. Angiolillo, Matthew J. Price


      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.10.001
       
  • Regulation of Platelet Activation and Coagulation and Its Role in Vascular
           Injury and Arterial Thrombosis
    • Authors: Maurizio Tomaiuolo; Lawrence F. Brass; Timothy J. Stalker
      Pages: 1 - 12
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Maurizio Tomaiuolo, Lawrence F. Brass, Timothy J. Stalker
      Teaser Hemostasis requires tightly regulated interaction of the coagulation system, platelets, blood cells, and vessel wall components at a site of vascular injury. Dysregulation of this response may result in excessive bleeding if the response is impaired, and pathologic thrombosis with vessel occlusion and tissue ischemia if the response is robust. Studies have elucidated the major molecular signaling pathways responsible for platelet activation and aggregation. Antithrombotic agents targeting these pathways are in clinical use. This review summarizes research examining mechanisms by which these multiple platelet signaling pathways are integrated at a site of vascular injury to produce an optimal hemostatic response.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.001
       
  • Pretreatment with Antiplatelet Agents in the Setting of Percutaneous
           Coronary Intervention
    • Authors: Davide Capodanno; Dominick J. Angiolillo
      Pages: 13 - 24
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Davide Capodanno, Dominick J. Angiolillo
      Teaser Administering antiplatelet agents before coronary angiography to patients referred to elective or urgent percutaneous coronary intervention (PCI) requires a careful evaluation of advantages and disadvantages associated with platelet inhibition to avoid overtreatment on one side and undertreatment on the other. The delicate balance between ischemic protection and bleeding demands the ability to undertake risk stratification and individualized decisions, which is particularly challenging in the setting of ad hoc PCI and urgent procedures. This review analyzes the current evidence on pretreatment with oral and intravenous P2Y12 inhibitors in patients undergoing coronary angiography with intent to undergo PCI.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.002
       
  • Optimal Duration of Dual Antiplatelet Therapy After Percutaneous Coronary
           Intervention
    • Authors: Arjun Majithia; Deepak L. Bhatt
      Pages: 25 - 37
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Arjun Majithia, Deepak L. Bhatt
      Teaser Dual antiplatelet therapy (DAPT) is an essential component of treatment in patients with coronary artery disease treated with percutaneous coronary intervention (PCI). Recommendations for duration of DAPT after PCI should consider patient-specific risk, clinical presentation, stent characteristics, and procedural factors. Prolonged DAPT results in a reduction of stent thrombosis (ST) and myocardial infarction (MI) at the cost of increased bleeding. Studies of shorter-duration DAPT demonstrate similar mortality, MI, ST, and less bleeding when compared with longer DAPT duration. We review current evidence for strategies of prolonged DAPT and abbreviated DAPT following PCI.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.003
       
  • Cangrelor
    • Authors: Matthew J. Price
      Pages: 39 - 47
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Matthew J. Price
      Teaser In clinical trials that assessed the safety and efficacy of cangrelor during percutaneous coronary intervention (PCI), cangrelor was administered as a 30-μg/kg bolus followed by a 4-μg/kg/min infusion for at least 2 hours or the duration of the PCI, whichever was longer. Cangrelor is currently indicated as an adjunct to PCI to reduce the risk of myocardial infarction, repeat coronary revascularization, and stent thrombosis in patients who have not been treated with a P2Y12 platelet inhibitor and are not being given a glycoprotein IIb/IIIa inhibitor.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.012
       
  • Ticagrelor
    • Authors: Wael Sumaya; Robert F. Storey
      Pages: 49 - 55
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Wael Sumaya, Robert F. Storey
      Teaser Platelet P2Y12 receptor inhibitors are crucial in the treatment of patients with acute coronary syndrome or undergoing percutaneous coronary intervention. Ticagrelor is a reversibly binding, potent oral P2Y12 inhibitor that also is a weak inhibitor of the equilibrative nucleoside transporter-1 pathway for cellular adenosine uptake. It is hypothesized that ticagrelor has clinically relevant “off-target” effects, independent of its effect on platelet aggregation and thrombosis. This review considers the pleiotropic effects of ticagrelor and some of the possible mechanisms related to these effects.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.004
       
