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Validation of the SYNTAX Revascularization Index to Quantify Reasonable Level of Incomplete Revascularization After Percutaneous Coronary Intervention
Incomplete revascularization is common after percutaneous coronary intervention (PCI). Whether a “reasonable” degree of incomplete revascularization is associated with a similar favorable long-term prognosis compared with complete revascularization remains unknown. We sought to quantify the proportion of coronary artery disease burden treated by PCI and evaluate its impact on outcomes using a new prognostic instrument—the Synergy Between PCI with Taxus and Cardiac Surgery (SYNTAX) Revascularization Index (SRI).Utility of Peak Creatine Kinase-MB Measurements in Predicting Myocardial Infarct Size, Left Ventricular Dysfunction, and Outcome After First Anterior Wall Acute Myocardial Infarction (from the INFUSE-AMI Trial)
Infarct size after ST-segment elevation myocardial infarction (STEMI) is associated with long-term clinical outcomes. However, there is insufficient information correlating creatine kinase-MB (CK-MB) or troponin levels to infarct size and infarct location in first-time occurrence of STEMI. We, therefore, assessed the utility of CK-MB measurements after primary percutaneous coronary intervention of a first anterior STEMI using bivalirudin anticoagulation in patients who were randomized to intralesion abciximab versus no abciximab and to manual thrombus aspiration versus no aspiration.Comparison of Outcomes in Patients With ST-Segment Elevation Myocardial Infarction Discharged on Versus Not on Statin Therapy (from the Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction Trial)
Statin therapy is indicated after ST-segment elevation myocardial infarction (STEMI) to reduce recurrent ischemic events, but approximately 6% of patients with STEMI do not receive a statin prescription at discharge. This substudy aimed to define the clinical outcomes and patient characteristics associated with statin nonprescription after STEMI. We compared clinical, angiographic, and procedural characteristics and in-hospital, 30-day, 1-year, 2-year, and 3-year outcomes in 3,512 patients discharged after STEMI with and without (6%) statin prescriptions in the harmonizing outcomes with revascularization and stents in acute myocardial infarction trial ( www.clinicaltrials.gov , NCT00433966 ).Association Among Leukocyte Count, Mortality, and Bleeding in Patients With Non–ST-Segment Elevation Acute Coronary Syndromes (from the Acute Catheterization and Urgent Intervention Triage StrategY [ACUITY] Trial)
Although inflammation is involved in the pathogenesis of acute coronary syndromes, the extent of inflammation is not routinely assessed, and its prognostic implications in patients with non–ST-segment elevation acute coronary syndrome have not been investigated in depth. We analyzed the prognostic implications of an elevated white blood cell count (WBCc) in patients with moderate and high-risk non–ST-segment elevation acute coronary syndrome undergoing an early invasive strategy in the large-scale Acute Catheterization and Urgent Intervention Triage StrategY trial.Comparison of Direct Stenting With Conventional Stent Implantation in Acute Myocardial Infarction
Small studies have suggested that direct stenting without balloon predilatation in ST-segment elevation myocardial infarction may reduce microcirculatory dysfunction. To examine the clinical benefits of direct stenting in a large cohort of patients who underwent primary percutaneous coronary intervention treated with contemporary pharmacotherapy, the 1-year outcomes from the multicenter, randomized Harmonizing Outcomes With Revascularization and Stents in Acute Myocardial Infarction (HORIZONS-AMI) trial were analyzed.
