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Acute Coronary Syndromes
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Cath Lab Digest explores the role of Acute Coronary Syndromes in the treatment of coranary artery disease. For more information, feel free to browse through some of articles below on the topic of Acute Coronary Syndromes. |
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Biology of the Vulnerable Plaque: Part I
Over 1.2 million cardiac catheterizations are performed in the United States each year, at a great cost to health care resources. The spectrum of clinical indications which lead to these procedures can for the most part be broadly divided into two categories: stable angina and the acute coronary syndromes, the latter manifested by unstable angina, acute myocardial infarction, and sudden death.
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How Drug-Eluting Stents Will Impact the Treatment of Acute Coronary Syndromes, Use of GP IIb/IIIa Inhibitors, and U.S. Hospitals
The basic pathophysiologic mechanism of acute coronary syndromes (ACS) involves a generalized, multicentric inflammatory arteritis. Stenting an isolated ?culprit? lesion does not ?treat? the non-culprit lesions which are usually present in these patients. Furthermore, drug-eluting stents (DES) are still associated with an appreciable incidence of periprocedural myocardial infarction (6.5% in the Sirolimus [SIRIUS] trial preliminary analysis) which is similar to that observed for non-DES. DES, as a focal or localized treatment for a more generalized underlying disease process, will likely require adjunctive pharmacotherapy to achieve optimal clinical outcomes. As we are currently on the eve of DES availability in the United States, a review of current understanding of the pathophysiologic processes involved in ACS and the proposed role of DES in its treatment is warranted.
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The ACUITY (Acute Catheterization and Urgent Intervention Triage StrategY) Trial: What?s the Next Step for Bivalirudin After REPLACE-2?
Everything starts in the emergency room when the patients present, and they will undergo one of three options: 1. The current standard, which is a heparin (in this case, the low-molecular weight heparin enoxaparin) and a IIb/IIIa inhibitor; 2. Bivalirudin plus a IIb/IIIa inhibitor, or; 3. Bivalirudin alone. There are three ...
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Clinical and Industry News
s cardioprotective drug, MC-1, Fast Track designation as a treatment to reduce cardiovascular and cerebrovascular events associated with ischemic and/or ischemic reperfusion injury in patients undergoing percutaneous coronary interventions, coronary artery bypass graft surgery or experiencing an acute coronary syndrome. Stents Open Totally Occluded Carotid Arteries Stenting restored blood flow in stroke patients who had complete blockage in a carotid artery, according to a preliminary report...
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Emerging Concepts in the Response to Antiplatelet Therapy
Platelet activation and aggregation is essential for the formation of thrombus, which normally represents a beneficial, hemostatic process after vascular injury (for example, after the removal of a femoral artery sheath using manual compression.)
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CEU OFFERING: Advances in Adjunctive Pharmacotherapy for Patients Undergoing PCI
The following CEU activity is supported by an unrestricted educational grant from Eli Lilly and Company.
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Clinical and Industry News: November 2006
Clinical and Industry News: November 2006 Industry News: Clinical and Industry News: November 2006 - FDA Grants Priority Review For Arixtra® (fondaparinux Sodium) in the Treatment of Acute Coronary Syndromes GlaxoSmithKline plc announced that the supplemental new drug application for its anticoagulant product Arixtra® (fondaparinux sodium) Injection has been accepted for priority review by the U.S. Food and Drug Administration. Arixtra is contraindicated in patients with active major ...
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In Search of the Vulnerable Stenosis: Imaging the Coronary Artery ? Lumen, Wall and Plaque Part 2 of 2
Tools to identify a vulnerable plaque, one which is likely to cause near-term acute myocardial infarction and adverse clinical sequelae, including sudden death, are currently limited to angiography and intravascular ultrasound (IVUS) imaging. Within the next decade, however, additional revolutionary, catheter-based techniques will emerge to identify, characterize, and treat the vulnerable plaque. This review will discuss three potential catheter-based modalities ? ultrasound, light, and thermal activity ? for imaging the vulnerable plaque, as well as current methods.
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Is it Time for Qualified Community Hospitals to Consider Non-Emergent Coronary Intervention without Cardiac Surgery?
While on vacation with his wife, William could no longer ignore the waxing and waning pressure he felt in his chest while driving through New Hampshire. He presented to Exeter Hospital?s emergency department [ED] for evaluation. In the ED, he was pain-free. His physical exam revealed a BP 183/113, heart rate 103, no neck vein distention, clear lungs, and an S4 gallop. Chest x-ray within normal limits. His electrocardiogram (EKG) was unremarkable (Figure 1, upper panel). Cardiac enzymes were elevated: troponin I 4.0, CPK MB 8.5. William, a 59 year-old computer programmer, had hypertension, dyslipidemia (later fasting triglycerides of 926 and glucose 99 were noted), obesity, and a family history of premature coronary disease.
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Angiographic Demonstration of Coronary Dethrombosis with Eptifibatide
ABSTRACT: When dealing with acute coronary syndromes, the interventionists often go straight to balloon and stents, because they work quick and well in the majority of cases. However, it is not to forget that vigorous antithrombotic treatment is frequently highly beneficial in these settings. We report here on two clinical cases of coronary thrombosis in which we could appreciate on the angiograms the effect of GpIIb-IIIa inhibitor eptifibatide alone or in conjunction with alteplase. Reprinted with permission from the Journal of Invasive Cardiology 2004; 16:343?344
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On Demand Medical Education
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