  • Protease-Activated Receptor-1 Antagonists Post-Percutaneous Coronary
           Intervention
    • Authors: Pierluigi Tricoci
      Pages: 57 - 66
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Pierluigi Tricoci
      Teaser Thrombin is a potent platelet agonist, and protease-activated receptor-1 (PAR-1) is the main thrombin receptor in human platelets and thrombin. PAR-1 antagonism has attracted interest as a potential therapeutic target to reduce atherothrombotic events in patients with atherosclerotic disease, especially coronary artery disease. In this review, the author describes the rationale of PAR-1 antagonism for the reduction of atherothrombotic events and reviews the key phase 3 trial results, with special attention to analyses in percutaneous coronary intervention patients.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.005
       
  • Switching P2Y12 Receptor Inhibiting Therapies
    • Authors: Fabiana Rollini; Francesco Franchi; Dominick J. Angiolillo
      Pages: 67 - 89
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Fabiana Rollini, Francesco Franchi, Dominick J. Angiolillo
      Teaser Antiplatelet therapy with aspirin and a P2Y12 receptor inhibitor is the cornerstone of treatment of patients with atherothrombotic disease manifestations. Switching between P2Y12 inhibitors occurs commonly in clinical practice for a variety of reasons, including safety, efficacy, adherence, and economic considerations. There are concerns about the optimal approach for switching because of potential drug interactions, which may lead to ineffective platelet inhibition and thrombotic complications, or potential overdosing due to overlap in drug therapy, which might cause excessive platelet inhibition and increased bleeding. This review provides practical considerations of switching based on pharmacodynamic and clinical data available from the literature.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.006
       
  • Antiplatelet and Antithrombotic Therapy in Patients with Atrial
           Fibrillation Undergoing Coronary Stenting
    • Authors: Mikhail S. Dzeshka; Richard A. Brown; Davide Capodanno; Gregory Y.H. Lip
      Pages: 91 - 117
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Mikhail S. Dzeshka, Richard A. Brown, Davide Capodanno, Gregory Y.H. Lip
      Teaser Stroke prevention is the main priority in the management cascade of atrial fibrillation. Most patients require long-term oral anticoagulation (OAC) and may require percutaneous coronary intervention. Prevention of recurrent cardiac ischemia and stent thrombosis necessitate dual antiplatelet therapy (DAPT) for up to 12 months. Triple antithrombotic therapy with OAC plus DAPT of shortest feasible duration is warranted, followed by dual antithrombotic therapy of OAC and antiplatelet agent, and OAC alone after 12 months. Because of elevated risk of hemorrhagic complications, new-generation drug-eluting stents, lower-intensity OAC, radial access, and routine use of gastric protection with proton pump inhibitors are recommended.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.007
       
  • Antiplatelet Therapy for Secondary Prevention After Acute Myocardial
           Infarction
    • Authors: Ilaria Cavallari; Marc P. Bonaca
      Pages: 119 - 129
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Ilaria Cavallari, Marc P. Bonaca
      Teaser Patients with prior myocardial infarction (MI) are at long-term heightened risk for recurrent ischemic events. Several large randomized controlled trials have demonstrated the benefit of more intensive antiplatelet strategies for long-term secondary prevention of cardiovascular death, recurrent MI, and stroke in patients with a history of MI at a cost of increased bleeding. The bleeding risk associated with long-term intensive antiplatelet strategies requires careful patient selection and involvement of patients in shared decision making regarding risks and benefits of therapy. Clinical characteristics, adherence to therapy, and integrated risk scores may aid clinicians in translating clinical trials into individualized therapy.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.008
       
  • Antithrombotic Therapy to Reduce Ischemic Events in Acute Coronary
           Syndromes Patients Undergoing Percutaneous Coronary Intervention
    • Authors: Freek W.A. Verheugt
      Pages: 131 - 140
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Freek W.A. Verheugt
      Teaser Antithrombotic therapy is essential in the prevention of periprocedural death and myocardial infarction during and after percutaneous coronary intervention. In the pathogenesis of acute coronary syndromes (ACS), both platelets and the coagulation cascade play an important role. Therefore, periprocedural antithrombotic therapy is even more important in ACS than in elective PCI. The most used agents are aspirin, platelet P2Y12 blockers, platelet glycoprotein IIb/IIIa blockers, and parenteral anticoagulants. The P2Y12 blockers must be continued at least 12 months. High-risk patients should be treated with glycoprotein IIb/IIIa receptor antagonists, especially those undergoing primary angioplasty for ST-elevation acute coronary syndrome.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.009
       
