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<1>
Accession Number
2009571231
Authors
Unverdorben M. Degenhardt R. Wiemer M. Horstkotte D. Schneider H. Nienaber
C. Bocksch W. Gross M. Boxberger M. Vallbracht C.
Institution
(Unverdorben, Degenhardt) Clinical Research Institute, Center of
Cardiovascular Diseases, Heinz-Meise-Strasse 100, D-36199 Rotenburg an der
Fulda, Germany.
(Wiemer, Horstkotte) Heart and Diabetes Center NRW, Cardiologic Clinic,
Bad Oeynhausen, Germany.
(Schneider, Nienaber) Clinic for Internal Medicine, Department of
Cardiology, University of Rostock, Rostock, Germany.
(Bocksch, Gross) Medizinische Klinik, Kardiologie,
Charite-Hochschulmedizin Berlin, Berlin, Germany.
(Boxberger) B.Braun Melsungen AG, Division Vascular, Systems, Berlin,
Germany.
(Vallbracht) Cardiologic Clinic, Center for Cardiovascular Diseases,
Rotenburg an der Fulda, Germany.
Title
The paclitaxel-eluting coroflex[trademark] please stent study (PECOPS I):
The 3-year clinical follow-up.
Source
Catheterization and Cardiovascular Interventions. 74(5)(pp 674-682),
2009. Date of Publication: 01 Nov 2009.
Publisher
Wiley-Liss Inc.
Abstract
Background: The evaluation of drug-eluting devices in humans should
include long-term follow-up owing to risk of late target vessel thrombosis
with the possible fatal sequel. Methods and Results: Therefore, the
three-year clinical outcome of the paclitax-eleluting Corofiex Please
stent in patients with de-novo coronary lesions was evaluated in the
single-arm PECOPS I pilot study. The clinical data of 123/125 (98.4%) of
all patients included were available 3.05 +/- 0.12 years following stent
deployment. In the intention-to-treat analysis the incidence of cardiac
death was 9/123 (7.3%), of myocardial infarction 4/123 (3.3%), and of
in-segment target lesion revascularization 14/123 (11.4%). Target lesion
revascularizations tended (p = 0.30) to occur less frequently (9/96
(16.6%)) in those patients in whom the stent length was longer than the
lesion (4.80 +/- 2.71 mm) compared to 5/27 (18.5%) in those patients in
whom the stent was shorter than the lesion (23.0 +/- 2.43 mm). Stent
thromboses occurred in 2/123 (1.6%) patients during the first 6 months,
one of which two days after premature discontinuation of clopidogrel. The
total 3-year MACE rate was 22/123 (17.9%). Conclusion: The present study
describes the paclitaxel-eluting Corotlex Please stent as a safe device
with good long term performance when deployed in native coronary arteries.
The occurrence of late major adverse events and late thromboses in
particular seem to be very low. copyright 2009 Wiley-Liss, Inc.
<2>
Accession Number
2009571189
Authors
Wiernek S. Szymanski R. Bialkowska B. Buszman P. Fil W. Stables R.
Bochenek A. Martin J. Tendera M.
Institution
(Buszman, Wiernek, Szymanski, Bialkowska, Buszman, Fil, Stables, Bochenek,
Martin, Tendera) Acute Coronary Care Unit, Upper Silesian Medical Center,
Katowice, Poland.
Title
Percutaneous versus surgical revascularization for multivessel coronary
artery disease: A single center 10 year follow-up of SOS trial patients.
Source
Catheterization and Cardiovascular Interventions. 74(3)(pp 420-426),
2009. Date of Publication: 01 Sep 2009.
Publisher
Wiley-Liss Inc.
Abstract
Objectives: To compare 10 year outcomes including death, left ventricular
ejection fraction (LVEF), major adverse cardiovascular and cerebrovascular
events (MACCE), repeat revascularization (RR), and severity of angina
(CCS) after randomization to stent supported percutaneous coronary
intervention (PCI) or surgical revascularization (CABG) in a single center
participating in the SOS trial. Background: Randomized studies show
increased RR following PCI, but otherwise similar results to CABG in
selected mutlivessel disease patients with up to 5 year follow up. There
is no 10 year data available. Materials and methods: The analysis involved
100 patients randomized into the SOS study in Poland. Results: Patients
were well matched for baseline demographic and angiographic
characteristics. During 9.6 +/- 0.85 year observation, there was no
significant difference between groups for survival, CCS, and LVEF.
Increased RR occurred following PCI; 21 (42%) vs. 9 (18%), P < 0.05. As a
consequence, the MACCE was also significantly higher following PCI; 36
(72%) vs. 28 (56%), P < 0.05. Excess RR predominantly occurred in the
first year and diminished over time with numerically less RR following PCI
from year 5 to 10; 2 (4%) vs. 7 (14%), P = ns. Conclusions: These findings
suggest that patients with multivessel coronary artery disease technically
suitable for either stent supported PCI or CABG have very similar 10 year
outcomes with respect to mortality, angina class, LVEF, and MACCE other
than RR. Excess RR following PCI predominantly occurs in early years and
is numerically lower following PCI in years 5-10. This underscores the
need for longer-term follow up from randomized trials. copyright 2009
Wiley-Liss, Inc.
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Accession Number
2009540492
Authors
Warren O.J. Rogers P.L.B. Watret A.L. De Wit K.L. Darzi A.W. Gill R.
