We must optimize stent deployment & maintain a registry of how well (or poorly) we use drug-eluting stents. Instead of asking “Which stent?” or “How much anti-platelet therapy?” we must ask “How effectively are we deploying our stents?”
Articles on the various questions, problems, and controversies currently plaguing drug-eluting stents: deployment techniques, stent qualities, antiplatelet therapies, and etiologies of post-DES thrombosis and restenosis.
Evaluation of Cypher Sirolimus Eluting Stent in Patients Undergoing Elective Revascularization of Nonacute Total Coronary Occlusions (TCO). Cordis Corp. Columbia Presbyterian, NYC. 2006-2011. (Not currently recruiting)
A major limitation of percutaneous therapy (PCI) for the treatment of chronic total occlusions (CTOs) is the inability to cross with a wire. We report successful recanalization of a CTO using Intraluminal Wire (tm)...
FDA says drug-eluting stents are safe & effective in stable patients with single-vessel disease; even so, they'll have to take Plavix (clopidogrel) & aspirin for a year or more...up to a lifetime. High-risk patients with multivessel disease are much more
Martin B. Leon, MD, violated academic ethics of the highest order by leaking results of the COURAGE trial prematurely, denigrating its design, discrediting its results, to protect pocketbooks of interventional cardiologists and stent industry. Sanctions
Raymond Gibbons, MD (Mayo Clinic, Pres/American Heart Association), said COURAGE trial findings suggest that "hundreds of thousands of Americans with stable angina who received coronary stents did not need them."
Electron Beam CT, or EBCT scans (formerly called ultrafast CT scans) are useful in detecting the presence of calcium deposits in the lining of the coronary arteries. The presence of calcium deposits is a strong indicator that coronary artery disease is al
For "traditional" cardiologists, CAD is a blockage or blockages in the coronary arteries, and the treatment is stents. For "nontraditional" cardiologists, CAD is a more systemic, diffuse condition, and the treatment is systemic.
After adjusting for other risk factors impaired fasting glucose was associated with a 2.5-fold increase in the risk of a fatal cardiac event within five years (hazard ratio 2.5, 95% CI 1.2-5.1), said Elizabeth L.M. Barr, M.P.H., of the International Diabe
Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts).
Two Swiss meta-analyses have found an increased rate of myocardial infarction and death with the Cypher (sirolimus-eluting) coronary stent, which is likely to put a serious chill in interventional cardiology's infatuation with drug-coated devices
Elevated levels of myeloperoxidase in otherwise healthy men and women increased the likelihood of overt coronary artery disease by 50% over 8 years compared with patients who had the lowest levels of the enzyme (P<0.001), according to a 2007 report publis
Overweight men and women assigned to drink fructose-sweetened beverages as 25% of their energy intake developed atherogenic lipid profiles in just two weeks; unlike glucose, fructose promotedatherogenic lioproprotein phenotypes and glucose intolerance/ins
it may no longer be enough to measure just HDL levels without determining levels of paroxonase and platelet-activating acetylhydrolase; levels of these enzymes may determine whether HDL is proinflammatory or protective. Likewise, measuring Lp(a) and small
In the Injury Theory, it's damage to the arterial endothelium, followed by platelet activation, then smooth muscle cell migration to injury, then macrophages, with resulting "foam cells." Engorged foam cells burst, starting the injury cycle all over again