  • Genetic Determinants of P2Y12 Inhibitors and Clinical Implications
    • Authors: Larisa H. Cavallari; Aniwaa Owusu Obeng
      Pages: 141 - 149
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Larisa H. Cavallari, Aniwaa Owusu Obeng
      Teaser There is significant interpatient variability in clopidogrel effectiveness, which is due in part to cytochrome P450 (CYP) 2C19 genotype. Approximately 30% of individuals carry CYP2C19 loss-of-function alleles, which have been consistently shown to reduce clopidogrel effectiveness after an acute coronary syndrome and percutaneous coronary intervention. Guidelines recommend consideration of prasugrel or ticagrelor in these patients. A clinical trial examining outcomes with CYP2C19 genotype–guided antiplatelet therapy is ongoing. In the meantime, based on the evidence available to date, several institutions have started clinically implementing CYP2C19 genotyping to assist with antiplatelet selection after percutaneous coronary intervention.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.010
       
  • Current Role of Platelet Function Testing in Percutaneous Coronary
           Intervention and Coronary Artery Bypass Grafting
    • Authors: Lisa Gross; Dirk Sibbing
      Pages: 151 - 166
      Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1
      Author(s): Lisa Gross, Dirk Sibbing
      Teaser There is interindividual variability in the pharmacodynamic response to antiplatelet medications. High on-treatment platelet reactivity, reflecting a failure to achieve adequate platelet inhibition, is associated with a higher risk for thrombotic events. Low on-treatment platelet reactivity, or an enhanced response to antiplatelet medications, has been linked to a higher risk for bleeding. There is evidence for the prognostic value of platelet function testing for risk prediction. This review presents the current evidence regarding platelet function testing in patients undergoing percutaneous cardiac intervention and coronary artery bypass grafting. The possible role of platelet function testing for individualized antiplatelet treatment is highlighted.

      PubDate: 2016-11-26T01:17:12Z
      DOI: 10.1016/j.iccl.2016.08.011
       
  • Despite Dramatic Progress, Significant Controversy and Critical Challenges
           for Patients with ST-Segment Elevation MI
    • Authors: Timothy D. Henry
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Timothy D. Henry


      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.07.001
       
  • Implementation of Regional ST-Segment Elevation Myocardial Infarction
           Systems of Care
    • Authors: Christopher B. Fordyce; Timothy D. Henry; Christopher B. Granger
      Pages: 415 - 425
      Abstract: Publication date: Available online 13 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Christopher B. Fordyce, Timothy D. Henry, Christopher B. Granger
      Teaser Current guidelines recommend that communities create and maintain a regional system of ST-segment elevation myocardial infarction (STEMI) care that includes assessment and continuous quality improvement of emergency medical services and hospital-based activities. Availability and timely access is a challenge in many areas of the United States. This article reviews clinical trial data supporting the use of primary percutaneous coronary intervention as the optimal reperfusion strategy, and fibrinolysis as an option when this is not possible. It then describes the outcomes and benefits of implementing regional systems of STEMI care, and discusses ongoing challenges for STEMI system implementation, including inadequate data collection and feedback, and hospital and physician competition.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.001
       
  • Time to Treatment
    • Authors: Juan Russo; Michel R. Le May
      Pages: 427 - 437
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Juan Russo, Michel R. Le May
      Teaser In the modern ST-elevation myocardial infarction (STEMI) system, the use of electrocardiogram by emergency medical services (EMS) personnel and the option to bypass emergency departments on route to a PCI-capable hospital is of particular importance. Through training and a standardized referral process, EMS personnel can now accurately diagnose and refer STEMI patients directly to the catheterization laboratory of a percutaneous coronary intervention–capable hospital. Regional STEMI models have been implemented successfully across North America, resulting in palpable reductions in door-to-balloon time, morbidity, and mortality.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.003
       
