Medicine and Health Sciences Commons^™

Gender Differences And Predictors Of Mortality In Spontaneous Coronary Artery Dissection: A Review Of Reported Cases, Ellen Thompson, Sueellen Ferraris, Todd Gress, Victor Ferraris

Ellen A. Thompson

Spontaneous coronary artery dissection (SCAD) is a rare but potentially lethal event.1,2 It is a separation between the intimal and medial wall of the coronary vessel. The potential result of the dissection is obstruction of the vessel lumen and subsequent myocardial ischemia. Prior to the widespread use of coronary angiography, diagnosis was made at autopsy.2 From reported cases, some trends have been identified. There are reported associations with female sex,2,3 exercise,4–7pregnancy and postpartum state,8–12 coronary artery disease,2, 13, 14 and connective tissue disorders.9,15,16 The left anterior descending artery is more affected in women; the right coronary artery is more often …

Gender Differences And Predictors Of Mortality In Spontaneous Coronary Artery Dissection: A Review Of Reported Cases, Ellen Thompson, Sueellen Ferraris, Todd Gress, Victor Ferraris

Todd W. Gress

Spontaneous coronary artery dissection (SCAD) is a rare but potentially lethal event.1,2 It is a separation between the intimal and medial wall of the coronary vessel. The potential result of the dissection is obstruction of the vessel lumen and subsequent myocardial ischemia. Prior to the widespread use of coronary angiography, diagnosis was made at autopsy.2 From reported cases, some trends have been identified. There are reported associations with female sex,2,3 exercise,4–7pregnancy and postpartum state,8–12 coronary artery disease,2, 13, 14 and connective tissue disorders.9,15,16 The left anterior descending artery is more affected in women; the right coronary artery is more often …

Simultaneous Very Late Angiographic Stent Thrombosis Of 2 Drug-Eluting Stents: A Case Report, Joseph Quercia, Bryan Kane, Kathleen Kane

Bryan G Kane MD

No abstract provided.

Aortic Aging In The Fischer 344 / Nniahsd × Brown Norway / Binia Rat, Kevin Rice, Miaozong Wu, Eric Blough

Eric Blough

Aging is now recognized as one of major risk factors for cardiovascular disease (CVD). It is well documented that elderly populations show increased incidence of CVD symptomology but whether these changes are directly related to aging is not well understood since the possibility exists that other age-associated pathologies in different organ systems could impact on cardiovascular function. Hence, the development of an aging model with reduced systemic illness could invigorate efforts to understand the direct role of aging in CVD progression. The Fischer 344 / NNIaHSD × Brown Norway / BiNia rat (F344BN) has been proposed as a potential model …

Resetting And Termination Of A Short Rp Tachycardia: What Is The Mechanism?, Anand Kenia

Anand S Kenia

No abstract provided.

Long-Term Cardiac Rhythm And Repolarization Abnormalities In Refractory Focal And Generalized Epilepsy, Maromi Nei

maromi nei

This prospective study evaluated 19 individuals with refractory focal or generalized epilepsy utilizing an implantable cardiac loop recorder. Recording averaged 15 months (range 12–19 months) in 18 patients and 1.5 months in one patient. A median of 37 seizures per patient (range 3–657) occurred, with 1,477 seizures total. Cardiac arrhythmias and repolarization abnormalities occurred frequently (in 42% of patients) in refractory epilepsy, particularly during generalized tonic–clonic and tonic seizures. Patients with Lennox-Gastaut syndrome may be at high risk for cardiac abnormalities.

Long-Term Trends In Short-Term Outcomes In Acute Myocardial Infarction, Hoa Nguyen, Jane Saczynski, Joel Gore, Molly Waring, Darleen Lessard, Jorge Yarzebski, George Reed, Frederick Spencer, Shu-Xia Li, Robert Goldberg

Jorge L. Yarzebski

BACKGROUND: The objectives of this study were to examine the magnitude of, and 20-year trends in, age differences in short-term outcomes among men and women hospitalized with acute myocardial infarction (AMI) in central Massachusetts.

METHODS: The study population consisted of 5907 male and 4406 female residents of the Worcester, MA, metropolitan area hospitalized at all greater Worcester medical centers with AMI between 1986 and 2005.

