ACC/AHA/SCAI 2005 Guideline Update for Percutaneous Coronary Intervention - Summary article: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (ACC/AHA/SCAI Writing Committee to Update the 2001 Guidelines for Percutaneous Coronary Intervention)
American College of Cardiology Foundation, 9111 Old Georgetown Road, Bethesda, MD 20814-1699, USA. Circulation
(Impact Factor: 14.43).
02/2006; 113(1):156-75. DOI: 10.1161/CIRCULATIONAHA.105.170815
Available from: Rose Mary Ferreira Lisboa da Silva
- "The procedures were performed under invasive blood
pressure monitoring, electrocardiographic recording, and oxygen saturation monitoring. Precordial pain was assessed based on its severity, according to Smokler's numerical
scale, being classified as mild, moderate, moderately severe and maximally
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ABSTRACT: Background: The autonomic nervous system plays a central role in cardiovascular regulation; sympathetic activation occurs during myocardial ischemia. Objective: To assess the spectral analysis of heart rate variability during stent implantation, comparing the types of stent. Methods: This study assessed 61 patients (mean age, 64.0 years; 35 men) with ischemic heart disease and indication for stenting. Stent implantation was performed under Holter monitoring to record the spectral analysis of heart rate variability (Fourier transform), measuring the low-frequency (LF) and high-frequency (HF) components, and the LF/HF ratio before and during the procedure. Results: Bare-metal stent was implanted in 34 patients, while the others received drug-eluting stents. The right coronary artery was approached in 21 patients, the left anterior descending, in 28, and the circumflex, in 9. As compared with the pre-stenting period, all patients showed an increase in LF and HF during stent implantation (658 versus 185 ms2, p = 0.00; 322 versus 121, p = 0.00, respectively), with no change in LF/HF. During stent implantation, LF was 864 ms2 in patients with bare-metal stents, and 398 ms2 in those with drug-eluting stents (p = 0.00). The spectral analysis of heart rate variability showed no association with diabetes mellitus, family history, clinical presentation, beta-blockers, age, and vessel or its segment. Conclusions: Stent implantation resulted in concomitant sympathetic and vagal activations. Diabetes mellitus, use of beta-blockers, and the vessel approached showed no influence on the spectral analysis of heart rate variability. Sympathetic activation was lower during the implantation of drug-eluting stents.
Available from: Hironori Kobayashi
- "Coronary stenosis was assessed morphologically according to the American College of Cardiology/American Heart Association (ACC/AHA) , and patients were classified into three groups, as follows: Non-CAD group (control), patients with no stenosis; Single-vessel group, patients with > 75% stenosis of one vessel; Multi-vessels group, patients with > 75% stenosis of two or more vessels. Angiographic evaluations were performed independently by 2 cardiologists who were blinded to the clinical features of the patients and, in case of disagreement, the decision was based on the judgment of a third, more experienced observer. "
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ABSTRACT: Adiponectin plays a role as a positive contributor to the stabilization of atherosclerotic plaques. Circulating total adiponectin (Total-APN) levels associates with the number of coronary vessels in men with coronary artery disease (CAD). We recently reported that adiponectin binds to C1q in human blood, and serum C1q-binding adiponectin (C1q-APN) /Total-APN levels are associated with CAD in type 2 diabetic subjects. The present study investigated the relationship between circulating C1q-APN levels and the number of angiographic coronary artery vessel in male subjects.
The study subjects were 53 male Japanese patients who underwent diagnostic coronary angiography. Blood total adiponectin (Total-APN), high-molecular weight adiponectin (HMW-APN), C1q-APN and C1q were measured by enzyme-linked immunosorbent assays.
Serum C1q-APN/Total-APN ratio significantly increased in subjects with single and multi-vessel coronary diseases (p = 0.029 for trend, the Kruskal-Wallis test). However, serum Total-APN, HMW-APN, C1q-APN and C1q levels did not correlate with number of diseased coronary vessels.
Serum C1q-APN/Total-APN ratio progressively increases in men with single and multi-vessel coronary disease.
Available from: PubMed Central
- "Coronary stents have emerged as the predominant form of PCI and are currently used in more than 90% of PCI procedures. Procedural success of PCI is usually determined by visual estimation by the operator, and usually, angiographic success after PCI is defined as the attainment of residual diameter stenosis of less than 30%, which is generally associated with at least a 20% improvement in diameter stenosis and relief of ischemia . However, such subjective estimation of the severity of coronary artery stenosis is thought to be of limited reliability. "
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ABSTRACT: Intravascular ultrasound (IVUS) is a useful diagnostic method that provides valuable information in addition to angiography regarding the coronary vessel lumen, dimensions, plaque burden, and characteristics. The major use of IVUS in coronary intervention is to guide interventional strategies and assess optimal stent deployment. Since the introduction of the drug-eluting stent (DES), concerns about restenosis have decreased. However, high-risk lesion subsets are being routinely treated with DESs, and the incidence of suboptimal results after stent deployment, such as stent underexpansion, incomplete stent apposition, edge dissection, geographic miss, and the risk of stent thrombosis, have correspondingly increased. Thus, optimization of stent deployment under IVUS guidance may be clinically important. In this review, we focus on the potential role of IVUS in stent optimization during percutaneous coronary intervention and its clinical benefits.
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