Athanasiou T.
Institution
(Warren, Rogers, Watret, De Wit, Darzi, Athanasiou) Department of
BioSurgery and Surgical Technology, Imperial College London, St. Mary's
Hospital, London, United Kingdom.
(Gill) Shackleton Department of Anaesthesia, Southampton University
Hospitals NHS Trust, Southampton, United Kingdom.
Title
Defining the role of recombinant activated factor VII in pediatric cardiac
surgery: Where should we go from here?.
Source
Pediatric Critical Care Medicine. 10(5)(pp 572-582), 2009. Date of
Publication: September 2009.
Publisher
Lippincott Williams and Wilkins
Abstract
OBJECTIVES: Postoperative hemorrhage is a recognized complication of
pediatric cardiac surgery. Both the immature coagulation system and
increased susceptibility to hemodilution increase the likelihood of
pediatric patients developing coagulopathy when compared with adult
counterparts. Treatment options remain limited. Recombinant factor VII
(rFVIIa) is a hemostatic agent increasingly used to reduce hemorrhage in
other surgical settings, the role of which is unclear in this population.
This article systematically reviews the published literature on the use of
rFVIIa in pediatric cardiac surgery. DATA SOURCES AND STUDY SELECTION: A
systematic literature search identified reports of rFVIIa administration
in pediatric patients undergoing cardiac surgery. Where possible,
individual patient-specific data were extracted and pooled statistical
analysis was performed. DATA EXTRACTION AND SYNTHESIS: Twenty-nine
articles reporting on the administration of rFVIIa to 169 patients were
identified. rFVIIa has been administered to patients with predefined
congenital abnormalities of hemostasis to arrest hemorrhage refractory to
other interventions and prophylactically in the hope of reducing blood
loss. Treatment regimens vary widely, in terms of both first and
cumulative dose. Data on chest tube blood loss and two markers of
coagulation were pooled and analyzed, and significant improvements were
demonstrated. Mortality was 4.4% for the entire cohort but 20% of patients
on extracorporeal membrane oxygenation suffered significant thromboembolic
complications. CONCLUSIONS: rFVIIa has an increasingly accepted role in
the management of patients with congenital coagulopathies undergoing major
surgery. However, randomized trials are required to define the role of
rFVIIa as an adjunct to control major hemorrhage in the pediatric cardiac
surgical population. Any future work must focus not only on benefits but
also on patient safety, particularly, risk of morbid thromboembolic
complication. copyright 2009 The Society of Critical Care Medicine and the
World Federation of Pediatric Intensive and Critical Care Societies.
<4>
Accession Number
2009559654
Authors
Andreotti F. Agati L. Conti E. Santucci E. Rio T. Tarantino F. Natale L.
Berardi D. Mattatelli A. Musumeci B. Bonomo L. Volpe M. Crea F. Autore C.
Institution
(Andreotti, Santucci, Rio, Tarantino, Crea) Institute of Cardiology,
Department of Cardiovascular Medicine, A. Gemelli University Hospital,
Largo Gemelli 8, 00168 Rome, Italy.
(Natale, Bonomo) Department of Radiology, A. Gemelli University Hospital,
Largo Gemelli 8, 00168 Rome, Italy.
(Agati, Berardi, Mattatelli) Department of Cardiology, 1st Faculty, La
Sapienza University, Rome, Italy.
(Conti, Musumeci, Volpe, Autore) Department of Cardiology, 2nd Faculty, La
Sapienza University, Rome, Italy.
(Volpe) IRCCS, Neuromed, Pozzilli Is, Italy.
Title
Update on phase II studies of erythropoietin in acute myocardial
infarction. Rationale and design of Exogenous erythroPoietin in Acute
Myocardial Infarction: New outlook and dose association study
(EPAMINONDAS).
Source
Journal of Thrombosis and Thrombolysis. 28(4)(pp 489-495), 2009. Date of
Publication: 2009.
Publisher
Springer Netherlands
Abstract
Erythropoietin (Epo) is a hematopoietic hormone produced mainly by the
kidneys in response to hypoxia. Recent acquisitions in the fields of
hematology, neurology, cardiology, and experimental medicine show
cytoprotective, angiogenetic and antinflammatory effects of Epo. Exogenous
erythroPoietin in Acute Myocardial Infarction: New Outlook aNd Dose
Association Study (EPAMINONDAS, EudraCTno. 200500485386) is one of four
ongoing randomized controlled trials, each testing the effects of Epo in
>100 patients with STEMI. EPAMINONDAS is a multicenter, prospective,
double-blind, placebo-controlled, dose-finding study assessing intravenous
moderate doses of human recombinant Epo (epoietin-alpha, 100 or 200
IU/kg/die) versus placebo, given on the first 3 days, in 102 patients with
first ST-segment elevation myocardial infarction. Initial dosing is within
12 h of primary percutaneous coronary revascularization. The primary
endpoint is infarct size, quantified by CK-MB time-concentration curve,
left ventricular wall motion score index, and pattern of contrast-enhanced
magnetic resonance imaging. Secondary endpoints are ischemic recurrences,
ventricular remodelling, and safety events, assessed in-hospital and at 12
months' follow-up. The results of current phase II studies will help
define the safety/efficacy profile of Epo for patients with STEMI.
copyright Springer Science+Business Media, LLC 2009.
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