RESULTS: Overall, among both men and women, older patients were significantly more likely to have developed atrial fibrillation, heart failure, and to have died during hospitalization and within 30 days after admission compared with patients …

Cost-Effectiveness Of Lowering Blood Pressure With A Fixed Combination Of Perindopril And Indapamide In Type 2 Diabetes Mellitus: An Advance Trial-Based Analysis, Paul Glasziou, Philip Clarke, Jan Alexander, Mohana Rajmokan, Elaine Beller, Mark Woodward, John Chalmers, Neil Poulter, Anushka Patel

Elaine Beller

Objective: To determine the cost-effectiveness of routine administration, irrespective of blood pressure (BP), of a fixed-dose combination of perindopril and indapamide to patients with type 2 diabetes mellitus.

Design, setting and participants: Prospective cost-effectiveness analysis within the Action in Diabetes and Vascular Disease: Preterax and Diamicron-MR Controlled Evaluation (ADVANCE) trial, an international, multicentre, randomised controlled trial of 11 140 participants with type 2 diabetes randomly allocated to receive perindopril plus indapamide (4mg-1.25mg/day) or placebo.

Main outcome measures: Health-related quality-of-life measured by the EuroQol-5D, resource utilisation, and cost-effectiveness (cost per death averted at 4.3 years' average follow-up, and …

Bucindolol: A Pharmacogenomic Perspective On Its Use In Chronic Heart Failure, Neil Smart

Neil Smart

Bucindolol is a non-selective ß-adrenergic receptor blocker with a-1 blocker properties and mild intrinsic sympatholytic activity. The Beta-Blocker Evaluation of Survival Trial (BEST), which is the largest clinical trial of bucindolol in patients with heart failure, was terminated prematurely and failed to show an overall mortality benefit. However, benefits on cardiac mortality and re-hospitalization rates were observed in the BEST trial. Bucindolol has not shown benefits in African Americans, those with significantly low ejection fraction and those in NYHA class IV heart failure. These observations could be due to the exaggerated sympatholytic response to bucindolol in these sub-groups that may …

Age And Sex Differences And 20-Year Trends (1986 To 2005) In Prehospital Delay In Patients Hospitalized With Acute Myocardial Infarction, Hoa Nguyen, Joel Gore, Jane Saczynski, Jorge Yarzebski, George Reed, Frederick Spencer, Robert Goldberg

Jorge L. Yarzebski

Background: The prompt administration of coronary reperfusion therapy for patients with an evolving acute myocardial infarction (AMI) is crucial in reducing mortality and the risk of serious clinical complications in these patients. However, long-term trends in extent of prehospital delay and factors affecting patient's care-seeking behavior remain relatively unexplored, especially in men and women of different ages. The objectives of this study were to examine the overall magnitude and 20-year trends (1986 to 2005) in duration of prehospital delay in middle-aged and elderly men and women hospitalized with AMI.

Methods and Results: The study sample consisted of 5967 residents of …

Body Mass Index, Treatment Practices, And Mortality In Patients With Acute Heart Failure, Timothy Fitzgibbons, Olga Hardy, Darleen Lessard, Joel Gore, Jorge Yarzebski, Robert Goldberg

Jorge L. Yarzebski

OBJECTIVES: Obesity is associated with an increased risk of heart failure (HF). Among patients presenting with acute HF, however, differences in clinical characteristics, treatment regimens, and short-term prognosis of varying weights are largely unknown, particularly from a broader population-based perspective. METHODS: A total of 3722 patients admitted with acute HF to 11 greater Worcester (Massachusetts, USA) hospitals during 1995 and 2000 were categorized as being lean (n = 216), normal weight (n = 1465), overweight (n = 1007), or obese (n = 1034) at the time of hospitalization. RESULTS: Obese patients with decompensated HF were significantly younger (mean age = …

Use Of Lipid-Lowering Medication In Patients With Acute Myocardial Infarction (Worcester Heart Attack Study), Robert Goldberg, Ira Ockene, Jorge Yarzebski, Judith Savageau, Joel Gore

Jorge L. Yarzebski

As part of a population-based longitudinal study, we examined the use of lipid-lowering medication in 3,824 patients hospitalized with acute myocardial infarction in the Worcester, Massachusetts metropolitan area between 1986 and 1993. The rate of utilization of lipid-lowering medication either before (1.8%) or during hospitalization (1.9%) for acute myocardial infarction was low.

Therapeutic Angiogenesis For Critical Limb Ischemia To Limit Or Avoid Amputation, Nicholas Kipshidze, Valeri Chekanov, Steven Knappes, Ahmed Abdurahman, Deb Hammen

Ahmed Dalmar, MD

No abstract provided.