  • Reperfusion Options for ST Elevation Myocardial Infarction Patients with
           Expected Delays to Percutaneous Coronary Intervention
    • Authors: David M. Larson; Peter McKavanagh; Timothy D. Henry; Warren J. Cantor
      Pages: 439 - 450
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): David M. Larson, Peter McKavanagh, Timothy D. Henry, Warren J. Cantor
      Teaser Primary percutaneous coronary intervention (PCI) is the preferred reperfusion strategy for ST elevation myocardial infarction (STEMI). However, only one-third of hospitals in the US have PCI availability 24/7. For non-PCI hospitals, transfer remains the optimal strategy. For expected delays of greater than 120 minutes, a pharmacoinvasive strategy is recommended. In patients with evidence of failed reperfusion or hemodynamic instability, immediate rescue PCI should be performed. All other patients should undergo routine cardiac catheterization and PCI within 24 hours after fibrinolysis. A pharmacoinvasive strategy is best implemented within an organized regional STEMI system with prospective standardized transfer protocols.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.004
       
  • False Activations for ST-Segment Elevation Myocardial Infarction
    • Authors: David C. Lange; Ivan C. Rokos; J. Lee Garvey; David M. Larson; Timothy D. Henry
      Pages: 451 - 469
      Abstract: Publication date: Available online 5 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): David C. Lange, Ivan C. Rokos, J. Lee Garvey, David M. Larson, Timothy D. Henry
      Teaser First-medical-contact-to-device (FMC2D) times have improved over the past decade, as have clinical outcomes for patients presenting with ST-elevation myocardial infarction (STEMI). However, with improvements in FMC2D times, false activation of the cardiac catheterization laboratory (CCL) has become a challenging problem. The authors define false activation as any patient who does not warrant emergent coronary angiography for STEMI. In addition to clinical outcome measures for these patients, STEMI systems should collect data regarding the total number of CCL activations, the total number of emergency coronary angiograms, and the number revascularization procedures performed.

      PubDate: 2016-08-06T09:48:54Z
      DOI: 10.1016/j.iccl.2016.06.002
       
  • In-Hospital ST Elevation Myocardial Infarction
    • Authors: Xuming Dai; Ross F. Garberich; Brian E. Jaski; Sidney C. Smith; Timothy D. Henry
      Pages: 471 - 480
      Abstract: Publication date: Available online 5 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Xuming Dai, Ross F. Garberich, Brian E. Jaski, Sidney C. Smith, Timothy D. Henry
      Teaser Timely reperfusion therapy reduces complications and improves survival in ST elevation myocardial infarction (STEMI). An effective chain of survival has been established for STEMIs occur in the community (outpatient STEMI). Recent studies have identified a subgroup of patients who develop STEMI while hospitalized for primary conditions, often not directly related to coronary artery disease (in-hospital STEMI or inpatient STEMI). This article summarizes current understanding of patient demographics, clinical characteristics, care delivery system and outcomes of in-hospital STEMI, comparing with outpatient STEMI. We also identified opportunities for quality improvement and proposed strategies and future directions to improve care for these patients.

      PubDate: 2016-08-06T09:48:54Z
      DOI: 10.1016/j.iccl.2016.06.005
       
  • Optimal Antiplatelet Therapy in ST-Segment Elevation Myocardial Infarction
    • Authors: Rafael Harari; Usman Baber
      Pages: 481 - 495
      Abstract: Publication date: Available online 12 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Rafael Harari, Usman Baber
      Teaser Cardiovascular disease is the leading cause of death worldwide. Case-fatality rates for myocardial infarction (MI) in the United States have decreased over the past decades, in large part due to advances in the treatment of acute MI and secondary preventive therapy after MI. Antiplatelet therapy remains the cornerstone of treatment of MI. This article reviews the current state of antiplatelet therapy in ST-segment elevation MI.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.007
       
