ABSTRACT
BACKGROUND: Percutaneous coronary intervention (PCI) on severely calcified coronary lesions is challenging. Coronary calcified nodule (CN) refers to an eccentric and protruding coronary calcification associated with plaque vulnerability and adverse clinical events. This study aims to conduct an extensive review of CNs, focusing on its prognostic impact in comparison with nonnodular coronary calcification (N-CN). METHOD: A systematic literature review on PubMed, MEDLINE, and EMBASE databases was conducted for relevant articles. Observational studies or randomized controlled trials comparing CNs and N-CNs were included. RESULTS: Five studies comparing CNs and N-CNs were pertinent for inclusion. The total number of individuals across these studies was 1456. There were no significant differences in the baseline demographic, clinical, and angiographic data between the CN and N-CN groups. Intracoronary imaging was always utilized. At follow-up, CNs were associated with significantly increased, target vessel revascularization [odds ratio (OR) 2.16; 95% confidence interval (CI): 1.39-3.36, P-value < 0.01, I2â=â0%] and stent thrombosis (OR 9.29; 95% CI: 1.67-51.79, P-valueâ=â0.01, I2â=â0%) compared with N-CN. A trend for greater cardiac death was also assessed in the CN group (OR 1.75; 95% CI: 0.98-3.13, P-valueâ=â0.06, I2â=â0%). CONCLUSION: CN has a significantly negative impact on outcomes when compared with N-CN.
Subject(s)
Coronary Artery Disease , Percutaneous Coronary Intervention , Vascular Calcification , Humans , Coronary Artery Disease/therapy , Coronary Artery Disease/diagnostic imaging , Vascular Calcification/diagnostic imaging , Vascular Calcification/therapy , Percutaneous Coronary Intervention/adverse effects , Risk Factors , Coronary Angiography , Treatment Outcome , Male , Female , Middle Aged , Risk Assessment , AgedABSTRACT
Data regarding angiographic characteristics, clinical profile, and inhospital outcomes of patients with coronavirus disease 2019 (COVID-19) referred for coronary angiography (CAG) are scarce. This is an observational study analyzing confirmed patients with COVID-19 referred for CAG from 10 European centers. We included 57 patients (mean age: 66 ± 15 years, 82% male) , of whom 18% had previous myocardial infarction (MI) and 29% had renal insufficiency and chronic pulmonary disease. ST-segment elevation myocardial infarction (STEMI) was the most frequent indication for CAG (58%). Coronavirus disease 2019 was confirmed after CAG in 86% and classified as mild in 49%, with 21% fully asymptomatic. A culprit lesion was identified in 79% and high thrombus burden in 42%; 7% had stent thrombosis. At 40 days follow-up, 16 (28%) patients experienced a major adverse cardiovascular event (MACE): 12 deaths (92% noncardiac), 1 MI, 2 stent thrombosis, and 1 stroke. In an European multicenter registry, patients with confirmed COVID-19 infection referred for CAG during the first wave of the severe acute respiratory syndrome coronavirus 2 pandemic presented mostly with STEMI and were predominantly males with comorbidities. Severity of COVID-19 was in general noncritical and 21% were asymptomatic at the time of CAG. Culprit coronary lesions with high thrombus burden were frequently identified, with a rate of stent thrombosis of 7%. The incidence of MACE at 40 days was high (28%), mostly due to noncardiac death.
Subject(s)
COVID-19 , Percutaneous Coronary Intervention , Aged , Aged, 80 and over , Coronary Angiography , Disease Outbreaks , Female , Humans , Male , Middle Aged , Registries , SARS-CoV-2 , Treatment OutcomeABSTRACT
There are many underlying mechanisms for cocaine-associated myocardial infarction, and the culprit must be elucidated for appropriate therapeutic management. Optical coherence tomography provides unique insights when angiography alone has limited diagnostic value; it also aids in the decision between conservative management and revascularization strategy and guides coronary interventions.
Subject(s)
Cocaine-Related Disorders/complications , Coronary Vessels/diagnostic imaging , Myocardial Revascularization , ST Elevation Myocardial Infarction , Thrombectomy/methods , Tomography, Optical Coherence/methods , Adult , Cocaine-Related Disorders/diagnosis , Coronary Angiography/methods , Drug-Eluting Stents , Electrocardiography/methods , Humans , Male , Myocardial Revascularization/instrumentation , Myocardial Revascularization/methods , Patient Selection , ST Elevation Myocardial Infarction/chemically induced , ST Elevation Myocardial Infarction/diagnosis , ST Elevation Myocardial Infarction/physiopathology , ST Elevation Myocardial Infarction/therapy , Shock/etiology , Shock/physiopathology , Shock/therapy , Substance Abuse Detection/methodsABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Angina, Unstable/complications , Catheterization/instrumentation , Catheterization/methods , Cardiac Catheterization/methods , Cardiac Catheterization , Tropicamide/therapeutic use , Retina/pathology , Retina , Echocardiography/methods , Ophthalmoscopy/methods , Ophthalmoscopy , Angioplasty/methods , Angioplasty , Retina/anatomy & histology , Retina/physiopathologySubject(s)
Herpes Simplex , Meningitis, Viral/virology , Adult , Humans , Lymphocytes , Male , RecurrenceABSTRACT
No disponible
