The Journal of invasive cardiology
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Randomized Controlled Trial Multicenter Study
Net clinical benefit of prehospital glycoprotein IIb/IIIa inhibitors in patients with ST-elevation myocardial infarction and high risk of bleeding: effect of tirofiban in patients at high risk of bleeding using CRUSADE bleeding score.
The aim of this subanalysis was to assess the net clinical effect of prehospital administration of tirofiban in ST-elevation myocardial infarction (STEMI) patients with high risk of bleeding. ⋯ Prehospital use of tirofiban in STEMI patients with high risk of bleeding improves post-PCI ST-segment resolution, but increases nonsignificantly the risk of non-CABG related bleeding. The net result is a balanced effect on 30-day NACE. Additional studies should clarify how use of bleeding risk scores should modify medical (antiplatelet) therapy.
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Randomized Controlled Trial
A high dose of adenosine to induce transient asystole for valvuloplasty in patients undergoing transcatheter aortic valve implantation (TAVI): is it a valid alternative to rapid pacing? A prospective pilot study.
Rapid right ventricular pacing (RRVP) at rates above 200 beats/minute is used to suppress cardiac output during balloon aortic valvuloplasty (BAV) in transcatheter aortic valve replacement (TAVI) patients. A risk of inducing myocardial ischemia with RRVP remains, especially in patients with left ventricular dysfunction. Alternatively, a transient cardiac arrest can be achieved with administration of adenosine. ⋯ BAV after administration of adenosine is feasible, safe, and may represent an option for high-risk TAVI patients in whom RRVP might not be well tolerated. The occurrence of ventricular ectopic contractions triggered by balloon inflation and deflations accounts for balloon displacement and crossover to RRVP.
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Randomized Controlled Trial
A prospective randomized clinical trial of the use of fluoroscopy in obtaining femoral arterial access.
There is no consensus on the utility of fluoroscopy in obtaining common femoral artery (CFA) access. ⋯ In this single-center, randomized trial, the use of fluoroscopy did not increase the probability of arterial puncture over the femoral head or the rate of successful CFA cannulation.
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Randomized Controlled Trial Clinical Trial
Magnesium sulphate during transradial cardiac catheterization: a new use for an old drug?
To assess the effect of intra-arterial magnesium on the radial artery during transradial cardiac catheterization. ⋯ This study demonstrates that magnesium is a more effective vasodilator when compared to verapamil, with a reduced hemodynamic effect, and is equally effective at preventing radial artery spasm. As such, the use of this agent offers distinct advantages over verapamil during radial catheterization.
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Randomized Controlled Trial
Intracoronary transplantation of autologous bone marrow mesenchymal stem cells for ischemic cardiomyopathy due to isolated chronic occluded left anterior descending artery.
Studies have revealed that stem cells improve clinical outcomes in patients with severe ischemic cardiomyopathy, but the role of bone marrow mesenchymal stem cells is not well understood. ⋯ Intracoronary transplantation of autologous bone marrow mesenchymal stem cells improved clinical outcomes in patients with chronic ischemic cardiomyopathy.