  • Controversies in the Management of ST Elevation Myocardial Infarction
    • Authors: Neeraj Shah; David Cox
      Pages: 497 - 511
      Abstract: Publication date: Available online 10 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Neeraj Shah, David Cox
      Teaser Anticoagulation is essential in patients with ST elevation myocardial infarction (STEMI) to prevent further thrombosis and to maintain patency of the infarct-related artery after reperfusion. The various anticoagulant medications available for use in patients with STEMI include unfractionated heparin (UFH), low-molecular-weight heparin, fondaparinux, and bivalirudin, a direct thrombin inhibitor. The authors review the current anticoagulation strategies for patients with STEMI undergoing primary percutaneous coronary intervention (PCI), fibrinolysis, or no reperfusion. The authors present the latest evidence and controversies on this topic, with a focus on bivalirudin versus UFH in the setting of primary PCI for STEMI.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.008
       
  • Controversies in the Management of ST-Segment Elevation Myocardial
           Infarction
    • Authors: Taylor C. Bazemore; Sunil V. Rao
      Pages: 513 - 522
      Abstract: Publication date: Available online 6 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Taylor C. Bazemore, Sunil V. Rao
      Teaser This article discusses the controversies surrounding the use of transradial versus transfemoral approaches in the management of patients with ST-segment elevation myocardial infarction, beginning with a review of the benefits of transradial percutaneous coronary intervention (PCI) in this population. The unanswered questions about the mechanism underlying the mortality benefit of transradial PCI are discussed, concluding with recommendations for safe and effective strategies for adoption of the transradial approach to optimize outcomes in these high-risk patients.

      PubDate: 2016-08-10T10:47:36Z
      DOI: 10.1016/j.iccl.2016.06.006
       
  • Controversies in the Treatment of Women with ST-Segment Elevation
           Myocardial Infarction
    • Authors: Vivian G. Ng; Alexandra J. Lansky
      Pages: 523 - 532
      Abstract: Publication date: Available online 30 July 2016
      Source:Interventional Cardiology Clinics
      Author(s): Vivian G. Ng, Alexandra J. Lansky
      Teaser Coronary artery disease is the leading cause of death in women. Women with ST-segment elevation myocardial infarctions continue to have worse outcomes compared with men despite advancements in therapies. Furthermore, these differences are particularly pronounced among young men and women with myocardial infarctions. Differences in the pathophysiology of coronary artery plaque development, disease presentation, and recognition likely contribute to these outcome disparities. Despite having worse outcomes compared with men, women clearly benefit from aggressive treatment and the latest therapies. This article reviews the treatment options for ST-segment elevation myocardial infarctions and the outcomes of women after treatment with reperfusion therapies.

      PubDate: 2016-08-01T08:42:38Z
      DOI: 10.1016/j.iccl.2016.06.014
       
  • Management of Multivessel Disease and Cardiogenic Shock
    • Authors: Amerjeet S. Banning; Anthony H. Gershlick
      Pages: 533 - 540
      Abstract: Publication date: Available online 13 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Amerjeet S. Banning, Anthony H. Gershlick
      Teaser Cardiogenic shock represents a state of low cardiac output and systemic hypoperfusion resulting in insufficient end-organ perfusion and consequent multiorgan failure. The main cause of this complication in the context of acute ST-elevation myocardial infarction is left ventricular dysfunction secondary to poor myocardial perfusion. In over 50% of cardiogenic shock cases, there is evidence of significant coronary stenosis within noninfarct-related arteries. Persistent ischemia in the noninfarct territory may contribute to ongoing hypotension. Currently, ESC and ACC/AHA/SCAI guidelines advocate complete revascularization in the context of multivessel coronary artery disease in the context of cardiogenic shock, although the evidence is weak.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.009
       
  • Controversies and Challenges in the Management of ST-Elevation Myocardial
           Infarction Complicated by Cardiogenic Shock
    • Authors: Byung-Soo Ko; Stavros G. Drakos; Frederick G.P. Welt; Rashmee U. Shah
      Pages: 541 - 549
      Abstract: Publication date: Available online 10 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Byung-Soo Ko, Stavros G. Drakos, Frederick G.P. Welt, Rashmee U. Shah
      Teaser The prognosis in ST-elevation myocardial infarction has improved with coronary care units, revascularization, and anticoagulant strategies; however, cardiogenic shock (CS) remains a highly fatal condition. Controversies remain about optimal pharmacologic therapies, revascularization strategies, the role of mechanical circulatory support (MCS), and evidence-based patient selection. The current informed consent paradigm for clinical trials creates challenges testing treatments in CS patients, who are too ill to consent and require immediate treatment. Several trials are underway comparing revascularization strategies and MCS options. Although the prognosis is grim, careful, new and existing treatments could change the course of this condition in the coming years.

