JACC. Cardiovascular interventions
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JACC Cardiovasc Interv · Jul 2010
Comparative StudyInsurance type influences the use of drug-eluting stents.
We sought to examine the effect of insurance type upon the likelihood of receiving a drug-eluting stent (DES). ⋯ Insurance status has a significant impact upon the decision to use DES. Efforts to address this disparity should focus on the patient-provider level.
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JACC Cardiovasc Interv · Jul 2010
Comparative StudyPre-hospital triage for primary angioplasty: direct referral to the intervention center versus interhospital transport.
We sought to study the impact of direct referral to an intervention center after pre-hospital diagnosis of ST-segment elevation myocardial infarction (STEMI) on treatment intervals and outcome. ⋯ After ambulance-based diagnosis of STEMI, direct transport to an intervention center with pre-hospital notification of the catheterization laboratory more than triples the proportion of patients treated within the time window of the guidelines. Time to balloon was an independent predictor of post-procedural TIMI flow grade 3, which underscores the need to reduce treatment delays.
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JACC Cardiovasc Interv · Jul 2010
Transcatheter closure of paravalvular defects using a purpose-specific occluder.
This study sought to describe a method of paravalvular leak closure using a purpose-specific occlusion device. ⋯ Closure of mitral and aortic prosthetic paravalvular leaks with the Vascular Plug III using either a transapical (mitral) or a retrograde (aortic) approach appears promising.
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JACC Cardiovasc Interv · Jun 2010
Impact of P2Y12 inhibition by clopidogrel on cardiovascular mortality in unselected patients treated by percutaneous coronary angioplasty: a prospective registry.
The aim of this study was to determine whether low platelet response to the P2Y(12) receptor antagonist clopidogrel as assessed by Vasodilator-stimulated phosphoprotein flow cytometry test (VASP- FCT) predicts cardiovascular events in a high-risk population undergoing percutaneous coronary intervention (PCI). ⋯ In patients undergoing PCI, LR to clopidogrel assessed by VASP-FCT is an independent predictor of cardiovascular death at the PRI cutoff value of > or =61%. The LR clinical impact seems to be dependent on the type of stent implanted.