      PubDate: 2016-08-14T12:12:53Z
      DOI: 10.1016/j.iccl.2016.06.010
       
  • Controversies in Out of Hospital Cardiac Arrest'
    • Authors: Rahul P. Sharma; Dion Stub
      Pages: 551 - 559
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Rahul P. Sharma, Dion Stub
      Teaser Cardiac arrest is a major cause of morbidity and mortality and accounts for nearly 500,000 deaths annually in the United States. In patients suffering out-of-hospital cardiac arrest, survival is less than 15%, with considerable regional variation. Although most deaths occur during the initial resuscitation, an increasing proportion occur in patients hospitalized after initially successful resuscitation. In these patients, the significant subsequent morbidity and mortality is due to “post cardiac arrest syndrome.” Until recently, most single interventions have yielded little improvement in rates of survival; however, there is growing recognition that optimal treatment strategies during the postresuscitation phase may improve outcomes.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.011
       
  • Public Reporting in ST Segment Elevation Myocardial Infarction
    • Authors: Michael C. McDaniel; S. Tanveer Rab
      Pages: 561 - 567
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Michael C. McDaniel, S. Tanveer Rab
      Teaser Public reporting provides transparency and improved quality of care. However, methods in estimating risk adjusted mortality in ST-segment myocardial infarction, particularly in cardiogenic shock and cardiac arrest are contentious. There are concerns that this has resulted in risk-averse behavior in publicly reporting states, resulting in suboptimal care in these patients.

      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/j.iccl.2016.06.012
       
  • Global Challenges and Solutions
    • Authors: Sameer Mehta; Roberto Botelho; Jamil Cade; Marco Perin; Fredy Bojanini; Juan Coral; Daniela Parra; Alexandra Ferré; Marco Castillo; Pablo Yépez
      Pages: 569 - 581
      Abstract: Publication date: Available online 16 August 2016
      Source:Interventional Cardiology Clinics
      Author(s): Sameer Mehta, Roberto Botelho, Jamil Cade, Marco Perin, Fredy Bojanini, Juan Coral, Daniela Parra, Alexandra Ferré, Marco Castillo, Pablo Yépez
      Teaser Major disparities exist between developed and developing countries in the management of acute myocardial infarction (AMI). These pronounced differences result in significantly increased morbidity and mortality from AMI in different regions of the world. Lack of infrastructure, insurance, facilities, and skilled personnel are the major constraints. Primary percutaneous coronary intervention has revolutionized the treatment of AMI; however, its global use is limited by the listed constraints. Telemedicine provides an efficient methodology that can hugely increase access and accuracy of AMI management.

      PubDate: 2016-08-17T13:16:58Z
      DOI: 10.1016/j.iccl.2016.06.013
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4
      Author(s): Matthew J. Price


      PubDate: 2016-09-12T01:47:08Z
      DOI: 10.1016/s2211-7458(15)00096-6
       
  • Interventional Cardiology Clinics
    • Authors: Matthew J. Price
      Abstract: Publication date: July 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 3
      Author(s): Matthew J. Price


      PubDate: 2016-07-03T00:59:34Z
      DOI: 10.1016/s2211-7458(15)00096-6
       
  • Antiplatelet and Anticoagulation Therapy in PCI
    • Abstract: Publication date: January 2017
      Source:Interventional Cardiology Clinics, Volume 6, Issue 1


      PubDate: 2016-11-26T01:17:12Z
       
  • Controversies in the Management of STEMI
    • Abstract: Publication date: October 2016
      Source:Interventional Cardiology Clinics, Volume 5, Issue 4


      PubDate: 2016-09-12T01:47:08Z
       
 
 
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